shukoor65/lab-rag-model huggingface dataset:
Incidence of cerebral hemorrhage after treatment with tissue plasminogen activator or streptokinase following embolic stroke in rabbits [corrected] [published erratum appears in Stroke 1991 Feb;22(2):285] We studied thrombolysis in an animal model of embolic stroke to determine the safety of tissue plasminogen activator and streptokinase. We occluded the middle cerebral arteries of 137 rabbits with radiolabeled blood clots and administered tissue plasminogen activator (n = 49), streptokinase (n = 40), or saline (n = 48) at various times after embolization. We assessed the rate of thrombolysis and cerebral hemorrhage 24 hours later. Both drugs were very effective in producing thrombolysis. Compared with saline, streptokinase caused a significant increase in the rate of cerebral hemorrhage (p less than 0.05), but tissue plasminogen activator did not. We conclude that thrombolytic therapy for acute stroke should be safer with tissue plasminogen activator than with streptokinase.
Ultrastructural heterogeneity of epithelioid cells in cutaneous organized granulomas of diverse etiology In organized granulomatous inflammation, activated macrophages terminally differentiate into epithelioid cells (ECs). By light microscopy, individual ECs appear similar, irrespective of the inciting agent. Ultrastructural analysis of a number of clinical and experimental granulomas in man and mice reveals, however, three distinct varieties of these cells. They are classified as follows: (1) EC-I cells containing a mixture of lysosomal-dense bodies and phagolysosomes and arrays of rough endoplasmic reticulum in the cytoplasm; (2) EC-II cells showing primarily a secretory mode with prominent Golgi bodies and rich arrangement of dilated rough endoplasmic reticulum with no phagocytic vacuoles; and (3) EC-III cells containing large multisized vesicles crowded throughout the cytoplasm and presently of unknown function. Although the unique appearance of these cells offers little diagnostic help, the cells do distribute differentially in different granulomas. The EC-I cells tend to predominate in infectious granulomas and where an excess of foreign material and debris is present. The EC-II cells are most characteristic of active sarcoidal granulomas, and the EC-III cells appear in chronic, long-standing granulomas. The heterogeneic nature of these cells seems to suggest their functions in granulomatous inflammation are not always the same.
Two studies of pacing in the nursing home. Two studies concerning pacing by nursing home residents are presented. The first was a cross-sectional survey of 402 residents, which found that 39% of the subjects were pacers. In comparison to residents who did not pace, the pacers had fewer medical diagnoses, better appetites, and had resided in the facility for fewer years. Additionally, pacing was positively related to cognitive impairment and to past life-threatening experiences. Results of the second study, an observational study of six cognitively impaired residents who paced frequently, showed that these residents paced more when the environmental conditions were conducive to pacing (e.g., adequate lighting, enough room within which to pace). We believe that pacing is a reflection of good health within the nursing home population and suggest that caregivers may want to encourage rather than inhibit this behavior in some nursing home residents.
Health implications of obesity. The health risks of obesity increase with its severity and reach significance at a weight greater than 20% above optimal, by using life insurance tables, or at a body mass index greater than 27. Risks include hypertension, insulin resistance and diabetes mellitus, cardiovascular disease, hypertriglyceridemia, low high-density-lipoprotein cholesterol, and, in some studies, high total-and low-density-lipoprotein cholesterol. There is an increased mortality from endometrial cancer in women and from colorectal cancer in men. Chronic hypoxia and hypercapnia, sleep apnea, gout, and degenerative joint disease can occur with more severe obesity. The distribution of body fat is directly related to these health risks. Abdominal obesity is more dangerous than gluteal-femoral obesity because the amount of intraabdominal fat seems to determine much of the increased peril; therefore, risks of cardiovascular disease, stroke, hypertension, and diabetes increase with abdominal obesity, even independently of total fat mass.
Helicobacter pylori and gastric histamine concentrations. An enzyme isotopic assay was used to determine the histamine concentration in the gastric mucosa of patients positive for Helicobacter pylori with (n = 11) and without duodenal ulceration (n = 9) and in negative controls (n = 7). A significant difference was observed when the histamine content of H pylori negative subjects was compared with that of positive patients. On the other hand, there was no significant difference in histamine concentration between H pylori positive patients with duodenal ulceration and those without duodenal ulceration. H pylori positive patients with and without duodenal ulceration had significantly lower gastric histamine concentrations than H pylori negative subjects. The lower gastric histamine concentration observed in H pylori positive patients might be due to increased histamine release which could in turn induce increased gastric acid secretion.
Review of fluorescein angiograms performed in one year. In this study 374 consecutive fundus fluorescein angiograms (FFAs) were performed on 330 patients. Of these, 165 (50%) were investigated for age related maculopathy. In only 12% did this investigation lead to an alteration in treatment. The remaining 50% of angiograms were requested for diabetic patients (15%), retinal vein occlusion (5%), tumours (6%), and various other disorders. In the diabetic patients treatment could have proceeded without FFA in 24% of patients who underwent it. Missed diagnoses corrected by angiography and areas where unnecessary angiograms were performed were identified. One interesting subgroup of eight patients with unexplained loss of central vision was identified. Careful clinical examination had failed to reveal any abnormality. FFAs were of no diagnostic value in these patients.
Diagnosis and treatment of primary and recurrent retroperitoneal liposarcoma. We retrospectively reviewed 16 patients in whom primary retroperitoneal liposarcoma was diagnosed and treated. These patients were classified according to the first definitive surgical procedure employed: complete excision with or without radiotherapy; partial excision followed by radiotherapy; only biopsy of tumor followed by radiotherapy. Distribution of tumors according to histologic type was: well differentiated myxoid type, 10; poorly differentiated myxoid type, 4; and mixed type, 2. The main factor in determining resectability was extent and fixation of tumor to vital structures. Recurrent retroperitoneal disease developed in four patients all of whom underwent secondary intervention. We concluded from our experience that complete surgical excision is the most effective primary therapeutic approach for patients with primary and recurrent retroperitoneal liposarcoma.
Anger and hostility in tension-type headache. A battery of standardized psychometric tests was administered to a group of 47 episodic tension-type headache sufferers and 47 headache-free controls. Compared to controls, headache subjects showed higher levels of anxiety, depression, and anger/hostility. The groups did not differ significantly on a measure of anger expressed toward persons or objects, but headache subjects showed significantly greater levels of suppressed anger. The results provide objective data that are in general agreement with predictions derived from psychosomatic theories about the interrelationships among anxiety,.
Brain biopsy in tuberculoma: the risks and benefits. In developing countries, 5 to 8% of the space-occupying lesions of the central nervous system are tuberculomas. Diagnosis can be difficult in the absence of extracranial tuberculosis; computed tomography is suggestive only. To assess the value of brain biopsies in tuberculomas, the records of 15 patients aged 6 to 80 years were reviewed. Histological confirmation was obtained in 15 patients, and acid-fast bacilli were cultured from 12 patients. Intracranial hypertension was the principal sign in 11 patients; other neurological signs were related to the location of the tuberculoma. One patient had evidence of extracranial tuberculosis. Biopsy-related complications consisted of an epidural hematoma in 1 patient and hydrocephalus in another; both required additional surgery. One case of tuberculous meningitis was probably related to surgery and poor drug compliance. There was no postoperative mortality. Thirteen patients (2 were lost to follow-up) were cured after an average of 16 months of antituberculous therapy. It was concluded that the brain biopsy is useful in diagnosing tuberculoma but that there is some associated risk.
Diagnostic accuracy of thallium-201 myocardial perfusion imaging. Myocardial thallium-201 (Tl-201) imaging performed in conjunction with exercise stress has enhanced the accuracy of detecting coronary artery disease among patients with chest pain. Sensitivity and specificity of qualitative visual Tl-201 scintigraphy for detection of coronary artery disease average 84% and 87%, respectively. Quantitative analysis of planar Tl-201 scintigrams has yielded sensitivity and specificity in the 90% range. Single photon emission computed tomographic imaging is associated with even higher sensitivity but with specificity in the 82-85% range. Perfusion defects representing ischemia can now be distinguished from scar by demonstration of delayed Tl-201 redistribution or enhanced uptake after reinjection of a second dose of Tl-201. Stenoses of the left circumflex coronary artery are less easily detected than lesions of the right and left anterior descending coronary arteries. False-positive Tl-201 perfusion defects may occur as a result of attenuation artifacts, most often caused by overlying breast tissue or by a high left hemidiaphragm. Patient motion during acquisition of single photon emission computed tomographic images results in artifactual defects on reconstruction. Abnormal Tl-201 uptake has been noted in patients with 1) left bundle branch block and normal coronary arteries, 2) hypertrophic cardiomyopathy, and 3) progressive systemic sclerosis.
Liver histology, blood biochemistry and RNA, DNA and subcellular protein composition of various skeletal muscles of rats with experimental cirrhosis: implications for alcoholic muscle disease. (1) Liver cirrhosis was induced in male rats by treatment with carbon tetrachloride and phenobarbitone for 130-142 days. Detailed histological examination showed all livers from rats treated with carbon tetrachloride had annular fibrosis, necrosis, loss of normal hepatic architecture and other features that were consistent with an established micronodular cirrhosis. (2) Plasma biochemical analysis showed a significant reduction in total protein concentration (13%), which was due entirely to a reduction in plasma albumin (29%). There were also large increases in the plasma activities of alkaline phosphatase (110%) and aspartate aminotransferase (159%), when compared to phenobarbitone-treated controls. Plasma cholesterol was also increased (67%), but other plasma analytes were not significantly altered. (3) The soleus (Type I), plantaris (Type II) and gastrocnemius (Types I and II) muscles were dissected and examined for possible differential effects. There were minor reductions in all three muscle weights, but these changes did not reach statistical significance. The protein, RNA and DNA concentrations, total muscle content and content relative to body weight in cirrhotic rats were also not significantly altered in any of the muscles. Cirrhosis did not cause any perturbations in derived parameters, i.e. amount of synthetic apparatus per cell, RNA/DNA ratio, apparent cell size, protein/DNA ratio and the capacity for protein synthesis or RNA/protein ratio. (4) The gastrocnemius was fractionated into soluble, stromal and myofibrillar proteins. The concentrations and contents of all three proteins were unaltered in cirrhotic animals, compared to controls. (5) It is concluded that in this experimental model of cirrhosis there were no effects on those skeletal muscle variables which are strikingly altered by chronic alcohol feeding.
Perinatal vertical transmission of human papillomavirus and subsequent development of respiratory tract papillomatosis. This study prospectively examined the potential for human papillomavirus (HPV) to be transmitted vertically to newborns during delivery. Exfoliated cervical cells were extracted from 72 pregnant women during the third trimester and again during labor prior to delivery, and tested for the presence of HPV DNA. These results were compared with HPV DNA specimens from their newborns, who were sampled by exfoliated cells from the oral-pharyngeal cavity and vulva or tissue from the foreskin 24 to 72 hours after delivery. Among the mothers, 18.1% (13 of 72) typed HPV-positive by the ViraPap/ViraType DNA hybridization technique. Two neonates (2.8% or 2 of 72) tested positive from oral-pharyngeal specimens. This finding supports the hypothesis that respiratory tract papillomatosis may develop as a result of perinatal vertical transmission of HPV. Furthermore, this study suggests that neither cesarean section nor prepartum treatment of HPV lesions will always protect against neonatal acquisition of HPV.
Postural compensation in children with congenital or early acquired bilateral vestibular loss. The relative roles of different receptor systems in compensating for vestibular loss were studied in 18 children (12 to 16 years of age) with congenital or early acquired bilateral vestibular loss (BVL) and impaired hearing, and compared to that in 33 normal children (9 to 16 years of age). Postural stability was studied with posturography evaluating the velocity of anterior-posterior body sway. With closed eyes the increase of sway velocity did not differ between the groups, either with or without simultaneous proprioceptive disturbances when the subjects were standing on a bare surface. Body sway velocities were found to increase more in subjects with a BVL than in normal children when subjects were standing on foam rubber. When proprioceptive cues were disturbed, body sway velocities increased in both groups, but significantly more in children with BVL when subjects stood on foam rubber. This occurred both with and without open eyes.
Tissue plasminogen activator as an alternative to vena cava interruption in recurrent pulmonary thromboembolism. We have described a woman with pulmonary thromboembolism (PTE) who had acute dyspnea, chest pain, and hypotension during adequate heparin therapy. Pulmonary angiography was consistent with recurrent PTE. The patient was given intravenous TPA and showed significant improvement. Repeat angiography showed resolution of the thrombus in the right main pulmonary artery. The patient did not require vena cava interruption.
Discourse analyses with closed head injured adults: evidence for differing patterns of deficits. To better characterize the verbal impairments of higher level closed head injured (CHI) adults, we used narrative stories to longitudinally sample their discourse abilities. Stories were analyzed at the levels of intersentential cohesion and story grammar. Two differing patterns of deficits that emerged are described. In the first, a CHI subject demonstrated excessive verbalization characterized by poorly organized, but task-appropriate, content. In the second, a CHI subject demonstrated fair to good organization but little appropriate content. Prognostically, the presence of appropriate, although disorganized, content was an early indication that the subject was able to appreciate potential relationships of characters in the stimulus picture. The second pattern represented a more severe cognitive dysfunction. This subject's attempts at stories, although well organized, were merely elaborate descriptions of the picture. Discourse analyses appear to be well suited for the assessment of CHI adults.
Lewy bodies are immunoreactive with antibodies raised to gelsolin related amyloid-Finnish type. Lewy bodies (LB) are intraneuronal, cytoplasmic inclusion bodies. They are invariably present in Parkinson's and diffuse LB diseases. Their composition by direct biochemical methods is unknown, although LBs are immunoreactive with a number of antibodies, including anti-ubiquitin and anti-neurofilament antibodies. Familial amyloidosis, Finnish type (FAF), is an autosomal-dominant form of systemic amyloidosis. The authors have isolated and partially sequenced the amyloid. The protein has significant sequence identity with gelsolin, an actin-modulating protein. Rabbit polyclonal antibodies raised to the FAF amyloid not only immunostain the amyloid but also LBs in the cortex and substantia nigra of Parkinson's and diffuse LB disease brains. Immunoreactivity is absorbed by the purified amyloid but is unaffected by ubiquitin. This provides a link between the LB and one of the human amyloidoses, FAF.
Monitoring functional patency of percutaneous transluminal angioplasty. Duplex scanning and Doppler-derived blood pressure measurements were used to serially monitor lower limb hemodynamics in 73 patients who underwent percutaneous transluminal angioplasty. Ninety percutaneous transluminal angioplasty sites judged technically satisfactory by arteriography were evaluated. Significant hemodynamic improvement was seen in 81 (90%) of the 90 limbs, although both hemodynamic and clinical improvement were achieved in only 77 (86%) limbs. Duplex scanning within 1 week of successful angioplasty identified moderate (20% to 49% diameter reduction) or severe (greater than 50% diameter reduction) residual stenosis in 49 (63%) of 77 balloon-dilated arterial segments. The presence of a greater than 50% diameter reduction residual stenosis predicted further restenosis and late clinical failure (11% success rate at 1 year). When the degree of residual stenosis at the percutaneous transluminal angioplasty site was less than 50% diameter reduction by duplex scanning, the procedure was durable (80% success rate at 2 years), even in patients with critical ischemia, poor runoff, or diabetes mellitus.
Vulvar vestibulitis syndrome: a clinico-pathological study. Twenty four patients with the vulvar vestibulitis syndrome formed the basis of this clinicopathological study. Entry dyspareunia was the constant presenting complaint and vestibular erythema with acute superficial tenderness the invariable clinical finding. In our series there was a marked predominance of Caucasians, patients were most often of social classes I and II and most frequently in the third decade. The results of laboratory investigation revealed that this syndrome has a diverse range of potential aetiologies including vulval infections, dysplasia and in one instance acute vasculitis.
Ventilatory response to sustained hypoxia during exercise. The ventilatory stimulating effects of hypoxia occurring at carotid bodies are potentiated by exercise. However, hypoxia also has central ventilatory depressive effects; the potential interactions between this hypoxic depression and exercise have not been studied. We examined the ventilatory response to a 20 min period of isocapnic hypoxia (end-tidal O2, PETO2, of 50 mm Hg), preceded and followed by a 5 min period of isocapnic hyperoxia in seven normal adult males at rest and during moderate exercise (45-75 W). When hypoxia was introduced at rest (PETO2 = 42 mmHg), ventilation initially increased from 13.73 +/- 3.04 (mean +/- SD) to 23.69 +/- 5.48 1.min-1 and then slowly declined to 19.01 +/- 4.68 1 min-1. The increase was caused by increases in tidal volume and respiratory frequency, but the decline was solely in tidal volume. During a background of moderate exercise (PETCO2 = 46 mmHg), introduction of hypoxia caused ventilation to increase from 30.84 +/- 6.31 to 56.44 +/- 10.58 1.min-1. Ventilation subsequently did not decline; at the end of the hypoxic period, ventilation was 57.06 +/- 12.59 1.min-1. The increase was also associated with an increase in tidal volume and respiratory frequency, as seen as rest, but with much larger magnitudes. Despite the absence of ventilatory decline, there was still a decline in tidal volume, but it was compensated by an increase in respiratory frequency. We conclude that exercise potentiated the acute ventilatory response to hypoxia by modifying both tidal volume and respiratory frequency but that exercise abolished or greatly reduced hypoxic decline by increasing respiratory rate.
Neurological and neuropathological sequelae of correction of chronic hyponatremia. The effect of correction of chronic hyponatremia at different rates was studied in 91 rats maintained at a plasma [Na+] of 112 +/- 1 mmol/liter for 19 +/- 1 days. Hyponatremia was corrected into normal ranges (140 to 145 mmol/liter) using three different methods. Rats corrected by water restriction achieved normal plasma [Na+] by 2.1 +/- 0.2 day and had a maximal (4 hr) correction rate of 1.0 +/- 0.1 mmol/liter.hr; rats corrected by water diuresis achieved normal plasma [Na+] by 1.6 +/- 0.1 day and had a maximal correction rate of 2.8 +/- 0.2 mmol/liter.hr; rats corrected by hypertonic saline infusion achieved normal plasma [Na+] by 5.4 +/- 0.3 hr and had a maximal correction rate of 5.7 +/- 0.4 mmol/liter.hr. A fourth control group was not corrected. No demyelinative lesions were found in the brains from the uncorrected rats, whereas the occurrence of such lesions in the brains of the corrected rats was highly correlated with the maximal rate of increase in plasma [Na+] (r = 0.68, P less than 0.001), and to a lesser degree with the magnitude of the increase in plasma [Na+] over the first 24 hours of correction (r = 0.41, P less than 0.001). Brain myelinolysis was first observed in animals whose maximal (4 hr) rate of correction exceeded 1.75 mmol/liter.hr, and the incidence of demyelination increased progressively in rats with more rapid rates of correction. Similarly, myelinolysis was first observed in rats whose magnitude of correction at 24 hours exceeded 16 mmol/liter and also increased in rats with larger 24 hour magnitudes of correction.
Multielement analysis of kidney tissue with renal calculi. Tissue distribution and concentration gradients of macro- and micro-elements in the papilla, medulla, and cortex of human kidney with renal calculi were measured with spectrometer. An uninvolved portion of the hypernephroma kidney was used as control. Cadmium (Cd), cobalt (Co), and molybdenum (Mo) were least in amount in renal papilla as compared with the cortex and medulla in renal stone kidney. Overall there was less Mo in stone kidney tissue, and also significantly less when compared with that of control renal papilla. Considering the reported fact that Mo was found in high concentrations in urinary tract stones and our data that Mo was less in stone kidney, it is speculated that Mo may play some unexplained but significant role in certain stage(s) of the stone formation.
A fatality after antipyrine administration. An 87-year-old woman died after the administration of an intravenous injection of antipyrine during the course of an investigation of the efficacy of oxerutins in venous ulceration. This is believed to be the first such fatality.