shukoor65/lab-rag-model huggingface dataset:
Receptor-mediated endocytosis of an extracellular steroid-binding protein (TeBG) in MCF-7 human breast cancer cells. Previous studies suggested that an extracellular steroid-binding protein, testosterone-estradiol-binding globulin (TeBG), can enter a variety of cells. Experiments were conducted to determine whether uptake of TeBG occurs by nonspecific fluid phase endocytosis or via a specific receptor-mediated process. In human breast carcinoma cells (MCF-7) maintained on serum-free medium, exposure to radiolabeled TeBG resulted in cellular uptake, which reached a plateau by 6 h and could be inhibited 80% by competition with unlabeled TeBG. Uptake was temperature dependent with cell-associated radioactivity at 37 C being 1.6-fold higher than at 4 C. Subsequent exposure of cells to pronase resulted in release of the cell-associated TeBG by 88% and 44% at 4 C and 37 C, respectively. After transfer to media devoid of TeBG, approximately 35% of cell-associated radioactivity was release into the medium at 37 C; it was not possible to distinguish whether this was released from the cell surface or from inside the cell. Investigation of the localization of TeBG-gold complexes by electron microscopy revealed that TeBG first binds to the plasmalemma. Within 15 min label appears in receptosomes, which fuse to form multivesicular endosomes. By 1 h all label is observed in multivesicular endosomes and lysosomes, most of which are in the Golgi zone. Localization of the internalized radioactivity using classical cell fractionation techniques showed it appears in a symmetrical band exhibiting the same buoyant density as the lysosomal marker acid phosphatase. The observations reported here show that: 1) TeBG binds to MCF-7 cells; 2) some of the bound TeBG is taken up via a mechanism with all the characteristics of receptor-mediated endocytosis; and 3) within these cells TeBG is localized in endosomes and lysosomes.
Dichotic listening failure in dysphoric neuropsychiatric patients who endorse multiple seizure-like symptoms. In the present investigation, the dichotic word listening performance of a sample of 25 dysphoric neuropsychiatric patients who endorsed multiple partial seizure-like symptoms was compared with that of matched samples of normal controls and patients with mood disorders who did not endorse multiple seizure-like symptoms. Eighty percent of the patients who endorsed multiple episodic phenomena failed the dichotic listening task, compared with 8% of normal controls and 28% of patients with typical mood disorders. After treatment with carbamazepine, a subsample of polysymptomatic patients manifested significantly fewer seizure-like symptoms. This clinical improvement was typically associated with markedly improved dichotic listening performance in most cases. The results are consistent with our previous hypothesis that "subclinical" electrophysiological dysfunction may severely disrupt the normal transmission and processing of auditory information. Because it is sensitive to this type of presumed cerebral dysfunction and relatively specific, impaired dichotic listening performance is likely to be a useful clinical marker for this complex neuropsychiatric syndrome.
Intrauterine applications of the resectoscope. The resectoscope, used for decades in the surgical treatment of the bladder, has important applications for gynecologic procedures as well. The surgeon may either resect intrauterine disease or ablate the endometrium with the use of the resectoscope. Both of these outpatient procedures offer women significant reduction in risk and cost compared with extensive surgical procedures that they replace. The resectoscope delivers surgical energy of equal effect to the neodymium:yttrium-aluminum-garnet laser at a fraction of the cost. Gynecologists who wish to learn this new technique must be familiar with hysteroscopy as well as fluid imbalance problems.
Leu-22 (L60). A more sensitive marker than UCHL1 for peripheral T-cell lymphomas, particularly large-cell types. Paraffin-embedded sections of 77 peripheral T-cell lymphomas (PTCLs) were stained with several monoclonal antibodies, including the preferential T-cell markers Leu-22 (L60[CD43]) and UCHL1 (CD45RO). The staining characteristics of L60 and UCHL1 were compared to determine the value of each in the immunophenotypic analysis of PTCLs. Lineage specificity was evaluated among 39 B-cell lymphomas and 33 cases of Hodgkin's disease (HD). L60 and/or UCHL1 stained 95% of PTCLs, whereas L60 and UCHL1 alone stained 90% and 69% of cases, respectively. L60 demonstrated significantly greater numbers of immunopositive tumor cells than UCHL1 in 37% of the PTCL cases, principally because of enhanced marking of large, neoplastic cells. UCHL1 was a better marker in only 10% of the PTCL cases. L60 stained 33% of B-cell lymphomas, usually small lymphocytic or lymphoplasmacytic types. UCHL1 stained only 8% of B-cell lymphomas, all large-cell types. L60 and UCHL1 stained Reed-Sternberg cells and variants in three cases of nodular sclerosing HD. These results suggest that both L60 and UCHL1 are useful markers of PTCLs in routinely processed tissue. L60 is a more sensitive marker of large neoplastic T-cells than UCHL1 but is less lineage-specific. These antibodies are most effective when used as part of a panel of monoclonal antibodies.
Herniated cervical disk presenting as ischemic chest pain. Myocardial ischemia must be the first concern of every emergency physician in evaluating chest pain in the adult patient. Any suspicion of myocardial ischemia must be promptly evaluated and admitted. The American College of Emergency Physicians has recently published a standards document on the care of chest pain in the adult patient. The emergency physician must be familiar with this document. Once myocardial ischemia and other life-threatening causes are ruled out, one can consider that cervical disk disease may be the cause of chest pain. The authors present two cases of patients who presented to the Emergency Department with signs and symptoms consistent with cardiac ischemia. Both patients were found to have herniated cervical disks. Subsequent surgical repair completely relieved their symptoms. Evaluation of the literature reveals that this entity was well described from 1950 to the 1960s. Most recent discussions do not mention disk herniation as even an infrequent cause of chest pain. If there is no life-threatening disease present, one should consider cervical disk disease.
Tissue characterization of an unusual right atrial mass by magnetic resonance imaging. In a 70-year-old man who had angina, exercise-induced ventricular tachycardia, and presyncopal symptoms, transthoracic and transesophageal echocardiography disclosed a large atrial mass that resembled a myxoma. Subsequent evaluation by magnetic resonance imaging identified the mass as an intracardiac lipoma attached to the posterior wall of the right atrium, a diagnosis that was confirmed by surgical intervention. Thus, the diagnostic utility of magnetic resonance imaging as an adjunct to echocardiographic evaluation of intracardiac masses was demonstrated.
Posttraumatic intradiploic leptomeningeal cyst in an adult: case report. We report the case of an adult with a posttraumatic intradiploic leptomeningeal cyst that caused a circumscribed osteolytic skull lesion. Local pain, the only symptom of the lesion, regressed after surgery. Intradiploic leptomeningeal cysts must be distinguished from intradiploic arachnoid cysts, which are of congenital origin.
Evidence for a new tumor-suppressor gene involved in gastrointestinal malignancies. Inactivation or loss of tumor-suppressor genes is believed to lead to the development or progression of malignancies. To determine whether a tumor-suppressor gene is located on chromosome 8, DNA was extracted from tumor and normal tissue of colorectal, gastric, and pancreatic specimens, and allele loss was investigated by Southern hybridization techniques with the chromosome 8 probe D8S7. Twenty-five percent of pancreatic carcinomas, 50% of gastric carcinomas, and 50% of colorectal carcinomas were found to have lost an allele on chromosome 8. These findings suggest the presence of a tumor-suppressor gene on chromosome 8, which is involved in colorectal carcinoma, gastric carcinoma, and pancreatic carcinoma. Definition of the frequency with which this tumor-suppressor gene is involved in gastrointestinal malignancies will await the study of many patients who are classified as informative and the use of multiple probes for chromosome 8.
Physical activity and risk of developing colorectal cancer among college alumni. The assessment of physical activity at a single time to evaluate its association with cancer may be limited, since such a measure may not adequately reflect activity over the long term. To overcome this limitation, we studied 17,148 Harvard alumni aged 30-79 years who were followed prospectively for the occurrence of colon cancer (n = 225) and rectal cancer (n = 44) from 1965 through 1988. Physical activity, based on self-reported stair climbing, walking, and sports play, was assessed in either 1962 or 1966 (1962/1966) and again in 1977. The increased activity evaluated using either assessment (1962/1966 or 1977) taken alone was not associated with risk of colon cancer. However, alumni who were highly active (energy expenditure of greater than 2500 kilocalories/wk) at both assessments had half the risk of developing colon cancer relative to those who were inactive (less than 1000 kilocalories/wk) at both assessments (age-adjusted rate ratio = 0.50; 90% confidence interval = 0.27-0.93), whereas those who were moderately active (1000-2500 kilocalories/wk) at both assessments had an age-adjusted rate ratio of 0.52 (90% confidence interval = 0.28-0.94). We conclude that either consistently higher levels of activity are necessary to protect against colon cancer or combining two assessments increased the precision of physical activity measurement. We found no evidence that increased physical activity protected against rectal cancer.
Combined effect of neonatal sympathectomy and adrenal demedullation on blood pressure and vascular changes in spontaneously hypertensive rats. Neonatal sympathectomy using a combined treatment with antiserum to nerve growth factor and guanethidine during the first 4 weeks after birth was carried out in spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto (WKY) rats. Bilateral adrenal demedullation was performed in 4-week-old sympathectomized SHR and WKY rats. The development of hypertension in SHR was prevented by sympathectomy, but the blood pressure (BP) was still higher than in age-matched WKY rats. Demedullation reduced the BP of sympathectomized SHR to the same level as that of WKY rats. Heart rates of SHR and WKY rats were not affected by the treatments. Morphometric measurements of the mesenteric arteries showed that sympathectomy significantly reduced the medial mass in the mesenteric arteries of SHR, mainly through a reduction in the number of smooth muscle cell layers. In sympathectomized SHR, demedullation increased the lumen size of muscular arteries under maximally relaxed conditions, which might explain the further reduction in BP in these animals. Demedullation in sympathectomized SHR and WKY rats caused a decrease in smooth muscle cell layers in the superior mesenteric artery, but the same treatment resulted in a slight increase in the number of smooth muscle cell layers in the large and small mesenteric arteries of SHR and WKY rats. Adventitial area was increased in some mesenteric arteries of SHR and WKY rats by sympathectomy, and demedullation caused a further increase in the size of adventitia in WKY rats. Heart weight in SHR was normalized to the level found in WKY rats by sympathectomy and demedullation. We conclude that in sympathectomized SHR, the elevated BP was maintained by the adrenal medulla.
An immunochemical and immunohistochemical study of aldolase isozymes in renal cell carcinoma. To assess changes in aldolase isozyme patterns (A, B, and C) in renal cell carcinoma (RCC) tissues and to evaluate whether serum aldolase A might be a useful marker for RCC, quantitative analysis by enzyme immunoassay and immunohistochemical localization were performed. Concentrations of aldolase A in RCC (7300 +/- 6300 ng./mg. protein n = 26) were significantly higher than those of normal cortex (720 +/- 410 ng./mg. protein, n = 14, p less than 0.01); concentrations of aldolase C in RCC (48.0 +/- 8.0 ng./mg. protein) were also significantly higher than those of normal cortex (8.7 +/- 4.7 ng./mg. protein, p less than 0.01). On the other hand, concentrations of aldolase B in normal cortex were 18,100 +/- 10,100 ng./mg. protein (n = 14), whereas the values in RCC were only 130 +/- 270 ng./mg. protein, a significant lowering (p less than 0.01). Immunohistochemically, aldolases A and C were found localized in all RCC tissues (n = 10); aldolase B was faintly stained in only a few tumor cells of two cases (20%). Levels of serum aldolase A were elevated (greater than 300 ng./ml.) in 30 (75%) of 40 patients with RCC as compared to three (6.3%) of 48 individuals with urogenital benign diseases and in seven (21%) of 34 cases with non-RCC urogenital malignancies. Since it is generally accepted that RCC are derived from renal proximal tubules, these findings indicate that aldolase B, the predominant isozyme in the normal case, changes into aldolases A and C during carcinogenesis and that serum aldolase A could be a new useful biomarker for RCC.
An ectopic pregnancy in the upper retroperitoneum following in vitro fertilization and embryo transfer. Thirty-seven days after successful embryo transfer, a chorionic vesicle was recovered from the upper abdominal retroperitoneal space in a patient presenting with an acute life-threatening hemorrhage. This is the first case report of a retroperitoneal ectopic pregnancy which, although uncommon, is a potentially fatal complication of in vitro fertilization-embryo transfer.
Spinal cord stimulation for chronic, intractable pain: superiority of "multi-channel" devices. Spinal cord stimulation has evolved over the past 20 years into an easily implemented technique, with low morbidity, for the treatment of intractable, chronic pain in properly selected patients. We report our experience with a series of 62 patients implanted between 1983 and 1987, with percutaneous and laminectomy electrodes, and with single- and "multi-channel" (programmable, multi-contact) devices. Fifty had chronic, intractable low back and leg pain ("failed back surgery syndrome," lumbar arachnoid fibrosis), five had spinal cord injuries, and seven "peripheral" pathology or stump pain. Statistical analysis of these and other patient characteristics and technical factors was undertaken to identify predictors of outcome. All patients were interviewed by a disinterested third party at a mean of 2.14 years following implantation. A majority of patients reported at least 50% sustained relief of pain and indicated that they would go through the procedure again for the same result. There was corresponding improvement in ability to perform various everyday activities, and decrease in use of analgesics. Ten of 40 failed back patients who were disabled before the procedure returned to work postoperatively. Superposition of stimulation paresthesias upon a patient's topography of pain was found to be a statistically significant predictor of successful relief of pain, by linear regression methods. Univariate and multivariate analysis of patient characteristics and technical factors as predictors of outcome demonstrated significant advantages for female patients, and for patients implanted with "multi-channel" devices. With these devices, electrode geometries with central cathode(s) flanked by rostral and caudal anode(s) were favored disproportionately. Technical improvements in implanted spinal cord stimulation devices, in particular the development of multi-contact percutaneous electrode arrays and supporting programmable electronics, have significantly improved clinical results.
Primary repair of colon injuries in a developing country. Because there are several specific disadvantages to a colostomy in a developing country, primary repair for colon injury was electively performed. Sixty-one consecutive patients with colon injury were seen between 1978 and 1989 and 57 of these (93 per cent) underwent primary repair. In four a colostomy was constructed. Emergency repair was carried out regardless of site or mode of injury, presence of hypotension or peritoneal contamination. There was one death unrelated to anastomotic complications and one anastomotic leakage. The faecal fistula closed spontaneously in 4 weeks. The wound infection rate was 10 per cent. These data support the emerging view that primary repair of colon injury is the management of choice.
The disappearance of the "cold patch" in recovered migraine patients: thermographic findings. In a previous paper we suggested that the vascular cold patch may be a useful prognostic index to followup migraine patients. Considerable criticism against our contention has been raised by Swerdlow and Dieter (Headache 29:562-568, 1989, ref. 1), who claim that the cold patch constitutes a "fixed geography" of the vasculature of migraine patients. In the present paper we replicate and extend our previous findings reporting the results of facial thermography in a sample of 246 consecutive migraine patients. Of these the 206 exhibiting a typical cold patch or a significant asymmetry in the forehead thermal dissipation were admitted to prophylactic treatment (beta blocker or calcium channel blocker). The thermography was performed at entry in the study and after six months of active treatment. The clinical outcome was compared to the thermographic findings. The patients were subdivided in three classes on the basis of the clinical outcome. Among the 136 patients who experienced complete or substantial relief from headache the cold patch disappeared or markedly improved in 85% of the cases. In the 46 patients with partial relief the thermogram showed an improved pattern in 48% of cases, most of the time of smaller extent than in the previous class. In 24 patients we observed no clinical improvement. Among these the thermogram remained unchanged in 85% of cases. Taken together these findings corroborate our previous suggestion that thermography is useful to monitor the clinical course of the disease. One additional suggestion from the present data is that thermography closely parallels the clinical course so as to represent a useful criterion for the decision of discontinuing the therapy.
Balloon dilatation of restrictive interatrial communications in congenital heart disease. An adequate interatrial communication is necessary for survival in several forms of congenital heart disease. Three children are presented in whom blade atrial septostomy proved either technically impossible or failed to achieve adequate interatrial communication. In all three an adequate communication was obtained by a balloon dilatation technique similar to that used for pulmonary valve dilatation. In one critically ill infant with mitral atresia the procedure was life saving.
Effect of enlarged adenoids on arterial blood gases in children. The enlarged adenoid is a common disorder in children resulting in nasopharyngeal obstruction. Many authors suggest that increased nasal resistance to respiration may cause disturbances in the pulmonary ventilation and carry the risk of obstructive sleep apnoea and/or cardiopulmonary syndrome. This study comprised 30 children complaining of long-standing nasal obstruction due to enlarged adenoids. Adenoidectomy was performed and the arterial blood gases were measured before and one month after surgery. Twelve normal children were also included as controls. Statistical evaluation of the results showed that O2 saturation and arterial O2 tension (PaO2) were significantly low before the operation, and increased significantly after surgery. Arterial CO2 tension (PaCO2) was insignificantly low before operation, but decreased significantly after adenoidectomy. It was concluded that enlarged adenoid may be associated with ventilatory impairment which is reversible after adenoidectomy.
Ursodeoxycholic acid for the treatment of home parenteral nutrition-associated cholestasis. A case report. Severe cholestasis associated with long-term home parenteral nutrition is rare, and no treatment is known to be effective. This study shows a case of a patient who developed jaundice while receiving long-term home parenteral nutrition. Causes of jaundice, other than the patient's parenteral feedings, were excluded. The patient's jaundice did not respond to alterations in his parenteral feeding program or to metronidazole. Ursodeoxycholic acid (600 mg/day) led to a prompt and sustained improvement in his hyperbilirubinemia. When ursodeoxycholic acid was stopped, the patient again became jaundiced, but this resolved with reinstitution of ursodeoxycholic acid. This case suggests that ursodeoxycholic acid may be an effective treatment for home parenteral nutrition--associated cholestasis and should be evaluated further in patients with cholestasis associated with parenteral feeding.
Value of planar 201Tl imaging in risk stratification of patients recovering from acute myocardial infarction. Although exercise ECG testing has been shown to have important prognostic value after acute myocardial infarction, exercise 201Tl scintigraphy offers several potential advantages, including: 1) increased sensitivity for detecting residual myocardial ischemia; 2) the ability to localize ischemia to a specific area or areas subtended by a specific coronary artery; 3) the ability to identify exercise-induced left ventricular dysfunction, which is manifested by increased lung uptake or transient left ventricular dilation; and 4) more reliable risk stratification of individual patients. The more optimal prognostic efficiency of 201Tl scintigraphy partially results from the fact that the error rate in falsely classifying patients as low risk is significantly smaller with 201Tl scintigraphy than with stress ECG. Because of these substantial advantages, there seems to be adequate rationale for recommending exercise perfusion imaging rather than exercise ECG alone as the preferred method for evaluating mortality and morbidity risks after acute myocardial infarction.
A prospective evaluation of myocardial contusion: correlation of significant arrhythmias and cardiac output with CPK-MB measurements. Over a nine-month period, patients with chest trauma were prospectively evaluated for myocardial contusion. Ninety-two patients with evidence of anterior chest trauma were entered into the study and had 1) an ECG on admission and daily for three days; 2) monitoring of the myocardial band fraction of creatine phosphokinase (CPK-MB) on admission and every eight hours for 24 hours; 3) continuous electrocardiographic Holter monitoring for three to five days; and 4) noninvasive pulsed-Doppler cardiac output measurements daily for three days. Twenty-three patients developed 25 significant arrhythmias (SARRs): 1 atrial fibrillation, 1 AV dissociation, 5 supraventricular tachycardias, and 18 paroxysmal ventricular tachycardias. Cardiac outputs were significantly higher in those patients without SARRs. The CPK-MB levels correlated with the SARRs but were neither sensitive nor specific. No patients required specific therapy and none developed adverse sequelae of the SARRs. We conclude that 1) CPK-MB monitoring should not be routinely used for screening and diagnosis; 2) continuous arrhythmia monitoring deserves further clinical investigation but not routine application; 3) stable patients at risk for myocardial contusion should be monitored for 24 hours; and 4) the Abbreviated Injury Score for "minor" myocardial contusion should be deleted for purposes of ISS tabulation.