shukoor65/lab-rag-model huggingface dataset:
Microinfarction in classic migraine? A study with magnetic resonance imaging findings. By means of magnetic resonance imaging we investigated a total of 45 patients suffering from classic migraine; 25 patients had been treated in our department for classic migraine over the past 2 years (group A), and 20 other patients investigated between 1976 and 1984 were reexamined for this study (group B). Thirty-two age- and roughly sex-matched healthy volunteers underwent magnetic resonance imaging and served as controls (group C). There was a trend for patients with classic migraine to have more subcortical patchy lesions on T2-weighted magnetic resonance imaging. In a comparison of our control subjects and patients with a history of greater than 20 attacks of classic migraine taken from groups A and B, this difference in number of lesions was significant (p = 0.02). The results suggest that patchy lesions in patients with classic migraine should be interpreted with particular caution before diagnosing a demyelinating disease since the lesions could be ischemic in origin.
Incidental appendectomy during videolaseroscopy. One hundred incidental appendectomies were performed in patients undergoing operative laparoscopy (videolaseroscopy) for evaluating and treating various major diseases of the reproductive organs. Except for a fever resolving within 24 hours in one case and mild periumbilical ecchymosis, there were no intraoperative or postoperative complications. All patients were discharged within 24 hours of surgery. Average hospital stay was 14 hours. All cases have been followed up for a minimum of 8 months. We believe any risk associated with elective appendectomy as reported here is minimal and outweighed by the benefits of eliminating future emergency appendectomy, simplifying future differential diagnosis of pelvic pain and removing unsuspected abnormality found in the appendix.
Pancytopenia secondary to short-term, high-dose intravenous infusion of amrinone. The incidence of amrinone-induced thrombocytopenia has been reported to be 2.4 percent in patients receiving intravenous therapy. To date there have been no reports of bleeding in these patients nor have there been reports of other hematologic abnormalities secondary to amrinone administration. This case report describes a patient whose hematologic values began to decrease after two days of amrinone therapy, reaching a nadir at day 8. Values returned to baseline eight days after treatment was discontinued. This report provides the first evidence that amrinone may induce pancytopenia in patients who receive short courses of high-dose, continuous-infusion amrinone.
Hepatic phosphofructokinase-1 activity and fructose 2,6-bisphosphate levels in patients with abdominal sepsis. 1. In sepsis various processes of carbohydrate metabolism, such as hepatic gluconeogenesis and glycolysis, are altered. Phosphofructokinase-1, a key glycolytic enzyme, is controlled in the long term via regulation of synthesis and degradation of the protein itself, while in the short term it is regulated by allosteric effectors, such as fructose 2,6-bisphosphate (the most potent). In the present study hepatic phosphofructokinase-1 activity as well as phosphofructokinase-2 activity and the concentration of fructose 2,6-bisphosphate were assayed to determine if they might contribute to the derangement of carbohydrate metabolism seen commonly in sepsis. 2. The levels of glycogen and fructose 2,6-bisphosphate and the activity of phosphofructokinase-1 and phosphofructokinase-2 were determined in hepatic biopsies obtained at laparotomy from six patients with and seven patients without abdominal septic foci. 3. A significant increase in plasma lactate concentration was observed in the septic patients, whereas no significant differences in tissue glycogen content or plasma glucose concentration were seen between the groups. 4. No significant change in plasma insulin concentration was observed. However, levels of the counter-regulatory hormones (glucagon, cortisol and adrenaline) were elevated in the septic patients. 5. A 60% decrease in hepatic phosphofructokinase-1 activity was seen in the septic patients. However, no significant changes in hepatic phosphofructokinase-2 activity and fructose 2,6-bisphosphate content were observed in the septic patients. 6. The present results demonstrate that the decrease in hepatic phosphofructokinase-1 activity occurring in sepsis does not appear to reflect alterations in the concentration of fructose 2,6-bisphosphate.
Meningioangiomatosis: clinical, radiologic, and histopathologic correlation. Meningioangiomatosis (MA) is a rare, benign, hamartomatous lesion of the leptomeninges; MA has been considered to be a forme fruste of neurofibromatosis. A review of pathology records for patients with MA who were seen between 1970 and 1989 at the authors' institutions revealed four patients (three male and one female; aged 2.5-21.0 years; mean, 10.8 years) with a history of seizures but without the stigmata or family history of neurofibromatosis. Three patients had undergone either computed tomographic (CT) or magnetic resonance (MR) imaging studies. All patients had undergone craniotomies to obtain tissue for pathologic analysis; a peripheral, leptomeningeal lesion was found in all four patients. At CT in two patients, the lesions were most consistent with calcification. At T2-weighted MR imaging in one patient, the lesion demonstrated a hyperintense periphery with associated edema of the white matter. Histopathologic examination demonstrated characteristic features of MA--cortical meningovascular fibroblastic proliferation and leptomeningeal calcification. The accurate diagnosis of MA is important since MA is a benign, surgically correctable cause of seizures.
Adenosine for paroxysmal supraventricular tachycardia. Adenosine is the most recent drug approved for the treatment of paroxysmal supraventricular tachycardia. Its advantage is that it is just as effective as verapamil and is far less toxic. The lack of toxicity is due to the extremely short half-life (one to seven seconds). The mechanism of action of adenosine is different from that of other antiarrhythmic agents. For the specific purpose of ameliorating paroxysmal supraventricular tachycardia, adenosine appears to be an ideal antiarrhythmic drug.
Recurrent focal segmental glomerulosclerosis after renal transplantation. In a young adult male with chronic renal failure from focal segmental glomerulosclerosis, massive proteinuria appeared within two weeks after transplantation. Although allograft biopsy at eight weeks was normal, a second biopsy eight months after transplant showed focal segmental glomerulosclerosis again. Sixteen months after transplantation maintenance hemodialysis had to be restarted.
Metastatic pattern of infiltrating lobular carcinoma of the breast: an autopsy study. We analyzed the autopsy records and autopsy histological slides of 261 patients with breast carcinoma who died at the Institute of Oncology, Ljubljana, from January 1972 to October 1989, with particular attention to the metastatic pattern of infiltrating lobular carcinoma (ILC) which we compared with infiltrating ductal carcinoma (IDC). In 226 of 261 patients who died with metastatic disease there were 25 cases of ILC, 195 cases of IDC, 4 cases of mixed IDC-ILC, and 2 cases of mucinous carcinoma. There was no statistically significant difference in frequency of metastases to common metastatic sites, such as the liver, bone, and pleura, with the exception of the lungs, in which IDC metastases prevailed (P less than 0.006). By contrast, a statistically highly significant prevalence of ILC metastases to the peritoneum/retroperitoneum, hollow viscera, internal genital organs, leptomeninges, and myocardium was found (P values of less than 0.006- less than 10(-6). The metastases to these sites were characterized by diffuse growth of neoplastic cells that infiltrated in a lymphoma or leukemia-like fashion. Such metastases may remain clinically silent for a long time, in spite of their extensiveness. The difference of metastatic pattern between ILC and IDC is insufficiently appreciated in most of the published studies on ILC.
Cerebrovascular complications after orthotopic liver transplantation: a clinicopathologic study. We analyzed 55 autopsy cases in 1,357 patients undergoing orthotopic liver transplantation at the University of Pittsburgh and found that 13 (23.6%) patients had intracranial bleeding, and five (9%) had infarcts. Eight patients had bleeding localized to one intracranial compartment: intracerebral hemorrhage (three patients); subarachnoid hemorrhage (three patients); and subdural hematoma (two patients). Five patients had combinations of multiple sites of bleeding: three with subarachnoid hemorrhage-intracerebral hemorrhage, one with subarachnoid hemorrhage-intracerebral hemorrhage-subdural hematoma, and one with subdural hematoma-intracerebral hemorrhage. Coexistent CNS infections (fungal or bacterial) were associated with hemorrhagic infarcts and intracerebral hemorrhage in four patients. Cerebral embolism and hemorrhagic infarction from bacterial endocarditis occurred in one patient. Five patients died of intracranial bleeding. Severe coagulopathy was the major cause of intracranial bleeding and was associated with systemic bleeding in 12 patients. Significant systemic or metabolic complications were present in all patients and masked the focal signs of the intracranial process in more than one half.
Digestion of bovine milk proteins in patients with a high jejunostomy. Digestion of milk proteins was studied in short-bowel patients. After ingestion of water, purified beta-lactoglobulin (beta-Ig), or skim milk, effluents were collected at the stoma. The flow rate of the effluent peaked in the first 30-min period after ingestion and returned to the basal value within the first 60 min. After milk ingestion 1) the nitrogen concentration of effluents peaked in the first 30 min, 2) SDS-polyacrylamide gel electrophoresis and Western blot indicated the presence of beta-Ig and alpha-lactalbumin (alpha-lac) in jejunal effluents but only during the first 30 min whereas caseins were detected during the initial 1-2 h effluents, and 3) immunoenzymo metric assay indicated that 64% and 44% of the beta-Ig and alpha-lac, respectively, were recovered in an intact antigenic form. Results indicate that the digestion of milk proteins in humans differs quantitatively. Digestion appeared partially incomplete in the upper jejunum, suggesting the importance of the ileum for completion of digestion.
Some genetic aspects of rolandic epilepsy: waking and sleep EEGs in siblings. Epileptic activity was recorded electroencephalographically in at least one sibling in 22 (51.16%) of 43 patients with rolandic epilepsy and/or centrotemporal spikes. In 26 of 69 (37.68%) siblings, epileptic discharges were observed. These were recorded only in waking in 1 subject (1.5%), in waking and sleep in 13 (18.8%), and in sleep only in 12 (17.4%). The greatest number of epileptic discharges was noted in waking during hyperventilation (52.4%) and in sleep stage C (88%). Foci were recorded in only 4 (5.8%) of the 26 cases with epileptic discharges, and generalized spike-wave complexes were recorded in 22 (31.9%). In one sibling, the sharp-wave focus was located in the right centrotemporal area, in a second in the left occipital, and in a third in the left frontal region with spreading to the centrotemporal; in the fourth, two independent foci were observed in the left and right centrotemporal area. One epileptic discharge was observed every 74.9 s in waking and every 150.9 s in sleep. Epileptic activity was greatest in the group between 5 and 12 years of age (54.3%). The same activation rates were noted in siblings of patients with (47.2%) and without seizures (42.9%), and no differences were noted in siblings with (40%) or without (37.5%) seizures. Family history and sex of the siblings of patient did not play a role in the rate of activation. An autosomal dominant inheritance is assumed, but further investigations are necessary.
IgM-associated primary diffuse mesangial proliferative glomerulonephritis: natural history and prognostic indicators. Fifty-four adults with primary mesangial proliferative glomerulonephritis and IgM deposition were observed for a minimum of three years or until end-stage renal failure. The actuarial renal survival was 80 per cent at 5 years and 64 per cent at 10 years; multivariate analysis identified microscopic haematuria, extent of mesangial proliferation and global glomerular sclerosis as independent prognostic indicators.
Immunohistochemical demonstration of neurone specific enolase in bone marrow infiltrated by neuroblastoma. One hundred and two bone marrow samples were analysed by histological and immunohistochemical methods for neurone specific enolase (NSE). The biopsies were performed to determine the extent of bone marrow disease in 84 neuroblastomas, nine embryonal rhabdomyosarcomas, five Ewing's sarcomas, two cases of Hodgkin's disease and two lymphoblastic lymphomas. Twenty seven (32%) of neuroblastoma bone marrows showed metastases by conventional histological techniques and 33 (39%) after immunohistochemical staining with NSE. Five embryonal rhabdomyosarcomas, five Ewing's sarcomas, and two lymphoblastic lymphomas showed bone marrow metastases. Only one of these cases was reactive for NSE. NSE represents a very sensitive immunomarker for the follow up of neuroblastoma and improves detection of bone marrow invasion by neuroblastoma.
Rheumatoid iliopsoas bursitis presenting as unilateral femoral nerve palsy. A 65-year-old woman with rheumatoid arthritis (RA) developed symptomatic compression of the femoral nerve secondary to an iliopsoas bursitis. Her adjacent hip joint was not severely affected by arthritis. This entity should be included among the entrapment neuropathies complicating RA.
Clinical aspects of pelvic inflammatory disease. Pelvic inflammatory disease is caused by spread of organisms from the vagina and cervix to the upper genital tract. The patient may have a life-threatening illness or may remain asymptomatic. The disease may be caused by sexually or nonsexually transmitted organisms. Polymicrobial infections are the rule. Therapy requires antibiotic agents with broad coverage of aerobic and anaerobic organisms, including Chlamydia trachomatis and Neisseria gonorrhoeae.