shukoor65/lab-rag-model huggingface dataset:
View from beneath: pathology in focus. ENT presentation of Ollier's disease. Cartilaginous tumours occurring in the head and neck are usually regarded and seen as solitary lesions. However, we present an unique case where the cartilaginous tumour in the ENT region was the presenting feature of Ollier's disease (multiple enchondromatosis). It is recommended that further investigations be carried out in patients with cartilaginous tumours presenting in the head and neck to exclude the possible presence of this unusual and interesting syndrome.
Hypoxia-inducible nuclear factors bind to an enhancer element located 3' to the human erythropoietin gene. Human erythropoietin gene expression in liver and kidney is inducible by anemia or hypoxia. DNase I-hypersensitive sites were identified 3' to the human erythropoietin gene in liver nuclei. A 256-base-pair region of 3' flanking sequence was shown by DNase I protection and electrophoretic mobility-shift assays to bind four or more different nuclear factors, at least two of which are induced by anemia in both liver and kidney, and the region functioned as a hypoxia-inducible enhancer in transient expression assays. These results provide insight into the molecular basis for the regulation of gene expression by a fundamental physiologic stimulus, hypoxia.
Primary pulmonary hypertension. Dyspnea is the most common symptom of primary pulmonary hypertension, an often fatal disease that has no apparent cause. Decreased cardiac output, congestive heart failure, and increased systemic venous pressure occur as the disease progresses. Use of oxygen therapy and vasodilators improves the prognosis in some patients. Those with little hope for long-term survival may benefit from heart and lung transplantation.
Perceptual filling in of artificially induced scotomas in human vision. Patients with scotomas or blind-spots in their visual field resulting from damage to the visual pathways often report that the pattern from the rest of the visual field 'fills in' to occupy the scotoma. Here we describe a novel technique for generating an artificial perceptual scotoma which enabled us to study the spatial and temporal characteristics of this filling-in process. A homogeneous grey square subtending 1.5 degrees was displayed against a background of twinkling two-dimensional noise of equal mean luminance. On steady eccentric fixation for 10 s the square vanished and was filled in by the twinkling noise from the surround. Using this display we found that 'filling in' is an active visual process that probably involves creating an actual neural representation of the surround rather than merely ignoring the absence of information from the scotoma; filling in can occur separately for colour and texture, suggesting separate mechanisms; the filling-in process does not completely suppress information from the scotoma, even after an image has faded completely from consciousness it can nevertheless contribute to motion perception; and the process can be strongly influenced by illusory contours.
Anal endosonography in the investigation of faecal incontinence. Forty-four consecutive patients with incontinence of solid stool of traumatic or idiopathic aetiology were examined by anal endosonography and standard anorectal physiology tests. Anal endosonography showed an external anal sphincter defect in four out of 11 (36 per cent) patients with idiopathic (neurogenic) incontinence. In the remaining seven patients both parts of the sphincter were intact and a linear relationship was found between the resting anal canal pressure and the endosonographic thickness of the internal anal sphincter. Twenty-eight out of 33 (85 per cent) patients with incontinence of traumatic origin had external sphincter defects, confirmed by concentric needle electromyogram mapping in the 19 patients in whom this was performed. Eleven of these 28 (39 per cent) patients also had disruption of the internal sphincter. Anal endosonography has revealed significant abnormalities in patients with faecal incontinence and has a complementary role to anorectal physiology in the routine investigation of these patients.
Appendicitis. Improvements in diagnosis and treatment. The results of therapy in cases of suspected acute appendicitis were reviewed in 844 consecutive cases of appendicitis occurring over a 3-year period. A diagnostic accuracy of 87.4 per cent was found as well as a perforation rate of 18.4 per cent. Complication rates varied with the clinical state of the appendix: 16 per cent in perforated, 5.6 per cent in nonperforated, and 11.3 per cent in normal appendices. Excellent results were routinely obtainable employing early operative intervention, perioperative antibiotics, and a systematic surgical approach.
Duodenocaval fistula in peptic ulceration. Duodenocaval fistula is usually caused by abdominal trauma. We report a patient in whom it was associated with peptic ulcer.
Acute ethanol intoxication decreases the likelihood of resuscitation from cardiac arrest in rats. BACKGROUND AND METHODS: Acute ethanol intoxication has been shown to depress myocardial performance in both laboratory and clinical studies. The present study was designed to examine the effect of acute ethanol intoxication on resuscitation of rats subjected to cardiac arrest. Rats were given 1.2 g ("moderately intoxicated") or 2.4 g ("highly intoxicated") of ethanol/kg, or distilled water ("nonintoxicated" rats). Using a standardized technique, we induced cardiac arrest. CPR was then attempted using chest compressions interposed with abdominal compressions. Resuscitation was said to be successful if BP returned spontaneously within 6 mins of institution of chest compressions interposed with abdominal compressions, and if systolic BP was 50% of its prearrest level within 10 mins of discontinuation of chest compressions interposed with abdominal compressions. Mean +/- SD serum ethanol levels were 121.3 +/- 12.9 mg/dL (26.3 +/- 2.8 mmol/L) (moderately intoxicated rats) and 254.4 +/- 34.6 mg/dL (55.2 +/- 7.5 mmol/L) (highly intoxicated rats). RESULTS: Resuscitation was successful in 75% (15/20) of nonintoxicated rats, 46.7% (7/15) of moderately intoxicated rats, and 33.3% (5/15) of highly intoxicated rats. The difference in resuscitation rates was significant for nonintoxicated rats compared with either intoxicated rats as a group (p = .021) or highly intoxicated rats (p = .019), but was not significant for nonintoxicated rats compared with moderately intoxicated rats. CONCLUSION: Acute ethanol intoxication appears to decrease the likelihood of successful resuscitation in a dose-dependent fashion.
Clostridial mycotic aneurysm of the suprarenal abdominal aorta. Clostridial mycotic aneurysms are unusual. We therefore record a fatal case of a ruptured clostridial mycotic aneurysm of the suprarenal aorta which developed several weeks after the resection of a segment of gangrenous small bowel.
Single-photon emission computed tomographic thallium imaging with adenosine, dipyridamole, and exercise. Stress thallium imaging is a sensitive technique for detecting coronary artery disease, particularly in those patients with multivessel disease. Single-photon emission computed tomography (SPECT) is superior to planar imaging; because of improved image quality and lack of overlap between normal and abnormal segments, SPECT has greater ability to detect diseased arteries. The inherent three-dimensional nature of the data presentation suggests the feasibility of quantifying the extent of myocardium at risk. Pharmacologic stressors such as adenosine and dipyridamole allow imaging with thallium (and probably other perfusion agents) even in patients who are not candidates for exercise testing or who cannot achieve adequate levels of exercise. Studies suggest that adenosine has unique advantages for use with SPECT perfusion imaging with a high degree of accuracy. In our experience the sensitivity of detecting one-vessel disease is higher with adenosine-thallium imaging than in exercise SPECT thallium imaging. The degree of coronary hyperemia is greater and the duration of action is shorter with adenosine than with dipyridamole.
Benign vascular sexual headache and exertional headache: interrelationships and long term prognosis. There is a definite relationship between the vascular type of benign sexual headache and benign exertional headache. Forty five patients with benign vascular sexual headache were reviewed. Twenty seven (60%) experienced benign vascular sexual headache alone and eighteen (40%) had experienced both benign vascular sexual headache and benign exertional headache on at least one occasion. The mean age was 34.3 years with a male:female ratio of 5.4:1. Thirty patients with a history of benign vascular sexual headache were followed for an average of 74 months. A personal history of migraine was found in 47% of cases and a family history of migraine in 30%. Forty one per cent of patients with benign vascular sexual headache alone had recurrences after diagnosis, and stress and fatigue were considered major contributing factors to the initial and recurrent headache. Nine patients had experienced benign vascular sexual headache and benign exertional headache within 72 hours of each other on at least one occasion, often with a residual headache between the two. Four patients experienced their benign vascular sexual headache and benign exertional headache separated by months to years. The prognosis of benign vascular sexual headache and the clinical and possible pathophysiological relationships between benign vascular sexual headache and benign exertional headache are discussed. Knowledge of the interrelationships of these varieties of headache is valuable in the counselling of patients.
Effect of antihypertensive drugs on insulin, glucose, and lipid metabolism. The close relationship between diabetes and hypertension has been recognized for decades. New information indicates that resistance to insulin action on glucose uptake in peripheral tissues is a common underlying mechanism in hypertension and diabetes. In prospective trials, the effects of antihypertensive agents on insulin sensitivity and lipoprotein metabolism have been evaluated. Both beta-blockers and thiazide diuretics worsen insulin resistance and deteriorate lipoprotein metabolism. Angiotensin-converting enzyme (ACE) inhibitors, Ca2(+)-channel blockers, and alpha-blockers are neutral or improve these factors. These data may explain the unexpectedly high incidence of the development of diabetes among treated hypertensives and the poor effect on risk for coronary heart disease in intervention trials.
Diagnostic imaging of osteosarcoma. The diagnosis, treatment planning, and follow-up evaluation of osteosarcoma rely heavily on a variety of imaging techniques. Plain roentgenography, radionuclide bone scanning, computed tomography, and magnetic resonance imaging play important roles in defining local tumor extent, detecting metastatic disease, and monitoring for recurrent tumor. Invasive studies such as angiography are now rarely necessary. In the future, newer imaging modalities, including positron emission tomography, can be expected to become important tools for evaluation of these tumors.
Analysis of adhesion molecules in the immunopathogenesis of giant cell arteritis. To explore the role of adhesion molecules in mediating mononuclear cell localisation, development of the granulomatous reaction, and cell mediated damage to the arterial wall in giant cell arteritis, 17 temporal artery biopsy specimens were examined. Eleven showed the histological features of giant cell arteritis and six showed no evidence of arteritis. All were examined for the expression of LFA-3, ICAM-1 and its receptor LFA-1, and HLA-DR. Temporal arteries with early features of arteritis, as well as histologically unaffected skip areas, showed a regional induction of ICAM-1 expression, but not HLA-DR, on smooth muscle cells of the media. ICAM-1 expression was detected in areas where a clinically important mononuclear cell infiltrate had not yet developed. In more florid cases of giant cell arteritis there was an additional widespread induction of ICAM-1 expression on intimal myofibroblasts. Strong expression of ICAM-1, HLA-DR, and LFA-3 was found on macrophages, epithelioid cells, and giant cells comprising the granulomatous lesion. The pattern of expression of these adhesion molecules suggests that they have a role in leucocyte traffic into the vascular lesion as well as in mediating the intercellular interactions which constitute the granulomatous response.
Axonal neuropathy with monoclonal IgG kappa that binds to a neurofilament protein. We report a 74-year-old woman with a slowly progressive sensory motor axonal neuropathy and a monoclonal IgG-kappa that bound to a 68-kd axonal protein identified as the low molecular weight neurofilament protein. The sera of control subjects and disease controls did not bind to neurofilament protein.
Polycystic ovary syndrome and the androgen-insulin connection. The association of hyperandrogenism, insulin resistance, and polycystic ovarian disease is well established. The accompanying hyperinsulinemia results in acanthosis nigricans, an epiphenomenon of this syndrome. The knowledge that states of insulin resistance of diverse causes are associated with ovarian hyperandrogenism makes the argument for insulin-driven ovarian androgen secretion compelling. However, equally compelling evidence suggests that hyperandrogenism may contribute to insulin resistance and hyperinsulinemia. The irreconcilable differences between these two hypotheses have resulted in an array of contradictory studies. In this article a unified concept of polycystic ovary syndrome and its androgen-insulin connection is proposed. The hypothesis incorporates the role of hyperinsulinemia in the androgen excess observed (and vice versa); the key to this connection is the androgen-dependent change in regional body fat distribution and its metabolic consequence. The pathophysiologic features of polycystic ovary syndrome, which has important clinical sequelae, deserve further consideration.
Diastolic mechanical properties of the left ventricle after global ischemia. The purpose of this study was to evaluate left ventricular (LV) diastolic mechanical properties after induced global ischemia using reliable new methods. The diastolic function of nonoxygenated crystalloid solution (CC sO2) was compared with those of oxygenated crystalloid (CC cO2) and oxygenated fluorocarbon cardioplegic (FC cO2) solutions. Postischemic ventricular performance was studied in 3 equal (no. 7) groups of dogs subjected to 120 minutes of global ischemia induced at an average myocardial temperature of 18.5 +/- 1.4 degrees C. LV diastolic function (chamber and myocardial stiffness) and relaxation (the exponential fall in LV pressure) were evaluated by sonomicrometry and Millar micrometers before ischemia and at 45 and 60 minutes after ischemia. LV chamber and myocardial stiffness in the CC sO2 group was significantly (p less than 0.05) elevated after ischemia, while the CC cO2 and FC cO2 groups did not show increases in LV chamber and myocardial stiffness after ischemia. LV relaxation before and after ischemia was not changed in any group. The myocardial water content of the CC sO2 group was significantly higher than that of the CC cO2 and FC cO2 groups (p less than 0.05). We conclude that (1) the postischemic increase in LV chamber stiffness in the CC sO2 group was dependent not only on the increase in intrinsic myocardial stiffness but also due to an increase in myocardial edema, and (2) there was no correlation between the LV relaxation rate and the leftward shift of diastolic compliance curves in the CC sO2 group.
Measurement of sound. The measurement of sound involves the analysis of frequency, intensity, and temporal dimensions of acoustic signals. Each dimension of sound can be related directly to clinically observed phenomena. Frequency information, measured in Hz, can be extracted from pure-tone and complex stimuli. Intensity represents the physical energy of a signal and is described by using the decibel scale--a logarithmic scale of ratios. Temporal characteristics of sound include duration, phase, and repetition rate. In the analysis of human hearing sensitivity, the middle ear system and its impedance characteristics also must be considered. In this article, we have reviewed some major principles of sound and have presented a series of practical clinical applications. Such principles as these help to predict and explain frequency of laryngeal tones, middle ear mechanics, ear canal resonance, real-ear measurements of hearing aids, the Articulation Index, hearing loss, understanding of speech in quiet and in noise, and the relation between hearing and speech.
Local cerebral glucose utilization in rats with petit mal-like seizures. The quantitative 2-[14C]deoxyglucose autoradiographic method was applied to the measurement of local cerebral metabolic rates for glucose in a model of genetic petit mal-like seizures in a strain of Wistar rats. During the experimental period, epileptic rats exhibited synchronous spike-and-wave discharges recorded from the cerebral cortex, whereas the electroencephalographic pattern of control animals was normal. An overall consistent increase in local cerebral metabolic rates for glucose was observed in epileptic rats as compared to nonepileptic control rats. This increase was statistically significant in 52 of the 59 cerebral structures studied and concerned all cerebral functional systems. These results are in accordance with positron emission tomography measurements in humans with typical childhood absence epilepsy. There is a lack of anatomical correlation between areas demonstrating hypermetabolism and areas where spike-and-wave discharges are recorded. Thus, the diffuse increase in cerebral energy metabolism in epileptic rats as compared to controls is not directly related to the occurrence of spike and wave discharges.
Clinical predictors for buserelin acetate treatment of uterine fibroids: a prospective study of 40 women. Buserelin acetate, a luteinizing hormone-releasing hormone agonist, is known to be effective in the shrinkage of uterine fibroids. A prospective trial was undertaken (1) to compare the efficacy of intranasal (IN) and subcutaneous (SC) administration of buserelin acetate and (2) to assess if tumor regression correlated with fibroid size and/or patient age. Forty patients were randomly allocated to receive 6 months of either IN buserelin acetate (n = 21) or SC buserelin acetate (n = 19). Four patients did not complete the study and were excluded from statistical analysis. Fibroid regression occurred in all 36 patients. Overall regression to 66% or less of the initial fibroid volume occurred in 70% of subjects. There was no significant difference in fibroid shrinkage between the two administration routes. A significant positive correlation was found between initial fibroid size and subsequent fibroid regression, with larger tumors being more likely to shrink than smaller fibroids. No correlation was found between the patient's age and the extent of fibroid regression.
Body image dissatisfaction in homosexual and heterosexual males. A nonclinical sample of 43 homosexual and 32 heterosexual men completed two self-report inventories regarding weight, body satisfaction, eating attitudes, and behaviors. Subjects were also asked to select their current and ideal figures, the weight they felt would be most attractive to a potential partner, and the weight to which they would be most attracted in a potential partner from figures representing very thin to very heavy physiques. Heterosexual men were significantly heavier than homosexual men and desired a significantly heavier ideal weight. Although the current and ideal physiques selected by the homosexual and heterosexual men were almost identical, homosexual men were more likely to desire an underweight ideal. A heightened pursuit of thinness may place homosexual men at an increased risk for developing eating disorders.
Blood transfusion and recurrent Crohn's disease. The effect of blood transfusion on the postoperative recurrence of Crohn's disease has been investigated. Clinical and pathological data from 197 patients treated by right hemicolectomy between 1947 and 1988 have been analysed. Symptomatic recurrences confirmed radiologically or histologically have been recorded and cumulative recurrence rates calculated for transfused and non-transfused patients. Perioperative blood transfusion does not influence the development of recurrent disease (log rank test, chi 2 = 0.112).
Radial artery hypoplasia: a further association with the VATER syndrome? A case of radial artery hypoplasia in a girl with the VATER syndrome is reported. This finding should alert surgeons dealing with vascular access for dialysis and suggests the possibility of intrauterine ischemia in the etiology of upper limb anomalies in these patients.
A histopathological study of 643 cutaneous horns. A retrospective study of 643 cutaneous horns examined in our department between 1970 and 1989 revealed that 38.9% were derived from malignant or premalignant epidermal lesions, and 61.1% from benign lesions. Four main features were associated with premalignant or malignant histopathological change at the base of a cutaneous horn (base pathology). These were: (i) age--the mean age of the patients whose cutaneous horns showed premalignant or malignant base pathology was 8.9 years greater than the mean age of the patients where base pathology was benign (P less than 0.0005); (ii) sex--males were more likely to develop a cutaneous horn with (pre)malignant base pathology (P less than 0.001); (iii) site--over 70% of all (pre)malignant lesions were found on the nose, pinnae, backs of hands, scalp, forearms and the face; a cutaneous horn found at these sites was 2.1 times more likely to have derived from a (pre)malignant base than from any other part of the body (P less than 0.0001); (iv) geometry of the lesion--lesions with a wide base or a low height-to-base ratio were significantly more likely to show (pre)malignant base pathology. Of those solar keratoses giving rise to cutaneous horns, 8.9% also showed histological evidence of change to squamous cell carcinoma (SCC); this figure was not significantly different from the 6.2% of solar keratoses without horns that showed SCC change during the same period (1970-89).
Flow cytometric studies of human osteosarcoma. A number of recent studies have emphasized the potential value of flow cytometry as a "marker" to assess the malignity and therefore to help predict the biologic behavior of neoplasms, including bone tumors. Using propidium iodide and a home-built flow cytometer, the authors have studied the DNA distribution in 95 patients with osteosarcoma and determined the percentage of cells in diploidy, S-phase, tetraploidy, and aneuploidy. Using these values and a derived one, mean DNA concentration, it was possible to demonstrate the extent of the abnormalities observed in this group of neoplasms and show their severity as compared with the normal pattern. When the data are compared against disease-free survival and total survival, correlations were noted that, although weak, suggested that some patterns were predictive of increased risk of metastasis and death. The effect of treatment could also be assessed by evaluating the pattern before and after chemotherapy and correlating these with survival. It seems likely that with some improvement in technology, flow cytometry will be of value in the future in assessing the prognosis for osteosarcoma and predicting whether treatment has been effective.
Endoscopic findings in carcinoid tumor of the duodenum. The endoscopic findings in six patients with carcinoid tumor of the duodenum were analyzed. Radiographic and endoscopic examinations revealed a smooth and round elevation (measuring 5-20 mm in diameter) in the duodenal bulb. In three patients, the lesion was accompanied by an irregularly shaped erythematous depression, a characteristic endoscopic finding of this tumor. Because the endoscopic forceps biopsy technique led to an accurate diagnosis, we wish to stress the clinical value of the endoscopic modalities.