shukoor65/lab-rag-model huggingface dataset:
Pediatric musculoskeletal MR imaging. In a review of the indications and uses for magnetic resonance (MR) imaging of the pediatric musculoskeletal system, MR evaluation of conditions unique to the pediatric musculoskeletal system were emphasized. Indications for MR imaging of the pediatric musculoskeletal system include evaluation of bone marrow, neoplastic processes, and periarticular disorders.
Immunohistochemical expression of carbohydrate antigen 19-9 in gastric carcinoma. Immunohistochemical localization for carbohydrate antigen 19-9 (CA19-9) was studied in the gastric tissues from 115 patients with advanced gastric carcinoma. We compared two groups: 57 patients who died of recurrence or metastases within 2 yr (group I) and 58 patients who survived 5 yr or more after resection (group II). The staining patterns were classified into negative, apical, and/or cytoplasmic type and stromal type. Thirty-three cases (58%) of group I showed a stromal type, whereas only 17 cases (30%) of group II showed the same type. In undifferentiated type carcinoma, the stromal type was seen in 20 cases (65%) of group I and seven cases (23%) of group II. However, in differentiated type carcinoma, there was only a small difference in the appearance of stromal type between group I (50%) and group II (37%). The immunohistochemical localization for CA19-9 in the tumor tissues, particularly in undifferentiated carcinoma, will be useful in predicting the prognosis of the patients with advanced gastric carcinoma.
Stomal recurrence after laryngectomy: interrelated risk factor study. This study was designed to identify pathogenic factors in recurrent carcinoma at the tracheal stoma. The charts of 444 patients with laryngeal cancer who were treated surgically between 1976 and 1988 revealed stomal recurrence in 15 (3.4%). Eighty percent of the patients with stomal recurrence had tumors in the subglottis. In comparison to patients with different sites involved this was significant (p less than 0.001). Other variables examined and analyzed included primary stage, previous treatment, neck pathologic status, neck treatment, age, sex, postoperative adjunctive therapy, and timing of tracheotomy. Tumor involvement of the subglottis is the single most important variable in stomal recurrence of carcinoma. Previous conservation laryngeal surgery and preoperative/emergency tracheotomy are not related to stomal recurrence of carcinoma. Mean length of survival for patients with stomal recurrence of carcinoma in our series was 8.9 months. Two patients were successfully treated with extensive surgical resection. The dismal prognosis of stomal recurrence of carcinoma suggests that management of this condition should focus on prevention. Treatment of patients with tumors of the subglottis should include attention to the paratracheal region and superior mediastinum, in conjunction with laryngectomy immediately after initial diagnosis.
Lung function abnormalities at 6 months of age after neonatal intensive care. Respiratory function was studied in 46 preterm infants (median gestational age 28 weeks) at 6 months of age. Respiratory function was assessed by measurement of thoracic gas volume, airways resistance (from which specific conductance was calculated), and functional residual capacity. To determine the effect of the duration of neonatal intermittent positive pressure ventilation (IPPV) on respiratory function, the infants' results were divided into three groups: group A, no IPPV; group B, IPPV for less than seven days; and group C, IPPV for more than seven days. Measurements of thoracic gas volume and functional residual capacity were similar to published reference ranges and there were no significant differences between the three groups. Measurements of airways resistance and specific conductance were higher than published reference ranges (mean airways resistance of group A, 34 cm H2O/l/sec; B, 34.1 cm H2O/l/sec, and C, 30.4 cm H2O/l/sec) but there was no significant difference between the three groups. The 95% confidence intervals of the difference of the means between groups A and B were -6.94 to 6.73 cm H2O/l/sec and between groups A and C -3.8 to 11.0 cm H2O/l/sec. Our results suggest that factors other than neonatal ventilation may be more important in the pathogenesis of chronic lung function abnormalities in preterm infants.
Efficacy and safety of intravenous pulsatile gonadotropin-releasing hormone: Lutrepulse for injection. A multicenter trial was undertaken to assess the ability of pulsatile gonadotropin-releasing hormone to restore physiologic ovulatory function in women with diminished or absent pulsatile gonadotropin-releasing hormone secretion. In 109 women with primary and secondary hypothalamic amenorrhea, pulsatile gonadotropin-releasing hormone (Lutrepulse [gonadorelin acetate] for Injection) was extremely effective, resulting in ovulation in 91% and 96% of patients, respectively. Overall complications of intravenous line placement ranged from 0% to 11% (mean = 7%). A 12% incidence of multiple pregnancy was noted, and a single case of ovarian hyperstimulation was reported in a woman who also received clomiphene citrate. Pulsatile gonadotropin-releasing hormone treatment appears to be of at least comparable efficacy to human menopausal gonadotropins, with the added benefit of reduced overall risks for the patient with hypothalamic amenorrhea.
Loss of heterozygosity for alleles on chromosome II in cervical carcinoma. The HeLa cell (a cervical carcinoma cell line) tumor-suppressor gene has been localized to the long arm of chromosome 11 by molecular genetic studies of nontumorigenic and tumorigenic hybrids derived from normal chromosome 11 x HeLa cell fusions. In the present study, 33 primary cervical carcinoma samples were analyzed using chromosome 11-specific polymorphic DNA markers. The RFLP analysis indicated a somatic loss of chromosome 11 heterozygosity in 10 (30%) of the primary tumors. Preferential loss of the long arm of the chromosome was observed in two of the primary tumors. In addition, at least eight-fold amplification of sequences in the q13 region, including those coding for the fibroblast growth factor-related gene (int-2), was observed in one of the primary tumors. These results suggest a possible role for gene(s) localized to chromosome 11, possibly that localized to the long arm in the development and/or progression of cervical carcinomas.
Flow cytometric deoxyribonucleic acid analysis in stage I renal cell carcinoma. Tumor deoxyribonucleic acid (DNA) content was analyzed by flow cytometry in 60 consecutive patients with stage I renal cell carcinoma. Of 59 evaluable tumors 27 (46%) were homogeneously diploid, 1 (2%) was tetraploid and 31 (52%) were aneuploid. Of the 32 nondiploid tumors 25 were heterogeneous concerning ploidy. One of the 27 patients with diploid tumors had metastases compared to 5 of the 32 patients with nondiploid tumors (not significant). There was a significant difference in survival between patients with diploid and nondiploid tumors (p = 0.043). Neither nuclear grade, tumor cell type nor tumor size correlated with survival. Analysis of DNA content seems to predict survival significantly for patients with stage I renal cell carcinoma.
Composite graft repair of Marfan aneurysm of the ascending aorta: results in 100 patients. One hundred consecutive patients with the Marfan syndrome underwent composite graft repair of an ascending aortic aneurysm between September 1976 and June 1989. Twenty-two patients had ascending aortic dissection at the time of composite graft repair; 18 patients also had a mitral valve procedure. There were no hospital deaths among 92 patients undergoing elective repair. One of 8 patients undergoing emergency repair of a ruptured aneurysm died in the operating room. The overall hospital mortality rate was 1%. There have been ten late deaths among the 99 hospital survivors (10.1%). Five deaths occurred among the first 11 patients in this series and five occurred among the last 88 patients (5.7%). Three late deaths resulted from composite graft endocarditis; 3 other patients with endocarditis are alive after aortic root replacement with cryopreserved homografts. Late coronary dehiscence caused death in 1 patient and was successfully repaired in a second. Actuarial survival for the 100 patients was 92.6% at 5 years and 75.8% at 10 years. Currently, composite graft repair of Marfan aneurysms of the ascending aorta can be performed with low hospital and late mortality. Marfan aneurysms with a diameter of 6 cm or greater should be repaired with the Bentall composite graft procedure, even if the patient is asymptomatic.
Vascularised fibular graft for congenital pseudarthrosis of the tibia. Long-term results. Five children with congenital pseudarthrosis of the tibia treated by free vascularised fibular grafts were followed up until skeletal maturity. The ipsilateral fibula was used in four cases, the contralateral fibula in one. All our cases achieved bone union, but leg length discrepancy, atrophy of the foot and ankle stiffness were frequent complications, due perhaps to the many previous operations. Vascularised fibular grafting might achieve better results if it were done as the primary procedure.
Optical urethrotomy under local urethral anaesthesia. A series of 46 patients underwent 76 optical urethrotomies under local urethral anaesthesia in the out-patient clinic; in 70% of patients the strictures were controlled by local anaesthetic urethrotomy alone; 61% felt either no pain or mild pain during the procedure; 72% expressed a preference for local anaesthesia should the procedure have to be repeated and 82% were happy with the result of their treatment. Optical urethrotomy under local urethral anaesthesia produces results comparable to those reported by others using general anaesthesia. If large numbers of patients are to be treated, possibly repeatedly, then out-patient urethrotomy may result in more efficient use of resources.
Differential expression of epidermal growth factor-related proteins in human colorectal tumors. Amphiregulin (AR) and cripto are proteins that are structurally related to epidermal growth factor (EGF) and transforming growth factor alpha (TGF-alpha). AR is also functionally related to this family of growth regulatory molecules and is able to bind and activate the 170-kDa EGF receptor (EGFR). Human EGFR-3 (HER3)/ERBB3 is a recently identified protein related to the EGFR that is widely expressed in breast carcinomas and is a candidate receptor for EGF-like growth factors. Differential expression of these putative ligands and receptors in transformed cells suggests that they may function in an autocrine manner to regulate tumor cell growth. Specific mRNA transcripts for TGF-alpha [4.8 kilobases (kb)], AR (1.4 kb), cripto (2.2 kb), and HER3 (6.2 kb) were expressed in a majority of human colon cancer cell lines. HER3 mRNA was detected in 55% of primary or metastatic human colorectal carcinomas but in only 22% of normal colon mucosa and 32% of normal liver samples. In contrast, cripto and AR mRNA were expressed in 60-70% of primary or metastatic human colorectal cancers but in only 2-7% of normal human colonic mucosa. Immunostaining also detected AR protein in primary and metastatic colorectal tumors but not in normal colon or uninvolved liver. These findings suggest that cripto and AR may be useful markers to discriminate between normal and malignant colonic epithelium and may provide a selective growth advantage for colorectal carcinomas.
Helicobacter pylori infection in healthy people: a dynamic process? Epidemiological studies using serological tests have shown that a large proportion of healthy people have antibodies against Helicobacter pylori (anti-Hp). It is uncertain whether the presence of anti-Hp indicates active infection or only past exposure to the micro-organism. In this study we determined anti-Hp with a specific enzyme linked immunosorbent assay in 100 healthy volunteers who were at the same time investigated for active H pylori infection by means of the 13C-urea breath test. Forty nine per cent had a high anti-Hp titre, but only 24% had active H pylori infection. Our study suggests that a considerable number of healthy people previously infected with H pylori have spontaneously eliminated this microorganism. We suggest that the inability of ulcer patients to eliminate H pylori may be important in the pathogenesis of peptic ulcer disease.
The state of the p53 and retinoblastoma genes in human cervical carcinoma cell lines. Human cervical carcinoma cell lines that were either positive or negative for human papillomavirus (HPV) DNA sequences were analyzed for evidence of mutation of the p53 and retinoblastoma genes. Each of five HPV-positive cervical cancer cell lines expressed normal pRB and low levels of wild-type p53 proteins, which are presumed to be altered in function as a consequence of association with HPV E7 and E6 oncoproteins, respectively. In contrast, mutations were identified in the p53 and RB genes expressed in the C-33A and HT-3 cervical cancer cell lines, which lack HPV DNA sequences. Mutations in the p53 genes mapped to codon 273 and codon 245 in the C33-A and HT-3 cell lines, respectively, located in the highly conserved regions of p53, where mutations appear in a variety of human cancers. Mutations in RB occurred at splice junctions, resulting in in-frame deletions, affecting exons 13 and 20 in the HT-3 and C-33A cell lines, respectively. These mutations resulted in aberrant proteins that were not phosphorylated and were unable to complex with the adenovirus E1A oncoprotein. These results support the hypothesis that the inactivation of the normal functions of the tumor-suppressor proteins pRB and p53 are important steps in human cervical carcinogenesis, either by mutation or from complex formation with the HPV E6 and E7 oncoproteins.
Renal cell carcinoma in children. Six cases of renal cell carcinoma in children between seven and nineteen years of age are reported. These patients differ from those with Wilms tumor chiefly in the age of presentation and response to chemotherapy. Radiographically, renal cell carcinoma cannot be distinguished from Wilms tumor. While the natural history of renal cell carcinoma appears to be similar in children and adults, it may have a more favorable prognosis below the age of ten years.
Delayed excitatory reaction following interaction of cocaine and monoamine oxidase inhibitor (phenelzine). A case report is presented in which a patient receiving the monoamine oxidase inhibitor, phenelzine, developed a delayed excitatory reaction following administration of topical cocaine spray during anaesthesia for vocal cord surgery. The pharmacological basis of the drug interaction is discussed.
Comorbidity of attention deficit hyperactivity disorder with conduct, depressive, anxiety, and other disorders. OBJECTIVE: Attention deficit hyperactivity disorder is a heterogeneous disorder of unknown etiology. Little is known about the comorbidity of this disorder with disorders other than conduct. Therefore, the authors made a systematic search of the psychiatric and psychological literature for empirical studies dealing with the comorbidity of attention deficit hyperactivity disorder with other disorders. DATA COLLECTION: The search terms included hyperactivity, hyperkinesis, attention deficit disorder, and attention deficit hyperactivity disorder, cross-referenced with antisocial disorder (aggression, conduct disorder, antisocial disorder), depression (depression, mania, depressive disorder, bipolar), anxiety (anxiety disorder, anxiety), learning problems (learning, learning disability, academic achievement), substance abuse (alcoholism, drug abuse), mental retardation, and Tourette's disorder. FINDINGS: The literature supports considerable comorbidity of attention deficit hyperactivity disorder with conduct disorder, oppositional defiant disorder, mood disorders, anxiety disorders, learning disabilities, and other disorders, such as mental retardation, Tourette's syndrome, and borderline personality disorder. CONCLUSIONS: Subgroups of children with attention deficit hyperactivity disorder might be delineated on the basis of the disorder's comorbidity with other disorders. These subgroups may have differing risk factors, clinical courses, and pharmacological responses. Thus, their proper identification may lead to refinements in preventive and treatment strategies. Investigation of these issues should help to clarify the etiology, course, and outcome of attention deficit hyperactivity disorder.
Alterations in myocyte shape and basement membrane attachment with tachycardia-induced heart failure. Chronic supraventricular tachycardia (SVT) results in left ventricular (LV) dilatation and dysfunction. However, the underlying mechanisms responsible for LV failure in this setting are not known. LV force production is dependent on the coupling of myocytes to the extracellular matrix, which is mediated through the basement membrane. This study was designed to determine whether alterations in myocyte geometry and basement membrane attachment are associated with LV failure in a pacing-induced model of cardiomyopathy. Echocardiographic measurement of LV function was performed in six pigs after 3 weeks of pacing-induced SVT (240 beats/min) and in eight sham-operated controls. Myocytes from these hearts were isolated, and attachment studies to specific components of the basement membrane were performed using laminin, fibronectin, and collagen IV. The SVT group when compared with the control group showed a significant reduction of LV fractional shortening (14 +/- 2% versus 31 +/- 2%, respectively; p less than 0.05), increased end-diastolic dimension (50 +/- 1 versus 35 +/- 1 mm, respectively; p less than 0.05), and lengthening of isolated myocytes (196 +/- 18 versus 142 +/- 9 microns, respectively; p less than 0.05). Myocyte attachment to laminin (50 micrograms/ml) was significantly decreased at 60 minutes in the SVT group compared with the control group (18.2 +/- 4.5 versus 60.9 +/- 4.5 cells/mm2, respectively; p less than 0.05). Similar reductions in myocyte attachment to fibronectin and collagen IV were observed. Ultrastructural examination of LV sections revealed focal disruptions of the basement membrane-sarcolemmal interface and a reduced number of sarcolemmal festoons in SVT hearts compared with control hearts (0.8 +/- 0.6 versus 2.8 +/- 0.8/4 microns, respectively; p less than 0.05). These alterations in myocyte morphology and basement membrane attachment may contribute to the LV failure associated with chronic SVT. Further, these structural changes may play a significant role in the progression of ventricular dysfunction as well as recovery from chronic SVT.
Selective cytotoxicity of low-density lipoprotein to helper T cells of cutaneous T-cell lymphoma after photoperoxidation with 8-methoxypsoralen. Lymphocyte-containing plasma subjected to photolysis in the presence of 8-methoxypsoralen (methoxsalen, 8-MOP) has previously been shown to be effective against cutaneous T-cell lymphoma and the AIDS-related complex. The mechanism of this effect was thought to involve photoreaction of 8-MOP with DNA, based on certain in vitro experiments. The results of this study suggest a different mechanism. Low-density lipoprotein (LDL) from fresh human plasma was photosensitized by addition of 8-MOP and exposure to UV light (mp-LDL), and the reactions of the LDL lipids and the chemical actions induced by these reactions were monitored. In a separate procedure, LDL was peroxidized with hydrogen peroxide and peroxidase (p-LDL). mp-LDL and p-LDL were then tested in cytotoxicity assays on HuT-78 helper T cells of cutaneous T-cell lymphoma. These results indicate that (a) LDL in plasma in the presence of very low concentrations of 8-MOP (200 ng/mL) can be peroxidized by UV light; (b) this photoperoxidized LDL is cytotoxic to helper T cells of cutaneous T-cell lymphoma in a dose-dependent manner; but (c) it does not kill normal lymphocytes under similar conditions. The findings also suggest alternative therapeutic strategies for treatment of cutaneous T-cell lymphoma, such as direct utilization of peroxidized LDL.
Monosialoganglioside in subarachnoid hemorrhage [published erratum appears in Stroke 1991 Jul;22(7):957] We studied 119 patients with disturbance of consciousness following subarachnoid hemorrhage, due mostly to verified aneurysm rupture, admitted to five Italian neurosurgical departments over 18 months. Level of consciousness as assessed by score on the Glasgow coma Scale ranged from 8 to 14 before the beginning of treatment; level of consciousness was assessed again 7, 14, and 21 days later. Patients were randomly allocated to treatment with monosialoganglioside or placebo according to a double-blind experimental design. The two treatment groups were homogeneous at entry with regard to the main clinical parameters. Both groups improved, but the rate and degree of improvement were greater in the monosialoganglioside-treated group. The difference was significant on days 14 (p = 0.04) and 21 (p = 0.02). Our results seem to confirm the hypothesis that monosialoganglioside reduces brain edema and provides nonspecific neuronal membrane protection.
Antenatal therapy to minimize neonatal intraventricular hemorrhage. Periventricular-intraventricular hemorrhage is an important problem, resulting in significant mortality and morbidity. Attempts to reduce this complication require an understanding of its pathogenesis. In this chapter a model was proposed, consisting of a series of events resulting in rapid changes of cerebral blood flow and intracranial pressure and leading to rupture of the unique fragile vessels of the germinal matrix and intraventricular regions. Understanding the beneficial physiologic changes induced by such agents such as phenobarbital and vitamin K and that such pharmacologic therapy must be started during the antenatal period has resulted in significant reductions of severe grades of IVH. Further prospective studies are needed to confirm these results using these two drugs alone and in combination. Other potentially beneficial drugs such as indomethacin should be investigated. Although the benefits of such therapy may improve perinatal outcome, the emphasis in our discipline should be the continued attempt to prevent the delivery of these VLBW infants.
Clinical and CT correlates in the diagnosis of intracranial tumours. The correlation between clinical and CT findings in cerebral tumours was prospectively studied in 1191 consecutive referrals for cerebral CT. CT revealed a mass lesion in 51 cases (4.3%): 32 neoplasms, five haematomas and one abscess. The diagnostic specificity of CT for neoplasmic tumours was 86% (32 of 37). The clinical suspicion of a cerebral neoplasm was correct in 25 cases (78%) and the clinical localisatory hypothesis was correct in 20 cases (63%) of the neoplasms. A cerebral tumour was found in 5% (11 out of 226) of patients investigated for their first seizure and in 1% (two of 207) investigated for headache without clinical signs.
Anorectal physiology testing. A survey of availability and use. Survey forms were sent to all members of the Coloproctology Section of the Royal Society of Medicine and the American Society of Colon and Rectal Surgeons to obtain their opinions of the availability, actual use, and perceived helpfulness of different methods for the evaluation of the physiology of the colon and rectum. Responses revealed a similarity in age and practice patterns in both groups. Of the 19 methods surveyed, greater than 90 percent of respondents in both groups rely on three traditional methods of patient evaluation: patient history, digital examination, and sigmoidoscopy. Four other methods have gained acceptance by the majority of respondents in both groups: colon transit studies, defecography, perfused-catheter manometry, and rectal compliance. The three methods ranked lowest in availability, actual use, and helpfulness by both groups were single-fiber electromyography, use of a perineometer, and evoked potential studies. Our study provides a baseline for future surveys on the investigative efforts of physicians studying the physiology of the colon, rectum, and anus.