shukoor65/lab-rag-model huggingface dataset:
Atrial natriuretic polypeptide inhibits hypertrophy of vascular smooth muscle cells. Vascular remodeling is central to the pathophysiology of hypertension and atherosclerosis. Recent evidence suggests that vasoconstrictive substances, such as angiotensin II (AII), may function as a vascular smooth muscle growth promoting substance. To explore the role of the counterregulatory hormone, atrial natriuretic polypeptide (ANP) in this process, we examined the effect of ANP (alpha-rat ANP [1-28]) on the growth characteristics of cultured rat aortic smooth muscle (RASM) cells. ANP (10(-7) M) significantly suppressed the proliferative effect of 1% and 5% serum as measured by 3H-thymidine incorporation and cell number, confirming ANP as an antimitogenic factor. In quiescent RASM cells, ANP (10(-7), 10(-6) M) significantly suppressed the basal incorporations of 3H-uridine and leucine by 50 and 30%, respectively. ANP (10(-7), 10(-6) M) also suppressed AII-induced RNA and protein syntheses (by 30-40%) with the concomitant reduction of the cell size. Furthermore, ANP also significantly attenuated the increase of 3H-uridine and leucine incorporations caused by transforming growth factor-beta (4 x 10(-11), 4 x 10(-10) M), a potent hypertrophic factor. These results indicate that ANP possesses an antihypertrophic action on vascular smooth muscle cells. Down-regulation of protein kinase C by 24-h treatment with phorbol 12,13-dibutyrate did not inhibit ANP-induced suppression on 3H-uridine incorporation. Based on the observation that ANP was more potent than a ring-deleted analogue of ANP on inhibiting 3H-uridine incorporation, we conclude that the ANP's inhibitory effect is primarily mediated via the activation of a guanylate cyclase-linked ANP receptor(s). Indeed 8-bromo cGMP mimicked the antihypertrophic action of ANP. Accordingly, we speculate that in addition to its vasorelaxant and natriuretic effects, the antihypertrophic action of ANP observed in the present study may serve as an additional compensatory mechanism of ANP in hypertension.
Combination chemotherapy for advanced adenocarcinoma of the cervix. A patient with advanced adenocarcinoma of the cervix was treated only with cisplatin and mitomycin C (MMC). The regimen achieved a complete response, confirmed by chest radiograph and computed axial tomography scan, lasting 50 months. The patient is alive with recurrent disease 59 months after diagnosis. No severe drug-related toxicity occurred.
Omega-3 fatty acids in health and disease and in growth and development. Several sources of information suggest that man evolved on a diet with a ratio of omega 6 to omega 3 fatty acids of approximately 1 whereas today this ratio is approximately 10:1 to 20-25:1, indicating that Western diets are deficient in omega 3 fatty acids compared with the diet on which humans evolved and their genetic patterns were established. Omega-3 fatty acids increase bleeding time; decrease platelet aggregation, blood viscosity, and fibrinogen; and increase erythrocyte deformability, thus decreasing the tendency to thrombus formation. In no clinical trial, including coronary artery graft surgery, has there been any evidence of increased blood loss due to ingestion of omega 3 fatty acids. Many studies show that the effects of omega 3 fatty acids on serum lipids depend on the type of patient and whether the amount of saturated fatty acids in the diet is held constant. In patients with hyperlipidemia, omega 3 fatty acids decrease low-density-lipoprotein (LDL) cholesterol if the saturated fatty acid content is decreased, otherwise there is a slight increase, but at high doses (32 g) they lower LDL cholesterol; furthermore, they consistently lower serum triglycerides in normal subjects and in patients with hypertriglyceridemia whereas the effect on high-density lipoprotein (HDL) varies from no effect to slight increases. The discrepancies between animal and human studies most likely are due to differences between animal and human metabolism. In clinical trials eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the form of fish oils along with antirheumatic drugs improve joint pain in patients with rheumatoid arthritis; have a beneficial effect in patients with ulcerative colitis; and in combination with drugs, improve the skin lesions, lower the hyperlipidemia from etretinates, and decrease the toxicity of cyclosporin in patients with psoriasis. In various animal models omega 3 fatty acids decrease the number and size of tumors and increase the time elapsed before appearance of tumors. Studies with nonhuman primates and human newborns indicate that DHA is essential for the normal functional development of the retina and brain, particularly in premature infants. Because omega 3 fatty acids are essential in growth and development throughout the life cycle, they should be included in the diets of all humans. Omega-3 and omega 6 fatty acids are not interconvertible in the human body and are important components of practically all cell membranes. Whereas cellular proteins are genetically determined, the polyunsaturated fatty acid (PUFA) composition of cell membranes is to a great extent dependent on the dietary intake.(ABSTRACT TRUNCATED AT 400 WORDS).
Abdominal wall tenderness: a useful sign in chronic abdominal pain. The outcome in 72 patients with obscure abdominal pain and a positive Carnett's (abdominal wall tenderness) test, seen in one firm's surgical outpatient clinic between 1975 and 1983, was sought by a combination of hospital note retrieval and general practitioner questionnaire. Full follow-up data to date or death were available for 58 (81 per cent) patients and partial follow-up for 14 patients. The study showed that the patients generated a good deal of investigation and a number of surgical procedures but that seldom were their symptoms attributable to serious pathology. Familiarity with the test, taken in the context of a proper history and examination, has been found helpful in assessing such patients and saves the inconvenience, expense and occasional hazard of investigation, and even surgery.
The inheritance of alcohol consumption patterns in a general population twin sample: I. Multidimensional scaling of quantity/frequency data. Quantity/frequency data on alcohol consumption were obtained by mailed questionnaire from 2,903 same-sex monozygotic and dizygotic Australian twin pairs. Nonmetric multidimensional scaling was applied to these data. A three-dimensional solution was required to account for the observed pattern of twin concordances for alcohol consumption. These results suggest separate determination of abstinence, frequency of consumption and quantity consumed when drinking, rather than inheritance of a single continuum of overall consumption level.
Leiomyosarcoma of the trachea. Case report. Leiomyosarcoma of the trachea is a rare primary tumor of the upper airway. Twelve cases have been reported in the English-language literature. Our experience with a patient with leiomyosarcoma of the cervical trachea is presented. The classic symptoms, diagnosis, and surgical management of this case are contrasted with those of the previously reported cases. The surgical technique used for our patient, primary tumor resection with skin grafting and placement of a Montgomery Laryngeal Stent, is a unique and effective treatment.
Midterm follow-up of young patients fused in situ for spondylolisthesis. To evaluate the results of posterolateral fusion alone (66 patients) and combined posterolateral and anterior fusion (39 patients) in situ, 105 consecutive patients younger than 25 years of age with spondylolisthesis, retrospectively were examined clinically and radiologically. The follow-up rate was 98% after a mean of 8.2 years (range, 2.0-15.3). Pre- and postoperative progression of slip was rare (6% and 1%, respectively), and no prognostic factors were found. The definite pseudarthrosis rate was 6%. In patients with low- and high-grade slip, 67% and 88% (respectively) were satisfied at follow-up, suggesting that the indication for operative treatment in patients with low-grade slip is relative.
Radioimmunoassay of insulin-like growth factors in cyst fluid of central nervous system tumors. Tumor cells are characterized by abnormalities in growth and metabolism, including the autocrine secretion of certain growth factors. The authors have previously shown the presence of insulin-like growth factor receptors in tumors of the central nervous system (CNS) and in this study examine whether CNS tumors are capable of autocrine secretion of insulin-like growth factors in situ. To investigate the production of insulin-like growth factors I and II by CNS tumors, the authors have developed specific radioimmunoassays for these growth factors. In situ production of insulin-like growth factors was studied by immunoassay of CNS tumor cyst fluid aspirated at the time of surgery from 12 cystic tumors: seven primary brain tumors, four metastatic tumors, and one spinal schwannoma. For immunoassay, cyst fluid was treated overnight with acetic acid, then insulin-like growth factors were separated from binding proteins by a refined solid-phase technique, then dried and reconstituted in immunoassay buffer. Normal human serum and cerebrospinal fluid served as controls. Insulin-like growth factor I was detected in all 12 tumors studied. In contrast, insulin-like growth factor II was detected only in three low-grade astrocytomas, the spinal schwannoma (which had the highest insulin-like growth factor II level of all tumors studied), and three metastatic lung cancers. These results suggest that CNS tumors may be capable of autocrine production of insulin-like growth factors in situ. Furthermore, there appears to be a difference in the type of insulin-like growth factors produced by different types of CNS tumors. Preferential production of insulin-like growth factors may be an important marker of tumor differentiation and useful as a diagnostic tool.
Cardiac angiosarcoma with ruptured right atrium diagnosed by echocardiography. A 41-year-old man was admitted to our hospital complaining of right-sided chest pain. Two-dimensional echocardiographic examination revealed a ruptured right atrium and a localized pericardial effusion. Color Doppler echocardiography and contrast echocardiography showed blood flow from the right atrium into pericardial effusion, which was confirmed at emergency surgery. The pathologic specimen from the right atrium showed a spindle cell angiosarcoma.
Histology of aural polyp as a predictor of middle ear disease activity. This study compares the histology of aural polyp with the subsequent clinical course of the middle ear disease. All cases of aural polyps that presented to the department during 1988 and 1989 were included. Patients who had previous ear surgery were excluded as were cases where the operation was part of clearance of known cholesteatoma rather than polypectomy alone. We found that the histology of the aural polyp was not a precise predictor of the presence or absence of cholesteatoma, nor of the subsequent course of the middle ear disease.
Effect of dialysis membrane and patient's age on signs of dialysis-related amyloidosis. The Working Party on Dialysis Amyloidosis. This 12 center study was designed to assess factors affecting the development and progression of beta 2-microglobulin amyloidosis in long-term dialysis. A total of 221 patients who were on hemodialysis for more than five years, and who were treated the entire time only with AN69, a biocompatible, highly permeable membrane, or cuprophane, a less permeable, poorly biocompatible membrane (Cell) were evaluated for time on dialysis, development of carpal tunnel syndrome, and cystic bone lesions. X-ray documentation was taken in a minimum of four of the six following joints: both hips, wrists and shoulders. The data demonstrate that patients treated solely by AN69 membranes display signs of bone amyloidosis less frequently than do those treated by Cell membranes. Age at onset of dialysis was found to have a striking correlation with the development of carpal tunnel syndrome and bone amyloidosis, while no significant influence was found for hyperparathyroidism, sex or year of first dialysis.
Color Doppler sonography in the evaluation of erectile dysfunction: patterns of temporal response to papaverine. Most studies of duplex Doppler sonography for the assessment of erectile dysfunction involve determination of peak systolic velocities 5 min after intracavernosal injection of papaverine. The purpose of this study was to determine the effect of the timing of Doppler measurements of flow after papaverine injection for establishing the presence of arterial and venous abnormalities. Color Doppler sonography was performed in 75 patients for evaluation of vasculogenic impotence. After intracavernosal injection of 60 mg of papaverine, measurements of peak systolic and end-diastolic velocities were obtained in each cavernosal artery at 5-min intervals for a total of 30 min. A peak systolic velocity of less than 25 cm/sec was used as the threshold for arterial insufficiency. An end-diastolic velocity of greater than 5 cm/sec was used to predict venous incompetence. Scanning was performed for direct assessment of dorsal venous flow. Thirty patients were subsequently evaluated by cavernosometry and cavernosography. In most patients (76%), maximum response to papaverine was achieved within the first 5 min. In eight patients, significant increases in systolic velocity were seen only after 5 min. In 10 patients, significant changes in end-diastolic velocity between 5 and 30 min resulted in diagnostic reclassification. Data acquisition for 30 min significantly improved the sensitivity (95%) and specificity (83%) for the prediction of venous incompetence in patients with correlative cavernosography. Transient, early dorsal vein flow was noted in normal subjects. Persistent dorsal vein flow had an 80% sensitivity and 100% specificity for venous incompetence. Our results suggest that, when using color Doppler sonography, gathering data for 30 min may improve the prediction of vasculogenic impotence.
Chronic abacterial prostatitis and hyperthermia. A possible new treatment? A group of 45 patients with chronic abacterial prostatitis or prostatodynia underwent 6 weekly, 1-hour sessions of local deep microwave hyperthermia (42.5 +/- 0.5 degrees C) to the prostate. All patients had a long history of symptoms typical of the condition. They all failed to respond to a variety of conventional treatments administered over several years by various specialists. Each patient served as his own control before and after the hyperthermic treatment. The results of this study are encouraging: 25% showed a sustained and complete loss of symptoms and 50% had a partial response; the remaining 25% reported no improvement. These results open up new possibilities in the treatment of this condition, which has so far responded poorly to conventional therapy.
Hypoechoic lesions in fatty liver. Quantitative study by histomorphometry. Ten patients with fatty liver changes were subjected to liver biopsies. In seven, ultrasonography showed focal hypoechogenicity within a "bright" liver, generally interpreted as focal sparing. Three patients had hyperechoic areas surrounded by "normal" parenchyma usually felt to represent local fat accumulation without diffuse involvement. Morphometric analysis was used to determine the total area occupied by fat (area density) and the number of lipid droplets (numerical density) per microscopic field in lesional and perilesional specimens. Compared with respective perilesional values, hypoechoic lesional numerical densities were significantly lower in 6 of 7 patients; the three hyperechoic samples had significantly higher values. In most cases, lesional and perilesional area densities were not significantly different. These hypoechoic focal lesions are believed to be merely areas in which a similar quantity of fat is contained in fewer droplets, and focal hyperechogenicity is believed to result from a larger number of fat-filled vacuoles with respect to that of the surrounding parenchyma. Variation in the number of solid-liquid interfaces causes the ultrasonic contrast between these lesions and the similarity fatty liver parenchyma surrounding them.
Continuous ambulatory ECG monitoring in the perioperative period: relationship of preoperative status and outcome. We have used continuous ambulatory electrocardiography in the perioperative period to monitor 108 patients with known cardiovascular disease undergoing non-cardiac surgery. There was a high incidence of ischaemic ST segment changes and ventricular arrhythmias. For the group as a whole, anaesthesia and surgery were followed by increased ventricular ectopic activity, but did not worsen myocardial ischaemia. However, the mean duration of ischaemic ST segment changes was increased significantly in those patients with treated hypertension. Of the risk factors considered, preoperative ischaemia and peroperative systolic arterial pressure were significant correlates with postoperative myocardial ischaemia.
Diagnostic value of measurement of serum type I procollagen carboxy terminal peptides in patients with scirrhous carcinoma of the stomach. We have evaluated the radioimmunoassay for type I procollagen carboxy terminal peptide (type I C-peptide), which is liberated from type I procollagen during its conversion to collagen, in the serodiagnosis of scirrhous carcinoma of the stomach. The mean (SD) serum concentration of type I C-peptide in 39 normal subjects was 41.7 (19.7) ng/ml. The mean serum values and the positive ratio of type I C-peptide in 11 patients with stages II and III scirrhous carcinoma of the stomach were 91.2 (41.9) ng/ml and 54.5%, respectively. In 10 patients with other types of gastric carcinoma, the mean type I C-peptide values were not significantly different from the normal value. Serum type I C-peptide values reflected the clinical course of scirrhous gastric carcinoma in five patients who underwent either operation or chemotherapy. The measurement of serum type I C-peptide concentrations could provide a useful way of diagnosing and monitoring scirrhous carcinoma of the stomach.
Effects of time required for reperfusion (thrombolysis or angioplasty, or both) and location of acute myocardial infarction on left ventricular functional reserve capacity several months later. The purpose of this study was to determine whether reperfusion of acute myocardial infarction (AMI) by recombinant tissue-type plasminogen activator (rt-PA) or percutaneous transluminal coronary angioplasty, or both, would improve left ventricular (LV) function when it is measured several months later at rest or maximal bicycle exercise, or both. Radionuclide angiography was performed in 44 patients 5 months (range 6 weeks to 9 months) after AMI to assess function, and tomographic myocardial thallium-201 imaging was performed at maximal exercise and delayed rest to determine whether there was any evidence of myocardial ischemia. As expected, no patient had chest pain or redistribution of a thallium defect during the exercise test, because patients had undergone angioplasty (n = 28) or coronary bypass graft surgery (n = 5) where clinically indicated for revascularization. The LV ejection fraction was plotted as a function of the time elapsed between the onset of chest pain and the time when coronary angiography confirmed patency of the infarct-related artery (achieved in 91% of 44 patients by rt-PA [n = 31] or percutaneous transluminal coronary angioplasty [n = 9] ). Functional responses differed markedly between patients with anterior (n = 20) versus inferior (n = 24) wall AMI. LV ejection fraction during exercise correlated with time to reperfusion in patients with an anterior wall AMI (r = -0.58; standard error of the estimate = 11.9%; p less than 0.02) but not in patients with an inferior AMI (r = 0.10; standard error of the estimate = 13.1%; difference not significant.
Cryosurgery in 50 cases of tongue carcinoma. From March 1975 to October 1985, 50 patients with primary tongue carcinoma were treated by cryosurgery. Forty-seven had squamous cell carcinoma, and 3 had other types of malignant tumors. The TNM clinical classification showed 12 patients with T1 lesions, 35 with T2, and 3 with T3. All patients were treated by cryosurgery in the outpatient clinic under local anesthesia. Three weeks after the primary tumors were controlled cryosurgically, 48 patients underwent radical neck dissections. All patients were observed for 3 to 10 years. After cryosurgery, the primary lesion disappeared in 45 (90%) patients; 5 were not controlled. The 3- and 5-year survival rates were 71.9% (23/32) and 72.3% (13/18), respectively. The recurrence rate in this series was 10% (5/50). Cryosurgery for tongue carcinoma was shown to be effective and safe.
Nd:YAG laser and photodynamic therapy for esophageal and endobronchial tumors under general and local anesthesia. Effects on arterial blood gas levels. STUDY OBJECTIVE: Our objective was to determine the respiratory and acid-base metabolism response to endoscopic laser surgery for obstructive tumors, as related to the duration and different types of endoscopy, anesthesia, and laser treatment. DESIGN: The design was a case-control, cohort analytic, nonrandomized controlled survey of case series before and after endoscopic procedures. SETTING: A referral-based surgery and oncology practice at one hospital's laser center. PATIENTS: We studied a sequential sample of 82 patients in the age range from 35 to 92 years, with malignant and benign, primary and metastatic, partially and completely obstructing esophageal (15 patients) and endobronchial (67 patients) tumors. INTERVENTIONS: A total of 229 diagnostic, laser treatment, and follow-up endoscopic procedures was performed under general or local anesthesia (46 esophagoscopies and 183 bronchoscopies). The latter group consisted of 29 cases of general and 154 cases of local topical anesthesia. The last group involved 37 diagnostic and toilet bronchoscopies, 86 cases of YAG-laser tumor ablation, and 31 cases of PDT. MEASUREMENTS AND MAIN RESULTS: Direct-reading electrode measurements of arterial blood, sampled before and immediately after the endoscopic procedure, revealed statistically significant (p less than 0.001) increases in PaCO2 (200 of 229 cases) and decreases in pH (195 of 229 cases) and PaO2 (215 of 229 cases). These findings were similar after bronchoscopy and esophagoscopy, general and local anesthesia (only the decrease in pH was less pronounced in the latter case), and explorative endoscopies and different laser treatments and did not correlate with the total duration of the procedure within the wide time range of 7 to 210 minutes. The initial preoperative level of PaCO2 was considerably higher and the level of PaO2 was significantly lower in patients with endobronchial tumors, as compared to patients with esophageal cancer. A strong, inverse linear relationship was found between the perioperative changes in PaO2 and its initial level and between PaCO2 and pH changes. CONCLUSIONS: The PDT for esophageal and endobronchial malignancies is no more harmful for acid-base metabolism and respiratory functions than YAG-laser tumor ablation or any other common, nonlaser endoscopic procedure.