shukoor65/lab-rag-model huggingface dataset:
Association of Epstein-Barr virus with undifferentiated gastric carcinomas with intense lymphoid infiltration. Lymphoepithelioma-like carcinoma. Some undifferentiated gastric carcinomas with intense lymphoid infiltration have a striking resemblance to nasopharyngeal lymphoepithelioma. The authors identified eight such cases (seven patients from Japan and one from the United States) of undifferentiated gastric carcinoma (lymphoepithelioma-like carcinoma [LELC]) and examined them for Epstein-Barr (EBV) viral sequences using polymerase chain reaction (PCR) and in situ hybridization (ISH) techniques. EBV was detected in seven of the eight cases by PCR, including a lymph-node metastasis. ISH that was performed in six of these cases showed EBV genomes to be uniformly present in the carcinoma cells and not present in the reactive lymphoid infiltrate or normal gastric mucosa. PCR of a polymorphic EBV locus (lymphocyte-determined membrane antigen) showed that a single genotype was present in each gastric LELC, consistent with a clonal process. These findings suggest that some undifferentiated gastric carcinomas are EBV-related and that focal EBV infection occurs before transformation.
The use of extracorporeal shock wave lithotripsy in patients with aortic aneurysms. Extracorporeal shock wave lithotripsy (ESWL*) has revolutionized management of most patients with urolithiasis. The effect of ESWL on patients with an aortic aneurysm is unknown and its safety is questioned by the absence of any case reports in the urological literature. A 68-year-old man with an abdominal aortic aneurysm underwent successful ESWL using the Medstone STS 1050 lithotriptor for right renal calculi. Continuous monitoring of the aneurysm was done using real-time ultrasound during the ESWL treatment. Careful preoperative evaluation in conjunction with appropriate intraoperative and postoperative monitoring makes ESWL management of patients with associated aortic aneurysm possible.
Arthroscopic surgery for treatment of closed lock. This study evaluates the first 51 consecutive cases treated for limitation of mandibular movement due to closed lock. Eighty joints (22 unilateral, 29 bilateral) were treated with arthroscopic surgery. The mean follow-up was 29.4 weeks, with a range of 6 to 77 weeks. These results showed an immediate improvement after arthroscopy followed by a more gradual improvement during the next 6 months, with a plateau in improvement thereafter. All cases, unilateral and bilateral, generally reached the same level of opening.
Laser treatment of benign cutaneous vascular lesions. Benign cutaneous vascular lesions have been treated with a wide array of modalities. Lasers are a comparatively new form of treatment for cutaneous blood vessel abnormalities. Initially, results following laser treatment were disappointing, primarily because of widespread thermal injury to surrounding normal tissue. Recent developments in laser technology and the introduction of the tunable dye laser offer the ability to selectively target laser energy at specific chromophores such as oxyhemoglobin. The technique of selective photothermolysis provides successful treatment of benign vascular lesions with minimal damage to adjacent structures.
Lipoprotein profiles in hypercholesterolemic children [published erratum appears in Am J Dis Child 1991 May;145(5):515] Atherosclerosis is a process that begins in early life. Coronary heart disease is the result of complex interactions among a variety of risk factors of which hypercholesterolemia is but one. During routine screening, 500 children were identified with total cholesterol levels above the 95th percentile of 5.2 mmol/L (200 mg/dL). Lipoprotein profiles were then performed to confirm and delineate their lipid abnormalities. A definable lipid disorder was present in 85% of such children. Abnormal lipoprotein patterns included 292 children with type IIa, 99 with type IIb, and 25 with type IV phenotypes. An abnormally low high-density lipoprotein cholesterol level of less than 0.9 mmol/L (35 mg/dL) was observed in 20 children. Only 5% of patients were identified as being hypercholesterolemic because they had high-density lipoprotein cholesterol levels above the 95th percentile of 1.8 mmol/L (70 mg/dL). Thirty-two percent of children with total cholesterol levels above 5.2 mmol/L had a family member (sibling, parent, uncle, aunt, or grandparent) with a myocardial infarction prior to 55 years of age. Data from this study support universal cholesterol testing after 3 years of age and lipoprotein profiles for those with levels above 5.2 mmol/L.
Failed back surgery syndrome: 5-year follow-up in 102 patients undergoing repeated operation. The indications for repeated operation in patients with persistent or recurrent pain after lumbosacral spine surgery are not well established. Long-term results have been reported infrequently, and in no case has mean follow-up exceeded 3 years. We report 5-year mean follow-up for a series of repeated operations performed between 1979 and 1983. Patient characteristics and modes of treatment have been assessed as predictors of long-term outcome. One hundred two patients with "failed back surgery syndrome" (averaging 2.4 previous operations), who underwent a repeated operation for lumbosacral decompression and/or stabilization, were interviewed by a disinterested third party a mean of 5.05 years postoperatively. Successful outcome (at least 50% sustained relief of pain for 2 years or at last follow-up, and patient satisfaction with the result) was recorded in 34% of patients. Twenty-one patients who were disabled preoperatively returned to work postoperatively; 15 who were working preoperatively became disabled or retired postoperatively. Improvements in activities of daily living were recorded, overall, as often as decrements. Loss of neurological function (strength, sensation, bowel and bladder control) was reported by patients more often than improvement. Most patients reduced or eliminated analgesic intake. Statistical analysis (including univariate and multivariate logistic regression) of patient characteristics as prognostic factors showed significant advantages for young patients and for female patients. Favorable outcome also was associated with a history of good results from previous operations, with the absence of epidural scar requiring surgical lysis, with employment before surgery, and with predominance of radicular (as opposed to axial) pain.
Extramedullary hematopoiesis in cerebellar hemangioblastoma. Extramedullary hematopoiesis and paraneoplastic erythrocytosis are uncommon in cerebellar hemangioblastoma, and their concomitant occurrence has not been reported. In a study of 26 cases of hemangioblastoma, we found extramedullary hematopoiesis in 4 tumors; one was associated with erythrocytosis. The significance of this association and the possible histogenetic origin of extramedullary hematopoiesis in cerebellar hemangioblastoma are discussed.
Cardiomyopathy in blacks. The intent in this chapter has been to bring to general awareness the fact that myocardial dysfunction represents a significant proportion of cardiovascular disease affecting blacks; in particular, dilated cardiomyopathy is a new frontier in cardiology, which demands an aggressive approach. At present, the prognosis is not good in the majority of cases; despite the best medical therapy, most of those with cardiomyopathy are doomed to death within a few years after the onset of congestive heart failure. Many of these are young African-American men in the prime of their lives. Cardiac transplantation offers some hope from this desperate situation, but donor shortages as well as restrictive criteria for prospective recipients and socioeconomic constraints, which may deny many blacks the opportunity to receive a transplant, make this option less than ideal.
Pathogenesis of migraine. Endothelial cells are not just a semipermeable membrane that forms a barrier between the blood and the vascular smooth muscles. This cell system is a highly active metabolic endocrine organ. It not only produces a number of important substances in vascular and neural homeostasis but also inactivates vasoactive substances such as serotonin and bradykinin. In addition, it produces endothelin-1 and angiotensin II; more importantly in the context of migraine, endothelial cells produce the vasodilators prostacyclin and EDRF-NO, both of which are local (paracrine) hormones. The physiologic function of endothelial cells is affected by aspirin, which prevents prostacyclin formation but has little effect on normal blood pressure. From this information, one can infer that endothelial cell production of prostacyclin does not play an important part in normal cardiovascular control. On the other hand, the administration of Ng-monomethyl-L-arginine causes immediate increases in blood pressure. Because the administration of this substance inhibits the release of EDRF-NO, it appears that this paracrine endothelial hormone actively dilates the normal circulation. It is of cardinal importance that damage or flow perturbations of cell membranes of the endothelial lining of blood vessels cause an increased production of prostaglandins. However, smooth muscle cells underlying the endothelial lining also synthesize prostacyclin. This mechanism is thought to be held in reserve to reinforce local production of prostacyclin and vasodilatation when cell damage to the endothelial lining occurs and EDRF-No is not produced. Many theories for the causation of migraine have been proposed, and some have been reviewed. Those holding sway tend to ignore inconsistencies and cite supporting evidence in favor of their pet explanation only. I therefore have no hesitation to show that the best explanation at present, based on the most recent cellular evidence, explains all features of migraine and the response of migraineurs to therapy. The endothelial cell is the most likely site of the primary abnormality (Fig. 1). Although under physiologic circumstances perivascular innervation and endothelial systems closely interact in the control of vascular tone during pathologic conditions such as ischemia, the dominant role in protecting the circulation is endothelium-mediated. The biology of headache is so diverse and our ignorance sufficiently pervasive that the investigation of endothelial cell function may solve the mystery of migraine. To match the postulated crucial role of the endothelial cell in the pathogenesis of migraine, another cell would have to be ubiquitously present throughout the vasculature and not just confined to the central nervous system.(ABSTRACT TRUNCATED AT 400 WORDS).
Use of bipolar endoprosthesis and bone grafting for acetabular reconstruction. Reconstruction operations for severe acetabular defects using bone grafting and a bipolar hemiarthroplasty retrospectively reviewed in 81 hips between 1983 and 1985. The most common indication was failed total hip arthroplasty. Bone grafts consisted of cancellous bone, bone blocks, and wafer-type grafts used singly or in combination. The follow-up period was 12 to 36 months postoperatively (mean, 16 months). There were 22 perioperative complications (27%) and 13 postoperative complications (16.7%). A majority of hips showed some graft resorption and component migration that worsened with time. There were four graft failures with subluxation of the component, one prosthesis dislocation, and one component disassembly. Ten hips had revision (13.3%) for a variety of reasons. Nevertheless, clinically, most patients (83%) believed the procedure had improved their condition. Reconstruction for severe acetabular defects can be achieved successfully using this technique, but long-term follow-up evaluation is needed to fully assess the role of this procedure in relation to other available options.
Calcifying odontogenic cyst. A review of ninety-two cases with reevaluation of their nature as cysts or neoplasms, the nature of ghost cells, and subclassification. Ninety-two cases of calcifying odontogenic cyst (COC) were reviewed with special consideration of their nature as cysts or neoplasms, the nature of ghost cells, and classification on the basis of clinicopathologic features. The cases were divided into 79 (85.9%) cysts and 13 (14.1%) neoplasms. The cysts occurred as four variants: (1) nonproliferative COC (35 cases), characterized by a simple unicystic structure; (2) proliferative COC (17 cases), characterized by a cystic structure with multiple daughter cysts, extensive ghost cell formations, and marked tendency for calcification; (3) ameloblastomatous COC (11 cases), characterized by ameloblastoma-like, cyst-lining epithelium with ghost cells and calcifications; and (4) COC associated with odontoma (16 cases), which combined features of COC and odontoma. The neoplasms occurred as three variants: (1) ameloblastoma ex COC (two cases), which showed unifocal and multifocal intraluminal and intramural ameloblastoma proliferating from the COC-lining epithelium; (2) peripheral epithelial odontogenic ghost cell tumor (eight cases), which occurred in the gingiva and resembled peripheral ameloblastoma except for clustered ghost cells in the central portion of epithelial islands and the presence of juxtaepithelial dentinoid; and (3) central epithelial odontogenic ghost cell tumor (three cases). The latter showed ameloblastomatous or adenomatoid odontogenic tumor-like epithelial clusters with ghost cell formation and juxtaepithelial dentinoid. The clinical features of cystic and neoplastic variants were tabulated and described. On the basis of histopathologic features and their immunohistochemical reaction to polyclonal antikeratin antibody, it is suggested that ghost cells might be the result of coagulative necrosis.
Expression of shared idiotypes in chronic lymphocytic leukemia and small lymphocytic lymphoma. The expression of shared idiotypes (Slds) has been studied on malignant CD5+B cells from patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) using a panel of 37 murine monoclonal antibodies previously demonstrated to be reactive with Slds derived from follicular B-cell lymphomas. Thirteen anti-Slds identified tumor cells from 31 of 105 (30%) CLL patients and 4 of 6 SLL patients. In comparison, the same panel of anti-Slds is reactive with 33% of follicular and diffuse B-cell lymphomas. Ten of these anti-Slds reacted with CLL cases at similar frequencies to that of the B-cell lymphomas. Two anti-Slds, which are known to react with autoantibodies, were significantly more prevalent in CLL than in B-cell lymphomas. These data confirm the presence of Slds in CLL and provide further evidence of an association between CLL and autoimmunity. The identification of a panel of antibodies reactive with a significant number of CLL and SLL patients will facilitate the application of anti-idiotype antibody therapy in these diseases.
Reversible operculum syndrome caused by progressive epilepsia partialis continua in a child with left hemimegalencephaly. In a child with left hemimegalencephaly and seizures, a reversible operculum syndrome developed when continuous epileptic discharges spread from the left hemisphere to the contralateral central regions. The operculum syndrome lasted for three months until left hemispherectomy was performed. Soon after surgery the seizures and the operculum syndrome resolved. The operculum syndrome is a facio-pharyngo-glosso-masticatory diplegia usually due to structural lesions in both opercular regions. The reversibility of the syndrome in the reported case demonstrates that the operculum syndrome is sometimes functional rather than lesional.
Ceftriaxone-associated gallbladder sludge. Identification of calcium-ceftriaxone salt as a major component of gallbladder precipitate Ceftriaxone, a third-generation cephalosporin, is partially excreted into bile. With its clinical use, the formation of gallbladder sludge detected by ultrasonography has been reported. Four surgical specimens were examined and no gallstones were found. Instead, fine precipitates of 20-250 microns were present. Microscopically, there was a small number of cholesterol monohydrate crystals and bilirubin granules among an abundant amount of granular-crystalline material that was not morphologically cholesterol monohydrate crystals. The chemical composition of the precipitates (n = 4) was determined. There was a small amount of cholesterol (1.7% +/- 0.8%) and bilirubin (13.9% +/- 0.74%). The major component of the precipitate was a residue. On further analysis using thin-layer chromatography, high-performance liquid chromatography, and electron microprobe analysis, the residue was identified as a calcium salt of ceftriaxone. The residue also had identical crystal morphology and chromatographic elution profile as authentic calcium-ceftriaxone standards. It is concluded that ceftriaxone, after excretion and being concentrated in the gallbladder bile, can form a precipitate. The major constituent has been identified as a ceftriaxone-calcium salt.
Distal transfer of the greater trochanter. After congenital dislocation of the hip, Perthes' disease and some other conditions, the femoral neck may be short and the greater trochanter in a relatively proximal position. Distal transfer of the greater trochanter is an effective and relatively simple operation to correct this deformity. We have reviewed 26 patients (27 hips) at a mean follow-up of eight years. Pain relief and improvement in gait were maintained in 74%, and the poor results were largely due to progression of osteoarthritis. We describe a 'gear-stick' sign of trochanteric impingement, which is useful in the pre-operative assessment of patients.
Surgical treatment of carcinoma of the gastric stump. To evaluate retrospectively the surgical treatment of patients with gastric stump cancer following gastrectomy for benign disease, we reviewed 52 patients operated on at the National Cancer Centre, Tokyo, between 1962 and 1988. Resection was carried out in 47 patients (90 per cent) and with curative intent in 36 (69 per cent). Stage distribution was: stage 1, 15 patients; stage 2, 5; stage 3, 9; stage 4, 23. In 36 cases curatively resected, 32 had completion total gastrectomy and four had subtotal resection. An R1 resection was performed in 11 patients and an R2 in 25. We had two hospital deaths and a 5-year survival rate excluding hospital deaths of 39 per cent. The 5-year survival rates of resected cases, curative cases and those having metastatic nodes were 43 per cent, 57 per cent and 29 per cent respectively. Radical resection is a reasonable treatment for gastric stump cancer as it is for primary cancer of the stomach.
The activity of 22-oxacalcitriol in osteoblast-like (ROS 17/2.8) cells. 22-Oxacalcitriol (OCT), a synthetic vitamin D analog, can mimic the ability of 1,25-dihydroxyvitamin D3[1,25-(OH)2D3] to differentiate leukemia and skin cells, to enhance the immune response and to suppress PTH secretion, but has much less calcemic activity. The mechanism for this selective action is not understood. OCT has been shown to have a diminished ability to mobilize calcium from bone in vivo, but in vitro findings are contradictory. Little is known about the effect of OCT on bone forming cells. Therefore, the present studies were designed to investigate the actions of OCT at the molecular level in the osteoblast-like cell line, ROS 17/2.8. 3H-OCT was bound to the vitamin D receptor (VDR) in intact cells at the same rate as 3H-1,25-(OH)2D3. As previously found for 1,25-(OH)2D3, the time course of specific binding of OCT was biphasic, with an initial plateau at 1 h and a further increase from 2-8 h. Scatchard analysis demonstrated that exposure to 3H-1,25-(OH)2D3 increased VDR from 24 fmol/mg protein at 2 h to 85 fmol/mg protein at 8 h. Exposure to 3H-OCT increased VDR from 22 to 76 fmol/mg protein, indicating that OCT is also capable of up-regulating the VDR in ROS 17/2.8 cells. In contrast to the lower affinity of OCT for VDR reported for chick intestine and HL-60 cells, the Kd for OCT in intact ROS 17/2.8 cells was identical to that for 1,25-(OH)2D3. The effect of OCT on osteocalcin secretion and alkaline phosphatase (ALP) activity in ROS 17/2.8 cells was also determined. Pretreatment for 24 h with either 1,25-(OH)2D3 or OCT resulted in a dose-dependent enhancement of osteocalcin secretion. A 2-fold stimulation by both compounds was observed with 10(-7)M. ALP activity was measured after a 72-h incubation with 10(-7)M 1,25-(OH)2D3 or OCT. Both compounds increased ALP activity to the same extent. Stimulation by OCT of VDR levels, ALP activity, and osteocalcin secretion were inhibited by the addition of 5 microM cycloheximide, indicating that these actions of OCT require new protein synthesis. Thus, OCT, like 1,25-(OH)2D3, up-regulates the vitamin D receptor, stimulates osteocalcin secretion, and increases ALP activity in ROS 17/2.8 cells, suggesting that the analog may be as active as 1,25-(OH)2D3 in stimulating bone formation in vivo. The low activity of OCT in mobilizing calcium from bone in vivo does not appear to be due to an inability of this compound to act on osteoblasts.
Neuropsychologic test performance in amateur boxers. Cognitive functions of 23 amateur boxers were assessed immediately before and after an amateur boxing event. A range of cognitive measures were employed including tasks of verbal, figural, and incidental memory, motor functions, attention and concentration, and information processing speed. Compared to their prefight performance, boxers demonstrated impairments in verbal and incidental memory, but enhanced executive and motor functions postfight. There were no observed differences between winners and losers on any of the measures. The results are compared to other studies that have shown only minor changes in cognitive functions in amateur boxers compared to controls.
Enterococcal meningitis in an HIV positive haemophilic patient. A 25 year old, human immunodeficiency virus (HIV) seropositive, severe haemophilic patient was treated for suspected Pneumocystis carinii infection with high dose intravenous cotrimoxazole and subsequently with prednisolone. When he improved he was discharged on oral treatment only to return two days later, extremely unwell, with headaches, fever, sweats, tachycardia and hypotension. A lumbar puncture showed modest neutrophil pleocytosis but despite empirical antibiotic treatment with intravenous benzylpenicillin and cefuroxime he continued to deteriorate. Culture of cerebrospinal fluid subsequently grew Enterococcus faecalis that was resistant to trimethoprim and sensitive to ampicillin, rifampicin, and vancomycin. After a change in treatment to intravenous ampicillin and rifampicin he dramatically improved. Enterococcal meningitis is rare in adults but important to recognise and treat appropriately in view of its high mortality and relative resistance to antibiotics. In our case the combination of HIV infection and previous treatment with antibiotics or steroids, or both, were probable predisposing factors.