shukoor65/lab-rag-model huggingface dataset:
Evaluation of biotinylated DNA probes for the detection of gene rearrangements in clinical specimens. To determine whether a nonisotopic procedure is suitable for analyzing clinical specimens for gene rearrangements, the authors hybridized DNA from 15 specimens of lymphoid tissue with biotinylated DNA probes directed to J beta I + J beta II (T-cell receptor beta chain gene), JH (immunoglobulin gene heavy chain J region), and J kappa (immunoglobulin gene kappa light chain J region). Five cases of benign lymphoid hyperplasia, one case of dermatopathic lymphadenopathy, and one case of small noncleaved follicular center cell lymphoma had germline hybridization patterns when digested with Bam HI, Eco RI, and Hind III restriction endonucleases. Four cases of B-cell lymphoma and three cases of T-cell lymphoma had clearly detectable rearrangements of the genes for immunoglobulin or the T-cell receptor or both. One case of dermatopathic lymphadenopathy had a faint, clonal rearrangement of the T-cell receptor after digestion with Eco RI and Bam III. The authors conclude that biotinylated DNA probes can be useful for analyzing gene rearrangements in clinical specimens.
Acute respiratory viral infections in ambulatory children of urban northeast Brazil. The morbidity of acute respiratory infections in young children and the role of respiratory viruses were evaluated in a 29-month household-based study in an impoverished urban population in Fortaleza, Brazil; subjects were 175 children less than 5 years of age in 63 families. Home visits were conducted three times weekly during which staff recorded the presence of respiratory and systemic symptoms and collected upper respiratory tract samples for viral isolation. A large and sustained burden of respiratory illness was observed, and respiratory viruses were isolated in 35% of the samples collected. Of the isolates, 45.6% were rhinoviruses, 16% parainfluenza viruses, 15.8% enteroviruses, 9.9% adenoviruses, 7.0% herpes simplex viruses, and 5.7% influenza viruses. The results indicate that poor children in northeast Brazil have a high prevalence of respiratory illness and that rhinovirus is the most frequent respiratory virus.
Preoperative evaluation of gastric cancer by endoscopic ultrasound. The preoperative use of endoscopic ultrasound was evaluated in 74 patients with confirmed gastric cancer. It was used in diagnosing the depth of invasion in the gastric wall, the infiltration to the adjacent organs, and the involvement of the perigastric lymph nodes. Results were compared with histological findings in resected specimens. Accuracy in staging gastric cancer using the T grade of the 1987 TNM system was 81.1% (60 of 74 patients). Endoscopic ultrasound provided excellent results compared with computed tomography and conventional ultrasound, particularly in evaluating perigastric lymph node metastasis and direct infiltration to the adjacent organs. The success rate in detecting lymph node metastasis was 50% (11 of 22 patients); the accuracy in diagnosing direct infiltration to the adjacent organs was 60% (three of five patients). This technique is useful in diagnosing malignant invasion and lymph node metastasis of gastric carcinomas but requires further refinement for use in diagnosing the disease itself. Its preoperative use is recommended for establishing surgical and other treatment plans, as well as in predicting the prognosis of gastric cancer.
Effects of endurance training on baroreflex sensitivity and blood pressure in borderline hypertension. Physical training offers a potential nonpharmacological strategy for control of mild and borderline hypertension, but its effect on blood pressure is controversial. We investigated the effects of endurance training on waking and sleeping blood pressure and on baroreflex sensitivity in 16 borderline hypertensive patients. First, 8 patients were assessed before and after a 6-month endurance training programme. Then, when it was clear that blood pressures were lower after training, a further 8 patients were studied not only at the end of the training programme but also after 4 months' abstention from exercise (detraining). Measurements were taken of baroreflex sensitivity (response to iv phenylephrine), blood pressure, R-R interval, and blood pressure and R-R variability. Ambulatory blood pressures were measured in 13 patients (7 trained, 6 detrained) and sleep blood pressures in 6 patients (3 trained, 3 detrained). Increased fitness was associated with a decline in resting arterial blood pressure of 9.7 (SE 2.0) mm Hg systolic and 6.8 (1.2) mm Hg diastolic, and with a decline in ambulatory blood pressure of 4.8 (1.4) mm Hg and 7.5 (2.1) mm Hg, respectively; both p less than 0.05. Baroreflex sensitivity was 14.0 (1.8) ms/mm Hg in the unfit and 17.5 (2.0) ms/mm Hg in the fit; p less than 0.05. Sleep blood pressures were not lower in the fit despite longer sleep R-R intervals. These findings indicate that, in some subjects with borderline or mild hypertension, a physical training programme is sufficient to bring the blood pressure within normal limits.
The long-term course of Lyme arthritis in children. BACKGROUND AND METHODS. The natural history of Lyme disease is not completely known. We studied the long-term course of Lyme arthritis in 46 children in whom the onset of the disease occurred between 1976 and 1979 and who received no antibiotic therapy for at least the first four years of the illness. RESULTS. Of the 46 children (age range, 2 to 15 years), 33 (72 percent) initially had erythema migrans, 7 (15 percent) had influenza-like symptoms, and 6 (13 percent) had migratory joint pain. These manifestations were followed by brief attacks of arthritis, particularly affecting the knee. The percentage of children with recurrent episodes of arthritis declined each year. By year 4, only 10 children still had a mean of two episodes of arthritis per year; the duration of arthritis was generally longer in older children (P less than 0.05). During the sixth year of illness, two children (4 percent) had keratitis, and more than 10 years after the onset of disease, a subtle encephalopathy developed in two other children. Of the 39 children whom we were able to contact in 1988-1989, 12 (31 percent) still had occasional brief episodes of joint pain and 1 (3 percent) had marked fatigue. All 46 children had positive IgG antibody responses to Borrelia burgdorferi throughout the illness and on long-term follow-up. As compared with those who became asymptomatic, the children with recurrent symptoms more often had IgM responses to the spirochete and had significantly higher IgG titers (P less than 0.05). CONCLUSIONS. The course of initially untreated Lyme disease in children may include acute infection followed by attacks of arthritis and then by keratitis, subtle joint pain, or chronic encephalopathy.
Neuroendocrine activation in congestive heart failure. Several changes in neuroendocrine activity follow failure of cardiac function to satisfy peripheral requirements and contribute to the clinical syndromes of heart failure. Afferent pathways are poorly understood and triggers are both central and peripheral, involving attenuation of atrial and arterial baroreceptor activity. Efferent sympathetic activity is generally increased with resulting vasoconstriction, but responses are organ-specific and differ among heart, kidney, lung and skeletal muscle. Changes in cardiac sympathetic activity are inadequately understood. Enhanced cardiac norepinephrine spillover contrasts with reduced tissue concentration and impaired activity of synthetic enzymes and neuronal catecholamine uptake. Beta-receptor down-regulation further complicates overall adrenergic responsiveness and the balance between enhancement of contractile function and reduction in arrhythmia threshold. Activation of the renin-angiotensin system is potentiated by the sympathetic nervous system and may contribute to vasoconstrictor hyporesponsiveness. Angiotensin II may in turn facilitate the central and peripheral effects of sympathetic activation and the release of vasopressin from the pituitary. Our understanding of the role of vasodilator peptides in heart failure remains rudimentary. It is likely that vasoconstrictor neuroendocrine response adversely influences optimal cardiac function in heart failure and may promote arrhythmogenesis. The neuroendocrine response in individual organs, however, requires intensive study.
Vipoma of the pancreas complicating ulcerative colitis. We report a case of vipoma of the pancreas in conjunction with ulcerative colitis in a 20-yr-old woman. Twenty months after the onset of ulcerative colitis, the patient complained of watery diarrhea and was found to have an electrolyte disorder. A pancreatic tumor was detected by ultrasonography and computed tomography, along with an elevation of serum vasoactive intestinal polypeptide (VIP). The secretory diarrhea diminished dramatically, and the serum VIP level decreased into the normal range immediately after resection of the pancreatic tumor. Immunohistochemical staining revealed a pancreatic vipoma. Despite removal of the vipoma, she underwent restorative proctocolectomy and ileal J-pouch anal anastomosis 2 yr later due to progression of the ulcerative colitis. Postoperative course was uneventful, with excellent functional results. Knowledge of this rare condition accompanying ulcerative colitis may help in the management of the patient with an atypical clinical course.
Contribution of increased endolymphatic pressure to hearing loss in experimental hydrops. After the induction of experimental hydrops there follows a strict sequence of compound action potential (CAP) audiogram changes. Within days a low-frequency loss (below 8 kHz) is detected; within weeks a very high-frequency loss (above 8 kHz) develops; and finally within months the 8-kHz region is also affected. Following the application of excess pressure, presumably to the endolymphatic spaces, via a cannula placed in the endolymphatic duct, a sequence of CAP audiogram changes occurs that is not similar to that observed with hydrops. There is first a very high-frequency loss (above 4 kHz), then a very low-frequency loss (below 4 kHz), and finally the 4 kHz region is also affected and thresholds for all frequencies become even more raised. The data thus suggest that a slow accumulation of endolymph as induced by blockage of the endolymphatic duct does not produce the same disorder as a rapid onset of a high pressure applied at the base of the cochlea. In addition the data suggest that raised endolymphatic pressure is not likely to be significant in early stages of hydrops, but could contribute to the later high-frequency sensitivity losses.
Bilateral adrenal tumours in primary aldosteronism: localization of a unilateral aldosteronoma by dexamethasone suppression scan. In a patient with primary aldosteronism, in which the postural endocrine tests suggested the presence of an aldosteronoma rather than hyperplasia, bilateral adrenal tumours were found by computer tomography. Adrenal scintigraphy using 6-131I-iodomethyl-19-norcholesterol (NP59) during dexamethasone suppression showed early unilateral adrenal visualization on the left side. After removal of the left adrenal gland, which contained a 2 x 2 x 2 cm adenoma, the blood pressure and aldosterone levels returned to normal. A CT-scan, performed 1 year after the pre-operative CT-scan, showed no change in size of the right adrenal tumour, consistent with a non-functioning adenoma. In this patient, the NP59 scan adequately distinguished a non-functioning from an aldosterone-producing adrenal tumour.
Long-term postoperative dysphagia in oral/pharyngeal surgery patients: subjects' perceptions vs. videofluoroscopic observations. Dysphagia commonly results from surgical resection of various structures within the oral, pharyngeal, and esophageal areas. The type and severity of swallowing dysfunction are based largely on the number and quantity of structures removed as well as the reconstructive procedure. Short term-recovery has been addressed in many studies. However, follow-up studies of long-term functional results and continuing swallowing problems following oral/pharyngeal surgery are unavailable. In this study, perception of swallowing dysfunction was compared with actual videofluoroscopic findings in subjects at least 1 year after oral/pharyngeal surgery. The comparative results of a questionnaire developed to evaluate patients' perception of continuing swallowing difficulty and an analysis of actual videofluoroscopic tapes indicated that the degree or type of dysphagia could not be determined from patients' subjective descriptions of the swallowing problem.
Partial atrial resection in advanced lung carcinoma with and without cardiopulmonary bypass. Combined pneumonectomy and partial resection of the left atrium was performed in 12 patients with advanced lung carcinoma (T3 and T4 in the new UICC classification). In the eight patients with a T3 lung carcinoma intrapericardial atrial resection with vascular clamping was carried out; four of the patients died within a year. The remaining four patients had a T4 tumour and underwent removal of the right lung and part of the left atrium under total cardiopulmonary bypass. One patient died shortly after the operation from cerebral and cerebellar infarction, and one died 11 months later from brain metastases. Two are alive and well. Complete resection appears to offer a chance for longer survival in patients with advanced lung carcinoma that extends directly into the intrapericardial pulmonary vessels or atrium.
Use of electron microscopy in examination of faeces and rectal and jejunal biopsy specimens. The stools and rectal biopsy specimens of 44 patients with AIDS and diarrhoea were examined by culture, light microscopy, and electron microscopy. In 13 patients examination of rectal biopsy material and faecal samples showed no pathogen, but in two of these, microsporidiosis was found by electron microscopical examination of jejunal biopsy specimens. This organism was also identified electron microscopically in one of the further five jejunal biopsy samples taken from patients with a known cause of diarrhoea. Blastocystis hominis infection was identified electron microscopically in six patients, all of whom had cryptosporidiosis additionally seen by light microscopy. Four of these six patients remained well for long periods, with only moderate diarrhoea, and follow up showed no evidence of blastocystis infection. In only four of 11 patients found to have cryptosporidium in their stools at light microscopy were organisms found at electron microscopy. Viral inclusions were only identified at electron microscopy in one of 10 patients with an opportunistic viral infection seen at light microscopy (cytomegalovirus n = 7, herpes simplex virus n = 3). No additional viral pathogens were detected in either stools or rectal biopsy material by electron microscopy. It is concluded that routine electron microscopic examination of stool samples or rectal biopsy material taken from patients with AIDS and diarrhoea is unnecessary and does not increase the yield of potential pathogens compared with standard microbiological techniques and histology.
Clinical spectrum of bronchogenic cysts of the mediastinum and lung in the adult. Bronchogenic cysts are closed sacs considered to be the result of an abnormal budding of the respiratory system. They are lined by ciliated epithelium and have focal areas of hyaline cartilage, smooth muscle, and bronchial glands within their walls. They are seldom seen in the adult, and most are thought to be asymptomatic and free of complications. During a 20-year period, 86 patients underwent resection of a bronchogenic cyst of the mediastinum (66 patients) and lung (20 patients). There were 47 women and 39 men whose ages ranged from 16 to 69 years. Seventy-two percent of patients (67% with mediastinal cysts and 90% with cysts of the lung) were symptomatic at the time of operation, and the majority had two or more symptoms. Despite extensive investigations, which in some cases included computed tomographic scanning (n = 12) and angiography (n = 22), a positive diagnosis was never made preoperatively even if it was suspected in 57% of patients. In nearly all patients, the operative approach was that of a posterolateral thoracotomy. All but two mediastinal bronchogenic cysts could be locally excised, but all bronchogenic cysts of the lung required pulmonary resection (lobectomy, 13; limited resection, 6; pneumonectomy, 1). Major operative difficulties were encountered in 35 patients, all of whom were symptomatic preoperatively. Thirty-three patients had a complicated cyst; the complications consisted of fistulization (n = 16), ulcerations of the cyst wall (n = 13), hemorrhage (n = 2), infection without fistulization (n = 1), and secondary bronchial atresia (n = 1). Overall, 82% of patients had a bronchogenic cyst that was either symptomatic or complicated or both.
Medical treatment of chronic otitis media: steroid or antibiotic with steroid ear-drops? The aim of this study was to evaluate whether, in the treatment of active non-cholesteatomatous chronic otitis media, the effectiveness of gentamicin with hydrocortisone ear-drops is due solely to the contained steroid or to the combination of antibiotic and steroid. Sixty-four patients presenting to the Ear, Nose and Throat outpatient department with active non-cholesteatomatous chronic otitis media were randomly allocated to receive either gentamicin with hydrocortisone ear-drops, or betamethasone ear-drops, for up to 4 weeks. Activity in the ear was assessed at 2 and 4 weeks. Gentamicin with hydrocortisone combination drops were significantly more effective than betamethasone drops (P less than 0.001) in producing inactivity of chronic otitis media, being effective in 80% as opposed to 29% of cases. The effectiveness of gentamicin with hydrocortisone ear-drops appears to be due to the combination of antibiotic and steroid.
Necrotizing soft-tissue infections in the head and neck: a clinicopathological study. The clinicopathological aspects of 15 patients with necrotizing soft-tissue infections in the head and neck are reviewed. Our relatively large series suggests that the disease occurs more frequently than described in the literature. Histological studies showed that tissue superficial and deep to the fascia is frequently involved with the infectious inflammatory process, even in early stages of the disease. These pathologic changes were also found in healthy-appearing tissues at the periphery of the lesions. The early recognition of the disease and the prompt and aggressive surgical and medical therapeutic approach have resulted in far lower mortality rates (7%) than those reported in the literature. Frozen-section examination contributed to the maximal eradication of the pathologic process. This successful outcome was achieved in spite of the adverse associated clinical conditions, such as old age, debilitating disease, or complications, observed in half of the patients.
Prolonged gastric pH monitoring in responder and nonresponder duodenal ulcer patients: response to placebo and to H2-blocker administration. We evaluated the circadian pattern of gastric acidity by prolonged intraluminal pHmetry in 15 "responder" and 10 "nonresponder" duodenal ulcer patients after nocturnal administration of placebo, ranitidine, and famotidine. Acidity was measured during predefined periods under the different drug regimens in the two groups of subjects, and a comparison was performed both within and between groups. With placebo, significantly lower median 24-h pH values were detected in patients with resistant ulcer than in responders (1.13 versus 1.63). On the contrary, no statistical difference was detected between the two groups during any time of day after administration of either ranitidine or famotidine. Within each group, no significant difference was noted between the two different H2-blockers. Thus, our data suggest that patients with resistant duodenal ulcer display an increased gastric acidity in control conditions but a "normal" response to administration of antisecretory drugs.
Identification of FAP locus genes from chromosome 5q21. Recent studies suggest that one or more genes on chromosome 5q21 are important for the development of colorectal cancers, particularly those associated with familial adenomatous polyposis (FAP). To facilitate the identification of genes from this locus, a portion of the region that is tightly linked to FAP was cloned. Six contiguous stretches of sequence (contigs) containing approximately 5.5 Mb of DNA were isolated. Subclones from these contigs were used to identify and position six genes, all of which were expressed in normal colonic mucosa. Two of these genes (APC and MCC) are likely to contribute to colorectal tumorigenesis. The MCC gene had previously been identified by virtue of its mutation in human colorectal tumors. The APC gene was identified in a contig initiated from the MCC gene and was found to encode an unusually large protein. These two closely spaced genes encode proteins predicted to contain coiled-coil regions. Both genes were also expressed in a wide variety of tissues. Further studies of MCC and APC and their potential interaction should prove useful for understanding colorectal neoplasia.
A summary index for the assessment of quality of life in angina pectoris. When exploring the effects of anti-anginal therapy on quality of life (QL), it is essential to use concise, reliable, outcome measures which focus on those aspects of the disease which are affected by the anginal pain, and which are expected to be responsive to medical intervention. Analysis based on a single comprehensive index is preferable to the use of several indexes as it avoids the potential for conflicting inferences from multiple comparisons. In this paper, we describe the development of a QL index which summarizes the three questionnaires used in the North Karelian Quality of Life (KarQuol) study. The summary index (SI) will be used to compare transdermal and oral nitrate therapy in patients with angina pectoris, and represents the first stage in the construction of a disease-specific evaluative index for future trials.
Metabolic and functional recovery of ischemic human myocardium after coronary angioplasty Although revascularization of hypoperfused but metabolically active human myocardium improves segmental function, the temporal relations among restoration of blood flow, normalization of tissue metabolism and recovery of segmental function have not been determined. To examine the effects of coronary angioplasty on 13 asynergic vascular territories in 12 patients, positron emission tomography and two-dimensional echocardiography were performed before and within 72 h of revascularization. Ten patients underwent late echocardiography (67 +/- 19 days) and eight underwent a late positron emission tomographic study (68 +/- 19 days). The extent and severity of abnormalities of wall motion, perfusion and glucose metabolism were expressed as wall motion scores, perfusion defect scores and perfusion-metabolism mismatch scores. Angioplasty significantly increased mean stenosis cross-sectional area (from 0.95 +/- 0.9 to 2.7 +/- 1.4 mm2) and mean cross-sectional luminal diameter (from 0.9 +/- 0.6 to 1.9 +/- 0.5 mm) (both p less than 0.001). Perfusion defect scores in dependent vascular territories improved early after angioplasty (from 116 +/- 166 to 31 +/- 51, p less than 0.002) with no further improvement on the late follow-up study. The mean perfusion-metabolism mismatch score decreased from 159 +/- 175 to 65 +/- 117 early after angioplasty (p less than 0.01) and to 26 +/- 29 at late follow-up (p less than 0.001 vs. before angioplasty; p = NS vs. early after angioplasty). However, absolute rates of glucose utilization remained elevated early after revascularization, normalizing only at late follow-up.