Refractory bradycardia after reversal of muscle relaxant in a diabetic with vagal neuropathy.
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Biomedical subjects
Publications and source records attributed to J Berg.
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Old scars of the pleura, for example from chronic empyema or therapeutic pneumothorax, can cause a malignant mesothelioma appearing some decades later. The authors describe two cases of primary pleural tumors, which probably had such an etiology. A literature review revealed 20 further cases, the majority of which were squamous cell carcinomas. Whether these tumors developed from metaplastic mesothelium or inplanted cells from the skin is not clear.
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A modern system for single photon emission computerized tomography has been modified in order to optimize examinations of the head. By cutting off part of the detector housing and collimators at one edge, it is possible to rotate the camera close to the skull while still covering the entire brain and the skull base. The minimum radius of revolution used in 32 patients was thereby reduced from about 20 cm to 12.7 +/- 0.8 cm. This, combined with an adjustment of the 64 X 64 matrix to a 26- by 26-cm field of view, resulted in an improvement of the spatial resolution from about 19 mm to 12.6 +/- 0.3 mm with a low-energy, all-purpose collimator, and to 10.4 +/- 0.3 mm (FWHM) with a low-energy, high-resolution collimator. The improved spatial resolution offers several clinical advantages in studies of the brain, the cerebrospinal fluid space, and the skull base.
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The 46, X, i(Xq) karyotype of isochromosome for the long arm of the X chromosome has been found to be a frequent structural abnormality in Turner's syndrome. To characterize the endocrine, metabolic, and psychometric features of such patients, nine subjects, aged 12 to 49 years, with this specific cytogenetic abnormality were studied. Although eight of the nine patients had a mosaic chromosome pattern, five had a greater proportion of i(Xq) cells than XO cells, and in four of these the proportion of i(Xq) cells was over 80%. Eight of the nine isochromosomes were metacentric and most had a single C-band. Two subjects were hypothyroid, six had thyroid antibodies present and five had parietal cell antibodies. Oral glucose tolerance testing was abnormal in three and elevated insulin levels were present in an additional two subjects. Psychometric testing showed some discrepancy between verbal and performance I.Q. scores, the performance scores generally being lower. Thus, thyroiditis, insulin insensitivity and diabetes mellitus, parietal cell antibodies, and a relatively low performance I.Q. are found in some of the 46, X, i(Xq) Turner's syndrome patients. The highest thyroid antibodies were present in the four subjects in whom more than 80% of cells were 46, X, i(Xq). Two of these subjects also had diabetes mellitus and three had antiparietal cell antibodies. These findings suggest an association of autoimmune disease with this particular cytogenetic abnormality.
The human liver probably removes circulating polymeric IgA by two routes: (1) secretory component-mediated endocytic transport of polymeric IgA from portal tract blood vessels into bile across biliary epithelial cells and (2) uptake with possible catabolism by hepatocytes and/or sinusoidal phagocytic cells by uncharacterized receptor(s). Failure of either clearance mechanism due to liver disease results in elevated serum polymeric IgA levels. In patients with cholestasis, the raised serum polymeric IgA concentration is due to reflux of biliary secretory immunoglobulin into the blood.
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A group of 87 consecutive patients with acute non-lymphocytic leukaemia (ANLL) who had been treated with large doses of hydroxyurea (HU) as a preliminary to protocol combination chemotherapy is reviewed. The outcome in patients whose initial leucocyte count was 100x10(9)/L or higher (HC group) is compared with that in the majority who had lower leucocyte counts. Contrary to reports in the literature, patients in the HC group had the same chance of achieving remission as the rest, and the survival of the responders was equally long in both groups. There were no deaths from intracerebral haemorrhage in the reportedly high-risk HC group, a fact which was attributed to the administration of HU to all new patients. Hydroxyurea rapidly lowered the leucocyte count in nearly all patients with ANLL and appeared to be a valuable addition to protocol therapy of this disease.
A case of glucagonoma syndrome with necrolytic migratory erythema, glossitis, anemia, hyperglucagonemia and a malignant, pancreatic A-cell tumour in a 68-year-old male is described. Gel filtration of the highly elevated circulating glucagon immunoreactivity (2200 pg/ml) demonstrated 60% pancreatic glucagon and 30% "proglucagon". Metabolic studies before operation demonstrated suppression of the total plasma glucagon concentration on oral glucose tolerance test, unchanged total plasma glucagon concentration during intravenous glucose tolerance test and insulin-induced hypoglycemia. Administration of arginine was followed by a rise in both the pancreatic glucagon and the "proglucagon", whereas alanine increased only the pancreatic glucagon. The plasma somatostatin level was immeasurable preoperatively. Somatostatin infusion completely suppressed the release of the pancreatic glucagon but did not significantly affect the "proglucagon". After removal of the tumour the skin lesions disappeared and the total plasma glucagon values fell to normal levels (120 pg/ml). Also, other abnormal laboratory findings returned to normal, including the preoperatively observed renal glucosuria.
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Three groups of DBA/2J mice were continuously exposed for 3, 6 or 9 days to a milled diet containing phenobarbital. Two additional groups were given a discontinuous drug administration schedule with either one or two 24 h drug-free periods interpolated among the 6 or 9 days of phenobarbital consumption, respectively. The discontinuous schedule of drug administration significantly attenuated the development of physical dependence as determined by the severity of withdrawal symptoms. Functional tolerance development was also attenuated in a manner that closely paralleled the effects on physical dependence development. The 5 group means showed a perfect rank order correlation between functional tolerance and physical dependence development.
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Report of a 2-years-period of obstetrical work in the maternity-hospital of the Univeristy, Oran in Algeria. Caesarean section as the most important obstetrical operation is examined more closely with regard to the indication and the methods of operation. The incidence of uterine rupture and caesarean hysterectomy is reported. Finally common experiences are mentioned.
Forty female rabbits were implanted with silicone vaginal devices containing ethynodiol diacetate for up to 8 weeks. As predicted from in vitro studies, a Q - t1/2 (matrix-controlled) release profile was observed in vivo. The in vivo drug release profile was compared with in vitro data measured at three hydrodynamic conditions, and the diffusional resistance across the vaginal wall was estimated. Drug released from silicone devices yielded a prolonged plasma level when compared with data following intravaginal or intravenous administration of a solution dose. The rate constant for elimination was unchanged. The plasma concentration of the drug was related to the intravaginal drug release profile both theoretically and experimentally and was above the concentration required to inhibit fertilization.
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