The semantic development of negation: a cross-linguistic longitudinal study.
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Child, Preschool↗
Biomedical subjects
S Choi
Publications and source records attributed to S Choi.
Spectral analysis of the EEG in craniocerebral trauma.
The objectives of the present study were to evaluate the relationship between the fractional amplitudes of the EEG derived from power spectral analysis (PSA) of the electroencephalogram (EEG) and depth of coma measured clinically with the Glasgow Coma Score, and to assess the accuracy of PSA in predicting long-term outcome. Thirty-two patients rendered unconscious by blunt head injury (mean (GCS = 7) had intermittent EEG recordings daily from 1-10 days post injury. There was a significant correlation between fractional amplitude of the EEG and the GCS. The rate and magnitude of change in the EEG and GCS were also correlated. There were significant differences in PSA parameters between improved and deteriorated patient groups at the termination of monitoring (p = .02) and in the change of PSA parameters over time (p = .02). Using linear discriminant analysis of PSA parameters, the accuracy of outcome prognostication based on the six month outcome was approximately 75%. Accurate classification of outcome was possible in a number of patients in whom there was little or no change in the GCS during the period of monitoring.
Adolescent↗
Proximal gastric vagotomy. The preferred operation for perforations in acute duodenal ulcer.
Simple closure, the conventional operation for perforated acute duodenal ulcers, is associated with symptomatic relapse in a large proportion of patients. In order to assess the role of immediate definitive surgery, 78 fit patients with perforated acute ulcers were prospectively randomized to undergo either closure alone or proximal gastric vagotomy with closure (PGV). Patients taking potentially ulcerogenic drugs or who had severe stress were excluded from the study. Both groups were comparable with respect to age, sex, general medical health, duration of perforation, length of ulcer history, and presence of duodenal scarring. There was no hospital mortality. Minor complications occurred in 7.3% after closure and 10.8% after PGV. At 3 years follow-up, the cumulative recurrence rates were 36.6% and 10.6% after closure and PGV, respectively (p = 0.001). Eighty-five per cent of recurrences after closure were symptomatic, and half of them required reoperation. Duodenal scarring itself did not appear to influence the outcome after closure. PGV was not associated with dumping, diarrhea or other unwanted side effects. Although less than that in chronic ulcers, there is a substantial risk of symptomatic relapse after closure of perforated acute duodenal ulcers. With judicious patient selection, PGV effectively reduces this risk without incurring disabling side effects associated with other ulcer operations.
Adult↗
Inner city deprivation and medical education: a survey of medical students by medical students.
A total of 330 preclinical and clinical medical students and house officers at St Mary's Hospital were surveyed by questionnaire to assess their knowledge and experience of inner city deprivation and health, and their opinions on the role of the doctor in responding to these problems. The response rate was 87%. Over 75% of the respondents had had no experience of inner city living conditions before coming to medical school, and they gained little experience during the medical course until well into the clinical years. Most preclinical students wanted more contact with the community early in the course; less than one-third of the clinical students wanted this. The differences in knowledge and attitudes between the year groups are discussed and possible reorientation in medical education is considered.
Attitude of Health Personnel↗
Detection of crystallization inhibitory activity of whole urine with a gel model.
The inhibitory activity of urine on calcium oxalate crystallization was measured as an inhibitory index using a gel model modified from Schneider et al. [8]. Urine samples from 36 recurrent stone formers and 21 controls in 3 separate periods (morning, afternoon and evening) were tested. Mean inhibitory indices of greater than 0 were observed among normal controls in the 3 sampled periods and among stone formers in the morning and afternoon samples. A significantly lower (negative) value was observed in the evening samples of stone formers, indicating a higher tendency towards crystallization than normal. The gel method may be applied to identify individuals at risk of stone formation if sufficient numbers of period-defined urine samples from the individual are tested for a statistically significant mean inhibitory index but whether this is practical in a clinical laboratory will need further evaluations.
Adult↗
Hypomagnesemia and renal magnesium wasting in renal transplant recipients receiving cyclosporine.
Following the adoption and use of cyclosporine as the drug of choice in the management of renal allograft recipients, several cases of symptomatic hypomagnesemia were noted. These observations prompted the current prospective study of serum concentration and urinary excretion of magnesium in 27 renal transplant recipients treated with cyclosporine and prednisone. Relevant laboratory measurements were obtained shortly before and regularly after transplantation. The results were compared with those obtained in a group of 17 allograft recipients treated with azathioprine and prednisone. The cyclosporine-treated patients showed a significant reduction in the serum magnesium concentration and an inappropriately increased urinary excretion and fractional excretion of magnesium, suggesting renal magnesium wasting. The observed hypomagnesemia required magnesium supplementation in nearly all cyclosporine-treated patients. In contrast, azathioprine-treated patients showed normal serum magnesium concentrations and required no magnesium supplementation. In conclusion, administration of cyclosporine in renal allograft recipients appears to be commonly associated with renal magnesium wasting and hypomagnesemia. Therefore, it is recommended that serum levels of magnesium be monitored regularly in renal allograft recipients receiving cyclosporine and that magnesium supplementation be employed as needed to avoid magnesium depletion.
Adult↗
Contribution of CSF and vascular factors to elevation of ICP in severely head-injured patients.
The authors studied the relative contribution of cerebrospinal fluid (CSF) and vascular parameters to the level of intracranial pressure (ICP) in 34 severely head-injured patients with a Glasgow Coma Scale score of less than 8. This was accomplished by first characterizing the temporal course of CSF formation and outflow resistance during the 5-day period postinjury. The CSF formation and outflow resistance were obtained from pressure responses to bolus addition and removal of fluid from an indwelling ventricular catheter. The vascular contribution to the level of ICP was assessed by withdrawing fluid at its rate of formation and observing the resultant change in equilibrium ICP level. It was found that, with the exception of patients with subarachnoid hemorrhage, CSF parameters accounted for approximately one-third of the ICP rise after severe head injury, and that a vascular mechanism may be the predominant factor in elevation of ICP.
Absorption↗
Pressure-volume index in head injury.
The authors studied intracranial pressure (ICP) and intracranial compliance as defined by the pressure-volume index (PVI) in 34 severely head-injured patients with a Glasgow Coma Scale score of 8 or less. The objective of the research was to determine if there was a correlation between the pressure-volume status and subsequent increase in ICP. The PVI and ICP measurements were obtained serially, and the temporal course of the pressure-volume status and ICP was determined during the 5-day period following injury. Aggressiveness of ICP was quantified by a therapy intensity level scale. A clear relationship between the PVI measured soon after injury and subsequent development of ICP emerged. Following mechanical trauma the PVI is reduced, and the degree of reduction and extent of biomechanical recovery are closely related to outcome and development of raised ICP.
Adolescent↗
Partial amino acid sequence analyses of human placental insulin receptor.
Tryptic peptides were isolated from human insulin receptor (1.8 nmol) by sequential reverse-phase HPLC on SynChropak RP-C8 and Vydac C-18. Nearly 20 peptides were analyzed for amino acid composition, which revealed that the yield of tryptic peptides averaged 300 pmol. By gas-phase microsequencing five peptides were sequenced. N-acetylglucosamine was found in two peptides. These data are compared with the amino acid sequence of the insulin receptor deduced from cloned cDNA encoding for human insulin receptor.
Amino Acid Sequence↗
Intraoperative flexible choledochoscopy for intrahepatic and extrahepatic biliary calculi.
This prospective study evaluates the use of intraoperative flexible choledochoscopy in the detection and removal of additional stones after conventional bile duct exploration. The biliary system of 109 patients was examined with an Olympus CHF-B4 choledochoscope after conventional methods of exploration. Sixty-five patients had only common duct stones and 44 patients had intrahepatic stones with or without stones in the common duct. Additional stones were detected in 11 patients (16.9%) in the group with common duct stones; eight of these patients had their stones completely removed. Unsuspected residual stones were discovered by means of postoperative cholangiography in three more patients (4.6%); thus the total number of patients with residual stones was six (9.2%). Additional stones were detected in 39 patients (88.6%) in the group with intrahepatic stones. Of these, only 13 patients managed to be freed of stones with the use of the choledochoscope. A further 10 patients underwent liver resection to achieve stone clearance. Unsuspected retained stones were found postoperatively in seven of the 28 patients (25%) whose biliary systems were considered clear of stones. The overall number of patients with retained stones in the group with intrahepatic stones was 23 (52.3%). We concluded that intraoperative flexible choledochoscopy is useful in detecting intrahepatic stones left behind after conventional exploration. However, complete removal of the stones is difficult to achieve.
Adult↗
Chronic antral gastritis in duodenal ulcer. Natural history and treatment with prostaglandin E1.
The natural history of chronic antral gastritis in relation to the healing of duodenal ulcer and its response to treatment, if any, are unknown. We performed a double-blind controlled trial using an oral prostaglandin E1, misoprostol, in 229 patients with active duodenal ulcer randomized to receive placebo (n = 76), misoprostol 200 micrograms (n = 77), or misoprostol 300 micrograms (n = 76), q.i.d. orally. Healing of duodenal ulcer was assessed biweekly up to 12 wk by endoscopy, during which procedures at least two antral and two fundal biopsy specimens were taken. The activity and the degree of chronic inflammation of gastritis, as assessed histologically by the infiltration of polymorphs and chronic inflammatory cells, respectively, was graded blindly by two pathologists as nil, mild, moderate, or severe. Before treatment, 99% of patients had chronic antral gastritis and 1.5% had chronic fundal gastritis. In the placebo group, healed duodenal ulcer was associated with significantly (p less than 0.01, life table analysis) higher incidence of improvement of the activity of the antral gastritis (nil or mild as endpoint) than unhealed ulcer (30% vs. 4% at week 8). Irrespective of whether duodenal ulcer was healed or unhealed, significantly (p less than 0.01) more patients on misoprostol (50% at week 8) showed improvement (nil or mild as endpoint) than the placebo group. The degree of chronic inflammation of the antral gastritis showed similar significant changes in favor of misoprostol. Smoking and alcohol intake had no significant effect on the improvement of chronic antral gastritis. In conclusion, healing of duodenal ulcer was associated with improvement of the activity of chronic antral gastritis, which, as shown for the first time, could be further enhanced by a therapeutic agent--prostaglandin E1.
Adult↗
Proximal gastric vagotomy in emergency peptic ulcer perforation.
In order to evaluate proximal gastric vagotomy (PGV) performed under different clinical conditions, we compared the late results of 93 patients who underwent emergency PGV for perforated duodenal ulcers with those of 60 patients who had elective PGV. The emergency group of patients were slightly younger and there was a higher male predominance but they were otherwise comparable with those in the elective group. There were no operative deaths and the postoperative morbidity rate was low in both groups. Three patients had a recurrence in the emergency group, and seven occurred in those in the elective group during the first three postoperative years. The cumulative recurrence-free rate of the emergency group was not lower than that of the elective group. The performance of the individual surgeon exerted a strong influence on the incidence of recurrent ulceration. In properly selected patients, whether the surgeons perform PGV in emergency or elective situations appears to have little influence on the outcome.
Adult↗
[Biliary endoprosthesis by using Carey-Coons Soft Stent kit].
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Adult↗
Effects of estradiol on platelet aggregation in mouse mesenteric arterioles and ex vivo.
Mice were implanted subcutaneously with a pellet containing 0.5 mg estradiol or with a placebo. Eight to 12 days later platelet aggregation was produced in mesenteric arterioles by injuring their endothelium in vivo with a noxious light/dye stimulus. The time between the onset of the noxious stimulus and the appearance of platelet aggregates was significantly shortened (p less than .01) in the estradiol treated mice. In contrast to this enhancement of aggregation, when platelets were tested ex vivo in platelet rich plasma (PRP), aggregation to sodium arachidonate was inhibited in estradiol treated mice. Aggregation of PRP by ADP was not affected by estradiol treatment of the mice. Thus the enhanced aggregation observed in injured mesenteric arterioles of estradiol treated mice may not reflect direct effects of estradiol on the platelet itself. Rather enhanced aggregation may reflect an effect of estradiol on endothelium or adjacent tissue. The data are discussed in light of other literature concerning estradiol effects in rodents, and in light of literature suggesting that an increased number of thromboembolic events occurs in humans receiving high doses of estrogens.
Adenosine Diphosphate↗
Lesser curve ischemia after proximal gastric vagotomy and splenectomy: conservative management with endoscopical surveillance.
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Aged↗
CT diagnosis of abdominal lymph node metastases in hepatocellular carcinoma.
CT scanning is useful for diagnosing abdominal lymph node metastasis. Using this technique, histologically confirmed abdominal lymph node metastases were detected in nine of 49 patients (33 autopsy cases and 16 laparotomy cases) with hepatocellular carcinoma (hepatoma). Among the 49 patients, three had periportal (6.1%), six peripancreatic (12.2.%) and six para-aortic adenopathies (12.2%). Two of the patients had adenopathy at all three sites. Retrospectively, CT detected two periportal, four peripancreatic and all six para-aortic adenopathies. Most of the hepatomas with adenopathy showed infiltrative growth; tumour thrombosis of the portal vein was a common complication.
Abdominal Neoplasms↗
Endochondral pseudocyst of the auricle in Chinese.
Thirty-one patients with endochondral pseudocysts of the auricle were seen over a four-year period in the Department of Surgery at the University of Hong Kong. The lesions chiefly affected Chinese males (90.3%); 80.6% involved the scaphoid fossa on the anterior surface of the pinna. They were usually asymptomatic and static in size. Excision of the anterior wall, followed by contour pressure dressing, gave cosmetically satisfactory results in 90% of the patients, and there were no recurrences. Pathologic studies revealed the absence of an epithelial lining as well as multiple cystic spaces that contained abundant glycosaminoglycans (acid mucopolysaccharides). We postulate that the overproduction of glycosaminoglycans engendered by repeated minor trauma to the cartilage was the primary cause of the pseudocysts.
Adult↗
Late problems after pharyngolaryngoesophagectomy and pharyngogastric anastomosis for cancer of the larynx and hypopharynx.
The late problems of 136 patients who had undergone pharyngolaryngoesophagectomy and pharyngogastric anastomosis were studied. The proportions of patients who required long-term thyroxine supplementation were 67 percent, 13 percent, and 5.3 percent of the patients who had total thyroidectomy, hemithyroidectomy, and no thyroidectomy, respectively. The proportions of patients who required calcium and vitamin D supplementation were 67 percent, 23 percent, and 17 percent, respectively. Speech rehabilitation was unsatisfactory. Alimentary functions were satisfactory in that the majority of patients were able to take in solid food. Although a sensation of obstruction of food was occasionally felt, no organic abnormality was found in any patient. Regurgitation was noted in 23 percent of the patients, and hematemesis was an occasional symptom of gastritis or gastric ulcer, although symptomatic gastric ulcer was found in only two patients. It is concluded that the long-term morbidity after this extensive procedure is mild and acceptable. The operation is recommendable for extensive tumors of the laryngopharyngeal region.
Adult↗