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[Association of lichen planus and discoid lupus erythematosus. A clinical and histopathological study of 2 cases].

Two patients showing features of both lichen planus and lupus erythematosus are described: reticular whitish patches in the oral mucosa coexisting with chronic, partly atrophic LED-like skin lesions located on the face were present in both of them. The histological, histochemical and immunopathological findings allowed to diagnose a "LP-LE coexistence" more than a mixed LP-LE disease. The clinical, histological and immunological relationships between LP and LE are discussed and it is suggested that the pathogenesis of the coexistence of the two diseases could be related to a common pathophysiological pathway. It might be that LP and LE are due to a single aetiological agent (e.g. a virus) interacting with different genetic backgrounds to cause LE in some, LP in others and an intermediate disease in a small group of patients. The histopathological and immunopathological features that distinguish LP from LE are the concentration of lymphocytes in areas of keratinocyte damage, the different colloid bodies patterns and the direct IF findings. The Authors conclude that further studies should be performed on "LP-LE coexistence".

Adult

[Urinary incontinence and prolapse. Medical treatment and functional treatment].

Urinary continence implies that the variations of the vesical pressure does not exceed the capacities of the cervico-urethral closure system. The aim of the various methods of treatment is to have a beneficial action on those two parameters: drug therapy will mainly reduce the intra-vesical pressure (parasympatholytics...) and also improve the urethral tone (alpha-adrenergics...), or have a mixed effect on both systems (tricyclic antidepressants, oestrogens...). The side effects are often numerous due to the impact on the vegetative or neuromuscular system. The re-education is complemented by: local and general kinesitherapy, sensorial retrocontrol, associated or not to electrotherapy. Motivation and active participation of the patient are essential. The indications covers all the various pathologies (perineal insufficiency, defects in the body pattern, prolapse, sphincteral insufficiency, transmission problems, vesical instability, urethral instability) and concerns patients of all age groups.

Biofeedback, Psychology

Subtypes in major depression without melancholia.

Using the Diagnostic and Statistical Manual of Mental Disorders (DSM III, 1980) criteria to diagnose major depression without melancholia, 70 adult patients were selected for further detailed clinical and neuro-endocrinological evaluation. Two subtypes emerged; changes in sleeping patterns, body mass and thyrotrophin response to thyrotrophin-releasing hormone constituted the distinguishing features between the two categories (P = 0.012).

Adult

General pharmacology of brotizolam in animals.

Brotizolam (2-bromo-4-(2-chlorophenyl)-9-methyl-6H-thieno[3,2-f]-1,2,4-triazolo [4,3-a]-1,4-diazepine, We 941, Lendormin) is a thienotriazolo-diazepine with profound sedative and hypnogenic properties. The side effects of the drug on general behavior, motocoordination, feeding pattern, body temperature, uropoietic and gastrointestinal functions, cardiovascular system, and respiration, as well as interactions with some biogenic amines are reported and discussed. The findings correlate with those known for other diazepines. Accordingly, effects on motocoordination were prominent, but were limited to an ataxia, whereas even extremely high doses scarcely eliminated the postural reflexes. Sleeping animals could invariably be woken and were capable of locomotion; thus, no comatose condition developed. The cardiovascular functions were not appreciably altered by brotizolam in anesthetized cats, while in conscious dogs minor fluctuations of blood pressure and heart rate occurred. Respiration was clearly inhibited when brotizolam was given intravenously. The cardiovascular effects of acetylcholine, norepinephrine, epinephrine, isoprenaline, and histamine were only slightly modulated. The orexigenic and hypothermic effects equalled those of other diazepines. The functions of kidney, stomach, and intestines were not affected. The entirety of the observations procured in ten different species suggest that brotizolam is well tolerated when given orally.

Animals

[Quantity of DNA, sex chromatin bodies and nucleoli in the nuclei of the muscle cells of normal and hypertrophied human atria].

Nuclei of myocytes of normal and hypertrophied human heart atrium were studied on squash preparations. Judging by the sex chromatin body pattern, it is the polyploidization that is responsible for the increased DNA contents in these nuclei. The cytophotometric DNA measurements demonstrated the up to 93% occurrence of polyploid nuclei even in myocytes of normal atrium. Myocytes of hypertrophied atrium contained nuclei of higher ploidy degrees. The total area of nucleoli per nucleus was shown to be proportional to a degree of ploidy.

Adult

[Hemophilia: evaluation of the nutritional status and growth in childhood].

Haemophilia is a bleeding disorder characterized by decreased activity of the circulating antihemophilic factor, with different degrees of severity. The prognosis of the disease for an useful normal life is good, providing an adeguate follow-up. We think that the auxological determinants of growth and nutritional status must enter as points of a multicentre follow-up sheet of haemophilia in the pediatric age. We have tried such an approach in 13 patients; preliminary results have shown that all patients are growing well with some degrees of discrete malnutrition (arm circumference less than -1.6 SD). From costitutional point of view, haemophilic boys show a discrete "lean" body pattern (W/H2 less than or equal to O SD(with their trunk longer than legs. Data from other studies are wellcome for confirming our first impressions.

Anthropometry

Cancer of the prostate: treatment and nursing implications.

PURPOSE/OBJECTIVES: To review the clinical manifestations, current treatment, and nursing management of prostate cancer. DATA SOURCES: Published articles, book chapters, American Cancer Society booklets. DATA SYNTHESIS: Prostate cancer is a slow-growing malignancy and usually is asymptomatic in its early stages. It causes acute urinary obstruction at more advanced stages, and patients may present with metastatic disease. Diagnosis is made by biopsy, and treatment options include periodic observation, surgery, radiotherapy hormonal manipulation, and chemotherapy with standard or investigational drugs or combination therapy. The major complications associated with surgery and radiation therapy are transient or permanent incontinence and impotence. CONCLUSIONS: Because no definitive method for identifying clinically important lesions exists, much controversy surrounds prostate cancer treatment. Issues significant to the diagnosis and treatment of all stages of prostate cancer are identified, and nursing care concerns focusing on treatment and disease-related problems are presented. IMPLICATIONS FOR NURSING PRACTICE: Nursing care focuses on providing patients with accurate information to make informed decisions regarding treatment for early stage disease, on promoting comfort, and on preventing and managing treatment and disease-related complications. Nursing diagnoses include knowledge deficit; altered sexual patterns, body image disturbance, altered urinary elimination, diarrhea, impaired skin integrity, and pain, fatigue, bleeding, and infection, all of which are related to surgery, pathologic fractures, spinal cord compression, and edema of the scrotum/lower extremities.

Humans

Frequency of feeding, weight reduction and energy metabolism.

A study was conducted to investigate the effect of feeding frequency on the rate and composition of weight loss and 24 h energy metabolism in moderately obese women on a 1000 kcal/day diet. During four consecutive weeks fourteen female adults (age 20-58 years, BMI 25.4-34.9 kg/m2) restricted their food intake to 1000 kcal/day. Seven subjects consumed the diet in two meals daily (gorging pattern), the others consumed the diet in three to five meals (nibbling pattern). Body mass and body composition, obtained by deuterium dilution, were measured at the start of the experiment and after two and four weeks of dieting. Sleeping metabolic rate (SMR) was measured at the same time intervals using a respiration chamber. At the end of the experiment 24 h energy expenditure (24 h EE) and diet-induced thermogenesis (DIT) were assessed by a 36 h stay in the respiration chamber. There was no significant effect of the feeding frequency on the rate of weight loss, fat mass loss or fat-free mass loss. Furthermore, fat mass and fat-free mass contributed equally to weight loss in subjects on both gorging and nibbling diet. Feeding frequency had no significant effect on SMR after two or four weeks of dieting. The decrease in SMR after four weeks was significantly greater in subjects on the nibbling diet. 24 h EE and DIT were not significantly different between the two feeding regimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Stature and body weight growth patterns from longitudinal data of Japanese children born during World War II.

Stature and body weight data of 100 boys and 100 girls from 7 to 17 years of age in Shimodate City who were born during World War II were longitudinally analyzed. The children were significantly smaller and lighter throughout their growth period than those born 11 years after the end of the war. The correlation coefficient between statures at each age and at age 17 showed a gradual increase with increasing age, while that between statures at each age and at age 7 decreased with age. However, a drop in the correlation coefficient was found during puberty, at age 11 for girls and at age 13 for boys. Comparing the normalized distance from mean values of stature and body weight at age 7, at puberty, and at age 17, only 51% of the children continued to be in the same relative position for both height and weight, 6% of boys and 4% of girls showing a decreasing pattern for both and 4% of boys and 7% of girls showing an increasing pattern for both. Thus, about 60% of the children of either sex presented parallel stature and body weight growth patterns for ages from 7 to 17.

Adolescent

Insulin sensitivity, glucose effectiveness, and body fat distribution pattern in nondiabetic offspring of patients with NIDDM.

OBJECTIVE: To determine the relationship of insulin sensitivity (SI), glucose effectiveness (glucose-dependent glucose transport [SG]), and body fat distribution patterns in glucose-tolerant offspring of patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Ten glucose-tolerant offspring of patients with NIDDM and 10 age-, sex-, and weight-matched healthy control subjects without family history of diabetes were studied with the minimal model method of Bergman et al. Body fat composition and distribution pattern were assessed by the bioelectrical impedance analyzer and waist-hip circumference ratios (WHR), respectively, in each subject. RESULTS: Mean fasting serum glucose (4.39 +/- 0.17 vs. 3.94 +/- 0.17 mM) and postglucose peak (18.50 +/- 1.50 vs. 13.20 +/- 1.06 mM) levels were significantly greater (P less than 0.05) in the offspring than in the control subjects. Mean fasting serum insulin levels were slightly greater but not significantly different in the offspring versus control subjects (64 +/- 14 vs. 29 +/- 7 pM). After intravenous stimulation with glucose and tolbutamide, the mean serum insulin rose to significantly greater (P less than 0.05) levels at t = 5 and 25 min in the offspring compared with the control subjects. Mean SI was significantly reduced by 45% in the offspring compared with the control subjects (4.77 +/- 0.67 vs. 8.37 +/- 1.24 x 10(-4) min-1.mU-1.L-1). However, SG was not different in the offspring versus control subjects (1.92 +/- 0.12 vs. 2.10 +/- 0.17 x 10(-2) min-1). SI correlated significantly and inversely with the percentage of body fat mass (r = -0.580, P less than 0.05) but not with the WHR (r = -0.019) in the offspring. We found a negative association between SI and basal serum insulin (r = -0.798, P less than 0.01) but not with the poststimulation incremental insulin responses in the offspring. Family history of diabetes independently accounted for at least 27% of variance in the SI in our subjects. CONCLUSIONS: Our study confirmed that insulin insensitivity but not a reduced glucose effectiveness exists in young glucose-tolerant offspring of patients with NIDDM. The reduced S1 appears to be causally related to the total body fat content and may be a familial and/or genetic trait in the offspring.

Adipose Tissue

The alpha beta T-cell receptor repertoire in inclusion body myositis: diverse patterns of gene expression by muscle-infiltrating lymphocytes.

Inclusion body myositis (IBM) is one member of a group of disorders known as idiopathic inflammatory myopathies (IIM) in which autoreactive T cells directed against muscle are thought to play a primary role in disease pathogenesis. We have utilized the polymerase chain reaction to determine the pattern of alpha beta T-cell receptor (TCR) variable (V) gene expression in muscle biopsies from 13 IBM patients. In the majority of biopsies, we detected oligoclonal patterns of TCR V gene expression by muscle-infiltrating lymphocytes; an average of six out of the 22 TCR V alpha gene families surveyed and seven out of 24 TCR V beta gene families surveyed were detected per biopsy. While no TCR V alpha gene families were over-represented in our survey, TCR V beta 3 and V beta 6 gene usage was a prominent feature of IBM muscle biopsies. TCR gene expression was characterized further by analysing the junctional sequence composition of both V beta 3 and V beta 6 clones from muscle biopsies of the IBM patients. A large number of structurally diverse V beta 3 and V beta 6 clonotypes were identified from these patients demonstrating a polyclonal pattern of T cell infiltration. These data, while describing prominent TCR V beta 3 and V beta 6 gene detection, do not suggest that a common antigen-driven T-cell response promotes chronic inflammation in muscle of IBM patients.

Adult

Relationship between spatial pattern of basal bodies and membrane skeleton (epiplasm) during the cell cycle of Tetrahymena: cdaA mutant and anti-membrane skeleton immunostaining.

Microtubular basal bodies and epiplasm (membrane skeleton) are the main components of the cortical skeleton of Tetrahymena. The aim of this report was to study functional interactions of basal bodies and epiplasm during the cell cycle. The cortex of Tetrahymena cells was stained with anti-epiplasm antibody. This staining produced a bright epiplasmic layer with a dark pattern of unstained microtubular structures. The fluorescence of the anti-epiplasm antibody disappeared at sites of newly formed microtubular structures, so the new basal body domains and epiplasmic layer could be followed throughout the cell cycle. Different patterns of deployment of new basal bodies were observed in early and advanced dividers. In advanced dividers the fluorescence of the epiplasmic layer diminished locally within the forming fission line where the polymerization of new basal bodies largely extincted. In wild type Tetrahymena, the completion of the micronuclear metaphase/anaphase transition was associated with a transition from the pattern of new basal body deployment and epiplasm staining of the early divider to the pattern of the advanced dividers. The signal for the fission line formation in Tetrahymena (absent in cdaA1 Tetrahymena mutationally arrested in cytokinesis) brings about 1) transition of patterns of deployment of basal bodies and epiplasmic layer on both sides of the fission line; and 2) coordination of cortical divisional morphogenesis with the micronuclear mitotic cycle.

Animals

Manometric patterns using esophageal body and lower sphincter characteristics. Findings in 1013 patients.

In order to determine the actual spectrum of abnormal esophageal motility, manometric patterns in 1013 consecutive tracings were established using a classification method that employs esophageal body and lower esophageal sphincter (LES) characteristics. Peristaltic performance and contraction wave parameters were measured in the esophageal body; basal pressure and relaxation were included for the LES. Nine hundred thirty (92%) of the tracings could be completely classified, and 33 different patterns were observed (915 occurring at a rate greater than 1%). Abnormalities were most common in contraction wave parameters (661 tracings, 65%), and least common in LES relaxation (105 tracings, 10%). Patterns most typical of achalasia and diffuse esophageal spasm were found in 6.4% and 5.0% of tracings, respectively. Statistical analysis of the patterns demonstrated that significant bidirectional predictive associations between categories were restricted to features representing pathology-based motor disorders (ie, achalasia and "scleroderma-esophagus"). This systematic classification method is capable of recognizing and cataloging common findings of motor dysfunction in the esophageal body and LES as well as uncommon patterns representing traditional motility disorders. Our findings provide reference data for clinical esophageal manometry.

Esophageal Motility Disorders

Non-Q-wave acute myocardial infarction: body surface potential map and ventriculographic patterns.

Day 5 body surface map and radionuclide angiographic patterns were compared among 56 patients with first non-Q-wave or Q-wave acute myocardial infarction (AMI). Three radionuclide angiographic patterns were recognized in patients with non-Q infarction: no wall motion abnormalities (n = 8), single-segment wall motion abnormalities (n = 10) and multiple-segment wall motion abnormalities (n = 9). In contrast, only 2 radionuclide angiographic patterns were identified in patients with Q-wave infarction: multiple-segment wall motion abnormalities (n = 25) and single-segment wall motion abnormalities (n = 4). The Q-wave distributions of 14 of 18 patients with non-Q infarction with 0 or 1 wall motion abnormalities were normal; 2 patients had "missed" anterior; 1 patient had inferior; and 1 had posterior AMI patterns. Of 9 patients with non-Q infarction who had multiple-segment wall motion abnormalities, 8 had infarct Q waves on the posterior torso. Q-wave patterns in patients with anterior (n = 17) and inferior (n = 12) Q-wave infarctions were typical and homogeneous for each group. Quantitative analysis of minimum Q-zone integral, sigma Q-wave integrals, ST-integral maximum, wall motion abnormality score and ejection fraction revealed no differences between patients with non-Q-wave and those with inferior Q-wave infarction. In contrast, patients with anterior AMI had significantly more abnormal values of all variables than either of the other groups. Overall, the data support the concept of non-Q-wave AMI as a distinct, if heterogeneous, pathophysiologic entity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

A basis for determining body surface potential patterns attributable to single-site coronary arterial occlusion.

The authors focus on computational separation of the individual patterns of occlusion of the major segments of the right coronary artery. The raw patterns of occlusion throughout 15 standard subdivisions of the coronary arterial tree and body surface isoarea maps for 8 consecutive 10-msec intervals of QRS were examined in 200 patients with known coronary artery disease. Mean patterns of occlusion and of potential distribution were formed into 15 groups according to which patients showed greater than or equal to 90% occlusion of the respective segments. By diagonalization of the occlusion matrix, individual potential map patterns were obtained to represent the effect of isolated occlusion of each segment. While these patterns appeared consistent with the known anatomy of ventricular myocardial perfusion, further correlative study will be needed. The authors suggest that the use of such prototypical patterns of single-site obstruction may be helpful in forming and assessing recognition patterns in the clinical setting of multiple-site, multiple-vessel disease.

Coronary Disease

Influence of direction of body weight change on pattern of gonadotropin secretion in ovariectomized beef heifers of equivalent body weight.

Our hypothesis was that alterations in pattern of gonadotropin secretion induced by level of dietary energy intake are dependent on direction of BW change. Beef heifers were assigned to one of two treatments 21 d after ovariectomy: 1) increasing followed by decreasing BW (I-D; n = 9) or 2) decreasing followed by increasing BW (D-I; n = 9). Heifers assigned to the I-D treatment received 15.4 Mcal ME/d (HE) from wk 0 to 8 followed by 4.3 Mcal ME/d (LE) from wk 9 to 16. Heifers assigned to the D-I treatment received the LE diet for the initial 8 wk followed by the HE diet for the subsequent 8 wk. At 2-wk intervals blood samples were collected at 10-min intervals for 11 h to determine the pattern of secretion and(or) concentration of gonadotropins in circulation (LH and FSH) and pituitary responsiveness to administration of 750 ng and 50 micrograms of LHRH. Frequency of LH pulses increased (P less than .05) in a quadratic fashion with increasing ADG in heifers in both treatment groups. Amplitude of LH pulses decreased (P less than .05) in a linear fashion with increasing ADG in heifers in both treatment groups and magnitude of this decline was greater (P less than .05) in heifers receiving the D-I treatment. Amplitude of response to 750 ng of LHRH decreased (P less than .05) in a linear fashion with increasing ADG in heifers receiving the D-I treatment but was unrelated to changes in ADG (P greater than .05) in heifers receiving the I-D treatment. When heifers in both treatment groups attained similar BW (P greater than .05; wk 14), amplitude of LH pulses, responsiveness to 750 ng of LHRH and mean concentration of FSH in serum were higher (P less than .05) in heifers receiving the I-D than in heifers receiving the D-I treatment. Thus, we accept the hypothesis that alterations in pattern of gonadotropin secretion in heifers fed diets with a low energy content are dependent on direction of BW change.

Animals

Body fat distribution patterns and blood pressure in black and white women.

The prevalence of obesity and being overweight and the distribution of body fat in relation to blood pressure were assessed in a college population of 181 black and white US women and 124 black Nigerian women. The mean ages ranged from 18.6 to 22.4 years. Twenty-nine percent of black US women were overweight and 12.9% were obese; whereas 13.6% of white US women were overweight and 2.3% were obese. Only 18.6% of Nigerians were overweight and 1.6% were obese. More upper body fat was found among the black US women and Nigerians than among white US women. There was no significant correlation between body fat distribution and blood pressure among Nigerians. In general, among US blacks and whites, there were positive associations among body mass index, waist-hip girth measurements, and blood pressure, particularly for systolic blood pressure.

Adipose Tissue

The blood flow velocity waveform in the fetal descending aorta; its relationship to fetal heart rate pattern, eye and body movements in normal pregnancy at 27-28 weeks of gestation.

In 13 normal pregnancies at 27-28 weeks of gestation the blood flow velocity waveform at the lower thoracic level of the fetal descending aorta was studied in relation to fetal heart rate pattern (FHRP), fetal eye movements (FEM) and fetal body movements (FBM). State parameter combinations in which high fetal heart rate (FHR) variability was present, were associated with a significant reduction in pulsatility index (PI) as compared with periods in which low FHR variability was present, irrespective of FEM and FBM, indicating a reduced peripheral vascular resistance. At 27-28 weeks of gestation FHR variability and PI might be linked to baroreceptor sensitivity. PI values derived from combinations FHRP-A, FEM(-), FBM(-) and FHRP-B, FEM(+), FBM(+) showed a significant inverse relationship (P less than 0.05) with FHR. FHR and FHR variability should be taken into account when studying flow velocity waveforms in the fetal descending aorta at 27-28 weeks of gestation.

Aorta, Thoracic