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At least 721 records · Page 40Linked to original sources
PubMed1984

Myocardial depression by anesthetic agents (halothane, enflurane and nitrous oxide): quantitation based on end-systolic pressure-dimension relations.

The end-systolic pressure-diameter relation of the left ventricle was used to examine the effect of halothane, enflurane and nitrous oxide on left ventricular (LV) contractility in 10 dogs chronically instrumented with dimension transducers to measure LV diameter and micromanometers to measure LV transmural pressure. Contractility was assessed by the slope (EES) of the end-systolic pressure-diameter relation. A new index that identifies the dose of anesthetic necessary to depress the inotropic state by 20% (ID20) was calculated to be 0.63% for halothane and 1.55% for enflurane, indicating a greater apparent myocardial depressant effect of halothane than enflurane. However, when these agents were compared at equi-anesthetic concentrations by normalizing the ID20 to the minimal alveolar concentration of each drug, they had comparable degrees of myocardial depressant effects. This measurement technique was used in 7 patients undergoing coronary artery bypass grafting conducted under narcotic anesthesia showing that halothane induced a similar depression of contractility. The use of ID20 should allow reclassification of anesthetic agents according to their myocardial depressant effects.

Anesthesia↗
PubMed1988

Long-term prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy.

The prognostic significance of ventricular arrhythmias in idiopathic dilated cardiomyopathy is controversial. Thus, 73 patients with idiopathic dilated cardiomyopathy who had both 24-hour Holter monitoring and angiography were followed for greater than or equal to 3 years. Twenty-eight patients (38%) died, 14 patients (19%) due to pump failure and 14 patients (19%) due to sudden death. Univariate analysis revealed ventricular tachycardias as a major risk indicator, among others. However, multivariate analysis determined the major independent risk factors in the following order: patients who died from pump failure, left ventricular filling pressure, left bundle branch block, the number of beats in the longest episode of ventricular tachycardia and left ventricular ejection fraction; patients who died from sudden death, left bundle branch block and left ventricular ejection fraction, but not any form of ventricular arrhythmias. Reclassification by means of the risk factors resulted in a meaningful identification of patients who died from pump failure; however, patients who died from sudden death could not be separated from survivors. Thus, in the present study Holter monitoring was unable to distinguish between patients who died from subsequent pump failure and patients who died from subsequent sudden death.

Adolescent↗
PubMed1990

Electrophysiologic determinants of recurrent atrial flutter after successful termination by overdrive pacing.

The potential ability of electrophysiologic abnormalities to predict recurrence of atrial flutter was evaluated. Twenty-five patients with chronic atrial flutter resistant to combined digitalis and quinidine therapy were studied electrophysiologically after restoration of sinus rhythm by overdrive pacing or by eventual direct current cardioversion. Recurrence of atrial flutter was observed in 12 patients during a mean follow-up period of 17 months (range 3 to 50). Electrophysiologic testing included programmed high right atrial stimulation at a paced drive cycle length of 600 ms and incremental pacing up to 200-ms paced intervals. When coupling intervals of 90% of the drive cycle length were compared to coupling intervals of 48% of the drive cycle length, the increase in S1A1 interval, defined as the interval between the stimulus artifact and the atrial activation near the atrioventricular junction, was greater in patients with subsequent recurrence of atrial flutter (47 +/- 11 vs 21 +/- 18 ms). Stepwise logistic regression analysis identified the S1A1 increase to be the sole independent predictor of recurrence (p = 0.0082) while previous episodes of atrial flutter or the presence of organic heart disease were identified as dependent variables. Reclassification showed a 91% sensitivity and a 92% specificity. Correct classification was achieved in 92% of patients. The initiation of atrial dysrhythmia had no predictive value. The assessment of the S1A1 interval by programmed atrial stimulation appears helpful in delineating the patient risk of recurrent atrial flutter after termination by overdrive pacing.

Atrial Flutter↗
PubMed1978

The importance of recognizing malignant giant cell tumor of soft parts.

Four tumors in the extremities were initially diagnosed as extraskeletal osteogenic sarcoma. Recent review of these tumors had led to their reclassification. Three of these are now recognized as malignant giant cell tumors of soft tissue and one as a malignant fibrous histiocytoma. All four patients have been cured. Some special features of malignant giant cell tumors of soft parts are described. The importance of treatment planning is stressed.

Adult↗
PubMed1977

Bilateral mandibular condylysis-a morphanalytic diagnosis.

Four cases of bilateral mandibular condylysis are presented. The condition does not appear to be included in current teaching or existing nomenclature and consists of an acquired absence of the mandibular condyles, unassociated with temporomandibular ankylosis or aural/facial anomalies. In the literature of condylar maldevelopment four published cases appear to justify reclassification as bilateral mandibular condylysis, bringing the recorded total to eight. Whereas previous writers have regarded the condition as a prenatal condylar aplasia or hypoplasia, morphanalysis studies of the four current cases have shown that the probable aetiology is postnatal local disturbance in the condylar region. The term condylysis has been chosen to emphasise the locally destructive (or lytic) mechanism which appears to be involved. Mandibular condylysis is distinguished from condylar aplasia by its non-association with aural/facial anomalies and because normal development appears to proceed until the lytic event occurs. It is further distinguished from primary and secondary condylar hypoplasia because the condyle is absent rather than small, because normal development appears to proceed until the lytic event occurs and because of its non-association with aural/facial anomalies or temporomandibular ankylosis.

Adolescent↗
PubMed1981

Cluster-oriented discriminant analysis; taxonomic classification of the thyroid function.

A computer assisted procedure for the diagnosis of thyroid diseases, based on seven clinical chemical parameters, is proposed. The population studied consisted of 592 consecutive outpatients with a tentative diagnosis of thyroid disease. Thyroxine, triiodothyronine, T3 uptake test, TSH before and after TRH application, its difference and thyroxine binding globulin have been determined. The patients were clinically examined and in each case a Tc-scintigram was obtained. As a first step, 20 biochemical patterns were defined by cluster analysis (pattern cognition). T check how good in grouping process was, linear discriminant analysis was applied after which the reclassification rates were very satisfactory. The clusters found corresponded well to the pathophysiological situations with some exceptions. As a second step, patients were assigned to these patterns by use of the derived discriminant functions (pattern recognition). The proposed method seems to have some advantages over other diagnostic models published hitherto.

Alpha-Globulins↗
PubMed1992

Pediatric malignant ovarian tumors: a 43-year review.

Thirty-eight girls with malignant ovarian tumors were reviewed and studied during a 43-year period, 1945 to 1988 inclusive. The age range was 3 to 16 years. Eighteen girls were prepubertal and 16 were pubertal at diagnosis. Precocious puberty was noted in 4 children. The most common presenting symptoms and signs were pain, abdominal swelling, and pelvic mass. Emergency surgery for acute pain (? appendicitis) was needed in only 7 patients. Tumor size and cysts did not relate to histology or outcome. Tumors were classified histologically (germ cell, sex cord/stromal, epithelial tumors). Twenty-one (54%) of the patients survived 1 to 27 years (median, 8 years). Sixteen were left with ovarian tissue, 11 functioning. Diagnosis and treatment have been aided by better noninvasive radiological methods, tumor markers, newer and better chemotherapy, and pathological review and reclassification of these tumors as pediatric experience slowly increases. We can make at least four statements that differ from our past experience: (1) pure endodermal sinus tumor was previously confused histologically with embryonal carcinoma; (2) gonadoblastoma is associated with 45,X/46,Y, 45,X, or 46,Y karyotype and is known to be premalignant; (3) sex cord/stromal tumors are not necessarily malignant and metastatic behavior cannot be predicted from the histology; and (4) currently, epithelial tumors are classified as cystadenomas and are considered to be borderline malignancy. Current management should aim at both cure and preservation of fertility with conservative surgery whenever possible. The future must lie in chemotherapy.

Adolescent↗
PubMed1984

Psychosocial factors and smoking as risk factors in lung carcinoma.

In a retrospective study as part of a larger study 419 male patients with bronchial carcinoma were questioned by means of a 'biographical questionnaire' concerning their life history, their personality, and their approach to life. Furthermore questions with regard to their smoking habits (tobacco smoke condensate exposure) were asked. Only patients who smoked cigarettes regularly were involved in the interrogation and the results were compared with those of smoking healthy controls and patients with non-malignant lung diseases (N = 162). For each pair group-controls a discriminant analysis was carried out. By reclassification a correct assignment of approx. 62% in each case could then be obtained. In addition, the answer pattern of the carcinoma patients was compared with a group of patients with non-malignant lung diseases. The results obtained were similar to those of the comparison with the healthy control group.

Arousal↗
PubMed1990

The load of genetic and partially genetic diseases in man. III. Mental retardation.

This paper summarizes estimates of detriment associated with different etiologic categories of mental retardation (MR) in Hungary. The basic data derive from an earlier study carried out in Budapest on 1276 school-age mentally retarded children (with some etiologic reclassification based on recent studies). Detriment associated with these different categories of MR is expressed in terms of years of lost and impaired life. About 30 per 10(3) school-age children in Hungary are mentally retarded (mild + severe MR), one-tenth of whom have severe MR (IQ less than or equal to 50); 50% of the latter are institutionalized. The breakdown on the basis of etiology is as follows: gene mutations and chromosomal abnormalities, about 4 per 10(3); 'familial' (multifactorial) causes, 12 per 10(3); adverse pre-, peri- and post-natal causes, 11 per 10(3); and 'causes as yet unknown', the remainder. The estimates of mean number of years of lost life range from 42 to 68 (depending on the etiologic category), with an overall mean of 58. The total number of years of lost life is about 36,000 per 10(4) live births of which over 70% is due to pre-, peri- and post-natal causes, 18% due to 'familial' causes and the remainder due to Mendelian and chromosomal diseases. The total number of years of impaired life is about 7300 per 10(4) livebirths, 50% of which is due to 'familial' causes. While admittedly approximate, these estimates suggest that detriment associated with MR-related causes is not inconsiderable. Additionally, they provide some indication of causes of MR which are minimizable.

Adolescent↗
PubMed1995

Familial pseudohypoaldosteronism: a review on the heterogeneity of the syndrome.

Pseudohypoaldosteronism is thought to be a rare salt-losing disorder, caused by resistance to the action of aldosterone. Defective aldosterone receptor binding is present in familial as well as sporadic cases and it has been suggested that the pathogenesis is due to a defect in the aldosterone receptor system. To date, however, molecular genetic analysis has been unable to identify a mutation in the aldosterone receptor gene itself. We have reviewed the findings in patients with pseudohypoaldosteronism, for clues which might enable us to identify the underlying pathogenesis. Although aldosterone receptor binding is regularly decreased or absent in monocytes of patients with pseudohypoaldosteronism, in some patients receptor protein can be detected with a fluorescence-labeled antibody. Receptor protein was detected in patients from familial autosomal dominant families and in sporadic cases, but was undetectable in two patients with the familial recessive form. To further elucidate the pattern of inheritance we studied the response of the renin-angiotensin-aldosterone system to the stimulation by sodium depletion in the familial autosomal dominant form and in two families with sporadic cases. In both "sporadic" families investigated, one parent and one sibling had an exaggerated response of renin and aldosterone to sodium depletion indicating a defect of sodium conservation apparent only during stress, leading to reclassification as familial cases. No additional family member in the "classical" autosomal dominant families responded abnormally to sodium depletion. These findings indicate that pseudohypoaldosteronism is unusually heterogeneous in its clinical, biochemical, and genetic presentations and findings and suggest that its pathogenesis is heterogeneous as well.

Genes, Dominant↗
PubMed1979

Stage A2 prostatic carcinoma: should staging system be reclassified?

Seventy patients with clinically localized prostatic carcinoma were studied for histologic differentiation of primary tumor and the incidence of lymph node metastasis. Also the urologic literature was reviewed regarding the survival of such patients under similar treatment. The results indicate that clinically staged A2 tumors are more aggressive biologically than tumors staged as B1, reaffirming the need for a change in the current staging system. The authors propose reclassification of clinically unsuspected, diffuse carcinoma from the A to the B2 stage.

Adenocarcinoma↗
PubMedDate not supplied

The clinical picture of the depressed form of puerperal psychosis.

The clinical features of 104 patients admitted to a mother and baby unit over a 5-year period with RDC diagnoses of depression or schizoaffective depression were studied by self-ratings, measurements of non-verbal behaviour from standardised videotaped interviews, and observer ratings based on multiple information sources. The hypothesis was tested that they included a large subset which represented the depressed form of a bipolar puerperal psychosis. It was deduced that these illnesses would start early in the puerperium, and would have some specific clinical features. A comparison of patients with onset of depression within 2 weeks of delivery with those with onset during pregnancy or much later in the postnatal period showed a number of significant differences. A discriminant function analysis using serial reclassification of atypical patients refined the early-onset group by the exclusion of about one third of the patients who had an atypical clinical picture; the patients who remained, who are considered to represent the depressed form of puerperal psychosis, showed less anger, less self-rated emotion and more animation than the other depressed patients.

Anger↗
PubMed1992

Passive smoking and sister-chromatid exchanges in lymphocytes.

The object of this study was to determine whether exposure to environmental tobacco smoke is associated with DNA damage reflected by the frequency of sister-chromatid exchange (SCE) in lymphocytes. Within a cross-sectional design, 106 male non-smoking adults, employees of two administrative companies, were divided on the basis of self-reported exposure into high and low passive smoking groups. The high exposed subjects (passive smokers, n = 50) lived with smokers, worked with smokers and were exposed to tobacco smoke for an average of 70 h/week. The low exposed non-smokers (n = 56) were exposed for an average of 5 h/week. Plasma cotinine levels for the passive smokers ranged between 0.4 and 9.0 ng/ml (median 1.4 ng/ml), and for the low exposed group between 0.0 and 1.9 ng/ml (median 0.4 ng/ml) (p less than 0.0001; Mann-Whitney test). No difference was observed between the two groups in the frequency of SCEs in lymphocytes: 4.66 +/- 0.05 for passive smokers and 4.68 +/- 0.04 for low exposed non-smokers (mean +/- SEM) (p = 0.80; t-test). Reclassification of subjects on the basis of plasma cotinine levels did not change the results substantially. These results are in accordance with observations that the increase in cancer risk due to passive smoking is small in comparison with the increase due to active smoking. The SCE test may be too insensitive to be useful for the evaluation of possible cytogenetic effects related to passive smoking.

Adult↗
PubMed1993

ADAMS: Aggregate Data Management System for epidemiologists and health-care managers.

An effective health-care policy is supported by the availability of data in the form of statistical tables for epidemiologists and health-care managers. Creation, analysis and exploitation of these data strongly support the monitoring of trends in mortality and morbidity phenomena and the evaluation of offered health services. This might imply the transformation of statistical tables to more suitable formats. A successful management, manipulation and querying of a statistical table is a complex activity requiring a considerable knowledge of statistical problems. Computerised support can be precious in this task and this led to the development of several data management systems. In this paper we sketch out the features of ADAMS (Aggregate Data Management System), a system conceived to allow an easy interaction with statistical tables, reshaping and browsing of their descriptive part. ADAMS aims at simplifying the problem of extracting information from a statistical database and performing statistical table manipulation. The following functionalities are provided: definition of a statistical database at descriptive level; storage of data in the database; manipulation of data according to the summarisation and reclassification operators; browsing between data and their descriptive part. It also supports different manipulation styles according to different user profiles.

Data Interpretation, Statistical↗
PubMed1990

Depression and antidepressant therapy: receptor dynamics.

1. The classical norepinephrine (NE) and serotonin (5-HT) theories of depression have been abandoned in light of recent chronic antidepressant drug studies. 2. The new NE and 5-HT theories of depression focus on the dynamics of receptor subtypes in depression and chronic antidepressant treatments. 3. Recent studies in molecular genetics suggest a reclassification of monoamine receptors based on receptor structural homologies in DNA and amino acid sequences rather than receptor affinity for ligands. 4. Electrophysiologic studies in rats suggest that 5-HT1 receptor function is facilitated by chronic antidepressant treatment. 5. Preclinical studies employing a range of 5-HT1 mediated behavioral models also suggest that chronic antidepressant treatment facilitates transmission at central 5-HT1 receptors. 6. Patient studies, employing a 5-HT1 mediated neuroendocrine model, suggest that depression is associated with decreased transmission at CNS 5-HT1 receptors; and that chronic antidepressant treatment facilitates 5-HT1 receptor responsiveness in depressed patients. 7. New 5-HT1 selective agonists have been developed and found to be clinically effective antidepressants. 8. The above clinical and preclinical data suggest that some forms of depression are related to a decreased responsiveness of 5-HT1 receptors which is reversed by chronic antidepressant treatment. 9. Beta adrenergic and NE-stimulated cyclic AMP studies suggest that chronic antidepressant treatment decreases the responsiveness of central beta-adrenergic receptors, particularly beta-1 receptors. 10. A novel approach to antidepressant drug development focuses on identifying centrally active beta-1 agonists, which like clinically proven antidepressants, decrease beta-1 receptor responsiveness with chronic treatment. 11. 5-HT2 receptor binding studies and initial studies of 5-HT2 receptor coupled PI turnover suggest that chronic antidepressant treatment decreases 5-HT2 receptor number and function. 12. The development of new atypical antidepressants with 5-HT2 receptor related mechanisms of action suggest that 5-HT2 receptors may be associated with certain types of depression and their clinical treatment.

Animals↗
PubMed1987

WDR response profiles of spinal dorsal horn neurons may be unmasked by barbiturate anesthesia.

The number of WDR (convergent, multireceptive) neurons encountered in the spinal dorsal horn of physiologically intact, awake, drug-free cats has been much smaller than expected (9% in intact, drug-free animals). Control studies in barbiturate-anesthetized or spinal cord transected animals indicate that the dearth of WDR neurons was not just an artifact of the chronic recording technique. In those preparations WDR neurons represented 34% and 61% of the sample, respectively. Initial studies in which the effects of light barbiturate anesthesia on spinal dorsal horn neurons (n = 12) have been examined revealed that a 20 mg/kg dose of pentobarbital can, in some neurons (n = 4), unmask thermally evoked activity that was not present in the intact, drug-free animal. Responses to noxious mechanical stimuli were also enhanced following barbiturate administration. These changes resulted in a reclassification of neural type from low threshold in the intact, awake, drug-free animal to WDR in the anesthetized animal.

Anesthetics↗
PubMed1983

Antifreeze glycopeptides of antarctic fishes.

A method is described for analysis of amino acid composition and concentration of antifreeze glycopeptides of Antarctic fish by automatic amino acid analysis of hydrolyzed samples purified by trichloroacetic acid fractionation. Preparations were 98% pure and showed characteristic alanine, threonine and proline compositions. Analyses were carried out in 17 known species of Ross Sea, Antarctica, fishes and in 11 undescribed species tentatively placed in genera, where possible, or families. Collections have been preserved for classification. The results provide evidence of species specificity in amino acid composition and plasma concentration of these substances. Closely related species showed nearly identical Pro/Ala ratios, but differing concentrations. The results do not support reclassification of Trematomus and Notothenia into a single genus or the inclusion of the genus Pleuragramma in the family Nototheniidae. Data obtained for developing ovaries of 6 species showed concentrations of these substances (per unit wet wt) about one-half those of plasma and similar, but not identical, amino acid compositions to those of plasma. The total amount in eggs was 4 times that of plasma in pre-spawning individuals. Calculations are presented to indicate the role of these substances in the protein metabolic economy of the animal for Nototheniidae and Channichthyidae.

Amino Acids↗
PubMed1989

A comparative study of the enzymatic and toxic properties of venoms of the Asian lance-headed pit viper (Genus Trimeresurus).

1. The lethalities, anticoagulant effects, hermorrhagic, thrombin-like enzyme, hyaluronidase, protease, arginine ester hydrolase, 5'-nucleotidase, L-amino acid oxidase, alkaline phosphomonoesterase, phosphodiesterase and phospholipase A activities of twenty-three samples of venoms from twelve species of Asian lance-headed pit vipers (genus Trimeresurus) were examined. 2. The results indicate that notwithstanding individual variations in venom properties, the differences in biological properties of the Trimeresurus venoms can be used for the differentiation of venoms from different species of Trimeresurus. 3. The results also suggest that differences in the biological properties of snake venoms are useful parameters in the classification of snake species. 4. Our results indicate that venoms from the species T. okinavensis exhibited biological properties markedly different from other Trimeresurus venoms examined. This observation supports the recently proposed reclassification of T. okinavensis as a member of the genus Ovophis, rather than the genus Trimeresurus.

5'-Nucleotidase↗