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3894574
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phi 80immP22dis, a hybrid between phi 80 and P22, carries all the late genes of phi 80 and most of the P22 early region including the immC and immI bipartite immunity loci. The presence of the immI region allows this hybrid to grow on lysogens of phi 80immP22 hybrids which have the immC locus, but not the immI locus. In addition to these P22 immunity regions, phi 80immP22dis contains the P22 att marker so that the prophage can be inserted into the chromosomal P22 attachment site adjacent to the proA-proB region of the host. Unlike its phi 80 parent which performs specialized transduction of the trp region, phi 80immP22dis transduces markers located adjacent to its attachment site to Escherichia coli K12 recipients at high frequencies (0.3% for argF and 0.18% for proA). Induction of phi 80immP22dis lysogens yields new hybrid phage clones which have incorporated E. coli K12 chromosomal segments in place of the P22 immI to att segment. Having lost the immI region, the new hybrids no longer grow in phi 80immP22 lysogens. These new hybrids, termed phi 80immP22dis-, possess specialized transducing properties, transferring the argF and proA markers at higher frequencies (21% for argF and 12% for proA) than previously obtained with the phi 80immP22dis phage.
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3894575
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An indirect enzyme-linked immunosorbent assay (ELISA) which uses monoclonal antibody as solid-phase immunosorbent was developed to measure specific polypeptides of respiratory syncytial virus (RSV). The assay was used to examine 43 nasopharyngeal (NP) aspirates from RSV-positive infants that had been examined previously for RSV by culture, direct immunofluorescence, and polyclonal antibody ELISA. Frozen NP aspirates were serially diluted and examined for the 66K mol. wt. fusion glycoprotein (F), the 84K large surface glycoprotein (G) and the 41K nucleoprotein (N) by monoclonal capture ELISA. F protein was detected in all 43 specimens, G protein was detectable in 20 (47%) and N protein in 22 (51%) of 43 NP aspirates. In specimens with detectable G and N proteins, F was detected by endpoint titration at approximately tenfold greater dilutions than either G or N. In 19 sequential NP aspirates from five patients with RSV infection, F was present in higher titre throughout infection. In 20 cases, matching cell culture isolates were examined by immunofluorescence with strain-specific monoclonal antibodies. Three of 20 isolates showed strain-specific differences by their lack of reaction with anti-G monoclonal antibody. Titration of the 20 cell culture isolates by monoclonal antibody capture ELISA showed the relative amount of F and N proteins to be equal in all cases, whereas levels of G protein tended to be slightly lower. Reconstruction experiments with NP aspirates demonstrated that degradation of F and N proteins did not occur in NP aspirates, but that G protein antigenicity appeared to be affected by nasal secretions. When compared with cell culture-grown material, nasal secretions contained abundant F protein but a surprisingly low concentration of N protein.
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3894576
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A retrospective analysis of 33 pregnancies with specific risk of an hereditary malformative pathology is presented. In these cases we have made an echographic diagnosis with careful chronology consequent the data from personal and familial anamnesis. The echographic and clinical diagnoses and the results of pregnancies are presented.
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3894577
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Three cases of triploidy have been diagnosed prenatally on ultrasonography and clinical features. A morphological and histological study of both foetus and placenta is made. The cases and a review of live-born triploid infants published in the literature allow a description of some characteristic malformations. Possibilities of triploïd pregnancy recognition are discussed.
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3894578
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34.2% of couples seen during the years 1982 and 1983 for genetic counselling had some kind of familial anamnesis such as affected partner or relative or children. They could have benefit from prenatal diagnosis who would have been accurate informative twice on three times. Indications methods and accuracy are studied in consideration to the reason of referring and the level of the risk. Genetic counselling and prenatal diagnosis appear as preventive means adapted to each consultant. Otherwise systematic ultrasonography allows a true prevention from which 17.6% of the couples having give birth to affected children could have benefit.
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3894581
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This study was designed to systematically investigate personality, psychophysiological, and cognitive appraisal variables in three groups of mothers, i.e., abusive (N = 14), neglectful (N = 13), and low-income control (N = 15). All subjects completed a Mini-Mult, the Repression-Sensitization Scale, the Group Embedded Figures Test, the Multiple Affect Adjective Checklist, and the Socialization scale of the California Psychological Inventory. They listened to an audiotape sequence of white noise, tone, and infant's cry sounds while cardiovascular and skin resistance measures were recorded. The mothers also rated six dimensions of the infant's cry on a semantic differential. The three groups of mothers differed on a variety of personality variables, e.g., on F, Depression (D), Psychopathic Deviate (Pd), Psychasthenia (Pt), and Schizophrenia (Sc) from the Mini-Mult, on their cognitive appraisal of the infant's cry, and on skin resistance measures. A combination of personality, psychophysiological, and cry rating variables was entered in a discriminant analysis that was successful in discriminating 80% of the subjects. The two significant discriminant functions were defined primarily by the Pd scale and a cognitive appraisal measure.
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3894583
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A high molecular weight fraction XM100R (MW A 100,000) was prepared by ultrafiltration from ovine pineals using two different extraction methods under red light conditions (lambda greater than 600 nm). This fraction stimulates the release of radioimmunologically active luteinizing hormone (LH) of anterior pituitaries in vitro. The ultrafiltration fraction PM30R (MW greater than 30,000 and less than 100,000) was found to be radioimmunologically active only when the "Bensinger" extraction procedure was applied. However, when comparable fractions were prepared under green light and incubated with half-pituitaries, all the incubation media of the ultrafiltrated fractions, XM100R, PM30R, PM10R (MW greater than 10,000 and less than 30,000) UM2R (MW greater than 1000 and less than 10,000), UM05R (MW greater than 500 and less than 1000) and UM05F (MW greater than 500), reacted with anti-LH. This may mean that under green light conditions the high molecular weight ovine pineal compounds in XM100R are disintegrated and/or split up into small molecules which can stimulate the release of LH, or crossreact with the anti-LH serum.
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3894584
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Most patients with metastatic carcinoma of the prostate have osteoblastic bone metastases and nonmeasurable pelvic disease. These features cause patients to be at high risk for myelosuppression after cytotoxic chemotherapy and make it difficult to evaluate response to treatment. A critical review of larger trials that have sought to assess the role of chemotherapy in treatment of carcinoma of the prostate leads to the following conclusions: (1) Although the aim of treatment is palliation, most trials have tried to evaluate tumor response rather than the more appropriate endpoints of quality and quantity of survival for all treated patients. (2) Criteria that have been used for tumor response are variable and contain large inherent errors; most patients who are labeled as "responders" are described as being "objectively stable," but this category may be a manifestation of slowly progressive disease rather than a response to treatment. (3) There is no evidence that chemotherapy causes a meaningful prolongation of survival. (4) Chemotherapy adds considerable toxicity, and reported trials have not adequately assessed its overall impact on quality of life. Because of these factors there is little evidence that chemotherapy provides palliation for patients with prostatic carcinoma, and it should not be regarded as part of standard management. Selected patients who are symptomatic and no longer responding to hormones may be considered for trials of chemotherapy. Future trials should randomize patients to chemotherapy or supportive care, with assessment of quality and quantity of survival for all randomized patients by an observer who is unaware of the treatment.
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3894585
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There is currently no effective systemic therapy for advanced pancreatic cancer. No definitive controlled data exist that demonstrate a survival benefit for any particular regimen yet developed. A statistically significant short-term survival benefit has been seen in three consecutive GITSG trials using the FAMe regimen in patients with advanced gastric cancer. Occasional long-term responders have been seen with a variety of regimens, but there is no evidence of improved long-term (more than two years) disease-free survival with any regimen reported to date. Continuing research with emphasis on new drug development, innovative alterations in chemotherapy combinations and administration schedules, or entirely new treatment strategies, are clearly required to allow the clinical investigator and the clinical practitioner to achieve their common goal--improved long-term survival for patients with advanced pancreatic and gastric cancer.
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3894586
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Sixty-two patients with refractory ovarian carcinoma or other malignancies principally confined to the peritoneal cavity were treated with an intraperitoneal combination chemotherapy regimen consisting of cisplatin (100 mg/m2 or 200 mg/m2) and cytosine arabinoside (4 X 10(-3) mol/L or 10(-2) mol/L). Sodium thiosulfate was simultaneously administered intravenously (IV) to protect against cisplatin-induced nephrotoxicity. Sixteen of 52 evaluable patients demonstrated evidence of a clinical response including 14 (36%) of 39 with refractory ovarian carcinoma. Systemic toxicity was not severe except for cisplatin-induced emesis and a single episode of major renal insufficiency. Dose-limiting toxicity was bone marrow suppression with cytosine arabinoside administered at 10(-2) mol/L. We conclude that combination intraperitoneal therapy with high-dose cisplatin and cytosine arbinoside can be safely administered with objective tumor responses observed in patients with ovarian carcinoma refractory to front-line chemotherapy and in occassional individuals with other malignancies principally confined to the peritoneal cavity.
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3894587
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One hundred fifty-five eligible women with metastatic breast cancer were randomly allocated to receive monthly cycles of either CMFP (cyclophosphamide, methotrexate, 5-fluorouracil, prednisone) or CAF (cyclophosphamide, doxorubicin, 5-fluorouracil), and 12 patients were studied to evaluate the effects of additional Corynebacterium parvum immunotherapy. Overall response rates of 53% were seen with CMFP and CAF. CAF was associated with significantly more complete responses than CMFP (17% v 5%). However, CAF therapy was administered for eight months and CMFP for six months. Only 13% of the CAF patients had a complete response during the first six months of chemotherapy, and this was not significantly different from the complete response rate on CMFP. The median response durations (CMFP, 6.3 months; CAF, 11.0 months), times to treatment failure (CMFP, 5.7 months; CAF, 7.8 months), and survival times (CMFP, 15.8 months; CAF, 18.6 months) were not statistically different. Other investigators who have compared CAF to CMF-containing regimens have reported a large advantage in CAF therapy among patients with "good risk" sites of metastases (local-regional recurrence, bone, lung nodules). Such a finding was not confirmed by our study: in multivariate analyses the groups associated with an advantage for CAF tended to have a poorer prognosis than the groups associated with an advantage for CMFP. There was significantly more nausea and vomiting after CAF treatment, and CMFP treatment was associated with significantly more edema, Cushingoid features, fever, and eye symptoms.
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3894582
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The behavioural, biochemical, neuroendocrinological and electrophysiological actions of the enantiomers of the dopamine (DA) analogue 3-(3-hydroxyphenyl)-N-n-propylpiperidine, 3-PPP, are extensively reviewed. (+)-3-PPP acts in a fashion similar to classical direct-acting DA agonists, stimulating both DA autoreceptors and postsynaptic DA receptors, although in some situations the drug appears to exhibit partial agonist activity. (-)-3-PPP exerts a variety of actions in different pharmacological models. Either agonistic, antagonistic or both agonistic and antagonistic activity are observed depending on the anatomical location of the relevant DA receptors and the experimental conditions. The actions of transdihydrolisuride (TDHL) and the trans-fused 7-OH-1,2,3,4,4a,5,6,10b-octahydrobenzo(f)quinoline (HW 165) are also discussed. These agents possess a similar spectrum of action to (-)-3-PPP suggesting a new generation of DA agonists which exhibit variable intrinsic activity at different DA receptors. Finally, evidence is presented indicating that the 3-PPP enantiomers display selectivity for DA receptors.
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3894588
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Seventy-eight patients with acute nonlymphoblastic leukemia in relapse were treated with high-dose cytosine arabinoside (3 g/m2 intravenously (IV) every 12 hours for 12 doses) alone, or with three days of anthracycline antibiotics (doxorubicin 20 mg/m2 or daunorubicin 30 mg/m2 IV daily) after completing the course of cytosine arabinoside. Consolidation and maintenance therapy was not given. When anthracyclines were added there was no increase in frequency or severity of nonhematologic toxicity including conjunctivitis, photophobia, dermatitis, cerebellar dysfunction, and gastrointestinal disturbance. All 78 patients achieved aplasia of the bone marrow. Five patients in each group died before bone marrow recovery. The use of anthracyclines did not prolong bone marrow recovery, with both groups demonstrating adequate granulocyte and platelet counts about four weeks after beginning treatment. Forty-one (53%) of the total 78 patients achieved a complete remission. In patients not clinically resistant to conventional-dose cytosine arabinoside, both regimens were equally effective inducing a complete remission (high-dose cytosine arabinoside alone, 12/19 [63%]; with anthracycline, 11/17 [65%], P = .270); in patients clinically resistant, the regimen including anthracycline was superior (15/27 [56%] v 3/15 [20%], P = .022). The duration of unmaintained response was similar (median, five months), but the longest remissions occurred when anthracyclines were used. Thus, high-dose cytosine arabinoside is effective in producing remissions in relapsed patients with acute nonlymphoblastic leukemia, and the addition of an anthracycline enhances this effect.
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3894589
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The Gynecologic Oncology Group has conducted a randomized prospective trial comparing cisplatin 50 mg/m2 every 21 days (regimen 1), 100 mg/m2 every 21 days (regimen 2), and cisplatin 20 mg/m2 for five consecutive days repeated every 21 days (regimen 3). Four hundred ninety-seven evaluable patients have been accrued on this study. The response rates were 20.7%, 31.4%, and 25.0%, for regimens 1, 2, and 3, respectively; the complete remission rates were 10.0%, 12.7%, and 8.6% for regimens 1, 2, and 3, respectively. The median duration of response ranged from 3.9 to 4.8 months, the median progression-free interval from 3.7 to 4.6 months, and the median survival time from 6.1 to 7.1 months. The difference in response rates for regimens 1 and 2 is statistically significant (P = .015) but less than the magnitude originally considered clinically significant. The differences in complete remission rates, response duration, progression-free interval, and survival times are not statistically significant. The following types of toxicity were observed: serum creatinine level greater than 2 mg/dL and/or BUN level greater than 40 mg/dL was 7%, 14%, and 17% on regimens 1, 2, and 3, respectively; leukocyte count less than 4,000/microL was 27%, 44%, and 41% on regimens 1, 2, and 3, respectively. Nausea and vomiting occurred in 74 patients (83%). The regimen consisting of a 100-mg/m2 single dose has produced a statistically significant higher response rate than the 50 mg/m2 regimen while producing no appreciable differences in complete remission rate, response duration, progression-free interval, or survival. In addition, the higher dose regimen was associated with greater myelosuppression and nephrotoxicity.
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3894591
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Placing neurons in tissue culture is one way to study how environmental factors affect their differentiation. Replacement of serum-supplementation of the culture medium with defined ingredients extends the experimenter's control of the culture environment; however it also introduces additional potential influences. In this report, we confirm the observation of Higgins and Burton (Higgins, D., and H. Burton (1982) Neuroscience 7:2241-2253) of increased frequency of electrical coupling in serum-free compared to serum-supplemented cultures of rat sympathetic neurons. In addition, experiments were performed to determine whether this effect results from the removal of serum or from the addition of the defined medium components to the culture environment. The results of testing individual ingredients of the defined medium recipe adapted for use on sympathetic neurons (Bottenstein, J.E., and G. H. Sato (1979) Proc. Natl. Acad. Sci. U. S. A. 76:514-517) show that insulin is capable of inducing electrical coupling in serum-free cultures. Thus, the formation of electrical synapses by sympathetic neurons can be hormonally regulated.
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3894592
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High pressure liquid chromatography (HPLC) followed by bioassay on isolated snail hearts were used to locate two related peptides, termed small cardioactive peptides A and B (SCPA and SCPB) in each of the central ganglia of Aplysia. The peptides are most concentrated in the buccal ganglia, the ganglia involved in the control of feeding movements. Immunocytology with antisera raised to conjugated SCPB stained three groups of neurons in the buccal ganglia. One group consisted of relatively small neurons that were tightly clustered. The second group was comprised of larger neurons that were more scattered. The third group was made up of several neurons including the two largest in the ganglia, identified cells B1 and B2. B1 and B2 and other neurons in this group innervate the gut by way of the esophageal nerve. HPLC-bioassay of single, individually dissected B1 or B2 neurons demonstrated that the two peptides are present in a single cell. For B2, but not B1, choline injected into the cell body was converted to the conventional transmitter, acetylcholine. This indicates that, in addition to the two peptides, B2 also contains choline acetyltransferase, and raises the possibility that acetylcholine and the SCPs may act as co-transmitters in B2. Strong immunocytological staining of fibers and varicosities was observed in the neuropilar region of the cerebral, pleural, pedal, and abdominal ganglia. In addition to the buccal ganglia, immunoreactive neurons were observed in all of the other central ganglia. The high concentration of the SCPs and the relatively large number of immunoreactive neurons in the buccal ganglion suggest a particularly important role of these peptides specifically in feeding behavior. However, the widespread occurrence of the SCPs in fibers and neuronal cell bodies throughout the nervous system suggests that these peptides also may have additional behavioral functions in Aplysia.
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3894593
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The morphological and functional differentiation of GABAergic interneurons present in cerebellar primary cultures has been examined by means of [3H]gamma-aminobutyric acid (GABA) autoradiography and [3H]GABA depolarization-evoked release. At 2 days in vitro these neurons showed scarce accumulation of radioactivity and no Ca2+-dependent K+-evoked or veratridine-induced release of [3H]GABA. At 5 days in vitro GABAergic interneurons appeared more intensely labeled and had grown out long and often branched neuritic processes; a large Ca2+-dependent release of [3H] GABA could be evoked by high K+. At later stages the progressive increase in labeling and branching of the neuritic processes was paralleled by a further increase in the amount and Ca2+ dependence of [3H]GABA release; a tetrodotoxin-sensitive, veratridine-stimulated release was also demonstrated. The [3H]GABA-accumulating stellate astrocytes present in the culture were not responsible for the observed release of the amino acid. GABAergic neurons were also identified by indirect immunofluorescence, using antibodies to the specific marker glutamic acid decarboxylase. Total renewal of the culture medium at 7 days in vitro caused a drastic (90%) reduction in the number of GABAergic neurons and a concomitant decrease in the amount of [3H]GABA uptake and release in the cultures. The disappearance of GABAergic neurons was caused by a low molecular weight (Mr less than 1000) fraction of the serum used to supplement the basal culture medium. This serum component did not significantly influence the survival of the major neuronal population of the culture (the granule cells) and appeared to be selectively toxic for GABAergic neurons only after they had reached a quite advanced degree of morphological and functional differentiation in vitro. The toxic activity was no longer present in neuronal or glial conditioned media.
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3894595
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Motor and sensory responses induced by trial stimulation were examined before stereotaxically implanting a permanent stimulating electrode for pain relief in 11 patients with intractable pain of central origin. The total number of points eliciting a response when stimulated was 70. The points of stimulation were determined as exactly as possible from Schaltenbrand and Bailey's Atlas. Motor responses were detected upon stimulating 21 points, the majority of which were in the posterior third of the posterior limb of the internal capsule (IC). Stimulation of these 21 points was accompanied by pain relief in only two points (10%). Warm (22) or cool sensations (three) were provoked in the most posteromedial portion of the posterior limb of the IC, nucleus reticularis pulvinaris, and area triangularis, and seven (28%) of these 25 sensations were accompanied by pain relief. A burning sensation was found upon stimulation of 12 points, with stimulation in the mesencephalic lateral tegmental field eliciting the most severe burning pain. A tingling sensation was elicited at 12 points, in a distribution similar to that of the warm sensation. Five (42%) of these 12 points provided pain relief. The best stimulating point for pain relief is not in the center of the posterior limb of the IC, directly lateral to the posterior commissure, but rather in its most posteromedial part; that is, at the nucleus reticularis pulvinaris or area triangularis.
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3894594
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Astrocytes in culture have very little cell surface fibronectin as detected by iodination or immunocytochemistry. Nonetheless, they synthesize and secrete this glycoprotein in amounts comparable with the production by fibroblasts. Astrocyte fibronectin has properties in common with other forms of the protein. It binds to gelatin- and heparin-coupled Sepharose and it is recognized by specific anti-fibronectin sera. It also exists as a dimer under non-reducing conditions. However, by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE), astrocyte fibronectin appears larger, under both reduced and non-reduced conditions, than other cellular fibronectins. This apparent size difference is not the result of post-translational modifications. If the cultures are treated with tunicamycin, the astrocytes produce fibronectin that is unglycosylated, as shown by [3H]glucosamine labeling, and is neither sulfated nor phosphorylated as indicated by [35S]O4 and [32P]O4 labeling studies. This astrocyte-derived, carbohydrate-free fibronectin resolves on SDS-PAGE as four bands, of which the heavier ones predominate. Fibroblasts produce a similar set of four bands, but in this form of fibronectin the less heavy bands predominate. Thus, we conclude that fibronectin is a major secreted protein of astrocytes in vitro and that these cells produce a variant form of the protein which is enriched in the higher molecular weight subunits.
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3894596
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As a planetary geologist, the author has analyzed results of the various space missions. Based upon this knowledge, he examines the benefits for mankind to be derived from exploration of the solar system. Findings from Venus and Mars have a bearing on Earth's history and geological make-up and climate. Plans to utilize the Moon's minerals and gases are being considered, and the possibility of capturing asteroids as a source of materials has been suggested. The author expresses the hope of peaceful cooperation in space among the major industrialized nations.
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3894598
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A randomized prospective double-blind trial of intrathecal morphine for postoperative pain relief following lumbar spine surgery is described. Intrathecal morphine significantly reduced the mean pain score in the postoperative period (p less than 0.01) and there was a corresponding significant reduction in the need for additional postoperative analgesia (p less than 0.05). The possible mechanism of action of intrathecal morphine and the potential advantages of this technique are discussed. Possible side effects are also considered, and caution is urged until wider experience has been obtained.
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3894597
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Results of a Phase I trial of the opiate antagonist naloxone for treatment of patients with acute spinal cord injury are reported. Naloxone was administered in doses ranging from 5 to 200 mg/sq m (0.14 to 5.4 mg/kg) for up to 48 hours. The patients ranged in age from 16 to 79 years (mean 37 years). Twenty patients received naloxone as a loading dose of 5 to 50 mg/sq m (0.14 to 1.43 mg/kg), followed by a maintenance dose of 20% of the loading dose given as a continuous infusion hourly for 47 hours (Group 1). Nine patients received a loading dose of 100 to 200 mg/sq m (2.7 to 5.4 mg/kg) and a maintenance dose of 75% of the initial dose hourly for 23 hours (Group 2). These higher doses (2.7 to 5.4 mg/kg) have been found to be effective in experimental spinal cord injury. Neurological examinations were performed and somatosensory evoked potentials (SEP's) were obtained as soon after admission as possible and again 1, 2, 3, and 7 days, 3 weeks, and 6 weeks to 6 months after admission. The 20 Group 1 patients who received 1.43 mg/kg or less of naloxone showed no improvement in neurological status or SEP's. All but three (15%) of these patients had a complete neurological deficit at the time of admission. Treatment was begun an average of 12.9 hours after injury. Among the nine Group 2 patients treated with 2.7 mg/kg or more, there were five patients (56%) with incomplete deficits. This group received naloxone an average of 6.6 hours after admission. Two of the five Group 2 patients with incomplete lesions showed improvement in their neurological condition and/or SEP's within 36 hours of receiving the drug. One of the four Group 2 patients with a complete lesion at the time of admission was able to localize pressure sensation in his legs 36 hours after completion of the drug infusion. Four Group 2 patients (two with complete and two with incomplete lesions) have shown improvement in their SEP's, suggesting recovery of SEP's in a dose-related fashion. Four patients experienced increased pain after administration of the loading dose and during the maintenance infusion; in only one patient was this severe enough to require discontinuation of the drug. Of the 29 patients treated with naloxone, four died within 6 weeks of admission, for a mortality rate of 13.8%.(ABSTRACT TRUNCATED AT 400 WORDS)
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3894599
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Thirty-three cases of true human tails have been reported in the modern English literature. A new case is described and its radiological and pathological features are presented. A review of the literature and analysis of the pathological characteristics of this interesting lumbosacral stigma indicate that the true human tail is a benign condition not associated with any underlying cord malformation.
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3894601
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The regulatory role of the liver with regard to circulating concentrations of insulin and glucagon was investigated in rats adapted to high carbohydrate (HC) or high protein (HP) diets, during the period of maximal nutrient absorption. In rats fed HC diet, high secretion of insulin into portal vein in conjunction with low hepatic uptake elicited systemic hyperinsulinemia. In rats fed HP diet, both insulin and glucagon were secreted in large amounts, but hormone removal by the liver was greater than in rats fed the HC diet. Hepatic fractional extraction was higher for insulin than for glucagon: systemic insulin/glucagon ratio was, therefore, lower than the portal insulin/glucagon ratio. Binding of insulin and glucagon to hepatocyte cell membranes was lower in rats fed HP diet than in those fed the HC diet: this could correspond in vivo to a higher rate of internalization of occupied receptors since affinities of the receptors were unchanged. The results indicate that in rats adapted to HP diets the liver undergoes specific adaptations for regulation of peripheral insulin/glucagon levels, along with its role of target tissue for these hormones.
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3894602
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Obese and lean Zucker rats were made diabetic by intracardiac injections of alloxan (65-72 mg/kg body weight) and then given daily injections of protamine zinc insulin [1.25 U/(100 g/d)] for 6, 9 and 12 d. Body weight, food intake, plasma glucose and immunoreactive insulin concentrations were not different for lean and obese diabetic rats of similar ages. Rates of increase in carcass protein, mixed muscle protein and myofibrillar protein were less in obese than in lean rats. However, rates of increase for the sarcoplasmic fraction were not different. Fractional rates of synthesis of total muscle protein and myofibrillar protein, as determined by continuous intravenous infusion of [14C]tyrosine, were comparable in the two genotypes. Fractional rate of myofibrillar protein degradation, as determined by urinary 3-methylhistidine excretion, was higher in obese than in lean rats. Differences in calculated absolute rates between genotypes did not parallel differences in the fractional rates, due mainly to a smaller protein mass in obese rats. As a consequence, absolute synthetic rates were lower in obese rats, while absolute degradation rates were similar in the two genotypes. In contrast, rates of liver protein synthesis were similar in obese and lean rats, whether expressed as fractional or absolute rates. These results indicate that decreased protein deposition in the obese animal is a consequence of both an absolute decrease in protein synthesis in muscle as well as a disproportionately elevated protein degradation in muscle. Hyperinsulinemia normally seen in obese rats may be an adaptive response to minimize the impaired balance between protein synthesis and degradation.
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3894608
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In a randomized, double-blind, placebo-controlled trial, 331 infants aged 6 to 12 months received orally, at an interval of 1 month, either two doses of live attenuated bovine rotavirus vaccine strain RIT 4237 or equivalent placebo. The vaccinations were carried out during September to November, a non-rotavirus season; only three cases of rotavirus diarrhea occurred in the study group before the vaccinations were completed. During the epidemic season from December to May, 31 patients with clinically significant rotavirus diarrhea required therapy. Five of these were among the 168 vaccine recipients, and 26 among the 160 placebo recipients (P less than 0.001), giving a vaccine protection rate of 82%. The incidence of clinically significant diarrhea from all causes was reduced by 76% in the vaccinees. As determined by an enzyme immunoassay antibody test with homologous virus antigen, seroconversion after vaccination was obtained in 53% of the initially seronegative infants. Clinical protection correlated well with seroconversion, but the vaccinees who failed to seroconvert also had less rotavirus diarrhea than the placebo recipients, suggesting that immunity may be mediated by factors other than serum EIA antibody. Seventeen of the 23 rotavirus isolates in the epidemic season that were typed were of serotype 1, two were of serotype 2, and four were of serotype 3. The protection rates against clinically significant diarrhea were 72%, 100%, and 100% for serotypes 1, 2, and 3, respectively. We conclude that epidemic infantile winter diarrhea associated with human rotaviruses can be significantly reduced by vaccination with the live attenuated RIT 4237 bovine rotavirus vaccine before the epidemic season.
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3894611
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A 34-month-old boy with intermittent diarrhoea and abdominal distension from 2 months of age, a chronic microabscess of the cheek, gastric antral narrowing, and perianal abscesses containing granulomata was found at colonscopy to have extensive, noncaseating, submucosal ileal and colonic granulomata. He was initially thought to have Crohn's disease, but then developed a cervical abscess, and a diagnosis of chronic granulomatous disease was established. This is an important, although rare, differential diagnosis of chronic inflammatory bowel disease in childhood.
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3894615
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The reformation of basement membrane antigens was examined during healing following gingivectomy procedures. Three antigens, Type IV collagen, bullous pemphigoid antigen and epidermolysis bullosa acquisita (EBA) antigen, were identified by indirect immunofluorescent tests. While all three antigens could be identified in the healing wound within 2 days, the antigens regenerated at different rates. The bullous pemphigoid antigen reformed the earliest and extended furthest along the healing front of epithelium. The Type IV collagen reformed at an intermediate rate and the EBA antigen formed the slowest. These results confirm that these three antigens are different and suggest that the gingival basement membrane is a heterogeneous structure which contains elements that form at different rates during secondary wound healing.
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3894613
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This study was designed to evaluate the potential for regeneration of a new attachment (alveolar bone, cementum and a functional periodontal ligament) in patients whose attachment apparatus had been destroyed by periodontal disease. In each of the three parts of the investigation, the most apical level of calculus on the root served as a histologic reference point to measure regeneration. In Part I, attempts were made to initiate the formation of a new attachment by surgical debridement, crown removal (coronectomy) and submersion of the vital root below the mucosa. Nonsubmerged, surgically debrided defects served as controls. In Part II, debrided intrabony defects were treated with and without demineralized freeze-dried bone allograft and the associated vital roots were submerged. Part III evaluated potential for regeneration of a new attachment in nonsubmerged roots with and without the use of demineralized freeze-dried bone allograft. Gingival grafts were placed over the experimental and control sites in an attempt to retard epithelial migration. Biopsies were obtained in 6 months and regeneration was evaluated histometrically. Preliminary results in 7 patients and 24 intrabony defects indicate that new attachment is possible on pathologically exposed root surfaces in a submerged environment with and without the incorporation of demineralized freeze-dried bone allografts. New attachment was observed on pathologically exposed root surfaces in a nonsubmerged environment when intrabony defects were grafted with demineralized freeze-dried bone allograft. New attachment was not observed on nongrafted, nonsubmerged, defects with and without the placement of gingival grafts over the defects.
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3894614
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A new method for covering localized areas of root exposure with free connective tissue grafts uses connective tissue obtained from the depth of the hard palate, leaving only a narrow surface defect at the donor site. The graft is positioned directly over the exposed root, but its major part is placed in an "envelope" previously created by an undermining partial thickness incision in the tissues surrounding the defect. In this way, both sides of the graft are in intimate contact with these tissues which offer support and nourishment. Clinical results 2 to 8 months postoperatively are favorable.
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3894619
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SLP is a lambda-like bacteriophage specific for Serratia marcescens strains. Morphological studies have demonstrated that SLP virions present two cross-bar structures on its tail not described in bacteriophages specific for Enterobacteriaceae. SDS-polyacrylamide gel electrophoresis of major capsid proteins as well as electron micrographs are reported.
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3894620
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The potencies of the R and S isomers of thiorphan and rigid analogs of thiorphan to produce analgesia in a mouse hot-plate assay have been compared with their potencies to inhibit enkephalin degradation by rat brain "enkephalinase A." The R and S isomers of thiorphan were equipotent as enzyme inhibitors (IC50 approximately 10(-9) M) but had significantly different analgesic profiles when injected i.c.v. Rigid analogs of thiorphan were less potent enzyme inhibitors (IC50 values of 10(-7) - 10(-4) M) but produced analgesia and potentiated Tyr-D-Ala-Gly-Phe-Met-NH2 induced analgesia at doses (i.c.v.) comparable to thiorphan. These observations suggest that inhibitors of enkephalinase A produce analgesia through a pharmacological mechanism which is not directly related to inhibition of enkephalin degradation.
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3894621
|
Subdiaphragmatic vagotomy caused chronic gastric distension and hypertrophy, and a reduction in voluntary food intake in rats fed a pelleted stock diet. These effects were minimized by feeding a more digestible semisynthetic diet. Vagotomized rats fed the pelleted diet showed lower rates of oxygen consumption than pair-fed controls, and the rise in metabolic rate (thermic response) following gastric intubation with a carbohydrate meal was diminished. This could be restored to normal by simultaneous injection of insulin. Thermic responses to fat and noradrenaline were normal in the vagotomized group. On the powdered semisynthetic diet, vagotomized rats gained more weight and showed greater efficiency of energy gain than pair-fed controls. The thermic response to a single meal of the semisynthetic diet was depressed in these vagotomized rats, but restored to normal by acute insulin treatment. The activity of the thermogenic proton conductance pathway in brown adipose tissue mitochondria (assessed from purine nucleotide binding) was reduced by vagotomy in animals on both diets, but was restored to normal by chronic insulin treatment, which also slightly raised brown fat activity in sham-operated rats. These results demonstrate that the reduced gastric activity and food intake following vagotomy is dependent on the digestibility and/or composition of the diet. When differences in food intake are abolished by pair feeding, vagotomy reduces thermogenic responses to carbohydrate, probably as a result of impaired insulin release. This may be responsible for the enhanced energetic efficiency and elevated weight and energy gains seen after vagotomy.
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3894624
|
The effects of the adrenoceptor blocking agents, phentolamine and propranolol, on the release of pancreatic glucagon and insulin in response to exogenous glucose have been investigated in conscious 2--6-week-old calves. There were no significant differences between the changes in mean plasma glucagon or insulin concentration, which occurred in response to hyperglycaemia, in calves pre-treated with both propranolol and phentolamine, phentolamine alone and normal calves. However, the rise in mean plasma insulin concentration was effectively abolished by pre-treatment with propranolol alone and there was a small but significant fall in mean plasma glucagon concentration which was not observed in any of the other groups. The results are discussed in relation to previous studies of the role of the autonomic innervation to the endocrine pancreas in the control of insulin release during hyperglycaemia in conscious calves and weaned lambs.
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3894623
|
The effects of exogenous glucose (0.05 mmol/kg . min) and vamin (0.02 mmol/kg . min) on the pancreatic endocrine responses to stimulation of the peripheral ends of the vagus nerves have been investigated in conscious 3-6-week-old calves with cut splanchnic nerves. Exogenous glucose potentiated both the basal release of insulin and that which occurred in response to vagal stimulation, while inhibiting both the basal release of glucagon and that during vagal stimulation. Vamin significantly inhibited basal release of insulin but not that which occurred during vagal stimulation although it significantly inhibited vagal release of glucagon. The inhibitory effect of exogenous glucose on the basal and vagally stimulated release of pancreatic glucagon were both significantly reduced in the presence of vamin. Neither glucose nor mixed amino acids were found to affect the release of pancreatic polypeptide either at rest or during nerve stimulation. It is concluded that the effects of vagal activity on the alpha- and beta-cells of the islets of Langerhans are normally modified by the existing concentration of both glucose and amino acids in these animals.
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3894622
|
Urinary Na+ and K+ excretion, plasma aldosterone levels (PAL) and plasma renin activity (PRA) were measured in three groups of four 3-day-old calves infused with aldosterone, ethacrynic acid and hydrochlorothiazide or with vehicle. Aldosterone infusion (16.7 micrograms/kg body wt. given by rapid injection, followed by the infusion of 33.3 micrograms/kg body wt. during 6 h) decreased urinary Na+ concentration and excretion during the 6 h period of infusion. This effect disappeared during the following 18 h. Ethacrynic acid (2 mg/kg body wt. by rapid injection, followed by the infusion of 1.5 mg/kg body wt..h during 6 h) and hydrochlorothiazide (8 mg/kg body wt. by rapid injection, followed by the infusion of 6 mg/kg body wt..h during 6 h) increased urinary volume and urinary excretion of Na+, but decreased urinary K+ concentration without affecting urinary K+ excretion during the 6 h period of infusion. During the same time, the plasma Na+ concentration decreased, PRA increased rapidly and was followed by a significant rise in PAL. These results demonstrate that in very young healthy calves, the renal tubules are able to respond to aldosterone. The renin-aldosterone system is also operative in these animals since it responds to Na+ depletion induced by the combination of diuretics and inhibitors of tubular Na+ reabsorption.
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3894627
|
This study evaluated various techniques for forming ceramic margins on metal-ceramic restorations. Marginal openings were measured using a scanning electron microscope on replicas derived from elastomeric impressions. Ceramic margins formed with a platinum foil backing showed significantly better fit than those formed with direct-lift techniques. With the platinum foil method these ceramic margins displayed a marginal fit comparable to that obtained with cast metal margins.
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3894628
|
The principles of cavity preparation, retention, pin placement, and finishing of the pin amalgam restoration differ in several respects when applied to the pin amalgam when it is intended to serve as a foundation for a cast restoration. A more conservative extension and removal of undermined enamel is indicated because the amalgam will be covered with a cast restoration. The axial reduction required during crown preparation frequently reduces retention of the pin amalgam foundation; therefore, it is necessary to plan for those alterations during the cavity preparation. The degree of finishing and polishing required is determined by the length of time the pin amalgam foundation is expected to function as an interim restoration.
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3894625
|
The effects of iontophoretically applied GABA (gamma-aminobutyric acid) and bicuculline on retinal ganglion cells were studied in the optically intact eye of the anaesthetized cat. GABA suppressed both the spontaneous activity and light-evoked discharge of all retinal ganglion cells, regardless of their type and regardless of the visual stimulus used. Bicuculline antagonized the action of iontophoretically applied GABA. Bicuculline enhanced the spontaneous activity of on-centre cells, but suppressed the spontaneous activity of most off-centre cells. The light-evoked response of on-centre cells was increased by bicuculline. A more complicated picture emerged for off-centre cells. Weak light responses were suppressed by bicuculline, but during strong light responses the initial transient phase of the response was dramatically enhanced. Amacrine cells of the inner nuclear layer and displaced amacrine cells of the ganglion cell layer were labelled, using glutamic acid decarboxylase (GAD) immunohistochemistry and [3H]muscimol uptake. GAD-positive dendrites were found throughout the inner plexiform layer and no sign of dendritic stratification was detected.
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3894626
|
Electrical spiking activity of different parts of the colonic wall was studied in relation to the mechanical events in conscious rats fitted with chronically implanted nichrome wire electrodes and miniaturized strain-gauge transducers. The progress of barium sulphate introduced into the caecum and measured radiographically at fixed intervals was used as an index of transit rate of colonic contents in both the fasted and fed state. The basic pattern of colonic myoelectrical activity was characterized by randomly occurring spike bursts at a higher frequency in the proximal (0.9/min) than the distal colon (0.5/min). Their duration in the fasted state, which was shorter in the proximal (5.5 +/- 1.7 s) than the distal colon (12.7 +/- 2.9 s), was similar following a meal. In the fasted state, integrated records showed cyclical periods of more intense electrical activity lasting about 20 and 40 min in the proximal and the distal colon, respectively. The cyclical pattern following a meal occurred at shorter intervals in the different parts of the colon. Conversely, the propulsion of the marker over the whole colon, which lasted 180-200 min, was accelerated by 30% after feeding. Laxatives disrupted these cyclical motor events on the colon, by inducing mass movements which impeded the pellet formation and increased the rate of transit. The cyclical motor activity was also disrupted following the administration of opiate agonists, the rate of transit being decreased and propulsive activity inhibited. The results are consistent with the concept of cyclical motor pattern playing an important part in the control of pellet formation and movement of digestive contents within the colon of the rat.
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3894630
|
A technique for the use of two stone layers to invest an interim partial denture has been presented. Holding all components on the master cast ensures accuracy.
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3894631
|
A technique is presented to facilitate the fabrication of single or multiple restoration die working casts. The technique allows a full remount potential for use especially in multiple centric relation record verification techniques. A die removal technique that will not damage the brass dowel pin is suggested.
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3894633
|
A technique has been described to ensure positive recovery of a cast by using wax to enlarge teeth that have diastemata and teeth that are periodontally involved with bone loss. On removal of the wax, a void is created in the impression. Stone poured into the void will strengthen the involved teeth so that the cast will not fracture on removal from the impression.
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3894634
|
Three clinical methods for testing marginal fit of complete cast crowns were investigated: the exploration, radiograph, and impression techniques. This work proved that the impression technique is the superior test and should become a standard part of the evaluation routine for complete cast crowns.
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3894635
|
The history of the development of adhesive fixed partial dentures was reviewed and present clinical problems discussed. Longitudinal studies are not available because adhesive prostheses with 4-META adhesive resin were introduced only a few years ago. However, scientific advances will make placement of resin-bonded metal prostheses a more stable, standard technique in fixed prosthodontics.
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3894636
|
A modification of existing designs for resin-bonded retainers has been introduced. This new design is appropriate for the extracoronal splinting of anterior teeth with reduced periodontal support. The design of the splint will accommodate the increased risk of these teeth for endodontic failure. The versatility and advantages of this design have been presented and compared with other anterior splinting techniques. At present, there appears to be no clinically significant difference in the retentiveness of perforated and nonperforated etched metal retainers.
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3894637
|
An improved method for removing dowels from endodontically treated teeth has been presented. It includes a cast supplementary device that supports the tooth while the dowel is being removed. Although the procedure requires more than one appointment, it provides a safe method for removing the dowel from the tooth.
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3894640
|
A special saucer-shaped wax pattern was designed to evaluate the castability of five casting machines and four casting alloys. The casting machines used included one broken arm unit, one induction unit, one resistance unit, and two vacuum air pressure units. The alloys included one base metal alloy, two high-fusing noble metal alloys, and one type III gold alloy. Results of analysis of variance showed that at the 95% confidence level there was a significant difference among casting machines and alloys, the casting machines had a stronger effect on castability. No attempt was made to evaluate the fit quality of the castings with regard to surface roughness or porosity.
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3894641
|
Criteria for an ideal surgical template for immediate dentures were presented. Laboratory and clinical studies were made of five types of templates. The Biostarformed template with improvements, followed by the sprinkled acrylic resin template, best fit the established criteria (Table I).
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3894649
|
Two patients with breast angiosarcoma and hepatic and splenic metastases developed a hemoperitoneum confirmed by ultrasound and CT scan imaging. This complication has further adverse effects on the already extremely poor prognosis of this disease.
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3894651
|
An in-vitro superfusion technique was used to study basal and depolarization-induced (32 mmol K+/l) release of LHRH from the mediobasal hypothalamus (MBH) of pullets at 8-25 weeks of age. Plasma LH concentrations and the incremental change (delta LH) after an i.v. injection of 1 or 15 micrograms synthetic ovine LHRH/kg body weight were also determined. Between 8 and 25 weeks of age, significant (P less than 0.01) increases in basal and depolarization-induced release of LHRH (93 and 330%, respectively) were accompanied by a significant (P less than 0.01) rise in the residual LHRH content of MBH tissue (152%), observations which suggest that the ability of the hypothalamus to synthesize and secrete LHRH increases as sexual maturation proceeds. However, plasma LH, which reached a maximum concentration of 2.05 +/- 0.43 micrograms/l at 15 weeks, fell significantly (P less than 0.05) to 1.14 +/- 0.05 micrograms/l at 25 weeks. Since delta LH in response to exogenous LHRH showed a marked and progressive decline between 12 and 20 weeks of age, the low plasma concentration of LH typical of the mature hen is probably attributable to a direct negative-feedback action of ovarian steroids on the anterior pituitary gland rather than to an impaired secretion of LHRH from the median eminence. It is suggested that a dramatic increase in the responsiveness of LHRH nerve terminals in the MBH to depolarization by 32 mmol K+/l between 20 and 25 weeks of age (mean age at onset of lay 21.9 weeks; range 19-25 weeks) may reflect the development of hypothalamic responsiveness to the positive feedback action of progesterone.
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3894652
|
Using the number of large ovarian follicles (Type 8) as an indicator of sexual maturation we found that urinary compounds released by adult males accelerated puberty while urine from females suppressed hormonal activity in juvenile female European pine voles. The release of chemosignals that delayed puberty of juvenile females was not influenced by ovarian hormones; urine from ovariectomized females was as effective as urine from unoperated animals.
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3894653
|
Boar sperm acrosin isolated by affinity chromatography on p-(p'-aminophenoxypropoxy)benzamidine linked to Sepharose was tested for its proteolytic effect on the zona pellucida of freshly ovulated pig eggs. During 1 h in a physiological medium there was no observable change in the morphology of the zona pellucida but subsequent 125I labelling of the structure followed by electrophoretic analysis revealed that acrosin had asserted a limited and selective proteolysis.
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3894655
|
The anti-sperm activities of a series of monoclonal antibodies to human sperm have been compared using agglutination, immunofluorescence, ELISA and 'panning' assays. The antibodies fell into two categories, those that could be detected by agglutination but not immunofluorescence assays and those that could be detected by immunofluorescence but not agglutination. Antibodies positive in the agglutination assays were also positive in the 'panning' assay. None of the antibodies tested was positive in the ELISA assays. These results, and others, are discussed in relation to the problems associated with the detection of anti-sperm antibodies in sub-fertile human populations.
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3894654
|
Food was withheld from female rats for 0-72 h at various stages of the oestrous cycle. Withholding food for periods of 24 h ending at 12:00 h on the day of pro-oestrus reduced the mating rate from 61 to 25% (P less than 0.05) but not the pregnancy rate of those rats that mated. Fasting for 24 h ending at 18:00 h on the day of pro-oestrus reduced the pregnancy rate from 82 to 18% (P less than 0.05) without affecting the mating rate and a 48-h fast starting at 12:00 h on the day of pro-oestrus reduced the pregnancy rate from 82 to 25% (P less than 0.05). Withholding food for 23 h ending at 17:00 h on the day of pro-oestrus prevented the LH and prolactin surges normally present at 17:00 h on this day. The treatments had no apparent effect on the ability of the adenohypophysis to release LH in response to injections of GnRH. When ovariectomized female rats fasted for 0-72 h and given 2 injections of oestradiol dibenzoate to test the ability of the hypothalamus to respond to an increasing plasma oestradiol concentration by stimulating the release of LH, a fast for 24 h reduced and a fast for 72 h completely prevented LH release.
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3894656
|
Gonozyme, a nonculture enzyme immunoassay for the detection of Neisseria gonorrhoeae antigens from urogenital swab specimens, was approved by the FDA and introduced in the United States in 1982. This assay was compared to standard culture for N. gonorrhoeae in a number of independent studies. In 1983 a modification of the original Gonozyme was developed to improve the specificity of the assay. This modification, which has now replaced the original Gonozyme, was evaluated in clinical studies at eight sites in the U.S.
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3894657
|
A clinical trial compared Chlamydiazyme (Abbott Laboratories, North Chicago, Illinois), an enzyme immunoassay being developed for the detection of Chlamydia trachomatis antigens, with isolation of the organism in cycloheximide-treated McCoy cells. Duplicate cervical swab specimens were obtained from 209 women undergoing abortion. C. trachomatis was isolated after subculturing from 18 of them (8.6%). Chlamydial antigens were found with Chlamydiazyme in 13 (72.2%) of the 18. The same number was detected with primary isolation. The specificity of Chlamydiazyme was 98.4%. Overall, 201 of 209 samples (96.2%) were identified correctly with Chlamydiazyme as compared to isolation after subculturing. Therefore, Chlamydiazyme could be used instead of primary isolation in this population.
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3894658
|
Multiple variations in the types, species and prevalence of cervical bacteria are described in the literature. A review of the literature was undertaken to determine the effect of delay on the ability to identify bacteria. Experiments were initiated to elaborate on those observations. The rate of organism isolation was related to the delay in transport to the laboratory.
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3894659
|
Laboratory methods for the diagnosis of sexually transmitted diseases (STDs) are continuously undergoing improvement. It remains the responsibility of the clinician to become familiar with the tests available for the diagnosis of STDs. Those tests depend on obtaining clinical specimens from the proper site and on transporting them to the laboratory under satisfactory conditions.
|
3894660
|
A skinning vulvectomy and split-thickness skin graft were used in the management of four women with benign vulvar disease after the failure of standard medical and surgical therapy. Three women remain free of the primary disease process, with a follow-up of 12-36 months. One woman with lichen sclerosus and another with "diffuse atrophy" developed recurrent disease in their skin grafts 45 and 96 months, respectively, after skinning vulvectomy. Symptomatic improvement was achieved subsequently in both women with the topical application of testosterone.
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3894661
|
Kidney size was studied ultrasonographically in 101 normal fetuses. A ratio of average kidney diameter to biparietal diameter was established and found to be constant across gestation. Three fetuses with known urinary tract pathology were then studied and were found to have ratios significantly different from normal ones.
|
3894664
|
The author in this paper reviews the recent literature relating to the education of medical students in the area of alcoholism. These articles, from the 1960s, 1970s, and 1980s, are divided into the following topics: attitudes toward alcoholism, measurement of increased knowledge about alcoholism, the status of training in alcoholism, descriptions of alcoholism training programs, and methodological approaches to assessing such programs. While teaching in alcoholism is increasing, the training needs to be expanded even more. The focus of the training should be on experiential/clinical approaches rather than on the more prevalent approach of using lectures in nonclinical settings and should be on changing medical students' attitudes so they will be more understanding of alcoholics and more optimistic about their treatment.
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3894667
|
Pulmonary trichomoniasis is usually caused by aspirated Trichomonas tenax. Adult men with chronic purulent or necrotic pulmonary disease are usually affected. Sixty-eight patients were previously described. A Russian study demonstrated pulmonary trichomoniasis in 19 of 112 patients (17%), mostly in patients with lung cancer, lung abscess, or bronchiectasis. Rarely, pulmonary trichomoniasis may be caused by an intra-abdominal (T. hominis) or genitourinary (T. vaginalis) infection. T. tenax is usually regarded as a harmless commensal of the human mouth. Its prevalence ranges from 4% to 53% and may exceed that of vaginal infection with T. vaginalis in adult females. It is frequently found in patients with poor oral hygiene. Cultural identification is superior to microscopic examination of wet-smear, gram-stained and Papanicolaou-stained preparations. Aspirated pulmonary trichomoniasis is an opportunistic infection. Until the question of possible pathogenicity is resolved, metronidazole should be given. The underlying pulmonary disease should be vigorously treated.
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3894668
|
A competitive ELISA procedure for the detection of Escherichia coli heat stable enterotoxin (ST) with monoclonal antibody has been developed. This test is 10 times more sensitive than the suckling-mouse bioassay and it is specific, simple and cheap. A set of 882 strains of E. coli isolated from man were tested both by ST-ELISA and suckling-mouse bioassay, the latter serving as the reference method. Positive results in both tests were obtained with 152 strains. The remaining strains gave negative results in both tests, with the exception of two strains, known to be ST producers, that gave negative results in the suckling-mouse assay, but gave positive results by the ELISA method.
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3894669
|
Seven materials used in the manufacture of tampons-four rayon, one modified rayon, one cotton and one carboxy-methyl cellulose (a modified cotton)-were compared for their effects in vitro on the physiology of a strain of Staphylococcus aureus isolated from a patient with Toxic Shock Syndrome. Experiments were performed in broth culture and, with the exception of two rayon samples, all of the materials tested reduced growth rate and cell yield compared with control values. Exocellular acid phosphatase, lipase, proteinase, hyaluronate lyase and haemolysin in culture filtrates were measured and the lethality of filtrates was determined in mice. The tampon materials had different effects on the levels of exocellular products. Cotton and carboxy-methyl cellulose cotton materials reduced the levels of all of the activities tested. The activities of the other enzymes were reduced or increased, depending on which material was present. All materials reduced both haemolytic activity and lethality of the culture filtrates. The in-vitro data suggest an extremely complex interaction between tampon materials and S. aureus.
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3894670
|
The effect of pretreatment of denture acrylic with chlorhexidine gluconate on the subsequent adherence of Candida albicans GDH 2346 was measured in vitro. Adherence was significantly reduced by pretreatment with chlorhexidine; maximal inhibition was achieved by incubation at room temperature for 30 min in 2% chlorhexidine. Inhibition of adherence was greatest when the organisms were grown in conditions that enhanced adherence the most, i.e., growth to stationary phase in high concentrations of galactose and sucrose. Yeasts grown in high concentrations of galactose, which were the most adherent to acrylic, were also the most sensitive to the fungicidal action of chlorhexidine gluconate, whereas those grown in a low concentration of glucose were the least adherent and also the most resistant. Adherence to acrylic of seven strains of C. albicans isolated from active infections (I strains) and grown in medium containing 500 mM sucrose was significantly higher than that of four strains obtained from asymptomatic carriers (C strains). A spectrum of adherence values was obtained when various yeasts other than C. albicans were tested.
|
3894672
|
Segmentation of large areas of light microscopic slides into N by N fields, and each of these fields into M digital image tiles, allows the scanning, storage and digital processing of large images. Any of the original N2 fields or composites of M adjacent tiles can be recalled to the video display for analysis. Developed procedures for use on a microscope equipped with a precision scanning stage allow registration of the image coordinates (X-Y) for any original or composite field and the alignment of one of these fields along the depth (Z) axis by means of external, machined fiducial marks in serial sections. To facilitate work whenever unavoidable, we have incorporated methods for digital image panning and zooming (changes of magnification) and discuss their use and implications.
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3894671
|
The present paper is concerned with an experimental study of effects of some agents on parameters pertinent to host resistance to infection of Serratia marcescens (S. marcescens) which was isolated from a patient. The results obtained are the following: In the control mice injected intravenously with S. marcescens, most of the bacteria were trapped in the liver, spleen and lung, the so-called reticuloendothelial system (RES), and the number of bacteria decreased gradually with time. In the kidney, the bacterial count did not decrease because of the existence of few macrophages in this organ. In the animals treated with X-irradiation and cyclophosphamide, the mortality rate increased, and the number of S. marcescens in the organs increased significantly with time. These observations were irreversible in the X-irradiated group, but were reversible in the cyclophosphamide-treated group, depending on the challenge dose. In the mice treated with carrageenan, which functions as a macrophage blocker, the mortality rate did not increase significantly, but there was a delay before the bacteria were eliminated from the liver indicating that the bacteria were not killed in the early phase. After intraperitoneal administration of proteose peptone, polymorphonuclear cells (PMNs) and macrophages accumulated in the peritoneal cavity on the 1st day and 4th day. When S. marcescens was injected intraperitoneally to these 2 groups. The 50% lethal dose (LD50) did not increase significantly in each group. After intraperitoneal inoculation of S. marcescens in a dose equal to 1.5 LD50 in normal mice, the elimination of bacteria from the peritoneal cavity was very rapid in the mice pretreated with proteose peptone.(ABSTRACT TRUNCATED AT 250 WORDS)
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3894674
|
When the chemical carcinogen N-2-acetylaminofluorene binds to DNA in vivo, two major adducts are formed, both at position C-8 of the guanine residue. One of these (the acetylaminofluorene adduct) retains the acetyl group, while the other (the aminofluorene adduct) is the corresponding deacetylated form. Unlike -AAF adducts, which trigger important structural changes of the DNA secondary structure (either the insertion-denaturation model or the induction of a Z-DNA structure, depending upon the local nucleotide sequence), -AF adducts bind to the C-8 of guanine residues without causing any major conformational change of the B-DNA structure. Well-defined adducts (either -AF or -AAF) can be formed in vitro by reacting DNA with either N-hydroxy-N-2-aminofluorene or N-acetoxy-N-2-acetylaminofluorene. Specific cleavage of the phosphodiester backbone at -AF adducts can be achieved by treating -AF-modified DNA in 1 M-piperidine at 90 degrees C. This observation led us to construct the spectrum for -AF binding to a defined DNA restriction fragment. It is found that only guanine residues react to form alkali-labile lesions and that the reactivity among the different guanines is similar. In a forward mutation assay, namely the inactivation of the tetracycline resistance gene, we found previously that more than 90% of mutations induced by -AAF adducts are frameshift mutations. Using the same assay, we show here that -AF adducts induce primarily base substitution mutations (85%), mainly of the G to T transversion type. There is therefore a strong correlation between the nature of the carcinogen-induced conformational change of the DNA structure and the corresponding mutation specificity. The -AF-induced base substitution mutations depend upon the umuC gene function(s). The data obtained in our forward mutation assay are compared to the data previously obtained in the histidine reversion assay (Ames test).
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3894673
|
The amide group of glutamine is a source of nitrogen in the biosynthesis of a variety of compounds. These reactions are catalyzed by a group of enzymes known as glutamine amidotransferases; two of these, the glutamine amidotransferase subunits of p-aminobenzoate synthase and anthranilate synthase have been studied in detail and have been shown to be structurally and functionally related. In some micro-organisms, p-aminobenzoate synthase and anthranilate synthase share a common glutamine amidotransferase subunit. We report here the primary DNA and deduced amino acid sequences of the p-aminobenzoate synthase glutamine amidotransferase subunits from Salmonella typhimurium, Klebsiella aerogenes and Serratia marcescens. A comparison of these glutamine amidotransferase sequences to the sequences of ten others, including some that function specifically in either the p-aminobenzoate synthase or anthranilate synthase complexes and some that are shared by both synthase complexes, has revealed several interesting features of the structure and organization of these genes, and has allowed us to speculate as to the evolutionary history of this family of enzymes. We propose a model for the evolution of the p-aminobenzoate synthase and anthranilate synthase glutamine amidotransferase subunits in which the duplication and subsequent divergence of the genetic information encoding a shared glutamine amidotransferase subunit led to the evolution of two new pathway-specific enzymes.
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3894675
|
A 150 picosecond molecular dynamics computer simulation of the C-terminal fragment of the L7/L12 ribosomal protein from Escherichia coli is reported. The molecular dynamics results are compared with the available high-resolution X-ray data in terms of atomic positions, distances and positional fluctuations. Good agreement is found between the molecular dynamics results and the X-ray data. The form and parameters of the interaction potential energy function and the procedures for deriving it are discussed. Some current misunderstandings concerning the ways of evaluating the efficiency of molecular dynamics algorithms and of application of bond-length constraints in protein simulations are cleared up. The 150 picosecond trajectory has been scanned in a search for correlated motions within and between secondary structure elements. The beta-strands have diffusional stretching modes, and uncorrelated transversal displacements. The dynamic analysis of alpha-helices shows a variety of features. The atomic fluctuations differ between the helix ends; this effect reflects long time-scale motions. Two alpha-helices, alpha A and alpha C, show diffusive longitudinal stretching modes. The third helix, alpha B, has a correlated asymmetric longitudinal stretching; the N-terminal part dominates this behaviour. Furthermore, alpha B presents a librational motion with respect to the other parts of the molecule with a frequency of approximately 5 cm-1. This motion is coupled to helix stretching. Interestingly, the regions of highly conserved residues contain the most mobile parts of the molecule.
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3894676
|
The morphologic-functional correlative studies that we have carried out in the past 25 years with the various catecholamines have served as an example for analyzing myocardial reaction patterns and the reactions of the cardiac muscle cells to insult. These studies disclosed the unique nature of isoproterenol in producing 'infarct-like' myocardial necrosis. It appears that the pathogenesis of the catecholamine-induced myocardial necrosis is multifactorial. Our early studies suggested the role of relative hypoxia. Later studies by using extracellular fine structural protein tracers demonstrated the importance of microcirculatory effects as well as, in the norepinephrine model, that of early sarcolemmal membrane permeability alteration. The Ca2+ overload theory is supported not only by the experimental observations but also by its successful application in clinical cardiology. A new contribution is the recognition of catecholamine oxidation products in producing myocardial injury. Experimental data indicate that catecholamines play an important role in reperfusion and ischemic myocardial injuries. The sequence of events demonstrated by our studies with catecholamines might represent a common pathway in the evolution of myocardial changes in humans who develop myocardial lesions without narrowing or obstruction of coronary arteries. Investigation in the field of molecular and cellular cardiology has led to a better understanding of current clinical problems and helped to devise procedures for the prevention and management of human myocardial disorders. The isoproterenol-induced myocardial necrosis served as model to Professor A. Fleckenstein to formulate the Ca2+ overload theory of myocardial injury and develop a series of now widely used Ca2+ antagonistic drugs for the management and the prevention of human myocardial diseases.
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3894678
|
The effects of ketosis on the norepinephrine-induced high rates of cardiac uptake of non-esterified fatty acids (NEFA = free fatty acids = FFA) and oxygen consumption were studied in anesthetized intact dogs. After a control infusion of norepinephrine (500 ng/kg.min into the left ventricle), the D(-) isomer or natural form of 3-hydroxybutyrate was infused intravenously as the arginine salt at rates of 20 mumol/kg.min in group A (10 dogs) and 80 mumol/kg.min in group B (10 dogs) and a second norepinephrine infusion was superimposed on the ketone treatment. At the time the effects of the second catecholamine infusion were measured, the arterial 3-hydroxybutyrate concentration averaged 1.2 +/- 0.1 mM in group A and 8.3 +/- 0.4 mM in group B, and the cardiac uptake of the ketone amounted to 17.4 +/- 0.6 and 35.8 +/- 5.3 mumol/min.100 g, respectively. Relative to the control norepinephrine infusion, the arterial NEFA concentration was reduced to 88 +/- 4% in group A and to 62 +/- 8% in group B, but the cardiac uptake of NEFA was significantly more depressed, to 65 +/- 7% in group A and to 35 +/- 8% in group B. These changes were not observed in ten non-ketotic animals under repeated norepinephrine infusion. Thus, ketosis inhibited the norepinephrine-stimulated uptake of NEFA, presumably through (1) a lowered availability of NEFA from arterial blood, attributable to a reduction of extracardiac lipolysis, and (2) competition of 3-hydroxybutyrate with NEFA for metabolism by the myocardium in the face of still high arterial NEFA concentrations, 1.7 +/- 0.1 mM in group A and 1.1 +/- 0.2 mM in group B. In both groups, the lowering of the contribution of NEFA to cardiac metabolism was associated with a reduction of the estimated oxygen demand per beat (ratio of cardiac oxygen consumption/min to the pressure-rate product), while the pressure response to norepinephrine was not modified. There was no evidence for abnormal cardiac function.
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3894677
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Acute histologic and ultrastructural changes, quantification and regional distribution (transmural, circumferential, transaxial) of damaged myocells from anesthetized, open-chested dogs following one hour of intravenous infusions of saline or increasing doses of isoproterenol (0.1, 1.0, 2.5 micrograms/kg/min) or norepinephrine (4.0 micrograms/kg/min) were investigated. Two predominant subsets of acute contraction band lesions were produced: 'paradiscal' involving aggregation of less than 15 sarcomeres adjacent to the intercalated disc and 'holocytic' involving coagulation of groups of adjoining sarcomeres into transverse bands interspersed with areas of myofibrillar rhexis throughout the cell. Both lesions were distributed as isolated cells or as small foci of myocells surrounded by normal myocardium. Quantification of 'paradiscal' and 'holocytic' contraction band lesions/mm2 of area was used as an index of the severity of catecholamine-induced necrosis. Numbers of 'paradiscal' myocells increased with increasing doses of isoproterenol, while 'holocytic' myocells were not present in any significant numbers until 1.0 microgram/kg/min) and increased further at 2.5 micrograms/kg/min. 'Paradiscal' myocells with both isoproterenol (2.5 micrograms/kg/min) and norepinephrine were distributed with the greatest number in the inner third of the free wall. This gradient was not significant for 'holocytic' lesions. There was, generally, no significant difference in distribution of either type of lesion around the circumference. However, transaxially there was a higher frequency of 'paradiscal' lesions at the apex with norepinephrine. The lesions were identical and present in comparable numbers at both the highest dose of isoproterenol and with norepinephrine. Thus, these two catecholamines result in a similar cardiotoxicity, each with two predominant subsets of lesions, despite their hemodynamic diversities.
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3894680
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Eight patients presenting with severe unilateral pulmonary injury responded poorly to conventional mechanical ventilation. Synchronous independent lung ventilation (SILV) was employed to provide support of ventilation and oxygenation without creating the ventilation/perfusion (V/Q) mismatch observed during conventional ventilation. All patients demonstrated improved oxygenation (mean increase, 80 torr) during SILV with the FIO2 unchanged from previous therapy. Invasive hemodynamic monitoring in five of eight patients showed no difference in the commonly measured cardiopulmonary parameters with the two forms of mechanical ventilation. Peak inspiratory pressure (PIP), continuous positive airway pressure (CPAP), and pressure change secondary to tidal volume delivery to the uninvolved lung were significantly less during SILV. SILV is an effective method of improving oxygenation in patients with severe unilateral pulmonary injury.
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3894679
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To test the hypothesis that cardiodynamic responses during endotoxemia are limited by intrinsic myocardial dysfunction, we studied contractile properties of isovolumic left ventricular (LV) preparations isolated from E. coli endotoxin-shocked guinea pigs. Compared to control hearts, shock hearts developed significantly lower LV systolic pressures (54 +/- 7 v. 84 +/- 2 mmHg; P less than 0.001) and maximal rates of LV pressure rise (+dP/dtmax; 886 +/- 106 v. 1246 +/- 39 mmHg/s; P less than 0.006) and fall (-dP/dtmax; 702 +/- 98 v. 1103 +/- 26 mmHg/s; P less than 0.001). The LV mechanical disadvantage of shock hearts was not correlated with changes in beating frequency, active state duration, or tissue water content; neither was it surmounted by pyruvate nor by maximally effective increases in coronary flow, diastolic stretch, or extracellular Ca2+ concentration. These findings suggest that endotoxin pathogenesis encompasses a decrease in intrinsic contractile reserves of the left ventricle, and that the resulting changes in myocardial contractile mechanisms may underlie cardiac involvement in endotoxin shock syndromes.
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3894681
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The interaction between trypomastigotes of Trypanosoma cruzi, amastigotes of Leishmania mexicana mexicana and tachyzoites of Toxoplasma gondii with chicken macrophages, obtained by cultivation of blood monocytes, was studied. Mouse macrophages were used for comparative purposes. All three protozoa are ingested by chicken macrophages. However, only T. gondii survives within cytoplasmic vacuoles. Trypomastigotes of T. cruzi and amastigotes of L. mexicana are destroyed within endocytic vacuoles of chicken macrophages, independently of the temperature of incubation (33 or 37 degrees C), while multiply within mouse macrophages. By use of horseradish peroxidase labeling of the chicken macrophage lysosomes we show that fusion of lysosomes with phagocytic vacuoles containing T. cruzi occurs. We also show, using ultrastructural cytochemistry, the presence of H2O2 within endocytic vacuoles containing T. cruzi. These results suggest that cellular mechanisms, besides the well known effect of complement, play some role in the refractiveness of birds to trypanosomatids.
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3894682
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An enzyme-linked immunosorbent assay (ELISA) using crude Schistosoma haematobium soluble egg antigen (ShSEA) was compared with a radioimmunoassay (RIA) employing purified heterologous species S. mansoni egg antigen (MSA1) for the serodiagnosis of schistosomiasis haematobium in a group of 45 Nigerian school children living in an area endemic for S. haematobium. Both assay systems appeared applicable. The ELISA proved to be more sensitive detecting 100% of the 27 parasitologically positive individuals while the RIA defined 89% of this group. Neither test had false-positive results for the 10 non-endemic area parasitologically negative controls, although the ELISA demonstrated that 56% of the 18 endemic area parasitologically negative controls had anti-ShSEA antibodies. The RIA indicated that 44% of this group had anti-MSA1 antibodies. These latter findings were interpreted as related to the hyperendemicity of schistosomiasis haematobium for the study area.
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3894683
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The first case of mycetoma caused by Aspergillus nidulans has been described from India in a young farmer of Jaisalmer situated in the Thar desert of Western Rajasthan, India. The diagnosis was confirmed by histopathological and mycological studies.
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3894684
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Plaque morphology indicated that the five Escherichia coli K1-specific bacteriophages (A to E) described by Gross et al. (R. J. Gross, T. Cheasty, and B. Rowe, J. Clin. Microbiol. 6:548-550, 1977) encode K1 depolymerase activity that is present in both the bound and free forms. The free form of the enzyme from bacteriophage E was purified 238-fold to apparent homogeneity and in a high yield from ammonium sulfate precipitates of cell lysates by a combination of CsCl density gradient ultracentrifugation, gel filtration, and anion-exchange chromatography. The enzyme complex had an apparent molecular weight of 208,000, as judged from its behavior on sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and was dissociated by sodium dodecyl sulfate at 100 degrees C to yield two polypeptides with apparent molecular weights of 74,000 and 38,500. Optimum hydrolytic activity was observed at pH 5.5, and activity was strongly inhibited by Ca2+; the Km was 7.41 X 10(-3) M. Rapid hydrolysis of both the O-acetylated and non-O-acetylated forms of the K1 antigen, an alpha 2----8-linked homopolymer of N-acetylneuraminic acid, and of the meningococcus B antigen was observed. Limited hydrolysis of the E. coli K92 antigen, an N-acetylneuraminic acid homopolymer containing alternating alpha 2----8 and alpha 2----9 linkages, occurred, but the enzyme failed to release alpha 2----3-, alpha 2----6-, or alpha 2----9-linked sialic residues from a variety of other substrates.
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3894686
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Aleutian disease virus (ADV) infection was analyzed in vivo and in vitro to compare virus replication in cell culture and in mink. Initial experiments compared cultures of Crandell feline kidney (CRFK) cells infected with the avirulent ADV-G strain or the highly virulent Utah I ADV. The number of ADV-infected cells was estimated by calculating the percentage of cells displaying ADV antigen by immunofluorescence (IFA), and several parameters of infection were determined. Infected cells contained large quantities of viral DNA (more than 10(5) genomes per infected cell) as estimated by dot-blot DNA-DNA hybridization, and much of the viral DNA, when analyzed by Southern blot hybridization, was found to be of a 4.8-kilobase-pair duplex monomeric replicative form (DM DNA). Furthermore, the cultures contained 7 to 67 fluorescence-forming units (FFU) per infected cell, and the ADV genome per FFU ratio ranged between 2 X 10(3) and 164 X 10(3). Finally, the pattern of viral antigen detected by IFA was characteristically nuclear, although cytoplasmic fluorescence was often found in the same cells. Because no difference was noted between the two virus strains when cultures containing similar numbers of infected cells were compared, it seemed that both viruses behaved similarly in infected cell culture. These data were used as a basis for the analysis of infection of mink by virulent Utah I ADV. Ten days after infection, the highest levels of viral DNA were detected in spleen (373 genomes per cell), mesenteric lymph node (MLN; 750 genomes per cell), and liver (373 genomes per cell). In marked contrast to infected CRFK cells, the predominant species of ADV DNA in all tissues was single-stranded virion DNA; however, 4.8-kilobase-pair DM DNA was found in MLN and spleen. This observation suggested that MLN and spleen were sites of virus replication, but that the DNA found in liver reflected sequestration of virus produced elsewhere. A final set of experiments examined MLN taken from nine mink 10 days after Utah I ADV infection. All of the nodes contained ADV DNA (46 to 750 genomes per cell), and although single-stranded virion DNA was always the most abundant species, DM DNA was observed. All of the lymph nodes contained virus infectious for CRFK cells, but when the genome per FFU ratio was calculated, virus from the lymph nodes required almost 1,000 times more genomes to produce an FFU than did virus prepared from infected cell cultures.(ABSTRACT TRUNCATED AT 400 WORDS)
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3894688
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From 1976 to 1983, 13 living related and 54 cadaver renal transplants were done in 62 patients more than 50 years old. Patients with no coronary or myocardial disease upon coronary angiography were selected preferentially for transplantation. Over-all 1-year patient and graft survival rates were 88 and 70 per cent, respectively. Among cadaver recipients graft survival was improved (p less than 0.001) when prophylactic antilymphoblast globulin was used. There were fewer steroid-related complications (p less than 0.001) in recipients managed with a low dose rather than a high dose maintenance prednisone regimen. With careful patient selection and a steroid-sparing immunosuppressive regimen, renal transplantation can be done safely in older recipients with no increased risk of death or graft loss.
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3894685
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Hybridomas secreting monoclonal antibodies specific for the adenovirus early region 1A (E1A) proteins were prepared from BALB/c mice immunized with a bacterial trpE-E1A fusion protein. This protein is encoded by a hybrid gene that joins a portion of the Escherichia coli trpE gene and a cDNA copy of the E1A 13S mRNA (Spindler et al., J. Virol. 49:132-141, 1984). Eighty-three hybridomas that secrete antibodies which recognize the immunogen were isolated and single cell cloned. Twenty-nine of these antibodies are specific for the E1A portion of the fusion protein. Only 12 of the monoclonal antibodies can efficiently immunoprecipitate E1A polypeptides from detergent lysates of infected cells. E1A polypeptides were analyzed on one-dimensional, sodium dodecyl sulfate-polyacrylamide gels and two-dimensional, isoelectric focusing polyacrylamide gels. The E1A proteins that are specifically immunoprecipitated by the monoclonal antibodies are heterogeneous in size and charge and can be resolved into approximately 60 polypeptide species. This heterogeneity is due not only to synthesis from multiple E1A mRNAs, but also at least in part to post-translational modification. Several of the monoclonal antibodies divide the E1A polypeptides into immunological subclasses based on the ability of the antibodies to bind to the antigen. In particular, two of the monoclonal antibodies bind to the polypeptides synthesized from the 13S E1A mRNA, but not to other E1A proteins.
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3894689
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A simple technique of translumbar splenectomy during renal and pancreatic transplantation is described. This unique approach was used in 18 patients. Postoperative septic complications must be considered.
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3894690
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A parallel incision, unstented extravesical ureteroneocystostomy was used in 203 human kidney transplants. The reoperation rate was 1 per cent. Extravasation of urine occurred in 3 patients, 1 of whom required surgical repair. One patient required transurethral fulguration of a ureteral bleeder. Two patients had grade 1 reflux and none required repair. No patient had ureteral obstruction at the anastomosis. This simple technique is useful because ureteral length and bladder dissection are minimal, and no separate cystotomy is required. The adequacy of the submucosal tunnel is judged when the ureter is passed through it.
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3894691
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Intravenous digital subtraction angiography has been performed on 39 patients with renal carcinoma. In 19 patients (group 1) imaging of the renal arteries was done following injection of 40 cc intravenous contrast medium through an antecubital vein. In 20 patients (group 2) 40 cc intravenous contrast medium were injected through a femoral vein and digital subtraction imaging of the inferior vena cava was obtained. In 12 of these patients the renal arteries also were visualized from the same injection of contrast medium. Intra-arterial digital subtraction angiography of the renal arteries also was done in 5 patients in group 2. Intravenous digital subtraction angiography satisfactorily demonstrated main renal arterial anatomy in 29 of 35 patients (83 per cent) over-all but failed to delineate the renal mass in most cases. Excellent visualization of the inferior vena cava was obtained in all 20 patients in group 2. Intraarterial digital subtraction angiography yielded an accurate diagnosis of renal carcinoma in all 5 patients with minimal doses of contrast medium. We conclude that intravenous digital subtraction imaging combined with computerized tomography scanning or ultrasonography yields satisfactory diagnostic and anatomical information for most patients with renal carcinoma.
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3894692
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The diagnosis of transitional cell carcinoma by cytological examination of exfoliated urinary cells is important in the early detection and followup of patients with this disease. Proper interpretation requires a skilled pathologist. Accuracy also is influenced by collection methods and nonmalignant pathological conditions of the bladder. An immunocytochemical technique using monoclonal antibodies G4 and E7 successfully identified tumor-associated antigens on the surface of transitional carcinoma cells obtained by bladder washings. The method, which uses immunoperoxidase staining, was compared to conventional Papanicolaou staining of bladder washings from 75 patients with and without transitional cell carcinoma. Patients were divided into 4 groups: group 1 (nontumor control)--15 patients with no pathological condition of the bladder or nonmalignant urological diseases, group 2 (nontransitional cell carcinoma)--19 patients with other urological malignancies, group 3-18 patients with active transitional cell carcinoma and group 4-23 patients with a history of transitional cell carcinoma but no evidence of tumor at the time of the washing. The incidence of positive staining in these groups was 0, 5, 78 and 0 per cent, respectively. The diagnostic value of immunoperoxidase staining was similar to that of Papanicolaou staining in the control group and in patients with high grade transitional cell carcinoma, and provided specific morphological criteria not possible by conventional cytology studies. Interpretation of immunoperoxidase staining was difficult in washings with a large number of inflammatory cells if endogenous peroxidase activity was not blocked properly. The application of the immunoperoxidase staining method for diagnosis of low grade tumor is under further investigation.
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3894693
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A prospective randomized clinical trial was done for 92 patients with carcinoma of the bilharzial bladder who underwent radical cystectomy alone or with 2,000 rad preoperative radiation. The postoperative mortality and morbidity were similar in both groups. Patients were followed for a minimum of 60 months. Over-all, there was a marginal, statistically insignificant improvement in survival among patients receiving preoperative radiotherapy. Nevertheless, 2 subpopulations demonstrated significant improvement in survival following preoperative radiation, that is patients with high stage (P3 and P4) and high grade tumors.
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3894694
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We evaluated 31 patients with clinically localized prostatic carcinoma by transrectal ultrasonography before radical prostatectomy. Results of ultrasonography were reviewed without previous knowledge of the extent of the disease and were compared to the pathological staging obtained by step section of the prostate. Preoperative transrectal ultrasonography was sensitive in detecting capsular and seminal vesicle involvement (89 and 100 per cent, respectively). However, the specificity of the method was low for capsular involvement (50 per cent), probably owing to the inability of this method to detect microscopic disease. This method is a valuable tool in the preoperative evaluation of patients with clinically localized prostatic carcinoma.
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3894696
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We report the computerized tomography and ultrasound-guided aspiration cytology results in the first case of renal cell carcinoma with bilateral adrenal involvement. The adrenal metastases were evident clinically 6 years after radical nephrectomy and were treated successfully by an operation. Aspiration cytology under computerized tomographic and sonographic guidance is an excellent procedure to evaluate enlarged adrenal glands in patients with renal cell carcinoma or other malignant neoplasms.
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3894697
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Post-transplantation lymphocele ordinarily is an early postoperative complication that infrequently causes symptoms, which usually result from impaired renal function secondary to cortical compression or ureteral obstruction. We recently encountered a patient in whom a lymphocele developed following trauma 7 years after cadaveric transplantation. Attempts to drain the lymphocele externally resulted in massive fluid loss, which caused hypotension, hypoproteinemia and profound electrolyte imbalance. Control of the massive fluid loss was achieved by marsupialization of the lymphocele into the peritoneal cavity.
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3894698
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Renal calculi complicating transplanted kidneys are uncommon but they can be an important cause of deterioration in graft function. We report 2 complicated cases managed by percutaneous nephrostolithotomy.
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3894699
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We describe an 11-year-old hypertensive girl who had a 5.0 cm. juxtaglomerular cell tumor. Of the 18 previously reported cases this appears to be the largest such tumor found. The benign nature of the tumor is emphasized, its clinical, radiological and microscopic appearance is illustrated, and appropriate treatment options are discussed.
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3894700
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The radiographic appearance of the hydronephrotic upper urinary tract due to congenital ureteropelvic junction obstruction may not return to normal even though the obstruction is relieved by surgical repair. We present a case of ureteropelvic junction obstruction in which the success of the repair was demonstrated dramatically only by diuretic radionuclide urography.
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3894702
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The activity of cis-diamminedichloroplatinum(II) was compared to two second generation platinum analogs, cis-diammine-1,1-cyclobutane dicarboxylate platinum(II) and cis-dichlorotransdihydroxybisisopropylamine platinum(IV) in the N-[4-(5-nitro-2-furyl)-2-thiazolyl]formamide-induced murine bladder tumor model and a tumor colony assay. Murine drug testing revealed that all three drugs were active against the MBT-2 tumor line, although cis-diamminedichloroplatinum(II) was more active than its analogs. All drugs produced enhanced inhibition of clonal growth with increasing drug exposure times. Cis-diamminedichloroplatinum(II) was more active against MBT-2 cells in the plateau growth phase versus the log growth phase after a one hour drug exposure. Similar differential activity depending upon the proliferative state of MBT-2 was not seen with the two platinum analogs. These two platinum analogs have somewhat less activity in vivo and in vitro than cis-diamminedichloroplatinum(II) and would be predicted to be less effective clinically in human bladder cancer than the parent compound.
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3894705
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Ten physicians recorded their treatment decisions and estimated probabilities of streptococcal infection for patients with sore throats. Of 308 throat cultures, 15 (4.9%) were positive for group A streptococci. The physicians overestimated the probability of a positive culture for 81% of their patients and their estimates and treatment decisions were strongly associated. Of 104 patients treated before culture results were available, only eight had positive cultures. Probability overestimation may have been due to neglect of the low culture-positive rate, assignment of undue importance to weakly predictive or highly intercorrelated clinical features, and a value-induced bias, occurring when features important for treatment are erroneously linked to the likelihood of disease. Cognitive limitations in information processing may limit the effectiveness of pharyngitis management protocols that require subjective estimates of disease probability.
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3894709
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In order to estimate the pulmonary blood volume between the pulmonary artery trunk and the left atrium (PBV PAT-LA), simultaneously with the pulmonary extravascular water volume (PEWV) in the chronically stable cardiac patients, we employed the double indicator dilution method using heat as a diffusible indicator and indocyanine green as a non-diffusible indicator. The PEWV was obtained as the extravascular lung thermal volume estimated in the aortic root (LTVAo). In the group of hemodynamically normal patients, in spite of ischemic heart disease (G-N, n = 22), the mean pulmonary artery wedge (PAW) pressure was 9.3 +/- 3.9 mmHg (mean +/- SD), PBVPAT-LA was 8.95 +/- 1.71 ml/kg, LTVAo was 5.71 +/- 1.37 ml/kg and PBVPAT-LA/LTVAo ratio was 1.64 +/- 0.44. In the group of hemodynamically slightly compromised patients with mitral stenosis (G-MS, n = 13), the mean PAW pressure was 14.2 +/- 2.6 mmHg, PBVPAT-LA was 11.12 +/- 2.86 ml/kg, LTVAo was 5.68 +/- 1.41 ml/kg and PBVPAT-LA/LTVAo ratio was 2.02 +/- 0.58. Between the two groups, LTVAo was not statistically significant, whereas the mean PAW pressure, PBVPAT-LA and PBVPAT-LA/LTVAo ratio were all significantly increased in G-MS (p less than 0.05). Neither PBVPAT-LA nor LTVAo correlated with the mean PAW pressure in both groups. From PBVPAT-LA/LTVAo ratio, fluid volume in the intravascular space was greater than that in the extravascular space in both groups. From LTVAo, PEWV in G-MS was identical with that in G-N, in spite of the elevated mean PAW pressure. Therefore, even in the patients with mitral stenosis, the interstitium in the lung is kept "dry" under conditions of the mean PAW pressure below 20 mmHg. The safety factors that prevent pulmonary edema, as evidenced in animal studies, seem to operate effectively in man.
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3894710
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An analysis was made of 91 cases of infective endocarditis (IE) with regard to causative organisms and their sensitivities to various antibiotics, the clinical features of the disease, the laboratory test results and other items were important in establishing a diagnosis of IE. The number of cases of IE has shown a tendency to increase in recent years, particularly in the number of elderly patients, and the ratio of total cases consisting of prosthetic valve endocarditis (PVE) has shown a sharp increase. The most common causative organism is still Streptococcus viridans, but there has been an increase in the incidence of IE due to benzyl-penicillin-resistant strains of Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus faecalis and other fastidious organisms. The percentage of underlying diseases represented by combined valvular diseases has been increasing, while the primary known cause of the infection of IE was dental treatments. A positive value for CRP, an accelerated value for ESR, leukocytosis, anemia, a decrease in serum Fe, a positive value for RA-T, were all parameters which showed a high correlation with IE, and these should be useful in establishing the diagnosis of IE. The use of cardioechography to detect cardiac vegetation is important in relation to establishing the diagnosis and prognosis of IE, and the evaluation of the therapeutic results.
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3894713
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Treatment of operable breast carcinoma by radical irradiation instead of total mastectomy was discussed in conformity with our experiences and reports. No significant differences were obtained between conservative management and radical mastectomy in the rate of locoregional control and survival. The cosmetic results were satisfactory in almost all of patients. This method must be considered and established on concepts based on the multimodal treatment of breast carcinoma in Japan.
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3894714
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To enhance the efficacy of abdominal echography, 3,970 people at high risk have been chosen from a mass screening of the stomach since may 1980. 942 individuals with 1,057 lesions including 22 primary malignancies of the liver, gallbladder, pancreas, and ren were found. Of the four were detected in the operable stages. To detected malignancies in their early (curable) stages, those examines at low risk should be more aggressively pursued, despite the tendency for the relative rate of detection to decline.
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