Measurement by impedance cardiography (ZCG) of cardiac output and contractility indices during exercise is a recent addition to exercise testing of the cardiac patient. To provide a needed standard of normal responses to exercise at integrals of resting oxygen consumption (METS), 10 healthy men were tested. Basal oxygen consumption (1MET) under standardized conditions was measured by mass spectrometry. Over several days the subjects were exercised on a treadmill at 2METS through 6METS with monitoring of heart rate, electrocardiogram, oxygen consumption per minute (VO2) and ZCG. The exercise routine was then repeated to look for test-retest effect. Values closely approximating presently accepted basal oxygen consumptions were achieved under these standardized but practical conditions. Cardiac output during sitting, fully supported rest was slightly higher than that at 2METS on treadmill owing to higher stroke volume. From 2METS through 6METS the curvilinear mean heart rate and stroke volume were mirror images, producing a linear increase in mean cardiac output which at 6METS was 145% of basal and 160% of the 2MET value, while the contractility index increased to 217% of basal. Comparison of the 2 trials revealed no significant test-retest effect.

Adult↗

PubMed1976

Treatment of idiopathic normogonadotropic oligoasthenospermia with synthetic luteinizing hormone-releasing hormone.

An assessment of the effectiveness of synthetic luteinizing hormone-releasing hormone (LH-RH) in the treatment of idiopathic normogonadotropic oligoasthenospermia was made in 21 subjects selected on the basis of at least three previous sperm counts; a history of long-standing infertility; normal urinary gonadotropin excretion; normal serum levels of luteinizing hormone, follicle-stimulating hormone, and testosterone; and lack of any evidence of other clinical, endocrine, vascular, infectious, and/or urologic involvement. On testicular biopsy, 14 patients showed hypospermatogenesis or arrest up to the spermatid stage (group 1), while the remaining 7 had more severe spermatogenetic disorders (group 2). Libido and/or potency were previously unaltered in all subjects. Five patients in group 1 and five patients in group 2 received intramuscular injection of 100 to 500 mug of LH-RH daily for no less than 60 days (long-term treatment); the remainder received the drug for 30-day periods, with 30-day intervals (short-term treatment). Qualitative and quantitative assessment of the results during and after treatment showed frank improvement in spermatozoal concentration, vitality, and motility in group 1 patients, particularly in those undergoing long-term treatment (three of five patients under these conditions were able to impregnate their wives). The long-term regimen also resulted in predomantly qualitative improvements in group 2 (one of five patients impregnated his wife). The short-term regimen was less effective. Improvements under either regimen usually occurred at the end of, or after, treatment. Six of seven patients in group 1 who were followed for a long period retained values above preliminary values for 90 to 150 days after the drug was discontinued. Increased libido and potency were spontaneously reported by 15 patients, 20 to 30 days after the start of administration of synthetic LH-RH.

Cell Count↗

PubMed1975

Use of synthetic luteinizing hormone-releasing hormone in treatment of oligospermic men: a preliminary report.

Synthetic luteinizing hormone-releasing hormone (LH-RH) was administered to four normogonadotropic, oligospermic men (24 to 39 years of age) who had no endocrinologic, urologic, or associated vascular disease, to assess its possible therapeutic value in male infertility. Previous testicular biopsies of these subjects indicated alteration of spermiogenesis only. LH-RH (mean dose, 500 mug/day) was administered intramuscularly for 100 to 135 days. Each patient had at least two sperm count before starting therapy and had one every 20 to 30 days during and for two to five months after treatment. The sperm count, semen volume, sperm motility and morphology, and seminal plasma concentrations of fructose and citric acid were studied in each semen sample. In three of the four patients, urinary LH and FSH excretion and plasma testosterone levels were also measured. The sperm count increased clearly in two subjects 30 to 80 days after therapy started; the response was small in the third subject and negative in the fourth. The remaining parameters followed variable courses. Libido increased in all subjects. In the post-treatment period, the two patients who had shown the best response during treatment experienced a new and abrupt increase in the sperm count which remained well above initial values at the end of follow-up. LH-RH appears to be of value in the treatment of certain types of oligospermia, but several issues remain unsettled.

Adult↗

PubMed1973

Ultrastructure of a virilizing ovarian sertoli-leydig cell. Tumor with familial incidence.

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Adolescent↗

PubMed1970

Hyperbaric enhancement of Coxsackievirus infection in mice.

Explore the source record for details and available documents.

Adipose Tissue, Brown↗

PubMedDate not supplied

Quantitative study of apoptosis in normal rat gastroduodenal mucosa.

The occurrence of apoptosis in the normal gastrointestinal mucosa has been given little consideration until now, although the phenomenon may be of interest in the light of recent hypotheses about its role in physiological cell renewal. In the present study, a quantitative evaluation conducted on normal gastric and duodenal mucosa of young rats has shown that apoptosis is a rare but constant phenomenon: 1.4 +/- 1.1 (mean +/- 1 s.d.) apoptotic bodies were observed within the surface epithelium of single gastric pits and 3 +/- 1 in duodenal villi. In both situations, the apoptosis showed a preferential localization in the juxtaluminal segments of the epithelium. This phenomenon appears distinct from passive exfoliation of mucosal cells and, as an expression of 'programmed cell death', it is likely to contribute to the normal intestinal epithelial cell turnover.

Animals↗

PubMedDate not supplied

Endocervical atypical glandular cells of undetermined significance. I. Morphometric and cytologic characterization of cases that "cannot rule out adenocarcinoma in situ".

OBJECTIVE: To determine whether evaluating morphologic features through morphometry and cytology can lead to a more-satisfactory characterization of endocervical atypical glandular cells of undetermined significance (AGUS) cases that "cannot rule out adenocarcinoma in situ" (AIS). STUDY DESIGN: Fifty-seven endocervical AGUS cases showing incomplete criteria of AIS were morphometrically compared to five smears with normal endocervical columnar cells (ECC) and to five histologically confirmed endocervical adenocarcinoma cases. For each atypical nucleus, the area and shape were measured. Twenty-five cytologic criteria were used to review the AGUS and neoplastic smears. RESULTS: AGUS nuclei showed an intermediate value in terms of area and shape as compared to the values of normal and neoplastic nuclei. In particular, AGUS nuclear enlargement (136.626 micron 2) was about twice the area of normal nuclei and half the value of the area of neoplastic nuclei (P < .0000). AGUS nuclei also had the greatest variability in size and shape, indicating that anisonucleosis may be a morphologic discriminator of endocervical AGUS. The cytologic features useful in discriminating AGUS from neoplastic smears were: presence of normal ECCs, singly or in sheets (P < .001); absence of necrosis (P < .001); bare atypical cells (P < .001); papillary groups (P < .01); anisonucleosis (P < .05); irregular chromatin distribution (P < .05); and hyperchromasia (P < .01). CONCLUSION: Morphometry and cytology led to a better characterization of endocervical AGUS cases that "cannot rule out AIS."

Adenocarcinoma↗

PubMedDate not supplied

Endocervical atypical glandular cells of undetermined significance. II. Morphometric and cytologic analysis of nuclear features useful in characterizing differently correlated subgroups.

OBJECTIVE: To evaluate whether some nuclear features analyzed by morphometry and cytology may be useful in characterizing differently correlated endocervical atypical glandular cells of undetermined significance (AGUS) subgroups. STUDY DESIGN: Fifty-four endocervical AGUS smears were subclassified into four subgroups on the basis of their different correlation: not otherwise specified subgroup (NOSs), tamoxifen (Ts), human papillomavirus infection (HPVs) and laser therapy (LTs). Area and shape of the atypical nuclei detected were morphometrically measured. The smears were then cytologically reviewed, and the shape and grade of expression of hyperchomasia in AGUS nuclei were analyzed. RESULTS: AGUS cases due to T therapy showed the largest nuclear area (148.845 micron 2; P < .0000) and the greatest anisonucleosis objectively measured by morphometry. HPVs had the shape that most differed from perfectly circular (15.341 versus 14.1) and showed the highest grade of expression of nuclear density. LTs and NOSs were less well characterized than the other subgroups. CONCLUSION: Analysis of nuclear features by morphometry and cytology was useful in characterizing the AGUS subgroups Ts and HPVs.

Antineoplastic Agents, Hormonal↗

PubMedDate not supplied

Prognostic value of serum and tumor tissue CA 72-4 content in gastric cancer.

To date no general agreement has been reached regarding the prognostic significance of CEA, CA 19-9 and CA 72-4 as serum markers in gastric cancer, and only scattered information is available on the predictive value of marker expression in tumor tissue. Therefore, a longitudinal study was designed to analyze the presurgical serum and tumor tissue content of CA 72-4, CEA and CA 19-9 in 166 patients at different stages of gastric cancer, and to evaluate the possible correlation with clinicopathological features in respect to prognostic information on relapse-free survival. The results obtained showed that 48.4% of patients with tumor recurrence had positive presurgical CA 72-4 levels compared to approximately 24% of patients who remained free of disease. Furthermore, the median presurgical serum CA 72-4 levels were significantly elevated in relapsing patients. Serosa and lymph node involvement as well as positive presurgical serum CA 72-4 levels had independent prognostic value in predicting recurrence. A significant association between disease-free survival and lymph node involvement, depth of invasion and tumor tissue content of CA 72-4 was also demonstrated. We may therefore conclude that CA 72-4 antigen can be considered the marker of choice in the follow-up of gastric cancer patients and may be used as a prognostic indicator of relapse.

Adult↗

PubMedDate not supplied

Evaluation of the CA 242 tumor antigen as a potential serum marker for colorectal cancer.

OBJECTIVE: The present study was designed to define the performance of serum CA 242 as a marker in colorectal cancer patients. PATIENTS AND METHODS: Serum samples from 1,013 subjects (440 healthy volunteers, 384 patients with primary or recurrent colorectal carcinoma and 189 with benign colorectal diseases) were evaluated. RESULTS: The measurement of serum CA 242 levels in the population of healthy subjects demonstrated the presence of positive levels in approximately 5% of the cases. Interestingly, similar results (5.8%) were obtained in patients with benign colorectal disease, demonstrating the high specificity of CA 242. When serum samples from colorectal cancer patients were analyzed, a sensitivity of 34.9% was observed. Moreover, 18.6% Stage A and B patients had positive CA 242 levels, compared to 33.3% and 58.8% of Stage C and D patients, respectively, indicating a correlation with the stage of disease. A comparison between preoperative and immediate postoperative CA 242 levels showed a consistent relationship between the efficacy of surgery and the reduction in serum CA 242 levels; further, elevated CA 242 levels were present in the immediate postsurgical follow-up of patients undergoing palliative surgery. A longitudinal evaluation of serum CA 242 levels demonstrated that this marker was indicative of the status of disease. CONCLUSIONS: The results obtained suggest the possible utility of CA 242 in monitoring the disease status, providing a rationale for future studies focusing on the longitudinal monitoring of colorectal cancer patients.

Adenocarcinoma↗

PubMedDate not supplied

[Mammography and prevention of breast carcinoma. Epidemiological considerations concerning female population of a Rome district].

At the present time breast cancer represents the primary reason of death caused by cancer amongst the female population of the western countries. Since the actuation of primary prevention programmes results impossible, the aim that must be considered primary is to attain a diagnosis of such tumour as precociously as possible. This research proposes to value the inclination of the female population of a District in Rome, of different classes of age, to have a mammography test in a state of spontaneous screening, in view of a next institution of a structured program of secondary prevention in the area of reference. The results have been examined with relation to the age limits considered as optimum for a correct application of this diagnostic methodology, in line with technical and epidemiological considerations.

Adult↗

PubMedDate not supplied

Colorectal Kaposi's sarcoma in an HIV-negative male in association with ulcerative rectocolitis: a case report.

A rare case and the first reported in Italy of a classic form of colorectal Kaposi's sarcoma, associated with ulcerative rectocolitis, is presented. Following a total proctocolectomy, the patient was disease-free at four years. Some epidemiological risk factors such as sex, age, place of birth and both advanced malaria and immunodepressive therapies have also been evaluated. Thus far, only five similar cases have been reported in the literature. However, the epidemiological, clinical and prognostic features of this form of Kaposi's sarcoma must still be investigated.

Adult↗

PubMedDate not supplied

[The megacolon in myotonic dystrophy: case report and review of the literature].

Myotonic dystrophy (MD) is an autosomal dominant inherit disease, slowly progressive, involving multiple organ systems. Disorders at any level of the gastrointestinal tract are relatively common and manifest as disturbances in motility, such as impaired esophageal transport, delayed gastric emptying, and megacolon. A 51 years-old man was admitted to our surgical department with obstructive symptoms. Diagnostic evaluation showed megacolon and the typical clinical features of the MD, such as weakness, myotonia, frontal baldness and testicular atrophy. Risk of perforation and dehydration led to emergency total colectomy with ileorectal stapled anastomosis. The patient didn't suffer for compliance related to surgical treatment but, after 1 month in intensive care, died of pneumonia and myocardial infarct. The overall frequency of perioperative complications in patients with MD ranges from 8.2 to 42.9%. The risk of perioperative pulmonary complications is particularly high. Thus, we believe that the conservative treatment of motility disorders of the bowel in patients with MD is to be justified and that surgical treatment should be reserved, as last resort, performing a early diagnosis and careful monitoring during perioperative period.

Fatal Outcome↗

PubMedDate not supplied

Comparative analysis of CA 242 and CA 19-9 serum tumor markers in colorectal cancer patients. A longitudinal evaluation.

OBJECTIVE: Following the encouraging results obtained on CA 242 as an adjunctive marker for colorectal cancer this study was designed to compare the clinical behavior of CA 242 to that of its related marker CA 19-9. PATIENTS AND METHODS: Sera from 630 patients with benign (n = 201) or malignant (n = 429) colorectal diseases were evaluated. Moreover, 50 patients with colorectal cancer were longitudinally monitored during. post-surgical follow-up for either a minimum of 5 years or until time of recurrence. Serum CEA, CA 19-9 and CA 242 levels were determined before treatment and at each scheduled follow-up. RESULTS: The distribution of CA 242 levels in colorectal cancer patients demonstrated a similar positivity rate (32.9%) compared to that of CA 19-9 (29.8%), although both sensitivities were lower than that of CEA (43.8%). Moreover, elevated CA 242 serum levels were found in metastatic disease (58.2%). A longitudinal evaluation demonstrated that serum CEA, CA 19-9 and CA 242 levels were elevated in 63.9%, 63.9% and 66.7% of recurrences. Combined evaluation of CEA, CA 19-9 and CA 242 serum levels in the overall population demonstrated a complementarity of CEA with the latter two markers. Conversely, a highly significant correlation was observed, suggesting that the two assays might recognize the same macromolecular complex. CONCLUSION: CA 242 determination does not seem to offer a particular advantage over CA 19-9, while CEA remains the marker of choice in monitoring colorectal cancer patients.

Adult↗