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This study correlates the fundus signs with the severity and signs of hypertension and evaluates the role of fluorescein angiography in detecting changes in the retinal and choroidal capillary bed in hypertension and defines its advantages over direct ophthalmoscopy. 37 hypertensives belonging to all grades of hypertension were studied. A thorough physical examination, hypertension work up, direct ophthalmoscopy and fluorescein angiography was done in all cases. A significant association was found between the presence of marked arteriolar narrowing and the presence of severe hypertension, left ventricular hypertrophy (LVH) and cardiomegaly. Patients having definite arterio-venous crossing changes and exudative retinopathy had a higher incidence of LVH and cardiomegaly. Renal functions and neurological signs in hypertension showed no correlation with the fundus signs. Capillary bed and choriodal abnormalities could be better studied on fluorescein angiography. Hard exudates were not visualized on fluorescein angiography. There was total resolution of exudative phenomenon on treatment.
Studies correlating prosthetic valve gradients determined by continuous wave Doppler echocardiography with gradients obtained by cardiac catheterization have, to date, been limited to patients with mitral and tricuspid prostheses or have compared nonsimultaneous measurements. Simultaneous Doppler and catheter pressure gradients in 36 patients (mean age, 63 +/- 13 years) with 42 prosthetic valves (20 aortic, 20 mitral, one tricuspid, and one pulmonary) were studied. Catheter gradients were obtained using a dual-catheter technique. The simultaneous pressure tracings and Doppler flow velocity profiles were digitized at 10-msec intervals to derive the corresponding maximal and mean gradients. The correlation between the maximal Doppler gradient and the simultaneously measured maximal catheter gradient was 0.94 (SEE = 6), and that between the Doppler gradient and the simultaneously measured mean catheter gradient was 0.96 (SEE = 3). There were no significant differences in correlation between gradients for the 32 mechanical valves (maximal gradients: r = 0.95, SEE = 6; mean gradients: r = 0.96, SEE = 3) and the 10 bioprosthetic valves (maximal gradients: r = 0.89, SEE = 6; mean gradients: r = 0.93, SEE = 3). In patients with mitral prostheses, Doppler gradients correlated well with the corresponding catheter gradients obtained with direct measurement of left atrial pressure (maximal gradients: r = 0.96, SEE = 2; mean gradients: r = 0.97, SEE = 1.2). A close correlation between corresponding Doppler and catheter gradients also was found in patients with aortic prostheses (maximal gradients: r = 0.94, SEE = 6; mean gradients: r = 0.94, SEE = 3). Thus, continuous wave Doppler echocardiography can accurately predict the pressure gradient across prosthetic valves.
The Southern California Sensory Integration Tests (SCSIT) and the Bender Gestalt are two measures used to evaluate children with suspected perceptual-motor deficits. Since these tests are used primarily by two groups of professionals, occupational therapists and psychologists, it was thought that studying the correlations between these two tests might help psychologists to know which children needed to be referred to an occupational therapist for sensory integrative evaluation, and might help the occupational therapist to understand the psychologist's use of the Bender Gestalt. The use of the Bender by the occupational therapist as a screening device for sensory integrative dysfunction was also investigated. The SCSIT and Bender were given to 26 children with suspected sensory integrative dysfunction. Scores on the Bender were found to be predictive of grouped scores on the Form and Space Perception and Praxis-Tactile sections of the SCSIT, but not of the Postural and Bilateral Integration section. It was concluded that when the Bender is used as a screening device for sensory integrative dysfunction, some measure of postural mechanisms must be included. Correlations between the Bender and individual tests of the SCSIT were also studied.
Correlative studies of serum digoxin levels, cardiac rhythm and related clinical laboratory data were carried out in 114 patients. Seventy-three patients who presented with 79 episodes of arrhythmias typical of digitalis intoxication could be separated into a normokalemic group of 55 patients whose serum digoxin level was 6.68 +/- 0.17 ng/ml (mean +/- standard error of the mean), and a hypokalemic group of 24 with a mean serum digoxin level of 1.13 +/- 0.04 ng/ml (P less than 0.001). Of 45 consectutive normokalemic patients with a high serum digoxin level (more than 2 mg/ml) who underwent serial studies, 17 had arrhythmias. Serial studies in 10 hypokalemic patients revealed an inconsistent relation between presence of arrhythmia and serum digoxin level. During repletion of serum potassium in seven of these patients with an arrhythmia, the arrhythmia disappeared without a significant change in serum digoxin level in four patients. A group of seven patients had 16 episodes of serum digoxin level greater than 2.2 ng/ml, but an arrhythmia occurred during only 3 of these episodes. A sharp border between toxic and therapeutic serum digoxin values was not found in these groups of study patients. The serum digoxin level at which arrhythmias occurred appeared to be variable for both groups and individual patients. However, correlative studies utilizing serum digoxin levels can define existing thresholds for therapeutic and toxic effects and may often be more useful than isolated observations.
The effects on zinc sulphate pretreatment of rats on stress-induced gastric ulcers and on changes in mast cell counts were studied and correlated with changes in gastric mucosal microcirculation. The effects on zinc sulphate on blood pressure responses and on growth were also examined. Stress (2 h restraint at 4 degrees C) produced marked glandular mucosal ulceration, lowered the stomach wall mast cell counts and increased the microcirculatory blood volume in the superficial glandular mucosa. Zinc sulphate (22, 44 or 88 mg/kg; injected i.p. 48 h before stress) reversed all these changes in a dose-related manner. Blood pressure responses to i.v. acetylcholine, adrenaline or histamine were unaffected and growth of the rats as observed for 7 days after injection was not impaired. On the basis of these findings the mechanism of the antiulcer action of zinc sulphate is the following: inhibition of the stress-induced release of vasoactive agents from gastric mast cells and thus prevention of the subsequent microciculatory changes known to produce mucosal ulceration. Interference with vascular responses through direct blockade or toxicity is unlikely.
Deleted mitochondrial DNA (mtDNA) has been shown to coexist with normal mtDNA (heteroplasmy) in muscles from chronic progressive external ophthalmoplegia, including Kearns-Sayre syndrome. In this study, we correlated heteroplasmic mtDNA abnormality with clinical, biochemical and histological findings with the following results: (1) large deletions ranging from 1.8 to 8.8 kb in 22 muscle specimens from 28 patients who had ophthalmoplegia clinically and focal cytochrome c oxidase (CCO) deficiency by histochemistry, (2) no difference in clinical and biochemical findings between patients with and without mtDNA deletions, (3) no relationship between the size, site or populations of deleted mtDNA and respiratory chain enzyme activities in muscles, (4) positive correlation between the number of CCO-deficient fibers and the populations of deleted mtDNA, and (5) higher incidence of CCO-negative fibers in patients with deleted mtDNA than in those with no deletion of mtDNA. These results suggest that deleted mtDNA is, at least in part, responsible for focal CCO deficiency as a phenotypic expression and that the investigation on pathogenetic mechanism of focal CCO deficiency may provide a clue to understanding the underlying pathophysiology in this disorder.
The sequential stages of bronchopulmonary dysplasia occurring in 18 infants after intensive respiratory therapy supplemented by oxygen in high concentrations were studied by correlative light, scanning, and transmission electron microscopy. Infant survival ranged from 3 to 225 days. The earliest stage was an exudative reaction with a predominance of hyaline membranes. This merged with a subacute reparative response that was replaced by a chronic fibroproliferative stage in infants of longest survival; this stage was complicated by pulmonary fibrosis and emphysema. Correlative scanning and transmission electron microscopy demonstrated that type 2 pneumocytes contributed significantly to the reparative fibroproliferative response by organization of hyaline membranes and reepithelialization of damaged septal walls.
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The literature on the biomechanics of the intervertebral disk is reviewed with emphasis on biomechanical--biochemical--morphological correlative studies. The deficiency of definitive correlative studies is apparent and an appeal is made to interested investigators to fill in the voids in this extremely important area of study. A comprehensive theory of intervertebral disk failure awaits application of existing biomechanical, biochemical and morphological techniques in a detailed and methodical manner to the normal and early degenerative human intervertebral disks.
We investigated correlations between serum biochemical changes and pathological alterations in caerulein-induced acute pancreatitis in rats. Seven consecutive doses of caerulein consisting of 50 mu g/kg, were given intraperitoneally, in 40 male Sprague-Dawley rats at hourly intervals. Serum biochemical and histological changes of the rats were studied at hours 7, 9, 12, 18, 24 and 36 after the first injection, as well as day 3 and 5 respectively. Serum amylase in the controlled rats (n = 6) was 2549 +/- 221 U/L (mean +/- SE). It was elevated to twenty times that of the baseline value (52630 +/- 11397 U/L) at the seventh hour, declined to about two times the control (5520 +/- 800 U/L) at the 18th hour, and returned to the baseline level at the 24th hour after the first caerulein injection. Serum lipase, elevated since the 7th hour, reached its peak value (631 +/- 34 U/L) at the 12th hour, then declined abruptly to the baseline value (0 U/L) at the 24th hour, after the first injection. However, severe histological changes of the pancreas were apparent at the 7th hour, reaching maximal destruction at the 18th hour, with severe inflammatory changes at the 24th hour; all after the first injection. The frank inflammation did not subside until 5 days after the first injection. These results suggest that, in the case of acute pancreatitis, normalization of serum biochemistries does not indicate recovery of the pancreas from acute inflammation.
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A direct CT-pathologic correlative study of interstitial pneumonia was performed using inflated and fixed lungs. The specimens, which were obtained from 26 patients at the time of autopsy or during surgery, had pathologic findings of interstitial pneumonia (UIP and/or DAD). The specimens were fixed in distension and air dried. They were then scanned with a GE CT/T9800. HRCT images of the specimens could be correlated with two different types of pathologic processes. One was the chronic fibrotic change which was seen in the subpleural area of the specimens both from the autopsied and surgical cases, and the other was the acute alveolar change which was seen in the diffuse area of the specimens only from autopsied cases. HRCT images of the chronic fibrotic change showed nodular opacities, ring like opacities, increased density (high density), and air-bronchiologram in the subpleural area. These findings were correlated with patchy fibrotic lesions, honeycombing, mucus stasis in cysts of the honeycomb, and dilatation of the airways. HRCT images of the acute alveolar change showed mainly diffuse increased densities (hazy appearance and high density) and diffuse nodular opacities. These findings were correlated with a diffuse thickening of the alveolar walls, hyaline membranes in the alveoli and alveolar ducts, and their organization. Understanding of the difference between HRCT images of these chronic and acute pathologic processes is helpful for the evaluation of disease processes of interstitial pneumonia by HRCT. The abnormal patterns of HRCT images of the specimens were influenced by several technical factors of CT scanning, such as reconstruction algorithm, thickness of the slice, window level, and window width. It is, therefore, necessary to know the influence to HRCT images by these technical factors for a better understanding of HRCT images in interstitial pneumonia.
A correlative study of CT, X-ray and pathology was done on 41 cases with pulmonary solitary nodule, including peripheral lung cancer 30 cases, benign lesion 10 and metastatic tumor 1. Results showed that CT was more sensitive than conventional X-ray in depicting the characteristic signs such as spiculate protuberance, minute calcifications, small vacuole sign and retraction of pleura. 2 mm thin slice CT scanning is helpful in differential diagnosis of lesions less than 2 cm in diameter. Correlation of CT findings with pathology indicated that spiculate protuberance was caused by infiltrative growth of tumor, whereas the small vacuole sign represented remnant of air containing cavity or slit. The shaggy border of inflammatory nodule was the result of extension of inflammatory process. A correct diagnosis of pulmonary solitary nodule lies in comprehensive analysis of CT manifestations. There is greater possibility of malignancy with mass greater than 4 cm in diameter, lobulation and spiculation are frequently present. Lung cancer less than 3 cm in diameter often presents as lobulated mass with spicules, small vacuole sign and pleural retraction.
A correlative study of roentgenogram, CT, surgical and pathological findings was investigated on 40 cases with primary lung cancer to evaluate differences between x-ray and CT of the chest in imaging pathological changes of lung cancer. The study revealed that CT was more sensitive than roentgenogram in showing lobulation, speculate and internal structure of SPN or masses, hilar and mediastinal adenopathy, invasion to neighbouring tissues and soft tissues of chest wall and abnormal pattern of the bronchus in cross section. Abnormal findings in CT was 67.4% higher than that in roentgenogram, CT provided more information in diagnosis of primary lung cancer. Some limitations of CT in diagnosis of primary lung cancer were also discussed.
Quantitative structure-activity correlation studies of thyroid hormone analogues have been utilized to examine (1) in vivo rat antigoiter activities; (2) in vitro binding affinities to intact rat hepatic nuclei, solubilized rat hepatic nuclear protein receptors, and the plasma protein thyroxine binding globulin; and (3) correlations between in vivo antigoiter activities and in vitro binding to nuclear receptors. These studies provide a more precise elucidation of the relative importance of the physiochemical factors which influence thyromimetic activities. In particular, they (1) provide the first systematic QSAR examination of drug-receptor interactions and of the dependence of in vivo activity on such interactions; (2) demonstrate the importance of the interactive effects of the 3' and 5' substituents and of the 4'-OH with each other as well as with nuclear receptors in influencing binding affinity; (3) support the hypothesis that binding to nuclear receptors is the first step in initiating the events which lead to subsequent hormonal expression; (4) show that the free energy of binding to nuclear receptors can be factored into the contributing physicochemical properties of the substituents; and (5) suggest factors that need to be considered in designing new analogues.
The purpose of this investigation was to make a correlative study between spermatogenesis and testicular acid and alkaline phosphatase activities in mature prostatectomized animals at different post-operative periods. The results demonstrate that there was a significant augmentation in the activity of testicular acid and alkaline phosphatases subsequent to 14 and 21 days of prostatectomy. A parallel quantitative study of spermatogenesis at stage VII of the seminiferous cycle, namely, type A spermatogonia (ASg), preleptotene spermatocytes (pLSc), mid-pachytene spermatocytes (mPSc) and step 7 spermatids (7sd), revealed that there was a significant reduction in the number of step 7 spermatids after 14 and 21 days. No change was observed in the above testicular enzymes and spermatogenesis after 7 days of prostatectomy. Therefore, it is concluded that prostatectomy can alter the above testicular enzyme activities and spermatogenesis in chronic prostatectomized state.