Differentiation of cardiac murmurs by dynamic auscultation

The techniques described in this monograph will aid in the accurate identification of the origin of a cardiac murmur or abnormal heart sound. They do not necessarily reveal the presence or severity of cardiac disease. No maneuver is 100% accurate in elucidation of cardiac abnormalities, and a given maneuver's effectiveness varies in its application. The systematic application of a combination of maneuvers improves the accuracy of diagnosis. Auscultatory findings must be interpreted with consideration of the total clinical examination including history, other physical findings, ECG, chest x-ray, and possibly an echocardiogram. Thus, the careful physiological approach to the physical examination represents a powerful noninvasive tool that can be used in combination with other information to accurately diagnose cardiac disease in many patients and efficiently direct further evaluation when necessary.     

Dietary Tryptophan Reverses Alcohol-induced Impairment of Facial Recognition But Not Verbal Recall

The present study demonstrates that alcohol-induced memory impairment can be attenuated by pretreatment with an oral tryptophan supplementation. These results provide support for the role of a brain serotonin deficit in this impairment and highlight the impact a dietary manipulation can have on a complex behavioral process.     

Tissue-specific regulation of pyroglutamate aminopeptidase II activity by thyroid hormones

Among the enzymes capable of degrading thyrotropin-releasing hormone (TRH) in vitro, two pyroglutamate aminopeptidases (PGA) are specific for TRH: thyroliberinase, a seric enzyme and PGAII, a membrane-bound peptidase. The effect of thyroid hormone status on the activity of these enzymes was evaluated in serum and various tissues. Only in adenohypophysis, triiodothyronine treatment increased PGAII to 376% of control; hypothyroidism produced the reverse effect (decrease to 23% of control). As previously reported, similar changes were observed for thyroliberinase. TRH degradation at the adenohypophysis level may participate in the negative feedback control of thyroid hormones.     

A novel hybridoma antibody (PASE/4LJ) to human prostatic acid phosphatase suitable for immunohistochemistry

A murine monoclonal antibody PASE/4LJ to prostatic acid phosphatase (PAP) was used to immunostain a wide variety of sections of benign and malignant tissues (654 blocks). Non-neoplastic adult and fetal prostatic glands, primary and metastatic prostatic carcinomas, and scattered cells in prostatic and penile urethra were positive. Rat, dog and rabbit prostates were negative. Nine of 400 tumours of non-prostatic origin showed some positivity: 6/36 carcinoids, 1/9 islet cell tumours, 1/55 ovarian adenocarcinomas (serous) and one carcinosarcoma of the lung (epithelial portion). Positive staining was seen in islet cells in 4/5 specimens of normal pancreas, and in 4/9 blocks of normal pancreas surrounding a pancreatic tumour. Loops of Henle, maculae densae, and distal tubules in 10/10 fetal and 2/9 adult kidneys were also positive, with proximal tubules and collecting ducts negative. All other 159 blocks of non-neoplastic adult and fetal tissues were negative. The antibody was also affinity purified from ascitic fluid, and shown not to inhibit the enzyme activity of prostatic acid phosphatase.     

Adjuvant systemic treatment of resectable breast cancer: eleven years results of a monoinstitutional chemo-hormone-immunotherapy trial

131 patients with resectable, node-positive breast cancer were treated at the National Institute for Cancer Research of Genoa, Italy with a systemic adjuvant regimen based on 14 cycles of chemotherapy, immunostimulation with levamisole, and--for postmenopausal patients--hormone therapy with tamoxifen. The present evaluation is performed eleven years after the admission of the first patient: so far, 75 patients (57.3%) have relapsed and 52 (39.7%) have died. An analysis of prognostic factors for relapse and death shows that the number of positive axillary lymph nodes and the dimension of the primary tumor are significantly associated with survival and relapse-free survival, while age and menopausal status are not.     

Prevalence of Candida tropicalis in clinical specimens from patients with variable clinical syndromes over a 5-year period

Summary. In this study, we have examined our records for the isolation of Candida tropicalis from clinical specimens of patients with heterogeneous clinical presentations during the past 5 years. We have found that this species ranks third among all yeasts in frequency of isolation from clinical specimens and that the trend of recovery from the specimens is rising over the years. The isolation rate of C. tropicalis was highest from urine specimens (36%) followed by respiratory specimens (22%). The frequency of isolation of C. tropicalis from vaginal specimens was relatively high (14%), however the trend was declining over the years. In general, the high recovery of Candida tropicalis from clinical specimens of patients with variable disease supports the views of this organism being a major pathogen.
Zusammenfassung. Die Studie basiert auf einer Durchsicht der Patientenarchive der letzten fünf Jahre auf die Isolationshäufigkeit von Candida tropicalis aus klinischen Untersuchungsmaterialien von Patienten mit unterschiedlichen klinischen Krankheitsbildern. Diese Hefeart war die dritthäufigste mit steigender Tendenz über die Jahre. Die Isolierungsrate von C. tropicalis war am höchsten aus Urin (36%), gefolgt von Respirationstrakt-Materialien (22%). Die Isolationshäufigkeit aus dem hinteren Scheidengewölbe war relativ hoch (14%), nahm jedoch mit den jahren ab. Allgemein unterstreicht die hohe Isolationsrate von C. tropicalis aus klinischen Untersuchungsmaterialien die ätiologische Bedeutung dieses Erregers.     

Memory clinic attenders: A review of 150 consecutive patients

The Dundee Memory Clinic was established in 1991. This paper reviews the diagnosis of the first 150 attenders and compares the findings with those of other memory clinics.