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This experiment tested the hypothesis that inotropic cardiovascular reactivity to stress is related to performance on heartbeat discrimination tasks. The experiment also compared the efficacy of a specific modification of two popular heartbeat discrimination paradigms, Whitehead's and Katkin's. Subjects were 48 male undergraduates who performed both discrimination tasks and then were subjected to mental arithmetic stress. Results indicated that high cardiovascular reactors were better detectors than low reactors. Results also indicated that subjects performed better on the modified Whitehead task than on the modified Katkin task. 相似文献
2.
SEEMA GOENKA M.B. B.S. CHRISTOPHER W. SHOLES M.D. F.A.C.C. ASHOK V. MEHTA M.D. F.A.C.C. 《Journal of interventional cardiology》1999,12(2):141-144
Case report of a 15-year-old white male with complex cyanotic heart disease and multiple cardiac surgery including bilateral modified Blalock-Taussig shunt. The patient developed worsening cyanosis and exercise intolerance for the last several months. He underwent percutaneous balloon angioplasty and placement of a PS 204 Palmaz-Schatz balloon expandable stent for correction of severe stenosis at the junction of the right subclavian artery and a 6-mm interposition Gore-Tex graft. Since he was not a candidate for definitive surgery, this palliative procedure was performed to avoid repeat thoracotomy and to provide long-term relief of the stenosis. Stent placement in children can be challenging due to vascular access and complex anatomy. We suggest long-term follow-up to validate the success of this procedure. 相似文献
3.
Evaluation of fibronectin as a marker of malignant ascites 总被引:2,自引:0,他引:2
R. A. SIDDIQUI R. KOCHHAR V. SINGH A. RAJWANSHI M. K. GOENKA S. K. MEHTA 《Journal of gastroenterology and hepatology》1992,7(2):161-164
The aim of the study was to assess the accuracy of fibronectin, a glycoprotein, for the diagnosis of malignant ascites and to compare it with conventional parameters. Ascitic fluid samples from 50 patients, 25 with intra-abdominal malignancy and 25 without it were analysed for total protein concentration, fluid/serum protein ratio, glucose concentration, leucocyte count, pH, fibronectin concentration (by ELISA) and for malignant cell cytology. Twenty-two of the 25 patients with ascites and intra-abdominal malignancy had documented peritoneal metastases in group A. The 25 patients with non-malignant ascites constituted group B. Mean values of ascitic fluid fibronectin, for groups A and B were 538 +/- 46 micrograms/mL and 60 +/- 4.92 micrograms/mL, respectively (P less than 0.001). Within the group with malignant ascites, patients who had positive malignant cytology (n = 12) exhibited a significantly higher ascitic fluid fibronectin concentration than patients with negative cytology (P less than 0.05). While mean ascitic fluid protein concentration showed a significant difference (P less than 0.01) between the two groups, there was no difference in respect to ascitic fluid pH, glucose concentration and leucocyte count. Malignant cell cytology was positive in 54.5% of group A patients with no false positive report in group B. The diagnostic accuracy for differentiating malignant from non-malignant ascites was 100% for a fibronectin value of greater than or equal to 110 micrograms/mL as compared with 78.7% for ascitic fluid protein concentration greater than or equal to 0.5 g/dL, 57.4% for leucocyte count greater than or equal to 1000/mm3, 59.6% for pH less than 7.45 and 78.7% for malignant cell cytology. 相似文献
4.
NOOPUR RAJE RAY POWLES SAMAR KULKARNI SARAH MILAN GARY MIDDLETON SEEMA SINGHAL JAYESH MEHTA BARBARA MILLAR CHRISTINE VINER JULIAN RAYMOND JENNIFER TRELEAVEN DAVID CUNNINGHAM & MARTIN GORE 《British journal of haematology》1997,97(1):153-160
In a sequential nonrandomized study, 204 consecutive unselected patients aged < 70 years received induction chemotherapy with infusional vincristine and adriamycin with oral methyl prednisolone (VAMP; n =75) or with additional cyclophosphamide, C-VAMP ( n =129). 38/129 C-VAMP patients also received verapamil during induction as part of a controlled trial with the aim to overcome drug resistance. A median of five courses (range 1–11) of chemotherapy were required before maximal response was attained and this was similar in both groups. An over-all response rate of 71% was noted at the end of induction. The complete remission (CR) rate with C-VAMP was 24%, which was significantly higher ( P =0.04) than the CR rate with VAMP alone (8%). The addition of verapamil did not alter the response rate of C-VAMP. Compliance to VAMP was overall 83% and not affected by the addition of cyclophosphamide. The proportion of patients going on to receive high-dose chemotherapy and an autograft was the same for VAMP and C-VAMP treated patients (71%). The median overall survival (OS) and progression-free survival (PFS) for the whole group were 4.4 years and 2.0 years and no difference in outcome was observed between the different treatment groups. Therefore the addition of weekly cyclophosphamide to VAMP induction therapy has significantly improved the response rates of previously untreated myeloma patients. C-VAMP was not more toxic and did not compromise the chances of receiving an autograft. Verapamil was without influence on any parameters in this study. 相似文献
5.
A technique for the culture of Barrett's oesophageal cells 总被引:2,自引:0,他引:2
SEEMA M KHAN S PRAGA PILLAY DAVID PAPADIMOS JOHN WK YONG H JOHN V ROBERTS DARRELL H CRAWFORD 《Journal of gastroenterology and hepatology》1997,12(8):606-611
Establishment of cells in tissue culture from Barrett's columnar epithelium has been difficult. The aim of this study was to develop a successful tissue culture method employing a serumfree medium for cultivation of Barrett's epithelial cells. Fragments of Barrett's mucosal tissue were explanted in a 3:1 mixture of Dulbecco's modification of Eagle's medium and Ham's F12, to initiate the outgrowth of epithelial cells. Subsequently, a commercial serum-free medium (formulated for the growth of keratinocytes) was used for the propagation of Barrett's oesophagus cells without fibroblast growth. Cells established in culture retained their epithelial morphology, stained positive for cytokeratin, and contained Alcian blue (pH 2.5) and periodic acid-Schiff reagent-positive/diastase-resistant vacuoles, confirming their origin from Barrett's epithelium. Electron microscopy showed tonofilaments, microvilli and desmosomes. Coating the surface of culture vessels was not required and four cell strains could be passaged up to 20 times with no fibroblast growth, in the keratinocyte serumfree medium. 相似文献
6.
RAM CHANDER M.D. TANVI GUPTA M.B.B.S. SEEMA RANI B.A. † ANITA NAGIA M.D. † 《Pediatric dermatology》2009,26(2):234-235
Abstract: Juvenile dermatomyositis (JDMS) is an inflammatory myopathy with various cutaneous manifestations, usually affecting children between 2 and 15 years of age. We describe a 9-year-old female diagnosed with Juvenile dermatomyositis presenting with generalized erythroderma, Gottron papules, inflammatory myopathy associated with systemic hypertension confirmed on histopathogical examination of skin and muscle biopsy. Since erythroderma, though rare, is an early manifestation of dermatomyositis (adult onset), presence in a pediatric case should prompt early investigations and effective management by a multispeciality team. 相似文献
7.
Comparative Left Ventricular Function Following Atrial, Septal, and Apical Single Chamber Heart Pacing in the Young 总被引:28,自引:0,他引:28
Ventricular pacing, typically initiated from a RV apical electrode, inherently causes abnormal biventricular activation, decreases LV function, and causes histopathological changes. Since pacing initiated in childhood can he expected to have a more protracted course compared with the adult, the consequences of this alteration in LV hemodynamics gain added significance among the young pacemaker recipient. The purpose of this study was to evaluate the potential of improving paced LV function by a septal electrode implant site. Acute alterations in cardiac index, LV pressure, and contraction indices, including dP/dt, Vmax. and Vpm, were compared among 22 patients (median age 10 years) with normal cardiac anatomy during intracardiac electrophysiological studies. LV hemodynamics were measured during intrinsic rhythms and following 15 minutes of atrial, HV apical, and septal pacing at an appropriate exercise rate for age of 150 ppm. Results showed a significant decrease in LV dP/dt, Vmax, and Vpm, and increase in LV end-diastolic pressure only with apical pacing. Septal pacing, in spite of loss of any atrial contribution to ventricular filling, maintained comparable indices with intrinsic and atrial paced rhythms. This study demonstrates that normalized LV function is maintained by septal and deteriorates with apical pacing acutely among young, nonischemic hearts. Continued evaluation of appropriate pacing electrode designs to permit septal implant is needed to ensure optimal chronically paced LV function. 相似文献
8.
Srikara V. PEELUKHANA Shilpi GOENKA Brian KIM Jay KIM Amit BHATTACHARYA Keith F. STRINGER Rupak K. BANERJEE 《Industrial health》2015,53(3):245-259
To formulate more accurate guidelines for musculoskeletal disorders (MSD) linked to
Hand-Arm Vibration Syndrome (HAVS), delineation of the response of bone tissue under
different frequencies and duration of vibration needs elucidation. Rat-tails were vibrated
at 125 Hz (9 rats) and 250 Hz (9 rats), at 49 m/s2, for 1D (6 rats), 5D (6
rats) and 20D (6 rats); D=days (4 h/d). Rats in the control group (6 rats for the
vibration groups; 2 each for 1D, 5D, and 20D) were left in their cages, without being
subjected to any vibration. Structural and biochemical damages were quantified using empty
lacunae count and nitrotyrosine signal-intensity, respectively. One-way repeated-measure
mixed-model ANOVA at p<0.05 level of significance was used for
analysis. In the cortical bone, structural damage quantified through empty lacunae count
was significant (p<0.05) at 250 Hz (10.82 ± 0.66) in comparison to the
control group (7.41 ± 0.76). The biochemical damage was significant
(p<0.05) at both the 125 Hz and 250 Hz vibration frequencies. The
structural damage was significant (p<0.05) at 5D for cortical bone
while the trabecular bone showed significant (p<0.05) damage at 20D
time point. Further, the biochemical damage increased with increase in the duration of
vibration with a significant (p<0.05) damage observed at 20D time
point and a near significant change (p=0.08) observed at 5D time point.
Structural and biochemical changes in bone tissue are dependent upon higher vibration
frequencies of 125 Hz, 250 Hz and the duration of vibration (5D, 20D). 相似文献
9.
A. S. GOENKA M. S. DASILVA G. J. CLEGHORN M. K. PATRICK R. W. SHEPHERD 《Journal of gastroenterology and hepatology》1993,8(1):44-51
Abstract The safety, effectiveness and capabilities of therapeutic upper fibreoptic endoscopy in children undergoing therapeutic endoscopic procedures ( n = 443) was studied. Therapy for gastrointestinal bleeding formed the major group (injection sclerotherapy for varices, n = 197 procedures; thermocoagulation for haemorrhagic gastritis, n = 1; and photocoagulation for Dieulafoy's disease, n = 1). Sclerotherapy was 97% effective in controlling acute bleeding and 84% effective in obliterating varices with no serious complications or deaths. Oesophageal dilatations for surgical, caustic, congenital and peptic strictures and achalasia ( n = 193) were performed with no oesophageal perforations or deaths. Foreign bodies were retrieved ( n = 34) with no failures or complications. Percutaneous endoscopic gastrostomy was performed ( n = 11) with one failure, proceeding to an unsuccessful surgical gastrostomy. Miscellaneous procedures included endoscopic transpyloric tube placement ( n = 5) and endoscopic diathermy of pyloric web ( n = 1). Therapeutic fibreoptic endoscopy is therefore concluded to be safe and effective in children, replacing rigid oesophagoscopy and some traditional surgical approaches. 相似文献
10.
Primary sclerosing cholangitis: An experience from India 总被引:1,自引:0,他引:1
RAKESH KOCHHAR MAHESH K GOENKA KINSUK DAS BIRENDER NAGI DEEPAK K BHASIN YOGESH K CHAWLA KIM VAIPHEI KARTAR SINGH JANG B DILAWARI 《Journal of gastroenterology and hepatology》1996,11(5):429-433
Primary sclerosing cholangitis (PSC) is considered to be rare in India. The aim of the present study was to investigate the incidence, clinical profile and outcome of PSC seen in a tertiary care centre. Over a period of 10 years (July, 1984-June, 1994) 18 patients of PSC were diagnosed at cholangiography (14 patients by endoscopic retrograde cholangiopancreatography, two patients by percutaneous transhepatic cholangiography and two patients by both methods). The presence of secondary causes, such as choledocholithiasis, biliary tract surgery, congenital biliary tract anomalies, cholangiocarcinoma and pancreatic diseases, were excluded. These patients were evaluated retrospectively with respect to their clinical presentation, radiological findings, presence of associated idiopathic ulcerative colitis (IUC), treatment instituted and outcome. The mean (±s.d.) age at diagnosis of PSC was 39.0 (±16.1) years with a male: female ratio of 1.57:1. Nine (50%) patients had associated IUC. The diagnosis of IUC preceded that of PSC in all but one case. Fifteen (83.3%) patients had cholestatic jaundice at presentation, while three (16.7%) patients had asymptomatic rise of alkaline phosphatase. Three (16.7%) patients had recurrent cholangitis and five (27.8%) patients developed portal hypertension during the course of the disease. At cholangiography, intrahepatic radicles were involved in all and extrahepatic radicles in 12 (66.6%) cases. Patients were managed with steroids (n= 7), colchicine (n= 3), ursodeoxycholic acid (UDCA; n= 2) and methotrexate (n= 1), along with symptomatic measures. Mean duration of follow up available in 11 (61%) patients was 20.1 months (range: 1 month-8 years). Four (36.4%) patients died. Steroids and colchicine did not have any effect while the one patient on UDCA and one on methotrexate showed improvement. In conclusion, in India PSC does not seem to be a rare entity. Its clinical profile and outcome are somewhat similar to those seen in Western countries. 相似文献
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