Determinants of exercise capacity in patients with coronary artery disease and mild to moderate systolic dysfunction. Role of heart rate and diastolic filling abnormalities.

Background: To test the hypothesis that diastolic filling abnormalities are an important cause of exercise limitation in some patients with coronary artery disease we assessed the factors limiting exercise capacity in a group of patients with coronary artery disease in whom exercise limitation was greater than expected from the degree of resting left ventricular systolic dysfunction.

Methods And Results: We assessed the relationship between exercise capacity (maximal oxygen consumption) during erect cycle ergometry, heart rate, radionuclide indices of left ventricular systolic function (ejection fraction) and diastolic filling (peak filling rate, and time to peak filling) during semi-erect cycle ergometry in 20 patients (15 male, five female) who were aged 42-72 years (mean 61 years) and had angiographically proven coronary artery disease and evidence of reversible myocardial ischaemia on thallium scintigraphy. All patients exhibited marked exercise limitation (maximal oxygen consumption 8.

Exercise capacity in hypertrophic cardiomyopathy. Role of stroke volume limitation, heart rate, and diastolic filling characteristics.

Background: We previously showed that exercise capacity in patients with hypertrophic cardiomyopathy (HCM) is related to peak exercise cardiac output. Cardiac output augmentation during exercise is normally dependent on heart rate (HR) response and stroke volume (SV) augmentation by increased left ventricular end-diastolic volume and/or increased contractility. We hypothesized that in contrast to normal subjects, peak exercise capacity in patients with HCM is determined by the diastolic filling characteristics of the left ventricle during exercise, which would in turn determine the degree to which SV is augmented, and that HR is a relatively unimportant determinant of peak exercise capacity.

Abnormal forearm vascular responses during dynamic leg exercise in patients with vasovagal syncope.

Background: We have reported previously that in some patients with normal hearts who present with exercise syncope, abnormal forearm vasodilation is seen during leg exercise and tilt table tests are positive. This suggests that exercise syncope may be a variant of vasovagal syncope. In this study we tested the hypothesis that there is loss of the normal forearm vasoconstrictor response during dynamic leg exercise in an unselected population of patients with classic vasovagal syncope.

Euclidean distance matrix analysis: confidence intervals for form and growth differences.

Analysis of biological forms using landmark data has received substantial attention recently. Much of the statistical work in this area has concentrated on the estimation of average form, average form difference, and average growth difference. From the statistical, as well as the scientific point of view, it is important that any estimate of a scientifically relevant quantity be accompanied by a statement regarding its accuracy.

Detection and prevention of childhood disability with the help of Anganwadi workers.

Objectives: To evaluate the role of Anganwadi Workers (AWW) for detection and prevention of disability in children below 6 years of age.

Design: Cross sectional and longitudinal follow up.

Setting: Ten Anganwadi Centers in ICDS Urban Project.

Basic fibroblast growth factor and receptor expression in human ovarian cancer.

Basic fibroblast growth factor (bFGF) and other members of the FGF family share several biological properties that have the potential to mediate neoplastic cell growth. To test the hypothesis that bFGF may play a role in human ovarian cancer cell growth, three ovarian cancer cell lines, A90, A121(P), and A121(A), were investigated for their ability to respond to bFGF as a mitogen, to express endogenous bFGF protein or message for FGF proteins, and to exhibit FGF receptor or its message. Addition of bFGF to cultures of all three cell lines maintained in chemically defined media resulted in a statistically significant increase in cell number.

Malignant melanoma of nasopharynx extending to the nose with metastasis in the neck.

Malignant melanoma is a rare tumor in otorhinolaryngology. In this paper, we have reported the first case of melanoma of nasopharynx which we came across in 20 years of ENT practice. A 55 year old male patient with complaints of swelling of nose and left side of neck, nasal blockage and epistaxis was diagnosed as melanoma of nose with metastasis in the neck based on clinical and radiological examination.

A coordinate-free approach to the analysis of growth patterns: models and theoretical considerations.

Developmental biology holds keys to our understanding of morphological pattern formation whether these patterns are expressed in the fossil record or among extant species. Though much is known about osseous growth at the cellular level (e.g.

Treatment of advanced ovarian carcinoma in the elderly.

This study retrospectively analyzes the treatment of advanced ovarian cancer (Stages III and IV) in elderly patients (> or = 65) compared to that in younger patients (< 65). The purpose of this study was to identify possible treatment bias toward the elderly and to statistically analyze the nature of these differences. Seventy patients were evaluated of which 29 were identified as elderly and 41 as young.

Nonfunctioning adrenocortical carcinoma.

The rarity of adrenocortical carcinoma prompted us to report a case who came with a history of swelling in the left flank associated with pain, weakness and loss of appetite. Ultrasonography revealed a left retroperitoneal mass which was removed by radical surgery along with the left kidney and spleen. On histopathological examination, a diagnosis of adrenocortical carcinoma was made.

On comparing biological shapes: detection of influential landmarks.

For problems of classification and comparison in biological research, the primary focus is on the similarity of forms. A biological form consists of size and shape. Several approaches for comparing biological forms using landmark data are available.

A laboratory evaluation of the Kowa laser flare-cell meter for the study of uveitis.

The Kowa FC-1000 laser flare-cell meter (LFCM) has been described as an instrument which will objectively quantify inflammation of the anterior chamber of the eye. We evaluated the LFCM using the intravenous endotoxin-induced uveitis (EIU) rabbit model of ocular inflammation. In vitro flare and cell calibration measurements utilizing bovine serum albumin (BSA) and latex particles, respectively, were also performed.

Euclidean distance matrix analysis: a coordinate-free approach for comparing biological shapes using landmark data.

For problems of classification and comparison in biological research, the primary focus is on the similarity of forms. A biological form can be conveniently defined as consisting of size and shape. Several approaches for comparing biological shapes using landmark data are available.

Some comments on coordinate-free and scale-invariant methods in morphometrics.

The unusual strategy for comparing biological shapes is to use some kind of superimposition of the two forms under study and then look at the "residuals" as the shape change. In this paper, I take a careful look at this general strategy and point out some subtle but inherent and important pitfalls. Additionally an alternative approach based on Euclidean Distance Matrix representation is presented.

Analysis of craniofacial growth in Crouzon syndrome using landmark data.

Finite-element scaling analysis (FESA), generalized procrustes analysis (GPA), and Euclidean distance matrix analysis (EDMA) are applied in a two-dimensional study of craniofacial growth in normal children and those affected with Crouzon syndrome. Longitudinal data are used and growth is measured as change local to 10 craniofacial landmarks. Although details of the results vary among the methods, all 3 methods determine Crouzon growth to be different from normal.

Adjuvant cisplatin-based chemotherapy for stage I ovarian adenocarcinoma: a preliminary report.

Thirty stage I patients with invasive ovarian adenocarcinoma were treated with 6 months of adjuvant induction cisplatin and monthly cisplatin, adriamycin, and cyclophosphamide. To date, 97% (29) are alive with no evidence of disease and normal CA-125 levels and 93% (28) are alive progression free with a median follow-up of 34 months (13-56).

Photodynamic therapy in gynecologic malignancies.

Twenty-one patients with recurrent gynecologic malignancies were treated with photodynamic therapy using Photofrin II and argon dye laser. Seven of twenty-one patients with cutaneous lesions treated palliatively had a complete response and four of eleven patients with cervical and vaginal recurrences had an objective response to phototherapy. Two of the patients with complete response continued to be free of disease after 28 and 36 months of follow-up.

Weekly cisplatin induction chemotherapy in the treatment of recurrent cervical carcinoma.

Sixty-nine patients with recurrent cervical carcinoma were treated with weekly cisplatin induction chemotherapy. A 27% objective response was obtained in 67 evaluable patients. The highest responses were seen in liver (33%), supraclavicular nodes (40%), and lung (48%), whereas only one out of 24 (4.

Surgically documented response to intraperitoneal cisplatin, cytarabine, and bleomycin after intravenous cisplatin-based chemotherapy in advanced ovarian adenocarcinoma.

Thirty-one evaluable patients with stages III and IV invasive ovarian adenocarcinoma were treated on a phase II protocol of second-line intraperitoneal cisplatin, cytarabine, and bleomycin. All 31 patients received first-line intravenous (IV) cisplatin-based chemotherapy; the size of the residual cancer was documented surgically before intraperitoneal chemotherapy in all patients. Response to intraperitoneal chemotherapy was documented by a third-look laparotomy in all patients not evidencing progression of disease clinically.

Five and ten year estimated survival and disease-free rates after intraperitoneal chromic phosphate; stage I ovarian adenocarcinoma.

From 1975 to 1982, 25 evaluable patients with FIGO Stage I ovarian cancer were treated with intraperitoneal chromic phosphate (32P). All patients underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy with (28%) or without (72%) omentectomy, with no other surgical staging procedures prior to referral. Patients were restaged by laparoscopy (inspection of diaphragms, abdomen, and pelvis), biopsy of suspicious lesions, and peritoneal cytologic washings prior to intraperitoneal chromic phosphate therapy.

Peritoneal papillary carcinoma.

Between 1977 and 1986, 325 patients with a diagnosis of ovarian carcinoma, peritoneal cancer, or malignant mesothelioma were reviewed with identification of 23 patients (7%) having peritoneal papillary cancer. Only 2 patients had disease confined to the pelvis and the rest had widespread abdominal disease. Various combination chemotherapeutic agents were used with over a 65% response rate to first-line chemotherapy.

Effect of adjuvant chemotherapy on time to recurrence and survival of stage I uterine sarcomas.

We have evaluated the effect of adjuvant chemotherapy on time to recurrence and survival in two prospective trials of women with stage I uterine sarcomas. The first trial compared surgery only to surgery plus Adriamycin. The 5-year estimated survival rate was 36% for surgery alone and 63% for surgery plus Adriamycin.

The impact of aggressive debulking surgery and cisplatin-based chemotherapy on progression-free survival in stage III and IV ovarian carcinoma.

Forty consecutive patients with stage III and IV invasive ovarian carcinoma were treated on a phase II protocol consisting of optimal debulking surgery, induction cisplatin, cisplatin, doxorubicin, and cyclophosphamide (PAC) chemotherapy, 6-month interval laparoscopy, reinduction cisplatin, PAC chemotherapy, and second-look procedure. All 40 patients have either disease progression or have completed the 12-month protocol. Eighty-seven percent of the patients (35) underwent optimal (less than or equal to 2 cm residual) debulking surgery before chemotherapy, in spite of the fact that 50% (20) were referred to Roswell Park Memorial Institute (RPMI) as inoperable after initial surgery elsewhere.