Showing papers by "Mayo Clinic published in 1969"
TL;DR: Thirty-second speech samples were studied of at least 30 patients in each of 7 discrete neurologic groups, each patient unequivocally diagnosed as being a representative of his diagnostic group, leading to results leading to these conclusions.
Abstract: Thirty-second speech samples were studied of at least 30 patients in each of 7 discrete neurologic groups, each patient unequivocally diagnosed as being a representative of his diagnostic group. Three judges independently rated each of these samples on each of 38 dimensions of speech and voice using a 7-point scale of severity. Computer analysis based on the means of the three ratings on each patient on each dimension yielded results leading to these conclusions: (1) Speech indeed follows neuroanatomy and neurophysiology. There are multiple types or patterns of dysarthria, each mirroring a different kind of abnormality of motor functioning. (2) These patterns of dysarthria can be differentiated; they sound different. They consist of definitive groupings of certain dimensions of speech and voice, deviant to distinctive degrees. (3) Five types of dysarthria were delineated: flaccid dysarthria (in bulbar palsy), spastic dysarthria (in pseudobulbar palsy), ataxic dysarthria (in cerebellar disorders), hypokine...
1,179 citations
TL;DR: Correlation matrices were used to demonstrate co-occurrence of deviant speech dimensions observed and led to the emergence of eight distinctive clusters of dysfunction, which may serve as hypotheses for more accurate physiologic and neurophysiologic measurements.
Abstract: Correlation matrices were used to demonstrate co-occurrence of deviant speech dimensions observed. Application of this technique led to the emergence of eight distinctive clusters of dysfunction. Each of seven neurologic disorders studied had its own unique group or pattern of clusters. However, any one cluster emerged in and was shared by more than one disorder. Inspection of the dimensions present in a cluster permitted giving the cluster a logically determined name based usually on the defective physiology responsible for the cluster. Knowledge of the neuromuscular characteristics of each disorder led to deductions concerning the neuromuscular substrate for each cluster. Intercluster correlations yielded clues concerning co-occurrence of certain neuromuscular defects. Further inspection led to identification of the probable neuromuscular bases of individual deviant speech dimensions. These conclusions may serve as hypotheses for more accurate physiologic and neurophysiologic measurements to further del...
701 citations
TL;DR: It is suggested that 5-fluorouracil (5-F.U.) significantly augments the effectiveness of radiation therapy for locally unresectable carcinoma of the stomach, pancreas, and large bowel.
691 citations
TL;DR: A review of the cases in which the current techniques were used indicates that the location and nature of the obstruction in the left ventricular outflow tract defies successful repair in most instances.
Abstract: Complete surgical correction of transposition of the great arteries associated with subvalvular pulmonary stenosis carries a high mortality rate. A new surgical technique that achieves redirection of the ventricular outflows and relieves pulmonary stenosis by bypassing it, was successfully used to repair complete transposition of the great arteries associated with ventricular septal defect (VSD) and valvular and subvalvular pulmonary stenosis in a 14½-year-old patient. The repair consists of (1) division of the pulmonary artery, the cardiac end of which is oversewn, (2) repair of the VSD with a patch in such a way as to connect the left ventricle with the aorta, and (3) reconstruction of the pulmonary artery with an aortic homograft, including the aortic valve, which is anastomosed between the distal end of the pulmonary artery and the right ventricle. A review of the cases in which the current techniques were used indicates that the location and nature of the obstruction in the left ventricular outflow t...
284 citations
218 citations
TL;DR: Erythrocyte volume, plasma volume, hematocrit, lean body mass, skinfold thickness, arm circumference, height, and weight were measured in 40 normal males, 38 normal females, and 12 obese females to derive equations for estimating erythrocytes and plasma volumes.
210 citations
TL;DR: It is found that the various modalities of sensation were lost in the following order: temperature, pain, touch, and, finally, joint position, which is a unique feature of dominantly inherited amyloidosis.
Abstract: IN A perspicuous report in 1952, Andrade 1 described the natural history of dominantly inherited amyloidosis. The hallmarks of the condition were (1) dominant inheritance, (2) onset in the second or third decade, (3) unremitting course to death, due to cachexia and infection, an average of seven to ten years later, and (4) characteristic pattern of symptoms. Affected persons exhibited paresis, early impairment of thermal and pain sensibilities, and anhidrosis in the lower limbs. Concomitant symptoms were nausea, vomiting, abdominal pains, and sexual and sphincter disorders. A unique feature was the dissociated sensory loss. Andrade found that the various modalities of sensation were lost in the following order: temperature, pain, touch, and, finally, joint position. On postmortem examination, amyloid deposits were found in large amounts in kidneys and peripheral nerves and to a lesser extent in other organs. No adequate anatomic or physiologic explanation for the dissociated sensory loss
191 citations
TL;DR: A glass bead test for platelet adhesiveness is described in which heparinized blood can be used and evidence is presented to suggest that the abnormality is due to the absence of a plasmatic factor.
Abstract: A glass bead test for platelet adhesiveness is described in which heparinized blood can be used. Anticoagulation allows the blood to be handled more conveniently and, furthermore, the flow rate can be exactly controlled. By means of this test, decreased platelet adhesiveness has been demonstrated in von Willebrand’s disease, and the difference between von Willebrand’s disease and normal is much greater than that demonstrated by the Salzman test. Evidence is presented to suggest that the abnormality is due to the absence of a plasmatic factor.
179 citations
TL;DR: Clinically, rupture occurred most frequently during the first week after infarction, and the major pathogenetic considerations probably are loss of tensile strength of the infarcted segment, increased tension in this area, and, in some cases, divergent vector forces.
Abstract: In a 15 year period 106 instances of myocardial rupture after myocardial infarction were observed at autopsy, an incidence of 8.6 per cent of fatal acute myocardial infarcts. This complication occurred most frequently in the seventh and eighth decades and was slightly more common in women. Clinically, rupture occurred most frequently during the first week after infarction. Historical evidence of previous coronary artery disease was uncommon. Hypertension had been present in 70 percent of the patients, but it persisted after the infarct in less than a third. Pathogenetic factors were sought in the clinical aspects of the patients. No definite role could be ascribed to anticoagulant or sympathomimetic drugs or digitalis. Physical activity after infarction may be a predisposing factor in some instances. Sudden death without antecedent change in symptoms most often occurred. Cardiac tamponade or vascular collapse was documented in a few instances prior to death. In most instances no physical findings, laboratory tests, or electrocardiographic features that indicated cardiac rupture could be ascertained. Based on histologie data, 90 per cent of the ruptures occurred during the first two weeks after infarction, at an average time of five days; 22 per cent were in the first 24 hours, and 69 per cent were in the first week. All of the infarcts were transmural and involved large areas of the left ventricle. Ruptures presented as distinct tears (79 per cent) or large areas of hemorrhagic dissection (9 per cent), or both (12 per cent). The most common site of rupture was through the anterior wall of the left ventricle; commonly, ruptures were near the septum or near the base of papillary muscle. The areas of rupture were more common in the basal two thirds of the ventricle than in the apical portion. The ruptures varied greatly in size. Most were situated within the area of infarction rather than at the junction between the infarcted and the normal myocardium. Unusual accumulations of polymorphonuclear leukocytes were not found in most specimens. Most hearts had severe coronary artery disease, but myocardial scarring was present in only a fourth. Cardiac hypertrophy was usually present. The amount of hemopericardium varied widely and was the apparent mechanism responsible for death in some patients. Mural hemorrhage, hypertension, degree of polymorphonuclear infiltration, degree of myocardial fibrosis and location of the infarct may all be of pathogenetic significance in post-infarction rupture in different situations, but these considerations did not have universal applicability. The only common morphologic features among the infarcts that ruptured were their large size and transmural extent. The major pathogenetic considerations probably are loss of tensile strength of the infarcted segment, increased tension in this area, and, in some cases, divergent vector forces.
164 citations
TL;DR: Distribution of values of serum calcium, serum magnesium, serum inorganic phosphorus, blood urea, total serum proteins, serum albumin, and serum alkaline phosphatase has been studied in 278 women and 298 men who upon careful examination have been found to be in good health.
152 citations
TL;DR: In thin bundles of dog ventricular myocardium, a slow inward current could be recorded under voltageclamp conditions and this inward current was influenced by changes in external calcium concentration, but it was not dependent on external sodium concentration.
Abstract: In thin bundles of dog ventricular myocardium, a slow inward current (distinct from the sodium inward current) could be recorded under voltageclamp conditions. This inward current was influenced by changes in external calcium concentration, but it was not dependent on external sodium concentration. Therefore, this current which contributes an appreciable amount of charge transfer during the plateau of the action potential, is carried by calcium ions. In sodium-free solution, the flow of calcium ions into the fiber is directly related to activation of contraction. In sodium-containing solution, however, calcium inward current serves primarily to fill up some intracellular stores from which calcium can be released by moderate depolarization.
TL;DR: Absorption of sodium and chloride against large concentration gradients contrasted with transport characteristics of the small intestine, emphasizing the normal conserving function of the colon for these electrolytes.
Journal Article•
TL;DR: It is affirms that fibrosarcoma is a distinctive lesion of bone, although it may be difficult to differentiate from some other tumors, notably fibroblastic osteogenic sarcoma, although the distinction should probably be maintained.
Abstract: A study conducted at the Mayo Clinic affirms that fibrosarcoma is a distinctive lesion of bone, although it may be difficult to differentiate from some other tumors, notably fibroblastic osteogenic sarcoma. The 5-year survival rate of 28.7% in fibrosarcoma is better than that in osteogenic sarcoma (even of the fibroblastic type), so the distinction should probably be maintained. Well-differentiated fibrosarcomas are associated with an appreciably better prognosis than are the more anaplastic ones. The principles for treatment in fibrosarcoma are similar to those in osteogenic sarcoma because both tumors are radioresistant. When applicable, amputation is usually the preferred treatment. Wide local resection may be successful for some of the smaller and less anaplastic fibrosarcomas of bones of the extremities and has been successful in eradicating tumors at selected other sites, notably the mandible. Radiation therapy is sometimes beneficial. No less than 30% of this total series of fibrosarcomas were secondary to other tumors or related to prior radiation, and the chance of survival after adequate therapy in this group was not significantly different from that of the remainder.
TL;DR: Six patients who had previously had gastric surgery exhibited the features necessary for the diagnosis of postoperative alkaline reflux gastritis and the surgical management by means of a Roux-en-Y gastrojejunal type of anastomosis is discussed.
Abstract: Six patients who had previously had gastric surgery exhibited the features necessary for the diagnosis of postoperative alkaline reflux gastritis. The clinical, endoscopic, and gastric secretory findings are discussed. The surgical management by means of a Roux-en-Y gastrojejunal type of anastomosis is discussed with a comment on the pertinent histologic data. Follow-up data are presented as well as the results of other studies on the subject of alkaline reflux into the stomach and the clinicopathologic effects thereof.
TL;DR: Of two investigational drugs studied, metoclopramide proved to be of no therapeutic value and metopimazine showed an indication of antiemetic effect in the absence of any significant sedative effect.
TL;DR: If Au(1) adequately reflects the presence of hepatitis virus, these findings would suggest that in some patients with chronic active liver disease, a chronic viral infection exists, even in the absence of cirrhosis.
TL;DR: The TMJ is more subject to nonspecific inflammatory systemic disease or localized degenerative joint changes than to other types of arthritis.
Abstract: The TMJ is more subject to nonspecific inflammatory systemic disease or localized degenerative joint changes than to other types of arthritis. Various treatment measures can be taken for both local and systemic diseases.
TL;DR: During pregnancy, when surgically reparable heart disease can no longer be medically manged, open- or closed-heart surgery is the procedure of choice without prior therapeutic abortion.
Abstract: During pregnancy, when surgically reparable heart disease can no longer be medically manged, open- or closed-heart surgery is the procedure of choice without prior therapeutic abortion. Cyanotic congenital heart disease in a pregnant patient when completely correctable surgically may be an indication for surgery in itself. Available data suggest that pregnancy per se does not increase the maternal risk of heart surgery with use of extracorporeal circulation. Fetal mortality in our series was 33%.
TL;DR: A simple procedure that monitors development of the steady state was developed and relationships between colonic transit, volume, and absorption were established by dye-dilution curves at different rates of perfusion.
TL;DR: One explanation for the abnormal myocardial pattern observed in this case is failure of the normal differentiation of the primitive ventricular wall into compact myocardium, which may have represented persistence of an embryonal pattern.
Abstract: Unusual ventricular myocardial patterns in a child are described. These patterns, demonstrated by angiocardiography, were associated with complex, congenital heart disease. Autopsy confirmed the bizarre, spongy myocardial patterns present in both ventricles. One explanation for the abnormal myocardial pattern observed in this case is failure of the normal differentiation of the primitive ventricular wall into compact myocardium. Thus, this case may have represented persistence of an embryonal pattern.
TL;DR: Esophageal perforations occurred in 33 (0.4 percent) of 8,038 patients who underwent peroral gastrointestinal endoscopic procedures at the Mayo Clinic from 1961 through 1967, and esophagoscopy was the procedure most often responsible.
TL;DR: Vagotomy permanently abolished the response of gastric electrical activity to insulin-induced hypoglycemia and did greatly diminish or eliminate the inhibitory effect of oil instillation on corporal PP propagation and on the occurrence of antral action potentials.
TL;DR: Changes in cerebral blood flow and cerebrovascular resistance (CVR) due to hypocapnia alone or hemodilution alone were of the expected directions and magnitudes, however, in dogs hyperventilated after he modilution, no change in CAR occurred.
Abstract: The effects of hypocapnia and dilutional anemia on cerebral metabolism and circulation were examined in 20 anesthetized dogs. In ten dogs, a reduction in Paco2 to 11 mm Hg did not alter the cerebral oxygen consumption rate (CMRo2), but with subsequent dilution of hemoglobin to 5 gm/100 ml of blood,
TL;DR: Findings suggest a fundamental difference in cholesterol metabolism in these two types of hyperlipidemia.
Abstract: Total daily bile acid excretion was measured in 10 patients with primary hypercholesteremia and in nine patients with combined hypercholesteremia and hypertriglyceridemia by using 14C-labeled cholic acid and 3H-labeled chenodeoxycholic acid. The average bile acid excretion by the patients with primary hypercholesteremia was 282 mg/day; that by the patients with combined hypercholesteremia and hypertriglyceridemia, 1,094 mg/day. These findings suggest a fundamental difference in cholesterol metabolism in these two types of hyperlipidemia.
TL;DR: The “cytoplasmic body” represents another basic pathological reaction of the Z disk and is characterized by a dense filamentous core, a surrounding lighter halo, randomly orientated thin and finer filaments in the halo and its restriction to white fibres.
Abstract: The “cytoplasmic body”, herein described, represents another basic pathological reaction of the Z disk. It is characterized by (1) its origin in the Z disk, (2) a dense filamentous core, (3) a surrounding lighter halo, (4) randomly orientated thin and finer filaments in the halo, (5) lack of a tetragonal filamentous array regardless of the plane of the section, (6) an accompanying focal decrease of mitochrondria from the affected fibre regions, and (7) its restriction to white (type 2) fibres. These features are compared with those of other anomalies of the Z disk.
TL;DR: Lymphocytes from healthy subjects and patients with diseases other than ulcerative colitis or granulomatous enterocolitis also were tested for cytotoxic effects in vitro on allogeneic colonic epithelial cells, and no cytotoxicity was found for gastric or ileal epithelial Cells.
TL;DR: In this article, the authors discuss a problem that arises much more frequently than the mathematically precise one of Murphy and Abbey, and they have never met such a problem in connection with clinical norms and believe that such problems are few and far between.
Abstract: In a recent paper, Murphy and Abbey’ have suggested that the usual “norms” found in medical literature are largely irrelevant to the decision problems faced in practice. The proper approach, according to them, is to locate a critical value for decision by minimizing some cost function. The circumstances under which it is possible to adopt this suggestion are: (1) there must be a specific problem in which, for some well-defined class (or subclass) of persons, it is appropriate to reach a decision solely on the basis of a set of laboratory measurements; and (2) this specific problem must be one in which quantitative terms can be expressed for the relative penalty (or cost) of a false-positive and a false-negative result. When faced with a problem that has both of these properties, few people, statisticians or clinicians, would disagree with the Murphy-Abbey approach. We have never met such a problem in connection with clinical “norms” and believe that such problems are few and far between. Usually, we have only vague qualitative indications of the “cost” of wrong decisions. It is our purpose to discuss a problem that we believe arises much more frequently than the mathematically precise one of Murphy and Abbey. Whether our concern is with errors in laboratory measurements, variability over time of the laboratory values for an individual, individual variability among healthy persons, or variability between states of health and disease, and whether the problem is univariate or multivariate, the characteristics of some frequency distribution(s) have to be determined on the basis of empirical observations. We shall consider the estimation of some percentage point of a frequency distribution. In our illustrations we have chosen the 95th percentile. In making such an estimate, we may have any one of several different purposes in mind:
TL;DR: Modification in the classical technic of radical neck dissection in order to preserve the spinal accessory nerve appears to be safe and justifiable in selected cases.
Abstract: Two hundred fifty radical neck dissections performed in 208 patients from January 1960 through December 1964 are reviewed. The spinal accessory nerve was sacrificed in the course of the dissection in 161 and was preserved in 89. Five patients died in the immediate postoperative period. The incidence and sites of recurrences in the remaining 245 dissections were analyzed. When lymph nodes of the cervical region were found histologically to be involved by tumor, recurrences developed on the side of dissection in 36 per cent of cases when the spinal accessory nerve was sacrificed and in 17 per cent when the nerve was preserved. In the latter group, there were no recurrences in the posterior cervical triangle or along the course of the nerve. In both groups, local recurrence on the side of dissection was associated with recurrence of the primary tumor in more than a third of the cases and with distant metastasis in approximately a half. When the cervical lymph nodes were not involved, the incidence of recurrent lesions in the neck was 12 per cent in the first group and 4 per cent in the second. Again a high proportion of cervical recurrences were accompanied by recurrence of the primary tumor. No patient in whom one or both spinal accessory nerves were preserved died as a result of local recurrence in the neck alone. Modification in the classical technic of radical neck dissection in order to preserve the spinal accessory nerve appears to be safe and justifiable in selected cases.