tbuckley/cabot-search huggingface dataset:
Reduction of dietary phosphorus absorption by phosphorus binders. A theoretical, in vitro, and in vivo study.
Authors: M S Sheikh, J A Maguire, M Emmett, C A Santa Ana, M J Nicar, L R Schiller, J S Fordtran
Journal: Journal of Clinical Investigation (1989)

Antacids used to decrease phosphorus absorption in patients with renal failure may be toxic. To find more efficient or less toxic binders, a three-part study was conducted. First, theoretical calculations showed that phosphorus binding occurs in the following order of avidity: Al3+ greater than H+ greater than Ca2+ greater than Mg2+. In the presence of acid (as in the stomach), aluminum can therefore bind phosphorus better than calcium or magnesium. Second, in vitro studies showed that the time required to reach equilibrium varied from 10 min to 3 wk among different compounds, depending upon solubility in acid and neutral solutions. Third, the relative order of effectiveness of binders in vivo was accurately predicted from theoretical and in vitro results; specifically, calcium acetate and aluminum carbonate gel were superior to calcium carbonate or calcium citrate in inhibiting dietary phosphorus absorption in normal subjects. We concluded that: (a) inhibition of phosphorus absorption by binders involves a complex interplay between chemical reactions and ion transport processes in the stomach and small intestine; (b) theoretical and in vitro studies can identify potentially better in vivo phosphorus binders; and (c) calcium acetate, not previously used for medical purposes, is approximately as efficient as aluminum carbonate gel and more efficient as a phosphorus binder than other currently used calcium salts.
575. Correction of Ventilation in Glycogen Storage Disease Type II Mice after Gel-Mediated Delivery of Adeno-Associated Virus Serotype 1 Vectors
Authors: Cathryn Mah, Lara R. DeRuisseau, Christina A. Pacak, Melissa A. Lewis, David D. Fuller, Barry J. Byrne
Journal: Molecular Therapy (2006)

Glycogen storage disease type II (GSDII) is an autosomal recessive disorder caused by a lack of functional acid α-glucosidase (GAA) and results in massive storage of glycogen in lysosomal compartments. It is characterized by progressive skeletal muscle weakness and affected patients suffer severe respiratory insufficiency, oftentimes requiring mechanical ventilation. Previously, we demonstrated that a novel gel-mediated method of delivery of recombinant adeno-associated virus serotype 1 (rAAV2/1) vector to diaphragm in a mouse model of GSDII (Gaa-/-) could restore therapeutic levels of diaphragmatic GAA enzymatic activity with concomitant clearance of glycogen in vivo. We have further characterized the effects of this treatment method on ventilatory function. Similar to the GSDII patient population, we demonstrate in Gaa-/- mice that there is an age-related progressive weakening of diaphragm contractile strength that is accompanied by ventilation impairments. We administered 1x1011 particles rAAV2/1-CMV-GAA to diaphragms of Gaa-/- mice at 3, 9, and 21-mos of age via the gel method. Diaphragm contractile strength and respiratory function were assessed by measuring force-frequency relationships and by barometric whole-body plethysmography, respectively. For plethysmography, ventilation was measured in conscious, unrestrained mice under conditions of normoxia (FIO2:0.21, FICO2: 0.00) and hypercapnia (FIO2: 0.21, FICO2: 0.07) to assess the extended range of ventilatory capacity. In mice treated at 3 mos of age, we show a significant improvement in contractile force at 6 mos (peak force of 24.833.31 vs 16.53±0.74 N/cm2) that is sustained through 1 yr (21.59±1.59 vs 13.94±1.15 N/cm2) of age as compared to age-matched untreated controls. Under conditions of normoxia, the ratio of minute ventilation (VE; mL/min) to expired CO2 (VE/ VCO2) (18.65±0.73 vs 13.3±0.74), and peak inspiratory flow (mL/sec) (4.11±0.17 vs 3.21±0.29) were significantly improved (p≤0.05) in mice treated at 3 mos of age and tested at 6 mos as compared tountreated controls. However, these improvements did not persist to 1 yr of age. In mice treated at 9 and 21 mos of age, there was significant improvement in contractile function in treated diaphragms 3 mos post-treatment (peak force of 21.28±1.49 at 1 yr and 17.21±0.29 N/cm2 vs 12.71±0.94 N/cm2 at 2 yrs of age, respectively) as compared to age-matched untreated controls. In all rAAV2/1- treated mice, minute ventilation and peak inspiratory flows were significantly improved during hypercapnia. These results demonstrate that gel-mediated delivery of rAAV2/1 vectors improve ventilatory function in a mouse model of muscular dystrophy.
Endobronchial Ultrasonography-Guided Transbronchial Needle Aspiration Biopsy for Preoperative Nodal Staging of Lung Cancer in a Veteran Population
Authors: Lorraine D. Cornwell, Faisal G. Bakaeen, Charlie K. W. Lan, Shuab Omer, Ourania Preventza, Brent Pickrell, Alex Nguyen, Roberto F. Casal
Journal: JAMA Surgery (2013)

Recently, preoperative lung cancer staging has evolved to include endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA) biopsies of the hilar and mediastinal lymph nodes, but the feasibility and usefulness of the procedure have not been well studied in the veteran population.To determine the safety and effectiveness of EBUS-TBNA as a key component of a preoperative staging algorithm for lung cancer in veterans.Review of a prospectively maintained thoracic surgery database that includes patients who underwent lung resection for lung cancer between January 1, 2009, and December 31, 2012, at a single Veterans Affairs medical center among a consecutive cohort of 166 patients with clinically early-stage (I or II) lung cancer who underwent lobectomy with nodal dissection.Endobronchial ultrasonography-guided transbronchial needle aspiration mediastinal staging (EBUS group) in 62 patients (37.3%) was compared with noninvasive nodal staging plus integrated positron emission tomography-computed tomography only (PET/CT-only group) in 104 patients (62.7%). The accuracy of nodal staging was assessed by comparison with the final pathological staging after complete nodal dissection (the gold standard).Primary outcomes were feasibility, safety, accuracy, and negative predictive value of EBUS-TBNA for preoperative nodal staging. A secondary outcome was the rate of nontherapeutic lung resection for occult N2 disease, with comparison between the EBUS group and the PET/CT-only group.No significant complications were attributable to the EBUS-TBNA procedure. In the EBUS group, 258 lymph node stations were sampled. N1 hilar metastases were diagnosed in 8 patients (12.9%) before surgery, and the remainder were staged N0. Accuracy and negative predictive value of EBUS-TBNA were 93.5% (58 of 62) and 92.6% (50 of 54), respectively. The overall rate of nontherapeutic lung resection performed in patients with occult N2 disease was 10.8% (18 of 166) (8.1% in the EBUS group and 12.5% in the PET/CT-only group) (P = .37).A preoperative lung cancer staging strategy that includes EBUS-TBNA seems to be safe and effective in a veteran population, resulting in a low rate of nontherapeutic operations because of occult N2 nodal disease.
Incidence of Diabetic Retinopathy and Relationship to Baseline Plasma Glucose and Blood Pressure
Authors: Arthur Teuscher, Hans Schnell, Peter WF Wilson
Journal: Diabetes Care (1988)

A nationwide, stratified population sample of 534 diabetic Swiss men and women, aged 35–54 yr, participated in a study of vascular disease. The study was based on a common protocol, standardized examination procedures, and centralized laboratory methods. Patients were chosen from a pool of diabetic Swiss with diabetes ≥1 yr. After selection, the participants were classified into groups according to age at diabetes onset (&amp;gt;30 or &amp;lt;30 yr) and insulin treatment status. Several variables thought to be related to retinopathy incidence were analyzed at the initial examinations: onset of diabetes before age 30, duration of disease, fasting plasma glucose, blood pressure, and insulin therapy. Follow-up examinations of 358 of 458 survivors, with a diabetes duration that averaged 20 yr, showed retinopathy significantly and independently associated with initial fasting plasma glucose, systolic blood pressure, and insulin use but not with diabetes duration. Lower rates of retinopathy development were observed during the follow-up period in diabetic patients on antihypertensive therapy at the baseline examination, suggesting that not only lower fasting plasma glucose and systolic blood pressure levels but also blood pressure therapy itself decreases the incidence of retinopathy.
Follow up policy after treatment for Hodgkin's disease: too many clinic visits and routine tests? A review of hospital records
Authors: J A Radford, A Eardley, C Woodman, D Crowther
Journal: BMJ (1997)

To examine the effectiveness of routine clinic review in detecting relapse after treatment for Hodgkin's disease.Review of hospital records.Regional centre for cancer treatment and research.210 patients with Hodgkin's disease recruited to a chemotherapy trial protocol between 1984 and the end of 1990 who had achieved a complete or partial remission after treatment.The number of clinic visits made by patients over the period of observation, the number of relapses occurring during that time, and the route by which relapse was detected.The 210 patients generated 2512 outpatient reviews, and 37 relapses were detected. Thirty relapses (81%) were diagnosed in patients who described symptoms, which in 15 cases had resulted in an earlier appointment being arranged. In only four cases (11%; 95% confidence interval 4% to 25%) was relapse detected as a result of routine physical examination on investigation of a patient who did not have symptoms.Relapse of Hodgkin's disease after treatment is usually detected as a result of the investigation of symptoms rather than by routine screening of asymptomatic patients. It is therefore proposed that the frequency of routine follow up visits should be reduced and greater emphasis placed on patient education. This should underline the importance of symptoms and encourage patients to arrange an earlier appointment if these develop.
Proceedings: Abnormalities in rheumatoid synovial collagen: studies on synovial polymeric collagens (PC) from normal individuals and patients with rheumatoid and other arthropathies.
Authors: J Weiss, S J Leibovich, J A Hunter, M I Cawley
Journal: Annals of the Rheumatic Diseases (1974)

DR. DAVIS I think you have missed the point.Our main concern has not been the measurement of viral antibodies as such, but antibodies against RNA; the two are not synonymous as I have explained.
Vascular Hamartomas and Angiodysplasias of the Extremities
Authors: Theodore B. Massell
Journal: JAMA (1969)

"Hamartomas," according to the authors, are tumor-like formations which cease to grow when body growth is complete. This treatise covers all the forms of vascular and lymphatic malformation of congenital origin and also includes acquired vascular lesions related to angiomas. A detailed classification of the different lesions serves as an introduction, while the bulk of the volume relates the authors' personal observations and studies in 100 cases. Clinical examinations were often supplemented by angiographic studies, oximetry of the venous blood, plethysmography, and histologic examination of biopsies. In six cases three dimensional reconstructions were made by the use of serial sections. The authors also made excellent use of the publications of other investigators, to which they referred in a 24-page bibliography. The result is a significant contribution to the understanding of vascular lesions that have previously been of little interest to and not well understood by most clinicians. The information imparted
Reviews and Notes: Cardiology: Clinical Cardiac Electrophysiology: Techniques and Interpretations
Authors: Ronald R. Hope
Journal: Annals of Internal Medicine (1993)

Literature of Medicine1 September 1993Reviews and Notes: Cardiology: Clinical Cardiac Electrophysiology: Techniques and InterpretationsRonald R. Hope, MDRonald R. Hope, MDSt. Anthony's Hospital, Oklahoma City, OK 73106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-5-199309010-00048 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Clinical Cardiac Electrophysiology: Techniques and InterpretationsSecond edition. Mark E. Josephson. 839 pages. Philadelphia: Lea & Febiger; 1993. $95.00.A generation ago, general medicine textbooks began to be accompanied by more specialized medical texts, which discussed subspecialties of medicine in greater depth and with greater authority. Subspecialty books were often written by one author but have since become multiauthored, monumental treatises themselves. This has become necessary with the vast development of general medical knowledge and the advancement of medical sciences.A general cardiology textbook is often more useful to an internist or general physician than to a cardiologist. The intense training of a ... Author, Article, and Disclosure InformationAffiliations: St. Anthony's Hospital, Oklahoma City, OK 73106. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAdrenergic Nervous System Influences on the Induction of Ventricular Tachycardia 1 September 1993Volume 119, Issue 5Page: 444-445KeywordsArrhythmiaCardiac ablationCardiac electrophysiologyCardiovascular diseasesCathetersPacemakersSub-specialty careTachycardia Issue Published: 1 September 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Portal Hypertension From Idiopathic Superior Vena Caval Obstruction
Authors: Eric W. Fonkalsrud
Journal: JAMA (1966)

An unusual combination of idiopathic superior and inferior vena caval obstruction occurred in a 15-yearold boy. Portal hypertension with ascites and associated bleeding esophageal varices developed as a result of hepatic outflow obstruction due to the occluded inferior vena cava. Surgical decompression of the portal venous system was accomplished by splenectomy and placement of a Teflon tube graft between the splenic vein and the divided pulmonary artery to the left lower lobe, since the standard methods of creating an Eck fistula were not possible in this patient. The patient has experienced marked clinical improvement during the nine months following operation.
Pollution most foul.
Authors: K. Chopin
Journal: BMJ (1992)

The Ozark chinkapin (<i>Castanea ozarkensis</i> Ashe [Fagaceae]) is a true chestnut that is native to the Ozark Highlands of Missouri, Arkansas, and Oklahoma and to the Ouachita Mountains of Arkansas. It has been decimated by chestnut blight, and the species' long-term survival is precarious. Few seed-producing trees can now be found in the wild, and the species requires very specific soil and site conditions, making it difficult to cultivate. We studied grafting Ozark chinkapin scions to its readily grown congener, Chinese chestnut (<i>Castanea mollissima</i> Blume) in controlled orchard settings at 2 Missouri sites, with orchard establishment in 2007 and grafting conducted in 2008. Our grafting success was 56% over all experimental parameters, but up to 83% with optimal combination of site, grafting technique, and scionwood type. Whip-and-tongue grafts were slightly (but not significantly) more successful than chip-bud grafts; however, a more vigorous scionwood type yielded significantly greater graft success (75%) compared with a second scionwood source (38%). By 2014, no indications of interspecific graft incompatibility were evident, and grafted trees were producing abundant nut yields. The successful demonstration that Chinese chestnut can be used as a rootstock for Ozark chinkapin has profound implications for the rapid propagation of Ozark chinkapin germplasm in <i>ex situ</i> orchards and as an important tool in a larger conservation context. In such settings, research, breeding, and mass propagation efforts with the threatened Ozark chinkapin can become much more simple, successful, and cost-efficient.
Pelvic Recurrence after Excision of Rectum for Carcinoma
Authors: B. C. Morson, E. G. Vaughan, H. J. R. Bussey
Journal: BMJ (1963)

Recurrence in the pelvis after excision of the rectum for carcinoma implies some form of incomplete removal of the primary tumour or metastases in its immediate neighbour- hood.Little is known of the incidence of pelvic recurrence or of the factors responsible for its development, though the painful effects of these surgical failures are only too often seen in the out-patient department.These considerations prompted an investigation into the pathology of pelvic recurrence in a large series of patients with rectal cancer in the hope of finding methods of prevention.Material and Methods Radical Excisions.-AtSt. Mark's Hospital during the 25-year period 1928-52 there were 1,596 survivors from radical operations for removal of the rectum for cancer.All these operations were of the excision type-that is, they removed the anal canal as well as the rectum and were not of a restorative nature.Moreover, all these opera- tions were " radical " in the sense that in each case it was thought by the surgeon that the primary growth and all known metastases had been completely removed.Palliative Excisions.-Theseinclude those operations of the excision type in which the surgeon was of the opinion that growth had been left behind, mostly because of incomplete local excision or because of the presence of hepatic metastases.During 1928-52 there were 200 operation survivors in this group.Anterior Resection.-Therewere 217 survivors after anterior resection during the 10-year period 1948-57.Of these, 177 were " radical " and 40 " palliative " as defined above.In this group the operations were nearly always palliative because of the presence of hepatic metastases.The attempt to follow up all these patients has been successful in 98.5% of the cases.Approximately half the patients continued to attend the out-patient department at regular intervals and thus received experienced aftercare.The remainder, usually living at a considerable distance from London, were followed up by means of biannual questionary letters.When death occurred in the absence of recent examination at St. Mark's Hospital, the opinion of the local practitioner on the cause of death was requested.Obviously only a thorough post-mortem examination in each case could establish beyond doubt whether or not there was a recurrence, and this was possible in only a very few patient.s. Definition of Pelvic RecurrenceIn this study the term " pelvic recurrence " refers to the presence of symptoms and signs, the most likely explanation of which was the growth of residual carcinoma in the pelvic region.These clinical manifestations-for radical non- restorative operations, for example-are listed in Table I.A perineal nodule, mass, or ulcer was evident in 48 patients, and in a further 26 cases similar lesions were found in the vaginal wall.' Histological proof of malignant growth was obtained by biopsy in about one-third of these cases.Perineal abscess was the presenting symptom in four patients, and in each case a biopsy was confirmatory.
Extramedical Influence of the Physician
Authors: P. W. Van Metre
Journal: JAMA (1963)

<h3>To the Editor:</h3> —In Dr. Barach's castigation of the physician who interdicts smoking in pulmonary disease, it is pertinent to inquire how one accomplishes "moderate smoking at times." The same goes for alcohol. Isn't this being realistic instead of moralistic? One questions if "the major religions" actually attempt to persuade man to "renounce the joys of this world." Rather, religion seeks to teach him the difference between fleeting joys, that leave in passing an unpleasant ash, and the lasting joys that show accretion and no remorse—such as self-denial, habitual expulsion from one's mind of all satanic thoughts and impulses, and learning to know and commune with one's Maker. From what old Bible ("innovators of the new Bible") did he gain the idea that would make Satan not a bad fellow but a blend of good and evil, not pure white— not pure black? The three foregoing letters were referred to
Low Risk of Post-Cesarean Section Infection in Insulin-Requiring Diabetic Women
Authors: Laura E Riley, Ruth E Tuomala, Tim Heeren, Michael F Greene
Journal: Diabetes Care (1996)

The purpose of this study was to determine if insulin-requiring diabetic women undergoing nonelective cesarean section are at higher risk for postoperative infection than nondiabetic women.Medical records of a cohort of insulin-requiring diabetic women who underwent cesarean section after labor or rupture of membranes and nondiabetic control subjects matched for age and insurance status were retrospectively reviewed. Data abstracted included maternal characteristics, antepartum, intrapartum, and postpartum events.Post-cesarean section infection including endometritis, wound infection, and septic pelvic thrombophlebitis occurred in 10.2% of 205 diabetic women and 12.1% of control subjects, in whom antibiotic prophylaxis was used in 79% of diabetic women and 84% of control subjects. Duration of rupture of membranes was a significant risk factor for post-cesarean section infection in both groups.Insulin-requiring diabetic women undergoing nonelective cesarean section with antimicrobial prophylaxis have a rate of postoperative infection similar to that for nondiabetic women.
Phenotypic and functional characterization of lymphocytes that bind human microvascular endothelial cells in vitro. Evidence for preferential binding of natural killer cells.
Authors: J R Bender, R Pardi, M A Karasek, E G Engleman
Journal: Journal of Clinical Investigation (1987)

The microvascular endothelium has been postulated to be a critical target in the rejection of vascularized allografts. This study was undertaken to examine the ability of human sheep erythrocyte rosette forming lymphocytes (E-RFC) to form stable conjugates with microvascular endothelial cells (EC), and to assess whether a receptor-ligand interaction mediates this event. Human foreskin microvascular EC monolayers were used as targets of chromium-51-labeled E-RFC in a quantitative adherence assay. Binding was saturable, displaceable by unlabeled E-RFC, augmented by recombinant interleukin 1 (rIL-1) and inhibited by anti-LFA1 antibody. The Leu-11+ lymphocyte subset, known to be enriched for natural killer (NK) cells, bound preferentially. Only the EC-adherent lymphocyte fraction contained NK effectors, which lysed EC and classical NK targets. Thus, NK cells adhere to microvascular EC via a specific receptor-ligand interaction. The possibility exists that such binding occurs in recipients of vascularized allografts, representing the initial stage of graft rejection.
Mycoplasma pneumoniae Infections
Authors: J. Thomas Grayston
Journal: JAMA (1965)

Mycoplasma pneumoniae (Eaton agent) caused a significant amount of acute febrile respiratory disease in Seattle during 1962 and 1963. The agent was isolated from 20% of 215 pneumonia patients and from 7% of 248 patients with febrile respiratory disease without pneumonitis. The highest isolation rate was from persons 10 to 25 years of age and the lowest from children under 5 years old. The pneumonia cases were similar clinically to previous descriptions of cold-agglutinin-positive primary atypical pneumonia. These infections occurred at all seasons of the year and were more frequent in males. A complement-fixation antibody test using a chloroformmethanol solvent-extracted antigen from broth-grown M pneumoniae was found to be highly sensitive and specific. The complement-fixation test is simple and inexpensive and should replace the cold-agglutinin test for routine diagnosis.