tbuckley/cabot-search huggingface dataset:
Molecular genetic analysis of 178 I-Abm12-reactive T cells.
Authors: J Bill, J Yagüe, V B Appel, J White, G Horn, H A Erlich, E Palmer
Journal: The Journal of Experimental Medicine (1989)

We have studied the genetic diversity of the TCR repertoire to the murine alloantigen I-Abm12 by generating a panel of 178 C57BL/10-derived I-Abm12-reactive T cell hybridomas. The expression of V alpha and V beta gene families was examined in this panel and the frequency of expression of V beta, but not ofV alpha, gene families differed significantly from that observed in a companion panel of random C57BL/10-derived hybridomas. The V beta 5 gene family was expressed significantly less frequently while the V beta 14, V beta 15, and V beta 16 genes were expressed significantly more frequently in the panel of I-Abm12-reactive than in the panel of random hybridomas. The junctional regions (VJ alpha and VDJ beta) of TCR V alpha and V beta genes from selected I-Abm12-specific hybridomas were amplified using the polymerase chain reaction, and directly sequenced. Surprisingly, no conserved J alpha, D beta, J beta, or N region-encoded sequences among these selected I-Abm12-reactive TCRs were identified. Thus, the T cell response to an I-A alloantigen that differs by only three amino acid residues from the I-A molecule of the responding strain is genetically complex but nonrandom. We have estimated that the repertoire to this alloantigen is comprised of at least 37 different TCRs.
Relationship between adipose tissue insulin resistance and liver histology in nonalcoholic steatohepatitis: A pioglitazone versus vitamin E versus placebo for the treatment of nondiabetic patients with nonalcoholic steatohepatitis trial follow-up study
Authors: Lauren N. Bell, Jiangxia Wang, Sriya Muralidharan, Sadhana Chalasani, Allison M. Fullenkamp, Laura A. Wilson, Arun J. Sanyal, Kris V. Kowdley, Brent A. Neuschwander-Tetri, Elizabeth M. Brunt, Arthur J. McCullough, Nathan M. Bass, Anna Mae Diehl, Aynur Unalp-Arida, Naga Chalasani
Journal: Hepatology (2012)

The PIVENS (Pioglitazone versus Vitamin E versus Placebo for the Treatment of Nondiabetic Patients with Nonalcoholic Steatohepatitis [NASH]) trial demonstrated that pioglitazone and vitamin E improved liver histology to varying degrees, but the mechanisms are unknown. We conducted a study to examine the changes in adipose tissue insulin resistance (Adipo-IR) during the PIVENS trial and its relationship to histological endpoints. Adipo-IR (fasting nonesterified fatty acids [NEFAs] × fasting insulin) was calculated at baseline and after 16 and 96 weeks of therapy. Compared to placebo, the baseline Adipo-IR was not different in either the vitamin E group ( P = 0.34) or the pioglitazone group ( P = 0.29). Baseline Adipo-IR was significantly associated with fibrosis score ( P = 0.02), but not with other histological features or nonalcoholic fatty liver disease (NAFLD) activity score (NAS). After 16 weeks, compared to placebo, the pioglitazone group had a significant reduction in Adipo-IR (−15.7 versus −1.91; P = 0.02), but this effect did not persist at 96 weeks (−3.25 versus −4.28; P = 0.31). Compared to placebo, Adipo-IR in the vitamin E group did not change significantly either after 16 weeks ( P = 0.70) or after 96 weeks ( P = 0.85). Change in Adipo-IR at week 16 was not associated with changes in any histological parameters at week 96, but improvement in Adipo-IR at week 96 was significantly associated with improvement in ballooning ( P = 0.03), fibrosis ( P = 0.004), and NAS ( P = 0.01). Conclusion : Vitamin E improved liver histology independent of changes in Adipo-IR, and pioglitazone treatment acutely improved Adipo-IR, but this was not sustained. Changes in Adipo-IR were associated with changes in liver histology, including fibrosis. (Hepatology 2012)
Serum type III procollagen peptide, type IV collagen 7S domain, central triple-helix of type IV collagen and tissue inhibitor of metalloproteinases in patients with chronic viral liver disease: Relationship to liver histology
Authors: Yoshikazu Murawaki, Yujiro Ikuta, Masahiko Koda, Hironaka Kawasaki
Journal: Hepatology (1994)

To assess the clinical value of serum biochemical markers, the aminoterminal peptide of type III procollagen, type IV collagen 7S domain, the central triple-helix of type IV collagen and tissue inhibitor of metalloproteinases, as a marker of hepatic fibrosis, we measured these four serum markers in 132 patients with chronic viral liver disease and compared these serum markers with liver histological findings. Serum levels of these markers increased closely with the progress of liver disease, and the abnormal percentages of type III procollagen peptide, type IV collagen 7S domain, central triple-helix of type IV collagen and tissue inhibitor of metalloproteinases in patients with cirrhosis were 97%, 95%, 83% and 48%, respectively. These four serum markers strongly correlated with the histological degree of periportal with or without bridging hepatocellular necrosis and of liver fibrosis and correlated weakly with the degree of intralobular degeneration and focal necrosis and the degree of portal inflammation. The correlation coefficients of serum type IV collagen 7S domain with periportal with or without bridging hepatocellular necrosis and with liver fibrosis were the highest among these four serum markers, suggesting that serum type IV collagen 7S domain is the most valuable diagnostic marker to assess the degree of liver fibrosis in chronic viral liver disease. When we assessed the ability of each serum marker to detect cirrhosis with a receiver operating curve, the best test was type IV collagen 7S domain, and the second best was type III procollagen peptide.(ABSTRACT TRUNCATED AT 250 WORDS)
Postsurgical wound progression monitored by temporal changes in the expression of matrix metalloproteinase-9
Authors: J.F. TARLTON, C.J. VICKERY, D.J. LEAPER, A.J. BAILEY
Journal: British Journal of Dermatology (1997)

It is important to monitor the early stages of postoperative wound repair in order to identify those problems associated with impaired healing. Many of the crucial cellular responses of early wound healing, such as inflammatory infiltration, angiogenesis and re-epithelialization, are made possible through the action of matrix metalloproteinases (MMPs). Expression of MMP-2 and MMP-9 is elevated in acute wounds, and still greater levels are found in chronic wounds, indicating that uncontrolled proteolysis is a characteristic of retarded healing. Therefore, comparative measurements of MMPs may be used to monitor the progression of early wound healing. To investigate this, wound fluids and sera were collected from mastectomy and colectomy patients throughout early stages of repair, and the temporal expression profile established. Wounds which were healing were expressed maximal levels of MMP-9 at 24 h, followed by a significant decline by 48 h. Persistent elevation of MMP-9 expression was associated with infected and chronic wounds, and was identified in postoperative wounds by the absence of the significant decline between 24 and 48 h. Measurement of MMP-9 in postoperative wound fluids, therefore, provides an early indicator of impaired healing, which may be evaluated non-invasively within 48 h of closure.
Blood Pressure during Supine Exercise in Idiopathic Orthostatic Hypotension
Authors: ROBERT J. MARSHALL, ALEXANDER SCHIRGER, JOHN T. SHEPHERD
Journal: Circulation (1961)

The arterial blood pressure was measured during exercise in six patients with idiopathic orthostatic hypotension. In five there was a pronounced fall of arterial pressure while the subjects exercised in the supine position on a horizontal table. The systolic and diastolic pressures fell by an average of 50 and 32 mm. of mercury, respectively. During comparable exercise with the table tilted 15 degrees head downward, the pressures fell to a similar degree. Thus, an abnormal response of blood pressure occurred under conditions in which venous pooling was unlikely to be present. It is suggested that the fall in blood pressure during exercise in the supine position was the result of failure of compensatory constriction of other vascular beds and not of failure of the cardiac output to increase. Thus, the net peripheral resistance in such patients is less than that in normal persons performing comparable exercise.
Live endoscopy events (LEEs): European Society of Gastrointestinal Endoscopy Position Statement – Update 2014
Authors: Mário Dinis-Ribeiro, Cesare Hassan, Alexander Meining, Lars Aabakken, Paul Fockens
Journal: Endoscopy (2014)

The European Society of Gastrointestinal Endoscopy (ESGE) is dedicated to improving the quality of gastrointestinal endoscopy through educational activities such as live endoscopy events (LEEs). The primary utility of LEEs is the educational value for the audience, and patients should not expect additional benefit from being treated during a LEE compared to a routine setting. Although there is no evidence that LEEs entail additional risks for patients, neither can possible unknown risks be excluded as the evidence available is limited. Therefore, necessary measures should be taken to assure patient safety. Patients must be adequately informed that the standard of care will be assured and that their identity will not be revealed. ESGE recommends that an endoscopist not belonging to the hosting unit is named as patient advocate. Clinical indications for the LEE procedures and the educational outputs must be clear and agreed between host and demonstrator teams. ESGE will ensure that in all ESGE-organized LEEs the indications, procedural descriptions, and adverse events will be registered, and that organizers requesting ESGE endorsement can demonstrate such a registry.
Pulmonary Edema
Authors: ALFRED P. FISHMAN
Journal: Circulation (1972)

The pathogenesis of clinical pulmonary edema is considered in the light of recent physiologic and anatomic insights. Pulmonary edema is depicted as a persistent imbalance between the forces that move water into the extravascular spaces and the biologic devices for its removal. In the normal lung, intricate anatomic arrangements coupled with elaborate physiologic mechanisms maintain the gas-exchanging surfaces moist and free of excess protein. A transient excess of water in the interstitial space is associated with an increase in lymphatic flow. Should the excess rate of formation persist or increase, pulmonary edema may become manifest clinically, first as interstitial edema and then as alveolar and airway edema. The distribution of edema within the lung may be nonuniform, often favoring the central portions early in its genesis but later redistributing under the influence of gravity. A critical limitation in anatomic design is imposed by the narrow channels through which lymph passes out of the thorax into systemic veins. Accordingly, the pulmonary lymphatic system, which seems better suited to return proteins than water to the systemic circulation, may become a limiting factor in relieving pulmonary edema in states of unremitting water movement into the extravascular spaces. The anatomic and physiologic principles are then applied to current clinical enigmas, such as "shock lung," high-altitude pulmonary edema, and the edema that follows an overdose of narcotic agents, such as heroin. In "shock lung" after severe systemic hypotension, nonuniform pulmonary hypoperfusion is identified as the critical pathogenetic factor in the pulmonary edema that occurs during recovery, i.e. after systemic blood pressures have been restored to normal by large transfusions. The corresponding etiologic role for high-altitude pulmonary edema is attributed to anatomic variations in precapillary resistances in the lungs during a burst of severe pulmonary hypertension. The situation is more complicated for the pulmonary edema that follows narcotic overdosage since not only may the medication elicit severe respiratory depression, arterial hypoxemia, respiratory acidosis, and their sequelae–left ventricular failure, leakage of minute pulmonary vessels, and impaired lymphatic drainage–but the self-administered medication may be contaminated with substances that may, per se, cause minute pulmonary vessels to leak.
Medical associations: guilds or leaders?
Authors: D. M Berwick
Journal: BMJ (1997)

In many Western nations traditional medical associations are encountering an opportunity in threat's clothing. If they see through the disguise, and act accordingly, they can lead health care. If they do not, they may find themselves bewildered by their sense of helplessness.

The opportunity comes from the social need for better health care. Any honest review of the literature in clinical science and health services research must conclude that there is a large gap between how health care could perform and how it does perform. In medical care error rates are too high, waste is too pervasive, technically correct clinical services are too often withheld, and technically incorrect procedures are too often used.1 Service characteristics of health care–such as waiting times, consistency of response, and attention to dignity–are well below those of many other industries.2 The patients whom we serve are neither insatiable nor ungrateful when they demand that we do better, although that demand is becoming more strident, inducing new forms of surveillance, regulation, market pressure, and media attention.

Therein lies the opportunity for new leadership from medical associations: not to explain why we cannot do better but to set about the task of leading improvements. Unfortunately (because it makes the job harder), leading improvement requires most medical associations to change both their attitude and agenda. The change in attitude is necessary because the associations' traditional aim–to perfect and protect the profession–will not suffice to meet the social need for improved care. To improve health care we require not better professions but better systems of work.

A “system” in this sense is a set of elements interacting to achieve a shared aim. Here is the trick: to improve the performance of a system, …
PD6-3-6: A phase 3 randomized, double blind, placebo-controlled study of patients with previously untreated extensive-stage small cell lung cancer (SCLC) treated with platinum plus etoposide chemotherapy with or without darbepoetin alfa
Authors: Robert Pirker, Rodryg Ramlau, Wolfgang Schuette, Petr Zatloukal, Irene Ferreira, Tom Lillie, Johan Vansteenkiste
Journal: Journal of Thoracic Oncology (2007)
Synergistic effects of Akt1 shRNA and paclitaxel-incorporated conjugated linoleic acid-coupled poloxamer thermosensitive hydrogel on breast cancer
Authors: Ding-Ding Guo, Seong-Ho Hong, Hu-Lin Jiang, Ji-Hye Kim, Arash Minai-Tehrani, Ji-Eun Kim, Ji-Young Shin, Tao Jiang, You-Kyoung Kim, Yun-Jaie Choi, Chong-Su Cho, Myung-Haing Cho
Journal: Biomaterials (2011)
Brain Scans in Diagnosis of Brain Tumors
Authors: Paul C. Bucy
Journal: JAMA (1965)

The present study is concerned with the use of a radioactive mercury compound in the diagnosis and localization of brain tumors. The results in over 900 patients, 80 with brain tumors, were analyzed. In 61 cases accurate localization was obtained. In eight cases the results were equivocal and in 11, negative. The technique is more valuable with supratentorial tumors. Certain tumors such as glioblastomas and meningiomas give the highest incidence of satisfactory results. The method is useful with many other tumors but a few, such as epidermoid cysts, have given negative results. Lesions other than tumors, granulomas, angiomas, and cerebral infarcts may also give positive results and must be differentiated from tumors by other means. The method is relatively simple, painless, and associated with little or no risk.
A calcium-binding protein in bile and gallstones
Authors: Michael F. Kestell, John Sekijima, Sum P. Lee, Han Z. Park, Michelle Long, Eric W. Kaler
Journal: Hepatology (1992)

Calcium salts are often present in the center of all types of gallstones. Matrix proteins are known to be essential for biomineralization and may therefore also be important in the formation and growth of gallstones. Other researchers have described an anionic peptide fraction of a biliary lipoprotein complex in bile and a low-molecular weight acidic glycoprotein present in gallstones. Our goal was to determine whether such a protein was present in bile and whether this protein has any calcium-binding properties. We identified a pigment-associated, highly acidic protein that precipitates from bile on addition of CaCl2 0.5 mol/L. In addition, the protein is selectively concentrated in cholesterol and pigment stones. We have, therefore, confirmed the findings of these other researchers, and we have extended the study of this protein's interactions with calcium. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis demonstrates a single band (molecular weight < or = 14 kD) that reacts positively with cationic stains. The protein was shown to inhibit the precipitation of CaCO3 from a supersaturated solution. The capacity to bind calcium was further confirmed by autoradiography with 45Ca++ and by a membrane adsorption-binding assay. Calcium-induced aggregation was demonstrated by equilibrium dialysis and by quasielastic light scattering studies. Protein measured by Lowry's assay method and amino acid analysis constitutes only 2% to 4% of the harvested material. We speculate that a substantial lipid component may also be present.(ABSTRACT TRUNCATED AT 250 WORDS)
Prognosis after Transient Monocular Blindness Associated with Carotid-Artery Stenosis
Authors: Oscar Benavente, Michael Eliasziw, Jonathan Y. Streifler, Allan J. Fox, Henry J.M. Barnett, Heather Meldrum
Journal: New England Journal of Medicine (2001)

Transient monocular blindness associated with internal-carotid-artery stenosis is a risk factor for stroke. The effect of carotid endarterectomy in patients who present with transient monocular blindness has not been determined.
Does the patient know best?: Authors' reply
Authors: J. Van-Tam, D. Baker
Journal: BMJ (1992)

their general practitioner.Taking into considera- tion the points already made about possible reasons for their visit to the department and the general nature of the question asked, the figure does not seem to differ from that found in other studies.2The study asked a vague general question about consultations with a general practitioner before the visit to the accident and emergency department and consequently got vague general data, from which no conclusions can be drawn.Perhaps more disturbing is the implied criticism of general practitioners' diagnostic ability.I hope that I am being hypersensitive after my second 120 hour week this month and that no such criticism was meant.
The Politics of Therapy
Authors: Marshall F. Gilula
Journal: JAMA (1971)

This important and significant book examines the proposition that "intellectually and morally the psychiatrist is more justified in taking forthright political stands than in striving only to maintain political neutrality." The author demonstrates that psychiatric intervention of any variety affects the distribution of power within the various social systems in which the patient moves. If politics is defined as the science of "how power is sought, distributed, and exercised within social systems," Dr. Halleck's arguments convincingly demonstrate that nearly all psychiatric treatment does have political consequences. A series of stimulating essay-chapters, which discuss social change, different forms of psychotherapy, community psychiatry, and social control on privacy, attempt to develop a philosophical ethical framework for psychiatric intervention, aware yet inevitably political. The author draws from his experience as a prison psychiatrist to expand a view of deviant behavior that includes student dissent, and will likely help the professional leader who has
Diabetes in Eskimos-Reply
Authors: Quentin A. Fisher
Journal: JAMA (1974)

To the Editor.—  It is interesting that Drs. Mouratoff and Scott have not found any new diabetics in their Eskimo study population since 1962. Our group of Eskimo diabetics may be of interest.  The native population of Barrow in the 1970 census was 2,313. Of those, 14% (315) were over 44 years of age. Seven patients have currently been proven to have diabetes mellitus, and two are suspect. All patients have been discovered since 1966. Records are not available to indicate whether there were any previously discovered diabetics since deceased.  A profile of the patients in the Table shows that all patients except two had onset after age 65, and all are somewhat overweight. This group by no means monopolizes age or adiposity in this town, however.  Whether this incidence of diabetes reflects overweight and increasing conformity to the standards of Western civilization, as the authors suggest, or merely is
Too much emotion?
Authors: Des Spence
Journal: BMJ (2011)

I grew up in a household of boys. We cleaned and cooked; we were domesticated beasts. But we also fought, teased, wrestled, and swore. And at school, teachers shouted and belted us. Then, for boys and girls alike, crying was not an option: no one wanted to be a “cry baby” for the rest of their school career. Neither did we tell on bullies, as fighting back was the prevailing psychological intervention of the 1980s. But my generation were wet blankets, compared with previous generations. Indeed, I consider myself …
Renal Pressor System and Neurogenic Control of Arterial Pressure
Authors: JAMES W. MCCUBBIN, IRVINE H. PAGE
Journal: Circulation Research (1963)

Angiotensin has an effect on the sympathetic nervous system which results in an enhanced response to agents and procedures that cause release of endogenous norepinephrine while having little or no effect on response to exogenous norepinephrine. The effect is peripheral, it does not appear to involve sensitization of norepinephrine receptors, it is dependent upon a functionally intact sympathetic nervous system, and it appears unrelated to the direct vasoconstrictor action of angiotensin. The response to tyramine is increased in both acute and chronic renal hypertension; this suggests that only very small amounts of angiotensin, difficult to detect by present assay methods, continue to have an effect on the sympathetic nervous system in chronic renal hypertension. By intensifying the effect of normal neurogenic vasomotor activity, this action of angiotensin, along with the upward shift of threshold and range of response of the carotid sinus buffer mechanism, might account to a major degree for the large neurogenic component of chronic renal hypertension.
Endotoxin-like Activity of Serum from Patients with Severe Localized Infections
Authors: Philip J. Porter, Alan R. Spievack, Edward H. Kass
Journal: New England Journal of Medicine (1964)

THE role of bacterial endotoxins in the pathogenesis of infections due to endotoxin-containing bacteria is not clear. It is commonly assumed that endotoxin is a major factor in determining toxicity and lethality in such infections, and it has also been suggested that it may mediate vascular collapse, premature delivery and other clinical occurrences.1 2 3 However, none of these suggestions have been rigorously examined in spontaneous infections, largely because no method for the demonstration of endotoxin is sensitive enough to detect the minimal amounts in blood and tissues that might be expected to be present.It is the purpose of the present . . .
GLUTAMICS: A RANDOMIZED CLINICAL TRIAL ON GLUTAMATE INFUSION IN PATIENTS OPERATED FOR ACUTE CORONARY SYNDROME
Authors: Rolf Svedjeholm, Mårten Vidlund, Erik Håkanson, Örjan Friberg, Sören Juhl-Andersen, Jonas Holm, Lena Sunnermalm, Jan-Olov Borg, Farkas Vanky, Rajiv Sharma
Journal: Journal of the American College of Cardiology (2011)