tbuckley/cabot-search huggingface dataset:
Contempo '81. Plastic surgery
Authors: R. C. Schultz
Journal: JAMA (1981)

Advances in plastic and reconstructive surgery during the past year have been in the areas of musculocutaneous flaps, breast reconstruction, craniofacial surgery, and microsurgery. With a few exceptions, the latter two disciplines have returned to and developed most strongly in the large university medical centers, where ancillary resources and specially trained personnel are more readily accessible. Although the well-trained plastic surgeon may attain sufficient skills to perform such surgery, the depth of support facilities and personnel required to prepare adequately for procedures and care for the patients postoperatively has become a factor in the establishment of regional tertiary care centers for referral of this type of surgery. This may change in the years ahead, as secondary care centers become more sophisticated. <h3>Musculocutaneous Flaps</h3> The fundamental concept of composite tissue coverage related to dependable musculocutaneous vascular circulation, based on the known vascularity of large muscle segments, has now been described and
Simulation of Lung Cancer By Metastatic Tumors
Authors: Milton B. Rosenblatt
Journal: JAMA (1966)

<h3>To the Editor:—</h3> The criteria for the diagnosis of bronchogenic carcinoma highlighted in "Current Concepts in Cancer—No. 9" (<b>195</b>:653, 1966) are illusory and help to perpetuate the erroneous diagnosis of bronchogenic carcinoma on the basis of biopsy and radiographic confirmation. Bronchial and scalene node biopsies positive for cancer are not pathognomonic of bronchogenic carcinoma. These findings are indicative only of a malignant tumor in the lung and do not specify whether the tumor is of primary or secondary origin. Metastatic involvement of the bronchi may simulate both the gross and histological appearance of bronchogenic tumors. Secondary tumors involving the subepithelial lymphatics may ulcerate through the bronchial mucosa and present an accessible mass visible on bronchoscopy (<i>Cancer</i><b>16</b>:1521, 1963). On occasion, histological examination of malignant biopsied material may reveal findings characteristic of certain extrathoracic carcinomas (thyroid, kidney, etc), but most often the tissue is reported as undifferentiated carcinoma apparently
Mental Stress Induces Transient Endothelial Dysfunction in Humans
Authors: Lorenzo Ghiadoni, Ann E. Donald, Mark Cropley, Michael J. Mullen, Gillian Oakley, Mia Taylor, Georgina O’Connor, John Betteridge, Nigel Klein, Andrew Steptoe, John E. Deanfield
Journal: Circulation (2000)

Background —Mental stress has been linked to increased morbidity and mortality in coronary artery disease and to atherosclerosis progression. Experimental studies have suggested that damage to the endothelium may be an important mechanism. Methods and Results —Endothelial function was studied in 10 healthy men (aged 50.4±9.6 years) and in 8 non–insulin-dependent diabetic men (aged 52.0±7.2 years). Brachial artery flow-mediated dilation (FMD, endothelium dependent) and response to 50 μg of sublingual glyceryl trinitrate (GTN, endothelium independent) were measured noninvasively by use of high-resolution ultrasound before and after (30, 90, and 240 minutes) a standardized mental stress test. The same protocol without mental stress was repeated on a separate occasion in the healthy men. In healthy subjects, FMD (5.0±2.1%) was significantly ( P &lt;0.01) reduced at 30 and 90 minutes after mental stress (2.8±2.3% and 2.3±2.4%, respectively) and returned toward normal after 4 hours (4.1±2.0%). Mental stress had no effect on the response to GTN. In the repeated studies without mental stress, FMD did not change. The diabetic subjects had lower FMD than did the control subjects (3.0±1.5% versus 5.0±2.1%, respectively; P =0.02) but showed no changes in FMD (2.7±1.1% after 30 minutes, 2.8±1.9% after 90 minutes, and 3.1±2.3% after 240 minutes) or GTN responses after mental stress. Conclusions —These findings suggest that brief episodes of mental stress, similar to those encountered in everyday life, may cause transient (up to 4 hours) endothelial dysfunction in healthy young individuals. This might represent a mechanistic link between mental stress and atherogenesis.
The Role of X Inactivation and Cellular Mosaicism in Women's Health and Sex-Specific Diseases
Authors: Barbara R. Migeon
Journal: JAMA (2006)

Sex-specific manifestations of disease are most often attributed to differences in the reproductive apparatus or in life experiences. However, a good deal of sex differences in health issues have their origins in the genes on the sex chromosomes themselves and in X inactivation-the developmental program that equalizes their expression in males and females. Most females are mosaics, having a mixture of cells expressing either their mother's or father's X-linked genes. Often, cell mosaicism is advantageous, ameliorating the deleterious effects of X-linked mutations and contributing to physiological diversity. As a consequence, most X-linked mutations produce male-only diseases. Yet, in some cases the dynamic interactions between cells in mosaic females lead to female-specific disease manifestations.
Nonsteroidal Anti-inflammatory Drug—Associated Azotemia in the Very Old
Authors: Jerry H. Gurwitz
Journal: JAMA (1990)

We conducted a prospective study in 114 elderly patients to determine the renal effects of short-term therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) in the very old. Study subjects were patients in a long-term care facility (mean age, 87 years) newly begun on a regimen of NSAID therapy. For the study group as a whole, the serum urea nitrogen level rose 1.7 mmol/L 5 to 7 days after initiation of therapy, with no significant changes in serum creatinine or potassium levels. In a comparison group of 45 patients not receiving NSAID therapy, no significant change in the serum urea nitrogen level was noted during a similar period. A subgroup of 15 patients (13%) experienced a greater than 50% increase in the serum urea nitrogen level during NSAID therapy, with a mean increase of 89% (8.6 mmol/L). A return to the baseline level occurred within 14 days after discontinuation of NSAID therapy. Two factors were significantly predictors of a greater than 50% increase in the serum urea nitrogen level: concurrent loop diuretic therapy (odds ratio, 2.2) and high NSAID dose (odds ratio, 2.0). These findings suggest that reversible azotemia develops in a sizable proportion of the very old who are treated with short-term NSAID therapy.
Does the Hepatitis B Antigen HBx Promote the Appearance of Liver Cancer Stem Cells?
Authors: Alla Arzumanyan, Tiffany Friedman, Irene O.L. Ng, Marcia M. Clayton, Zhaorui Lian, Mark A. Feitelson
Journal: Cancer Research (2011)

Hepatitis B virus (HBV) is a major etiologic agent of chronic liver disease and hepatocellular carcinoma (HCC). HBV-encoded X antigen, HBx, and pathways implicated in the self-renewal of stem cells contribute to HCC, but it is not clear whether HBx expression promotes "stemness." Thus, experiments were designed to test the hypothesis that HBx triggers malignant transformation by promoting properties that are characteristic of cancer stem cells (CSC). To test this hypothesis, HepG2 cells were stably transduced with HBx and then assayed for phenotypic and molecular characteristics of "stemness." The relationship between HBx and "stemness"-associated markers was also evaluated by immunohistochemical staining of liver and tumor tissue sections from HBV-infected patients. The results showed that Oct-4, Nanog, Klf-4, β-catenin, and epithelial cell adhesion molecule (EpCAM) were activated by HBx in vitro and in vivo. EpCAM was detected in the nuclei of human HCC cells from infected patients. HBx promotes "stemness" by activating β-catenin and epigenetic upregulation of miR-181, both of which target EpCAM. HBx expression was also associated with depressed levels of E-cadherin. Moreover, HBx stimulated cell migration, growth in soft agar, and spheroid formation. This work is the first to propose that HBV promotes "stemness" in the pathogenesis of HCC. HBx-associated upregulated expression of multiple "stemness" markers supports the hypothesis that HBx contributes to hepatocarcinogenesis, at least in part, by promoting changes in gene expression that are characteristics of CSCs.
The Serine Proteinase Inhibitor (Serpin) Plasminogen Activation Inhibitor Type 2 Protects against Viral Cytopathic Effects by Constitutive Interferon α/β Priming
Authors: Toni M. Antalis, May La Linn, Karen Donnan, Luis Mateo, Joy Gardner, Joanne L. Dickinson, Kathy Buttigieg, Andreas Suhrbier
Journal: The Journal of Experimental Medicine (1998)

The serine proteinase inhibitor (serpin) plasminogen activator inhibitor type 2 (PAI-2) is well characterized as an inhibitor of extracellular urokinase-type plasminogen activator. Here we show that intracellular, but not extracellular, PAI-2 protected cells from the rapid cytopathic effects of alphavirus infection. This protection did not appear to be related to an effect on apoptosis but was associated with a PAI-2–mediated induction of constitutive low-level interferon (IFN)-α/β production and IFN-stimulated gene factor 3 (ISGF3) activation, which primed the cells for rapid induction of antiviral genes. This primed phenotype was associated with a rapid development of resistance to infection by the PAI-2 transfected cells and the establishment of a persistent productive infection. PAI-2 was also induced in macrophages in response to viral RNA suggesting that PAI-2 is a virus response gene. These observations, together with the recently demonstrated PAI-2–mediated inhibition of tumor necrosis factor-α induced apoptosis, (a) illustrate that PAI-2 has an additional and distinct function as an intracellular regulator of signal transduction pathway(s) and (b) demonstrate a novel activity for a eukaryotic serpin.
Mosaic Turner Syndrome in a Newborn
Authors: J. C. Lee
Journal: JAMA (1973)

<h3>To the Editor.—</h3> A few cases of newborn infants with phenotypic features originally described by Turner and supposed 45,X-chromosome complement have been found to have ovaries with germ cells or primordial follicles. It has been suggested that these cases actually represent unrecognized 45, X/46, XX mosaicism.<sup>1-4</sup>This letter describes a newborn female patient with some Turner phenotypic features. The possibility of a 45, X/46, XX mosaicism is suggested by the presence of a Barr body in some tissues and 45, X-chromosome complement in two other tissues. <h3>Report of a Case.—</h3> A female infant, weighing 2,500 grams, was born at the 38th week of gestation to a 24-year-old para 2 white mother. The initial Apgar score was 7. Within the first 3 to 4 hours of life, respiratory distress and cyanosis developed. A few hours later, a grade 2/5 midsystolic ejection murmur was heard at the left sternal border. The temperature
Hepatocellular carcinoma in Central Europe: prognostic features and survival
Authors: M Schoniger-Hekele
Journal: Gut (2001)

We investigated the influence of baseline characteristics of patients with hepatocellular carcinoma (HCC) on prognosis and developed a multivariate Cox model predicting survival. All patients were from Central Europe.All 245 patients seen at the Department of Gastroenterology and Hepatology at the University of Vienna, Austria, from July 1991 to March 1998 were included in this retrospective study. Nineteen different clinical characteristics and survival time from date of diagnosis were noted. Factors determining survival time were analysed by univariate and multivariate analysis using Cox proportional hazard regression models and a new classification model was constructed. The validity of this model was tested on an independent group of 89 patients, seen from April 1998 to September 1999.Median survival in patients with HCC was 8.0 months. In a multivariate analysis bilirubin (>2 mg/dl), portal vein thrombosis, prothrombin time (<70%), alpha fetoprotein (>180 microg/l), tumour mass >50%, and enlarged lymph nodes were independent predictors of survival. A newly constructed Cox proportional hazard model (Vienna survival model for HCC=VISUM-HCC) identified three disease stages with different durations of survival (median survival stage 1, 15.2 months; stage 2, 7.2 months; and stage 3, 2.6 months; p=0.00001). Applying the VISUM-HCC survival model to patients in Okuda stage 2 identified subgroups with an excellent and very poor prognosis for which different treatment modalities should be offered.Our patients with HCC had a poor median survival of eight months. Six easily measurable clinical variables were significant predictors of survival in patients with HCC. The new VISUM-HCC survival model may be useful for stratifying patients with HCC for various clinical treatment modalities.
Indian proposals to revalidate doctors get mixed reception
Authors: Ganapati Mudur
Journal: BMJ (2005)

A proposal by India's health minister that doctors should take exams every five years to keep themselves updated on medical advances and reregister to retain their licenses has triggered debate in the medical community.

The health minister, Anbumani Ramadoss, is a medical doctor, and his proposals are in line with recommendations first made by the Indian health ministry five years ago but which were never implemented. The United Kingdom has similar plans to revalidate its doctors. Due to take effect next month, these were postponed after the Shipman inquiry recommendations …
Gastric Freezing for Peptic Ulceration in Man – A Note of Caution
Authors: Donald C. Nabseth, Jules M. Seletz, Sidney Gentin, Leonard S. Gottlieb, Norman Zamcheck
Journal: New England Journal of Medicine (1964)

IN 1962 Wangensteen and his associates1 reported the achievement of "physiological gastrectomy" by gastric freezing. At that time these investigators presented results on 24 patients with duodenal ulcers who were subjected to a one-hour period of gastric freezing. In this group of patients there was excellent subjective relief of symptoms, significant decreases in gastric secretory response and disappearance of duodenal-ulcer craters. In parallel animal studies these workers found that isolated gastric pouches, whether Pavlov, Heidenhain or antral, when frozen for an hour (with inflowing coolant at temperatures of -17 to -20°C.), became unresponsive to physiologic stimuli. They postulated that the . . .
Prevention and cure of type 2 diabetes
Authors: J. Pinkney
Journal: BMJ (2002)

The Department of Health has published the first part of the national service framework defining standards of care for people with diabetes. The substance—how these standards will be achieved—is now awaited. Type 2 diabetes, however, is reaching epidemic proportions, and epidemics are seldom controlled unless their causes are addressed. Obesity is strongly and causally linked to type 2 diabetes. Recent data suggest that the prevention of diabetes is feasible if weight management is addressed adequately in individuals at high risk. More controversially, weight management also has the potential to make a significant impact in those with established type 2 diabetes.

The most common definition of obesity is a body mass index greater than 30 kg/m2. In the nurses' health study the risk of type 2 diabetes in women with an index of 29-31 was 28-fold increased compared with women with an index lower than 22, and an index greater than 35 carried a 93-fold increased risk.1

The overall prevalence of self …
A SUPPURATING HYDATID OF THE CRURA OF THE DIAPHRAGM
Authors: J. Oliver
Journal: BMJ (1914)

LJoa^f 231 urine contained no sugar.or albumin, and-only the merest trace of acetone and diacetic aci(l.The smell in the breath grew stronger, and at the same time both dyspnoea and dropsy increased; the pulse becaine irregular, and a polygraph tracing showed this to be " total," associated with disappearance of the auriculo-systolic wave from the jugular curve.Mental obscuration became pronounced, and the urine, which did not total more than 16 oz.in the twenty-four hours, had to be withdrawn by catheter.Some excitement began to manifest itself, and this subsequently developed into an active delirium, the patient getting out of bed and demanding his clothes, and so on; tihe pupils were small.There was never anv vomiting, but from the fourth day after admission an incessant foul diarrhoea began.to develop, reaching its maximum on November 22nd, when no less than twenty-three actions were recorded.This may have
Abstract 5130: Efficacy of Two Long-Term Intervention Strategy to Promote Long-Term Adherence to Lifestyle Changes and to Reduce Cardiovascular Event in Patients with Coronary Artery Disease
Authors: Margherita Vona
Journal: Circulation (2008)

It is known that an incomplete adherence to life style changes and to medical treatment is responsible of an increase number of cardiovascular events (CE) in the follow-up (FU). Aim. We assessed th...
Commentary: International collaboration needed on device clinical standards
Authors: A. G. Fraser, M. W. Krucoff, R. G. Brindis, M. Komajda, S. C. S. Jr
Journal: BMJ (2011)

No implantable medical device is perfectly safe. It is the duty of manufacturers and regulators to minimise risks—and the purpose of evaluating and regulating devices is to ensure safety and effectiveness.

The product life cycle of many medical devices is short—often quoted as an average of two years or less—because of the rapid rate of technological change and because of frequent modifications (called iterative changes) to their design, manufacture, or programming. It would be desirable for all implantable devices to undergo long term clinical studies—but there is pressure from interventional specialists as well as from industry to base approval on shorter term studies with surrogate rather than clinical end points. This facilitates innovation but transfers responsibility for proof of safety and clinical efficacy to follow-up studies. 

Regulatory approval in Europe hinges on the principle that as long as a device has been shown to perform its stated task, it can be approved if its potential benefits outweigh any expected risks. Approval on this basis can mean estimating benefit before clinical effectiveness has been confirmed, and it means accepting some risk as the trade-off for more rapid availability of devices. The system of approval by 74 notified bodies in the European Union (EU) …
Stanley James Holt
Authors: P. Lantos
Journal: BMJ (2009)

Stanley James Holt, professor emeritus of experimental biochemistry of the University College and Middlesex School of Medicine, London, died from cardiorespiratory insufficiency on 30 October 2008 at the age of 90 in the Royal Free Hospital, London.

Holt, or Holtie to his colleagues and friends, was a cell biologist of international reputation. During his long professional life, he continued working long after his official retirement; he made substantial contributions to histochemistry and later to the developing science of cell biology. His first seminal paper, published in Nature in 1952, on the histochemical localisation of hydrolytic enzymes, he introduced new methods to achieve superior results. Using electron microscopy to visualise the finer details of cells, he was the first in 1961, with Professor Marian Hicks, to demonstrate these enzymes within lysosomes, the newly discovered cell organelles. This pioneering publication led to he realisation that cells have individual organelles, each performing a different aspect of metabolism with different sets of enzymes. He was an outstanding teacher who advocated academic research in medicine: many of his PhD students benefited from his expertise and wisdom, becoming professors …
Coexistence of Hypertrophic Cardiomyopathy and Fibromuscular Dysplasia of the Superior Mesenteric Artery
Authors: Michael Safioleas, John Kakisis, Christine Manti
Journal: New England Journal of Medicine (2001)

To the Editor: Hypertrophic cardiomyopathy and fibromuscular dysplasia of the superior mesenteric artery that causes ischemic colitis are rare clinical entities. Their coexistence would probably be...
Ipilimumab versus placebo after radiotherapy in patients with metastatic castration-resistant prostate cancer that had progressed after docetaxel chemotherapy (CA184-043): a multicentre, randomised, double-blind, phase 3 trial
Authors: Eugene D Kwon, Charles G Drake, Howard I Scher, Karim Fizazi, Alberto Bossi, Alfons J M van den Eertwegh, Michael Krainer, Nadine Houede, Ricardo Santos, Hakim Mahammedi, Siobhan Ng, Michele Maio, Fabio A Franke, Santhanam Sundar, Neeraj Agarwal, Andries M Bergman, Tudor E Ciuleanu, Ernesto Korbenfeld, Lisa Sengeløv, Steinbjorn Hansen, Christopher Logothetis, Tomasz M Beer, M Brent McHenry, Paul Gagnier, David Liu, Winald R Gerritsen
Journal: The Lancet Oncology (2014)
Clinically significant pulmonary barotrauma after inflation of party balloons
Authors: A. D Mumford, K. Ashkan, S. Elborn
Journal: BMJ (1996)

Although pneumothorax is the commonest presentation of pulmonary barotrauma unrelated to mechanical ventilation, systemic air embolism and emphysema within the pulmonary interstitium, mediastinum, retroperitoneum, pericardium, and subcutaneous tissues have all been described.1 We report a case of pulmonary barotrauma after inflation of party balloons.

A 24 year old previously healthy, non-smoker presented with a 48 hour history of a sensation of crackling under the skin. His symptoms were initially confined to the neck but within 24 hours had affected his chest wall, trunk, and legs. The next day he developed retrosternal pleuritic chest pain and attended the accident and emergency department. He reported that 24 hours before the onset of symptoms he had inflated about 20 party balloons over one hour. He had not experienced chest pain or shortness of breath at the time or immediately afterwards. …
Molecular imaging for assessment of mesenchymal stem cells mediated breast cancer therapy
Authors: Liang Leng, Yuebing Wang, Ningning He, Di Wang, Qianjie Zhao, Guowei Feng, Weijun Su, Yang Xu, Zhongchao Han, Deling Kong, Zhen Cheng, Rong Xiang, Zongjin Li
Journal: Biomaterials (2014)
Repression of interleukin-4 in T helper type 1 cells by Runx/Cbfβ binding to the <i>Il4</i> silencer
Authors: Yoshinori Naoe, Ruka Setoguchi, Kaori Akiyama, Sawako Muroi, Masahiko Kuroda, Farah Hatam, Dan R. Littman, Ichiro Taniuchi
Journal: The Journal of Experimental Medicine (2007)

Interferon γ (IFNγ) is the hallmark cytokine produced by T helper type 1 (Th1) cells, whereas interleukin (IL)-4 is the hallmark cytokine produced by Th2 cells. Although previous studies have revealed the roles of cytokine signaling and of transcription factors during differentiation of Th1 or Th2 cells, it is unclear how the exclusive expression pattern of each hallmark cytokine is established. The DNaseI hypersensitivity site IV within the mouse Il4 locus plays an important role in the repression of Il4 expression in Th1 cells, and it has been named the Il4 silencer. Using Cbfβ- or Runx3-deficient T cells, we show that loss of Runx complex function results in derepression of IL-4 in Th1 cells. Binding of Runx complexes to the Il4 silencer was detected in naive CD4+ T cells and Th1 cells, but not in Th2 cells. Furthermore, enforced expression of GATA-3 in Th1 cells inhibited binding of Runx complexes to the Il4 silencer. Interestingly, T cell–specific inactivation of the Cbfβ gene in mice led to elevated serum immunoglobulin E and airway infiltration. These results demonstrate critical roles of Runx complexes in regulating immune responses, at least in part, through the repression of the Il4 gene.