tbuckley/cabot-search huggingface dataset:
Lichenoid eruption to STI 571
Authors: Davin Lim, James Muir
Journal: American Journal of Hematology (2002)

To the Editor: Amyloidoma is a rare clinicopathologic entity characterized by localized amyloid deposits without any plasma cell dyscrasias or elevation of serum protein [1].``Primary solitary amyloidosis'' and ``amyloid tumor'' are synonyms that are used for this condition.The various sites involved by amyloidoma are the soft tissue [1], bone [2], urinary bladder [3], and lower genitourinary tract [4].To the best of our knowledge, amyloidoma has not been reported in the lymph node.Herein we report a case of recurrent amyloidoma of the lymph node in a 45-year-old Indian male.A 45-year-old male, apparently well 3 years ago, spontaneously developed left axillary lymphadenopathy, which measured 5 cm in diameter.Subsequently, FNAC performed was non-contributory.Biopsy performed revealed the presence of eosinophilic acellular material almost replacing the nodal architecture (Fig. 1).Congo red staining showed apple-green birefringence under polarized light (Fig. 2a).The material was resistant to prior 5% potassium permanganate treatment.Immunohistochemical staining for amyloid light chain protein (Aj,Ak) and amyloid-associated protein (AA) were performed using the indirect immunoperoxidase method.The material was immunoreactive for amyloid light chain (Aj) only, thus con®rming the amyloid to be primary in nature.The ultrastructure substantiated the immunohistochemical ®nding (Fig. 2b).The patient remained asymptomatic for 1 year without any treatment, and the axillary swelling subsided.Subsequently, he developed left cervical lymphadenopathy, which when biopsied showed similar amyloid deposits.Considering a possibility of plasma cell dyscrasia, complete skeletal survey, urine analysis including electrophoresis, serum electrophoresis, serum immunoglobulin estimation, and bone marrow aspiration with biopsy were performed.There was no evidence of any monoclonal spike in urine or serum electrophoreses.Bone marrow examination did not show plasmacytosis.Bence Jones protein was not detected.Serum urea (31 mg/dL), creatinine (0.9 mg/dL), calcium (10.2 mg/dL), and serum immunoglobulin (IgG, 111.0 mg/dL; IgA, 300 mg/dL; IgM, 135 mg/dL) were within normal limits.Therefore, a diagnosis of primary localized amyloidosis was oered.No treatment was given to the patient, and the swelling subsided.He remained asymptomatic for 2 years and now again presented to us with submental lymphadenopathy.Biopsy from the lymph node again revealed amyloid deposits, with similar staining character as before.Systemic work up including aspiration of abdominal fat and repeat bone marrow ex-
Long-Term Entecavir Therapy Results in the Reversal of Fibrosis/Cirrhosis and Continued Histological Improvement in Patients with Chronic Hepatitis B†,‡
Authors: Ting-Tsung Chang, Yun-Fan Liaw, Shun-Sheng Wu, Eugene Schiff, Kwang-Hyub Han, Ching-Lung Lai, Rifaat Safadi, Samuel S. Lee, Waldemar Halota, Zachary Goodman, Yun-Chan Chi, Hui Zhang, Robert Hindes, Uchenna Iloeje, Suzanne Beebe, Bruce Kreter
Journal: Hepatology (2010)

Abstract One year of treatment with entecavir (0.5 mg daily) in nucleoside-naive patients with hepatitis B e antigen (HBeAg)-positive or HBeAg-negative chronic hepatitis B (CHB) resulted in significantly improved liver histology and virological and biochemical endpoints in comparison with lamivudine. Patients who received at least 3 years of cumulative entecavir therapy in phase 3 studies and a long-term rollover study and underwent long-term liver biopsy were evaluated for improvements in histological appearance. Sixty-nine patients [50 HBeAg-positive and 19 HBeAg-negative] receiving entecavir therapy underwent long-term liver biopsy (median time of biopsy = 6 years, range = 3-7 years). Histological improvement was analyzed for 57 patients who had adequate baseline biopsy samples, baseline Knodell necroinflammatory scores ≥2, and adequate long-term biopsy samples. At the time of long-term biopsy, all patients in the cohort had a hepatitis B virus DNA level &lt;300 copies/mL, and 86% had a normalized alanine aminotransferase level. Histological improvement (≥2-point decrease in the Knodell necroinflammatory score and no worsening of the Knodell fibrosis score) was observed in 96% of patients, and a ≥1-point improvement in the Ishak fibrosis score was found in 88% of patients, including all 10 patients with advanced fibrosis or cirrhosis at the phase 3 baseline. Conclusion: The majority of nucleoside-naive patients with CHB who were treated with entecavir in this long-term cohort achieved substantial histological improvement and regression of fibrosis or cirrhosis.
Beyond MICRA: New Ideas for Liability Reform
Authors: Michael J. Werner
Journal: Annals of Internal Medicine (1995)

Letters1 October 1995Beyond MICRA: New Ideas for Liability ReformMichael J. Werner, JDMichael J. Werner, JDAmerican College of Physicians; Philadelphia, PA 19106-1572Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-123-7-199510010-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Mr. Uzych criticizes the College's position in support of liability reforms that are based on MICRA. These criticisms are misplaced.Independent analyses have found that traditional tort reforms, such as those called for by the College, have reduced the direct costs of medical malpractice [1]. In fact, liability insurance premiums in California have stabilized since the implementation of these reforms. Moreover, traditional tort reforms will provide a measure of stability and predictability to an otherwise out-of-control system [2].Whether implementation of these reforms would impede the ability of an injured person to receive compensation, as Mr. Uzych suggests, ...References1. Defensive Medicine and Medical Malpractice. Washington, DC: United States Office of Technology Assessment Report; 1994; OTA-H-602. Google Scholar2. Annual Report to Congress. Washington, DC: Physician Payment Review Commission; 1995. Google Scholar3. Hickson GB, Clayton EW, Entman SS, Miller CS, Githens PB, Whetten-Goldstein K, et al. Obstetricians' prior malpractice experience and patients' satisfaction with care. JAMA. 1994; 272:1583-7. Google Scholar4. Huycke LI, Huycke MM. Characteristics of potential plaintiffs in malpractice litigation. Ann Intern Med. 1994; 120:792-8. Google Scholar5. Physician and Public Opinion on Health Care Issues. Chicago: American Medical Association; 1992. Google Scholar Author, Article, and Disclosure InformationAffiliations: American College of Physicians; Philadelphia, PA 19106-1572 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1995Volume 123, Issue 7Page: 554KeywordsHealth careHealth care qualityInsuranceQuality improvement Issue Published: 1 October 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Idiopathic Acute Esophageal Necrosis: Report of a New Case
Authors: J. C. Erdozain, A. Herrera, E. Molina, F. Muñoz, M. Presa, C. Martin-de-Argila
Journal: Endoscopy (1994)

See also: Idiopathic Acute Esophageal Necrosis: Not Necessarily a Terminal EventEndoscopy 1993; 25(08): 534-538DOI: 10.1055/s-2007-1009121
Albinism in Nigeria: a clinical and sociological study
Authors: A.N. Okoro
Journal: British Journal of Dermatology (1974)

Journal Article Albinism in Nigeria: a clinical and sociological study Get access A.N. Okoro A.N. Okoro General Hospital, Enugu, Nigeria Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 91, Issue s10, 1 July 1974, Page 24, https://doi.org/10.1111/j.1365-2133.1974.tb12489.x Published: 01 July 1974
Revisiting graft-versus-host disease models of autoimmunity: new insights in immune regulatory processes
Authors: William J. Murphy
Journal: Journal of Clinical Investigation (2000)

Graft-versus-host disease (GVHD) commonly occurs when immunocompetent donor cells attack a genetically disparate host.GVHD occurs primarily after allogeneic bone marrow transplantation (BMT) and remains a significant cause of morbidity, thus limiting the efficacy of this treatment.GVHD can exist as two distinct clinical entities: acute (affecting multiple solid organs) and chronic (presenting with solid organ pathology but also with autoimmune-like sequelae) (1, 2).New means to reduce the toxicity but retain the antitumor potential of BMT include donor lymphocyte infusions, nonmyeloablative conditioning, and the use of G-CSF to mobilize peripheral blood stem cells, all of which have led to significant reductions in the occurrence of acute GVHD (1).Unfortunately, with the decline of acute GVHD, chronic GVHD is emerging as a dominant complication in BMT (1, 2).Researchers examining GVHD have used numerous model systems, which has often resulted in confusion in extrapolating results from one model to another.GVHD models differ from one another with respect to three key features: the extent and type of conditioning or cytoreductive treatment of the recipient using total body irradiation or chemotherapy; the extent of genetic disparity between donor and host; and the purity, type, and number of donor cells transferred.These three variables have a dramatic impact on the type and extent of the resulting GVHD.
Electrophysiologic Substrate in Congenital Long QT Syndrome
Authors: Ramya Vijayakumar, Jennifer N.A. Silva, Kavit A. Desouza, Robert L. Abraham, Maria Strom, Frederic Sacher, George F. Van Hare, Michel Haïssaguerre, Dan M. Roden, Yoram Rudy
Journal: Circulation (2014)

Background— Congenital Long QT syndrome (LQTS) is an arrhythmogenic disorder that causes syncope and sudden death. Although its genetic basis has become well-understood, the mechanisms whereby mutations translate to arrhythmia susceptibility in the in situ human heart have not been fully defined. We used noninvasive ECG imaging to map the cardiac electrophysiological substrate and examine whether LQTS patients display regional heterogeneities in repolarization, a substrate that promotes arrhythmogenesis. Methods and Results— Twenty-five subjects (9 LQT1, 9 LQT2, 5 LQT3, and 2 LQT5) with genotype and phenotype positive LQTS underwent ECG imaging. Seven normal subjects provided control. Epicardial maps of activation, recovery times, activation-recovery intervals, and repolarization dispersion were constructed. Activation was normal in all patients. However, recovery times and activation–recovery intervals were prolonged relative to control, indicating delayed repolarization and abnormally long action potential duration (312±30 ms versus 235±21 ms in control). Activation–recovery interval prolongation was spatially heterogeneous, with repolarization gradients much steeper than control (119±19 ms/cm versus 2.0±2.0 ms/cm). There was variability in steepness and distribution of repolarization gradients between and within LQTS types. Repolarization gradients were steeper in symptomatic patients (130±27 ms/cm in 12 symptomatic patients versus 98±19 ms/cm in 13 asymptomatic patients; P &lt;0.05). Conclusions— LQTS patients display regions with steep repolarization dispersion caused by localized action potential duration prolongation. This defines a substrate for reentrant arrhythmias, not detectable by surface ECG. Steeper dispersion in symptomatic patients suggests a possible role for ECG imaging in risk stratification.
CARDIAC FUNCTIONAL TESTS
Authors: HAROLD H. BRITTINGHAM
Journal: JAMA (1922)

The Eldorado of a cardiologist would be some test or combination of tests which would definitely deter- mine the functional capacity of a given heart.This has been long sought, but is still an accomplishment for the future.The methods which have been devised and reported may be roughly classed as exercise tests, respiratory tests, tests based on the estimation of blood flow by various methods and a few other procedures. EXERCISE TESTS IN GENERALIt seems worth while to describe briefly the char- acter and field of some of these, and then, in more Read before the Boston Association of Cardiac Clinics, Boston
One-Year Outcomes in Survivors of the Acute Respiratory Distress Syndrome
Authors: Margaret S. Herridge, Angela M. Cheung, Catherine M. Tansey, Andrea Matte-Martyn, Natalia Diaz-Granados, Fatma Al-Saidi, Andrew B. Cooper, Cameron B. Guest, C. David Mazer, Sangeeta Mehta, Thomas E. Stewart, Aiala Barr, Deborah Cook, Arthur S. Slutsky
Journal: New England Journal of Medicine (2003)

As more patients survive the acute respiratory distress syndrome, an understanding of the long-term outcomes of this condition is needed.We evaluated 109 survivors of the acute respiratory distress syndrome 3, 6, and 12 months after discharge from the intensive care unit. At each visit, patients were interviewed and underwent a physical examination, pulmonary-function testing, a six-minute-walk test, and a quality-of-life evaluation.Patients who survived the acute respiratory distress syndrome were young (median age, 45 years) and severely ill (median Acute Physiology, Age, and Chronic Health Evaluation score, 23) and had a long stay in the intensive care unit (median, 25 days). Patients had lost 18 percent of their base-line body weight by the time they were discharged from the intensive care unit and stated that muscle weakness and fatigue were the reasons for their functional limitation. Lung volume and spirometric measurements were normal by 6 months, but carbon monoxide diffusion capacity remained low throughout the 12-month follow-up. No patients required supplemental oxygen at 12 months, but 6 percent of patients had arterial oxygen saturation values below 88 percent during exercise. The median score for the physical role domain of the Medical Outcomes Study 36-item Short-Form General Health Survey (a health-related quality-of-life measure) increased from 0 at 3 months to 25 at 12 months (score in the normal population, 84). The distance walked in six minutes increased from a median of 281 m at 3 months to 422 m at 12 months; all values were lower than predicted. The absence of systemic corticosteroid treatment, the absence of illness acquired during the intensive care unit stay, and rapid resolution of lung injury and multiorgan dysfunction were associated with better functional status during the one-year follow-up.Survivors of the acute respiratory distress syndrome have persistent functional disability one year after discharge from the intensive care unit. Most patients have extrapulmonary conditions, with muscle wasting and weakness being most prominent.
Intrathecal immunoglobulin production in patients with systemic lupus erythematosus with neuropsychiatric manifestations
Authors: M. Yin Mok, E. Y T Chan, W. Sing Wong, C. Sing Lau
Journal: Annals of the Rheumatic Diseases (2007)

Thymic atrophy and the progressive immune decline that accompanies it is a major health problem, chronically with age and acutely with immune injury. No solution has been defined. Here we demonstrate that one of the three mesenchymal cell subsets identified by single-cell analysis of human and mouse thymic stroma is a critical niche component for T lymphopoiesis. The Postn+ subset is located perivascularly in the cortical-medullary junction, medulla and subcapsular regions. Cell depletion demonstrated that it recruits T competent cells to the thymus and initiates T lymphopoiesis in vivo. This subset distinctively expresses the chemokine Ccl19 necessary for niche functions. It markedly declines with age and in the acute setting of hematopoietic stem cell transplant conditioning. When isolated and adoptively transferred, these cells durably engrafted the atrophic thymus, recruited early T progenitors, increased T cell neogenesis, expanded TCR complexity and enhanced T cell response to vaccination. These data define a thymus lymphopoietic niche cell type that may be manipulated therapeutically to regenerate T lymphopoiesis.
Smoking, alcohol, and analgesics in dyspepsia and among dyspepsia subgroups: lack of an association in a community.
Authors: N J Talley, A R Zinsmeister, C D Schleck, L J Melton
Journal: Gut (1994)

Dyspepsia is common in the general population, and despite a paucity of data, smoking, alcohol, and analgesics are believed to be important risk factors. The role of these environmental factors in subjects with uninvestigated dyspepsia was evaluated in a representative population sample. An age and gender stratified random sample of residents of Olmsted County, Minnesota, aged 20 to 64 years was mailed a valid self report questionnaire; 77% responded (n = 1644). Age and gender adjusted (1990 US white population) prevalence rates for dyspepsia (defined as frequent pain located in the upper abdomen, or nausea in the absence of a history of peptic ulcer disease) were calculated. Logistic regression analysis was used to estimate the association between dyspepsia and potential risk factors. The age and gender adjusted prevalence (per 100) of dyspepsia in the community was 21.8 (95% confidence interval 19.6, 23.9). Dyspepsia was significantly more common in younger subjects and females. Adjusting for age and gender, paracetamol (odds ratio (OR) = 2.2), aspirin (OR = 1.8), and smoking (OR = 1.5), but not alcohol (OR = 0.9), were associated with dyspepsia (all p < 0.05). When non-gastrointestinal somatic complaints were included in the logistic models, however, these environmental factors were no longer significant (OR = 1.3, 1.1, 1.2 and 0.9, respectively). Similar results were obtained when ulcer-like, dysmotility-like, and reflux-like dyspepsia were considered separately. The results were not significantly changed when subjects with a history of ulcer disease were included in the analyses. Smoking, alcohol, and analgesics may not therefore be important risk factors for dyspepsia in the community.
Auscultatory Clicks Produced by Pacemaker Catheters
Authors: MYRON I. MURDOCK
Journal: Annals of Internal Medicine (1968)

A presystolic click produced by permanent intracardiac pacemaker catheters is described. Its pitch, timing, and respiratory variation preclude an intracardiac origin. Fluoroscopy shows that it is not due to diaphragmatic movement. It is concluded that the click is produced by pacemaker-induced contraction of the intercostal muscles of the left anterior chest wall.
Nonabsorbable disaccharides plus neomycin in hepatic encephalopathy: Do they enhance each other?
Authors: Livio Capocaccia, Oliviero Riggio
Journal: Hepatology (1990)

The beneficial effect of disaccharides, lactulose and lactitol, in prevention and treatment of hepatic encephalopathy is well established but their use in combination with neomycin is still controversial. We studied in vitro the fecal bacterial growth, acid and gas formation in presence of lactitol (beta–galactosidesorbitol) and neomycin alone or in combination. The results indicate that neomycin only inhibits the growth of susceptible bacteria (E. coli, Staph. aureus) which, conversely, are poor lactitol fermenters. The resistent organisms (Lactobacillus acidophilus, Clostridium perfringens) that are efficient disaccharide fermenters continue to metabolize lactitol still when antibiotic is added. Addition of lactitol 10% increased the inhibitory effect of neomycin on bacterial growth by 25-50% within 60-70 min. These preliminary data suggest that lactitol and neomycin may have additional or synergistic effects in vivo when used together in presence of favourable intestinal microbial environment.
Diagnosis of Lower-Limb Deep Venous Thrombosis: A Prospective Blinded Study of Magnetic Resonance Direct Thrombus Imaging
Authors: Douglas G.W. Fraser, Alan R. Moody, Paul S. Morgan, Anne L. Martel, Ian Davidson
Journal: Annals of Internal Medicine (2002)

Background: Current magnetic resonance techniques generate high signal from venous blood and show thrombi as filling defects. Magnetic resonance direct thrombus imaging (MRDTI) directly visualizes acute thrombus. Objective: To determine the accuracy of MRDTI for diagnosis of acute symptomatic deep venous thrombosis (DVT) below and above the knee. Design: Prospective, blinded study. Setting: A 1355-bed university hospital. Patients: 101 patients with suspected DVT who had had routine venography. Participants were recruited from a cohort of patients with suspected DVT. All patients with a positive venogram and one quarter of patients with a negative venogram were selected by using a random sequence. Intervention: MRDTI was performed within 48 hours of venography and was interpreted by two reviewers. Measurements: Diagnosis of DVT overall; isolated calf, femoropopliteal, and ileofemoral DVT; and thrombus in the calf, femoropopliteal, and iliac segments. Results: The reports from two readers had sensitivities of 96% and 94% and specificities of 90% and 92% for diagnosis of DVT. Sensitivities were 92% and 83% for isolated calf DVT, 97% and 97% for femoropopliteal DVT, and 100% and 100% for ileofemoral DVT. Specificities were 94% and 96% for isolated calf DVT and 100% and 100% for both femoropopliteal and ileofemoral DVT. Similarly, sensitivity and specificity within each of the venous segments ranged from 91% to 100%. Interobserver variability measured by using a weighted κ statistic ranged from 0.89 to 0.98 for these measures. Conclusion: Magnetic resonance direct thrombus imaging is an accurate noninvasive test for diagnosis of DVT, and its accuracy is maintained below the knee. Comparison of individual venous segments showed that results of MRDTI agreed strongly with findings on venography. Scanning was well tolerated, and interpretation was highly reproducible.
The dendritic cell subtype-restricted C-type lectin Clec9A is a target for vaccine enhancement
Authors: Irina Caminschi, Anna I. Proietto, Fatma Ahmet, Susie Kitsoulis, Joo Shin Teh, Jennifer C. Y. Lo, Alexandra Rizzitelli, Li Wu, David Vremec, Serani L. H. van Dommelen, Ian K. Campbell, Eugene Maraskovsky, Hal Braley, Gayle M. Davey, Patricia Mottram, Nicholas van de Velde, Kent Jensen, Andrew M. Lew, Mark D. Wright, William R. Heath, Ken Shortman, Mireille H. Lahoud
Journal: Blood (2008)
Sustained virological response in hepatitis C virus type 1b infected patients is predicted by the number of mutations within the NS5A-ISDR: a meta-analysis focused on geographical differences
Authors: M Pascu
Journal: Gut (2004)

<b>Background and aims:</b> There is growing evidence that the response of hepatitis C virus (HCV) genotype 1b infected patients towards interferon (IFN) therapy is influenced by the number of mutations within the carboxy terminal region of the NS5A gene, the interferon sensitivity determining region (ISDR). <b>Patients and methods:</b> In order to attain better insight into this correlation, a file comprising published data on ISDR strains from 1230 HCV genotype 1b infected patients, mainly from Japan and Europe, was constructed and analysed by logistic regression. Sustained virological response (SVR) was defined as negative HCV RNA six months after treatment. <b>Results:</b> The distribution of wild-, intermediate-, and mutant-type ISDR sequences differed significantly between Japanese (n = 655) (44.1%, 37.6%, and 18.3%) and European patients (n = 525) (24.8%, 63.4%, and 11.8%; p&lt;0.001). There was a significant positive correlation between the number of ISDR mutations and SVR rate, irrespective of geographical region. The likelihood of SVR with each additional mutation within the ISDR was considerably more pronounced in Japanese compared with European patients (odds ratios 1.82 <i>v</i> 1.39; p&lt;0.001). Pretreatment viraemia of &lt;6.6 log copies/ml and ISDR mutant-type infection was associated with an SVR rate of 97.1% in Japanese patients but only 52.5% in European patients. Pretreatment viraemia was a stronger predictor of SVR than ISDR mutation number in Japanese patients whereas in European patients both parameters had similar predictive power. <b>Conclusion:</b> These data support the concept that mutant-type ISDR strains may represent a subtype within genotype 1b with a more favourable response towards IFN therapy.