tbuckley/cabot-search huggingface dataset:
Intraurethral Cocaine Administration
Authors: John C. Mahler
Journal: JAMA (1988)

<h3>To the Editor.</h3> —More than 100 years ago<i>JAMA</i>reported the intraurethral administration of cocaine as an anesthetic for "the introduction of a bougie."<sup>1</sup>To warn clinicians that this route has now become a method of self-administration of cocaine,<sup>2</sup>we report the following case and its extravagant complications. <h3>Report of a Case.</h3> —A 34-year-old man was admitted to a local hospital with a three-day history of priapism and paraphimosis. During the previous weeks he had occasionally administered cocaine intraurethrally prior to intercourse to enhance sexual performance. Except for priapism and paraphimosis, findings from initial evaluation were unremarkable. There was no evidence of intranasal or intravenous substance use or of any of the usual causes of priapism.<sup>3-5</sup>Aspiration of the corpus cavernosa was attempted without benefit and a Foley catheter was inserted to relieve his difficulty in voiding. On the third hospital day the priapism and paraphimosis spontaneously resolved,
Obtaining the correct information
Authors: R. Chaplin
Journal: BMJ (2000)

The carer of a middle aged man with schizophrenia alerted one of our community nurses that he had had a relapse. Among other symptoms, he was reported to have been receiving information from his salad cream and had stopped attending his day centre. He lived in a private residential care home but had a considerable forensic history and had lived in a special hospital for many years in his youth. More recently, his mental health had improved substantially, and he was free from …
Regional myocardial dysfunction during coronary angioplasty: Evaluation by two-dimensional echocardiography and 12 lead electrocardiography
Authors: Daniel Wohlgelernter, Michael Cleman, H. Ainsley Highman, Robert C. Fetterman, James S. Duncan, Barry L. Zaret, C. Carl Jaffe
Journal: Journal of the American College of Cardiology (1986)
BRONCHOSCOPY FOR THE REMOVAL OF A COLLAR BUTTON FROM THE LUNG.
Authors: E. FLETCHER INGALS
Journal: JAMA (1905)

<h3>Patient.</h3> —C. D. H. was sent to me May 23, 1904, by Dr. F. W. Wilcox, of Minonk, I11. He was a man 22 years of age, who had formerly weighed 142 pounds, but who then weighed 107½ pounds. <h3>History.</h3> —He told me that 14 months previously he had accidentally drawn a collar button, presumably of vegetable ivory, into the air passages. He at once felt the sensations caused by it near the upper part of the sternum on a level with the second rib; subsequently he had some soreness in the same place. He expectorated a little blood a few minutes after the accident, and he said that there quickly appeared a peculiar squeak in the breath sounds. Pneumonia developed on the left side within 24 hours and lasted for one month. He had coughed ever since. He had sometimes felt something moving up and
A Novel Antidiabetic Drug, Troglitazone — Reason for Hope and Concern
Authors: Hiroo Imura
Journal: New England Journal of Medicine (1998)

Type II (non-insulin-dependent) diabetes mellitus is characterized by insulin resistance, increased hepatic glucose production, and impaired secretion of insulin by pancreatic beta cells. Although the primary defect underlying these abnormalities is still not known, previous longitudinal studies have indicated that insulin resistance precedes any evidence of glucose intolerance in most patients.The goal of oral therapy with antidiabetic drugs is to lower blood glucose concentrations toward normal by improving the pathophysiologic abnormalities. Several classes of drugs are now available for the management of type II diabetes mellitus. The oldest are the sulfonylurea compounds. Although they may have some extrapancreatic actions, . . .
The association of familial hyperbetalipoproteinaemia with Waardenburg's syndrome
Authors: MOHAMMED AMER, MOHAMMED EL-SHAZLY
Journal: British Journal of Dermatology (1974)

Journal Article The association of familial hyperbetalipoproteinaemia with Waardenburg's syndrome Get access MOHAMMED AMER, MOHAMMED AMER Dermatology Department, School Health Centre, Kuwait Search for other works by this author on: Oxford Academic Google Scholar MOHAMMED EL‐SHAZLY MOHAMMED EL‐SHAZLY Dermatology Department, School Health Centre, Kuwait Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 90, Issue 3, 1 March 1974, Pages 255–262, https://doi.org/10.1111/j.1365-2133.1974.tb06399.x Published: 01 March 1974 Article history Accepted: 22 June 1973 Published: 01 March 1974
Screening tests II
Authors: P. Sedgwick
Journal: BMJ (2009)

This question follows on from last week’s question on indices used to describe the performance of a screening test.1 These indices help when assessing new screening tools for use in clinical practice. A new rapid urine test was evaluated as a screening tool for Chlamydia trachomatis infection in men.2 The test was compared with the gold standard diagnostic test for Chlamydia infection—polymerase chain reaction (PCR) assay. The rapid urine screening test was reported to have a positive predictive value of 84.1%, negative predictive value of 98.3%, and a likelihood ratio for a positive result of 53.5. Which of the following statements, if any, are true?
Surgical Anatomy of the Abdomen and Pelvis
Authors: Edward A. Edwards
Journal: JAMA (1972)

Audiovisual presentation may have started with cave drawings, progressing to proclamations on stone and papyrus, thence to books. In our day, displays of various sorts enlarge our armamentarium of audiovisual material. Hence it seems reasonable to review in this section ofThe JournalSchlossberg's and Zuidema's transparencies of surgical anatomy of the abdomen and pelvis. Each plate is of a size to fit a panel of the standard X-ray film viewing box. Viewed thus the excellent drawings and vivid colors allow an immediate grasp of the material presented. They can also be adequately seen when laid on a table under ordinary light. The plates are of regional anatomy significant in surgery, executed for the most part in an idealized rather than realistic manner. Several present in diagrammatic form physiological themes pertinent to surgery, such as the control of secretion of gastric acid, or pathways for pain. Explanatory material equivalent to
"Wrong" women taking HRT
Authors: G. Kenyon
Journal: BMJ (1999)

Australian menopausal women may be the largest users of oestrogen-based hormone replacement therapy in the world, according to an Australian university study published in the Medical Journal ofAustralia.

However, according to the researchers, the right women are not using it. Women who are at risk of heart disease and those with osteoporosis, who would benefit the most, …
Response to Letter Regarding Article, “Riboflavin Lowers Homocysteine in Individuals Homozygous for the <i>MTHFR</i> 677C→T Polymorphism”
Authors: Helene McNulty, Le Roy C. Dowey, J.J. Strain, Mary Ward, Liadhan B. McAnena, Joan P. Hughes, Mary Hannon-Fletcher, Adrian Dunne, Anne M. Molloy, John M. Scott
Journal: Circulation (2006)

Response to Letter Regarding Article, "Riboflavin Lowers Homocysteine in Individuals Homozygous for the MTHFR 677C3 T Polymorphism"We thank Powers et al for their positive comments on our article. 1Their criticism is that our sample is not representative of the United Kingdom or European populations, and that our interpretation of the results in relation to food policy is therefore inappropriate.The statement that statistical inference is compromised is misleading because it is very clear in our article that the inference is not being made about the general population, but rather a subpopulation, ie, people homozygous for the MTHFR 677C3 T polymorphism (ie, TT genotype).To specifically investigate this subpopulation, we screened 680 healthy adults and identified just over 10% with the TT genotype; this is typical of populations worldwide.Powers et al have inappropriately compared homocysteine levels in our TT subpopulation with those found in the general UK population.The correct comparison is with other studies that report homocysteine levels in TT genotype subpopulations.Homocysteine values in one such meta-analysis 2 were comparable with our data and were 25% higher in people with TT compared with CC (wild-type) genotypes; however, the extent of elevation varied considerably between studies, 2 presumably because of differences in the prevailing status of folate and/or riboflavin.The elevated homocysteine in TT supopulations is generally far less marked within US compared with European populations where (unlike the United States) there is no exposure to mandatory fortification with folate or riboflavin.Correspondingly, this polymorphism carries an increased risk of cardiovascular disease in European populations but not in those in North America. 3e feel that our findings can contribute to the debate regarding food fortification with folate and related B-vitamins currently being considered by many governments.In our study, 1 the marked homocysteine-lowering effect of riboflavin in people with the TT genotype was achieved with very low doses (1.6 mg/d, ie, recommended dietary level).If a sufficiently powered clinical trial proves that homocysteine is linked in a causative way to heart disease or stroke, then exposure of the general population to low-dose riboflavin through fortification (as in the United States) may offer a cheap, safe, and effective means of reducing disease risk among substantial subpopulations who carry the TT genotype and are unaware of it.
Rib Stress Fractures
Authors: Leonard P. Connolly, Susan A. Connolly
Journal: Clinical Nuclear Medicine (2004)

The ribs are an uncommon site of stress fracture. Typical locations are the first rib anterolaterally, the fourth through ninth ribs laterally and posterolaterally, and the posteromedial upper ribs. Muscular forces are predominantly responsible for these fractures. This article reviews the mechanisms of injury in various activities and illustrates the scintigraphic appearance of rib stress fractures.
Hair follicle expression of 1,25-dihydroxyvitamin D3 receptors during the murine hair cycle
Authors: J. REICHRATH, M. SCHILLI, A. KERBER, F.A. BAHMER, B.M. CZARNETZKI, R. PAUS
Journal: British Journal of Dermatology (2006)

Because the hair follicle is a highly hormone-sensitive miniorgan, the role of hormones produced locally in the skin in the control of hair growth deserves systematic analysis. It has been shown previously that the potent steroid hormone 1,25-dihydroxyvitamin D3 (1,25-D3) modulates growth and differentiation of keratinocytes via binding to a high-affinity nuclear vitamin D receptor (VDR). In this study, we have examined the in situ expression of VDR during the murine hair cycle. VDR expression was detected immunohistochemically. To obtain defined stages of the murine hair cycle, hair growth was induced by depilation in C57 BL-6 mice. In addition to the recognized VDR expression of outer root sheath keratinocytes, we detected VDR immunoreactive cells in the dermal papilla, the mesenchymal key structure of the hair follicle. Furthermore, VDR immunoreactivity in the nuclei of outer root sheath keratinocytes and in dermal papilla cells was stronger during anagen IV-VI and catagen than during telogen and anagen I-III. This suggests hair cycle-associated changes in the expression of VDR, and points to a potential role for 1,25-D3 in hair follicle biology. Selected follicular cell populations may display hair cycle-dependent sensitivity to 1,25-D3 stimulation.
Fatigue in Medical Personnel
Authors: Rolf Paulson
Journal: JAMA (1981)

To the Editor.—  In the MEDICAL NEWS section ofThe Journal, Phil Gunby (1981;245:900) writes of interesting and pertinent studies going on at the National Aeronautics and Space Administration regarding airline pilots,  lag, and its effect on their level of performance. This is especially pertinent if you ride airplanes. Investigators at Harvard Medical School made some comments and recommendations.  I would suggest that the investigators could find equally pertinent subject material regarding jet lag closer to home: hospital nurses, house staff, emergency room staff, and others—those who are entrusted in large degree with the care of hospital inpatients.  Working two to three different shifts in the same week—double shifts and doubling back (on one, off one, on one)—is taken for granted by the nursing profession. The resulting burnout from this has been one of the big factors in the present nursing shortage. Beyond its effect on quantity though, I
Photosensitive dermatitis with actinic reticuloid syndrome: an immunohistological study of the cutaneous infiltrate
Authors: ELISABETH RALFKIAER, GUNHILD LANGE WANTZIN, H. STEIN, D.Y. MASON
Journal: British Journal of Dermatology (1986)

Cryostat sections of skin biopsies from five patients with chronic photosensitivity dermatitis with actinic reticuloid syndrome (PDAR) have been examined immunohistologically by the alkaline phosphatase: anti‐alkaline phosphatase staining technique using a panel of 24 monoclonal antibodies against lymphoid cells and their subsets. The lymphoid infiltrates in all cases had an essentially identical cellular composition, containing a mixture of T‐lymphocytes, T‐cell accessory cells (Langerhans cells) and other types of HLA‐DR positive dermal macrophages. In two patients there was an excess of T‐helper/inducer cells relative to T‐suppressor cells, while in the other three patients the numbers of T‐cells in these two subsets were approximately equal. Many of the infiltrating T‐cells expressed activation (HLA‐DR, interleukin‐2 receptor) or proliferation (the Ki67 nuclear antigen, transferrin receptor) associated markers. These data indicate that a T‐cell immune response is operative in cutaneous PDAR lesions.
Tumor Growth Inhibition by Intratumoral Inoculation of Defective Herpes Simplex Virus Vectors Expressing Granulocyte–Macrophage Colony-Stimulating Factor
Authors: Masahiro Toda, Robert L. Martuza, Samuel D. Rabkin
Journal: Molecular Therapy (2000)

To evaluate the potential of defective herpes simplex virus (HSV) amplicon vectors as in vivo cytokine gene transfer vehicles for active immunotherapy, we generated a defective HSV vector that encodes the murine granulocyte–macrophage colony-stimulating factor (GM-CSF) gene, using a replication-defective HSV as helper virus. A variety of murine tumor cell lines were efficiently infected in vitro with the defective GM-CSF vector (dvGM), and this led to the synthesis and secretion of murine GM-CSF. In an established bilateral subcutaneous tumor model with Harding–Passey murine melanoma, unilateral intratumoral inoculation of dvGM significantly inhibited tumor growth of both the inoculated and noninoculated contralateral tumors. This tumor inhibition was dose-dependent and resulted in increased survival of the dvGM-treated mice. Inoculation of a lacZ-expressing defective vector had no effect on tumor growth. We conclude that this defective HSV vector system offers an effective method for cytokine gene delivery in vivo and that GM-CSF expression in tumors has antitumor activity. To evaluate the potential of defective herpes simplex virus (HSV) amplicon vectors as in vivo cytokine gene transfer vehicles for active immunotherapy, we generated a defective HSV vector that encodes the murine granulocyte–macrophage colony-stimulating factor (GM-CSF) gene, using a replication-defective HSV as helper virus. A variety of murine tumor cell lines were efficiently infected in vitro with the defective GM-CSF vector (dvGM), and this led to the synthesis and secretion of murine GM-CSF. In an established bilateral subcutaneous tumor model with Harding–Passey murine melanoma, unilateral intratumoral inoculation of dvGM significantly inhibited tumor growth of both the inoculated and noninoculated contralateral tumors. This tumor inhibition was dose-dependent and resulted in increased survival of the dvGM-treated mice. Inoculation of a lacZ-expressing defective vector had no effect on tumor growth. We conclude that this defective HSV vector system offers an effective method for cytokine gene delivery in vivo and that GM-CSF expression in tumors has antitumor activity.
Points from Letters: Schistosomiasis in the West Indies
Authors: P. A. Clearkin
Journal: BMJ (1964)

Until benzidine was taken off the market because of carcinogenic risks to those engaged in its manufacture the test most widely used was the Gregersen slide-test.'It was in general use on the Continent and in America, and was becoming more generally used in this country.It was recommended in many of the textbooks.5In general practice and in hospital side- wards there are obvious objections to tests, such as the test-tube benzidine and ortho- tolidine tests commonly employed in clinical laboratories, which may give positive results with gum-bleeding and after the eating of meats in moderate amount.Ogilvie, who was the first in this country to describe the Gregersen slide-test,8 affirmed that with it a blue or green-blue colour appearing within 30 seconds is proof of the presence of occult blood irrespective of the patient's diet, with the obvious exceptions of foods with a high blood-pigment concentration such as liver, black pudding, and bone-marrow.Now it is recognized that salicylates also should be withheld.Bockus' employs the Gregersen slide-test as a routine procedure.Benzidine is now produced under safe con- ditions of manufacture and is again on the market.Put up in waxed paper the powders will last indefinitely.The Greger- sen slide-test is cheap and simple and can be performed just as quickly as the tablet tests.Its reliability has been widely proved over the years, and it should be finding its way back into our hospital side-rooms and our consulting-rooms.-Iam, etc., Edinburgh 9. S. LIPETZ.
Intraoperative use of thrombolytic agents: Procedure requires appropriate imaging: Authors' reply
Authors: J J Earnshaw, J D Beard
Journal: BMJ (1993)

kinase advocated by Eamshaw and Beard.23 Their conclusion that "intraoperative thrombolysis . .has considerable advantages" is surprising given the paucity of experience with the technique.We suggest that surgeons interested in the technique should first discuss it with a vascular radiologist and perhaps carry out thrombolysis in the angiographic suite before surgery if required.
Outer Periarteriolar Lymphoid Sheath Arrest and Subsequent Differentiation of Both Naive and Tolerant Immunoglobulin Transgenic B Cells Is Determined by B Cell Receptor Occupancy
Authors: Matthew C. Cook, Antony Basten, Barbara Fazekas de St. Groth
Journal: The Journal of Experimental Medicine (1997)

T-dependent B cell responses in the spleen are initiated in the outer periarteriolar lymphoid sheath (PALS) and culminate in the generation of proliferative foci and germinal center reactions. By pulsing anti–hen egg lysozyme (HEL) immunoglobulin transgenic (IgTg) B cells with various concentrations of HEL in vitro before adoptive transfer into normal recipients, it was shown that a critical number of B cell receptors (BCRs) must be ligated for B cells to undergo arrest in the outer PALS. T cell help was manipulated independently of the BCR stimulus by incubating B cells expressing the appropriate major histocompatibility complex class II antigen with a peptide recognized by CD4+ TCR Tg T cells. B cells which either failed to arrest in the outer PALS due to a subthreshold BCR stimulus, or arrested only transiently due to the brevity of the BCR stimulus, underwent an abortive response within the follicles when provided with T cell help. In contrast, naive B cells stimulated by a sustained, suprathreshold concentration of either foreign or self-antigen and given T cell help, proliferated in the outer PALS and then differentiated. Outer PALS arrest was not influenced by the nature of the B cells occupying the follicle, but appeared to be determined solely by the magnitude of BCR stimulation. Thus antigen-pulsed B cells arrested in the outer PALS in an identical manner irrespective of whether the follicles comprised a population of normal B cells with multiple specificities, a monoclonal naive population, or a monoclonal population of tolerant B cells. In addition, tolerant B cells were found to relocate from the follicles to the outer PALS of HEL/anti-HEL double Tg mice in which the concentration of soluble self-antigen had been increased by zinc feeding. Similarly, when anti-HEL Tg mice were crossed with a second HEL Tg strain expressing a higher concentration of soluble HEL, the tolerant anti-HEL Tg B cells were located constitutively in the outer PALS. Thus, subtle variations in antigen concentration resulted in dramatic changes in positioning of B cells within the spleen. A series of mixed bone marrow chimeras in which the effective antigen concentration was inversely related to the number of self-reactive B cells due to absorption of antigen by transgene-encoded membrane and secreted Ig, was used to confirm that alteration in B cell position previously attributed to changes in follicular composition could be explained on the basis of available antigen concentration, rather than the diversity of the repertoire.
Abstract 1009: Leptin induces Src/Gbr2/Gab2/STAT3 activation and Rac-1 crosstalk to regulate VEGF/VEGFR2 in breast cancer
Authors: Miles Fuller, Manzy Byrd, Shanchun Guo, Ruben Rene Gonzalez-Perez
Journal: Cancer Research (2011)

Abstract Leptin and its receptor, OB-R, are overexpressed in cancer cells and their levels correlate to worse prognosis of cancer patients. Leptin is an important inducer of VEGF/VEGFR2 in breast cancer under normoxia through the activation of several signaling pathways and HIF-1α/NFκB/SP1. However, the specific mechanisms of leptin-mediated regulation of VEGF/VEGFR2 genes are still partially unknown. VEGF/VEGFR2 directly regulates tumor angiogenesis and also works as an essential autocrine/paracrine process for cancer cell proliferation and survival. We have previously shown that disruption of leptin signaling with our novel antagonists, PEG-LPrAs, significantly impaired the growth of breast tumors and reduced the levels of VEGF/VEGFR2. We hypothesize that leptin regulation of VEGF/VEGFR2 in breast cancer involves the activation of Src and Gbr2/Gab2/STAT3 and crosstalk to Rho-GTPases. Methods: To test this hypothesis, VEGF/VEGFR2 expression and activation of signaling intermediaries were determined in mouse and human breast cancer cells challenged with leptin as well as genetic and pharmacologic kinase inhibitors. Results: Inhibition of JAK2 partially reduced leptin-induced pSTAT3 levels but increased VEGF protein and mRNA. Moreover, leptin-induced pSTAT3 was related to Src and Gab2. Inhibition of Src increased leptin-induced VEGF and dramatically reduced VEGFR2. Rac1 inhibition also abrogated leptin-induced pSTAT3 and decreased pGab2 and VEGF/VEGFR2 levels. Conclusions: Leptin activation of Rac1 upregulates VEGF/VEGFR2 and promotes a negative feed-back, which downregulates leptin activation of Src/Gbr2/Gab2/STAT3. In addition, leptin activation of Src/Gbr2/Gab2 and Rac1 are needed for the induction of VEGFR2. These data suggest a high complexity of signaling crosstalk is involved in leptin regulation of pro-angiogenic factors and breast cancer growth. Therefore, PEG-LPrA combined with inhibitors for leptin-sensitive regulatory signaling partners could provide novel multiple target therapies for breast cancer. This could be of paramount importance for the higher risk patients: obese and postmenopausal women who show highest leptin levels. Our proposed studies could also be relevant to patients having the very aggressive and difficult to treat triple negative breast cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1009. doi:10.1158/1538-7445.AM2011-1009