tbuckley/cabot-search huggingface dataset:
Sir Victor Horsley—an inspiration
Authors: Michael Powell
Journal: BMJ (2006)

You probably know nothing of this extraordinary late Victorian and Edwardian age surgeon, but you should. Horsley contributed on so many different fronts: pioneering neurosurgeon, ardent experimenter, medical politician, social reformer, and author. If you ever need a doctor as a role model, a medical figure of international importance who was also a vocal social conscience, look no further. 

By the age of 29, Horsley was a fellow of the Royal Society and had become the first surgeon in the world appointed to a hospital post as a “brain surgeon,” with an impressive series of operative firsts to his name. He had confirmed the cause of rabies and helped to abolish the disease from the United Kingdom, and he had researched and published widely on many anatomical and physiological topics. 

By his early death at 59, he had reformed the British Medical Association (BMA), Medical Defence Union (MDU), and the General Medical Council (GMC). He had also attempted and failed to reform the Royal College of Surgeons of England (no change there). He had espoused many radical socialist causes, pushing a somewhat reluctant medical establishment into supporting National Insurance, and making himself thoroughly unpopular supporting such issues as votes for women.⇓ 



Sir Victor Horsley, FRS (1857-1916) 



Horsley was born into London's artistic aristocracy in 1857. His father was a painter, a royal academician, who invented the Christmas card in 1843. His grandfather was a composer; his aunt inspired the composer Felix Mendelssohn. The house where he was born, in Camden Hill, Kensington, was a small artist's colony: artists Holman Hunt and Edward Lear, the water colourist who taught Queen Victoria, lived there. Horsley was named by the Queen, who became his godmother. He shared his birthday with her youngest child, Princess Beatrice. 

By the time he entered London's University …
Leflunomide protects from T-cell-mediated liver injury in mice through inhibition of nuclear factor ?B
Authors: Motoaki Imose, Masahito Nagaki, Kiminori Kimura, Shinji Takai, Motohiro Imao, Takafumi Naiki, Yosuke Osawa, Takahiko Asano, Hideki Hayashi, Hisataka Moriwaki
Journal: Hepatology (2004)

Leflunomide is a novel immunosuppressive and anti-inflammatory agent for the treatment of autoimmune disease. The aim of this study was to investigate whether leflunomide protects from liver injury induced by concanavalin A (Con A), a T-cell-dependent model of liver damage. BALB/c mice were injected with 25 mg/kg Con A in the presence or absence of 30 mg/kg leflunomide. Liver injury was assessed biochemically and histologically. Levels of circulating cytokines and expressions of cytokine messenger RNA (mRNA) in the liver and the spleen were determined. Treatment with leflunomide markedly reduced serum transaminase activities and the numbers of dead liver cells. Leflunomide significantly inhibited increases in plasma tumor necrosis factor alpha (TNF-α) and interleukin 2 concentrations, and also reduced TNF-α mRNA expression in the liver after administration of Con A. These findings were supported by the results in which leflunomide administration decreased the number of T lymphocytes infiltrating the liver as well as inhibiting their production of TNF-α. Activation of nuclear factor κB (NF-κB), which regulates TNF-α production, was inhibited in the liver of mice treated with leflunomide, resulting in a reduction of TNF-α production from lymphocytes infiltrating the liver. In conclusion , leflunomide is capable of regulating T-cell-mediated liver injury in vivo and that this event may depend on the decrease of TNF-α production in the liver through inhibition of NF-κB activation caused by leflunomide. (Hepatology 2004.)
Anatomic and physiologic heterogeneity in patients with syndrome X: An intravascular ultrasound study
Authors: Joseph G. Wiedermann, Allan Schwartz, Mark Apfelbaum
Journal: Journal of the American College of Cardiology (1995)

We used intravascular ultrasound imaging of the epicardial vessels to assess coronary morphology, vasomotor response to exercise and exercise-vasomotion after betaadrenoceptor blockade in patients with syndrome X. Syndrome X is defined as chest pain, abnormal exercise test results and normal coronary angiographic findings. Because of the limitations of coronary angiography, intravascular ultrasound was used to define coronary pathophysiology. Thirty patients with syndrome X were studied with intravascular ultrasound imaging (30 MHz, 4.3F catheter) of all three major epicardial vessels. Supine arm exercise was performed during coronary imaging. Lumen area was assessed at rest and during peak exercise. The exercise-imaging protocol was repeated after loading with 0.1 mg/kg body weight of intravenous propranolol. Three morphologic groups were identified using intravascular ultrasound: normal coronary arteries (no plaque, intimal thickness <0.25 mm, n = 12), atheromatous disease (mean [±SD] area stenosis 37.9 ± 7.2%, n = 10) and marked intimal thickening (0.73 ± 0.11 mm, n = 8). Patients with normal coronary arteries displayed a vasodilatory response to exercise (+ 16.9% area increase); patients with abnormal coronary arteries displayed a vasoconstrictive response to exercise (−17.4% in the group with plaque; −17.6% in the group with intimal thickening). Propranolol loading attenuated the vasodilatory response in the group with normal coronary arteries (+6.4% area increase) and attenuated the vasoconstrictive response in the two groups with abnormal coronary arteries (−8.0% in the group with plaque; −8.8% in the group with intimal thickening). Most patients with syndrome X have abnormal coronary arteries by intravascular ultrasound. Intravascular ultrasound identifies three distinct morphologic groups: normal coronary arteries, atheromatous plaque and intimal thickening. Exercise-vasomotion is normal in patients with syndrome X who have normal coronary arteries by ultrasound; patients with abnormal arteries (plaque or intimal thickening) have an abnormal (constrictive) response to exercise. Propranolol loading attenuates vasoreactivity in all subgroups, suggesting divergent therapeutic utility.
It's Over, Debbie
Authors: Gregory B. DiRusso
Journal: JAMA (1988)

To the Editor.  —Nonmaleficence, that a physician should  no harm, was one of the first concepts introduced to us and our classmates during orientation to medical school. As physicians, we will be entrusted with the care of the human being and will continually encounter hopeless situations. Nevertheless, the role of the physician is to provide the best possible care to the patient. The taking of a life is not appropriate action for a care giver.  After the physician's emotionally detached account of the action taken to end the patient's life in the article entitled It's Over, Debbie, 1 we realize that there are practicing physicians who either  not take the time to think of the maleficence of their actions or who are ignorant of such a notion. The resident who injected an overdose of morphine into Debbie violated the principle of do no harm.  Although the resident may
<i>Lactobacillus rhamnosus</i>CNCM I-3690 and the commensal bacterium<i>Faecalibacterium prausnitzii</i>A2-165 exhibit similar protective effects to induced barrier hyper-permeability in mice
Authors: L Laval, R Martin, JN Natividad, F Chain, S Miquel, C Desclée de Maredsous, S Capronnier, H Sokol, EF Verdu, JET van Hylckama Vlieg, LG Bermúdez-Humarán, T Smokvina, P Langella
Journal: Gut Microbes (2014)

Impaired gut barrier function has been reported in a wide range of diseases and syndromes and in some functional gastrointestinal disorders. In addition, there is increasing evidence that suggests the gut microbiota tightly regulates gut barrier function and recent studies demonstrate that probiotic bacteria can enhance barrier integrity. Here, we aimed to investigate the effects of Lactobacillus rhamnosus CNCM I-3690 on intestinal barrier function. In vitro results using a Caco-2 monolayer cells stimulated with TNF-α confirmed the anti-inflammatory nature of the strain CNCM I-3690 and pointed out a putative role for the protection of the epithelial function. Next, we tested the protective effects of L. rhamnosus CNCM I-3690 in a mouse model of increased colonic permeability. Most importantly, we compared its performance to that of the well-known beneficial human commensal bacterium Faecalibacterium prauznitzii A2-165. Increased colonic permeability was normalized by both strains to a similar degree. Modulation of apical tight junction proteins expression was then analyzed to decipher the mechanism underlying this effect. We showed that CNCM I-3690 partially restored the function of the intestinal barrier and increased the levels of tight junction proteins Occludin and E-cadherin. The results indicate L. rhamnosus CNCM I-3690 is as effective as the commensal anti-inflammatory bacterium F. prausnitzii to treat functional barrier abnormalities.
Vibration Sensory Thresholds Depend On Pressure of Applied Stimulus
Authors: Leslie M Lowenthal, T Derek, R Hockaday
Journal: Diabetes Care (1987)

Vibration sensory thresholds (VSTs) were estimated in 40 healthy subjects and 8 with diabetic peripheral neuropathy. A vibrameter and a biothesiometer were used at four sites and at differing pressures. In normal subjects, with the vibrameter at 200 g, mean VST ± SE for all sites was 1.87 μm ± 0.22 and at 400 g dropped to 1.08 μm ± 0.15 (P &amp;lt; .0001). In 20 of these subjects with a biothesiometer at 200 and 400 g, mean VST fell from 12.8 ± 1.5 to 11.1 ± 1.1 (arbitrary units) (P = .01) when the greater pressure was applied. In the 8 subjects with peripheral neuropathy, with the vibrameter at 200 and 400 g, respectively, mean VST fell from 70.7 ± 26 to 7.2 ± 1.8. VST in these subjects was estimated again after 1 mo and showed strong correlations with the previous values. Biothesiometer results correlated with vibrameter results at all sites. Thus, VST decreases as the pressure of the applied stimulus is increased and this effect appears to be more marked in peripheral neuropathy. This has important consequences in monitoring this condition.
Localization of Bone-Seeking Agent Within a Desmoid Tumor
Authors: HARRY J. LESSIG, JOHN E. DEVENNEY
Journal: Clinical Nuclear Medicine (1979)

This is a case report of a patient who had a desmoid tumor which localized 99m Tc-diphosphonate. The mechanism for this localization was felt to be the affinity of the bone agent for the immature proliferating collagen in this tumor.
Detection of cell surface and intracellular antigens by human monoclonal antibodies. Hybrid cell lines derived from lymphocytes of patients with malignant melanoma.
Authors: A N Houghton, H Brooks, R J Cote, M C Taormina, H F Oettgen, L J Old
Journal: The Journal of Experimental Medicine (1983)

This study represents an initial attempt to analyze the humoral immune reactions of patients with malignant melanoma by hybridoma methodology. Using lymphocytes from regional lymph nodes, peripheral blood and tumor infiltrates, 158 fusions were performed with SKO-007 (human myeloma line), LICR-LON-HMy2 (LICR-2), GM 4672 (human lymphoblastoid lines), or NS-1 (mouse myeloma line). Fusion of lymph node lymphocytes with NS-1 resulted in a 3-4 times higher frequency of clones than fusion with LICR-2, and a 10 times higher frequency than fusion with SKO-007 or GM 4672. In the case of peripheral blood lymphocytes, fusion with NS-1 gave greater than 25 times higher frequency of clones than fusion with LICR-2 or SKO-007. Production of human mu, gamma, or alpha heavy chains was detected in 50-80% of wells containing growing clones, and the levels of immunoglobulin ranged from 0.3 micrograms to 40 micrograms/ml. NS-1-derived clones could be easily subcultured, while LICR-2 and SKO-007 clones grew more slowly on subculturing. In this study, Ig secretion appeared to be a more stable property of LICR-2-derived clones than NS-1-derived clones. A panel of 20 human cancer cell lines was used to screen 771 Ig-secreting cultures for antibody to cell surface or intracellular antigens. Reactivity with cell surface antigens was found infrequently (6 cultures), whereas reactivity with intracellular antigens was more common (27 cultures). A new cell surface antigen with properties of a glycolipid was defined with an IgM monoclonal antibody secreted by a tetraploid cell derived from a fusion of LICR-2 with lymphocytes from the axillary lymph node of a patient with melanoma. The hybrid cell line has been subcloned four times and secretes 5 micrograms IgM/ml. The antigen detected by this IgM antibody was found on 5 of 23 melanoma cell lines and 12 of 30 epithelial cancer cell lines. No reactions were found with 11 cultures derived from normal cells. Stable cell lines secreting human antibody that detected nuclei, nucleoli, cytoskeletal elements, Golgi complex, or other cytoplasmic components were also isolated in this study. One of these antibodies detected an intracellular antigen that is restricted to cells of neuroectodermal derivation, and a second antibody reacted primarily with cells of epithelial origin. Using these methods to isolate and analyze human monoclonal antibody, it should now be possible to define the repertoire of the humoral immune response to melanoma.
Frank Dudley Hart
Authors: Allan St J Dixon
Journal: BMJ (2004)

​InIn his long life Frank Dudley Hart saw the promotion of rheumatology from a subsection of physical and spa medicine to a recognised specialty.




Figure 1




During the second world war, while serving as a major in the Royal Army Medical Corps in Iraq, north Africa, and Italy, he became interested in ankylosing spondylitis, a not uncommon problem in young recruits. Leaving the RAMC with the rank of lieutenant colonel in 1946 he was appointed consultant physician at the Westminster Hospital, where he established the first specialist rheumatology clinic in a London teaching hospital.

Unlike American teaching at the time, Hart differentiated ankylosing spondylitis from rheumatoid arthritis on clinical grounds. He was proved right after the transplant scientist David James asked whether any rheumatic disease “ran in families.” Hart and his colleague Derrick Brewerton nominated ankylosing spondylitis. Tissue typing showed that the inherited human leukocyte antigen HLA B27 was present in over 90% of people with ankylosing spondylitis but only rarely in rheumatoid arthritis.

Hart pioneered the concept of a specialist institute that could support a national rheumatology research effort. This came to fruition as the Kennedy Institute, now affiliated to the Charing Cross Hospital. As chairman of the Royal College of Physicians rheumatism subcommittee he helped to get rheumatology accepted as a specialty of medicine.

After retiring from the NHS in 1974 he continued in private practice until 1987.

He leaves a son and two daughters.

Francis Dudley Hart, former consultant physician London (b 1909; q Edinburgh 1933), d 10 April 2004.
Repeated abortions increase the risk of premature and low birthweight births
Authors: I. Torjesen
Journal: BMJ (2012)

Women who have had three or more abortions are more likely to give birth prematurely or have a baby of low birth weight when they carry their first child to term, according to a study published online in the journal Human Reproduction on Thursday. 

The study, one of the largest ever to look at the effects of abortion on subsequent pregnancy outcomes, found that women were three times more likely to have a very premature first baby, born before 28 weeks, if they had had three or more abortions previously.1

Finnish researchers reviewed the pregnancy outcomes of more than 300 800 Finnish women who gave birth for the first time between 1996 and 1998. More than 10% of these women had undergone one induced abortion (31 083 women), 1.5% had had two (4417 women) and 0.3% three or more (942 women). …
Liver stiffness increases acutely during sickle cell vaso‐occlusive crisis
Authors: Christopher Koh, Tiffany Turner, Xiongce Zhao, Caterina P. Minniti, Jordan J. Feld, Jennifer Simpson, Mary Demino, Anna K. Conrey, Mary J. Jackson, Catherine Seamon, David E. Kleiner, Gregory J. Kato, Theo Heller
Journal: American Journal of Hematology (2013)

Acute vaso-occlusive crisis (VOC) in sickle cell disease (SCD) is an important cause of end-organ damage. It is estimated that 10-39% of VOC occurs with hepatic involvement. Current assessments of hepatic involvement during VOC are unsatisfactory. We investigated transient elastography (TE) as a marker of hepatic involvement, its relationship with histology, and biochemical markers during VOC. SCD patients were evaluated with biochemical markers and TE at steady-state and during VOC. Change in TE and biochemical markers were correlated with length of hospital stay. When available, liver biopsy and tricuspid regurgitation velocity (TRV) at steady-state were correlated with TE. Twenty-three patients were evaluated (mean age = 34.3 years, standard deviation = 7.96). In 15 patients with liver biopsies, TE correlated with fibrosis (P = 0.01) and TRV (P = 0.0063), but not hepatic iron. Hemolysis biomarkers changed during VOC (P < 0.022), but not alanine aminotransferase (ALT). Paired comparison of TE at steady-state and during VOC showed an increased from 6.2 to 12.3 kPa (P = 0.0029). Increasing TE during VOC associated with increasing ALT and alkaline phosphatase (P = 0.0088 and 0.0099, respectively). At steady-state, increasing inflammation on biopsy (P = 0.0037) and TRV (P = 0.0075) correlated with increasing TE during VOC. Increased hospital stay was associated with higher ALT (P = 0.041), lower albumin (P = 0.046), hemoglobin/hematocrit (P < 0.0021) but not TE. TE may identify patients with hepatic involvement during VOC independent of biochemical measures. Increase in TE may reflect both hepatic passive congestion and hepatic involvement during VOC. TE may serve as a physiological biomarker for hepatic features of VOC.
Schistosomiasis in the West Indies
Authors: J. R. L. Roberts
Journal: BMJ (1964)

BRICAWTWJUNALstreams in the island, numbering several hun- ,dreds, contained infested snails (Planorbis); -and stool examination showed that infestation -was just as widespread in the population.The reason for the disease being confined 1or so long to one circumscribed locality and then suddenly between 1956 and 1960 spread- ing over the whole island is not clear, but it ijs worthy of mention that in 1955 nearly the -whole town of Soufriere was burnt down, -with the result that many of the inhabitants had to find homes in other parts of the island.-I am, etc.,
Remarks on THE SYMPTOMS AND DIAGNOSIS OF PLACENTA PRAEVIA
Authors: B. Solomons
Journal: BMJ (1929)

TMiE task which has been set mtie to openi a discussioni on the symnptomns anid diagnosis of placenta pi aevia is indeed a difficult one, for the treatment (lepenids so miiuchl on dia- gnosis that it is inearly as impossible to divorce these two aspects of the suibject a-s it is to separate the Ghlost from the play of H.mamlet, om., at the present jun-icture, the Gaelic language fro1n Ireland.In spite of this, the effort will be made, and if occasionially a casuial remark is let fall on the subject of treatment wheni it is n-ecessary durinig the course of the discussioni on diagnosis, those who realize the difficulties of the situation will excuse; those wlho do not, will not notice. NOMENCLATURE.It is absolutely indispenisable in a consideration of this subject that the nomenclature should he made very clear.
Defenestration of Hepatic Sinusoids in the Pathogenesis of Alcoholic Hyperlipoproteinemia
Authors: Robert Scheig
Journal: Hepatology (1990)

The hepatic sinusoidal endothelium separates sinusoidal blood from hepatocytes; changes in the porosity of this endothelium may affect the passage of chylomicrons into hepatocytes and influence lipid metabolism. Chronic exposure to ethanol reduces the porosity of the endothelium; this mechanism may underlie the hyperlipoprotelium; hyperlipoproteinaemia observed in some people who drink heavily.
Ratio of males to females in China
Authors: T. Liu, X.-y. Zhang
Journal: BMJ (2009)

Is still high, but only partly because of the one child policy

China’s one child policy is one of the most controversial social policies ever implemented. The policy reduced the fertility rate and has helped raise living standards for most people in China, but it has been heavily criticised for violating human rights and having many negative social consequences, one of which is an excess number of male births.1

In the linked study (doi:10.1136/bmj.b1211), Zhu and colleagues assess trends and geographical patterns in the sex ratio at birth and in people under 20 years of age in China, in addition to the influence of sex selective abortion and the one child policy.2 They find that in 2005 China had more than 32 million excess males under the age of 20, and over 1.1 million excess male births. The authors present a discouraging picture of very high and worsening male to female ratios in the reproductive age group in China for the next two decades.

By showing that sex ratios for different age groups and places of residence vary with how …
Military Declassifies Some Gulf War Documents
Authors: Paul Cotton
Journal: JAMA (1994)

THE MILITARY is declassifying documents from Operation Desert Storm, hoping to quash reports of chemical warfare and other speculation surrounding symptoms reported by Gulf War veterans (<i>JAMA</i>. 1994;271:1559-1561). The move follows assertions by Sen Donald Riegle, Jr (D, Mich), that there is "clear evidence" from interviews his staff conducted with more than 600 Persian Gulf War veterans that troops were exposed to harmful levels of chemical, and possibly biological, agents during the war, and that such exposure may explain many of the symptoms some veterans are suffering. These include fatigue, progressive neuropathies, respiratory and gastrointestinal problems, skin rashes, chest pains, joint pain, irritability, memory and concentration problems, nervousness, depression, weakness, and sensitivity to certain chemicals. Some spouses and children of veterans also report the symptoms, suggesting that the syndrome is transmissible, according to a report issued by the Senate Committee on Banking, Housing and Urban Affairs, which Riegle chairs. That
A case of mucinous cystadenocarcinoma of the pancreas with spontaneous rupture diagnosed by endoscopic retrograde pancreatography
Authors: A. Imoto, D. Masuda, Y. Kurisu, S. Onda, T. Ogura, M. Takii, E. Umegaki, M. Hayashi, K. Uchiyama, K. Higuchi
Journal: Endoscopy (2013)

Mucinous cystic neoplasm (MCN) of the pancreas is characterized by a multilocular cystic lesion lined by mucin-producing columnar epithelium and an ovarian-type stroma [1]. MCNs are often found incidentally and may occasionally cause symptoms. Rupture of a pancreatic MCN is a rare complication, and only a few cases have been reported to date [2] [3] [4] [5]. Many of these cases occurred during pregnancy [2] [3] [5]. This report is the first to describe a case of ruptured MCN with an associated invasive carcinoma of the pancreas diagnosed by endoscopic retrograde pancreatography (ERP).