tbuckley/cabot-search huggingface dataset:
BASSINI AND HALSTED OPERATIONS FOR INGUINAL HERNIA.LIGATION OF FEMORAL FOR TRAUMATIC ANEURISM— MASTOID DISEASE—PELVIC ABSCESS ESCAPING THROUGH GREAT SACRO SCIATIC NOTCH—HEMOPHILITIC KNEE JOINT. (Surgical notes Presbyterian Hospital, June 10, 1894.)
Authors: ARTHUR DEAN BEVAN
Journal: JAMA (1894)

<i>Case 1</i>.—The first case which I present to you is one of double inguinal hernia. This patient is 30 years of age, is a laborer; general health and history good. Has had this double rupture for twelve years. Examination demonstrates that they are oblique inguinal hernæ; from long existence the internal ring has been dragged down until it is opposite the external ring, thus simulating direct hernia. The term, straight hernia, is used to designate this condition. This man has continuously worn a truss, but even with the truss the condition has been a source of constant annoyance to him. My personal experience with the operation for radical cure of hernia, something more than thirty cases, has been so gratifying both with regard to permanence of cure and freedom from mortality that I feel warranted in advising this man to submit to operation. On the right side I shall do
Falsely Negative Enzyme Paper Tests for Urinary Glucose
Authors: Houghton Gifford
Journal: JAMA (1961)

TAPES OR STICKS impregnated with glucose oxidase and peroxidase have achieved widespread use for the detection of glucose in urine. Replacement of the Benedict's test by these enzymatic glucose determinations has occurred in many hospitals and clinics, as well as in medical offices and patients' homes.<sup>1</sup>The tapes are strips of paper continuously impregnated with glucose oxidase and peroxidase, while the sticks are strips of paper containing a narrow band of similar impregnation. In the following paragraphs, we wish to: (1) call attention to inhibitory substances for enzymes in some urines; (2) point out an advantage of the tape over the stick paper; and (3) suggest certain precautions in the use of these glucose enzyme test papers. It was found in our general hospital laboratory that an occasional urine was positive to the routine Benedict's test but negative to the enzyme dipsticks (Combistix) for glucose. An additional step
Abstract 5470: Genotoxic effect and epigenetic alterations induced by the environmental carcinogen dibenzo[a, l]pyrene in oral tissues of mice
Authors: Shang-Min Zhang, Yuan-Wan Sun, Kun-Ming Chen, Cesar Aliaga, Krishnegowda Gowdahalli, Shantu Amin, Karam El-Bayoumy
Journal: Cancer Research (2012)

Abstract Oral cancer is the major form of head and neck squamous cell carcinoma, which is the fifth most common cancer worldwide. Tobacco smoking is one of the leading causes of oral cancer. Dibenzo[a, l]pyrene (DB[a, l]P) is the most potent carcinogenic polycyclic aromatic hydrocarbon found in tobacco smoke. Recently we developed a novel mouse model of oral cancer induced by DB[a, l]P; we also showed the remarkable carcinogenicity and specificity of the fjord region diol epoxide metabolite, (±)-anti-11,12-dihydroxy-13,14-epoxy-11,12,13,14-tetrahydrodibenzo[a, l]pyrene (DB[a, l]PDE). Using immunohistochemistry (IHC), we have shown over-expression of p53 protein in mice oral squamous cell carcinoma and dysplastic tissues induced by DB[a, l]P and DB[a, l]PDE. Current understanding of molecular pathogenesis of oral cancer in humans suggests that both genetic and epigenetic alterations are crucial and complement each other. Our hypothesis is that both genetic and epigenetic alterations induced by DB[a, l]P can contribute to the development of oral cancer. P53 protein overexpression detected by IHC may result from p53 gene mutation or exposure to genotoxic stress. To determine whether p53 over-expression is in part due to p53 mutations, Exons 5 to 8 of p53 from 5 tumor tissues were analyzed by polymerase chain reaction single-strand conformation polymorphisms (PCR-SSCP) and direct sequencing. G to T transversion was detected in Exon 5, leading to mutation of codon 155 Arg to Leu; A to T transversion was detected in Exon 7, resulting in mutation of codon 232 Lys to stop codon. To test the epigenetic effect of DB[a, l]P, methylation specific PCR and bisulfate sequencing were used to detect methylation alteration of p16 and RAR-β promoters. Promoter hypermethylation of both p16 and RAR-β were detected in tumors induced by DB[a, l]PDE; also in oral tissues of mice treated with DB[a, l]P (24nmol, 3 times per week, for 5 weeks, sacrificed at 48 h, 1, 2 and 4 weeks after last dose). These results suggested that genotoxic DNA adducts derived from DB[a, l]P can induce mutations in critical genes, such as tumor suppressor gene p53; this environmental carcinogen also can induce p16 and RAR-β promoter hypermethylation at early stage, which can contribute to the promotion and progression of oral carcinogenesis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5470. doi:1538-7445.AM2012-5470
THE SO-CALLED CUTANEOUS TYPE OF PERIARTERITIS NODOSA.
Authors: M. RUITER
Journal: British Journal of Dermatology (1958)

Journal Article THE SO‐CALLED CUTANEOUS TYPE OF PERIARTERITIS NODOSA. Get access M. RUITER M. RUITER Dermatological Department, University of Groningen, The Netherlands Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 70, Issue 3, 1 March 1958, Pages 102–106, https://doi.org/10.1111/j.1365-2133.1958.tb13298.x Published: 01 March 1958
Hemoglobin Bart's Disease in an Italian Boy
Authors: David H.K. Chui, Margaret Patterson, Carol E. Dowling, Haig H. Kazazian, Alan G. Kendall
Journal: New England Journal of Medicine (1990)

HEMOGLOBIN is a tetramer consisting of two pairs of globin chains, each of which is associated with a heme group. In adults, the predominant hemoglobin — hemoglobin A — is composed of two α-globin and two β-globin chains (α2β2); the principal fetal hemoglobin — hemoglobin F — is made up of two α-globin and two γ-globin chains (α2γ2). α-Globin chains are coded for by two adjacent α-globin genes on the short arm of each chromosome 16. The embryonic ζ-globin chains, which resemble α-globin chains, are coded for by a ζ-globin gene on . . .
Ecto-5′-Nucleotidase Activity in Human T Cell Subsets. DECREASED NUMBERS OF ECTO-5′-NUCLEOTIDASE POSITIVE CELLS FROM BOTH OKT4+ AND OKT8+ CELLS IN PATIENTS WITH HYPOGAMMAGLOBULINEMIA
Authors: Linda F. Thompson, Andrew Saxon, Richard D. O'Connor, Robert I. Fox
Journal: Journal of Clinical Investigation (1983)

T lymphocytes from control subjects were separated into subsets using monoclonal antibodies of the OKT series and complement lysis and analyzed for ecto-5′-nucleotidase activity both by quantitative radiochemical assay and a histochemical stain. T cells from 15 control subjects contained 54±4% OKT4+ (helper/inducer) cells and 32±3% OKT8+ (cytotoxic/suppressor) cells. Total T cell ecto-5′-nucleotidase activity was 10.9±2.1 nmol/h per 106 cells with 25±7% positive by histochemical stain. Ecto-5′-nucleotidase activity in OKT4-enriched populations was 5.43±1.8 nmol/h per 106 cells with 14±2% positive by histochemical stain; that in OKT8-enriched populations was 17.1±5.9 nmol/h per 106 cells with 35±8% positive by histochemical stain.
Book Review Patient Autonomy and the Ethics of Responsibility (Basic Bioethics.) By Alfred I. Tauber. 328 pp. Cambridge, Mass., MIT Press, 2005. $62 (cloth); $25 (paper). 0-262-20160-7 (cloth); 0-262-70112-X (paper).
Authors: Marshall B. Kapp
Journal: New England Journal of Medicine (2006)
Percutaneous endoscopic gastrostomy feeding.
Authors: J. Payne-James
Journal: BMJ (1992)

ing (including fine bore tube feeding) have been well documented,5 but nasogastric feeding remains an essential part of nutritional support.Percutaneous endoscopic gastrostomy is a major technical advance in obtaining access for nutritional support, and though its safety is well.established, it is still an invasive procedure and not suitable for all.What has not been well established, and which neither Park and colleagues or Forgacs and colleagues addressed, is the indication for nutritional support in patients with disabling neurological conditions.Research and training in nutritional support are needed to define and outline the risks and benefits of nutritional intervention in such patients.Percutaneous endoscopic gastrostomy feeding is an advance for those who require long term tube feeding, and we would not have con- sidered randomising patients who had already had four weeks of nasogastric tube feeding.We do not see percutaneous endoscopic gastrostomy feeding as a panacea for all, nor will its use "prevent the degrading spectacle of elderly, under- nourished patients with their hands bandaged to the side of the bed."2Let clinicians decide whether nutritional support is appropriate and then institute appropriate treatment using well proved techno- logical advances such as percutaneous endoscopic gastrostomy.
Marked Liver Tumorigenesis by <i>Helicobacter hepaticus</i> Requires Perinatal Exposure
Authors: Bhalchandra A. Diwan, Marek Sipowicz, Daniel Logsdon, Peter Gorelick, Miriam R. Anver, Kazimierz S. Kasprzak, Lucy M. Anderson
Journal: Environmental Health Perspectives (2008)

BackgroundAlthough severe hepatitis and liver tumors occur in a high percentage of A/J male mice naturally infected with Helicobacter hepaticus, these effects have not been observed after injection of adult mice with the bacteria.ObjectivesWe tested the hypothesis that perinatal exposure to the bacteria is required for liver tumorigenesis.MethodsA/J female mice were infected by intragastric (ig) or intraperitoneal (ip) treatment with 1.5 × 108 H. hepaticus before pregnancy. We examined offspring at progressive time intervals, including some kept until natural death in old age. A/J, BALB/c, and C57BL/6 weanling male mice were similarly treated ig with the bacteria and observed for up to 2 years.ResultsAfter ip bacterial infection of A/J females, 41% of their male offspring developed hepatitis and 33% had hepatocellular tumors, including 18% with hepatocellular carcinoma. Treatment by the ig route resulted in a similar incidence of hepatitis in offspring (35%) but fewer total liver tumors (8%) and carcinomas (4%). By contrast, ig instillation of H. hepaticus in weanling A/J, C57BL/6, or BALB/c mice resulted in low incidence of hepatitis (0–20%) and few liver tumors, despite presence of bacteria confirmed in feces.ConclusionsResults indicate that a high incidence of liver tumors in mice infected with H. hepaticus requires perinatal exposure. Contributing perinatal factors could include known high sensitivity of neonatal liver to tumor initiation, and/or modulation of immune response to the bacterium or its toxins. Mechanisms of human perinatal sensitivity to such phenomena can be studied with this model.
P554 ASSESSMENT OF PROGNOSIS IN HEPATOCELLULAR CARCINOMA USING A BIOMARKER BASED APPROACH: VALIDATION AND EXTENSION OF THE BALAD MODEL
Authors: R. Fox, S. Berhane, M. Teng, T. Cox, T. Tada, H. Toyoda, T. Kumada, C. Kagebayashi, S. Satomura, P. Johnson
Journal: Journal of Hepatology (2014)
Frontiers in Intravascular Imaging Technologies
Authors: Yasuhiro Honda, Peter J. Fitzgerald
Journal: Circulation (2008)

I n 1971, Bom et al 1 developed one of the first catheter- based real-time imaging techniques for use in the cardiac system.In placing a set of phased-array ultrasound transducers within the cardiac chambers, Bom and colleagues showed that higher frequencies than those used in transthoracic ultrasound imaging could be used to produce high-resolution images of cardiac structures.By the late 1980s, Yock et al 2 had successfully miniaturized a single-transducer system to enable transducer placement within coronary arteries.Since then, intravascular ultrasound (IVUS) has become a pivotal catheter-based imaging technology, having provided practical guidance for percutaneous interventions and scientific insights into vascular biology in clinical settings.Technical developments currently being explored consist of further device improvements, a variety of advanced image analyses, and the extension of this ultrasound-based approach to diverse intravascular imaging techniques with other energy sources.
918 VIROLOGICAL EFFICACY OF BOCEPREVIR (BOC) AND TELAPREVIR (TVR) PLUS PEGINTERFERON alfa-2a (P)/ RIBAVIRIN (R) UNTIL WEEK 12 IN DRUG ADDICTED PATIENTS WITH GT-1 INFECTION: FIRST REAL LIFE REPORT
Authors: B. Weber, B. Ablasmaier-Stuetzel, U. Naumann, D. Schleehauf, C. Bachner, J. Goelz, F. Bannout, K. Isernhagen, J. Gottberg, N. Forestier, K.-G. Buescher, A. Baumgarten, M. Backmund, U. Alshuth, S. Walcher
Journal: Journal of Hepatology (2013)
Delayed Reaction to Aqueous Hyposensitization Material
Authors: F. J. deCastro
Journal: JAMA (1970)

<h3>To the Editor.—</h3> Delayed local reaction to hyposensitization emulsion extracts have been a major drawback in their use.<sup>1</sup>However, delayed local reactions rarely occur with aqueous hyposensitization extracts.<sup>2,3</sup>We report a case of what seems to be a delayed local reaction to aqueous hyposensitization extract. <h3>Report of a Case.—</h3> A 17-year-old Negro girl showed "lumps on the arm" starting in September 1967. Three months later, the lumps began to drain serous watery material. The patient had developed seasonal asthma (June to September) at 11 years of age. Thereafter, she received epinephrine in aqueous or oily suspension in the deltoid area. The last epinephrine in oil injection was received in August of 1966. Skin tests revealed positive reactions to house dust, trees, grass and weed pollens, and mold extracts. Subcutaneous injections of aqueous preparations of these were administered from Aug 18, 1966 to Sept 14, 1967. The maintenance dose
A 42 year old man with bilateral exophthalmos and weight loss
Authors: S. Tigas, A. Tsatsoulis
Journal: BMJ (2011)

A 42 year old white man who was concerned about a recent change in the appearance of his eyes was referred to the outpatient clinic for evaluation and treatment. He reported weight loss of more than 15 kg during the preceding six months, even though his appetite had been good. He was a smoker. Apart from alopecia universalis since childhood, he did not report any other significant medical history, and he was not taking any medication. 

On examination he appeared restless. His body weight was 98 kg and height 168 cm. He was afebrile, with a resting tachycardia of 100 beats/min, and his blood pressure was 140/80 mm Hg. His skin was moist and warm, and there was fine tremor of the outstretched hands. He had marked bilateral exophthalmos associated with swelling and erythema of the eyelids and redness of the conjunctivae, as well as punctate keratopathy (corneal epithelial erosions). His eye movements were restricted, particularly upward gaze. His thyroid gland was diffusely enlarged with no tenderness on palpation.



### 1 What is the diagnosis on the basis of the clinical information provided?

#### Short answer

The presence of symptoms and signs of thyrotoxicosis in a patient with bilateral exophthalmos and a diffusely enlarged thyroid gland indicate a diagnosis of hyperthyroidism caused by Graves’ disease.

#### Long answer

The clinical diagnosis of Graves’ hyperthyroidism is relatively straightforward when a patient presents with the typical symptoms and signs of thyrotoxicosis—that is, a diffuse goitre and one or more of the features that are specific to Graves’ disease such as ophthalmopathy or, more rarely, dermopathy (pretibial myxoedema) or thyroid acropachy (finger clubbing). Although lid retraction and lid lag due to sympathetic overactivity may …
Julian Stanley Martyn Toms
Authors: C. L. Crichton
Journal: BMJ (2013)

Julian Stanley Martyn Toms moved from early hospital jobs in his native Cornwall to the Highlands of Scotland, thereafter to remain as a naturalised Scot and very proud of the Celtic connection, but equally proud of his Launceston roots.

He was accepted at Cambridge to read classics, but then promptly decided to study medicine (having expeditiously to obtain pre-entry Science qualifications, and doing so in record time). He did most of his general …
Carcinoma of the Tail of the Pancreas
Authors: George X. Trimble
Journal: JAMA (1962)

the Editor:—  In the June 16 issue ofThe Journal, in the article  of the Tail of the  Presenting with Gastrointestinal Bleeding (180:974), the statement is made, with respect to pancreatic carcinoma, To our knowledge only one long survivor (7 years) is reported.4The reference cited appeared in a 1934 publication.  The authors of the article justifiably point out the extremely poor prognosis of carcinoma of the pancreas when the neoplastic process is located in the body and tail of the pancreas. On the other hand, it may not be readily appreciated that when the carcinoma is situated in the head of the pancreas, the outlook, at times, may be much brighter, as is indicated by the following reports of long-term survival in pancreatic cancer:   Role of Biopsy and Radical Operation in the Management of Carcinoma of the Head of Pancreas (Ann Surg 150:290
210 Zoledronic acid prevents bone loss at 3 months in liver transplant patients: an interim analysis
Authors: B CRAWFORD, C KAM, J PAVLOVIC, A DONAGHY, P ANGUS, G MCCAUGHAN
Journal: Hepatology (2003)

Polymer-based monoliths with interconnected porous structure have attracted much attention as a high-performance stationary phase for online digestion liquid chromatography-mass spectrometry (LC-MS) system. In this study, a poly(glycidyl methacrylate-co-methyl methacrylate) (PGM) monolith prepared via thermally induced phase separation (TIPS) was used as a solid support to covalently immobilize pepsin. The PGM monolith was modified with aminoacetal to yield an aldehyde-bearing (PGM-CHO) monolith. Pepsin was immobilized onto the PGM-CHO monolith via reductive amination. The immobilized pepsin showed better pH and thermal stability compared with free pepsin. Furthermore, the PGM-CHO monolith modified with pepsin was applied for online protein digestion followed by LC-MS and LC-MS/MS analyses. As a result, a larger number of peptides are reproducibly identified compared to those by polystyrene/divinylbenzene particle (POROS)-based online pepsin column.
A memorable patient: Patient empowerment
Authors: P H Chew
Journal: BMJ (2001)

He was 62 years old, a teacher by profession, and had recently had hypertension diagnosed. Metoprolol had been started two weeks ago and his next appointment was not for another two months, but this morning he had insisted on being seen.

He sat demurely opposite me and, just as I finished reviewing his case history, looked straight at me and said, “Doctor, I would like to have you know that for the past two weeks my corpus spongiosum has not been filling up adequately.”

I was stumped. For about 20 seconds, which seemed like an eternity, my mind was a complete blank. I have forgotten much of my medical school anatomy. And then, by a miracle, I remembered. “Why don't you tell me you are not able to have an erection?” I asked defensively.

“I thought you doctors like to be technical,” he retorted without meaning to be impolite. “Anyway, I read from the internet that metoprolol can cause impotence.”

Knowledge is power. The internet, that maze of information, is becoming available to increasing numbers of Malaysians. Many of my patients are getting a profusion of medical information from the internet, some of it accurate and some totally unreliable.

I am a firm and passionate believer in patient empowerment, but that particular morning the impact of knowledge and patient empowerment hit me like a ton of bricks. With that little discourse, I realised that the internet has provided this patient with the knowledge that his recently acquired impotence was drug induced. Without this information, he would probably have considered his erectile dysfunction as a normal part of ageing and never mentioned it to his doctor. Instead, patient empowerment made him feel comfortable about “confronting” his doctor with his suspicion, a behaviour that is not usual in Malaysian society, especially when the issue is sexual and so very personal.

I changed his antihypertensive medication. Two weeks later, he called to tell me that he had regained his sexual prowess. Had it not been for the internet and patient empowerment, an important aspect of his life would have vanished.

Today, when I run my clinic my computer is always on line in case a patient raises any query as a result of surfing the net, and when I explain anything to a patient I consciously use simple terms so as not to be “technical,” and sitting on my table is a message to my patients: “Your health is as much your responsibility. Take charge.”
Rational Therapeutic Drug Monitoring
Authors: H. Friedman
Journal: JAMA (1986)

FOR MANY drugs, the measurement of concentrations in serum or plasma has become widely available and accepted as an important component of clinical decision making. While these drug levels often do allow more objective monitoring and titration of therapy, the information also has the potential to be valueless or even misleading. Laboratories sometimes report that a serum concentration is in the "toxic" range, when the patient is doing well and has no evidence of toxic effects. Or, conversely, the drug is not detectable in serum. Such discrepancies between measured serum drug concentrations and observed clinical drug effects may occur for numerous reasons. This article will review some principles and problems associated with therapeutic drug monitoring. <h3>RATIONALE FOR MONITORING SERUM DRUG LEVELS</h3> For a serum drug concentration to be potentially useful for purposes of therapeutic monitoring, at least two requisites must be fulfilled.<sup>1</sup>First, the serum drug concentration must reflect
Improved Assessment of Coronary Stenosis Severity Using the Relative Flow Velocity Reserve
Authors: Dietrich Baumgart, Michael Haude, Guenter Goerge, Junbo Ge, Sabine Vetter, Nikolaos Dagres, Gerd Heusch, Raimund Erbel
Journal: Circulation (1998)

Background —Myocardial fractional flow reserve (FFR) is based on pressure measurements. We have now sought to establish a Doppler-based concept of relative flow velocity reserve (RFVR) for the functional assessment of stenosis severity in epicardial coronary arteries. A clear threshold value to discriminate the functional severity of a coronary stenosis does not exist for coronary flow velocity reserve (CVR) based on intracoronary Doppler measurements. In contrast, the concept of FFR, which is based on intracoronary pressure measurements, has been extensively validated. An FFR value below 0.75 reliably indicates a significant stenosis. Methods and Results —RFVR is calculated as the ratio between distal CVR in the stenosed target vessel and distal CVR in a nonstenotic reference vessel. In 21 patients, RFVR was determined in 24 target vessels by use of intracoronary adenosine and correlated to the FFR, determined as the ratio of mean poststenotic to aortic pressures, in the target vessel. Stenosis severity was classified according to quantitative coronary angiography analysis. Reference diameter was 3.0±0.4 mm (mean±SD), and area stenosis was 74±15% (range, 40% to 95%). CVRs in the target and reference vessels were 2.1±0.5 and 2.6±0.7, respectively. FFR ranged from 0.49 to 0.99 (mean, 0.81±0.15) and RFVR from 0.53 to 1.0 (mean, 0.82±0.13). Poststenotic CVR did not correlate with either percent area stenosis ( r =0.27, P =NS) or FFR ( r =0.33, P =NS). In contrast, FFR as well as RFVR showed a curvilinear relation to percent area stenosis ( r =0.89, P &lt;0.0001 and r =0.79, P &lt;0.0001, respectively). There was a close linear correlation between FFR and RFVR ( r =0.91, P &lt;0.0001). Conclusions —RFVR correlates closely to FFR and to percent area stenosis, whereas the correlation of CVR with FFR and percent area stenosis is rather poor. RFVR is a promising new concept for assessment of coronary stenosis severity and clinical decision making based on Doppler measurements.