tbuckley/cabot-search huggingface dataset:
Successful ERCP in a Roux-en-Y gastric bypass patient, performed via a small remnant of gastrogastric communication
Authors: A. Madan, S. Urayama
Journal: Endoscopy (2011)

Endoscopic retrograde cholangiopancreatography (ERCP) can be challenging in patients after Roux-en-Y gastric bypass surgery. We present a case of such a patient with choledocholithiasis who underwent successful ERCP though a remnant of gastrogastric communication.
765 HCV CORE PROTEIN MODULATES TGF-ß RESPONSES IN AN AUTOCRINE AND PARACRINE MANNER, A NOVEL PARADIGM FOR THE INTERPLAY BETWEEN HOST- AND VIRAL-RELATED CARCINOGENETIC SIGNALS
Authors: N. Benzoubir, S. Battaglia, B. Testoni, D. Samuel, M. Levrero, C. Bréchot
Journal: Journal of Hepatology (2011)
Hunger striking prisoners: the doctors' dilemma
Authors: Bernadette Gregory
Journal: BMJ (2005)

N ews of further hunger strikes and force feeding at Camp X-Ray, the temporary US detention centre at Guantanamo Bay, Cuba, again brings into sharp relief the ethical debate on the position of doctors in a hunger strike by prisoners. A series of hunger strikes has occurred at the camp since it was opened, but they have gone largely unnoticed. What little coverage the media have given them seems to accept without question the right of prison authorities to force feed hunger striking prisoners against their will.

The World Medical Association, in its 1975 Declaration of Tokyo and again in the 1991 Declaration of Malta, prohibits the use of force feeding of hunger strikers. Details at Guantanamo Bay are predictably sketchy, but prison authorities seem to justify force feeding on the basis of preventing suicide. Any justification that is based on an assumption that a hunger strike is a form of prolonged suicide has been almost universally rejected. The aim of suicide is death. Hunger strikers do not …
Evidence that the fibrinogen binding domain of Apo(a) is outside the lysine binding site of kringle IV-10: a study involving naturally occurring lysine binding defective lipoprotein(a) phenotypes.
Authors: O Klezovitch, C Edelstein, A M Scanu
Journal: Journal of Clinical Investigation (1996)

It is now established that the lysine binding site (LBS) of apo(a) kringle IV-10, and particularly Trp72, plays a dominant role in the binding of lipoprotein(a) [Lp(a)] to lysine. To determine the role of the LBS in the binding of Lp(a) to fibrinogen, we examined the binding to plasmin-modified (PM) fibrinogen of human and rhesus monkey Lp(a) species classified as either Lys' or Lys- based on their capacity to bind lysine Sepharose and to have Trp or Arg, respectively, in position 72 of the LBS of kringle IV-10. We also examined the free apo(a)s obtained by subjecting their corresponding parent Lp(a)s to a mild reductive procedure developed in our laboratory. Our results show that both Lyst and Lys- Lp(a)s and their derived apo(a)s, bound to PM-fibrinogen with similar affinities (Kds: 33-100 nM), whereas the B(max) values were threefold higher for apo(a)s. Both the lysine analog epsilon-aminocaproic acid and L-proline inhibited the binding of Lp(a) and apo(a) to PM fibrinogen. We conclude that the LBS of kringle IV-10 is not involved in this process and that apo(a) binds to PM-fibrinogen via a lysine-proline-sensitive domain located outside the LBS and largely masked by the interaction of apo(a) with apoB100. The significant difference in the PM fibrinogen binding capacity also suggests that apo(a) may have a comparatively higher athero-thrombogenic potential than parent Lp(a).
How much specific is the association between hymenoptera venom allergy and mastocytosis?
Authors: P. Bonadonna, R. Zanotti, M. Pagani, B. Caruso, O. Perbellini, S. Colarossi, E. Olivieri, A. Dama, M. Schiappoli, G. Senna, A. Antico, G. Passalacqua
Journal: Allergy (2009)

The preferential association of mastocytosis with hymenoptera sting reactions is well known, but there is no data on the prevalence of clonal mast cell disorders in subjects with severe systemic reactions due to foods or drugs.Patients with food- or drug-induced severe systemic reactions, including anaphylaxis, and increased serum tryptase were studied for the presence of mastocytosis, and compared with a population of patients with hymenoptera allergy. The aetiological role of foods or drugs was assessed according to current recommendations. Systemic reactions were graded in severity according to the procedure described by Mueller. Serum tryptase was considered increased if the level was >11.4 ng/ml. Subjects with increased tryptase had dermatological evaluation and Bone marrow(BM) aspirate-biopsy, which included histology/cytology, flow cytometry and detection of KIT mutations.A total of 137 subjects (57 male, mean age 42 years) were studied. Of them, 86 proved positive for drugs and 51 for foods. Overall, out of 137 patients, only nine (6.6%) had a basal tryptase >11.4 ng/ml, and only two (1.5%) were diagnosed with mastocytosis. This was clearly different from patients with hymenoptera allergy, where 13.9% had elevated tryptase and 11.1% had a clonal mast cell disorder.The association of clonal mast cell disorders with hymenoptera allergy seems to be more specific than that with food- or drug-induced systemic reactions.
MENACE OF THE UNVACCINATED
Authors: VICTOR G. HEISER
Journal: JAMA (1923)

One hundred and twenty-seven years ago, Jenner made knowledge available which, if effectively applied, would have brought smallpox under complete control. But its adoption was not universal, and millions have died from smallpox since then. The antivaccinationists of the past have largely contributed to such a result, but that is behind us and cannot be remedied. The future, however, is still before us. Shall a few fanatics, with their unproved allegations, be allowed to spread disfiguration, blindness and death to innocent victims of their folly? Should we suffer a person to burn down his house because he believes it noninflammable, if his action menaces the houses of others? Certainly not. Yet we remain complacent when persons promote conditions that destroy lives and happness.  Those who are indifferent and who fail to have their children vaccinated are also contributors to the continuance of smallpox—that disgrace to civilization. The catastrophe that recently
Unilateral Corneal Arcus Without Carotid Artery Stenosis
Authors: E. M. Kaptein
Journal: JAMA (1977)

To the Editor.—  A 65-year-old woman with hyperlipidemia (fasting cholesterol level, 315 mg/dl; triglyceride level, 568 mg/dl) was noted to have unilateral corneal arcus of the right eye. Onset of the arcus was unknown. She had no symptoms to suggest amaurosis fugax, cerebral ischemia, or infarction. Her past history included erysipelas involving the right eye at the age of 4 years and subsequent recurrences of erythema, pain, and swelling involving the maxillary regions with periorbital swelling of either or both eyes without corneal involvement. This was associated with exacerbations of chronic otitis media. The remainder of her past and family history was noncontributory.  Results of the physical examination showed a moderately obese (weight, 76.4 kg; height, 157 cm), mildly hypertensive (blood pressure, 150/95 mm Hg) woman with corneal arcus of the right eye involving the entire circumference of the cornea, separated from the limbus by a lucid zone (Figure). No
Influence of Temperature on Development of Rigor Mortis in Dog Hearts
Authors: HANSIOERG KOLDER, ALAN D. HORRES, GERHARD A. BRECHER
Journal: Circulation Research (1963)

The effect of temperature (1°C to 50°C) on the onset and maximal development of rigor mortis in dog hearts was studied systematically under static conditions. Excised hearts were submerged in Ringer's solution so that the ventricle could assume an elastic equilibrium state. This was characterized by zero transmural pressure and the presence of a certain volume in the ventricle. Pressure-volume curves were obtained in 29 experiments by removal as well as by addition of fluid. The pressure-volume relations were the same at all temperatures prior to the onset of rigor mortis. The criterion for the beginning of rigor mortis was the first change in pressure-volume relations and for maximum rigor the constancy of the attained relations. The shortest interval between cessation of the circulation and the beginning of rigor mortis was 25 minutes at 37°C, and three hours at 10°C. These measurements provide data defining the minimal period during which pressure-volume determinations can be made without post mortem alterations. The phenomenon of "primary dilatation" was observed irrespective of a withdrawal or an addition of fluid to the ventricle. The weight gain of the quiescent ventricle in Ringer's solution was determined until autolysis began and was found to be 5% during the first five hours at all temperatures ranging from 5°C to 45°C.
Contrast M-mode ultrasonography of the inferior vena cava.
Authors: N K Wise, S Myers, T D Fraker, J A Stewart, J A Kisslo
Journal: Circulation (1981)

Contrast M-mode and two-dimensional ultrasonography of the inferior vena cava were performed in 65 patients with various acquired and congenital cardiac disorders. After saline was injected into a peripheral arm vein, the inferior vena cava was visualized by both methods in 60 patients (92%). The M-mode approach was better for correlating the appearance of contrast within the inferior vena cava with the ECG. This precise correlation served as the basis for differentiating patients with tricuspid insufficiency (visualization of contrast after the QRS) from those with impaired right ventricular filling (visualization of contrast before the QRS) or arrhythmia. Results with the M-mode approach suggest that conditions other than tricuspid insufficiency may cause the appearance of contrast within the inferior vena cava. M-mode echocardiography should be used to further investigate patients with impaired right ventricular filling.
TIMP-3 promoter gene polymorphisms in BFL
Authors: R Janssen
Journal: Thorax (2005)

<h3>Introduction</h3> In Inflammatory Bowel Disease (IBD), clonal evolution and field cancerisation precedes the development of colitis-associated colorectal cancer (CA-CRC), however the extent and spread of pre-cancerous clones in the IBD colon remains incompletely determined and consequently clinical practice is poorly informed of how best to detect these clones by endoscopy and accurately predict future cancer risk. This study aims to quantify the number and size of mutant clones arising across the length of the colitic bowel, reveal the mechanism of how they arise and spread, and through this gain a detailed molecular understanding of the evolutionary dynamics of progression to CA-CRC. <h3>Methods</h3> Three IBD patients undergoing a total panproctocolectomy for multifocal dysplasia or CA-CRC were recruited prospectively. Fresh-frozen biopsies were taken at regularly spaced intervals (~2cm) across the entire colon (rectum to caecum, comprising 118, 108 and 25 biopsies respectively). Epithelial tissue was isolated from each biopsy using laser capture microdissection and DNA was extracted. Low pass whole genome sequencing (lpWGS) was performed to generate genome-wide copy number alteration (CNA) profiles. <h3>Results</h3> Analysis from the first 45 samples from colon 1 show; 1) Multiple CNA events occur in macroscopically ‘normal’ parts of the colon. 2) Recurrent CNAs were shared between biopsies, revealing clonal expansions in multiple areas of the colon, both proximal and distal to the cancer, and comprising normal, inflamed, dysplastic and cancer-adjacent tissue. 3) Clonal expansions ranged from 2-14cm in size, and were separated by distances of 4-30cm. 4) Certain CNA events occur more commonly across the colon, both independently and from within different clonal patches, such as a gain on chromosome 7 and 20, and losses on chromosomes 5, 8 and 17. 5) Whole genome doubling events within clonal clades. <h3>Conclusions</h3> These data show that across the IBD bowel, CNAs occur and expand in ostensibly ‘normal’ cells, demonstrating evidence of field cancerisation. Moreover, the fact that similar and independent patterns of CNAs are seen throughout the whole colon provide evidence to suggest both convergent and independent evolutionary events occurring respectively. Further work is needed to more precisely quantify clonal and sub-clonal distribution across the IBD colon, in addition to deriving measures of intra-colon, intra-lesion and intra-clade genomic diversity to complement the above measures of evolvability.
Sedation depth and long-term mortality in mechanically ventilated critically ill adults: a prospective longitudinal multicentre cohort study
Authors: Yahya Shehabi, Lucy Chan, Suhaini Kadiman, Anita Alias, Wan Nasrudin Ismail, Mohd Ali T. Ismail Tan, Tien Meng Khoo, Saedah Binti Ali, Mat Ariffin Saman, Ahmad Shaltut, Cheng Cheng Tan, Cow Yen Yong, Michael Bailey
Journal: Intensive Care Medicine (2013)

To ascertain the relationship among early (first 48 h) deep sedation, time to extubation, delirium and long-term mortality. We conducted a multicentre prospective longitudinal cohort study in 11 Malaysian hospitals including medical/surgical patients (n = 259) who were sedated and ventilated ≥24 h. Patients were followed from ICU admission up to 28 days in ICU with 4-hourly sedation and daily delirium assessments and 180-day mortality. Deep sedation was defined as Richmond Agitation Sedation Score (RASS) ≤−3. The cohort had a mean (SD) age of 53.1 (15.9) years and APACHE II score of 21.3 (8.2) with hospital and 180-day mortality of 82 (31.7 %) and 110/237 (46.4 %). Patients were followed for 2,657 ICU days and underwent 13,836 RASS assessments. Midazolam prescription was predominant compared to propofol, given to 241 (93 %) versus 72 (28 %) patients (P < 0.0001) for 966 (39.6 %) versus 183 (7.5 %) study days respectively. Deep sedation occurred in (182/257) 71 % patients at first assessment and in 159 (61 %) patients and 1,658 (59 %) of all RASS assessments at 48 h. Multivariable Cox proportional hazard regression analysis adjusting for a priori assigned covariates including sedative agents, diagnosis, age, APACHE II score, operative, elective, vasopressors and dialysis showed that early deep sedation was independently associated with longer time to extubation [hazard ratio (HR) 0.93, 95 % confidence interval (CI) 0.89–0.97, P = 0.003], hospital death (HR 1.11, 95 % CI 1.05–1.18, P < 0.001) and 180-day mortality (HR 1.09, 95 % CI 1.04–1.15, P = 0.002), but not time to delirium (HR 0.98, P = 0.23). Delirium occurred in 114 (44 %) of patients. Irrespective of sedative choice, early deep sedation was independently associated with delayed extubation and higher mortality, and thus was a potentially modifiable risk in interventional trials.
CONTROL OF OPHTHALMIA NEONATORUM
Authors: F. Park Lewis
Journal: JAMA (1923)

<h3>To the Editor:</h3> —When, in 1909, a Committee on Ophthalmia Neonatorum was appointed by the American Medical Association with directions to use its effort to prevent blindness resulting from the neglect of proper care of the new-born infant's eyes, there was reason to expect that much in time might be accomplished. It was a difficult but not an impossible undertaking. The committee worked for a number of years through local and state health boards, and ophthalmologic, gynecologic and other medical societies, with a large measure of success. The percentage of admissions in the schools for the blind of children who had lost their sight from this cause was reduced during the decade and a half between the years 1908 and 1923 from 26.6 to 14.2 per cent. This was a great gain. It meant that many more were saved from a lifetime of blindness than the records indicated. But eternal
Hypercalcemic and Hypocalcemic Crises
Authors: Stephen R. Newmark
Journal: JAMA (1974)

THE crisis of acute hypercalcemia constitutes one of the more common endocrine emergencies. Within the past few years, new therapeutic modalities have become available for the medical management of this entity. We review these modalities and suggest a regimen for the rational treatment of the hypercalcemic patient. In addition, a system of medical management will be presented for the treatment of the patient with acute hypocalcemia. <h3>Hypercalcemic Crisis</h3><h3>Diagnosis.—</h3> Acute hypercalcemia can have a variety of manifestations.<sup>1</sup>Common symptoms include nausea and vomiting (with subsequent dehydration), anorexia, constipation, and polyuria. Severe abdominal pain is common and frequently is related to an associated peptic ulcer or pancreatitis. Other symptoms include weakness ranging from mild fatigue to neuromuscular paralysis, fever, and coma. Objective signs include ectopic calcification, such as band keratopathy, nephrocalcinosis, arterial calcification, and skin calcification. A decreased Q-T interval is seen on the electrocardiogram. The most common causes of
Prospective identification of ventricular septal defects in infancy using subxiphoid two-dimensional echocardiography.
Authors: F Z Bierman, K Fellows, R G Williams
Journal: Circulation (1980)

The objective of this study was to establish a dependable technique for imaging the interventricular septum and ventricular septal defects in infants. Subxiphoid two-dimensional echocardiograms were performed on 81 infants who were 1 day to 12 months (median 43 days) old and weighed 1.6-8.6 kg (median 3.4 kg). A short-focus, 5-MHz crystal with a 13-mm active element diameter was used in all studies. The interventricular septum was visualized in 80 of 81 infants. Defects in the membranous, atrioventricular canal, conoventricular and muscular segments of the sentum were identified using three standard transverse subxiphoid projections. All defects in the membranous and atrioventricular canal segments, as well as malalignment type conoventricular communications, were correctly identified when compared with selective angled cineangiocardiography. Only two of the three subpulmonic and four of 11 muscular defects were identified successfully. Limitations in imaging defects in the muscular septum reflected the varied morphology of these interventricular communications and the tangential orientation of the echo beam to the extreme apical and anterior segments of the muscular septum.
Short incubation non-A, non-B hepatitis transmitted by factor VIII concentrates in patients with congenital coagulation disorders.
Authors: M Bamber, A Murray, B A Arborgh, P J Scheuer, P B Kernoff, H C Thomas, S Sherlock
Journal: Gut (1981)

Ten cases are reported of short incubation (one to four weeks) non-A, non-B hepatitis occurring after infusion of various preparations of factor VIII concentrates into patients with coagulation disorders. Five patients were symptomatic and, in all, serum transaminase levels were increased for at least six months. These cases of chronic hepatitis exhibited none of the features of autoimmune chronic hepatitis: autoantibodies were negative and serum immunoglobulins were normal. Hepatic histology confirmed acute hepatitis in two cases biopsied early in the illness, and chronic active hepatitis (three) of chronic persistent hepatitis (two) in five cases studied later. Lobular inflammation was a prominent feature in all cases. Other features not commonly associated with type A or B hepatitis included fatty change and damaged bile ducts.
Histaminase and Medullary Thyroid Carcinoma
Authors: Kenneth E. W. Melvin
Journal: New England Journal of Medicine (1970)

The recognition of circulating gene products of tumor cells, and the development of sensitive methods for their detection in the serum of affected patients, is a potentially rewarding approach to the early diagnosis of cancer. Occurring probably as a result of genome derepression, these gene products frequently take the form of peptides or proteins, which may be appropriate to the normal function of the cell of origin in some tumors and inappropriate in others. An example of the latter is the ectopic production of peptide hormones by nonendocrine tumors. In such cases, the presence of the tumor may be declared . . .
Benefits of cooperation
Authors: A. J. Vallance-Owen
Journal: BMJ (2010)

The ideology behind the BMA’s campaign on the wasteful commercialisation of the NHS is hard to understand.1The NHS has been working and contracting with the commercial sector for decades. For example, although most of the country’s care homes are in the private sector, over 70% of Bupa’s 19 000 care beds are funded by …
Ethanol-induced cytochrome P4502E1 causes carcinogenic etheno-DNA lesions in alcoholic liver disease
Authors: Ying Wang, Gunda Millonig, Jagadeesan Nair, Eleonora Patsenker, Felix Stickel, Sebastian Mueller, Helmut Bartsch, Helmut K. Seitz
Journal: Hepatology (2009)

Oxidative stress is thought to play a major role in the pathogenesis of hepatocellular cancer (HCC), a frequent complication of alcoholic liver disease (ALD). However, the underlying mechanisms are poorly understood. In hepatocytes of ALD patients, we recently detected by immunohistochemistry significantly increased levels of carcinogenic etheno-DNA adducts that are formed by the reaction of the major lipid peroxidation product, 4-hydroxynonenal (4-HNE) with nucleobases. In the current study, we show that protein-bound 4-HNE and etheno-DNA adducts both strongly correlate with cytochrome P450 2E1 (CYP2E1) expression in patients with ALD (r = 0.9, P < 0.01). Increased levels of etheno-DNA adducts were also detected in the liver of alcohol-fed lean (Fa/?) and obese (fa/fa) Zucker rats. The number of nuclei in hepatocytes stained positively for etheno-DNA adducts correlated significantly with CYP2E1 expression (r = 0.6, P = 0.03). To further assess the role of CYP2E1 in the formation of etheno-DNA adducts, HepG2 cells stably transfected with human CYP2E1 were exposed to ethanol with or without chlormethiazole (CMZ), a specific CYP2E1 inhibitor. Ethanol increased etheno-DNA adducts in the nuclei of CYP2E1-transfected HepG2 cells in a concentration-dependent and time-dependent manner, but not in vector mock-transfected control cells. CMZ blocked the generation of etheno-DNA adducts by 70%-90% (P < 0.01).Our data support the assumption that ethanol-mediated induction of hepatic CYP2E1 leading inter alia to highly miscoding lipid peroxidation-derived DNA lesions may play a central role in hepatocarcinogenesis in patients with ALD.