tbuckley/cabot-search huggingface dataset:
Reviews, Notes, and Listings: Gastroenterology: Gastrointestinal Bleeding
Authors: Gary Zuckerman
Journal: Annals of Internal Medicine (1993)

Literature of Medicine15 March 1993Reviews, Notes, and Listings: Gastroenterology: Gastrointestinal BleedingGary Zuckerman, MDGary Zuckerman, MDWashington University School of Medicine, St. Louis, MO 63110.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-118-6-199303150-00038 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Gastrointestinal BleedingFirst edition. Choichi Sugawa, Bernard Schuman, and Charles Lucas; eds. 564 pages. New York: Igaku-Shoin; 1992. $138.50.The acquisition of information on the overall diagnosis and management of patients with gastrointestinal bleeding has become easier with the availability of this book. Any physician managing patients with gastrointestinal bleeding can reach for this book as a first resource. It contains the expected chapters on surgical, radiographic and endoscopic management of patients with gastrointestinal bleeding, including short-term management and identification of risk factors. It also covers topics such as hematologic problems in gastrointestinal bleeding and the approach to rebleeding after surgery for ... Author, Article, and Disclosure InformationAffiliations: Washington University School of Medicine, St. Louis, MO 63110. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1993Volume 118, Issue 6Page: 479KeywordsBloodHemorrhageLiver diseasesMedical risk factorsPathogenesisPeptic ulcersShockSmall intestineSurgeryUlcers ePublished: 15 August 2000 Issue Published: 15 March 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
A Case of Bilateral Fatigue Fracture of the Fibula
Authors: D. A. Richmond, J. Shafar
Journal: BMJ (1955)

Fracture of a bone may result from ordinary func tional activity in the absence of any obvious injury or violence. Such fractures are referred to as fatigue or stress fractures, and occur spontaneously in apparently normal bone as a consequence of the summation of stresses which singly are insufficient to produce frac ture (Burrows, 1948). The incidence of this condition rose sharply during the second world war, but since then, as judged by published cases, it would appear to be an infrequent finding. By far the commonest site of this form of fracture is in one of the metatarsal bones; the tibia is involved five or six times less frequently, and the fibula forty times less frequently (Hartley, 1943). The series of 32 fatigue fractures analysed by Richmond, 1945, showed the following locations: metatarsals, 25; upper third of tibia, 5, and lower third of fibula, 2. The case reported below is an example of fatigue fractures involving the lower third of both fibulae in a middle-aged housewife.
Altered regulation of Src tyrosine kinase by transforming growth factor ?1 in a human hepatoma cell line
Authors: Kazuto Fukuda, Sumio Kawata, Shinji Tamura, Yukihiko Matsuda, Yoshiaki Inui, Takumi Igura, Satoshi Inoue, Takahiko Kudara, Yuji Matsuzawa
Journal: Hepatology (1998)

Transforming growth factor betas (TGF-betas) are the potent growth inhibitors for various cell types. Certain transformed cells, however, show poor response to TGF-beta-induced growth inhibition, which contributes to their uncontrolled proliferation. Recently, we have reported that TGF-beta1 induces degradation of activated Src tyrosine kinase in rat fibroblasts. To elucidate the alteration in TGF-beta signaling pathway in tumor cells that cannot respond to the cytokine, we compared the effects of TGF-beta1 on Src kinase in two human hepatoma cell lines, TGF-beta1-insensitive Mahlavu cells and TGF-beta1-sensitive HepG2 cells. TGF-beta1 decreased Src kinase activity in HepG2 cells, but increased cellular Src levels and Src kinase activity in Mahlavu cells. Co-incubation of Mahlavu cells with TGF-beta1 and 12-O-tetradecanoyl phorbol 13-acetate (TPA) decreased Src protein levels and Src kinase activity, inducing TGF-beta1 sensitivity. TGF-beta1 induced tyrosine dephosphorylation of Ras guanosine triphosphatase-activating protein (Ras-GAP) and Ras inactivation in HepG2 cells, but induced Ras-GAP phosphorylation and Ras activation in Mahlavu cells. The Src kinase inhibitor abolished the increase of Src kinase activity in TGF-beta1-treated Mahlavu cells, and induced TGF-beta1 sensitivity. These findings suggest that regulation of Src kinase by TGF-beta1 is altered in Mahlavu cells. The altered regulation of Src may contribute to TGF-beta1 insensitivity in this cell line, at least in part through activation of Ras.
Adaptation of the distal convoluted tubule of the rat. Structural and functional effects of dietary salt intake and chronic diuretic infusion.
Authors: D H Ellison, H Velázquez, F S Wright
Journal: Journal of Clinical Investigation (1989)

We studied the effects of dietary NaCl intake on the renal distal tubule by feeding rats high or low NaCl chow or by chronically infusing furosemide. Furosemide-treated animals were offered saline as drinking fluid to replace urinary losses. Effects of naCl intake were evaluated using free-flow micropuncture, in vivo microperfusion, and morphometric techniques. Dietary NaCl restriction did not affect NaCl delivery to the early distal tubule but markedly increased the capacity of the distal convoluted tubule to transport Na and Cl. Chronic furosemide infusion increased NaCl delivery to the early distal tubule and also increased the rates of Na and Cl transport above the rates observed in low NaCl diet rats. When compared with high NaCl intake alone, chronic furosemide infusion with saline ingestion increased the fractional volume of distal convoluted tubule cells by nearly 100%, whereas dietary NaCl restriction had no effect. The results are consistent with the hypotheses that (a) chronic NaCl restriction increases the transport ability of the distal convoluted tubule independent of changes in tubule structure, (b) high rates of ion delivery to the distal nephron cause tubule hypertrophy, and (c) tubule hypertrophy is associated with increases in ion transport capacity. They indicate that the distal tubule adapts functionally and structurally to perturbations in dietary Na and Cl intake.
Who to treat with adjuvant therapy in Dukes B/stage II colorectal cancer? The need for high quality pathology
Authors: E. J A Morris, N. J Maughan, D. Forman, P. Quirke
Journal: Gut (2007)

To identify by routine pathology which Dukes B colorectal cancer patients may benefit from chemotherapy.Retrospective study of the five year survival of colorectal cancer patients for whom colorectal pathology minimum datasets had been collected between 1997 and 2000 in the Yorkshire region of the UK. The study population consisted of 1625 Dukes B and 480 Dukes C patients who possessed one positive node treated between 1997 and 2000. The predictive ability of the Petersen prognostic model was investigated and survival of Dukes B patients with potentially high risk pathological features was compared to that of Dukes C patients with one positive node.Only 23.3% of patients had all the pathological variables required for the application of Petersen's index reported. The index offered a statistically significant survival difference of 24.3% and 30.3% between high and low risk colon (p<0.01) and rectal cancer patients (p<0.01). The size of these effects was smaller than predicted by the original model. Survival of Dukes B patients with any of the high risk pathological factors or low nodal yields was lower than that of Dukes C patients who possessed one positive node.Petersen's index discriminated between high and low risk Dukes B colorectal tumours, but inadequate pathological reporting diminished its ability to identify all high risk patients. The survival of patients with any high risk feature was lower than the threshold for adjuvant therapy of one lymph node positive Dukes C colorectal cancer. Chemotherapy may benefit patients with such features. Improving the quality of pathological reporting is vital if high risk patients are to be reliably identified.
628 PRESENCE OF HEPATITIS B VIRUS BASIC CORE PROMOTER MUTATIONS BEFORE HBEAG LOSS MAY IDENTIFY PATIENTS REQUIRING LONG TERM-TREATMENT AFTER SEROCONVERSION
Authors: D. Tabernero, M.J. Sánchez, M. Homs, F. Rodríguez-Frías, R. Jardí, M. Schaper, R. Esteban, M. Buti
Journal: Journal of Hepatology (2010)
The Outside Hospital
Authors: Jeremy D. Graham
Journal: Annals of Internal Medicine (2013)

On Being a Doctor1 October 2013The Outside HospitalJeremy D. Graham, MA, DOJeremy D. Graham, MA, DOFrom Providence Internal Medicine Residency Spokane, Spokane, Washington.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-7-201310010-00015 Audio Reading - “The Outside Hospital” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Outside Hospital," by J.D. Graham. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A species of chauvinism colonizes our teaching centers. William Osler detected it at least a century ago: “Strife seems rather to be the very life of the practitioner, whose warfare is incessant against disease ... sad to have to admit, he too often lets his angry passions rise against his professional brother.” Somewhere, these angry passions became encoded in a long-lived sarcastic joke and spread across many teaching centers’ views of one another.For the individual, a joke may release and redirect repressed feelings of stress. Within a social group, gibes about outsiders communicate a collective self-image of group superiority. ... Author, Article, and Disclosure InformationAuthors: Jeremy D. Graham, MA, DOAffiliations: From Providence Internal Medicine Residency Spokane, Spokane, Washington.Corresponding Author: Jeremy D. Graham, MA, DO, Providence Internal Medicine Residency Spokane, 101 West 8th Avenue, Main Floor, Spokane, WA 99204; e-mail, [email protected]. PreviousarticleNextarticle Advertisement Audio Reading - “The Outside Hospital” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "The Outside Hospital," by J.D. Graham. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 1 October 2013Volume 159, Issue 7Page: 500-501KeywordsAdolescentsAlcoholismAlcoholsBlood pressureBrainCarotid arteriesDrugsEmotionsEpilepsyEpileptic seizuresEtiologyFallsFearInternetResidencySodiumStrokeSurgeonsSurgeryUrine ePublished: 1 October 2013 Issue Published: 1 October 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Writing and speaking in medicine. Numerical results: some hints on presentation.
Authors: T D Swinscow
Journal: BMJ (1976)

Numerical results: some hints on presentation T D V SWINSCOW Two fairly distinct kinds of articles with numerical data appear in medical journals.The aim of the first is primarily educational.The author is not putting forward any original, novel, or unusual material.He is trying to present his ideas in the most memorable way possible.In this type of article diagrams and graphs often serve his purpose well by embodying his message in an easily remembered picture.The hints on presentation to be given here are concerned with the second type of article.Its aim is to record a discovery in such a way that the facts and the inferences drawn from them can be examined with precision from every viewpoint and withstand all reasonable criticism of their validity.Too often scientific results in the second type of article are presented in a manner more appropriate to the first type of article.Here the following passage from Bradford Hill' is worth bearing in mind."Graphs should always be regarded as subsidiary aids to the intelligence and not as the evidence of associations or trends.
Proinsulin, insulin, and C-peptide concentrations in human portal and peripheral blood.
Authors: D L Horwitz, J I Starr, M E Mako, W G Blackard, A H Rubenstein
Journal: Journal of Clinical Investigation (1975)

Concentrations of insulin, proinsulin, and C-peptide were measured in portal and peripheral venous blood in six nondiabetic, nonobese subjects. Portal vein samples were obtained by umbilical vein catheterization. Three subjects were studied with intravenous infusion of 25 g glucose, and three with 30 g arginine. Insulin and proinsulin were determined in the insulin immunoassay after separation by gel filtration, and C-peptide was measured by direct immunoassay. With both glucose and arginine stimulation, portal vein levels of all three peptides peaked at 90-120 s after the onset of the stimulus. Relative increases in insulin concentration were greater than those of proinsulin or C-peptide. In peripheral venous blood, maximal levels of the three peptides were observed later (2-5 min), and the increase in insulin relative toproinsulin and C-peptide was not as great. At the time of peak secretion, portal vein insulin and C-peptide approached equimolar concentrations, and proinsulin, as measured against an insulin standard, comprised approximately 2.5% of the total immunoreactive insulin. After stimulation by glucose or arginine, portal insulin, proinsulin and C-peptide levels were not correlated with the concentrations measured in simultaneously drawn peripheral samples. At all sampling times, however, significant correlation was found between insulin and C-peptide in both peripheral and portal blood. The results indicate that under the conditions studied, insulin and C-peptide are secreted in equimolar concentrations in man, and that proinsulin is secreted in the same proportion to insulin as found in the pancreas. Consideration of the relative secretory and metabolic rates of the three beta cell peptides explains their peripheral concentrations. The data further support the use of plasma C-peptide as an indicator of beta cell secretory function.
Glucagon selectively increases splanchnic blood flow in patients with well-compensated cirrhosis
Authors: Samuel S. Lee, Richard Moreau, Antoine Hadengue, Raimondo Cerini, Abraham Koshy, Didier Lebrec
Journal: Hepatology (1988)

To delineate the circulatory effects of glucagon in cirrhosis, we infused two moderately supraphysiological doses of this hormone into 19 patients with cirrhosis and determined hemodynamic responses. Patients were divided into a group with good liver function (Pugh Class A, n = 8) and poorer function (Pugh Class B and C, n = 11). All patients received glucagon at 10 ng per kg per min for 20 min, then 20 ng per kg per min for a further 20 min. These doses raised serum glucagon levels to a similar degree in both groups of patients. Serum glucose levels also rose in both groups but to a lesser degree in Class BC patients. Serum noradrenaline and adrenaline remained unchanged in both groups. Heart rate, mean arterial pressure, cardiac index, systemic vascular resistance, hepatic venous pressure gradient and hepatic blood flow were measured basally and during the second glucagon infusion. None of these measurements significantly changed in either group of patients. Azygos and renal venous blood flow were measured basally and during the first and second infusions. Azygos flow increased significantly only in Group A patients: basal, 0.32 ± 0.03 liter per min; first infusion, 0.40 ± 0.06 liter per min; second infusion, 0.49 ± 0.07 liter per min. Corresponding values in Group BC patients were: 0.54 ± 0.08, 0.54 ± 0.08 and 0.52 ± 0.08 liter per min. Renal blood flow did not change significantly. One patient with a portacaval shunt increased superior mesenteric venous flow from 0.78 liter per min to 0.95 liter per min with glucagon. These results, showing a selective increase in superior portocollateral flow in well-compensated patients, suggest that glucagon can act as a splanchnic vasodilator. However, since progression of liver disease was associated with attenuation of this response, we suggest that glucagon may mediate splanchnic hyperemia only in the early stages of cirrhosis.
From reifying mental pictures to reifying spatial models
Authors: Zenon W. Pylyshyn
Journal: Behavioral and Brain Sciences (2004)

Assuming that the vehicle of imaginal thought is a spatial model may not be quite as egregious an error as assuming it is a two-dimensional picture, but it represents no less a reification error. Because the model is not a literal physical layout, one is still owed an explanation of why spatial properties hold in the model – whether because of architectural constraints or by stipulation. The difference is like the difference between explaining behavior from a principle and predicting it by looking it up in a list. In the latter case no purpose is being served by calling it a mental model.
Up regulation of monocyte chemoattractant protein-1 expression in anti-citrulline antibody and immunoglobulin M rheumatoid factor positive subjects precedes onset of inflammatory response and development of overt rheumatoid arthritis
Authors: S Rantapaa-Dahlqvist, K Boman, A Tarkowski, G Hallmans
Journal: Annals of the Rheumatic Diseases (2006)

<b>Objective:</b> To analyse the inflammatory mediators, including monocyte chemoattractant protein-1 (MCP-1), in blood samples donated years before onset of rheumatoid arthritis. Previously, it has been shown in these individuals that antibodies against cyclic citrullinated peptide (anti-CCP) detectable years before the onset of symptoms have a high predictive value for development of rheumatoid arthritis. <b>Methods:</b> A nested case–control study was performed: patients with rheumatoid arthritis were identified from among blood donors antedating onset by a median of three years (pre-patients, n = 92); four matched controls were selected randomly for each pre-patient. Plasma were analysed for secretory phospholipase A2 (sPLA2) and MCP-1 using ELISA, for high-sensitivity C reactive protein (hsCRP) using the chemiluminescence method and for interleukin-6 using a sensitive bioassay. <b>Results:</b> When the results were stratified for the presence of anti-CCP antibodies and immunoglobulin M-rheumatoid factor (IgM-RF), only MCP-1 levels were found to be significantly raised in patients with anti-CCP and IgM-RF compared with controls. <b>Conclusion:</b> Levels of MCP-1 were significantly increased in the plasma of patients having anti-CCP antibodies or IgM-RF and who later developed rheumatoid arthritis. These findings indicate up regulation of chemotactic activity for leucocytes before the development of rheumatoid arthritis.
Psychotherapy in General Medicine
Authors: Henry M. Fox
Journal: New England Journal of Medicine (1947)

IT HAS now become generally recognized that some way must be found to teach medical students and house officers the kind of personal therapy that has always been carried out by the family physician without his even being aware of the fact that he was doing anything unusual. Modern conditions of medical practice, with increasing emphasis on specialization and with the growth of large urban medical centers, have made it increasingly difficult for patients to be understood in terms of personal history in a family setting. The discoveries of psychiatry during the course of the past fifty years concerning the . . .
Taking aim at translation for tumor therapy
Authors: Bryan C. Barnhart, M. Celeste Simon
Journal: Journal of Clinical Investigation (2007)

Increased cap-dependent mRNA translation rates are frequently observed in human cancers. Mechanistically, many human tumors often overexpress the cap binding protein eukaryotic translation initiation factor 4E (eIF4E), leading to enhanced translation of numerous tumor-promoting genes. In this issue of the JCI, Graff and colleagues describe potent antitumor effects using second-generation antisense oligonucleotides for eIF4E (see the related article beginning on page 2638). If their results are recapitulated in a clinical setting, this strategy will provide a promising antitumor therapy with broad-reaching applications.
Effect of vitamin D3 supplementation on Staphylococcus aureus nasal carriage: a randomized, double-blind, placebo-controlled trial in healthy adults
Authors: S. Slow, P.C. Priest, S.T. Chambers, A.W. Stewart, L.C. Jennings, C.M. Florkowski, J.H. Livesey, C.A. Camargo, R. Scragg, D.R. Murdoch
Journal: Clinical Microbiology and Infection (2013)
Receptor-directed inhibition of chemotactic factor-induced neutrophil hyperactivity by pyrazolon derivatives. Definition of a chemotactic peptide antagonist.
Authors: C Dahinden, J Fehr
Journal: Journal of Clinical Investigation (1980)

The two pyrazolon derivatives, phenylbutazone and sulfinpyrazone, selectively inhibit chemotactic peptide-induced effects on neutrophils. As they antagonize the induction of acute neutropenia in vivo and of cellular hyperadhesiveness, lysosomal enzyme release, hexose monophosphate shunt activity, and superoxide production in vitro, these effects occur with a specificity not shared with other prostaglandin biosynthesis inhibition by these drugs resembles the competitive type of antagonism and occurs at concentrations attainable in vivo under clinical conditions. The locomotory machinery, the direction-finding mechanisms, and the basic metabolic machinery of the cell are unaffected. These drugs interfere with specific binding of the formylpeptide to its receptor on neutrophils.
Mitotic spindle destabilization and genomic instability in Shwachman-Diamond syndrome
Authors: Karyn M. Austin, Mohan L. Gupta, Scott A. Coats, Asmin Tulpule, Gustavo Mostoslavsky, Alejandro B. Balazs, Richard C. Mulligan, George Daley, David Pellman, Akiko Shimamura
Journal: Journal of Clinical Investigation (2008)

Deficiencies in the SBDS gene result in Shwachman-Diamond syndrome (SDS), an inherited bone marrow failure syndrome associated with leukemia predisposition. SBDS encodes a highly conserved protein previously implicated in ribosome biogenesis. Using human primary bone marrow stromal cells (BMSCs), lymphoblasts, and skin fibroblasts, we show that SBDS stabilized the mitotic spindle to prevent genomic instability. SBDS colocalized with the mitotic spindle in control primary BMSCs, lymphoblasts, and skin fibroblasts and bound to purified microtubules. Recombinant SBDS protein stabilized microtubules in vitro. We observed that primary BMSCs and lymphoblasts from SDS patients exhibited an increased incidence of abnormal mitoses. Similarly, depletion of SBDS by siRNA in human skin fibroblasts resulted in increased mitotic abnormalities and aneuploidy that accumulated over time. Treatment of primary BMSCs and lymphoblasts from SDS patients with nocodazole, a microtubule destabilizing agent, led to increased mitotic arrest and apoptosis, consistent with spindle destabilization. Conversely, SDS patient cells were resistant to taxol, a microtubule stabilizing agent. These findings suggest that spindle instability in SDS contributes to bone marrow failure and leukemogenesis.