tbuckley/cabot-search huggingface dataset:
Anatomy of the tricuspid annulus. Circumferential myofibers as the structural basis for atrial flutter in a canine model.
Authors: D K Racker, P C Ursell, B F Hoffman
Journal: Circulation (1991)

Little anatomic information is available on the annular myocardium. This study was conducted to determine the anatomic substrate for atrial flutter due to circus movement around the tricuspid annulus in the Y-shaped incision canine model of atrial flutter.We studied photographs of the annular myocardium serial histological sections, made in either of three different planes, and compared these with photographs of the intact and blocked gross heart specimens. We found that the annulus is the most caudal region of the atrial wall. The epicardial aspect of the annulus abuts the ventricular septum or the aortic root in the medial region; in other regions, it is covered by the fat of the coronary sulcus. Its endocardial aspect is delimited by the tricuspid leaflets inferiorly and by the pectinate muscle bundles superiorly, except in the medial region where the pectinate muscle bundles are absent. The annular myocardium is bilaminated. A continuous subepicardial circumferential lamina is the most prominent and is robust in the anterior, lateral, and posterior regions, but it attenuates to a fine muscular connection in the medial region. Myofibers of its superior border merge with the pectinate muscle bundles or are admixed in the medial region with myocardium at the base of the medial atrial wall. Its inferior border makes little contact with the annulus fibrosus about the ring; however, in the medial region, these myofibers insert into fibrous tissue superior to the septal leaflet. A discontinuous, subendocardial perpendicular lamina contains myofibers that descend from the atrium; most of these myofibers insert into the annulus fibrosus about the ring, but the lamina is absent in the anteromedial region.We conclude that the continuous circumferential lamina provides the anatomic substrate for circus movement of excitation in this model.
US neurosurgeons earn nearly $0.5m in their first year
Authors: J. H. Tanne
Journal: BMJ (2009)

Neurological surgeons in the United States who have just completed their training in residencies or fellowships earn more than any other newly qualified doctors in their first year, a survey of doctors’ recruiters has found.

In 2008 neurological surgeons earnt a median salary of $445 000 (£270 000; €320 000) in their first year after completing their residency or fellowship, the highest of any US specialty. The median salary in the first year for all neurological surgeons joining a new practice (presumably including more experienced surgeons) was …
CHRONIC INHIBITION OF PYRUVATE DEHYDROGENASE KINASE WITH DICHLOROACETATE, IMPROVES CARDIAC METABOLISM AND FUNCTION IN RIGHT VENTRICULAR HYPERTROPHY IN FAWN-HOODED RATS
Authors: Lin Piao, Vaninder K. Sidhu, Yong-Hu Fang, Thenappan Thenappan, Gary Lopaschuk, Stephen Archer
Journal: Journal of the American College of Cardiology (2012)
Key Issues in the Role of Peroxisome Proliferator–Activated Receptor Agonism and Cell Signaling in Trichloroethylene Toxicity
Authors: Nagalakshmi Keshava, Jane C. Caldwell
Journal: Environmental Health Perspectives (2006)

Peroxisome proliferator-activated receptor alpha (PPARalpha) is thought to be involved in several different diseases, toxic responses, and receptor pathways. The U.S. Environmental Protection Agency 2001 draft trichloroethylene (TCE) risk assessment concluded that although PPAR may play a role in liver tumor induction, the role of its activation and the sequence of subsequent events important to tumorigenesis are not well defined, particularly because of uncertainties concerning the extraperoxisomal effects. In this article, which is part of a mini-monograph on key issues in the health risk assessment of TCE, we summarize some of the scientific literature published since that time on the effects and actions of PPARalpha that help inform and illustrate the key scientific questions relevant to TCE risk assessment. Recent analyses of the role of PPARalpha in gene expression changes caused by TCE and its metabolites provide only limited data for comparison with other PPARalpha agonists, particularly given the difficulties in interpreting results involving PPARalpha knockout mice. Moreover, the increase in data over the last 5 years from the broader literature on PPARalpha agonists presents a more complex array of extraperoxisomal effects and actions, suggesting the possibility that PPARalpha may be involved in modes of action (MOAs) not only for liver tumors but also for other effects of TCE and its metabolites. In summary, recent studies support the conclusion that determinations of the human relevance and susceptibility to PPARalpha-related MOA(s) of TCE-induced effects cannot rely on inferences regarding peroxisome proliferation per se and require a better understanding of the interplay of extraperoxisomal events after PPARalpha agonism.
FDA acts to limit exposure to acetaminophen in combination products
Authors: M. McCarthy
Journal: BMJ (2014)

Healthcare providers should stop prescribing combination drug products that contain more than 325 mg of acetaminophen (paracetamol) per dosage unit because of the increased risk of liver injury, the US Food and Drug Administration has said.1

Many prescription drugs for pain on the market combine acetaminophen with an opioid, such as codeine, oxycodone, or hydrocodone. Such prescription products containing acetaminophen combinations make up 20% of the acetaminophen market and include some of the most widely prescribed drugs in the United States.

Inadvertent overdoses from acetaminophen combination products account for nearly half …
SOME TRUTHS ABOUT SLEEP.
Authors: NORMAN BRIDGE
Journal: JAMA (1906)

In the popular mind there must be some mistakes about sleep, so variant and dissimilar are the views as to the need of sleep, the effects of it, and of the lack of it. One man is sure that for health and strength he needs only four or five hours of sleep out of each day of twenty-four hours, and he quotes numerous people above childhood who have like views and experiences. Another must have eight or nine hours and cannot do with less, and, as all men tend to measure others by the yardstick that fits themselves, he is sure to believe that no one should have less than one-third of his existence spent in sleep. The medical profession freely teaches this latter view and insists that children especially must have an abundance of sleep or be in peril of nervous and mental bankruptcy. We are told that infants
Health Care Systems in World Perspective
Authors: Ronald Andersen
Journal: JAMA (1978)

This volume is as much the autobiography of Milton Roemer covering the years of his professional writing career as it is an integrated interpretation of the varied health systems of the world. It includes 30 papers covering 45 countries written over a 25-year period. Roemer has worked in or visited all of the countries of which he writes. Few authors possess his breadth of knowledge and experience in health care provision and have also documented their experiences and impressions for others to share. All but four of the articles have been previously published or widely distributed, but many are not easily accessible. The book is divided into sections dealing with developing countries, industrialized countries, specific health programs such as rural health and occupational health, and general problems for health services systems such as regulation and consumerism. While time passes and the countries discussed change, Roemer's underlying ideology about health service
Importance of Transmural Pressure and Lung Volume in Evaluating Drug Effect on Pulmonary Vascular Tone
Authors: DALI J. PATEL, ALEXANDER J. MALLOS, FLAVIO M. DE FREITAS
Journal: Circulation Research (1961)

The effect of norepinephrine (NE) on pulmonary vascular resistance (PVR) was studied in 11 thoracotomized dogs. Comparisons between the test and control states were made at corresponding average intravascular pressures in the pulmonary vascular bed and at the same airway pressure. A significant increase in PVR ( P &gt; 0.01) suggesting active vasoconstriction was found during NE administration.
Circulating immune complexes after repeated halothane anaesthesia.
Authors: B D Williams, N White, P L Amlot, J Slaney, P A Toseland
Journal: BMJ (1977)

A patient developed hepatitis after receiving three halothane anaesthetics in 22 days. Twenty-four hours after the onset of jaundice she developed an acute serum sickness syndrome with polyarthralgia, proteinuria, and transient impairment of renal function. Serum concentrations of complement components C1q, C4, and C3 were substantially reduced, and immune complexes capable of activating the complement system via the classical pathway were present in the serum and synovial fluid. A metabolite of halothane was associated with these complexes. Fourteen months after exposure to halothane her lymphocytes were stimulated in vitro by this metabolite. The conditions under which stimulation occurred were unusual--namely, a 7S fraction of the serum, presumably IgG, was necessary. Our results provide strong evidence that halothane may be immunogenic and that its immunogenicity is dependent on the non-covalent binding of one of its metabolites to plasma proteins.
Hemoperfusion in Drug Overdose
Authors: Curt R. Freed
Journal: JAMA (1979)

<h3>To the Editor.—</h3> We were surprised to read the article by Smiley et al (240:2736, 1978) and the editorial and letter in the same issue that stated hemoperfusion was effective for digoxin poisoning. The data presented by Smiley et al in case 1 and by Gleeson et al (240:2731, 1978) in fact show no effect of hemoperfusion. The data of Smiley et al actually show an increase in plasma digoxin concentration during four hours of hemoperfusion (plasma clearance, 3.23 to 3.64 ng/mL). Gleeson et al show that the blood level fell from 9.9 to 5.0 ng/mL in 24 hours. This half-life is only slightly shorter than the usual half-life of 30 to 36 hours.<sup>1</sup> The reason for the failure of both hemodialysis and hemoperfusion is that while these methods can clear drugs from 100 to 200 mL of blood per minute, digoxin is distributed in an apparent volume of
Splenectomy attenuates superoxide anion release into the hepatic sinusoids after lipopolysaccharide challenge
Authors: Takeshi Mizukami, Hirokazu Yokoyama, Yukishige Okamura, Hideki Ohgo, Masahiko Fukuda, Yoshitaka Kamegaya, Shinzo Kato, Hiromasa Ishii
Journal: Journal of Hepatology (1999)
Role of LKB1-CRTC1 on Glycosylated COX-2 and Response to COX-2 Inhibition in Lung Cancer
Authors: Chunxia Cao, Ruli Gao, Min Zhang, Antonio L. Amelio, Mohammad Fallahi, Zirong Chen, Yumei Gu, Chengbin Hu, Eric A. Welsh, Brienne E. Engel, Eric B. Haura, W. Douglas Cress, Lizi Wu, Maria Zajac-Kaye, Frederic J. Kaye
Journal: JNCI Journal of the National Cancer Institute (2014)

Cyclooxygenase-2 (COX-2) directs the synthesis of prostaglandins including PGE-2 linking inflammation with mitogenic signaling. COX-2 is also an anticancer target, however, treatment strategies have been limited by unreliable expression assays and by inconsistent tumor responses to COX-2 inhibition. We analyzed the TCGA and Director's Challenge lung cancer datasets (n = 188) and also generated an LKB1-null lung cancer gene signature (n = 53) to search the Broad Institute/Connectivity-MAP (C-MAP) dataset. We performed ChIP analyses, real-time polymerase chain reaction, immunoblotting, and drug testing of tumor cell lines (n = 8) and primary lung adenocarcinoma surgical resections (n = 13). We show that COX-2 is a target of the cAMP/CREB coactivator CRTC1 signaling pathway. In addition, we detected a correlation between LKB1 status, CRTC1 activation, and presence of glycosylated, but not inactive hypoglycosylated COX-2 in primary lung adenocarcinoma. A search of the C-MAP drug database discovered that all high-ranking drugs positively associated with the LKB1-null signature are known CRTC1 activators, including forskolin and six different PGE-2 analogues. Somatic LKB1 mutations are present in 20.0% of lung adenocarcinomas, and we observed growth inhibition with COX-2 inhibitors in LKB1-null lung cancer cells with activated CRTC1 as compared with LKB1-wildtype cells (NS-398, P = .002 and Niflumic acid, P = .006; two-tailed t test). CRTC1 activation is a key event that drives the LKB1-null mRNA signature in lung cancer. We also identified a positive feedback LKB1/CRTC1 signaling loop for COX-2/PGE2 regulation. These data suggest a role for LKB1 status and glycosylated COX-2 as specific biomarkers that provide a framework for selecting patients for COX-2 inhibition studies.
Will Pay for Performance Improve Quality of Care? The Answer Is in the Details
Authors: Arnold M. Epstein
Journal: New England Journal of Medicine (2012)

In the past decade, provision of financial incentives for a higher quality of care (pay for performance) has spread across the country and beyond. In October, the federal government introduced pay for performance to all hospitals paid by Medicare nationwide. Yet most studies of pay for performance have shown modest or inconsistent effectiveness in improving quality.An early but influential study of the Premier Hospital Quality Incentive Demonstration (HQID), involving more than 250 hospitals and serving as the model for the federal program, showed an increase of 2.6 to 4.1 percentage points in process-quality measures during the first 2 years . . .
Reply to a Letter on Carotid Endarterectomy
Authors: John R. Feussner
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 September 1989Reply to a Letter on Carotid EndarterectomyJohn R. Feussner, MD, David B. Matchar, MDJohn R. Feussner, MDSearch for more papers by this author, David B. Matchar, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-6-540_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:We need to reply to several comments in Drs. Gomez and Horenstein's letter (1) in the 15 July issue. We believe that clinical experience, combined with formal training in research methods and analytical techniques such as decision analysis, facilitates critical evaluation of the clinical literature and crafting of recommendations that maximize patient benefit. We believe that two important concepts in our paper (2) were not fully appreciated by Drs. Gomez and Horenstein. First, throughout our analysis we coupled diagnostic decisions to therapeutic actions. Second, we emphasized theneedto know information that affects patient management rather than...References1. GomezHorenstein CS. Assessment of the carotid arteries [Letter]. Ann Intern Med. 1989;111:183-4. LinkGoogle Scholar2. FeussnerMatchar JD. When and how to study the carotid arteries. Ann Intern Med. 1988;109:805-18. LinkGoogle Scholar3. WinslowSolomonChassin CDM. The appropriateness of carotid endarterectomy. N Engl J Med. 1988;318:721-7. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center Durham, NC 27710 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1989Volume 111, Issue 6Page: 540-541KeywordsCarotid endarterectomyDecision analysis Issue Published: 15 September 1989 PDF downloadLoading ...
The Impact of Non-Cardiac Surgery on Electrocardiograph Changes, Troponin Levels in patients with Intermediate and High Risk According to Framingham General Cardiovascular Disease Risk Score
Authors: Miraç Vural, Serkan Bulur, Osman Köstek, Berrin Erok, Orçun Can, Yavuz Onur Danacıoğlu, Aytekin Oğuz
Journal: Journal of the American College of Cardiology (2013)
Peripheral atherosclerosis and serum lipoprotein(a) in diabetes.
Authors: F Wollesen, G Dahlén, L Berglund, C Berne
Journal: Diabetes Care (1999)

Serum lipoprotein(a) [Lp(a)] is strongly associated with atherosclerosis in nondiabetic individuals. To see if atherosclerosis is also associated with serum Lp(a) in both IDDM and NIDDM, we determined the correlation between the toe systolic blood pressure index (TSPI) and serum Lp(a) in tightly controlled diabetic patients without nephropathy.Cross-sectional study of 57 IDDM and 35 NIDDM patients. All patients had been under strict glycemic control for at least 6 months. The main outcome measure was TSPI of both lower extremities. In addition, we measured serum Lp(a) and other serum lipids, serum uric acid, total plasma homocysteine, plasma C-peptide, HbA1c, albumin excretion rate, glomerular filtration rate, BMI, abdominal fat distribution, left ventricular hypertrophy, probabilities for cardiovascular disease (CVD), and routine clinical parameters.TSPI was closely and independently related to serum Lp(a) in IDDM patients: R2 = 0.2999, partial P = 0.0005, and in NIDDM patients: R2 = 0.7326, partial P = 0.0030. TSPI was associated with symptoms of CVD. Median serum Lp(a) concentration was normal in IDDM (45 mg/l [range 10-870]) and NIDDM (72 mg/l [11-803]) patients.Systemic atherosclerosis measured as the degree of peripheral occlusive arterial disease is strongly associated with serum Lp(a) in both IDDM and NIDDM patients. Serum Lp(a), however, is normal in both types of diabetic patients. Thus, it is indicated that serum Lp(a) should be measured in diabetic patients when assessing their risk profile for atherosclerosis.
BMP4-Expressing Muscle-Derived Stem Cells Differentiate into Osteogenic Lineage and Improve Bone Healing in Immunocompetent Mice
Authors: Vonda J Wright, Hairong Peng, Arvydas Usas, Brett Young, Brian Gearhart, James Cummins, Johnny Huard
Journal: Molecular Therapy (2002)

Recent advances in molecular biology have led the way for novel approaches to improve bone healing. The ideal growth factor, vector, and delivery systems for producing bone in an immune competent animal model, however, have yet to be identified. Using a retrovirus encoding BMP4 and recently isolated muscle-derived stem cells (MDSCs), we demonstrated the following: MDSCs undergo osteogenic differentiation in response to BMP4 in a dose-dependent manner; retrovirus encoding BMP4 can efficiently transduce MDSCs, both enhancing osteogenic differentiation and inhibiting myogenic differentiation; transduced MDSCs can produce high levels of functional BMP4 as they differentiate toward an osteogenic lineage; allogeneic transduced MDSCs can induce robust de novo bone formation in immunocompetent mice despite the presence of an immune reaction, demonstrating the ability of this retroviral-BMP4-muscle construct to provide sufficient stimuli for osteoinduction in vivo; MDSCs appear to deliver BMP4, respond to the human BMP4 in an autocrine manner, and actively participate in bone formation, thus serving both osteoinductive and osteoproductive roles; and the BMP4-expressing MDSCs can induce bone formation and improve bone healing in a critical-sized skull defect in immunocompetent mice. Therefore, we believe that technology based on the MDSCs and vector system has great potential for promoting bone healing in a variety of musculoskeletal conditions. Recent advances in molecular biology have led the way for novel approaches to improve bone healing. The ideal growth factor, vector, and delivery systems for producing bone in an immune competent animal model, however, have yet to be identified. Using a retrovirus encoding BMP4 and recently isolated muscle-derived stem cells (MDSCs), we demonstrated the following: MDSCs undergo osteogenic differentiation in response to BMP4 in a dose-dependent manner; retrovirus encoding BMP4 can efficiently transduce MDSCs, both enhancing osteogenic differentiation and inhibiting myogenic differentiation; transduced MDSCs can produce high levels of functional BMP4 as they differentiate toward an osteogenic lineage; allogeneic transduced MDSCs can induce robust de novo bone formation in immunocompetent mice despite the presence of an immune reaction, demonstrating the ability of this retroviral-BMP4-muscle construct to provide sufficient stimuli for osteoinduction in vivo; MDSCs appear to deliver BMP4, respond to the human BMP4 in an autocrine manner, and actively participate in bone formation, thus serving both osteoinductive and osteoproductive roles; and the BMP4-expressing MDSCs can induce bone formation and improve bone healing in a critical-sized skull defect in immunocompetent mice. Therefore, we believe that technology based on the MDSCs and vector system has great potential for promoting bone healing in a variety of musculoskeletal conditions.
The hereditary palmoplantar keratoses: an updated review and classification
Authors: G.P.H. LUCKER, P.C.M. VAN DE KERKHOF, P.M. STEIJLEN
Journal: British Journal of Dermatology (1994)

SUMMARY The palmoplantar keratoses (PPKs) comprise a heterogeneous group of disorders of keratinization, which can be subdivided into hereditary and acquired forms. Many authors have attempted to classify the hereditary forms,1–5 and most classifications have been based on the morphology, distribution, associated symptoms and mode of inheritance. Subsequently, many new forms have been recognized, and what were previously considered to be distinct types have been shown to be variants of a single type, both of which limit the usefulness of previous classifications. Hence, we propose a new, updated classification, which enables accurate diagnosis of these disorders.
Multi-center experience with a novel Ir192vascular brachytherapy device for in-stent restenosis: Final results of the Angiorad Radiation Therapy for In-Stent Restenosis Intracoronaries II (ARTISTIC II) trial
Authors: Dean J. Kereiakes, Ron Waksman, Anikumar Mehra, Carlos E. Morales, Ray Magorien, Melissa Mazzoni, Jeffrey J. Popma
Journal: Journal of the American College of Cardiology (2003)
"B12 Shots"—Still Another Side of the Coin
Authors: A. A. Fisher
Journal: JAMA (1975)

<h3>To the Editor.—</h3> In his article "'B<sub>12</sub>Shots': Flip Side" (231:289, 1975) McCurdy states: "My first article emphasized that most cyanocobalamin injections have little justification, although they may sometimes have a placebo effect. The flip side of this coin: when cyanocobalamin therapy is needed,<i>it is really needed and needed permanently</i>." To continue the metaphor, a three-sided coin would be needed, since, whether the cyanocobalamin shot is therapeutic or acts as a placebo, there is always the possibility of an allergic reaction. I have described such a reaction<sup>1</sup>in a 63-year-old woman who noted that following each injection of cyanocobalamin the area of injection had become red, tender, and pruritic. Oral ingestion of cyanocobalamin produced similar flares in the sites of previous injections. This patient had positive patch reactions to a 2% aqueous solution of cobalt chloride and to cyanocobalamin solutions in the strengths of 100μg and 1,000μg/
A Phase I Evaluation of the Safety and Immunogenicity of Vaccination with Recombinant gp160 in Patients with Early Human Immunodeficiency Virus Infection
Authors: Robert R. Redfield, Deborah L. Birx, Nzeera Ketter, Edmund Tramont, Victoria Polonis, Charles Davis, John F. Brundage, Gale Smith, Steven Johnson, Arnold Fowler, Thomas Wierzba, Avigdor Shafferman, Franklin Volvovitz, Charles Oster, Donald S. Burke
Journal: New England Journal of Medicine (1991)

Despite multiple antiviral humoral and cellular immune responses, infection with the human immunodeficiency virus (HIV) results in a progressively debilitating disease. We hypothesized that a more effective immune response could be generated by postinfection vaccination with HIV-specific antigens.