tbuckley/cabot-search huggingface dataset:
Resolution of liver fibrosis requires myeloid cell–driven sinusoidal angiogenesis
Authors: Chahrazade Kantari‐Mimoun, Magali Castells, Ralph Klose, Anna‐Katharina Meinecke, Ursula J. Lemberger, Pierre‐Emmanuel Rautou, Hélène Pinot‐Roussel, Cécile Badoual, Katrin Schrödter, Christoph H. Österreicher, Joachim Fandrey, Christian Stockmann
Journal: Hepatology (2014)

Angiogenesis is a key feature of liver fibrosis. Although sinusoidal remodeling is believed to contribute to fibrogenesis, the impact of sinusoidal angiogenesis on the resolution of liver fibrosis remains undefined. Myeloid cells, particularly macrophages, constantly infiltrate the fibrotic liver and can profoundly contribute to remodeling of liver sinusoids. We observe that the development of fibrosis is associated with decreased hepatic vascular endothelial growth factor (VEGF) expression as well as sinusoidal rarefication of the fibrotic scar. In contrast, the resolution of fibrosis is characterized by a rise in hepatic VEGF levels and revascularization of the fibrotic tissue. Genetic ablation of VEGF in myeloid cells or pharmacological inhibition of VEGF receptor 2 signaling prevents this angiogenic response and the resolution of liver fibrosis. We observe increased expression of matrix metalloproteases as well as decreased expression of tissue inhibitor of metalloproteases confined to sinusoidal endothelial cells in response to myeloid cell VEGF. Remarkably, reintroduction of myeloid cell–derived VEGF upon recovery restores collagenolytic acitivity and the resolution of fibrosis. Conclusion : We identify myeloid cell–derived VEGF as a critical regulator of extracellular matrix degradation by liver endothelial cells, thereby unmasking an unanticipated link between angiogenesis and the resolution of fibrosis. (H epatology 2015;61:2042–2055)
Abstract 14249: Ectonucleoside Triphosphate Diphosphohydrolase-1 (ENTDP-1/CD39) Down-Regulates P-Selectin Expression in a Murine Model of Deep Venous Thrombosis
Authors: Anuli C Anyanwu, Jose A Diaz, Wrobleski K Shirley, Hui Liao, Jessica J Ray, Matthew C Hyman, Daniel D Myers, Thomas W Wakefield, David J Pinsky
Journal: Circulation (2011)

Background: Deep venous thrombosis (DVT) is a major health care concern in the United States. CD39 is co-localizes on the surface of endothelial cells (EC), leukocytes and platelets where it regula...
Ceftazidime versus Aminoglycoside and (Ureido)Penicillin Combination in the Empirical Treatment of Serious Infection
Authors: N Finer, P Goustas
Journal: Journal of the Royal Society of Medicine (1992)

Urgent treatment of serious infections with broad spectrum antibiotics usually starts before bacteriological evidence of the infective organism(s) becomes available. In this study 471 patients with a clinical diagnosis of sepsis were treated empirically with ceftazidime (CAZ) monotherapy (249 patients), or with an aminoglycoside+(ureido)penicillin combination (AG+PEN) (222 patients) to establish clinical outcome and bacteriological response. Up to 72 h post-treatment 94.5% of patients in the CAZ group and 93.8% in the AG+PEN group were treated successfully (treatment difference 0.7%, P&lt;0.01, 95% confidence interval −3.8%, 5.2%), 2–4 weeks after treatment neither regimen proved clinically superior. The differences in bacteriological response up to 72 h, and at 2–4 weeks after treatment, were 5.6% and 12.4% in favour of CAZ, however, these were not statistically significant. Overall, 56 patients reported 72 adverse events in the CAZ group, compared with 33 patients reporting 41 adverse events in the AG+PEN group. Deaths, 40 on CAZ and 21 on AG+PEN, were mainly related to their underlying condition. The two regimens were shown to be clinically equivalent in seriously ill patients treated empirically.
Chronic Upper Airway Obstruction: Value of the Flow Volume Loop Examination in Assessment and Management
Authors: G B Brookes, A J Fairfax
Journal: Journal of the Royal Society of Medicine (1982)

Chronic obstructive lesions of the upper airways such as post-traumatic strictures, bilateral vocal cord paralysis and chronic inflammatory foci are uncommon. The functional assessment of the severity and character of an obstruction is important both for diagnosis and management, and may also allow evaluation of the efficacy of medical and surgical treatment. There are limitations of simple spirometric pulmonary function tests, which are evident when assessing upper airways obstruction. The flow volume loop is a graphic recording of airflow during maximal respiration and expiration at different lung volumes, and may be affected in a characteristic way by alterations in the airway resistance. Three unusual cases of chronic upper airway obstruction are presented which illustrate the value of the flow volume loop examination in their management.
Malignant ovarian germ cell tumours: Long-term treatment outcome
Authors: A. Maheshwari, S. Gupta, H. B. Tongaonkar
Journal: Journal of Clinical Oncology (2005)

5132 Background: Malignant ovarian germ cell tumors (MOGCT) constitute less than 5% of all ovarian malignancies. Conservative surgery followed by platinum based combination chemotherapy is the standard treatment. These patients have an excellent prognosis. Long-term menstrual and reproductive outcomes are of great interest and importance in this group of patients. Methods: We performed a retrospective review of 114 cases of MOGCT treated at our centre between Jan 1995 and Dec 1999. Results: The median age at diagnosis was 18 years (5–42 years). The majority of patients (n=85) had attained menarche at the time of diagnosis. Histopathological examination revealed that dysgerminoma was the commonest type (39%), followed by teratoma (20%), endodermal sinus tumor (18%) and mixed GCT (18%). The primary treatment was surgery followed by adjuvant chemotherapy in 70 cases, surgery alone in 34 cases and neo-adjuvant chemotherapy followed by surgery in 10. In 80% of cases (n=90) conservative surgery was performed with preservation of the uterus and opposite ovary. The majority of patients had stage-I disease (72%, n=82). Optimum cytoreduction was possible in 82% (n=94) of patients. BEP was the regimen used in 96% (n=76) of cases who received chemotherapy during initial management. At a median follow-up of 50 months the 5-year disease-free survival was 57% and the overall survival was 90%. Thirty nine patients have relapsed at a median of 12 months; 11 patients (28.2%) relapsed more than 2 years after completion of treatment. In 39 out of 41 patients evaluable for menstrual function, menstruation returned to normal during follow-up. There were twelve full term normal pregnancies and 1 abnormal pregnancy among 20 patients desirous of fertility. Conclusions: The long-term outcome of patients of MOGCT is excellent. The majority of patients who relapse after initial observation without chemotherapy can be cured of their disease. Relapses continue to take place well beyond 2 years of follow-up and therefore long-term surveillance is appropriate. The majority of patients can be managed with fertility sparing surgery and can expect good menstrual and reproductive outcomes. No significant financial relationships to disclose.
Optimal Biomaterial for Creation of Autologous Cardiac Grafts
Authors: Tsukasa Ozawa, Donald A. G. Mickle, Richard D. Weisel, Nobuya Koyama, Sumiko Ozawa, Ren-Ke Li
Journal: Circulation (2002)

The optimal cardiac graft for the repair of congenital heart defects will be composed of autologous cells and will grow with the child. The biodegradable material should permit rapid cellular growth and delayed degradation with minimal inflammation. We compared a new material, epsilon-caprolactone-co-L-lactide sponge reinforced with knitted poly-L-lactide fabric (PCLA), to gelatin (GEL) and polyglycolic acid (PGA), which are previously evaluated materials.Syngenic rat aortic smooth muscle cells (SMCs, 2x10(6)) were seeded onto GEL, PGA, and PCLA patches and cultured (n=11 per group). The DNA content in each patch was measured at 1, 2, and 3 weeks after seeding. Histological examination was performed 2 weeks after seeding. Cell-seeded patches were employed to replace a surgically created defect in the right ventricular outflow tract (RVOT) of rats (n=5 per group). Histology was studied at 8 weeks following implantation.In vitro studies showed that the DNA content increased significantly (P<0.05) in all patches between 1 and 3 weeks after seeding. Histology and staining SMCs for anti-alpha-smooth muscle actin (alphaSMA) revealed better growth of cells in the interstices of the grafts with GEL and PCLA than the PGA graft. In vivo studies demonstrated that seeded SMCs survived at least 8 weeks after the patch implantation in all groups. PCLA scaffolds were replaced by more cells with larger alphaSMA-positive areas and by more extracellular matrix with larger elastin-positive areas than with GEL and PGA. The patch did not thin and expanded significantly. The GEL and PGA patches thinned and expanded. All grafts had complete endothelialization on the endocardial surface.SMC-seeded biodegradable materials can be employed to repair the RVOT. The novel PCLA patches permitted better cellular penetration in vitro and did not thin or dilate in vivo and did not produce an inflammatory response. The cell-seeded PCLA patch may permit the construction of an autologous patch to repair congenital heart defects.
An analysis of EGFR expression and tumour imaging in non-small cell carcinomas of lung
Authors: Vijayalakshmi Thanasekaraan, Prathiba Duvuru, Shalinee Rao, Safreena Mohamed, Samuel John Sundar
Journal: European Respiratory Journal (2011)

Introduction:  Non-small cell carcinomas (NSLC) accounts for 80% of all lung cancers. Epidermal growth factor receptor (EGFR) is frequently overexpressed in NSLC and it plays a significant role in tumour cell proliferation and progression. The correlation of EGFR expression with radiological features may reveal their possible relationship.   Aim:  To evaluate EGFR expression in NSLC and correlate with their radiological features.   Material and method:  Twenty -two cases of NSLC were histologically subcategorized based on WHO classification of lung carcinomas. Immunostaining for TTF-1, p63 and EGFR were performed on paraffin embedded tissue sections and their expression evaluated. Chest tomography was reviewed to assess for tumour location, diameter, contours, margins, cavitation and lymph node enlargement. Findings of radio-imaging and EGFR immunoexpression were correlated.   Results:  Fourteen cases of adenocarcinoma and 8 cases of squamous cell carcinoma were identified. Epidermal growth factor receptor expression was noted in 86.3% of tumours. About 92.8% of adenocarcinomas and 75% of squamous cell carcinomas were EGFR positive. On radiology, mean diameter of lesion was found to be 36.4mm and 6.1mm in EGFR positive and negative tumours respectively. Fourteen EGFR positive cases were well defined and five poorly defined. Each of all the eight cases with pleural effusion and regional lymphadenopathy were EGFR positive.   Conclusion:  Major percentage of NSLC showed EGFR expression reinforcing its utility for targeted therapy. A positive EGFR correlation was noted with tumour size, regional lymphnode enlargement and pleural effusion which reflect biologically aggressive property of EGFR positive tumours.
Chemotherapy-related toxicity in infants treated according to the Second National Wilms' Tumor Study.
Authors: E Morgan, E Baum, N Breslow, J Takashima, G D'Angio
Journal: Journal of Clinical Oncology (1988)

Babies under 12 months of age have been included in the National Wilms' Tumor Study (NWTS) series of clinical trials. Undue chemotherapy-related toxicity was encountered early during the course of the second NWTS. The prescribed doses of actinomycin D (AMD), vincristine (VCR), and Adriamycin ([ADR] doxorubicin; Adria Laboratories, Columbus, OH) were therefore halved. The frequency of severe hematologic toxic episodes was reduced (30 of 64 or 47% for babies receiving full doses [FD], and six of 48 or 13% for those given reduced doses [RD]). Similar reductions in pulmonary and hepatic effects were noted, and treatment-related deaths were reduced from 6% to 0 for the FD and RD samples, respectively. These frequencies among RD babies were similar to those encountered in 530 older children administered FD. Reduction of dose did not compromise therapeutic effectiveness.
Recognizing Syncope: Pitfalls and Surprises
Authors: T Lempert
Journal: Journal of the Royal Society of Medicine (1996)

Loss of consciousness and falling are the key features of syncope. Common accompaniments include tonic and myoclonic muscle activity, eye deviations, automatisms, vocalizations and hallucinations which may render the distinction from epileptic seizures difficult. Differential diagnosis is based on the specific features and not the mere presence of these phenomena. Recognition of syncope depends also on accurate information about precipitants, premonitory symptoms and postictal events: the absence of postictal confusion has been identified as the single most powerful factor discriminating syncope from epileptic seizures whereas incontinence and head injury are common in both conditions. Investigations such as electroencephalogram, tilt testing and postictal prolactin or creatine kinase levels may be helpful but are never diagnostic in isolation. Exceptionally, hypoxic and epileptic mechanisms interact within a single attack.
Abstract 2878: Emergency Intracoronary Stem Cell Transplantation in Patients with Acute Myocardial Infarction (TCT-STAMI-2): Long-Term Outcome
Authors: Rongchong Huang, Kang Yao, Juying Qian, Lei Ge, Yanlin Li, Yuhong Niu, Yiqi Zhang, Aijun Sun, Feng Zhang, Yunzeng Zou, Junbo Ge
Journal: Circulation (2008)

In this prospective, randomized, controlled study, we evaluate the safety and change of left ventricular systolic function and infarct area with varied imaging techniques after BMCs transplantation in AMI patients within 3 h after emergency percutaneous coronary intervention (PCI). A total of 271 patients with a first ST-segment-elevation myocardial infarction who had undergone stenting of the infarct-related artery were randomly assigned to receive either unselected BMCs (n=137) transplant or saline (n=134) within 3 hours after successful PCI to the distal vessel of the infarct-related artery through micro-catheter. All patients were followed up within 12 months. Intracoronary BMCs application did not incur cardiovascular events, including ventricular arrhythmias or syncope, occurred during 12-month follow-up. By quantitative LV angiography at six months, LV ejection fraction (LVEF) significantly increased ( p &lt;0.001) and the change of LVEF significantly higher than that in the control group ( p &lt;0.001). Contrast-enhanced magnetic resonance imaging after one year revealed an increased EF (7.7%±6.9%), reduced infarct size (−7.0%±7.5%). In patients with AMI, intracoronary infusion of BMCs within 3 hours after primary PCI is effective and safe in long-term follow-up.
Initial Surgical Versus Conservative Strategies in Patients With Asymptomatic Severe Aortic Stenosis
Authors: Tomohiko Taniguchi, Takeshi Morimoto, Hiroki Shiomi, Kenji Ando, Norio Kanamori, Koichiro Murata, Takeshi Kitai, Yuichi Kawase, Chisato Izumi, Makoto Miyake, Hirokazu Mitsuoka, Masashi Kato, Yutaka Hirano, Shintaro Matsuda, Kazuya Nagao, Tsukasa Inada, Tomoyuki Murakami, Yasuyo Takeuchi, Keiichiro Yamane, Mamoru Toyofuku, Mitsuru Ishii, Eri Minamino-Muta, Takao Kato, Moriaki Inoko, Tomoyuki Ikeda, Akihiro Komasa, Katsuhisa Ishii, Kozo Hotta, Nobuya Higashitani, Yoshihiro Kato, Yasutaka Inuzuka, Chiyo Maeda, Toshikazu Jinnai, Yuko Morikami, Ryuzo Sakata, Takeshi Kimura
Journal: Journal of the American College of Cardiology (2015)
Prophylaxis of Graft-versus-host Disease in Identical Sibling Donor Bmt By Anti-il-2 Receptor Monoclonal-antibody Lo-tact-1
Authors: Augustin Ferrant, Dominique Latinne, Hervé Bazin, Nicole Straetmans, A. Cornet, B. Delaparra, Jl. Michaux
Journal: Blood (1994)
Small intestinal neuroendocrine tumors with liver metastases and resection of the primary: Prognostic factors for decision making
Authors: Emilio Bertani, Massimo Falconi, Chiara Grana, Edoardo Botteri, Antonio Chiappa, Pasquale Misitano, Francesca Spada, Davide Ravizza, Barbara Bazolli, Nicola Fazio
Journal: International Journal of Surgery (2015)
Psychiatric Response to the Clapham Rail Crash
Authors: T P Burns, S C Hollins
Journal: Journal of the Royal Society of Medicine (1991)

The psychiatric response to the Clapham rail crash is described. The psychiatric input was short term, dealing with the 38 inpatients and over 200 hospital staff involved in the response. The need to evolve a compact, responsive team structure is noted. The value of a proactive approach and provision of psychological debriefing is defended. Incorporation of components of the psychiatric response into the Hospital's major incident plan is reported.
Detection of Intrauterine Growth Retardation by Ultrasound: Preliminary Communication
Authors: Cheryl Ellis, M J Bennett
Journal: Journal of the Royal Society of Medicine (1981)

In this study, ultrasonic measurements of the fetal head area and abdominal area were obtained in 1200 patients with singleton pregnancies. The results from the 434 who have delivered, indicate that a large proportion of growth-retarded infants cannot be identified by a single late ultrasonic measurement of either area, at 32-34 weeks gestation, as has been previously suggested.
High-Flow Nasal Oxygen Therapy for Postextubation Acute Hypoxemic Respiratory Failure—Reply
Authors: François Stéphan
Journal: JAMA (2015)

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A randomized phase III/IV study to determine benefit and safety of cytarabine liposome injection for treatment of neoplastic meningitis
Authors: W. R. Shapiro, M. Schmid, M. Glantz, J. J. Miller
Journal: Journal of Clinical Oncology (2006)

1528 Background: Cytarabine liposome injection (CLI) maintains cytotoxic concentrations in the cerebral spinal fluid (CSF) for &gt;14 days with a single 50 mg dose. This study compared patient benefit and safety of intrathecal CLI with methotrexate (MTX) or nonliposomal cytarabine (Cyt) against solid tumor neoplastic meningitis (STNM) and lymphomatous neoplastic meningitis (LNM), respectively. Methods: This multicenter, randomized, open-label, active-controlled study was powered to detect a 50% hazard ratio for progression-free survival (PFS; i.e., days from randomization to neurological progression or death) in STNM patients. STNM patients (n=103) were randomized to CLI or MTX and LNM patients (n=25) to CLI or Cyt. Patients had either histologically documented STNM or LNM confirmed by ventricular or lumbar CSF cytology or symptomatic meningeal tumor verified by magnetic resonance imaging or computed tomography. CLI treatment consisted of 6 Induction Cycles (2 weeks per cycle) and 4 Maintenance Cycles (4 weeks per cycle). Results: By per-protocol Cox regression analysis, CLI (STNM and LNM combined) was noninferior to MTX and Cyt combined (Control Group). The median PFS was 35 days and 43 days (p=0.7321), respectively; the hazard ratio (95% CI) was 0.98 (0.65, 1.46). CLI was also noninferior to MTX in the STNM group, where the hazard ratio was 0.94 (0.58; 1.53). In the LNM group, superiority of CLI over Cyt was demonstrated a hazard ratio of 0.12 (0.02, 0.77). Median PFS was 34 and 50 days, respectively. More LNM patients had complete response (clearance of tumor cells from CSF) with CLI (33.3%) than with Cyt (16.7%; p=0.3640). All patients experienced AEs; 48% and 60% of the patients in CLI and Control Group, respectively, experienced drug-related AEs. The incidence of serious AEs was 86% and 77%, respectively. Conclusions: These results demonstrate at least comparable patient benefit between CLI and control treatments for STNM and improved benefit for CLI in LNM patients. Intrathecal CLI provides patients with the added convenience of bimonthly treatment. [Table: see text]
Abstract P295: Oxidative Stress Biomarkers and Incidence of Post-Operative Atrial Fibrillation in the OPERA Trial
Authors: Jason H Wu, Roberto Marchioli, Roberto Latini, Serge Masson, Maria G Silletta, Frank W Sellke, Peter Libby, Ginger L Milne, Dariush Mozaffarian
Journal: Circulation (2015)

Background: Post-operative atrial fibrillation (PoAF) commonly complicates cardiac surgery. Animal studies point to oxidative stress as a key mechanism triggering PoAF, and yet, the extent to which oxidative stress might relate to PoAF risk in humans remains speculative. Methods and Results: We assessed the association of validated oxidative stress biomarkers (F 2 -Isoprostanes, F 2 -IsoP, Isofurans, IsoF, and F 3 -Isoprostanes, F 3 -IsoP) in plasma and urine, with incident PoAF among 551 cardiac surgery patients. Biomarkers were measured using standardized methods at baseline, the end of surgery, and post-op day 2. PoAF lasting ≥ 30seconds was confirmed by rhythm strip or ECG, and centrally adjudicated. Outcomes were assessed until hospital discharge or post-operative day 10, whichever occurred first. Urine level of each oxidative stress biomarkers demonstrated a rise at the end of surgery (2-3 fold over baseline, P &lt;0.001), which subsequently fell and were comparable to baseline by post-op day 2. In contrast, plasma levels remained relatively stable throughout. Urine F 2 -iso and IsoF at the end of surgery were 20% and 50% higher in subjects who developed PoAF ( P ≤ 0.009). Baseline biomarker levels did not associate significantly with PoAF, whereas end of surgery and post-op day 2 Isop and IsoF did associate with PoAF. For example, the end of surgery extreme quartile multivariate adjusted odds ratio (95% CI) for urine IsoF and F 3 -IsoP were 1.95 (1.05-3.62; P for trend = 0.01) and 2.10 (1.04-2.25, P for trend = 0.04), respectively. Analyses using restricted cubic splines suggested continuous (monotonic) associations of biomarkers of oxidative stress at the end of surgery and post-op day 2 with incident PoAF ( Figure ) There was little evidence that associations of IsoP and IsoF with PoAF varied by demographic, surgery type, and medication use ( P ≥ 0.29 for each). Conclusions: Elevated end of surgery and post-op day 2 oxidative stress as assessed by IsoP and IsoF relate independently to higher risk of PoAF.