tbuckley/cabot-search huggingface dataset:
Thymus Cells in Myasthenia Gravis Selectively Enhance Production of Anti-Acetylcholine-Receptor Antibody by Autologous Blood Lymphocytes
Authors: John Newsom-Davis, Nick Willcox, Linda Calder
Journal: New England Journal of Medicine (1981)

We investigated the role of the thymus in 16 patients with myasthenia gravis without thymoma by studying the production of anti-acetylcholine-receptor antibody by thymic and blood lymphocytes cultured alone or together. In 19 responders (with the highest receptor-antibody titers in their plasma), cultured thymic cells spontaneously produced measurable receptor antibody. Receptor-antibody production by autologous blood lymphocytes was enhanced by the addition of responders' thymic cells, irradiated to abrogate antibody production and suppression (P less than 0.01). This enhancement was greater and more consistent than that by pokeweed mitogen; it depended on viable thymic cells, appeared to be selective for receptor antibody, and correlated with the ratio of thymic helper (OKT4-positive or OKT4+) to suppressor (OKT8+) T cells (P less than 0.01). These results suggest that myasthenic thymus contains cell-bound acetylcholine-receptor-like material or specific T cells (or both) that can aid receptor-antibody production. This may be relevant to the benefits of thymectomy in myasthenia and to the breakdown in self-tolerance in this and other autoimmune diseases.
NHS agrees discount with Microsoft to save £330m on software over nine years
Authors: Susan Mayor
Journal: BMJ (2004)

The NHS in England has agreed a discounted price with the computer company Microsoft for renewing its licence to use the company's desktop software, the health minister announced last week.

Under the new arrangement the NHS will be able to use up to 900 000 licences rather than the current 500 000, allowing the software to be used on more desktop and laptop computers at no extra cost. The licences will be held on a perpetual …
NONSTEROIDAL ANTIINFLAMMATORY DRUG TREATMENT IS ASSOCIATED WITH INCREASED RISK OF ATRIAL FIBRILLATION AND STROKE IN PATIENTS WITH PRIOR MYOCARDIAL INFARCTION -A NATIONWIDE STUDY
Authors: Anne-Marie Schjerning Olsen, Emil Fosbol, jesper lindhardsen, Fredrik Folke, Jonas Olesen, Mette Charlot, Morten Lamberts, Martin Ruwald, Lars Kober, Peter R. Hansen, Christian Torp-Pedersen, Gunnar Gislason
Journal: Journal of the American College of Cardiology (2012)
Impact of compensatory enlargement of atherosclerotic coronary arteries on angiographic assessment of coronary artery disease.
Authors: G M Stiel, L S Stiel, J Schofer, K Donath, D G Mathey
Journal: Circulation (1989)

To determine whether compensatory enlargement of atherosclerotic coronary arteries occurs and to what degree it affects the angiographic assessment of coronary artery disease, we performed postmortem coronary angiography of 30 human hearts with suspected coronary artery disease and studied 70 histologic cross sections of the proximal left anterior descending artery and proximal right coronary artery. Angiographic and morphometric analyses of 50 stenoses in proximal and middle sections of the left anterior descending artery, right coronary artery, and left circumflex artery were performed. The control group of 10 human hearts without suspected coronary artery disease was evaluated in the same way. For this purpose, coronary arteries were filled with a methylmethacrylic radiopaque resin at a pressure of 100 mm Hg and closely embedded in a methylmethacrylic resin by use of which shrinkage and mechanical artifacts could be avoided. The area circumscribed by the internal elastic lamina was taken as a measure of the area of the arterial lumen if no plaque had been present. The angiographic and corresponding morphometric degree of stenosis was assessed. A significant correlation (r = 0.85, p less than or equal to 0.0001) was found between the internal elastic lamina area and the area of the plaque (lesion area), suggesting that coronary arteries may enlarge as lesion area increases. With the morphometric degree of stenosis, the expected anatomic diminution of the coronary artery was abolished (r = 0.79, p less than or equal to 0.0001), indicating compensatory enlargement in atherosclerotic segments. Accordingly, the degree of stenosis assessed from in vitro angiograms was underestimated. Compensatory coronary enlargement of the stenotic segment was the main reason for angiographic underestimation. The underestimation factor of up to 3.50 for very mild stenoses decreased to 1.37 at an angiographic degree of 50% area stenosis and 30% diameter stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Abstract 808: Endocrine resistance: The influence of stromal-epithelial interaction on intracrine pathways of oestrogen synthesis
Authors: Atul Purohit, Joshua M. Odendaal, Carlo Palmieri
Journal: Cancer Research (2012)

Abstract Resistance to endocrine therapy, both de novo and acquired, poses a significant clinical challenge. Two primary pathways, the aromatase and steroid sulphatase (STS) pathways, exist for the production of estrogenic steroids from androstenedione and DHEAS, respectively. Numerous studies have demonstrated an upregulation of these pathways in breast tumour tissue compared to normal breast tissue. Therapies targeting oestrogenic pathways form the mainstay of the pharmacological approach to breast cancer treatment. The SERM, Tamoxifen, and aromatase inhibitors (AI) such as Letrozole, have shown substantial clinical benefit in hormone-dependent breast cancer patients. Additionally, to date one STS inhibitor has entered clinical trials. Despite this success, a proportion of hormone-receptor positive patients do not respond to hormone therapy with 40% of patients who initially show a response to Tamoxifen relapsing. As little is known about the influence of the tumour microenvironment, particularly stromal-fibroblasts, on these pathways in the development of endocrine resistance, we have examined the influence of stromal-epithelial interactions on the expression of enzymes of steroidogenesis in endocrine resistant cells. Wild type and tamoxifen-resistant MCF-7 breast cancer cells (MCF-7wt and MCF-7TamR, respectively) were indirectly co-cultured with primary fibroblasts derived from breast tumour and reduction mammoplasty samples, using 0.4μm 6-well inserts. Expression levels of 17α-hydroxysteroid dehydrogenase types 1 (17α-HSD1) and 2, (17α-HSD2), aromatase, oestrogen receptor ≤ (ERα) and β, progesterone receptor, steroid sulphatase (STS), and steroid sulphotransferase were assessed basally and in co-culture using RT-PCR. Significantly higher basal expression of STS (p&amp;lt;0.001), aromatase (p=0.012) and 17α-HSD2 (p=0.032) was seen in fibroblast versus epithelial lines. On co-culture a 2.5 - 5 fold up-regulation of aromatase expression was seen in MCF-7wt and MCF-7TamR (p=0.009, p=0.046 respectively). The expression of STS (p=0.150, p=0.05) and 17α-HSD1 (p=0.001, p=0.071) was also increased. Epithelial lines showed a significant down-regulation in ERα on co-culture. Both malignant and normal fibroblast lines demonstrated up-regulation of aromatase expression on co-culture (p=0.037). These data suggest that stromal-fibroblasts make a significant contribution to the tumour hormonal environment through both expression and modulation of the pathways associated with intracrine oestrogen production. The differential effect of cell-type combinations implicates these interactions in both oestrogen sensitivity and insensitivity. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 808. doi:1538-7445.AM2012-808
P276 The value of vital capacity and daytime pulse oximetry to predict hypercapnia in obese patients
Authors: E. Boleat, S. Mandal, E. Suh, N. Hart
Journal: Thorax (2011)

<h3>Introduction</h3> The Health Survey for England reported that 25% of UK adults are obese with a 10% rise over 15 years. Consequently, clinicians are faced with a rising number of obese patients referred for bariatric and non-bariatric surgery. Previous data indicates a 50% incidence of obstructive sleep apnoea in patients with a BMI &gt;40 kg/m<sup>2</sup> with obesity hypoventilation syndrome present in up to a third. These patients have higher risk of peri-operative complications. A screening tool to predict hypercapnic respiratory failure (P<sub>a</sub>CO<sub>2</sub> &gt;6 kPa) based on simple clinic tests would be useful. Correlations were performed to determine which tests may be useful. <h3>Methods</h3> Data from all obese patients (BMI &gt;30 kg/m<sup>2</sup>) with evidence of sleep-disordered breathing on oximetry initiated on home ventilatory support between August 2005 and December 2010 were obtained from a discharge summary database. <h3>Results</h3> 205 patients were included for analysis. The group mean age was 54.9 (SD 14.2) years, daytime clinic oxygen saturations (SpO<sub>2clinic</sub>) 91.0% (5.8%), FEV<sub>1</sub> 1.8 l (0.96 l), FVC 2.2 l (1.11 l), weight 132.8 kg (28.5 kg), BMI 47.6 kg/m<sup>2</sup> (9.6) and Epworth sleepiness score 8.9 (5.6). Mean daytime P<sub>a</sub>CO<sub>2</sub> was 6.68 kPa (1.31). Significant correlations were found between P<sub>a</sub>CO<sub>2</sub> and BMI (r=0.20; p&lt;0.005), FEV<sub>1</sub>% predicted (r=−0.20; p&lt;0.005), FVC% predicted (r=−0.20; p&lt;0.005) and SpO<sub>2clinic</sub> (r=−0.52; p&lt;0.005). Receiver operating characteristics (ROC) analysis was used to determine the utility of SpO<sub>2clinic</sub> and FVC to predict hypercapnia. The area under the curve (AUC) for SpO<sub>2clinic</sub> was 0.81 (p&lt;0.001); a cut-off of SpO<sub>2clinic</sub> of &lt;92% demonstrated a sensitivity of 86% and specificity of 52% in predicting hypercapnia. The AUC for FVC was found to be 0.77 (p&lt;0.0001); a cut-off of &lt;1.94 l demonstrated a sensitivity of 77% and specificity of 61% in detecting hypercapnia (see Abstract P276 figure 1). <h3>Conclusion</h3> These data have significant clinical utility for clinicians involved in providing respiratory support services for obese patients undergoing bariatric and non-bariatric surgery. In particular, it could form the foundations of a screening algorithm including simple measures such as home oximetry, spirometry and clinic pulse oximetry, to identify the highest risk patients that need to be reviewed by sleep and ventilation clinicians.
Suppression of host defences by Aspergillus fumigatus.
Authors: M D Robertson, A Seaton, L J Milne, J A Raeburn
Journal: Thorax (1987)

An important feature of the microbicidal action of phagocytic cells is their ability to produce reactive oxygen intermediates. In an attempt to identify the mechanisms by which the fungus Aspergillus fumigatus resists normal host defences the effect of spores and spore diffusates of A fumigatus on the production of superoxide anion and hydrogen peroxide by primed rodent phagocytic cells has been measured. For comparison we have used the non-pathogenic fungus Penicillium ochrochloron. Production of these reactive oxygen intermediates in response to A fumigatus was significantly lower than that in response to P ochrochloron. A similar reduction was achieved by diffusate prepared from freshly washed spores. The inhibitory component was of low molecular weight (less than 14,000) and its effect was dose dependent. These results suggest that spores of A fumigatus fail to trigger and also inhibit the production of reactive oxygen intermediates by phagocytic cells.
Protective effect ofL-carnitine in ammonia-precipitated encephalopathy in the portacaval shunted rat
Authors: G Therrien, C Rose, J Butterworth, R F Butterworth
Journal: Hepatology (1997)

l–carnitine administration prevents the neurological symptoms of acute ammonia toxicity. To further evaluate its efficacy in the prevention of hepatic encephalopathy in hyperammonemic conditions, l–carnitine (16 mmol/kg, intraperitoneally [i.p.) was administered 1 hour before ammonium acetate (NH4OAc) (8.5 mmol/kg, subcutaneously) to portacaval shunted (PCS) rats. Cerebrospinal fluid (CSF) ammonia, lactate, and amino acid levels were measured in relation to deteriorating neurological status in these animals. None of 35 l–carnitine–treated animals showed neurological deterioration after NH4OAC administration compared with saline–treated controls; the latter manifested severe encephalopathy progressing through loss of righting reflex to coma. Survival rate was 100% in the l–carnitine–treated group compared with 5% in saline–treated controls. Following NH4OAC administration to PCS rats, CSF ammonia increased to 0.93 ± 0.15 mmol/L and 1.24 ± 0.15 mmol/L at precoma and coma stages of encephalopathy (P &lt; .01) respectively. Treatment with l–carnitine reduced CSF ammonia at both precoma and coma stages; the time–course of this protective effect paralleled blood and CSF l–carnitine accumulation. CSF alanine and lactate increases following NH4OAC administration to PCS rats were significantly attenuated following l–carnitine treatment. However, L– carnitine treatment did not lead to significant reductions in plasma ammonia nor CSF or brain glutamine in these animals. These findings show the therapeutic efficacy of l–carnitine in ammonia–precipitated coma in PCS rats and suggest that this protective effect is centrally mediated involving improved mitochondrial respiration. l–carnitine could be of therapeutic benefit in the prevention of hepatic encephalopathy precipitated by ammoniagenic conditions in humans with chronic liver disease.
Increased Incidence of Thyrotoxicosis in Immigrants
Authors: W B SPAULDING
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
New method for detection of C34-T mutation in the AMPD1 gene causing myoadenylate deaminase deficiency.
Authors: M Gross
Journal: Annals of the Rheumatic Diseases (1994)

Blood pressure measurements were made on children in their fourth year at secondary schools in parts of Scunthorpe Health District supplied with drinking water of varying sodium content. Of the 3131 children, 2740 were examined (1394 boys and 1346 girls). Boys had slightly higher systolic pressures and slightly lower diastolic pressures than the girls. There was no difference between the blood pressure distributions of children in areas supplied with water containing 105 mg/l sodium, 50 mg/l sodium, or less than 15 mg/l sodium. Small differences were found in the weights of children in these areas, and slightly more of the children in the area supplied with water containing more than 105 mg/l sodium had relatives who had been treated for hypertension. Standardisation for these factors did not show any relation between water salinity and either systolic or diastolic blood pressure. Studies of the urinary sodium, potassium, and the ratios of these to creatinine on a sample of 769 boys showed no correlation with assessments of usual sodium intake, but urinary sodium correlated well with salt and fluid intake at the meal immediately preceding examination. The relation between median blood pressure and urinary sodium concentration and lack of a clear relation with sodium creatinine ratio supports the hypothesis that it may be the ratio of salt to fluid intake rather than total dietary sodium that is relevant to the regulation of blood pressure.
Laboratory Medicine in Clinical Practice: Practical and Efficient Use of the Laboratory in Patient Management
Authors: Rex B. Conn
Journal: JAMA (1984)

This concise discussion of diagnostic laboratory tests is intended to provide the practicing physician with a system-oriented overview of test selection and interpretation. It succeeds in accomplishing this objective.  The editor, medical director of a community hospital in Norwich, Conn, the associate editor, and 25 other contributors (half of whom are affiliated with Yale Medical School) have compressed a remarkable amount of information into a brief volume, yet skillful editing has resulted in a presentation that is readable as well as informative. The editorial approach is described succinctly in the chapter on blood gases and electrolytes, which demonstrates an approach to the laboratory results, but does not require the ability to derive the Henderson-Hasselbach equation.  The first chapter discusses references ranges, called normal values with quotation marks, diagnostic sensitivity, diagnostic specificity, and predictive values. The presentation is relatively unsophisticated, but does point out some of the problems in distinguishing normality
Telomerase Activity in Hematopoietic Cells Is Associated with Self-Renewal Potential
Authors: Sean J Morrison, Karen R Prowse, Peter Ho, Irving L Weissman
Journal: Immunity (1996)

It has been proposed that the biological clock underlying the limited division potential of eukaryotic cells is telomere length. We assayed telomerase activity in single cells of the hematopoietic and immune systems. We examined hematopoietic stem cells at four stages of differentiation, lineage-committed progenitors, and mature myeloid and lymphoid cells. The frequency of telomerase-expressing cells within each population was proportional to the frequency of cells thought to have self-renewal potential. Among bone marrow hematopoietic stem cells, 70% exhibited detectable telomerase activity. The telomerase-expressing somatic cells observed in this study are not thought to be immortal, and expression was not correlated with cell cycle distribution or differentiation state. This study demonstrates that the developmental characteristic most consistently associated with telomerase expression is self-renewal potential.
Hypostatic ulceration and Klinefelter's syndrome.
Authors: R Howell
Journal: BMJ (1978)

graphic deterioration, in the patient and others affected by aerosols of contaminated water in other factories2 3 no radiographic changes were evident after several years' exposure, and no functional abnormalities persisted when away from work.Furthermore, the symptoms were prominent in the early part of the week, improving while continuing at work, but recurring on return to work after an absence.This pattern is similar to the "Monday fever" of byssinosis, but differs so far as we know in the site of reaction, being predominantly bronchial in byssinosis and peripheral in "humidifier fever."The source of the antigens was identified in this case but the precise causal agent was not, and it may, as Edwards suggested, be derived from free-living amoebae.4Awareness of this unusual pattern of reaction should allow earlier identification of its cause, although confirmation may be obtained only by systematic observations at work or by inhalation testing.
Death Resulting From Ipecac Syrup Poisoning
Authors: Alan G. Adler
Journal: JAMA (1980)

IPECAC syrup is commonly used to induce emesis in patients who have ingested toxic substances. Its relative safety and effectiveness have been proved over many years of use.<sup>1</sup>Miser and Robertson<sup>2</sup>have recently reviewed the 14 reports in the literature, from 1908 until 1978, of ipecac poisoning. All but three were due to the accidental ingestion of the fluid extract, which has not been commercially available since the mid-1960s. Among these reports, however, were three cases of ipecac syrup poisoning, all of which were associated with phenothiazine overdose, which inhibited emesis; these patients survived. We report here the first death, to our knowledge, due to ipecac syrup poisoning. The ipecac was being taken as a means of inducing emesis to lose weight. <h3>Report of a Case</h3> A 26-year-old woman without previous medical problems was admitted to Thomas Jefferson University Hospital, Philadelphia, with palpitations, chest tightness, exertional dyspnea, and
Incidence and management of malignant digestive endocrine tumours in a well defined French population
Authors: C Lepage
Journal: Gut (2004)

<b>Background and aims:</b> Little is known about the epidemiology of malignant digestive endocrine tumours. The aim of this study was to report on their incidence and management in a well defined population. <b>Methods:</b> Data were obtained from the population based Digestive Cancer Registry of Burgundy (France) over a 24 year period. Incidence rates were calculated by sex, age groups, and period of diagnosis. Treatment and stage at diagnosis were also investigated. Prognosis was determined using crude and relative survival rates. A multivariate relative survival analysis was performed. <b>Results:</b> Between 1976 and 1999, 229 cases were recorded. Age standardised incidence rates were 0.76/100 000 for men and 0.50/100 000 for women. They increased over time in both sexes. The resectability rate was 74.1%. Among recorded cases, 26.6% did not extend beyond the organ, 20% had lymph node metastases, and 53.3% had visceral metastases or were unresectable. There was no improvement in the resection rate or in the stage at diagnosis over the study period. The overall relative survival rate was 66.9% at one year, 50.4% at five years, and 40.6% at 10 years. Stage at diagnosis, age at diagnosis, and subsite were independent significant prognostic factors. <b>Conclusions:</b> Although their incidence is increasing, malignant digestive endocrine tumours remain a rare cancer, representing 1% of digestive cancers. Stage at diagnosis and prognosis at a population level are worse than those reported in hospital series. In the short term, new therapeutic possibilities represent the best way to improve their prognosis.