tbuckley/cabot-search huggingface dataset:
Juvenile Rheumatoid Arthritis
Authors: Robert S. Katz
Journal: JAMA (1979)

Miller has written a readable, short book on juvenile rheumatoid arthritis (JRA). Actually, JRA is a group of pediatric arthritides, most of which are distinct from adult rheumatoid arthritis. The term "JRA" is, therefore, a misnomer. The British prefer to call it juvenile chronic polyarthritis. Whatever the name, it is clear that there are definable subgroups that are pathogenically and clinically different. The current categorization of JRA is discussed in this book. Because JRA is a group of different arthritides, it can be confusing to discuss the pathogenesis, immunology, and treatment of JRA as a single entity. This book frequently avoids this pitfall. For instance, the chapter on medical therapy discusses gold and aspirin treatment in general terms. One wonders about the author's experience in controlling the systemiconset-type of JRA with gold, or whether he prefers indomethacin or tolmetin to aspirin for HLA-B27 arthritis. Otherwise this chapter is excellent and
MERTK receptor tyrosine kinase is a therapeutic target in melanoma
Authors: Jennifer Schlegel, Maria J. Sambade, Susan Sather, Stergios J. Moschos, Aik-Choon Tan, Amanda Winges, Deborah DeRyckere, Craig C. Carson, Dimitri G. Trembath, John J. Tentler, S. Gail Eckhardt, Pei-Fen Kuan, Ronald L. Hamilton, Lyn M. Duncan, C. Ryan Miller, Nana Nikolaishvili-Feinberg, Bentley R. Midkiff, Jing Liu, Weihe Zhang, Chao Yang, Xiaodong Wang, Stephen V. Frye, H. Shelton Earp, Janiel M. Shields, Douglas K. Graham
Journal: Journal of Clinical Investigation (2013)

Metastatic melanoma is one of the most aggressive forms of cutaneous cancers. Although recent therapeutic advances have prolonged patient survival, the prognosis remains dismal. C-MER proto-oncogene tyrosine kinase (MERTK) is a receptor tyrosine kinase with oncogenic properties that is often overexpressed or activated in various malignancies. Using both protein immunohistochemistry and microarray analyses, we demonstrate that MERTK expression correlates with disease progression. MERTK expression was highest in metastatic melanomas, followed by primary melanomas, while the lowest expression was observed in nevi. Additionally, over half of melanoma cell lines overexpressed MERTK compared with normal human melanocytes; however, overexpression did not correlate with mutations in BRAF or RAS. Stimulation of melanoma cells with the MERTK ligand GAS6 resulted in the activation of several downstream signaling pathways including MAPK/ERK, PI3K/AKT, and JAK/STAT. MERTK inhibition via shRNA reduced MERTK-mediated downstream signaling, reduced colony formation by up to 59%, and diminished tumor volume by 60% in a human melanoma murine xenograft model. Treatment of melanoma cells with UNC1062, a novel MERTK-selective small-molecule tyrosine kinase inhibitor, reduced activation of MERTK-mediated downstream signaling, induced apoptosis in culture, reduced colony formation in soft agar, and inhibited invasion of melanoma cells. This work establishes MERTK as a therapeutic target in melanoma and provides a rationale for the continued development of MERTK-targeted therapies.
CATARACT OPERATIONS.Clinical lecture delivered at the Illinois Charitable Ear and Eye Infirmary, January 4, 1893.
Authors: W. T. MONTGOMERY
Journal: JAMA (1893)

On account of the holidays we have an accumulation of cases for operation to-day and among them several cases of cataract. This will be our subject to-day. We have cases illustrating different phases of this disease, and will present them and speak of them as we go along. <i>Case 1</i>.—We have here first a patient who had double cataract. James S., aged 64, farmer, was first admitted into the infirmary nearly two years ago with mature cataract in right eye and immature in left eye. I then made a simple extraction on the right eye, leaving as you see a round, natural pupil. When I illuminate the area of the pupil by focusing the rays of light by means of this strong double convex lens, you will see stretching across the pupil a grayish white band. That is the remains of the capsule, and interferes more or less with his
Dorsal Penile Nerve Block for Circumcision
Authors: Anne A. Fischell
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Stang et al,<sup>1</sup>in the March 11 issue of<i>JAMA</i>, found that dorsal penile nerve block (DPNB) for neonatal circumcision reduced behavioral distress and cortisol response in 20 infants and recommended that the procedure be generally applied. However, we should be cautious before recommending local anesthesia for all newborn circumcisions, because there has been only limited experience with DPNB. Newborn circumcision without anesthesia, when properly performed, is a quick and safe procedure. Since the early 1940s, 50 to 60 million US infants have been circumcised (1.2 to 1.5 million infants per year) with very few complications. Although no doubt exists that newborns feel pain, behavioral changes are transitory and disappear within 24 hours<sup>2</sup>with no evidence of long-term psychological consequences. Dorsal penile nerve block prolongs circumcision and adds a new procedure with some known risks, such as hematoma and local necrosis.<sup>3</sup>Of special concern
Intradiaphragmatic Cyst: A Diagnostic Challenge
Authors: Michael Greenberg
Journal: JAMA (1974)

CYSTS of the diaphragm have been classified by previous investigators as (1) mesothelial, (2) bronchogenic, and (3) fibrous.<sup>1-4</sup>Such lesions are rare and provide a difficult challenge in differential diagnosis. In this article, we describe a 26-year-old man with mesothelial cyst of the diaphragm, with chronic hemorrhage and inflammation, not associated with trauma. To our knowledge, a few cases of mesothelial cyst of the diaphragm with clear fluid have been reported. Only one description of a case of cystic hematoma of the diaphragm exists and this was defined primarily as hematoma due to trauma with degeneration.<sup>5</sup> <h3>Report of a Case</h3> A 26-year-old man complained of pain in the right side of the abdomen and thorax with radiation to the right shoulder, which began approximately two months before admission. This pain was described as dull aching, with acute exacerbations. There were no associated symptoms, such as nausea, vomiting, or
In vitro diagnosis of cow's milk protein sensitive enteropathy by organ culture method.
Authors: N Iyngkaran, M Yadav, S Balabaskaran, E Sumithran
Journal: Gut (1981)

The criteria that are used at present to diagnose cow9s milk protein sensitive enteropathy (CMPSE) are based on an in vivo milk challenge which can be hazardous and life threatening. We have used an organ culture model to determine the usefulness of this technique in establishing the diagnosis of CMPSE on the basis of a single biopsy with in vitro milk challenge. Fourteen infants with diarrhoea clinically suspected to have CMPSE were studied prospectively. On the basis of milk challenge studies seven infants had CMPSE. They had clinical reaction to cow9s milk with associated histological changes and depression of alkaline phosphatase levels in the jejunal mucosa. In all seven cases parallel changes in alkaline phosphatase levels were noted in the organ culture specimens of initial biopsy subjected to in vitro challenge. The seven control infants tolerated cow9s milk and did not have histological changes. The alkaline phosphatase levels were moderately increased in the jejunal mucosa in five of the seven infants. The alkaline phosphatase levels in the organ culture specimens of initial biopsy were increased after in vitro challenge in all seven infants. This study suggests that organ culture methods may be useful in the vitro diagnosis of CMPSE, and also obviate the need for in vivo oral milk challenges and repeated biopsies.
Stabilization of eyelid height after aponeurotic ptosis repair
Authors: Susan M Tucker, Steven J Verhulst
Journal: Ophthalmology (1999)

To develop guidelines for revision of ptosis surgery in the early postoperative period by establishing what percentage of eyelids after anterior levator advancement have reached their final height by the first postoperative week.Prospective noncomparative case series.An analysis was performed on 164 eyelids in 97 patients with involutional aponeurotic ptosis.Anterior levator advancement was performed on each of these 164 eyelids. Exclusion criterion consisted of a history or evidence of neurologic or muscular disease, preceding trauma, an anophthalmic socket, or prior eyelid surgery.The marginal reflex distance, eyelid excursion, and degree of swelling were recorded perioperatively; additionally, photographs were obtained before surgery and at 1 and 6 weeks after surgery.At 1 week after surgery, only 40% of eyelids had reached their final height; 52% continued to rise a mean of 1.1 mm. The percentage of eyelids continuing to rise after the first postoperative week varied with the amount of swelling present at 1 week, although a direct correlation did not exist (Pearson correlation, 0.22; P < 0.26). Although this increase ranged from 0.5 to 3.0 mm for 71% of eyelids, the subsequent increase was 1 mm or less. Maximal eyelid height was achieved almost universally by 6 weeks, after which 18% of eyelids subsequently dropped a mean of 0.8 mm.Based on this study, the authors suggest revision at 1 week after anterior levator advancements in which minimal-to-moderate eyelid swelling exists for contour abnormalities, if the eyelid height is 0.5 mm or more above or more than 1.0 mm below the target height, or if asymmetry between the eyelids is 1.0 mm or more. The authors do not advise early revision for patients with excessive swelling still present 1 week after surgery.
An Intern Meets Ty Cobb
Authors: Joseph E. Hardison
Journal: JAMA (1981)

In the summer of 1960 I was a brand-new medical intern. I still thrilled at hearing my name called over the hospital paging system. I walked with a swagger and carried (like six-guns) my stethoscope in my right and my percussion hammer in my left coat pocket. The only challenge to my competence, composure, and training had been limited to the inevitable question: "Are you an intern or a doctor?" That is, until I tried to work up Tyrus Raymond Cobb. Mr Cobb was 73 years old and in pain from metastatic cancer of the prostate. He was not in a good humor. I introduced myself and got no further. Mr Cobb informed me he would have none of my pestering and poking. I was to give him something for pain right then.<i>Suddenly, there was the roar of the crowd. I was on the mound (I was a pitcher</i>
Polychlorinated biphenyls (PCBs) exert thyroid hormone-like effects in the fetal rat brain but do not bind to thyroid hormone receptors.
Authors: Kelly J Gauger, Yoshihisa Kato, Koichi Haraguchi, Hans-Joachim Lehmler, Larry W Robertson, Ruby Bansal, R Thomas Zoeller
Journal: Environmental Health Perspectives (2003)

Polychlorinated biphenyls (PCBs) are ubiquitous environmental contaminants routinely found in human and animal tissues. Developmental exposure to PCBs is associated with neuropsychologic deficits, which may be related to effects on thyroid hormone (TH) signaling in the developing brain. However, PCBs may interfere with TH signaling solely by reducing circulating levels of TH, or they may exert direct effects on TH receptors (TRs). Therefore, we tested whether maternal exposure to a commercial PCB mixture, Aroclor 1254 (A1254), exerts effects in the fetal brain by one or both of these mechanisms. Dams were dosed daily with 0, 1, or 4 mg/kg A1254 from gestational day 6 (GD6) until they were sacrificed on GD16. A1254 significantly reduced circulating levels of triiodothyronine (T3) and thyroxine (T4) in pregnant rats but increased the expression of several TH-responsive genes in the fetal cortex, including neuroendocrine-specific protein A (NSP-A), RC3/neurogranin, and Oct-1. These findings are consistent with a direct action of PCBs on TRs. However, we did not identify parent PCB congeners or metabolites that bound to rat TRs isolated from hepatic nuclei. These findings indicate that PCBs can interfere with TH signaling in the fetal brain by direct actions on the fetus rather than by producing maternal hypothyroidism.
CD38 and ZAP-70 are functionally linked and mark CLL cells with high migratory potential
Authors: Silvia Deaglio, Tiziana Vaisitti, Semra Aydin, Luciana Bergui, Giovanni D'Arena, Lisa Bonello, Paola Omedé, Maria Scatolini, Ozren Jaksic, Giovanna Chiorino, Dimitar Efremov, Fabio Malavasi
Journal: Blood (2007)

Our interest in chronic lymphocytic leukemia (CLL) derives primarily from the exploitation of human diseases as strategic models for defining the in vivo biological roles of CD38. Using this model, we showed that CD38 triggers robust proliferation/survival signals modulated through the interactions with the CD31 ligand expressed by nurse-like cells and by the stromal/endothelial components. By analyzing a cohort of 56 patients with clinically and molecularly characterized CLL, we show that (1) patients with CD38(+)/ZAP-70(+) are characterized by enhanced migration toward Stromal derived factor-1alpha (SDF-1alpha)/CXCL12; (2) CD38 ligation leads to tyrosine phosphorylation of ZAP-70, showing that these markers are functionally linked; (3) ZAP-70 represents a limiting factor for the CD38 pathway in the CLL context, as shown by studying CD38-mediated signal transduction in 26 molecularly characterized patients; and (4) the CLL subgroup of patients defined on the basis of migratory potential is marked by a specific genetic signature, with a significant number of differentially expressed genes being involved in cell-cell interactions and movement. Altogether, the results of this work provide biological evidence for why the combined analysis of CD38 and ZAP-70 expression as determined in several clinical trials results in more dependable identification of patients with CLL who have aggressive disease.
Chronic Problem Wounds
Authors: Richard A. Bomberger
Journal: JAMA (1984)

<i>Chronic Wound Problems</i>is a superb book dealing with a problem that is given little if any discussion in most surgical textbooks. It may be read in one or two evenings, and any surgeon who deals with problem wounds will find it difficult to lay down. The book is written concisely, without the redundancy seen in many multiauthored books. The initial chapters deal with the basics of wound care. In the first, on the biology of wound healing, the authors stress the importance of "myofibroblasts" in producing wound contracture and adequate, perhaps even pulsatile blood flow, in promoting wound closure. In the second chapter, on the pros and cons of dressings, one editor shows his general preference for wet-to-wet dressings, warning, however, that they may reduce tissue maceration and provide an environment in which bacteria may flourish. Other chapters deal with dressing materials and various techniques used to accelerate healing.
METABOLIC IN VIVO TISSUE CHARACTERIZATION OF REPERFUSED MYOCARDIM BY POSITRON-CT (PCT) IN A CHRONIC DOG MODEL
Authors: M. Schwaiger, H. W. Hansen, D. J. Elison, R. Keen, S. Wittmer, L. A. Yeatman, J. R. Barrio, H. R. Schelbert
Journal: Clinical Nuclear Medicine (1983)

Schwaiger, M.; Hansen, H. W.; Elison, D. J.; Keen, R.; Wittmer, S.; Yeatman, L. A.; Barrio, J. R.; Schelbert, H. R.Author Information
The Sorbitol Pathway and the Complications of Diabetes
Authors: Philip R. Steinmetz, Christine Balko, Kenneth H. Gabbay
Journal: New England Journal of Medicine (1973)

SINCE the introduction of insulin therapy 50 years ago, ketoacidosis and infections are no longer the main problems in the care of diabetic patients. Today, the diabetic patient faces the development of cataracts, retinopathy, nephropathy, neuropathy and accelerated generalized atherosclerosis. The morbidity and incapacity associated with these complications are staggering1 2 3: diabetes is a leading cause of blindness in the United States, and 60 per cent of the death certificates mentioning renal or cardiovascular disease carry an associated diagnosis of diabetes.1 Although the literature is divided on the role of good control of diabetes as a factor in reducing the . . .
Thiazide-Induced Hypercalcemia
Authors: Cristobal G. Duarte, John L. Winnacker, Kenneth L. Becker, Angelo Pace
Journal: New England Journal of Medicine (1971)

IT is now frequently recognized that thiazide diuretics can appreciably influence calcium metabolism. A decrease in urinary calcium has been related to the oral administration of chlorothiazide and hydrochlorothiazide to normal subjects, and to patients with congestive heart failure.1 Other studies have indicated that healthy subjects2 3 4 and patients with metabolic bone disease2 , 5 6 7 and with idiopathic hypercalciuria2 , 5 6 7 8 9 also respond to thiazide administration with a reduction in urinary calcium.Hypercalcemia related to thiazide administration is relatively uncommon and has usually been associated with other pathologic conditions.2 , 7 , 10 , 11 The patient described below experienced hypercalcemia on several occasions when challenged by the administration of hydrochlorothiazide. . . .
Role of gastrointestinal hormones in the response to massive resection of the small bowel.
Authors: A A D'sa, K D Buchanan
Journal: Gut (1977)

Hypersecretion of gastric acid and accelerated intestinal transit are largely unexplained consequences of massive resection of the small bowel; several postulated humoral mechanisms remain unsubstantiated. The purpose of the study was to investigate the effects of 75% resection of the distal small bowel in dogs on circulating levels of a range of gastrointestinal hormones. Basal and meal-stimulated concentrations of insulin, secretin, gastrin, pancreatic glucagon, and total glucagon-like immunoreactivity (GLI) were measured by radioimmunoassay techniques. After resection, significant depletions of basal and stimulated total GLI (p less than 0.05 -- p less than 0.001) and a significant rise of stimulated gastrin (p less than 0.05) were discovered. These hormonal alterations may produce an important imbalance of humoral influences on gastrointestinal function. It is suggested that these changes may hold a key to the aetiology of the complications of massive resection of the small bowel.
Interruption of cell-cell communication in Chinese hamster V79 cells by various alkyl glycol ethers: implications for teratogenicity.
Authors: R Loch-Caruso, J E Trosko, I A Corcos
Journal: Environmental Health Perspectives (1984)

Intercellular communication most likely plays a significant coordinating role in morphogenesis. Blockage of a specific type of intercellular communication, that mediated by gap junctions, has been proposed as a mechanism of action of some teratogens. Several glycol ethers have recently been shown to be teratogenic in laboratory animals. Because these compounds are negative in genotoxic assays, it is suggested that they may act by nongenetic, perhaps membrane-mediated mechanisms. In the present study several structurally related alkyl glycol ethers were examined for their ability to block junction-mediated intercellular communication. Interruption of intercellular communication was measured in vitro by an assay that depends on the transfer of metabolites via gap junctions, i.e., metabolic cooperation. All compounds tested--ethylene glycol (EG), ethylene glycol monomethyl ether (EGME), ethylene glycol monoethyl ether (EGEE), ethylene glycol monopropyl ether (EGPE), and ethylene glycol monobutyl ether (EGBE)--were able to block metabolic cooperation in vitro. The potencies of the compounds were inversely related to the length of the aliphatic chain, the dose required for maximum blockage increasing as the aliphatic chain shortened. Some differences in the maximum amount of blockage were detected, but these were not consistent and hence were not considered significant. Cytotoxicity, as measured by cell survival, was also related to the structure of the compound, generally increasing with increased length of the aliphatic chain. There were structurally related differences in the concentration ranges over which the compounds were effective.(ABSTRACT TRUNCATED AT 250 WORDS)
When used appropriately, NICE's traffic light system for febrile children helps clinicians make safe and appropriate decisions
Authors: M. S. Murphy, M. Baker
Journal: BMJ (2014)

Spence suggests that the traffic light system in the National Institute for Health and Care Excellence’s latest clinical guideline on feverish illness in children leads to poor clinical practice.1 2 We disagree. Fever in children is usually caused by a minor illness but can occasionally be caused by a life threatening infection. This poses a challenge for experienced and inexperienced healthcare professionals alike. Carefully considered guidance is needed.

The traffic light system identifies “red” (high risk), “amber” (intermediate risk), and “green” (low risk) symptoms and signs to help in clinical evaluation and clinical decision making. Spence believes …
A NEW SUPPOSITORY FOR THE MEDICAL AND SURGICAL TREATMENT OF THE NASAL CAVITIES.
Authors: EDWARD BAUM
Journal: JAMA (1906)

Specialists in nose and throat work, especially the former, generally desire to render the effects of applications made to the nose or throat of longer duration than is usually the case with the swab, spray, nebula, ointment, or insufflation. It is to this end that I have devoted much time and attention, the result of which I desire to submit for consideration. The shape of the nasal suppository, which I present, conforms to the nasal cavities (Figs. 1 and 2). It is an oblong, oval-shaped body. The inner surface is flat (Fig. 2); the outer one is irregular (Fig. 1). The distal end is rounded and has a handle-shaped proximal end. The outer surface approaching the turbinates is irregular, with two longitudinal oval ribs corresponding to and fitting into the meati (Fig. 3); the lower rests on the floor of the nose and adapts itself to the inferior meatus. The
The social and economic milieu of health care provision: quality, access, and cost
Authors: L. E. Jensen
Journal: JAMA (1979)

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