tbuckley/cabot-search huggingface dataset:
Bradykinin Mediation of Ca <sup>2+</sup> -Activated K <sup>+</sup> Channels Regulates Coronary Blood Flow in Ischemic Myocardium
Authors: Koichi Node, Masafumi Kitakaze, Hiroaki Kosaka, Tetsuo Minamino, Masatsugu Hori
Journal: Circulation (1997)

Background Endothelium-dependent hyperpolarizing factor relaxes vascular smooth muscles by opening the Ca 2+ -activated K + (K Ca ) channels. The role of the opening of K Ca channels in coronary vasodilation during myocardial ischemia was investigated. Methods and Results The left anterior descending coronary arteries of open-chest dogs were perfused with blood through an extracorporeal bypass tube from the carotid artery. Intracoronary administration of bradykinin increased coronary blood flow (CBF) in dogs treated with N G -nitro- l -arginine methyl ester (L-NAME), an inhibitor of nitric oxide synthase; this effect was completely inhibited by the K Ca channel blocker iberiotoxin. In dogs treated with L-NAME, the bypass tube was occluded to reduce CBF to one third of the baseline value, after which coronary perfusion pressure was maintained constant. Intracoronary administration of iberiotoxin for 20 minutes further decreased CBF (from 33±2 to 19±2 mL·100 g −1 ·min −1 , P &lt;.01), fractional shortening, and lactate extraction ratio during coronary hypoperfusion. Bradykinin was released, and the bradykinin receptor antagonist HOE-140 blocked the effects of iberiotoxin on coronary hemodynamic and metabolic parameters during myocardial ischemia. Although the combination of L-NAME and the adenosine receptor antagonist 8-sulfophenyltheophylline reduced reactive hyperemic flow after 20 seconds of coronary occlusion, the additional presence of iberiotoxin resulted in a further decrease in this parameter. Conclusions The opening of K Ca channels in response to endogenous bradykinin contributed to coronary vasodilation and reduced contractile and metabolic dysfunction during myocardial ischemia in open-chest dogs.
Interventional oncology for older patients with liver and kidney malignancies.
Authors: Lorenzo Monfardini, Franco Orsi, Guido Bonomo, Paolo Della Vigna, Silvio Monfardini
Journal: Journal of Clinical Oncology (2012)

e14607 Background: Less invasive procedures, such as those provided by interventional oncology are often offered to older patients(pts) believing that the benefits outweigh the drawbacks for non-fit vulnerable older pts, but reports in the English literature are very few. The purpose of this study was then to provide information on results and complications of interventional oncology procedures in pts with liver and kidney cancer older than 70 years ,analysing the incidence of complications, loco regional responses and duration of hospital staying and to compare these findings with those of pts younger than 70. Methods: Prospectively collected data on all pts that underwent liver bland arterial embolisation (BAE) with or without radiofrequency ablation and kidney radiofrequency ablation (RFA) at the Interventional Radiology Unit of the European Institute of Oncology, were analyzed comparing incidence of complications, loco regional responses and duration of hospital staying for pts older and younger than 70 years. Results: From April 2007 to March 2011 163 pts (109 males and 54 females) , 66 (40.5 %) older and 97 ( 59.9 %) younger than 70 years were treated with interventional oncology procedures. Of these 56 had an hepatocarcinoma,76 liver metastases and 31 a kidney cancer. The ASA score was homogeneously distributed in older and younger patients. The overall complication rate in patients older than 70 was 4.5 % (3/66) and in younger 3,1 % (3/97), without a significant difference (p=0.69). In pts older than 70 years mean hospitalization was 2.3 nights (36 were inpts for 2 nights, 8 for 3 and 3 for 4) while in the 81 younger pts the mean hospitalization was 2.2 nights (67 were inpts for 2 nights, 12 for 3 and 2 for 4). Objective response rates were 52.8% in older versus 46.3% in younger pts (p=0.55). Conclusions: Our study has confirmed thatliver BAE even followed by RFA and renal RFA in older liver and renal cancer pts are as safe and effective as in younger ones. Age alone should then not be considered as a risk factor in selected older pts.
ON A NEW TYPE OF NEURASTHENIC DISORDER—ANGIO—PARALYTIC OR "PULSATING" NEURASTHENIA.
Authors: CHARLES L. DANA
Journal: JAMA (1895)

The present tendency to analysis and differentiation of clinical types is a helpful one. It may at first sight seem to encumber our nosology needlessly, but the final result is to secure a better comprehension of disease, its cause and its treatment, as well as to lead eventually to simpler classifications. This fact has been well illustrated in the history of neurology. I feel sure that the differentiation of a good many types of neurasthenic disorder will eventually be made and that this, if carefully done, will help to remove the indefiniteness at present suggested to our minds by the word. Such is my apology for attempting to describe a new type of neurasthenic disorder now. I have had six patients who all presented very distinct and peculiar symptoms. Coming to me at varying intervals I have been struck with the similarity of their symptoms. It justifies me in claiming
Quality and Quantity in Medical Education
Authors: Henry R. Mason
Journal: JAMA (1971)

About 60 years ago, there was published bulletin 4 of the Carnegie Foundation for the Advancement of Teaching entitled<i>Medical Education in the United States and Canada</i>. This book by Abraham Flexner, which came to be known as the "Flexner Report," described a study of the medical schools in the United States and Canada by the Carnegie Foundation, a study for which the American Medical Association was largely responsible. This report was followed by tremendous changes in medical education, to the great benefit of the public. These changes recognized primarily the need for medical practitioners to have substantial grounding in the biomedical sciences. Eventually, the quality of medical schools in the United States and Canada reached a level which, with respect to both the advancement of medical science and the training of physicians, is not exceeded, if indeed equalled, any place in the world. While the ascendancy of the Flexner
Modified Electrocoagulation and Its Possibilities in the Control of Gastrointestinal Bleeding
Authors: W. Matek, P. Frühmorgen, B. Kaduk, H.-D. Reidenbach, F. Bodem, L. Demling
Journal: Endoscopy (1979)

In acute experiments in the stomach of dogs electrocoagulation with simultaneous instillation of water (EHT-electrode i.e. electro-hydro-thermo-electrode) proved the most effective electrocoagulation method for controlling standardized bleeding: Optimal visibility at the bleeding site, extension of the therapeutic range as well as the avoidance of charring at the bleeding site are its major advantages. Disturbing adhesion of coagulated material on the electrode is also avoided. The electro-hydro-thermo-electrode is a cheap and portable means of controlling bleeding.
Malignant Bileaflet Mitral Valve Prolapse Syndrome in Patients With Otherwise Idiopathic Out-of-Hospital Cardiac Arrest
Authors: Chenni S. Sriram, Faisal F. Syed, M. Eric Ferguson, Jonathan N. Johnson, Maurice Enriquez-Sarano, Frank Cetta, Bryan C. Cannon, Samuel J. Asirvatham, Michael J. Ackerman
Journal: Journal of the American College of Cardiology (2013)
Serum immunoglobulin free light chain measurements and heavy chain isotype usage provide insight into disease biology in patients with POEMS syndrome
Authors: Trista Stankowski-Drengler, Morie A. Gertz, Jerry A Katzmann, Martha Q. Lacy, Shaji Kumar, Nelson Leung, Suzanne R. Hayman, Francis Buadi, Robert A. Kyle, S. Vincent Rajkumar, Angela Dispenzieri
Journal: American Journal of Hematology (2010)

POEMS (polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, skin changes) syndrome is a rare paraneoplastic syndrome in which nearly all patients have a monoclonal lambda restricted plasma cell disorder. We investigated whether patients with POEMS have abnormal serum immunoglobulin free light chain (FLC) ratios. Fifty patients with newly diagnosed POEMS syndrome were assessed. Cystatin C levels were measured to discern whether subclinical renal insufficiency could account for FLC elevations in the presence of a normal FLC ratio. Forty-five patients (90%) had elevated lambda FLC; however, only nine (18%) had abnormal FLC ratios. The rise in serum FLC of POEMS patients appeared to be multifactorial-both a function of subclinical renal insufficiency and polyclonal activation of medullary and extramedullary plasma cells. Those patients expressing a clonal IgA were more likely to have clonal plasmacytosis observed on iliac crest biopsy than those with IgG. In summary, serum immunoglobulin profiles are unique in POEMS syndrome as compared with other plasma cell disorders.
Influence of Intimal Thickening on Coronary Blood Flow Responses in Orthotopic Heart Transplant Recipients
Authors: Eugene A. Caracciolo, Thomas L. Wolford, R. Dent Underwood, Thomas J. Donohue, Richard G. Bach, Leslie W. Miller, Morton J. Kern
Journal: Circulation (1995)

Background Intravascular ultrasound imaging detects epicardial intimal thickening in the majority of heart transplant recipients with angiographically normal epicardial coronary arteries. Although coronary artery vasoreactivity is abnormal after cardiac transplantation, intimal thickening does not appear to affect conduit vessel responses. However, the effect of intimal thickening on both conduit and resistance vessel responses, as measured by changes in volumetric coronary blood flow (CBF), is unknown. Methods and Results Epicardial coronary artery conductance and microvascular resistance vessel responses were studied after intracoronary adenosine and nitroglycerin administration in 36 orthotopic heart transplant recipients 1 month to 7 years after transplantation. Sequentially measured coronary flow average peak velocity ([APV, cm/s] 0.018 in Doppler guide wire) and epicardial luminal cross-sectional area ([CSA, mm 2 ] 4.3F 30-MHz ultrasound catheter) data were obtained at baseline and during peak hyperemia after administration of 12 to 18 μg IC adenosine and 150 to 200 μg IC nitroglycerin. Volumetric CBF (mL/min) was calculated as CBF=APV (cm/s)×CSA (mm 2 )×60 seconds/1 min×1 cm 2 /100 mm 2 ×0.5. Measurements were made from a discrete position in the proximal left anterior descending (LAD) artery (n=22), mid-LAD artery (n=7), proximal circumflex artery (n=6), and proximal right coronary artery (n=1). Intimal thickening was present in 19 of 32 patients (60%). Both adenosine and nitroglycerin increased APV (from 18.9±4.9 to 56.0±11.5 cm/s for adenosine and from 20.2±5.3 to 49.1±11.5 cm/s for nitroglycerin; both P &lt;.05). Coronary flow velocity reserve was significantly higher for adenosine compared with nitroglycerin (3.1±0.6 versus 2.5±0.7, respectively; P &lt;.001). Epicardial luminal CSA was unchanged during adenosine hyperemia compared with baseline (17.4±3.8 versus 17.3±4.0 mm 2 , respectively; P =NS) but was significantly greater during nitroglycerin hyperemia compared with baseline (18.7±3.8 versus 17.3±4.0 mm 2 , 6.2±3.6% change; P &lt;.05). Baseline CBF was similar before drug administration. Hyperemic adenosine and nitroglycerin CBF responses (297±99 and 276±87 mL/min, respectively; P =NS) and CBF reserve (3.0±0.7 and 2.7±0.7, respectively; P =NS) were not significantly different. Importantly, intimal thickening did not diminish resting or hyperemic APV, coronary flow velocity reserve, luminal CSA, CBF, or CBF reserve responses. Conclusions In this study of angiographically normal heart transplant recipients, epicardial intimal thickening does not diminish conduit and resistance vessel responses during endothelial-independent vasodilator administration.
Introduction: Innovation Forum
Authors: R. Lambert, T. Rösch
Journal: Endoscopy (2004)

The aim of the Innovation Forum is to present new and special techniques that are at various stages of development, ranging from animal experiments to case series at single centers in which the technique was developed. The diagnostic and therapeutic techniques presented share the common features in that they offer interesting and challenging approaches and that they have not reached the status of being fully clinically assessed. They are not yet state-of-the-art techniques in certain clinical situations, but may well become so in the future.
Children with myelomeningocele
Authors: P. Robson, D. Scrutton
Journal: BMJ (1967)

M&U=Jou1its therapeutic effectiveness in rheumatic fever and rheumatoid arthritis.In these conditions a high concentration of salicylate in the blood must be maintained.This can be accomplished by either sodium salicylate or aspirin.The latter is completely hydrolysed in a few hours after ingestion, and thus furnishes salicylate ions.There is no evi- dence that aspirin itself has any anti- inflammatory action.Since large doses of aspirin may induce gastrointestinal bleeding, even in patients with no evidence of a bleed- ing disease, it seems logical to use sodium salicylate to maintain a high level of salicylate in the blood.Recent studies in my laboratory indicate that this drug, unlike aspirin, does not cause the diapedetic or mucous mem- brane bleeding.-Iam, etc.,
Pseudomembranes in a patient with flare-up of inflammatory bowel disease (IBD): Is it only<i>Clostridium difficile</i>or is it still an IBD exacerbation?
Authors: T. Berdichevski, I. Barshack, S. Bar-Meir, S. Ben-Horin
Journal: Endoscopy (2010)

A 60-year-old man with Crohn colitis controlled with mesalamine was hospitalized for fever, bloody diarrhea, and lower abdominal pain. Two weeks of empiric treatment with metronidazole, ofloxacin, and oral steroids did not result in significant improvement. Sigmoidoscopy revealed inflamed mucosa covered by white membranes, compatible with pseudomembranous colitis ([Fig. 1]); a stool sample was positive for Clostridium difficile toxin.
Amyloid β and Alzheimer disease therapeutics: the devil may be in the details
Authors: John R. Cirrito, David M. Holtzman
Journal: Journal of Clinical Investigation (2003)

Alzheimer disease (AD) is characterized by the progressive accumulation of amyloid β protein (Aβ) in areas of the brain serving cognitive functions such as memory and language. The first of two separate reports (see the related articles beginning on pages 415 and 440) reveals that intrinsic T cell reactivity to the self-antigen Aβ exists in many humans and increases with age. This finding has implications for the design of Aβ vaccines. The second report demonstrates that a number of FDA- approved nonsteroidal anti-inflammatory drugs are capable of lowering Aβ levels in mice. The work suggests that further testing of the therapeutic utility of these types of compounds for the potential treatment of AD is warranted.
THE DRUG TREATMENT OF SPASMODIC RHINORRHOEA
Authors: W. M. Mollison
Journal: BMJ (1929)

DRUG TREATMENT OF SA'A1l)UJLC RHINORRHOEA.aind oxvgen, te paiiis a-re conitrolled, aiid tearinig of the perineumi is avolided.I am quite CoiivinCCed in my owni iiiind that anyone wh-1o las seeni a labouir conlducted Iunlder gas anid oxygenl anial- g,esia, with a brief period of ana.esthesia for' thie actual ;)irth, will never willingly give anyvthing else.The i1meth1od is conmparatively new in th1is country, anid it mway take years to developl and spread, blut I feel suIr that bv its a(do)tion a cer1taini i1ll1nuber of lives-both of mnothers anld chiidien-w\ould he saved.This is a poinit of par.amountimportanlce, an)]d on1e that I anm cer1tain1 will appeal greatly to everyone wl-ho hias thle welfare of womiieni in childbirth at hicart.
MEDICAL ASSOCIATIONS AND IDEALS.
Authors: J. N. HALL
Journal: JAMA (1896)

In retiring from the chair I wish to thank the members of this society, for myself and my brother officers, for the cordial support which has been accorded us during the year. As the custom of the society requires that the President shall make some remarks upon laying down the gavel, I shall ask you to consider with me the relations of physicians to medical societies, their duties toward them and the advantages to be derived from membership in them. The function of the medical school is to teach anatomy, pathology, medicine and surgery, and the other branches which go to make up a physician's education. But the graduate, with this knowledge, is not all that a physician should be, for there are many things yet for him to learn before he can become a polished member of the profession. Where the medical school leaves off the medical society should
PERIPHERAL VASCULAR FUNCTION MAY BE A PREDICTOR OF EXERCISE PERFORMANCE IN FONTAN-PALLIATED PATIENTS
Authors: Bryan H. Goldstein, Jessica R. Golbus, Angela M. Sandelin, Nicole Warnke, Lindsay Gooding, Karen K. King, Janet E. Donohue, James G. Gurney, Caren S. Goldberg, Albert P. Rocchini, John R. Charpie
Journal: Journal of the American College of Cardiology (2011)
Female Development — All by Default?
Authors: Ieuan A. Hughes
Journal: New England Journal of Medicine (2004)

It has been an indisputable fact that the constitutive sex in mammalian fetal development is female. Furthermore, a functioning ovary is not required for the female phenotype, whereas a testis is mandatory for male development. More than 50 years after Jost performed experiments in rabbit embryos in which castration was followed by testis engraftment, his observations remain a beacon of clarity illuminating the mechanism of fetal sexual differentiation — the physical phenotype consistent with male or female sex.1 Another indisputable fact of mammalian fetal sexual development is the morphogenesis of a bipotential gonad in the genital ridge, dual internal genital . . .
Pure Terebene in the Treatment of Winter-Cough
Authors: C. W. Suckling
Journal: BMJ (1886)

Heemorrhage is not a very common symptom of tubal occlusion and distension, but, when present, is apt to be severe, and, when accom- panied by signs so nearly resembling nodular myoma of the uterus, may be specially misleading.I operated on a case presenting these features on December 10th of'last year.Excessive menstruation had
Childhood Malignancy: The Psychosocial Care of the Child and His Family
Authors: Margaret P. Sullivan
Journal: JAMA (1980)

The author has prepared a most useful "how-to" book for medical students, house officers, pediatric oncologists, pediatric oncology nurses, and administrators. Dr Adams describes clearly the organization and function of mental health services for a pediatric oncology unit, including the role of each participant. More important for those concerned with patient care, and thus with family care, Dr Adams sympathetically describes in detail the psychological impact on the patient and family of the diagnosis of cancer and the various phases of cure achievement and disease progression. A 5 1/3-page table entitled "Childhood Leukemia: An Example of an Illness Cycle," correlates observations concerning families, family responses, and child responses, providing extremely useful insights, particularly for newcomers to pediatric oncology. This table together with the author's discussions of coping mechanisms should help staff members to understand and tolerate repetitious questions, forgotten discussions, and searches for other information, including that related to unorthodox
Reply to Polat and colleagues
Authors: Tom Treasure, John Pepper
Journal: Journal of the Royal Society of Medicine (2010)

Polat and colleagues pose key questions about our study and the future of bespoke external aortic root support (EARS). The 66 patients excluded from analysis did not match prespecified criteria, namely a first-time, elective, aortic root operation, in the same time frame and setting. The 28 patients used for comparison had similar intraoperative myocardial ischaemic, cardiopulmonary bypass, and circulatory arrest exposure as 254 root replacements in Polat's experience.1 We have shown that EARS obviates these potentially harmful, but necessary, surgical adjuncts to root replacement.2

Will EARS prevent aortic dissection within the supported segment? Our expectation is that it will reduce both the risk of dissection and, should it occur, the severity of its consequences. We have already shown that EARS holds the supported aortic segment at, or smaller than, its preoperative size.3 The dimensions across the three aortic sinuses were measured on duplicate magnetic resonance images of 37 non-operated Marfan patients and before and after (>1 year) images of the first 10 EARS patients. The 96 images were presented in random sequence to a radiologist blind to their identity and to the hypothesis. The stability of the external support, predicted from the characteristics of the material and the engineered design, was confirmed.3 We agree that there is no threshold aortic root size that precludes dissection4-6 but the risk is size-related and is the reason expansion is monitored.7

There are benefits other than avoidance of warfarin, but being spared anticoagulation is valued by patients.8 The wider question is whether EARS will prove a better option overall than total root replacement. This we need to establish but wrapping the aorta with graft material9 (an approach largely abandoned) cannot be equated with EARS precisely modelled to intimately follow the contours of the aorta.3
ORAL METOLAZONE PLUS FRUSEMIDE FOR HOME THERAPY IN PATIENTS WITH REFRACTORY HEART FAILURE
Authors: DanJ. Aravot, NicholasR. Banner, Francesco Musumeci, Melissa Fitzgerald, Brendan Madden, Asghar Khaghani, MagdiH. Yacoub, J.S. Friedland, J.G.G. Ledingham
Journal: The Lancet (1989)
The Corpuscles: Adventurers in Inner-Space
Authors: Ruth Andrea Seeler
Journal: JAMA (1990)

This is a child's storybook of the adventures of various types of blood cells through the circulation and in fighting an infection. As such, it is an imaginative introduction to the workings of the various components of the blood as well as the circulation. It is probably as much fun for the parent health care worker as it is entertaining and educational for the child. The "story" is how the body responds when a child gets a splinter in her finger, which becomes infected. The concepts include bone marrow serving as the source; the roles of the heart, spleen, arteries, and veins; transmission of pain; and the various messengers that draw white blood cells to the source of infection. For example, in the illustration on page 13, prostaglandin molecules are personified as "messengers." Although there is a glossary on the back cover, the concepts are probably not easily understood by
Siblings, daycare, and culture-confirmed viral respiratory infections in the first year of life
Authors: K.A. Roberg, C. Tisler, K. Carlson-Dakes, E. Anderson, D. DaSilva, Z. Li, C. Kirk, P. Shult, R. Gangnon, J. Gern, R. Lemanske
Journal: Journal of Allergy and Clinical Immunology (2003)