tbuckley/cabot-search huggingface dataset:
Dermatomyositis, Myocardial Involvement, and Carcinoid Syndrome
Authors: Dorothy Yang
Journal: JAMA (1978)

DERMATOMYOSITIS and polymyositis are diffuse inflammatory disorders of skeletal muscles that cause weakness of proximal muscle groups. When skin changes occur in addition to muscle involvement, the term "dermatomyositis" is used. Although general reference texts state that the heart can be involved in polymyositis and dermatomyositis, only six cases of myocardial involvement have been reported. Four of these six patients had well-documented pathologic changes in the myocardium.<sup>1-4</sup>Our patient had dermatomyositis with severe, diffuse myocarditis and a malignant carcinoid tumor. Malignant tumors are frequently found in patients with dermatomysitis and polymyositis, but to our knowledge, no previous cases have been reported in association with the carcinoid syndrome. <h3>Report of a Case</h3> A 48-year-old man began to experience difficulty climbing stairs and had a diffuse, erythematous rash eight years before admission. Biopsy specimens of the skin and of the deltoid and quadriceps femoris muscles showed chronic inflammation, necrosis of muscle
Ventilation strategies affect surfactant aggregate conversion in acute lung injury.
Authors: Y Ito, R A Veldhuizen, L J Yao, L A McCaig, A J Bartlett, J F Lewis
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

This study evaluated the effects of varying tidal volumes (VT) and positive end-expiratory pressure (PEEP) levels on surfactant aggregate conversion and lung function in an animal model of lung injury induced by N-nitroso-N-methylurethane. Lung-injured adult rabbits were initially ventilated using a VT of 10 ml/kg (VT10), a respiratory rate of 30 breaths/min (RR30), and a PEEP of 3.5 cm H2O. A trace dose of radiolabeled rabbit large surfactant aggregates was instilled after the onset of ventilation, and animals were then ventilated at different ventilator settings for 1 h. Ventilation strategies involving a lower VT (VT5, RR60) resulted in significantly superior oxygenation and lower surfactant aggregate conversion rates than strategies involving a higher VT ([VT10, RR30], [VT15, RR20], p < 0.05). Increasing the PEEP level to 8.0 cm H2O improved oxygenation, but it was sustained only with a low VT (VT5, RR60), and deteriorated with a high VT (VT10, RR30). Varying VT but not PEEP levels resulted in significant changes in surfactant aggregate conversion. We conclude that increased surfactant aggregate conversion resulting from suboptimal ventilation of injured lungs may play an important role in the pathophysiology of ventilation-induced lung dysfunction in acute lung injury.
Pharmacologic Principles of Cancer Treatment
Authors: Richard L. Meyer
Journal: JAMA (1983)

Dr Chabner has edited an excellent text. His objective was "to provide a comprehensive and detailed examination of the preclinical and clinical pharmacology of the anti-neoplastic drugs." He has accomplished his objective. However, the detail and sophistication of the presentations will limit his readers to the most serious students of this aspect of medical oncology. The book is divided into two sections. The first deals with the role of neoplastic drugs, chemical and cellular pharmokinetics, cell kinetics, and the late complications of chemotherapy. The second discusses specific drugs or classes of drugs. Although there is not a set pattern for each chapter that explores a drug or class of drugs, the author usually covers chemistry, mechanism of action, cellular pharmacology and metabolism, pharmokinetics, drug interactions, and toxicity of that particular agent or class of agents. Clinical studies when mentioned are kept to a whisper. The 21 chapters cover 445 pages
The Limits of Two-Year Bioassay Exposure Regimens for Identifying Chemical Carcinogens
Authors: James Huff, Michael F. Jacobson, Devra Lee Davis
Journal: Environmental Health Perspectives (2008)

Chemical carcinogenesis bioassays in animals have long been recognized and accepted as valid predictors of potential cancer hazards to humans. Most rodent bioassays begin several weeks after birth and expose animals to chemicals or other substances, including workplace and environmental pollutants, for 2 years. New findings indicate the need to extend the timing and duration of exposures used in the rodent bioassay.
Abstract IA11: Functionalization the cancer genome
Authors: Gordon B. Mills, Yiling Lu, Wai Ting Cheung, Kenneth Scott, Han Liang
Journal: Cancer Research (2012)

Abstract As we begin to implement next-generation sequencing into patient care, a central challenge will involve determining which aberrations in a given tumor represent “drivers” that determine tumor behavior versus “passengers” resultant from the inherent instability of cancer genomes. Critically even within cancer genes, many aberrations could still be passengers. Indeed, given the broad landscape of aberrations in human tumors, it is possible that genomic aberrations in a cancer gene could be hypomorphs (decreasing activity of a tumor suppressor gene), hypermorphs (increasing activity of an oncogene) or neomorphs (changing function of the protein). Neomorphs such as those engendered by mutations in IDH1 in glioma could be particularly challenging as their therapeutics liabilities are not likely to be predictable from known functions of the wild-type protein. Targeting driver aberrations should improve outcomes for patients, while targeting passenger aberrations would be without benefit and may instead result in unnecessary toxicity and delay implementation of effective therapies. It will also be critical to select the drug or drugs most likely to benefit each patient based on underlying aberrations in their own tumor. Unfortunately, there is a complete lack of practical high-throughput platforms able to identify and select optimal therapies targeting driver aberrations. We have implemented a high-throughput pipeline that consists of generation of patient tumor mutations in open reading frames (ORF) and determining the effect of shRNA, wild-type ORFs and mutant ORFs in the BAF3 IL3 dependent sensor line. Aberrations that increase cell viability and proliferation are established as stable lines. Stable lines are then probed with a chemical genomic library of tool compounds targeting critical pathways as well as through a high-throughput reverse phase protein array (RPPA) functional proteomics platform. The intersection of functional effects in the platforms identifies potential drivers and elicits their mechanistic activity and potential therapeutic liabilities. This pipeline has the potential to elicit tumor drivers and identify individualized therapeutic approaches. Citation Format: Gordon B. Mills, Yiling Lu, Wai Ting Cheung, Kenneth Scott, Han Liang. Functionalization the cancer genome [abstract]. In: Proceedings of the AACR Special Conference on Chemical Systems Biology: Assembling and Interrogating Computational Models of the Cancer Cell by Chemical Perturbations; 2012 Jun 27-30; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2012;72(13 Suppl):Abstract nr IA11.
Operator Experience and Carotid Stenting Outcomes in Medicare Beneficiaries
Authors: Brahmajee K. Nallamothu, Hitinder S. Gurm, Henry H. Ting, Philip P. Goodney, Mary A. M. Rogers, Jeptha P. Curtis, Justin B. Dimick, Eric R. Bates, Harlan M. Krumholz, John D. Birkmeyer
Journal: JAMA (2011)

Context Although the efficacy of carotid stenting has been established in clinical trials, outcomes of the procedure based on operator experience are less certain in clinical practice.Objective To assess association between outcomes and 2 measures of operator experience: annual volume and experience at the time of the procedure among new operators who first performed carotid stenting after a national coverage decision by the Centers for Medicare & Medicaid Services (CMS). Design, Setting, and PatientsObservational study using administrative data on fee-for-service Medicare beneficiaries aged 65 years or older undergoing carotid stenting between 2005 and 2007.Main Outcome Measure Thirty-day mortality stratified by very low, low, medium, and high annual operator volumes (Ͻ6, 6-11, 12-23, and Ն24 procedures per year, respectively) and treatment early vs late during a new operator's experience (1st to 11th procedure and 12th procedure or higher). ResultsDuring the study period, 24 701 procedures were performed by 2339 operators.Of these, 11 846 were performed by 1792 new operators who first performed carotid stenting after the CMS national coverage decision.Overall, 30-day mortality was 1.9% (n= 461) and rate of failure to use an embolic protection device was 4.8% (n= 1173) .The median annual operator volume among Medicare beneficiaries was 3.0 per year (interquartile range, 1.4-6.5)and 11.6% of operators performed 12 or more procedures per year during the study period.Observed 30-day mortality was higher among patients treated by operators with lower annual volumes (2.5% [95% CI, 2.1%-2.9%],1.9% [95% CI, 1.6%-2.3%],1.6% [95% CI, 1.3%-1.9%],and 1.4% [95% CI, 1.1%-1.7%]across the 4 categories; PϽ.001) and among patients treated early (2.3%; 95% CI, 2.0%-2.7%)vs late (1.4%; 95% CI, 1.1%-1.9%;PϽ.001) during a new operator's experience.After multivariable adjustment, patients treated by very low-volume operators had a higher risk of 30-day mortality compared with patients treated by high-volume operators (adjusted odds ratio, 1.9; 95% CI, 1.4-2.7;PϽ.001).Similarly, we found a higher risk of 30-day mortality in patients treated early vs late during a new operator's experience (adjusted odds ratio, 1.7; 95% CI, 1.2-2.4;P=.001).Conclusion Among older patients undergoing carotid stenting, lower annual operator volume and early experience are associated with increased 30-day mortality.
Thyroid Cancer Due to X-ray Treatment of Acne
Authors: Ervin Epstein
Journal: JAMA (1969)

To the Editor:—  The scare propaganda regarding x-ray therapy has interfered with the proper therapeutic application of that modality in cutaneous derangements. One of the avered dangers is the possibility that an epithelioma of the skin may develop despite the fact that the x-ray therapy which the patient received was insufficient to cause a radiodermatitis. However, these statements are based on case reports and not on statistical evidence. Statistics previously reported indicate that cancer develops only after excessive administration of ionizing radiation.1More recently, publications have appeared claiming that x-ray therapy for acne has caused an increase in thyroid cancer in the young.2These articles are uncritical. The number of cases reported are small. The dosage to the skin, and especially the thyroid, is seldom, if ever, mentioned. Some of the patients included in these series did not even receive x-ray therapy. It has been pointed out that
Prognostic role of micrometastases in sentinel lymph node in patients with invasive breast cancer
Authors: Francesca Rovera, Anna Fachinetti, Stefano Rausei, Corrado Chiappa, Matteo Lavazza, Veronica Arlant, Marina Marelli, Luigi Boni, Gianlorenzo Dionigi, Renzo Dionigi
Journal: International Journal of Surgery (2013)
DESENSITIZATION TO INSULIN ALLERGY
Authors: Leona M. Bayer
Journal: JAMA (1934)

This is the report of a case in which increasingly severe constitutional reactions to insulin were shown, which largely subsided after an intensive course of desensitization. There being a growing recognition of the occurrence of insulin allergy, and the constitutional type of reaction being more difficult to control than the local wheal, it was thought that an account might be of practical interest. The literature on the subject is by this time quite extensive, although there appear to be only some ten cases of generalized reaction on record. Three articles, in English,<sup>1</sup>French<sup>2</sup>and German,<sup>3</sup>respectively, cover the subject to date and among them list a large bibliography. <h3>REPORT OF CASE</h3> Mrs. H. S., aged 48, came of a family in which diabetes developed in the mother and each of three siblings between the ages of 35 and 54. Her own involvement manifested itself at the age
The circulation of the small bowel mucosa.
Authors: O Lundgren
Journal: Gut (1974)

Progress reportThe circulation of the small bowel mucosa Absorption, secretion and motility, the three major functions of the small intestine, are localized in different parts of the intestinal wall and have nutritional demands of different magnitudes.'Active' absorption across the intestinal epithelium and secretion which, according to the classical concepts, occurs mainly in the crypts, are processes consuming considerable amounts of oxygen.The motility of the muscularis, on the other hand, requires compara- tively little oxygen.It is generally believed that the magnitude of the blood supply to a tissue is closely adjusted to its current demand for oxygen and that regulatory mechanisms exist which increase blood flow to an organ in situations of enhanced metabolism1.It seems therefore reasonable to assume that blood flow is unevenly distributed within the intestinal wall.Moreover, changes in flow may only occur in a certain wall layer, eg, a vasodilatation may be restricted to the muscularis during intestinal motility.From the discussion above it seems clear that it would be interesting to be able to study, eg, mucosal blood flow separately.However, few investiga- tions have until recently been devoted to the study of intestinal intramural flow distribution.One aim of this article is to summarize the recent progress in this field and to discuss the relationship between villous blood flow and intestinal absorption. Methods for Measuring Intestinal Flow DistributionDuring the last two decades some attempts have been made to quantify the intestinal flow distribution in experimental animals using different tracer techniques.In the early studies water-soluble compounds, such as 86Rb, were injected intravascularly and the amount of tracer in the different wall layers was determined and taken as a measure of flow distribution2,3'4'5.Apart from the disadvantage that only one experiment could be performed on each animal, it seems unlikely that the tissue uptake of lipid-insoluble compounds is limited by flow, since only a small fraction of the total capillary surface area is available for the exchange of water-soluble compounds6.In this laboratory two techniques have been developed for the study of intestinal flow distribution.In one an inert lipophilic gas, 85Kr, dissolved in saline, was injected intraarterially as a slug7'8.The disappearance of the radioactive gas from the small bowel was followed by a-and/or ,B-radiation detectors.The disappearance curve recorded with a scintillation detector was as expected multiexponential, reflecting the heterogenity of flow within the intestinal tissue, and the curve could be resolved into four components.Using a number of independent techniques it was possible to demonstrate that each component mainly reflected the washout from a certain intestinal wall layer.The second method, based on the indicator-dilution principle, 1005on July 12,
Clinical Decision Making: From Theory to Practice
Authors: Prentiss Taylor
Journal: JAMA (1996)

This book collects the famous series of<i>JAMA</i>essays by David Eddy, MD, PhD, published in the early 1990s, updates some of them, and adds to them. The 31 essays were published between 1982 and 1994 (three are reprinted from the<i>New England Journal of Medicine, Health Affairs</i>, and<i>the Bulletin of the American College of Surgeons</i>). Eddy tackles such issues as writing practice guidelines and practicing under those guidelines, evaluating guidelines, physician uncertainty, evidence-based medicine, balancing quality and cost, rationing, and the responsibilities of managed care organizations and physician societies. Eddy, who has been surgeon, engineer, professor at Stanford and Duke University Medical Schools, software inventor, and consultant to the managed care industry, is a boldly original health thinker. It is evident that he, unlike some other ethicists and policymakers, has seen quite a few patients in the course of his distinguished career. The book will be of
Effect of supranormal coronary blood flow on energy metabolism and systolic function of porcine left ventricle
Authors: G. G Schwartz, S. Schaefer, S. D Trocha, J. Garcia, S. Steinman, B. M Massie, M. W Weiner
Journal: Cardiovascular Research (1992)

Objective: The goal was to determine if supranormal coronary blood flow increases myocardial oxygen consumption, high energy phosphate levels, and systolic function in the in situ autoperfused heart. Methods: Thirteen anaesthetised open chest pigs with an intact, autoperfused coronary circulation, weight 30-40 kg, were studied. Measurements were made under basal conditions and during regional hyperperfusion of the anterior left ventricle produced by intracoronary infusion of adenosine (mean dose 3.3 μmol·min−1). Doppler coronary blood flow velocity in the anterior descending coronary artery, arterial and anterior interventricular venous blood oxygen content, high energy phosphates (by transmurally localised 31P NMR), and myocardial wall thickening (by sonomicrometry) were measured. Results: With adenosine, coronary flow was increased to 355(SEM 59)% of control. Supranormal coronary flow produced no significant changes in anterior left ventricular oxygen consumption [99(12)% of control]. 31P NMR spectroscopy revealed no significant changes in the peak intensities of phosphocreatine or ATP in either the subendocardium or subepicardium (90-97% of control). Systolic anterior left ventricular wall thickening also did not change [107(13)% of control]. Conclusions: Supranormal coronary flow does not augment myocardial oxygen consumption, high energy phosphates, or systolic function in the in situ autoperfused heart. Myocardial oxygen delivery does not limit oxidative metabolism under normal conditions. Cardiovascular Research 1992;26:1001–1006
Ventricular Septal Defect with Aortic Regurgitation
Authors: ALEXANDER S. NADAS, OTTO G. THILENIUS, C. GRANT LAFARGE, ANNA J. HAUCK
Journal: Circulation (1964)

Thirty-four patients with ventricular septal defect and aortic regurgitation, representing less than 5 per cent of our patients with ventricular septal defect, are discussed. A loud, systolic murmur, characteristic of ventricular septal defect, is noted during infancy, whereas evidences of aortic regurgitation (protodiastolic murmur and wide pulse pressure) does not usually appear until sometime between 2 and 10 years of age. Clinical and catheterization data indicate that the principal hemodynamic load is aortic regurgitation, whereas the ventricular septal defect does not usually result in a large pulmonary blood flow or high pulmonary arterial pressure. In about 50 per cent of the patients, a significant pressure gradient across the right ventricular outflow tract exists. Detailed pathologic studies indicate that the ventricular septal defects are high and anterior and encroach to a greater or lesser degree on the membranous bulbar septum. The right coronary cusp is the one most severely involved, and, by its prolapse, causes aortic regurgitation; the noncoronary cusp is always less severely affected. The anatomic basis of the pressure gradient observed across the right ventricular outflow tract is not always clear.
The Role of Tt Virus Infection in Acute Viral Hepatitis
Authors: Tatsuo Kanda, Osamu Yokosuka, Tetsu Ikeuchi, Toshikatsu Seta, Shigenobu Kawai, Fumio Imazeki, Hiromitsu Saisho
Journal: Hepatology (1999)

Recently, transfusion-transmitted virus (TTV) was discovered to be a potential causative agent for non-A-E hepatitis. Little is known about the relation between TTV and the clinical courses of various types of acute viral hepatitis. One hundred twenty-five patients with acute viral hepatitis who were admitted to the Chiba University Hospital between 1984 and 1998 and 100 persons with normal liver function tests were tested for the presence of TTV in their sera. Serum samples were tested for TTV DNA and genotype by polymerase chain reaction (PCR). TTV DNA was detected in 15 of 35 patients (43%) with non-A-E hepatitis, 14 of 33 patients (42%) with hepatitis C, 8 of 28 patients (29%) with hepatitis A, 7 of 29 patients (24%) with hepatitis B, and 37 of 100 subjects with normal liver function tests (37%). The detection rate did not differ statistically between non-A-E hepatitis and hepatitis A, B, C, or controls. The distribution of TTV genotypes was similar in non-A-E, A, B, C types, and controls. The clinical characteristics of the acute illnesses were similar for patients with or without TTV in hepatitis non-A-E, A, B, or C. Although TTV was detected frequently in non-A-E acute hepatitis, no etiologic role for TTV could be established.
Electrohydraulic lithotripsy of the common bile duct stone under transnasal direct cholangioscopy
Authors: A. Mori, K. Sakai, N. Ohashi, T. Maruyama, H. Tatebe, T. Shibuya, H. Inoue, M. Okuno
Journal: Endoscopy (2008)

Electrohydraulic lithotripsy (EHL) has been recognized as a useful technique for the removal of choledocholithiasis, which is usually performed under the control of a peroral ”mother-baby” cholangioscopic system or percutaneous transhepatic choledochoscopy [1] [2]. However, the method may be disadvantageous due to its complicated procedure. Recently, the use of an ultraslim endoscope to direct cholangioscopy [3] as well as endoscopic retrograde cholangiopancreatography [4] [5] has been reported. Here, we report on a novel technique of EHL under the control of direct cholangioscopy using an ultrathin scope.
391 IgE, IgE-containing circulating immune complexes (IgE-CIC) IgE-rheumatoid factor (RF) and skin IgE-deposition in rheumatoid arthritis (RA) patients (pts)
Authors: L DECLERCK, M WESTEDT, A CATS, B VERMEER, E WELTEVREDEN, C BRIDTS, W STEVENS
Journal: Journal of Allergy and Clinical Immunology (1985)
Role of adenosine in coronary blood flow regulation after reductions in perfusion pressure.
Authors: W P Dole, N Yamada, V S Bishop, R A Olsson
Journal: Circulation Research (1985)

We employed intracoronary infusion of adenosine deaminase to test the hypothesis that endogenous adenosine contributes to regulation of coronary blood flow following acute reductions in coronary artery pressure. In 16 closed-chest anesthetized dogs, we perfused the left circumflex coronary artery from a pressurized arterial reservoir and measured coronary blood flow following changes in perfusion pressure before and 10 minutes after the start of intracoronary adenosine deaminase, 5 U/min per kg body weight. Parallel studies showed that this dose of enzyme resulted in cardiac lymph adenosine deaminase concentrations of 3.2 +/- 0.4 U/ml. Adenosine deaminase abolished the vasodilator response to intracoronary adenosine, 4 and 8 micrograms, but had no effect on the vasodilator response to intracoronary papaverine, 200 and 300 micrograms, demonstrating enzyme efficacy and specificity. Additional experiments demonstrated that adenosine deaminase reversibly attenuated myocardial reactive hyperemia following 5- and 10-second coronary occlusions by 30% (P less than 0.05), evidence that the infused enzyme effectively degraded endogenous adenosine. However, adenosine deaminase did not alter the time course for coronary autoregulation or the steady state autoregulatory flow response over the pressure range between 125 and 75 mm Hg. Further, adenosine deaminase did not alter steady state coronary flow when perfusion pressure was reduced below the range for effective autoregulation (60-40 mm Hg). Such results show that adenosine is not essential for either coronary autoregulation or for the maintenance of coronary vasodilation when autoregulatory vasodilator reserve is expended.