tbuckley/cabot-search huggingface dataset:
Abstract 4655: Retrograde Ethanol Infusion in the Vein of Marshall for Ablation of Atrial Fibrillation: Tissue Ablation, Effects on Regional Vagal Innervation and First Human Experience
Authors: Miguel Valderrábano, Harvey R Chen, Jasvinder S Sidhu, Liyun Rao, Yuesheng Ling, Dirar S Khoury
Journal: Circulation (2008)

The vein of Marshall (VOM) is an attractive target during ablation of atrial fibrillation due to its autonomic innervation and its location anterior to the left pulmonary veins and drainage in the coronary sinus. We studied 14 dogs. A coronary sinus venogram showed a VOM in 10, which was successfully cannulated with an angioplasty wire and a 2 mm balloon. In 5 dogs, electroanatomical (Carto) maps of the left atrium were performed at baseline and after ethanol (100%, 4 – 8 cc) was infused in the VOM, which demonstrated the creation of a new crescent-shaped scar in the left atrium, extending from the annular left atrium towards the posterior wall and left pulmonary veins. In 4 dogs, both cervical vagal trunks were isolated in the carotid sheath and cuff stimulation electrodes were attached to them. Effective refractory periods (ERP) were measured in 3 sites of the left atrium, before and after high-frequency bilateral vagal stimulation. The baseline ERP was 113.6±35.0 ms, and decreased to 82.2±25.4 ms (p&lt;0.05) after vagal stimulation. After alcohol infusion in VOM, vagally-mediated ERP decrease was eliminated (from 108±27.2 ms to 95.6 ±16.7ms, p=NS). This elimination of vagal effects was not uniform and was limited in sites in proximity with the VOM (baseline ERP 105±18.7ms vs post vagal 98.±37.6ms, p=NS, as opposed to 106.7±27.1ms vs post vagal 73.3±19.7ms, p&lt;0.05, in sites remote to VOM). We also tested feasibility of VOM alcohol infusion in humans: 2 patients undergoing pulmonary vein antral isolation had successful VOM cannulation: left atrial voltage maps demonstrated new scar involving the infero-posterior left atrial wall extending towards the left pulmonary veins. Retrograde alcohol infusion in the VOM achieves significant left atrial tissue ablation, abolishes local vagal responses and is feasible in humans.
Targets are suggestions to be modified
Authors: S. C Jones, S. M Marshall
Journal: BMJ (1995)

EDITOR,--In presenting the results of their audit of glycaemic control in the diabetic population of South Glamorgan, Chris Butler and colleagues report yearly recording of glycated haemoglobin in 76% of an estimated 70% of the total diabetic population. Mean haemoglobin A1c concentrations were 10.5% and 10.0%, depending on the assay used.1 Although the paper's title refers to a comparison between …
Abstract 11321: Very Late Vascular Response After Bare Metal Stent Implantation in Human Coronary Arteries
Authors: Katsumi Inoue, Masao Imai, Kyohei Yamaji, Kenji Ando, Masakiyo Nobuyoshi, Takeshi Kimura
Journal: Circulation (2014)

Background:  Bare metal stents (BMSs) continue to be used in percutaneous coronary intervention, even after the introduction of drug-eluting stents; however, very long-term pathological findings, for example, beyond 10 years after their implantation, have yet to be clarified.   Methods and Results:  Histopathological studies were performed in 22 lesions (les) obtained from 19 patients autopsied after noncardiac death 5-16 years (Y) poststenting. The interval between BMS implantation and death was distributed as follows: 5-8 Y, 5 les; 8-10 Y, 5 les; 10-12 Y, 4 les; 12-14 Y, 5 les; and 14-16 Y, 3 les. All examined BMS were stainless steel stents, such as Palmaz-Schatz, Multilink, and NIR stents. Neointima of the arteries that had been stented more than 5 Y showed full endothelial coverage, and the smooth muscle cells (SMCs) were atrophic and sparse, with abundant proliferation of collagen fibers. However, there was significant infiltration of inflammatory cells (T lymphocytes and macrophages (MΦ)) surrounding the stent struts. Although neointima beyond 7 Y resembled fibrotic scar with SMC depletion and replacement by collagen fibers, prominent infiltration by lipid-laden MΦ with strong collagen-degrading matrix metalloprotease immunoreactivity was evident around the struts. Beyond 10 Y, marked necrotic core formation with cholesterol clefts around the struts, and peristrut calcification including fine calcium deposits in the cytoplasm of many MΦ were evident. Furthermore, clusters of a lot of lipid-laden MΦ were also visible adjacent to the subendothelial spaces, accompanied by significant intimal thickening. In neointima beyond 13 Y, remarkable extracellular lipid core formation and calcification were typical in the superficial layer as well as the peristent area. In 4 of these lesions, advanced luminal narrowing occurred, and the luminal surface of the stented segments was focally disrupted and covered by nonocclusive mural thrombi in 2 other cases.   Conclusions:  This extended late-phase (>10 Y) pathologic observation after BMS implantation demonstrated that neointima often transforms into lipid-laden tissue, and such advanced atherosclerotic progression may be associated with recurrence of myocardial ischemia, including ACS.
Time to abandon the use of HSMRs in the NHS
Authors: Jammi N Rao
Journal: BMJ (2015)

The latest evidence on the lack of correlation between avoidable mortality and the hospital standardised mortality ratio (HSMR) should lead us to abandon its use.1 2

The use of HSMRs has been questioned before, 3 4 and there remain serious theoretical objections that have never been adequately addressed by its proponents.5

As the chair of my trust’s …
Abstract 272: Intralipid Protects Late Pregnant Mouse Heart Against Ischemia/Reperfusion Injury More Efficiently than Cyclosporine-A
Authors: Jingyuan Li, Marjan Amjedi, Sandhya Nadadur, Mansoureh Eghbali
Journal: Circulation (2011)

Introduction Recently, we found that hearts of late pregnant (LP) mice have higher vulnerability to ischemia/reperfusion (I/R) injury compared to hearts of non-pregnant mice. We also found intralipid (ITLD), a clinically safe compound protects the male rodent hearts against I/R injury if administrated at reperfusion. Here we explored whether ITLD can protect the function of LP mouse hearts against I/R injury, and compared its action with cyclosporine-A (CsA), a potent inhibitor of mithochondrial permeability transition pore (mPTP) opening. Methods Isolated LP mouse hearts were subjected to 20 min ischemia followed by reperfusion with i) Krebs Henseleit buffer (CTRL), ii) additional 1% ITLD or iii) 1.5µM CsA. The duration of reperfusion was 40 min for heart functional measurements and infarct size assessment and 10 min for measurements of mitochondrial calcium retention capacity (CRC). Two way ANOVA was used for statistical analysis. P&lt;0.05 were considered statistically significant. Values are expressed as mean± SEM. Results The heart functional recovery of LP mice after ischemia was very poor. Postischemic administration of ITLD significantly improved the cardiac function of LP mice; the rate pressure product (RPP) at the end of reperfusion was improved from 1614±438 mmHg*beats/min (n=4) to 11556±784 mmHg*beats/min (n=3) with addition of ITLD. The infarct size was also significantly reduced by ITLD to 17±2% (n=3) from 59±5% (n=4) in CTRL (P&lt;0.01). Interestingly, ITLD was even more efficient than CsA in protecting the hearts of LP mice against ischemia reperfusion injury as in CsA group the RPP was significantly lower at the end of reperfusion (5960±1332, n=4) and the infarct size was larger (25±3%, n=4) compared to ITLD(P&lt;0.05). ITLD-induced cardioprotection of LP mouse hearts against I/R was associated with a delay in the opening of the mPTP similar to CsA. The calcium load required for triggering the opening of the mPTP increased from 180±7 nM/mg (n=6) protein in CTRL to 290±12 nM/mg (n=6) protein in ITLD (P&lt;0.01), which was not significantly different than 276±20 nM/mg protein in CsA group. Conclusion ITLD protects late pregnant mouse hearts against I/R injury more efficiently than CsA by inhibiting the mPTP opening.
Abstract 9906: Losartan/hydrochlorothiazide Combination was Superior to High-dose Losartan in Controlling Morning Hypertension and Reducing Urinary Albumin Excretion
Authors: Hisashi Kai, Tamenobu Ueda, Masashi Kaneyuki, Miwako Shihara, Yasuyuki Toyama, Tsutomu Imaizumi
Journal: Circulation (2012)

Background: There is little evidence for treatment of morning hypertension, an independent risk for cardiovascular events. Thus, we compared the efficacy of losartan/hydrochlorothiazide combination and high-dose losartan in patients with morning hypertension. Methods: A total of 216 outpatients having hypertension medication were enrolled in a 3-month, prospective, randomized, open-labeled, multicenter trial, when they had systolic blood pressure (SBP) greater than 135 mmHg and/or diastolic blood pressure greater than 85 mmHg in the morning on home blood pressure self-measurement. An antihypertensive drug was randomly switched to a 50-mg losartan/12.5-mg hydrochlorothiazide combination tablet (Combination group, N=109) or 100-mg losartan (High-dose group, N=106). Results: At baseline, SBP levels, clinical background, and biochemical parameters were similar in the two groups. Primary end-point: Morning SBP was reduced by 18 mmHg in Combination group and by 8 mmHg in High-dose group (p&lt;0.001 for both), whereas the resultant levels were lower in Combination group than in High-dose group (P&lt;0.001). Secondary end-points: Urinary albumin excretion (UAE) was reduced in Combination group (P&lt;0.05), but not in High-dose group, although estimated glomerular filtration rates were not changed in either group. Serum uric acid (UA) was decreased in High-dose group (P&lt;0.001), but was not changed in Combination group. %UAE reduction was significantly associated with %morning SBP reduction, UA reduction (negatively), or combination regimen. Multiple linear regression analysis exhibited that %morning SBP reduction was an independent factor associated with %UAE reduction (β=0.277, P&lt;0.05). After adjustments for treatment regimen and UA reduction, %UAE reduction was positively correlated with the tertiles based on morning SBP reduction levels (P=0.02 for trend). Conclusions: Losartan/hydrochlorothiazide combination was more effective than high-dose losartan for controlling morning hypertension and reducing UAE. The reduction in morning SBP was associated with UAE reduction in patients with morning hypertension.
The Development of a Decision Analytic Model of Changes in Mean Deviation in People with Glaucoma
Authors: Steven M. Kymes, Dennis L. Lambert, Paul P. Lee, David C. Musch, Carla J. Siegfried, Sameer V. Kotak, Dustin L. Stwalley, Joel Fain, Chris Johnson, Mae O. Gordon
Journal: Ophthalmology (2012)
Clinical significance of CD45RO+ memory T cell in human esophageal cancer
Authors: Koji Enomoto, Masayuki Sho, Kohei Wakatsuki, Takeo Nomi, Masato Ueno, Tomoyoshi Takayama, Sohei Matsumoto, Shinji Nakamura, Takahiro Akahori, Ichiro Yamato, Yoshiyuki Nakajima
Journal: Cancer Research (2008)

263   Memory T cells survive for many months and years and critically important for host defence in humans. In tumor immunity, they have been also suggested to play a significant role in tumor progression and metastasis. However, the clinical importance of memory T cells in actual human cancer remains largely unknown. In this study, we tried to reveal the clinical significance of tumor-infiltrating CD45RO+ memory T cells in human esophageal cancer. We examined 60 esophageal cancer patients who underwent surgery in our department. The median age of the patients was 61.9 years, with a range of 42 to 75 years. Forty-six patients were male and 14 were female. Histopathological and clinical findings were scored according to the UICC-TNM classification. We performed immunohistochemistry on esophageal cancer tissues and counted the cells stained positively for CD45RO+ infiltrating into cancer tissue. The mean number of positively stained cells was 104 (range 105-211). Then we defined 30 patients with high density of CD45RO+ T cells (more than 104 positive cells per HPF) as CD45RO+hi and 30 patients with low density of CD45RO+ T cells as CD45RO+lo (fewer than 104 positive cells per HPF). Interestingly, CD45RO+hi patients with esophageal cancer had a significantly better prognosis than CD45RO+lo patients (1-year survival rate; 86.7% vs 70%, 3-year survival rate; 64.8% vs 30.8%, 5-year survival rate; 54.1% vs 30.8%, respectively; P=0.036). In addition, among T1 tumors, there was significant difference in postoperative overall survival rate between CD45RO+hi and CD45RO+lo patients with esophageal cancer (1-year survival rate; 100% vs 83.3%, 3-year survival rate; 83.3% vs 33.3%, 5-year survival rate; 83.3% vs 33.3%, respectively; P=0.011). Further analysis revealed that there was significant correlation of CD45RO status with positive venous invasion (P=0.045: 5 of 30, 16.7% CD45RO+hi versus 12 of 30, 40% CD45RO+lo). In conclusion, we have demonstrated for the first time that CD45RO+ memory T cell has a significant prognostic value in human esophageal cancer, and also our data suggested that adaptive immune response is functionally critical in human esophageal cancer.
Regulation of Fe65 during neuronal differentiation
Authors: Niina Koistinen, Kristin Jacobsen, Kerstin Iverfeldt
Journal: Molecular Neurodegeneration (2013)

Background Fe65 is a ~97kDa neuronal adaptor protein which has been shown to interact with amyloid-b precursor protein (APP) and its homologues APLP1 and APLP2. Fe65 has the ability to bind to the C-terminal YENPTY motif of APP and is believed to be involved in the regulation of APP processing. APP is a type 1-transmembrane protein which can undergo regulated intramembrane proteolysis (RIP) allowing the release of a secreted ectodomain (sAPP) and a small intracellular domain called AICD. AICD has been suggested to function in regulation of gene expression by the formation of a multimeric complex with Fe65. According to previous studies retinoic acid (RA) can up-regulate the expression of both mRNA and protein levels of APP family members in SH-SY5Y cells. Because Fe65 may be essential in APP-mediated transcriptional regulation, the extent of Fe65 protein expression and its localization were investigated in RA differentiated SH-SY5Y cells. Phosphorylation of APP at specific residues has also shown to affect the processing of APP and its binding to specific adaptor proteins, such as Fe65. To further characterize how phosphorylation affects interactions between Fe65 and APP, Fe65 constructs were designed with a tandem affinity purificationtag (TAP-tag) and several Ser/Thr/ Tyr mutant constructs of myc-tagged APP was generated. APP mutants were coexpressed in SH-SY5Y cells with Fe65-TAP in order to investigate if the mutated phosphorylation sites affect the ability of Fe65 to interact with APP or if the gain/loss of interaction with Fe65 affects the processing of APP.
血管紧张素受体阻断剂预防男性人群痴呆发生风险研究：前瞻性队列分析（摘要）
Authors: Nien-Chen, Li, Austin, Lee, Rachel, Whitmer, Miia, Kivipelto, Elizabeth, Lawler, Lewis, Kazis, Benjamin, Wolozin, 夏曙, 于世英
Journal: BMJ (2010)
Patent Foramen Ovale: Innocent or Guilty?
Authors: Irene Meissner, Bijoy K. Khandheria, John A. Heit, George W. Petty, Sheldon G. Sheps, Gary L. Schwartz, Jack P. Whisnant, David O. Wiebers, Jody L. Covalt, Tanya M. Petterson, Teresa J.H. Christianson, Yoram Agmon
Journal: Journal of the American College of Cardiology (2005)
Emergency Blood Services
Authors: George W. Miller
Journal: JAMA (1963)

Abstract
The prime and essential function of any emergency blood service is to provide ample supplies of blood and blood derivatives to the medical services operating in the post-nuclear disaster period with as much despatch and precision as possible. To meet these needs, a plan has been devised in Canada whereby 600,000 units of whole blood may become available for the treatment of an estimated 200,000 living casualties in the two- to three-week period immediately following a national disaster. The disaster organization is based upon the existing Canadian Red Cross Blood Transfusion Service which is currently providing blood and blood fractions to all hospitals, coast to coast, through its 16 depots.

The key to the emergency operation is the establishment of shadow depots in preselected sites 50 to 75 miles from the existing depots and in places free of fallout.

Stockpiling of essential blood transfusion supplies and equipment, along with a peace-time training program of essential personnel, is a prerequisite for the success of the plan.
Pattern of Failure Analysis in Metastatic EGFR-Mutant Lung Cancer Treated with Tyrosine Kinase Inhibitors to Identify Candidates for Consolidation Stereotactic Body Radiation Therapy
Authors: Hani Al-Halabi, Karl Sayegh, Subba R. Digamurthy, Andrzej Niemierko, Zofia Piotrowska, Henning Willers, Lecia V. Sequist
Journal: Journal of Thoracic Oncology (2015)

The role of stereotactic body radiation therapy (SBRT) in patients with metastatic lung cancer harboring epidermal growth factor receptor (EGFR) mutations is not defined. We evaluated the pattern of failure in patients receiving tyrosine kinase inhibitor (TKI) therapy to identify candidates for consolidation SBRT.Computed tomography scans were reviewed in a cohort of EGFR-mutant patients enrolled on prospective TKI trials. Initial progression in sites of original disease (primary/metastatic) or new sites was classified as original site failure (OF) or distant site failure (DF), respectively. Simultaneous OF/DF was labeled ODF. Disease characteristics were analyzed for associations with patterns of failure using actuarial competing risks methodology.Complete serial imaging was available in 49 patients with measurable disease. Median time to any progression was 8.3 months. The majority failed initially in original disease sites with OF, ODF, and DF frequencies being 47.0%, 32.6%, and 20.4%, respectively. Primary tumor size was the most significant predictor of OF in univariate and multivariate analysis (p = 0.004). Median time to progression was 3 months shorter in patients with OF compared with DF. Ten patients (20%) were retroactively classified as consolidation SBRT candidates based on the extent of disease at time of best response to TKI therapy, and in seven of these, initial progression occurred in original tumor sites.Initial progression of TKI-treated cancers occurred predominantly in original disease sites. Consolidation SBRT was judged feasible in a subset of patients following maximum TKI response and may have prevented oligoprogression in most of these. In addition, we hypothesize that consolidation SBRT for residual disease could delay subsequent metastatic reseeding.
Abstract 6192: Endovascular Stent-Graft Repair of Type B Aortic Dissection: Intermediate to Long-Term Results
Authors: Ung Kim, Seong-Jin Hong, Jung-Sun Kim, Young-Guk Ko, Dong-hoon Choi, Yang-Soo Jang, Won-Heum Shim, Seung-Yun Cho
Journal: Circulation (2008)

The aim of this study is to assess mid- to long-term clinical results of the endovascular stent-graft repair in patients with type B aortic dissection. Retrospective analysis was done on 73 patients (average age: 55.6 ± 12.4) who underwent stent-graft repair at our center from June 1994 to December 2007. The indications of case selection were progression of dissection despite adequate medical treatment, dynamic obstruction, intractable pain, aortic diameter of 6cm or more, or continuous false lumen leakage in either acute or chronic presentation. Median follow-up duration was 43 months (5 ~ 97 months, 64.4 ± 38.8 months). There was an absence of immediate postprocedural mortality or paraplegia. Angiographic success, defined as immediate closure of entry site without any significant endoleak, was obtained in 67/73 (91.7%) patients. Clinical success, defined as the complete obliteration or complete thrombosis of the false lumen at follow-up, was achieved in 53/73 (72.6%) patients. 22/73 (30.1%) patients demonstrated complications such as persistent type I endoleak, false lumen flow patency at distal portion of stent-graft, and 5/73 (6.8%) patients such as type II endoleak. Among these endoleaks, 5 cases were progressed and 17 cases were remained unchanged. There were unintended left subclavian artery occlusion (1 case), transient acute renal failure (1 case), saccular aneurysm (5 cases) and stent-graft migration or torsion (2 cases) as complications. During medial follow-up 43 months, 4 patients (5.5%) were died. In conclusion, cIinical outcomes of stent-graft repair of type B aortic dissection were favorable and should be considered as a safe and effective treatment option of type B aortic dissection, particularly in patients with a high risk surgical mortality or mobility.
Diverticulitis
Authors: Danny O. Jacobs
Journal: New England Journal of Medicine (2007)

A previously healthy 45-year-old man presents with severe lower abdominal pain on the left side, which started 36 hours earlier. He has noticed mild discomfort in this region periodically before but has not sought medical treatment. He reports nausea, anorexia, and vomiting associated with any oral intake. On physical examination, his temperature is 38.5°C and his heart rate is 110 beats per minute. He has abdominal tenderness on the left side without peritoneal signs. How should his case be managed?
Overview: white norms and psychiatric diagnosis of black patients
Authors: Victor R. Adebimpe
Journal: American Journal of Psychiatry (1981)

Allegations of psychiatric misdiagnosis of black patients are supported by only a few examples of such errors, but there is a modest body of circumstantial evidence suggesting that black patients run a higher risk of being misdiagnosed than white patients. The author reviews the studies providing such evidence and concludes that greater awareness among clinicians and research into more appropriate diagnostic criteria for black patients are desirable.