tbuckley/cabot-search huggingface dataset:
Ulcerative Colitis and Diffuse Interstitial Lung Disease: Rare Association or Complete Coincidence?-Reply
Authors: Dominic J. Balestra
Journal: JAMA (1989)

<h3>In Reply.—</h3> Ulcerative colitis has an estimated prevalence of 70 to 150 per 100 000.<sup>1,2</sup>If one assumes a similar prevalence for idiopathic pulmonary fibrosis, the probability that both diseases independently will occur by chance in the same patient is roughly one per million. Such an infrequent association of the two diseases contradicts the approximately 25% to 50% prevalence of physiological pulmonary disease and the 4% to 6% prevalence of radiographic interstitial lung disease in reported series of patients with inflammatory bowel disease.<sup>3,4</sup> Several chronic inflammatory disorders of unknown etiology have commonly associated interstitial pulmonary disease: specifically, rheumatoid arthritis, progressive systemic sclerosis, and polymyositis/dermatomyositis. The interstitial lung disease in these disorders is indistinguishable from idiopathic pulmonary fibrosis and is attributable to the specific collagen-vascular disease purely on clinical grounds. In fact, the associated frequency of interstitial lung disease in rheumatoid arthritis or systemic sclerosis (25% to 50%) approximates
Increased lysophosphatidylcholine and pancreatic enzyme content in bile of patients with anomalous pancreaticobiliary ductal junction
Authors: Kazuo Shimada, Jiro Yanagisawa, Fumio Nakayama
Journal: Hepatology (1991)

A high incidence of inflammation and carcinoma of the biliary tract in patients with anomalous pancreaticobiliary ductal junction has been well documented. The change in biliary phospholipids as a result of the reflux of pancreatic juice into the biliary tract through anomalous pancreaticobiliary ductal junction may be responsible for it. We developed a new method of analysis of phospholipid classes using aminopropyl Bond Elut cartridge for extraction and high-performance liquid chromatography for separation. Satisfactory recovery was achieved (i.e., more than 95% for both phosphatidylcholine and lysophosphatidylcholine). With this method, the bile of 11 patients with anomalous pancreaticobiliary ductal junction was examined. The concentration and proportion of lysophosphatidylcholine in bile were much higher in the presence of anomalous pancreaticobiliary ductal junction than in controls (3.44 +/- 1.50 mmol/L vs. 0.52 +/- 0.25 mmol/L, 60.0% +/- 31.0% vs. 2.3% +/- 1.4% in gallbladder bile; p less than 0.001). In contrast, the concentration of phosphatidylcholine and the sum of phosphatidylcholine and lysophosphatidylcholine in gallbladder bile significantly decreased (p less than 0.001), but in hepatic bile they did not. An inverse correlation was found between the proportion of lysophosphatidylcholine and phospholipid concentration in gallbladder bile. Phospholipase A2 and amylase activities in bile were markedly high. Increased total fatty acid concentration and proportion of unsaturated fatty acid in bile were found. Total bile acid concentration in gallbladder bile was significantly lower than in controls. These results suggest that a considerable amount of lysophosphatidylcholine, which is known to have a cytotoxic effect, isp reduced by phospholipase A2 in refluxing pancreatic juice, and an increased concentration of lysophosphatidylcholine gives rise to cell damage causing mucosal hyperplasia and metaplasia.(ABSTRACT TRUNCATED AT 250 WORDS)
Ductal Carcinoma In Situ: Should the Name Be Changed?
Authors: S. Graff
Journal: JNCI Journal of the National Cancer Institute (2009)

Speakers at the National Institutes of Health state-of-the-science conference on ductal carcinoma in situ (DCIS) in September set out to assess critical areas in the field and ended up with a range of research recommendations: Improve risk stratification of patients, look closer at biomarkers, and compare the effectiveness of treatment methods. Surprisingly, though, after an unexpected fl urry of comments from participants, panel members also decided to give emphasis to nomenclature. The topic of a name change not only ended up in the fi nal conference statement but also spurred calls for another meeting, now in the planning stage, to discuss whether omitting “carcinoma” — what some call the “anxietyproducing term” — is appropriate. “The panel in general felt that it was very important for the medical community at large to at least consider the terminology of DCIS
Protein kinase C delta mediates arterial injury responses through regulation of vascular smooth muscle cell apoptosis
Authors: Dai Yamanouchi, Kaori Kato, Evan J. Ryer, Fan Zhang, Bo Liu
Journal: Cardiovascular Research (2009)

A balance between apoptosis and proliferation of vascular smooth muscle cells (VSMC) influences the development of intimal hyperplasia. We have previously demonstrated that protein kinase C delta (PKCδ) regulates both apoptosis and proliferation of VSMC in vitro. Here we investigate the role of PKCδ in intimal hyperplasia through gene deletion or overexpression in rodent models of arterial injury. Arterial injury was induced in mice and rats by means of carotid ligation or balloon angioplasty, respectively. Overexpression of PKCδ was achieved by adenovirus-mediated gene transfer immediately after balloon injury in rat carotid arteries. Levels of PKCδ protein were profoundly increased in the carotid wall 3–7 days after balloon injury, co-localizing to TUNEL-positive medial cells. When subjected to arterial injury, PKCδ gene-deficient mice responded with an enhanced intimal hyperplasia accompanied by an 80% reduction in the number of TUNEL-positive cells detected in the injured arteries as compared with their wild-type littermates. Conversely, arterial gene transfer of PKCδ further increased the arterial expression of PKCδ, which was associated with a marked increase in apoptosis and reduction of intimal hyperplasia. Neither manipulation led to significant alteration in cell proliferation, suggesting that the function of PKCδ after arterial injury is predominantly pro-apoptotic. This notion is further supported by our observation of high PKCδ expression in human restenotic lesions that also co-localized with apoptosis. The expression of PKCδ is upregulated in the arterial wall in response to injury. This induction appears to be a mechanism of arterial response that negatively influences the degree of intimal hyperplasia by stimulating VSMC apoptosis.
Quantification of area at risk during coronary occlusion and degree of myocardial salvage after reperfusion with technetium-99m methoxyisobutyl isonitrile.
Authors: A J Sinusas, K A Trautman, J D Bergin, D D Watson, M Ruiz, W H Smith, G A Beller
Journal: Circulation (1990)

Serial myocardial imaging with technetium-99m methoxyisobutyl isonitrile (99mTc-MIBI) has been proposed for evaluating myocardial salvage after reperfusion. To define 99mTc-MIBI uptake before and after reperfusion, 17 open-chest dogs underwent 3 hours of left anterior descending artery occlusion and 3 hours of reperfusion. 99mTc-MIBI was injected during occlusion (group 1) or after 90 minutes of reperfusion (group 2). Myocardial 99mTc-MIBI activity was correlated with microsphere flow during occlusion and reperfusion. Anatomic risk area and infarct area were defined by postmortem vital staining and correlated with the perfusion defects defined by analysis of 99mTc-MIBI macroautoradiographs and gamma camera images of myocardial slices. The left ventricle was divided into 96 segments for gamma well counting. Flow and 99mTc-MIBI activity were normalized to nonischemic values. Myocardial segments were grouped, based on occlusion flow, into zones: severely ischemic (less than or equal to 30% nonischemic), moderately ischemic (greater than 30%, less than or equal to 60% nonischemic), mildly ischemic (greater than 60%, less than or equal to 90% nonischemic), and nonischemic (greater than 90%, less than or equal to 120% nonischemic). Among dogs injected with 99mTc-MIBI during coronary occlusion (group 1), myocardial 99mTc-MIBI activity correlated linearly with occlusion flow for both endocardial (r = 0.91) and transmural (r = 0.91) segments. The risk area defined by 99mTc-MIBI autoradiography (group 1) correlated with the postmortem risk area (rho = 0.94) but was 29% smaller than the anatomic risk area (p = 0.03), reflecting the contribution of collateral flow. Among dogs injected with 99mTc-MIBI after reperfusion (group 2), myocardial 99mTc-MIBI did not correlate with reperfusion flow in either endocardial or transmural segments. Among group 2 dogs, myocardial 99mTc-MIBI activity was significantly less than reperfusion flow at the time of injection in the severely ischemic (25 +/- 5% versus 74 +/- 24% nonischemic, p = 0.002), moderately ischemic (54 +/- 12% versus 96 +/- 15% nonischemic, p = 0.001), and mildly ischemic (84 +/- 6% versus 93 +/- 3% nonischemic, p = 0.002) zones. The defect area defined by 99mTc-MIBI autoradiography (group 2) correlated very closely with the postmortem infarct area (rho = 0.98). Thus, the myocardial uptake of 99mTc-MIBI during coronary occlusion correlates with occlusion flow and reflects the "area at risk." When 99mTc-MIBI was given after 90 minutes of reperfusion following 3 hours of coronary occlusion, the myocardial activity was significantly reduced compared with reperfusion flow in both necrotic and perinecrotic regions, reflecting myocardial viability more than the degree of reperfusion.
Regulation of allergen‐induced bone marrow eosinophilopoiesis: role of CD4<sup>+</sup> and CD8<sup>+</sup> T cells
Authors: M. Rådinger, A. Bossios, A.‐S. Alm, P. Jeurink, Y. Lu, C. Malmhäll, M. Sjöstrand, J. Lötvall
Journal: Allergy (2007)

Background: The mechanisms of the distant stimulation of the bone marrow (BM) after airway allergen exposure remain largely obscure. T cells have been implicated in allergic airway inflammation but their role in allergen‐induced BM eosinophilopoiesis is poorly understood. The aim of this study was to determine the role of CD4 + and CD8 + T cells in allergen‐induced BM eosinophilopoiesis. Methods: Ovalbumin (OVA)‐sensitized wild type (WT), CD4 knockout (CD4−/−) and CD8 knockout (CD8−/−) mice were exposed intranasally to OVA or saline. Bromo‐deoxyuridine (BrdU) was used to label newly produced cells. Bone marrow, blood and bronchoalveolar lavage (BAL) were sampled 24 h after the final exposure. Immunostaining for newly produced eosinophils (i.e. BrdU + /MBP + ) and BM eosinophil progenitor [CD34 + /CD45 + /interleukin‐5 (IL‐5)Ralpha + ] cells was performed. Results: The number of newly produced BM eosinophils (BrdU + /MBP + cells) was significantly reduced in allergen exposed CD4−/− or CD8−/− mice compared with allergen exposed WT mice, which was followed by a subsequent decrease in newly produced blood and airway eosinophils. Furthermore, BM eosinophil progenitors were significantly reduced in allergen exposed CD4−/− and CD8−/− mice compared with WT mice. Finally, serum IL‐5 and Bronchoalveolar lavage fluid eotaxin‐2 levels were abolished in allergen exposed CD4−/− mice to levels seen in saline exposed WT mice. Conclusions: These data suggests that both CD4 + and CD8 + T cells have a regulatory role in allergen‐induced BM eosinophilopoiesis, whereas CD4 + T cells are obligatory for allergen‐induced airway eosinophilia. The subsequent traffic of eosinophils to the airways is likely to be at least partly regulated by a CD4 + T‐cell‐dependent local airway eotaxin‐2 production.
STUDIES ON THE ETIOLOGY AND TRANSMISSION OF EPIDEMIC DIARRHEA OF INFANT MICE
Authors: Lisbeth M. Kraft
Journal: The Journal of Experimental Medicine (1957)

Transmission experiments have shown that epidemic diarrhea of infant mice of the CFW strain is infectious and communicable. Cage to cage spread can take place by the air-borne route. The agent appears to be a fairly heat-resistant virus that can be serially transferred and that is neutralized by specific hyperimmune antiserum from rabbits. Mice are susceptible to it by the oral route from at least the 3rd day after birth to the 10th or 11th day. Thereafter they appear to become resistant. The shortest incubation period observed has been 40 hours from the time of feeding infectious material; the longest period could not be ascertained under the conditions of test. Factors relative to the differentiation of this virus from other viruses are briefly discussed.
Physiologic basis and interpretation of common indices of respiratory mechanical function.
Authors: J M Drazen
Journal: Environmental Health Perspectives (1976)

Tests of pulmonary mechanical function may be used in determining the prominent site of pulmonary reaction to intervention. Responses may be localized from a knowledge of changes in lung resistance and compliance. A peripheral airway or parenchymal response is characterized by a decrease in lung compliance. A central airway reaction is characterized by an increase in pulmonary resistance. In mixed reactions both parameters may change. In this communication some of the physiologic determinants of pulmonary resistance and compliance are discussed and examples of localized responses given.
The Electrophoretic Distribution of Proteins in Plasma in Rheumatoid Arthritis12
Authors: M. W. Ropes, G. E. Perlmann, D. Kaufman, W. Bauer
Journal: Journal of Clinical Investigation (1954)

Abnormalities in the electrophoretic patterns of plasma proteins in rheumatoid arthritis have been described by various workers.With few excep- tions an increase in the relative concentration of a,-, a2-, and y-globulin and of fibrinogen and lower- ing of the albumin concentration have been ob- served and have been associated consistently with activity of the disease (1-15).Olhagen (4, 10) and Svartz and Olhagen (8) ascribed a possible prognostic significance to isolated elevation of aor y-globulin.They suggested that an ele- vation of the a-globulins without an increase in the y-fraction, often noted in acute cases, indi- cated a tendency to more rapid healing, whereas a high y-globulin with low a-globulins repre- sented a poor prognosis.Wallis (13) described a "T component" in three patients with active rheumatoid arthritis.A protein with a similar electrophoretic mobility, y'-globulin, was noted by Paul and Routh (14) in normal sera.These authors observed a small decrease of this fraction in the sera of seven patients with rheumatoid spon- dylitis but found no change in 27 patients with gen- eralized rheumatoid arthritis.Recently, Laurell (16) and Mehl and Golden (17) have demonstrated the occurrence of small amounts of two proteins with isoelectric pH values lower than that of serum albumin when electrophoresis was per- formed in acetate buffer of pH 4.5.The concen- tration of one component, which at pH 8.6 in diethylbarbiturate migrates with a mobility of the a2-globulin, was considerably increased in sera from patients with rheumatoid arthritis (17) and disappeared on treatment with cortisone (16).
Upper gastrointestinal haemorrhage in cirrhotic patients (a French survey) epidemiology and clinical practices: a population study in 4 French areas
Authors: Stephane Lecleire, Pierre Czernichow, Frederic Di Fiore, Sophie Herve, Michel Amouretti, J.Louis Dupas, H. Gouerou, Raymond Colin
Journal: Journal of Hepatology (2002)
165. Tracking of Baculovirus Biodistribution In Vivo by Magnetic Resonance Imaging
Authors: Jani K. Raty, Thomas Wirth, Kari J. Airenne, Tuulia Huhtala, Timo Liimatainen, Ale Narvanen, Juhana Hakumaki, Seppo Yla-Herttuala
Journal: Molecular Therapy (2005)

There is a need to develop new imaging methods for non-invasive real time detection of viral vectors in gene therapy. Imaging of the viral biodistribution using conventional immunohistological or PCR approaches is laborious and lacks non-invasive real-time option. Baculoviruses have recently been shown to be effective gene transfer vectors also in vertebrate cells. Avidin displaying baculovirus (Baavi) enables coating of the virus with different biotinylated molecules and thus results in a versatile platform to study and affect baculovirus-mediated gene delivery. The current study was designed to develop a technique allowing non-invasive imaging of baculoviral biodistribution in vivo by Magnetic resonance imaging (MRI).
VICHY, AND ITS WATERS
Authors: J. Barr
Journal: BMJ (1927)

A great deal of psycho-analysis, he thinks, is so silly that only pec,ple deficient in common sense and lacking in a sense of tumour could have invented it.From this it will be seen that Mr. Sullivan, as a priest of the new religion, does not feel bound to adopt the attitude of bewilderment and humility.
Role of GPs in communicating lifestyle messages that are good for health and the climate
Authors: G. A. Johnson
Journal: BMJ (2013)

The BMJ , and Costello and colleagues, should be congratulated for taking a lead, once again, on the importance of climate change for public health and healthcare.1 The authors suggest several actions that health workers should take in response to this great and urgent challenge. Most of these—such as carbon taxes, reducing poverty and equity, stopping fossil fuel subsidies, and supporting green and energy saving …
Nephropathy in Patients with Type 2 Diabetes
Authors: Giuseppe Remuzzi, Arrigo Schieppati, Piero Ruggenenti
Journal: New England Journal of Medicine (2002)

A 60-year-old man with recently diagnosed type 2 diabetes mellitus has a serum creatinine level of 1.5 mg per deciliter (133 μmol per liter), and a dipstick test shows proteinuria (++). His blood pressure is 150/90 mm Hg. He smokes half a pack of cigarettes daily. What can be done to reduce the risk of progressive renal disease?
Medical Mission Report on El Salvador
Authors: Alfred Gellhorn
Journal: New England Journal of Medicine (1983)

Alarmed by reports of the harassment, murder, and disappearance of doctors, dentists, nurses, members of the medical faculty, social and physical scientists, and members of related health professions, the National Academy of Sciences, the Institute of Medicine, the American Association for the Advancement of Science, the New York Academy of Sciences, and the International League for Human Rights cosponsored a medical mission* to San Salvador. The mission's purpose was to determine the fate of those professionals and to assess the impact of conditions in El Salvador on medical institutions and on the health of the people.From January 11 through . . .
Commentary: Clinical reasoning
Authors: Ed Peile
Journal: BMJ (2004)

Many BMJ readers have participated in the web discussion of this evolving case presentation and have been intrigued by the complexities of diagnosis. Initially, there was consensus around the broad diagnosis of heart failure, but responding to the twists and turns of the evolving clinical story, many medical readers showed traits of the amateur detective and the crossword puzzle enthusiast. It was this that led me to comment favourably on the learning to be had from doctors interacting with one another's clinical reasoning processes. I hope that the trend away from just submitting answers in a right or wrong format towards exposing the workings of our medical minds will continue.

What is clinical reasoning? The process by which doctors funnel their thinking towards probable diagnosis is classically thought of as a mixture of pattern recognition and “hypothetico-deductive” reasoning.1,2 The reasoning process depends on medical knowledge in areas such as disease prevalence and pathophysiological mechanisms. Teaching on the process of reasoning, as diagnostic tests provide new information, has included modifications of Bayes's theorem in an attempt to get clinicians to think constructively about pre-test and post-test possibilities.1

Looking at the web discussions, we can see more everyday clinical reasoning processes at work. The maxim that “common things occur commonly” is obviously tried and trusted by many. We also see a good example of biases affecting the cognitive process, when wily clinicians are aware that cases published in the BMJ are likely to have uncommon aspects. An aspect of clinical reasoning that is perhaps under-represented in these discussions is intuition.3

Learning from experts is a traditional foundation of medical learning. But, experts4 are not always the best people to teach—because they have become unconscious of the processes that novices and those with intermediate levels of proficiency need to learn.5 This is the value of learning from each other.

A word of caution. Just as in bedside teaching doctors and students need to be aware of the sensitivities of the patient from whom we are learning, so in these interactive case discussions we need to avoid getting so absorbed in the trail of diagnostic clues that we forget the patient. All patients have consented, and they are well cared for throughout the publication process by the case contributors, but it behoves us to check that this novel form of learning (where potentially serious diagnoses are bandied around) does not cause harm. I am pleased to see doctors still debating energetically the patient communication issues.
Decreased anion exchanger 2 immunoreactivity in the liver of patients with primary biliary cirrhosis
Authors: Juan F. Medina, Eduardo Martínez-Ansó, Jaime J. Vázquez, Jesús Prieto
Journal: Hepatology (1997)

Chloride–bicarbonate anion exchanger 2 (AE2) is expressed in a variety of tissues, including the liver and salivary glands, where it may participate in the generation of hydroionic fluxes into secretions. We have previously reported decreased hepatic levels of AE2 messenger RNA in patients with primary biliary cirrhosis (PBC), a cholestatic condition frequently associated with pluriglandular exocrine failure. Here we investigated the expression of AE2 protein in the liver of PBC patients. Using a monoclonal antibody against an AE2 peptide, immunohistochemistry was performed on liver biopsy specimens from subjects with normal liver (n = 7), patients with PBC (n = 13), and patients with cirrhosis or cholestasis other than PBC (n = 17 and 11, respectively). Immunostaining was graded from 0 to 7, according to its intensity and distribution. AE2 immunoreactivity was observed in normal livers, as previously reported, and in many pathological liver biopsy specimens, being mainly restricted to canaliculi and the luminal membrane of terminal and interlobular bile ducts. Canalicular and ductular scores were significantly reduced in the PBC group compared with each control group (normal liver and cirrhosis or cholestasis other than PBC), whereas no differences in immunoreactivity scores were observed among control groups. When four patients with primary sclerosing cholangitis (PSC) were analyzed, they also differed from those with PBC. These results suggest that PBC is characterized by diminished expression of AE2 in the liver. Reduced levels of this transporter protein might be involved in the pathogenesis of cholestasis in PBC.
SUCCESS AND FAILURE IN THE TREATMENT OF CHILDHOOD SCHIZOPHRENIA
Authors: IRVING KAUFMAN, THOMAS FRANK, JEANNETTE FRIEND, LORA W. HEIMS, RUTH WEISS
Journal: American Journal of Psychiatry (1962)

It appears that with so severe an illness as childhood schizophrenia, the absence of any one of the following 3 environmental supports: competent psychotherapy, positive parental attitudes, strong adjunctive therapy, such as school or day care, may tip the balance against improvement.