tbuckley/cabot-search huggingface dataset:
Contribution of complement-stimulated hepatic macrophages and neutrophils to endotoxin-induced liver injury in rats
Authors: Hartmut Jaeschke, Anwar Farhood, Wayne C. Smith
Journal: Hepatology (1994)

The role of complement as potential activator for tissue macrophages and neutrophils was investigated in an experimental model of endotoxin-induced liver injury in male Fischer rats. Injection of Salmonella enteritidis endotoxin (1 mg/kg) into Corynebacterium parvum-pretreated animals (7 mg/kg; single dose 6 days before endotoxin) resulted in severe oxidant stress, as indicated by a 37-fold increase of plasma levels of glutathione disulfide (basal concentration, 0.36 +/- 14 mumol/L), accumulation of neutrophils in the liver (600 +/- 31 neutrophils/50 high-power fields) and liver injury (plasma ALT, 1184 +/- 185 U/l; necrosis; 19% +/- 3%) 10 hr after endotoxin. The oxidant stress induced by 1 mg/kg endotoxin in the C. parvum-treated animals was always significantly higher than that in control animals receiving the same dose of endotoxin. Inhibition of complement activation with the soluble complement receptor type 1 attenuated the oxidant stress and liver injury by 50% to 65% but had no effect on hepatic neutrophil accumulation or plasma tumor necrosis factor-alpha levels. Treatment with a monoclonal antibody directed against the alpha-chain of CD11b/CD18 adhesion proteins (clone 17), which was highly effective in attenuating ischemia-reperfusion injury in the liver by reducing the number of neutrophils and functionally inactivating these cells, neither protected against parenchymal cell injury nor affected hepatic neutrophil infiltration in the C. parvum model. We conclude that reactive oxygen derived from complement-stimulated macrophages is critical for the development of liver injury in the C. parvum/endotoxin model.
Hybrid Approaches to Thoracic Aortic Aneurysms
Authors: Roy K. Greenberg, Fady Haddad, Lars Svensson, Sean O’Neill, Esteban Walker, Sean P. Lyden, Daniel Clair, Bruce Lytle
Journal: Circulation (2005)

Background— Thoracic aortic aneurysm affecting the arch and proximal descending thoracic aorta requires 2-stage repairs that include proximal elephant trunk graft placement and completion of thoracic or thoracoabdominal repair. The application of endovascular grafting to complete the proximal procedure avoids a thoracotomy and may improve the morbidity and mortality of the patient population at risk. Methods and Results— A retrospective review of 399 thoracic endovascular grafts at our institution between 2000 and 2004 identified 22 patients who required elephant trunk and endovascular completion. Three patients underwent mesenteric bypass in addition to their proximal repairs. Mean follow-up was 10 months (range 1 to 42 months); there were no ruptures, and all patients returned for follow-up. Technical success was achieved in all patients. The 1-, 12-, and 24-month mortality rates (by Kaplan-Meier analysis) were 4.5%, 15.8%, and 15.8%, respectively. Caudal migration of the endograft occurred in 1 patient, and all but 2 aneurysms decreased or remained stable in size. The 2 patients with growth included a type III endoleak (which resolved after treatment) and pressurization through an expanded PTFE stentgraft. Three cases of transient paraparesis occurred (all in patients requiring mesenteric bypass or abdominal aortic aneurysm repair), and there were no paraplegias or strokes. Conclusions— Endovascular completion of elephant trunks is feasible and can be accomplished with minimal mortality. Meticulous imaging follow-up is required to detect persistent aneurysm pressurization and to verify the integrity of the repair. Improvements in implant design and delivery systems will further simplify the second-stage portion of these complex aneurysm repairs.
Zinc Gluconate Lozenges for Treating the Common Cold
Authors: Michael L. Macknin
Journal: Annals of Internal Medicine (1997)

Letters1 May 1997Zinc Gluconate Lozenges for Treating the Common ColdMichael L. Macknin, MD, Sherif B. Mossad, MD, and Sharon V. Medendorp, MPHMichael L. Macknin, MDCleveland Clinic Foundation, Cleveland, OH 44195Search for more papers by this author, Sherif B. Mossad, MDCleveland Clinic Foundation, Cleveland, OH 44195Search for more papers by this author, and Sharon V. Medendorp, MPHCleveland Clinic Foundation, Cleveland, OH 44195Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-9-199705010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We do not agree with Farr and colleagues that the placebo used in our study resulted in biased results favoring beneficial treatment effects of the zinc lozenges. Patients receiving zinc lozenges who reported no side effects of the medication before the end of the study reported a duration of symptoms similar to that in persons with side effects. The number of placebo and zinc recipients who believed that their medication had helped alleviate their cold symptoms did not significantly differ. No clear pattern of movement was seen regarding a patient's guesses about which medication he or she was ...References1. Korant BD, Butterworth BE. Inhibition by zinc of rhinovirus protein cleavage: interaction of zinc with capsid polypeptides. J Virol. 1976; 18:298-306. Google Scholar2. Salas M, Kirchner H. Induction of interferon-γ in human leukocyte cultures stimulated by Zn2+. Clin Immunol Immunopathol. 1987; 45:139-42. Google Scholar3. Novick SG, Godfrey JC, Godfrey NJ, Wlder HR. How does zinc modify the common cold? Clinical observations and implications regarding mechanism of action. Med Hypotheses. 1996; 46:295-302. Google Scholar4. Pasternak CA. A novel form of host defence: membrane protection by Ca2+ and Zn2+. Biosci Rep. 1987; 7:81-91. Google Scholar5. Kelly RW, Abel MH. Copper and zinc inhibit the metabolism of prostaglandin by the human uterus. Biol Reprod. 1983; 28:883-9. Google Scholar Author, Article, and Disclosure InformationAuthors: Michael L. Macknin, MD; Sherif B. Mossad, MD; Sharon V. Medendorp, MPHAffiliations: Cleveland Clinic Foundation, Cleveland, OH 44195 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1997Volume 126, Issue 9Page: 739KeywordsCell membranesCommon coldEpitheliumInterferonsNursesZinc ePublished: 15 August 2000 Issue Published: 1 May 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
An evaluation of emergency sclerotherapy of varices in randomized trials: looking the needle in the eye
Authors: C. Triantos, J. Goulis, D. Patch, G. Papatheodoridis, G. Leandro, D. Samonakis, E. Cholongitas, A. Burroughs
Journal: Endoscopy (2006)

Background: The role of sclerotherapy for acute variceal bleeding is challenged by vasoactive drugs and by ligation. Aim: A meta-analysis was performed to evaluate whether sclerotherapy remains a gold standard in acute variceal bleeding. Methods: Sclerotherapy was evaluated across four randomized trial groups: (a) combined with vasoconstrictors vs. vasoconstrictors alone (five trials, with 400 patients); (b) vs. vasoconstrictors alone (15 trials, with 1296 patients); (c) vs. combination of vasoconstrictors and sclerotherapy (eight trials, with 1026 patients); (d) vs. ligation (12 trials, with 1309 patients). We used the risk difference (absolute risk reduction) as our main effect measure. Results: The efficacy of acute sclerotherapy was highest vs. ligation at 95 %, with a small advantage for ligation (an overtube was used in eight trials) of 2.5 % (95 % CI 0.4 % to 4.6 %) (P = 0.018), but no survival difference. Efficacy of sclerotherapy combined with vasoconstrictors vs. vasoconstrictors alone was 86 %, whereas it was 83 % for sclerotherapy vs. vasoconstrictors alone. In both these groups sclerotherapy was superior for control of bleeding at, respectively, 16.3 % (95 % CI 8.7 % to 23.9 % (P = 0.0001) and 5.9 % (95 % CI, 1.5 % to 10.3 %) (P = 0.008), with increased survival in the latter. In the combination group of sclerotherapy with vasoconstrictors, the efficacy of sclerotherapy alone was 69 %, with the combination superior in controlling bleeding, at 13.2 % (95 % CI, 8.4 % to 18.1 %) (P < 0.0001) but with no survival difference. Conclusion: This comparison of sclerotherapy across trials demonstrates a problem in defining its real efficacy. The conclusive evidence for substituting banding ligation or the combination of vasoconstrictors with sclerotherapy as better therapeutic approaches has not been provided in randomized trials. Sclerotherapy can remain a gold standard in variceal bleeding but there is scope for further studies of ligation and vasoactive drugs.
Babywalkers and infant burns
Authors: M A Birchall, H P Henderson
Journal: BMJ (1988)

abnormality.Histological, microbiological, and chemical pathological examination yielded unremarkable results, and the sudden infant death syndrome was diagnosed by exclusion.A few months later at a confidential survey of postperinatal mortality we were informed of the high rectal temperature and the fact that the child had slept in a carry cot placed on an uncarpeted floor equipped with off peak heating controlled with a time switch.As one of us (MAG) had experience of severe burns sustained by adults lying unconscious on uncarpeted floors with underfloor heating we decided to determine the ambient temperatures reached in a carry cot placed on such a floor.In a maisonette equipped with similar underfloor heating the thermostat was set at 16°C, and temperature was measured with a pen recorder continuously for four days.The recorder was placed in the cot and covered with two blankets as the child had been, though the child had also been wearing a vest, a nappy, and a babysuit.The lowest temperature recorded under the blankets in the carry cot was 31°C at noon, when the heating had been off for several hours.Peak temperatures of 42°C were reached when the heating was on, and temperatures ranged from 34°C to 38°C for several hours at a time.Temperatures where the cot base touched the floor reached a maximum of 44°C and were often above 40°C.
Human bone marrow lymphocytes. Cytotoxic effector cells in the bone marrow of normal individuals.
Authors: A S Fauci, J E Balow, K R Pratt
Journal: Journal of Clinical Investigation (1976)

This study was undertaken to determine the capability of lymphocytes in the bone marrow of normal individuals to mediate nonspecific killer cell functions in assays of phytohemagglutinin (PHA)-induced cellular cytotoxicity, and antibody-dependent cellular cytotoxicity (ADCC) against 51Cr-labeled chicken erythrocyte target cells. Relatively pure mononuclear cell suspensions were obtained from bone marrow aspirates in 30 normal volunteers by sucrose gradient centrifugations and from the peripheral blood of the same individuals by Hypaque-Ficoll density centrifugations. At an effector: target ratio of 10:1, the PHA-induced cellular cytotoxicity of peripheral blood was 78.8 +/- 1.3%, while that of bone marrow was not significantly less at 66 +/- 9% (P greater than 0.1). At low effector:target ratios, the ADCC of bone marrow was negligible, while at higher effector:target ratios (20:1) bone marrow ADCC was 69 +/- 3.7%, which was comparable to that of peripheral blood. The lymphocytes themselves in the mononuclear cell suspensions of both peripheral blood and bone marrow were capable of cytotoxicity activity since depletion of monocytes from the suspensions by adherence to rayon wool and G-10 Sephadex columns did not remove the cytotoxic activity. Blocking of the Fc receptor on the effector cells by the addition of aggregated gamma globulin to the cultures suppressed the ADCC but not the PHA-induced cellular cytotoxicity of both peripheral blood and bone marrow, indicating that ADCC is dependent on an Fc receptor on the effector cell in both compartments. These studies demonstrate that the bone marrow of normal humans contains populations of lymphoid cells which have highly efficient killer cell capacities. It is uncertain what portion of these cells arise in the bone marrow and what portion enter the bone marrow parenchyma as part of the recirculating lymphocyte pool. These findings have relevance in the clearer understanding of the killer cell potential of grafted human marrow, as well as the bone marrow sequestration of functionally capable lymphocyte subpopulations in disease states and during chemotherapy.
C.C.H.M.S. and Consultant Contract
Authors: J. A. Fleming
Journal: BMJ (1972)

This procedure would have two advan- tages.The first is that it would overcome many of the administrative difficulties, both on the ward and in the laboratory, which arise from the necessity of sending a plasma sample and request card to the laboratory on one day and the 24-hour urine sample with a second request card on the following day.If the plasma is taken when the collec- tion is completed, both specimens can be sent with a single request card.The second, perhaps less important, advantage is that with this procedure the change in creatinine clearance will be greater than with the conventional method should the plasma creatinine be rising or falling during the period of the urine collection.For example, if renal function were deteriorating and plasma creatinine rising the creatinine clear- ance would be lower if the plasma is taken at the end of the urine collection than if it is taken in the middle.There is no doubt that clinical biochemistry laboratories would welcome this change in procedure, and it appears to have no clinical disadvantages.-Weare, etc.,
Mechanism of the Pharmacokinetic Interaction between Methotrexate and Benzimidazoles
Authors: Pauline Breedveld, Noam Zelcer, Dick Pluim, Özgür Sönmezer, Matthijs M. Tibben, Jos H. Beijnen, Alfred H. Schinkel, Olaf van Tellingen, Piet Borst, Jan H. M. Schellens
Journal: Cancer Research (2004)

The antifolate drug methotrexate (MTX) is transported by breast cancer resistance protein (BCRP; ABCG2) and multidrug resistance-associated protein1-4 (MRP1-4; ABCC1-4). In cancer patients, coadministration of benzimidazoles and MTX can result in profound MTX-induced toxicity coinciding with an increase in the serum concentrations of MTX and its main metabolite 7-hydroxymethotrexate. We hypothesized that benzimidazoles interfere with the clearance of MTX and/or 7-hydroxymethotrexate by inhibition of the ATP-binding cassette drug transporters BCRP and/or MRP2, two transporters known to transport MTX and located in apical membranes of epithelia involved in drug disposition. First, we investigated the mechanism of interaction between benzimidazoles (pantoprazole and omeprazole) and MTX in vitro in membrane vesicles from Sf9 cells infected with a baculovirus containing human BCRP or human MRP2 cDNA. In Sf9-BCRP vesicles, pantoprazole and omeprazole inhibited MTX transport (IC50 13 microm and 36 microm, respectively). In Sf9-MRP2 vesicles, pantoprazole did not inhibit MTX transport and at high concentrations (1 mm), it even stimulated MTX transport 1.6-fold. Secondly, we studied the transport of pantoprazole in MDCKII monolayers transfected with mouse Bcrp1 or human MRP2. Pantoprazole was actively transported by Bcrp1 but not by MRP2. Finally, the mechanism of the interaction was studied in vivo using Bcrp1-/- mice and wild-type mice. Both in wild-type mice pretreated with pantoprazole to inhibit Bcrp1 and in Bcrp1-/- mice that lack Bcrp1, the clearance of i.v. MTX was decreased significantly 1.8- to 1.9-fold compared with the clearance of i.v. MTX in wild-type mice. The conclusion is as follows: benzimidazoles differentially affect transport of MTX mediated by BCRP and MRP2. Competition for BCRP may explain the clinical interaction between MTX and benzimidazoles.
AN IMPROVED DIFFRACTION METHOD FOR DIAGNOSING AND FOLLOWING THE COURSE OF PERNICIOUS AND OTHER ANAEMIAS
Authors: A. Pijper
Journal: BMJ (1929)

A MKTHOD FOR DIAGNOSIG PRRNICIOIJS ANAEMIA.l BprT= 635 beneficial effect at all.Intravenous injections of eusol in doses of 50 c.cm. (double strength in distilled water) was tried in one case, and appeared to have some influence in nodifying the fever.In conclusion we would like to acknowledge ouir indebtedness to Dr. J. T. Duncan of the London School of Hygiene and Tropical Medicine, and Messrs. F. W. Foster and W. J
NEW APPARATUS: (1) AN ASEPTIC PROTECTIVE SHEET FOR MASTOID SURGERY, AND (2) A PRACTICAL ALGESIMETER.
Authors: H. O. REIK
Journal: JAMA (1906)

<h3>I. ASEPTIC PROTECTIVE SHEET FOR MASTOID SURGERY.</h3> One of the important problems confronting the aural surgeon is the maintenance of strict asepsis of the mastoid wound without unduly disfiguring the patient, even temporarily, by extensive removal of hair. The practice of different operators, as regards the preparation of the field for a mastoid operation, varies from removal of only a small amount of hair immediately surrounding the area to be opened, to a close shaving of the entire head. I have never felt justified in exposing an extensive area of the scalp, except in a premeditated brain investigation, and yet, in my efforts to save the patient from unnecessary loss of hair, I have frequently been sorely troubled by hairs encroaching on the wound at a critical stage of the operation. In preparing for a simple mastoidectomy it has been my custom to have the scalp shaved for a distance
KLF2-induced actin shear fibers control both alignment to flow and JNK signaling in vascular endothelium
Authors: Reinier A. Boon, Thomas A. Leyen, Ruud D. Fontijn, Joost O. Fledderus, Josefien M. C. Baggen, Oscar L. Volger, Geerten P. van Nieuw Amerongen, Anton J. G. Horrevoets
Journal: Blood (2009)
Metastatic Prostatic Carcinoma Presenting as an Anterior Mediastinal Mass on Gallium Imaging
Authors: MOHAN MAKHIJA
Journal: Clinical Nuclear Medicine (1991)

A great majority of mediastinal lymph node metastases originate from primary neoplasms within the thorax. Mediastinal metastases from other malignancies are not infrequently encountered but are uncommon from a prostatic primary site. Since prostatic metastases may mimic lymphomatous nodes, it is important to be aware that mediastinal adenopathy occurring in a patient with prostatic carcinoma may be caused by metastases from that site rather than from lymphoma, or be secondary to some unknown primary malignancy elsewhere in the body. The author presents a case of metastatic prostatic carcinoma in the anterior mediastinum that was detected on Ga-67 citrate imaging and confirmed on a CT scan.
Cholestatic Jaundice in Association with Desacetylmethylcolchicine
Authors: Humberto A. Velasco, Joseph E. Sokal
Journal: New England Journal of Medicine (1959)

CONSIDERABLE information has accumulated in the medical literature about the effects of desacetylmethylcolchicine,§ an alkaloid with antimitotic properties closely related to colchicine, since its recent introduction as a therapeutic agent in gout and in some neoplastic diseases, particularly chronic myelocytic leukemia. Published reports indicate that this drug has little toxic effect upon the liver when used within the therapeutic dose range of 3 to 6 mg. daily. Some authors suggest that the possibility of hepatotoxicity exists, although the nature or the degree of the hepatic alterations has not been determined in the clinical experience. Storti and Gallinelli1 observed a case . . .
Trends in antihypertensive drug use in the United States: do the JNC V recommendations affect prescribing? Fifth Joint National Commission on the Detection, Evaluation, and Treatment of High Blood Pressure
Authors: D. Siegel
Journal: JAMA (1997)

The choice of pharmacological treatment for the approximately 50 million people in the United States with hypertension has important therapeutic and financial implications.To describe national antihypertensive medication prescribing patterns for 1992 and 1995; to explore the influence of the Fifth Joint National Committee on the Detection, Evaluation, and Treatment of High Blood Pressure (JNC V), published in 1993, which recommended diuretics and beta-blockers as first-line antihypertensive therapy unless contraindicated; and to estimate the impact of these prescribing patterns on the cost of antihypertensive treatment.All prescriptions for drugs approved for the treatment of hypertension dispensed by 35000 retail pharmacies were tabulated for 1992 and 1995 (62% of all US retail pharmacies were surveyed).Number of prescriptions for each dosage form of medication and national cost estimates based on wholesale costs of medications dispensed.In 1992, of the 10 most frequently prescribed antihypertensive drugs, 3 were calcium antagonists, 3 were angiotensin-converting enzyme (ACE) inhibitors, 3 were beta-blockers, and 1 was the combination of triamterene and hydrochlorothiazide. In 1995, 4 were calcium antagonists, 3 were ACE inhibitors, 1 was a beta-blocker, 1 was the combination of triamterene and hydrochlorothiazide, and 1 an alpha-blocker. In 1992, calcium antagonists accounted for 33% of antihypertensive prescriptions compared with 38% in 1995, ACE inhibitor use went from 25% to 33%, beta-blocker use from 18% to 11%, and diuretic use from 16% to 8%. The estimated wholesale costs for calcium antagonists in 1995 dollars increased from $2.67 billion in 1992 to $2.86 billion in 1995; ACE inhibitor costs increased from $1.37 billion to $1.67 billion; costs for diuretics declined from $353 million to $168 million; and costs for beta-blockers declined from $763 million to $433 million.From 1992 to 1995 use of calcium antagonists and ACE inhibitors for treatment of hypertension increased and diuretics and beta-blockers declined, suggesting that the recommendations from JNC V had little effect on prescribing patterns. The cost implications of these practice patterns are enormous.
825 SILYBIN CONJUGATED WITH PHOSPHATIDYLCHOLINE AND VITAMIN E IMPROVES LIVER DAMAGE IN PATIENTS WITH NAFLD: THE RESULTS OF A RANDOMIZED MULTICENTRE DOUBLE-BLIND VS PLACEBO TRIAL
Authors: P. Andreone, M.C. Brise, M. Chiaramonte, A. Federico, A. Floreani, M.A. Freni, A. Grieco, S. Lobello, S. Milani, L. Okolicsanyi, P. Portincasa, A. Smedile, I. Sporea, P. Sorrentino, R. Vecchione, C. Tuccillo, C. Loguercio
Journal: Journal of Hepatology (2011)
The New Dimensions of Submarine Medicine
Authors: John H. Ebersole
Journal: New England Journal of Medicine (1960)

THERE is no better way to illustrate the challenge of environmental control in prolonged submergence and the degree to which this challenge has been met than to compare prenuclear submarines with those of the nuclear era. The statements of two veteran submariners, speaking of events separated in time by fourteen years, dramatize this evolution in long submergence capability.Captain Edward L. Beach1 writes of USS Trigger on war patrol in 1944 and describes the environment as follows:... the bow and stern planes and steering have been put into hand operation instead of hydraulic, and brawny sailors sweat profusely as . . .
The Syniatrist
Authors: Henry K. Silver
Journal: JAMA (1971)

To clarify terminology describing allied health professionals, it is recommended that a new term, "syniatrist," defined as "an individual practicing in association, union, or together with a physician," be adopted as the generic name for health professionals who carry out functions and activities traditionally performed by physicians. The name syniatrist would apply only to health workers who have direct contact with patients in providing health care under a physician's supervision. A classification of syniatrists is proposed with two principal subdivisions: (1) area of specialty of practice, and (2) relationship of syniatrist to physician. The latter subdivision would be based on the degree of independence and competence expected from the syniatrist in the application of his professional skills.