tbuckley/cabot-search huggingface dataset:
Introduction to Abdominal Surgery: 50 Clinical Studies
Authors: Robert E. Hermann
Journal: JAMA (1981)

This is an excellent book by the late Clarence J. Schein, MD, and is a fitting epitaph in the surgical literature for this distinguished surgeon and surgical educator. The 50 casestudies cover the broad range of surgical problems that occur in the abdomen. They have been taken from the teaching conferences at the Montefiore Hospital and Medical Center, Bronx, NY, that were organized by Dr Schein. The cases are given in a realistic fashion with the chief complaint and history and, occasionally, brief physical findings in an introductory paragraph. The reader is then asked to make a tentative or provisional diagnosis. A discussion follows based on the initial presentation and findings. A more complete physical examination and results of laboratory and roentgenographic studies are then given, a differential diagnosis is made and discussed, and therapeutic alternatives are provided. The operative approach and brief discussion of operative technique and perioperative management
Ex Vivo Gene Delivery of IL-1Ra and Soluble TNF Receptor Confers a Distal Synergistic Therapeutic Effect in Antigen-Induced Arthritis
Authors: Seon Hee Kim, Eric R. Lechman, Sunyoung Kim, Joan Nash, Thomas J. Oligino, Paul D. Robbins
Journal: Molecular Therapy (2002)

Intra-articular expression of antagonists of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in arthritic rabbit knee and mouse ankle joints by direct adenoviral-mediated intraarticular delivery results in amelioration of disease pathology in both the treated and contralateral untreated joints. Previous experiments suggest that direct adenoviral infection of resident antigen-presenting cells (APCs) and subsequent traveling of these cells to other sites of inflammation and lymph nodes might be responsible for this “contralateral effect.” To determine whether genetic modification of APCs is required for the contralateral effect, we have used an ex vivo approach utilizing genetically modified fibroblasts to express IL-1 receptor antagonist protein (IL-1Ra) and soluble TNF-α receptor (sTNFR) locally in arthritic joints. Retroviral vectors carrying IL-1Ra, sTNFR-Ig, or both genes together were used to stably infect autologous rabbit fibroblasts that were then injected intra-articularly into arthritic rabbit knee joints. The intra-articular delivery of either IL-1Ra- or sTNFR-Ig-expressing fibroblasts was antiinflammatory and chondro-protective in both the injected and noninjected contralateral joints. In addition, we demonstrate that the co-delivery of both antagonists in combination results in a synergistic effect in disease amelioration in both the treated and nontreated joints. These ex vivo results suggest that trafficking of vector-modified inflammatory cells is not the main mechanism responsible for the observed distal spread of the therapeutic effect. Moreover, the results demonstrate that local, ex vivo gene therapy for arthritis could be effective in blocking pathologies within untreated, distant arthritic joints.
Highly Drug-Resistant Tuberculosis-Reply
Authors: Lisa Fine Sherman
Journal: JAMA (1997)

<h3>In Reply.</h3> —As Dr Ponce de Leon and colleagues note, the epidemiology of drug-resistant TB must be evaluated locally. Drug resistance is the result of improper treatment—incorrect regimens and insufficient emphasis on ensuring treatment completion by direct observation. If antituberculosis drugs are introduced without adequate treatment programs, acquired drug resistance increases. After acquired drug resistance increases, primary drug resistance will increase with the pace of the increase greatly accelerated in populations where HIV is common. Effective treatment programs decrease the incidence of drug-resistant tuberculosis.<sup>1,2</sup> Referral centers tend to attract patients with acquired drug resistance, and, hence, drug resistance and molecular epidemiologic investigations of patients treated at such centers, as Ponce de Leon and colleagues note, are not representative. Findings about specific DNA patterns cannot be generalized from our report. What can be learned is that, in the absence of an effective tuberculosis control program and the presence of HIV, multidrug-resistant TB
Patients Leaving Emergency Departments Without Being Seen by a Physician-Reply
Authors: Arthur L. Kellermann
Journal: JAMA (1992)

<h3>In Reply.</h3> —Several points are raised in these letters that require a response. It is ironic that funding for the National Health Service Corps Scholarship program has been curtailed at a time when the need for primary care practitioners in physician shortage areas is greater than ever. The alternative of paying a bonus, instituting debt forgiveness, or providing tax incentives to physicians who choose to locate in such areas is an intriguing concept that merits further consideration. As an active practitioner, I also fear "frivolous" lawsuits, but I have grave reservations about a system of arbitration or review that would be imposed only on the poor. If an approach to tort reform that is fair to patients and providers alike can be found, it should be applied to all. The shrinking number of primary care practitioners able or willing to provide care to the poor is clearly exacerbating our
Intact human ceruloplasmin oxidatively modifies low density lipoprotein.
Authors: E Ehrenwald, G M Chisolm, P L Fox
Journal: Journal of Clinical Investigation (1994)

Ceruloplasmin is a plasma protein that carries most of the copper found in the blood. Although its elevation after inflammation and trauma has led to its classification as an acute phase protein, its physiological role is uncertain. A frequently reported activity of ceruloplasmin is its ability to suppress oxidation of lipids. In light of the intense recent interest in the oxidation of plasma LDL, we investigated the effects of ceruloplasmin on the oxidation of this lipoprotein. In contrast to our expectations, highly purified, undegraded human ceruloplasmin enhanced rather than suppressed copper ion-mediated oxidation of LDL. Ceruloplasmin increased the oxidative modification of LDL as measured by thiobarbituric acid-reacting substances by at least 25-fold in 20 h, and increased electrophoretic mobility, conjugated dienes, and total lipid peroxides. In contrast, ceruloplasmin that was degraded to a complex containing 115- and 19-kD fragments inhibited cupric ion oxidation of LDL, as did commercial preparations, which were also degraded. However, the antioxidant capability of degraded ceruloplasmin in this system was similar to that of other proteins, including albumin. The copper in ceruloplasmin responsible for oxidant activity was not removed by ultrafiltration, indicating a tight association. Treatment of ceruloplasmin with Chelex-100 removed one of seven copper atoms per molecule and completely blocked oxidant activity. Restoration of the copper to ceruloplasmin also restored oxidant activity. These data indicate that ceruloplasmin, depending on the integrity of its structure and its bound copper, can exert a potent oxidant rather than antioxidant action on LDL. Our results invite speculation that ceruloplasmin may be in part responsible for oxidation of LDL in blood or in the arterial wall and may thus have a physiological role that is quite distinct from what is commonly believed.
701-2 The Final % Cross-sectional Narrowing (Residual Plaque Burden) is the Strongest Intravascular Ultrasound Predictor of Angiographic Restenosis
Authors: Gary S. Mintz, Ya Chien Chuang, Jeffrey J. Popma, Augusto D. Pichard, Kenneth M. Kent, Lowell F. Satler, Theresa A. Bucher, Jennifer Griffin, Martin B. Leon
Journal: Journal of the American College of Cardiology (1995)
Evidence for Encapsidation of Prokaryotic Sequences during Recombinant Adeno-Associated Virus Production and Their in Vivo Persistence after Vector Delivery
Authors: Gilliane Chadeuf, Carine Ciron, Philippe Moullier, Anna Salvetti
Journal: Molecular Therapy (2005)

Recombinant adeno-associated virus vectors (rAAV) have been successfully used for long-term gene expression in animal models and in patients. However, while the therapeutic potential of rAAV appears promising, safety issues, including contaminants found in vector stocks, must be further evaluated. We previously reported that a cis-acting replication element present within the AAV-2 p5 promoter was responsible for the encapsidation of rep–cap sequences observed during rAAV production. In that study, we also noticed that plasmid-derived prokaryotic sequences (such as the ampicillin resistance gene) could be found packaged into AAV capsids. In this report, first we confirmed and extended the latter observation by analyzing rAAV stocks produced using different procedures. Second, we demonstrated that these plasmid-derived sequences were transferred and persisted in vivo after rAAV injection into different tissues. Third, our data showed that at least some of these packaged plasmid molecules were linked to the AAV ITRs and were present in vivo in a form that could be rescued through bacterial transformation. This study highlights the need for more stringent characterization of rAAV stocks and provides useful information on the development of rAAV production methods that are able to circumvent or limit the generation of such undesirable particles.
China is top of contraception league
Authors: J. Wise
Journal: BMJ (1996)

The United Kingdom France and Hong Kong are second only to China in the use of contraception with more than 80% of married couples using some form.  There are 16 countries in Africa where less than 10% of the population uses modern contraception according to the league tables of 98 countries drawn up by the family planning charity Marie Stopes International.  Worldwide the most popular form of contraception is female sterilization with the contraceptive pill most commonly use in Europe.  (full text)
New pathological findings in emphysema of childhood: 2. Overinflation of a normal lobe
Authors: A. Hislop, L. Reid
Journal: Thorax (1971)

A quantitative study of the structure of the affected lobe from a patient with childhood lobar emphysema is here reported. The left upper lobe was removed from a child aged 2½ months who was suffering from acute respiratory distress and showing on his radiograph hypertransradiancy of the left lung. At operation the lobe was found to be increased in volume and rotated through 180° on its pedicle. After laboratory injection of some of the pulmonary artery branches and distension of the lobe, the stage of development of the various lung structures was studied quantitatively. The arteries and bronchi were normal in number and structure: the alveolar number was normal for the age of the child but the volume of an alveolus was increased four to five times, as was total lung volume. The antenatal development of this lobe was normal and it seems that the emphysema could have followed the rotation of the lobar hilum, although no cause for this rotation was found.
Hepatic Injury during Propylthiouracil Therapy in Patients with Hyperthyroidism: A Cohort Study
Authors: Yun-Fan Liaw
Journal: Annals of Internal Medicine (1993)

Objective: To evaluate the incidence, severity, and course of propylthiouracil-induced hepatic injury in patients with hyperthyroidism. Design: Cohort study. Setting: Outpatient clinic of a university-based hospital. Patients: Fifty-four patients with normal aspartate aminotransferase (AST) and alanine aminotransferase (ALT) values and a definite diagnosis of hyperthyroidism. Intervention: Treatment with propylthiouracil, 300 mg/d for 2 months followed by 100 to 150 mg/d for 3 months and a subsequent maintenance dose of 100 mg/d. Measurements: Liver biochemical tests were studied before therapy and 2 months and 5 months after starting propylthiouracil therapy. The patients were monitored with clinical evaluation and weekly liver bio-chemical tests after AST or ALT levels became abnormal. Serologic markers of hepatitis A, B, C, and delta virus infection were also studied when appropriate. Results: Fifteen (28%; 95% CI, 16% to 42%) of the 54 patients showed ALT elevations 2 months after propylthiouracil therapy. The mean peak ALT level for these patients was 1.35 µkat/L (range, 0.65 3.85 µkat/L). None of these patients had symptoms or hyperbilirubinemia. Liver biopsy in three patients showed mild perivenular focal necrosis or ill-defined granuloma composed of foamy histiocytes with ceroid pigment and mild fatty metamorphosis. Despite continued propylthiouracil therapy at a reduced dose, ALT levels returned to normal in 13 of 15 patients in the following 3 months. None of these ALT elevations resulted from hepatitis A, B, C, or delta virus infection. No statistical difference was seen in the pretreatment characteristics between patients with and those without ALT elevation, except that the former had a higher pretreatment T4 level (270 ± 12.9 compared with 237 ± 7.72 nmol/L, P = 0.027) and T3 level (7.22 ± 0.72 compared with 5.85 ± 0.39 nmol/L, P = 0.048). Conclusions: Propylthiouracil-induced subclinical liver injury is common and is usually transient and asymptomatic. Therapy with propylthiouracil may be continued with caution in the absence of symptoms and hyperbilirubinemia.
Heme oxygenase–1 and carbon monoxide suppress autoimmune neuroinflammation
Authors: Ângelo A. Chora, Paulo Fontoura, Andreia Cunha, Teresa F. Pais, Sílvia Cardoso, Peggy P. Ho, Lowen Y. Lee, Raymond A. Sobel, Lawrence Steinman, Miguel P. Soares
Journal: Journal of Clinical Investigation (2007)

Heme oxygenase-1 (HO-1, encoded by HMOX1) dampens inflammatory reactions via the catabolism of heme into CO, Fe, and biliverdin. We report that expression of HO-1 dictates the pathologic outcome of experimental autoimmune encephalomyelitis (EAE), a model of multiple sclerosis (MS). Induction of EAE in Hmox1(-/- )C57BL/6 mice led to enhanced CNS demyelination, paralysis, and mortality, as compared with Hmox1(+/+) mice. Induction of HO-1 by cobalt protoporphyrin IX (CoPPIX) administration after EAE onset reversed paralysis in C57BL/6 and SJL/J mice and disease relapse in SJL/J mice. These effects were not observed using zinc protoporphyrin IX, which does not induce HO-1. CoPPIX protection was abrogated in Hmox1(-/-) C57BL/6 mice, indicating that CoPPIX acts via HO-1 to suppress EAE progression. The protective effect of HO-1 was associated with inhibition of MHC class II expression by APCs and inhibition of Th and CD8 T cell accumulation, proliferation, and effector function within the CNS. Exogenous CO mimicked these effects, suggesting that CO contributes to the protective action of HO-1. In conclusion, HO-1 or exposure to its end product CO counters autoimmune neuroinflammation and thus might be used therapeutically to treat MS.
[195] EFFECT OF THE ANTIBIOTIC NORFLOXACIN ON HYPERDYNAMIC CIRCULATION, VASCULAR CONTRACTILITY, AND EXTRAHEPATIC VASCULAR PKG ACTIVITY IN CIRRHOTIC RATS
Authors: M. Hennenberg, J. Trebicka, D. Buecher, T. Sauerbruch, J. Heller
Journal: Journal of Hepatology (2007)
Ads: Television icons join fight over stem cell research
Authors: F. Charatan
Journal: BMJ (2002)

Don't criminalise scientists, says fictional couple Harry and Louise

Big advertising has joined the battle in the United States over stem cell research. As recently as last month, a Gallup poll found that most Americans opposed both cloning for reproductive purposes and research cloning performed to harvest stem cells from human embryos. President George W Bush, referring to reproductive cloning and research cloning, said on 10 April, “I believe all human cloning is wrong, and both forms of cloning should be banned.”

A bill banning all forms of cloning was passed in the United States House of Representatives last year. The current US Senate version—introduced by Republican senator Sam Brownback of Kansas and Democratic senator Mary Landrieu of Louisiana—not only prohibits all forms of human cloning, but sets civil and criminal penalties for violators of the law. The debate on the Senate bill, put off several times, is being heavily lobbied and is the source of a number of emotional advertising campaigns.

Last April, an alliance of patient groups, concerned parents, and leaders in …
Experience with an Artificial Plasma for Use with Extracorporeal Circulation
Authors: David L. Siegal
Journal: JAMA (1962)

EXTRACORPOREAL circulation produces trauma to the blood, and the by-products of this trauma may be deleterious to the body. The feasibility of diverting the animal's blood from the circulation while perfusing with an artificial-plasma red-blood-cell mixture and then removing this mixture while readministering the animal's unperfused blood was investigated. Such a technique should lessen the volume of harmful by-products of blood trauma remaining in the animal's body following extracorporeal circulation. Methods Artificial Plasma.—It was found necessary to modify the formula for the plasma substitute originally devised by Dahlback and his co-workers. Packed red blood cells were added to this solution in sufficient quantity to give a hematoerit level of 20% to 30% (Fig. 1). The pH of the cells was adjusted to 7.4 with tromethamine (Talatrol) prior to their addition to the solution. <i>Heart-Lung Machine</i>.—A DeWall-Lillehei type bubble oxygenator was modified to provide a reservoir to receive and hold the
Hidden Illness in the White House
Authors: James G. Burrow
Journal: JAMA (1989)

With one presidential assassination and three other attempts in the last three decades, much of the public may have come to believe that the perils of the presidency arise principally from violence. If so, this volume by Kenneth R. Crispell, MD, university professor of medicine and law emeritus at the University of Virginia, and Carlos F. Gomez, a fellow in the Pew program of the University of Chicago, should dispel this illusion. In a work that will interest many physicians, they deal with dangers to the presidency arising from disabling and undisclosed illness in the 20th-century White House. In fact, they show that illnesses deliberately concealed from the public may have had decisive effects on elections and certainly left some presidents incapable of performing their duties properly. The book is largely devoted to a careful study of the health conditions of three 20th-century presidents—Woodrow Wilson, Franklin D. Roosevelt, and John
Review: Vitamin and antioxidant supplements do not prevent adverse cardiovascular events
Authors: Christopher M. Rembold
Journal: Annals of Internal Medicine (2013)

Source Citation Myung SK, Ju W, Cho B, et al. Efficacy of vitamin and antioxidant supplements in prevention of cardiovascular disease: systematic review and meta-analysis of randomised controlled trials. BMJ. 2013;346:f10. 23335472
Recovery from Decompensated Non-insulin-dependent Diabetes Mellitus: Studies of C-Peptide Secretion
Authors: Marc Rendell, Joan Zarriello, Helen Mikesell Drew, Barbara Dranbauer, Gregory Wilson, John Waud, David Ross
Journal: Diabetes Care (1981)

Eleven non-insulin-dependent diabetic patients presented with decompensated hyperglycemia. Nine had pronounced ketonuria, five with acidosis. In seven cases, precipitating factors were identified. In the other four cases, including three cases of diabetic ketoacidosis, no identifiable triggering events were present. In each case, recovery from the initially decompensated diabetic state occurred. Eventually, all patients were managed by diet alone. Seven patients demonstrated nondiabetic glucose tolerance tests (GTT). Several patients underwent stressful situations after “recovery” without recurrence of hyperglycemia. Glucose-stimulated C-peptide levels were determined postrecovery. C-peptide secretion was in the normal range and, in fact, was identical, in relation to glucose levels, to that in a group of nondiabetic volunteers. In 6 of the 11 cases, C-peptide secretion was measured at the time of initial presentation. These levels were markedly lower than comparable values during the GTT postrecovery. Non-insulin-dependent diabetes, even when presenting in a decompensated state, is subject to a considerable degree of reversibility and even recovery to a nondiabetic state in some cases. Recovery is associated with a return to normal C-peptide secretion.
THE BORDET-GENGOU BACILLUS OF PERTUSSIS
Authors: Martha Wollstein
Journal: The Journal of Experimental Medicine (1909)

The bacillus of Bordet and Gengou is present in the sputum in early cases of pertussis, and in the lungs at autopsy in fatal cases of the disease. After the second week it is not present in the sputum in sufficiently large numbers to be readily isolated. The influenza bacillus is found at as early a stage of pertussis as is the Bordet-Gengou bacillus, and it persists in the sputum for a longer time. The agglutinins in the blood of pertussis patients are not more regular and not always higher for the Bordet-Gengou bacillus than for B. influenzae. The two organisms are culturally distinct and their action on laboratory animals different. Complement deviation tests with the serum of immunized rabbits show a further difference in the immune bodies produced by the two varieties of bacilli. The negative results of the complement deviation tests with the patients' serum in this study, compared with the positive results of similar tests made by Bordet and Gengou, I am not able to account for. This study has contributed support to the view that the Bordet-Gengou bacillus is the possible cause of pertussis, but it has not produced any distinctively new evidence of this relationship beyond the proof of the wide dissemination of the peculiar bacillus in nature and its occurrence in pertussis. A study of bronchial secretions in other acute diseases of the respiratory tract for the bacillus has not yet been extensively made and is called for. I shall hope to report on this phase of the subject at another time.