tbuckley/cabot-search huggingface dataset:
Gene Transfer into the Fetal Primate: Evidence for the Secretion of Transgene Product
Authors: Janet E. Larson, Susan L. Morrow, Joseph B. Delcarpio, Rudolf P. Bohm, Marion S. Ratterree, James L. Blanchard, J. Craig Cohen
Journal: Molecular Therapy (2000)

In utero adenoviral-mediated transfer of genes via the amniotic fluid results in sustained high-efficiency expression in rodent lung and intestine. Rhesus macaque (Macaca mulatta) fetuses were injected with adenovirus vectors encoding reporter genes at different gestational ages to evaluate feasibility and timing in primates. The fetuses developed normally following gene transfer and no maternal adverse affects were noted. Highly efficient viral uptake and transgene protein expression occurred in the target organs. The lungs exhibited no immune response and transgenic protein was observed up to 30 days postinfection. Unexpectedly, large amounts of reporter gene protein were released, apparently from the lung, into the circulation and accumulated in the renal proximal tubules and bladder. PCR detection for adenovirus DNA was consistently negative in tissues not in contact with the amniotic fluid, such as kidneys, liver, gonads, and eyes. Treatment of primate fetuses at 110 days gestation with an adenovirus expressing the cystic fibrosis transmembrane conductance regulator (cftr) gene resulted in accelerated differentiation of the lung. These studies demonstrate the efficacy of in utero gene therapy in primates and its potential application to genetic diseases. In utero adenoviral-mediated transfer of genes via the amniotic fluid results in sustained high-efficiency expression in rodent lung and intestine. Rhesus macaque (Macaca mulatta) fetuses were injected with adenovirus vectors encoding reporter genes at different gestational ages to evaluate feasibility and timing in primates. The fetuses developed normally following gene transfer and no maternal adverse affects were noted. Highly efficient viral uptake and transgene protein expression occurred in the target organs. The lungs exhibited no immune response and transgenic protein was observed up to 30 days postinfection. Unexpectedly, large amounts of reporter gene protein were released, apparently from the lung, into the circulation and accumulated in the renal proximal tubules and bladder. PCR detection for adenovirus DNA was consistently negative in tissues not in contact with the amniotic fluid, such as kidneys, liver, gonads, and eyes. Treatment of primate fetuses at 110 days gestation with an adenovirus expressing the cystic fibrosis transmembrane conductance regulator (cftr) gene resulted in accelerated differentiation of the lung. These studies demonstrate the efficacy of in utero gene therapy in primates and its potential application to genetic diseases.
Esophageal Motor Disorder Diagnosed by Esophageal Transit Scintigraphy
Authors: Ashwani Sood, Sanjay Gambhir, Arun Baburao Sewatkar, Satyawati Deswal, Vivek Sarswat, Rakesh Kumar
Journal: Clinical Nuclear Medicine (2004)

Esophageal transit scintigraphy (ETS) is used to evaluate esophageal motility disorder (EMD). The authors describe a 52-year-old mane who had recurrent symptoms of regurgitation and heartburn 3 months after antireflux surgery (Nissen fundoplication). Esophageal manometry and 24-hour pH monitoring showed normal lower esophageal sphincter pressure, good esophageal motility, and severe reflux. An ETS done to rule out motility disorder clearly showed reflux and retention of Tc-99m sulfur colloid-labeled semisolid jelly bolus in the mid segment of the esophagus. This case highlights the role of ETS in the diagnosis of EMD in patients with recurrent gastrointestinal symptoms, whereas other investigations were inconclusive.
Hepatic Injury Related to Tromethamine
Authors: Gabriel G. Nahas
Journal: JAMA (1968)

<h3>To the Editor:—</h3> The paper by Goldenberg et al (<b>205</b>:81, 1968) describing liver damage in infants receiving concentrated tromethamine (THAM) solution (1.2M, pH 10.2) through the umbilical vein confirms previous observations. Indeed, a review of the literature concerning the effect of the infusion of hypertonic alkaline solutions indicates that such administration does produce liver damage. Brinkman et al<sup>1</sup>reported in 1961 that administration of 1.5M tromethamine (pH 10.2) in a diabetic patient who subsequently died presented hydropic degeneration of liver cells as well as kidney. In 1963, it was reported that fetal rhesus monkeys treated by injection of sodium carbonate (pH 10.5, 0.7M solution, 2,100 mOsm) into the umbilical vein were found to have liver damage at the time of postmortem examination.<sup>2</sup>This damage was described as areas of hemorrhage with necrosis of liver cells. By contrast, diabetic patients treated with tromethamine (0.3M) did not present any microscopic
The Kinetics of Intramolecular Distribution of 15N in Uric Acid after Administration of [15N]Glycine A REAPPRAISAL OF THE SIGNIFICANCE OF PREFERENTIAL LABELING OF N-(3 + 9) OF URIC ACID IN PRIMARY GOUT
Authors: Oded Sperling, James B. Wyngaarden, C. Frank Starmer
Journal: Journal of Clinical Investigation (1973)

THE CONCEPT OF AN ABNORMALITY OF GLUTAMINE METABOLISM IN PRIMARY GOUT WAS FIRST PROPOSED ON THE BASIS OF ISOTOPE DATA: when [(15)N]glycine was administered to gouty subjects, there was disproportionately great enrichment of N-(3 + 9) of uric acid, which derive from the amide-N of glutamine. An unduly high concentration of (15)N in glutamine was postulated, and attributed to a hypothetical defect in catabolism of glutamine. Excess glutamine was proposed as the driving force of uric acid overproduction. WE HAVE REEXAMINED THIS PROPOSITION IN FOUR GOUTY SUBJECTS: one mild overproducer of uric acid with "idiopathic gout," one marked overproducer with high-grade but "partial" hypoxanthine-guanine phosphoribosyl-transferase deficiency, and two extraordinary overproducers with superactive phosphoribosylpyrophosphate synthetases. In the last three, the driving force of excessive purine biosynthesis is a known surplus of alpha-5-phosphoribosyl-1-pyrophosphate. Disproportionately high labeling of N-(3 + 9) was present in all four gouty subjects, most marked in the most flamboyant overproducers. The precursor glucine pool was sampled by periodic administration of benzoic acid and isolation of urinary hippuric acid. Similarly, the precursor glutamine pool was sampled by periodic administration of phenylacetic acid and isolation of the amide-N of urinary phenylacetylglutamine. The time course of (15)N enrichment of hippurate differed from that of the amide-N of glutamine. Whereas initial enrichment values of hippurate were very high, those of glutamine-amide-N were low, increasing to a maximum at about 3 h, and then declining less rapidly than those of hippurate. However, enrichment values of hippurate and of phenacetyl glutamine were normal in all of the gouty subjects studied. Thus, preferential enrichment of N-(3 + 9) in gouty overproducers given [(15)N]glycine does not necessarily reflect a specific abnormality of glutamine metabolism, but rather appears to be a kinetic phenomenon associated with accelerated purine biosynthesis per se.In addition, greater enrichment of N-9 than of N-3 on days 1 and 2 provided suggestive evidence for a second pathway for synthesis of the initial precursor of purine biosynthesis, phosphoribosylamine, perhaps utilizing ammonia rather than the amide-N of glutamine as nitrogen donor. In this limited study, the activity of this potential second pathway did not appear to be selectively increased in gout.
Where Borders Become Meeting Places: Review of Charles C. Camosy,<i>Peter Singer &amp; Christian Ethics: Beyond Polarization</i>
Authors: Samuel Roberto, Ashley K. Fernandes
Journal: The American Journal of Bioethics (2013)

"Where Borders Become Meeting Places: Review of Charles C. Camosy, Peter Singer & Christian Ethics: Beyond Polarization ." The American Journal of Bioethics, 13(2), pp. 61–62
Effects of nutrient liquids on human gastroduodenal motor activity.
Authors: C M White, V Poxon, J Alexander-Williams
Journal: Gut (1983)

The effects of intragastric infusion of 10% Intralipid and 10% dextrose on the intraluminal pressures in the antrum, pylorus and duodenal bulb have been examined. Ten studies with each infusate have been performed in 10 normal subjects and the results compared with those obtained previously in 22 studies during intragastric infusion of isotonic saline. During saline infusion, contractile activity varied. In six studies fasting motor activity persisted; in the remainder, variable activity, without recognisable pattern was recorded. With saline, the gastroduodenal region usually functioned as a unit and the pylorus was the least autonomous part. Neither a sustained rise of basal pressure nor rhythmic, independent contractions were recorded from the pylorus. The contractile activity of the gastroduodenal region with Intralipid and dextrose was more uniform than with saline. Fasting motor activity was always abolished. The gastroduodenal region ceased to contract as a unit and the pylorus acquired autonomous activity. Rhythmic, independent contractions of the pylorus were recorded in nine of 10 studies during Intralipid infusion and six of 10 studies with dextrose. In addition, a sustained rise in pyloric basal pressure was recorded in eight of 10 studies with Intralipid and three of 10 studies with dextrose. Pyloric motility indices were significantly greater with fat than with dextrose. The observed differences in gastroduodenal motility are consistent with a role for the pylorus in the control of emptying of liquid from the stomach.
Decreased Glucagon-Like Peptide 1 Fasting Levels in Type 2 Diabetes
Authors: Ioannis N. Legakis, Costas Tzioras, Costas Phenekos
Journal: Diabetes Care (2003)

The significance of over- or underproduction of glucagon-like peptide 1 (GLP-1) (7–36) amide in diabetes remains controversial (1,2). Although it has been proposed that at least one factor contributing to the pathogenesis of type 2 diabetes is desensitization of the GLP-1 receptor on β-cells (2), exogenous administration of GLP-1 in patients with type 2 diabetes fully normalizes fasting hyperglycemia and reduces postprandial glycemic increments (3). Also, the GLP-1 response to oral glucose is not altered in postmenopausal women with impaired glucose tolerance (2). The purpose of the present study was to establish any difference in the fasting state concentration …
[788] A PROSPECTIVE COMPARATIVE STUDY OF PROPHYLACTIC OR THERAPEUTIC USE OF LAMIVUDINE FOR CHEMOTHERAPY-ASSOCIATED HEPATITIS B (HBV) REACTIVATION IN NON-HODGKIN'S LYMPHOMA (NHL) PATIENTS
Authors: C. Hsu, C.A. Hsiung, I.J. Su, W.S. Hwang, M.C. Wang, S.F. Lin, T.H. Lin, H.H. Hsiao, J.H. Young, M.C. Chang, M.T. Huang, Y.M. Liao, C.C. Li, H.B. Wu, T.Y. Chao, T.W. Liu, A.L. Cheng, P.T. Chen
Journal: Journal of Hepatology (2007)
Ode to MKSAP
Authors: Warren W. Furey
Journal: Annals of Internal Medicine (1992)

Ad Libitum1 September 1992Ode to MKSAPWarren W. Furey, MDWarren W. Furey, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-117-5-440 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMedical education is not a compendium of facts to be memorized.• it is the daily living and doing of being a physician,• it is being the first lights on in the neighborhood and an earlier than traffic ride to the hospital,• it is rounds on real people, friends, or just people looking for help, and sorting out their problems,• it is phone calls, house calls, and office calls and listening and sorting out and searching for answers to what you hear and accumulating all of those experiences and forever searching the new information that explains what... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 251 East Chicago Avenue Chicago, IL 60611 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1992Volume 117, Issue 5Page: 440-440KeywordsMedical education ePublished: 1 December 2008 Issue Published: 1 September 1992 PDF downloadLoading ...
Stability of Cognitive Performance in Older Patients With Schizophrenia: An 8-Week Test-Retest Study
Authors: Philip D. Harvey, Barton W. Palmer, Robert K. Heaton, Somaia Mohamed, John Kennedy, Adam Brickman
Journal: American Journal of Psychiatry (2004)

OBJECTIVE: It is important to understand the stability of cognitive performance in schizophrenia in order to understand 1) the potential improvements in performance associated with the beneficial effects of cognitive-enhancing medications and 2) the potential variation in performance on cognitive measures that are components of neuroimaging studies. There are several factors that could lead to spurious improvements in cognitive test scores, including practice effects and random test-retest errors. METHOD: Forty-five older patients with schizophrenia who were receiving conventional antipsychotic medications participated in the study. All subjects completed a comprehensive neuropsychological test battery at baseline and again at an 8-week follow-up evaluation. RESULTS: Performance on all of the cognitive measures was stable over time, as evidenced by significant test-retest correlations, and practice effects were generally absent or minimal. Tests administered with alternate forms were no more temporally stable than tests administered twice with the same form. Very few individual cases had substantial variation at retest across the 22 test scores. From these data, “norms for evaluating change” were developed and described using the reliable change index method. CONCLUSIONS: The data suggest that the findings of modest cognitive improvements seen in some prior studies of schizophrenia patients when treated with second-generation antipsychotic medications were probably not due to simple retesting artifacts. At the same time, because of the variance in some of these test-retest performances, relatively substantial changes in performance on the part of individual patients would be required to be clearly interpretable.
Four decades of surgery for bronchogenic carcinoma in one centre
Authors: A. Spiliopoulos, M. de Perrot
Journal: European Respiratory Journal (2000)

Since the authors9 initial experience in the surgical management of bronchogenic carcinoma in 1956, more than 40 years have passed. The purpose of this report was to review the authors9 data and compare the results by decade (1956-1966; 1967-1976; 1977-1986; and 1987-1996) in order to assess the changing patterns in bronchogenic carcinoma. A total of 1,597 thoracotomies have been performed. Between the first and last decades of the study, patients9 mean age increased from 57 to 63 yrs, the ratio of males to females decreased from 19:1 to 3:1 and the proportion of adenocarcinoma cases increased from 10 to 34%. The operative mortality decreased from 10% in 1967- 1976 to 4% in 1987-1996 and the overall 5-yr survival improved from 27 to 36% during the same period. The rate of lobectomy progressively increased from 32% in 1956-1966 to 61% in 1987-1996, whereas that of pneumonectomy and exploratory thoracotomy decreased from 42 to 28% and from 20 to 4%, respectively. Changing patterns of patient characteristics, histology and type of surgery were associated with a constant improvement in the overall 5-yr survival. This improvement was particularly evident among patients with advanced-stage carcinoma.
I-123-Iodophenylpentadecanoic Acid (IPPA) overestimates myocardial salvage early after reperfusion
Authors: David K. Glover, Mirta Ruiz, Hiwot Desta, Dennis A. Calnon, William H. Smith, Denny D. Watson, George A. Beller
Journal: Journal of the American College of Cardiology (1996)
The Impact of Dermatology Consultation on Diagnostic Accuracy and Antibiotic Use Among Patients With Suspected Cellulitis Seen at Outpatient Internal Medicine Offices
Authors: Ryan Y. Arakaki, Lauren Strazzula, Elaine Woo, Daniela Kroshinsky
Journal: JAMA Dermatology (2014)

Cellulitis is a common and costly problem, often diagnosed in the outpatient setting.Many cutaneous conditions may clinically mimic cellulitis, but little research has been done to assess the magnitude of the problem.OBJECTIVE To determine if obtaining dermatology consultations in the outpatient primary care setting could assist in the diagnosis of pseudocellulitic conditions and reduce the rate of unnecessary antibiotic use.DESIGN, SETTING, AND PARTICIPANTS Nonblinded randomized clinical trial of competent adults who were diagnosed as having cellulitis by their primary care physicians (PCPs), conducted at outpatient internal medical primary care offices affiliated with a large academic medical center. INTERVENTIONS Outpatient dermatology consultation.MAIN OUTCOMES AND MEASURES Primary outcomes were final diagnosis, antibiotic use, and need for hospitalization.RESULTS A total of 29 patients (12 male and 17 female) were enrolled for participation in this trial.Nine patients were randomized to continue with PCP management (control group), and 20 patients were randomized to receive a dermatology consultation (treatment group).Of the 20 patients in the dermatology consultation group, 2 (10%) were diagnosed as having cellulitis.In the control group, all 9 patients were diagnosed as having cellulitis by PCPs, but dermatologist evaluation determined that 6 (67%) of these patients had a psuedocellulitis rather than true infection.All 9 patients (100%) in the control group were treated for cellulitis with antibiotics vs 2 patients (10%) in the treatment group (P < .001).One patient in the control group was hospitalized.All patients in the treatment group reported improvement of their cutaneous condition at the 1-week follow-up examination.CONCLUSIONS AND RELEVANCE Dermatology consultation in the primary care setting improves the diagnostic accuracy of suspected cellulitis and decreases unnecessary antibiotic use in patients with pseudocellulitic conditions.Obtaining an outpatient dermatology consultation may be a cost-effective strategy that improves quality of care.
Is AIDS Caused by a Neurotropic Virus?
Authors: Wilson Radding
Journal: JAMA (1985)

<h3>To the Editor.—</h3> Among the collected data about the acquired immunodeficiency syndrome (AIDS) are features that, taken together, might imply that the disease involves the nervous system. First, is the latency period, estimated at six months to two years, second, the apparent infectiousness of semen despite the fact that the virus appears to infect blood cells, and third, the appearance of encephalopathy in patients, which is accompanied in approximately one third of the cases by detectable human T-cell lymphotropic virus (HTLV-III) DNA in the brain.<sup>1</sup> It may be possible to discern a neural pathway by which the disease could progress. Studies using horse-radish peroxidase have demonstrated that the nucleus ambiguus of the brain stem innervates the larynx, bronchus, stomach, and heart,<sup>2</sup>and also the pancreas,<sup>3</sup>probably through parasympathetic cholinergic neurons. Although the intestine, nasopharyngeal area, testis, prostate, and spleen have not been investigated this way, it seems
An Evaluation of Risks — Bypass versus Obesity
Authors: William W. Faloon
Journal: New England Journal of Medicine (1976)

One of the early lessons that a thoughtful physician learns is that all therapy is an evaluation of risks. In other words, does the treatment, although associated with risks, have a better result than the natural course of the disease? In massive "intractable" obesity, such an evaluation compares the increased mortality due to cardiac and cerebrovascular disease, gallstones, and diabetes mellitus of these patients with the hazards of radical measures such as intestinal "bypass" operations. The latter include mortality due to operation and the hepatic failure that has been recorded. Perhaps even more appropriate is the comparison of the nonfatal . . .
Definition of ambulatory blood pressure targets for diagnosis and treatment of hypertension in relation to clinic blood pressure: prospective cohort study
Authors: G. A. Head, A. S. Mihailidou, K. A. Duggan, L. J. Beilin, N. Berry, M. A. Brown, A. J. Bune, D. Cowley, J. P. Chalmers, P. R. C. Howe, J. Hodgson, J. Ludbrook, A. A. Mangoni, B. P. McGrath, M. R. Nelson, J. E. Sharman, M. Stowasser
Journal: BMJ (2010)

Twenty-four hour ambulatory blood pressure thresholds have been defined for the diagnosis of mild hypertension but not for its treatment or for other blood pressure thresholds used in the diagnosis of moderate to severe hypertension. We aimed to derive age and sex related ambulatory blood pressure equivalents to clinic blood pressure thresholds for diagnosis and treatment of hypertension.We collated 24 hour ambulatory blood pressure data, recorded with validated devices, from 11 centres across six Australian states (n=8575). We used least product regression to assess the relation between these measurements and clinic blood pressure measured by trained staff and in a smaller cohort by doctors (n=1693).Mean age of participants was 56 years (SD 15) with mean body mass index 28.9 (5.5) and mean clinic systolic/diastolic blood pressure 142/82 mm Hg (19/12); 4626 (54%) were women. Average clinic measurements by trained staff were 6/3 mm Hg higher than daytime ambulatory blood pressure and 10/5 mm Hg higher than 24 hour blood pressure, but 9/7 mm Hg lower than clinic values measured by doctors. Daytime ambulatory equivalents derived from trained staff clinic measurements were 4/3 mm Hg less than the 140/90 mm Hg clinic threshold (lower limit of grade 1 hypertension), 2/2 mm Hg less than the 130/80 mm Hg threshold (target upper limit for patients with associated conditions), and 1/1 mm Hg less than the 125/75 mm Hg threshold. Equivalents were 1/2 mm Hg lower for women and 3/1 mm Hg lower in older people compared with the combined group.Our study provides daytime ambulatory blood pressure thresholds that are slightly lower than equivalent clinic values. Clinic blood pressure measurements taken by doctors were considerably higher than those taken by trained staff and therefore gave inappropriate estimates of ambulatory thresholds. These results provide a framework for the diagnosis and management of hypertension using ambulatory blood pressure values.
Chekhov's Doctors 11. Dorn
Authors: Jack Coulehan
Journal: JAMA (1997)

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