tbuckley/cabot-search huggingface dataset:
Caution on Bone Scans in Eosinophilic Granuloma
Authors: CHARLES EIL
Journal: Annals of Internal Medicine (1978)

Letters and Corrections1 August 1978Caution on Bone Scans in Eosinophilic GranulomaCHARLES EIL, M.D., PH.D., BRUCE T. ADORNATO, M.D.CHARLES EIL, M.D., PH.D.Search for more papers by this author, BRUCE T. ADORNATO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-89-2-289_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Multifocal eosinophilic granuloma (Hand-Schüller-Christian disease) often produces lytic lesions of the skeletal system. Scintiscanning with bone-seeking agents is thought to be a usually reliable and early means of detecting such lesions (1, 2). We have recently reported (3) the case of a patient with multifocal eosinophilic granuloma who suffered extradural C7 to T1 nerve root compression associated with a radiotomographically demonstrable T1 vertebral body lesion but had a negative technetium-99m-diphosphonate bone scan.We report here the case of a second patient with extradural spinal root compression with histologically verified multifocal eosinophilic granuloma in whom conventional radiographs, computerized...References1. ZINKHAM W: Multifocal eosinophilic granuloma: natural history, etiology and management. Am J Med 60:457-463, 1976 CrossrefMedlineGoogle Scholar2. KAUFMANBUKBERGWERLINYOUNG APSI: Mutlifocal eosinophilic granuloma ("Hand-Schuller-Christian disease"). Report illustrating H-S-C chronicity and diagnostic challenge. Am J Med 60:541-548, 1976 CrossrefMedlineGoogle Scholar3. EILADORNATO CB: Radicular compression in multifocal eosinophilic granuloma. Successful treatment with radiotherapy. Arch Neurol 34:786-787, 1977 CrossrefMedlineGoogle Scholar4. SILBERSTEINSAENGERTOFEALEXANDERPARK EEAGH: Imaging of bone metastases with 99m Tc-Sn-EHDP (diphosphonate), 18F, and skeletal radiography. A comparison of sensitivity. Radiology 107:551-556, 1973 CrossrefMedlineGoogle Scholar5. MAJDFRANKEL MR: Radionuclide imaging in skeletal inflammatory and ischemic disease in children. Am J Roent Genol Radium Ther Nucl Med 126:832-841, 1976 CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: National Institutes of Health Bethesda, MD 20014 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1978Volume 89, Issue 2Page: 289-289KeywordsBoneComputersGranulomasLesionsNerves Issue Published: 1 August 1978 PDF DownloadLoading ...
Continuing Medical Education Through Television
Authors: S. Spence Meighan
Journal: JAMA (1967)

Many physicians do not participate in organized continuing medical education. While some show reluctance to accept their need to become involved, others express concern that they lack the opportunity to influence the design of the educational courses offered. The Oregon Medical Association, therefore, decided to sponsor a series of television programs for the continuing education of its members. By the placement of this responsibility in the state medical association, the entire membership theoretically becomes involved in attempting to design and organize an effective system of continuing medical education. <h3>Organization</h3> Plans for program production were laid at a meeting of the television committee of the medical association and the production staff of Oregon Educational Broadcasting (part of the Oregon State System of Higher Education). The television committee then selected 17 physicians and made each responsible for the development of one program. Criteria for the selection of these physicians were vague; a
Insensitivity of the cold pressor stimulation test for the diagnosis of coronary artery disease.
Authors: A G Wasserman, L Reiss, R J Katz, R Leiboff, P Cleary, V M Varma, R C Reba, A M Ross
Journal: Circulation (1983)

Cold pressor stimulation (CPS) was compared with supine bicycle exercise during radionuclide ventriculography as a procedure for diagnosing coronary artery disease (CAD). Thirty patients were studied. In the 18 patients with angiographically proved CAD, left ventricular ejection fraction (LVEF) decreased a mean of 5.0 +/- 1.0 ejection fraction units (+/- SEM) in response to CPS. Only two patients developed a new wall motion abnormality. In response to maximal supine exercise, the CAD group showed a mean decrease in LVEF from rest of 1.9 +/- 1.1%. Nine patients developed an exercise-induced wall motion abnormality. In the 12 patients with angiographically proved normal coronary arteries, LVEF decreased a mean of 5.8 +/- 1.3 units in response to CPS and increased a mean of 9.2 +/- 1.2% in response to exercise. Thus, the LVEF response to CPS was not significantly different in the CAD and normal groups (5.0 +/- 1.0 vs 5.8 +/- 1.3, NS). These same patients demonstrated the expected difference in LVEF response to exercise. We conclude that CPS produces similar changes in LVEF in patients with and without CAD, and therefore is not useful in diagnosing ischemic heart disease.
An Externally Validated Model for Predicting Long-Term Survival after Exercise Treadmill Testing in Patients with Suspected Coronary Artery Disease and a Normal Electrocardiogram
Authors: Michael S. Lauer, Claire E. Pothier, David J. Magid, S. Scott Smith, Michael W. Kattan
Journal: Annals of Internal Medicine (2007)

Background: The exercise treadmill test is recommended for risk stratification among patients with intermediate to high pretest probability of coronary artery disease. Posttest risk stratification is based on the Duke treadmill score, which includes only functional capacity and measures of ischemia. Objective: To develop and externally validate a post–treadmill test, multivariable mortality prediction rule for adults with suspected coronary artery disease and normal electrocardiograms. Design: Prospective cohort study conducted from September 1990 to May 2004. Setting: Exercise treadmill laboratories in a major medical center (derivation set) and a separate HMO (validation set). Patients: 33 268 patients in the derivation set and 5821 in the validation set. All patients had normal electrocardiograms and were referred for evaluation of suspected coronary artery disease. Measurements: The derivation set patients were followed for a median of 6.2 years. A nomogram-illustrated model was derived on the basis of variables easily obtained in the stress laboratory, including age; sex; history of smoking, hypertension, diabetes, or typical angina; and exercise findings of functional capacity, ST-segment changes, symptoms, heart rate recovery, and frequent ventricular ectopy in recovery. Results: The derivation data set included 1619 deaths. Although both the Duke treadmill score and our nomogram-illustrated model were significantly associated with death (P < 0.001), the nomogram was better at discrimination (concordance index for right-censored data, 0.83 vs. 0.73) and calibration. We reclassified many patients with intermediate- to high-risk Duke treadmill scores as low risk on the basis of the nomogram. The model also predicted 3-year mortality rates well in the validation set: Based on an optimal cut-point for a negative predictive value of 0.97, derivation and validation rates were, respectively, 1.7% and 2.5% below the cut-point and 25% and 29% above the cut-point. Limitations: Blood test–based measures or left ventricular ejection fraction were not included. The nomogram can be applied only to patients with a normal electrocardiogram. Clinical utility remains to be tested. Conclusion: A simple nomogram based on easily obtained pretest and exercise test variables predicted all-cause mortality in adults with suspected coronary artery disease and normal electrocardiograms.
Psyllium laxative‐induced anaphylaxis, asthma, and rhinitis
Authors: S. K. Vaswani, R. G. Hamilton, M. D. Valentine, N. F. Adkinson
Journal: Allergy (1996)

A 69‐year‐old nurse was evaluated for a recent episode of anaphylaxis that had occurred after psyllium ingestion. She had experienced recurrent rhinitis and asthma related to psyllium exposure for the past 15 years. The diagnosis of psyllium hypersensitivity was established by a positive psyllium puncture skin test, an elevated psyllium‐specific IgE level in serum, and a confirmatory soluble‐antigen competitive inhibition test. The patient was symptomatic for several years, and this diagnosis was not considered until she suffered potentially life‐threatening anaphylaxis. Psyllium hypersensitivity may be a more common phenomenon than is currently appreciated by physicians and other health‐care providers.
Protease Inhibitors Bring New Social, Clinical Uncertainties to HIV Care
Authors: Rebecca Voelker
Journal: JAMA (1997)

LAZARUS NEVER had a Visa card charged to the hilt. Or a life insurance policy that was sold at maybe 60% of its face value. Or the prospect of going back to work while having to maintain a complex regimen of multiple antiretroviral drugs. For clinicians, politicians, and patients with the human immunodeficiency virus (HIV), the era of life-prolonging treatment with protease inhibitors has become as much a cause of uncertainty as it is of celebration. Even though optimism about powerful new drug combinations has been widespread, "we are on the threshold of a new set of problems with these treatment modes," said Willie Brown Jr, mayor of San Francisco, Calif, where a multidisciplinary group of people with HIV, clinicians, and social and legal services workers met last month for the 9th National AIDS Update Conference. <h3>Back to Work Issues</h3> For many patients who have had success with combination therapy
Activation of Notch1 signaling is required for -catenin-mediated human primary melanoma progression
Authors: K. Balint
Journal: Journal of Clinical Investigation (2005)

Notch is a highly conserved transmembrane receptor that determines cell fate. Notch signaling denotes cleavage of the Notch intracellular domain, its translocation to the nucleus, and subsequent activation of target gene transcription. Involvement of Notch signaling in several cancers is well known, but its role in melanoma remains poorly characterized. Here we show that the Notch1 pathway is activated in human melanoma. Blocking Notch signaling suppressed whereas constitutive activation of the Notch1 pathway enhanced primary melanoma cell growth both in vitro and in vivo yet had little effect on metastatic melanoma cells. Activation of Notch1 signaling enabled primary melanoma cells to gain metastatic capability. Furthermore, the oncogenic effect of Notch1 on primary melanoma cells was mediated by beta-catenin, which was upregulated following Notch1 activation. Inhibiting beta-catenin expression reversed Notch1-enhanced tumor growth and metastasis. Our data therefore suggest a beta-catenin-dependent, stage-specific role for Notch1 signaling in promoting the progression of primary melanoma.
Diagnosis of Chloroquine Cardiomyopathy by Endomyocardial Biopsy
Authors: Norman B. Ratliff, Melinda L. Estes, Jonathan L. Myles, Earl K. Shirey, James T. McMahon
Journal: New England Journal of Medicine (1987)

CHLOROQUINE and hydroxychloroquine are antimalarial agents that are often used in the treatment of collagen vascular diseases. However, both drugs can cause a toxic skeletal-muscle myopathy, the histology of which has been carefully described.1 2 3 4 5 6 7 8 9 Chloroquine toxicity results in cardiomyopathy in animals, but documentation of cardiac involvement in humans has been limited to evidence of conduction abnormalities in one patient, congestive heart failure in another patient, and the finding of vacuolar degeneration of cardiac muscle during two autopsies.1 , 4 5 6 7 8 This report describes the light and electron microscopical findings in chloroquine and hydroxychloroquine myocardial toxicity in two patients, as revealed by endomyocardial biopsy. . . .
Philip Henry Nicholls Wood
Authors: A. S. J Dixon, B. Milburn, J. K Wood
Journal: BMJ (2009)

Philip Henry Nicholls Wood was a unique figure in the history of British rheumatic disease epidemiology. His insights into professional rheumatology initiated large changes and he made a major contribution to improving the situation of disabled people. Perhaps most significantly, he revised the international classification of disease through his work for the World Health Organization, originating a new concept of disablement and changing the way of thinking about disease and its consequences for the individual and for society.

Born in Cardiff on 23 October 1928 and educated at Churcher’s College, Petersfield, Philip became a medical student at Sheffield University in 1946. He completed only his first year as other interests, including amateur dramatics, had taken preference to his studies. He was then “de-reserved” and spent his two years’ national service with the Royal Army Medical Corps as a medical hygienist and later as chief clerk at the Military Hospital in York. It was to this period that he attributed the birth of his interest in public health.

After this he applied to every medical school in the country but was turned down by all except St Bartholomew’s Hospital Medical College. He qualified from there in 1955. After a series of significant junior hospital jobs, he won a scholarship and moved to the Royal Postgraduate Medical School’s rheumatology department, where he studied the pharmacology of aspirin. He made noteworthy discoveries and developed his compassion for patients with rheumatic diseases.

While still a student, Philip met Cherry Charlish, who was teaching arts and crafts at a social priority school in north London. They shared a love for literature, music, painting, and political interests, and married in 1952. Philip’s considerable intellectual abilities were recognised by his boss and lasting friend, the rheumatologist Allan Dixon. In 1963, Allan encouraged Philip to take up the …
TCT-519 Randomized study to assess the effect of ThRombus aspiration on flow area in STEMI patients: an Optical Frequency domain Imaging study (TROFI). Two- and Three-dimensional analysis of Six-month OFDI follow-up
Authors: Yoshinobu Onuma, Leif Thuesen, Robert-Jan van Geuns, Martin van der Ent, Gerhard Schuler, Jean Fajadet, Takashi Muramatsu, Felix Zijlstra, Hector Garcia-Garcia, Patrick Serruys
Journal: Journal of the American College of Cardiology (2012)
893 SERIAL DECREASE OF PLASMA VASCULAR ENDOTHELIAL GROWTH FACTOR LEVELS AFTER TRANSCATHETER ARTERIAL CHEMOEMBOLIZATION MAY PREDICT EFFECTIVENESS OF PROCEDURE; A PROSPECTIVE STUDY
Authors: S.H. Ryu, J.H. Park, H.H. Kim, J.A. Kim, J.H. Lee, Y.S. Kim, J.S. Moon
Journal: Journal of Hepatology (2010)
A Case of Hydrophobia Eighteen Months after Infection
Authors: P. J. Freyer
Journal: BMJ (1919)

Histologically it was shown by Mariinesco that the lesions were of an inflammatory nature, and were characterized by adventitial infiltration of the small vessels, particularly the venules, by plasma cells and lymphocytes.The five following cases occurring about the same time, and during the period of the influenza epidemic in France, are similar in many respects clinically to the case of encephalitis lethargica reported in 1918.CASE I. Pte.W.; admitted to bospital on January 5t]h,
Molecular cloning and sequence analysis of full‐length cDNAs encoding new group of Cyn d 1 isoallergens*
Authors: L.C. Au, S.T. Lin, H.J. Peng, C.C. Liang, S.S. Lee, C.D. Liao, Z.N. Chang
Journal: Allergy (2002)

Background: Cyn d 1, the major allergen of Bermuda grass pollen, contains some acidic/basic isoforms. The N ‐terminal amino acid sequences of some acidic Cyn d 1 isoforms were found to be different from those of Cyn d 1 cDNA clones identified previously. Methods: A predicted 17‐meric oligonucleotide probe was designed to fish the unidentified isoallergen cDNAs out of BGP cDNA library. The reactive clones were isolated and verified by sequencing. Two of them were expressed in the yeast Pichia pastoris to obtain recombinant Cyn d 1 proteins. Results: All four cDNA clones encode the full‐length Cyn d 1 with mature proteins of 244 amino acid residues. A 97–99% identity was found among the deduced amino acids of these four clones while an 86% identity was elicited between the four clones and the ones previously identified. The predicted isoelectric focusing (pI) values of the newly identified Cyn d 1s are acidic while pIs of the previously identified Cyn d 1s are basic. The two recombinant acidic Cyn d 1 proteins possess the epitopes recognized by mouse and rabbit polyclonal anti‐Cyn d 1 antibodies, and have human IgE‐binding capacity as revealed by immunodot assay. Conclusions: The present study identified full‐length cDNAs encoding new isoallergens of Cyn d 1, and separated Cyn d 1 gene into an acidic group and a basic group.
Hemodynamic and hormonal adaptations to beta-adrenoceptor blockade. A 24-hour study of acebutolol, atenolol, pindolol, and propranolol in hypertensive patients.
Authors: A H van den Meiracker, A J Man in 't Veld, H J van Eck, F Boomsma, M A Schalekamp
Journal: Circulation (1988)

Comparison of the hemodynamic and hormonal effects of beta-adrenoceptor antagonists with different ancillary properties may help to clarify the antihypertensive mechanism of these drugs. Under strict basal conditions, the effects of acebutolol (400 mg b.i.d.), atenolol (100 mg b.i.d.), pindolol (10 mg b.i.d.), and propranolol (80 mg t.i.d.), were studied for the first 24 hours in 40 hypertensive patients. With pindolol, mean arterial pressure was reduced (p less than 0.05) 1 hour after administration, whereas the cardiac index and the systemic vascular resistance index did not change. With the other three drugs, the fall in mean arterial pressure was delayed 2-3 hours. With these drugs, the fall in mean arterial pressure was preceded by a rise in the resistance index, which compensated for the initial fall in cardiac index. With each drug, the decrements in mean arterial pressure were associated with parallel decrements in the resistance index, and percent changes in mean arterial pressure and the resistance index were always significantly (p less than 0.001) correlated. At the end of the 24-hour period, the four drugs shared an equal antihypertensive effect, which varied 14-17%. This was associated with a return of the cardiac index toward control values by acebutolol, atenolol, and propranolol treatment and a moderately increased cardiac index above pretreatment values (13%, p less than 0.01) with pindolol. The secondary rise in the cardiac index was inversely correlated (p less than 0.001) with the fall in mean arterial pressure with all four drugs. Plasma renin was maximally suppressed 2 hours after treatment, thus before any change in mean arterial pressure had occurred with acebutolol, atenolol, and propranolol. Pretreatment values of active renin and the reduction of mean arterial pressure 24 hours after administration were not correlated in any of the four groups. Despite the "vasodilator" action of the four drugs, plasma norepinephrine did not rise. Our data show that the main hemodynamic change that occurs at the time blood pressure falls after beta-adrenoceptor antagonism is vasodilation. Neither autoregulation of blood flow nor renin suppression can explain this vasodilator action. The absence of an increase in norepinephrine, despite vasodilation, suggests that beta-adrenoceptor antagonism interferes with sympathetic vasoconstrictor nerve activity. This effect may explain the vasodilator and antihypertensive potential of beta-adrenoceptor antagonists.
The Use of Seat Belts
Authors: Albert Weissman
Journal: JAMA (1987)

To the Editor.—  Studies suggest that universal  belt use could [save] 18 000 lives each  noted Goldbaum et al, 1 yet seat belt use costs nothing [and] requires little time. To be consistent, proponents of any public policy should compare its benefits and costs commensurately. If deaths caused by failure to use  belts are expressed in aggregate (18 000 each year, if numbers from Goldbaum et al are taken at face value), then time expended fastening  belts should also be expressed in aggregate. Let us make the crudest, round estimate: If the average driver takes three trips each day, and if buckling and unbuckling consume 10 s each, on the average, then that driver would spend about one minute each day, or six hours each year, fastening and unfastening. If there are about 180 million drivers in the United States, then about a billion hours each
Motor Vehicle Fatalities and the Minimum Drinking Age
Authors: Mike Males
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Decker et al<sup>1</sup>raise a good question: Do young people respond better to general or to youth-targeted measures aimed at reducing fatal accidents? However, the finding by Decker et al that nighttime (alcoholprobable) fatalities among persons aged 19 through 20 years did not decrease after Tennessee enacted stricter anti— driving under the influence of alcohol laws in 1982, but did fall after the drinking age was raised from 19 to 21 years in 1984, is not an adequate answer. The largest decrease in the rate of nighttime fatal crashes (NFCs) among persons aged 19 through 20 years in Tennessee occurred in 1985,<sup>2</sup>when more than half this age group could still drink legally under the "grandfather clause" (under which the 21 drinking age was phased in over 2 years). Persons aged 20 years had a particularly large decrease in the rate of NFCs in 1985,
Pathways of adenine nucleotide catabolism in erythrocytes.
Authors: F Bontemps, G Van den Berghe, H G Hers
Journal: Journal of Clinical Investigation (1986)

The exact pathway whereby the initial catabolism of the adenine nucleotides proceeds from AMP and the possibility of a recycling of adenosine were investigated in human erythrocytes. Adenine nucleotide catabolism, reflected by the production of hypoxanthine, is very slow under physiologic conditions and can be greatly increased by suppression of glucose or alkalinization of the medium. Experiments with inhibitors of adenosine deaminase and adenosine kinase demonstrated that under physiologic conditions the initial catabolism of AMP proceeds by way of a deamination of AMP, followed by dephosphorylation of inosine monophosphate, and that no recycling occurs between AMP and adenosine. Under glucose deprivation, approximately 75% of the 20-fold increase of the catabolism of the adenine nucleotides proceeded by way of a dephosphorylation of AMP followed by deamination of adenosine, and a small recycling of this nucleoside could be evidenced. Inhibition of adenosine transport showed that the dephosphorylation of AMP occurred intracellularly. When the incubation medium was alkalinized in the presence of glucose, the 15-fold increase in the conversion of AMP to hypoxanthine proceeded exclusively by way of AMP deaminase but a small recycling of adenosine could also be evidenced. The threefold elevation of intraerythrocytic inorganic phosphate (Pi) during glucose deprivation and its 50% decrease during alkalinization as well as experiments in which extracellular Pi was modified, indicate that the dephosphorylation of red blood cell AMP is mainly responsive to variations of AMP, whereas its deamination is more sensitive to Pi.
Absence of donor T-cell–derived soluble TNF decreases graft-versus-host disease without impairing graft-versus-tumor activity
Authors: Chiara Borsotti, Anna R. K. Franklin, Sydney X. Lu, Theo D. Kim, Odette M. Smith, David Suh, Chris G. King, Andrew Chow, Chen Liu, Onder Alpdogan, Marcel R. M. van den Brink
Journal: Blood (2007)