tbuckley/cabot-search huggingface dataset:
Endothelium-derived relaxing factor and coronary vasospasm.
Authors: P M Vanhoutte, H Shimokawa
Journal: Circulation (1989)

The endothelium releases the powerful vasodilator and antiaggregatory substance, EDRF, both under basal conditions and upon stimulation by a wide variety of agents. Endothelial injury or dysfunction may play an important role in the spasmogenicity of the coronary artery, although other possible alterations related to atherosclerosis should also be considered. Among the possible stimuli, aggregating platelets are important as a source of vasoconstrictor substances. The endothelium may also produce the vasoactive substances EDHF and EDCF(s). Their pathophysiologic significance remains to be determined.
Looking Back on &lt;emph type="ital"&gt;The House of God&lt;/emph&gt;
Authors: Alan R. Katz
Journal: JAMA (2008)

To the Editor: I enjoyed the Literatim essay on The House of God by Dr Markel.1 As a senior medical student in 1979, I also eagerly read this book. Its seemingly exaggerated perspective was disturbing, engaging, and entertaining.
Clinical Orthopaedics. Number Fifteen: Winter, 1959. [The Hand. Part II.]
Authors: Claude N. Lambert
Journal: JAMA (1960)

This book follows the format of previous ones in the series, having one major subject as the main portion of the volume and devoting the remainder to other orthopedic problems. The major portion of the book concerns the hand, although Part 1 on the hand was contained in the previous volume. There are 13 chapters devoted to various hand disabilities and these are all extremely well presented. The second section of the book, devoted to general orthopedics, consists of five articles on orthopedic problems; the third section presents interesting case reports. This volume, like its predecessors, is a good survey of the recent literature and is recommended for students and practicing orthopedists.
Effect of Added Fat on Plasma Glucose and Insulin Response to Ingested Potato in Individuals With NIDDM
Authors: Mary C Gannon, Nacide Ercan, Sydney A Westphal, Frank Q Nuttall
Journal: Diabetes Care (1993)

OBJECTIVE— In normal subjects, ingestion of butter with potato resulted in considerably lower blood glucose levels but similar or higher insulin concentrations compared with those observed in the same subjects after potato ingestion alone. We determined whether butter ingested with potato would result in a greater stimulation in insulin secretion than ingestion of potato alone in subjects with NIDDM. RESEARCH DESIGN AND METHODS— Seven male subjects with untreated NIDDM ingested 50 g CHO alone or 50 g CHO with 5, 15, 30, or 50 g fat as a breakfast meal. Fat was ingested in the form of butter, and CHO was given in the form of potato. Subjects received 50 g glucose on two separate occasions for comparative purposes. The subjects also were given only water and were studied over the same time period (water control). Plasma glucose, glucagon, alpha-amino nitrogen, nonesterified fatty acids, serum insulin, C-peptide, and triglyceride concentrations were determined over 5 h. The integrated area responses were quantified over the 5-h period using the water control as a baseline. RESULTS— The mean plasma glucose area response after ingestion of potato with or without the various amounts of butter were all similar and were 82% of that observed after ingestion of 50 g glucose. The mean insulin area response to potato alone was 532 pmol · h · L−1. The mean insulin area responses to potato plus 5,15,30, and 50 g of fat meals were 660,774,750, and 756 pmol · h · L−1, respectively. Thus, the mean insulin areas were all greater than for ingestion of potato alone, and a maximal response was observed with addition of 15 g fat (1.4-fold). The C-peptide data did not confirm an increase in insulin secretion. Overall the area responses after ingestion of meals containing fat were not different from the response to potato ingestion alone, although the responses were erratic. The glucagon area response was positive after ingestion of all fat containing meals except for that containing only 5 g fat, and there was a dose-response relationship. The plasma alpha-amino nitrogen and nonesterified fatty acid area responses were negative after potato ingestion and were not significantly different when fat was added. The serum triglyceride concentration increase was greater after the ingestion of butter with the potato as expected. CONCLUSIONS— In contrast to the results in normal subjects after ingestion of butter with potato, the glucose response was not smaller in subjects with NIDDM. The insulin response was greater. The insulin area response data indicated the presence of a dose-response relationship. Whether similar responses will be observed with other dietary fat and CHO sources remains to be determined.
Two Fatal Cases of Convulsions of a Peculiar Character
Authors: T. Dalton
Journal: BMJ (1869)

roboration of this view, that section of the iscniatic nerve in mne Irog, which contains, mixed up with the ordinary sensitive and motor fibrils, the sympathetic filaments which are distributed to the arteries of the limbs, was followed by dilatation of the arteries, with a fuller and more rapid circulation in the web.The blood in the capillaries and veins being, at the same time, unusually loaded with red corpuscles, the general effect to the naked eye was increased redness, not only of the web, but of the whole limb.*An eventual result was opacity of the web, indicating an altered state of nutrition.In the cases related in the first part of this paper, the eyes, though seriously impaired in function, have not suffered disorganisation such as was observed in the animals subjected to the experiment of dividing the trunk of the sympathetic in the neck.In the latter cases, the influence of the sympathetic on the circulation in the eye was com- pletely cut off.In the former, the injury to the sympathetic, from the concussion of the spinal marrow, has been such only as to impair and pervert its influence on the circulation in the eye.It is to be remarked that the subjective symptoms which first attract notice in such cases may exist for some time without any material alteration of structure being distinctly observable under the ophthalmoscope.It is also to be remarked, in conclusion, that the inability which the patients laboured under to exert their sight for any ordinary length of time, which ac- companied the amaurotic failure of sight, was different from the com- mon form of asthenopia.The inability to exert the sight was owing, partly, to the irritable congested state of the eyes, and was, partly, one manifestation, among others, of the impaired energy of body-sense and mind generally-which we saw to be a characteristic of all the cases which have been passed under review.
Incomprehensible consent forms:Plain English is important
Authors: Robert Dingwall
Journal: BMJ (2005)

The General Medical Council and the future of revalidation GMC member respondsEditor-Esmail and Kmietowicz give an inaccurate account of the General Medical Council's policy development on revalidation, ignoring an iterative process with interested parties since 1998 in an attempt to introduce the most fundamental change to medical regulation since its foundation in 1858. 1 2 The GMC clearly has had regard to the legitimate interests of three principal groups-government and the NHS, patients and the public, and the various tribes that make up the UK medical profession.Despite suggestions to the contrary, an initial exploratory meeting on revalidation convened by Sir Donald Irvine in June 1998 was held in the context of a high profile professional conduct case, but well before the Bristol inquiry report and absolutely nothing to do with Rodney Ledward or, indeed, Harold Shipman.It was recognised then that some doctors were not keeping fully up to date nor were they indulging in reflective practice.Irvine correctly proposed that there was a need to make registration with the GMC more meaningful to the public than a mere recognition that doctors had reached a certain standard of professional knowledge in their early 20s.Both articles promote the idea that the doctors' regulator should be filling the vacuum within the NHS created by its failing to fulfil its public responsibility to monitor doctors' clinical standards.Clinical governance is now, slowly, being developed and eventually will extend from systems and teams to individuals-but is it reasonable, as both authors postulate, that such monitoring should become the financial and moral responsibility of the GMC sitting in London and Manchester rather than local managers at the coalface?Although revalidation is a continuing process, it becomes summative only every five years.The NHS and its local systems must not be allowed to abrogate their responsibility for the safety of patients on a day to day basis.Nor should they demand that the GMC and its prime function of assuring fitness to practise and the meaning of the medical register be inappropriately promoted as the first line of defence for the maintenance of clinical quality and safety.
Role of commensal gut bacteria in inflammatory bowel diseases
Authors: Gunnar Loh, Michael Blaut
Journal: Gut Microbes (2012)

Aberrant immune responses toward commensal gut bacteria can result in the onset and perpetuation of inflammatory bowel diseases (IBD). Reduced microbiota diversity in conjunction with lower proportion of Gram positive and higher proportion of Gram negative bacteria than in healthy subjects is frequently reported in IBD patients. In a subset of IBD patients, E. coli strains with specific features trigger disease. Important molecular mechanisms underlying this effect have been identified. However, in the majority of patients the exact nature of host-microbe interactions that contribute to IBD development has so far not been defined. The application of metagenomic techniques may help to identify bacterial functions that are involved in the aggravation or alleviation of IBD. Subsequently, the relevance for disease development of bacterial candidate genes may be tested taking advantage of reductionist animal models of chronic gut inflammation. This approach may help to identify bacterial functions that can be targeted in future concepts of IBD therapy.
Antigen persistence and time of T-cell tolerization determine the efficacy of tolerization protocols for prevention of skin graft rejection
Authors: Stephan Ehl, Peter Aichele, Hansruedi Ramseier, Winfried Barchet, Joachim Hombach, Hanspeter Pircher, Hans Hengartner, Rolf M. Zinkernagel
Journal: Nature Medicine (1998)
Enhanced levels of CD154 (CD40 ligand) on platelets in patients with chronic heart failure
Authors: Christian Stumpf, Christoph Lehner, Saeed Eskafi, Dorette Raaz, Atilla Yilmaz, Susanne Ropers, Alexander Schmeisser, Joseph Ludwig, Werner G. Daniel, Christoph D. Garlichs
Journal: European Journal of Heart Failure (2003)
Effect of alcoholic liver disease and hepatitis C infection on waiting list and posttransplant mortality and transplant survival benefit
Authors: Michael R. Lucey, Douglas E. Schaubel, Mary K. Guidinger, Santiago Tome, Robert M. Merion
Journal: Hepatology (2009)

Disease-specific analysis of liver transplant survival benefit, which encompasses both pre- and posttransplant events, has not been reported. Therefore, we evaluated the effect of alcoholic liver disease (ALD) and hepatitis C virus (HCV) infection on waiting list mortality, posttransplant mortality, and the survival benefit of deceased donor liver transplantation using United States data from the Scientific Registry of Transplant Recipients on 38,899 adults placed on the transplant waiting list between September 2001 and December 2006. Subjects were classified according to the presence/absence of HCV and ALD. Cox regression was used to estimate waiting list mortality and posttransplant mortality separately. Survival benefit was assessed using sequential stratification. Overall, the presence of HCV significantly increased waiting list mortality, with a covariate-adjusted hazard ratio (HR) for HCV-positive (HCV+) compared with HCV-negative (HCV−) HR = 1.19 (P = 0.0001). The impact of HCV+ was significantly more pronounced (P = 0.001) among ALD-positive (ALD+) patients (HR = 1.36; P < 0.0001), but was still significant among ALD-negative (ALD−) patients (HR = 1.11; P = 0.02). The contrast between ALD+ and ALD− waiting list mortality was significant only among HCV+ patients (HR = 1.14; P = 0.006). Posttransplant mortality was significantly increased among HCV+ (versus HCV−) patients (HR = 1.26; P = 0.0009), but not among ALD+ (versus ALD−) patients. Survival benefit of transplantation was significantly decreased among HCV+ compared with HCV− recipients with model for end-stage liver disease (MELD) scores 9-29, but was significantly increased at MELD ≥30. ALD did not influence the survival benefit of transplantation at any MELD score. Conclusion: Except in patients with very low or very high MELD scores, HCV status has a significant negative impact on the survival benefit of liver transplantation. In contrast, the presence of ALD does not influence liver transplant survival benefit. (HEPATOLOGY 2009.)
Open Renal Biopsy
Authors: Guy W. Leadbetter
Journal: JAMA (1965)

To the Editor:—  The necessity of obtaining a satisfactory renal biopsy frequently confronts the internist and urologist. At the Massachusetts General Hospital requests for renal biopsy have been frequent because of a study conducted by Richard Field, MD,4in juvenile diabetics with retinopathy who are under consideration for pituitary stalk section. Initially in this study percutaneous needle biopsy of the kidney was performed. Tissue was not obtained from approximately 25% of the patients. In addition, the complications of bleeding, ie, colic due to the passage of clot, and perinephric hematoma requiring drainage appeared with sufficient frequency to demand reappraisal of biopsy techniques. After due consideration, open renal biopsy was instituted. This has now been done in 95 patients. The surgical approach has been standardized, the complication rate negligible, and renal tissue always obtained.  Surgical Technique:—  Kidney position, the presence of a solitary kidney, or other gross abnormality is determined
Prevalence of asthma and allergic disorders among children in united Germany: a descriptive comparison.
Authors: E. von Mutius, C. Fritzsch, S. K. Weiland, G. Roll, H. Magnussen
Journal: BMJ (1992)

To compare the prevalence of asthma and allergic disorders among children in Munich, western Germany, and Leipzig, eastern Germany, where environmental exposure, particularly air concentrations of sulphur dioxide and particulate matter, and living conditions have differed over the past 45 years.Prevalence surveys among school-children aged 9-11 years in Leipzig and Munich. Self completion of written questionnaire by the children's parents and lung function measurements.1051 children in Leipzig and 5030 in Munich.Primary schools.Reported lifetime prevalence of asthma and allergic disorders, and bronchial hyperresponsiveness assessed by cold air inhalation challenge.The lifetime prevalence of asthma diagnosed by a doctor was 7.3% (72) in Leipzig and 9.3% (435) in Munich; prevalence of wheezing were 20% (191) and 17% (786) respectively. The prevalence of diagnosed bronchitis was higher in Leipzig than Munich (30.9% (303) v 15.9% (739); p < 0.01). A significant drop in forced expiratory volume (> 9%) after cold air challenge was measured in 6.4% (57) of children in Leipzig and in 7.7% (345) of those in Munich. Hay fever (2.4% (24) v 8.6% (410); p < 0.01) and typical symptoms of rhinitis (16.6% (171) v 19.7% (961); p < 0.05) were reported less often in Leipzig than in Munich.No significant differences were seen in the lifetime prevalence of asthma, wheezing, and bronchial hyperresponsiveness between children in Leipzig and Munich. The lifetime prevalence of bronchitis was higher in Leipzig than in Munich. The lower prevalence rates of allergic disorders in Leipzig could point toward aetiological factors that are associated with Western lifestyle and living conditions.
IDH2 mutation-induced histone and DNA hypermethylation is progressively reversed by small-molecule inhibition
Authors: Andrew Kernytsky, Fang Wang, Erica Hansen, Stefanie Schalm, Kimberly Straley, Camelia Gliser, Hua Yang, Jeremy Travins, Stuart Murray, Marion Dorsch, Sam Agresta, David P. Schenkein, Scott A. Biller, Shinsan M. Su, Wei Liu, Katharine E. Yen
Journal: Blood (2014)
Retreatment With Chloroquine in Porphyria Cutanea Tarda
Authors: Michael J. Kowertz
Journal: JAMA (1975)

To the Editor.—  Two years ago, I reported inThe Journal(223:515,1973) the correction of the hepatic abnormalities as well as the cutaneous manifestations of porphyria cutanea tarda (PCT) by the oral administration of chloroquine, and suggested that this agent, directly or indirectly, selectively destroyed those cells (or their organelles) that were responsible for abnormal porphyrin synthesis. Although I still believe this to be the case, longer observation of the two patients reported, and of three additional patients with PCT who were similarly treated, has revealed a slight to moderate increase in uroporphyrin excretion six months to three years after initial treatment. This would imply that all porphyrinproducing structures had not been destroyed, or that they were capable of regeneration. The rise after only six months would favor the former explanation; the increase after three years, the latter.  Alcohol intake was evidently not causally related to the rise. The patient
Therapy-related myelodysplastic syndrome–acute myelogenous leukemia in patients treated for acute promyelocytic leukemia: an emerging problem
Authors: Roberto Latagliata, Maria Concetta Petti, Susanna Fenu, Marco Mancini, Maria Antonietta Aloe Spiriti, Massimo Breccia, Gregorio A. Brunetti, Giuseppe Avvisati, Francesco Lo Coco, Franco Mandelli
Journal: Blood (2002)
Fate of gap junctions in isolated adult mammalian cardiomyocytes.
Authors: N J Severs, K S Shovel, A M Slade, T Powell, V W Twist, C R Green
Journal: Circulation Research (1989)

The fate of gap junctions in dissociated adult myocytes, maintained for up to 22 hours in culture medium, was investigated by semiquantitative analysis of thin sections and by freeze-fracture electron microscopy. Gap junctions in the dissociated myocyte are intact bimembranous structures seen either as invaginated surface-located structures or as annular profiles in the cytoplasm. Surface-located junctions are sealed from the exterior by a sheet of nonjunctional membrane originating (together with the "outer" junctional membrane) from the formerly neighboring cell. Serial sectioning was used to establish that at least part of the annular gap junction population in the freshly isolated myocyte represents truly discrete cytoplasmic vesicles; thus, some gap junctions are rapidly endocytosed after myocyte separation. Analysis of the surface-located-to-annular gap junction ratio suggested that no further endocytosis occurred in rabbit and cat myocytes maintained for 22 and 15 hours, respectively. Guinea pig myocytes, by contrast, did appear to continue endocytosis in culture. Analysis of the distance of gap junctional structures from the cell surface suggested that little if any inward migration of gap junction vesicles occurred. Hypoxia had no detectable effect on the internalization or inward movement of gap junctions. The quantity of ultrastructurally detectable gap junction membrane appeared to remain constant over time, as did the incidence of "complex structures" (i.e., annular gap junction profiles with features previously suggested to represent degradation). New gap junction formation was negligible, and a reappraisal of the nature of "complex structures" led to the conclusion that the origin of these structures need not be related to degradation. Taken together, the findings suggest that degradation and disappearance of gap junctional membrane after isolation of the mature myocyte constitute a much slower process than previously believed, and the possibility that the cardiac gap junction protein has a longer half-life than its counterpart in liver remains open.
266 CLINICAL MARKERS OF THE METABOLIC SYNDROME ARE ASSOCIATED WITH HCV GENOTYPE 1 INFECTION AND ARE STRONG NEGATIVE PREDICTORS OF EARLY VIROLOGICAL RESPONSE
Authors: E. Jaeckel, E. Zehnter, C. John, T. Lutz, W. Schmidt, R. Link, P. Geyer, G. Teuber, M. Stern, H.R. Bruch, K.H. Hey, R. Heyne, B. Moeller, G. Bellmann, A. Schober, S. Stoll, M.P. Manns
Journal: Journal of Hepatology (2010)
The transcription factor Spi-B regulates human plasmacytoid dendritic cell survival through direct induction of the antiapoptotic gene BCL2-A1
Authors: Julien J. Karrich, Melania Balzarolo, Heike Schmidlin, Marion Libouban, Maho Nagasawa, Rebecca Gentek, Shimeru Kamihira, Takahiro Maeda, Derk Amsen, Monika C. Wolkers, Bianca Blom
Journal: Blood (2012)
Thrombolysis for Stroke-Reply
Authors: Geoffrey A. Donnan, Stephen M. Davis, Brian R. Chambers, Peter C. Gates, Graeme J. Hankey, John J. McNeil, David Rosen, Edward G. Stewart-Wynne, Roger R. Tuck
Journal: JAMA (1997)

In Reply.  —Dr Pincus raises some important points concerning thrombolytic therapy in acute ischemic stroke. The first of these is the precision with which patients can be certain of the time of onset. The current indications for the use of t-PA in the United States are based on the NINDS trial and stipulate administration of the drug within 3 hours of onset. Clearly, it will not always be possible for patients to be absolutely certain of the time of ictus, although our experience in the ASK trial 1 would suggest that the majority of people are reasonably certain within this relatively short time frame. If uncertainty does exist, then it would be unreasonable to administer thrombolytic therapy, particularly if the time after stroke onset was approaching 3 hours.  The issue concerning variability of infarct size and location influencing disability scores, such as the Barthel Index, is an interesting one. To our knowledge,
Looking Through a Keyhole at the Tobacco Industry
Authors: Stanton A. Glantz
Journal: JAMA (1995)

<h3>Objective.</h3> —To introduce a series of papers discussing previously undocumented tobacco industry activities regarding strategies to avoid products liability litigation, understand nicotine addiction, and manipulate both internal and external scientific research on the effects of both active and passive smoking. <h3>Data Sources.</h3> —Documents from Brown and Williamson Tobacco Corporation (B&amp;W), the British American Tobacco Company (BAT), and other tobacco interests provided by an anonymous source, obtained from Congress, and received from the private papers of a former BAT officer. <h3>Study Selection.</h3> —All available materials, including confidential reports regarding research and internal memoranda exchanged between tobacco industry lawyers. <h3>Conclusions.</h3> —These documents provide our first look at the inner workings of the tobacco industry during the crucial period in which the scientific case that smoking is addictive and kills smokers solidified. The documents show a sophisticated legal and public relations strategy to avoid liability for the diseases induced by tobacco use. The documents show that lawyers steered scientists away from particular research avenues, which is inconsistent with the company's purported disbelief in the causation and addiction claims; if the company had been genuinely unconvinced by the causation and addiction hypotheses, then it should have had no concern that new research would provide ammunition for the enemy. Quite the contrary, the documents show that B&amp;W and BAT recognized more than 30 years ago that nicotine is addictive and that tobacco smoke is "biologically active" (eg, carcinogenic). (<i>JAMA</i>. 1995;274:219-224)