tbuckley/cabot-search huggingface dataset:
Is Pocket Mobile Echocardiography the Next-Generation Stethoscope? A Cross-sectional Comparison of Rapidly Acquired Images With Standard Transthoracic Echocardiography
Authors: Max J. Liebo, Rachel L. Israel, Elizabeth O. Lillie, Michael R. Smith, David S. Rubenson, Eric J. Topol
Journal: Annals of Internal Medicine (2011)

Background: A pocket mobile echocardiography (PME) device is commercially available for clinical use, but public data documenting its accuracy compared with standard transthoracic echocardiography (TTE) are not available. Objective: To compare the accuracy of rapidly acquired PME images with those acquired by standard TTE. Design: Cross-sectional study. At the time of referral for TTE, ultrasonographers acquired PME images first in 5 minutes or less. Ultrasonographers were not blinded to the clinical indication for imaging or to the PME image results when obtaining standard TTE images. Two experienced echocardiographers and 2 cardiology fellows who were blinded to the indication for the study and TTE results but not to the device source interpreted the PME images. Setting: Scripps Clinic Torrey Pines and Scripps Green Hospital, La Jolla, California. Patients: Convenience sample of 97 patients consecutively referred for echocardiography. Measurements: Visualizability and accuracy (the sum of proportions of true-positive and true-negative readings and observer variability) for ejection fraction, wall-motion abnormalities, left ventricular end-diastolic dimension, inferior vena cava size, aortic and mitral valve pathology, and pericardial effusion. Results: Physician-readers could visualize some but not all echocardiographic measurements obtained with the PME device in every patient (highest proportions were for ejection fraction and left ventricular end-diastolic dimension [95% each]; the lowest proportion was for inferior vena cava size [75%]). Accuracy also varied by measurement (aortic valve was 96% [highest] and inferior vena cava size was 78% [lowest]) and decreased when nonvisualizability was accounted for (aortic valve was 91% and inferior vena cava size was 58%). Observer agreement was fair to moderate for some measurements among less-experienced readers. Limitation: The study was conducted at a single setting, there was no formal estimate of accuracy given the small convenience sample of patients, and few abnormal echocardiographic measurements occurred. Conclusion: The rapid acquisition of images by skilled ultrasonographers who use PME yields accurate assessments of ejection fraction and some but not all cardiac structures in many patients. Further testing of the device in larger patient cohorts with diverse cardiac abnormalities and with untrained clinicians obtaining and interpreting images is required before wide dissemination of its use can be recommended. Primary Funding Source: National Institutes of Health.
UNITY, PEACE AND CONCORD.A FAREWELL ADDRESS TO THE MEDICAL PROFESSION OF THE UNITED STATES.
Authors: WILLIAM OSLER
Journal: JAMA (1905)

On this occasion I have had no difficulty in selecting a subject on which to address you. Surely the hour is not for the head but for the heart, out of the abundance of which I may be able to express, however feebly, my gratitude for the many kindnesses I have received from the profession of this country during the past twenty-one years, and from you, my dear colleagues of this state and city, during the sixteen years I have dwelt among you. Truly I can say that I have lived my life in our beloved profession—perhaps too much! but whatever success I have had has come directly through it, and my devotion is only natural. Few men have had more from their colleagues than has fallen to my lot. As an untried young man my appointment at McGill College came directly through friends in the faculty who had confidence
Reversal of Ischemic Tubular Atrophy
Authors: TEWFIK NAWAR
Journal: Annals of Internal Medicine (1970)

A 52-year-old patient had severe obstruction of the left renal artery, and renal biopsy of the left kidney showed diffuse ischemic tubular atrophy. A thromboendarteriectomy was done. The patient died suddenly, 6 years later. Autopsy showed a patent left renal artery, and a detailed study of the left kidney failed to show any ischemic tubular atrophic lesions. This is the first report of reversal of ischemic tubular atrophy in humans.
An anti-CD18 antibody limits infarct size and preserves left ventricular function in dogs with ischemia and 48-hour reperfusion
Authors: Masazumi Arai, David J. Lefer, SO Takehiko, Anthony Dipaula, Thomas Aversano, Lewis C. Becker
Journal: Journal of the American College of Cardiology (1996)

This study investigated whether an antibody against neutrophil adhesion protein CD18 could limit myocardial infarct size and preserve left ventricular function after prolonged reperfusion in a canine model. Myocardial reperfusion injury is mediated in part by accumulation of activated neutrophils. Although antibodies against CD18 have been shown to reduce neutrophil influx and infarct size after ischemia and 3 to 4 h of reperfusion, it is unknown whether protection is sustained beyond this time or whether there is meaningful preservation of ventricular function. Dogs undergoing 90-min circumflex coronary artery occlusion and 48-h reperfusion were randomized to receive 1 mg/kg bodyweight of R15.7 (an anti-CD18 antibody, n = 12) or saline (control, n = 12) 10 min before reperfusion. Contrast left ventriculography was used to measure left ventricular ejection fraction and regional chord shortening at baseline, during occlusion and at 48 h. Microspheres injected during occlusion were used to measure collateral flow and risk region size. Postmortem infarct size was measured with triphenyltetrazolium chloride. In the dose administered, R15.7 bound to neutrophils in vivo, with >85% saturation of CD18 for >24 h, with sustained antibody excess in the plasma. R15.7 significantly reduced infarct size after adjusting for the effect of collateral flow (p = 0.0002, analysis of covariance). In a subgroup of dogs with collateral flow <30% of nonischemic flow, infarct size was reduced from 34.6 ± 3.9% (mean ± SE) of the region at risk in the control group to 19.5 ± 3.3% in the antibody group (p = 0.008). Ejection fraction and regional chord shortening did not differ between the two groups at baseline or during occlusion, but after 48-h reperfusion, ejection fraction and inferior wall regional cord shortening (representing the infarct zone) were both higher in the R15.7 group than the control group (43.6 ± 2.9% vs. 28.5 ± 1.8%, p < 0.01; 2.55 ± 0.29% vs. 1.06 ± 0.18%, p < 0.05). A single injection of an anti-CD18 antibody given before reperfusion can limit myocardial infarct size by nearly 50% and preserve global and regional left ventricular function after 48 h of reperfusion.
The Role of Proteolytic Enzymes in the Development of Pulmonary Emphysema and Periodontal Disease
Authors: James Travis, Rob Pike, Takahisa Imamura, Jan Potempa
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Pulmonary emphysema and periodontal disease are each characterized by the uncontrolled proteolysis of connective tissue proteins by proteinases derived from human neutrophils. Although these diseases would not appear to be related in terms of the initial insult to individual tissues, the ultimate result in each disease is the accumulation and degranulation of neutrophils at inflammatory sites, apparently as a result of frustrated phagocytosis and specific activation of these phagocytic cells. This result is easily recognized in the case of emphysema, where there is clear evidence that the primary cause of the disease is the accumulation of foreign materials in the lung (e.g., smoke condensate), followed by the recruitment of neutrophils to the organ and the release of oxidative and hydrolytic enzymes. In periodontitis, however, the problem begins with the accumulation of plaque at the base of the teeth, followed by the growth of opportunistic anaerobic bacteria below the gum line. These parasitic microbes, which are resistant to killing by both monocytes and granulocytes, secrete proteinases that can activate the kallikrein-kinin pathway, degrade clotting factors, and release the potent neutrophil chemotactic factor, C5a, from complement. It is under such conditions that neutrophils are recruited to infected sites within the periodontium. After the neutrophil-recruitment stage, the two diseases become similar in that degranulation of neutrophils occurs during attempted phagocytosis of either cigarette smoke components (emphysema) or bacteria (periodontitis), followed by inactivation of tissue proteinase inhibitors and degradation of connective tissue proteins, the ultimate result being the destruction of the alveolus or gingiva, respectively.
Blockage of Drug Resistance In Vitro by Disulfiram, a Drug Used to Treat Alcoholism
Authors: Tip W. Loo, David M. Clarke
Journal: JNCI Journal of the National Cancer Institute (2000)

Background: P-glycoprotein (P-gp) pumps a wide range of cytotoxic drugs out of cells. Inhibiting maturation of P-gp would be a novel method for circumventing P-gp-mediated multidrug resistance, which complicates cancer chemotherapy and treatment of patients infected with human immunodeficiency virus. We examined the effect of disulfiram (Antabuse™) on the maturation and activity of P-gp. Methods: Embryonic kidney cells were transfected with a complementary DNA for the P-pg gene, and the effects of disulfiram on the sensitivity of the transfected cells to cytotoxic agents were determined. Enzyme assays were used to determine the effects of disulfiram on the verapamil-stimulated adenosine triphosphatase (ATPase) activity of P-gp. Disulfiram modifies cysteine residues, and mutant forms of P-gp that lack individual cysteines were used to determine whether particular cysteine residues mediate disulfiram's effects on P-gp activity. Maturation of recombinant P-gp was followed on immunoblots. Results: Disulfiram increased the sensitivity of P-gp-transfected cells to vinblastine and colchicine and inhibited P-gp's verapamil-stimulated ATPase activity. Half-maximal inhibition of ATPase activity occurred at 13.5 μM disulfiram. Disulfiram (at 100 μM) inhibited a P-gp mutant by 43% (95% confidence interval [CI] = 37%–48%) when cysteine was present at position 431 only and by 72% (95% CI = 66%–77%) when cysteine was present at position 1074 only. Treatment of P-gp-transfected cells with 50 nM disulfiram blocked maturation of recombinant P-gp. Conclusions: Disulfiram can potentially reduce P-gp-mediated drug resistance by inhibiting P-gp activity (possibly via cysteine modification) and/or by blocking its maturation. These results suggest that disulfiram has the potential to increase the efficacy of drug therapies for cancer and acquired immunodeficiency syndrome.
Shattuck Lecture — The Health Care Priorities of the Bush Administration
Authors: Louis W. Sullivan
Journal: New England Journal of Medicine (1989)

The timing of this lecture is appropriate. The nation has a new president and a new secretary of health and human services. Therefore, it is important to articulate the direction of the Bush administration's health care policies. Because the quality and cost of health care have become more visible and complex national issues, the challenges and opportunities facing the Department of Health and Human Services deserve careful scrutiny as never before.In this lecture I would like to discuss five priorities of immediate concern. Undoubtedly, there are others of importance. But these five concerns present national health care challenges and . . .
Modulation of drug effects by regional sympathetic denervation and supersensitivity.
Authors: M S Stanton, D P Zipes
Journal: Circulation (1991)

BACKGROUND Regional sympathetic denervation, such as that produced by a myocardial infarction, causes electrophysiological heterogeneity in the ventricles. The purpose of this study was to test the hypothesis that such denervation could cause drugs to exert heterogeneous myocardial effects. METHODS AND RESULTS Sympathetic stimulation increases the amplitude of cesium chloride-induced early afterdepolarizations (EADs). The amplitude of these induced EADs was used to determine whether drug responses were different in innervated versus denervated areas of the heart. A canine model of sympathetic denervation was created at the cardiac apex by either transmural myocardial infarction (n = 19) or phenol application (n = 11). Cesium chloride (84 mg/kg) was infused while monophasic action potential recordings were simultaneously obtained from the base and apex of the left ventricle using an epicardial contact electrode. We found that control (innervated) dogs (n = 17) showed no difference in the EAD amplitude recorded from the apex compared with the base. In dogs with apical sympathetic denervation, the EAD amplitude was greater at the innervated base during ansae subclaviae stimulation than at the denervated apex (25.8 +/- 6.6% at base versus 18.8 +/- 6.7% at apex, p less than 0.001). However, during norepinephrine infusion, the EADs recorded from the denervated apex were greater than those recorded from the innervated base (23.3 +/- 7.6% at apex versus 20.6 +/- 6.0% at base, p less than 0.02) due to denervation supersensitivity. CONCLUSIONS These data show that regional myocardial denervation creates autonomic and electrophysiological heterogeneity and the substrate for heterogeneous drug actions. This drug-induced electrophysiological heterogeneity may be another mechanism for proarrhythmia.
TC-99M SESTAMIBI SCINTIGRAPHY IN THE DIFFERENTIAL DIAGNOSIS OF BREAST MASSES
Authors: R I Lima, J C Meneghetti, ACSD Barros, J A Pinotti, A Z Souza, M A Oliveira, AP Costa Filho, M Izaki, J Soares Jr, MCP Giorgio, F Mishkin, I Khalkhali
Journal: Clinical Nuclear Medicine (1995)

Lima, R I; Meneghetti, J C; Barros, ACSD; Pinotti, J A; Souza, A Z; Oliveira, M A; Filho, AP Costa; Izaki, M; Jr, J Soares; Giorgio, MCP; Mishkin, F; Khalkhali, I Author Information
ON THE TREATMENT OF SYPHILIS
Authors: D. Power
Journal: BMJ (1912)

SYPHILIS lias been so much discussed and its cause and pathology have been miiade so clear within the last ten years that tlhe treatment has been -revolutionized, and it has becom-le necessary to focus our newly acquired know- ledge, avoiding rash generalizations on the one liand and an] undue conservatism on the other.The field is already so large that it cannot be surveyed satisfactorily by any single observer, and the Royal Society of Medicine has done vwisely, therefore, iin clloosing several Fellows to open this *discussion and in allotting to each of them a separate plot.To me has fallen the consideration of moderni methods of treatment, partly, perhaps, becauise I am engaged in general surgery, and so lhave no special bias towards any particular plan of treatmlienit, partly because, for some years past, I hlave kept one or two beds in mny male and femiale wards at St. Bartholomewv's Hospital for the especial purpose of comparing the relative value of the new methods of treatment.AMy colleagues at the hospital have placed mlie under an obligation by allowing Mr. J. E. H. Roberts to collate the results of the cases of syphilis whiclh they have treated, whiilst Mr. Roberts himself hlas done excelleint service in bringing forw'ard the cases upon the -preselnt occasion.The pathological department-of the hospital, too, under the abl'e superintendenice of Dr. F. W. Andrewes and Dr. Mervyn H. Gordon, has given ulistintedl help in
Tuberculin reversion rate
Authors: K M Goel, R A Shanks, T A McAllister, E A C Follett
Journal: BMJ (1977)

1100 and 1600) while he continued on bromocriptine (increased to 7-5 mg daily) and dexa- methasone (0-5 mg daily).A four-week course of pituitary irradiation (4500 rads) was started at eight weeks.The patient has continued to gain strength.He has lost his Cushingoid appearance and is no longer thirsty.There has been a return of sexual potency and his blood pressure has fallen to 135/90 mm Hg.His ECG is now normal.We hope to phase out his medical therapy when pituitary irradiation has taken effect.It is apparent that in this case bromo- criptine has successfully lowered the plasma ACTH levels, thereby maintaining normal plasma cortisol levels with relief of symptoms and signs of Cushing's syndrome.One could postulate that the action of bromocriptine on ACTH release may be similar to its action on growth hormone release and, as in some cases of acromegaly treated with bromo- criptine, there is the bonus of return of sexual finction.
Presence of immunoglobulin (Ig) M and IgG double isotype-bearing cells and defect of switch recombination in hyper IgM immunodeficiency.
Authors: Y Akahori, Y Kurosawa, Y Kamachi, S Torii, H Matsuoka
Journal: Journal of Clinical Investigation (1990)

We established a transformed B cell line expressing both IgM and IgG on the cell surface from a patient with hyper IgM immunodeficiency using Epstein-Barr viruses. DNA and RNA of the cells were analyzed. DNA rearrangements of Ig JH gene loci were observed on both chromosomes. Cloning and DNA sequence analyses showed that one has a VHDHJH structure while the other has a DHJH structure. Southern hybridization with 5'-S mu and S gamma region-containing probes indicated germline configuration in the switch regions of mu and gamma genes on both chromosomes. To test expression of mu and gamma chains in the transformed cells at the mRNA-level, we used the polymerase chain reaction with three kinds of synthetic oligonucleotides as primers, one of which was part of the VH gene, while the other two were complementary to parts of C mu and C gamma genes. Sequence analysis of the amplified products showed that the same VHDHJH sequence is directly connected with either the C mu or the C gamma sequence in the mRNAs. This is direct evidence showing that in double isotype-bearing cells one VHDHJH exon in the transcript is alternatively spliced to C mu or C gamma without DNA rearrangement. The defect in this disease could be at the S-S recombination stage.
Dengue outbreak affects more than 7000 people in Nepal
Authors: S. P. Sharma
Journal: BMJ (2010)

<h3>Abstract</h3> <h3>Background</h3> Rotavirus incidence remains relatively high in low-income countries (LICs) compared to high-income countries (HICs) after vaccine introduction. Ghana introduced monovalent rotavirus vaccine in April 2012 and despite the high coverage, vaccine performance has been modest compared to developed countries. The predictors of low vaccine effectiveness in LICs are poorly understood, and the drivers of subnational heterogeneity in rotavirus vaccine impact are unknown. <h3>Methods</h3> We used mathematical models to investigate variations in rotavirus incidence in children &lt;5 years old in Ghana. We fit models to surveillance and case-control data from three different hospitals: Korle-Bu Teaching Hospital in Accra, Komfo Anokye Teaching Hospital in Kumasi, and War Memorial Hospital in Navrongo. The models were fitted to both pre- and post-vaccine data to estimate parameters describing the transmission rate, waning of maternal immunity, and vaccine response rate. <h3>Results</h3> The seasonal pattern and age distribution of rotavirus cases varied among the three study sites in Ghana. Our model was able to capture the spatio-temporal variations in rotavirus incidence across the three sites and showed good agreement with the age distribution of observed cases. The rotavirus transmission rate was highest in Accra and lowest in Navrongo, while the estimated duration of maternal immunity was longer (∼5 months) in Accra and Kumasi and shorter (∼3 months) in Navrongo. The proportion of infants who responded to the vaccine was estimated to be high in Accra and Kumasi and low in Navrongo. <h3>Conclusions</h3> Rotavirus vaccine impact varies within Ghana. A low vaccine response rate was estimated for Navrongo, where rotavirus is highly seasonal and incidence limited to a few months of the year. Our findings highlight the need to further explore the relationship between rotavirus seasonality, maternal immunity, and vaccine response rate to determine how they influence vaccine effectiveness and to develop strategies to improve vaccine impact. <h3>Highlights</h3> Marked variations in rotavirus incidence and vaccine impact within Ghana Similar rotavirus seasonality before and after vaccine introduction A shift in age distribution occurred following vaccine introduction The models provide satisfactory predictions of rotavirus outbreaks and vaccine impact
Pluripotency Redux — Advances in Stem-Cell Research
Authors: John Gearhart, Evanthia E. Pashos, Megana K. Prasad
Journal: New England Journal of Medicine (2007)

Interview with Douglas Melton on the promise and limitations of recent advances in stem-cell research. (08:22)Download A cell's ability to give to rise to all the cell types of the embryo and the adult organism is called pluripotency. Pluripotent cells are found within mammalian blastocysts and persist briefly in embryos after implantation. Embryonic stem cells, derived from the inner cell mass of blastocysts, are a renewable source of pluripotent stem cells that are proving valuable in basic science studies and may eventually become a source of cells for safe, effective cell-based therapies. Much embryonic stem-cell research has focused on determining the molecular signature of pluripotency, and a picture is emerging of a complex interaction among transcription . . .
Metastatic Neuroendocrine Carcinoma Presenting as a “Superscan” on 68Ga-DOTANOC Somatostatin Receptor PET/CT
Authors: Niraj Naswa, Sellam Karunanithi, Ramya Soundararajan, Kalpa Jyoti Das, Krishan Kant Agarwal, Arun Malhotra, Chandrasekhar Bal, Rakesh Kumar
Journal: Clinical Nuclear Medicine (2012)

PET/CT imaging using Ga-labeled somatostatin analogs has become a popular noninvasive diagnostic modality in the workup of patients with neuroendocrine tumors. A 65-year-old man with pancreatic neuroendocrine tumor with confirmed liver metastases on conventional imaging underwent restaging Ga-DOTANOC PET/CT to monitor response to cold octreotide therapy. Previous PET/CT had shown presence of multiple liver and skeletal metastases along with a primary pancreatic tumor showing intense tracer uptake. The present PET/CT study showed an increase in number and uptake of the metastatic lesions suggestive of progressive disease resulting in the appearance of a superscan.
Galactosylated ternary DNA/polyphosphoramidate nanoparticles mediate high gene transfection efficiency in hepatocytes
Authors: Xue-Qing Zhang, Xu-Li Wang, Peng-Chi Zhang, Zhi-Lan Liu, Ren-Xi Zhuo, Hai-Quan Mao, Kam W. Leong
Journal: Journal of Controlled Release (2004)
REMOVAL OF THE UTERINE APPENDAGES FOR UTERINE FIBROIDS.
Authors: FRANKLIN H. MARTIN
Journal: JAMA (1896)

Battey, Tait and Hegar independently conceived, performed and contributed to modern surgery the operation of removal of the uterine appendages. In 1865 Battey "conceived" but did not publish "the idea of producing an artificial menopause for the remedy of disease." His idea was published in 1872. Hegar operated on the first case with the object of establishing an artificial menopause, a few days before Aug. 1, 1872, the memorable date of Tait's first operation for the same purpose. Battey did his first operation just sixteen days later, or Aug. 17, 1872. Thus the time was ripe and three great men of three great nations, separated by thousands of miles, discovered the fact, independently of each other, and shook the tree of progress which has resulted in such an abundant harvest. The removal of the appendages for the cure of fibroids of the uterus is based on the facts: 1, that