tbuckley/cabot-search huggingface dataset:
Clinical significance of bone marrow micrometastasis detected by nested RT-PCR for cytokeratin-19 in breast cancer patients.
Authors: L Hur, Y Jung, K Kim
Journal: Cancer Research (2009)

Abstract Abstract #4032 Purpose: Breast cancers frequently undergo distant metastasis during the early phase, on which the survival of patients is greatly dependent. It has been suggested that the occurrence of micrometastasis relates with other prognostic features of breast cancer, such as lymph node metastasis and the presence of vascular invasion. The aim of this study was to examine the presence of cytokeratin-19 mRNA in bone marrow aspirates obtained from breast cancer patients, and their possible correlation with distant disease free survival.&amp;#x2028; Method: Between 1999 and 2003, bone marrow samples were obtained from 254 breast cancer patients during primary surgery. We separated the mononuclear fraction from the samples and carried out nested reverse transcriptase polymerase reaction (RT-PCR) for the detection of cytokeratin-19 mRNA using two different pairs of primers. The clinical and pathological data and the results of the bone marrow cytokeratin-19 nested RT- PCR were reviewed and analyzed together with clinical results on distant recurrence and survival. We also studied the possible correlations between CK-19 and the tumor size, nodal involvement, stage, and distant metastasis. The median follow up time was 57 months. The median age of patients was 46 years old.&amp;#x2028; Results: 66(26%) of the 254 samples were cytokeratin-19 positive. And four stage VI patients and two patients lost during follow up period were excluded. 16 cases (24%) of in the cytokeratin-19 positive group showed a recurrent disease in distant organs. Whereas, 23(12.5%) out of 182 cytokeratin-19 negative patients had distant recurrences. Therefore CK-19 positive group have more distant recurrence than CK-19 negative group (p=0.024). And we found that CK-19 positive group have lower disease free survival rate than CK-19 negative group (p=0.017). However, there was no statistically significant difference in overall survival (p=0.083). The stage, nodal status, and estrogen receptor were independent of bone marrow micrometastasis.&amp;#x2028; Conclusion: Bone marrow micrometastasis, detected by nested RT-PCR for cytokeratin-19, could be a useful predictive marker for the distant metastasis of breast cancer. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4032.
Say no to Viagra
Authors: G. Dunea
Journal: BMJ (1998)

Judging by the recent success of Viagra (sildenafil) a visitor from outer space might conclude that what truly distinguishes man from other species is his desire to take pills affecting his reproductive functions. For here comes the sensational blue diamond shaped pill that for $7-10 (£4-6) inhibits phosphodiesterase type 5, maintains high levels of cyclic guanosine monophosphate in the corpus cavernosum, causes local vasodilatation and smooth muscle relaxation, and promises to revolutionise the love life of 140 million people in the world.

Studied in over 4000 people, including a 74 year old retired senator who had undergone prostatectomy, it helped some 60-80% of people suffering from erectile dysfunction a condition well studied by plethysmography and an …
Ghrelin Attenuates Sepsis-induced Acute Lung Injury and Mortality in Rats
Authors: Rongqian Wu, Weifeng Dong, Mian Zhou, Fangming Zhang, Corrado P. Marini, Thanjavur S. Ravikumar, Ping Wang
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Our study has shown that plasma levels of ghrelin, a stomach-derived peptide, are significantly reduced in sepsis, and that ghrelin administration improves organ blood flow via a nuclear factor (NF)-kappaB-dependent pathway. However, it remains unknown whether ghrelin has any protective effects on severe sepsis-induced acute lung injury (ALI) and, if so, whether inhibition of NF-kappaB plays any role in it.To test the hypothesis that ghrelin reduces severe sepsis-induced ALI and mortality through inhibition of NF-kappaB.Sepsis was induced in rats by cecal ligation and puncture (CLP). Five hours after CLP, a bolus intravenous injection of 2 nmol of ghrelin was followed by continuous infusion of 12 nmol of ghrelin via a minipump for 15 hours. Samples were harvested 20 hours post-CLP (i.e., severe sepsis). Pulmonary levels of ghrelin and proinflammatory cytokines were measured by ELISA. NF-kappaB p65 and IkappaBalpha expression and NF-kappaB activity were measured by Western blot analysis and ELISA, respectively. Pulmonary blood flow was measured with radioactive microspheres. In additional animals, the necrotic cecum was excised 20 hours post-CLP and 10-day survival was recorded.Pulmonary levels of ghrelin decreased significantly 20 hours post-CLP. Ghrelin administration restored pulmonary levels of ghrelin, reduced lung injury, increased pulmonary blood flow, down-regulated proinflammatory cytokines, inhibited NF-kappaB activation, and improved survival in sepsis. Administration of a specific ghrelin receptor antagonist worsened the survival rate after CLP and cecal excision.Ghrelin can be developed as a novel treatment for severe sepsis-induced ALI. The protective effect of ghrelin is mediated through inhibition of NF-kappaB.
Association of neonatal myasthenia gravis with antibodies against the fetal acetylcholine receptor.
Authors: B Vernet-der Garabedian, M Lacokova, B Eymard, E Morel, M Faltin, J Zajac, O Sadovsky, M Dommergues, P Tripon, J F Bach
Journal: Journal of Clinical Investigation (1994)

The specificities of autoantibodies directed against the acetylcholine receptor (AChR) for embryonic and adult muscle AChR were studied in 22 mothers with myasthenia gravis (MG) and in their newborns using human fetus and normal adult muscle AChR preparations. 12 mothers had transmitted MG to their neonates with, in three cases, antenatal injury. A clear correlation was found between occurrence of neonatal MG (NMG) and the high overall level of anti-AChR antibodies (embryonic or adult muscle AChR). However, a strong correlation was also found between occurrence of NMG and the ratio of anti-embryonic AChR to anti-adult muscle (Te/Ta) AChR antibodies (P < 0.0002). Taken together, these data suggest that autoantibodies directed against the embryonic form of the AChR could play a predominant role in the pathogenesis of NMG. Paradoxically, the three cases with antenatal injury presumably the most severe form of NMG, were not associated with high Te/Ta. At the clinical level, these observations could prove helpful in the prediction of transmission of NMG.
The Relations between the Conformation of the Cranium and that of the Eye
Authors: E. Landolt
Journal: BMJ (1881)

IN one of my works, which was not long since translated into English, I said a few words on the relations existing between the con- formation of the cranium and the condition of the refraction of the eye.In many cases, flatness of the forehead, of the bridge of the nose, and of the zygomatic arches, is accompanied with hypermetropia; whereas one would be more likely to find myopic eyes in deep orbits, surrounded by more largely developed bones.If there are many exceptions to this rule-as, for instance, when an eye has become myopic from choroiditis, without an excessive development of the cranium-there is at least one relation between the shape of the head and that of the eyes, which presents fewer exce[tions; and that is, asymmetry of the cranium, accompanied by anisometropia and astigmatism.
Abdominal Activity in Cerebrospinal Fluid Cisternography
Authors: J. VERDÚ, M. L. RODRIGUEZ, E. RODEÑO, J. M. ZAPIRAIN, V. LLORENS, J. C. FOMBELLIDA
Journal: Clinical Nuclear Medicine (1994)

A 21-year-old man with severe frontal headache and fever was admitted to the hospital. Cerebrospinal fluid culture yielded positive streptococcus virldans findings. The patient had been involved in a car accident 2 years prior, suffering a complex frontal fracture, and 4 months prior to admission an acute Haemophllus Influenzae meningitis was diagnosed. Following rhinorrhea lasting 15 days, a cerebrospinal fluid leak was confirmed through In-111 DTPA cisternography. Scintillation counts of nasal cotton pledgets showed a significant difference between the right and left side (1.5x106 cpm versus 342 cpm, respectively). Abdominal bowel activity was observed over 24 and 48 hours, indicating ingestion of cerebrospinal fluid.
Inhibition of Protein Kinase Cβ Prevents Impaired Endothelium-Dependent Vasodilation Caused by Hyperglycemia in Humans
Authors: Joshua A. Beckman, Allison B. Goldfine, Mary Beth Gordon, Leslie A. Garrett, Mark A. Creager
Journal: Circulation Research (2002)

The bioavailability of nitric oxide is decreased in animal models and humans with diabetes mellitus. Hyperglycemia, in particular, attenuates endothelium-dependent vasodilation in healthy subjects. In vitro and in vivo animal studies implicate activation of protein kinase Cβ as an important mechanism whereby hyperglycemia decreases endothelium-derived nitric oxide. Accordingly, this study tested the hypothesis that inhibition of protein kinase Cβ would prevent impairment of endothelium-dependent vasodilation in healthy humans exposed to hyperglycemia. This study was a randomized, double-blind, placebo-controlled, crossover trial. Healthy subjects were treated with an orally active, selective, protein kinase Cβ inhibitor, LY333531, or matching placebo once a day for 7 days before vascular function testing. Forearm blood flow was measured using venous-occlusion, strain-gauge plethysmography. Endothelium-dependent vasodilation was measured via incremental brachial artery administration of methacholine chloride (0.3 to 10 μg/min) during euglycemia and after 6 hours of hyperglycemic clamp. The forearm blood flow dose-response curve to methacholine was significantly attenuated by hyperglycemia after placebo treatment ( P =0.009 by ANOVA, euglycemia versus hyperglycemia) but not after treatment with LY333531. Inhibition of protein kinase Cβ prevents the reduction in endothelium-dependent vasodilation induced by acute hyperglycemia in healthy humans in vivo. These findings suggest that hyperglycemia impairs endothelial function, in part, via protein kinase Cβ activation.
Abuse of Medical Students
Authors: Arturo R. Hervada
Journal: JAMA (1990)

<h3>To the Editor. —</h3> I have read with great interest the articles and the editorial on medical school abuse.<sup>1-3</sup> George B. Shaw, in a letter to Mrs Molly Tompkins, described accurately man's educational process: "Education in the ways of the world is a series of humiliations, like learning to skate. All you can do is to laugh at yourself with the crowd." Perhaps the best example of the irreversible trauma resulting from attending medical school is the following: Pio Baroja (1872-1956), a foremost Spanish novelist, graduated from medical school (Madrid University) at the end of the last century. After substituting for a village physician for a few months, he quit medicine forever, becoming a prolific novelist. His most autobiographical work is the novel<i>El Arbol de la Ciencia (The Science Tree)</i>, in which he was extremely critical of some of his medical school professors. For over 50 years of
Partial portal decompression–-partially proven
Authors: Bernard Langer
Journal: Hepatology (1987)

In a serial analysis of splanchnic hemodynamics, we compared partial with total portal decompression in 16 alcoholic cirrhotic patients who underwent portacaval shunts for variceal hemorrhage. Partial decompression was achieved with 8 or 10 mm polytetrafluoroethylene portacaval H grafts and aggressive collateral ligation. Total decompression was achieved with larger diameter H grafts (12 or 14 mm). Early and follow-up (mean interval, 18 months) postoperative studies of portal hemodynamics included: (1) direct measurement of shunt gradients, (2) scintigraphic quantitation of portal and mesenteric flow distribution to the liver, and (3) a portal and splenic collateral scoring system developed from standardized splenic venography. Partial portal decompression reduced portal pressure by 43% ± 8% compared with 81% ± 5% after total decompression (p < 0.01). Scintigraphy demonstrated that partial decompression provided a greater fraction of portal flow to the liver than did total decompression (57% ± 9% versus 2% ± 1% intrahepatic radioactivity) and mesenteric flow distribution (14.5% ± 5.4% versus 1.2% ± 0.7%). Only one patient with partial decompression had a significant loss of portal perfusion during the interval studies. Significantly more residual collaterals were visualized in patients with partial decompression than in those with total decompression, and interval studies showed no significant changes from early studies. We conclude that partial decompression maintains higher portal pressures, more residual collaterals, and a greater fraction of portal and mesenteric flow to the liver than does total decompression. A modest but uniform reduction of portal pressure minimizes stimulus for new collateral formation and further shunting of portal flow.
Layering of Activity Around a Breast Implant Capsule During Lymphoscintigraphy
Authors: Borys R. Krynyckyi, Jungho Shim, Martin Goyenechea, Chun K. Kim
Journal: Clinical Nuclear Medicine (2004)

A 44-year-old woman with bilateral breast implants and biopsy-proved infiltrating, moderately differentiated duct carcinoma was referred for lymphoscintigraphy for sentinel lymph node biopsy. Injection of Tc-99m sulfur colloid was performed perilesionally, taking great care not to inject into the breast implant, which was to remain in the chest. A layer of activity eventually spread along the capsule enclosing the breast implant from the perilesional injection. Subsequently, an areolar–cutaneous junction injection was performed to further augment activity in the sentinel node. The original sentinel node was enhanced along with what represents a reverse echelon node.
Anal Carcinoma: Prognostic Value of Endorectal Ultrasound (ERUS). Results of a Prospective Multicenter Study
Authors: M. Giovannini, V. J. Bardou, R. Barclay, L. Palazzo, G. Roseau, T. Helbert, P. Burtin, O. Bouché, B. Pujol, O. Favre
Journal: Endoscopy (2001)

Background and Study Aims: The classification of anal carcinoma is based on the clinical examination and the estimation of the tumor height (Union Internationale Contre le Cancer (UICC) 1987 Classification). This classification has a direct therapeutic application since tumors which are designated T1 and T2 are generally treated by radiotherapy whereas T3, T4 or N+ lesions are treated by concomitant radiation and chemotherapy. The aim of this prospective multicenter study was to evaluate endorectal ultrasound (ERUS) and to define an ERUS-based classification.
Lobby groups call for closure of "revolving door" between drug regulators and industry
Authors: N. Hawkes
Journal: BMJ (2011)

The European Commission has been urged to review procedures at the European Medicines Agency (EMA) and the staff regulations that govern the conduct of EU officials, after claims that a former executive director of EMA arranged to become a consultant to the drug industry while still employed by the agency. 

Thomas Lonngren, who ran Europe’s drug regulatory agency for 10 years before stepping down at the end of 2010, has already been told by the EMA that he should not provide product related advice to drug companies nor take managerial, executive, or consultative positions in the industry for a period of two years.

But …
Lacking proof of identity
Authors: M. E Black
Journal: BMJ (2010)

Last Saturday night we had a family outing to a police station on planet Earth. Despite having all our papers in order, including reissued birth certificates no more than six months old, and using our connections to avoid a lengthy weekday queue, we failed to complete our children’s biometric passports. The computer would recognise only two first names, and both children have three each. We puzzled over this: dropping the third name meant the papers would not match, and sticking the second and third name together on the passports looked dodgy. So back again to …
Conjunctivitis with Follicles Associated with Adenovirus Type 22
Authors: John L. Sever, Renee G. Traub
Journal: New England Journal of Medicine (1962)

RELIABLE information concerning the association of clinical illness with the higher-numbered adenoviruses (Types 19 through 28) has been extremely limited. Only 1 case of documented illness has been reported.1 The following case of infection with adenovirus Type 22 provided an opportunity to follow the clinical and laboratory course of this infection.Clinical SummaryA 22-year-old female laboratory technician inadvertently sprayed a small quantity of tissue-culture fluid containing adenovirus Type 22 in her left eye on June 30, 1961. She immediately washed her face and eye with running tap water and took particular care to avoid contamination of her right eye. . . .
No Evidence for Tumorigenesis of AAV Vectors in a Large-Scale Study in Mice
Authors: Peter Bell, Lili Wang, Corinna Lebherz, Douglas B. Flieder, Mark S. Bove, Di Wu, Guang Ping Gao, James M. Wilson, Nelson A. Wivel
Journal: Molecular Therapy (2005)

Six hundred ninety-five mice received adeno-associated virus (AAV) vectors, mostly via portal vein injection. At necropsy, the livers were inspected for tumors, and tissue sections were prepared for histology. We observed only one tumor, a lipoma, resulting in a tumor frequency of 0.14%. This tumor contained fewer vector genomes per total DNA than the surrounding liver tissue, as shown by quantitative PCR. In another mouse we found a macroscopically visible nodule containing lymphocytes. Immunohistochemistry revealed cells not of monoclonal origin, and they contained fewer AAV genomes than the surrounding hepatocytes. There were no macroscopic tumors in 226 control mice. Upon microscopic examination, lymphocytic infiltrates were found in 5% of livers of both control and vector-treated mice; no transgene expression was seen in those infiltrates in AAV-injected animals. Compared to an average frequency of spontaneous liver tumors in C57BL/6 mice (0-10%), and given the absence of high levels of vector DNA in the observed tumor, we conclude that AAV vectors do not predispose these target animals to the formation of liver tumors.
Government policy is damaging people most vulnerable to alcohol misuse, warns leading doctor
Authors: J. Wise
Journal: BMJ (2013)

The United Kingdom’s failure to adopt a minimum price for a unit of alcohol is damaging the most vulnerable in society, Ian Gilmore, the Royal College of Physicians’ special adviser on alcohol, warned this week.

Speaking at a joint conference of the Royal College of Physicians, the British Society of Gastroenterology, and the British Association for the Study of the Liver on Monday …
Conduction Disturbances in Patent Ductus Arteriosus
Authors: M. MIROWSKI, F. AREVALO, G. A. MEDRANO, F. A. CISNEROS
Journal: Circulation (1962)

A study of conduction disturbances in 200 patients with patent ductus arteriosus was carried out. The atrioventricular (AV) conduction was found generally disturbed as compared with normal cases. A significant delay in AV conduction was demonstrated by the high incidence (10.5 per cent) of first-degree AV block, by the elevated percentage of high values of the P-R index and by a high mean P-R index in the whole series (0.85 versus 0.75 in normal subjects). After surgery a significant improvement in AV conduction was noted. First-degree AV block disappeared in 79 per cent of the cases, and in some instances the block decreased in intensity. In cases without diagnosis of AV block the improvement, as manifested by the diminution of the P-R index, was observed in 62 per cent of the cases. The improvement in AV conduction was greater in those groups with higher preoperative P-R index. The impression was that a large number of cases with high values of the P-R index, although still below the upper limit of normal (1.00), actually have first-degree AV block, undiagnosed by the usual criteria. The mean P-R index after surgery for the whole group was 0.79. It was suggested that the AV conduction disturbances in patent ductus arteriosus are related, in some way, to the hemodynamic conditions of this entity and particularly to the left-to-right shunt between aorta and pulmonary artery. Six cases (3 per cent) of incomplete right bundle-branch block and five (2.5 per cent) of incomplete left bundle-branch block were found. These disturbances did not change after surgery.
Bran yesterday... bran tomorrow?
Authors: H C Trowell, D P Burkitt
Journal: BMJ (1984)

asphyxia as a delay of two minutes or longer to sustained respiration (hoping thereby to include all infants likely to require active resuscitation), or the performance of active resuscitative measures (excluding mucus extraction or the giving of oxygen at ambient pressure).Asphyxia so defined occurred in 437 infants-that is, in 13-50' of all deliveries.Using the x2 test with Yates's correction the incidence of asphyxia in various subgroups was compared with the overall rate of asphyxia.Poisson's test was applied to groups of five or less.The overall incidence of birth asphyxia in infants delivered between 26 and 36 weeks' gestation was significantly increased at 52/195 (27%) (p<02), but it can be seen from table I that preterm infants delivered from 35 weeks onwards did not have a significantly increased incidence of asphyxia.The complications of pregnancy listed in table II were associated with a significant increase in the inci- dence of asphyxia, but the medical complications listed in table III were not.TABLE I-Influence of gestational age on incidence oj birth asphyxia No of Gestational No of babies with age (weeks) babies asphyxia p (%,0) 26-32 30 15 (50) <0-002 33-34 40 13 (33) <0-
Oral Solutions for Fluid and Electrolyte Replacement-Reply
Authors: Richard L. Westerman
Journal: JAMA (1983)

In Reply.—  I agree with Dr Meroney that one of the most common applications for both commercial and noncommercial electrolyte formulas is in the treatment of diarrheal states. This is not an area where the important contributions by the armed forces in heat stress disorders would apply.  It bears reemphasis that the recently popular, nonprescription, ready-to-use commercial liquid products for oral consumption are not well designed for use in gastrointestinal (GI) tract disorders. If used, it should be solely on a short-term emergency basis. Changing these compositions by adding ingredients is not recommended despite its simplicity.  Dry-ingredient formulas that are administered orally after dilution were originally designed for use in GI tract disorders and have been commercially available for many years. The greatest risk associated with the use of these products (homemade formulas) is the creation of complex fluid/electrolyte disorders when the dilution and administration are done improperly, especially when
False-Positive ST-T-Wave Changes Secondary to Hyperventilation and Exercise
Authors: WILLIAM F. JACOBS
Journal: Annals of Internal Medicine (1974)

Eleven patients had "positive" ST-segment depression, with exercise testing and with forced hyperventilation at rest. None of the five patients who had coronary arteriograms had evidence of coronary artery disease, and the clinical impression was that the other six patients did not have coronary artery disease. Four patients had mitral valve abnormalities, shown by the left ventricular angiographic findings of mitral valve prolapse or auscultatory evidence of the systolic click-late systolic murmur syndrome. None of the 17 control patients who had positive exercise tests and positive coronary arteriograms had positive hyperventilation studies at rest. Coronary artery disease does not seem to cause the ST-segment changes in these 11 patients; their cause is still unknown.