tbuckley/cabot-search huggingface dataset:
Excision of Tonsils: A Correction.
Authors: W. H. Peters
Journal: JAMA (1899)

Lafayette, Ind., March 15, 1899. <h3>To the Editor:</h3> —In my article on the "Excision of Tonsils" (videJournalMarch 11, p. 532), I misspelled the name of Dr. Andrew T. Veeder of Pittsburg, Pa. I am deluged with letters of inquiry concerning the instrument. It is not patented and I have no financial interest in it, but I will cheerfully answer every letter personally. The tips suggested by Dr. Veeder were too good for me to modify them, hence I adopted them under his name.
Steroid-sparing properties of sargramostim in patients with corticosteroid-dependent Crohn's disease: a randomised, double-blind, placebo-controlled, phase 2 study
Authors: J F Valentine, R N Fedorak, B Feagan, P Fredlund, R Schmitt, P Ni, T J Humphries
Journal: Gut (2009)

<h3>Objective:</h3> Although treatment with corticosteroids induces remission in Crohn's disease, prolonged exposure to corticosteroids is undesirable. This randomised clinical trial evaluated the efficacy of recombinant human granulocyte–macrophage colony-stimulating factor (sargramostim), an activator of innate immunity, in corticosteroid-dependent patients with Crohn's disease. <h3>Design:</h3> Patients were randomised in a 2:1 ratio, to sargramostim 6 μg/kg subcutaneously once daily or placebo for up to 22 weeks. The study consisted of (1) an adjunctive phase (weeks 1–4) in which patients received study drug plus corticosteroid therapy; (2) a forced corticosteroid tapering phase (weeks 4–14); and (3) an observation phase (4 weeks) in which patients received study drug plus prednisone ⩽7.5 mg. The primary endpoint was corticosteroid-free remission (Crohn's Disease Activity Index (CDAI) ⩽150) 4 weeks after corticosteroid elimination. Secondary endpoints were corticosteroid-free response (CDAI decreased by ⩾100) and induction of remission in patients who reduced the dose of corticosteroid to 2.5–7.5 mg. <h3>Results:</h3> Eighty-seven patients were randomised to sargramostim and 42 to placebo. Significantly more sargramostim-treated patients than placebo patients achieved corticosteroid-free remission (18.6% vs 4.9%; p = 0.03). Similar differences were seen for corticosteroid-free response and in patients who tapered corticosteroids to 2.5–7.5 mg/day. Sargramostim treatment was also associated with significant improvements in health-related quality of life. Patients who received sargramostim were more likely to experience musculoskeletal pain, injection site reactions and dyspnoea. <h3>Conclusions:</h3> Sargramostim was more effective than placebo for inducing corticosteroid-free remission in patients with Crohn's disease with corticosteroid dependence. Sargramostim may provide significant benefit in this population if these findings are confirmed. <h3>Trial registration number:</h3> NCT00206596.
BLOOD PLASMA PROTEIN PRODUCTION AS INFLUENCED BY AMINO ACIDS
Authors: S. C. Madden, W. A. Noehren, G. S. Waraich, G. H. Whipple
Journal: The Journal of Experimental Medicine (1939)

When blood plasma proteins are depleted by bleeding with return of the washed red blood cells (plasmapheresis) it is possible to bring dogs to a steady state of hypoproteinemia and a uniform plasma protein production on a basal low protein diet. These dogs are clinically normal. By the introduction of variables into their standardized existence insight into the formation of plasma proteins can be obtained. The liver basal diet maintains health in such hypoproteinemic dogs during periods as long as a year. 17 to 27 per cent of its protein content (entirely liver protein) is presumably converted into plasma protein. Gelatin alone added to the liver basal diet causes very little if any extra plasma protein production. The addition to gelatin of cystine, or tyrosine, or tryptophane, or of both tyrosine and tryptophane has little or no effect on its potency for plasma protein production. When gelatin is supplemented by cystine and either tryptophane or tyrosine, 25 to 40 per cent of the protein content of the combination is converted into plasma protein-an efficiency equaling that of any protein hitherto tested. Preliminary experiments indicate that methionine cannot substitute for cystine nor can phenylalanine substitute for tyrosine in the efficient combination of gelatin plus cystine plus tyrosine. Laked red blood cells given by vein afford little or no material for plasma protein formation. When the reserve stores of plasma protein building material are exhausted the dog can form little if any plasma protein during protein-free diet periods.
Percutaneous Visceral Catheterization for Infusion Cancer Chemotherapy
Authors: Frederick M. Golomb, Billy P. Sammons, Jane C. Wright
Journal: JAMA (1964)

In a new method for the intra-arterial chemotherapy of tumors, polyethylene catheters are introduced into the common femoral artery in the thigh by percutaneous puncture, and the catheter tips manipulated under fluoroscopic control. Anticancer drugs are then infused into the major artery supplying the tumor. By this method, 27 such catheterizations and treatments have been carried out in 15 patients, with no complications due to the technique. Repeated treatments have been carried out in several patients. Arteriograms taken with catheters in situ permit serial evaluations of antitumor effect in ordinarily nonvisualizable areas. The vessels used included the hepatic, celiac, splenic, internal iliac, femoral, brachial, common and external carotid arteries. Others, including the renals, bronchials, internal mammary, and mesenterics, could also be used.
The First Composite Face and Maxilla TransplantFIRST COMPOSITE FACE, MAXILLA TRANSPLANT
Authors: Wayne F. Larrabee
Journal: JAMA (2009)

Daniel S. Alam, MD; Frank Papay, MD; Risal Djohan, MD; Steven Bernard, MD; Robert Lohman, MD; Chad R. Gordon, DO; Mark Hendrickson, MD; Maria Siemionow, MD, PhD, DScObjective: To discuss the technical and anatomical analysis and design of an osteocutaneous allograft transplant incorporating the donor maxilla and the execution of the operative protocol during the transplant.Methods: The Cleveland Clinic reported the world's first successful combined face and maxilla transplant in December 2008. Unlike the 3 prior face transplants, this surgical procedure was done as a salvage operation in a patient who had undergone 23 major reconstructive procedures. The additional complexity due to significant postoperative scarring and recipient vessel depletion presented a unique challenge in this case. The extensive 3-dimensional losses of facial structures in multiple tissue planes required a Le Fort III osteomyocutaneous allotransplant incorporating the donor maxilla.Results: We report the first successful transfer of a complete bony framework and soft-tissue envelope. The allograft has shown excellent integration and no long-term rejection. The traditional conception based on anatomical studies suggested this transfer would require independent dissection of the internal maxillary vascular system. This was not required in our patient whose allograft was based solely on the facial arterial system and its arcades.Conclusions: Successful near-total face and maxilla allograft transplant can be accomplished based on the facial arterial system and its arcades. This presents a novel method for reconstructing massive facial injuries with significant involvement of the facial skeleton.
A lethal variant of osteogenesis imperfecta has a single base mutation that substitutes cysteine for glycine 904 of the alpha 1(I) chain of type I procollagen. The asymptomatic mother has an unidentified mutation producing an overmodified and unstable type I procollagen.
Authors: C D Constantinou, K B Nielsen, D J Prockop
Journal: Journal of Clinical Investigation (1989)

A fraction of the pro alpha 1(I) and pro alpha 2(I) chains in type I procollagen synthesized by the fibroblasts from a proband with a lethal variant of osteogenesis imperfecta were overmodified by posttranslational reactions. After digestion with pepsin, some of the alpha 1(I) chains were recovered as disulfide-linked dimers. Mapping of cyanogen bromide peptides indicated that the disulfide link was contained in alpha 1-CB6, the cyanogen bromide fragment containing amino acid residues 823-1014 of the alpha 1(I) chain. Nucleotide sequencing of cDNA clones demonstrated a substitution of T for G that converted glycine 904 of the alpha 1(I) chain to cysteine. A large fraction of the type I procollagen synthesized by the proband's fibroblasts had a thermostability that was 3-4 degrees C lower than the normal type I procollagen as assayed by brief proteinase digestion. In addition, the type I procollagen synthesized by the proband's fibroblasts was secreted with an abnormal kinetic pattern in that there was a lag period of about 30 min in pulse-chase experiments. The mutation of glycine to cysteine was not found in type I procollagen synthesized by fibroblasts from the proband's parents. Therefore, the mutation was a sporadic one. However, the mother's fibroblasts synthesized a type I procollagen in which part of the pro alpha chains were overmodified and had a lower thermostability. Therefore, the proband may have inherited a mutated allele for type I procollagen from her mother that contributed to the lethal phenotype. The mother was asymptomatic. She was somewhat short and had slightly blue sclerae but no definitive signs of a connective tissue abnormality. The observations on the mother indicated, therefore, that a mutation that causes synthesis of a type I procollagen with a lowered thermal stability does not necessarily produce a heritable disorder of connective tissue.
Platelet Activation and Coronary Stent Implantation
Authors: Meinrad Gawaz, Franz-Josef Neumann, Ilka Ott, Andreas May, Albert Scho¨mig
Journal: Circulation (1996)

Background Platelet activation and surface expression of adhesive glycoproteins play a key role in ischemic thrombotic complications after coronary intervention. The purpose of this case-control study was to evaluate the effects of two different antithrombotic regimens on platelet function after coronary Palmaz-Schatz stent implantation. Methods and Results The study group consisted of 46 “low-risk” patients who were treated with ticlopidine (250 mg BID) and aspirin (100 mg BID) after stenting. The control group was derived from a cohort of 151 patients receiving conventional anticoagulation therapy, including phenprocoumon (target international normalized ratio, 3.5), heparin (activated partial thromboplastin time, 80 to 120 seconds), and aspirin (100 mg BID) after stenting. Criteria for matching were indication for stenting, target vessel, balloon size, inflation pressure, and number of inserted stents. Matches were obtained for 38 patients. Platelet function was evaluated before and daily for 12 days after stenting in venous blood samples with immunologic activation markers. Patients receiving anticoagulation therapy showed a significantly increased surface exposure of LIBS1 (activated fibrinogen receptor; P &lt;.05) and CD62P (P-selectin; P &lt;.001) above prestent values, peaking days 3 to 6 after stenting. In contrast, in patients receiving ticlopidine, expression of LIBS1 decreased ( P &lt;.01) and expression of CD62P remained basically unchanged after stenting. Platelet count significantly decreased after stenting in patients treated by anticoagulation (day 3; P &lt;.01), whereas no significant changes were found in the ticlopidine group. Conclusions Significant platelet activation occurs in patients receiving anticoagulation therapy after stenting, while platelet deactivation is found in patients treated with combined antiplatelet therapy. This may contribute to a lowering of the incidence of subacute stent thrombosis.
Weil's Disease Treated with Penicillin
Authors: A. E. Carragher
Journal: BMJ (1945)

MEDICAL MEMORANDA BRITISII 119 present, and a positive Kernig's sign and Brudzinski's neck sign were found.The C.N.S. showed normal cranial nerves and reflexes apart from absent abdominals.No abnormality was detected clinically in the chest, cardiovascular system, abdomen, throat, or eardrums, and the urine was normal.Lumbar puncture on admission revealed a turbid C.S.F.under pressure: cells, 600 per c.mm., of which 66% were polymorphs; protein, 100 mg. per 100 c.cm.-globulin test positive; sugar, present but reduced; chlorides, 680 mg. per 100 c.cm. Microscopy showed numerous extraand intra-cellular diplococci.Culture yielded a pure growth of N. meningitidis which proved sensitive to penicillin and sulphonamides.A blood count done at the same time showed R.B.C. 4,650,000 per c.mm., Hb 12.5 g.%, W.B.C. 16,200 per c.mm., of which polymorphonuclear cells comprised 59%, lymphocytes 29%, and monocytes 12%.Shortly after being admitted the child had a convulsion and was comatose.As an alternative to intramuscular sulphonamide a request was made for, penicillin.This was supplied and an intra- muscular drip set up containing 67,500 units in 16 fl.oz. of 0.9%/, saline.The temperature was then 101.5', pulse 122.Overnight the temperature rose to 103'.Owing to poor absorption only 23,000 units were given in the first 24 hours after the drip was started.During the second period of 24 hours 112,000 units were given, made up in 0.45% saline, about 8 fl.oz.being used.The patient was now taking fluids by mouth.At this time the urine contained acetone and reduced Benedict's reagent fully.
NONUNION IN FRACTURES: THE MASSIVE BONE GRAFT
Authors: MELVIN S. HENDERSON
Journal: JAMA (1923)

Ununited fractures may be divided into those delayed in uniting and those in a fixed state of nonunion. In the former there is still evidence of attempts at union, but in the latter all such evidence is lacking. At operation a false joint is found, many times with a sac smoothly lined and filled with amber colored, slightly viscid fluid. Delayed union may exist as long as two or three years after the original injury, and nonunion as early as a few months.  In delayed union the bones may be induced to unite by such means as weight bearing, use of the Thomas dam, pounding between tourniquets, and so forth; such methods are useless in cases of nonunion.  REVIEW OF CASES  This paper is based on a review of 221 cases of nonunion culled from approximately 1,000 cases of old fractures, consisting of malunions and delayed unions, and so forth,
THE INFLUENCE OF ILIAC ARTERY OCCLUSION ON CENTRAL BLOOD PRESSURE AND AUGMENTATION INDEX AT THE ASCENDING AORTA
Authors: Kojiro Miki, Kenichi Fujii, Masashi Fukunaga, Hiroto Tamaru, Takahiro Imanaka, Mitsumasa Ohyanagi, Tohru Masuyama
Journal: Journal of the American College of Cardiology (2014)
A study of the correction factor for ultraviolet phototherapy dose measurements made by the indirect method
Authors: C.J. Martin, H. Clouting, A. Aitken
Journal: British Journal of Dermatology (2003)

Optimization of ultraviolet (UV) phototherapy for treatment of psoriasis and other skin conditions requires accurate dosimetry. One factor involved in whole body treatments is the correction that needs to be applied to radiometer measurements of irradiance made remotely without a person in the phototherapy cabin.To evaluate the correction factor for cabins of different design and to consider whether different factors should be used for different phototherapy cabins and radiometers.An automated UV dosimetry system capable of recording irradiances at positions around the circumference of a circle equating to a human trunk has been developed. The system has been combined with a phantom to derive values for the ratio between irradiance measurements made by the direct method with a person in a cabin, and indirect measurements recorded remotely. In addition, values for the ratio in UVA cabins have been derived from comparisons between measurements made directly by persons in a cabin and indirect measurements.Variations in direct to indirect ratio (DIR) with cabin type were less than between individual sets of measurements. The mean DIR obtained for cabins with TL01 lamps was 0.85 +/- 0.02, while that for UVA cabins was 0.80 +/- 0.05. The DIR for dual lamp (TL01/UVA) cabins, when TL01 lamps were illuminated, was higher (0.92).The DIR should be applied to any measurements made using radiometers without a person or equivalent phantom in a cabin. It is proposed that standard values are appropriate for groups of cabins with a single type of lamp and similar reflectors.
(18) The treatment of portwine stains with the tunable dye laser at 577 nm
Authors: S.W. Lanigan, P. Cartwright, J.A. Cotterill
Journal: British Journal of Dermatology (1987)

Journal Article (18) The treatment of portwine stains with the tunable dye laser at 577 nm Get access S.W. Lanigan, S.W. Lanigan Department of Dermatology, The General Infirmary at Leeds, Leeds Search for other works by this author on: Oxford Academic Google Scholar P. Cartwright, P. Cartwright Department of Dermatology, The General Infirmary at Leeds, Leeds Search for other works by this author on: Oxford Academic Google Scholar J.A. Cotterill J.A. Cotterill Department of Dermatology, The General Infirmary at Leeds, Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 117, Issue s32, 1 June 1987, Pages 40–41, https://doi.org/10.1111/j.1365-2133.1987.tb12036.x Published: 01 June 1987
Effects of Changing Body Position upon Improved Ventilation-Perfusion Relationships
Authors: ROY H. CLAUSS, BERTRAND Y. SCALABRINI, JEFFERSON F. RAY, GEORGE E. REED
Journal: Circulation (1968)

Ventilation-perfusion relationships were studied in patients in the lateral and supine positions by monitoring blood gas tensions of peripheral arterial and pulmonary vein blood samples. West observed in erect subjects that the apex of the lung, while oxygenating less blood than the base, effected a higher P o o2 . This study shows that in patients not in the erect position the nondependent lung, lobe or portion of lung achieved higher P o o2 values than the dependent. The supine position was found to be associated with low peripheral arterial oxygen tensions. The simple maneuver of having the patient turn to a lateral position was found to increase oxygen tensions to satisfactory levels.
Increased cd1d expression on small bile duct epithelium and epithelioid granuloma in livers in primary biliary cirrhosis
Authors: Koichi Tsuneyama, Mitsue Yasoshima, Kenichi Harada, Katsushi Hiramatsu, M. Eric Gershwin, Yasuni Nakanuma
Journal: Hepatology (1998)

Cluster of differentiation 1 (CD1) is a family of four distinct nonpolymorphic major histocompatibility complex class I-like molecules that can present microbial nonpeptide lipid antigens to T cells. Among the CD1 gene family, CD1d is found in a wide range of tissues including the intestine and liver, and has been proposed to play an important role in mucosal immunity. Primary biliary cirrhosis (PBC) is an immune-mediated liver disease involving the intrahepatic small bile ducts, which also belong to the mucosal immune system. In this study, we studied the expression of CD1d in patients with PBC and compared the data with those of patients with hepatic sarcoidosis, primary sclerosing cholangitis (PSC), chronic viral hepatitis (CVH), and normal liver as controls. CD1d was found to be expressed in hepatocytes in all cases examined, and in epithelioid granuloma cells in 19 of 22 PBC livers and in 4 of 4 livers with hepatic sarcoidosis. In addition, CD1d was focally expressed on epithelial cells of the small bile ducts in approximately 50% of the PBC patients but in no controls. Such bile duct epithelial staining of CD1d was seen in early-stage PBC and virtually absent in late-stage PBC. Moreover, there was no evidence of expression of CD1d in large bile duct epithelial cells of PBC. The CD1d on biliary epithelial cells in PBC may be involved in the antigen presentation of microbial lipid antigen(s) to surrounding T cells. Alternatively, modified endogenous lipidic compounds may share analogy with bacterial lipid antigens and explain CD1d expression, a possible epiphenomenon rather than a proof of bacterial involvement.
Reiter's Syndrome and Abacterial Pyuria
Authors: F. L. Lydon
Journal: BMJ (1947)

From a limited experience of the operation the impression is gaining ground that the presence of pre-morbid obsessional traits is of good prognostic significance when considering candidates for leucotomy.This appears not only to explain the good results claimed in obsessional neurosis and depression but appears to be at the.back of the improvement obtained in this case.Before accepting the operation as the treatment of choice in any case of psychoneurosis a thorough exploration and evaluation of the psychodynamic factors are indicated, and only if these are considered unmodifiable by any other practicable means should the operation be recommended.-Iam, etc., Shenley, Herts.B. C. GILSENAN.SIR,-I was glad to see the article by Drs.William Sargant and C. M. Stewart (Nov. 29,p. 866) reporting a case of such battle neurosis treated by leucotomy.Sincere clinical reports, however inadequate they may be from the psychologist's viewpoint, are much needed.In the final comment it is said that the case is reported partly to encourage patients and relations to agree to this form of treatment when it is recommended.It must be agreed that in the matter of leucotomy the final decision must come from the good sense of the lay public, doctors being perhaps less able than other people are to see wider issues than the immediate relief of an individual's symptoms and distress.There is still one doctor, however, who hopes that the public that clamours for whatever is on tap at the moment will stop' short of asking to be leucotomized.He has lost hope that those who in their distress cry out even for a mutilating operation may be refused what they ask by the doctors them- selves.-Heis, etc., London, W. .
Toll-Like Receptor 4–Dependent Microglial Activation Mediates Spinal Cord Ischemia–Reperfusion Injury
Authors: Marshall T. Bell, Ferenc Puskas, Viktor A. Agoston, Joseph C. Cleveland, Kirsten A. Freeman, Fabia Gamboni, Paco S. Herson, Xianzhong Meng, Phillip D. Smith, Michael J. Weyant, David A. Fullerton, T. Brett Reece
Journal: Circulation (2013)

Background— Paraplegia continues to complicate thoracoabdominal aortic interventions. The elusive mechanism of spinal cord ischemia–reperfusion injury has delayed the development of pharmacological adjuncts. Microglia, the resident macrophages of the central nervous system, can have pathological responses after a variety of insults. This can occur through toll-like receptor 4 (TLR-4) in stroke models. We hypothesize that spinal cord ischemia–reperfusion injury after aortic occlusion results from TLR-4–mediated microglial activation in mice. Methods and Results— TLR-4 mutant and wild-type mice underwent aortic occlusion for 5 minutes, followed by 60 hours of reperfusion when spinal cords were removed for analysis. Spinal cord cytokine production and microglial activation were assessed at 6 and 36 hours after surgery. Isolated microglia from mutant and wild-type mice were subjected to oxygen and glucose deprivation for 24 hours, after which the expression of TLR-4 and proinflammatory cytokines was analyzed. Mice without functional TLR-4 demonstrated decreased microglial activation and cytokine production and had preserved functional outcomes and neuronal viability after thoracic aortic occlusion. After oxygen and glucose deprivation, wild-type microglia had increased TLR-4 expression and production of proinflammatory cytokines. Conclusions— The absence of functional TLR-4 attenuated neuronal injury and microglial activation after thoracic aortic occlusion in mice. Furthermore, microglial upregulation of TLR-4 occurred after oxygen and glucose deprivation, and the absence of functional TLR-4 significantly attenuated the production of proinflammatory cytokines. In conclusion, TLR-4–mediated microglia activation in the spinal cord after aortic occlusion is critical in the mechanism of paraplegia after aortic cross-clamping and may provide targets for pharmacological intervention.