tbuckley/cabot-search huggingface dataset:
Textbook of Disorders and Injuries of the Musculoskeletal Svstem: Introduction to Orthopaedics. Rheumatology, Metabolic Bone Disease, Rehabilitation and Fractures
Authors: Lee H. Riley
Journal: JAMA (1970)

<i>Textbook of Disorders and Injuries of the Musculoskeletal System</i>has been written specifically for the medical student. In this era of rapid change in the curriculum of many medical schools, this text offers in a concise fashion the "core" information which the author feels necessary for any medical student. The book is well organized, and presents the pertinent basic anatomical, developmental, biochemical, and physiologic background necessary for a basic understanding of the clinical topics discussed. The entire field of orthopedic surgery is covered, including adults' and children's elective orthopedics, such as tumors, congenital abnormalities, degenerative disorders, and neuromuscular diseases, as well as acute fractures, dislocations, and soft-tissue injuries in the adult and in the child. The text is exceptionally well illustrated, clearly and concisely written, and covers its topics adequately. A methodical approach to clinical problems is stressed with great emphasis placed upon the importance and techniques of obtaining a
Dyspnoea in a 60 year old man
Authors: Y. K. Gupta, A. A. Mazumder, D. V. Hughes, D. C. Howlett
Journal: BMJ (2010)

A previously well 60 year old man was referred by his general practitioner with a six week progressive history of exertional shortness of breath, without cough, wheeze, or pain. He was a non-smoker. On auscultation his chest was clear. His oxygen saturation was 98% on air, with a respiratory rate of 15 breaths/min. He was afebrile, with a pulse rate of 78 beats/min and blood pressure of 160/95 mm Hg. Physical examination showed enlarged bilateral neck nodes in the anterior cervical chain. Chest radiography was performed (fig 1⇓).



Fig 1 Chest radiograph





### 1 What are the radiographic findings

#### Short answer

The radiograph shows symmetrical lobular enlargement of both pulmonary hila, with no signs of cardiomegaly or vascular abnormality (fig 2⇓). This appearance is consistent with bilateral hilar lymphadenopathy.



Fig 2 Chest radiograph showing bilateral hilar lymphadenopathy (arrows)



#### Long answer

Bilateral hilar lymphadenopathy can be defined as evidence of bilateral enlargement of the hilar nodes, commonly discovered on a chest radiograph.1 It can manifest on chest radiography as abnormal hilar density, size, or shape. Hilar adenopathy appears as round or lobulated abnormal soft tissue arising from the hila. Lack …
Percutaneous Closure of Patent Foramen Ovale in Patients With Paradoxical Embolism
Authors: Stephan Windecker, Andreas Wahl, Tushar Chatterjee, Ali Garachemani, Franz R. Eberli, Christian Seiler, Bernhard Meier
Journal: Circulation (2000)

Patients with a patent foramen ovale (PFO) and paradoxical embolism are at risk for recurrent thromboembolic events. This study investigated the long-term risk of recurrent thromboembolic events in patients with PFO and paradoxical embolism after percutaneous PFO closure.Since 1994, a total of 80 patients with PFO and at least 1 paradoxical embolic event (transient ischemic attack [TIA], cerebrovascular accident [CVA], peripheral embolism) have undergone percutaneous PFO closure with 5 different devices. There were 30 women and 50 men, with a mean age of 52+/-12 years. Sixty patients had only a PFO, whereas 20 patients had both a PFO and an atrial septal aneurysm. The implantation procedure was successful in 78 patients (98%). During 5 years of follow-up (mean, 1.6+/-1.4 years; range, 0.1 to 5.0 years), the actuarial annual risk to suffer a recurrent thromboembolic event was 2.5% for TIA, 0% for CVA, 0.9% for peripheral emboli, and 3.4% for the combined end point of TIA, CVA, or peripheral embolism. A postprocedural shunt was a predictor of recurrent paradoxical embolism (RR, 4.2; 95% CI, 1.1 to 17.8; P=0.03). The risk for recurrent thromboembolic events in patients with both atrial septal aneurysm and PFO was not significantly increased compared with patients with only PFO (RR, 1.0; 95% CI, 0.2 to 4.7; P=0.95).Percutaneous PFO closure appears to be a promising technique in the prevention of recurrent systemic thromboembolism in patients with a PFO after a first event. Prospective studies comparing percutaneous PFO closure with antithrombotic medications or surgery must define its therapeutic value.
Compulsory Pasteurization of Milk
Authors: P. B. Roth
Journal: BMJ (1937)

The authors consider four aspects of contemporary medical ethics in France: abortion and contraception; artificial insemination; suicide and euthanasia, and drug trials on healthy human volunteers, and then outline the various ethical codes which apply to French doctors. Many in France who accept technological progress are unwilling or unable to acknowledge the impact upon medical ethics of this progress. The conflict is epitomised by the new role being demanded from the doctor. Where formerly he was regarded as the guardian of traditional values today he is urged to adapt, to change, to take account of the technological innovations in medicine. `In such a situation,9 the authors ask, `how is it possible to avoid a feeling of uneasiness?9
WHERE ARE WE AT?
Authors: AP MORGAN VANCE
Journal: JAMA (1899)

In the last several months there has been much discussion pro and con of the commission evil, i. e., the mutual arrangement between the general practitioner and the specialist for a division of fees accruing from work which has been referred from one to the other. It would seem that this discussion followed an article in the<i>Colorado Medical Journal</i>, last July, by Dr. Melville Black, a specialist of Denver, Colo., who under certain conditions advocated the payment by the specialist to the practitioner of a portion of the fees obtained by him from patients referred. Feeling that this society is representative and should not be behindhand in anything pertaining to our work, I thought it fit to bring this matter up for discussion to-night. If any of us are guilty of these practices, the free discussion of them may do us good in causing us to see the error
pp60c-src Activation in hepatocellular carcinoma of humans and LEC rats
Authors: Tsutomu Masaki, Masato Okada, Yasushi Shiratori, William Rengifo, Kozou Matsumoto, Shinn Maeda, Naoya Kato, Fumihiko Kanai, Yutaka Komatsu, Mikio Nishioka, Masao Omata
Journal: Hepatology (1998)

For the related Src kinases, a close correlation exists between elevated tyrosine kinase activity and cell transformation. However, the involvement of pp60 c-src in hepatocellular carcinoma (HCC) remains obscure. The aim of this study was to evaluate whether pp60 c-src tyrosine kinase activity is elevated in HCC. We analyzed the kinase activity of pp60 c-src in normal liver tissue, chronic hepatitis liver tissue, and tumorous and adjacent nontumorous portions of HCC tissue from patients and Long-Evans cinnamon (LEC) rats that are known to develop liver cancer spontaneously. The kinase activity of pp60 c-src was rarely detected in the normal human liver tissue and chronic hepatitis liver tissue, but it was elevated in tumorous and nontumorous portions of HCC tissue. Furthermore, the kinase activity of pp60 c-src was significantly elevated in tumorous tissues compared with nontumorous tissues. The kinase activity of pp60 c-src was also higher in poorly differentiated HCC. In addition, the kinase activity of pp60 c-src increased proportionately with the development of HCC of LEC rats. Our results suggest that activation of the protooncogene product pp60 c-src may play an important role in the malignant transformation of hepatocytes in human and LEC rats, and that it may be closely related to the histopathological grading of human HCC.
Patency of the Ductus Arteriosus at 90
Authors: Paul D. White, Stanley J. Mazurkie, Antonio E. Boschetti
Journal: New England Journal of Medicine (1969)

PATENCY of the ductus arteriosus is a common congenital defect, but it is rare in very old age. In fact we know of no case confirmed at autopsy in a patient so old as John Wood, whom we describe and who lived to the age of 90 years, eight months and 11 days. Furthermore, it is equally remarkable that Mr. Wood, a textile manufacturer, lived such a strenuous life as he did until a few months before he died. His death was caused by heart failure and acute bilateral bronchopneumonia.A very interesting fact in the case of Mr. Wood . . .
TB or not TB, That Is the Question
Authors: Stephen Ciesielski
Journal: JAMA (1992)

<h3>To the Editor.</h3> —In their article "Prevalence of Tuberculin Positivity and Skin Test Anergy in HIV-1-Seropositive and —Seronegative Intravenous Drug Users"<sup>1</sup>Graham et al suggest that anergy among HIV-1-seropositive individuals may make current TB testing protocols an insensitive measure of infection. The higher prevalence of TB in certain demographic and social groups is a function of both increased contact and probably decreased host resistance also. In our study<sup>2</sup>we reported that active TB among black American migrant farm workers was 300 times the national prevalence and that purifed protein derivative (PPD) positivity was three times that of the subjects in the study by Graham et al. Groups with the highest risk for infection and active disease had the highest rates of anergy (14% of black Americans had<i>Candida</i>reactions of 0 mm). Several risk factors for infection with TB, such as homelessness, had significant associations with both anergy
Risk of High Blood Pressure Among Young Men Increases With the Degree of Immaturity at Birth
Authors: Stefan Johansson, Anastasia Iliadou, Niklas Bergvall, Torsten Tuvemo, Mikael Norman, Sven Cnattingius
Journal: Circulation (2005)

Survivors of preterm birth constitute a new generation of young adults, but little is known about their long-term health. We investigated the association between gestational age (GA) and risk of high blood pressure (HBP) in young Swedish men and whether GA modified the risk of HBP; ie, whether HBP was related to being born small for gestational age (SGA).This population-based cohort study included 329 495 Swedish men born in 1973 to 1981 who were conscripted for military service in 1993 to 2001. Multivariate linear- and logistic-regression analyses were performed. Main outcome measures were systolic and diastolic BPs at conscription. Linear-regression analyses showed that systolic BP increased with decreasing GA (regression coefficient -0.31 mm Hg/wk, P<0.001). Systolic and diastolic BPs both increased with decreasing birth weight for GA, but the association with systolic BP was most evident (regression coefficient -0.67 mm Hg per SD score in birth weight for GA, P<0.001). Compared with men born at term (GA, 37 to 41 weeks), the adjusted odd ratios (95% confidence intervals [CIs]) for high systolic BP (> or =140 mm Hg) were as follows: moderately preterm (33 to 36 weeks), 1.25 (1.19 to 1.30); very preterm (29 to 32 weeks), 1.48 (1.30 to 1.68); and extremely preterm (24 to 28 weeks), 1.93 (1.34 to 2.76). Being SGA was associated only with an increased risk of high systolic BP among men born at 33 weeks or later. The risk estimates for high diastolic BP (> or =90 mm Hg) increased with decreasing GA, but the risk reached significance only among men born moderately preterm.Preterm birth, a common pregnancy complication, is a risk factor for HBP in young men. The risk of high systolic BP associated with birth weight for GA is modified by GA, suggesting that perinatal contributions to BP elevation later in life may be induced by different biological pathways.
The Emerging Threat of Untreatable Gonococcal Infection
Authors: Gail A. Bolan, P. Frederick Sparling, Judith N. Wasserheit
Journal: New England Journal of Medicine (2012)

Gonorrhea, which disproportionately affects marginalized populations, is the second most commonly reported communicable disease in the United States. Over the past 3 years, the gonococcus has shown decreased susceptibility to our last line of antimicrobial defense.
Cancer Risk in Relatives of Testicular Cancer Patients by Histology Type and Age at Diagnosis: A Joint Study from Five Nordic Countries
Authors: Elham Kharazmi, Kari Hemminki, Eero Pukkala, Kristina Sundquist, Laufey Tryggvadottir, Steinar Tretli, Jörgen H. Olsen, Mahdi Fallah
Journal: European Urology (2015)
Refractoriness of eucapnic hyperventilation-induced bronchoconstriction in rabbits.
Authors: A Ohtsuka, S Koyama, T Horie
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

The mechanism of refractoriness in bronchoconstriction after repeated hyperventilation was investigated in 18 sensitized rabbits. Rabbits were separated into three groups: an untreated control group (n = 7), a cimetidine-treated group (n = 6), and an indomethacin-treated group (n = 5). After anesthetization, hyperventilation was performed for 15 min (120 breaths/min, 7 ml/kg tidal volume) with dry air containing 5% CO2. Total lung resistance (RL) and dynamic compliance (Cdyn) were measured before (baseline) and after hyperventilation challenge. After RL and Cdyn had returned to baseline values, the hyperventilation challenge was repeated. In the control group maximal increase in percent RL (max %RL) was 49 +/- 9% after the first challenge, but 16 +/- 4% after the second challenge, indicating refractoriness. A similar tendency was observed in percent Cdyn. In the cimetidine- and indomethacin-treated groups, max %RL were 42 +/- 3% and 60 +/- 15% after the first challenge, and 35 +/- 8% and 60 +/- 7% after the second challenge, respectively, indicating no refractoriness. These results suggest that the H2-receptor and bronchodilating prostanoids play an important role in producing the refractoriness to bronchoconstriction observed in sensitized rabbits after repeated hyperventilation.
Aminophylline for Bradyasystolic Cardiac Arrest Refractory to Atropine and Epinephrine
Authors: Sami Viskin
Journal: Annals of Internal Medicine (1993)

Endogenous adenosine, which accumulates during hypoxia and ischemia, may perpetuate asystole. Therefore, patients with cardiac arrest were prospectively studied to see if their immediate outcome could be improved with aminophylline, a competitive antagonist of adenosine. Fifteen consecutive patients with cardiac arrest due to asystole or to nonperfusing bradyarrhythmias, who failed to respond to intravenous atropine and epinephrine, were treated with aminophylline (rapid intravenous injection of 250 mg). Establishment of a stable heart rhythm with sufficient blood pressure to allow discontinuation of closed-chest cardiac massage was achieved in 11 of 15 (73%) patients. All these 11 patients were alive 60 minutes after resuscitation. One patient survived, without neurologic damage. We conclude that the immediate outcome of patients with asystole refractory to standard treatment may be improved with aminophylline. Further study is warranted to determine if earlier administration of aminophylline during cardiac arrest will improve long-term outcome.
Gonadal Dysgenesis in a Newborn Infant
Authors: Ralph Richart, Kurt Benirschke
Journal: New England Journal of Medicine (1958)

MANY cases of the entity now known as gonadal dysgenesis have been reported in the literature since 1938, when Turner1 described the syndrome associated with his name. Although cases have been reported under many different names1 2 3 4 5 6 7 8 and with many variations and associated anomalies,9 they all have in common rudimentary gonadal anlagen without germinal cells, and female external genitalia.The purpose of this paper is to present a case of a newborn infant with gonadal dysgenesis autopsied nineteen days after birth, whose gonadal histology is unusual and in whom one umbilical artery was lacking.Case ReportThe mother of this baby . . .
Macrophage Subpopulations Are Essential for Infarct Repair With and Without Stem Cell Therapy
Authors: Tamar Ben-Mordechai, Radka Holbova, Natalie Landa-Rouben, Tamar Harel-Adar, Micha S. Feinberg, Ihab Abd Elrahman, Galia Blum, Fred H. Epstein, Zmira Silman, Smadar Cohen, Jonathan Leor
Journal: Journal of the American College of Cardiology (2013)
Anomalous Atrioventricular Excitation (Wolff-Parkinson-White Syndrome)
Authors: LOUIS WOLFF
Journal: Circulation (1959)

An opportunity to study the mechanism in pre-excitation was provided by 3 patients with unusual features: coexistence of right bundle-branch block and pre-excitation, occurrence of 2 types of anomalous ventricular complex, and simultaneous occurrence of pre-excitation and varying grades of atrioventricular block (first degree to complete). The conclusion was reached that a functioning structural atrioventricular neuromuscular bypass is present in these cases.
The Medical Department of the Army.
Authors: Charles Smart
Journal: JAMA (1898)

Washington, D. C., August 27, 1898. <h3>To the Editor:</h3> —In theJournalof August 20, Wm. Cuthbertson, late Major and Surgeon of the First Illinois Cavalry, gives it as his opinion that the Medical Department of the Army is incompetent and inefficient, and he explains what he considers to be the causes of these alleged conditions and how they are to be remedied. Of all things literary I dislike a newspaper or journal controversy; but my thirty-six years of active service as an army surgeon will not permit me to be silent when I find in the columns of the Journal of our National Association a criticism of Army medical methods by one who, in every line of his published article, shows himself to have been incompetent for the position of regimental surgeon, on the holding of which he evidently bases his claim to criticise. He begins his attack by
Further Observations on the Pathogenesis of Acne
Authors: J. A. Cotterill, W. J. Cunliffe, B. Williamson, L. Bulusu
Journal: BMJ (1972)

The composition of the lipid of the forehead skin surface and the sebum excretion rate were determined in 217 subjects and controls. Acne was associated with an increase in serum excretion rate and in the squalene and wax and sterol esters in surface lipid. The changes in sebum excretion rate and squalene were statistically significant only in women, but acne in men was associated with a significant decrease in the free fatty acid content or surface lipid.The increased amounts of squalene and wax esters may lead to pilosebaceous obstruction in acne subjects. The increased sebum excretion rate in acne may ensure increased production of sebaceous triglyceride substrate available for lipolysis to irritant free fatty acids, which may then mediate the inflammatory changes of acne.
β-catenin regulates innate and adaptive immunity in mouse liver ischemia-reperfusion injury
Authors: Bibo Ke, Xiu-Da Shen, Naoko Kamo, Haofeng Ji, Shi Yue, Feng Gao, Ronald W. Busuttil, Jerzy W. Kupiec-Weglinski
Journal: Hepatology (2012)

Dendritic cells (DCs) are critical mediators of immune responses that integrate signals from the innate immune system to orchestrate adaptive host immunity. This study was designed to investigate the role and molecular mechanisms of STAT3-induced β-catenin in the regulation of DC function and inflammatory responses in vitro and in vivo . STAT3 induction in lipopolysaccharide (LPS)-stimulated mouse bone marrow-derived DCs (BMDCs) triggered β-catenin activation by way of GSK-3β phosphorylation. The activation of β-catenin inhibited phosphatase and tensin homolog delete on chromosome 10 (PTEN) and promoted the phosphoinositide 3-kinase (PI3K)/Akt pathway, which in turn down-regulated DC maturation and function. In contrast, knockdown of β-catenin increased PTEN/TLR4 (Toll-like receptor 4), interferon regulatory factor-3 (IRF3), nuclear factor kappa B (NF-κB) activity, and proinflammatory cytokine programs in response to LPS stimulation. In a mouse model of warm liver ischemia and reperfusion injury (IRI), disruption of β-catenin signaling increased the hepatocellular damage, enhanced hepatic DC maturation/function, and PTEN/TLR4 local inflammation in vivo. Conclusion : These findings underscore the role of β-catenin to modulate DC maturation and function at the innate-adaptive interface. Activation of β-catenin triggered PI3K/Akt, which in turn inhibited TLR4-driven inflammatory response in a negative feedback regulatory mechanism. By identifying the molecular pathways by which β-catenin regulates DC function, our findings provide the rationale for novel therapeutic approaches to manage local inflammation and injury in IR-stressed liver. (Hepatology 2013)
Some Properties of Ionic and Nonionic Semipermeable Membranes
Authors: ALEXANDER MAURO
Journal: Circulation (1960)

Some fundamental properties of barriers are reviewed. The barrier of biologic significance is the plasma membrane. The role of the barrier in the transport of solvent and neutral solute species is discussed; 2 fundamental transport processes, namely, diffusion and mass flow are emphasized. The latter is shown to arise as the barrier offers increasing impedance to the movement of a given solute species; the barrier is then referred to as a semipermeable membrane, and the transport of the solvent as osmosis. The osmotic movement, undoubtedly one of the most important transport mechanisms in physiologic systems, is shown to arise from a gradient of hydrostatic pressure in the barrier. The need for the consideration of profiles of thermodynamic quantities is stressed. Finally, the third thermodynamic quantity, electrical potential, is introduced when ionic species are considered in the analysis of the "fixed charge" membrane.
Panniculitis and Pancreatic Disease
Authors: ROBERT A. MCDONALD
Journal: Annals of Internal Medicine (1977)

Letters and Corrections1 November 1977Panniculitis and Pancreatic DiseaseROBERT A. MCDONALD, M.D., NICHOLAS LOWE, M.B., M.R.C.P.ROBERT A. MCDONALD, M.D.Search for more papers by this author, NICHOLAS LOWE, M.B., M.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-87-5-634_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Subcutaneous nodular fat necrosis associated with pancreatic diseases is an entity distinct from other forms of panniculitis. Rubinstein and associates (1) have further associated this cutaneous marker of pancreatitis with their finding of alpha1-antitrypsin deficiency in two patients. We believe, however, that their patients had clinical features of nodular fat necrosis of pancreatic disease rather than relapsing febrile nonsuppurative panniculitis (Weber-Christian disease).Their patients developed the classic subcutaneous nodules on the legs and trunk that occasionally drained an odorless fluid. At autopsy panniculitis with fat necrosis was revealed. Szymanski and Bluefarb (2) reported five cases of nodular...References1. RUBINSTEIN H, JAFFER A, KUDRNA J, LERTRATANAKUL Y, CHANDRASEKHAR A, SLATER D, and SCHMID F: Alpha1-antitrypsin deficiency with severe panniculitis. Report of two cases. Ann Intern Med 86:742-744, 1977 LinkGoogle Scholar2. SZYMANSKI F and BLUEFARB S: Nodular fat necrosis and pancreatic disease. Arch Dermatol 83:224-229, 1961 CrossrefMedlineGoogle Scholar3. DEMIS D: Clinical Dermatology. Hagerstown, Maryland, Harper and Row Publishers, Inc., 1977, Unit 8-5 Google Scholar4. LEVER W and SCHAUMBURG-LEVER G: Histopathology of the Skin, 5th ed. Philadelphia, J.B. Lippincott Company, 1975, pp. 231-234 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT A. MCDONALD, M.D.; NICHOLAS LOWE, M.B., M.R.C.P.Affiliations: Department of Medicine University of Wisconsin Madison, WI 53706 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byEntzündliche Erkrankungen des Unterhautbindegewebes 1 November 1977Volume 87, Issue 5Page: 634-635KeywordsAutopsyFatsNecrosisPancreatic diseasesPancreatitis ePublished: 1 December 2008 Issue Published: 1 November 1977 PDF downloadLoading ...