tbuckley/cabot-search huggingface dataset:
Oophorectomy Without Hysterectomy-Reply
Authors: Edward F. Lewison
Journal: JAMA (1978)

I agree that a 52-year-old woman who is considered menopausal though still menstruating irregularly should have an endometrial biopsy or dilation and curettage. However, this consideration is not germane to the critical problem regarding the proper palliative treatment of a patient with known breast cancer metastases. Lung cancer metastases from breast cancer are notoriously lethal, and I would recommend oophorectomy or radiation castration at this age as the initial treatment of choice. Estrogen receptor assays would have been most important but were not available. Although there may be a slightly greater risk for the development of cancer of the endometrium in women with breast cancer, there is a decidedly lower risk for the development of cancer of the cervix in women with breast cancer. A concomitant hysterectomy adds to the surgical trauma, lowers the many factors of host resistance, and, in my opinion, would be considered meddlesome surgery,
Matrix Metalloproteinase-10 Effectively Reduces Infarct Size in Experimental Stroke by Enhancing Fibrinolysis via a Thrombin-Activatable Fibrinolysis Inhibitor–Mediated Mechanism
Authors: J. Orbe, J. Barrenetxe, J.A. Rodriguez, D. Vivien, C. Orset, W.C. Parks, T.P. Birkland, R. Serrano, A. Purroy, S. Martinez de Lizarrondo, E. Angles-Cano, J.A. Páramo
Journal: Circulation (2011)

The fibrinolytic and matrix metalloproteinase (MMP) systems cooperate in thrombus dissolution and extracellular matrix proteolysis. The plasminogen/plasmin system activates MMPs, and some MMPs have been involved in the dissolution of fibrin by targeting fibrin(ogen) directly or by collaborating with plasmin. MMP-10 has been implicated in inflammatory/thrombotic processes and vascular integrity, but whether MMP-10 could have a profibrinolytic effect and represent a promising thrombolytic agent is unknown.The effect of MMP-10 on fibrinolysis was studied in vitro and in vivo, in MMP-10-null mice (Mmp10(-/-)), with the use of 2 different murine models of arterial thrombosis: laser-induced carotid injury and ischemic stroke. In vitro, we showed that MMP-10 was capable of enhancing tissue plasminogen activator-induced fibrinolysis via a thrombin-activatable fibrinolysis inhibitor inactivation-mediated mechanism. In vivo, delayed fibrinolysis observed after photochemical carotid injury in Mmp10(-/-) mice was reversed by active recombinant human MMP-10. In a thrombin-induced stroke model, the reperfusion and the infarct size in sham or tissue plasminogen activator-treated animals were severely impaired in Mmp10(-/-) mice. In this model, administration of active MMP-10 to wild-type animals significantly reduced blood reperfusion time and infarct size to the same extent as tissue plasminogen activator and was associated with shorter bleeding time and no intracranial hemorrhage. This effect was not observed in thrombin-activatable fibrinolysis inhibitor-deficient mice, suggesting thrombin-activatable fibrinolysis inhibitor inactivation as one of the mechanisms involved in the MMP-10 profibrinolytic effect.A novel profibrinolytic role for MMP-10 in experimental ischemic stroke is described, opening new pathways for innovative fibrinolytic strategies in arterial thrombosis.
Comparison of insulin resistance and serum high-sensitivity C-reactive protein levels according to the fasting blood glucose subgroups divided by the newly recommended criteria for fasting hyperglycemia in 10059 healthy Koreans
Authors: Eun-Jung Rhee, Young-Choon Kim, Won-Young Lee, Chan-Hee Jung, Ki-Chul Sung, Seung-Ho Ryu, Ki-Won Oh, Sun-Woo Kim
Journal: Metabolism (2006)
Pulmonary edema fluid protein in high-altitude pulmonary edema
Authors: P. H. Hackett
Journal: JAMA (1986)

To the Editor.—  The ratio of edema fluid protein to serum protein is a measurement used to differentiate hydrostatic from permeability edema. Since it was demonstrated that highaltitude pulmonary edema (HAPE) is noncardiogenic, 1,2 HAPE has been classified as a type of permeability edema. The only previous protein ratio reported in HAPE, however, was 0.6, 3 which is between that expected for hydrostatic ( 0.7) edemas. 4 This measurement may have been flawed, since a tracheal specimen was used, which was probably diluted with other airway secretions. Recently, Schoene et al 5,6 lavaged the lungs of persons with HAPE as well as controls and demonstrated a 60-fold higher total protein level in the HAPE lavage fluid. Because of the lavage technique, the dilution with normal saline precluded determination of the total protein ratio. We wish to report protein measurements of undiluted edema fluid from a patient with HAPE.
Is Justification of Animal Research Necessary?
Authors: Peter Singer
Journal: JAMA (1993)

<h3>To the Editor.</h3> —While I applaud Dr Vance's<sup>1</sup>exposure of the myths that the ALRM is emotional or denies that there are differences between animals and humans, I am puzzled that he should see it as a weakness of the movement that it includes philosophers who argue from different ethical outlooks toward similar conclusions. I would have thought, rather, that it is a sign of the strength of a movement that people starting from different premises should agree on the need for a radical change in our attitudes to animals. Does Vance think that the case against cutting down rain forests—to take just one example—is weaker because some argue exclusively from the effects that this will have on human beings, while others believe that there is intrinsic value in the preservation of complex ecosystems? On the contrary, the convergence of different arguments makes the conclusion more robust. Similarly, the
Diagnosis and management of peripheral arterial disease
Authors: G. Peach, M. Griffin, K. G. Jones, M. M. Thompson, R. J. Hinchliffe
Journal: BMJ (2012)

#### Summary points

Peripheral arterial disease (PAD) is an atherosclerotic process that causes stenosis and occlusion of non-cerebral and non-coronary arteries. It has an estimated worldwide prevalence of almost 10%, rising to 15-20% in people over 70 years of age,1 2 and it affects around 27 million people in Europe and North America alone.3 Critical limb ischaemia—the most severe manifestation of the disease—can lead to limb loss or even death if not treated promptly. Each year, 500-1000 new cases of critical limb ischaemia are diagnosed per million of the population, with an estimated annual cost to the NHS of more than £200m (€255m; $314m).4

#### Sources and selection criteria

We searched Medline, Embase, and the Cochrane Database for systematic reviews and meta-analyses related to the diagnosis and management of peripheral arterial disease. We also consulted relevant national and international guidelines published by the National Institute for Health and Clinical Excellence, the Trans-Atlantic Inter-Society Consensus for the Management of Peripheral Arterial Disease, and the International Working Group on the Diabetic Foot.

Increased awareness of the disease, enhanced medical treatment, and new endovascular interventions have dramatically improved the management of patients with PAD.5 6 With the publication of new National Institute for Health and Clinical Excellence (NICE) guidelines on the management of this disease, this review offers a timely summary of current evidence relating to PAD and provides …
SOME ANOMALIES OF THE EAR DUE TO ERRORS IN DEVELOPMENT.
Authors: GEORGE C. STOUT
Journal: JAMA (1901)

The earliest sign of the ear in the embryo appears about the third week, and is the anlage of the complex labyrinth. It begins as an ectodermic thickening just above the first gill-cleft (hyo-mandibular). Later there is a depression of this thickened area—the auditory pit —which grows deeper and deeper, its edges finally uniting and thus forming the otic vesicle. The otic vesicle being surrounded only by mesodermic tissue is in close proximity to the after-brain and in close relation to the acoustico-facial ganglion. By repeated evaginations, invaginations, unequal growths and foldings, the complex membranous labyrinth is developed, the otic vesicle proper representing the epithelial lining of the entire labyrinth; those of its cells found in the region of the distribution of the nerve of special sense —the maculæ acusticæ and cristæ acusticæ and the organ of Corti—become highly specialized, the rest of the cells remaining as simple columnar epithelium.
Assessment of inhaled BDP-dose dependency of exhaled nitric oxide and local and serum eosinophilic markers in steroids-naive nonatopic asthmatics
Authors: R. Dal Negro, C. Micheletto, S. Tognella, P. Turco, A. Rossetti, L. Cantini
Journal: Allergy (2003)

The aim of the present study was to assess the dose‐dependency from inhaled steroids of changes of airways inflammation [eosinophils count and eosinophil cationic protein (ECP)] measures in induced sputum and in serum, as well as that of exhaled nitric oxide. Twenty steroid‐naive patients with nonatopic asthma of mild to moderate degree [forced expiratory volume in 1 s (FEV 1 ) = 70% of predicted] and with negative response to the standard tests for allergy were selected; after a 1‐week run‐in period they were randomized to receive a 12‐week treatment period of inhaled beclomethasone dipropionate dry powder given with the Pulvinal® inhaler (Clenil P®, Chiesi Farmaceutici S.p.A., Parma, Italy) in two different dose regimens, 400 μ g bid (high dose) or 200 μ g bid (low dose), over a double blind, parallel groups design. The following outcome measures were assessed in baseline and after 1, 6 and 12 weeks of treatment: FEV 1 (l), eosinophils count in sputum (%), is ECP ( μ g/l), serum eosinophils count (%), serum ECP ( μ g/l) and exhaled NO (ppb). The results showed that all the considered parameters improved in both groups: the increase over baseline of FEV 1 and the decrease of NO were significant at any time in the high‐dose group and only at week 12 in the low‐dose group (NS between groups), whereas the markers of eosinophilic activity showed more consistent reductions in the high‐dose than in the low‐dose group when measured in induced sputum ( P &lt; 0.05 between groups after 6 and 12 weeks for eosinophils count and after 12 weeks for ECP). Decreases over baseline of markers measured in serum were more rapid in the high‐dose group, without differences between groups. A marked trend towards a negative correlation was found between FEV 1 and ECP, ( r = −0.72, P &lt; 0.05), between FEV 1 and eosinophils in sputum ( r = −0.31, NS) and between FEV 1 and exhaled NO ( r = −0.38, NS), all of them only in the high‐dose group. The results of the study demonstrate that changes of levels of eosinophilic activity in the airways are dependent from the daily dose of inhaled steroids when measured in induced sputum and that the local assessment can therefore represent a practical and noninvasive method to monitor the extent of airways inflammation.
Hyperglycaemia and complications of diabetes.
Authors: R Rasch, H J Gunderson
Journal: BMJ (1977)

dissemination of Gaussian-based "signifi- cance" tests.If or when the percentile method of expressing interindividual differences has been widely adopted, there will still remain two much more difficult problems: (a) the collection, from healthy and diseased subjects, of data that are reliable and are applicable to the particular patient under investigation; and (b) the question of where to make the cut-off points between "normal" and "abnormal"what risks of error (false-positives and false- negatives) are acceptable.For the balancing of these risks-often a different balance with respect to different disorders, different consequences of error, and even different patients -we must look to clinicians, not to biochemists or other laboratory workers, or to statisticians as such.It would be interesting if the SI units compensated somewhat for their adverse effects by promoting the use of a sensible method of expressing intermeasurement variation and by allowing us to focus attention on how to collect data and apply them to individual patients.
Kinins — Possible Physiologic and Pathologic Roles in Man
Authors: R. W. Kellermeyer, Richard C. Graham
Journal: New England Journal of Medicine (1968)

Pathophysiology in Specific Pathologic StatesIn the initial report describing bradykinin activity,2 it was proposed that this substance might have a pathogenic function in shock because of its hypotensive properties. Subsequently, kinins have been implicated in pancreatitis, the toxemia of burns, asthma, pulmonary edema, gout, rheumatoid arthritis, osteoarthritis, foreign-body granuloma, hereditary angioneurotic edema, carcinoid syndrome, certain types of blood-transfusion reactions and wasp stings. Although the role of the kinins in these diseases is not clearly defined, or in some cases even disputed, sufficient data have been collected to indicate that kinins may be active in several pathologic processes.PancreatitisThe . . .
ADAPTIVE SERVO-VENTILATION DECREASED MORTALITY AND ADMISSION RATES IN HEART FAILURE PATIENTS WITH CHEYNE-STOKES RESPIRATION IN A 18 MONTHS PROSPECTIVE STUDY
Authors: Arild Hetland, Kristina Haugaa, Maria Vistnes, Kristian Hovde Liland, Margareth Olseng, Morten B. Jacobsen, Thor Edvardsen
Journal: Journal of the American College of Cardiology (2014)
Glaucoma--2: Treatment
Authors: P T Khaw
Journal: BMJ (2004)

The main aim of treatment in glaucoma is to reduce intraocular pressure. Good evidence from multiple large randomised trials shows that reducing intraocular pressure is effective in preventing disease progression in ocular hypertension, primary open angle glaucoma, and even in so called normal tension glaucoma. Target pressures in the low teens are associated with the lowest progression rates.

### βblockers

blockers—for example, timolol, carteolol, betaxolol levobunolol, and metipranolol—reduce the secretion of aqueous and are the most commonly prescribed topical treatment. Contraindications to their use include a history of lung or heart disease, as the drops may cause systemic β blockade. Topical β blockers can unmask latent and previously undiagnosed chronic obstructive pulmonary disease in elderly people.

Systemic effects from eye drops can be reduced by occlusion of the punctum (finger pressed on the caruncle, which is felt as a lump at the inner canthus of the eye) or shutting the eyes for several minutes after putting in the drops. This reduces the lacrimal pumping mechanism and stops the drops running down the lacrimal passages and being absorbed systemically through the nasal mucosa or by inhalation directly into the lungs. It may also enhance ocular absorption of the drugs. Drops are usually given twice a day, but long acting forms can be given once a day, either alone or in combination with other drops.

   ![][1] 

Eye closure to reduce systemic side effects after instilling drops

### Prostaglandin analogues

Prostaglandin analogues (such as, latanoprost, travoprost, and bimatoprost) reduce the intraocular pressure by increasing aqueous outflow from the eye through the uveoscleral pathway. These drugs can reduce intraocular pressure by 30-35%.

Systemic side effects are minimal, but a few patients with light irides experience a gradual, permanent darkening of the iris. Eyelashes may also increase in length and darken. For optimum effect, these drops are used once daily (at …

 [1]: /embed/graphic-1.gif
Abstract 3421: Serial whole exome sequencing showed the genetic aggravation of refractory osteosarcoma
Authors: Su Jin Heo, Ji Woong Kim, Woo Sun Kwon, Hyo K. Kim, Min Hee Hong, Woo Ick Yang, Se-Kyu Kim, Hyo Song Kim, Hyun Cheol Chung, Tae Hyun Hwang, Sun Young Rha
Journal: Cancer Research (2014)

Abstract Osteosarcoma is the most common malignant bone tumor in children and adolescents with frequent lung metastasis. As the survival has not been improved with chemotherapy for the last two decades, novel therapeutic approaches are required to efficiently treat osteosarcoma. Genomic analyses have revealed biologically useful information and genetically altered therapeutic targets. The subject of this study was a 25 year old patient with conventional high-grade osteosarcoma with multiple metastasis of lung, lymph nodes and chest wall, who had failed from several palliative systemic chemotherapies and radiotherapy. We performed whole exome sequencing of the gDNA from peripheral blood mononucleated cells (PBMC) and formalin fixed paraffin embedded (FFPE) tissues of primary tumor, secondary (recurrence 1) and tertiary (recurrence 2) metastatic tumors. Samples were sequenced using one lane of paired-end, 100 bp reads on Illumina Hiseq for each sample. Here, we present an analysis result using VarScan and custom-made programs for the detection of somatic mutations and loss of heterozygosity (LOHs) in exome data from changes of genetic variations throughout the disease progression compared to blood germ-line sequencing data. As a result, we observed the 36 common somatic mutated genes, including p73 and TSHR, in three tumor types. And we indentified the somatic mutations affecting the functions of known cancer genes, RBM15, SYNE1, GNAQ and XPA, which were only present in the secondary and/or tertiary metastatic tumors but not in the primary tumor. Especially, GNAQ mutations which is found in the metastatic tumors, is known to be mutated in 50% of melanoma and driven constitutive activity of the MAPK pathway. Therefore, GNAQ mutation in recurrent osteosarcoma patient might be a potential marker for new therapeutic strategies of inhibiting MAPK pathway. In conclusion, the ability to track clonal evolution in cancers may provide new strategies and opportunities for drug development, especially in refractory and rare diseases. Citation Format: Su Jin Heo, Ji Woong Kim, Woo Sun Kwon, Hyo Ki Kim, Min Hee Hong, Woo Ick Yang, Se-Kyu Kim, Hyo Song Kim, Hyun Cheol Chung, Tae Hyun Hwang, Sun Young Rha. Serial whole exome sequencing showed the genetic aggravation of refractory osteosarcoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3421. doi:10.1158/1538-7445.AM2014-3421
Extracorporeal ultrafiltration and intravenous reinfusion of ascitic fluid vs. large-volume paracentesis: A randomized controlled trial Bruno S, Borzio M, Romagnoni M, Battezatti PM, Rossi S, Chiesa A, et al. Comparison of spontaneous ascites filtration and reinfusion with total paracentesis with intravenous albumin infusion in cirrhotic patients with tense ascites. BMJ 1992; 304: 1655–1658
Authors: M Antillon
Journal: Hepatology (1993)
Pancreatic Transplantation: Impact on the quality of life of diabetic renal transplant recipients
Authors: Frances K Milde, Laura K Hart, Pamela S Zehr
Journal: Diabetes Care (1995)

OBJECTIVE To determine the impact of pancreas transplantation on the quality of life of renal transplant recipients with diabetes. RESEARCH DESIGN AND METHODS In this quasi-experimental comparative study of 41 successful pancreas transplant (SP) recipients, 13 failed pancreas transplant (FP) recipients, and 28 kidney alone (KA) transplant recipients, we collected data from individuals who had their pancreas/kidney or kidney alone transplants ≥6 months before at a university tertiary care center. This study was an extension of a 1992 study of SP and FP recipients. The subject group was enlarged with additional pancreas/kidney recipients and a control group of KA recipients. Five dimensions of life quality were measured. RESULTS Groups did not differ significantly regarding age, gender, marital status, comorbidity, type of prior dialysis, current kidney function, length of time since transplant, physical activity, symptom burden, emotional state, and feelings of well-being. A significant time by group interaction occurred for quality of life (P = 0.0023) and health (P = 0.0001). Patients in the SP and KA groups perceived their past life and health quality to be significantly lower and their present and future life and health quality to be significantly better than did the FP group. The groups' major concerns differed significantly. The FP group's concern related to diabetes, the SP group's to immunosuppression, and the KA group's to graft rejection. CONCLUSION Patients with failed pancreas but successful kidney transplants see less improvement in their quality of life than do patients who meet their transplant goals, irrespective of whether they receive a pancreas.
ATOPY TO ACACIA
Authors: Leon Felderman
Journal: JAMA (1933)

To the Editor:  —I have read with interest the report of the case Atopy to Acacia (Gum Arabic) by Drs. Aaron D. Spielman and Horace S. Baldwin (The Journal, August 5, p. 444). It seems that some clinicians speak of allergy and atopy in interchangeable terms. Arthur F. Coca in his volume on Asthma and Hay Fever in Theory and Practice (Baltimore, Charles C. Thomas, 1931) defines atopy as a form of human hypersensitiveness which does not occur, so far as known, in the lower animals, but which is subject to hereditary influence. This suggestion, however, does not detract from the splendid contribution of this report.
Cirrhosis of Liver
Authors: P. N. Coleman
Journal: BMJ (1948)

are analysed, and show that, including two major epidemics during this period, out of 631 cases 98.4% were microsporon infections (97.1% M. audouini) and 84.15% were in boys.These figures correspond closely to recent figures from other parts of Scotland and from the U.S.A. Infection most commonly appeared to occur in barbers' shops.Wood's light was found essential in the diagnosis and manage- ment of microsporon and favus infections but of no use in trichophyton cases.Epilation by x rays or thallium is still the most rapid and successful means of cure, but fungicides assisted by a wetting agent in carbo-wax 1500 offer a chance of cure in at least a fair proportion of cases after a considerably longer period of treatment.It must be realized that, especially with the animal microspora, a modified kerion reaction may occur leading to spontaneous cure, so that in assessing the value of any " cure " for ringworm the actual fungus causing the condition and the criteria of cure must be known.A brief note is made of the organization required for a centre to deal with cases of ringworm and the standards necessary for ensuring that patients are non-infectious before their return to school.
Importance of Soft Tissue to Treatment of Chronic Osteomyelitis
Authors: Robert A. Murray
Journal: JAMA (1962)

Hematogenous or traumatic osteomyelitis persists because of (1) bacterial infection, (2) sequestration, (3) cavitation or dead space, (4) inadequacy or scarring of soft tissue. Frequently, loss of soft tissue and scarring plus cavitation (noncollapsible dead space) are the most important factors in the continuance of osteomyelitis. These problems are not solved by either sequestrectomy or administration of antibiotic agents. Ideally, treatment should include extirpation of devitalized bone and dense scar tissue. Cavities must be collapsed or filled so that only healthy vascular tissue remains in the extremity. Antibiotic control of responsible organisms is advisable and usually is mandatory. Because treatment of the patient with chronic osteomyelitis must be individualized, this therapeutic ideal frequently must be compromised.