tbuckley/cabot-search huggingface dataset:
THE DISTRIBUTION OF AFFERENT NERVES IN THE SKIN.
Authors: MAX von FREY
Journal: JAMA (1906)

While the question as to how the ventral roots of the spinal nerves are engaged in the innervation of the muscles is in its main features cleared up, especially through the researches of Sherrington,<sup>1</sup>our insight into the distribution of the afferent fibers is still very incomplete. Here again the work of Sherrington represents by far the most important contribution, his experiments being the more interesting because of their having been made mostly on monkeys. Sherrington<sup>2</sup>determined the extent of the cutaneous areas of the dorsal roots of all the spinal nerves and found that these areas are always continuous for each single root and that they overlap to a considerable extent. His method of observation was that of remaining anesthesia, as Head has termed it. The skin field of a spinal root is isolated by dividing as many adjacent roots as is necessary to surround the skin
Decrease in dendritic cells in endomyocardial biopsies of human dilated cardiomyopathy
Authors: Rudin Pistulli, Sebastian König, Stefanie Drobnik, Daniel Kretzschmar, Ilonka Rohm, Michael Lichtenauer, Michael Fritzenwanger, Gerhard Mall, Gita Mall, Hans‐Reiner Figulla, Atilla Yilmaz
Journal: European Journal of Heart Failure (2013)
Allelic sequence variation in the HLA class II genes and proteins in patients with autoimmune hepatitis
Authors: Derek G. Doherty, Peter T. Donaldson, James A. Underhill, Mark J. Farrant, Ann Duthie, Giorgina Mieli-Vergani, Ian G. McFarlane, Philip J. Johnson, Adrian L. W. F. Eddleston, Alex P. Mowat, Roger Williams
Journal: Hepatology (1994)

Susceptibility to autoimmune hepatitis in white patients is associated with the human leukocyte antigen class II antigens DR3 and DR4. To analyze the molecular basis of these associations, we used oligonucleotide probes to determine the DRB, DQA and DQB hypervariable nucleotide sequences in 119 patients with autoimmune hepatitis and 177 matched controls. DRB3*0101, which encodes DR52a, predisposed patients most strongly to the disease. It was present in 58% of patients and 25% of controls (corrected P < 0.000005), whereas DQA1*0101 and 0102 conferred protection in males only. The DR4 subtype, DRB1*0401, was raised in the DRB3*0101-negative patients; 81% possessed either DRB3*0101 or DRB1*0401, compared with 42% of controls (corrected P < 0.0000001). These alleles encode the amino acid sequence Leu-Leu-Glu-Gln-Lys-Arg at positions 67 to 72 of the DR beta polypeptide, which was present in 94% of patients and 64% of controls (corrected P < 0.000001) and in all patients who tested positive for autoantibodies to the hepatic asialoglycoprotein receptor. The patients with DRB1*0401 had less severe disease, relapsed less frequently and were first seen significantly later in life than those patients with DRB3*0101; and whereas a single copy of DRB1*0401 predisposed to autoimmune hepatitis, DRB3*0101-associated susceptibility had a dose-related effect. These data provide evidence that specific residues in the DR beta polypeptides predispose to autoimmune hepatitis in white patients and genes linked to DRB3*0101 and DRB1*0401 may determine two clinically distinct disease patterns.
Management of threatened miscarriage in early pregnancy.
Authors: R C Lyle
Journal: BMJ (1991)

A total of 67 people (54%) felt that partner notification would have been acceptable, the reasons given being to seek earlier treatment (51; 76%), to prevent infecting others (47; 70%), to plan their lives better if test results were positive (41; 61%), and to live more healthily (34; 51%).Fifty eight men felt that they would prefer not to have been notified, because it might cause unnecessary anxiety (36; 62%), it risks breaking confidentiality (43; 74%), and it can affect being able to obtain insurance and mortgages (20; 34%).In a separate study of 50 women positive for HIV, 40 women had had a sexual partner subse- quent to diagnosis.Of these 40, 24 (60%) had informed their partners and the remaining 16 (40%) had not.Despite these figures, when the men in our study were asked whether a pilot scheme based on the Swedish model for voluntary partner notification ought to be instituted, 90 (72%) agreed and only 35 (28%) said no.The survey highlighted particular worries among patients such as anxiety and lack of confidentiality, which might be assuaged by appropriate counselling before and after testing, with assurances of confidentiality at all stages.Partner notification has been shown to be efficacious in Sweden6 and South Carolina,7 and pilot studies to assess efficacy, with careful audit, are now overdue in this country.This study shows that the majority of patients who have gone through the experience of testing positive for HIV would support this.
Spontaneous Amputation of Cervix
Authors: I. F. MacMath
Journal: BMJ (1950)

BJ,,gm,SH -~~~~~~~~~~~~~~~MIA ORA limited duties to teach junior students in the wards.This arrangement already exists on paper; it is time it was fully implemented.Tutoring of a kind exists at a number of medical schools, but is applied throughout the course at very few.At many centres students do not have ready access to the dean, and they have no tutor to whom they can turn for advice on reading, for guidance on methods of work, or
Natural Course vs Interventions to Clear Common Bile Duct Stones
Authors: Mats Möller, Ulf Gustafsson, Finn Rasmussen, Gunnar Persson, Anders Thorell
Journal: JAMA Surgery (2014)

The optimal strategy for common bile duct stones (CBDSs) encountered during cholecystectomy is yet to be determined.To evaluate the outcomes after various interventional techniques to clear the bile ducts and the natural course of CBDSs found during intraoperative cholangiography.In a large retrospective cohort analysis, we analyzed data from the Swedish Registry for Gallstone Surgery and Endoscopic Retrograde Cholangiopancreatography (GallRiks). We included all patients with CBDSs found on intraoperative cholangiography during cholecystectomy from May 1, 2005, through December 31, 2009.Presence of CBDSs on intraoperative cholangiography.Relation between strategies for handling CBDSs in terms of complication rates and/or incomplete clearance with need of intervention (ie, unfavorable outcomes).In 38,864 cholecystectomies, CBDSs were found in 3969 patients, of whom 3828 underwent analysis. Earlier or ongoing symptoms were more common with increasing stone size (P < .001). In total, postoperative unfavorable outcomes were found in 14.9% but less frequently for patients with smaller stones (P < .01). Among patients in whom no intraoperative measures were taken (representing natural course), the risk for unfavorable outcomes was 25.3%. This risk was significantly lower in patients in whom any measure was taken to clear the ducts (12.7%; odds ratio, 0.44 [95% CI, 0.35-0.55]). The same was found when small (<4 mm) and medium (4-8 mm) stones were analyzed separately (odds ratio, 0.52 [95% CI, 0.34-0.79] and 0.24 [95% CI, 0.17-0.32], respectively).The high rates of unfavorable outcomes associated with taking no measures when CBDSs are found during cholecystectomy suggest that the natural course might not be as favorable as earlier suggested. This finding implies that, in general, efforts should be made to clear the bile ducts.
The FDA and the Case of Ketek
Authors: David B. Ross
Journal: New England Journal of Medicine (2007)

The FDA and the Case of Ketek Since the FDA approved the drug Ketek (telithromycin), concerns have arisen about both safety and fraud. Dr. David Ross writes that there are lessons to be learned from an examination of the events surrounding the approval of this product. Dr. David Ross discusses the FDA review process for the antibiotic Ketek, problems with data integrity, and the “culture of approval” at the FDA. Dr. Ross is a clinical assistant professor at George Washington University School of Medicine and Health Sciences, Washington, D.C., and a former medical reviewer for the FDA.
Book: Chronic Fatigue Syndrome (CFS/ME): The Facts
Authors: G. Hossain
Journal: BMJ (2001)

Michael Sharpe, Frankie Campling Oxford University Press, £9.99, pp 290 ISBN 0 19 263049 0 Rating: ![Graphic][1]</img> ![Graphic][2]</img> ![Graphic][3]</img> The past decade has seen an outpouring of publicity, and more than a trickle of research, about chronic fatigue syndrome. Yet, despite all this activity, the subject remains a cause of frustration for doctors and patients alike. This is not for want of information, but rather the opposite, an internet-led flood of anecdotal evidence and advice. Sharpe and Campling, the former a consultant psychiatrist and the latter a … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Treatment of bleeding from portal hypertensive gastropathy by portacaval shunt
Authors: Marshall J. Orloff, Mark S. Orloff, Susan L. Orloff, Kevin S. Haynes
Journal: Hepatology (1995)

Portal hypertensive gastropathy is a vascular disorder of the gastric mucosa distinguished by ectasia of the mucosal capillaries and submucosal veins without inflammation. During 1988 to 1993, 12 patients with biopsy-proven cirrhosis (10 alcoholic, 2 posthepatitic) were evaluated and treated prospectively by portacaval shunt for active bleeding from severe portal hypertensive gastropathy. Eleven patients had been hospitalized for bleeding three to nine times previously, and one was bleeding uncontrollably for the first time. Requirement for blood transfusions ranged from 11 to 39 units cumulatively, of which 8 to 30 units were required specifically to replace blood lost from portal hypertensive gastropathy. Admission findings were ascites in 9 patients, jaundice in 8, severe muscle wasting in 10, hyperdynamic state in 9. Child's risk class was C in 7, B in 4, A in 1. Ten of the 12 patients had previously received repetitive endoscopic sclerotherapy for esophageal varices, which has been reported to precipitate portal hypertensive gastropathy. Eight patients had failed propranolol therapy for bleeding. Portacaval shunt was performed emergently in 11 patients and electively in 1, and permanently stopped bleeding in all by reducing the mean portal vein-inferior vena cava pressure gradient from 251 to 16 mm saline. There were no operative deaths, and two unrelated late deaths after 13 and 24 months. During 1 to 6.75 years of follow-up, all shunts remained patent by ultrasonography, the gastric mucosa reverted to normal on serial endoscopy, and there was no gastrointestinal bleeding. Recurrent portal-systemic encephalopathy developed in only 8% of patients. Quality of life was generally good.(ABSTRACT TRUNCATED AT 250 WORDS)
HIGH FUROSEMIDE DOSE IS AN INDEPENDENT RISK FACTOR FOR MORTALITY IN PATIENTS WITH CHRONIC HEART FAILURE
Authors: John Terrovitis, Christos Kapelios, Elisavet Kaldara, George Sainis, Vassilios Sousonis, Nickolaos Michelinakis, Stefania Sventzouri, Zafeiria Margari, Argyrios Ntalianis, John Nanas
Journal: Journal of the American College of Cardiology (2012)
Significance of immunoglobulin G4 (IgG4)-positive cells in extrahepatic cholangiocarcinoma: Molecular mechanism of IgG4 reaction in cancer tissue
Authors: Kenichi Harada, Shinji Shimoda, Yasushi Kimura, Yasunori Sato, Hiroko Ikeda, Saya Igarashi, Xiang-Shan Ren, Hirohide Sato, Yasuni Nakanuma
Journal: Hepatology (2012)

IgG4 reactions consisting of marked infiltration by immunoglobulin G4 (IgG4)-positive plasma cells in affected organs is found in cancer patients as well as patients with IgG4-related diseases. Notably, extrahepatic cholangiocarcinomas accompanying marked IgG4 reactions clinicopathologically mimic IgG4-related sclerosing cholangitis. The regulatory cytokine interleukin (IL)-10 is thought to induce the differentiation of IgG4-positive cells. In this study, to clarify the mechanism of the IgG4 reaction in extrahepatic cholangiocarcinoma, we investigated nonprofessional antigen-presenting cells (APCs) generating IL-10-producing regulatory T cells (anergy T cells) and Foxp3-positive regulatory cells producing IL-10. Immunohistochemistry targeting IgG4, HLA-DR, CD80, CD86, and Foxp3 was performed using 54 cholangiocarcinoma specimens from 24 patients with gallbladder cancer, 22 patients with common bile duct cancer, and eight patients with cancer of the Papilla of Vater. Moreover, a molecular analysis of Foxp3 and IL-10 was performed using a cultured human cholangiocarcinoma cell line. Consequently, 43% of the cholangiocarcinomas were found to be abundant in IgG4. Those expressing HLA-DR but lacking costimulatory molecules (CD80 and CD86) and those expressing Foxp3 detected by an antibody recognizing the N terminus accounted for 54% and 39% of cases, respectively. Moreover, the number of IgG4-positive cells was larger in these cases than in other groups. In cultured cells, the presence of a splicing variant of Foxp3 messenger RNA and the expression of IL-10 were demonstrated.Extrahepatic cholangiocarcinoma is often accompanied by significant infiltration of IgG4-positive cells. Cholangiocarcinoma cells could play the role of nonprofessional APCs and Foxp3-positive regulatory cells, inducing IgG4 reactions via the production of IL-10 indirectly and directly, respectively.
Arrhythmogenic effect of high blood pressure: some observations on its mechanism
Authors: D A SIDERIS, S T TOUMANIDIS, E B KOSTIS, A DIAKOS, S D MOULOPOULOS
Journal: Cardiovascular Research (1989)

An increase in aortic pressure is a reproducible way of causing ventricular ectopic rhythms. This study sought to determine whether it is the aortic pressure per se or the concommitant increase in afterload or preload that has a direct arrhythmogenic effect. Experiments were carried out in 17 anaesthetised dogs. For each 10 s period the pressure and the presence of a ventricular arrhythmia (at least one ectopic beat) were noted. In nine animals an aortic valve gradient was created (and released). The results were compared to those obtained by impeding the aortic flow at the ascending aorta. The mean systolic left ventricular pressure was significantly higher in the arrhythmia associated periods in 8/9 experiments when there was an aortic valve gradient and in 5/9 experiments when there was not. In 4/9 experiments the mean aortic pressure associated with arrhythmia was significantly lower with an aortic valve gradient than when there was no gradient and no arrhythmia. In 7/9 of these experiments, coronary sinus flow was measured volumetrically during the manoeuvres applied. The coronary flow was significantly lower when there was neither arrhythmia nor aortic valve gradient than when there was an arrhythmia (with or without an aortic valve gradient). In another eight experiments a pressure reservoir in the aorta was either raised or lowered while another pressure reservoir in the left atrium was moved in the opposite direction. Thus the mean aortic pressure could be increased while the left atrial pressure was decreased and vice versa. If the left atrial pressure was taken into account, the mean difference of the aortic pressure from its expected value, derived from the aortic v left atrial pressure regression equation, was significantly higher when there was an arrhythmia than it was when there was no arrhythmia in all eight experiments. On the other hand, the mean difference in the left atrial pressure from its expected value was significantly higher when there was an arrhythmia in 1/8, lower in 2/8 and not significantly different in 5/8 experiments. It is concluded that when the blood pressure is raised, it is the increase in afterload rather than an increase in aortic pressure itself or in the preload that has an arrhythmogenic effect on the ventricles.
Characterisation of inorganic microparticles in pigment cells of human gut associated lymphoid tissue.
Authors: J J Powell, C C Ainley, R S Harvey, I M Mason, M D Kendall, E A Sankey, A P Dhillon, R P Thompson
Journal: Gut (1996)

Macrophages at the base of human gut associated lymphoid tissue (GALT), become loaded early in life with dark granular pigment that is rich in aluminium, silicon, and titanium. The molecular characteristics, intracellular distribution, and source of this pigment is described. Laser scanning and electron microscopy showed that pigmented macrophages were often closely related to collagen fibres and plasma cells in GALT of both small and large intestine and contained numerous phagolysosomes, previously described as granules, that are rich in electron dense submicron sized particles. Morphological assessment, x ray microanalysis, and image electron energy loss spectroscopy showed three distinct types of microparticle: type I - spheres of titanium dioxide, 100-200 nm diameter, characterised as the synthetic food-additive polymorph anatase; type II - aluminosilicates, &lt; 100-400 nm in length, generally of flaky appearance, often with adsorbed surface iron, and mostly characteristic of the natural clay mineral kaolinite; and type III - mixed environmental silicates without aluminium, 100-700 nm in length and of variable morphology. Thus, this cellular pigment that is partly derived from food additives and partly from the environment is composed of inert inorganic microparticles and loaded into phagolysosomes of macrophages within the GALT of all human subjects. These observations suggest that the pathogenicity of this pigment should be further investigated since, in susceptible individuals, the same intracellular distribution of these three types of submicron particle causes chronic latent granulomatous inflammation.
Use of myocardial contrast echocardiography in identifying patients with failed reperfusion after thrombolysis in acute myocardial infarction: Comparison with TIMI myocardial perfusion grade and clinical markers of reperfusion
Authors: Luciano Agati, Stefania Funaro, Gabriele Veneroso, Mariapina Madonna, Flavia Celani, Francesca De Maio, Carlo Iacoboni, Rachele Adorisio, Francesco Fedele
Journal: Journal of the American College of Cardiology (2003)
Alpha-adrenoceptor stimulation, lysophosphoglycerides, and lipid peroxidation in reoxygenation induced calcium uptake in rabbit myocardium
Authors: M. A TONES, P. A POOLE-WILSON
Journal: Cardiovascular Research (1985)

Journal Article Alpha-adrenoceptor stimulation, lysophosphoglycerides, and lipid peroxidation in reoxygenation induced calcium uptake in rabbit myocardium Get access MICHAEL A TONES, MICHAEL A TONES From the Department of Cardiac Medicine, The Cardiothoracic Institute, 2 Beaumont Street, London, WIN 2DX Search for other works by this author on: Oxford Academic PubMed Google Scholar PHILIP A POOLE-WILSON PHILIP A POOLE-WILSON * From the Department of Cardiac Medicine, The Cardiothoracic Institute, 2 Beaumont Street, London, WIN 2DX *Correspondence and requests for reprints to be addressed to PAPW at the above address. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 19, Issue 4, April 1985, Pages 228–236, https://doi.org/10.1093/cvr/19.4.228 Published: 01 April 1985
Interleukin-6 Causes Myocardial Failure and Skeletal Muscle Atrophy in Rats
Authors: Sofie P.M. Janssen, Ghislaine Gayan-Ramirez, An Van Den Bergh, Paul Herijgers, Karen Maes, Erik Verbeken, Marc Decramer
Journal: Circulation (2005)

Background— The impact of interleukin (IL)-6 on skeletal muscle function remains the subject of controversy. Methods and Results— The effects of 7-day subcutaneous administration of recombinant human IL-6 were examined at 3 doses, 50, 100, or 250 μg · kg −1 · d −1 , in rats. Skeletal muscle mass decreased dose-dependently (with increasing dose: in the diaphragm, −10%, P =NS; −15%, P =0.0561; and −15% P &lt;0.05; and in the gastrocnemius, −9%, P =NS; −9%, P =NS; and −18%, P &lt;0.005) because of decreases in cross-sectional area of all fiber types without alterations in diaphragm contractile properties. Cardiovascular variables showed a dose-dependent heart dilatation (for end-diastolic volume: control, 78 μL; moderate dose, 123 μL; and high dose, 137 μL, P &lt;0.001), reduced end-systolic pressure (control, 113 mm Hg; moderate dose, 87 mm Hg; and high dose, 90 mm Hg; P =0.037), and decreased myocardial contractility (for preload recruitable stroke work: control, 79 mm Hg; moderate dose, 67 mm Hg; and high dose, 48 mm Hg; P &lt;0.001). Lung edema was confirmed by an increased wet-to-dry ratio (control, 4.2; moderate dose, 4.6; and high dose, 4.5; P &lt;0.001) and microscopy findings. These cardiovascular alterations led to decreases in organ blood flow, particularly in the diaphragm (control, 0.56 mL · min −1 · g −1 ; moderate dose, 0.21 mL · min −1 · g −1 ; and high dose, 0.23 mL · min −1 · g −1 ; P =0.037). In vitro recombinant human IL-6 administration did not cause any alterations in diaphragm force or endurance capacity. Conclusions— IL-6 clearly caused ventilatory and peripheral skeletal muscle atrophy, even after short-term administration. Blood flow redistribution, resulting from the myocardial failure induced by IL-6, was likely responsible for this muscle atrophy, because IL-6 did not exert any direct effect on the diaphragm.
Mr. Shaw on Doctors
Authors: Sigmund L. Wilens
Journal: JAMA (1966)

When the eminent playwright George Bernard Shaw was beginning to age, he wrote a play called<i>Back to Methuselah</i>which he considered to be his masterpiece since in it he portrayed his idea of Utopia. The elite characters in this play lived to be 300 years old and all were brilliant conversationalists just like the author. They apparently did little else but converse. An aging man is likely to regard young adults as mere children. Shaw at this time believed that a proper adolescence lasted 78 years and that a man could not become an adult unless he turned 100. However, when the great dramatist reached his 90's he seems to have lost his zest for a three-century life span. In fact, he lost his enthusiasm for most of the opinions that he had propounded during his career. But his antagonism towards doctors persisted. In the preface to<i>Far Fetched</i>
Gastric cancer risk after vagotomy.
Authors: G Lundegardh, A Ekbom, J K McLaughlin, O Nyren
Journal: Gut (1994)

The risk of gastric cancer after vagotomy for benign gastric and duodenal disease was examined in a population based cohort of 7198 patients operated on during 1971-79 and followed up until 1988. After exclusion of the first year of follow up there were 34 cases of gastric cancer compared with 25.6 expected (standardised incidence ratio (SIR) = 1.33; 95% confidence intervals (CI) 0.92 to 1.86). Separate analyses by duration of follow up, sex, age at operation, underlying diagnosis, and operative procedures did not show any significant increased or decreased risk of gastric cancer in any of the subgroups. In conclusion, decreased gastric acid secretion after vagotomy does not increase the risk of gastric cancer in the first 10 years after operation or in the subgroup followed up for 10-18 years. A longer follow-up is needed before an excess risk can be excluded.
Book Review Alex and Me: How a Scientist and a Parrot Discovered a Hidden World of Animal Intelligence — And Formed a Deep Bond in the Process By Irene M. Pepperberg. 240 pp., illustrated. New York, Collins, 2008. $23.95 (cloth); $18.95 (e-book). 978-0-06-167247-7 (cloth); 978-0-06-171723-9 (e-book).
Authors: Allan H. Ropper
Journal: New England Journal of Medicine (2009)
Case 32-1972
Authors: Richard C. Cabot, Benjamin Castleman, Robert E. Scully, Betty U. McNeely, Charles A. Sanders, Martin H. Flax
Journal: New England Journal of Medicine (1972)

Presentation of CaseA 65-year-old woman was admitted to the hospital* because of progressive confusion.She had been well until five weeks previously, when there was the onset of fatigue. One week later a hacking cough developed, followed by a sharp pain in the anterior aspect of the chest, with burning discomfort in the right upper abdominal quadrant that radiated to the back and was not relieved by an antacid. One week before entry, because of persistent chest pain, she was admitted to another hospital, where a diagnosis of acute myocardial infarction was made, and jaundice was noted. The glutamic . . .