tbuckley/cabot-search huggingface dataset:
Coronary Artery-Right Ventricular Communication Associated with Pulmonary Atresia and Ventricular Septal Defect
Authors: WILLIAM P. BAKER, JOHN H. K. VOGEL, S. GILBERT BLOUNT
Journal: Circulation (1967)

A case of pulmonary atresia and right ventricular-left coronary artery fistulae with an associated ventricular septal defect is described. Hemodynamic findings like those reported in similar cases, but with an intact ventricular septum are also described. The implications of these observations in the genesis of right ventricular-coronary artery fistulae are discussed.
A NONTRAUMATIC PHARYNGEAL AIRWAY
Authors: Arthur E. Guedel
Journal: JAMA (1933)

The pharyngeal airway has become an indispensable part of the anesthetist's equipment. Heretofore, various forms have been made of metal; but metal airways are all more or less traumatizing, even when carefully used, frequently producing cut or bruised lips, chipped or broken teeth, or lacerations of the pharyngeal mucosa. The airway herewith depicted is made of rubber and is sufficiently soft and flexible not to traumatize yet amply rigid to maintain an open oropharyngeal air passage under all conditions. Its flexibility permits it to conform to the varied oropharyngeal curves in different individuals. The metal insert extends into the airway for about 2 cm. from the oral opening and prevents collapse of the rubber between the teeth. 520 North Bedford Drive.
RADIOTHERAPY IN VIENNA
Authors: W. M. Levitt
Journal: BMJ (1959)

Background/Aim: The head is a body site with a particular predisposition to skin malignancies due to exposure to UV radiation. The aim of the study was to better elucidate the characteristics of skin lesions that develop on the scalp. Patients and Methods: A retrospective review of all excised and histologically assessed lesions of the scalp at a single dermatosurgery unit throughout a five-year period was performed. Demographic features and lesion characteristics were compiled and analyzed. Results: Among 5,601 procedures during the analyzed period, 293 were performed on lesions on the scalp area (5.2%) with a mean patient age of 66±19.7 years. The defects were closed, mainly using primary closure, followed by skin grafts, and, least often, flaps (65.1%, 28.5%, 4.9%, respectively). Two thirds of the excised scalp lesions were histologically confirmed as malignant scalp tumors (mostly basal cell carcinomas followed by squamous cell carcinomas). Conclusion: The vast majority of scalp lesions referred for surgical procedures appeared to be malignant. Therefore, dermatologists should pay special attention to the scalp by examining it thoroughly, as the lesions may be hidden by hair.
Preventing Physician Suicide
Authors: Douglas A. Sargent
Journal: JAMA (1987)

Physicians are good at taking care of other people, but often we are not very good at taking care of ourselves or each other. We are vulnerable to all of the ills that affect our patients, including suicide. But, even more than our suicidal patients, when we are seriously troubled we tend to deny our vulnerability, delay seeking help, and resist the need for psychiatric hospitalization.<sup>1</sup>A collaborative study of physician suicide by the American Medical Association (AMA) and the American Psychiatric Association (APA) has found ways to overcome these and other impediments to rational care for troubled physicians. The preliminary findings of the study are reported in this issue ofThe Journal.<sup>2</sup>The study had a long gestation. As John Donne pointed out long ago,<i>any</i>man's death diminishes us. But a physician's death by his own hand is peculiarly painful. To colleagues, patients, and the wider
Radiology of the Heart: Cardiac Imaging in Infants, Children, and Adults
Authors: Otto G. Thilenius
Journal: JAMA (1986)

This textbook is written from the radiologist's point of view, relating chest roentgenogram findings to angiograms and echocardiograms (M mode and two dimensional). It is closer to an atlas than a textbook: its main thrust is the large number of superb reproductions, many of which are a full or half page in size. Whenever needed, schematic drawings are used to further understanding. Cardiovascular nuclear medicine and magnetic resonance imaging are discussed in single chapters but are not interwoven with the rest of the text. Digital subtraction angiography is excluded. The chapters on specific methodologies such as echocardiography, nuclear medicine, or angulated views for coronary arteriography, are short; they serve as general introductions and are not intended for the serious student of the field. The extensive clinical material represents the personal experience of the authors and their colleagues. The representation of less common lesions is uneven: some are covered in detail,
Hypothermic cardiopulmonary bypass in paramyotonia congenita: a case report.
Authors: I J Reece, J A Kennedy, J A Simpson, K M Taylor
Journal: Thorax (1983)

Paramyotonia congenita is a non-progressive disease characterised by myotonia (failure of muscle relaxation) induced by the exposure of the affected muscles to cold.Episodes of flaccid paralysis occur and may be related to hyperkalaemic periodic paralysis.Proximal myopathy or muscular hypertrophy may occur.The condition is inher- ited as an autosomal dominant.'Severe paralysis may occur with comparatively slight increases in plasma potas- sium concentration.During an attack of paralysis there is loss of potassium from muscle cells, which become depolarised.
The Melanocortin System in Fugu: Determination of POMC/AGRP/MCR Gene Repertoire and Synteny, As Well As Pharmacology and Anatomical Distribution of the MCRs
Authors: Janis Klovins, Tatjana Haitina, Davids Fridmanis, Zuzana Kilianova, Ivo Kapa, Robert Fredriksson, Nicole Gallo-Payet, Helgi B. Schiöth
Journal: Molecular Biology and Evolution (2004)

The G-protein–coupled melanocortin receptors (MCRs) play an important role in a variety of essential functions such as the regulation of pigmentation, energy homeostasis, and steroid production. We performed a comprehensive characterization of the MC system in Fugu (Takifugu rubripes). We show that Fugu has an AGRP gene with high degree of conservation in the C-terminal region in addition to a POMC gene lacking γ-MSH. The Fugu genome contains single copies of four MCRs, whereas the MC3R is missing. The MC2R and MC5R are found in tandem and remarkably contain one and two introns, respectively. We suggest that these introns were inserted through a reverse splicing mechanism into the DRY motif that is widely conserved through GPCRs. We were able to assemble large blocks around the MCRs in Fugu, showing remarkable synteny with human chromosomes 16 and 18. Detailed pharmacological characterization showed that ACTH had surprisingly high affinity for the Fugu MC1R and MC4R, whereas α-MSH had lower affinity. We also showed that the MC2R gene in Fugu codes for an ACTH receptor, which did not respond to α-MSH. All the Fugu receptors were able to couple functionally to cAMP production in line with the mammalian orthologs. The anatomical characterization shows that the MC2R is expressed in the brain in addition to the head-kidney, whereas the MC4R and MC5R are found in both brain regions and peripheral tissues. This is the first comprehensive genomic and functional characterization of a GPCR family within the Fugu genome. The study shows that some parts of the MC system are highly conserved through vertebrate evolution, such as regions in POMC coding for ACTH, α-MSH, and β-MSH, the C-terminal region of AGRP, key binding units within the MC1R, MC2R, MC4R, and MC5R, synteny blocks around the MCRs, pharmacological properties of the MC2R, whereas other parts in the system are either missing, such as the MC3R and γ-MSH, or different as compared to mammals, such as the affinity of ACTH and MSH peptides to MC1R and MC4R and the anatomical expression pattern of the MCRs.
Voluntary Death by Breath Holding
Authors: Vincent J. Derbes, Andrew Kerr
Journal: New England Journal of Medicine (1953)

OF historic and physiologic interest are various reports of voluntary death by breath holding. These accounts are found in writings from the classical period to modern times. Several of these were collected by Haller,1 the erudite scholar of catholic interests, and are recorded in his well documented Elementa Physiologiae of 1759.In the classical period cases are referred to by Appianus,2 Galen,3 Pliny4 and Valerius Maximus.6 Galen3 cites the case of a foreign slave who in a spiteful anger killed himself by holding his breath ("Servus barbarus qui, cum vehementi ira concitatus mortem sibi decreuisset prostatus humi, respirationeque cohibita... postea . . .
The future of the physician scientist. Presidential address delivered before the 76th annual meeting of the American Society for Clinical Investigation, Washington, DC, 4 May 1985.
Authors: R M Glickman
Journal: Journal of Clinical Investigation (1985)

3,000,000,000 units in a human cell (uncoiled = 2 m) * 10,000,000 genes possible * Information content comparable with a full set of Encyclopedia Britannica * Only about 1% active (rest 'selfish'?)* 100,000 proteins probably make up the constituents of the human body * About 1,000 proteins have names and can be guessed to be present in the body * About 100 proteins have been isolated and definitely characterized in humans * About 10 human proteins have medical uses today SCHEME I
Meningococcal infections: reducing the case fatality rate by giving penicillin before admission to hospital.
Authors: J. R. Strang, E. J. Pugh
Journal: BMJ (1992)

OBJECTIVE--To determine whether parenteral penicillin given before admission to hospital reduces the case fatality rate in patients with meningococcal disease. DESIGN--Retrospective analysis of 46 consecutive patients admitted to hospital with meningococcal disease from January 1986 to March 1991. SETTING--District general hospital. MAIN OUTCOME MEASURE--Hospital case fatality rate. RESULTS--None of the 13 patients given parenteral penicillin by the referring doctor before admission died, compared with eight deaths (24%) in 33 patients admitted without such treatment. CONCLUSION--Parenteral penicillin given before admission probably contributed to a reduction in the case fatality rate from meningococcal disease, and primary care physicians should be encouraged to give such treatment immediately on suspicion of the diagnosis before transferring the patient to hospital. Public health physicians are well placed to inform and alert general practitioners of the potential benefit of this action.
Increasing Single Epirubicin Doses in Advanced Soft Tissue Sarcomas
Authors: M. Lopez
Journal: Journal of Clinical Oncology (2002)

PURPOSE: To evaluate the maximum-tolerated dose and the clinical efficacy of epirubicin in patients with advanced soft tissue sarcoma. PATIENTS AND METHODS: Sixty-one patients were treated at three different epirubicin dose levels: 140 mg/m2 (six patients), 160 mg/m2 (52 patients), and 180 mg/m2 (three patients). Cycles were repeated every 3 weeks for a maximum of eight cycles. The first two dose levels proved to be feasible and safe without dose-limiting toxicity (DLT). Because the first three patients entering the third dose level experienced DLT, subsequent patients received the next lower dose level. RESULTS: The overall response rate was 44% (95% confidence interval, ± 12%), with six complete (10%) and 21 partial (34%) responses. Responses seemed related to epirubicin dose level, because the response rate was 17%, 44%, and 100% for the three dose levels (χ2 test for trend, P = .02). Median response duration, median time to progression, and median overall survival were 10, 8, and 15 months, respectively. Myelosuppression was the most frequent side effect, with grade 3 or 4 neutropenia occurring in 79% of the patients; 31% of patients were febrile. Nonhematologic toxicity was mainly grades 1 and 2. The mean epirubicin dose-intensity was 49 mg/m2 per week. CONCLUSION: The third epirubicin dose level (180 mg/m2) was the maximum-tolerated dose. The recommended drug dose for clinical use is 160 mg/m2 every 3 weeks with hematopoietic support. Single high-dose epirubicin is effective as first-line treatment and should be preferentially used whenever a high response rate is important to allow the resection of an otherwise unresectable disease or whenever it might result in a significant symptomatic benefit.
Cutaneous Mucormycosis
Authors: Douglas L. Sheldon
Journal: JAMA (1979)

Localized, spontaneously healing ulcers due to<i>Rhizopus rhizopodoformis</i>developed under postoperative wound dressings in two orthopedic patients. Clinically and morphologically similar ulcers of unconfirmed cause appeared in two other patients. This rare cutaneous form of mucormycosis, occurring in nondiabetic, nonimmunosuppressed patients, is suspected to have been caused by skin inoculation under contaminated dressing material. A skin biopsy specimen is important for prompt and definitive diagnosis of cutaneous mucormycosis, especially in immunosuppressed patients. (<i>JAMA</i>241:1032-1034, 1979)
Insulin Action in Cirrhosis
Authors: R. Taylor, R. J. Heine, J. Collins, O. F.W. James, K. G.M.M. Alberti
Journal: Hepatology (1985)

In vivo insulin sensitivity and adipocyte insulin binding and action were assessed in 16 patients with histologically proven hepatic cirrhosis and 11 age-, weight- and sex-matched normal control subjects. The cirrhotic group displayed impaired oral glucose tolerance, despite an exaggerated serum immunoreactive insulin response, and in vivo insulin resistance as assessed both by the euglycemic hyperinsulinemic clamp and the glucose-insulin infusion techniques. Adipocytes of the cirrhotic patients bound significantly less insulin than those of the control subjects (2.21 +/- 0.12% vs. 2.64 +/- 0.13%; p less than 0.05). Although the adipocytes from the cirrhotic patients were less sensitive to insulin stimulation in vitro (half-maximal stimulation at 60.0 +/- 8.0 vs. 21.8 +/- 3.3 pM; p less than 0.001), they exhibited higher maximum rates of lipogenesis. Comparison of the responses of the alcoholic, primary biliary cirrhosis and cryptogenic subgroups suggested pronounced differences in the maximum rates of lipogenesis. There were significant negative correlations between specific binding to adipocytes and both fasting serum immunoreactive insulin and in vivo insulin resistance as assessed by glucose-insulin infusion. Monocyte insulin binding was normal in the cirrhotic group and did not correlate with in vivo insulin resistance. It is concluded that both binding and postbinding defects in insulin target organ cells contribute to the marked in vivo insulin resistance of hepatic cirrhosis.
Fear of the known
Authors: T. Dalrymple
Journal: BMJ (2010)

The persistence of charlatanry irritates doctors, who would much prefer to have a monopoly of foolishness as well as of wisdom. How is it that those who strain at the gnats of science so often swallow the camels of superstition?

Dr Verdo, from the town of Marmande in the Lot and Garonne, set out in 1867 to answer this question in his short book Charlatanry and Charlatans in Medicine: A Psychological Study . He classified firstly the consumers and then the producers of charlatanry, using his own experience and intuition rather than the methods favoured today. This conduced to brevity, if not necessarily to accuracy.

Dr Verdo says that women are in first place …
Occupational Diseases and Industrial Medicine
Authors: Lemuel C. McGee
Journal: JAMA (1961)

This is a well-arranged contribution to an increasingly significant application of the art and science of medicine—that of occupational health. Part 1 describes the history, scope, techniques, and team approach to industrial medicine as it evolved present-day action aimed at maintenance of health and prevention of occupational illness. Consideration is given to social and economic factors, insurance, rehabilitation, job placement, the employment of handicapped workers, and the existing lack of knowledge on the part of physicians generally of the nature of occupational diseases in shops, mills, offices, or wherever men toil. The final chapter of part 1 reviews the difficulties involved in diagnosing occupational disease. Part 2 takes up occupational diseases by categories, starting with noxious gases and concluding with ionizing radiation. The modern touch is exemplified by a chapter on propellants, high energy fuels, and oxidizers. The writing is clear and concise and allows a surprisingly large amount of useful information to be compressed into one volume.
Remarks on the Treatment of Abscesses by Hyperdistension with Carbolised Water
Authors: G. W. Callender
Journal: BMJ (1876)

W\n are familiarwith the good resultwhich follows the waslhing out of the sac of an abscess with carbolised water, and afterwards draining it.In some cases, however, abscesses are divided by septa, or have ex- tended amongst tissues so as to form several chambers communicating by narrow passages.They are practically multilocular, and, if iashed out in an ordinary way, are not effectually treated, because parts of
Human Growth Hormone Replacement Therapy: Pharmacological and Clinical Aspects
Authors: JENS OTTO LUNDE JØRGENSEN
Journal: Endocrine Reviews (1991)

ADMINISTRATION of GH to hypopituitary children. was first reported more than 50 yr ago (1). Initially, GH was prepared from animal sources, but it became evident that nonprimate GH was inactive in man (1). Beck et al. (2) were the first to employ short-term administration of human GH (hGH) in a pituitary dwarf. This was followed by Raben's report in 1958 of an increase in linear height in a pituitary dwarf treated for 10 months with hGH (3). This finding was confirmed in a number of subsequent case reports (4–8). In 1964, Soyka et al. (9) published results from hGH therapy for up to 2.5 yr in 34 patients with short stature. The treatment schedule was 2 mg (the biopotency of the first pituitary preparations was 1 IU/mg) three times a week by the im route. The growth response was more pronounced in the hypopituitary patients, and it was concluded that treatment should be restricted to this group in view of the scarce supply of the hormone. The introduction of a radioimmunoassay (RIA) for measurements of plasma GH (10) enabled quantitative assessment of GH secretion. The diagnosis of GH deficiency was thereafter corroborated by measuring circulating GH after certain well-defined stimuli or during sleep. It was also revealed that a number of patients apparently had isolated GH deficiency (11). A review on the clinical use of GH after 1968 was presented by Frasier in 1983 (12). He summarized that therapy should be started as early as possible and administered im in a dose of 0.06–0.10 IU/kg three times a week (the biopotency of highly purified pituitary GH is 2 IU/mg). He also recommended treatment to be continuous and given until closure of the, epiphyses.
Taking a longer term view of cardiovascular risk: the causal exposure paradigm
Authors: A. D. Sniderman, P. P. Toth, G. Thanassoulis, M. J. Pencina, C. D. Furberg
Journal: BMJ (2014)

<b>Allan D Sniderman and colleagues</b> argue that many people already have advanced arterial damage when they are identified to be at high risk of a cardiovascular event and that a better approach would be to prevent the damage by earlier intervention against the treatable causes of cardiovascular disease
Who Should Be Doing Gastrointestinal Endoscopy?
Authors: Melvin Schapiro
Journal: JAMA (1981)

THE QUESTION of who should be doing gastrointestinal (GI) endoscopy is a problem that confronts hospital committees charged with granting endoscopic privileges.<sup>1</sup>The Joint Commission on Accreditation of Hospitals requires that individual medical staffs set criteria for privileges and have a process for delineation of these privileges. The Federation of Digestive Disease Societies has approved<i>Guidelines for Training in Endoscopy</i><sup>2</sup>and the American Society for Gastrointestinal Endoscopy has prepared<i>Guidelines for Standards of Practice of Gastrointestinal Endoscopy</i>.<sup>3</sup>These two documents may guide hospital committees and require further interpretation in that event. <h3>Training Guidelines</h3> The<i>Guidelines for Training</i>apply to residency-fellowship programs and, when adhered to, provide for physicians who are skillful in the ability both to perform endoscopy and to relate the procedures to the care of the patient. Some gastroenterologists as well as many general and colorectal surgeons have not had their training in programs that
Inequality of health
Authors: R R Gordon
Journal: BMJ (1994)

EDITOR, - Peter Phillimore and colleagues described at widening gap in the mortality ratios between the most and least deprived electoral wards in the Northern region.1 Both groups of wards showed a fall in mortality from 1981 to 1991, but the fall was greater in the richer wards. Dermot O'Reilly gives good evidence that similar “gaps” between the councils of Northern Ireland are related to healthy people leaving a council and increasing the role of unhealthy people.2 …
Tests of Blood Coagulation and Hemostasis
Authors: Paul Didisheim
Journal: JAMA (1967)

Previous articles in this series have dealt with the prothrombin time (PT) and the coagulation time (CT).<sup>1,2</sup>For many years these were the only tests available for the detection of clotting disorders. With the development of the thromboplastin generation test (TGT) and the partial thromboplastin time (PTT<sup>3,4</sup>), clinically important clotting defects which previously went undetected now can be identified. The TGT and PTT are not substitutes for the PT; they are sensitive to different clotting factors. However, the use of the TGT and PTT has largely done away with the usefulness of the Lee-White test. Even when the CT is made more sensitive by the use of tubes coated with silicone, the test remains less sensitive to mild clotting disorders than the TGT or PTT (unpublished data). In addition, for the detection of clinically significant deficiencies of factor VIII (antihemophilic factor) or IX (plasma thromboplastin component), the PTT
Cryotherapy for Oral Cancer
Authors: Andrew A. Gage
Journal: JAMA (1968)

Freezing with liquid nitrogen was used for treatment of oral and oropharyngeal cancers in 50 patients. Reasons for the choice of cryotherapy included resistance to radiotherapy, location in areas difficult to excise, desire to avoid disabling sacrifice of mandible or palate, and presence of severe cardiopulmonary disease. The technique was well suited to oral cancer because of its accessibility to treatment and observation. In terms of survival, results appeared comparable to those of excision. Of 24 patients treated more than a year ago, failure to control the primary lesion occurred in three, all of whom had large oropharyngeal lesions not considered suitable for excision. Some of the remaining 21 have died of heart disease or metastatic cancer, but more (17) are alive and apparently well.
A Prospective, Randomized, Double-masked Comparison of a Zonal-Progressive Multifocal Intraocular Lens and a Monofocal Intraocular Lens
Authors: Roger F. Steinert, Charles T. Post, Stephen F. Brint, Charles D. Fritch, Donald L. Hall, Lowell W. Wilder, I. Howard Fine, Stephen B. Lichtenstein, Samuel Masket, Charles Casebeer, Henry Oksman
Journal: Ophthalmology (1992)