tbuckley/cabot-search huggingface dataset:
A Variant of an Accessory Common Bile Duct
Authors: B. Leung, P. Lai, A. Chan, Y. L. Chan, W. Y. Lau
Journal: Endoscopy (2000)

While variations of the common bile duct are relatively common, true duplication of the common bile duct is very rare. Such deviation from normal anatomy, if unrecognized, may cause problems during surgical intervention. Here we present a case of a unique variant of an accessory bile duct which arises from the confluence of the right and left hepatic ducts and runs down to join the pancreatic duct to form a long, common channel before opening into the papilla with the main duct.
Dopamine — Clinical Uses of an Endogenous Catecholamine
Authors: Leon I. Goldberg
Journal: New England Journal of Medicine (1974)

THE third endogenous catecholamine, dopamine, has been extensively investigated in recent years. Dopamine, the immediate precursor of norepinephrine, is found in high concentrations in sympathetic nerves and adrenal glands. In addition, it has been identified in areas where norepinephrine does not occur, and accumulating evidence suggests that dopaminergic nerves and receptors exert unique functions in the brain and elsewhere. Investigations of the physiologic role of dopamine in the basal ganglions resulted in the use of 1-dopa, the precursor of dopamine, in the treatment of Parkinson's disease.Dopamine also exerts unusual cardiovascular actions that appear to be due to action on . . .
Splenic and Mediastinal Calcifications in Histoplasmosis
Authors: Jeremy Topin, Gökhan M Mutlu
Journal: New England Journal of Medicine (2006)

A 37-year-old woman from Illinois with a history of an idiopathic T-cell deficiency (CD4 cell count, 249 cells per cubic millimeter, and negative for infection with the human immunodeficiency virus), histoplasma pneumonia in childhood, and recurrent vulvovaginal candidiasis presented with nausea and odynophagia for three days. Physical examination was unremarkable except for the presence of oral candidiasis and mild tenderness in the left upper quadrant. As a part of the workup, she underwent computed tomography (CT) of the abdomen, which showed extensive, diffuse calcification of the spleen (Panel A, large arrow) with several calcified lymph nodes within the abdominal cavity . . .
Human metapneumovirus infection in an immunocompetent adult presenting as mononucleosis-like illness
Authors: Iris W.S. Li, Kelvin K.W. To, Bone S.F. Tang, Kwok-Hung Chan, Chee-Kin Hui, Vincent C.C. Cheng, Kwok-Yung Yuen
Journal: Journal of Infection (2008)

A 37-year-old man was presented with incidental findings of neutropenia, atypical lymphocytosis, thrombocytopenia and deranged liver parenchymal enzymes. Four days later, he developed fever, sore throat and cervical lymphadenopathy, compatible with mononucleosis-like illness (MLI). Polymerase chain reaction (PCR) and viral culture of the nasopharyngeal swab showed human metapneumovirus (hMPV). There was a >/=4-fold rise in IgG against hMPV. This is the first case report illustrating the natural clinical course of hMPV-related MLI.
PUVA-induced lichen planus pemphigoides
Authors: N. Kuramoto, S. Kishimoto, R. Shibagaki, H. Yasuno
Journal: British Journal of Dermatology (2000)

Abstract A 72-year-old woman had suffered from parapsoriasis en plaque (large plaque type) controlled by topically applied psoralen ultraviolet A (PUVA) therapy. The parapsoriasis lesions gradually disappeared, but numerous tiny red papules with pruritus appeared over the forearms and lower legs 120 days after starting PUVA therapy. These papules developed to form violaceous plaques. Histological findings demonstrated the characteristics of lichen planus. Two months later, tense bullae developed on the plaques and on uninvolved skin of the limbs. These were subepidermal, with linear deposits of IgG and C3 along the basement membrane zone (BMZ) in immunofluorescence of peribullous skin, and immunodeposits of type IV collagen along the floor of the bullae. We therefore, diagnosed lichen planus pemphigoides (LPP). Using systemic and topical steroid therapy, the lesions rapidly resolved and there has been no recurrence. This case suggests that the combination of basal cell injuries caused by chronic inflammation and PUVA therapy could expose BMZ components to autoreactive lymphocytes and induce LPP.
The Medical Record— A Dialogue?
Authors: Marlene Kelm
Journal: JAMA (1984)

A registered nurse proposes, in JAMA's "A Piece of My Mind" column, that patients should be allowed to contribute statements to their medical records describing their attitudes toward their illnesses and treatment and expressing their desire for or against artificial life support in case of terminal illness. This mechanism could serve to enhance patient participation in care decisions while preserving the dignity of both patient and physician.
The antifungal antibiotic, clotrimazole, inhibits Cl- secretion by polarized monolayers of human colonic epithelial cells.
Authors: P A Rufo, L Jiang, S J Moe, C Brugnara, S L Alper, W I Lencer
Journal: Journal of Clinical Investigation (1996)

Clotrimazole (CLT) prevents dehydration of the human HbSS red cell through inhibition of Ca++-dependent (Gardos) K+ channels in vitro (1993. J. Clin Invest. 92:520-526.) and in patients (1996. J. Clin Invest. 97:1227-1234.). Basolateral membrane K+ channels of intestinal crypt epithelial cells also participate in secretagogue-stimulated Cl- secretion. We examined the ability of CLT to block intestinal Cl- secretion by inhibition of K+ transport. Cl- secretion was measured as short-circuit current (Isc) across monolayers of T84 cells. CLT reversibly inhibited Cl- secretory responses to both cAMP- and Ca2+-dependent agonists with IC50 values of approximately 5 microM. Onset of inhibition was more rapid when CLT was applied to the basolateral cell surface. Apical Cl- channel and basolateral NaK2Cl cotransporter activities were unaffected by CLT treatment as assessed by isotopic flux measurement. In contrast, CLT strongly inhibited basolateral 86Rb efflux. These data provide evidence that CLT reversibly inhibits Cl- secretion elicited by cAMP-, cGMP-, or Ca2+-dependent agonists in T84 cells. CLT acts distal to the generation of cAMP and Ca2+ signals, and appears to inhibit basolateral K+ channels directly. CLT and related drugs may serve as novel antidiarrheal agents in humans and animals.
A STATISTICAL REVIEW OF GASTRIC AND DUODENAL ULCER
Authors: D. Smith
Journal: BMJ (1928)

GASTRIC AND DUODENAL ULCER.tTHR BBIJrT 293softer food for some time.In every case individual care mIlust be giveni and eaclh food treated as an experimnent.It is cleal that the intelligent co-operationi of the patielnt is of the utmost help, anid lhe should be taught to observe with care the foods which cause hiinm any inconvenience.At the end of two years from the cessation of symptomis tr eatmiient by medicines miiay cease and a greater freedom in diet be permitted.Treatment along these lines gives satisfactoryiresults in the great majoiity of cases.It is sometinmes objected that the timie of treatment is long.This is tr ue, btit, except for a leriod of from one to thlee months at the beginning, the patient is going about freely and is enjoying a liberal diet. SURGERY.It may be asked wlhether surgeriy is no longer to play aniy part in the treatment of peptic ulcerationi.I do not thilnik that we have vet arrived at so desirable a position.Apart from such acute emergencies as perforation, in which almost the whole chance of surivival depenids on speedy oper'ation, such conditions as pyloric steniosis are only ameniable to surgical aid (one must be careful, however, to be sure that there is pyloric stenosis, for many cases that appear to be such clear up admirably under medical treat- inent).Again, where there are adhesions causing pain and discomnfort it may be necessary to operate; but, for uncomplicated ulcer, is operatioin necessary?I thinik the indications for operation will in future be social ratlher tlhan clinico-pathological.An une(lucated or uniintelligent patient will neglect to follow the careful regime thiat is necessary for the success of medical treatment.A patienit in poor circumstances will find himself unable to provide hiimself with what is riequiired.In these cases I think surgerv offers a better prospect.It is necessary, lhowever, to say that if sulrlgelry is to get its best riesults operation must be followed by care niearly as meticuilous as that required for purely medical treatment.It is iiot my object to put miiedicine and siul'geryv in competition, but rather to try to place .beforeyou a statement of whlat a patient may nowadays expect frolmi medical treatmenit.
A NEWLY DEVELOPED RAPAMYCIN-ELUTING STENT WITH A BIODEGRADABLE POLYMER REDUCES NEOINTIMAL FORMATION WHILE ALLOWING GREATER ENDOTHELIALIZATION
Authors: Marc M. Vorpahl, Gaku Nakazawa, Pinar Nebol, Frank Kolodgie, Renu Virmani
Journal: Journal of the American College of Cardiology (2010)
Paraneoplastic hypertrichosis lanuginosa acquisita: uncommon or overlooked?
Authors: P.H.T.J. Slee, R.I.F. van der Waal, J.H. Schagen van Leeuwen, R.A. Tupker, R. Timmer, C.A. Seldenrijk, M.A.M. van Steensel
Journal: British Journal of Dermatology (2007)

Acquired hypertrichosis lanugo-type or hypertrichosis lanuginosa acquisita (HLA) is often associated with metabolic and endocrine disorders and use of certain drugs. The occurrence of HLA with malignancy was first noted in 1865, and it has since been described in 56 patients as a paraneoplastic syndrome both in women and in men. Sometimes HLA occurs concurrent with acanthosis nigricans, papillary hypertrophy of the tongue, and glossitis. The predominance of female cases is striking. Malignancy-associated HLA seems to occur especially in the age group 40-70 years. In women with HLA the most frequent malignancy is colorectal cancer, followed in order by lung cancer and breast cancer; in men lung cancer is the malignancy most frequently associated with HLA, followed by colorectal cancer. In 3 years we saw 10 patients with HLA, in whom the malignancy was usually metastasized. Only one patient had local disease; after removal of the primary tumour it took 2 years before the lanugo hair recurred. The aetiology of the syndrome is not clear: no specific hormonal or biochemical abnormalities have been identified as yet. The difference between hirsutism and lanugo-type hypertrichosis is discussed. It is stressed that the appearance of lanugo-type hypertrichosis in body areas previously perceived by patients as 'hairless' is highly indicative of internal malignancy.
Obesity drug is licensed in the UK
Authors: A. Brooks
Journal: BMJ (1998)

Fears of a £750m ($1.2bn) annual drugs bill for orlistat (Xenical), a drug for obesity launched this week in Britain, have led to inevitable comparisons with sildenafil (Viagra). Unlike sildenafil, however, the drug has been put on the NHS drugs list after approval by the European Medicines Evaluation Agency.

The manufacturer, Roche Pharmaceuticals, announced this week that a single tablet will cost 51p. The predicted cost of £750m, widely reported in the media, assumed a cost of over £1 …
Detection of a Carcinoid Tumor by the Radionuclide Method
Authors: V. CRASSET, E. DELCOURT, W. DEKONINCK
Journal: Clinical Nuclear Medicine (1994)

The authors describe a patient with carcinoid tumor. Results of all the usual investigations, except scintigraphy were normal. Both 1–123 MIBG and ln-111 octreotide (OCT) scintiscans showed multiple abnormal hot spots in the right lower abdomen. With a sensitivity of 55% and 90%, respectively, 1–123 MIBG or ln-111 OCT scintigraphy are effective for detecting carcinoid tumors, especially when the results of the usual examinations are not contributive.
BILHARZIASIS IN SOUTH AFRICA
Authors: F. G. CAWSTON
Journal: JAMA (1918)

In certain parts of South Africa a varying proportion of the population suffers from hematuria, caused by the presence in the urine of numerous spine-pointed eggs. The condition is due to a trematode worm,<i>Schistosoma</i>, which inhabits the blood-vessels of the bladder and portal system. It is especially prevalent among the school children of the low veldt, and careful analysis of certain schools has shown that 80 per cent. of the boys and one in ten of the girls are infected. Many of the young persons who harbor the<i>Bilharzia</i>worm complain of no other sympton than that of hematuria; but in most instances this is remarkably protracted and, when the more obvious signs of the disease have disappeared for many years, ova may still be present in the urine. In the severer forms of the disease patients complain of constant or occasional aching pains in the back, pain on
Margaret Leslie Stephen (nee Macalister)
Authors: I B M Stephen
Journal: BMJ (2002)

The greatest medical historian of his generation dies at the age of 55 The sudden and premature death of Professor Roy Porter at the age of 55 has removed one of our most creative and productive commentators on the medical enterprise, past and present.He died from a heart attack, cycling to his allotment in St Leonards, East Sussex.He had moved to St Leonards last May, in anticipation of his retirement last
Quality of colonoscopy performance among gastroenterology and surgical trainees: a need for common training standards for all trainees?
Authors: J. Leyden, G. Doherty, A. Hanley, D. McNamara, C. Shields, M. Leader, F. Murray, S. Patchett, G. Harewood
Journal: Endoscopy (2011)

<b>Background and study aim:</b> Cecal intubation and polyp detection rates are objective measures of colonoscopy performance. Minimum cecal intubation rates greater than 90% have been endorsed by the American Society for Gastrointestinal Endoscopy (ASGE) and the Joint Advisory Group (JAG) UK. Performance data for medical and surgical trainee endoscopists are limited, and we used endoscopy quality parameters to compare these two groups. <b>Methods:</b> Retrospective review of all single-endoscopist colonoscopies done by gastroenterology and surgical trainees ("registrars," equivalent to fellows, postgraduate year 5) with more than two years' endoscopy experience, in 2006 and 2007 at a single academic medical center. Completion rates and polyp detection rates for endoscopists performing more than 50 colonoscopies during the study period were audited. Colonoscopy withdrawal time was prospectively observed in a representative subset of 140 patients. <b>Results:</b> Among 3079 audited single-endoscopist colonoscopies, seven gastroenterology trainees performed 1998 procedures and six surgery trainees performed 1081. The crude completion rate was 82%, 84% for gastroenterology trainees and 78% for surgery trainees (<i>P</i> < 0.0001). Adjusted for poor bowel preparation quality and obstructing lesions, the completion rate was 89%; 93% for gastroenterology trainees, and 84% for surgical trainees (<i>P</i> < 0.0001). The polyp detection rate was 19% overall, with 21% and 14% for gastroenterology and surgical trainees, respectively (<i>P</i> < 0.0001). The adenoma detection rate in patients over 50 was 12%; gastroenterology trainees 14% and surgical trainees 9% (<i>P</i> = 0.0065). In the prospectively audited procedures, median withdrawal time was greater in the gastroenterology trainee group and polyp detection rates correlated closely with withdrawal time (<i>r</i> = 0.99). <b>Conclusion:</b> The observed disparity in endoscopic performance between surgical and gastroenterology trainees suggests the need for a combined or unitary approach to endoscopy training for specialist medical and surgical trainees.
Toward Less Hazardous Cigarettes-Reply
Authors: Cornelius J. Lynch
Journal: JAMA (1979)

We appreciate Dr Warner's perceptive comments on our recent article inThe Journal. Dr Warner states that it is unreasonable to assume that the majority of two-a-day smokers inhale. Scientific data on inhalation practices of two-a-day smokers are sparse, because of relatively few such smokers in the general population. However, an ongoing epidemiologic study sponsored by the National Cancer Institute's Smoking and Health Program in eight US cities<sup>1</sup>has found that of 274 two-a-day smokers, 157 (57%) inhale. A similar study in Western Europe<sup>2</sup>has thus far identified only 47 two-a-day smokers, but 29 (62%) of them inhale. Although the sample sizes of these studies are small, we believe they represent some of the most comprehensive data available on the inhalation practices of two-a-day smokers. Further, respondents to tobacco questionnaires frequently understate their tobacco consumption practices, so the actual percentage of inhalers is likely to be larger
Urinary Tract Infection with Enterococcus faecalis
Authors: George A. Jacoby
Journal: Annals of Internal Medicine (1995)

Letters1 February 1995Urinary Tract Infection with Enterococcus faecalisGeorge A. Jacoby, MDGeorge A. Jacoby, MDLahey Clinic, Burlington, MA 01805. Graduate Hospital, Philadelphia, PA 19146. Philadelphia Department of Public Health, Philadelphia, PA 19146.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-122-3-199502010-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Fraimow and colleagues [1] report the first instance of a vancomycin-dependent organism but not the first example of a clinical isolate that required an antimicrobial agent for growth. In 1955, Finland [2] reviewed reports of clinical isolates, including tubercle bacilli, that needed streptomycin for growth. In one report, the condition of a patient with a streptomycin-dependent strain detected in the urine worsened when therapy with streptomycin was resumed after being discontinued for several days. In the laboratory, bacteria dependent on chloramphenicol [2], erythromycin [3], penicillin [2], rifampin [4], and spectinomycin [5] have been obtained. The discovery of ...References1. Fraimow HS, Jungkind DL, Lander DW, Delso DR, Dean JL. Urinary tract infection with an Enterococcus faecalis isolate that requires vancomycin for growth. Ann Intern Med. 1994; 121:22-6. Google Scholar2. Finland M. Emergence of antibiotic-resistant bacteria. N Engl J Med. 1955; 253:1019-28. Google Scholar3. Sparling PF, Blackman E. Mutation to erythromycin dependence in Escherichia coli K-12. J Bacteriol. 1973; 116:74-83. Google Scholar4. Dabbs ER. New tool for studying interactions of components of ribonucleic acid polymerase: rifampin-dependent mutants. J Bacteriol. 1979; 139:1072-4. Google Scholar5. Dabbs ER. A spectinomycin dependent mutant of Escherichia coli. Mol Gen Genet. 1977; 151:261-7. Google Scholar Author, Article, and Disclosure InformationAuthors: George A. Jacoby, MDAffiliations: Lahey Clinic, Burlington, MA 01805. Graduate Hospital, Philadelphia, PA 19146. Philadelphia Department of Public Health, Philadelphia, PA 19146. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1995Volume 122, Issue 3Page: 238KeywordsAntimicrobialsBacteriaChloramphenicolEnterococcus faecalisErythromycinPenicillinResearch laboratoriesStreptomycinUrine ePublished: 15 August 2000 Issue Published: 1 February 1995 Copyright & PermissionsCopyright © 1995 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Depression During Mania: Clinical Observations and Theoretical Implications
Authors: JOEL KOTIN, FREDERICK K. GOODWIN
Journal: American Journal of Psychiatry (1972)

In the course of longitudinal studies of patients with manic-depressive illness, the authors regularly observed clear features of depression during periods of acute mania. The relationship of depression to mania in 20 hospitalized patients was systematically investigated through an analysis of nurses' and physicians' behavioral ratings and notes. Statistically significant positive associations between mania and depression were found in the majority of cases. The psychological implications of the concurrent presence of depression and mania are discussed.
Neutrophil-mediated oxidative burst and host defense are controlled by a Vav-PLCγ2 signaling axis in mice
Authors: Daniel B. Graham, Charles M. Robertson, Jhoanne Bautista, Francesca Mascarenhas, M. Julia Diacovo, Vivianne Montgrain, Siu Kit Lam, Viviana Cremasco, W. Michael Dunne, Roberta Faccio, Craig M. Coopersmith, Wojciech Swat
Journal: Journal of Clinical Investigation (2007)

Oxidative burst, a critical antimicrobial mechanism of neutrophils, involves the rapid generation and release of reactive oxygen intermediates (ROIs) by the NADPH oxidase complex. Genetic mutations in an NADPH oxidase subunit, gp91 (also referred to as NOX2), are associated with chronic granulomatous disease (CGD), which is characterized by recurrent and life-threatening microbial infections. To combat such infections, ROIs are produced by neutrophils after stimulation by integrin-dependent adhesion to the ECM in conjunction with stimulation from inflammatory mediators, or microbial components containing pathogen-associated molecular patterns. In this report, we provide genetic evidence that both the Vav family of Rho GTPase guanine nucleotide exchange factors (GEFs) and phospholipase C-gamma2 (PLC-gamma2) are critical mediators of adhesion-dependent ROI production by neutrophils in mice. We also demonstrated that Vav was critically required for neutrophil-dependent host defense against systemic infection by Staphylococcus aureus and Pseudomonas aeruginosa, 2 common pathogens associated with fatal cases of hospital-acquired pneumonia. We identified a molecular pathway in which Vav GEFs linked integrin-mediated signaling with PLC-gamma2 activation, release of intracellular Ca2+ cations, and generation of diacylglycerol to control assembly of the NADPH oxidase complex and ROI production by neutrophils. Taken together, our data indicate that integrin-dependent signals generated during neutrophil adhesion contribute to the activation of NADPH oxidase by a variety of distinct effector pathways, all of which require Vav.
Efficacy of Azelastine HCl/Fluticasone Propionate Nasal Spray in the Treatment of Nasal Congestion in Patients with Seasonal Allergic Rhinitis (SAR)
Authors: William E. Berger, Jonathan A. Bernstein, Eli O. Meltzer, Paul H. Ratner, Nancy Ruiz
Journal: Journal of Allergy and Clinical Immunology (2015)
Pharmacologic control of a humanized gene therapy system implanted into nude mice.
Authors: S R Magari, V M Rivera, J D Iuliucci, M Gilman, F Cerasoli
Journal: Journal of Clinical Investigation (1997)

Systemic delivery of specific therapeutic proteins by a parenteral route of administration is a recognized practice in the management of several gene defects and acquired diseases. As an alternative to repetitive parenteral administration, gene therapy may provide a novel means for systemic delivery of therapeutic proteins while improving patient compliance and therapeutic efficacy. However, for gene therapy to be an efficacious and safe approach to the clinical management of such diseases, gene expression must be tightly regulated. These investigations demonstrate precise in vivo control of protein expression from cells that are engineered to secrete human growth hormone (hGH) in response to stimulation by rapamycin. The cells were implanted intramuscularly into nu/nu mice and stimulated by intravenous or oral administration of rapamycin. In vivo experiments demonstrate that the activity and pharmacokinetics of rapamycin determine the level of serum hGH that result from the engineered cells. In addition, responsiveness of the cells to rapamycin, number of cells implanted, hGH expression kinetics, and the pharmacokinetics of hGH itself, also influence the circulating levels of hGH after rapamycin stimulation. Controlled manipulation of several of these parameters, either independently or in combination, allows for precise regulation of circulating hGH concentration in vivo.