tbuckley/cabot-search huggingface dataset:
A New Long-Range Through-the-Scope Balloon Applicator for Photodynamic Therapy in the Esophagus and Cardia
Authors: None Gossner, None May, None Sroka, None Ell
Journal: Endoscopy (1999)

Photodynamic therapy (PDT) is a new local, endoscopically controlled therapeutic technique based on the sensitization of malignant and precancerous lesions prior to light-induced tissue destruction. PDT of Barrett's esophagus with severe dysplasia, or of mucosal carcinomas and superficial squamous-cell cancer of the esophagus, requires light application devices allowing homogeneous illumination of the tissue surface in spite of esophageal motility and respiratory movement. On the basis of a commercially available through-the-scope balloon system, we developed a long-range light applicator for homogeneous and circumferential irradiation during PDT, and describe here the initial clinical experience with the device.The new balloon applicator consists of a flexible cylindrical diffuser fiber with a length of up to 10 cm, depending on the lesion to be illuminated, and an inflatable balloon based on the type of balloon used for esophageal dilation. The balloon is made of a transparent polyurethane membrane with negligible absorption (<5%) at lambda = 600-700 nm, and it can be positioned through the biopsy channel of a conventional endoscope, with direct endoscopic visualization of the targeted lesion. The light intensity distribution perpendicular to the optical axes of the diffuser was measured for red laser light (lambda = 632.8 nm) and for green laser light (lambda = 542 nm). The study of photodynamic treatment included two women and four men (aged 48-79 years) with histologically proved high-grade dysplasia (n = 2) or mucosal cancer in Barrett's esophagus (n = 2) and superficial squamous-cell cancer (SCC) (n = 2), who had undergone EUS staging showing uT0 or uT1N0. Laser light irradiation was conducted after oral ingestion of 5-aminolevulinic acid (5-ALA) or intravenous administration of meta-(tetrahydroxyphenyl)chlorin (mTHPC).Both in vitro and in vivo, precise positioning of the new application system at the targeted tissue and homogeneous illumination were feasible, safe and effective. The total efficiency of transmitted light at wavelengths of lambda = 632.8 nm and lambda = 542 nm was 85-90%. A high degree of homogeneity was measured with applicator lengths of between 15 mm and 95 mm, and the maximum deviation from the mean intensity extended over a range of 40% over the total length of 80 mm. High-grade dysplasia was eradicated in all patients, and in addition mucosal cancer was successfully destroyed in three-quarters of them, requiring an average of 1.3 treatment sessions, with a mean follow-up of 12 months (range 10-15 months).This centering balloon system may in the future be capable of improving light application techniques during esophageal photodynamic therapy, making PDT a more reliable alternative modality for minimally invasive treatment of high-grade dysplasia and early Barrett's esophagus or squamous-cell carcinoma, as compared with esophagectomy.
ABC of Medical Computing: KEEPING YOUR COMPUTER HEALTHY AND LEGAL
Authors: A. Millman
Journal: BMJ (1995)

<h3>Abstract</h3> Although we experience complex patterns over our entire body, how we selectively perceive multi-site touch over our bodies remains poorly understood. Here, we characterized tactile search behavior over the body using a tactile analog of the classic visual search task. Participants judged whether a target stimulus (e.g., 10-Hz vibration) was present or absent on the upper or lower limbs. When present, the target stimulus could occur alone or with distractor stimuli (e.g., 30-Hz vibrations) on other body locations. We varied the number and spatial configurations of the distractors as well as the target and distractor frequencies and measured the impact of these factors on search response times. First, we found that response times were faster on target-present trials compared to target-absent trials. Second, response times increased with the number of stimulated sites, suggesting a serial search process. Third, search performance differed depending on stimulus frequencies. This frequency-dependent behavior may be related to perceptual grouping effects based on timing cues. We constructed models to explore how the locations of the tactile cues influenced search behavior. Our modeling results reveal that, in isolation, cues on the index fingers make relatively greater contributions to search performance compared to stimulation experienced on other body sites. Additionally, co-stimulation of sites within the same limb or simply on the same body side preferentially influence search behavior. Our collective findings identify some principles of attentional search that are common to vision and touch, but others that highlight key differences that may be unique to body-based spatial perception. <h3>New &amp; Noteworthy</h3> Little is known about how we selectively experience multi-site touch over the body. Using a tactile analog of the classic visual search paradigm, we show that tactile search behavior for flutter cues is generally consistent with a serial search process. Modeling results reveal the preferential contributions of index finger stimulation and two-site interactions involving ipsilateral and within-limb patterns. Our results offer initial evidence for spatial and temporal principles underlying tactile search behavior over the body.
Effects of fortified milk on morbidity in young children in north India: community based, randomised, double masked placebo controlled trial
Authors: Sunil Sazawal, Usha Dhingra, Pratibha Dhingra, Girish Hiremath, Jitendra Kumar, Archana Sarkar, Venugopal P Menon, Robert E Black
Journal: BMJ (2006)

<b>Objective</b> To evaluate the efficacy of milk fortified with specific multiple micronutrients on morbidity in children compared with the same milk without fortification. <b>Design</b> Community based, double masked, individually randomised trial. <b>Setting</b> Peri-urban settlement in north India. <b>Participants</b> Children (n=633) aged 1-3 randomly allocated to receive fortified milk (n=316) or control milk (n=317). <b>Intervention</b> One year of fortified milk providing additional 7.8 mg zinc, 9.6 mg iron, 4.2 µg selenium, 0.27 mg copper, 156 µg vitamin A, 40.2 mg vitamin C, 7.5 mg vitamin E per day (three feeds). <b>Main outcome measures</b> Days with severe illnesses, incidence and prevalence of diarrhoea, and acute lower respiratory illness. <b>Results</b> Study groups were comparable at baseline; compliance in the groups was similar. Mean number of episodes of diarrhoea per child was 4.46 (SD 3.8) in the intervention (fortified milk) group and 5.36 (SD 4.1) in the control group. Mean number of episodes of acute lower respiratory illness was 0.62 (SD 1.1) and 0.83 (SD 1.4), respectively. The fortified milk reduced the odds for days with severe illnesses by 15% (95% confidence interval 5% to 24%), the incidence of diarrhoea by 18% (7% to 27%), and the incidence of acute lower respiratory illness by 26% (3% to 43%). Consistently greater beneficial effects were observed in children aged ≤24 months than in older children. <b>Conclusion</b> Milk is well accepted as a means of delivery of micronutrients. Consumption of milk fortified with specific micronutrients can significantly reduce the burden of common morbidities among preschool children, especially in the first two years of life. <b>Trial registration</b>NCT00255385.
Lowering Plasma Cholesterol by Raising LDL Receptors — Revisited
Authors: Stephen G. Young, Loren G. Fong
Journal: New England Journal of Medicine (2012)

Thirty-one years ago, Mabuchi and colleagues1 reported in the Journal that a statin called compactin reduced plasma low-density lipoprotein (LDL) cholesterol levels by 29% in patients with heterozygous familial hypercholesterolemia. This drug inhibits an early step in cholesterol synthesis catalyzed by the enzyme 3-hydroxy-3-methylglutaryl–coenzyme A (HMG-CoA) reductase. In an accompanying editorial entitled "Lowering Cholesterol by Raising LDL Receptors," Brown and Goldstein2 noted that heterozygotes for familial hypercholesterolemia have a deficiency of LDL receptors on cells, resulting in reduced cholesterol uptake by cells and high levels of cholesterol in the plasma. They explained that cholesterol levels within cells are tightly controlled, . . .
Quantification and genotyping of hepatitis B virus in a single reaction by real-time PCR and melting curve analysis
Authors: Shiou-Hwei Yeh, Ching-Yi Tsai, Jia-Horng Kao, Chun-Jen Liu, Ti-Jung Kuo, Ming-Wei Lin, Wen-Ling Huang, Shu-Fen Lu, Jane Jih, Ding-Shinn Chen, Pei-Jer Chen
Journal: Journal of Hepatology (2004)
Re: David J. McConkey, Woonyoung Choi, Colin P.N. Dinney. New Insights into Subtypes of Invasive Bladder Cancer: Considerations of the Clinician. Eur Urol 2014;66:609–10
Authors: Mattias Aine, Fredrik Liedberg, Gottfrid Sjödahl, Mattias Höglund
Journal: European Urology (2014)
An Optimistic View of the National Cooperative Gallstone Study
Authors: Robert H. Palmer, Martin C. Carey
Journal: New England Journal of Medicine (1982)

There is frequently a cyclical pattern to the reception given to new drugs: At first, exciting preliminary observations lead to exaggerated claims of efficacy and safety. Secondly, controlled trials find the therapy either to be less effective than initially claimed or to have unexpected side effects. Thirdly, widespread disillusionment leads to a considerable decrease in use of the drug. In time, a better perspective emerges, with appropriate balancing of the risks and benefits as they apply to the individual patient, and leads to renewed use of the therapy. Furthermore, information acquired on the interrelation between structure, function, and toxicity accelerates . . .
Reply to J.-F. Chatal et al
Authors: Samuel A. Wells, Bruce G. Robinson, Robert F. Gagel, Henning Dralle, James A. Fagin, Massimo Santoro, Eric Baudin, Rossella Elisei, Barbara Jarzab, James R. Vasselli, Jessica S. Read, Peter Langmuir, Anderson J. Ryan, Martin J. Schlumberger
Journal: Journal of Clinical Oncology (2012)

We thank Chatal et al 1 for their comments and offer the following response to their critique of our manuscript.Regarding the concern about "whether progression-free survival can be considered a true surrogate for overall survival (OS) in this population," we made no claim that progression-free survival was a surrogate for OS.3][4] Chatal et al 1 argue that we did not take into consideration the progression kinetics of metastatic disease and that patients with calcitonin DTs of greater than 2 years should have been excluded from our trial. 5Their clinical study, 6 which Chatal et al cite as the basis for using calcitonin DTs as an eligibility criterion, was not a randomized trial, but rather a retrospective comparison of two combined treatment groups to a historical control group.Furthermore, there is a discrepancy in their data describing the trial in that 19 patients, not 29, had calcitonin DTs of less than 2 years, and 39 patients, not 69, were in the untreated control group.The authors found no statistically significant difference in OS between the treatment and control groups.However, on subset analysis there was a significant difference in OS favoring the 19 patients with calcitonin DTs of less than 2 years, compared with 24 untreated patients with similar calcitonin DTs.Thepatientsinourtrialhadasubstantialtumorburdenatthetimeof random assignment: 95% had metastatic disease, and in 90%, more than one organ was involved, most often the liver.Furthermore, the trial was prospectively randomized and the treatment and control groups were comparable.Analysis of our data did show a greater progression-free
Effectiveness, side-effects and period of remission after treatment with methotrexate in localized scleroderma and related sclerotic skin diseases: an inception cohort study
Authors: E.B.M. Kroft, M.C.W. Creemers, F.H.J. van den Hoogen, J.B.M. Boezeman, E.M.G.J. de Jong
Journal: British Journal of Dermatology (2009)

Detailed information is lacking on effectiveness of methotrexate (MTX) in sclerotic skin diseases, side-effects, and duration of remission after discontinuation.To determine effectiveness, side-effects and period of remission gained by use of MTX in sclerotic skin diseases.All patients with a sclerotic skin disease who were treated with MTX (group A) or MTX with corticosteroids (CS) (group B) between 1995 and 2007 were evaluated. Detailed information was collected on dosage and duration of MTX treatment, concomitant immunosuppressive medication and CS treatment, effectiveness, side-effects, duration of the remission period, and time until restart.Fifty-eight patients (A, n = 47; B, n = 11) were evaluated. Clinical assessment revealed that 38 patients (81%) treated with MTX and 11 patients (100%) treated with MTX + CS showed improvement of sclerotic skin. After one treatment course 51% of the patients treated with MTX and 73% treated with MTX + CS reached remission status with a median follow-up time of 55 and 58 months. Patients showing relapse still responded to a second and even to a third course of MTX. Patients who showed a relapse had received a lower cumulative dose, due to a shorter period of treatment with MTX in the first course. Serious side-effects were seen in six patients (10%).MTX was an effective treatment for various sclerotic skin diseases with a long period of remission and relatively low toxicity. Patients showing relapse still responded to a second and third course of MTX.
The Quandary of Quality Assessment
Authors: Walter J. McNerney
Journal: New England Journal of Medicine (1976)

Inevitably, quality assurance reflects the context of which it is a part (e.g., underuse or overuse of services is partly a function of their availability and financing). Thus, it can promote change or rationalize lack of it, save money or cost money. Given the current state of the art, it is imperative to develop quality assurance on an evolutionary path while options are kept open and focus is clearly on outcomes. Also, quality assessment must be conceptualized as a behavioral tool, not a policing mechanism; its scope must be broadened to include the total episode of illness, taking into account life-style and environmental factors, with criteria developed and applied as close to the point of patient care as possible, within broad guidelines; it is essential to build on in-place capacities -- e.g., carrier data -- rather than to create new overlapping systems. Finally, the management setting within which quality assurance functions, in both the public and private sectors, must be improved.
Evaluation of Changes at Echocardiographic Parameters after Renal Transplantation at Patients with End Stage Renal Disease
Authors: Arzu Er, Mustafa Serkan Karakaş, İrem Kılınçkaya, Arzu Ateş, Refik Emre Altekin, İbrahim Demir, Gültekin Süleymanlar
Journal: Journal of the American College of Cardiology (2013)
Immunoregulatory T Cell Subsets in Chronic Hepatitis B Virus Infection: The Influence of Homosexuality
Authors: Fredric G. Regenstein, Stanford T. Roodman, Robert P. Perrillo
Journal: Hepatology (1983)

The purposes of this study were 2-fold: (i) To enumerate peripheral immunoregulatory T cell subsets in untreated patients with chronic hepatitis B virus (HBV) infection and (ii) to examine the relationship between disturbances in the balance of lymphocyte subsets with liver disease and the presence of homosexuality. Circulating T lymphocyte subsets were evaluated by monoclonal antibodies to the following cell antigens: OKT3 (total T cells), OKT4 (helper/inducer T cells), and OKT8 (suppressor/cytotoxic T cells). The following groups of subjects were examined: (i) 16 heterosexuals with HBV-associated chronic active hepatitis (CAHB); (ii) 10 heterosexual, healthy HBsAg carriers, and (iii) 16 male homosexuals with CAHB. Controls included 51 healthy heterosexuals and 12 healthy, noninfected male homosexuals. We were able to demonstrate that heterosexuals with CAHB had T4/T8 ratios which did not differ from those of noninfected heterosexuals. Both healthy carriers and healthy homosexuals, however, exhibited significantly lower T4/T8 ratios than did noninfected heterosexuals (p less than 0.05, p less than 0.01, respectively). In addition, homosexuals with CAHB had lower (1.5 +/- 0.1) T4/T8 ratios than did heterosexuals with CAHB (2.0 +/- 0.2). A possible mechanism for these findings is discussed. The data indicate that the presence of homosexuality may be an important factor to consider when evaluating immunoregulatory subsets in CAHB.
Activation of human monocyte--derived macrophages with lipopolysaccharide decreases human immunodeficiency virus replication in vitro at the level of gene expression.
Authors: M S Bernstein, S E Tong-Starksen, R M Locksley
Journal: Journal of Clinical Investigation (1991)

Activation of T lymphocytes infected with the human immunodeficiency virus-1 (HIV-1) results in enhancement of viral replication mediated in part by activation of cellular NF kappa B capable of binding directly to sequences in the viral long terminal repeat, or LTR. Together with CD4+ T cells, macrophages constitute a major target for infection by HIV-1. Unlike lymphocytes, however, stimulation of mononuclear phagocytes is not associated with cell division and proliferation. Human monocyte-derived macrophages transfected with HIV-LTR-CAT constructs demonstrated down-regulation of CAT activity after stimulation with bacterial lipopolysaccharide (LPS) that mapped to a region distinct from NF kappa B binding sites. In contrast, fresh monocytes and the promonocytic U937 cell line both demonstrated up-regulation of HIV-LTR-CAT expression by LPS. Differentiation of U937 by PMA to establish a nondividing phenotype resulted in down-regulation of transfected HIV-LTR-CAT activity by LPS similar to that in mature macrophages. Human monocyte-derived macrophages infected with HIV-1 in vitro demonstrated a decrease in viral p24 release after incubation in LPS that was comparable to the negative regulation that occurred in the transient transfection assays. Factors controlling HIV replication may differ in dividing and nondividing hematopoietic cells and may contribute to restricted viral expression in nondividing cells.
REPORT OF A CASE OF A PECULIAR FORM OF CARCINOMA OF THE SKIN OF SLOW GROWTH.
Authors: WILLIAM FRICK
Journal: JAMA (1901)

We can conceive of several conditions under which a carcinomatous tumor of the skin may have a history of long duration. A growth may be innocent in its character in the early history of its development, and change after many years of duration to a carcinomatous type. A known epithelioma may remain stationary, or nearly so, for years, apparently neither increasing nor decreasing, after which it increases more rapidly; this will give a long history to the tumor. Then again, carcinomatous cells may be encapsulated, according to some observers, which may prevent their extension for many years. The case we have to report had a duration of 35 years, and did not present the usual appearance of a carcinoma either clinically or microscopically. The patient was seen by a large number of medical men, some of whom were skilled diagnosticians, and yet no one hazarded a diagnosis of carcinoma from
HEART DISEASE AND MILITARY SERVICE
Authors: Thomas, W. Mattingly
Journal: JAMA (1963)

The report by RuDusky in this issue ofThe Journal(p 1004) directs our attention once more to the existing disabilities from heart disease in our youth population. In this study the extent of disability was evaluated in military registrants during the period from 1960 to 1962. RuDusky's findings constitute a sample of what might be expected in the way of a national military manpower problem from cardiac disability in the event of a major mobilization 20 years after World War II. In this 20-year period, advances in diagnosis, in medical and surgical therapy, and in prophylaxis of rheumatic and congenital heart disease should have produced an effective reduction in both these disabilities. We would expect the current incidence of rheumatic heart disease and disqualifying congenital defects in youths to be greatly reduced from that found in 1941. As reported, rejections in 20,597 registrants from a regional locality in 1961,
A Specific Pattern of Phosphodiesterases Controls the cAMP Signals Generated by Different G <sub>s</sub> -Coupled Receptors in Adult Rat Ventricular Myocytes
Authors: Francesca Rochais, Aniella Abi-Gerges, Kathleen Horner, Florence Lefebvre, Dermot M.F. Cooper, Marco Conti, Rodolphe Fischmeister, Grégoire Vandecasteele
Journal: Circulation Research (2006)

Compartmentation of cAMP is thought to generate the specificity of Gs-coupled receptor action in cardiac myocytes, with phosphodiesterases (PDEs) playing a major role in this process by preventing cAMP diffusion. We tested this hypothesis in adult rat ventricular myocytes by characterizing PDEs involved in the regulation of cAMP signals and L-type Ca2+ current (I(Ca,L)) on stimulation with beta1-adrenergic receptors (beta1-ARs), beta2-ARs, glucagon receptors (Glu-Rs) and prostaglandin E1 receptors (PGE1-Rs). All receptors but PGE1-R increased total cAMP, and inhibition of PDEs with 3-isobutyl-1-methylxanthine strongly potentiated these responses. When monitored in single cells by high-affinity cyclic nucleotide-gated (CNG) channels, stimulation of beta1-AR and Glu-R increased cAMP, whereas beta2-AR and PGE1-R had no detectable effect. Selective inhibition of PDE3 by cilostamide and PDE4 by Ro 20-1724 potentiated beta1-AR cAMP signals, whereas Glu-R cAMP was augmented only by PD4 inhibition. PGE1-R and beta2-AR generated substantial cAMP increases only when PDE3 and PDE4 were blocked. For all receptors except PGE1-R, the measurements of I(Ca,L) closely matched the ones obtained with CNG channels. Indeed, PDE3 and PDE4 controlled beta1-AR and beta2-AR regulation of I(Ca,L), whereas only PDE4 controlled Glu-R regulation of I(Ca,L) thus demonstrating that receptor-PDE coupling has functional implications downstream of cAMP. PGE1 had no effect on I(Ca,L) even after blockade of PDE3 or PDE4, suggesting that other mechanisms prevent cAMP produced by PGE1 to diffuse to L-type Ca2+ channels. These results identify specific functional coupling of individual PDE families to Gs-coupled receptors as a major mechanism enabling cardiac cells to generate heterogeneous cAMP signals in response to different hormones.
Acute Pancreatitis and Steroid Therapy-Reply
Authors: Wil B. Nelp
Journal: JAMA (1962)

To the Editor:—  It is not too surprising that long-term steroid administration may result in damage to the pancreas. The primary purpose for reporting the recent cases of acute pancreatitis which occurred during steroid therapy was to point out that this complication should be considered when a patient on steroid treatment develops abdominal pain. I agree that gratifying relief of pain and defervescence of fever may result from the use of steroids in the initial treatment of acute pancreatitis.  On the other hand, I feel there is some question regarding the occurrence of a possible deleterious effect on the pancreas even after short-term courses of steroids. In one instance, a 21-year-old male developed symptoms of pancreatitis after only 14 days of prednisone ( 60 mg. per day ). A 16-year-old girl developed severe pancreatitis after 17 days of prednisone therapy with a dose no greater than 30 mg. per day. This week