tbuckley/cabot-search huggingface dataset:
External aortic root support for Marfan syndrome: early clinical results in the first 20 recipients with a bespoke implant
Authors: John Pepper, KM John Chan, Jemyrr Gavino, Tal Golesworthy, Raad Mohiaddin, Tom Treasure
Journal: Journal of the Royal Society of Medicine (2010)

Summary Objectives Fatal aortic dissection occurs at young age in Marfan syndrome. Prevention relies on elective replacement of the aortic root. The placement of an external aortic root support, tailored to the anatomy of the individual patient has been proposed as a feasible alternative. Design, setting and main outcome measures External aortic root support was offered to patients with Marfan syndrome with aortic root diameter of 40–55 mm and without aortic regurgitation. By computer-aided design, a model of the individual patient's aorta was created from cardiac magnetic resonance images and a bespoke external aortic support was manufactured. Comparative measurements were made of the ascending aorta at the level of closure of the aortic valve cusps from magnetic resonance imaging studies taken preoperatively, at first follow-up, and at most recent follow-up. For patients having aortic root surgery at the same institution, in the same time frame as the first 10 patients, clinical data were retrieved on Marfan and other patients having aortic root replacement to serve as a reference data. Results Twenty patients were operated upon from May 2004 to October 2009, 13 men and 7 women, median age 33 years. All 20 patients are alive and well at the time of last follow-up. Preoperative aortic diameters were 40–54 mm. All postoperative images were satisfactory with an overall reduction in aortic root dimensions. The surgery took half the time of other aortic root surgery. Cardiopulmonary bypass was used only in the first patient, myocardial ischemia was not required in any patient, and no postoperative anticoagulation is mandated. Conclusions The primary objective of this surgery was fully achieved in 19 of the 20 patients, reinforcing the ascending aorta while leaving the native aortic valve intact and conserving the blood/endothelium interface.
In Vivo Cardiac Gene Transfer of Kv4.3 Abrogates the Hypertrophic Response in Rats After Aortic Stenosis
Authors: Djamel Lebeche, Roger Kaprielian, Federica del Monte, Gordon Tomaselli, Judith K. Gwathmey, Arnold Schwartz, Roger J. Hajjar
Journal: Circulation (2004)

Background— Prolongation of the action potential duration (APD) and decreased transient outward K + current ( I to ) have been consistently observed in cardiac hypertrophy. The relation between electrical remodeling and cardiac hypertrophy in vivo is unknown. Methods and Results— We studied rat hearts subjected to pressure overload by surgical ascending aortic stenosis (AS) and simultaneously infected these hearts with an adenovirus carrying either the Kv4.3 gene ( Ad.Kv4.3 ) or the β-galactosidase gene ( Ad.β-gal ). I to density was reduced and APD 50 was prolonged ( P &lt;0.05) in AS rats compared with sham rats. Kv4.2 and Kv4.3 expressions were decreased by 58% and 51%, respectively ( P &lt;0.05). AS rats infected with Ad.β-gal developed cardiac hypertrophy compared with sham rats, as assessed by cellular capacitance and heart weight–body weight ratio. Associated with the development of cardiac hypertrophy, the expression of calcineurin and its downstream transcription factor nuclear factor of activated T cells (NFAT) c1 was persistently increased by 47% and 36%, respectively ( P &lt;0.05) in AS myocytes infected with Ad.β-gal compared with sham myocytes. In vivo gene transfer of Kv4.3 in AS rats was shown to increase Kv4.3 expression, increase I to density, and shorten APD 50 by 1.6-fold, 5.3-fold, and 3.6-fold, respectively ( P &lt;0.05). Furthermore, AS rats infected with Ad.Kv4.3 showed significant reductions in calcineurin and NFAT expression. ( P &lt;0.05). Conclusions— Downregulation of I to , APD prolongation, and cardiac hypertrophy occur early after AS, and in vivo gene transfer of Kv4.3 can restore these electrical parameters and abrogate the hypertrophic response via the calcineurin pathway.
Measured Turbulence and Its Effect on Thrombus Formation
Authors: PAUL D. STEIN, HANI N. SABBAH
Journal: Circulation Research (1974)

Turbulence is one of the hydraulic disturbances implicated in thrombus formation, even though absolute proof of its contributory effect is lacking. Because of the importance of a possible effect of turbulence on thrombus formation, the relation was studied in eight dogs. In each dog, two arteriovenous shunts were established, one from each femoral artery to the contralateral femoral vein. Only one shunt contained a turbulence-producing device; otherwise, the shunts were identical in shape, size, and material. The intensity of turbulence distal to the turbulence generator was quantified in vitro by measuring the relative magnitude of the randomly fluctuating velocities. In each of the eight dogs, more thrombi, by weight, accumulated in the turbulent shunt than in the laminar shunt ( P &lt; 0.001). Thrombi from the turbulent shunt weighed 180 ± 30 ( SE ) mg, whereas those from the laminar shunt weighed 0.9 ± 0.6 mg. The weight of thrombi that accumulated within the turbulent system appeared to be related to the intensity of turbulence. A linear relation was observed between the Reynolds number in the region of the turbulence-producing orifice and the weight of the thrombi within the turbulent shunt ( r = 0.90). The relative intensity and the absolute intensity of turbulence distal to the turbulence generator were also linearly related to the Reynolds number ( r = 0.97 and 0.90, respectively). The results of this study therefore indicate that turbulence is a characteristic of blood flow that can contribute to the formation of thrombi.
Fatty acid-induced beta cell hypersensitivity to glucose. Increased phosphofructokinase activity and lowered glucose-6-phosphate content.
Authors: Y Q Liu, K Tornheim, J L Leahy
Journal: Journal of Clinical Investigation (1998)

Diabetic states are characterized by a raised serum/islet level of long chain fatty acids and a lowered ED50 for glucose-induced insulin secretion. Prolonged culture (> 6 h) of islets with long chain fatty acids replicates the basal insulin hypersecretion. We examined this effect in rat islets cultured for 24 h with 0.25 mM oleate. Insulin secretion at 2.8 mM glucose was doubled in combination with a 60% lowered islet content of glucose-6-phosphate (G6P). Investigation of the lowered G6P showed: (a) increased glucose usage from 0.5 to 100 mM glucose with identical values measured by [2-3H]glucose and [5-3H]glucose, (c) indicating little glucose- 6-phosphatase activity, (b) unchanged low pentose phosphate shunt activity, (c) 50% increased phosphofructokinase (PFK) Vmax, (d) a normal ATP/ADP ratio, and (e) unchanged fructose 2,6 bisphosphate content. Triacsin C, an inhibitor of fatty acyl-CoA synthetase, prevented the increase in PFK activity and the lowered G6P content. These results suggest that long chain acyl-CoA mediates the rise in PFK activity, which in turn lowers the G6P level. We speculate that the inhibition of hexokinase by G6P is thus attenuated, thereby causing the basal insulin hypersecretion.
In vivo quantification of myocardial muscarinic receptors in heart transplant patients.
Authors: D Le Guludec, J Delforge, A Syrota, M Desruennes, H Valette, I Gandjbakhch, P Merlet
Journal: Circulation (1994)

BACKGROUND Decreased myocardial adenylate cyclase activity in response to guanine nucleotide stimulation has been recently demonstrated in denervated myocardium of transplant patients, suggesting that changes in left ventricular muscarinic receptors may occur. METHODS AND RESULTS The concentration and affinity constants of myocardial muscarinic receptors were determined by positron emission tomography with 11C-labeled methylquinuclidinyl benzilate (MQNB), a specific hydrophilic antagonist, in six transplant patients 4.7 +/- 2.3 months after surgery and in six normal subjects. Patients had no sign of cardiac rejection at endomyocardial biopsy. After intravenous injections of MQNB, time-activity curves were obtained over different regions of interest and were fitted to a nonlinear mathematical model. No difference in the concentration of muscarinic receptors was found in transplant patients compared with control subjects: 24 +/- 4 versus 26 +/- 7 pmol/mL tissue, respectively (P = NS). The association rate constant k+1, the dissociation rate constant k-1, and thus the equilibrium-dissociation constant Kd were the same in transplant patients compared with control subjects. CONCLUSIONS Despite known decreased GTP-stimulated adenylate cyclase activity in transplant patients, the density and affinity constants of myocardial muscarinic receptors are not altered. This suggests abnormalities of the signal-transduction function, such as a change in the guanine nucleotide binding proteins.
A Posterior Mediastinal Dermoid Tumour with Marked Anatomical Differentiation
Authors: W. P. Philip, K. Harrison, D. B. Cruickshank
Journal: Thorax (1954)

In a review of the literature between 1940 and 1950 inclusive we have found records of 79 media- stinal dermoid tumours.Six of these were pos- terior, a proportion of approximately 8%.One of them was malignant and one contained teeth.The records of these six " posterior " mediastinal teratomas are summarized in Table I.The case reported here adds another to this list.
752. Delivery of Non-Microparticle Naked DNA Vaccine Using Supersonic Flow by a Low-Pressure Gene Gun
Authors: Chi-Chen Lin, Ying-Chang Wang, Men-Chi Yen, Ming-Derg Lai
Journal: Molecular Therapy (2006)

DNA vaccines are a new and powerful approach to generation of immunological responses against infectious disease and cancer. DNA can be delivered either into muscle by simple injection or into epidermal by gene gun. Intramuscular injection requires large amount of DNA (100microgram/per mouse) to elicit the immune response; in contrast, microparticlulate bombardment system can induce immune response using very low amount of DNA (1 microgram/per mouse). One disadvantage of gene gun bombardment is that non-biodegradable gold or tungsten may skew the immune response or cause adverse side effect when accumulated. In this report, we have demonstrated the direct delivery of naked DNA without any microparticle using a modified gene gun. The modified gene gun is based on the aerodynamic theory that a supersonic flow is generated when the pressure difference between the inside and the outside pressure of the nozzle is greater than 1.9atm. This high speed airflow can carry the particle from stationary state to accelerate to an extreme high speed (200m/sec). In this way, the naked DNA may be directly transformed into the mammalian cells. Previous study indicated that this modified gene gun achieve similar deliver efficacy as the gene gun commercially available using gold-coated DNA. In this report, we showed that the modified gene gun can achieve 10–40% delivery efficacy as the gold particle coated with DNA in Balb/C mice, C57BL/6 mice, and C3H mice using luciferase gene reporter driven by CMV promoter. Then, we examined the immune responses elicited by inoculation of DNA encoding HBV large surface protein expressed by its own promoter. The non-microparticle DNA and gold-coated DNA elicited similar humoral immunity as shown by antibody titer. Similar overall cytokine profile was induced by either type of DNA vaccine. Furthermore, we examined the therapeutic responses with the DNA vaccine against the extracellular domain of neu on the mouse tumor (MBT-2) naturally overexpressing neu in C3H mice. The results indicated that non-microparticle naked neu DNA vaccine can achieve similar anti-tumor effect as the gold-coated neu DNA vaccine in C3H mice at the dose of 1 microgram/per mouse. Ying-Chang Wang is an employee of BioWare Technologies Co., Ltd, Taipei, Taiwan.
Identification of high-risk lesions through automated natural language processing (NLP) of pathology reports.
Authors: EM Ozanne, J Sharko, B Drohan, G Grinstein, KS Hughes
Journal: Cancer Research (2009)

Abstract Abstract #3001 Purpose&amp;#x2028; Pathology reports contain extensive research information that is inaccessible except through costly and time consuming chart reviews. This is due to the fact that pathology reports are recorded as semi-structured prose with critically important descriptive text intended for human interpretation. Key challenges for processing this data include interpreting multiple methods of describing the same finding, and subsequently aggregating the findings of multiple reports into episodes of care. Investigators tested NLP techniques in the processing of pathology reports into structured data and episodes of care, allowing for the rapid identification and epidemiologic modeling of high-risk breast lesions.&amp;#x2028; Methods&amp;#x2028; Using state-of-the-art NLP software (ClearForest, A Thomson Reuters Company, Waltham, MA), breast pathology reports stored as text files were processed into a structured electronic database using these steps: 1) identification of diagnosis of interest (i.e. high risk lesions, cancer), 2) use of NLP to identify all terms and phrases used to report each finding (e.g. atypical hyperplasia, hyperplasia with atypia), 3) grouping of relevant terms into categories, 4) identification of categories occurring in each patient report, and 5) grouping of patient reports into episodes of care (defined as all reports within 6 months of an initial diagnosis).&amp;#x2028; Results&amp;#x2028; Under IRB approval, 27,931 breast pathology reports from Massachusetts General Hospital in 16,208 patients seen between 1990-2007 were analyzed. The results were compared against manually reviewed pathology reports for quality control. For DCIS diagnoses, the initial error rate for both the NLP process and the manual process was 2%. The NLP process was then re-tuned using the identified discrepancies which reduced the error rate to zero. Using the refined model, we identified 1) patients with atypical lesions (atypical ductal hyperplasia (ADH), severe ADH, atypical lobular hyperplasia (ALH), and lobular carcinoma in situ (LCIS)) without prior or concurrent cancer, and 2) patients who developed cancer greater than 6 months post diagnosis.&amp;#x2028; &amp;#x2028; Conclusion&amp;#x2028; This process successfully identified high-risk diagnoses that were otherwise relatively inaccessible, and appears to match the accuracy of a human research associate. The results of this first implementation are promising and will be further validated over time. In the future, this approach can be applied to other medical reports and diseases. NLP has significant potential to decrease the cost of research and for improving patient care. Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 3001.
Electrokymographic Studies of the Normal Cardiac Cycle
Authors: HENRY MEDNICK, JOHN B. SCHWEDEL, PHILIP SAMET
Journal: Circulation (1950)

Normal subjects were studied by employing two electrokymograms simultaneously. By comparing the sequence of events in the carotid pulse, auricle and ventricle, measurements were made of the phases of the cardiac cycle. The normal electrokymogram is discussed and illustrated. Simultaneous electrokymography of the right- and left-sided chambers and vessels of the heart provides a simple method for comparing synchronicity of events in normal and pathologic states. Data obtained in normal subjects is presented.
European interlaboratory comparison of breath 13CO2 analysis
Authors: F Stellaard, B Geypens
Journal: Gut (1998)

Virulent Helicobacter pylori strains which have been clinically associated with severe outcome induce increased gastric mucosal immune responses.Although several bacterial pathogenic factors have been shown to have a considerable role in H pylori infection, variability in host immune responses may also contribute to mucosal damage in H pylori associated gastritis.
Video guide to suicide is shown on television
Authors: D. Josefson
Journal: BMJ (2000)

<b>PURPOSE</b> Patients who make frequent office visits (frequent attenders) in primary care are often considered a major burden on resources, yet we know little about their perceptions and expectations. We wanted to explore how these patients viewed their rates of consultation, what they expected from the consultation, and how they perceived their relationship with the primary health care team. <b>METHODS</b> Using a qualitative study design, we undertook in-depth semi-structured interviews with frequent attenders at 4 primary care practices of the Mersey Primary Care R&amp;D Consortium in the North West of England. Participants were identified on the basis of office visits at least twice the mean standardized rate for 1 year and a medical assessment that these visits had no important clinical outcome. Interviews with 30 patients aged 24 to 81 years (18 men) were audiotaped and transcribed, and the text was methodically coded; data were analyzed by generating common themes. <b>RESULTS</b> Participants were unable or unwilling to quantify their consultation rates. Despite the assertion by many participants that family doctors are caring, authority figures, there was an underlying tension between such perceptions and the apparent medical mismanagement of symptoms. Their expectations of the consultation were complex and included the presentation of old and new symptoms implicitly embedded within an illness framework. Gaining access to family doctors was generally perceived as problematic. <b>CONCLUSION</b> The criteria held by family doctors and researchers regarding the appropriate rate of consultations in primary care may not be shared by patients who attend frequently. Such patients require family doctors to acknowledge their symptoms and to provide reassurance
Hepatic zinc content in patients with various stages of alcoholic liver disease and in patients with chronic active and chronic persistent hepatitis
Authors: Johann Christian Bode, Peter Hanisch, Harald Henning, Wolfgang Koenig, Friedrich-Wilhelm Richter, Christiane Bode
Journal: Hepatology (1988)

The hepatic zinc content was determined in liver biopsies of patients with alcoholic and nonalcoholic liver disease using proton-induced X-ray emission. The values obtained in postmortem specimens of the liver from 27 patients with no evidence of acute or chronic liver disease served as controls. The mean value and the range of the zinc content in the controls (75 ± 24 ppm wet weight) are in good agreement with those reported in the literature. The hepatic zinc content in the control group showed no significant age or sex dependence. The mean zinc content was significantly decreased in all groups of patients with alcoholic liver disease. The decrease was comparable in biopsies from patients with alcoholic fatty liver (−56.7%, n = 12), mild alcoholic hepatitis (−50.5%, n = 6) and alcoholic cirrhosis (−45.6%, n = 10). The hepatic zinc content was also distinctly reduced in patients with chronic active hepatitis (−60.3%, n = 15) and in those with chronic persistent hepatitis (−44.9%, n = 8). The estimation of the zinc content in subcellular fractions of the liver performed in postmortem specimens from seven patients with alcoholic liver cirrhosis and in six controls revealed a significant reduction in the zinc content in the fraction containing cell nuclei and membranes and in the mitochondrial fraction. A similar decrease was seen in the 100,000 g supernatant; however, the difference did not attain statistical difference. The zinc content of the microsomal fraction in the controls was lower than in the other three cell fractions. There was no significant difference in microsomal zinc content between the samples of the two groups studied. The results of this study underline the fact that zinc deficiency in the liver occurs not only in cirrhotics but also in less advanced alcoholic and nonalcoholic liver disease.
Role of Free Fatty Acids in Growth Hormone Regulation During Fasting.
Authors: Paul Cianci
Journal: Annals of Internal Medicine (1972)

Meeting Abstracts1 May 1972Role of Free Fatty Acids in Growth Hormone Regulation During Fasting.Paul Cianci, Richard E Reitz, M.D., Harold V. Werner, M.D., Richard L. Weinstein, M.D.Paul CianciSearch for more papers by this author, Richard E Reitz, M.D.Search for more papers by this author, Harold V. Werner, M.D.Search for more papers by this author, Richard L. Weinstein, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-5-857_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe effect of nicotinic acid administration (100 mg, intravenously, each 15 min, two doses) on mean plasma levels of free fatty acids (FFA), growth hormone, Cortisol, and glucose was determined before and after a 72-hour fast in five healthy men. Nicotinic acid administration to patients in the fed state further decreased normal levels of FFA (0.41 → 0.21 mEq/liter), whereas levels of growth hormone (2.0 → 1.7 ng/ml), Cortisol (15.1 → 12.0 μg/100 ml), and glucose (87.6 → 90.0 mg/100 ml) showed no significant change. In fasting patients nicotinic acid suppression of elevated levels of FFA (1.46 → 0.67 mEq/liter... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Oakland and San Francisco, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1972Volume 76, Issue 5Page: 857-857KeywordsBlood plasmaCortisolFatty acidsGlucoseGrowth hormoneNiacin Issue Published: 1 May 1972 PDF downloadLoading ...
Electrocardiographic Changes in Head Injuries
Authors: COLIN HERSCH
Journal: Circulation (1961)

Electrocardiograms of 164 Bantu patients with head trauma were recorded and studied with reference to two control groups, 100 Bantu patients with trauma to limbs and 164 healthy Bantu subjects. The electrocardiographic abnormalities that occurred more commonly in the head injury group than in either of the control groups were an increased Q-T c interval and an increased voltage of the P wave. Both traumatic groups differed from the healthy controls in showing a higher incidence of increased QRS voltage and raised S-T segments in precordial leads, inverted T waves in precordial leads V 4 to V 6, U waves of more than 1 mm. in height, sinus arrhythmia with fixed pacemaker, and sinus arrhythmia with pacemaker wandering in the sinoatrial node. The number of electrocardiographic abnormalities increased as the level of consciousness deteriorated.
Skeletal Scintigraphy in Congenital Syphilis
Authors: SYDNEY HEYMAN, GERALD A. MANDELL
Journal: Clinical Nuclear Medicine (1983)

Two infants with congenital syphilis are described. Both had bone scans, the one showing significant changes in a focal lesion, while the other was unremarkable. Radiographic changes were evident at the time of the scan in the second infant, but only became apparent later in the first case. The possible cause for this discrepancy is discussed.