tbuckley/cabot-search huggingface dataset:
Management of Radionecrosis
Authors: David W. Robinson
Journal: JAMA (1971)

The resultant damage to bone following radiation for carcinoma is a severe complication<sup>24</sup>and difficult to treat. The primary pathological process is necrosis of bone, but infection and residual cancer often complicate the picture. The patient suffers severe unremitting pain and may have a draining wound, fetor oris, and trismus. In the head and neck, the mandible is most frequently involved. The essentials of treatment are wide removal of the affected bone plus coverage by adequate soft tissue with good blood supply. <h3>Pathogenesis.—</h3> Late change in arteries (obliterative endoarteritis) gradually shuts off the blood supply provided by osseous nutrient vessels and periosteum.<sup>25</sup>As long as there is viable soft tissue coverage, these changes, although progressive and inexorable,<sup>26</sup>remain unnoticed. Should the skin or mucosal covering be broken, however, infection from the surface bacteria can spread rapidly through the fibrotic, nearly bloodless, soft tissue where defensive mechanisms have
Time-dependent effect of prostaglandin E2 inhalation on airway responses to bronchoconstrictor agents in normal subjects.
Authors: E H Walters, C Bevan, R W Parrish, B H Davies, A P Smith
Journal: Thorax (1982)

Studies were performed to investigate whether hyperresponsiveness of the airways could be induced in normal subjects by inhalation of prostaglandin E2 (PGE2). During the initial bronchodilator phase of PGE2 action the bronchoconstrictor effect of inhaled histamine was significantly antagonised. When bronchoconstrictor challenges were started shortly after the end of the bronchodilator response to PGE2, however, significant enhancement of the effects of both inhaled histamine and methacholine occurred. It was predominantly sensitivity to these agents that was increased, with a parallel shift of the dose-response curves towards increased bronchoconstriction. Thus PGE2 may be protective in the acute phase of a bronchoconstrictor challenge, but in a chronic inflammatory condition its net effect may be a balance between this beneficial action and a non-specific potentiation of the activity of bronchoconstrictor agents.
The Body at Risk: Photography of Disorder, Illness, and Healing
Authors: Janice Hopkins Tanne
Journal: BMJ (2006)

A mong the risks to the bodies that we see in this photographic exhibition are ageing, child labour, poverty, pollution, domestic violence, war, and infectious diseases such as polio and HIV/AIDS. The striking photographs show sadness and misery, but also some hope. Just taking the photograph and getting it published has helped bring about change. Life is much better now for many people compared with what is recorded in these pictures.

Almost all the photographs here, taken by 16 noted photographers, are black and white, and there are two videos. Most show American subjects.

The exhibition begins with century-old photographs of child labourers, taken by Lewis Wickes Hine, who worked for the National Child Labor Committee. This group sought to put an end to children working in glass and textile …
Fatalities From Blood Transfusion
Authors: Jerry Kolins
Journal: JAMA (1981)

<h3>To the Editor.—</h3> The report by Byron A. Myhre, MD, PhD (1980;244:1333), entitled "Fatalities From Blood Transfusion" contains information essential for the design of a safe transfusion service. These data concerning transfusion-related fatalities have been collected by the Food and Drug Administration since December 1975. Unfortunately, the government has done little more than collect this information. It took the initiative and creativity of the blood banking community to obtain, interpret, and make useful the collected information. This was first published by Paul J. Schmidt, MD.<sup>1</sup> The information was not made readily available to Dr Schmidt, and a Freedom of Information Act request was required to obtain access to the reports. Both Schmidt and Myhre concluded that more than one half of the fatal reactions could be prevented, and they stress that the most common causes of fatal transfusion reactions involve clerical identity errors resulting in transfusion of blood to
Dexamethasone alters messenger RNA levels but not synthesis of collagens, fibronectin, or laminin by cultured rat fat-storing cells
Authors: T Niki, D Schuppan, P J de Bleser, R Vrijsen, M Pipeleers-Marichal, R Beyaert, E Wisse, A Geerts
Journal: Hepatology (1996)

Glucocorticoids have been shown to suppress collagen synthesis and gene expression by fibroblasts. However, little is known about their effects on fat–storing cells, the major matrix–producing cells in liver fibrosis. In this study we investigated the effect of dexamethasone on the extracellular matrix expression by cultured rat fat–storing cells. Fat–storing cells were isolated from male Wistar rats by collagenase/pronase digestion and purified by density gradient centrifugation. Fat–storing cells in early primary culture (3–day–old, representing a relatively quiescent phenotype) and in subculture (one passage, about 2–week–old, representing an activated phenotype) were treated with 10–6 mol/L dexamethasone for messenger RNA (mRNA) study or with 10–8 to 10–6 mol/L dexamethasone for protein study. Expression of collagen type I, III, IV, fibronectin, and laminin was analyzed at the mRNA level by Northern hybridization, and at the protein level by metabolic labeling and immunoprecipitation. Dexamethasone had a variable effect on the expression of collagen α1(I) mRNA level. While a tendency for modest suppression was observed (5%–50%) in primary cells, the difference was not statistically significant. Variable response was observed in subcultured cells. Collagen α1(III) mRNA level showed a tendency for stimulation. Dexamethasone stimulated the expression of collagen α1 (IV), fibronectin, and laminin B1 mRNA levels by 1.4–, 2.4–, and 1.6–fold respectively, in primary fat–storing cells. Subcultured cells showed a similar response, but the magnitude of stimulation was more variable than that of primary cells. Unexpectedly, at the protein level dexamethasone had no effect on the expression of these proteins. Our results indicate that glucocorticoids do not possess a net suppressive effect on extracellular matrix synthesis by fat–storing cells. Beneficial effects of glucocorticoids may be attributable to other mechanisms of action, such as their anti–inflammatory effect.
Health Literacy, Health Inequality and a Just Healthcare System
Authors: Angelo E. Volandes, Michael K. Paasche-Orlow
Journal: The American Journal of Bioethics (2007)

Abstract Limited health literacy is a pervasive and independent risk factor for poor health outcomes. Despite decades of reports exhibiting that the healthcare system is overly complex, unneeded complexity remains commonplace and endangers the lives of patients, especially those with limited health literacy. In this article, we define health literacy and describe the empirical evidence associating health literacy and poor health outcomes. We recast the issue of poor health literacy from within the ethical perspective of the least well-off and argue that poor health outcomes deriving from limited health literacy ought to be understood as a fundamental injustice of the healthcare system. We offer three proposals that attempt to rectify this injustice, including: universal precautions that presume limited health literacy for all healthcare users; expanded use of technology supported communication; and clinical incentives that account for limited health literacy. Keywords: Health Literacyhealth disparitiesjusticehealth policyhealth outcomespay for performance Acknowledgment We thank Muriel Gillick for commenting on an earlier draft of this article.
Multiple Myeloma Associated with Two Serum M Components, γG Type K and γA Type L
Authors: Barbara J. Rosen, Thomas W. Smith, Kurt J. Bloch
Journal: New England Journal of Medicine (1967)

ON paper electrophoresis, the serum proteins of many patients with multiple myeloma are characterized by a single M component consisting of globulin molecules of uniform electrophoretic mobility. M components in this disease may be assigned to either the γG or γA, or rarely the γD1 class of human immunoglobulins on the basis of physicochemieal and antigenic properties of their heavy chains, designated γ, α and δ, respectively.1 , 2 Unlike normal gamma globulins which consist of a mixture of molecules having either kappa (60 per cent) or lambda (30 per cent) light chains,3 M component molecules uniformly possess either one or the . . .
724-5 Retrograde Atrial Activation in Patients with Atrioventricular Nodal Reentry: Evidence for a Single Anterior Nodal Exit
Authors: Michael Biehl, Sanjay Deshpande, Jasbir Sra, Anwer Dhala, Zalmen Blanck, R. Dent Underwood, Edward T. Keelan, Masood Akhtar, Mohammad Jazayeri
Journal: Journal of the American College of Cardiology (1995)
EMPLOYABILITY OF THE CHRONICALLY ILL AND DISABLED
Authors: Howard A. Rusk
Journal: JAMA (1952)

Intent on remaining at peace, the democracies of the Western World have determined that under current world conditions the most effective way of achieving that purpose is to remain strong through defense preparation. In the mobilization of our material, human, financial, social, and spiritual resources for defense, it is readily apparent that the major factor of our success will be dependent on manpower. This has been evident since Adam Smith advanced this thesis in his "Wealth of Nations" and the world turned from an agricultural to an industrial economy. It is a matter of simple arithmetic to see that today the North Atlantic Pact countries fall far short of our potential enemies in the gross number of men available for military service. On the basis of our past performance it seems obvious, however, that our industrial power, when fully mobilized, can more than offset this numerical advantage. If the latest
Common variation in KITLG and at 5q31.3 predisposes to testicular germ cell cancer
Authors: Peter A Kanetsky, Nandita Mitra, Saran Vardhanabhuti, Mingyao Li, David J Vaughn, Richard Letrero, Stephanie L Ciosek, David R Doody, Lauren M Smith, JoEllen Weaver, Anthony Albano, Chu Chen, Jacqueline R Starr, Daniel J Rader, Andrew K Godwin, Muredach P Reilly, Hakon Hakonarson, Stephen M Schwartz, Katherine L Nathanson
Journal: Nature Genetics (2009)
Abstract 2686: Methioninase S-phase block of cancer cells imaged in real time by cell-cycle-specific fluorescence reporters
Authors: Shuya Yano, Shukuan Li, Qinghong Han, Yuying Tan, Toshiyoshi Fujiwara, Robert M. Hoffman
Journal: Cancer Research (2012)

Abstract A general feature of cancer cells is their elevated requirement for methionine compared to normal cells, which may be due to excessive methylation reactions in cancer cells since methionine is the global source of cellular methyl groups. When deprived of methionine, cancer cells undergo a cell-cycle arrest in late S-phase. The recombinant bacterial enzyme, methionine β, α-lyase (methioninase or METase) degrades methionine very efficiently and effects an S-phase block selectively in cancer cells. In order to image the kinetics of cell cycle arrest of cancer cells due to deprivation of methionine by METase, cancer cells were engineered to express cell cycle-dependent fluorescent proteins using fluorescent ubiquitination-based cell cycle indicator (FUCCI) whereby cancer cells express Azami-green only in S-phase and Kusabira-orange only in G1. Thus, each cancer could be followed in real time as it becomes blocked in S-phase after METase treatment. FUCCI imaging demonstrated that cancer cells could remain in S-phase for 5 days before starting to die which indicates a new type of cancer cell dormancy. The use of METase treatment and cell-cycle specific fluorescent reporters provide a unique opportunity to image and study the cancer cell cycle and the consequences and advantages of an S-phase block in cancer cells. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2686. doi:1538-7445.AM2012-2686
Allergen-Specific increase in interleukin (IL)-4 and IL-5 secretion from peripheral blood mononuclear cells during birch-pollen immunotherapy
Authors: R. Movérare, S. Rak, L. Elfman
Journal: Allergy (1998)

The mechanisms behind the effects of immunotherapy (IT) with birch‐pollen extract are largely unknown. In this pilot study, we measured the cytokine secretion in vitro from peripheral blood mononuclear cells (PBMC) obtained from birch‐pollen‐allergic patients undergoing IT treatment ( n =4) or placebo administration (n=4), collected before treatment, 1 and 4 weeks after start of treatment, and during and just after the pollen season (12–14 weeks after start of treatment). The PBMC were stimulated with birch‐pollen extract in vitro for 7 days, followed by restimulation with the mitogens phytohemagglutinin (PHA) and phorbol 12‐myristate 13‐acetate (PMA) for 24 h, to enhance the production of cytokines. The supernatants were analyzed with ELISA and radioimmunoassay for interferon‐gamma (IFN‐y), interleukin (IL)‐4, and IL‐5. In the therapy group, we noted an increased secretion of IL‐4 and IL‐5 from PBMC collected at 4 weeks after the start of treatment (IL‐4: 29±21 pg/ml [day 0] to 3741448 pg/ml [week 4], mean± SD; IL‐5: 95+48 pg/ml to 11471697 pg/ml). No increase was seen in the placebo group. During the pollen season, we noted a trend toward increased IL‐4 and IL‐5 secretion in both groups. We conclude that the temporary increase in serum IgE observed in many IT studies may be a consequence of increased IL‐4 production due to the allergen exposure.
6 EXTRACORPOREAL LIVER SUPPORT BY FRACTIONATED PLASMA SEPARATION AND ADSORPTION (PROMETHEUS) IN PATIENTS WITH ACUTE-ON-CHRONIC LIVER FAILURE (HELIOS STUDY): A PROSPECTIVE RANDOMIZED CONTROLLED MULTICENTER STUDY
Authors: K. Rifai, A. Kribben, G. Gerken, S. Haag, S. Herget-Rosenthal, U. Treichel, C. Betz, C. Sarrazin, H. Van Vlierberghe, E. Hoste, À. Escorsell, P. Ginès, C. Hafer, M. Schuchmann, P.R. Galle, M. Bernardi, P. Caraceni, D. Abeles, F. Berr, M. Knotek, J. Kozik-Jaromin
Journal: Journal of Hepatology (2010)
Prognostic impact of hepatic resection for hepatocellular carcinoma: The role of the surgeon in achieving R0 resection – A retrospective cohort study
Authors: Chen Huan-wei, Liao Shan, Lau Wan-Yee, Wang Feng-jie, Deng Fei-wen, Lai Eric Chun-hung, Zhen Zuo-jun
Journal: International Journal of Surgery (2014)
Blocking the NOTCH Pathway Inhibits Vascular Inflammation in Large-Vessel Vasculitis
Authors: Kisha Piggott, Jiusheng Deng, Kenneth Warrington, Brian Younge, Jessica T. Kubo, Manisha Desai, Jörg J. Goronzy, Cornelia M. Weyand
Journal: Circulation (2011)

Background— Giant cell arteritis is a granulomatous vasculitis of the aorta and its branches that causes blindness, stroke, and aortic aneurysm. CD4 T cells are key pathogenic regulators, instructed by vessel wall dendritic cells to differentiate into vasculitic T cells. The unique pathways driving this dendritic cell–T-cell interaction are incompletely understood, but may provide novel therapeutic targets for a disease in which the only established therapy is long-term treatment with high doses of corticosteroids. Methods and Results— Immunohistochemical and gene expression analyses of giant cell arteritis-affected temporal arteries revealed abundant expression of the NOTCH receptor and its ligands, Jagged1 and Delta1. Cleavage of the NOTCH intracellular domain in wall-infiltrating T cells indicated ongoing NOTCH pathway activation in large-vessel vasculitis. NOTCH activation did not occur in small-vessel vasculitis affecting branches of the vasa vasorum tree. We devised 2 strategies to block NOTCH pathway activation: γ-secretase inhibitor treatment, preventing nuclear translocation of the NOTCH intracellular domain, and competing for receptor-ligand interactions through excess soluble ligand, Jagged1-Fc. In a humanized mouse model, NOTCH pathway disruption had strong immunosuppressive effects, inhibiting T-cell activation in the early and established phases of vascular inflammation. NOTCH inhibition was particularly effective in downregulating Th17 responses, but also markedly suppressed Th1 responses. Conclusions— Blocking NOTCH signaling depleted T cells from the vascular infiltrates, implicating NOTCH- NOTCH ligand interactions in regulating T-cell retention and survival in vessel wall inflammation. Modulating the NOTCH signaling cascade emerges as a promising new strategy for immunosuppressive therapy of large-vessel vasculitis.
The Scar Sign
Authors: Suat-Jin Lu, Victor K. Lee, Suat W. Loo
Journal: Clinical Nuclear Medicine (2013)

Scar involvement is a rare but characteristic cutaneous manifestation of sarcoidosis. The concurrent presence of FDG-avid lymphadenopathy and scar involvement (the "scar sign") is a useful finding on FDG PET/CT to suggest sarcoidosis, especially when biopsy specimens are difficult to obtain. A 46-year-old woman who presented with fever, cough, and weight loss was found to have mediastinal and hilar lymphadenopathy on chest radiography and CT scan. FDG PET/CT scan showed FDG-avid lower cervical, mediastinal, hilar, and inguinal lymphadenopathy. There was also increased FDG uptake along an old hysterectomy scar. Mediastinoscopy and nodal biopsy revealed noncaseating granulomas compatible with sarcoidosis.
ST-Elevation Acute Coronary Syndromes in the Platelet Inhibition and Patient Outcomes (PLATO) Trial
Authors: Paul W. Armstrong, Hany Siha, Yuling Fu, Cynthia M. Westerhout, Ph. Gabriel Steg, Stefan K. James, Robert F. Storey, Jay Horrow, Hugo Katus, Peter Clemmensen, Robert A. Harrington, Lars Wallentin
Journal: Circulation (2011)

Background— Ticagrelor, when compared with clopidogrel, reduced the 12-month risk of vascular death/myocardial infarction and stroke in patients with ST-elevation acute coronary syndromes intended to undergo primary percutaneous coronary intervention in the PLATelet inhibition and patient Outcomes (PLATO) trial. This prespecified ECG substudy explored whether ticagrelor's association with vascular death and myocardial infarction within 1 year would be amplified by (1) the extent of baseline ST shift and (2) subsequently associated with fewer residual ST changes at hospital discharge. Methods and Results— ECGs were evaluated centrally in a core laboratory in 3122 ticagrelor- and 3084 clopidogrel-assigned patients having at least 1 mm ST-elevation in 2 contiguous leads as identified by site investigators on the qualifying ECG. Patients with greater ST-segment shift at baseline had higher rates of vascular death/myocardial infarction within 1 year. Among those who also had an ECG at hospital discharge (n=4798), patients with ≥50% ΣST-deviation (ΣST-dev) resolution had higher event-free survival than those with incomplete resolution (6.4% versus 8.8%, adjusted hazard ratio 0.69 (0.54–0.88), P =0.003). The extent of ΣST-dev resolution was similar irrespective of treatment assignment. The benefit of ticagrelor versus clopidogrel on clinical events was consistent irrespective of the extent of baseline ΣST-dev ( P (interaction)=0.728). When stratified according to conventional times from symptom onset, ie, ≤3 hours, 3 to 6 hours, &gt;6 hours, the extent of baseline ΣST-dev declined progressively over time. As time from symptom onset increased beyond 3 hours, the benefit of ticagrelor appeared to be more pronounced; however, the interaction between time and treatment was not significant ( P =0.175). Conclusions— Ticagrelor did not modify ΣST-dev resolution at discharge nor was its benefit affected by the extent of baseline ΣST-dev. These hypothesis-generating observations suggest that the main effects of ticagrelor may not relate to the rapidity or the completeness of acute reperfusion, but rather the prevention of recurrent vascular events by more powerful platelet inhibition or other mechanisms. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00391872.
Auto-regulated Hepatic Insulin Gene Expression in Type 1 Diabetic Rats
Authors: Ruihuan Chen, Marcia L. Meseck, Savio L.C. Woo
Journal: Molecular Therapy (2001)

Paradigms of insulin gene therapy for type 1 diabetes should incorporate vigorous control for insulin gene expression to be effective in correcting postprandial hyperglycemia and to be safe in preventing fasting hypoglycemia. We hypothesize that hepatic insulin gene expression auto-regulated positively by glucose and negatively by insulin might be both effective and safe in the treatment of type 1 diabetes. Expression of the glucose 6-phosphatase (G6Pase) gene in the liver is both stimulated by glucose and suppressed by insulin. The G6Pase promoter incorporated with intronic enhancers of the aldolase B gene was used to direct insulin gene expression in the liver of streptozotocin-induced diabetic nude rats. In the treated animals, blood insulin levels were elevated after feeding, and nonfasting hyperglycemia was significantly reduced. Glucose tolerance testing also illustrated that the treated animals exhibited accelerated glucose utilization rates. Upon fasting, blood glucose was reduced to normoglycemic range within 4 h and maintained at that level during the prolonged fasting of 16 h. No hypoglycemia was observed in any treated animals at any time throughout the fasting period, as blood insulin gradually declined to the normal range. These results suggest that auto-regulated hepatic insulin expression can potentially be developed as an effective and safe treatment modality for type 1 diabetes.
A CASE OF PNEUMOCOCCIC CONJUNCTIVITIS
Authors: J. Cropper
Journal: BMJ (1916)

PNEUMOCOMCO-0-OJUNCTIVITIS.r MZmCAL 5UUWI 4 was impossible-without an anaesthetiq.There was dullness on percussion over the flanks, and I detected free fluid inl *ese regions by what I call the " staccato touch."'To carry out this test the flank is struck lightly and sharply in a staccato fashion with the tip of the finger; if free fluid be present, the sound
Uses and Abuses of Psychiatric Consultation
Authors: John J. Schwab
Journal: JAMA (1968)

The psychiatric consultation is used for diagnosing and treating patients, for education, and for clarification of staff problems. The referring physician abuses the consultation when he (1) does not make explicit the reason for referral, (2) uses referral as a last-resort measure, (3) ignores the nurse's role, (4) fails to refer some dying patients, (5) is inconsistent in referring patients with personality disorders, or (6) misdiagnoses organic brain syndromes. The psychiatrist abuses the consultation by (1) delaying his response, (2) not obtaining a comprehensive view of the patient—failing to review the medical record, (3) writing a lengthy consultation note filled with jargon, (4) "taking over" the referring physician's patient, or (5) not using the consultation for teaching and learning. Correct use requires proper timing, understanding the psychosocial background, and implementing recommendations for continuing care.