tbuckley/cabot-search huggingface dataset:
Stimulation of Androgen Production by Insulin-like Growth Factor I
Authors: JOHN E. NESTLER
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 November 1986Stimulation of Androgen Production by Insulin-like Growth Factor IJOHN E. NESTLER, M.D.JOHN E. NESTLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-105-5-796_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: To Dr. Braunstein's (1) list of causes for the menstrual abnormalities seen in some women with growth-hormone-secreting pituitary tumors, I propose an additional possible mechanism: insulin-like growth factor I (IGF-I) stimulation of androgen production. Although Lim and Dingman (2) have previously shown adrenal androgenic hyperfunction in acromegaly, they proposed that growth hormone induced an enzymatic block that shunted corticosteroid precursors into androgenic biosynthetic pathways. Recent evidence indicates that in vitro both insulin and IGF-I have a stimulatory effect on various steroidogenic steps, including lipoprotein uptake and metabolism (3) and P450 cholesterol side-chain cleavage enzyme levels (4). Extending...References1. BRAUNSTEIN G. Diagnosis, pp 244-7. In: MELMED S, moderator. Pituitary tumors secreting growth hormone and prolactin. Ann Intern Med. 1986;105:238-53. LinkGoogle Scholar2. LIM N and DINGMAN J. Androgenic adrenal hyperfunction in acromegaly. N Engl J Med. 1964;271:1189-94. CrossrefMedlineGoogle Scholar3. VELDHUIS J, NESTLER J, STRAUSS J, and Gwynne J. Insulin regulates low-density lipoprotein metabolism by swine granulosa cells. Endocrinology. 1986;118:2242-53. CrossrefMedlineGoogle Scholar4. VELDHUIS J, RODGERS R, DEE A, and SIMPSON E. The insulin-like growth factor, somatomedin C, induces the synthesis of cholesterol side-chain cleavage cytochrome P-450 and adrenodoxin in ovarian cells. J Biol Chem. 1986;261:2499-502. CrossrefMedlineGoogle Scholar5. BARBIERI R and RYAN K. Hyperandrogenism, insulin resistance, and acanthosis nigricans: a common endocrinopathy with distinct pathophysiologic features. Am J Obstet Gynecol. 1983;147:90-101. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JOHN E. NESTLER, M.D.Affiliations: Medical College of Virginia Richmond, VA 23298-0001 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byIntroduction to the history of inositols: A tale of scientists 1 November 1986Volume 105, Issue 5Page: 796-796KeywordsAcromegalyAndrogensCholesterolEnzyme metabolismEnzymesGrowth hormoneInsulinInsulin-like growth factorsLipoproteinsPituitary tumors ePublished: 1 December 2008 Issue Published: 1 November 1986 PDF downloadLoading ...
LACERATION OF THE ANTERIOR WALL OF THE FEMALE URETHRA AND ITS REPAIR
Authors: W. Lee
Journal: BMJ (1929)

tACERATION OF -TIE FEMALE URETHRA.XDIC DJoA - 2. Sevenity-sixpatients whio had had scarilet fever nine months previously were Dick-tested.These cases liad all been treated with anti-scarlatinal serum.Thlis latter group Automatically selected itself, as aniti-scarlatinal serum had onily been used for the first time on these cases.
Fundholding will remain voluntary
Authors: L Beecham
Journal: BMJ (1994)

The minister for health has assured the chairman of the General Medical Services Committee that fundholding would definitely remain voluntary. At a meeting last week Mr Gerald Malone told Dr Ian Bogle that ministers had not set targets and they did not intend to do so. Mr Malone promised to pass on to officials the GMSC's wish that it would be part of any negotiations about purchasing arrangements for all general practitioners and about the new arrangements for fundholding which the health secretary announced at the conservative party conference (22 October, p 1039). Dr Bogle will ask for assurances in writing that health authorities will give equal support to commissioning non-fundholding general practitioners as it does to fundholders.

Several GMSC members said that there was a difference between what the minister said and what was happening. Although there had not been pressure to become a fundholder in north Tyneside, Dr George Rae reported that his family health services authority had been told to make only the fundholding scheme attractive. At a meeting in Leeds Dr Sadiq Ali and his colleagues were told that they would all eventually become fundholders.

At a press briefing after the meeting one of the GMSC's negotiators, Dr Brian Goss, said that each practice needs to choose freely the appropriate form of commissioning. “An unwilling fundholder,” he said, “is no use to anyone.”

As well as seeking assurances in writing the committee will ask for examples of where there has been undue pressure of coercion to become a fundholder.

Representatives of Britain's 35 000 general practitioners have totally rejected the government's proposals for their role in supporting patients' claims for incapacity benefit. They believe that it will put them in a policing role, will jeopardise patients' confidentiality, was a way of providing a cheap service, and …
Pulmonary thromboembolism--update
Authors: Manuel Viamonte, Harvey Koolpe, Warren Janowitz, Frank Hildner
Journal: JAMA (1980)

PULMONARY thromboembolism (PTE) is a common, frequently misdiagnosed, potentially fatal occurrence. 1,2 Its protean clinical and radiological manifestations depend on the location, extent, and acuteness of the disease, the status of the underlying lung, and the adequacy and promptness of its resolution. The workup of acute pulmonary thromboembolism is outlined in Fig 1.  Suggestive Abnormalities  Clinical History.—  PTE may be observed in patients with recent surgery, trauma, phlebitis, congestive heart failure, atrial fibrillation, previous PTE, oral contraceptives, malignant neoplasms, prolonged bed rest, respiratory failure, postpartum state, and pancreatitis. A known cause may not exist.  Symptoms.—  Tachypnea, retrosternal or pleuritic chest pain, hemoptysis, cough, or syncope are nonspecific and may be present or absent, singly or in combination. Symptoms from preceding or complicating pulmonary disease, cardiac disease, or both may overlap. 3   Physical Findings.—  Tachycardia, auscultatory abnormalities (particularly a wide split of expiratory second pulmonic sound), pleural friction rub, signs of
Clinical and Biochemical Heterogeneity of Depressive Disorders
Authors: J. W. MAAS
Journal: Annals of Internal Medicine (1978)

Indirect evidence, mostly pharmacologic, has suggested a role for brain neurotransmitter amines such as norepinephrine in the production of depression or mania. Clinical investigations have supported this concept but also indicate that depression is probably a biochemically heterogeneous group of illnesses. There may be a clinically, biochemically, and pharmacologically definable subtype of depression in which there is a disorder of norepinephrine metabolism or disposition in brain. I review here the experimental data from which this hypothesis is derived.
Antiretroviral Agents — How Best to Protect Infants from HIV and Save Their Mothers from AIDS
Authors: Hoosen Coovadia
Journal: New England Journal of Medicine (2004)

Preventing transmission of human immunodeficiency virus type 1 (HIV-1) and caring for those already infected are essential services in any comprehensive program, and enhancing the mutually beneficial effect of each is an international goal.1 These reinforcing effects are clearly illustrated in the two articles from the Perinatal HIV Prevention Trial (PHPT) Group in this issue of the Journal. The first report, by Lallemant et al., demonstrates the considerable efficacy of a dual antiretroviral regimen in reducing mother-to-child transmission of HIV-1,2 whereas the second, by Jourdain et al., evaluates the effects of subsequent provision of highly active antiretroviral therapy (HAART) . . .
Hepatocyte apoptosis: Is transforming growth factor-B1 the kiss of death? Oberhammer FA, Pavelka M, Sharma S, Tietenbacher R, Purchio AF, Bursch W, Schulte-Hermann R. Induction of apoptosis in cultured hepatocytes and in regressing liver by transforming growth factor β1. Proc Natl Acad Sci USA 1992;89:5408–5412
Authors: N Fausto
Journal: Hepatology (1993)
Multiple endocrine neoplasia associated with von Recklinghausen's disease.
Authors: D F Griffiths, G T Williams, E D Williams
Journal: BMJ (1983)

Details were studied of three patients with duodenal carcinoid tumour in association with neurofibromatosis and phaeochromocytoma, and of four patients with duodenal carcinoid and either von Recklinghausen's disease or phaeochromocytoma. The rarity of these endocrine tumours, together with the unusual morphological features and somatostatin content of the two duodenal carcinoids examined, suggest that this combination of tumours is not a chance association. It is suggested that this linkage of neurofibromatosis, phaeochromocytoma, and duodenal carcinoid is a specific multiple endocrine neoplasia syndrome.
Left ventricular function in patients with chronic obstructive pulmonary disease
Authors: John F. Williams, Richard H. Childress, Daniel L. Boyd, Lawrence M. Higgs, Roy H. Behnke
Journal: Journal of Clinical Investigation (1968)

Left ventricular function was assessed in six patients with essentially normal cardiopulmonary function, in five patients with primary myocardial disease, and in 16 patients with chronic obstructive pulmonary disease by determining the response of the ventricle to an increased resistance to ejection. Studies were performed at the time of cardiac catheterization and increased resistance to left ventricular ejection was produced by the intravenous infusion of methoxamine. In the control patients, methoxamine produced an increase in stroke volume index (SVI), in stroke work index (SWI), and stroke power index (SPI), whereas left ventricular end-diastolic pressure (LVEDP) increased only moderately. In contrast SVI, SWI, and SPI fell, whereas LVEDP increased inordinately in the patients with myocardiopathy. The patients with chronic obstructive pulmonary disease responded to the infusion with an increase in SVI, SWI, SPI, and LVEDP comparable to the control patients. Furthermore, in this latter group of patients, a quantitatively similar response was observed in those with essentially normal resting hemodynamics, in those with resting pulmonary hypertension, and in those whose disease had progressed to the stage of right ventricular failure. This study provides no evidence that chronic obstructive pulmonary disease results in chronic impairment of left ventricular function, but on the contrary, has demonstrated that the left ventricle responds normally to an increased pressure load in these patients.
CORONARY PHYSIOLOGICAL INDICES IN PATIENTS WITH MYOCARDIAL BRIDGING
Authors: Shigemitsu Tanaka, Yasuhiro Honda, Ryotaro Yamada, Yuhei Kobayashi, Ingela Schnittger, Paul Yock, Alan Yeung, Peter Fitzgerald, William Fearon, Jennifer Tremmel
Journal: Journal of the American College of Cardiology (2014)
Factors Influencing the Treatment of Salmonella Carriers.
Authors: B. Tynes
Journal: Annals of Internal Medicine (1962)

s1 April 1962Factors Influencing the Treatment of Salmonella Carriers.B. Tynes, M.D., J. P. Utz, M.D., F.A.C.P.B. Tynes, M.D.Search for more papers by this author, J. P. Utz, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-692_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTwenty-six adult carriers of Salmonella, who incidentally were the source of over 150 cases of Salmonella infection with two deaths, are the basis of this study. Nearly all had received antibiotics previously. Antibiotic regimens at the Clinical Center included prolonged treatment with tetracycline and chloramphenicol, paramomycin, kanamycin, and up to 1,860 million units of penicillin plus probenecid.With antibiotics alone, only the three carriers without demonstrable gall stones were cured. Cholecystectomy alone cured only five of nine patients, whereas all nine treated by cholecystectomy combined with antibiotic therapy were cured.Cultures of bile and the gall bladder were positive in... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: B. Tynes, M.D.; J. P. Utz, M.D., F.A.C.P.Affiliations: Bethesda, Md. (CS) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 692-692KeywordsAntibioticsBileBladderChloramphenicolCholecystectomyPenicillinSalmonellaTetracyclines ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
Alopecia Areata and Presence of Cytomegalovirus DNA
Authors: R. B. Skinner, W. H. Light, G. F. Bale, E. W. Rosenberg, C. Leonardi
Journal: JAMA (1995)

<h3>To the Editor.</h3> —Using polymerase chain reaction (PCR) technique, we found evidence of cytomegalovirus (CMV) DNA in paraffin-block sections of lesions of alopecia areata. Our interest in this association was first aroused by a 15-year-old male patient who developed sore throat, arthralgias, fever, chills, and diffuse lymphadenopathy. Evaluation by several other physicians had failed to uncover a cause. Tests for mononucleosis, among others, were negative. He developed widespread alopecia areata with loss of most of the hair on his scalp and body. His symptoms suggested CMV infection; a convalescent serum IgG by enzyme immunoassay titer to CMV was 1.30, with normal being less than 0.25. Because of this case, we instituted further studies. Twenty-one of 35 alopecia areata patients had similarly elevated antibody titers. Results of in situ hybridization tests on paraffin-block biopsy specimens of 10 patients with alopecia areata were all negative. Specimens for PCR study were chosen from
Electrocardiogram and Vectorcardiogram in Right Ventricular Hypertrophy and Right Bundle-Branch Block
Authors: W. R. MILNOR, Charles A. Bertrand, Frederick R. Mugler
Journal: Circulation (1957)

Electrocardiographic and vectorcardiographic studies on normal subjects and patients with heart disease suggest that criteria for the diagnosis of right ventricular hypertrophy can be improved and simplified. This report proposes new criteria for the electrocardiographic diagnosis of right ventricular hypertrophy. These criteria decrease the incidence of "false negative" and "false positive" interpretations, and also make possible the recognition of right ventricular hypertrophy in the presence of the R' - V 1 pattern, provided the QRS duration is less than 0.12 second. The findings and limitations of vectorcardiography in right ventricular hypertrophy and "right bundle-branch block" are discussed.
CIRCADIAN DEPENDENCE OF INFARCT SIZE AND CLINICAL OUTCOMES IN 6,710 PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION
Authors: Aruni Seneviratna, Gek Hsiang Lim, Anju Devi, Leonardo Carvalho, Tian Hai Koh, Terrance Chua, Huay Cheem Tan, David Foo, Khim-Leng Tong, Hean-Yee Ong, Mark Richards, Khuan Yew Chow, Mark Chan
Journal: Journal of the American College of Cardiology (2014)
Intravascular Ultrasound Observation of an Obstruction of the Left Main Coronary Artery Caused by Displaced Leaflet Calcification and Hematoma After Transcatheter Aortic Valve Implantation
Authors: Tomohiko Taniguchi, Naritatsu Saito, Kenji Minakata, Masao Imai, Hirotoshi Watanabe, Toshiaki Toyota, Shin Watanabe, Junichi Tazaki, Shigeki Koizumi, Shingo Hirao, Kazuhiro Yamazaki, Hiroki Daijo, Ryuzo Sakata, Takeshi Kimura
Journal: Circulation (2015)
Cytokines in pulmonary arterial hypertension: consider sensitivity when using multiplex technology
Authors: Denis Monneret
Journal: European Respiratory Journal (2014)

Cytokines in pulmonary arterial hypertension: consider sensitivity when using multiplex technologyTo the Editor: CRACOWSKI et al. [1] have recently published an interesting substudy in which they analysed the association of 17 baseline plasma cytokine concentrations with mortality in patients suffering from pulmonary arterial hypertension (PAH), using multiplex technology.The authors showed that four cytokines were independently associated with an increase in the adjusted hazard of mortality.Previously, SOON et al. [2] demonstrated that elevated levels of cytokines in PAH also predict survival over a 5-year period.Both these studies reinforce the increasing evidence that inflammation is associated with PAH remodelling.Nevertheless, it is known that concentrations of circulating cytokines are very low, in the pg?mL -1 range, requiring highly sensitive methods.In the letter by CRACOWSKI et al.[1], despite a well-defined design and a robust statistical analysis, as previously described [3], no information is provided about the analytical performances of the method for cytokine quantification.In order to strengthen such cytokine-based clinical studies, the sensitivity of multiplex technology is herein discussed.Table 1 shows the mean baseline circulating cytokine concentrations from the two predictive PAH-related studies of CRACOWSKI et al.[1] and SOON et al.[2], using different multiplex technologies: the Biochips-Array from Randox (Crumlin, UK) and the plate-based Multi-Array from Meso Scale Discovery (MSD; Rockville, MD, USA), respectively.In addition, the table 1 details, for each cytokine, the sensitivities reported by the manufacturers, and those determined in analytical studies by FITZGERALD et al. [4] and DABITAO et al. [5].Sensitivity must be considered for cytokines when using multiplex technology in PAH-related clinical studies http://ow.
Ventilation and oxygenation induce endothelial nitric oxide synthase gene expression in the lungs of fetal lambs.
Authors: S M Black, M J Johengen, Z D Ma, J Bristow, S J Soifer
Journal: Journal of Clinical Investigation (1997)

At birth, ventilation and oxygenation immediately decrease pulmonary vascular resistance (PVR) and increase pulmonary blood flow (PBF); more gradual changes occur over the next several hours. Nitric oxide, produced by endothelial nitric oxide synthase (eNOS), mediates these gradual changes. To determine how ventilation and oxygenation affect eNOS gene expression, 12 fetal lambs were ventilated for 8 h without changing fetal descending aortic blood gases or pH (rhythmic distension) or with 100% oxygen (O2 ventilation). Vascular pressures and PBF were measured. Total RNA, protein, and tissue sections were prepared from lung tissue for RNase protection assays, Western blotting, and in situ hybridization. O2 ventilation increased PBF and decreased PVR more than rhythmic distension (P < 0.05). Rhythmic distension increased eNOS mRNA expression; O2 ventilation increased eNOS mRNA expression more and increased eNOS protein expression (P < 0.05). To define the mechanisms responsible for these changes, ovine fetal pulmonary arterial endothelial cells were exposed to 1, 21, or 95% O2 or to shear stress. 95% O2 increased eNOS mRNA and protein expression (P < 0.05). Shear stress increased eNOS mRNA and protein expression (P < 0.05). Increased oxygenation but more importantly increased PBF with increased shear stress induce eNOS gene expression and contribute to pulmonary vasodilation after birth.
Syncope in High-Risk Cardiomyopathy Patients With Implantable Defibrillators: Frequency, Risk Factors, Mechanisms, and Association With Mortality
Authors: Martin H. Ruwald, Ken Okumura, Takeshi Kimura, Kazutaka Aonuma, Morio Shoda, Valentina Kutyifa, Anne-Christine H. Ruwald, Scott McNitt, Wojciech Zareba, Arthur J. Moss
Journal: Circulation (2013)

There is a relative paucity of studies investigating the mechanisms of syncope among heart failure patients with implantable cardioverter-defibrillators, and it is controversial whether nonarrhythmogenic syncope is associated with increased mortality.The Multicenter Automatic Defibrillator Implantation Trial-Reduce Inappropriate Therapy (MADIT-RIT) randomized 1500 patients to 3 different implantable cardioverter-defibrillator programming arms: (1) Conventional programming with therapy for ventricular tachycardia ≥170 bpm; (2) high-rate cutoff with therapy for ventricular tachycardia ≥200 bpm and a monitoring zone at 170 to 199 bpm, and (3) prolonged 60-second delay with a monitoring zone before therapy. Syncope was a prespecified safety end point that was adjudicated independently. Multivariable Cox models were used to identify risk factors associated with syncope and to analyze subsequent risk of mortality. During follow-up, 64 of 1500 patients (4.3%) had syncope. The incidence of syncope was similar across the 3 treatment arms. Prognostic factors for all-cause syncope included the presence of ischemic cardiomyopathy (hazard ratio [HR], 2.48; 95% confidence interval [CI], 1.42-4.34; P=0.002), previous ventricular arrhythmias (HR, 2.99; 95% CI, 1.18-7.59; P=0.021), left ventricular ejection fraction ≤25% (HR, 1.65; 95% CI, 0.98-2.77; P=0.059), and younger age (by 10 years; HR, 1.25; 95% CI, 1.00-1.52; P=0.046). Syncope was associated with increased risk of death regardless of its cause (arrhythmogenic syncope: HR, 4.51; 95% CI, 1.39-14.64, P=0.012; nonarrhythmogenic syncope: HR, 2.97; 95% CI, 1.07-8.28, P=0.038).Innovative programming of implantable cardioverter-defibrillators with therapy for ventricular tachycardia ≥200 bpm or a long delay is not associated with increased risk of arrhythmogenic or all-cause syncope, and syncope caused by slow ventricular tachycardias (<200 bpm) is a rare event. The clinical risk factors associated with syncope are related to increased cardiovascular risk profile, and syncope is associated with increased mortality irrespective of the cause.http://www.clinicaltrials.gov. Unique identifier: NCT00947310.
Risk of high-grade dysplasia or carcinoma in gastric biopsy-proven low-grade dysplasia: an analysis using the Vienna classification
Authors: S.-J. Cho, I. Choi, C. Kim, J. Lee, M.-C. Kook, S. Park, K. Ryu, J. Lee, Y.-W. Kim
Journal: Endoscopy (2011)

Background and aims: Therapeutic guidelines have not yet been established for low-grade gastric adenomas/dysplasias (LGD), which have a low risk of progression to high-grade adenomas/dysplasias (HGD) or to invasive carcinomas. This study aimed to evaluate risk factors for HGD/carcinoma that indicate a need for resection in biopsy-proven LGD lesions.
Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine
Authors: Rocco Vivenzio
Journal: Annals of Internal Medicine (2001)

Medical Writings: Book Notes1 May 2001Geriatrics Review Syllabus: A Core Curriculum in Geriatric MedicineRocco Vivenzio, MDRocco Vivenzio, MDPenfield, New York. (Vivenzio)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-9_Part_1-200105010-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Fourth edition. Three volumes. Cobbs EL, Duthie EH Jr, Murphy JB. Dubuque, IA: Kendall/Hunt; 2000. Single-user price, $395.00. ISBN 0787256757. Order phone 800-228-0810.Field of medicine: General internal medicine and geriatrics.Format: Textbook and CD-ROM software.Minimum system requirements: PC: Windows 95 or higher, 486 66-MHz processor with 6 Mb of free hard disk space, 16 Mb of RAM, a 2× CD-ROM drive, and SVGA monitor with 256-color display. Macintosh: System 7.5 or higher, 66-MHz PowerPC with 6 Mb of free hard disk space, 16 Mb of RAM, a 2× CD-ROM drive, and a monitor with thousands of colors display.... Author, Article, and Disclosure InformationAffiliations: Penfield, New York. (Vivenzio) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 2001Volume 134, Issue 9_Part_1Page: 800KeywordsAgingGeriatricsHealth careLong-term careNursing administrationNursing homesNutritionPhysiciansPrimary careSoftware tools ePublished: 1 May 2001 Issue Published: 1 May 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...