tbuckley/cabot-search huggingface dataset:
Histological Analysis of Endoscopic Resection Specimens From 326 Patients with Barrett’s Esophagus and Early Neoplasia
Authors: M. Vieth, C. Ell, L. Gossner, A. May, M. Stolte
Journal: Endoscopy (2004)

Endoscopic resection has been recommended as a local curative approach for Barrett's neoplasia, but large series are still rare. In the present study we analyzed the histological characteristics of endoscopic resection specimens of Barrett's neoplasia.742 endoscopic resection specimens obtained from 326 patients were assessed. The following histological characteristics were evaluated: type of neoplasia, grade of differentiation, depth of infiltration, invasion into lymphatic and blood vessels, and resection status (tumor-free margins were regarded as indicating R0 status).31 patients had no neoplasia and were excluded from the analysis. Among the remaining 295 patients (711 resection specimens), histological findings were: low-grade intraepithelial neoplasia, 1.0 %; high-grade intraepithelial neoplasia, 2.7 %; and mucosal carcinoma 80.3 %. Carcinomas infiltrating the submucosal layer were rare (sm1 7.5 %; sm2 3.7 %; sm3 4.8 %), as were those invading lymph vessels (3.5 %), and there were none with venous invasion. Most of the carcinomas were well-differentiated (72.2 %), and many of these (92.7 %) were limited to the mucosa, in contrast to moderately and poorly differentiated carcinomas (73.7 % and 22.7 %, respectively). R0 status was achieved in 74.5 % of patients; in 47.8 % this was after repeated endoscopic resection. In 26.8 % of patients, R0 resection was achieved at the first attempt.Our study demonstrates that early Barrett's neoplasms removed by endoscopic resection are mostly limited to the mucosa, are well to moderately differentiated, and very rarely show invasion of the lymph or blood vessels. Although these lesions seem to be low risk with regard to metastatic spread and therefore treatable endoscopically, improved endoscopic resection methods for achieving one-piece (en bloc) R0 resection should be developed.
Nature and Nurture in Diabetic Glomerulopathy
Authors: Samuel Vaisurb
Journal: JAMA (1976)

When we differentiate hereditary from environmental factors in disease, we generally do so at the level of the individual patient. Can similar differentiation apply to an individual organ and its metabolic environment?  This question arises when an organ bears the brunt of pathologic damage in the course of a systemic disease. Such was the case not too long ago with hypertension. Some authorities believed that lowering the blood pressure would not prevent or arrest the pathologic changes in the affected organs because these changes did not result from hemodynamic stresses but inhered in the organs themselves as an integral part of the disease. Experience has since proved the fallacy of this belief.  Can experience shed similar light on organ involvement in diabetes, particularly on diabetic nephropathy? Is the diseased kidney of an insulin-dependent diabetic patient earmarked for characteristic pathologic changes by a heritable diabetic trait, or are these changes secondary
ONE HUNDRED CASES OF TYPHOID FEVER.
Authors: H. G. McCORMICK
Journal: JAMA (1897)

Since the first day of September, 1893, I have treated 124 cases of typhoid fever. The first year I treated twenty-four cases; twenty-one recovered and three died. From Sept. 1, 1894, to March 1, 1897, I treated 100 cases of typhoid fever with one death. Why this great difference in mortality? This is the question I purpose answering for you today. The first twenty-four cases were treated as the text-books and college professors teach that such cases should be treated. Baths were used where such treatment was practicable, and where I could persuade the patient that a cold bath was a pleasant pastime. The diet was carefully regulated and in the absence of my knowledge of a better drug, sulpho-carbolate of zinc was given. I believed then what was greatly taught on this subject, that typhoid fever was a self-limited disease and that I must carefully watch the symptoms, and
Calcitonin gene-related peptide is a stimulator of renin secretion.
Authors: A Kurtz, R Muff, W Born, J M Lundberg, B I Millberg, M P Gnädinger, D E Uehlinger, P Weidmann, T Hökfelt, J A Fischer
Journal: Journal of Clinical Investigation (1988)

Calcitonin gene-related peptide (CGRP) was found to stimulate renin secretion in vivo in normal human volunteers. Moreover, CGRP stimulated the release of renin in vitro from isolated rat renal juxtaglomerular cells (half-maximal effective concentration [EC50] 100 nM) concomitant with stimulation of cAMP production (EC50 60 nM). Immunoreactive CGRP was recognized in rat renal cortical nerve fibers, and intact rat CGRP was identified in extracts of the rat renal cortex. Because CGRP containing sensory nerve fibers are seen in the region of the juxtaglomerular apparatus, it would seem that the release of CGRP from these afferent nerves may be involved in the physiological control of renin secretion.
Graham Morton Robertson
Authors: James Fisher
Journal: BMJ (2004)

​FormerFormer general practitioner Bournemouth (b 1926; q Oxford 1949; FRCGP), d 21 July 2004.




Figure 1




Graham Robertson joined his uncle in general practice in Bournemouth in 1953, after national service and an assistantship in Port Talbot. He retired in 1986 at the age of 60, but within four years had a stroke that virtually confined him to a wheelchair for the rest of his life. Despite this he carried on with his meticulous watercolour painting and active membership of the Bournemouth and Poole Medical Society until a few months of his death. He leaves his second wife, Elene, and three children by his first wife, Jean, who also survives him
P223 Consent For Medical Thoracoscopy: The Truth, The Whole Truth And Nothing But The Truth?
Authors: S. Jafri, K. Ramsay, P. Beckett, R. Berg
Journal: Thorax (2014)

<h3>Introduction</h3> Failure to provide adequate information for valid informed consent may impact negatively on patient satisfaction and trust, and is a common cause of medical litigation. Some professional societies produce standardised consent forms in an attempt to reduce variation in quality of consent. There is no published national guideline standard for consent for medical thoracoscopy. We reviewed the quality of consents for medical thoracoscopy in a unit performing an average of 40 medical thoracoscopies per year. <h3>Methods</h3> Case records of 80 patients who had undergone medical thoracoscopy were retrospectively reviewed. Consent forms were assessed for mention of potential complications, and grade and competency at thoracoscopy of consent-takers. We analysed the consistency between consents taken by the same individuals at different times, and numbers of patients experiencing complications for which they were not consented. <h3>Results</h3> Consent was taken by 19 individuals. Consultant thoracoscopists took 54% of consents; non-thoracoscopist consultants took 15% and trainees 31%. Potential complications consented for were: bleeding (100%), ‘infection’ (99%), persistent pneumothorax/trapped lung (81%), pain (73%), Empyema (46%), damage to underlying organs (28%), respiratory distress (28%), non-diagnostic procedure (20%), (talc related) fever (16%), cardiac complications (15%) and haemothorax (10%). Consultant thoracoscopists were significantly more likely than all other consent-takers to consent patients for empyema; 72% vs 16% of consents, p &lt; 0.001, and pain; 93% vs 49%, p &lt; 0.001. Consistency with which consent-takers omitted or mentioned complications varied by individual and complication. For example, those individuals who consented at least once for empyema (7/19 consent-takers) did so collectively on 80% of their consents (individual range 25%-100%), whereas those who took consent for damage to underlying organs (10/19 consent-takers) did so on only 35% of their consents (range 5%-100%). Empyema occurred in 5% of patients, all of whom had been consented for this complication. 38/80 patients (48%) experienced significant pain, of whom 34% were not consented for this. <h3>Conclusion</h3> Information provided on thoracoscopy consent forms is inconsistent, both for common minor and serious complications. Even experienced thoracoscopists may fail to clarify significant complications. Introduction of a standardised consent form could reduce variation and consequent potential for patient distress and medico-legal risk.
Proceedings: Histocompatibility antigen (HL-A 27) and its relation to disease.
Authors: D A Brewerton, M Cafrey, A Nicholls, D C James
Journal: Annals of the Rheumatic Diseases (1974)

DR. R. D. STURROCK (Glasgow) These results are very interesting.We confirm the findings of HL-A 27 in spondylitis, but using serum
THE ACTION OF VITAMIN D IN PREVENTING THE SPREAD AND PROMOTING THE ARREST OF CARIES IN CHILDREN
Authors: M. Mellanby, C. L. Pattison
Journal: BMJ (1928)

IN papers published in 1S24 anld 1q26 respctively,' 2 we recorded investigations showing that the dietetic factor-s wh-hich control the structure of teeth in puppies also in- fluence the initiation and spread of caries in clhildren.Animail experinlentS 5 had proved that food substances wlhiclh contained the antirachitic or calcifyinlg vitamin, now called vitamin D, greatly stimulated the calcification of teetls, whlile cereals, and especially oatmeal, inhibited perfect calcification of the teeth when this vitamin was deficient in thio diet.In the investigatiolns 'on childreni refeired to above we found that diets favourable to calcifi- cationi lim-lited the initiation and spread of caries, w-hile diets of lower vitamin content, and containling oatmeal, had not) suceli effect.In miiany cases also diets rich in vitamiiin D caused " lhardening " of teeth in whiclh caries had started, a-nd tlius tended to suppress the active carionis process.Oni the other haid, diets with low calcifying properties lhad no such retarding influence.In both investigatiolns caries was extensive at the beginning, alid an attempt was Iiade to group the children in such a way as to start with approximately equal amounts of caries in eaclh group.In the first series of cases ( 1924) we attemipted in one group to raise the calcifying properties of the ordinary lhospital diet by adding extra milk and eggs and by giving cod-liver oil.In another group these extras were omitted anid oatmeal was added.It may be stated that all the diets were good, and contained a fair amount of milk and otlher-whlolesome foods; in fact, from any nutritional standpoint they were probably mucll better than those cateni by the average child in this country.Table I gives a sumimiary of the results obtained.TABLE Ir. lAI.aditfer es cs diet.As.Abundant fat-soluble vitamins and ca!cium; diminished cereal Bi.Muclh less fat-soluble vitamins and calcium than As; more cereal, including oatmeal Ci.Intermediate between As and Bs as regards fat-soluble vita- mins and calcium and cereal No. of patients in grcup.Aversage No. of teeth per child -
The plasma membrane-actin linking protein, ezrin, is a glomerular epithelial cell marker in glomerulogenesis, in the adult kidney and in glomerular injury
Authors: Christian Hugo, Masaomi Nangaku, Stuart J. Shankland, Raimund Pichler, Katherine Gordon, Manuel R. Amieva, William G. Couser, Heinz Furthmayr, Richard J. Johnson
Journal: Kidney International (1998)
Accuracy of serial myocardial perfusion scintigraphy with thallium-201 for prediction of graft patency early and late after coronary artery bypass surgery. A controlled prospective study.
Authors: M Pfisterer, H Emmenegger, H E Schmitt, J Müller-Brand, J Hasse, E Grädel, M B Laver, D Burckhardt, F Burkart
Journal: Circulation (1982)

To assess the accuracy of serial myocardial perfusion scintigraphy with thallium-201 (201Tl) to predict graft patency early and late coronary artery bypass surgery, rest and exercise 201Tl and coronary arteriography were performed preoperatively and 2 weeks and 1 year after operation. The scintigraphic results were compared with graft patency, symptoms, left ventricular function and physical work capacity in a consecutive series of 55 patients with a total of 154 grafts. Serial 201Tl had an 80% sensitivity, 88% specificity and 86% overall accuracy in detecting or excluding graft occlusion, which was predicted by reversible ischemia as well as persistent "new scar" segments. Occluded grafts were correctly localized by 201Tl scintigraphy in 61%. Postoperative apical 201Tl defects were frequent (two-thirds of cases), and were the result of intraoperative transapical venting of the left ventricle. After coronary bypass graft surgery, ejection fraction at rest was unchanged. Left ventricular end-diastolic pressure and physical work capacity improved significantly. In the presence of new perfusion defects detected postoperatively, physical work capacity was reduced significantly. New 201Tl defects in addition to typical or atypical angina provided a high probability of graft occlusion, while in the absence of new 201Tl defects all grafts were patent in more than 90% of patients, all of whom had no or only atypical chest pain. We conclude that serial 201Tl imaging after coronary artery bypass surgery is an accurate noninvasive method that can be used routinely to assess graft function, to localize spatially occluded grafts and to identify patients with a high likelihood of graft occlusion who may need invasive studies.
Interleukin 1 gene expression in cultured human keratinocytes is augmented by ultraviolet irradiation.
Authors: T S Kupper, A O Chua, P Flood, J McGuire, U Gubler
Journal: Journal of Clinical Investigation (1987)

Interleukin 1 (IL-1) is a family of polypeptides initially found to be produced by activated monocytes and macrophages that mediate a wide variety of cellular responses to injury and infection. Epidermal epithelial cells (keratinocytes) produce "epidermal cell-derived thymocyte activating factor" or ETAF, which has been recently shown to be identical to IL-1. Human epidermis is normally exposed to significant amounts of solar ultraviolet radiation. Certain ultraviolet wavelengths (UVB, 290-320 nm) are thought to be responsible for most of the immediate and long-term pathological consequences of excessive exposure to sunlight. In this study, we asked whether exposure to UVB irradiation induced IL-1 gene expression in cultured human keratinocytes. Cultured human keratinocytes contain detectable amounts of IL-1 alpha and beta mRNA and protein in the absence of apparent stimulation; these levels could be significantly enhanced 6 h after exposure to 10 ng/ml of 12-O-tetradecanoyl-phorbol-13-acetate (TPA). Exposure to UVB irradiation with an emission spectrum comparable to that of sunlight (as opposed to that of an unfiltered artificial UV light source) significantly increased the steady state levels IL-1 alpha and beta mRNA in identical populations of human keratinocytes. This was reflected in the production of increased IL-1 activity by these cultures in vitro. In the same cell population, exposures to UVB irradiation did not alter the level of actin mRNA; therefore, the effect of UV irradiation on IL-1 represents a specific enhancement of IL-1 gene expression. Local increases of IL-1 may mediate the inflammation and vasodilation characteristic of acute UVB-injured skin, and systemic release of this epidermal IL-1 may account for fever, leukocytosis, and the acute phase response seen after excessive sun exposure.
Intrathoracic extramedullary haemopoiesis in a patient with hereditary spherocytosis
Authors: Heena Mistry, Nilushi Ranaweera, Diane E Laws
Journal: Thorax (2015)

A 63-year-old Thai man with hereditary spherocytosis presented with pruritus of his legs and subsequently found to have a raised serum ferritin of 1638 µg/L. He had previously not required transfusional support. A referral was made to the gastroenterologists for investigation of iron overload. The HFE gene was not detected, thereby excluding hereditary haemochromatosis.

A T2* MRI scan was performed to identify areas of high iron load as part of the transfusion programme at the Royal Bournemouth Hospital for patients with myelodysplastic syndromes. This showed a large mass in the posterior right chest and a 3 cm×4 cm mass in the inferomedial left chest (figures …
Health in Africa: In Taiwan, taking action on road safety made a difference
Authors: Min-Huei Hsu, Yu-Chuan Li, Wen-Ta Chiu
Journal: BMJ (2005)

Time to wake up to cancer's tollEditor-As exemplified by your theme issue on Africa of 1 October, cancer has remained comparatively neglected in Africa although increasingly prevalent: 70% of people with cancer live in the economically developing world, where by 2020 the annual death toll is predicted to reach 20 million. 1 In sub-Saharan Africa measures to prevent cancer emphasised in the developed world-such as smoking cessation and screening-are not nationally adopted.One third of African cancers are preventable, but the influence of tobacco companies with mass media advertising and high crop payments is real.Traditional cancers, such as gastric and hepatocellular carcinoma, and newer cancers, such as lung cancer, breast cancer, and AIDS related Kaposi's sarcoma, are increasing in incidence. 2 3 Patients' expectations for oncological treatment are low in Africa.Lack of money, or a concern not to place their family in debt, prevents many from seeking medical help. 4 Lack of awareness of predisposing factors, warning symptoms or signs of cancer, or treatment options mean that patients present late.Cost and difficulty of travel over rough terrain also discourage service use.After diagnosis patients may tend to look for peace of mind and spiritual comfort rather than a physical cure.In Africa disease modifying cancer treatment and basic control of symptoms are largely absent.Even when analgesia is available, patients with cancer may experience severe and inadequately managed pain, as health professionals underprescribe strong analgesics, fearing drug dependency. 5 Individual sub-Saharan countries cannot tackle the challenges of cancer in isolation.A new, cooperative approach and research base are being advocated for preventing, treating, and palliating cancer to bridge the gap between developed and developing nations.
FDA panel recommends tighter rules for prescribing opioids
Authors: M. McCarthy
Journal: BMJ (2013)

An advisory panel of the US Food and Drug Administration has recommended that the FDA reclassify hydrocodone combination products as schedule II drugs, defined as those having a high potential for abuse and severe threat of dependence. These products include the popular combination of hydrocodone and acetaminophen (paracetamol), such under brands such as Vicodin.

The panel, which met on 24-25 January, voted 19 to 10 in favor of rescheduling. Although such recommendations are considered only advisory, the FDA usually follows its advisory panels’ guidance.

Hydrocodone combination products are currently classified as schedule III drugs, recognizing that they pose a “moderate” risk of dependence. But …
Injuries and deaths caused by unexploded ordnance in Afghanistan: review of surveillance data, 1997-2002
Authors: Oleg O Bilukha, Muireann Brennan
Journal: BMJ (2005)

CommentClomifene was not associated with any increased risk of hypospadias.Several factors should be taken into account when interpreting this study.The full and independent registration of births, birth outcome, and prescriptions prevented selection bias and some types of information bias as this study was based on routinely recorded data.Any non-compliance with the use of clomifene, however, might bias the estimates of risk towards the null.
An Orally Active Iron Chelator
Authors: David G. Nathan
Journal: New England Journal of Medicine (1995)

Iron is essential for all organisms from bacteria to humans; but like excessive amounts of alcohol, which is so pleasant in moderation, a surfeit of iron is fatal. The lethal effects of iron overload can be immediate, as in an accidental or deliberate overdose of medicinal iron, or slow, as in congenital hemochromatosis and transfusional hemosiderosis. In the slowly developing conditions — the former due to hyperabsorption of iron in food and the latter to iatrogenic, as well as, in the case of thalassemia, hyperabsorptive factors — iron stores in the reticuloendothelial system are filled to the brim with nontoxic . . .
Abstract 5174: Novel signaling interactions of type XV collagen: Implications for tumor suppression
Authors: Anthony G. Clementz, Michael J. Mutolo, Ann Harris
Journal: Cancer Research (2012)

Abstract Most clinical therapeutics used to date depend on specific targeting of cellular components to treat cancers. However, the environment outside the tumor cell is also critical since it may provide new targets to treat malignant and resistant cancers, independent of the tumor. We aim to advance the understanding of the early stages of cancer, prior to metastasis by determining the role of a non-fibrillar collagen (Type XV) and its interactions with the tumor stroma and extracellular environment. Type XV collagen (COLXV) is found in basement membrane zones where it assumes a pretzel-like structure but unlike the majority of fibrillar collagens does not form tight lattice networks surrounding the cell. Loss of COLXV during progression of aggressive cancers (including breast, pancreas, and ovarian carcinomas and melanomas) precedes basement membrane invasion and metastasis. Moreover, the loss of COLXV from the distal side of basement membrane zones and the resulting deficit in its interactions with other proteins may determine its specific function in tumor progression and eventual metastasis. In this context we have identified critical collagen-binding cell surface receptors on the tumor cell, which interact with COLXV and appear to mediate its functions. These receptors have also been reported to show altered signaling in cancer. We previously showed that over-expression of COLXV in cervical cancer cells alters the growth properties of these cells both in vitro and in vivo, and showed that type XV collagen is a dose-dependent suppressor of tumorigenicity in vivo. We now show that over-expression of COLXV inhibits epithelial to mesenchymal transition (EMT) in vitro and has a dramatic effect on the associated signaling events. We are now further investigating the mechanisms of tumor/stroma crosstalk that are impacted by COLXV and subsequently by its depletion. 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 5174. doi:1538-7445.AM2012-5174