tbuckley/cabot-search huggingface dataset:
Detection of Bile Leakage from Traumatic Right Hepatic Duct Laceration with Technetium-99m DISIDA Cholescintigraphy
Authors: MAQBOOL SALAM, JERRY V. GLOWNIAK, R MARK VETTO, JERRY E. JARBOE, JAMES E. HAINES, GERBAIL T. KRISHNAMURTHY
Journal: Clinical Nuclear Medicine (1987)

A woman was admitted to the hospital after blunt abdominal trauma. Initial ultrasound was equivocal but suggested a localized hepatic laceration. The patient was discharged but returned three weeks later with ascites and mild pain in the right upper abdominal quadrant. Hepatobiliary imaging identified a large bile leak originating from the porta hepatis but showed no evidence of parenchymal injury. No hepatic injury was found at surgery, but a laceration of the right hepatic duct was identified. Hepatobiliary imaging is the procedure of choice in diagnosing bile leaks from the extrahepatic biliary system.
SP0104 The Molecular Basis of Autoimmune Disease
Authors: D.A. Hafler
Journal: Annals of the Rheumatic Diseases (2014)

<h3></h3> Genome-wide association studies have identified numerous genetic associations between common SNPs and risk of autoimmune diseases, some of which are shared between diseases. Along with clinical evidence, this suggests that some genetic risk factors with their biologic effects may be shared across diseases. We evaluate the extent of this sharing for 107 immune disease-risk SNPs in seven diseases and developed a novel statistic for <i>C</i>ross <i>P</i>henotype <i>M</i>eta-<i>A</i>nalysis which detects association of a SNP to multiple, but not necessarily all, phenotypes. We find evidence that 47/107 (44%) immune-mediated disease risk SNPs are associated to multiple – but not all – immune-mediated diseases (SNP-wise <i>P</i><sub>CPMA</sub>&lt; 0.01). Distinct groups of interacting proteins are encoded near SNPs that predispose to the same subsets of diseases; we propose these as the mechanistic basis of shared disease risk. We have begun efforts to identify the biologic effects of disease causing SNPs at non-coding regions of the genome where it has been difficult to assign function to DNA sequence and to compare these effects across different autoimmune diseases. We use fine-mapping genetic data to identify causal mutations and integrate these data with chromatin maps of ten defined human CD4<sup>+</sup> T-cell populations. These investigations identified risk variants disrupting the enhancers of distinct cell types among the different autoimmune diseases, particularly in AP-1 and NFkB. Finally, autoimmune disease results from untoward interactions between genetics and the environment. We recently showed that increased salt (NaCl) concentrations found locally under physiological conditions <i>in vivo</i> dramatically boost the induction of Th17 cells mediated by SGK1. The Th17 cells generated under high-salt display a highly pathogenic and stable phenotype characterized by the up-regulation of the pro-inflammatory cytokines GM-CSF, TNFα and IL-2. Recent data revealed that higher NaCl levels also decreased the function of human CD4<sup>+</sup>CD25<sup>+</sup>FoxP3<sup>+</sup> Tregs isolated <i>ex vivo</i>. Mice fed with a high-salt diet develop a more severe form of EAE, in line with augmented central nervous system infiltrating and peripherally induced antigen specific Th17 cells. It was of interest to observe that RNA array analyses of genes induced by NaCl were markedly enhanced among GWAS hits. Identifying specific sites where a single, non-coding nucleotide variant is responsible for disease risk may pinpoint specific disruptions of consensus transcription factor binding sites that ultimately define disease risk as related to environmental factors. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6254
Three cases of meningococcal pneumonia.
Authors: E M Jones, N M Brown, J E Harvey, D S Reeves, A P MacGowan
Journal: Thorax (1997)

Three cases of pneumonia due to Neisseria meningitidis are described. In all three cases the organism was isolated only from blood cultures, but in the presence of good clinical and radiological evidence of pneumonia. The isolates belonged to three different serogroups: B type 2b, C, and Y. The cases illustrate the fact that N meningitidis can cause pneumonia and that culture of blood plays an important part in the diagnosis. Clinically there is nothing to differentiate meningococcal pneumonia from other causes of community acquired pneumonia. Predisposing factors include aspiration, immunosuppression, influenza, and adenovirus infections. When diagnosed, pneumonia due to N meningitidis should be notified and prophylaxis given as for meningitis or septicaemia.
Science, medicine, and the future: Microdialysis
Authors: M. Muller
Journal: BMJ (2002)

Monitoring tissue chemistry in patients by microdialysis is likely to become routine in clinical practice


Many diagnostic and therapeutic decisions in medical practice are based on measuring blood concentrations of endogenous molecules. Yet most biochemical and pharmacological events take place in the tissues. Assessing tissue chemistry should theoretically provide more accurate data, and this can now be achieved relatively cheaply and minimally invasively with microdialysis. This review describes the technique of microdialysis and its application in clinical research, drug monitoring, and drug development. It also discusses how, in the future, measurement of tissue rather than blood chemistry may become the standard for some clinical investigations. 


Summary points


Microdialysis enables the in vivo measurement of tissue chemistry in humans and is feasible in virtually every human organ


It is currently being used to monitor brain ischaemia and metabolic control


The technique is set to become a standard tool in drug monitoring and development


In the future “bedside” microdialysis will allow monitoring of tissue metabolism in a wide range of diseases
Diagnosis of Creutzfeldt-Jakob Disease by Western Blot Identification of Marker Protein in Human Brain Tissue
Authors: Paul Brown, Millicent Coker-Vann, Kitty Pomeroy, Maryellen Franko, David M. Asher, Clarence J. Gibbs, D. Carleton Gajdusek
Journal: New England Journal of Medicine (1986)

We tested purified preparations of brain tissue from 39 patients with Creutzfeldt-Jakob disease, Gerstmann-Sträussler-Scheinker syndrome, or kuru, and from 32 patients with a variety of nonspongiform degenerative diseases, with the use of Western blots against an antiserum to a similarly purified fraction made from scrapie-infected hamster brain. Positive reactions occurred in 81 percent of the 31 specimens from the patients with Creutzfeldt-Jakob disease (and in all of the 7 specimens that were stored frozen for less than one year), in 3 of the 4 specimens from the patients with kuru, in 3 of the 4 specimens from the patients with Gerstmann-Sträussler-Scheinker syndrome, and in none of the specimens from the patients with other neurologic degenerative disorders, including familial or sporadic Alzheimer's disease; dementia associated with myoclonus, motor neuron disease, or parkinsonism; and acquired-immunodeficiency-syndrome encephalopathy. Immunologic testing has thus begun to provide a useful and rapid adjunct to neuropathological examinations and animal-transmission experiments for the diagnosis of the spongiform encephalopathies.
Etiology of Nongonococcal Urethritis — One Piece in the Puzzle
Authors: William M. McCormack
Journal: New England Journal of Medicine (1975)

And the Lord spake unto Moses and to Aaron, saying, "Speak unto the children of Israel and say unto them, when any man hath a running issue of his flesh, because of his issue he is unclean." [Leviticus 15:1–2]The above quotation is often cited by venereologists as evidence that gonorrhea existed in biblical times. In actuality, from the clinical information with which we are provided, there is no way to determine if the good Lord was referring to gonococcal urethritis or to nongonococcal urethritis or, as is most probable, to both conditions. The capability to differentiate these diseases did . . .
Relationships between hepatic neoplasms and related lesions and exposure to toxic chemicals in marine fish from the U.S. West Coast.
Authors: M S Myers, J T Landahl, M M Krahn, B B McCain
Journal: Environmental Health Perspectives (1991)

English sole (Parophrys vetulus) inhabiting polluted waterways and embayments of Puget Sound, Washington, are affected with a variety of multiple, co-occurring idiopathic hepatic lesions, including unique degenerative conditions, putatively preneoplastic foci of cellular alteration, and neoplasms. Results of a statistical analysis of the patterns of co-occurrence of these lesions in wild English sole are consistent with the concept that these lesions represent morphologically identifiable steps forming a sequence of progression ultimately leading to the development of hepatic neoplasms. This progressive sequence parallels the pattern identified in experimental models of chemically induced hepatocarcinogenesis in rodents. The rationale for the hypothesis that these lesions in wild English sole can be caused by exposure to certain hepatoxic and hepatocarcinogenic xenobiotic compounds in the marine environment is based on the demonstration of significant and consistent statistical associations between levels of aromatic hydrocarbons (AHs) in sediment and prevalences of these idiopathic liver lesions; a significant contribution by sediment AHs to the variability in hepatic neoplasm prevalence in a logistic regression model; significantly increased probabilities for several idiopathic lesions in sole from chemically contaminated sites in Puget Sound; significant correlations between uptake of polycyclic aromatic hydrocarbons, as measured by levels of fluorescent metabolites of aromatic compounds in bile of sole, and prevalences of several hepatic lesion types; and experimental induction of unique degenerative, proliferative, and putatively preneoplastic focal lesions in English sole injected with either benzo(a)pyrene or a polycyclic aromatic hydrocarbons (PAH) enriched fraction of an extract from a contaminated urban sediment from Puget Sound.(ABSTRACT TRUNCATED AT 250 WORDS)
A Dose of Spanish Fly
Authors: Andrew J. Presto
Journal: JAMA (1970)

Acute cantharides intoxication, characterized by crampy abdominal pain, diarrhea, hematemesis, increased urinary frequency, dysuria, hematuria, and the appearance of blisters, was treated with intravenous fluid therapy and supportive care. Since our patient easily obtained his dose at a hippie gathering, we may encounter such poisonings more frequently.
Cloning of the α–adducin gene from the Huntington's disease candidate region of chromosome 4 by exon amplification
Authors: S.A.M. Taylor, R.G. Snell, A. Buckler, C. Ambrose, M. Duyao, D. Church, C.S. Lin, M. Altherr, G.P. Bates, N. Groot, G. Barnes, D.J. Shaw, H. Lehrach, J.J. Wasmuth, P.S. Harper, D.E. Housman, M.E. MacDonald, J.F. Gusella
Journal: Nature Genetics (1992)
Constitutively Active Lck Kinase in T Cells Drives Antigen Receptor Signal Transduction
Authors: Konstantina Nika, Cristiana Soldani, Mogjiborahman Salek, Wolfgang Paster, Adrian Gray, Ruth Etzensperger, Lars Fugger, Paolo Polzella, Vincenzo Cerundolo, Omer Dushek, Thomas Höfer, Antonella Viola, Oreste Acuto
Journal: Immunity (2010)

T cell antigen receptor (TCR) and coreceptor ligation is thought to initiate signal transduction by inducing activation of the kinase Lck.Here we showed that catalytically active Lck was present in unstimulated naive T cells and thymocytes and was readily detectable in these cells in lymphoid organs.In naive T cells up to ∼40% of total Lck was constitutively activated, part of which was also phosphorylated on the C-terminal inhibitory site.Formation of activated Lck was independent of TCR and coreceptors but required Lck catalytic activity and its maintenance relied on monitoring by the HSP90-CDC37 chaperone complex to avoid degradation.The amount of activated Lck did not change after TCR and coreceptor engagement; however it determined the extent of TCR-ζ phosphorylation.Our findings suggest a dynamic regulation of Lck activity that can be promptly utilized to initiate T cell activation and have implications for signaling by other immune receptors.
Multicenter Analysis of 80 Solid Organ Transplantation Recipients With Post-Transplantation Lymphoproliferative Disease: Outcomes and Prognostic Factors in the Modern Era
Authors: Andrew M. Evens, Kevin A. David, Irene Helenowski, Beverly Nelson, Dixon Kaufman, Sheetal M. Kircher, Alla Gimelfarb, Elise Hattersley, Lauren A. Mauro, Borko Jovanovic, Amy Chadburn, Patrick Stiff, Jane N. Winter, Jayesh Mehta, Koen Van Besien, Stephanie Gregory, Leo I. Gordon, Jamile M. Shammo, Scott E. Smith, Sonali M. Smith
Journal: Journal of Clinical Oncology (2010)

PURPOSE Adult post-transplantation lymphoproliferative disease (PTLD) has a reported 3-year overall survival (OS) of 35% to 40%. The impact of rituximab on the outcome of PTLD is not well defined. METHODS We examined the clinical features and outcomes among a large cohort of solid organ transplantation (SOT) -related patients with PTLD who were recently treated at four Chicago institutions (from January 1998 to January 2008). Results Eighty patients with PTLD were identified who had a median SOT-to-PTLD time of 48 months (range, 1 to 216 months). All patients had reduction of immunosuppression as part of initial therapy, whereas 59 (74%) of 80 patients received concurrent first-line rituximab with or without chemotherapy. During 40-month median follow-up, 3-year progression-free survival (PFS) for all patients was 57%, and the 3-year overall survival (OS) rate was 62%. Patients who received rituximab-based therapy as part of initial treatment had 3-year PFS of 70% and OS 73% compared with 21% (P < .0001) and 33% (P = .0001), respectively, without rituximab. Notably, of all relapses, only 9% (4 of 34 patients) occurred beyond 12 months from PTLD diagnosis. On multivariate regression analysis, three factors were associated with progression and survival: CNS involvement (PFS, 4.70; P = .01; OS, 3.61; P = .04), bone marrow involvement (PFS, 2.95; P = .03; OS, 3.14; P = .03), and hypoalbuminemia (PFS, 2.96; P = .05; OS, 3.64; P = .04). Furthermore, a survival model by multivariate CART analysis that was based on number of adverse factors present (ie, 0, 1, > or = 2) was formed: 3-year PFS rates were 84%, 66%, 7%, respectively, and 3-year OS rates were 93%, 68%, 11%, respectively (P < .0001). CONCLUSION This large, multicenter, retrospective analysis suggests significantly improved PFS and OS associated with early rituximab-based treatment in PTLD. In addition, clinical factors at diagnosis identified patients with markedly divergent outcomes.
Risk of gastric or peritoneal recurrence, and long-term outcomes, following pancreatic cancer resection with preoperative endosonographically guided fine needle aspiration
Authors: S. Ngamruengphong, C. Xu, T. Woodward, M. Raimondo, J. Stauffer, H. Asbun, M. Wallace
Journal: Endoscopy (2013)

<b>Background and study aims: </b>There have been concerns regarding tumor cell seeding along the needle track or within the peritoneum caused by preoperative endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). The aim of this study was to evaluate whether preoperative EUS-FNA is associated with increased risk of stomach/peritoneal recurrence and whether the procedure affects long term survival. <b>Methods:</b> The records of patients diagnosed with malignant solid and cystic pancreatic neoplasms who underwent surgery with curative intent between 1996 and 2012 were reviewed. <b>Results:</b> A total of 256 patients with similar baseline characteristics were included: 48 patients in the non-EUS-FNA group and 208 in the EUS-FNA group. Recurrence data were available for 207 patients. Median length of follow-up was 23 months (range 0 – 111 months). A total of 19 patients had gastric or peritoneal recurrence; 6 (15.4 %) in the non-EUS-FNA group vs. 13 (7.7 %) in the EUS-FNA group (<i>P</i> = 0.21). Three patients had recurrence in the stomach wall: one (2.6 %) patient in the non-EUS-FNA group vs. two patients (1.2 %) in EUS-FNA group (<i>P</i> = 0.46). A total of 16 patients had peritoneal recurrence: 5 patients (12.8 %) in the non-EUS-FNA group and 11 patients (6.5 %) in the EUS-FNA group (<i>P</i> = 0.19). In a multivariate analysis, undergoing EUS-FNA was not associated with increased cancer recurrence or decreased overall survival. <b>Conclusion: </b>Pre-operative EUS-FNA was not associated with an increased rate of gastric or peritoneal cancer recurrence in patients with resected pancreatic cancer. Two patients had gastric wall recurrence following the procedure, but this may be explained by direct tumor extension. This suggests that EUS-FNA is not associated with an increased risk of needle track seeding.
Anatomy and Physiology of the Bladder, Trigone, and Urethra
Authors: Saul Boyarsky
Journal: JAMA (1972)

Already recognized as a pioneer surgeon and scientist in vesicoureteral reflux, Hutch now clarifies bladder and urethral function by his baseplate theory. Clinically, this theory has been slow in achieving acceptance, possibly due to its piecemeal presentation in the urological literature. Now, this well-illustrated monograph allows the reader to study and evaluate it. Briefly, the author presents evidence to show that the three smooth muscle layers of the bladder are fashioned for specific functions. From the middle layer, the circular fibers terminate at the bladder neck, fuse with the trigone to form a fundus ring as part of the baseplate. The middle outer longitudinal layer inserts loops of muscle into the transverse precervical arc anteriorally and into the apex of the deep trigone posteriorally, as well as sending a third component around the bladder neck anteriorally as a detrusor loop. The trigone tissues pass uninterruptedly as a middle layer of
Case of Scarlet Fever, Followed by Symptoms of Effusion on the Brain: Mercurial Treatment: Recovery
Authors: F. F. Giraud
Journal: BMJ (1846)

woman should break her leg, it will be inmputed to sowething that happened at her lying-in, and 'he doctor mnust bear the blame."But if his reputation is built on a surer basis than the mere breath of fanme, it will be certain to rise above these evil-reports, unsbaken by any such side blasts, and to remain a monument of truth alike the admiration and envy pf all who are beneath.-It is only the ignorant wtho have to fear such under-currents of slander, for in our pro- fession ignorance is indeed weakness, and " to -be weak is to be miserable, either-doing or suffering ;" but knowledge, on the contrary, is indeed power.Know- ledge, however, for every-day use, requires to be dressed.in an agreeable exterior; and if there is one thing, in fine, which will insure success in midwifery practice, it is a patient, kind, and attentive manner.There is no descriptior\ of practice to which the trite a&age' "taiter in modo fortiter in re" applies nore aptly.We should ever remember that our patients belong to that sex, who from their confiding nature, are always wont to lookl up to ours for protection and support, and we should accordingly endeavour to forget our own inconveniences in our diligent attendance upon thein at this trying and distressing period.These feelings, although they may be nurtured and fostered by that liberal education which every member of our profes- sion ought to have received, yet to be genuine they should take root in that temporary sacrifice of self to the all-absorbing interest in the sufferings of fellow creatures, which so emninently characterizes the true gentleman, the philanthropist, and the cbristian.
Postlicensure Safety Surveillance for Varicella Vaccine
Authors: Robert P. Wise
Journal: JAMA (2000)

Since its licensure in 1995, the extensive use of varicella vaccine and close surveillance of the associated anecdotal reports of suspected adverse effects provide the opportunity to detect potential risks not observed before licensure because of the relatively small sample size and other limitations of clinical trials.To detect potential hazards, including rare events, associated with varicella vaccine, and to assess case reports for clinical and epidemiological implications.Postlicensure case-series study of suspected vaccine adverse events reported to the US Vaccine Adverse Event Reporting System (VAERS) from March 17, 1995, through July 25, 1998.Numbers of reported adverse events, proportions, and reporting rates (reports per 100,000 doses distributed).VAERS received 6574 case reports of adverse events in recipients of varicella vaccine, a rate of 67.5 reports per 100,000 doses sold. Approximately 4% of reports described serious adverse events, including 14 deaths. The most frequently reported adverse events were rashes, possible vaccine failures, and injection site reactions. Misinterpretation of varicella serology after vaccination appeared to account for 17% of reports of possible vaccine failures. Among 251 patients with herpes zoster, 14 had the vaccine strain of varicella zoster virus (VZV), while 12 had the wild-type virus. None of 30 anaphylaxis cases was fatal. An immunodeficient patient with pneumonia had the vaccine strain of VZV in a lung biopsy. Pregnant women occasionally received varicella vaccine through confusion with varicella zoster immunoglobulin. Although the role of varicella vaccine remained unproven in most serious adverse event reports, there were a few positive rechallenge reports and consistency of many cases with syndromes recognized as complications of natural varicella.Most of the reported adverse events associated with varicella vaccine are minor, and serious risks appear to be rare. We could not confirm a vaccine etiology for most of the reported serious events; several will require further study to clarify whether varicella vaccine plays a role. Education is needed to ensure appropriate use of varicella serologic assays and to eliminate confusion between varicella vaccine and varicella zoster immunoglobulin. JAMA. 2000;284:1271-1279
Clinical Diagnosis of Cutaneous Malignant Melanoma
Authors: Wallace H. Clark
Journal: JAMA (1976)

Proper management of the cutaneous pigmented lesion is of concern to virtually every clinician. The initial step, and one of the most important steps, in the management of pigmented lesions is clinical diagnosis. Paramount among the various possible diagnoses, because of its potential life threat, is malignant melanoma. Probably the majority of physicians are unaware that primary cutaneous malignant melanomas, even in their initial stages of development, usually have a distinctive appearance that should result in considerable accuracy in clinical diagnosis. Proper clinical diagnosis in the early developmental stages of the various forms of cutaneous malignant melanoma should result in a series of diagnostic and therapeutic procedures that should result in a high cure rate for this disease (a disease once regarded as one of the more formidable neoplasms to affect man, a reputation undeserved in the light of recent studies<sup>1,2</sup>). Kopf et al, in a recent article,<sup>3</sup>
Three-dimensional echocardiographic comparison of right ventricular mass and volumes following trans vs. non-transannullar patch repair in post-operative patients with Tetralogy of Fallot
Authors: R.E. Kardon, C. Laskari, P. Acar, J. Rnodes, Q.L. Cao, A.K. Jacques, N.G. Pandian, K.G. Warner, G.R. Marx
Journal: Journal of the American College of Cardiology (1998)