tbuckley/cabot-search huggingface dataset:
IDDM Accompanied by a Growth Hormone-Producing Pituitary Adenoma: A case report
Authors: Fumio Otsuka, Toshio Ogura, Takayoshi Yamauchi, Kenichi Shikata, Jingo Kageyama, Hirofumi Makino
Journal: Diabetes Care (1997)

CASE HISTORY A 30-year-old Japanese man who presented with recurrent ketoacidosis caused by IDDM was found to have increased secretion of growth hormone (GH). On initial cranial magnetic resonance imaging (MRI), no pituitary lesion was detected; however, a pituitary microadenoma was found 2 years later during a repeat MRI. In spite of the hypersecretion of GH, serum IGF-I was dramatically suppressed. Transsphenoidal surgery was performed to resect the pituitary tumor that was histologically an acidophilic pituitary adenoma. Although the GH excess rapidly improved postoperatively, the IGF-I level remained low. Subsequent insulin therapy initiated 1 year after the operation elevated the serum IGF-I level to within the normal range. DISCUSSION The first case of coexistent IDDM and a GH-producing pituitary adenoma suggests that patients with uncontrolled IDDM may develop GH hypersecretion. Furthermore, the low IGF-I levels may be closely associated with the GH excess and with the development or progression of GH-secreting pituitary adenomas.
Abstract C57: The role of stromal cells in tumor metastases
Authors: Annique Duyverman, Dan G. Duda, Ernst J.A. Steller, Dai Fukumura, Rakesh K. Jain
Journal: Cancer Research (2009)

Abstract Background: In 1889, Stephen Paget hypothesized that metastatic cells - the “seeds” - only grow in the secondary sites - the soil” - with a permissive microenvironment. Here, we show that the “seeds” can carry their own “soil” - activated fibroblasts from primary site of metastatic tumors. Moreover, we report that carryover of these non-malignant host-derived cells during metastatic cell colonization in the lungs can increase cancer's metastatic efficiency. Materials and Methods: We use multiple animal models and two lung tumor cell lines (LLC1 and LA-P0297) to study the composition, origin and role of fragments shed by tumors in the metastatic process. Results: We have shown that, in addition to single cells (81%), tumors shed fragments consisting of both tumor and host cells. We show that these fragments are more viable in the circulation compared to tumor cells alone (p&amp;lt;0.05).When we selectively deplete the host cells in the tumor microenvironment the spontaneous formation of metastases is significantly reduced three weeks after primary tumor resection compared to control mice (p&amp;lt;0.05). Next, survival was significantly increased when we deplete host-cells in mice with metastases after co-implantation of CAFs with LLC1, but had no effect in mice implanted with cancer cells alone (p&amp;lt;0.01) Lastly, we have assessed the nature of these host stromal cells using immunohistochemistry and RT-PCR and identified them being of fibroblast origin. Discussion: We found that tumor-associated stromal cells can escape primary tumors along with cancer cells, survive in blood circulation and in metastatic nodules. Pre-existence of a tissue-like structure in the form of heterotypic cell fragments may increase the viability of cancer cells in blood circulation and modulate metastasic efficiency. How this mechanism contributes to the organo-tropism of certain metastatic tumors is not known, but demonstration of the involvement of tumor “soil” in both the primary tumor as well as the metastatic site, has important conceptual and clinical implications for colonization during metastasis progression. Citation Information: Cancer Res 2009;69(23 Suppl):C57.
GM‐CSF‐mediated impairment of liver to synthesize albumin, cholinesterase, and cholesterol
Authors: Masuhiro Takahashi, Kohji Nikkuni, Yoshiaki Moriyama, Akira Shibata
Journal: American Journal of Hematology (1991)

Abstract Serum albumin, cholinesterase, and cholesterol were measured in ten patients with aplastic anemia and eight with myelodysplastic syndrome who received the administration of recombinant human GM‐CSF. Serum albumin, cholinesterase, and cholesterol were significantly lowered by the administration of GM‐CSF and recovered after the cessation of GM‐CSF. These data suggest that GM‐CSF impairs the biosynthesis of liver cells and that cholesterol‐lowering activity of GM‐CSF, which is previously reported, is due to the impairment of liver biosynthesis by GM‐CSF.
Adjustment of Reflex Bradycardia to Elevated Arterial Pressure in Conscious Rabbits
Authors: Natalie Alexander, Marjorie De Cuir
Journal: Circulation Research (1962)

Angiotensin was infused into intact, conscious rabbits to produce a continuous, moderate elevation of arterial pressure. The reflex cardiac rate response was studied. Within two hours of initial drop in heart rate, average time 37 minutes for 13 rabbits, the heart rate began to rise. The rates of rise were between 1.2 and 6.0 per cent of the initial drop per minute. Thus, in the presence of elevated arterial pressure, the cardiac reflex mechanism can adjust so that heart rate reaches control values within an average time of one hour in most animals. One additional animal showed no tendency for adjustment in over seven hours of infusion. The time between start of heart rate rise and restoration of 50 per cent of the initial drop was directly related to the sensitivity of the initial reflex response, i.e., heart rate drop per mm. Hg increase in diastolic pressure. Most of the animals developed a postinfusion tachycardia which was directly related to the amount of increase in heart rate attained by the end of the infusion. We conclude that in the presence of continuously elevated arterial pressure, the reflex cardiac slowing mechanism can adjust within a relatively short time, and the evidence that this represents a resetting of the mechanism within the central nervous system is discussed.
Sensitivity and Specificity of Death Certificates for Diabetes
Authors: W. Susan Cheng, Deborah L. Wingard, Donna Kritz-Silverstein, Elizabeth Barrett-Connor
Journal: Diabetes Care (2008)

OBJECTIVE—Diabetes is the sixth leading cause of death in U.S adults, which may be an underestimate because of under-reporting on death certificates. In this study we examined death certificate sensitivity and specificity for diabetes, as well as the factors related to better reporting, in a community-based sample. RESEARCH DESIGN AND METHODS—Death certificates were obtained for 3,209 decedents who were enrolled in the Rancho Bernardo cohort in 1972–1974 and followed through 2003. Diabetes status was reassessed at periodic clinic visits and annual mailed surveys during an average follow-up of 15.2 ± 7.6 years. Diabetes reported anywhere on death certificates was abstracted. Sensitivity and specificity calculations among diabetic participants were stratified by age, sex, year, place, cause of death, and diabetes medication use. RESULTS—Among 1,641 men and 1,568 women, 378 decedents had a history of diabetes, 168 of whom had diabetes listed anywhere on their death certificates. The sensitivity and specificity were 34.7 and 98.1%. Diabetes reporting on death certificates did not improve over time or vary significantly by age and sex, but sensitivity for diabetes reporting was better for recent (1992–2003) cardiovascular disease (CVD) deaths compared with any other causes of death (48.9 vs. 28.6%, respectively, P &amp;lt; 0.05). CONCLUSIONS—Although diabetes reporting on death certificates did not improve over time, sensitivity was better for diabetes in the context of CVD deaths, probably reflecting the increasing recognition that diabetes is a major cardiovascular risk factor.
Names for mycobacteria.
Authors: C H Collins, M D Yates, J M Grange
Journal: BMJ (1984)

To the founding fathers of bacteriology the nomenclature of pathogens was straightforward. Tuberculosis was caused by the tubercle bacillus and leprosy was caused by the leprosy bacillus and when these pathogens were allocated to the genus Myco bacteriwn this posed no problem, they merely became M tuberculosis and M leprae. This golden age of simplicity in nomenclature was, however, short lived as it soon became apparent that tubercle bacilli were not all identical and that some tuberculosis-like infections were caused by other myco bacterial species that normally existed as saprophytes in the inanimate environment. In our experience mycobacterial nomenclature is a frequent source of confusion to physicians and we will thus attempt to shed some light on this subject.
Poliomyelitis in Mother and Child in Trieste
Authors: A. E. Read
Journal: BMJ (1954)

~~~~~~~~MEDICAL JOURNALextremely low or no excretion of 17-ketosteroids, and after injection of insulin under controlled conditions delay of blood sugar in returning to normal.The 17-ketosteroid output was often low in anorexia nervosa, but in no case entirely absent.Although neither test is specific, they believe that tke combination of both enables a diagnosis of pan-hypopituitarism to be made with fair accuracy (Hemphill, 1944).In the above case the 17-ketosteroid excretion was 5.8 mg. a day (normal range, 4-20 mg. a day).The insulin-tolerance test showed no delay in the return of the blood sugar to normal after 120 minutes (see Table II).It would therefore seem that the pituitary was functioning normally.TABLE II.-Insulin-tolerance Test (0.3 Unit per kg.Body Weight Given Intravenously at 7.15 a.m.) Blood Taken Result (g./100 ml.)Before insulin given . .
P2-216: Induction chemoradiation and complete surgical resection provide better survival for non-small-cell lung carcinomas of the superior sulcus
Authors: Tetsuzo Tagawa, Koji Yamazaki, Tatsuro Okamoto, Takuro Kometani, Hiroshi Wataya, Takashi Seto, Yukito Ichinose
Journal: Journal of Thoracic Oncology (2007)
Interstate Outbreak of Salmonella newbrunswick Infection Traced to Powdered Milk
Authors: Richard N. Collins
Journal: JAMA (1968)

During the investigation of an interstate outbreak of gastroenteritis due to<i>Salmonella newbrunswick</i>, epidemiologic data led to the hypothesis that instant nonfat dry milk was the vehicle of infection. The same serotype was isolated from shelf samples of the product and from a single large milk-drying plant where equipment and processing were conductive to introduction and spread of salmonellae. Subsequent surveys of milk-drying plants in various states resulted in isolation of numerous<i>Salmonella</i>serotypes from dried milk products. Instant nonfat dry milk should be considered to be a possible source of infection in future epidemiologic investigations of cases of human salmonellosis.
STUDIES ON THE IMMUNE RESPONSE OF THE RHEUMATIC SUBJECT AND ITS RELATIONSHIP TO ACTIVITY OF THE RHEUMATIC PROCESS. VI. THE SIGNIFICANCE OF THE RISE OF ANTISTREPTOLYSIN LEVEL IN THE DEVELOPMENT OF RHEUMATIC ACTIVITY 1
Authors: Alvin F. Coburn, Ruth H. Pauli
Journal: Journal of Clinical Investigation (1935)

The authors have observed that respiratory infection with a strain of hemolytic streptococcus producing strong toxin is not invariably followed by rheumatic recrudescence 2 in a susceptible sub- ject.This observation has been made under sev- eral different circumstances.(a) Two rheumatic children escaped rheumatic activity in spite of infection with a strain of hemolytic streptococcus that produced severe recrudescences in fourteen others living in the same home (1). (b) In- fections with a scarlatinal strain of hemolytic streptococcus, occurring simultaneously in two rheumatic siblings were followed by rheumatic attacks, one of which was severe and prolonged, the other extremely mild (2).(c) Scarlet fever in one rheumatic subject under close observation was followed by only mild carditis.(d) Several of the strains described in the fourth paper of this series (2) produced strong toxin and streptolysin but were not effective in initiating recrudes- cences.The one characteristic common to all of these individuals who escaped attacks was the failure to develop a significant rise in antistreptolysin titer.The present paper deals with the significance of changes in antistreptolysin level in the rheu- matic subject.The natural antistreptolysin level and the average range in good hea-lth It has already been shown (3) that the natural antistreptolysin level in subjects who have been free of hemolytic streptococcus infection is ap-
Industry group suspends drug company for breaching code
Authors: Owen Dyer
Journal: BMJ (2006)

Merck Sharp & Dohme UK (MSD) has been suspended from the Association of the British Pharmaceutical Industry for offering a blood pressure testing service only to doctors who prescribed the company's hypertension drug losartan (Cozaar).

The company, the British subsidiary of Merck, was found to have committed serious breaches of the industry watchdog's code of practice. Clause 2 of …
Letter: prophylaxis against deep vein thrombosis.
Authors: L T Cotton, V C Roberts
Journal: BMJ (1975)

They might, for example, have mentioned the reviewed series of over 2000 patients in seven clinical trials in which embolisom (25 cases) was detected only within that group, making up 25 % of the total, who had positive I.F.T.s.4We ihave screened more t,han 700 surgical patients.The overall incidence of D.V.T. wuas 32%, of clinicalily detectaible D.V.T. approximately 10%/, of symptomatic pul- monary embolisim 2%, and of fatal embolismn 03%.We have detected neither D.V.T.
Left Ventricular Response to Exercise in Regular Runners and Controls
Authors: MASOOD AHMAD, JERZY P. DUBIEL
Journal: Clinical Nuclear Medicine (1990)

Radionuclide angiography was performed during upright exercise to compare left ventricular function in nine regular runners to nine age-matched, healthy controls. Heart rate, blood pressure, left ventricular ejection fraction (LVEF), end diastolic volume index (EDVI), end systolic volume index (ESVI), and stroke volume index (SVI) were measured at rest and at 40%, 60%, 80%, and 100% of maximum work capacity (mean maximal workload [KPM ± SD] was 1,773 ± 157 in runners and 1,260 ± 324 in controls). The resting data of runners and controls were similar. There were no significant differences in heart rate, systolic blood pressure, and LVEF between runners and controls during exercise. SVI and EDVI were higher in runners during exercise (P<0.05). ESVI was lower in controls at a 60% level of exercise (P<0.05). The data indicate that an early and sustained increase in the diastolic volume of the left ventricle is important for enhanced cardiac performance of regular runners during exercise
Cleavage of Misfolded Nuclear Receptor Corepressor Confers Resistance to Unfolded Protein Response–Induced Apoptosis
Authors: Angela Ping Ping Ng, Jek Howe Fong, Dawn Sijin Nin, Jayshree L. Hirpara, Norio Asou, Chien-Shing Chen, Shazib Pervaiz, Matiullah Khan
Journal: Cancer Research (2006)

Abstract We have recently reported that accumulation of misfolded nuclear hormone receptor corepressor (N-CoR) as insoluble protein aggregates in acute promyelocytic leukemia (APL) cells induces endoplasmic reticulum (ER) stress and activates unfolded protein response (UPR). Although accumulation of misfolded proteins is known to trigger UPR-induced cytotoxic cell death in several neurodegenerative disorders, APL cells are notably resistant to UPR-induced apoptosis. The molecular basis for the paradoxical response of APL cells to UPR is not known. Here, we report that a glycoprotease, selectively expressed in APL cells, regulates the response of APL cells to UPR-induced apoptosis through processing of misfolded N-CoR protein. Results show that misfolded N-CoR is cleaved selectively in APL cells, and cellular extracts of APL cells and human primary APL cells contain activity that cleaves N-CoR protein. Purification and spectrometric analysis of N-CoR cleaving activity from an APL cell line reveals that it is a glycoprotein endopeptidase known as OSGEP. Furthermore, the cleavage of N-CoR in APL cells could be blocked by the broad-spectrum protease inhibitor AEBSF and by RNA interference–mediated down-regulation of OSGEP expression. AEBSF selectively inhibits growth and promotes apoptosis of APL cells possibly through a mechanism involving AEBSF-induced accumulation of insoluble N-CoR protein and by triggering ER stress. Taken together, these findings suggest that selective induction of protease activity in APL cells may represent a novel cytoprotective component of UPR, which could be exploited by tumor cells to survive the toxic insult of misfolded protein(s). (Cancer Res 2006; 66(20): 9903-12)
Transgastrostomic endoscopy-assisted endoscopic submucosal dissection
Authors: S. Nishiwaki, H. Araki, Y. Shirakami, Y. Niwa, M. Iwashita, H. Hatakeyama, K. Saitoh
Journal: Endoscopy (2009)

Endoscopic submucosal dissection (ESD) allows large-sized superficial gastric tumors to be obtained en-bloc [1]. One of the technical problems in ESD is the difficulty of maintaining a clear view of the submucosal layer of the gastric wall during the procedure. We report our experience of ESD assisted by transgastrostomic endoscopy (TGE) in five patients with gastric tumors (three well-differentiated adenocarcinoma, one adenoma, and one carcinoid tumor) after percutaneous endoscopic gastrostomy.
Cardiac arrhythmias in thalassaemia major: evaluation of chelation treatment using ambulatory monitoring.
Authors: S B Kaye, M Owen
Journal: BMJ (1978)

found post mortem.The presence of a higher end-diastolic pressure in the left ventricle in our patient is very suggestive of myocardial restriction.4Late onset pericardial constriction has been reported only in one case,5 and, like the case reported here, pericardiectomy led to improvement.This case report shows that the absence of clinical findings within five years does not preclude the later development of significant radiation-induced heart disease.
Activity of gentamicin against Pseudomonas and hospital Staphylococci.
Authors: M. Barber, P. M. Waterworth
Journal: BMJ (1966)

Gentamicin is a new basic antibiotic complex isolated from an actinomycete, Microrn?nospora purpurea, in the Research Laboratories of the Schering Corporation, New Jersey. It consists of two components, referred to as gentamicin Q and gentamicin C2, which are closely related in structure and have a similar antibacterial spectrum. Both substances contain a 2-deoxystreptamine component and are chemically related to the streptomycin group of antibiotics (Rosselet et al., 1963). Gentamicin is supplied as the sulphate, which is a white powder readily soluble in water. Gentamicin has been shown to be bactericidal in vitro against a wide range of Gram-positive and Gram-negative bacteria, including hospital drug-resistant strains of Staphylococcus aureus and coliform bacilli, and has outstanding activity against Pseudomonas pyocyanea (see White, 1963 ; Weinstein et al., 1963 ; Rubenis et al., 1963 ; Rabinovich et al., 1963). Early clinical trials showed that the antibiotic is effective in the treatment of infections of the urinary tract due to many Gram-negative bacilli, including Ps. pyocyanea (Bulger et ed., 1963 ; Jao and Jackson, 1963 ; Bray ton and Louria, 1964 ; Klein et al., 1964), but if the blood level rises to about 15 /xg./ml. or more there is a danger of severe vestibular damage (Jao and Jackson, 1964). Stone et al. (1964, 1965) reported the successful treatment of severe burns with Ps. pyocyanea septicaemia, both systemic treatment and local gentamicin ointment being used. The present investigation was undertaken in order to compare the activity of gentamicin with that of other streptomycin-like antibiotics against strains of Staph. aureus and coliform bacilli isolated in a British hospital.
Osteoporotic fractures Target whole population for prevention
Authors: M H Duncan
Journal: BMJ (1994)

a much higher percentage of people receives specialist inpatient palliative care.Many more people receive specialist palliative care in their home or in hospital.The results of the survey for 1992, which are being collated now, include the number of patients seen by home care nurses.Questionnaires were sent to the 360 teams listed in a directory of hospice and palliative care services.3Altogether 198 teams replied that they had seen 54816 patients during the year.This implies that, with 360 teams, about 99 000 patients were seen by a home care service.It thus seems that almost two thirds of patients dying of cancer are seen by specialist home care (including Macmillan) nurses.Yet more patients are seen by hospital support (palliative care) staff, and we hope to estimate this figure in a future survey.The palliative care services do reach a considerable proportion of people in need of palliative care, including more than half ofthose dying of cancer.
Bronchoalveolar lavage fluid cell counts in cryptogenic fibrosing alveolitis and their relation to therapy.
Authors: P L Haslam, C W Turton, A Lukoszek, A J Salsbury, A Dewar, J V Collins, M Turner-Warwick
Journal: Thorax (1980)

Bronchoalveolar lavage was used to sample inflammatory cells from the lungs of 51 patients with cryptogenic fibrosing alveolitis (CFA) (24 smokers, 12 ex-smokers, and 15 non-smokers). The smokers with CFA have been compared with 15 smoking control subjects in whom there was no radiographic abnormality or clinical evidence of chronic bronchitis. Significantly lower volumes of lavage fluid were recovered from the smokers with CFA (p < 0.001) and the fluid contained lower percentages of macrophages (p < 0.01), reflecting increased percentages of eosinophils (p < 0.001) and neutrophils (p < 0.01). Similar changes were seen in the ex-smokers and non-smokers. There was also an increase in the percentages of lymphocytes when the whole group of CFA patients was compared with the control subjects (p less than or equal to 0.05). No significant differences were found when patients with "lone" CFA were compared with those having associated systemic disease. The only feature distinguishing smokers from non-smokers with CFA was the presence of pigmented cytoplasmic inclusions in the macrophages from the smokers (p < 0.001). However, there were lower numbers of pigmented macrophages in the smoking CFA patients by comparison with the control subjects suggesting either a change in phagocytic capacity or turnover rate in this disease. Profiles of differential cell counts in individual patients showed that increases of eosinophils over 3% or neutrophils over 4% or both with lymphocyte counts of less than 11% related to a poor clinical response to corticosteroids, but lymphocyte percentages greater than 11% related to improvement (p < 0.05).
GPs' earnings fall by 2% in third year of new contract
Authors: J. Wise
Journal: BMJ (2008)

Average earnings before tax of GPs in the United Kingdom fell in 2006-7 by 2.1% from the previous year, to £107 667 (€136 367; $185 241), says a report published this week.

An analysis of tax returns by the NHS Information Centre found that the average gross earnings of GPs on the general medical services (GMS) or primary medical services (PMS) contract rose by 1% to £247 362 in 2006-7. However, this rise was more than offset by the 3.5% increase in the cost of running a practice, with average expenses rising to £139 694 for the year.

The provisional figures …
Somatic mutations and germline sequence variants in the expressed tyrosine kinase genes of patients with de novo acute myeloid leukemia
Authors: Michael H. Tomasson, Zhifu Xiang, Richard Walgren, Yu Zhao, Yumi Kasai, Tracie Miner, Rhonda E. Ries, Olga Lubman, Daved H. Fremont, Michael D. McLellan, Jacqueline E. Payton, Peter Westervelt, John F. DiPersio, Daniel C. Link, Matthew J. Walter, Timothy A. Graubert, Mark Watson, Jack Baty, Sharon Heath, William D. Shannon, Rakesh Nagarajan, Clara D. Bloomfield, Elaine R. Mardis, Richard K. Wilson, Timothy J. Ley
Journal: Blood (2008)