tbuckley/cabot-search huggingface dataset:
Cellular mechanisms of myocardial infarct expansion.
Authors: H F Weisman, D E Bush, J A Mannisi, M L Weisfeldt, B Healy
Journal: Circulation (1988)

Infarct expansion is acute regional dilatation and thinning of the infarct zone. There are several possibilities for the mechanism of this alteration in cardiac shape: thinning could be caused by 1) cell rupture, 2) a reduction in the intercellular space, or 3) stretching of myocytes or 4) slippage of groups of myocytes so that less cells are distributed across the wall. To determine the relative contributions of these cellular mechanisms of wall thinning and dilatation, detailed study of transverse histological sections of rat hearts with infarct expansion was performed 1, 2, and 3 days after coronary ligation. The number of cells across the wall was determined in six regions within, adjacent to, and remote from the infarct. Cell counting was performed so that the total number of cells across the wall and the number of cells per unit length (cell density) across the wall were determined. The transmural cell count and the cell density were correlated with the wall thickness in each region. Myocyte cross-sectional areas and sarcomere lengths were also measured. The results from the infarct expansion hearts were compared with those of sham-operated control hearts that had been similarly analyzed. To ensure that mechanisms identified in the rat were applicable to human infarct expansion, five hearts from patients who died within 3 days of infarction and two hearts from patients without coronary disease were studied histologically in a similar fashion. Wall thinning occurred in all regions of the rat infarct expansion hearts compared with controls (p less than 0.0001) but, as expected, was most pronounced in the infarct zone. A decrease in the number of cells across the wall accompanied the wall thinning at each site (p less than 0.0001), and this change in cell number was highly correlated with the changes in wall thickness (r = 0.915, p less than 0.001). Cell density increased from controls only within the infarct zone (p less than 0.001) and accounted for at most 20% of the thinning in that region. The change in cell density was attributable to both cell stretch (measured by increased sarcomere length and decreased myocyte cross-sectional area) and a decrease in the intercellular space. A similar strong correlation between wall thinning and decreased number of cells across the wall was identified in the human hearts (r = 0.94, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
Cardiac hypertrophy impairs recovery from ischaemia because there is a reduced reactive hyperaemic response
Authors: A. M. McAinsh, M. A. Turner, D. O'Hare, R. Nithythyananthan, D. G. Johnston, D. J. O'Gorman, D. J. Sheridan
Journal: Cardiovascular Research (1995)

The aim was to investigate whether impaired coronary flow reserve associated with cardiac hypertrophy could significantly limit the flow debt repayment following short periods of coronary occlusion and exacerbate or prolong episodes of myocardial ischaemia.Left ventricular hypertrophy was induced in guinea pigs by aortic constriction and the hearts were isolated six weeks later for Langendorff perfusion. Sham operated animals served as controls. The reactive hyperaemic response was studied following various lengths of occlusion of flow and the extent of aerobic and anaerobic metabolism was assessed in each group.Heart weight/body weight ratio was increased by approximately 25% (P < 0.001) with aortic constriction. The reactive hyperaemic flow response in isolated hearts was impaired by hypertrophy in both magnitude (P < 0.05) and duration. The repayment of flow debt was also significantly reduced, suggesting an inadequate recovery of the myocardium following the occlusion. The total amount of O2 consumed by the heart throughout the duration of hyperaemia was less in hypertrophy than in sham operated controls, suggesting a decrease in aerobic metabolism. Total lactate discharge expressed as a ratio of O2 consumed, which provides an estimation of the degree of anaerobic in relation to aerobic metabolism, was greater in hypertrophy than in sham operated controls.The hypertrophied heart is more vulnerable to brief periods of ischaemia because of an impaired reactive hyperaemic response which results in delayed metabolic recovery. These abnormalities may contribute to the increased morbidity associated with cardiac hypertrophy.
Residencies Roll Out New Training System
Authors: Mike Mitka
Journal: JAMA (2013)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
PWE-136 Hepatocellular Cancer Detected In The Cirrhosis Surveillance Programme Have Better Outcomes Than Those Diagnosed Symptomatically
Authors: F Clegg, L Bailey, P Ramachandran, P Dundas, S English, L McLeman, B Vijayan, A Fraser, A Mukhopadhya
Journal: Gut (2014)

<h3>Introduction</h3> Hepatocellular cancer (HCC) is a recognised complication of liver cirrhosis.<sup>1</sup> The cause of liver cirrhosis is varied, but the prevalence of certain conditions like non-alcoholic fatty liver disease (NAFLD) is rising.<sup>2</sup> This study aimed to identify the time trends of HCC over the last 10 years focusing on the aetiopathology of cirrhosis and modality of diagnosis. Hepatoma surveillance clinics have been established within the last 10 years, wherein cirrhotic patients are screened 6 monthly with ultrasound and alpha fetoprotein. We also aimed to compare the clinical characteristics of patients identified by this surveillance programme with those diagnosed when they presented with symptoms. <h3>Methods</h3> Symptomatic HCC cases were identified by review of medical records coding with “Hepatocellular carcinoma” and the HPB multidisciplinary team meeting lists between 1/1/04 and 31/12/13. The hepatoma screening programme records were accessed to identify cases detected on routine screening. Electronic patient records were used to identify the underlying pathology, date of diagnosis, date of death and other baseline data. <h3>Results</h3> During this ten year period 146 individuals were diagnosed with HCC of which 25 cases were detected by the surveillance programme. The mean incidence of HCC rose from 11.6/year during the period 2003–08 to 17.6/year in the years 2009–13. NAFLD was the most prevalent pathology in all years, but showed no significant change in incidence between these two time periods (42.1 vs. 36.6%). The mean age at diagnosis in the screened group was significantly lower (57.1 ± 8.3) than symptomatic (69 ± 9.7; p &lt; 0.001). The rate of curative therapy (Resection, OLT) was higher in the screening group as opposed to the symptomatic (24 vs. 7.2%) as also palliative therapy (TACE, RFA) (20 vs. 13.5%). Transplant free survival was greater at 1 and 3 years in the screened group (35 vs. 25.5%; 20 vs. 8.2%), but no significant difference was noted at 5 years (0 vs. 2%). <h3>Conclusion</h3> We demonstrated a significant increase in incidence of HCC within our population in the last five years in keeping with other published studies,<sup>2</sup> but no increase in NAFLD-related hepatoma. Within our population we have been able to show a positive effect of the hepatoma screening programme in terms of early age of diagnosis, suitability for a therapeutic option and better short and medium term survival rates. <h3>References</h3> Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. <i>Gastroenterology</i> 2004;127(1):S35-S50 Davila JA, El-Serag HB. The rising incidence of hepatocellular carcinoma in the United States: an update. <i>Gastroenterology</i> 2012;142(1):S914 <h3>Disclosure of Interest</h3> None Declared.
The Association of Military Surgeons of the Wisconsin National Guard.
Authors: Ralph Chandler
Journal: JAMA (1891)

<h3>To the Editor:</h3> —In response to a call from the Surgeon-General, N. Senn, for February 26, 1891, the surgeons of the Wisconsin National Guard met in Milwaukee for the purpose of organizing an association for the advancement of military and accidental surgery and to be called "The Association of Military Surgeons of the Wisconsin National Guard." The work of the Association will be clinical, experimental, original, etc., pertaining to military surgery. Surgeon-General Nicholas Senn was elected President; Major F. J. Wilkes, 2nd Reg. W. N. G., Vice-President; Lieutenant Ralph Chandler, 1st Light Battery W. N. G., Secretary and Treasurer. The surgeons responded to a man. The Association has a membership of fifteen and will meet once every four months. The day was spent very profitably in clinical work at the Milwaukee Hospital, Soldier's Home Hospital, and in demonstrative and experimental work in intestinal surgery and gun-shot wounds of the abdomen,
Home visiting by general practitioners in England and Wales
Authors: P. Aylin, F A. Majeed, D. G Cook
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To use data from the fourth national survey of morbidity in general practice to investigate the association between home visiting rates and patients9 characteristics. <b>Design</b>: Survey of diagnostic data on all home visits by general practitioners. <b>Setting</b>: 60 general practices in England and Wales. <b>Subjects</b>: 502 493 patients visited at home between September 1991 and August 1992. <b>Main outcome measures</b>: Home visiting rates per 1000 patient years and home visiting ratios standardised for age and sex. <b>Results</b>: 10.1% (139 801/1 378 510) of contacts with general practitioners took place in patients9 homes. The average annual home visiting rate was 299/1000 patient years. Rates showed a J shaped relation with age and were lowest in people aged 16-24 years (103/1000) and highest in people aged &gt;/=85 years (3009/1000). 1.3% of patients were visited five or more times and received 39% of visits. Age and sex standardised home visiting ratios increased from 69 (95% confidence interval 68 to 70) in social class I to 129 (128 to 130) in social class V. The commonest diagnostic group was diseases of the respiratory system. In older age groups, diseases of the circulatory system was also a common diagnostic group. Standardised home visiting ratios for the 60 practices in the study varied nearly eightfold, from 28 to 218 (inter-quartile range 67 to 126). <b>Conclusions</b>: Home visits remain an important component of general practitioners9 workload. As well as the strong associations between home visiting rates and patient characteristics, there were also large differences between practices in home visiting rates. A small number of patients received a disproportionately high number of home visits. Further investigation of patients with high home visiting rates may help to explain the large differences in workload between general practices and help in allocation of resources to practices. <h3>Key messages</h3> Annual home visiting rates declined by 27% between 1981-2 and 1991-2, from 411/1000 patient years to 299/1000, suggesting that general practitioners are altering the way in which they provide care to provide less care in patients9 homes; however, home visits were responsible for 10% of all contacts with general practitioners Home visiting rates showed a J shaped relation with age and, after standardisation for age and sex, were twice as high in people from social class V as in people from social class I There was a nearly eightfold variation in age and sex standardised home visiting ratios among the 60 general practices in this study, and just over 1% of patients registered with general practitioners received nearly 40% of all home visits Further investigation of both patients and practices with high home visiting rates may help to explain the large differences in workload among general practices and also help in the allocation of resources to practices
Abstract 4472: NVP-BKM120, a pan class I PI3K inhibitor impairs microvascular permeability and tumor growth as detected by DCE-MRI and IFP measurements via radio-telemetry: Comparison with NVP-BEZ235
Authors: Christian R. Schnell, Samuel Arnal, Mike Becquet, Peter Allegrini, Charles Voliva, Robert Cozens, Carlos Garcia-Echeverria, Sauveur Michel Maira
Journal: Cancer Research (2010)

Abstract Tumor blood vessels are distinctly abnormal in structure and function. When compared to normal vessels, they are enlarged and tortuous and leaky, poorly covered by pericytes and with a defective basement membrane. VEGF is a prominent cytokine responsible for the hyperpermeable state of tumor microvasculature to plasma macromolecules. The phosphatidylinositol 3-kinase (PI3K)-Akt signaling pathway functions downstream of VEGF and can activate the production of the free radical gas nitric oxide (NO) through the enzyme endothelial NO synthase (eNOS), a key player for the in vivo biological activity of VEGF. In the present study, we investigated the effect of NVP-BKM120, a novel, synthetic low molecular mass compound, which potently inhibits class I PI3K activity, on vascular leakage in tumors and its impact on tumor progression in an orthotopic breast cancer model (BN472) in syngeneic rats. Effects on the vasculature were investigated in normal and tumor tissues with a variety of technologies: dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), tumor interstitial fluid pressure (IFP) measurements in conscious animals via radio-telemetry and a modified Miles assay, representing non invasive, minimally invasive and invasive methods, respectively. Tumor histology and western blots were used to confirm pathway inhibition. For comparison, the effect of NVP-BEZ235, a potent pan class I PI3K and mTOR activity inhibitor, was assessed head-to-head in the same experiments. BKM120 induced significant decreases in VEGF-induced vascular leakage in normal and tumor tissues. These effects were similar to those obtained following BEZ235 treatment. Western blot of total ear lysates from treated mice clearly demonstrated pathway inhibition. The inhibition of vessel permeability observed with BEZ235 and BKM120 correlated with their respective anti-tumor activities, IFP change and Ktrans (vascular permeability transfer constant measured by DCE-MRI) decrease. In conclusion, our data demonstrate that in BN472 tumors, BKM120 significantly decreases tumor microvascular leakage similar to BEZ235 at equipotent antitumor dose. Changes in Ktrans may be a useful independent clinical surrogate biomarker for NVP-BKM120 efficacy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4472.
SOCIAL CLASS, SCHIZOPHRENIA AND THE PSYCHIATRIST
Authors: ROBERT A. MOORE, ELISSA P. BENEDEK, JOHN G. WALLACE
Journal: American Journal of Psychiatry (1963)

In recent years increasing attention has focused on the effect social class has on the clinical picture of various mental disorders as well as the relation of the social class of the psychiatrist to the social class of the patient. Often there has been a tendency to confuse the effects of two variables—social class and diagnosis—on symptom complexes and the choice of who is to be treated by particular methods. To avoid this, a group of 200 schizophrenic women admitted for the first time and for at least 30 days to the Neuropsychiatric Institute of the University of Michigan Medical Center were studied. Social class was determined by the Hollingshead Two Factor Index of Social Position. Comparison of 90 upper class women (classes I, II, and III) with 110 lower class women (classes IV and V) at time of admission shows a significantly higher number of upper class women came for help because of psychic suffering (P = .01) and a significantly higher number of lower class women came because of physical suffering (P = .05). Upper class women were more anxious (P>.05) and lower class women were more likely to hallucinate (P>. 05). Once hospitalized, the psychiatrist reacted quite differently to the groups, being more likely to rely on drugs (P = .02) or having a transfer to a state hospital arranged (P<.05) for the lower class group, whereas he used psychotherapy more often with the upper class women (P>.01). The upper classes at discharge had a greater chance of being improved (P<.05). However, the crucial variable that determines the psychiatrist's reaction seems to be the patient's attitude toward the mature of her illness (psychological compared to physical or social). Comparing these attitudes, unrelated to social class, demonstrates those with a psychological view of their illness were more likely treated with psychotherapy (P = .01) and more likely to improve (P>.05). Thus, the significance of social class to the psychiatrist seems to be primarily as it influences the patient's view of her illness. The psychiatrist places great emphasis on the patient's willingness to see her illness as the psychiatrist sees it. The patient from the same social class as the psychiatrist sees her illness as he does and thus is more effectively treated by him. This demonstrates how necessary it is for psychiatrists to be more familiar with the attitudes of lower class patients toward mental illness and psychiatric treatment, if more effective treatment is to be made available.
Hepatitis C virus–like particles combined with novel adjuvant systems enhance virus-specific immune responses
Authors: Ming Qiao, Kazumoto Murata, Anthony R. Davis, Sook-Hyang Jeong, Jake T. Liang
Journal: Hepatology (2003)

We have previously described the generation of hepatitis C virus-like particles (HCV-LPs) in insect cells and shown that immunization with HCV-LPs elicited both humoral and cellular immune responses in mice. To further characterize the HCV-LPs as a vaccine candidate, we evaluated the effects of adjuvant AS01B (monophosphoryl lipid A [MPL] and QS21), CpG 10105, and the combination of the 2 adjuvants on the immunogenicity of HCV-LPs in AAD mice (transgenic for HLA-A2.1). All HCV-LP-immunized mice (with or without adjuvant) developed high titers of anti-HCV E1/E2 antibodies after 4 injections intramuscularly. However, antibody titers in mice immunized with HCV-LP plus AS01B, plus CpG 10105, or plus the combination of AS01B and CpG 10105 were 4, 3, and 10 times higher, respectively, than that of HCV-LP alone. Isotype analysis of the induced anti-envelope antibodies showed that HCV-LP alone induced a predominant immunoglobulin (Ig) G1 response. In contrast, when the 2 adjuvants AS01B and CpG 10105 were combined, the response became predominantly IgG2a whereas HCV-LP plus AS01B or CpG 10105 gave a mixed IgG1 and IgG2a response, indicating that AS01B and CpG 10105 promote a more T-helper type 1 (Th1) response and that combining the 2 adjuvants results in an additive or synergistic interaction. These observations were further confirmed by the results of CD4(+) enzyme-linked immunospot assay for interferon (IFN)-gamma and interleukin (IL)-4 and intracellular cytokine staining of IFN-gamma producing CD8(+) cells. In conclusion, HCV-LP is a promising vaccine candidate against HCV infection and the adjuvants used are potent immune enhancers for this approach.
von willebrand disease type IIC with different abnormalities of von willebrand factor in the same sibship
Authors: J. Batlle, M. F. Lopez Fernandez, J. Lasierra, A. Fernandez Villamor, C. Lopez Berges, A. Lopez Borrasca, Z. M. Ruggeri, T. S. Zimmerman
Journal: American Journal of Hematology (1986)

Abstract A family with von Willebrand disease has been identified in which different members of the same sibship exhibit different abnormalities of von Willebrand factor (vWF). The two most severely affected sibs (bleeding time over 20 min) had abnormalities of vWF similar to those seen in type IIC. The smallest detectable multimer was increased and the triplet structure of individual multimers was replaced with a single band. The largest multimers could not be detected and there were relatively more small multimers than intermediate sized forms. vWF antigen (vWF:Ag) was decreased to 12.5‐17% by electroimmunoassay (EIA) and to 3.2‐5.5% by immunoradiometric assay (IRMA). In the less severely affected sibling (bleeding time 12.5 min) there was a similar relative increase in the smallest detectable multimer. However, the larger multimers were present and the relative concentration of large to small multimers was similar to normal. The triplet structure was altered in that the relative proportion of satellite bands to the central predominant band was decreased. vWF:Ag concentrations were moderately decreased (40‐80% by EIA and 25‐35% by IRMA). The father and grandfather showed a vWF multimeric pattern similar to the less severely affected sibling but there was no decrease in vWF:Ag concentration and their bleeding times were normal. These observations suggest that the interplay of several genetic factors is responsible for the expression of von Willebrand disease in this family.
Bing's Local Diagnosis in Neurological Diseases
Authors: Benjamin Boshes
Journal: JAMA (1970)

The 15th edition of this volume comes 12 years after the previous edition in English. The recent era has been a remarkable one for the neurological sciences. The new advances have caused the modern clinical neurologist to leave his role as a symptomatologist and become a person who understands metabolic cycles, chemoanatomical pathways, and neurophysiologically related parts. To include this new knowledge Dr. Haymaker had to rewrite the entire book and add chapters. The volume, therefore, becomes a refreshing review of neuroanatomy, neurophysiology, and neurochemistry as we know them now. The references are recent and generous. The summaries particularly are meaningful as they tie difficult details into cogent wholes. The 15th edition is dedicated to Dr. Robert Wartenberg, a remarkably knowledgeable clinician, a splendid teacher, but in addition a lovable person whom the author knew well, as did the reviewer. Dr. Haymaker captures Dr. Wartenberg's as well as Dr. Bing's