tbuckley/cabot-search huggingface dataset:
Diagnosis and Localization of Aldosterone-Producing Adenomas by Adrenal-Vein Catheterization
Authors: James C. Melby, Richard F. Spark, Sidney L. Dale, Richard H. Egdahl, Paul C. Kahn
Journal: New England Journal of Medicine (1967)

EVEN when the diagnosis of primary aldosteronism is obvious before operation, there is no way to localize the adenoma. Preoperative demonstration of the tumor radiographically, as by retroperitoneal pneumography and aortography, is rarely successful because of its relative avascularity and its small size (from a few millimeters to several centimeters in dimension), which may also cause it to escape notice during transabdominal exploration. A bilateral adrenalectomy may thus be necessary.A method is needed to improve preoperative diagnostic certainty in many ambiguous cases and to localize the tumor in one or, rarely, both adrenal glands. A comparison of aldosterone concentrations . . .
A novel missense mutation causing abnormal LMAN1 in a Japanese patient with combined deficiency of factor V and factor VIII
Authors: Takayuki Yamada, Yuta Fujimori, Atsuo Suzuki, Yuhri Miyawaki, Akira Takagi, Takashi Murate, Masayuki Sano, Tadashi Matsushita, Hidehiko Saito, Tetsuhito Kojima
Journal: American Journal of Hematology (2009)

Abstract Combined deficiency of coagulation factor V (FV) and factor VIII (FVIII) (F5F8D) is an inherited bleeding disorder characterized by a reduction in plasma concentrations of FV and FVIII. F5F8D is genetically linked to mutations in either LMAN1 or MCFD2 . Here, we investigated the molecular basis of F5F8D in a Japanese patient, and identified a novel missense mutation (p.Trp67Ser, c.200G&gt;C) in the LMAN1 , but no mutation in the MCFD2 . The amount of LMAN1 in Epstein‐Barr virus‐immortalized lymphoblasts from the patient was found to be almost the same as that in cells from a normal individual. Interestingly, an anti‐MCFD2 antibody did not co‐immunoprecipitate the mutant LMAN1 with MCFD2 in lymphoblasts from the patient, suggesting the affinity of MCFD2 for the mutant LMAN1 is weak or abolished by the binding of the anti‐MCFD2 antibody. In addition, a Myc/6×His‐tagged recombinant form of wild‐type LMAN1 could bind to D‐mannose, but that of the mutant could not. The p.Trp67Ser mutation was located in the carbohydrate recognition domain (CRD), which is thought to participate in the selective binding of LMAN1 to the D‐mannose of glycoproteins as well as the EF‐motif of MCFD2. Taken together, it was suggested that the p.Trp67Ser mutation might affect the molecular chaperone function of LMAN1, impairing affinity for D‐mannose as well as for MCFD2, which may be responsible for F5F8D in the patient. This is the first report of F5F8D caused by a qualitative defect of LMAN1 due to a missense mutation in LMAN1 . Am. J. Hematol. 2009. © 2009 Wiley‐Liss, Inc.
The salutary effect of milk on amoebiasis and its reversal by iron.
Authors: M J Murray, A Murray, C J Murray
Journal: BMJ (1980)

Observations among milk-drinking African nomads showed an unusual freedom from infection with Entamoeba histolytica compared with similar nomads taking a mixed diet. A controlled study among Maasai pastoralists showed that the administration of iron to correct their dietary iron deficiency sharply increased their susceptibility to amoebiasis. Examination of the milk of their Zebu cattle showed that it not only had a concentration of iron below the minimum necessary for the growth of E histolytica but also contained partly saturated lactoferrin and transferrin, which may actively compete with the parasite in the colon for ambient iron. These observations suggest the possibility of a long-standing ecological compromise between nomads, their milk diet, and E histolytica.
Probiotics: Application of “healthy” bacteria to liver transplant recipients
Authors: Josh Levitsky
Journal: Hepatology (2006)

Abstract Bacterial infections frequently occur early after liver transplantation. We recently reported significant progress with a synbiotic composition, consisting of one lactic acid bacteria (LAB) and one fiber, which reduced the infection rate from 48% (with selective bowel decontamination) to 13%. Now, our aim is to study if a combination of different LAB and fibers would further improve outcome. A prospective randomized double-blind trial was undertaken in 66 liver transplant recipients. All patients received enteral nutrition immediately post-operatively. Comparison was made between one group (A) receiving a composition of four LAB and four fibers and another group (B) receiving the fibers only. The treatment started the day before surgery and continued for 14 days. Thirty-day infection rate, length of hospital stay, duration of antibiotic therapy, non-infectious complications and side effects of enteral nutrition were recorded. The incidence of post-operative bacterial infections was significantly reduced; being 48% with only fibers and 3% with LAB and fibers. In addition, the duration of antibiotic therapy was significantly shorter in the latter group. In both groups, mainly mild or moderate infections occurred. Fibers and LAB were well tolerated. Early enteral nutrition supplemented with a mixture of LAB and fibers reduces bacterial infection rates following liver transplantation. Treatment with only fibers led to a low incidence of severe infections.
Mitral commisurotomy versus replacement. Preoperative evaluation by echocardiography.
Authors: N C Nanda, R Gramiak, P M Shaah, J A DeWese
Journal: Circulation (1975)

Echocardiographic studies of the mitral valve were performed in 57 patients with pure or predominant mitral stenosis who subsequently underwent surgery (30 commissurotomy, 27 valve replacement). Mitral valve calcification was graded heavy (thick, conglomerate echoes), light (multiple, discrete linear echoes) or none (thin, single or duplicate signals). Valve mobility, measured as the excursion from the systolic closed position to the fully opened position in diastole, was classified as normal (20 mm or over), restricted (16-19 mm) or poor (15 mm or less). Absence of mitral valve caclification was the most useful echocardiographic indicator for commissurotomy (18 of )9 cases. The most reliable criteria for valve replacement were heavy valve calcification (11 of 11 cases) and poor cusp mobility (11 of 11 cases). The poor mobility group included 3 patients with heavily calcified valves. Thus 37 of 57 cases (65%) could be reliably categorized regarding the type of surgery performed using these three parameters. The remaining echocardiographic parameters (normal mobility, restricted mobility and light calcification) were less valuable in the assignment of the operative category. Echocardiographic assessment of mitral valve calcification and mobility appears to be of value in planning the surgical approach in patients with pure or predominant mitral stenosis.
Prediction Models for Prolonged Intensive Care Unit Stay After Cardiac Surgery
Authors: Roelof G.A. Ettema, Linda M. Peelen, Marieke J. Schuurmans, Arno P. Nierich, Cor J. Kalkman, Karel G.M. Moons
Journal: Circulation (2010)

Background— Several models have been developed to predict prolonged stay in the intensive care unit (ICU) after cardiac surgery. However, no extensive quantitative validation of these models has yet been conducted. This study sought to identify and validate existing prediction models for prolonged ICU length of stay after cardiac surgery. Methods and Results— After a systematic review of the literature, the identified models were applied on a large registry database comprising 11 395 cardiac surgical interventions. The probabilities of prolonged ICU length of stay based on the models were compared with the actual outcome to assess the discrimination and calibration performance of the models. Literature review identified 20 models, of which 14 could be included. Of the 6 models for the general cardiac surgery population, the Parsonnet model showed the best discrimination (area under the receiver operating characteristic curve=0.75 [95% confidence interval, 0.73 to 0.76]), followed by the European system for cardiac operative risk evaluation (EuroSCORE) (0.71 [0.70 to 0.72]) and a model by Huijskes and colleagues (0.71 [0.70 to 0.73]). Most of the models showed good calibration. Conclusions— In this validation of prediction models for prolonged ICU length of stay, 2 widely implemented models (Parsonnet, EuroSCORE), although originally designed for prediction of mortality, were superior in identifying patients with prolonged ICU length of stay.
A Population-Based Study of Multiple Sclerosis in Twins
Authors: George C. Ebers, Dennis E. Bulman, Adele D. Sadovnick, Donald W. Paty, Sharon Warren, Walter Hader, T. Jock Murray, T. Peter Seland, Pierre Duquette, Trevor Grey, Robert Nelson, Michael Nicolle, Donald Brunet
Journal: New England Journal of Medicine (1986)

Results from studies of twin concordance in multiple sclerosis have not conclusively differentiated between environmental and genetic factors that determine susceptibility to the disease. Published studies that have been based on case finding by public appeal have been characterized by difficulties in ascertainment. The data reported here are from a large population-based study of multiple sclerosis in twins, in which ascertainment has been relatively unbiased and the cooperation of patients nearly complete. A total of 5463 patients attending 10 multiple sclerosis clinics across Canada were surveyed. Twenty-seven monozygotic and 43 dizygotic twin pairs were identified, and the diagnosis of multiple sclerosis was verified by examination and laboratory investigation. Seven of 27 monozygotic pairs (25.9 percent) and 1 of 43 dizygotic pairs (2.3 percent) were concordant for multiple sclerosis. The concordance rate for 4582 nontwin siblings of patients at two multiple sclerosis clinics was 1.9 percent, closely paralleling the concordance rate in dizygotic twins. To the extent that the difference in concordance rates between monozygotic and dizygotic twins indicates genetic susceptibility, the results of this study show a major genetic component in susceptibility to multiple sclerosis. (N Engl J Med 1986; 315:1638–42.)
Response to Type III Polysaccharide in Women Whose Infants Have Had Invasive Group B Streptococcal Infection
Authors: Carol J. Baker, Marcia A. Rench, Dennis L. Kasper
Journal: New England Journal of Medicine (1990)

THERE is considerable mortality and morbidity in the United States from perinatal group B streptococcal disease.1 , 2 Approximately 3 neonates per 1000 live births, or an estimated 11,000 infants annually, have invasive group B streptococcal disease; two thirds of these infections are caused by the Type III capsular serotype.3 Pregnancy-related morbidity (e.g., urinary tract infection, chorioamnionitis, postpartum endometritis and bacteremia, and wound infections complicating cesarean section) affects approximately 50,000 women each year.2 , 3 One method proposed for the prevention of group B streptococcal disease in mothers and their infants is active immunization of women. This proposal is based on the observation that . . .
Coronary artery bypass grafting for the reduction of mortality: an analysis of the trials
Authors: E Varnauskas
Journal: BMJ (1985)

Economies in the NHS SIR,-If Mr Fowler is keen on economies in the NHS he should look no further than the Welsh Office where before DHSS circulars are forwarded to family practitioner com- mittees, district health authorities, local medical committees, community health councils, etc, they are retyped on Welsh Office stationery.The Welsh Office also changes the reference numbers and dutifully corrects references within the circular so that it conforms to previous Welsh Office modi- fications to old DHSS circulars.The result of all this bureaucratic nonsense is unnecessary expense, delay, and chaos.We frequently learn of changes to regulations in the medical press but are then informed by the Welsh Office that these changes do not apply to Wales until the appropriate circular has been released.During reorganisation some of these circulars were delayed for up to six months.About six years ago, as an LMC secretary, I received, with a covering letter from the FPC, a photostat of a letter from the DHSS to the Welsh Office, a photostat of a letter from the Welsh Office to the FPC, and a modified Welsh Office circular, informing us that the drug tariff book would be delayed through lack of paper.The recent circular concerning the new regulations controlling barbiturate drugs, which came into effect on 1 January 1985, was not received by our FPC for redistribution until 15 January 1985.As usual, chaos reigned as pharmacists were refusing to dispense prescriptions issued before we were notified of the regulation change.As all DHSS circulars refer equally to England and Wales, there would be a resultant increase in efficiency and reduction in ex- penditure if all these circulars were sent out directly by the DHSS.No doubt similar economies could be made in Scotland and Northern Ireland.
Relationships between Alexithymia, Emotional Control, and Quality of Life in Patients with Inflammatory Bowel Disease
Authors: Ramiro Verissimo, Rui Mota-Cardoso, Graeme Taylor
Journal: Psychotherapy and Psychosomatics (1998)

&lt;b&gt;Background:&lt;/b&gt; Although the constructs of alexithymia and emotional control have been associated with physical health, the relationship between these constructs is unclear and their influence on health-related quality of life has not been investigated previously. This study examined the relationships between alexithymia, emotional control, and quality of life in 74 patients with inflammatory bowel disease (IBD). &lt;b&gt;Methods: &lt;/b&gt;The subjects completed the 20-item Toronto Alexithymia Scale (TAS-20), the Emotional Expression and Control Scale (EEC), and the Inflammatory Bowel Disease Questionnaire (IBDQ) for assessing quality of life. &lt;b&gt;Results: &lt;/b&gt;The TAS-20 correlated negatively and significantly with the IBDQ global score and with subscales assessing bowel symptoms, systemic symptoms, and emotional functioning; the emotional control subscale of the EEC correlated positively and significantly with these measures. Although the TAS-20 correlated significantly and negatively with the emotional control subscale, alexithymia and quality of life scores were unrelated to subscales of the EEC assessing tendencies to either hold back or express emotions. A hierarchical stepwise multiple regression analysis revealed that alexithymia and, to a lesser extent, emotional control play a role in predicting quality of life in patients with IBD. &lt;b&gt;Conclusions:&lt;/b&gt; Alexithymia and emotional control are negatively related constructs and each construct has an independent influence on the subjective health status of patients with IBD.
C/EBPA methylation is common in T-ALL but not in M0 AML
Authors: Louis Terriou, Raouf Ben Abdelali, Christophe Roumier, Ludovic Lhermitte, John de Vos, Pascale Cornillet, Olivier Nibourel, Kheira Beldjord, Hervé Dombret, Guy Leverger, Vahid Asnafi, Claude Preudhomme, Elizabeth Macintyre
Journal: Blood (2009)
Alterations in 3,3'5'-triiodothyronine metabolism in response to propylthiouracil, dexamethasone, and thyroxine administration in man.
Authors: J S LoPresti, A Eigen, E Kaptein, K P Anderson, C A Spencer, J T Nicoloff
Journal: Journal of Clinical Investigation (1989)

To elucidate the mechanisms involved in altering serum 3,3',5'-triiodothyronine (rT3) levels with absolute or relative low 3,5,3'-triiodothyronine (T3) states in man, agents capable of lowering circulating T3 levels were sequentially administered to six euthyroid subjects. These agents included propylthiouracil (PTU) (300 mg/6 h X 5 d), dexamethasone (DEX) (2 mg/6 h X 5 d), and thyroxine (T4) (3.0 mg load and 0.3 mg/d X 5 d). [125I] rT3 clearance rates and rT3 production rates were then determined. Increased serum rT3 levels and rT3/T4 values occurred with both PTU and DEX as compared with control, while T4 increased serum rT3 but did so without changing rT3/T4 values. The rT3 clearance rate was significantly decreased by PTU without altering production rate, while DEX increased the rT3 production rate without altering the rT3 clearance rate. T4 administration did not change rT3 clearance but proportionately increased rT3 production. These responses indicate that circulating rT3 predominantly originates from a non-PTU inhibitable deiodinase enzyme system located in extrahepatic tissues. This enzyme system appears to have a high capacity and low affinity for T4 and can be stimulated by DEX administration.
Phase I/II Study of Docetaxel, Cisplatin, and Concomitant Boost Radiation for Locally Advanced Squamous Cell Cancer of the Head and Neck
Authors: Anne S. Tsao, Adam S. Garden, Merrill S. Kies, William Morrison, Lei Feng, J. Jack Lee, Fadlo Khuri, Ralph Zinner, Jeffery Myers, Vassiliki Papadimitrakopoulou, Jan Lewin, Gary L. Clayman, K. Kian Ang, Bonnie S. Glisson
Journal: Journal of Clinical Oncology (2006)

Purpose To investigate the feasibility of combining concomitant boost accelerated radiation with docetaxel and cisplatin and assess the regimen's toxicity, locoregional control rate, and survival in patients with locally advanced head and neck cancer (HNSCC). Patients and Methods Patients with stage III-IV HNSCC were eligible. Phase I included two schedules of docetaxel and cisplatin: arm 1, once per week during weeks 1 to 4; arm 2, every 21 days for weeks 1 and 4. Radiation consisted of 72 Gy in 42 fractions over 6 weeks (concomitant boost). Results Twenty patients were enrolled in phase I. The arm 1 maximum-tolerated dose (MTD) was defined at docetaxel 15 mg/m 2 and cisplatin 20 mg/m 2 based on prolonged mucositis in 29% of patients. The initial dose level in arm 2 was above the MTD. In total, 52 patients were treated using the arm 1 regimen in phase II. Acute toxicity included grade 3 mucositis and dermatitis in 81% and 44% of patients. The 2-year locoregional control rate was 71%. The 2-year progression-free and overall survival rates were 61% and 65%. Median survival was 37.8 months. Late effects included feeding tube dependence in 17% of patients alive and free of disease. Conclusion Locoregional control, survival, and acute toxicity with this regimen were comparable with other trials utilizing taxanes and/or platins and concomitant conventional or altered fractionation radiation. Our data suggest that chemotherapy added to concomitant boost fractionation may increase rates of long-term feeding tube dependence. Phase III trials are needed to assess the contribution of concomitant boost fractionation to chemoradiotherapy.
Present-Day Medical Education and the Medical-Center Concept
Authors: H. Houston Merritt
Journal: New England Journal of Medicine (1964)

THE first medical school in the Colonies was not established until 1765, when the University of Pennsylvania was opened, but the size of its faculty was insufficient to award the degree of doctor of medicine. This was first done in 1770 by King's College (later Columbia University), which was established in 1757 with a full complement of 6 professors, necessary to make the award. It is interesting that medical education in this country, at Pennsylvania, King's College and Harvard Medical School (established in 1783), was greatly influenced by the Scottish school and by the University of Leyden. Of the 6 . . .
Gray-Scale Ultrasonography of the Neck
Authors: Gretchen A. W. Gooding
Journal: JAMA (1980)

ULTRASONOGRAPHY of the neck is a valuable tool not only in the diagnosis of diseases of the thyroid, parathyroid, and major salivary glands, but also in the characterization of cervical masses and in the delineation of vascular structures in this relatively superficial anatomical area. Since depth penetration is not needed, high-resolution 5-MHz 6-mm transducers produce the sharpest images for direct-contact B-mode gray-scale ultrasonography of the neck. Gray-scale sonographic units using a water bath are also commercially available, as is an automated sector scanner that uses water-delay technology. The most advanced real-time sonographic units for the neck have a 10-MHz transducer for improved resolving power.<sup>1</sup> Because the vast majority of masses in the neck are palpable, a manual examination of the neck precedes ultrasonography and defines the area in question. For anterior and lateral lesions of the neck, the patient lies supine, with the neck hyperextended by a sponge. Posteriorly
Parathyroid Hormone and Hypophosphatemia
Authors: Jørgen Thode, Niels Fogh-Andersen, Ib Transbøl, Stig Nistrup Holmegaard
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 April 1988Parathyroid Hormone and HypophosphatemiaJØRGEN THODE, M.D., NIELS FOGH-ANDERSEN, M.D., IB TRANSBØL, M.D., PH.D., STIG NISTRUP HOLMEGAARD, M.D., PH.D.JØRGEN THODE, M.D.Search for more papers by this author, NIELS FOGH-ANDERSEN, M.D.Search for more papers by this author, IB TRANSBØL, M.D., PH.D.Search for more papers by this author, STIG NISTRUP HOLMEGAARD, M.D., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-4-641_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: It has been suggested that nonrenal hypophosphatemia is associated with decreased sensitivity of renal tubules to parathyroid hormone in rats (1). To our knowledge there are no studies in humans supporting this concept.A 42-year-old woman had had gastroduodenitis at gastroscopy 5 years ago. She used 10 mL of antacid three to four times daily, initially a coprecipitate of aluminum hydroxide and magnesium carbonate, later an aluminum oxide and magnesium oxide containing antacid. After treatment with antacid for 1.5 years, she developed musculoskeletal symptoms; first, pain over the loin, decreased force in the muscles of the lower...References1. LEVINE B, HO L, PASIECZNIK K, and COBURN J. Renal adaptation to phosphorus deprivation: Characterization of early events. J Bone Min Res. 1986;1:33-40. CrossrefMedlineGoogle Scholar2. THODE J, HOLMEGAARD S, and SIGGAARD-ANDERSEN O. Serum ionized calcium, nephrogenous and total urinary cyclic AMP and urinary phosphate in normal subjects. Scand J Clin Lab Invest. 1984;44:111-8. CrossrefMedlineGoogle Scholar3. THODE J. The calcium ion activity and the standardized excretion rate of calcium in urine of healthy adults. Scand J Clin Lab Invest. 1985;45:327-34. CrossrefMedlineGoogle Scholar4. THODE J, FINNERUP B, and PARVIN C. A simplified protocol for biochemical evaluation of recurrent renal calcium stone disease. Miner Electrolyte Metab. 1988; [In press]. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JØRGEN THODE, M.D.; NIELS FOGH-ANDERSEN, M.D.; IB TRANSBØL, M.D., PH.D.; STIG NISTRUP HOLMEGAARD, M.D., PH.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byDisorders of Phosphate Metabolism 1 April 1988Volume 108, Issue 4Page: 641-642KeywordsCarbonatesGastroenterology and hepatologyMagnesiumMusclesMyalgiaParathyroid hormone ePublished: 1 December 2008 Issue Published: 1 April 1988 PDF downloadLoading ...
Fibroblast growth factor-23 and Klotho in chronic kidney disease
Authors: Marc G. Vervloet, Tobias E. Larsson
Journal: Kidney International Supplements (2011)

The well-established increased cardiovascular risk that is a hallmark of chronic kidney disease (CKD) has directed research to metabolic changes that are typical of CKD. Epidemiological data point to derangements of mineral metabolism to be involved in this risk profile. Subsequently, newly discovered humoral factors—such as fibroblast growth factor (FGF)-23—that are involved in mineral and vitamin D homeostasis turned out to be associated with clinical outcome, independently of the minerals they regulate. Additional proteins involved in FGF-23 signaling, such as Klotho, subsequently appeared to have FGF-23-independent effects as well. In this review, the discovery, mode of action, and clinical implications of these new factors are outlined.