tbuckley/cabot-search huggingface dataset:
Clinical Lecture on Various Modes of Testing for Albumen in the Urine
Authors: G. Johnson
Journal: BMJ (1883)

I PROPOSE to describe, demonstrate, and critically review the various modes of testing for albumen in the urine in the light of recent knowledge and research.The two tests for albumen which,h.avehitherto been most generally used are heat and nitric acid.I pour into a test-tube a column of urine about two inches in height, and place it over a spirit-lamp.Before the liquid reaches the boiling point, thealbumen begins to coagulate; and the more abundant the albumen, the lower is the temperature at which coagulation [commences.When the urine is highly albuminous, as the heating proceeds and coagulation commences, the tube must be continually and briskly shaken, to prevent the sudden expulsion of the partially coagulated liquid by the steam generated beneath a dense film on the surface.Now observe that, when albuminous urine is alkaline, heat alone will not show the presence of albumen.I take some of this albumi- nous urine, and before applying heat, I add a drop or two of liquor potassi.You see that, when boiled, it remains clear; the potash has combined with the albuLmen, and the resulting albu, minate of potash is not coagulable by heat; but if now I add a few drops of strong nitric acid, coagulation at once takes place.Again, some specimens of urine, when boiled, give a precipitate which has the appearance of albumen, though none is present.The non-albuminous urines which are thus acted on by heat are usually neutral or alkaline, and the turbidity is due to the precipitation of phosphates.To a specimen of normal urine I add a drop or two of liquor potassme, and, when heated over the lamp, you see that it becomes turbid.This phosphatic turbidity is easily distinguished from an albuminous coagulum by the addition of a drop or two of nitric acid, or even of acetic acid, or citric acid solutioni, which dissolves the phosphates while coagulated albumen remains undissolved.You see, then, that if heat alone were relied upon as a test for albumen, it might mislead in two opposite directions: (1) by not detecting, albumen in alkaline urines, and (2) by givinog a delusive phosphatic precipitate in non-albuminous urine.Nitric acid has long been known and employedl as a valuable test for albumen.To this clear specimen of urine, I add a few drops of strong nitric acid, and an abundant coagulumn of albumen is imme-
FKBPL Regulates Estrogen Receptor Signaling and Determines Response to Endocrine Therapy
Authors: Hayley D. McKeen, Christopher Byrne, Puthen V. Jithesh, Christopher Donley, Andrea Valentine, Anita Yakkundi, Martin O'Rourke, Charles Swanton, Helen O. McCarthy, David G. Hirst, Tracy Robson
Journal: Cancer Research (2010)

The HSP90 chaperone and immunophilin FKBPL is an estrogen-responsive gene that interacts with estogen receptor alpha (ERalpha) and regulates its levels. In this study, we explored the effects of FKBPL on breast cancer proliferation. Breast cancer cells stably overexpressing FKBPL became dependent on estrogen for their growth and were dramatically more sensitive to the antiestrogens tamoxifen and fulvestrant, whereas FKBPL knockdown reverses this phenotype. FKBPL knockdown also decreased the levels of the cell cycle inhibitor p21WAF1 and increased ERalpha phosphorylation on Ser(118) in response to 17beta-estradiol and tamoxifen. In support of the likelihood that these effects explained FKBPL-mediated cell growth inhibition and sensitivity to endocrine therapies, FKBPL expression was correlated with increased overall survival and distant metastasis-free survival in breast cancer patients. Our findings suggest that FKBPL may have prognostic value based on its impact on tumor proliferative capacity and sensitivity to endocrine therapies, which improve outcome.
Mycobacterium tuberculosis Bacteremia in the Acquired Immunodeficiency Syndrome
Authors: Brian R. Saltzman
Journal: JAMA (1986)

THE ACQUIRED immunodeficiency syndrome (AIDS) is characterized by a defect in cellular immunity and the occurrence of opportunistic infections or unusual malignant neoplasms. The most commonly reported bacterial infection suggestive of a defect in cellular immunity, which meets the Centers for Disease Control (Atlanta) case definition for AIDS, is disseminated<i>Mycobacterium avium-intracellulare</i>infection.<sup>1</sup>Disseminated infection due to<i>Mycobacterium tuberculosis</i>has also been reported in AIDS.<sup>2</sup>Bacteremia is common in disseminated<i>M avium-intracellulare</i>infection in patients with AIDS.<sup>3</sup>In contrast, bacteremia in disseminated<i>M tuberculosis</i>is rare<sup>4-6</sup>and has not been reported previously in patients with AIDS, to our knowledge. We recently diagnosed disseminated infection due to<i>M tuberculosis</i>, in which bacteremia also occurred, in an intravenous drug abuser with AIDS. <h3>Report of a Case</h3> A 35-year-old man with a three- to five-year history of intravenous heroin and cocaine abuse developed anorexia and weight loss in November
Transient anticardiolipin antibodies, functional protein S deficiency, and deep vein thrombosis
Authors: Z. M. Sthoeger, D. Sthoeger, S. D. Mellnick, D. Steen, A. Berrebi
Journal: American Journal of Hematology (1991)

Abstract A 30‐year‐old man presented with an episode of deep vein thrombosis. He was found to have primary antiphospholipid syndrome with anticardiolipin antibodies and protein S deficiency. All other investigations were negative. Three months later, anticardiolipin antibodies were negative and protein S levels were normal. The transient presence of anticardiolipin antibodies and functional protein S deficiency in this patient suggests a new mechanism for the association between anticardiolipin antibodies and venous thrombosis.
Tolbutamide in Treatment of Multiple Sclerosis and Parkinsonism
Authors: Edwin W. Gates
Journal: JAMA (1961)

<h3>To the Editor:—</h3> I had the opportunity to read the paper by Drs. Heller, DeJong, and Magee before it was published in this issue ofThe Journal, page 148, and I discussed it with Dr. Irving Hyman, who was the co-author with me on the preliminary report of "The Use of Tolbutamide in Paralysis Agitans." While I have no explanation for the failure of Drs. Heller, DeJong, and Magee to see any change in their patients, I would like to say more about the development of our findings. The first patient on whom the effects of tolbutamide in paralysis agitans were noted was in the hospital, as stated in our paper, he was unable to hold a cup of coffee without spilling it, even when he used both hands. This coarse tremor had been present for a long time. This so-called unstable diabetic was given tolbutamide in an attempt to
Acute exacerbation and hepatitis B virus clearance after emergence of YMDD motif mutation during lamivudine therapy
Authors: Yun-Fan Liaw, Rong-Nan Chien, Chau-Ting Yeh, Sun-Lung Tsai, Chia-Ming Chu
Journal: Hepatology (1999)

Lamivudine is a potent inhibitor of hepatitis B virus (HBV) replication, but its long-term use may be associated with HBV tyrosine-methionine-aspartate-aspartate (YMDD) motif mutation. To examine the clinical features and course after emergence of YMDD mutants, 55 patients who received lamivudine therapy over 104 weeks at our unit were assayed for YMDD mutation(s). Thirty-two of them were found to have the YMDD mutation. They continued lamivudine therapy and were followed up weekly or biweekly if clinically indicated. Thirty (93.7%) of them showed elevation of alanine transaminase (ALT), and 13 (40.6%) experienced acute exacerbation at 4 to 94 weeks (median, 24 weeks) after emergence of the YMDD mutant. The incidence of exacerbation is much higher than 4.3% in patients without the YMDD mutation ( P = .003). Compared with patients without exacerbation, patients with exacerbation had a significantly higher serum HBV-DNA level after emergence of the YMDD mutant ( P &lt; .005). Before exacerbation, serum HBV-DNA level was rising to its peak, followed by the peaking of ALT (247-2,010 U/L) 1 to 4 weeks later. Three patients developed hepatic decompensation, but then in association with hepatitis B e antigen (HBeAg) seroconversion, recovered. Of the 12 evaluable patients, 8 (75%) showed HBeAg seroconversion, and 3 showed mutant clearance within 1 to 5 months after exacerbation. In contrast, none of the patients without exacerbation showed HBeAg seroconversion ( P &lt; .001). These results indicate that acute exacerbations may occur after emergence of the YMDD mutation. The incidence, clinicopathological features, and subsequent course, and possibly the underlying immune mechanisms, are similar to those of wild-type HBV chronic infection. Because severe hepatitis may occur, patients should be followed carefully once the YMDD mutant emerges.
Transesophageal echocardiography is superior to transthoracic echocardiography in the diagnosis of sinus venosus atrial septal defect
Authors: Itzhak Kronzon, Paul A. Tunick, Robin S. Freedberg, Naresh Trehan, Barry P. Rosenzweig, Matthew E. Schwinger
Journal: Journal of the American College of Cardiology (1991)
Relationship Between C-Reactive Protein and Subclinical Atherosclerosis
Authors: Amit Khera, James A. de Lemos, Ronald M. Peshock, Hao S. Lo, Harold G. Stanek, Sabina A. Murphy, Frank H. Wians, Scott M. Grundy, Darren K. McGuire
Journal: Circulation (2005)

Elevated levels of C-reactive protein (CRP) are associated with increased risk for incident cardiovascular events on the basis of observations from several prospective epidemiological studies. However, less is known regarding the relationship between CRP levels and atherosclerotic burden.We measured CRP in 3373 subjects 30 to 65 years of age who were participating in the Dallas Heart Study, a multiethnic, population-based, probability sample. Electron-beam CT scans were used to measure coronary artery calcification (CAC) in 2726 of these subjects, and MRI was used to measure aortic plaque in 2393. CRP levels were associated with most traditional cardiovascular risk factors. Subjects with CAC had higher median CRP levels than those without CAC (men: median, 2.4 versus 1.8 mg/L, P<0.001; women: median, 5.2 versus 3.6 mg/L, P<0.001), and there was a modest trend toward increasing CRP levels with increased CAC levels in men (P for trend=0.003) but not in women (P for trend=0.08). Male subjects with aortic plaque also had higher CRP levels than those without (median, 2.3 versus 1.8; P<0.001). In multivariate analysis adjusted for traditional cardiovascular risk factors, body mass index, and estrogen and statin medication use, the associations between CRP levels and CAC and CRP levels and aortic plaque were no longer statistically significant.In a large, population-based sample, subjects with higher CRP levels had a modest increase in the prevalence of subclinical atherosclerosis, but this association was not independent of traditional cardiovascular risk factors. CRP is a poor predictor of atherosclerotic burden.
Gate Wait for Better Air
Authors: Carol Potera
Journal: Environmental Health Perspectives (2011)

Gel Tackles Tohoku WasteCNN reports Japanese officials are using a product called DeconGel to clean up areas contaminated by the March 2011 Tohoku earthquake and tsunami. 1 The product is applied as a liquid to surfaces contaminated by hazardous chemicals or radiation and then dries into a gel that can be peeled off, taking contaminants with it.DeconGel has been used to clean up polychlorinated biphenyls, mercury, chromium, beryllium, and radioactive materials.Although the product can't neutralize radioactivity-no product canits developer claims it can reduce labor and disposal costs. 2 DeconGel being used on a fire truck in Japan.
Metabolic effects of salbutamol: comparison of aerosol and intravenous administration.
Authors: A Neville, J B Palmer, J Gaddie, C S May, K N Palmer, L E Murchison
Journal: BMJ (1977)

The effects of intravenous salbutamol (4 mug/kg) were compared with those of aerosol salbutamol (200 mug) in 10 asthmatic patients in a double-blind placebo-controlled study. Both methods of administration produced equal bronchodilatation. Intravenous salbutamol caused significant increases in plasma insulin and glucose levels and a fall in serum potassium concentration in addition to tachycardia and tremor, whereas aerosol salbutamol produced only a small transient increase in the plasma glucose level. The initially raised non-esterified fatty acid levels decreased significantly after aerosol and placebo but not after intravenous salbutamol.
Regression of coronary artery dimensions after successful aortic valve replacement.
Authors: B Villari, O M Hess, C Meier, A Pucillo, A Gaglione, M Turina, H P Krayenbuehl
Journal: Circulation (1992)

BACKGROUND The effect of regression of myocardial hypertrophy on coronary artery dimensions was evaluated in patients with aortic valve disease who underwent valve replacement. METHODS AND RESULTS Cross-sectional area (CSA) of the three major coronary arteries (left anterior descending [LAD], left circumflex [LCx], and right coronary artery) was determined by quantitative coronary arteriography in 15 patients with aortic valve disease before and 38 months (range, 14-113 months) after successful aortic valve replacement. Twelve normal subjects served as controls. Left ventricular (LV) angiographic mass was calculated according to the method of Rackley. CSA of the left coronary artery was larger in aortic valve disease than in controls (LAD, 15 versus 8 mm2, p less than 0.001; LCx, 14 versus 6 mm2, p less than 0.001). After valve replacement, CSA of the left coronary artery decreased (LAD, 12 mm2, p less than 0.05 versus before surgery; LCx, 11 mm2, p less than 0.05 versus before surgery) but remained significantly larger than in controls. CSA of the right coronary artery in patients with aortic valve disease was not different from controls. LV muscle mass was significantly increased in aortic valve disease patients before (364 g) and after (250 g) valve replacement compared with controls (135 g). The appropriateness of coronary artery size with respect to muscle mass was evaluated by normalizing CSA of the left coronary artery (LAD + LCx) per 100 g of LV muscle mass (mm2/100 g). This index amounted to 11 mm2/100 g in controls, to 8 mm2/100 g in preoperative patients (p less than 0.05 versus controls), and to 10 mm2/100 g in postoperative patients with aortic valve disease (p = NS versus controls). CONCLUSIONS In patients with aortic valve disease, CSA of the proximal LAD and LCx is increased, but this increase is not sufficient to keep CSA per 100 g of LV mass within normal limits. The postoperative decrease in muscle mass is associated with a decrease in the size of LAD and LCx, whereas the size of the right coronary artery remains unchanged. In contrast to the preoperative state, the residually hypertrophied LV myocardium after aortic valve replacement is supplied by an enlarged but adequately sized LAD and LCx.
Gut reaction: the case against IL-23
Authors: Ruth Williams
Journal: The Journal of Experimental Medicine (2006)

The prime suspect behind inflammatory bowel disease (IBD) has been wrongly accused. Work by Hue et al. (page 2473) and Kullberg et al. (page 2485) reveals that the cytokine IL-12 was merely a cover for the real IBD culprit, IL-23. IL-23 promotes inflammation by corrupting not only adaptive immunity, as previously thought, but also the innate immune system.






Figure 1

Intestinal inflammation is reduced by anti-p19 treatment (bottom).




IL-12, an activator of adaptive immunity via the induction of Th1 cells, is composed of two subunits, p35 and p40. In mouse models of intestinal inflammation, antibodies against p40 prevent the chronic inflammation that occurs in IBD in response to intestinal bacteria. Thus, IL-12 was considered responsible for driving IBD.

Case closed? Not quite. In 2000, it was discovered that p40 can also dimerize with p19 to form IL-23. Thus, all studies using antibodies against p40, including studies of other autoimmune diseases (see J. Exp. Med. 201:163), required reevaluation. Using mouse models of IBD, Kullberg et al. show that mice incapable of producing p35 but still able to produce the p40 subunit develop intestinal inflammation in response to bacterial challenge, whereas mice that lack IL-23 resist the disease. Furthermore, Hue et al. show that an anti-p19 antibody strongly inhibits bacterially induced intestinal inflammation.

IL-23, which shows increased expression in mice with intestinal inflammation, was previously thought to activate adaptive Th17 cells only. But here, Kullberg et al. show evidence that both Th1 and Th17 cells may be overactivated by IL-23. Hue et al. also show, using mice that lack B and T lymphocytes, that IL-23 can also induce intestinal inflammation via the innate immune system. It remains to be determined both how IL-23 controls these diverse responses and what leads to its own overexpression in IBD.
A PLEA FOR A RATIONAL SYSTEM OF INSTRUCTION IN ANATOMY
Authors: Leo Mayer
Journal: JAMA (1918)

To the Editor:  —During the past three months, while conducting a course for military surgeons at the Post-Graduate Medical School and Hospital dealing with the surgery of nerves and tendons,  was struck by the students' ignorance of the simplest elements of anatomy. Their ignorance was all the more surprising because they represented an unusually intelligent, alert group of men, many of whom were surgeons of standing. It was interesting to see how they welcomed a chance to study anatomy when presented in a simple form, and how easily they acquired a practical working knowledge of all the important tendons and peripheral nerves during the two weeks of the course. On talking the matter over with them  came to the conclusion that the method of teaching anatomy current in our medical schools is to a large extent responsible for their anatomic ignorance. As one man put it, I was
Lumbar puncture needn't be a headache
Authors: S. A Broadley, G. N Fuller
Journal: BMJ (1997)

<b>Objective:</b> To determine the levels of sound to which infants are exposed during routine transport by ambulance, aircraft, and helicopter. <b>Design:</b> Sound levels during 38 consecutive journeys from a regional level III neonatal intensive care unit were recorded using a calibrated data logging sound meter (Quest 2900). The meter was set to record “A” weighted slow response integrated sound levels, which emulates the response of the human ear, and “C” weighted response sound levels as a measure of total sound level exposure for all frequencies. The information was downloaded to a computer using MS HyperTerminal. The resulting data were stored, and a graphical profile was generated for each journey using SigmaPlot software. <b>Setting:</b> Eight journeys involved ambulance transport on country roads, 24 involved fixed wing aircraft, and four were by helicopter. <b>Main outcome measures:</b> Relations between decibel levels and events or changes in transport mode were established by correlating the time logged on the sound meter with the standard transport documentation sheet. <b>Results:</b> The highest sound levels were recorded during air transport. However, mean sound levels for all modes of transport exceeded the recommended levels for neonatal intensive care. The maximum sound levels recorded were extremely high at greater than 80 dB in the “A” weighted hearing range and greater than 120 dB in the total frequency range. <b>Conclusions:</b> This study raises major concerns about the excessive exposure of the sick newborn to sound during transportation.
COMPARATIVE RESULTS IN SEIZURE CONTROL USING PHENOBARBITAL, DILANTIN, AND MESANTOIN
Authors: D. B. RUSKIN
Journal: American Journal of Psychiatry (1950)

Phenobarbital is still the most effective anticonvulsant in treatment of grand mal epilepsy. Phenobarbital, if incompletely effective, when used alone, is still more effective when supplemented with either Dilantin or Mesantoin than any single drug used alone or in other combination. Using a supplemental drug when indicated doubles the number of patients that respond to phenobarbital. Maintaining a reasonable dosage results, in this study, in complete absence of toxic effects from phenobarbital. Mesantoin is twice as effective as Dilantin as an anticonvulsant but is twice as toxic.
A Rational Basis for Chemoprevention of Prostate Cancer
Authors: Caroline J. Huang, Matthew L. Baum
Journal: The American Journal of Bioethics (2011)

In his article “What's Wrong with Chemoprevention of Prostate Cancer?,” Stewart Justman (2011) argues that finasteride and dutasteride—two drugs known as 5-alpha reductase inhibitors (5-ARIs)—are o...
Correlation of heat production of culprit atherosclerotic lesion with soluble cell adhesion molecules
Authors: Konstantinos Toutouzas, Christodoulos Stefanadis, Eleftherios Tsiamis, Manolis Vavouranakis, Ioannis Kallikazaros, Sophia Vaina, Christina Chrysochoou, Dimos Panagiotakos, Marina Toutouza, Pavlos Toutouzas
Journal: Journal of the American College of Cardiology (2002)
Exercise-induced ST depression and ST/heart rate index to predict triple-vessel or left main coronary disease: A multicenter analysis
Authors: Marco Bobbio, Robert Detrano, Johann-Jackob Schmid, Andras Janosi, Alberto Righetti, Matthias Pfisterer, Walter Steinbrunn, Kern H. Guppy, Pierre Abi-Mansour, Jaap W. Deckers, Antonio Colombo, Kenneth G. Lehmann, Harold G. Olson
Journal: Journal of the American College of Cardiology (1992)
Points from letters: Whooping-cough vaccination
Authors: A Donaldson
Journal: BMJ (1975)

October, p 25) is not alone.At the inception of the NHS in 1948 I was an assistant in general practice and lived above the surgery in a traffic-congested area.At that time I managed my rounds quite easily on a bicycle.Unfortunately both your clientele and your colleagues come to regard you as an outsider, which adds to your emotional burden.The car becomes your
Intracardiac short circuit.
Authors: I J Copperman, S Low, S Yung
Journal: BMJ (1975)

In the past few years many centres have tended to prefer the pervenous to the transthoracic approach when implanting permanent pacemakers because of the reduced hospital stay and the lower postoperative morbidity.The disadvantages of this approach, however, are an increased failure rate and a greater incidence of late complications associated with the electrode.It may change in position and may fail to "capture" the ventricles.In addition perforation of the, catheter through the skin sometimes occurs, particularly with the neck approach.This latter complication was the first of a series of problems encountered in the patient described here.
Letter: Malaria vaccines.
Authors: K N Brown
Journal: BMJ (1975)

Solitary Pulmonary Nodules SIR,-In your leading article on this subject (26 April, p. 157) the statement is made that "with few exceptions the nature of the lesion can be establislhed only if it is reseoted and submitted to pathological examination."We have found that aspiration biopsy under television fluoroscopic control' has markedly increased the number of such lesions whose nature can be establi-sAed without resection.Out of a total of 334 patients examined a definitive diagnosis was made in 70%.The lesion was malignant in 83% of cases and non-malignant in 29%.By integrating this technique with the usual in- vestigations (sputum cytology, bronchoscopy with biopsy and/or bronchial washings, and mediastinoscopy) we have been able to obtain a definitive diagnosis without thoracotomy in over 90%,b of all carcinomas which have passed through our unit in the past few years.Specific diagnoses have also been obtained in some cases of tuberculosis, fungal infections, and sarcoidosis by the use of aspiration biopsy.The only significant complication of this technique is pneumothorax, which has oc- curred in approximately 25 % of patients, half of whom have required temporary in- tubation.