tbuckley/cabot-search huggingface dataset:
THE QUESTION OF THE EXISTENCE OF AMYLOID CASTS
Authors: E. R. SALEEBY
Journal: JAMA (1925)

While many textbooks on medicine and clinical pathology contain the statement that  or waxy casts are commonly found in the urine of patients with or without amyloid disease of the kidneys, the existence of such casts has been questioned. It is true that casts of a peculiar waxy appearance are sometimes encountered in microscopic urinalysis, and it is likewise true that the diagnosis of amyloid infiltration of the kidneys has later been confirmed by postmortem examinations. Since it is difficult for any one observer to collect a series of such data, it seemed a matter of some practical interest to study this problem by means of histologic sections of amyloid kidneys.  It may be recalled that, in the kidney, amyloid is usually present around the coats of the glomeruli, in the walls of the vessels in general, and in the lining of the basement membrane of some parts of
HIV Infection in Thailand: The Use of Condoms
Authors: Mark VanLandingham
Journal: JAMA (1994)

To the Editor.  —The article by Dr Nelson and colleagues 1 is a useful contribution to our understanding of the dynamics of human immunodeficiency virus (HIV) infection in Thailand. Especially helpful is the link between HIV status and hypothesized social and behavioral factors. One very surprising finding is that condom use with prostitutes was not shown to be protective of prevalent HIV infection. The authors offer a number of possible explanations for this result, but do not address what I view to be the most likely factors: weak operational measures and a misspecified causal model. At stake is more than an arcane statistical argument, since a failure to demonstrate the protective benefits of condom use could lead to the impression that promotion of condom use with prostitutes is a misguided policy in Thailand's campaign against HIV. In fact, Nelson et al conclude by implying that programs to combat sexually transmitted
Dendritic cells for NK/LAK activation: rationale for multicellular immunotherapy in neuroblastoma patients
Authors: Dominique Valteau-Couanet, Christophe Leboulaire, Kim Maincent, Muriel Tournier, Olivier Hartmann, Jean Bénard, Françoise Beaujean, Catherine Boccaccio, Laurence Zitvogel, Eric Angevin
Journal: Blood (2002)
ROLE OF CT SCAN IN PREDICTING RECURRENCE FOLLOWING PRIMARY TRAUMATIC SHOULDER DISLOCATION
Authors: Adeel Akhtar Muhammad, Paul Jenkins, Fiona Ashton, Ian Beggs, Michael Robinson Christopher
Journal: British Journal of Sports Medicine (2013)

Background Shoulder dislocation is a common sporting injury. Glenoid deficiency is thought to be a risk factor for recurrent shoulder dislocations. This study was performed to assess the role of CT scan in predicting recurrence following primary traumatic anterior shoulder dislocation. Methods Prospective data was collected for 39 patients following first time traumatic anterior shoulder dislocation between April 2008 and June 2009 under the care of a specialist shoulder surgeon, including demographic details and CT scan findings to identify structural defects of the glenoid and humeral head in the form of bony bankart lesion, glenoid flattening and Hill sach's lesion. Electronic records from emergency and orthopaedic departments were checked in January 2013 to confirm recurrent shoulder dislocations. Results The mean age was 26 years (range 15–56). There were 36 males and 3 females. CT scan showed bony bankart lesion in ten patients (26%), glenoid flattening in seven patients (18%) and Hill sach's lesion in thirtythree patients (85%). Patients were divided into groups according to the number of bone defects on CT scan (No bone defect-0, bony bankart lesion-1, glenoid flattening-1 and Hill sach's lesion-1). Group A (no bone defect) had six patients (15%), Group B (Bone defect) had thirtythree patients (85%); twenty-two patients (56%) had 1 bone defect (Group C), five patients (13%) had 2 bone defects (Group D) and six patients (15%) had 3 bone defects ( Group E). Group A (no bone defect) had 1 recurrent shoulder dislocation (16%) and Group B (Bone defect) had 16 recurrent shoulder dislocations (48%). Group C (1 bone defect) had 11 recurrent shoulder dislocations (50%), Group D (2 bone defects) had 2 recurrent shoulder dislocations (40%) and Group E (3 bone defects) had 3 recurrent shoulder dislocations (50%). Discussion/Conclusion We studied the structural defects of glenoid and humeral head on the CT scan following primary shoulder dislocations and risk of recurrence in the presence of bone defects. Hill sach's lesion was the most common finding on the CT scan (85%). Patients with bone defects had a higher rate of recurrent shoulder dislocations (48% vs 16%). We recommend the use of CT scan following primary shoulder dislocations to identify structural defects of humeral head and glenoid before deciding the appropriate treatment to prevent recurrence.
Late Coronary Occlusion After Intracoronary Brachytherapy
Authors: Marco A. Costa, Manel Sabaté, Wim J. van der Giessen, I. Patrick Kay, Pavel Cervinka, Jurgen M. R. Ligthart, Pedro Serrano, Veronique L. M. A. Coen, Peter C. Levendag, Patrick W. Serruys
Journal: Circulation (1999)

Intracoronary brachytherapy appears to be a promising technology to prevent restenosis. Presently, limited data are available regarding the late safety of this therapeutic modality. The aim of the study was to determine the incidence of late (>1 month) thrombosis after PTCA and radiotherapy.From April 1997 to March 1999, we successfully treated 108 patients with PTCA followed by intracoronary beta-radiation. Ninety-one patients have completed at least 2 months of clinical follow-up. Of these patients, 6.6% (6 patients) presented with sudden thrombotic events confirmed by angiography 2 to 15 months after intervention (2 balloon angioplasty and 4 stent). Some factors (overlapping stents, unhealed dissection) may have triggered the thrombosis process, but the timing of the event is extremely unusual. Therefore, the effect of radiation on delaying the healing process and maintaining a thrombogenic coronary surface is proposed as the most plausible mechanism to explain such late events.Late and sudden thrombosis after PTCA followed by intracoronary radiotherapy is a new phenomenon in interventional cardiology.
The AMA, Chiropractic, and Judge Getzendanner's Injunction
Authors: Mark G. Jameson
Journal: JAMA (1988)

To the Editor.  —Judge Getzendanner's1court order compellingJAMAto publish a permanent injunction against the American Medical Association represents another assault against the freedom of the  The US District Court is within its jurisdiction to convict the American Medical Association of antitrust violations, but the court has no constitutional authority to coerce a free press to publish government edicts during peacetime. The Constitution does not empower either the executive or the judicial branches of government to compel a free press to publish government documents. To the contrary, the First Amendment to the Constitution specifically protects the freedom of the press by stating that Congress shall make no law... abridging the freedom of speech, or of the press. To the best of my knowledge, no other organization has been forced by the courts to publish an injunction in its journal or newsletter. Court rulings are readily accessible in
Cellular mechanisms of endotoxin-induced myocardial depression in rabbits.
Authors: J Hung, W Y Lew
Journal: Circulation Research (1993)

We investigated the mechanisms by which endotoxic shock induces intrinsic myocardial depression by studying cardiac myocytes isolated from 10 anesthetized instrumented rabbits given 172 +/- 42 (mean +/- SD) micrograms/kg IV endotoxin. Left ventricular (LV) depression developed 4 +/- 1 hours after endotoxin administration, with a 15 +/- 4% increase in LV internal end-systolic diameter, measured with sonomicrometers at a matched LV end-systolic pressure of 65 +/- 10 mm Hg. Normal LV pressure, arterial PO2, and pH were maintained to minimize confounding effects of ischemia, hypoxia, and acidosis. Cardiac myocytes from endotoxin-exposed rabbits had less unloaded cell shortening and lower peak rates of cell shortening (-dL/dt) and lengthening (+dL/dt) at [Ca2+] levels ranging from 0.5 to 16 mM when compared with myocytes isolated from normal rabbits or rabbits undergoing an identical protocol but without exposure to endotoxin. At 2 mM [Ca2+], cell shortening was depressed by approximately 25% because of a decrease in action potential duration (207 +/- 70 versus 375 +/- 64 milliseconds). In contrast, there was only mild impairment of sarcoplasmic reticulum (SR) function. When myocytes were restimulated after rest periods of 4 to 480 seconds, the decrement in cell shortening (rest decay), peak -dL/dt and peak +dL/dt, and the recovery from rest decay were similar in myocytes from endotoxin-treated and normal rabbits. There was a greater decrement in cell shortening in the second beat of postrest recovery in myocytes from endotoxin-treated rabbits than in normal myocytes. This was partly due to a 12% decrement in action potential duration with rest decay, which did not occur in normal myocytes. The SR Ca2+ content assessed by contractures in 10 mM caffeine was similar in the two groups. We conclude that endotoxic shock produces a LV depression in vivo that persists in isolated myocytes studied in vitro. This intrinsic myocardial depression is largely related to endotoxin-mediated sarcolemmal alterations, which shorten action potential duration, and is not due to alterations in SR function.
CORONARY ANGIOGRAPHIC FINDINGS AND RESULTS OF PERCUTANEOUS CORONARY INTERVENTION (PCI) IN NONAGENARIANS: A SINGLE TERTIARY CARE CENTER EXPERIENCE
Authors: Ashok K. Kondur, Hari Pawan, Ramanjit Kaur, Praveen Guntipalli, Luis Afonso, Theodore Schreiber
Journal: Journal of the American College of Cardiology (2010)
Epigenetic silencing of the tumor-suppressing gelsolin gene involves histone deacetylation of its promoter region in human urinary bladder cancer
Authors: Kazunori Haga, Hisakazu Fujita, Ataru Sazawa, Masato Takimoto, Nobuo Shinohara, Tomohiko Koyanagi, Noboru Kuzumaki
Journal: Nature Genetics (2001)
Tiotropium Respimat® Add-On To Inhaled Corticosteroids Improves Lung Function In Patients With Symptomatic Mild Asthma: Results From A Phase III Trial
Authors: Pierluigi Paggiaro, David M.G. Halpin, Roland Buhl, Michael Engel, Valentina Zubek, Zuzana Blahova, Petra Moroni-Zentgraf, Emilio Pizzichini
Journal: Journal of Allergy and Clinical Immunology (2014)
Case 27-1997
Authors: Stephen L. Boswell, Mark van Gorder
Journal: New England Journal of Medicine (1997)

Presentation of CaseA 38-year-old man was admitted to the hospital because of increasing dyspnea, chest pain, and an undiagnosed pulmonary process.One year earlier, the patient had presented with weight loss and thrush, and a diagnosis of the acquired immunodeficiency syndrome (AIDS) had been made. His history included numerous homosexual contacts but no intravenous drug abuse. The CD4+ lymphocyte count was 88 per cubic millimeter. Chest radiographs showed a rounded density, 5 mm in diameter, projecting over the right anterior fifth rib and seen only on the posteroanterior view. A computed tomographic (CT) scan of the chest revealed patchy . . .
New therapeutic approach for brain tumors: Intranasal delivery of telomerase inhibitor GRN163
Authors: Rintaro Hashizume, Tomoko Ozawa, Sergei M. Gryaznov, Andrew W. Bollen, Kathleen R. Lamborn, William H. Frey, Dennis F. Deen
Journal: Neuro-Oncology (2008)

The blood-brain barrier is a substantial obstacle for delivering anticancer agents to brain tumors, and new strategies for bypassing it are greatly needed for brain-tumor therapy. Intranasal delivery provides a practical, noninvasive method for delivering therapeutic agents to the brain and could provide an alternative to intravenous injection and convection-enhanced delivery. We treated rats bearing intracerebral human tumor xenografts intranasally with GRN163, an oligonucleotide N3'-->P5'thio-phosphoramidate telomerase inhibitor. 3'-Fuorescein isothiocyanate (FITC)-labeled GRN163 was administered intranasally every 2 min as 6 microl drops into alternating sides of the nasal cavity over 22 min. FITC-labeled GRN163 was present in tumor cells at all time points studied, and accumulation of GRN163 peaked at 4 h after delivery. Moreover, GRN163 delivered intranasally, daily for 12 days, significantly prolonged the median survival from 35 days in the control group to 75.5 days in the GRN163-treated group. Thus, intranasal delivery of GRN163 readily bypassed the blood-brain barrier, exhibited favorable tumor uptake, and inhibited tumor growth, leading to a prolonged lifespan for treated rats compared to controls. This delivery approach appears to kill tumor cells selectively, and no toxic effects were noted in normal brain tissue. These data support further development of intranasal delivery of tumor-specific therapeutic agents for brain tumor patients.
Prescribing and taking medicines
Authors: G. Jones
Journal: BMJ (2003)

<b>Background:</b> Few reports described outcomes of complete compared with infarct related artery (IRA) only revascularization in patients with ST elevation myocardial infarction (STEMI) and multivessel coronary disease (CAD). Moreover there are no studies comparing simultaneous treatment of non-IRAs with the IRA treatment followed by elective procedure for the other lesions (staged revascularization). <b>Methods:</b> We studied the outcomes of 214 consecutive patients with STEMI and multivessel CAD undergoing primary angioplasty. Before the first angioplasty patients were randomized to 3 different strategies: 1) culprit vessel angioplasty only (COR group), 2) staged revascularization (SR group), and 3) simultaneous treatment of non-IRAs (CR group). <b>Results:</b> During a mean follow-up of 2.5 years, 42 (50.0%) patients in COR group experienced at least one major adverse cardiac event (MACE), 13 (20.0%) in SR group, and 15 (23.1%) in CR group, p&lt;0.001. In-hospital death, repeat revascularization and re-hospitalization occurred more frequently in COR group (all p&lt;0.05), while there was no significant difference in re-infarction among the 3 groups. Survival free of MACE was significantly reduced in COR group but it was similar in CR and SR groups. <b>Conclusions:</b> Culprit vessel only angioplasty was associated with the highest rate of long-term MACE as compared to multivessel treatment. Patients scheduled for staged revascularization experienced a similar rate of MACE as patients undergoing complete simultaneous treatment of non-IRAs.
Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia. Implications for the pathogenesis of central pontine myelinolysis.
Authors: Y H Lien, J I Shapiro, L Chan
Journal: Journal of Clinical Investigation (1991)

Osmotic injury induced by rapid correction of severe chronic hyponatremia has been implicated in the development of central pontine myelinolysis. Organic osmolytes known previously as "idiogenic osmoles" accumulate intracellularly to protect cells from osmotic injury. We investigated the changes of these organic osmolytes as well as electrolytes in the brain during the induction and correction of chronic hyponatremia. Using 1H-nuclear magnetic resonance spectroscopy and HPLC, we found that in rats with chronic hyponatremia (3 d, serum sodium = 109 +/- 3 meq/liter), brain concentrations of myoinositol (41%), glycerophosphorylcholine (45%), phosphocreatine/creatine (60%), glutamate (53%), glutamine (45%), and taurine (37%) were all significantly decreased compared with control values (percentage control value shown, all P less than 0.01). The contribution of measured organic osmolytes and electrolytes to the total brain osmolality change was 23 and 72%, respectively. With rapid correction by 5% NaCl infusion, significant brain dehydration and elevation of brain Na and Cl levels above the normal range occurred at 24 h. These changes were not seen with slow correction by water deprivation. Reaccumulation of most organic osmolytes except glycerophosphorylcholine is delayed during the correction of hyponatremia and is independent of the correction rate of serum sodium. It is concluded that: most of the change of brain osmolality in chronic hyponatremia can be accounted by the changes in organic osmolytes and brain electrolytes; and rapid correction of hyponatremia is associated with an overshoot of brain sodium and chloride levels along with a low organic osmolyte level. The high cerebral ion concentrations in the absence of adequate concentrations of organic osmolytes may be relevant to the development of central pontine myelinolysis.
The UK needs office dermatologists
Authors: J. Rees
Journal: BMJ (2012)

Before I started training in dermatology in the 1980s my boss suggested that I went to Vienna (a Mecca for all things dermatological) to see how others practised medicine. They accepted me as a visiting fellow, observing clinical practice and doing research. What still shocks me is how differently medical care can be configured.

I had just completed the mandatory pre-dermatology training of one year of house jobs and three years of internal medicine. Things were very different in Vienna. Not only did my new colleagues think I had wasted several years studying subjects peripheral to my career choice, but they were incredulous to hear that UK patients were unable to access dermatological care directly, having instead to go through the gatekeeper of the general practitioner.

I repeated the standard NHS mantra about how patients needed a primary care doctor to help them navigate the complexities of medicine. My Austrian colleagues initially assumed that our differences resulted from linguistic confusion secondary to my rudimentary German. They spoke slower, in English: “You mean that …
Optical Coherence Tomographic Analysis of In-Stent Neoatherosclerosis After Drug–Eluting Stent Implantation
Authors: Soo-Jin Kang, Gary S. Mintz, Takashi Akasaka, Duk-Woo Park, Jong-Young Lee, Won-Jang Kim, Seung-Whan Lee, Young-Hak Kim, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park
Journal: Circulation (2011)

We report findings from optical coherence tomography (OCT) of in-stent neoatherosclerosis as a cause of drug-eluting stent (DES) failure.Optical coherence tomography and grayscale and virtual histology intravascular ultrasound were performed in 50 patients (30 stable, 20 unstable angina) with 50 DES in-stent restenosis lesions and intimal hyperplasia >50% of stent area. Median follow-up time was 32.2 months. Overall, 26 lesions (52%) had at least 1 OCT-defined in-stent thin-cap fibroatheroma (TCFA)-containing neointima and 29 (58%) had at least 1 in-stent neointimal rupture. Patients presenting with unstable angina showed a thinner fibrous cap (55 μm [interquartile range 42 to 105 μm] versus 100 μm [interquartile range 60 to 205 μm], P=0.006) and higher incidence of OCT-defined TCFA-containing neointima (75% versus 37%, P=0.008), intimal rupture (75% versus 47%, P=0.044), thrombi (80% versus 43%, P=0.010), and red thrombi (30% versus 3%, P=0.012) than stable patients. Fibrous cap thickness negatively correlated with follow-up time (r=-0.318, P=0.024). Compared with DES <20 months after implantation (the best cut-off to predict TCFA-containing neointima), DES ≥20 months after implantation had a higher incidence of TCFA-containing neointima (69% versus 33%, P=0.012) and red thrombi (27% versus 0%, P=0.007). Patients with unstable (versus stable) angina had an increasing number of unstable OCT findings including TCFA-containing neointima, neointima rupture, and thrombus (P=0.027). The rate of agreement between grayscale intravascular ultrasound and OCT for detecting intimal rupture was 50% and for detecting thrombus was 44%. The agreement between virtual histology intravascular ultrasound and OCT for identifying TCFA-containing neointima was 78%.In-stent neoatherosclerosis may be an important mechanism of DES failure, especially late after implantation.
Increased β1 Integrin Is Associated with Decreased Survival in Invasive Breast Cancer
Authors: Evelyn S. Yao, Hui Zhang, Yunn-Yi Chen, Brian Lee, Karen Chew, Dan Moore, Catherine Park
Journal: Cancer Research (2007)

Abstract Aberrant microenvironments and loss of balance in cell-extracellular matrix signaling are associated with breast cancer invasion, metastasis, and resistance to therapy. We have recently shown that increased β1 integrin signaling is involved in malignant progression and that inhibitory antibody to β1 integrin leads to selective apoptosis and decreased proliferation in three-dimensional cultures and in xenograft models of breast cancer in vivo. To investigate the clinical importance of these findings, in the present study we examined the expression of β1 integrin and extracellular β1 integrin ligands fibronectin and laminin-1 in a cohort of 249 breast cancer patients who had a median follow-up of 8.4 years. Among the 149 scorable cases, the highest β1 integrin intensity score (3+ versus 0–2+) was associated with significantly decreased 10-year overall survival of 48% versus 71% (P &amp;lt; 0.03) and decreased disease-free survival of 50% versus 80% (P &amp;lt; 0.05). Importantly, high fibronectin expression was associated with decreased overall and disease-free survival on univariate analysis (P &amp;lt; 0.04) and β1 integrin intensity score was significantly correlated with fibronectin expression (Kendall's tau-b = 0.19; P = 0.03). In a multivariate Cox proportional hazards model, β1 integrin intensity score remained a significant independent predictor of overall survival [hazard ratio (HR), 1.69; 95% confidence interval (95% CI), 1.19–2.38; P &amp;lt; 0.003] and disease-free survival (HR, 1.87; 95% CI, 1.21–2.88; P &amp;lt; 0.005). These findings show that β1 integrin expression has potential prognostic value in invasive breast cancer and that coexpression of fibronectin may help identify patients with more aggressive tumors who may benefit from targeted therapy. [Cancer Res 2007;67(2):659–64]