tbuckley/cabot-search huggingface dataset:
99mTc-Sodium Pertechnetate Permeation into Cerebrospinal Fluid
Authors: A BORKAR, H DaCOSTA
Journal: Clinical Nuclear Medicine (1979)

The integrity of the blood-brain barrier may be reflected by the blood and cerebrospinal fluid (CSF) if these two compartments are sampled at an appropriate interval after the administration of certain substances. After reading through the controversial literature, this study was undertaken to determine the frequency with which 99mTc-sodium pertechnetate entered the CSF to an abnormal extent, and to see whether this was related to any particular pathology. The plasma-to-CSF ratios were determined in 51 patients 4 hours following the intravenous administration of 0.5-10 mCi 99mTc-sodium pertechnetate. In 23 patients with active CNS tuberculosis, the mean value of the pertechnetate plasma-to-CSF ration was 32.12. In contradistinction, the plasma-to-CSF pertechnetate in 28 nontuberculous subjects was considerably higher (144.63). For the purpose of correlation, a 82Br partition test was also done on each subject 48 hours following the oral administration of NHS82Br. The 48-hour study in each of these cases was generally in agreement with the pertechnetate studies: the plasma-to-CSF ratio mean value was 1.25 in patients with active CNS tuberculosis, while for the nontuberculous patients it was 3.32
Framework for children aims to produce “cultural change”
Authors: Kathryn Godfrey
Journal: BMJ (2004)

The government has announced a 10 year plan to change the way children's health services are delivered in England, putting children at the centre of care.

Health Secretary John Reid proclaimed at the launch of the national service framework last week that children need more personalised services that are tailored to meet their individual needs. “Children and young people are not just mini-adults,” he said.

The standards in the framework promise accessible and age appropriate services, earlier diagnosis and intervention, and a smoother transition from child to adult services.

It details more services for adolescents, closer working with parents, and a reduction in inequalities in health between children. The framework also aims to integrate health, social, and education services in children's centres.

The framework, which has been three …
Primary antiphospholipid antibody syndrome with mutations in the phospholipid binding domain of ?2-glycoprotein I
Authors: Francisca C. Gushiken, Frank C. Arnett, Perumal Thiagarajan
Journal: American Journal of Hematology (2000)

β2-Glycoprotein I, an anionic phospholipid-binding 50-kDa plasma protein, circulates in the plasma at a concentration of 30–200 μg/ml. Its physiological role remains uncertain, but an important clue to this role is suggested by the finding that antibodies to this protein are frequently found in patients with antiphospholipid antibodies and thrombosis. β2-Glycoprotein I belongs to the complement control protein (CCP) superfamily with five CCP domains. The fifth CCP domain of β2-glycoprotein I has a unique structure and contains a stretch of positively charged amino acids that mediates the binding to phospholipids. This interaction may mediate the clearance of anionic phospholipid-containing surfaces from the circulation. Mutations in this domain affect its binding to phospholipids. We have identified a patient with primary antiphospholipid syndrome who is a compound heterozygous for two mutations in the fifth CCP. One mutation is located in exon 7 (codon 306), and the second mutation is in exon 8 (codon 316). The mutant β2-glycoprotein I was present in normal quantities in his plasma but did not bind to cardiolipin. He had recurrent deep vein thrombosis and pulmonary embolism at age 28 and a thrombotic stroke at age 35, with no other identifiable risk factor for a hypercoagulable state. This report offers some insight into the mechanism of formation of antiphospholipid antibodies and suggests the possible role of the deficiency of β2-glycoprotein I in the pathogenesis of thrombosis. Am. J. Hematol. 65:160–165, 2000. © 2000 Wiley-Liss, Inc.
Characterization of the cellular infiltrate during successful topical treatment of lentigo maligna with imiquimod
Authors: P. Michalopoulos, N. Yawalkar, M. Bronnimann, A. Kappeler, L.R. Braathen
Journal: British Journal of Dermatology (2004)

Lentigo maligna (LM) is an in situ melanoma which usually occurs in sun-damaged skin on the head and neck of elderly patients. Depending on the anatomical site and its size treatment of LM can be problematic and usually includes surgical excision or radiotherapy. Recent reports indicate that topical imiquimod may be an effective treatment. However, no data on the underlying immune response in the skin during treatment of LM with topical imiquimod are available so far. We report a 62-year-old caucasian woman with a histologically verified LM which was successfully treated with topical imiquimod 5% cream. Skin biopsy specimens were obtained before, during (at week 10) and 4 weeks after cessation of topical treatment with imiquimod 5% cream. Histological and immunohistochemical examination was performed in order to detect residual atypical melanocytes and to characterize the inflammatory infiltrate. A complete clinical and histological clearance of the skin lesion was achieved, with no recurrence up to 9 months after the end of treatment. During topical application of imiquimod 5% cream a depletion of epidermal and dermal CD1a+ dendritic cells was observed. The inflammatory infiltrate consisted of CD68+ macrophages and mainly of CD3+ T cells with a slight predominance of CD8+ T cells. An enhanced expression of granzyme B and TIA-1 was also noted particularly in the epidermis and near the dermoepidermal junction. In conclusion, our data indicate that imiquimod 5% cream induces a cytotoxic T-cell-mediated immune response in situ which may account for the complete destruction of the malignant melanocytes in LM. Further clinical trials and longer follow-up periods on the use of imiquimod for LM are warranted.
Generation and Characterization of E1/E2a/E3/E4-Deficient Adenoviral Vectors Encoding Human Factor VIII
Authors: Julie L. Andrews, Michael J. Kadan, Mario I. Gorziglia, Michael Kaleko, Sheila Connelly
Journal: Molecular Therapy (2001)

The use of adenoviral vectors for gene therapy has been limited due to host immune responses directed toward the vector and/or transgene and vector toxicity. To decrease adenoviral vector immunogenicity and toxicity, we attenuated viral gene expression by eliminating E1, E2a, E3, and E4 early genes from the adenoviral backbone. Two highly attenuated, fourth-generation (Av4) E1/E2a/E3/E4-deficient adenoviral vectors encoding human factor VIII (FVIII) under the control of a liver-specific albumin promoter were generated. One Av4 vector (Av4DeltaE4FVIII) was deficient in the entire E4 coding region and the second vector contained a deletion of the E4 region, except for open reading frame 3 (orf 3; Av4orf3FVIII). The Av4 vectors were compared to an E1/E2a/E3-deficient third-generation vector (Av3H8101) containing an analogous transgene expression cassette in vitro and in vivo following intravenous administration in hemophiliac mice. In vitro transduction of Hep3B cells revealed at all three vectors expressed functional FVIII. However, the Av4DeltaE4FVIII vector could not be scaled-up for in vivo studies. Both Av3H8101 and Av4orf3FVIII initially expressed similar levels of FVIII in hemophiliac mice. However, at 3 months, animals treated with the Av4orf3FVIII vector no longer expressed FVIII while Av3H8101-treated mice displayed persistent FVIII expression. Liver enzyme analyses of plasma samples revealed that the Av4orf3FVIII vector was significantly less hepatotoxic than the Av3H8101 vector. These data demonstrate that further attenuation of the adenoviral vector backbone by removal of the majority of the E4 coding region significantly diminished vector toxicity; however, the duration of transgene expression was reduced.
NEUROLOGIC ASPECTS OF LOW-BACK PAIN
Authors: HENRY ALSOP RILEY
Journal: JAMA (1928)

Any exhaustive discussion of the etiologic factors that may be responsible for pain in the back is impossible in a presentation of this kind, but there are a group of deviations from the normal which must come forward prominently for discussion when low-back pain is the subject under consideration. Many etiologic factors, extraneural in origin, deserve a prominent place in such a discussion, but in this connection attention is chiefly directed to those conditions in which pain is the result of an involvement of the nervous system. The neurologist, for one or many reasons, is constantly called on to determine the cause of pain. This situation has arisen as a result of the concurrent action of a considerable number of factors, the most weighty of which is perhaps the prevalence of pain as a symptom of a functional disturbance. This differentiation, even to the neurologist and psychiatrist, constantly in contact
A NOTE ON FOOD ALLERGY
Authors: A. M. Kennedy
Journal: BMJ (1932)

of the liver, and Glenard himself showed the importance of the hepatic element in such conditions.Insulin treat- ment, combined with glucose feeding, also constitutes ani important element in the treatment of such patients, lout is not successful with all of them.It is better applied in a nursing home.Crenotherapy must be applied to such patients when their condition is not far advanced.The Vichy type of spa is essentially indicated, because it acts as Glenard has shown, through the modification of the functions of the liver.Carlsbad and Chatel-Guyon are indicated in forms with distinct constipation; Harro- gate, Bridge-of-Allan Spa, Cheltenham Spa, Leamington Spa, Vittel, Kissingen, and Wiesbaden for a milder treatment.Surgery must be considered only as an adjuvant method, anid is indicated exclusively, in may opinion, when the luodenum is involved.Even in this case everything must be done to treat the patient medically before there is any surgical intervention, and also to continue inter-IlistiC treatment after surgical operation.I have seen so many patients, after a more or less short temporary relief following operation, relapse into their previous condition, that I am becoming more and more sceptical about the success of these procedures.I am asking myself if that temporary relief has not been determined by the enforced rest and severe treatment in a nursing home necessitated by the operation.Such nursing home treat- ient, incidentally, is much indicated in these cases.GASTRO-ENTEROPTOSIS WITH PERIVISCERITIS This is the fourth form of gastro-enteroptosis, and differs from a clinical, physiopathological, and thera- peutical point of view from the others.Clinically it is characterized principally by the fact that pains are more intense, more permanent, and are not relieved in the horizontal position, nor by Glenard's test.Digestive disturbances, gastric or intestinal, are also more marked, more permanent, and also persist in the horizontal position or in the eliciting of the Glenard's test.The general
PTU-068 Biliary matrix metalloproteinase 9 levels are independent of neutrophil gelatinase-associated lipocalin in patients with malignant biliary obstruction
Authors: A Latif, A Zabron, V Horneffer-Van der Sluis, C Wadsworth, D Westaby, P Vlavianos, S Taylor-Robinson, R Edwards, S Khan
Journal: Gut (2012)

<h3>Introduction</h3> Better biomarkers are urgently needed to assist accurate diagnosis and appropriate treatment of malignant biliary obstruction, as, although malignancy is a common cause of obstructive jaundice, current diagnostic techniques often fail to differentiate benign from malignant disease. Molecular analysis of bile has recently produced promising candidate biomarkers. Previous work from our group found that biliary neutrophil gelatinase-associated lipocalin (NGAL), a small extracellular 25-kDa protein with several biological functions, differentiates obstructive jaundice from malignancy from that in benign disease. The mechanism of NGAL in hepatopancreatobiliary (HPB) malignancy is unknown, although in other systems it promotes neoplastic diffusion by complexing and stabilising matrix metalloproteinase-9 (MMP9), enabling local invasion. <h3>Aims</h3> (1) To investigate possible biliary complexing of MMP9 and NGAL as a mechanism of tumorigenesis. (2) To validate our previous findings of biliary NGAL as a novel biomarker of malignancy in biliary obstruction. <h3>Methods</h3> Bile samples were collected from 77 patients undergoing ERCP (n=77, 22 with malignant disease and 55 with benign disease) at Imperial College London. ELISA was used to quantify levels of MMP9/NGAL complexes and of NGAL and MMP9 occurring independently in bile. Pearson9s correlation analysis was used to determine the relationship between NGAL, MMP9 and NGAL/MMP9 complex levels, and statistical significance assessed by the Mann–Whitney U test. <h3>Results</h3> Biliary NGAL levels were significantly higher in malignant biliary obstruction compared to benign disease (median 1555 ng/ml vs 402 ng/ml, p=0.003), giving a ROC AUC of 0.74. Biliary MMP9 and NGAL/MMP9 complex levels were not different between these groups (p=0.527, p=0.760). Unbound biliary NGAL and MMP9 levels correlated poorly (r<sup>2</sup>=0.03, p&gt;0.05). Unbound NGAL correlated poorly with complex (r<sup>2</sup>=0.07, p&gt;0.05) whereas unbound MMP9 correlated with NGAL/MMP9 complex level (r<sup>2</sup>=0.73, p&lt;0.05). <h3>Conclusion</h3> This study is novel in confirming the presence of MMP9 in bile, alone and in complex with NGAL. However, although NGAL was increased in malignancy, MMP9 and MMP9/NGAL complex were not, suggesting that NGAL acts independently of MMP9 in endobiliary HPB malignancy. Mechanisms remain to be elucidated. This study also supports previous reports of NGAL as a novel and independent bile biomarker of malignant biliary obstruction. <h3>Competing interests</h3> None declared.
Subcutaneously administered antibiotics: a national survey of current practice from the French Infectious Diseases (SPILF) and Geriatric Medicine (SFGG) society networks
Authors: E. Forestier, M. Paccalin, C. Roubaud-Baudron, T. Fraisse, G. Gavazzi, J. Gaillat
Journal: Clinical Microbiology and Infection (2014)
Hypovitaminosis D and ethnic differences in insulin resistance
Authors: Hong-Fang Ji
Journal: Hepatology (2010)

I read with great interest the article by Guerrero et al.,1 who used a large population-based study and several spectroscopic and imaging methodologies to assess the contribution of body fat distribution to the differing rates of hepatic steatosis in the three major US ethnic groups (African American, Hispanic, and Caucasian). They suggested that the differing rates of hepatic steatosis among the three ethnic groups are associated with similar differences in visceral adiposity. Interestingly, in comparison with either Hispanics or Caucasians, African Americans appear to be more resistant to the hypertriglyceridemia associated with insulin resistance despite their lower levels of intraperitoneal and liver fat.1 Here I propose hypovitaminosis D as a potential underlying mechanism for the high prevalence of insulin resistance in African Americans on the basis of the following findings. First, numerous studies have demonstrated that vitamin D insufficiency and hypovitaminosis D are more prevalent among African Americans than other Americans.2-6 This is primarily due to the fact that pigmentation reduces vitamin D production in the skin.2 A cross-sectional analysis of serum 25-hydroxyvitamin D levels showed that hypovitaminosis D was present in a substantial proportion of the studied African American population, even in the South and among those meeting recommended dietary guidelines.5 Moreover, no significant difference was found in the proportion of vitamin D insufficiency between obese and nonobese preadolescent African American children.6 Second, previous studies have established that vitamin D insufficiency and hypovitaminosis D are associated with insulin resistance.7-9 For instance, by using a hyperglycemic clamp technique in a group of healthy, glucose-tolerant subjects, Chiu et al.9 showed a positive correlation between the 25-hydroxyvitamin D concentration and insulin sensitivity, and subjects with hypovitaminosis D were found to be at higher risk for insulin resistance and metabolic syndrome. These findings make it rational for us to infer that the prevalence of vitamin D insufficiency and hypovitaminosis D among African Americans can increase their risk of insulin resistance. This may account in part for the fact that despite the lower levels of intraperitoneal and liver fat in African Americans, their prevalence of insulin resistance is similar to that of Hispanics, who possess the highest intraperitoneal and liver fat levels.1 Therefore, vitamin D insufficiency and hypovitaminosis D in African Americans may provide useful clues for understanding their high prevalence of insulin resistance. Hong-Fang Ji Ph.D*, * Shandong Provincial Research Center for Bioinformatic Engineering and Technique, Shandong University of Technology, Zibo, People's Republic of China.
Generation of cytolytic T cells in individuals infected by Mycobacterium tuberculosis and vaccinated with BCG.
Authors: A D Pithie, M Rahelu, D S Kumararatne, P Drysdale, J S Gaston, P B Iles, J A Innes, C J Ellis
Journal: Thorax (1992)

Some reports have suggested that naloxone, a short-acting opiate receptor blocker given intravenously, has a beneficial effect on the symptoms of senile dementia of the Alzheimer type. We have performed a double-blind, crossover trial of naltrexone, an orally active, long acting opiate antagonist, in 17 Alzheimer-type dementia patients. None showed any improvement in assessments of day-to-day living skills or on a battery of neuropsychological tests. No side effects were noted. In the dosage used, naltrexone appears not to be useful in Alzheimer-type dementia.
Ethics in sports medicine
Authors: S. Holm, M. McNamee
Journal: BMJ (2009)

Professional standards need to be clarified and acted on

Doctors and other healthcare professionals have been involved in facilitating both legitimate and illegitimate performance enhancement in sport.1 2 The recent “bloodgate” affair in Rugby Union shows that healthcare professionals can be involved in producing fake injuries in situations where the apparent “injury” creates an advantage for the team.3 

The incident happened last April at the semifinals of the European Rugby Cup match between Harlequins and the eventual winners Leinster. Normally in Rugby Union players cannot return to play once they have been substituted except to replace a player who has a “blood injury.” A Harlequins player produced an apparent blood injury through the use of a fake blood capsule so that a specialist goal kicker could be brought back on to the field to try to secure victory in the last few minutes. At the behest of the head coach, the team physiotherapist had purchased fake blood capsules in advance of the game and had delivered one to the player during …
14C triolein breath test: an assessment in the elderly.
Authors: K Mylvaganam, P R Hudson, A Herring, C P Williams
Journal: Gut (1989)

14C triolein breath tests are highly sensitive in detecting fat malabsorption in adults, but experience in the elderly is sparse. We have evaluated 48 9normal9 subjects over the age of 65 years and compared the results with those of 46 normal subjects under 65 from a previous study. Results were calculated as eight hour cumulative values and expressed as percentages of the administered dose. Reference ranges have been calculated separately for the following age groups: 65 years or less (201 to 460), 66 to 75 (182 to 405) and over 75 (141 to 336). A clear age related decline in eight hour cumulative values was noted. The values fell by 23% between the ages of 17 and 65 years and by 25% between the ages of 65 and 87 years. Pancreatic insufficiency or bacterial colonisation of the small bowel is unlikely, but delayed intestinal absorption or the effects of slower metabolic rate cannot be excluded. This test is simple and practicable in the elderly and the study emphasises the importance of age in the interpretation of results.
Leiomyoma of the Stomach with Ulceration
Authors: S. I. Levy, J. S. Horn
Journal: BMJ (1941)

The patient should be moved as little as possible on his return to bed.He should be placed in the right lateral position, and be allowed to recover in peace, a careful watch being kept to prevent any obstruction of the airway.Apart from any other consideration, anoxaemia seems to be a pronounced predisposing factor in the causation of vomiting.Post-operative sedation should be applied, and the use of suppositories.g., nembutal-should not be forgotten.Vomiting which is actually occurring may be treated by a variety of remedies.Drinks of hot water, to which 10 to 15 grains of sodium bicarbonate may be added, strong hot black coffee, Lugol's iodine, and sips of champagne all have their measure of success.Lenevitch (1892) advised washing out the stomach with warm alkaline solution (sodium bicarbonate).Though suggested at such a relatively early date, this line of treatment has proved most efficaciobs, especially in cases of persistent vomiting. SummaryThe incidence of post-anaesthetic vomiting in 1,000 consecutive cases is compared with that in four series, each of 100 cases, in which a different anaesthetic sequence was used.The effect of sex and of certain surgical procedures on the incidence of post-anaesthetic vomiting is shown, particular refer- ence being made to oro-nasal and minor gynaecological operations.Lines of treatment for this condition are suggested.My thanks are due to Dr. I. W.
Non-clinical bed management strategies in psychiatry
Authors: S. M. Smith, D. Herlihy
Journal: BMJ (2010)

The MDR1 gene product, P-glycoprotein, has been localized to the apical surface of the renal proximal tubule, but its functional role in the kidney is unknown. We studied renal luminal and antiluminal uptake of three known substrates of P-glycoprotein: vinblastine, vincristine and colchicine, by using the single pass multiple indicator dilution method under control conditions and in the presence of increasing concentrations of cyclosporin A, a potent inhibitor of P-glycoprotein. A bolus of [125I]albumin (plasma reference), L-[14C]glucose (extracellular and glomerular reference) and tracer 3H-substrate was injected into the left renal artery of anesthetized dogs and timed serial samples were collected from the left renal vein and left and right ureters. In a single pass, approximately 38, 13 and 8% of [3H]vinblastine, [3H] vincristine and [3H]colchicine, respectively, was extracted from the postglomerular circulation. Drug binding to plasma proteins was determined to be 81% for [3H]vinblastine, 71% for [3H] vincristine and 23% for [3H]colchicine. Despite the high degree of drug protein binding, the urine recoveries of [3H]vinblastine, [3H]vincristine and [3H]colchicine relative to L-[14C]glucose were 0.75 +/- 0.06, 0.69 +/- 0.06 and 0.94 +/- 0.02, confirming net secretion of each of these substrates. Infusion of cyclosporin A (0.1-5 microM) significantly decreased the urine recovery of [3H] vinblastine and [3H]vincristine relative to L-[14C]glucose in a dose-dependent manner. The renal excretion of [3H]colchicine was not affected by cyclosporin A at the concentrations tested (1-2 microM). The evidence suggests that net secretion of [3H]vinblastine and [3H]vincristine occurs across the luminal membrane of the renal cell.(ABSTRACT TRUNCATED AT 250 WORDS)