tbuckley/cabot-search huggingface dataset:
Management of the Thoracic-Outlet Syndrome
Authors: Harold C. Urschel, Maruf A. Razzuk
Journal: New England Journal of Medicine (1972)

THORACIC-outlet syndrome refers to compression of the subclavian vessels and brachial plexus at the superior aperture of the thorax. It was previously designated according to presumable etiologies such as scalenus anticus, costoclavicular, hyperabduction, cervical rib and first-thoracic-rib syndromes. Wider clinical recognition of this syndrome can be attributed to improved methods of diagnosis and therapy. The determination of ulnar-nerve conduction velocity (UNCV) for objective evaluation of compression has improved diagnosis, selection of treatment and assessment of therapeutic results. Surgical therapy is currently directed toward extirpation of the first rib, the common denominator for most of the compression mechanisms (Fig. 1).Diagnosis . . .
Natural history of small untreated hepatocellular carcinoma in cirrhosis: A multivariate analysis of prognostic factors of tumor growth rate and patient survival
Authors: Luigi Barbara, Giovanna Benzi, Stefano Gaiani, Fabio Fusconi, Gianni Zironi, Sebastiano Siringo, Alessandra Rigamonti, Carlotta Barbara, Walter Grigioni, Alighieri Mazziotti, Luigi Bolondi
Journal: Hepatology (1992)

We analyzed the growth pattern of tumor masses and the survival of 39 asymptomatic Italian patients with a total of 59 small (⩽ 5 cm in diameter) hepatocellular carcinomas arising from cirrhosis. The total length of the observation period ranged from 90 to 962 days, with an average of 364 ± 229 (mean ± S.D.). Doubling time ranged from 27.2 to 605.6 days (mean ± S.D., 204.2 ± 135; median = 171.6 days). Three different growth patterns were recognized: (a) tumors with no or very slow initial growth pattern (doubling time > 200 days), 10 cases (37%); (b) tumors with declining growth rate over time, 9 cases (33.4%); and (c) tumors with almost constant growth rate, 8 cases (29.6%). Using the stepwise discriminant analysis, we found a score based on albumin, alcohol intake, number of nodules, echo pattern and histological type that allowed a correct prediction of short doubling time (⩽ 150 days) in 55.6%, medium doubling time (151 to 300 days) in 60% and long doubling time (>300 days) in 100% of cases. The estimated survival rate of the 39 patients, calculated by the Kaplan-Meier method was 81% at 1 yr, 55.7% at 2 yr and 21% at 3 yr. Stepwise discriminant analysis showed that a score based on sex, HBsAg status, alcohol consumption, ascites, γ-glutamyltranspeptidase, prothrombin time, Child-Pugh class and all the sonographical parameters could predict 2-yr survival in 100% of cases. We conclude that great variability of growth patterns exists among and within small hepatocellular carcinomas. Prediction of subsequent growth rate is unreliable in most cases. The sonographical characteristics, together with the histological features, can, however, help in identifying cases with long doubling time (>300 days). The discriminant analysis on survival of cirrhotic patients with small hepatocellular carcinomas demonstrates that the underlying liver disease plays a key role in the long-term survival probability. (HEPATOLOGY 1992;16:132–137.)
Chinese government pledges to tackle pollution crisis
Authors: J. Parry
Journal: BMJ (2014)

China’s premier, Li Keqiang, has declared a “war on pollution,” saying that the country would tackle it with the same determination it has used to fight poverty in the past three decades.

Speaking at the annual meeting of the National People’s Congress, Premier Li said the priority was to reduce emissions of particulate matter with an aerodynamic diameter of less that 10 micrometres and less than 2.5 micrometres (PM10 and PM2.5, respectively), through measures such as the closure of 50 000 small coal fired furnaces and the decommissioning of six million old vehicles, the Xinhua news agency reported. 

The announcement came a week after the country had experienced record levels of air pollution across wide swathes of the country. The Ministry of Environmental Protection’s satellite monitoring showed that on 22 February around 800 000 square kilometres of central and eastern China were under heavily polluted skies, …
Inactivation of extrahepatic vascular Akt improves systemic hemodynamics and sodium excretion in cirrhotic rats
Authors: G. Fernández-Varo, P. Melgar-Lesmes, G. Casals, M. Pauta, V. Arroyo, M. Morales-Ruiz, J. Ros, W. Jiménez
Journal: Journal of Hepatology (2010)
NLRP12 Suppresses Colon Inflammation and Tumorigenesis through the Negative Regulation of Noncanonical NF-κB Signaling
Authors: Irving C. Allen, Justin E. Wilson, Monika Schneider, John D. Lich, Reid A. Roberts, Janelle C. Arthur, Rita-Marie T. Woodford, Beckley K. Davis, Joshua M. Uronis, Hans H. Herfarth, Christian Jobin, Arlin B. Rogers, Jenny P.-Y. Ting
Journal: Immunity (2012)
Auditory System: Anatomy, Physiology (Ear)
Authors: Robert W. Cantrell
Journal: JAMA (1975)

In the introduction of this book, George von Békésy, who became a Nobel laureate for his research on the ear, states that it is best to write a handbook when the number of research findings reach a maximum, and newer experiments show a certain redundancy. He refers to books on hearing by von Helmholtz (1863) and Bethe and Bergmann (1928) as examples of textbooks published at the right time, and predicts this volume (actually one of three volumes to be published) will form a platform from which new advances can be made. This superb work will surely live up to that prediction. The editors, Keidel of Erlangen, and Neff of Bloomington, are both highly respected in the neural sciences, and they could have contributed much by including some of their own writing. They chose, instead, to select authors who would write about the work in the field that each knew
Determination of Total Effective Vascular Compliance in Patients with Sepsis Syndrome
Authors: FRANÇOIS STEPHAN, ANA NOVARA, BRUNO TOURNIER, JEAN-MICHEL MAILLET, GÉRARD M. LONDON, MICHEL E. SAFAR, JEAN-YVES FAGON
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Changes in capacitance vessels have important consequences on cardiac filling pressure and fluid volume distribution in patients with sepsis syndrome. Vascular compliance may be evaluated from the slope of the relationship between changes in total blood volume ( Δ TBV) and changes in central venous pressure ( Δ CVP) during acute volume expansion (450 ml of gelatin fluid over 6 min), i.e., from the Δ TBV/ Δ CVP ratio. The mean ratio (ml × mm Hg− 1 × kg− 1) was 2.03 ± 0.21 in control subjects, 1.43 ± 0.25 in mechanically ventilated patients without sepsis syndrome, and 0.94 ± 0.24 in mechanically ventilated patients with sepsis syndrome (p < 0.0001 versus the other two groups). Based on echocardiographic determinations, cardiac performance was constantly found within the normal range (cardiac output ranged from 5.6 ± 1.2 to 6.7 ± 2.0 L/min in nonseptic patients from 6.8 ± 1.9 to 7.8 ± 2.2 in septic patients). Effective compliance of the total vascular bed is therefore reduced in patients with sepsis syndrome, independently of the hemodynamic modifications due to mechanical ventilation.
Hypertensive rats produced by in vivo introduction of the human renin gene.
Authors: N Tomita, J Higaki, Y Kaneda, H Yu, R Morishita, H Mikami, T Ogihara
Journal: Circulation Research (1993)

We established an efficient and nontoxic in vivo gene transfer method mediated by the Sendai virus (hemagglutinating virus of Japan [HVJ]), liposomes, and nuclear protein. In this study, to produce a hypertensive model rat that is dependent on human renin, the human renin gene was introduced into adult rat liver by our efficient in vivo gene transfer method using HVJ and liposomes (HVJ-liposomes). The rats treated with HVJ-liposomes containing the human renin gene showed a significant elevation of blood pressure for 6 days compared with control rats, which received injections of HVJ-liposomes without the human renin gene. On day 5 after the transfer, human active renin as well as angiotensin II were found in the plasma of rats in which the human renin gene was introduced. Moreover, the blood pressure of these rats was significantly correlated with the plasma levels of human active renin and angiotensin II. To confirm that the elevated blood pressure was due to the expression of the human renin gene, we administered a newly developed specific human renin inhibitor, FK 906. The elevated blood pressure was normalized by the intravenous administration of this drug. These data indicate that this hypertensive rat was produced by the in vivo transfer of the human renin gene into rat liver and that the expressed human renin cleaved rat substrate (angiotensinogen). This hypertensive rat produced by in vivo gene transfer should be useful in further studies on hypertension.
Female-to-Male Transmission of HTLV-III-Reply
Authors: Robert R. Redfield
Journal: JAMA (1986)

<h3>In Reply.—</h3> Because AIDS has been diagnosed almost exclusively in members of "high-risk" groups, physicians often do not consider the diagnosis of HTLV-III infection in individuals who do not belong to these risk groups. We have looked for evidence of HTLV-III infection in all patients (of either sex) presenting to our infectious disease service with the appropriate signs or symptoms and also their sexual partners. This case-finding methodology is etiologically based and epidemiologically sound. Our report documented the occurrence of HTLV-III disease in non-drug-using heterosexual males and females, thus providing scientifically sound evidence for bidirectional heterosexual transmission. Our report did not purport to define the relative risk of infection that is associated with either multiple heterosexual contacts or prostitute contacts. In a heterosexual population, we suggested that the risk of infection with HTLV-III will be more likely in individuals with multiple sexual partners or in individuals whose sexual contacts (eg,
Functional Evaluation of the Medtronic Stentless Porcine Xenograft Mitral Valve in Sheep
Authors: P. Dagum, G. R. Green, T. A. Timek, G. T. Daughters, L. E. Foppiano, T. L. Tye, A. F. Bolger, N. B. Ingels, D. C. Miller
Journal: Circulation (1999)

Recently, renewed interest in allograft and stentless "freehand" bileaflet xenograft mitral valve replacement has arisen. The variability of human papillary tip anatomy and scarcity of donors limit allograft availability, making xenograft mitral valves an attractive alternative; however, these valves require new surgical implantation techniques, and assessment of their hemodynamics and functional geometry is lacking.Seven sheep underwent implantation of a new stentless, glutaraldehyde-preserved porcine mitral valve (Physiological Mitral Valve [PMV], Medtronic) and were studied acutely under open-chest conditions. A new method of retrograde cardioplegia was developed. Hemodynamic valve function was assessed by epicardial Doppler echocardiography. 3D motion of miniature radiopaque markers sutured to the valve leaflets, annulus, and papillary tips was measured. Six other sheep with implanted markers served as controls.Both papillary muscle tips avulsed in the first animal, leaving 6 other animals. Mitral regurgitation was not observed in any xenograft valve. The peak and mean transvalvular gradients were 4.6+/-1.8 mm Hg and 2.6+/-1.5 mm Hg, respectively. The average mitral valve area was 5.7+/-1.6 cm(2). Valve closure in the xenograft group occurred later (30+/-11 ms, P<0. 015) and at higher left-ventricular pressure (61+/-9 mm Hg, P<0.001) than in the control group; furthermore, leaflet coaptation was displaced more apically (5.6+/-2.2 mm, P<0.001) and septally (5. 8+/-1.5 mm, P<0.001), and the anterolateral papillary tip underwent greater septal-lateral displacement (2.7+/-1.5 mm, P<0.001). Annular contraction during the cardiac cycle was similar in the 2 groups (xenograft 9.2+/-4.5% versus control 10.6+/-4.5% [mean+/-SD; 2-factor ANOVA model]).Successful freehand stentless porcine mitral valve implantation is feasible in sheep and was associated with excellent early postoperative hemodynamics. Physiological mitral valve annular contraction and functional leaflet closure mechanics were preserved. Long-term valve durability, calcification, and hemodynamic performance remain to be determined in models.
Minimum alcohol price is compatible with EU law, says Scottish court
Authors: B. Christie
Journal: BMJ (2013)

<h3>Objective</h3> To identify the risk factors associated with complaints, malpractice claims and impaired performance in medical practitioners. <h3>Design</h3> Systematic review. <h3>Data sources</h3> Ovid-Medline, Ovid Embase, Scopus and Cochrane Central Register of Controlled Trials were searched from 2011 until March 2020. Reference lists and Google were also handsearched. <h3>Results</h3> Sixty-seven peer-reviewed papers and three grey literature publications from 2011 to March 2020 were reviewed by pairs of independent reviewers. Twenty-three key factors identified, which were categorised as demographic or workplace related. Gender, age, years spent in practice and greater number of patient lists were associated with higher risk of malpractice claim or complaint. Risk factors associated with physician impaired performance included substance abuse and burn-out. <h3>Conclusions</h3> It is likely that risk factors are interdependent with no single factor as a strong predictor of a doctor’s risk to the public. Risk factors for malpractice claim or complaint are likely to be country specific due to differences in governance structures, processes and funding. Risk factors for impaired performance are likely to be specialty specific due to differences in work culture and access to substances. New ways of supporting doctors might be developed, using risk factor data to reduce adverse events and patient harm. <h3>PROSPERO registration number</h3> PROSPERO registration number: CRD42020182045.
Chronic Hepatitis C Virus Infection — A Disease in Waiting?
Authors: Albert J. Czaja
Journal: New England Journal of Medicine (1992)

The existence of non-A, non-B hepatitis was deduced in the mid-1970s when the new serologic tests for hepatitis B virus infection could not explain a substantial proportion of the cases of transfusion-associated hepatitis.1 Subsequent studies showed that non-A, non-B hepatitis was transmitted mainly by exposure to contaminated blood or blood products, but sporadic or community-acquired disease was also recognized.2 The acute infection was characterized as mild, but with persistent inflammatory activity as a potential long-term liability.3 Retrospective analyses were initially unable to confirm the projections of morbidity due to chronic non-A, non-B infection, emphasizing instead its relatively benign short-term prognosis. . . .
Hypoxia alters early gestation human cytotrophoblast differentiation/invasion in vitro and models the placental defects that occur in preeclampsia.
Authors: O Genbacev, R Joslin, C H Damsky, B M Polliotti, S J Fisher
Journal: Journal of Clinical Investigation (1996)

During normal human pregnancy a subpopulation of fetal cytotrophoblast stem cells differentiate and invade the uterus and its arterioles. In the pregnancy disease preeclampsia, cytotrophoblast differentiation is abnormal and invasion is shallow. Thus, the placenta is relatively hypoxic. We investigated whether lowering oxygen tension affects cytotrophoblast differentiation and invasion. Previously we showed that when early gestation cytotrophoblast stem cells are cultured under standard conditions (20% O2) they differentiate/invade, replicating many aspects of the in vivo process. Specifically, the cells proliferate at a low rate and rapidly invade extracellular matrix (ECM) substrates, a phenomenon that requires switching their repertoire of integrin cell-ECM receptors, which are stage-specific antigens that mark specific transitions in the differentiation process. In this study we found that lowering oxygen tension to 2% did not change many of the cells' basic processes. However, there was a marked increase in their incorporation of [3H]thymidine and 5-bromo-2'-deoxyuridine (BrdU). Moreover, they failed to invade ECM substrates, due at least in part to their inability to completely switch their integrin repertoire. These changes mimic many of the alterations in cytotrophoblast differentiation/invasion that occur in preeclampsia, suggesting that oxygen tension plays an important role in regulating these processes in vivo.
Remodeling of Sinus Node Function in Patients With Congestive Heart Failure
Authors: Prashanthan Sanders, Peter M. Kistler, Joseph B. Morton, Steven J. Spence, Jonathan M. Kalman
Journal: Circulation (2004)

Experimental and clinical studies have demonstrated diffuse atrial remodeling in congestive heart failure (CHF). We hypothesized that patients with CHF would demonstrate derangement of sinus node function.Eighteen patients with symptomatic CHF (left ventricular ejection fraction, 26+/-5%) and 18 age-matched control subjects were studied. Under autonomic blockade, the following were evaluated: intrinsic sinus cycle length, corrected sinus node recovery time (CSNRT), sinoatrial conduction time, number and duration of fractionated electograms or double potentials along the crista terminalis, and location of the earliest sinus activity. Electroanatomic mapping was performed to evaluate the location and nature of the sinus node complex, to characterize sinoatrial propagation, and to evaluate conduction abnormalities and voltage amplitude along the crista terminalis. Patients with CHF demonstrated the following findings compared with age-matched control subjects: prolongation of the intrinsic sinus cycle length (P=0.005), prolongation of CSNRT (P<0.0001), caudal localization of sinus activity both during sinus rhythm (P=0.03) and after pacing (P=0.002), prolongation of sinoatrial conduction time (P=0.02), greater number (P<0.0001) and duration (P<0.0001) of fractionated electrograms or double potentials along the crista terminalis, loss of voltage amplitude along the crista terminalis (P=0.02), and abnormal and circuitous propagation of the sinus impulse.This study demonstrates that patients with CHF have significant sinus node remodeling characterized by anatomic and structural changes along the crista terminalis with a reduction in functional sinus node reserve. This finding may have implications for the development of clinical bradycardia in CHF and for the use of negatively chronotropic agents and pacing in this condition.
Adrenal Gland Obtained at Percutaneous Renal Biopsy
Authors: Maurice Pearl
Journal: JAMA (1966)

<h3>To the Editor:—</h3> I was unaware that adrenal tissue had been obtained on any renal biopsies, and this is, indeed, a rare complication. No mention is made of this complication in the Ciba symposium on renal biopsy, which represented the experiences of more than 5,000 percutaneous renal biopsies. Slotkin and Madsen (<i>J Urol</i><b>87</b>:13, 1962) did not mention this complication in a survey of an equal number of cases. At the Charity Hospital in New Orleans I was aware of only one case of adrenal tissue being obtained. This was on a liver biopsy, and the patient died as a result of that complication. It is not uncommon to obtain liver tissue, especially if the kidney biopsy is done on the right side, and once I obtained a piece of pancreas when I biopsied the left kidney.
The DCCT and Medical Care for Diabetes in the U. S.
Authors: Maureen I Harris, Richard C Eastman, Carolyn Siebert
Journal: Diabetes Care (1994)

The Diabetes Control and Complications Trial (DCCT) has convincingly established that intensive treatment of insulin-dependent diabetes mellitus (IDDM) can substantially reduce the incidence and progression of retinopathy, nephropathy, and neuropathy (1). Development of retinopathy in those without retinopathy at baseline was reduced by 76%, and progression of retinopathy in those with early retinal disease at baseline was reduced by 54%. Intensive therapy was associated with a 39% reduction in the occurrence of microalbuminuria (≥40 mg of urine albumin per 24 h) and a 54% reduction in the incidence of albuminuria (≥300 mg of urine albumin per 24 h). Development of clinical neuropathy was reduced by 60%. A reduction also occurred in macrovascular disease events (41%), although this did not reach statistical significance.
Biphasic effect of p21Cip1 on smooth muscle cell proliferation: Role of PI 3-kinase and Skp2-mediated degradation
Authors: M BOND, G SALANEWBY, Y WU, A NEWBY
Journal: Cardiovascular Research (2005)

Proliferation of vascular smooth muscle cells (VSMC) is an important event in atherogenesis, in-stent restenosis and late vein-graft failure. Cell-cycle progression is positively regulated by cyclin:cdk complexes and negatively regulated by cyclin-dependent kinase inhibitors, including p21Cip1. Here we investigate the mechanisms regulating p21Cip1 levels in VSMCs and its role in controlling VSMC proliferation.We studied the S-phase-associated kinase protein-2 (Skp2), an F-box protein implicated in the ubiquitination of p21Cip1. Overexpression of wild-type Skp2 or dominant-negative Skp2 decreased or increased p21Cip1 levels, respectively. Interestingly, levels of endogenous p21Cip1 and Skp2 were both increased in a phosphoinositide PI 3-kinase-dependent manner in late G1 phase. Increased expression of p21Cip1 occurred despite significantly increased Skp2-mediated proteasomal degradation. To determine the role of p21Cip1 in regulating VSMC proliferation, we used adenovirus-mediated overexpression and small-interfering RNA to elevate or silence p21Cip1 expression, respectively. Overexpression of p21Cip1 significantly inhibited VSCM proliferation. p21Cip1 silencing also inhibited proliferation and increased apoptotic cell death.Taken together, this data demonstrates that a balance between PI 3-kinase-driven upregulation and Skp2-mediated degradation controls the level of p21Cip1, which regulates VSMC proliferation in a biphasic manner. Low levels of p21Cip1 are also essential to counter apoptosis during cell-cycle progression.