tbuckley/cabot-search huggingface dataset:
Epicardial mapping of segmental myocardial function: an echocardiographic method applicable in man.
Authors: M Likoff, N Reichek, M St John Sutton, J Macoviak, A Harken
Journal: Circulation (1982)

A technique for epicardial mapping of segmental myocardial function at multiple sites over both right and left ventricles was developed using a high-resolution, 7.5-MHz, short-focus, miniaturized, M-mode echocardiographic transducer worn on the fingertip. Myocardial function was determined from the extent and time course of systolic thickening and diastolic thinning at each site mapped. The technique was characterized in an open-chest canine model of myocardial ischemia. Ischemia was induced by transient or permanent coronary occlusion in 17 dogs. Acute occlusions produced reduced segmental thickening within 10-15 seconds and, often, overt systolic thinning of ischemic myocardium. Rhodamine fluorescence perfusion maps were compared with echocardiographic maps in nine dogs. Segmental thickening was reduced in perfused segments adjacent to, but not involved by, ischemia, as well as ischemic segments. Reproducibility appeared satisfactory for quantitative analysis of grouped data on multiple segments, and qualitative analysis in individual segments. Initial human studies performed during coronary bypass surgery in 11 subjects showed echocardiographic abnormalities in the six patients with ventriculographic abnormalities and in four with normal ventriculograms. Transmural infarctions were akinetic, showing no change in thickness throughout the cardiac cycle. Hypokinetic segments distal to high-grade coronary stenosis were common, although most segments distal to stenosis contracted normally. Reversal of segmental contraction abnormalities by coronary bypass grafting was shown in three subjects, while worsening of function was seen in previously abnormal segments in two and in a previously normal segment in one subject. Epicardial echocardiographic mapping is a practical method for intraoperative assessment of myocardial function during coronary surgery in man that may enhance our understanding of the pathophysiology of coronary disease and the effects of coronary surgery.
Academic Medical Centers under Siege
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1994)

The future viability of academic medical centers is threatened. These institutions have flourished since the 1960s, even managing to survive the shift toward prospective payment over the past decade, but many are now in danger of becoming seriously compromised. In battles for the rapidly expanding number of managed-care patients, and in vigorous competition with nonacademic hospitals, teaching hospitals and their faculty-practice plans are being forced to negotiate bargain-basement rates of payment. In fact, they are often forced to price services below cost. In response to these pressures, many have reduced the number of faculty members and other personnel.1 At present, . . .
1031-107 The vascular endothelial growth factor +405 CC promotor polymorphism is associated with an impaired prognosis in patients with chronic heart failure: For the MERIT-HF study group
Authors: Peter Van der Meer, Rudolf A De Boer, Hazel L White, Alistair S Hall, Hans Hillege, Dirk J Van Veldhuisen
Journal: Journal of the American College of Cardiology (2004)
Journal Ads, Shelf Space, and the American Way
Authors: D. J. Shulkin
Journal: JAMA (1990)

<h3>To the Editor.—</h3> America's two most popular medical journals are in competition for space on my bookshelves. Bothjournals have increased in size over the years. After a decade of subscriptions there is little space left and they have now begun to pile up in my cellar. It is no accident that a year's printing is called a "volume." It is merely a natural consequence of the information explosion, I assumed. Then one day, as I paged through the advertisements while searching for an article listed in the table of contents, I realized that it is the advertisements that are eating up my shelf space. I counted the number of ads for 6 consecutive months in<i>JAMA</i>for 1979 and again for 1989. I repeated this for a 6-month period in the<i>New England Journal of Medicine</i>for 1978 and 1988. Classified ads and American Medical Association informational ads were
Radiologic Bone Changes and Hypocalcemia with Anticonvulsant Therapy in Epilepsy
Authors: EERO A. SOTANIEMI
Journal: Annals of Internal Medicine (1972)

Disturbances of calcium metabolism induced by anticonvulsants were investigated in 91 adult epileptics. X-ray analysis showed that the upper end of the femur had significantly greater trabeculation loss than in controls. Epileptics also had reduced serum calcium levels, lowered serum phosphorus values, and raised serum alkaline phosphatase values. The femoral changes correlated with the reduced serum calcium level. Hypocalcemic epileptics had significantly more radiologic changes and elevated values of alkaline phosphatase, and they were more often treated with many drugs than were the normocalcemic patients. Disturbances of calcium metabolism correlated neither with the duration of anticonvulsant therapy nor to the occurrence of backache or bone fractures in epileptics. Individuality in drug therapy may be more important in the bone and metabolic changes than the pure usage of anticonvulsants. Combined effects of several factors disturbing calcium metabolism are probably required before development of clinical osteomalacia.
The PRELIMINARY COMMUNICATION 'Transcutaneous Temporary Pacing in the Operating Room'
Authors: Rodney H. Falk
Journal: JAMA (1986)

To the Editor.—  The article by Berliner et al,1Transcutaneous Temporary Pacing in the Operating Room, reaffirms the efficacy of this temporary. pacing mode. However, the authors reach misleading and erroneous conclusions based on incorrect use of statistics and errors in data analysis, the extent of which is remarkable.  The abstract of the article states that threshold was influenced by electrode position and also, possibly, by age, heart size, and chest  Yet the text clearly states that no statistically significant difference was found when heart size, transverse chest diameter, and age were examined as possible factors influencing threshold. Examination of each of these factors, based on the authors' data, reveals an error in each, as follows.  1. Heart size. Patients with thresholds equal to or less than 100 mamp had slightlylargermean cardiothoracic ratios (0.45 ± 0.07) than those with thresholds over 100 mamp (0.44 ± 0.06)
TELESCOPIC VISION AND MEDICAL ECONOMICS
Authors: ERNEST E. IRONS
Journal: JAMA (1930)

I would invite attention to the importance, in our conception of the causes and cure of certain acute medical economic problems of today, of thinking of them from a broad point of view, with due regard to collateral facts which seem often to be missed by the telescopic method of investigation. Among these problems are the cost of medical care, the relation of clinics to the community and to the physician, the alleged passing of the family doctor, the decrease of physicians in rural communities, attempts to apply principles of mass production to the practice of medicine, the extension of governmental agencies further into the field of medical practice, and the problems of state medicine which, in some European states, have already made the practice of medicine a function of a political bureaucracy tending toward a deadly leveling of individual effort. These problems concern the public quite as much as
Overview of inhalation toxicology.
Authors: M A Dorato
Journal: Environmental Health Perspectives (1990)

The development of inhalation toxicology as a distinct discipline can be traced back well over one hundred years. The technology has advanced in terms of materials and designs used to construct inhalation chambers and the equipment used to generate controlled test atmospheres of a wide variety of gases, vapors, dusts, and droplets. Consideration of metered dose inhalers, a relatively recent concern, has led to the design of new equipment for administering this unique dosage form. The parameters used to evaluate inhalation toxicity are similar to those used for any other route of administration. In addition, there are some unique procedures for early screening of pulmonary toxicity, especially within a series of related chemicals.
Activation of the bgl operon by adaptive mutation
Authors: B. G. Hall
Journal: Molecular Biology and Evolution (1998)

In growing Escherichia coli K12 cells, the cryptic bgl operon is activated 98% of the time by insertions of IS1 or IS5 into the control region, designated bglR. The activated bgl operon permits utilization of the beta-glucoside sugar arbutin as a sole carbon and energy source. The bgl operon is also activated by late-occurring mutations during prolonged selection on arbutin. The late-occurring mutations that occurred during prolonged carbon starvation in the presence of arbutin were "adaptive mutations" because they were specific to the presence of arbutin, and they did not occur during prolonged starvation in the absence of arbutin. The spectrum of late-arising mutations differed from that of early-arising, growth-dependent mutations in that 20% of the late-arising mutants resulted from mutations at the hns locus. This provides the first direct evidence for adaptive mutagenesis mediated by the insertion of IS elements. Because no special genetic background is required to select Bgl+ mutants, this affords the opportunity to study IS-element-mediated adaptive mutagenesis in a variety of genetic backgrounds, including the backgrounds of natural isolates of E. coli.
Laboratory Tests for Hyperparathyroidism
Authors: Gilbert S. Gordan
Journal: JAMA (1968)

The diagnosis of parathyroid overfunction or underfunction can be suspected clinically but can be established only by laboratory means. Development of a sensitive test for parathyroid hormone by the Berson and Yalow radioimmunoassay technique has paved the way for direct measurement of parathyroid function. With present techniques, however, hormone levels are elevated in only half the cases of proved hyperparathyroidism.1Undoubtedly, direct measurement of parathyroid hormone will be of great diagnostic value when the method is perfected. At present, however, parathyroid function is still estimated indirectly.  The established actions ofexcessparathyroid hormone in man upon which tests of parathyroid function are based are (1) elevation of serum and urine calcium levels, for the most part due to mobilization of calcium from bone reservoirs, and (2) inhibition of renal tubular reabsorption of phosphate, often but not always resulting in hypophosphatemia. Secondarily, prolonged hypercalcemia may damage the kidney and uncompensated
Elevated pulse pressure on admission after acute myocardial infarction reduces short- and long-term all-cause and cardiac mortality: an analysis of survival trials
Authors: None Yee Guan Yap, Trinh Duong, Martin Bland, Marek Malik, Christian Torp-Pederson, Lars Kober, Bradley Marchant, A.John Camm
Journal: Journal of the American College of Cardiology (2002)
Monitoring serum gold values to improve chrysotherapy in rheumatoid arthritis.
Authors: A Lorber, C J Atkins, C C Chang, Y B Lee, J Starrs, R A Bovy
Journal: Annals of the Rheumatic Diseases (1973)

Forestier (1929) first used gold salts to treat rheumatoid arthritis (RA), and controlled studies (e.g.Empire Rheumatism Council, 1960, 1961) later confirmed their effectiveness.An empirical schedule of treatment (conventional chrysotherapy) evolved, using 50 mg.monthly, but this might be further improved if dosage could be adjusted for each patient according to the serum level of gold.Atomic absorption spectrophotometric analysis now makes practicable the repeated estimation of gold in serum and urine, offering a considerable advantage over the methods used by previous authors (Goodwin, 1954; Smith, Peak, Kron, Hermann, Deltoro, and Goldman, 1958;Freyberg, Block,and Levey, 1941).We report below the results of a comparison of the effectiveness of fixed-dose conventional chrysotherapy with a dosage varied according to the concentration of gold in the serum of the individual patient.
Rheumatoid arthritis after Chikungunya fever: a prospective follow-up study of 21 cases: Table 1
Authors: E Bouquillard, B Combe
Journal: Annals of the Rheumatic Diseases (2009)

In 2005–6, more than 1.5 million people in the Indian Ocean area were infected with Chikungunya fever. In Reunion Island, 38.3% of the population, approximately 300 000 people, were infected.1 Only 6% of the cases were asymptomatic. Chikungunya fever is a viral infection transmitted to humans by Aedes mosquitoes.2,3 Chikungunya infection usually causes a syndrome characterised by fever, headaches, chills, conjunctivitis, rash, myalgia and severe joint pain with or without swelling. Joint symptoms vary from polyarthralgia to symmetrical polyarthritis. The outcome is usually benign, but persistent joint pain and stiffness may occur.3,4,5,6,7,8

We report 21 cases …
Conventional Therapy and Newer Drug Classes for Cardiovascular Protection in Hypertension
Authors: Ji-Guang Wang, Jan A. Staessen
Journal: Journal of the American Society of Nephrology (2002)

Recently published actively controlled outcome trials in hypertension compared conventional therapy (diuretics and beta-blockers) with newer antihypertensive drug classes, including angiotensin-converting enzyme inhibitors, calcium channel blockers, alpha-blockers, and angiotensin II antagonists. In a quantitative overview of nine trials including 62,605 randomized patients, it was found that conventional therapy and newer drug classes had similar long-term efficacy in preventing cardiovascular complications of hypertension. BP lowering largely accounted for most, if not all, of the observed benefits in cardiovascular outcome. These findings emphasize the desirability of lowering BP as much as possible to maximize the reduction in cardiovascular complications. Furthermore, several clinical trials have been specifically designed to highlight specific mechanisms of action of the newer drugs by measuring intermediate end points, such as carotid intima-media thickening or renal dysfunction, or by studying subgroups of patients with specific disorders, such as diabetes mellitus. In these trials, calcium channel blockers were more effective than conventional therapy in preventing carotid intima-media thickening and mild renal dysfunction, whereas use of calcium channel blockers or angiotensin-converting enzyme inhibitors was associated with a lower incidence of diabetes mellitus in some studies. However, whether or not these specific effects of the newer drugs on intermediary and/or metabolic end points in the long run also lead to fewer cardiovascular complications remains to be proved.
Relation of a Hypoxia Metagene Derived from Head and Neck Cancer to Prognosis of Multiple Cancers
Authors: Stuart C. Winter, Francesca M. Buffa, Priyamal Silva, Crispin Miller, Helen R. Valentine, Helen Turley, Ketan A. Shah, Graham J. Cox, Rogan J. Corbridge, Jarrod J. Homer, Brian Musgrove, Nick Slevin, Philip Sloan, Pat Price, Catharine M.L. West, Adrian L. Harris
Journal: Cancer Research (2007)

Abstract Affymetrix U133plus2 GeneChips were used to profile 59 head and neck squamous cell cancers. A hypoxia metagene was obtained by analysis of genes whose in vivo expression clustered with the expression of 10 well-known hypoxia-regulated genes (e.g., CA9, GLUT1, and VEGF). To minimize random aggregation, strongly correlated up-regulated genes appearing in &amp;gt;50% of clusters defined a signature comprising 99 genes, of which 27% were previously known to be hypoxia associated. The median RNA expression of the 99 genes in the signature was an independent prognostic factor for recurrence-free survival in a publicly available head and neck cancer data set, outdoing the original intrinsic classifier. In a published breast cancer series, the hypoxia signature was a significant prognostic factor for overall survival independent of clinicopathologic risk factors and a trained profile. The work highlights the validity and potential of using data from analysis of in vitro stress pathways for deriving a biological metagene/gene signature in vivo. [Cancer Res 2007;67(7):3441–9]
HNK-1 antibody detects an antigen expressed on neuroectodermal cells.
Authors: M Lipinski, K Braham, J M Caillaud, C Carlu, T Tursz
Journal: The Journal of Experimental Medicine (1983)

The HNK-1 antibody known to define a subpopulation of human lymphocytes with natural killer and killer cell activities was shown to detect a common neuroectodermal antigen. Most tumor lines and paraffin-embedded tumors and normal tissues of neuroectodermal origin were specifically stained by HNK-1. Lines and tissues of other derivations were negative except a trophoblastic tumor line and a percentage of Ewing's sarcomas, whose histogenesis is poorly understood. These data indicate that HNK-1 antibody could be of interest in clinical histopathology but cannot be considered as specific for a lymphocyte subset.
Mechanisms of ischemic myocardial cell damage assessed by phosphorus-31 nuclear magnetic resonance.
Authors: J T Flaherty, M L Weisfeldt, B H Bulkley, T J Gardner, V L Gott, W E Jacobus
Journal: Circulation (1982)

Phosphorus-31 nuclear magnetic resonance (31P NMR) can estimate tissue intracellular pH as well as the content of high-energy phosphate metabolites in isolated perfused hearts. We used 31P NMR to examine mechanisms associated with the recovery of ventricular function in hearts subjected to global ischemia and reperfusion, with special emphasis on intracellular pH, a previously unreported variable. Single-dose and multiple-dose administration of a hyperkalemic cardioplegic solution were compared with hypothermia alone in 18 isolated perfused rabbit hearts. Hearts in group 1 were subjected to 24 degrees C hypothermia during 60 minutes of global ischemia; group 2 hearts received a single injection of 37-mM KCL cardioplegic solution at 10 degrees C at the onset of ischemia; and group 3 hearts received a similar initial cardioplegic injection followed by two subsequent 24 degrees C injections at 20-minute intervals during the ischemic period. Using an intraventricular balloon, maximal dP/dt provided a quantitative index of left ventricular performance before and after ischemia. Return of ventricular function expressed as a percentage of control was 54 +/- 11% for group 1, 84 +/- 6% for group 2, and 101 +/- 18% for group 3. Differences in the rate of development of intracellular acidosis were noted during the 60-minute ischemic period. Intracellular pH fell to 6.09 +/- 0.12 in group 1, 6.31 +/- 0.09 in group 2, an 6.79 +/- 0.03 in group 3. In all three groups intracellular pH returned to control (pH 7.20) within 10 minutes of reflow. The metabolic correlates of functional recovery appeared to be the tissue content of ATP at the end of ischemia and after reflow. ATP content at the end of ischemia was 22 +/- 2% of control in group 1 hearts, 31 +/- 4% in group 2 and 64 +/- 2% in group 3. After 45 minutes of reperfusion, ATP levels recovered to 33 +/- 9% of control in group 1, to 71 +/- 9% in group 2 and to 86 +/- 6% in group 3. Although there were no differences between groups in the content of creatine phosphate after 60 minutes of ischemia, the rates of creatine phosphate decline were dissimilar. Further, during the early reflow period, a marked overshoot in tissue creatine phosphate was detected, especially in groups 1 and 2. Histologic damage assessed by light microscopy correlated with the metabolic data, confirming that multidose cardioplegia provided the best preservation of cellular morphology. These results demonstrate that the magnitude of intracellular acidosis and the associated increase in inorganic phosphate correlate inversely with recovery of postischemic ventricular structure and function. ATP, but not creatine phosphate, content correlates with return of contractile performance after reperfusion. The overshoot in creatine phosphate during early reperfusion might impede optimal restoration of ATP content and, as a result, optimal recovery of cell functions.
Rise in spending on NHS has not been matched by rise in activity
Authors: Ahmed Kassem
Journal: BMJ (2004)

Spending on health care in the United Kingdom rose to 8.3% of gross domestic product in 2003, reaching the level of many mid-performing European countries but still falling short of health spending in Germany, France, and Italy, new research shows.

The extra cash being pumped into the health service has not, however, been matched by a similar rise …
Low bone turnover state in primary biliary cirrhosis
Authors: Anthony J. Stellon, Adrian Webb, Juliet Compston, Roger Williams
Journal: Hepatology (1987)

To determine whether bone loss in patients with chronic cholestatic liver disease is the consequence of a high or low bone turnover state, 30 female patients with biopsy-proven primary biliary cirrhosis underwent iliac crest biopsy following double tetracycline labeling. The mean trabecular bone volume was decreased as a result of trabecular plate thinning in both the premenopausal (p less than 0.02) and postmenopausal (p less than 0.05) patients, compared to age- and sex-matched controls. Indications that osteoblastic function was impaired included a significantly lower mean wall thickness (p less than 0.01) and mean osteoid seam width (p less than 0.05), and this in association with a decreased mineral appositional rate and prolonged mineralization lag time was suggestive of a defect in matrix synthesis. Further evidence of impaired osteoblastic activity was the significantly lower bone formation rate at both tissue (p less than 0.001) and basic multicellular unit levels (p less than 0.05) in the postmenopausal patients. Total resorption surfaces and fasting urinary calcium/creatinine ratios were significantly increased (p less than 0.005 and 0.05, respectively) in the premenopausal patients and mean interstitial bone thickness reduced in both pre- and postmenopausal patients, suggesting that increased resorption may also contribute to bone loss in primary biliary cirrhosis.
[439] ADDITIVE TO SYNERGISTIC ANTIVIRAL EFFECTS OF AN NS3/4A PROTEASE INHIBITOR (ITMN-191) AND AN NS5B RNA-DEPENDENT RNA POLYMERASE INHIBITOR (R1479) IN AN HCV REPLICON SYSTEM
Authors: S.D. Seiwert, H. Tan, L.M. Blatt
Journal: Journal of Hepatology (2007)
Fatal Jaundice after Administration of Pheniprazine
Authors: P. H. Fentem, G. Howitt
Journal: BMJ (1961)

MEDICAL MEMORANDA IB T 0 necrotic and yellow, only reddish portion was towards posterior cusp of mitral valve.Mural thrombus in left ventricle 5 by 3 by 5 cm.Thrombosis of right coronary artery 1 cm.from ostium.Mottling of right ventricle.Gross atheroma of aorta.Slight fibrosis of testes.Diverticulosis of sigmoid.Solid appendix.Prostate measured 3 cm.and showed hyperplasia.Anatomical diagnosis: myocardial infarction; atheroma and thrombosis of coronary arteries; peripheral gangrene.(Dorsalis pedis artery left taken for section.)Histology: Heart showed recent infarct and fibrosis.Dorsalis pedis artery appears substantially normal.Lung, spleen, kidney, and pituitary showed little of interest.COMMENT In this case the symmetrical nature of the lesions, the presence of all peripheral pulses, and the absence of disease in the artery examined histologically indicate that gangrene resulted from either prolonged hypotension or peripheral vasoconstriction, or both in combination.Non-occlusive symmetrical peripheral gangrene, an uncommon disorder, has been reviewed by Cotton and Bedford (1956).It is nearly always a complication of cardiovascular disease in which there is reduced cardiac output.The patient was admitted to hospital under the care of Dr. T. E. Gumpert, senior physician, Sheffield Royal Hospital, whom I thank for permission to report the case.