tbuckley/cabot-search huggingface dataset:
The Foreign Medical Resident Training in the United States
Authors: MICHAEL M. DACSO
Journal: Annals of Internal Medicine (1968)

Fifty foreign and 50 U. S. internal medicime residents from medical school-affiliated teaching hospitals were randomly selected for participation in this investigation. Information was elicited concerning the residents' educational, professional, and social background, motivation, adjustment to the training program and to personality structure in the United States, attitudes toward U. S. and foreign doctors, and expectations about the United States. Each of the resident's supervisors was asked to rate his trainee's performance and facility with the English language on a specially designed rating form. Although there were some similar motives between the two groups, foreign residents attributed more importance to nationalism as a reason for choosing internal medicine as a career than did their U. S. counterparts. Most foreign residents reported satisfaction with their training programs and with the United States, although they were relatively dissatisfied when they were compared with U. S. residents. The most satisfied foreign residents reported more frequent social and intellectual contacts with their U. S. colleagues. That foreign residents obtained less favorable scores on standardized, objective, self-reporting personality measures reflects the difficulty in adjusting to a new environment. Finally, the supervisors found the foreign residents' performance less adequate in comparison with that of their U. S. counterparts, although their performance was satisfactory. While a number of theoretical interpretations were made on the basis of individual results, an overview suggests that the degree of Americanization of foreign residents was an important factor in their supervisors' evaluation of their performance and in their personal and professional adjustment to both the United States and their training programs.
Reorganisation of prescribing practices should not be delayed
Authors: A D McKendrick, H Leslie, P W Thornton, F R G Crosby, A I M Easton, E McNaughton, L J Morton, J E Hunter, S Pflanz
Journal: BMJ (1995)

practitioners could then be offered appropriate financial incentives to change their prescribing.For many this will require a greater interest in pharmacology and cost-benefit analysis and a reappraisal of our relationship with the pharma- ceutical industry.
Reduced Epinephrine Secretion and Hypoglycemia Unawareness in Diabetic Autonomic Neuropathy
Authors: ROBERT D. HOELDTKE
Journal: Annals of Internal Medicine (1982)

The cause of the susceptibility of certain diabetic patients to severe hypoglycemia is not known. Because the awareness of hypoglycemia is heightened by catecholamine-mediated physiologic responses, deficient catecholamine secretion may cause frequent and severe hypoglycemia. Plasma epinephrine and norepinephrine were measured after insulin-induced hypoglycemia in 18 diabetic patients, nine with autonomic neuropathy, and in nine normal volunteers. Our results show that two thirds of patients with diabetic autonomic neuropathy have moderate to severe deficits in epinephrine secretion and that these patients have diminished or delayed subjective responses to low blood sugar and are at risk for developing severe hypoglycemia and its neurologic consequences.
Digitoxin Elimination Reduced During Quinidine Therapy
Authors: MOSHE GARTY
Journal: Annals of Internal Medicine (1981)

Elevated serum digoxin concentrations and clinicial toxicity have been reported in patients receiving quinidine. The present study was undertaken to ascertain whether a similar interaction occurs between quinidine and another cardiac glycoside, digitoxin, and if so to evaluate the pharmacokinetic basis in five healthy volunteers. In the presence of quinidine the serum digitoxin concentration was elevated, the mean digitoxin elimination half-life was increased from 87.8 ± 11.6 to 218.3 ± 20.6 h (mean ± SEM) (p < 0.01), and mean total body clearance was reduced from 5.01 ± 1.18 to 1.87 ± 0.20 mL/h · kg (p < 0.052). No change was observed in the apparent volume of distribution or in the volume of the central compartment for digitoxin. The data suggest that the mechanism for this interaction is a reduction in elimination and not displacement of digitoxin from tissue binding sites.
Lung Transplantation Comes of Age
Authors: James Theodore, Norman Lewiston
Journal: New England Journal of Medicine (1990)

Students of human-organ transplantation have watched with attention the progress in lung transplantation during the past decade. A clinical reality since 1981, lung transplantation is now generally accepted as a useful procedure. Progress in its development has not always been smooth. Early attempts at single-lung transplantation were marked by infection, rejection, and in particular bronchial dehiscence. Even the technically more successful heart—lung transplantations were plagued by a new entity called obliterative bronchiolitis, which became an important cause of late death after transplantation. In the past few years, however, advances in surgical technique, organ preservation, and postoperative management have permitted improvements . . .
Factors influencing the size distribution of aerosols from jet nebulisers.
Authors: M M Clay, D Pavia, S P Newman, S W Clarke
Journal: Thorax (1983)

The size distribution of saline and bronchodilator (terbutaline) aerosol droplets generated from four widely used jet nebulisers (Acorn, Upmist, Turret, and Inspiron Mini-neb) has been measured with a Malvern 2200 Laser Particle Sizer. The mass median diameter of aerosol droplets generated by each nebuliser was strongly influenced by the driving flow rate of compressed air. By increasing the flow rate from 4 to 8 1 min-1 mass median diameters were halved (p less than 0.01) and there was an increase in the mass of aerosol within the optimum respirable range (less than 5 micron). To achieve this range the following individual flow rates were required: Turret 4 1 min-1, Acorn and Upmist 6 1 min-1, and Inspiron Mini-neb 8 1 min-1. A significant inverse relation (p less than 0.001) was found between mass median diameter and the geometric standard deviation, indicating that the aerosols were smaller but more heterodisperse at high flow rates. Changes in drug concentration had little effect on aerosol size. In 72% of the nebulisations followed to dryness there was no significant change in mass median diameter during the course of nebulisation and in the remainder it was less than 1.3 micron.
Abstract 3893: Mechanism of radiosensitization by inhibitors of poly(ADP-ribose) polymerase (PARP)
Authors: Denise C. Hegan, Peter M. Glazer
Journal: Cancer Research (2011)

Abstract Inhibitors of poly(ADP-ribose) polymerase (PARP) are in clinical trials for cancer therapy based on specific lethality to cancer cells deficient in BRCA1 or BRCA2. In addition, pre-clinical work has shown that PARP inhibition induces radiosensitization in cancer cells. To provide a basis for the clinical application of PARP inhibitors as radiosensitizers, we conducted mechanistic studies to elucidate the pathways by which PARP inhibitors influence radiation response. Cells treated or not with PARP inhibitors and treated or not with siRNAs or other reagents to manipulate gene expression were assayed for radiation response by clonogenic survival assays. DNA double strand break repair was assayed using a chromosomally integrated GFP-based reporter construct. Although it was previously thought that PARP plays a role in DNA repair and radiation response primarily via the base excision repair (BER) pathway and recruitment of BER factors to sites of damage, we found that inhibitors of PARP can disrupt repair of double strand breaks (DSBs) by suppressing expression of BRCA1 and RAD51, key factors in homology-dependent repair (HDR) of DSBs. Treatment of human cancer cells with PARP inhibitors or with siRNAs targeted to PARP-1 yielded reduced levels of BRCA1 and RAD51. Radiosensitization by PARP inhibition was also seen in cells in which BER was already attenuated (via expression of a dominant negative variant of polymerase beta). Direct measurement of HDR using a GFP-based chromosomal reporter assay demonstrated reduced HDR in cells treated with PARP inhibitors. This work demonstrates that PARP inhibition can suppress the HDR pathway of DSB repair by down-regulation of BRCA1 and RAD51 expression. As such, it identifies a novel mechanism by which PARP regulates DNA repair and promotes radiosensitization, providing further rationale for therapeutic strategies combining PARP inhibition and radiation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3893. doi:10.1158/1538-7445.AM2011-3893
A Functional Variant in APOA5/A4/C3/A1 Gene Cluster Contributes to Elevated Triglycerides and Severity of CAD by Interfering With MicroRNA 3201 Binding Efficiency
Authors: Guanglin Cui, Zongzhe Li, Rui Li, Jin Huang, Haoran Wang, Lina Zhang, Hu Ding, Dao Wen Wang
Journal: Journal of the American College of Cardiology (2014)

Recent genome-wide association studies identified the APOA5/A4/C3/A1 gene cluster polymorphisms influencing triglyceride level and risk of coronary artery disease (CAD). The purposes of this study were to fine-map triglyceride association signals in the APOA5/A4/C3/A1 gene cluster and then explore the clinical relevance in CAD and potential underlying mechanisms. We resequenced the APOA5/A4/C3/A1 gene cluster in 200 patients with extremely high triglyceride levels (≥10 mm/l) and 200 healthy control subjects who were ethnically matched and genotyped 20 genetic markers among 4,991 participants with Chinese Han ethnicity. Subsequently, 8 risk markers were investigated in 917 early-onset and 1,149 late-onset CAD patients, respectively. The molecular mechanism was explored. By resequencing, a number of newly and potentially functional variants were identified, and both the common and rare variants have remarkable cumulative effects on hypertriglyceridemia risk. Of note, gene dosage of rs2266788 demonstrated a robust association with triglyceride level (p = 1.39 × 10−19), modified Gensini scores (p = 1.67 × 10−3), and numbers of vascular lesions in CAD patients (odds ratio: 1.96, 95% confidence interval: 1.31 to 2.14, p = 8.96 × 10−4). Functional study demonstrated that the rs2266788 C allele destroyed microRNA 3201 binding to the 3′ UTR of APOA5, resulting in prolonging the half-life of APOA5 messenger RNA and increasing its expression levels. Genetic variants in APOA5/A4/C3/A1 gene cluster play an important role in the regulation of plasma triglyceride levels by an increased APOA5 concentration and contribute to the severity of CAD.
Clinical Relevance of Immunohistochemical Detection of Multidrug Resistance P-Glycoprotein in Breast Carcinoma
Authors: P. Verrelle, M. Frederic, Y. Fonck, V. Feillel, C. Dionet, F. Kwiatkowski, R. Plagne, J. Chassagne
Journal: JNCI Journal of the National Cancer Institute (1991)

In 20 women with breast carcinoma, 17 of whom had locally advanced cancer and 3 of whom had confirmed metastases, the expression of P-glycoprotein was evaluated before the start of a chemotherapy regimen that included multidrug resistance-related drugs. With the use of the C494 monoclonal antibody in an avidin-biotin-immuno-peroxidase technique, P-glycoprotein was detected in 17 of 20 tumor samples. Results were expressed in a semiquantitative manner, taking into account the number of positive tumor cells (N index) and the specific staining intensity (I index). The 17 patients with non-metastatic cancer were followed from the first cycle of chemotherapy to cancer recurrence; subsequent to six cycles of chemotherapy, all of these patients except one were rendered clinically disease-free through surgery and/or radiation. The end point was defined as either local/regional recurrence or metastasis. Strong P-glycoprotein-positive staining in a majority of tumor cells (the N+/I+ phenotype) was significantly correlated with no initial response to chemotherapy ( P < .02) and with a shorter progression-free survival ( P < .02). Thus, the pretreatment evaluation of P-glycoprotein expression may be of prognostic value in patients with locally advanced breast cancer. [J Natl Cancer Inst 83:111–116, 1991]
Physician Certification in Alcohol and Drug Dependence
Authors: Margaret Bean-Bayog
Journal: JAMA (1988)

<h3>To the Editor.</h3> —It is only in recent years that the treatment of addictive illness has been recognized as a legitimate focus for medical specialization.<sup>1</sup>A growing awareness of the magnitude of this public health problem, however, has eventuated in the establishment of the American Medical Society on Alcoholism and Other Drug Dependencies and in the growth of its membership to more than 2800 physicians. Most recently, the society responded to an expressed need for establishing criteria for expertise in the addiction field and developed a procedure for certifying physicians' expertise in alcohol and drug dependence. This is based on an applicant's (1) professional credentials, including medical licensure, involvement in the field, and demonstration of good standing in their medical community; and (2) passing a five-hour examination consisting of multiple-choice and patient-management questions. Of 869 applicants in the first year, 735 were certified in 1987. An additional 701 physicians
Prevalence of ischemic resting and stress electrocardiographic abnormalities and angina among 40- to 59-year-old men in selected U.S. and U.S.S.R. populations.
Authors: J R Abernathy, M D Thorn, G B Trobaugh, L G Ekelund, M Maciolowski, B Lupovetsky, S Shelnova, G Zhukovsky, D Shestov, A Deev
Journal: Circulation (1988)

The prevalence of electrocardiographic (ECG) abnormalities and angina was investigated in 40- to 59-year-old men from two samples, one from a U.S.S.R. study in two locations and one from a U.S. study in nine locations. ECG abnormalities were defined by the Minnesota code and angina was defined by the Rose questionnaire. No differences were found in the prevalence of major Q waves and major or minor ischemia between the two samples, but differences were found in specific indicators of major ischemia. Major ischemic changes were more prevalent in older subjects in both samples. Estimated prevalence of angina was 50% less in the U.S. sample than in the U.S.S.R. sample, and this was consistent with the proportion of subjects excluded from the exercise test because of angina. In both samples, subjects with ECG abnormalities had higher systolic blood pressures. No difference in exercise test abnormalities was found between samples; however, more subjects with a history compatible with coronary artery disease were excluded from the U.S.S.R. sample.
Surgeon on Iwo: Up Front With the 27th Marines
Authors: John D. Archer
Journal: JAMA (1985)

Four decades ago, almost 100,000 men and boys assembled on a live volcano in the Pacific and held a killing match. When it was over five weeks later, about half were casualties. Almost all the Japanese were dead, and an even greater number of Americans had been killed or wounded—some rewounded and a few wounded yet again. The place was the island of Iwo Jima, site of the Marine Corps' penultimate great land battle of World War II. James Vedder, MD, then a 33-year-old Navy Lieutenant Commander serving with the Fifth Marine Division, has written a book,<i>Surgeon on Iwo</i>, describing his experiences as the chief medical officer of a unit assigned to a front-line battalion. The book gives a day-by-day account of the progress of the battle from the author's intimate vantage point. He and his men provided the initial treatment to the many wounded Marines in their sector,
Tumors of Bone and Soft Tissue
Authors: H. Andrew Wissinger
Journal: JAMA (1965)

The title of this book does not do justice to its contents. The broad focus emphasizes many areas of diagnosis and treatment which are rarely a part of texts dealing with connective tissue neoplasms. The radiologists present excellent sections on diagnosis and treatment of bone and soft-tissue tumors. Of particular interest is the section on systematic roentgen diagnosis of bone tumors. In this part Lodwick offers a system of roentgen diagnosis which he feels can yield proper identification of a tumor in 80% of cases. The treatment of sarcomas with radiation and tissue hypoxia are also discussed. Robert A. Robinson presents a remarkably clear, concise section on the morphology and function of the cellular components of bone which is of interest to the more casual reader but particularly to those preparing for board examinations. The treatment of sarcomas receives a complete survey which discusses the various disciplines currently in use
Insulin immunization of nonobese diabetic mice induces a protective insulitis characterized by diminished intraislet interferon-gamma transcription.
Authors: A Muir, A Peck, M Clare-Salzler, Y H Song, J Cornelius, R Luchetta, J Krischer, N Maclaren
Journal: Journal of Clinical Investigation (1995)

We reported previously that daily injections of isophane insulin prevented both hyperglycemia and insulitis in nonobese diabetic (NOD) mice (Atkinson, M., N. Maclaren; and R. Luchetta. 1990. Diabetes. 39:933-937). The possible mechanisms responsible include reduced immunogenicity of pancreatic beta-cells from "beta-cell rest" and induced active immunoregulation to insulin (Aaen, IK., J. Rygaard, K. Josefsen, H. Petersen, C. H. Brogren, T. Horn, and K. Buschard. 1990. Diabetes. 39:697-701). We report here that intermittent immunizations with insulin or its metabolically inactive B-chain in incomplete Freund's adjuvant also prevent diabetes in NOD mice, whereas immunizations with A-chain insulin or with BSA do not. Adoptive transfer of splenocytes from B-chain insulin-immunized mice prevented diabetes in recipients co-infused with diabetogenic spleen cells, an effect that was abolished by prior in vivo elimination of either CD4+ or CD8+ cells. Insulin immunization did not reduce the extent of intraislet inflammation (insulitis); however, it did abolish expression of IFN-gamma mRNA within the insulitis lesions. Immunizations with insulin thus induce an active suppressive response to determinants on the B-chain that converts the insulitis lesion from one that is destructive to one that is protective.
Ethical Issues in Epidemiologic Research
Authors: Bartholomew Clemente
Journal: JAMA (1987)

In this work, ethics in psychiatric research is covered in eight chapters. The first has a review of research on informed consent, confidentiality, and the right to refuse treatment. There is an awareness that patients need the best information concerning their care so that they can become more equally responsible along with the physician in the extended treatment. Chapter 2 looks at the ethical needs for reliable and valid categories in psychiatry and how these categories may be used in avoiding "abuse," for instance misdiagnosis that depends on subjective criteria and bias. Chapter 3 investigates the many ethical issues that mental health policy raises, especially policy that emerges from the structure of the community mental health movement and the deinstitutionalization of the psychiatric patient. Chapter 4 addresses the need for appropriate investigation of the natural history of mental illness, longitudinal studies, and how to protect the privacy of the patient
Binding of the Trichodysplasia Spinulosa–Associated Polyomavirus Small T Antigen to Protein Phosphatase 2A: Elucidation of a Potential Pathogenic Mechanism in a Rare Skin Disease
Authors: Harrison P. Nguyen, Anjali Patel, Rebecca A. Simonette, Peter Rady, Stephen K. Tyring
Journal: JAMA Dermatology (2014)
Efflux of protons from acidic vesicles contributes to cytosolic acidification of hepatocytes during ATP depletion
Authors: Steven F. Bronk, Gregory J. Gores
Journal: Hepatology (1991)

The objective of this study was to determine the relationship between cytosolic pH and vesicular pH during ATP depletion. Using digitized video microscopy and single, cultured rat hepatocytes, cytosolic pH and vesicular pH were quantitated by ratio imaging of BCECF (2', 7' biscarboxyethyl-5,6-carboxyfluorescein) fluorescence and fluorescein-dextran fluorescence, respectively. Basal value for cytosolic pH was 7.26 and basal value for vesicular pH was 4.86. During ATP depletion by metabolic inhibition with KCN plus iodoacetic acid or antimycin A, cytosolic pH decreased 0.71 units to 6.55. In separate experiments under identical conditions, vesicular pH increased 1.59 units to 6.45, suggesting that protons were leaking from acidic vesicles during ATP depletion. Fluorescein-dextran fluorescence remained punctate, indicating that the rise in vesicular pH was due to an efflux of protons from vesicles and not loss of vesicle integrity. To determine whether efflux of protons from acidic vesicles can acidify cytosolic pH, we used two maneuvers that result in leakage of protons from acidic vesicles without significantly decreasing cellular ATP: (a) hypotonic stress in K(+)-free media and (b) exposure of the cells to the H(+)-ATPase inhibitor NBD-Cl. Both hypotonic stress and NBD-Cl decreased cytosolic pH 0.4 units to 6.86 and increased vesicular pH 2.0 units to 6.76, resulting in near-equilibration of cytosolic pH and vesicular pH. Thus an efflux of protons from intracellular compartments will acidify cytosolic pH of hepatocytes (pH 6.86), but not to the same degree as ATP depletion (pH 6.55).(ABSTRACT TRUNCATED AT 250 WORDS)
Four-Step Endoscopic Esophageal Mucosal Resection (EEMR) Tube Method of Resection for Early Esophageal Cancer
Authors: H. Makuuchi, T. Yoshida, C. Ell
Journal: Endoscopy (2004)

Remarkable advances in endoscopic diagnosis have been made with the increasingly widespread use of high-resolution video endoscopy and chromoendoscopy. Clinicians are detecting increasing numbers of early and superficial malignant lesions not only in the stomach and intestines, but also in the esophagus. The same trend can be seen in adenocarcinoma detected in Barrett's esophagus.
THE DEVELOPMENT OF HARD TISSUE IN THE PULP OF HUMAN TEETH.
Authors: Douglas E Caush
Journal: JAMA (1904)

Of the functions performed by the various organs of the body there are few, if any, more interesting or have the power of producing more varied results than that of the tooth pulp. In health it is the benefactor of the surrounding hard tissue; in disease, the medium whereby we are warned of the mischief that is going on. Among the varied functions of this organ may be placed the power of developing "secondary dentin." Nature in many cases endeavors to overcome the evil produced by the destroying microbe, by forming a layer of fresh tissue between the soft, sensitive pulp and the dentin that is being broken down by decay; the same protective measure also occurs in those cases where erosion has commenced its destructive work, as well as in many other instances where disintegration of the hard tissue has been produced, by the various known causes. In all