tbuckley/cabot-search huggingface dataset:
Extending the boundaries of transplantation
Authors: S. Hettiaratchy
Journal: BMJ (2003)

Solid organ transplantation has been one of the most striking medical success stories of the past 50 years. Today even the most complex cardiac transplants are viewed as routine, although it is only 35 years since the first successful heart transplant was performed. One of the main reasons for this success is the introduction of new more specific immunosuppressants that have improved our ability to control the transplant patient's immune response. This has reduced the incidence of acute graft loss and the side effects of immunosuppressive regimens. These factors have led some transplant teams to suggest that transplantation should no longer be reserved for life threatening conditions but be used for any problem that can be solved with allogenic tissue. Citing this rationale, surgeons have begun using cadaveric tissue to reconstruct structural, non-life threatening defects of the human body. Over the past five years 20 hand transplants and a laryngeal transplant have been successfully carried out.1 2 Others have transplanted knees, nerves, and even the flexor tendon apparatus of the hand.3–5 However, reconstructive transplantation is very different from other forms of transplantation. Whether it is appropriate at the present time is the subject of debate.

Reconstructive transplantation differs from other forms of transplantation in numerous ways. It is performed in healthy patients who have a normal life expectancy; they do not have a chronic …
Jejunal mucosal enzyme activities, regulatory peptides and organelle pathology of the enteropathy of common variable immunodeficiency.
Authors: J Dawson, M G Bryant, S R Bloom, T J Peters
Journal: Gut (1986)

Jejunal biopsies from six patients having the small bowel enteropathy associated with common variable immunodeficiency have been subjected to analytical subcellular fractionation and enzymic and regulatory peptide microassay to define the organelle pathology of this syndrome.Compared with normal subjects, the immunodeficient patients had decreased activities of the three brush border enzymes: alkaline phosphatase, y-glutamyl transferase and aglucosidase.The other organelle marker enzyme activities and all the regulatory peptide concentrations did not differ from the controls.Density gradient experiments showed a complete loss of particulate 3-glucosidase (lactase) with activity entirely located in the cytosol.The integrity of other organelles was normal.These data indicate that the enteropathy of common variable immunodeficiency is associated with abnormalities in the jejunal brush border analogous to those present in tropical malabsorption syndrome.Gastrointestinal symptoms are found in up to 60% of patients with common variable immunodeficiency (idiopathic acquired hypogammaglobulinaemia).lThe cause of these symptoms is probably multi- factorial but malabsorption is often prominent and certain jejunal histological abnormalities have been described and compared with those found in coeliac disease and tropical malabsorption.2-4The bio- chemical abnormalities found in the mucosa in these two diseases are, however, distinct, probably reflectin the different pathogenesis of the mucosal damage.Furthermore, the mucosal regulatory peptides show characteristic abnormalities in these two forms of enteropathies.8 9 There are, however, no reports of investigations into the pathogenesis of the enteropathy of common variable immuno- deficiency at the cellular and subcellular level.In this study we have assayed the mucosal enzyme activities and regulatory peptide concentrations and investigated the intracellular organelles in the jejunum from six patients with common variable immunodeficiency undergoing investigation for pro- fuse diarrhoea.
Factors Considered Important at the End of Life by Patients, Family, Physicians, and Other Care Providers
Authors: Karen E. Steinhauser
Journal: JAMA (2000)

ContextA clear understanding of what patients, families, and health care practitioners view as important at the end of life is integral to the success of improving care of dying patients. Empirical evidence defining such factors, however, is lacking.ObjectiveTo determine the factors considered important at the end of life by patients, their families, physicians, and other care providers.Design and SettingCross-sectional, stratified random national survey conducted in March-August 1999.ParticipantsSeriously ill patients (n = 340), recently bereaved family (n = 332), physicians (n = 361), and other care providers (nurses, social workers, chaplains, and hospice volunteers; n = 429).Main Outcome MeasuresImportance of 44 attributes of quality at the end of life (5-point scale) and rankings of 9 major attributes, compared in the 4 groups.ResultsTwenty-six items consistently were rated as being important (&gt;70% responding that item is important) across all 4 groups, including pain and symptom management, preparation for death, achieving a sense of completion, decisions about treatment preferences, and being treated as a "whole person." Eight items received strong importance ratings from patients but less from physicians (P&lt;.001), including being mentally aware, having funeral arrangements planned, not being a burden, helping others, and coming to peace with God. Ten items had broad variation within as well as among the 4 groups, including decisions about life-sustaining treatments, dying at home, and talking about the meaning of death. Participants ranked freedom from pain most important and dying at home least important among 9 major attributes.ConclusionsAlthough pain and symptom management, communication with one's physician, preparation for death, and the opportunity to achieve a sense of completion are important to most, other factors important to quality at the end of life differ by role and by individual. Efforts to evaluate and improve patients' and families' experiences at the end of life must account for diverse perceptions of quality.
Injudicious Use of Steroid-Containing Eye Drops
Authors: Donald P. Tucker
Journal: New England Journal of Medicine (1958)

THE injudicious use of eye drops containing steroids can result in permanent loss of vision, and even in loss of the eye. Although this fact has been stressed for several years in the ophthalmic literature, it has not frequently enough reached the readers of general medical journals. The problem therefore deserves repetition here.Thygeson considers herpes-simplex keratitis to be the most important corneal disease leading to loss of vision in this country today. The herpes virus is insensitive to any presently known antibiotics, and numerous clinical and experimental studies1 , 2 have shown adrenal steroids to have a detrimental effect on progress . . .
WALL STRESS-MASS-HEART RATE PRODUCT AS AN ESTIMATE OF MYOCARDIAL OXYGEN CONSUMPTION PREDICTS HEART FAILURE IN MILD TO MODERATE ASYMPTOMATIC AORTIC STENOSIS
Authors: Charlotte Burup Kristensen, Johanna Axelsson, Anders Greve, Casper Bang, Christa Gohlke-Baerwolf, Christoph Nienaber, Simon Ray, Terje Pedersen, Antero Kesniemi, Kurt Boman, Kenneth Egstrup, Kristian Wachtell
Journal: Journal of the American College of Cardiology (2014)
SERIAL STUDIES OF 6-MINUTE WALK TEST IMPROVE THE PREDICTION OF PUMP FAILURE DEATH, NOT SUDDEN DEATH, IN PATIENTS WITH MILD TO MODERATE CHRONIC HEART FAILURE: A 10-YEAR PROSPECTIVE STUDY
Authors: Takahisa Yamada, Yuji Okuyama, Takashi Morita, Yoshio Furukawa, Koji Tanaka, Yusuke Iwasaki, Taku Yasui, Michihiro Ueda, Takeshi Okada, Masato Kawasaki, Yuki Kuramoto, Masatake Fukunami
Journal: Journal of the American College of Cardiology (2010)
Classical and Relational Psychology
Authors: L. Ectors
Journal: Psychotherapy and Psychosomatics (1970)

Moulding and contact of man with himself and his environment brings about knowledge and signposting of the neural pathways used, thereby giving rise to reasoning, thought, imagination, creativity and consciousness. There is no instinct and no recording of perceptions. Learning maps out the nerve pathways used. The living body reproduces its past relations, it has no recording memory.
The Use and Abuse of Salicylic Acid
Authors: G. Kemp
Journal: BMJ (1881)

5s0 TlE RUITISH MEDICAL 7OURNAL.tApril 2, i88i.with one-third of a grain of morphia, were given.The following day the patient seemed to be much exhausted, the eyes fixed, and the corners of the mouth retracted; attempts at deglutition excited spasm in the throat, with a sense of impending suffocation, and occasional pain with much distress-in the prxecordial region.The chloral and morphla was repeated, but little sleep obtained; there were profuse perspiration and much thirst, and any attempt to relieve them aggravated the spasm and restlessness.On the evening of the tenth day, .aneffort to take some beef-tea brought on a violent convulsion, which, though mitigated by the immediate administration of chloroform, caused death in about half an hour from its onset.The temperature rose to 1000 on the evening of the ninth day, but fell in a few hours to 99, and was not again ele- vated; while the pulse on the morning of the ninth day went to too, and on the tenth to 120.No post maitem examination was allowed.NERVE-STRETCHING.
Sensitivity of human tissue heme oxygenase to a new synthetic metalloporphyrin
Authors: Richard J. Chernick, Pavel Martasek, Richard D. Levere, Raimund Margreiter, Nader G. Abraham
Journal: Hepatology (1989)

Heme oxygenase, the rate-limiting enzyme for heme degradation, can be inhibited by several new synthetic metalloporphyrins. Under certain conditions, a depression in heme oxygenase activity has important clinical significance in the treatment of hyperbilirubinemia, and, in this regard, tin-protoporphyrin has been shown to decrease the production of bilirubin in vitro as well as in vivo. Similarly, our study was concerned with finding a new metalloporphyrin which will inhibit heme oxygenase. Many of the synthetic heme analogs that we analyzed were quite effective inhibitors of heme oxygenase, but the most powerful inhibitor was found to be zinc-deuteroporphyrin IX, 2,4-bisglycol. This metalloporphyrin almost completely inhibits liver heme oxygenase at concentrations as low as 0.5 microM. Its potency as an inhibitor was found to be greater than that of tin-protoporphyrin; the Ki of zinc-deuteroporphyrin IX, 2,4-bisglycol was calculated to be 0.003 microM. In conclusion, we demonstrated that zinc-deuteroporphyrin IX, 2,4-bisglycol has potent inhibitory effects on human liver, kidney and brain heme oxygenase so that this metalloporphyrin can be considered as an alternative to tin-protoporphyrin in the treatment of hyperbilirubinemia.
Abstract PD03-02: A Randomized Pre-Surgical Trial of Metformin in Breast Cancer. Preliminary Feasibility and Safety Results
Authors: B Bonanni, M Cazzaniga, M Puntoni, G Pruneri, D Serrano, M Lazzeroni, A Guerrieri-Gonzaga, D Macis, A Luini, P Veronesi, V Galimberti, E.O. DeCensi A.
Journal: Cancer Research (2010)

Abstract Background: Metformin has been associated with decreased breast cancer (BC) incidence in diabetic patients in epidemiological studies. Moreover, this drug results in initiation of an AMPK-dependent energy stress response which can adversely affect survival of breast cancer cell lines and inhibition of PI3K/Akt/mTOR signaling leading to reduced proliferation of BC cell lines. Methods: We conducted a randomized, pre-surgical, phase IIb, placebo-controlled, biomarker trial in women with stage I-III BC candidate to elective surgery. The primary endpoint was the change in cell proliferation in malignant, dysplastic and hyperplastic tissue as measured by Ki-67 labeling index (LI). With 150 subjects, the study was 80% powered to test for the interaction between metformin activity and ER status. Two interim analyses are being planned after 100 and 200 women enrolled. Results: As of June 18, 2010, 175 subjects have been randomized and 162 have completed treatment. Here we report data on the first 100 women enrolled. At the symposium, full data on the first 200 women enrolled will be available. As of December 31, 2009, a total of 163 women were screened, 26 were not eligible and 40 refused to participate, 6 dropped out during the study for AEs (n=2) or refusal to continue treatment (n=4), thus leaving 95 subjects assessable for the primary endpoint. The main subject and tumor characteristics blinded as to the allocated arm were mean age 52 (31-77), Pre/postmenopause, 54/41, mean BMI, 23.6 (18.0-40.2). At baseline, median Ki-67LI was 18% (range 4%-65%) at biopsy and 19% (4%-70%) after 4 weeks at surgery. All adverse events except for 1 SAE were grade 1 or 2, consisting of G2 nausea and G2 diarrhea in 4% and 6% of the cases, respectively. The prevalence of ductal intraepithelial neoplasia was 91% (median Ki-67 LI, 10%) in samples both adjacent and distant from the tumor, whereas the prevalence of ductal hyperplasia was 77% (median Ki-67LI, 2%) in samples distant from the tumor. Conclusions: Our preliminary results show the feasibility, high compliance and safety of a metformin trial in breast cancer patients. Assessment of tissue and circulating biomarkers is currently ongoing to characterize the whole spectrum of metformin activity in malignant and dysplastic tissue. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr PD03-02.
Contrasting epidemiology of aortic aneurysm and peripheral vascular disease in England and Wales
Authors: D. Coggon, P. Winter, C. Martyn, H. Inskip
Journal: BMJ (1996)

Age standardised death rates from aortic aneurysm in England and Wales rose 20-fold in men and 11-fold in women between 1950 and 1984.1 Similar trends have been reported in other Western countries, most of the increase being in deaths from abdominal aneurysms. The scale of the increase suggests that it is probably not simply an artefact of improved diagnosis. Moreover, a review of all necropsies at Malmo General Hospital during 1958-86 showed a clear rise in the prevalence of aortic aneurysmal disease when it was assessed by standard examination techniques.2

The increase in aortic aneurysm is remarkable because it has occurred when rates of other forms of vascular disease, particularly coronary heart disease and stroke, have been falling.3 We therefore examined the distribution of mortality from aortic aneurysm further and …
Heat and Life: The Development of the Theory of Animal Heat
Authors: Lester S. King
Journal: JAMA (1964)

Present-day history of science tends to emphasize the origin and development of important concepts. Dr. Mendelsohn has studied from the historical standpoint the influence of physical and chemical theories upon one particular area of physiology, namely, the theory of animal heat. The impact of the physical sciences upon biology, and the alterations in the conceptual framework produced thereby, makes a fascinating theme. He begins his study with a brief consideration of "innate" heat, as represented principally by the doctrines of Aristotle and Galen. Then he emphasizes the changes that occurred in the 17th century, under the influence of men such as Harvey, Descartes, van Helmont, and Boyle, among others. More precise physical concepts began to replace the older idea of "vital" properties, and to establish a relationship, however vague, between the processes that occurred in the human body and those that occurred in various physical phenomena and chemical mixtures. While
Circumferential Pulmonary-Vein Ablation for Chronic Atrial Fibrillation
Authors: Hakan Oral, Carlo Pappone, Aman Chugh, Eric Good, Frank Bogun, Frank Pelosi, Eric R. Bates, Michael H. Lehmann, Gabriele Vicedomini, Giuseppe Augello, Eustachio Agricola, Simone Sala, Vincenzo Santinelli, Fred Morady
Journal: New England Journal of Medicine (2006)

We conducted a randomized, controlled trial of circumferential pulmonary-vein ablation for the treatment of chronic atrial fibrillation.A total of 146 patients with a mean (+/-SD) age of 57+/-9 years who had chronic atrial fibrillation were randomly assigned to receive amiodarone and undergo two cardioversions during the first three months alone (the control group) or in combination with circumferential pulmonary-vein ablation. Cardiac rhythm was assessed with daily telephonic transmissions for one year. The left atrial diameter and the severity of symptoms were assessed at 12 months.Among the 77 patients assigned to undergo circumferential pulmonary-vein ablation, ablation was repeated because of recurrent atrial fibrillation in 26 percent of patients and atypical atrial flutter in 6 percent. An intention-to-treat analysis showed that 74 percent of patients in the ablation group and 58 percent of those in the control group were free of recurrent atrial fibrillation or flutter without antiarrhythmic-drug therapy at one year (P=0.05). Among the 69 patients in the control group, 53 (77 percent) crossed over to undergo circumferential pulmonary-vein ablation for recurrent atrial fibrillation by one year and only 3 (4 percent) were in sinus rhythm without antiarrhythmic-drug therapy or ablation. There were significant decreases in the left atrial diameter (12+/-11 percent, P<0.001) and the symptom severity score (59+/-21 percent, P<0.001) among patients who remained in sinus rhythm after circumferential pulmonary-vein ablation. Except for atypical atrial flutter, there were no complications attributable to circumferential pulmonary-vein ablation.Sinus rhythm can be maintained long term in the majority of patients with chronic atrial fibrillation by means of circumferential pulmonary-vein ablation independently of the effects of antiarrhythmic-drug therapy, cardioversion, or both. The maintenance of sinus rhythm is associated with a significant decrease in both the severity of symptoms and the left atrial diameter.
Progressive Post-Operative Gangrene of the Skin
Authors: A. J. Blaxland
Journal: BMJ (1935)

The dramatic in surgery is not confined to the extirpation of enormous growths by skilful operation, but embraces also certain conditions which would terminate fatally but for minor surgical intervention.When a lethal process of this nature is in itself a complication of a previous operation a successful issue is doubly gratifying to the surgeon.Such a condition is progressive post-operative cutaneous gangrene.It is comparatively rare, but it is extremely serious if not recognized in an early stage.Although two cases have recently been described in the British Journal of Surgery, I think it advisable again to draw the attention of the profession to its existence by recording two cases which have come under my own care.The first of these occurred sixteen years ago.The fatal nature was not recognized until too late, and the patient died.In the second, a recent case, the diagnosis was made early and appropriate treatment instituted with immediate and successful response.The first account of this condition to be published in England appeared in an article by F. Hector Scotson' in the Lancet of January 14th, 1933, a case successfully treated by excision being recorded.So far as I can discover only two other cases have been reported in this country-one by H. J. Nightingale and E. C. Bowden2 in the British Journal of Surgery of October, 1934, and the other, in the same journal, in April, 1935, where there is an excellent descrip- tion of the lesion by A. M. Stewart-Wallace,3 with a full bibliography and an analysis of the thirty-seven other cases which have been reported up to date.I take this opportunity of acknowledging my indebtedness to the authors of these publications.It was to a large extent due to these that I recognized the nature of my second case at an early stage, and carried out the treatment recommended by them.
Tc-99m MDP Three-Phase Bone Scintigraphy of Tuberculous Dactylitis Involving the Middle Finger in the Adult
Authors: Mim-Woo Kim, Seok Tae Lim, Myung-Hee Sohn
Journal: Clinical Nuclear Medicine (2004)

Tuberculous dactylitis is a rare manifestation of adult skeletal tuberculosis. A 73-year-old man with painful swelling of the left middle finger underwent Tc-99m MDP 3-phase bone scintigraphy. Perfusion and blood pool images showed diffusely increased activity around the proximal phalanx and metacarpal head of the left middle finger with focal uptake in the region of the proximal interphalangeal (PIP) joint. Delayed imaging showed intensely increased uptake in the bony region adjacent to the PIP joint. These findings corresponded to the destructive lesions on radiographs and soft tissue abscess on ultrasonogram. An open biopsy with curettage confirmed tuberculosis.
Inhibition of 20-HETE synthesis and action protects the kidney from ischemia/reperfusion injury
Authors: Uwe Hoff, Ivo Lukitsch, Lyubov Chaykovska, Mechthild Ladwig, Cosima Arnold, Vijay L. Manthati, T. Florian Fuller, Wolfgang Schneider, Maik Gollasch, Dominik N. Muller, Bert Flemming, Erdmann Seeliger, Friedrich C. Luft, John R. Falck, Duska Dragun, Wolf-Hagen Schunck
Journal: Kidney International (2010)
Treatment of Gonorrhea in Males With Cephaloridine
Authors: James B. Lucas
Journal: JAMA (1966)

Since the isolation of a strain of<i>Cephalosporium acremonium</i>by Brotzu in 1945,<sup>1</sup>the recovery of seven natural antibiotic substances from this fungus has been reported.<sup>2</sup>One of these antibiotic substances is cephalosporanic acid.<sup>3</sup>This nucleus is chemically closely related to the penicillin nucleus, 6-aminopenicillanic acid, differing by having a fused dihydrothiazine B lactam ring, rather than a fused thiazolidine B lactam ring.<sup>4</sup>Synthetic manipulation of the 7-aminocephalosporin nucleus by Chauvette et al<sup>5</sup>has resulted in the development of cephalothin (Keflin), now available commercially in the United States. A second important derivative, cephaloridine, chemically 7-[α-(2-Thienyl) acetamido]-3-(1-pyridylmethyl)-3-cephem-4-carboxylic acid betaine, has been produced in England and has been the subject of several favorable clinical reports from that country.<sup>6,7</sup> Cephaloridine has essentially the same spectrum of antimicrobial activity as cephalothin, but is more potent against gram-positive organisms. Generally, the pharmacological properties of the two drugs are similar.
Animals as sentinels of human health hazards of environmental chemicals.
Authors: W H van der Schalie, H S Gardner, J A Bantle, C T De Rosa, R A Finch, J S Reif, R H Reuter, L C Backer, J Burger, L C Folmar, W S Stokes
Journal: Environmental Health Perspectives (1999)

A workshop titled "Using Sentinel Species Data to Address the Potential Human Health Effects of Chemicals in the Environment," sponsored by the U.S. Army Center for Environmental Health Research, the National Center for Environmental Assessment of the EPA, and the Agency for Toxic Substances and Disease Registry, was held to consider the use of sentinel and surrogate animal species data for evaluating the potential human health effects of chemicals in the environment. The workshop took a broad view of the sentinel species concept, and included mammalian and nonmammalian species, companion animals, food animals, fish, amphibians, and other wildlife. Sentinel species data included observations of wild animals in field situations as well as experimental animal data. Workshop participants identified potential applications for sentinel species data derived from monitoring programs or serendipitous observations and explored the potential use of such information in human health hazard and risk assessments and for evaluating causes or mechanisms of effect. Although it is unlikely that sentinel species data will be used as the sole determinative factor in evaluating human health concerns, such data can be useful as for additional weight of evidence in a risk assessment, for providing early warning of situations requiring further study, or for monitoring the course of remedial activities. Attention was given to the factors impeding the application of sentinel species approaches and their acceptance in the scientific and regulatory communities. Workshop participants identified a number of critical research needs and opportunities for interagency collaboration that could help advance the use of sentinel species approaches.