tbuckley/cabot-search huggingface dataset:
Kielland's forceps.
Authors: M Burke, C Wood
Journal: BMJ (1979)

acceptable" must be rejected.Any method of delivery that increases perinatal morbidity is open to challenge, particularly when that method is directly responsible for a perinatal mortality rate of 35 per 1000.In their second paper Drs Chiswick and James ignore the role of the active management of labour in avoiding the type of complications leading up to Kielland's delivery.Several papers have been published which conclusively demonstrate that these problems are avoid- able.-'-5None of the correspondents appear to recognise the essential difference between intracranial haemorrhage due to trauma and that due to asphyxia.Tentorial tears, which cause subdural haemorrhage, have been shown to be 11 times more common when forceps have been applied, with or without intrapartum hypoxia,6 and virtually all cases of gross intracranial haemorrhage occurring during labour are due to trauma.In contrast, asphyxial intracranial haemorrhage in the mature infant is characteristically subarachnoid and petechial.Finally, in the broader context of the role of Kielland's forceps in modern obstetrics my experience convinces me that they have no place.This personal experience is based on exposure to about 12 000 deliveries where labour was actively managed and Kielland's forceps unavailable (at the National Maternity Hospital, Dublin).
Dissociation of effects of nitroglycerin on regional refractoriness and regional myocardial blood flow following acute coronary occlusion
Authors: S. P. MICHAELSON, W. P. BATSFORD, B. L. ZARET
Journal: Cardiovascular Research (1979)

Nitroglycerin is known to affect the electrophysiological properties of the ischaemic ventricle, possibly by altering regional myocardial blood flow. This study correlated the effects of nitroglycerin, given after acute coronary occlusion, on regional ventricular refractoriness and regional myocardial blood flow. Nitroglycerin returned ventricular refractory periods to their pre-occlusion values in spite of no significant effect on regional myocardial blood flow. Although the beneficial electrophysiological effects of nitroglycerin were not explained by increased regional flow to the ischaemic myocardium, an improved myocardial oxygen supply-demand balance may have produced these favourable effects. This study emphasises the need for electrophysiological evaluation of the effects of interventions intended to limit infarct size.
Orthotopic liver transplantation for acute and subacute hepatic failure in adults
Authors: Rene R. Peleman, Judith S. Gavaler, David H. Van Thiel, Carlos Esquivel, Robert Gordon, Shunzaburo Iwatsuki, Thomas E. Starzl
Journal: Hepatology (1987)

The role of liver transplantation in 29 patients with fulminant and subacute hepatic failure due to a variety of different causes was examined by comparing the outcome and a variety of “hospitalization” variables. Transplanted patients (n = 13) were more likely to survive (p &lt; 0.05), were younger (p &lt; 0.05) and spent more time in the hospital (p &lt; 0.025) than did those who were not transplanted (n = 16). Despite spending a much longer time in the hospital, transplanted patients spent less time in the intensive care unit (p &lt; 0.05) in coma (p &lt; 0.01) and on a respirator (p &lt; 0.01) than did those not transplanted. Most importantly, the survival rate for transplanted patients was significantly improved (p &lt; 0.05) as compared to those not transplanted. We conclude that liver transplantation can be applied successfully to the difficult clinical problem of fulminant and subacute hepatic failure.
Inpatient management of diabetic foot problems: summary of NICE guidance
Authors: T. Tan, E. J. Shaw, F. Siddiqui, P. Kandaswamy, P. W. Barry, M. Baker
Journal: BMJ (2011)

Foot problems that are related to diabetes ("diabetic foot" problems) affect a substantial number of people with diabetes, and 15% of people with diabetes will have a foot ulcer at some point in their lives. Diabetic foot ulcers precede more than 80% of amputations in people with diabetes and are the most common cause of non-traumatic limb amputation in the United Kingdom. Delays in diagnosis and management of diabetic foot problems increase morbidity and mortality, contribute to a higher amputation rate,1 and seriously affect patients' quality of life—for example, by reducing mobility, leading to loss of employment, depression, and damage to or loss of limbs. Diabetic foot problems have a financial impact on the NHS through increased outpatient costs and bed occupancy and prolonged stays in hospital. This article summarises the most recent recommendations in a short clinical guideline from the National Institute for Health and Clinical Excellence (NICE) on the management of diabetic foot problems in inpatients.2 NICE recommendations are based on systematic reviews of best available evidence and explicit consideration of cost effectiveness. When minimal evidence is available, recommendations are based on the Guideline Development Group's experience and opinion of what constitutes good practice. Evidence levels for the recommendations are given in italic in square brackets. ### Multidisciplinary foot care team
Methadone treatment increases in EU
Authors: R. Watson
Journal: BMJ (1997)

Over 200 000 people in the European Union receive methadone treatment for drug addiction, a threefold increase over the past three years.

The figures, which come from the European Monitoring Centre for Drugs and Drug Addiction, show that the practice is most widely used in Italy, where methadone is prescribed to 50 000 people. In France, which has permitted …
A simple modification in operative technique can reduce the incidence of nonanastomotic biliary strictures after orthotopic liver transplantation
Authors: Howard N. Sankary, Lawrence McChesney, Elizabeth Frye, Steven Cohn, Preston Foster, James Williams
Journal: Hepatology (1995)

Nonanastomotic strictures after liver transplantations are a source of significant morbidity, often necessitating retransplantation. The purpose of this study was twofold: first to identify features associated with the development of this lesion; second, to make technical modifications that will decrease the incidence of this problem. In the first part of this study, 15 of 131 patients were diagnosed with nonanastomotic biliary stricture. A stepwise logistic-regression analysis associated donor cold ischemic time and dopamine dose with the development of nonanastomotic biliary strictures. All these patients had arterial reconstruction after partial revascularization of the liver with portal venous blood. Because the bile duct receives its blood supply from only the hepatic artery, we hypothesized that the prolonged period of warm ischemia from staged reconstruction of the vascular supply would promote the development of this lesion. In a second part of this study, the stricture rate in 45 patients with simultaneous revascularization using both the hepatic artery and portal vein was compared with that in 83 patients from the first part of this study initially revascularized with portal venous blood. All patients in the second study had grafts preserved using UW solution. Only 1 patient with simultaneous revascularization developed a nonanastomotic biliary stricture. Because we were unable to identify any significant complications related to this method of revascularization, we propose that the hepatic artery and portal vein should be released simultaneously, especially in patients receiving a graft with prolonged storage time.
Relapsing typhilitis to CFHR5 nephropathy: the thrill of discovery
Authors: Kamran Abbasi
Journal: Journal of the Royal Society of Medicine (2011)

I expect you have never heard of CFHR5 nephropathy? Neither had I until I helped judge a grand rounds contest. It isn't the kind of case you would expect to find in a multispecialty journal like JRSM, but what fascinates me about it is the thrill of discovery, a mystery unravelled. Daniel Gale, the prize winner of the RSM Grand Rounds Competition 2010 describes a clinical quest whose solution was hidden in gene analysis and the Troodos Mountains of Cyprus (JRSM 2011;104:186–90).

Gale's account resonates with a past age of medicine when new clinical findings were first presented at this society and in this journal. The scientific world has moved on, with blockbuster discoveries – if any such are possible – being trumpeted at international specialty congresses and in the pages of the highest impact factor journals. Education instead of revelation has become the central purpose of the majority of medical societies and medical journals.

But rediscovering the past remains a valuable learning experience, and is the rationale for a series of extracts from Doctoring History, an RSM Press publication on the most ‘famous, popular and influential’ articles from this journal's archive published between 1809 and 1907. The series continues with Frederick Treve's first surgical operation for appendicitis or ‘relapsing typhilitis’ as he preferred to describe it (JRSM 2011;104:191–7). Indeed, William Osler considered ‘appendicitis’ to be medical jargon and dissuaded James Murray from including it in the New English Dictionary.

Treves did not remove the appendix in his operation, say Manoj Ramachandran and Jeffrey Aronson, the authors of the new book, he merely straightened out a kink and closed the abdomen. But Treves had to fend off the claims of an American surgeon, Thomas George Morton, whose first appendix operation was performed in 1888. Treves was able to counter that he had operated in February 1887 and brought the matter before the Royal Medical and Surgical Society in September 1887. Treves was first, the American second. The journal article confirms the date Treves report on ‘Relapsing typhilitis treated by operation’ was received and the date it was read at the Society. His patient, incidentally, made a ‘perfect recovery’.

Scientific disputes live on, and so does the possibility of discovering a new disease or inventing a novel operation, as Gale has demonstrated. We can now move from clinical presentation to gene analysis in a matter of moments. But we have paid a heavy price. Invention of medical jargon far outstrips medical discovery. Osler and Treves would despair at our folly.
Involvement of the tyrosinase gene in the deposition of cardiac lipofuscin in mice. Association with aortic fatty streak development.
Authors: J H Qiao, C L Welch, P Z Xie, M C Fishbein, A J Lusis
Journal: Journal of Clinical Investigation (1993)

Lipofuscin pigment, a terminal oxidation product, accumulates within cells during the normal aging process and under certain pathological conditions. We have analyzed a genetic cross between two inbred mouse strains, BALB/cJ and a subline of C57BL/6J, which differ in lipofuscin deposition. A comparison of the segregation pattern of cardiac lipofuscin with the albino locus (c) on mouse chromosome 7 revealed complete concordance. Analysis of spontaneous mutants of the tyrosinase gene, encoded by the albino locus, confirmed that the tyrosinase gene itself controls lipofuscin formation. Genetic analysis of other strains indicated that one or more additional genes cab contribute to the inheritance of lipofuscin. We also present evidence for an association between cardiac lipofuscin deposition and aortic fatty streak development in the mouse.
HIGH-SENSITIVITY C-REACTIVE PROTEIN IS POWERFUL PREDICTIVE MARKER IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Authors: Sungmin Lim, Ik Jun Chol, Mineok Chang, Jin Jin Kim, Minkyu Kang, Byung-Hee Hwang, Pum Joon Kim, Kiyuk Chang, Wook Sung Chung, Tae-Hun Kim, Suk Min Seo, Yoon Seok Koh, Eun ho Choo, Donggyu Moon, Jae Gyung Kim, Ki-Bae Seung
Journal: Journal of the American College of Cardiology (2013)
Abstract 1342: Effects of the plasticizer metabolite 2 ethyl-1-hexanol on human lymphoblast cells
Authors: Carlos A. Rosado-Berrios, Christian Vélez, Beatriz Zayas
Journal: Cancer Research (2011)

Abstract The study main objective was to determine the toxicity of 2-ethyl-1-hexanol (EH) and to compare them to its precursor di-ethylhexyl phthalate (DEHP) on the TK6 human lymphoblast cell line. EH is an organic alcohol produced in cells as result of the biotransformation of DEHP. Release of EH from lung cancer cells was also reported recently. Environmental human exposure to the parent DEHP can result through interaction with personal care products, paint lacquer, inks, rubber, dry cleaning and plasticizers such as PVC. Analyzed effects in this study included doses that inhibit cell growth (IC50), damage to the mitochondrial membrane, generation of Reactive Oxygen Species (ROS), and activation of caspase 3 and 7. TK6 cells were cultured on 12.5cm2 flasks with modified RPMI 1640 culture media with 10% FBS, and incubated at 37°C with 5% CO2. IC50 was determined by trypan blue exclusion and mitochondrial membrane permeability applying the Mito PT JC-1 assay from Immunochemistry. For ROS determination the fluorescent dye 2,7-dichlorofluorescein diacetate (DCFH-DA) was applied. For caspases 3 and 7 analysis the Magic RedTM assay from Immunochemistry was applied. Results indicated that IC50s of DEHP and EH on TK6 cells were 234 μM and 75nM respectively. Cells where then exposed to the identified IC50 for 48 hours to measure effects on mitochondria and ROS generation. ROS results indicated that EH generated an average of 96.31 Fluorescence Standard Units (FSU), the negative control Dimethyl Sulphoxide (DMSO) generated 58.22 FSU, the compound used as positive control cis-Di ammine platinum (II) dichloride (Cisplatin) generated 1309.67 FSU and for DEHP the ROS analysis resulted on 793.27 FSU. The level of ROS generated between the parent and this metabolite are not consistent with the degree of toxicity observed. Determination and comparison of the mitochondrial membrane permeabilization as well as Caspases 3 and 7-activation assays of EH are still developing. The preliminary results, however indicates a wide difference in citotoxicity between the parent compound and its metabolite clearly supporting the need for prevention strategies reducing exposure to these controversial plasticizer and therefore potential health effects. 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 1342. doi:10.1158/1538-7445.AM2011-1342
Effector and regulatory T-cell function is differentially regulated by RelB within antigen-presenting cells during GVHD
Authors: Kelli P. A. MacDonald, Rachel D. Kuns, Vanessa Rowe, Edward S. Morris, Tatjana Banovic, Helen Bofinger, Brendan O'Sullivan, Kate A. Markey, Alistair L. Don, Ranjeny Thomas, Geoffrey R. Hill
Journal: Blood (2007)
Re: Willem M. Brinkman, Irene M. Tjiam, Barbara M.A. Schout, et al. Results of the European Basic Laparoscopic Urological Skills Examination. Eur Urol 2014;65:490–6
Authors: Riccardo Autorino, Antonio Cicione, Jens Rassweiler, Estevao Lima
Journal: European Urology (2013)
進行性NSCLC患者におけるカルボプラチンとパクリタキセルを併用した,TRAIL-R1アゴニスト単クローン抗体マパツムマブの無作為化第2相試験
Authors: J Von Pawel, J H Harvey, D R Spigel, M Dediu, M Reck, C L Cebotaru, E Kumm, G Gallant, N Fox, D R Camidge
Journal: Journal of Clinical Oncology (2010)
Paroxysmal Tachycardia after Exercise
Authors: PERRY B. MILLER, LAWRENCE W. POLLARD
Journal: Circulation (1962)

Two cases of coronary artery heart disease are presented in which the Master two-step exercise test provoked short bursts of paroxysmal tachycardia. In one patient, nodal tachycardia was present; in the other, the tachycardia was either ventricular or nodal with aberrant conduction. Difficulties in assessing the probable etiology of paroxysmal tachycardia after exercise, which appears as an isolated finding in the coronary age group, are discussed.
Reply from Authors re: Thomas B.L. Lam, Sam McClinton. Between a Rock and a Hard Place: The Uncertainties in Managing Renal Stones. Eur Urol 2015;67:138–9
Authors: Riccardo Autorino, Shuba De, Fernando J. Kim, Homayoun Zargar, Manoj Monga, Marco De Sio
Journal: European Urology (2014)
Effective treatment of small murine hepatocellular carcinoma by dendritic cells
Authors: Wei-Chen Lee, Hui-Chuan Wang, Long-Bin Jeng, Yang-Jen Chiang, Chen-Rong Lia, Pei-Fang Huang, Miin-Fu Chen, Shiguang Qian, Lina Lu
Journal: Hepatology (2001)

Hepatocellular carcinoma (HCC) is a common malignancy with a poor prognosis. This investigation examined whether dendritic cell-based immunotherapy can treat murine HCC effectively. Bone marrow-derived dendritic cells were propagated from C57BL/10J mice in GM-CSF (4 ng/mL) and interleukin (IL)-4 (1,000 μ/mL). The dendritic cells were pulsed with a Hepa1-6 lysate overnight and employed to treat murine HCC. For in vivo study, HCC was created by inoculation of hepa1-6, 5 × 10 5 cells, in the flank of C57BL/10J mice. HCC were categorized into small (3 × 3-mm) and large (5 × 5-mm) tumors. These HCC were treated by dendritic cells intravenously, twice at weekly intervals. The results revealed that lymphocytes could be gathered around small HCC after administration of Hepa1-6 lysate-pulsed dendritic cells. Seven of 12 (58.3%) small HCC could be eradicated completely by dendritic cell-based immunotherapy, and 33.3% of the small tumors responded to immunotherapy partially which were held in a stable condition for 34.0 ± 7.4 days before the tumors regrew. For large HCC, lymphocytes did not gather around the tumors, and the tumors cannot be eradicated effectively by dendritic cells. However, dendritic cell-based immunotherapy could slow down the growth rate of large tumors (116.2 ± 91.4 mm 3 vs. 234.0 ± 149.1 mm 3 of the control on day 7, P = .043; and 280.3 ± 224.7 mm 3 vs. 870.0 ± 418.9 mm 3 of the control on day 17, P &lt; .001). Conclusively, dendritic cells pulsed with a Hepa1-6 lysate can be employed to treat small HCC in vivo effectively. However, the efficacy of dendritic cell-based immunotherapy decreases while tumors grow.
Risk of monoclonal gammopathy of undetermined significance: A case-referent study
Authors: Paolo Pasqualetti, Antonio Collacciani, Raffaele Casale
Journal: American Journal of Hematology (1996)

A retrospective study was conducted in 285 cases of monoclonal gammopathy of undetermined significance (MGUS) and in 570 sex-and age-matched hospital controls in order to investigate the possible association between socioeconomic status, residence, alcohol and tobacco habits, occupation, occupational exposure to toxic substances, chronic antigenic stimulation, and risk of MGUS. Significant associations with the risk of MGUS were found for farmers (P < 0.005) and for workers in industry (P < 0.025). Occupational exposure to asbestos, fertilizers, mineral oils and petroleum, paints and related products, pesticides, and radiation was significantly (P < 0.05) associated with an increase in risk of MGUS. Chronic immune-stimulating conditions, when considered as a group, presented a significant (P < 0.025) association with the risk of MGUS, but no specific disease has been found to be significantly associated. These data are in agreement with the previous reports on multiple myeloma, suggesting that these factors may play an important role in the development of monoclonal gammopathies. However, these findings need to be confirmed in prospective larger population-based studies. © 1996 Wiley-Liss, Inc.
ODOR IN THE ORR TREATMENT OF OSTEOMYELITIS AND ITS PREVENTION BY LACTOSE
Authors: ALLAN D. WALLIS
Journal: JAMA (1942)

One of the few aspects of the Orr treatment of osteomyelitis about which there is universal agreement is the unpleasantness of the odor which is apt to develop in the casts. Remarkably little attention seems to have been paid to the cause and prevention of this odor. It is our purpose herein to offer a hypothesis as to the cause and to suggest a simple method for the prevention.  REVIEW OF THE LITERATURE  Orr1states that bad odor is always due to a complicating mixed infection. Trueta2notes that the odor is worse when the wound is inadequately drained. Aside from this, we have been able to find no speculation as to the cause.  Various remedies have been suggested. Key3noted some decrease in the odor when using iodoform gauze soaked in balsam of Peru. McAleese4used oil of cloves paste instead of petrolatum gauze. Attempts
Implementation of clinical governance is patchy, report says
Authors: Z. Kmietowicz
Journal: BMJ (2003)

The concept of clinical governance in the NHS, whereby patients take centre stage and staff learn from their mistakes to improve the quality of care, is starting to reap benefits for patients, although some trusts are doing better than others, says a report.

According to the National Audit Office three quarters of trusts in England can identify specific improvements in patient care that have grown out of clinical governance. However, the overall implementation of clinical governance is patchy, with large variations between and within trusts, it says …
Activation ofN-methyl-D-aspartate receptors in rat brainin vivo following acute ammonia intoxication: Characterization byin vivo brain microdialysis
Authors: Carlos Hermenegildo, Pilar Monfort, Vicente Felipo
Journal: Hepatology (2000)

Ammonia is considered the main agent responsible for the neurological alterations in hepatic encephalopathy. It was suggested that ammonia toxicity is mediated by activation of N -methyl-d-aspartate (NMDA) receptors. The aim of this work was to assess, by in vivo brain microdialysis in freely moving rats, whether acute ammonia intoxication leads to activation of NMDA receptors in the cerebellum of the rat in vivo . We measured the effects of ammonia intoxication on the neuronal glutamate-nitric oxide-cyclic guanosine monophosphate (cGMP) pathway, by measuring the ammonia-induced increase of extracellular cGMP. Ammonia intoxication increases extracellular cGMP, and this increase is prevented by (5R,10S)-5-methyl-10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine hydrogen maleate (MK-801). There is a good correlation between the increase in cGMP and the seriousness of the neurological symptoms elicited by different doses of ammonia. Ammonia doses inducing coma did not affect extracellular glutamate, while doses leading to death increased it by 349%. The time courses of ammonia-induced increases in extracellular ammonia, cGMP, and glutamate indicate that NMDA receptor activation occurs before the increase in extracellular glutamate. Ammonia-induced increase in glutamate is prevented by MK-801. These results indicate that ammonia intoxication leads to activation of NMDA receptors in the animal in vivo , and that this activation is not caused by increased extracellular glutamate. The possible underlying mechanism is discussed.
Treatment of Schizophrenia
Authors: J. Lomas
Journal: BMJ (1957)

TREATMENT OF ECLAMPSIA 9.6%, which is about 1.5% higher than the result obtained by the new method.The eclampsia perinatal mortality rate over the same period was 36%, which is about 10% higher than the figure for the new method of sedation, and this figure is statistically significant. REFEUENCES
Dynamics of the Normal Aorta
Authors: MERRILL P. SPENCER, FRANK R. JOHNSTON, ADAM B. DENISON
Journal: Circulation Research (1958)

The contour of the flow pulse along the normal unopened aorta of human subjects and dogs was established by recording with the surgical probe type, square-wave magnetic flowmeter. The contour at a given vessel segment was found to be the result of the transforming action of the arterial system on the ventricular ejection pulse. The characteristics of the aorta and its branches were found to be analagous to a low-pass electric tuned circuit, which resonates at 3 to 6 c.p.s. The resonant frequency, apparent from midsystole throughout diastole, was independent of heart rate, damped to extinction during diastole and renewed with each systole. New terms for elastic hydraulics are proposed and defined.