tbuckley/cabot-search huggingface dataset:
Activation Delay After Premature Stimulation in Chronically Diseased Human Myocardium Relates to the Architecture of Interstitial Fibrosis
Authors: Tokuhiro Kawara, Richard Derksen, Joris R. de Groot, Ruben Coronel, Sara Tasseron, André C. Linnenbank, Richard N.W. Hauer, Hans Kirkels, Michiel J. Janse, Jacques M.T. de Bakker
Journal: Circulation (2001)

Background — Progressive activation delay starting at long coupling intervals of premature stimuli has been shown to correlate with sudden cardiac death in patients with hypertrophic cardiomyopathy. The purpose of this study was to elucidate the mechanism of increased activation delay in chronically diseased myocardium. Methods and Results — High-resolution unipolar mapping (105, 208, or 247 recording sites with interelectrode distances of 0.8, 0.5, or 0.3 mm, respectively) of epicardial electrical activity was carried out during premature stimulation in 11 explanted human hearts. The hearts came from patients who underwent heart transplantation and were in the end stage of heart failure (coronary artery disease, 4; hypertrophic cardiomyopathy, 1; and dilated cardiomyopathy, 6). Eight hearts were Langendorff-perfused. Epicardial sheets were taken from the remaining hearts and studied in a tissue bath. Activation maps and conduction curves were constructed and correlated with histology. Conduction curves revealing prominent increase of activation delay were associated with zones of dense, patchy fibrosis with long fibrotic strands. Dense, diffuse fibrosis with short fibrotic strands only marginally affected conduction curves. The course of conduction curves in patchy fibrotic areas greatly depended on the direction of propagation relative to fiber direction. Conclusions — The study demonstrates that in chronically diseased human myocardium, nonuniform anisotropic characteristics imposed by long fibrotic strands cause a progressive increase of activation delay, starting at long coupling intervals of premature stimuli. The increase strongly depends on the direction of the wave front with respect to fiber direction and the architecture of fibrosis.
The Use of Fiberoptics in Clinical Cardiac Catheterization
Authors: PAUL G. HUGENHOLTZ, WALTER J. GAMBLE, R. GRIER MONROE, MICHAEL POLANYI
Journal: Circulation (1965)

The fiberoptic instrument and catheters described in the preceding study were employed in the measurement of indocyanine-green concentrations in the circulatory system by a simple change of filters. Cardiac output was calculated from the recorded curves in 19 instances. In 13 of these, the results were compared with cardiac output determinations simultaneously obtained by a conventional method. There was good agreement for each of the values obtained (range 2.37 to 7.32L./min., r = 0.985). The only blood withdrawn in each patient was the 8 ml. needed for calibration. Distinct step-function was seen in the descending as well as the ascending portions of the curves. In three instances left ventricular injections were done and end-diastolic and end-systolic volumes calculated. The results are similar to those reported for thermodilution methods. From the rapidly changing concentration of dye within one cardiac cycle in the presence of aortic regurgitation, a formula was derived by which the amount of regurgitation could be calculated. This method was tested in a model where regurgitation varied up to twice the forward stroke volume by means of a ther-modilution method. Good agreement between measured and calculated degrees of regurgitation (r = 0.928) in 26 observations is shown. The application of the formula to a patient with proven aortic regurgitation is demonstrated.
Genetic control of eosinophilia in guinea pig strains inbred for high or low bronchial allergic reactivity 2. A genetic study of spontaneous and immunization‐induced eosinophilia
Authors: M. Ploug Winthereik, J. V. Spärck, L. Lundberg, D. Sompolinsky
Journal: Allergy (1992)

Ploug Winthereik M, Spärck JV, Lundberg L, Sompolinsky D. Genetic control of eosinophilia in guinea pig strains inbred for high or low bronchial allergic reactivity. 2. A genetic study of spontaneous and immunization‐induced eosinophilia. In 4 inbred strains of guinea pig the tendency to develop peripheral high‐eosinophilia was shown to be genetically controlled. The development of eosinophilia with age and following immunization was examined in high‐ and low‐eosinophilic parental strains, in F 1 ‐hybrids and in backcross offspring. The results show that probably only one or a very few segregating genes control eosinophilia, and they also indicate that different genes are involved in the determination of spontaneous (age‐related) and immunization‐induced eosinophilia.
Rupture of the Spleen
Authors: Herbert F. Philipsborn, Howard S. Traisman, David Greer
Journal: New England Journal of Medicine (1955)

THE purpose of this paper is to discuss 4 cases of erythroblastosis fetalis complicated by rupture of the spleen. In 3 infants exchange transfusion had been completed. In the other death occurred before definitive therapy. In each case splenic rupture was discovered at autopsy.The infrequency of this complication is established by the fact that a review of the literature yielded the report of only 1 such case, that of Slotkowski and Hand1 in 1948. This is the first of the 4 cases to which we refer. In the same year Gruenwald2 mentioned a case in which rupture of the . . .
Prevention of Maternal Deaths in Developing Countries
Authors: Doug Campos-Outcalt
Journal: JAMA (1989)

<h3>To the Editor.—</h3> I was pleased to read the excellent article by Dr Rosenfield<sup>1</sup>that illustrated the dramatic differences in maternal mortality between developed and developing countries. Dr Rosenfield was successful at making a case for a regional approach to this problem, rather than trying to solve it at a village level because of a lack of available interventions. There is another reason, even more pertinent, why the problem of maternal mortality is unlikely to be solved at the grass roots. Using Papua New Guinea as an example, because I have spent several years in that country and am familiar with the situation there, let us look at what the statistics, as presented by Dr Rosenfield, translate into. More than 80% of the population of Papua New Guinea live in villages of less than 500 people. In a village of this size, using the national birth rate of 34.2
AIDS and Other Epidemics
Authors: Virginia M. Anderson
Journal: JAMA (1992)

AIDS and Other Epidemicsis a relatively short (under 30 minutes) videocassette produced by Films for the Humanities & Sciences for its seriesThe Doctor Is In. It is an attempt to chronicle epidemics throughout recent human history and relate these events to the current devastating AIDS (acquired immunodeficiency syndrome) pandemic.  The technique is to tell the story of a particularly compelling person with little information on the impact of the disease on whole populations. Bubonic plague, influenza, tuberculosis, polio, smallpox, yellow fever, malaria, and Lyme disease are presented. Hardly mentioned are morbidity or the consequences of the death and destruction of previously healthy persons in their prime. The tone is hopeful. The storyline emphasizes success. However, sharp comparisons between the spread of human immunodeficiency virus (HIV) and other epidemics are missing.  The example of polio particularly holds out the promise of a vaccine to persons at risk of HIV
Ischaemic preconditioning preferentially increases protein S-nitrosylation in subsarcolemmal mitochondria
Authors: Junhui Sun, Tiffany Nguyen, Angel M. Aponte, Sara Menazza, Mark J. Kohr, David M. Roth, Hemal H. Patel, Elizabeth Murphy, Charles Steenbergen
Journal: Cardiovascular Research (2015)

Nitric oxide (NO) and protein S-nitrosylation (SNO) have been shown to play important roles in ischaemic preconditioning (IPC)-induced acute cardioprotection. The majority of proteins that show increased SNO following IPC are localized to the mitochondria, and our recent studies suggest that caveolae transduce acute NO/SNO cardioprotective signalling in IPC hearts. Due to the close association between subsarcolemmal mitochondria (SSM) and the sarcolemma/caveolae, we tested the hypothesis that SSM, rather than the interfibrillar mitochondria (IFM), are major targets for NO/SNO signalling derived from caveolae-associated eNOS. Following either control perfusion or IPC, SSM and IFM were isolated from Langendorff perfused mouse hearts, and SNO was analysed using a modified biotin switch method with fluorescent maleimide fluors. In perfusion control hearts, the SNO content was higher in SSM compared with IFM (1.33 ± 0.19, ratio of SNO content Perf-SSM vs. Perf-IFM), and following IPC SNO content significantly increased preferentially in SSM, but not in IFM (1.72 ± 0.17 and 1.07 ± 0.04, ratio of SNO content IPC-SSM vs. Perf-IFM, and IPC-IFM vs. Perf-IFM, respectively). Consistent with these findings, eNOS, caveolin-3, and connexin-43 were detected in SSM, but not in IFM, and IPC resulted in a further significant increase in eNOS/caveolin-3 levels in SSM. Interestingly, we did not observe an IPC-induced increase in SNO or eNOS/caveolin-3 in SSM isolated from caveolin-3−/− mouse hearts, which could not be protected with IPC. In conclusion, these results suggest that SSM may be the preferential target of sarcolemmal signalling-derived post-translational protein modification (caveolae-derived eNOS/NO/SNO), thus providing an important role in IPC-induced cardioprotection.
GASTRO-INTESTINAL STUDIES. I. GASTRIC JUICE IN PERNICIOUS ANEMIA
Authors: O. M. Helmer, Paul J. Fouts, L. G. Zerfas
Journal: Journal of Clinical Investigation (1932)

Several authors have indicated that the determination of the hydro- chloric acid, in itself, is not an adequate measure of the impairment of the secretory activity of the gastric mucosa.Michaelis (1) demonstrated this fact by the simultaneous determination of acid and enzymes in gastric juice from cases of low and high acidity and achylia.Polland and Bloomfield (2) stated that a low pepsin output is a more delicate index of gastric function than low acid values.Davies (3) similarly reported low pepsin values in the achylia of pernicious anemia.Since the determination of the enzyme content of the gastric juice may be a valuable aid in the differential diagnosis of certain types of anemia, we are presenting the data that we have obtained in a series of pernicious anemia cases and normal controls.In a later paper data will be presented on secondary anemia and some obscure types of anemia.In this series of experiments we have determined the gastric enzymes, pepsin and rennin, the free and total acid, the hydrogen ion concentration and the nitrogen, chloride, and phosphorus content, in order to determine as fully as possible the extent of the dysfunction of the gastric glands in the achylia gastrica occuring in patients with pernicious anemia.
Bran in hypertriglyceridaemia: a failure of response.
Authors: W F Bremner, P M Brooks, J L Third, T D Lawrie
Journal: BMJ (1975)

Atheroma is still the major cause of mortality in the Western world, and the difference in prevalence of atheroma in developed and developing countries has caused speculation that absence of a dietary constituent may play a major aetiological part in the production of arterial disease. Interest has recently centred on the possible role of dietary fibre intake in the pathogenesis of atheroma. Bran reduces the bacterial degradation of bile salts in the colon and may increase colonic transit times, though these results are difficult to interpret because of the variability of these values. Several workers have suggested that dietary roughage may play a significant part in lipid metabolism. Moore has shown that atheromatous degeneration in rabbits that were fed an atherogenic diet was reduced by the presence of dietary roughage. Recently Heaton and Pomare showed a significant lowering of serum triglycerides and plasma calcium levels in both normal volunteers and patients with gall bladder disease when unprocessed wheat bran was added to their diet. Connell et al., however, failed to show any effect of bran on cholesterol or triglyceride levels in a group of normal medical students. The exact place of bran in the management of lipid disorders is therefore uncertain. In the light of these conflicting reports and because raised triglyceride levels are a significant risk factor in the genesis of atheroma we thought it important to clarify the problem by studying the effect of wheat bran on raised triglyceride levels in patients with primary type IV hyperlipoproteinaemia.
Associations Between Serum Cholesterol Levels and Cerebral Amyloidosis
Authors: Bruce Reed, Sylvia Villeneuve, Wendy Mack, Charles DeCarli, Helena C. Chui, William Jagust
Journal: JAMA Neurology (2013)

Because deposition of cerebral β-amyloid (Aβ) seems to be a key initiating event in Alzheimer disease (AD), factors associated with increased deposition are of great interest. Whether elevated serum cholesterol levels act as such a factor is unknown.To investigate the association between serum cholesterol levels and cerebral Aβ during life early in the AD process.A multisite, university medical center-based, cross-sectional analysis of potential associations between contemporaneously assayed total serum cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and cerebral Aβ, measured with carbon C11-labeled Pittsburgh Compound B (PIB) positron emission tomography. Seventy-four persons (mean age, 78 years) were recruited via direct outreach in stroke clinics and community senior facilities following a protocol designed to obtain a cohort enriched for cerebrovascular disease and elevated vascular risk. Three patients had mild dementia. All others were clinically normal (n = 33) or had mild cognitive impairment (n = 38).Cerebral Aβ was quantified using a Global PIB Index, which averages PIB retention in cortical areas prone to amyloidosis. Statistical models that controlled for age and the apolipoprotein E ε4 allele revealed independent associations among the levels of LDL-C, HDL-C, and PIB index. Higher LDL-C and lower HDL-C levels were both associated with a higher PIB index. No association was found between the total cholesterol level and PIB index. No association was found between statin use and PIB index, and controlling for cholesterol treatment in the statistical models did not alter the basic findings.Elevated cerebral Aβ level was associated with cholesterol fractions in a pattern analogous to that found in coronary artery disease. This finding, in living humans, is consistent with prior autopsy reports, epidemiologic findings, and animal and in vitro work, suggesting an important role for cholesterol in Aβ processing. Because cholesterol levels are modifiable, understanding their link to Aβ deposition could potentially and eventually have an effect on retarding the pathologic cascade of AD. These findings suggest that understanding the mechanisms through which serum lipids modulate Aβ could offer new approaches to slowing Aβ deposition and thus to reducing the incidence of AD.
Peyer's Patch Dendritic Cells Process Viral Antigen from Apoptotic Epithelial Cells in the Intestine of Reovirus-infected Mice
Authors: Marina N. Fleeton, Nikhat Contractor, Francisco Leon, J. Denise Wetzel, Terence S. Dermody, Brian L. Kelsall
Journal: The Journal of Experimental Medicine (2004)

We explored the role of Peyer's patch (PP) dendritic cell (DC) populations in the induction of immune responses to reovirus strain type 1 Lang (T1L). Immunofluorescence staining revealed the presence of T1L structural (σ1) and nonstructural (σNS) proteins in PPs of T1L-infected mice. Cells in the follicle-associated epithelium contained both σ1 and σNS, indicating productive viral replication. In contrast, σ1, but not σNS, was detected in the subepithelial dome (SED) in association with CD11c+/CD8α−/CD11blo DCs, suggesting antigen uptake by these DCs in the absence of infection. Consistent with this possibility, PP DCs purified from infected mice contained σ1, but not σNS, and PP DCs from uninfected mice could not be productively infected in vitro. Furthermore, σ1 protein in the SED was associated with fragmented DNA by terminal deoxy-UTP nick-end labeling staining, activated caspase-3, and the epithelial cell protein cytokeratin, suggesting that DCs capture T1L antigen from infected apoptotic epithelial cells. Finally, PP DCs from infected mice activated T1L-primed CD4+ T cells in vitro. These studies show that CD8α−/CD11blo DCs in the PP SED process T1L antigen from infected apoptotic epithelial cells for presentation to CD4+ T cells, and therefore demonstrate the cross-presentation of virally infected cells by DCs in vivo during a natural viral infection.
Time to legalise assisted dying?: Do we make decisions by our feelings or the truth?
Authors: Anne M H Williams
Journal: BMJ (2005)

EDITOR—The BMJ seems to accept the policy of neutrality towards physician assisted suicide, despite reported undemocratic voting at the annual representative meeting.1

Tannsjo argues for euthanasia, not just physician assisted suicide.2 He follows the modern trend to make decisions by what “feels comfortable” rather than by what is objectively right. He then looks for a suitable framework to justify his opinion. …
The two histological types of gastric carcinoma in Northern Nigeria.
Authors: O A Mabogunje, S G Subbuswamy, J H Lawrie
Journal: Gut (1978)

Sixty-five specimens of gastric carcinoma from Northern Nigeria were classified using the criteria of Lauren (1965). Forty were intestinal, 16 diffuse, 2 mixed, and 7 unclassifiable. The intestinal type predominated in both men and women and in all age groups contrary to the expectation of a diffuse predominance because of the relatively young age groups of the population and the low risk for gastric carcinoma in this region.
Neoplasms After Childhood Irradiation of the Thymus Gland
Authors: Murray L. Janower
Journal: JAMA (1971)

The oncogenic effects of childhood irradiation of the thymus gland were investigated by following up 466 irradiated subjects, 506 unirradiated subjects with similar illnesses, and the siblings of both series. In the irradiated group there were two malignant and nine benign thyroid neoplasms, indicating an excess risk in this group. There was also a suggestion of an increased risk of breast cancer. There was no evidence of difference between the hospital and sibling controls; this supports the validity of previous studies using sibling controls.
"Idiopathic" Thrombosis in the Vertebrobasilar Arterial System in Young Men
Authors: D. I. Graham, H. Adams
Journal: BMJ (1972)

Two young men died as a result of cerebellar infarction due to thrombosis in the vertebrobasilar arterial system in the absence of atheromatous stenosis, other identifiable intrinsic arterial disease, or embolism. In each case the swollen cerebellar infarct had produced tonsillar herniation and hydrocephalus.
CLINICAL UTILITY OF THE SYNTAX SCORE AND SERUM EICOSAPENTAENOIC ACID FOR CARDIAC RISK STRATIFICATION OF DIABETIC PATIENTS TREATED WITH PERCUTANEOUS CORONARY INTERVENTION
Authors: Kenji Yamazaki, Raisuke Iijima, Masato Nakamura, Kaoru Sugi
Journal: Journal of the American College of Cardiology (2014)
CASE OF A SPOOL EMBEDDED IN THE CERVIX UTERI
Authors: A. P. STONER
Journal: JAMA (1910)

<h3>History.—</h3> S. L., aged 16, colored, entered my service at the surgical dispensary of Drake University, July 14, with a history of pelvic trouble of some years standing. She menstruated at 13 for 5 successive periods, after which time the period ceased altogether. <h3>Examination.—</h3> Her general condition and appearance was good and she was of average intelligence. On investigation the underclothing was found to be saturated with urine and the vulvar region was excoriated. A vegetative growth of small size and of a reddish hue, surrounded the meatus, and urine was trickling from the vagina. The examining finger came in contact with a foreign body in the vagina, which proved to be a wooden spool. Further examination showed that one end of the spool which measured about 5 centimeters in length, was securely embedded in the cervix. The free end was grasped with a pair of forceps and an attempt
A Doctor's Dilemma: Stress and the Role of the Carer
Authors: A. Wider
Journal: BMJ (1996)

John W Holland Free Association Books, £15.95, pp 182 ISBN 1 85343 306 3

In all clinical work the demands on the doctor's own emotional world are great, and this is particularly so in general practice. Here the willingness to encounter a patient at an emotional level within the surround of the continuing doctor-patient relationship is often more important than the apparent “medicine” that the relationship carries.

Most publications about stress and burnout among doctors are concerned with facts and figures. They list the hours worked and other external pressures such as the (assumed) changes in patients' expectations or the additional (and often conflicting) roles that recent legislation has added to the general practitioner's …
TCT-776 Risk Factors And Clinical Significance Of Intra-Procedural Haemodynamic Instability In Patients Undergoing Transcatheter Aortic Valve Implantation
Authors: Gennaro Giustino, Matteo Montorfano, Alaide Chieffo, Vasileios F. Panoulas, Azeem Latib, Filippo Figini, Remo D. Covello, Annalisa Franco, Eustachio Agricola, Pietro Spagnolo, Ottavio Alfieri, Antonio Colombo
Journal: Journal of the American College of Cardiology (2014)
Aspirin and Perioperative Blood Loss
Authors: Eric L. Michelson
Journal: JAMA (1981)

<h3>To the Editor.—</h3> I cannot agree with the statement by Amrein et al (1981; 245:1825) that an average additional blood loss of 400 mL "is not of great clinical importance." Interestingly, we noted a similar degree of excessive blood loss attributable to aspirin use in patients undergoing coronary artery bypass graft surgery.<sup>1</sup>We also saw excessive bleeding in patients with normal bleeding times, including some patients who had ingested only 600 mg of aspirin in the week before surgery.
995 SORAFENIB IN THE PALLIATIVE TREATMENT OF HEPATOCELLULAR CARCINOMA (HCC) DEVELOPED IN NON-FIBROTIC LIVER (F0-F1): SAFETY, EFFICACY. SINGLE-CENTER SERIE OF 33 CASES
Authors: J.-F. Blanc, C. Gauthier, L. Possenti, P. Lepicard, C. Castain, B. Le-Bail, H. Trillaud
Journal: Journal of Hepatology (2012)
Induction of cyclin A gene expression by homocysteine in vascular smooth muscle cells.
Authors: J C Tsai, H Wang, M A Perrella, M Yoshizumi, N E Sibinga, L C Tan, E Haber, T H Chang, R Schlegel, M E Lee
Journal: Journal of Clinical Investigation (1996)

Homocysteine is an important and independent risk factor for arteriosclerosis. We showed previously that homocysteine stimulates vascular smooth muscle cell proliferation, a hallmark of arteriosclerosis. We show here that homocysteine and serum increased DNA synthesis synergistically in both human and rat aortic smooth muscle cells (RASMCs). Treatment of quiescent RASMCs with 1 mM homocysteine or 2% calf serum for 36 h increased cyclin A mRNA levels by 8- and 14-fold, respectively, whereas homocysteine plus serum increased cyclin A mRNA levels by 40-fold, indicating a synergistic induction of cyclin A mRNA. Homocysteine did not increase the half-life of cyclin A mRNA (2.9 h), but it did increase the transcriptional rate of the cyclin A gene in nuclear run-on experiments. The positive effect of homocysteine on cyclin A gene transcription was confirmed by our finding that homocysteine increased cyclin A promoter activity and ATF-binding protein levels in RASMCs. Finally, 1 mM homocysteine increased cyclin A protein levels and cyclin A-associated kinase activity by threefold. This homocysteine-induced expression lesions by promoting proliferation of vascular smooth muscle cells.