tbuckley/cabot-search huggingface dataset:
In vitro modulation of intracellular oxidative stress of endothelial cells by diagnostic cardiac ultrasound
Authors: G BASTA, L VENNERI, G LAZZERINI, E PASANISI, M PIANELLI, N VESENTINI, S DELTURCO, C KUSMIC, E PICANO
Journal: Cardiovascular Research (2003)

Diagnostic cardiac ultrasound are commonly assumed to pose no hazard to the patient—but this is not synonymous with being biologically inert. The production of intracellular reactive oxygen species (ROS) on endothelial cells is a key modulator of atheroprotective (at low level) and atherogenic (at high levels) actions. The aim of the study was to evaluate in vitro the effects on intracellular ROS of endothelial cells after ultrasound exposure of variable duration with commercially available cardiac imaging systems. Endothelial cells fluorescence was evaluated in vitro after sham (transducer off) exposure to ultrasound and after 5', 15' and 30' of ultrasound irradiation with second harmonic 1.3/2.6 MHz cardiac ultrasound scan (mechanical index 1.5). Intracellular ROS were 83 at baseline, and rose to 86, 112 and 122 fluorescence intensity at 1 h incubation after 5', 15' and 30' of ultrasound exposure respectively (P<0.01 for 30' versus baseline and 5' comparison). There were microscopic signs of endothelial damage only following 30' stage. Ultrasound exposure induced significant DNA laddering and LDH leakage after 15' of ultrasound exposure. Effects on endothelial cells could be reproduced by adding exposed extracellular medium to unexposed cells, and could be prevented removing exposed medium from cell culture or pretreating the medium with catalase. Cardiac ultrasound of current clinical diagnostic use increases intracellular oxidative stress on endothelial cells in vitro. This increase is accompanied by morphological evidence of endothelial damage only after longer exposure times, persists 1 h after withdrawal of ultrasound, and can be modulated over a wide range according to the duration of ultrasound exposure. Free radical production in the extracellular medium is the likely mediator of ultrasound effect.
Sin and Crime — Anesthetic Addiction —Chair Pusher's Delight
Authors: John Lister
Journal: New England Journal of Medicine (1960)

GOOD morning, Sir, vice again, Sir?" This, said Sir John Wolfenden, C.B.E., was the friendly question with which he was frequently greeted by the porter at the Home Office when he had become a well known visitor there as chairman of a special committee enquiring into the problem of prostitution and homosexuality. He was addressing the members of the Royal College of Physicians, who were recently privileged to hear him speak about his views on the practical and philosophic aspects of sin and crime.He explained that one of the first tasks of his committee was to assess what sort . . .
Extensive Skeletal Involvement Detected by Gallium-67 Citrate in a Patient with Multiple Myeloma
Authors: HIROSHI NISHIYAMA, THOMAS M. MORAND, VICENT J. SEIWERT
Journal: Clinical Nuclear Medicine (1988)

Extensive skeletal involvement of multiple myeloma was detected by Ga-67 citrate imaging while searching for infectious foci. The case was unique in that a radiographic skeletal survey showed typical lytic lesions only in the skull, and extensive myeloma involvement in the skeletal system was an incidental finding. A high tumor cell burden was presumed to be present, which led to a rapid and fulminant clinical course in this patient.
Research Training in Subspecialty Programs
Authors: Don C. Rockey
Journal: Annals of Internal Medicine (2001)

Letters15 May 2001Research Training in Subspecialty ProgramsDon C. Rockey, MDDon C. Rockey, MDDuke University Medical Center; Durham, NC 27710 (Rockey)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-134-10-200105150-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their study on subspecialty research training and the new American Board of Internal Medicine (ABIM) Research Pathway, Whitcomb and Walter (1) reported that “few internal medicine subspecialty programs are currently designed to provide adequate research training as defined by the Institute of Medicine and the ABIM.” However, this conclusion should be tempered. The study focused more on general research in fellowships than on basic science or ABIM-defined research. Given the traditional fellowship structure, it is understandable that global research is suffering; fellows have historically filled clinical service roles and performed clinical research as time permits. Even ...References1. Whitcomb ME, Walter DL. Research training in six selected internal medicine fellowship programs. Ann Intern Med. 2000;133:800-7. [PMID: 11085843] LinkGoogle Scholar2. Rosenberg LE. Young physician-scientists: internal medicine's challenge. Ann Intern Med. 2000;133:831-2. [PMID: 11085847] LinkGoogle Scholar3. Rosenberg L. The physician-scientist: an essential—and fragile—link in the medical research chain. J Clin Invest. 1999;103:1621-6. [PMID: 10377167] CrossrefMedlineGoogle Scholar4. Rockey D. The physician-scientist: a new generation or the last? J Investig Med. 1999;47:25-30. [PMID: 10071478] MedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Duke University Medical Center; Durham, NC 27710 (Rockey) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoResearch Training in Six Selected Internal Medicine Fellowship Programs Michael E. Whitcomb and Deborah L. Walter Young Physician-Scientists: Internal Medicine's Challenge Leon E. Rosenberg Metrics 15 May 2001Volume 134, Issue 10Page: 1009KeywordsEmotionsFellowshipsSub-specialty care ePublished: 15 May 2001 Issue Published: 15 May 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
On optimality and movement disorders: A dynamic systems perspective
Authors: R. E. A. van Emmerik, R. C. Wagenaar
Journal: Behavioral and Brain Sciences (1996)

Abstract The argument that disordered or changed motor patterns can be adaptive or optimal given the constraints imposed is supported. Two major points of criticism are made, concerning the perceived superstates of the primary disorder and the absence of a systematic approach to identifying this adaptivity and optimality. We have tried to give the general outlines of such an approach to disordered movements from a dynamic systems perspective.
Comminuted Fractures of the Distal Humerus
Authors: William E. Bickel
Journal: JAMA (1963)

Treatment of severely comminuted fractures of the elbow long has been a subject of controversy, and basically is represented by two schools of thought: the school that favors closed methods, and the one that prefers open methods. This report primarily reviews the methods of treatment of these fractures and secondarily presents the results of the authors' experience in open treatment of them. It is concluded that comminuted fractures of the elbow do not present hopeless situations. Rather, in the hands of a competent surgeon, open reduction with anatomic assemblage and internal fixation of the fragments offers a sufficiently high return in good results in selected cases to merit the additional hazards entailed.
Pemphigus — Decoding the Cellular Language of Cutaneous Autoimmunity
Authors: Richard L. Edelson
Journal: New England Journal of Medicine (2000)

The primary causes of the most common autoimmune disorders have been elusive. Pemphigus foliaceus has attracted considerable attention, despite its low incidence, because the associated autoantibodies are directly pathogenic, their target protein is known, and the presence of foci of endemic disease suggests an infectious cause in at least one variant of the disorder. Since the clinical hallmark of pemphigus foliaceus is the disruption of the superficial part of the epidermis, the manifestations have been simple to monitor, and the responses to therapy easy to assess.Pemphigus (from the Greek pemphix, meaning bubble or blister) encompasses a group of autoimmune . . .
THE "PATENT MEDICINE" AND NOSTRUM EVILS.
Authors: J. M. ANDERS
Journal: JAMA (1906)

Encouraged by a small measure of success resulting from the efforts put forth in the recent past to stamp out the "patent medicine" and secret nostrum evils, it behooves the medical profession at large to forward the beneficent effects of an awakening that has come none too early, until victory for reputable therapeutics and pharmacy is no longer in doubt. Individual members of our profession and medical organizations can aid the progress of this praiseworthy work by a calm, temperate, dispassionate discussion of the question, more particularly by pointing out the reasons for the phenomenal success of these doubtful preparations and by urging measures of relief in the interests of the public and professional weal. It is the province of the trained and disinterested physician to give appropriate and efficient direction to the movement. <h3>THE NATURE OF THE BUSINESS.</h3> It is well known that adulterants are extensively introduced into foodstuffs
Sharpen your look on liver progenitor cells
Authors: Laurent Dollé, Konrad L. Streetz, Leo A. van Grunsven
Journal: Hepatology (2011)

The molecular identification of adult hepatic stem/progenitor cells has been hampered by the lack of truly specific markers. To isolate putative adult liver progenitor cells, we used cell surface-marking antibodies, including MIC1-1C3, to isolate subpopulations of liver cells from normal adult mice or those undergoing an oval cell response and tested their capacity to form bilineage colonies in vitro. Robust clonogenic activity was found to be restricted to a subset of biliary duct cells antigenically defined as CD45(-)/CD11b(-)/CD31(-)/MIC1-1C3(+)/CD133(+)/CD26(-), at a frequency of one of 34 or one of 25 in normal or oval cell injury livers, respectively. Gene expression analyses revealed that Sox9 was expressed exclusively in this subpopulation of normal liver cells and was highly enriched relative to other cell fractions in injured livers. In vivo lineage tracing using Sox9creER(T2)-R26R(YFP) mice revealed that the cells that proliferate during progenitor-driven liver regeneration are progeny of Sox9-expressing precursors. A comprehensive array-based comparison of gene expression in progenitor-enriched and progenitor-depleted cells from both normal and DDC (3,5-diethoxycarbonyl-1,4-dihydrocollidine or diethyl1,4-dihydro-2,4,6-trimethyl-3,5-pyridinedicarboxylate)-treated livers revealed new potential regulators of liver progenitors.
Primary care in the accident and emergency department: I. Prospective identification of patients
Authors: J. Dale, J. Green, F. Reid, E. Glucksman
Journal: BMJ (1995)

<h3>Abstract</h3> <b>Objective</b>:To compare patient characteristics and consultation activities for attenders at accident and emergency departments assessed by nurse triage as presenting with "primary care" or "accident and emergency" type problems. <b>Design</b>:One year prospective study. <b>Setting</b>:A busy, inner city accident and emergency department in south London. <b>Subjects</b>:Of the 5658 patients treated for new problems during a stratified random sample of 204 three hour sessions between 10 am and 9 pm during June 1989 to May 1990, all "primary care" (2065 patients) and a 10% random sample of "accident and emergency" (291 patients) were included in the analysis. <b>Main outcome measures</b>:Patient9s age, sex, duration of presenting problem, diagnosis, laboratory and radiographic investigations, treatments, and referrals. <b>Results</b>:40.9% of attenders with new problems were classified by triage as presenting with "primary care" problems (95% confidence interval 39.6% to 42.2%). Primary care attenders were more likely than accident and emergency patients to be young adults, to have symptoms with a duration of longer than 24 hours, and to present problems not related to injury (all P&lt;0.001). Accident and emergency patients were considerably more likely to be referred to on call teams and to be admitted. Even so, 9.7% of primary care patients were referred to on call teams and a further 8.9% were referred to the fracture clinic or advised to return to the accident and emergency department for follow up. <b>Conclusion</b>:Accident and emergency triage can be developed to identify patients with problems that are more likely to be of a primary care type, and these patients are less likely to receive an investigation, minor surgical procedure, or referral. Many patients in this category, however, receive interventions likely to support their decision to attend accident and emergency rather than general practice. This may reflect limitations in the sensitivity of triage practice or a clinical approach of junior medical staff that includes a propensity to intervene.
TCT-353 Long-Term Outcomes of Biodegradable Polymer Drug-Eluting Stents versus Durable Polymer Sirolimus-Eluting Stents in Patients with Diabetes: A Pooled Analysis of Individual Patient Data from the ISAR-TEST 4 and LEADERS Randomized Trials
Authors: Lamin King, Antoinette de Waha, Lamin King, Robert Byrne, Salvatore Cassese, Adnan Kastrati, Stephan Windecker
Journal: Journal of the American College of Cardiology (2012)
A Case of Cholecystotomy: A Remarkable Gall Stone
Authors: M. Wardle
Journal: BMJ (1896)

THE authors have investigated the rhythmic contractility of the spleen, which was discovered by Roy 2, and the influence of nerves, drugs, and animal extracts upon it.For this pur- pose the changes in its volume have been studied by aid of a specially constructed plethysmograph, so arranged as to aford the least possible obstruction to the blood vessels entering and leaving the hilum.Under these circum-
Mitochondrial dysfunction in patients with primary congenital insulin resistance
Authors: Alison Sleigh, Philippa Raymond-Barker, Kerrie Thackray, David Porter, Mensud Hatunic, Alessandra Vottero, Christine Burren, Catherine Mitchell, Martin McIntyre, Soren Brage, T. Adrian Carpenter, Peter R. Murgatroyd, Kevin M. Brindle, Graham J. Kemp, Stephen O’Rahilly, Robert K. Semple, David B. Savage
Journal: Journal of Clinical Investigation (2011)

Mitochondrial dysfunction is associated with insulin resistance and type 2 diabetes. It has thus been suggested that primary and/or genetic abnormalities in mitochondrial function may lead to accumulation of toxic lipid species in muscle and elsewhere, impairing insulin action on glucose metabolism. Alternatively, however, defects in insulin signaling may be primary events that result in mitochondrial dysfunction, or there may be a bidirectional relationship between these phenomena. To investigate this, we examined mitochondrial function in patients with genetic defects in insulin receptor (INSR) signaling. We found that phosphocreatine recovery after exercise, a measure of skeletal muscle mitochondrial function in vivo, was significantly slowed in patients with INSR mutations compared with that in healthy age-, fitness-, and BMI-matched controls. These findings suggest that defective insulin signaling may promote mitochondrial dysfunction. Furthermore, consistent with previous studies of mouse models of mitochondrial dysfunction, basal and sleeping metabolic rates were both significantly increased in genetically insulin-resistant patients, perhaps because mitochondrial dysfunction necessitates increased nutrient oxidation in order to maintain cellular energy levels.
Improved Postprandial Metabolic Control After Subcutaneous Injection of a Short-Acting Insulin Analog in IDDM of Short Duration With Residual Pancreatic β-Cell Function
Authors: Simone Pampanelli, Elisabetta Torlone, Carlo Ialli, Paola Del Sindaco, Marco Ciofetta, Mauro Lepore, Linda Bartocci, Paolo Brunetti, Geremia B Bolli
Journal: Diabetes Care (1995)

OBJECTIVE To compare postprandial metabolic control after subcutaneous injection of a short-acting insulin analog [Lys(B289),Pro(B29)] (Lispro) or human regular insulin (Humulin R U-100 [Hum-R]) in insulin-dependent diabetes mellitus (IDDM) of short duration with residual β-cell function. RESEARCH DESIGN AND METHODS Six IDDM patients (age 25 ± 2 years, diabetes duration 14 ± 2 months, HbA1c 6.4 ± 0.5%) with residual pancreatic β-cell function (fasting plasma C-peptide 0.19 ± 0.02 nmol/l) were studied on three different occasions. Postbreakfast plasma glucose was maintained at ∼ 7.1 mmol/l by means of intravenous insulin until either 1200 when 0.1 U/kg Hum-R was injected or until 1225 when 0.1 U/kg of either Hum-R or Lispro was injected subcutaneously. Lunch (mixed meal, 692 Kcal) was served at 1230 (0 min). Six nondiabetic control subjects were also studied. RESULTS After Lispro administration, the 120-min plasma glucose decreased more (6.1 ± 0.3 mmol/l) than after injection of Hum-R at −30 min (7.7 ± 0.3 mmol/l) or −5 min (9.9 ± 0.2 mmol/l). By the end of the study, plasma glucose was still lower after Lispro was injected (6.7 ± 0.3 mmol/l) than after Hum-R was injected at −30 min (7.6 ± 0.3 mmol/l) or −5 min (7.3 ± 0.2 mmol/l) (P &amp;lt; 0.05). Two IDDM patients required glucose to prevent hypoglycemia after being injected with Lispro, but four required glucose after being injected with Hum-R at −5 min (Lispro ∼ 27 mmol glucose infused between 90 and 240 min; Hum-R ∼ 80 mmol between 240 and 390 min). After Lispro, plasma insulin peaked earlier (at 30 min, 342 ± 29 pmol/l) than after Hum-R injection at −30 min (at 90 min, 198 ± 28 pmol/l) and was superimposable on that of nondiabetic subjects. In Hum-R injected at −5 min, plasma insulin peaked later (at 120 min) and subsequently remained &amp;gt; in the two other studies. CONCLUSIONS Despite the lack of a time interval between injection and meal, Lispro controls postprandial plasma glucose concentration better than Hum-R given 30 min before meals and, to an even greater extent, better than Hum-R given 5 min before meals. In addition, Lispro minimizes the risk of postprandial hypoglycemia, thus closely mimicking the postprandial glucose homeostasis of nondiabetic subjects. IDDM patients with residual pancreatic β-cell function are the ideal candidates for prandial use of Lispro because they can maintain near-normoglycemia longer after subcutaneous analog injection because of residual endogenous insulin secretion.
Good Morning, Sister — Flickering Candlelight — Lilian Board
Authors: John Lister
Journal: New England Journal of Medicine (1971)

I AM sure that I have previously referred to my first experience of American nursing when I was sent on temporary duty to an American Army hospital in Munich just after the end of the war in Europe. On my first morning in the ward, when I was introduced to the chief nurse by the American medical officer, I greeted her in customary British fashion by saying, "Good morning, Sister." She was young and good looking, but froze me with her stare and rebuked me smartly by saying, "Lieutenant to you, Captain."I suppose that our chief ward nurses have . . .
Endosymbiotic Gene Transfer and Transcriptional Regulation of Transferred Genes in Paulinella chromatophora
Authors: E. C. M. Nowack, H. Vogel, M. Groth, A. R. Grossman, M. Melkonian, G. Glockner
Journal: Molecular Biology and Evolution (2010)

Paulinella chromatophora is a cercozoan amoeba that contains "chromatophores," which are photosynthetic inclusions of cyanobacterial origin. The recent discovery that chromatophores evolved independently of plastids, underwent major genome reduction, and transferred at least two genes to the host nucleus has highlighted P. chromatophora as a model to infer early steps in the evolution of photosynthetic organelles. However, owing to the paucity of nuclear genome sequence data, the extent of endosymbiotic gene transfer (EGT) and host symbiont regulation are currently unknown. A combination of 454 and Illumina next generation sequencing enabled us to generate a comprehensive reference transcriptome data set for P. chromatophora on which we mapped short Illumina cDNA reads generated from cultures from the dark and light phases of a diel cycle. Combined with extensive phylogenetic analyses of the deduced protein sequences, these data revealed that 1) about 0.3–0.8% of the nuclear genes were obtained by EGT compared with 11–14% in the Plantae, 2) transferred genes show a distinct bias in that many encode small proteins involved in photosynthesis and photoacclimation, 3) host cells established control over expression of transferred genes, and 4) not only EGT, but to a minor extent also horizontal gene transfer from organisms that presumably served as food sources, helped to shape the nuclear genome of P. chromatophora. The identification of a significant number of transferred genes involved in photosynthesis and photoacclimation of thylakoid membranes as well as the observed transcriptional regulation of these genes strongly implies import of the encoded gene products into chromatophores, a feature previously thought to be restricted to canonical organelles. Thus, a possible mechanism by which P. chromatophora exerts control over the performance of its newly acquired photosynthetic organelle may involve controlling the expression of nuclear-encoded chromatophore-targeted regulatory components of the thylakoid membranes.
Thrombolysis in strokes carries large risk
Authors: K. Abbasi
Journal: BMJ (1997)

Thrombolysis in acute ischaemic stroke carries a substantial risk and uncertain benefit, according to a systematic review of the evidence.

In the United States tissue plasminogen activator (tPA) is licensed for use within three hours of a stroke, and its use in this setting is recommended by American medical organisations. However, Dr Joanna Wardlaw, senior lecturer in the department of neuroradiology at the University of Edinburgh, and her team of researchers, concludes that the evidence does not support such an approach and more randomised trials are needed ( Lancet 1997;350:607-14).

Her team carried …
Evaluation for Coronary Artery Disease and Medicare Spending
Authors: Joseph A. Ladapo
Journal: JAMA (2012)

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Angiopoietin-1 alters microvascular permeability coefficients in vivo via modification of endothelial glycocalyx
Authors: Andrew H.J. Salmon, Christopher R. Neal, Leslie M. Sage, Catherine A. Glass, Steven J. Harper, David O. Bates
Journal: Cardiovascular Research (2009)

AimsIn this study, we wished to determine whether angiopoietin-1 (Ang1) modified the permeability coefficients of non-inflamed, intact continuous, and fenestrated microvessels in vivo and to elucidate the underlying cellular mechanisms.