tbuckley/cabot-search huggingface dataset:
Peroxisomal bifunctional enzyme deficiency.
Authors: P A Watkins, W W Chen, C J Harris, G Hoefler, S Hoefler, D C Blake, A Balfe, R I Kelley, A B Moser, M E Beard
Journal: Journal of Clinical Investigation (1989)

Peroxisomal function was evaluated in a male infant with clinical features of neonatal adrenoleukodystrophy. Very long chain fatty acid levels were elevated in both plasma and fibroblasts, and beta-oxidation of very long chain fatty acids in cultured fibroblasts was significantly impaired. Although the level of the bile acid intermediate trihydroxycoprostanoic acid was slightly elevated in plasma, phytanic acid and L-pipecolic acid levels were normal, as was plasmalogen synthesis in cultured fibroblasts. The latter three parameters distinguish this case from classical neonatal adrenoleukodystrophy. In addition, electron microscopy and catalase subcellular distribution studies revealed that, in contrast to neonatal adrenoleukodystrophy, peroxisomes were present in the patient's tissues. Immunoblot studies of peroxisomal beta-oxidation enzymes revealed that the bifunctional enzyme (enoyl-CoA hydratase/3-hydroxyacyl-CoA dehydrogenase) was deficient in postmortem liver samples, whereas acyl-CoA oxidase and the mature form of beta-ketothiolase were present. Density gradient centrifugation of fibroblast homogenates confirmed that intact peroxisomes were present. Immunoblots of fibroblasts peroxisomal fractions showed that they contained acyl-CoA oxidase and beta-ketothiolase, but bifunctional enzyme was not detected. Northern analysis, however, revealed that mRNA coding for the bifunctional enzyme was present in the patient's fibroblasts. These results indicate that the primary biochemical defect in this patient is a deficiency of peroxisomal bifunctional enzyme. It is of interest that the phenotype of this patient resembled neonatal adrenoleukodystrophy and would not have been distinguished from this disorder by clinical study alone.
Liberal Democrats want coalition to run NHS
Authors: J. Warden
Journal: BMJ (1997)

The Liberal Democrats, at their party conference in Eastbourne, chastised Britain's Labour government for its handling of the health service and proposed an all party coalition to shape the future of the NHS.

The health spokesman, Simon Hughes, proposed the creation of a permanent standing conference from the health service, made up of political leaders, health professionals, and patients' groups. He said …
Endoscopic Prosthesis for Advanced Esophageal Cancer
Authors: G.N.J. Tytgat, F.C.A. den Hartog Jager, J.F.W.M. Bartelsman
Journal: Endoscopy (1986)

Dysphagia, regurgitation and hypersalivation due to local destruction or incessant coughing in the presence of a tracheo-broncho-esophageal fistula become the most important distressing factors in the end stage of malignancies in the upper gastrointestinal tract. Inevitably such patients have a short life expectancy. It is often desirable to avoid the morbidity associated with surgery, radiotherapy or chemotherapy. The non-operative insertion of a prosthesis is increasingly being carried out to palliate malignant dysphagia.
Question of the Month Made Hard
Authors: YORSANANT SAENGWATANARERK
Journal: Annals of Internal Medicine (1971)

ExcerptTo the editor: To one type of Question of the Month in the ANNALS, the reader needs to know a set of codes before he can make a correct choice of answers.These codes are:When the answer is "A," the correct choices are 1, 2, 3.When the answer is "B," the correct choices are 1, 3.When the answer is "C," the correct choices are 2, 4.When the answer is "D," the correct choice is 4.When the answer is "E," the correct choices are 1, 2, 3, 4.I noticed when this type of question was...
Cyclophosphamide and low-dose prednisolone in idiopathic pulmonary fibrosis and fibrosing nonspecific interstitial pneumonia
Authors: Y. Kondoh, H. Taniguchi, T. Yokoi, O. Nishiyama, T. Ohishi, T. Kato, K. Suzuki, R. Suzuki
Journal: European Respiratory Journal (2005)

The present study compared the efficacy of cyclophosphamide combined with low-dose prednisolone in the treatment of idiopathic pulmonary fibrosis (IPF) with efficacy in idiopathic fibrosing nonspecific interstitial pneumonia fibrosing (NSIP). A total of 27 patients with IPF and 12 patients with fibrosing NSIP were included in this study. All patients had undergone surgical lung biopsy. The diagnoses were made based on clinical, radiological and pathological findings. All patients were treated with intermittent pulse therapy with methylprednisolone for 4 weeks, followed by cyclophosphamide with low-dose prednisolone. According to pulmonary function tests, four of 27 patients with IPF had improved, 22 remained unchanged, and one had worsened at the completion of pulse therapy. After 1 yr of combination therapy, four of 27 patients had improved, 14 remained unchanged, and nine had worsened. After pulse therapy, four of 12 patients with fibrosing NSIP had improved, and eight remained unchanged. After 1 yr of combination therapy, eight of 12 patients had improved, four remained unchanged, and none had worsened. Median survival of IPF patients was 4.1 yrs, which is significantly worse than that of fibrosing NSIP patients. In conclusion, patients with fibrosing nonspecific interstitial pneumonia had a more favourable response to combination therapy and a better survival than those with idiopathic pulmonary fibrosis.
The person in the patient
Authors: A. M Santhouse
Journal: BMJ (2008)

> “The care of the human mind is the most noble branch of medicine”
> 
>  Aloysius Sieffert 1
> “Psychiatrist—a man who asks you a lot of expensive questions your wife asks you for nothing”
> 
>  Sam Bordell 1
My opinion of the branch of medicine that I have given my career to, psychiatry, veers unsteadily between two extremes. At times I am carried away by the nobility of my calling, while at other times I am left wondering at the validity and usefulness of modern psychiatry. I am talking about the vast bulk of mental illness largely ignored by psychiatry but that forms the greatest burden of mental suffering in the population: depression, anxiety disorders, conversion disorders, somatoform disorders, and a variety of other similar disorders. Why are these disorders becoming more prevalent? Is our treatment effective? Is our understanding of the illnesses adequate? Surely the context influences the development of mental health problems; and perhaps understanding the context of our patients and the society in which they live is crucial. After …
Concerning Hepatotoxicity of Halothane
Authors: Charles S. Davidson, Bernard Babior, Hans Popper
Journal: New England Journal of Medicine (1966)

No one knows at present whether halothane is toxic to the liver. For several years a study¶ to determine the answer to this question has been going on. It is now completed and a summary report has been issued.1 Although the study did not provide an absolute answer to the question, it did provide a quantitative one: if halothane induces liver disease, the occurrences are at least uncommon if not rare.The summary report itself is rather long and probably will not be completely read by all those concerned. We have undertaken here to interpret this summary report. What we . . .
Embolization of the Tip of a Central Venous Catheter into the Pulmonary Artery
Authors: Andreas J Morguet, Heinz-Peter Schultheiss
Journal: New England Journal of Medicine (2005)

A 56-year-old man who had recently undergone coronary-artery bypass grafting and replacement of the mitral and aortic valves underwent aortobifemoral bypass surgery for Fontaine stage IIb arterial occlusive disease. The postoperative course was complicated by retroperitoneal bleeding. On day 10 after surgery, a routine chest radiograph in the intensive care unit revealed an object projecting to the left pulmonary hilus (Panel A [posteroanterior view], arrow, and Panel B [right lateral view], arrows). Thoracic computed tomography and fluoroscopy showed that the object was located in the lower left pulmonary artery (Panel C, arrow and video clip 1). The foreign body was . . .
Bronchial Obstruction Due to Pulmonary Artery Anomalies
Authors: STEPHEN CONTRO, ROBERT A. MILLER, HARVEY WHITE, WILLIS J. POTTS
Journal: Circulation (1958)

A left pulmonary artery, coursing anomalously above the right bronchus and behind the trachea en route to the left lung, can produce disabling respiratory symptoms. Three cases observed by the authors are presented in detail and 5 similar cases, previously reported, are reviewed. The clinical features are those of tracheobronchial obstruction, occurring early in life, associated with endoscopic evidence of extrinsic pressure on the right bronchus and posterior wall of the trachea. The importance of the clinical recognition of this anomaly is stressed, since it appears to be amenable to surgical correction.
THE SECOND COMPONENT OF HUMAN COMPLEMENT: ITS ISOLATION, FRAGMENTATION BY C'1 ESTERASE, AND INCORPORATION INTO C'3 CONVERTASE
Authors: Margaret J. Polley, Hans J. Müller-Eberhard
Journal: The Journal of Experimental Medicine (1968)

A method has been described for the purification and isolation of the second component of complement (C'2) from human serum. The protein is a beta(1)-globulin with an approximate molecular weight of 117,000. Immunochemical analysis using a variety of specific antisera, including a monospecific antiserum to the isolated protein, indicate that the C'2 protein represents a heretofore unrecognized human serum constituent. Isolated C'2 contained 2 x 10(9) "effective molecules" per microgram and 1000 hemolytically active C'2 molecules were required to produce a single hemolytically effective C'2 site on erythrocytes undergoing immune cytolysis. C'1 esterase treatment of C'2 resulted in reduction of both its electrophoretic mobility and its molecular size, the latter observation indicating fragmentation of the molecule. Direct evidence was presented for the physical presence of C'2 as an integral part of the enzyme C'3 convertase.
Hepatitis associated with amoxycillin-clavulanic acid combination report of 15 cases.
Authors: D Larrey, T Vial, A Micaleff, G Babany, M Morichau-Beauchant, H Michel, J P Benhamou
Journal: Gut (1992)

Fifteen cases of hepatitis related to a combination of amoxycillin and clavulanic acid are reported. Most patients were aged 60 years or more and there were more men than women (sex ratio 4:1). The amoxycillin-clavulanic acid had been given at doses ranging from 0.5 to 6 g/day (mean 2 g/day) for seven to 60 days (mean 18 days). In 11 cases, the first symptoms appeared one to four weeks after stopping treatment. Jaundice was observed in all patients and was frequently associated with pruritus. Serum aminotransferase activities were increased in all patients and were generally two to 10 times the upper limit of normal. Serum alkaline phosphatase activity was considerably increased, from two to seven times the upper limit of normal. Histological examination of the liver, performed in seven patients, showed centri- or panlobular cholestasis in all cases, associated with granulomatous hepatitis in one. The prognosis of amoxycillin-clavulanic acid induced hepatitis seemed to be good. None of the patients exhibited biological or clinical features of hepatic failure and the course of the disease was characterised by the resolution of jaundice within one to eight weeks and a complete recovery within four to 16 weeks. Taking into account the number of treated subjects and reported cases, we estimated the risk of developing hepatitis with this drug combination to be very low, probably below 1/100,000. Our data suggest that the risk of hepatotoxicity may be increased in elderly men given lengthy treatment. The association of hepatitis and signs of hypersensitivity may suggest an immunoallergic mechanism of hepatotoxicity in some patients.
Evaluation of chitosan–gelatin films for use as postoperative adhesion barrier in rat cecum model
Authors: Elias Shahram, Seyed Homayoon Sadraie, Gholamreza Kaka, Hadi Khoshmohabat, Mohammad Hosseinalipour, Farzad Panahi, Mohammad Reza Naimi-Jamal
Journal: International Journal of Surgery (2013)
Accurate Electrocardiographic Measurement of the Rate of Artificial Pacemakers
Authors: JOHN B. KOSTIS
Journal: Annals of Internal Medicine (1973)

A new method accurately (2 msec, 0.2 beats/minute) measures the cycle length of artificial pacemakers with the conventional electrocardiograph and the 60-Hz AC interference artifact. The measurements are easily performed by a technician in less than 10 minutes and, in the absence of pacemaker clinic facilities, may be used to predict pacemaker battery failure in most currently manufactured models.
Long-Term Heart Rate Reduction Induced by the Selective <i>I</i> <sub>f</sub> Current Inhibitor Ivabradine Improves Left Ventricular Function and Intrinsic Myocardial Structure in Congestive Heart Failure
Authors: Paul Mulder, Stephane Barbier, Abdeslam Chagraoui, Vincent Richard, Jean Paul Henry, Françoise Lallemand, Sylvanie Renet, Guy Lerebours, Florence Mahlberg-Gaudin, Christian Thuillez
Journal: Circulation (2004)

Heart rate reduction (HRR) improves left ventricular (LV) filling, increases myocardial O2 supply, and reduces myocardial O2 consumption, which are all beneficial in congestive heart failure (CHF). However, the long-term effects of HRR on cardiac function and remodeling are unknown.We assessed, in rats with CHF, the effects of long-term HRR induced by the selective I(f) current inhibitor ivabradine (as food admix for 90 days starting 7 days after coronary artery ligation). To assess intrinsic modifications of LV tissue induced by long-term HRR, all parameters were reassessed 3 days after interruption of treatment. Ivabradine decreased heart rate over the 90-day treatment period (-18% versus untreated at 10 mg x kg(-1) x d(-1)), without modifying blood pressure, LV end-diastolic pressure, or dP/dt(max/min). Ivabradine significantly reduced LV end-systolic but not end-diastolic diameter, which resulted in preserved cardiac output due to increased stroke volume. In the Langendorff preparation, ivabradine shifted LV systolic but not end-diastolic pressure-volume relations to the left. Ivabradine decreased LV collagen density and increased LV capillary density without modifying LV weight. Three days after interruption of treatment, the effects of ivabradine on LV geometry, shortening, and stroke volume persisted despite normalization of heart rate.In rats with CHF, long-term HRR induced by the selective I(f) inhibitor ivabradine improves LV function and increases stroke volume, preserving cardiac output despite the HRR. The improvement of cardiac function is related not only to the HRR per se but also to modifications in the extracellular matrix and/or function of myocytes as a consequence of long-term HRR.
Abstract A23: Repression of Id4 (inhibitor of DNA binding 4) by the polycomb group protein EZH2 in prostate cancer
Authors: Swathi Chinaranagari, Pankaj Sharma, Jaideep Chaudhary
Journal: Cancer Research (2013)

Abstract Introduction: Inhibitor of DNA binding/differentiation protein 4 (Id4) is dominant negative regulator of basic helix loop helix (bHLH) family of transcription factors. Id4 shares the homology of HLH domain with other Ids and lack the basic DNA binding region. Unlike Id1, Id2 and Id3, Id4 acts as a tumor suppressor in prostate cancer by attenuating cell proliferation and promote apoptosis. We have previously shown that decreased Id4 expression in prostate cancer is due to its promoter hypermethylation. In this study we investigated the molecular mechanism by which Id4 promoter is hypermethylated. Here, we demonstrate that Id4 promoter methylation is initiated by EZH2 dependent tri-methylation of histone 3 at lysine 27 (H3K27me3). Experimental procedures: Id4 protein expression was analyzed on human prostate adenocarcinoma samples by Immunohistochemistry and prostate cancer cell lines (LNCaP, C81 and DU145) by Western blot. EZH2 was silenced in DU145 cells and confirmed through western blot and Immunocytochemistry. Chromatin Immunoprecipitation (ChIP) was performed with IgG, RNA polymerase, EZH2 and H3K27Me3 antibodies in both prostate cancer cell lines and prostate cancer tissue samples. Results: IHC demonstrated decreased Id4 protein expression in human prostate tissue samples whereas higher nuclear Id4 expression was found in normal prostate tissues. Re-expression of Id4 in EZH2 silenced Du145 demonstrated that Id4 is regulated in an EZH2 dependent manner. ChIP data on prostate cancer samples and cell lines suggested EZH2 occupancy and H3K27Me3 marks in the Id4 promoter region in cell lines and prostate cancer tissue specimens. Conclusions: Id4 appears as a potential tumor suppressor gene that is epigenetically silenced during prostate cancer development. H3K27Me3 marks and EZH2 occupancy suggest a PRC2 dependent mechanism in Id4 promoter silencing in prostate cancer. Acknowledgement: The research was supported by NIH/NCI-RO1CA128914 and in part by NIH/NCRR/RCMI G12RR03062 Citation Format: Swathi Chinaranagari, Pankaj Sharma, Jaideep Chaudhary. Repression of Id4 (inhibitor of DNA binding 4) by the polycomb group protein EZH2 in prostate cancer. [abstract]. In: Proceedings of the AACR Special Conference on Chromatin and Epigenetics in Cancer; Jun 19-22, 2013; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2013;73(13 Suppl):Abstract nr A23.
A 16 year old boy with chest pain
Authors: A. M. N. Walker, Y. Parviz, J. Heppenstall, J. Best, E. D. Grech
Journal: BMJ (2014)

A 16 year old boy awoke with a crushing pain in the centre of his chest. He was clammy, nauseated, and vomited once. He had a history of antiphospholipid syndrome and had been prescribed low molecular weight heparin injections. He admitted to being poorly adherent to this treatment before presentation. He also had hypertension, which was thought to be secondary to poor blood supply to a shrunken, poorly functioning right kidney. He was a smoker and occasional user of cocaine and amphetamines, but he had not used either illicit drug for at least two weeks before the event. An ambulance was called, and the paramedics performed electrocardiography⇓.





### 1. What does his electrocardiograph show?

#### Short answer

Sinus rhythm at 58 beats/min, normal axis, ST elevation in leads II, III, and aVF, with reciprocal ST depression in leads I and aVL. Appearances are consistent with an inferior ST elevation myocardial infarction (STEMI).

#### Long answer

Sinus rhythm at 58 beats/min, normal axis, ST elevation in leads II, III, and aVF, with reciprocal ST depression in leads I and aVL. There is also T wave inversion in leads V1, V2, aVR, and aVL (fig 2⇓).



Fig 2 Electrocardiograph showing ST elevation in leads II, III, and aVF, with reciprocal ST depression in leads I and aVL



The electrocardiograph indicates an inferior STEMI. The right coronary artery supplies the inferior surface of the heart in around 85% of cases. The left circumflex artery supplies the inferior surface of the heart in the remaining 15% of patients.

The table⇓ gives details of the coronary artery …
Immediate Effect on Cardiac Output of Reversion to Sinus Rhythm from Rapid Arrhythmias
Authors: J. S. Wright, J. Fabian, E. J. Epstein
Journal: BMJ (1970)

Cardiac output was estimated immediately before and after conversion to sinus rhythm in nine patients with rapid arrhythmias. Conversion was by synchronized direct-current shock in eight patients, and by direct atrial wall stimulation in the other. In seven patients there was an immediate increase in cardiac output after restoration of sinus rhythm. The percentage increase in output was directly proportional to the rate of the arrhythmia immediately before conversion (r=0.91, P<0.01). The critical heart rate, above which an immediate increase in cardiac output might be expected on conversion to sinus rhythm, appeared in these patients to be about 160 beats per minute.
Peripheral adaptations in trained aged rats with femoral artery stenosis.
Authors: H T Yang, R W Ogilvie, R L Terjung
Journal: Circulation Research (1994)

The development and functional significance of exercise-induced peripheral adaptations were evaluated in aged animals with peripheral arterial insufficiency. Fisher 344 male rats (21 months old) were subjected to bilateral stenosis of the femoral arteries sufficient to limit active hyperemia but not to impair resting blood flow. Beginning the third day after stenosis, animals were (1) exercised by walking (n = 12) on a treadmill at 20 m/min at 15% inclination, twice a day, 5 days per week, or (2) limited to cage activity (n = 10). Exercise tolerance improved from approximately 5 to approximately 35 minutes (P &lt; .001) over the 8 weeks of the training program but increased only marginally to approximately 8 minutes for the sedentary group. An isolated hind limb preparation perfused at equivalent blood flows (approximately 1 ml.min-1 x g-1 with an arterial blood oxygen content of approximately 20 vol%) was used to assess the functional and metabolic impact of muscle-specific adaptations during sequential contraction periods at 4, 8, 15, 30, 45, 60, 75, and 90 tetani per minute. An initially similar force development of approximately 10 N/g was better maintained (P &lt; .001) by the trained group. The peak oxygen consumption attained by the trained group of 5.68 +/- 0.34 mumol.min-1 x g-1 was greater (P &lt; .01) than that of the sedentary group (4.34 +/- 0.29 mumol.min-1 x g-1). This was due to a greater oxygen extraction, since oxygen delivery was the same (approximately 10 mumol.min-1 x g-1) to muscles of both groups.(ABSTRACT TRUNCATED AT 250 WORDS)
IMPROVED METHOD OF COCAIN ANESTHESIA FOR NASAL MUCOUS MEMBRANES.
Authors: P. L. ANDERSON
Journal: JAMA (1897)

Many of the unpleasant effects of cocain may be averted and much of the dread of operations may be dispelled by using the following method of local anesthesia. As a preliminary step (preparatory for the application of a stronger solution) a spray of one-tenth per cent. cocain solution is used. In about half a minute, the same spray may be repeated and the thirty seconds between these two sprays may be utilized in arranging a very small amount of cotton on the probe for immediate use. Although this requires but a minute of time, the membranes are sufficiently anesthetized to allow the introduction of the probe without giving the patient any annoyance from the contact of the cotton with sensitive parts. The cotton on the probe has been moistened in a 25 per cent. solution of cocain. Anesthesia will take place in from three to five minutes, by rubbing the
Unusual Manifestation of Libman-Sacks Endocarditis in Systemic Lupus Erythematosus
Authors: Carsten Schneider, Edda Bahlmann, Matthias Antz, Rudolph Bauer, Jacobus Reimers, Werner Raut, Christian Busch, Frank Rathjen, Roland Moll, Karl-Heinz Kuck
Journal: Circulation (2003)
TUBERCULOSIS IN THE NEGRO.
Authors: SEALE HARRIS
Journal: JAMA (1903)

Tuberculosis was a rare disease among the slaves in the southern states, yet, after a little more than a quarter of a century, it causes more deaths among the emancipated negroes than all the other infectious diseases. The negro death rate from tuberculosis is more than three times that of the whites from the same disease. These statements, as startling to some as they are true, announce the motive which induced me to select for my theme on this occasion, "Tuberculosis in the Negro"; and if I can be the means of inciting any of you to consider the causes of this enormous mortality from that disease in the negro race and the measures to be taken for their relief, the objects of this paper will have been attained. From the best information which I can gather, tuberculosis is unknown among the savage tribes in the interior of Africa.