tbuckley/cabot-search huggingface dataset:
Inhibition of acetylcholine induced intestinal motility by interleukin 1 beta in the rat.
Authors: A C Aube, H M Blottiere, C Scarpignato, C Cherbut, C Roze, J P Galmiche
Journal: Gut (1996)

BACKGROUND/AIMS: The fact that raised interleukin 1 beta (IL 1 beta) concentrations have been found in the colonic mucosa of rats with experimentally induced colitis and of patients with inflammatory bowel disease indicates that this cytokine may participate in the disturbed intestinal motility seen during inflammatory bowel disease. This study investigated whether IL 1 beta could change the contractility of (a) a longitudinal muscle-myenteric plexus preparation from rat jejunum, ileum, and colon and (b) isolated jejunal smooth muscle cells. METHODS: Isometric mechanical activity of intestinal segments was recorded using a force transducer. Moreover, smooth muscle cell length was measured by image analysis. RESULTS: Although IL 1 beta did not affect jejunal, ileal, and colonic basal contractility, it significantly reduced contractile response to acetylcholine (ACh). This significant inhibition was seen only after 90 or 150 minutes of incubation with IL 1 beta. Pretreatment with cycloheximide blocked IL 1 beta induced inhibition of ACh stimulated jejunal contraction, suggesting that a newly synthesised protein was involved in the effect. NW-nitro-L-arginine (a nitric oxide synthase inhibitor) did not prevent the inhibition induced by IL 1 beta. Blocking neural transmission with tetrodotoxin abolished the IL 1 beta effect on jejunal contractile activity, whereas IL 1 beta had no effect on isolated and dispersed smooth muscle cells. CONCLUSIONS: IL 1 beta inhibits ACh induced intestinal contraction and this inhibitory effect involves protein synthesis but is independent of nitric oxide synthesis. This effect does not involve a myogenic mechanism but is mediated through the myenteric plexus.
Patients' views of priority setting in health care: an interview survey in one practice
Authors: A. Dicker, D. Armstrong
Journal: BMJ (1995)

To explore the assumptions underlying consumers' responses to questions of resource priorities in the NHS.Qualitative analysis of semi-structured interviews with a heterogeneous sample of 16 patients drawn from a general practice.Interviewees were not persuaded that they had a legitimate role to play in the prioritisation of services. They supported the principle of equity and were reluctant to use their own personal needs as a basis for resource allocation; instead they argued from what they perceived to be the needs of others.Paradoxically, surveys of consumers' views on health care priorities probably do not elicit the personal ideas of respondents but tap into a more general ideological position closer to an earlier collectivist notion of health care.
The Relationship Between Sinoatrial Conduction Time and Sinus Cycle Length During Spontaneous Sinus Arrhythmia in Adults
Authors: JAMES A. REIFFEL, J. THOMAS BIGGER, MARVIN A. KONSTAM
Journal: Circulation (1974)

It is well known that atrioventricular conduction varies as a function of atrial rate. However, rate related changes in sinoatrial conduction time (SACT) have not been examined. To determine the relationship between SACT and sinoatrial cycle length (SCL) in man, atrial and His bundle electrograms were recorded during atrial premature stimulation in each of nineteen patients with sinus arrhythmia. Ten of nineteen had asymptomatic, intermittent sinus bradycardia; 3/19 had persistent sinus bradycardia with nonspecific symptoms; 6/19 were felt to represent the sick sinus syndrome. In 18/19 individuals, there was a clearcut, inverse, linear relationship between SACT and SCL, i.e., as SCL increased, SACT decreased. Although this resembles the increase in PR interval that occurs with a decrease in atrial cycle length during atrial pacing, it contrasts sharply with the unchanged or increased PR interval that accompanies spontaneous increases in SCL. Although the range of patients' SACTs at any given SCL was large, the slope of ΔSACT/ΔSCL was remarkably similar in most patients and was quite steep. One patient had episodes of 2:1 S-A block. As predicted, these occurred only at her shortest SCLs. Possible explanations for this behavior are considered and the clinical relevance of these observations is discussed.
Discovery of new glomerular disease–relevant genes by translational profiling of podocytes in vivo
Authors: Ivica Grgic, Andreas F. Hofmeister, Giulio Genovese, Andrea J. Bernhardy, Hua Sun, Omar H. Maarouf, Vanesa Bijol, Martin R. Pollak, Benjamin D. Humphreys
Journal: Kidney International (2014)
Humanism and the Medical Past
Authors: Lester S. King
Journal: JAMA (1970)

The word "humanism" has almost as many meanings as there are people who use it. As a historical term it has many fine shadings, important for understanding the past, while in the present it has distinct meanings in different categories—theology, philosophy, education. And within each of these are further shadings. To discuss humanism in medicine we must limit ourselves sharply. In the realm of education the humanist would say that our medical teaching lays too much stress on science and not enough on a group of subjects loosely called the humanities. I will not try to define or even enumerate these but they have in common an emphasis on man as a person, as an individual who has ideals and values; who faces conflicts and disappointments; who experiences joys and fulfillment; who lives in a world of qualities and meanings, the rich real world portrayed in novels and poetry and
Increasing hospital admissions for systemic allergic disorders in England: analysis of national admissions data
Authors: R. Gupta
Journal: BMJ (2003)

decade of age) and lower LVEF (0.94 (0.89 to 0.99) for each 10% increase) were independent risk factors for azotaemia.For severe hyperkalaemia (serum potassium > 6.0 mmol/l) we added to the model baseline serum creatinine concentration and whether the patient was taking potassium supplementation.In this analysis the NYHAFC (3.36 (1.17 to 9.69) for each class) and lower LVEF (0.37 (0.15 to 0.95) for each 10% increase) were predictive factors.
ANOTHER WANDERING SHRAPNEL BALL
Authors: H. L. Gregory
Journal: BMJ (1917)

February 24th protmpts me to record the following case, in which a shrapnel ball entered the body between two ribs and was removed from the common iliac vein:The sequence of events was, baldly, as follows: January 9th.Wounded between ninth and tenth ribs, anterior axillary line, right side.January9th to 14th.X-rayed at castualty clearing station.Bullet seen in chest
Resuscitation: How Do We Decide?
Authors: Peter D. Mott
Journal: JAMA (1986)

To the Editor.—  In their recent article, Charlson et al 1 conclude that there has been too much emphasis in recent years on discussing with all patients how aggressive they want their care to be in the event of life-threatening illness. Such an effort is unrealistic, they state, and should perhaps be reserved for those patients showing a steady deterioration or when death is imminent. The basis for this was the finding that mortality and morbidity rates were not significantly affected by the physicians' preference regarding aggressiveness of care.  The literature has been deluged with articles advocating the opposite course. Indeed, there is a developing movement—both popular and professional—supporting the patient's right to know and decide issues of life and death. Court cases increasingly back such individual rights. Because it flies in the face of such overwhelming sentiment, the Cornell article would assume great importance if the study it reports
Abstract P1-01-27: Level III and Interpectoral Lymph Nodes Involvement in Breast Cancer with Positive Axillary Lymph Nodes after Neoadjuvant Chemotherapy
Authors: Z Fan, J Li, T Wang, Y Xie, T Fan, B Lin, T. Ouyang
Journal: Cancer Research (2010)

Abstract Background: In the era of sentinel node biopsy (SNB), mainly aimed at local control, the axillary dissection (AD) was performed for breast cancer with positive node. It was argued that only level I/II lymph nodes dissection might be inadequate because nodes involvement was found in level III and interpectoral region when axillary node was positive. It is necessary to assess the extent of AD after modern preoperative axillary staging. The aim of this study was to investigate the incidence and associated factors of node involvement in level III/interpectoral region. Methods: A consecutive series of 338 core needle biopsy confirmed T0-2 invasive breast cancer cases were included in this study. Axillary node metastases were proved by ultrasound guided needle biopsy (NB) if ultrasonographic abnormal node was detected prior to SNB or by SNB if no abnormal node was detected. Cases of negative NB but positive SNB with image abnormal node were excluded. Prior to AD included level III and interpectoral lymph nodes, 4 to 8 cycles of neoadjuvant chemotherapy with anthrocyclin and/or taxane regimen were completed for each case. The chi-square test was used to determine the relation between level III/interpectoral lymph nodes metastases and clinicopathological factors. Multivariate logistic regression was analyzed for covariate selection. Results: A median of 19 axillary nodes was harvested per case (range: 5-46, average: 19.2). The pathologic complete response rate of axillary nodes was 35.3% (70/198) in NB positive subgroup. Level III and interpectoral lymph nodes were harvested in 76.9% (260/338) of cases (range: 1-8, average: 1.9, median: 1) and 49.7% (168/338) of cases (range: 1-10, average: 1.6, median: 1), respectively. The incidence of positive level III and interpectoral lymph nodes were 8.9% (30/338) and 8.9% (30/338), respectively. Node involvement of level III/interpectoral region was found in 13.3% (45/338) of these cases. The incidence of node involvement in level III/interpectoral region of NB positive subgroup (14.6%, 29/198) was not significantly higher compared with SNB positive subgroup (11.4%, 16/140, P=0.391). Increasing tumor size was significantly correlated with increasing likelihood of node involvement in level III/interpectoral region (T0-1: 6.3% vs T2: 16.7%, P=0.008). In SNB positive T0-1 subgroup, there was no positive node found in level III/interpectoral region. Multivariate analysis showed that tumor size was the only independent factors predicting node involvement in level III/interpectoral region (OR=3.488, 95%CI:1.427-8.528, P=0.006). Conclusions: The incidence of node involvement in level III/interpectoral region was 13.3% of nodes positive T0-2 breast cancer treated with neoadjuvant chemotherapy. Tumor size may be the predictor of node involvement in this region. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-27.
A ketogenic diet suppresses seizures in mice through adenosine A1 receptors
Authors: Susan A. Masino, Tianfu Li, Panos Theofilas, Ursula S. Sandau, David N. Ruskin, Bertil B. Fredholm, Jonathan D. Geiger, Eleonora Aronica, Detlev Boison
Journal: Journal of Clinical Investigation (2011)

A ketogenic diet (KD) is a high-fat, low-carbohydrate metabolic regimen; its effectiveness in the treatment of refractory epilepsy suggests that the mechanisms underlying its anticonvulsive effects differ from those targeted by conventional antiepileptic drugs. Recently, KD and analogous metabolic strategies have shown therapeutic promise in other neurologic disorders, such as reducing brain injury, pain, and inflammation. Here, we have shown that KD can reduce seizures in mice by increasing activation of adenosine A1 receptors (A1Rs). When transgenic mice with spontaneous seizures caused by deficiency in adenosine metabolism or signaling were fed KD, seizures were nearly abolished if mice had intact A1Rs, were reduced if mice expressed reduced A1Rs, and were unaltered if mice lacked A1Rs. Seizures were restored by injecting either glucose (metabolic reversal) or an A1R antagonist (pharmacologic reversal). Western blot analysis demonstrated that the KD reduced adenosine kinase, the major adenosine-metabolizing enzyme. Importantly, hippocampal tissue resected from patients with medically intractable epilepsy demonstrated increased adenosine kinase. We therefore conclude that adenosine deficiency may be relevant to human epilepsy and that KD can reduce seizures by increasing A1R-mediated inhibition.
Effects of air pollutants on acute stroke mortality.
Authors: Yun-Chul Hong, Jong-Tae Lee, Ho Kim, Eun-Hee Ha, Joel Schwartz, David C Christiani
Journal: Environmental Health Perspectives (2002)

The relationship between stroke and air pollution has not been adequately studied. We conducted a time-series study to examine the evidence of an association between air pollutants and stroke over 4 years (January 1995-December 1998) in Seoul, Korea. We used a generalized additive model to regress daily stroke death counts for each pollutant, controlling for seasonal and long-term trends and meteorologic influences, such as temperature, relative humidity, and barometric pressure. We observed an estimated increase of 1.5% [95% confidence interval (CI), 1.3-1.8%] and 2.9% (95% CI, 0.3-5.5%) in stroke mortality for each interquartile range increase in particulate matter < 10 microm aerodynamic diameter (PM(10)) and ozone concentrations in the same day. Stroke mortality also increased 3.1% (95% CI, 1.1-5.1%) for nitrogen dioxide, 2.9% (95% CI, 0.8-5.0%) for sulfur dioxide, and 4.1% (95% CI, 1.1-7.2%) for carbon monoxide in a 2-day lag for each interquartile range increase in single-pollutant models. When we examined the associations among PM(10) levels stratified by the level of gaseous pollutants and vice versa, we found that these pollutants are interactive with respect to their effects on the risk of stroke mortality. We also observed that the effects of PM(10) on stroke mortality differ significantly in subgroups by age and sex. We conclude that PM(10) and gaseous pollutants are significant risk factors for acute stroke death and that the elderly and women are more susceptible to the effect of particulate pollutants.
A Proteomic Approach for the Identification of Vascular Markers of Liver Metastasis
Authors: Beatrice Borgia, Christoph Roesli, Tim Fugmann, Christoph Schliemann, Marta Cesca, Dario Neri, Raffaella Giavazzi
Journal: Cancer Research (2009)

Vascular proteins expressed at liver metastasis sites could serve as prognostic markers or as targets for pharmacodelivery applications. We employed a proteomic approach to define such proteins in three syngeneic mouse models of liver metastasis. Vascular structures were biotinylated in vivo by a terminal perfusion technique, followed by mass spectrometric analysis of accessible biotinylated proteins. In this manner, we identified 12 proteins for which expression was selectively associated with liver metastasis, confirming this association by tissue immunofluorescence or in vivo localization with radiolabeled antibodies. In summary, our findings identify vascular proteins that may have prognostic or drug-targeting use in addressing liver metastases, a common issue in many advanced cancers.
MEDICOLEGAL USE OF MAGGOTS
Authors: R. H. McClellan
Journal: JAMA (1931)

To the Editor:  —Since the work of the late William S. Baer at Baltimore, the use of the larvae of certain flies in the treatment of osteomyelitis has been given considerable publicity and has caused widespread discussion. I became interested in the production of larvae in the summer of 1930. Since that time through the Oliver Memorial Research Foundation we have kept colonies of flies to supply our own needs and those of others continuously.  There have been many unusual problems encountered, of course—not the least of which was the great dearth of information available in textbooks in regard to larvae and their cultivation and the scarcity of entomologists who know anything about this work on a grand scale. The most unusual aftermath of the publicity and search for ways and means of cultivating maggots has been the establishment of a brand new medicolegal sidelight. It is this first use
Intracellular pH regulation in hep G2 cells: Effects of epidermal growth factor, transforming growth factor-α, and insulinlike growth factor-II on Na+/H+ exchange activity
Authors: Mario Strazzabosco, Carlo Poci, Carlo Spirlì, Akos Zsembery, Anna Granato, Maria Luisa Massimino, Gaetano Crepaldi
Journal: Hepatology (1995)

Intracellular pH (pHi) plays an important role in the metabolic activation of quiescent cells after a proliferative stimulus, and Na+/H+ exchange activity is required for growth in some extrahepatic tumors. To investigate intracellular acid/base homeostasis in hepatoma cells and the effects of putative liver growth factors on Na+/h+ exchange activity, we have studied intracellular pH (pHi) regulation in Hep G2 cells, a well-differentiated hepatoma cell line, both in resting conditions and after administration of epidermal growth factor (EGF), transforming growth factor-alpha (TGF alpha), and insulinlike growth factor-II (IGF-II). The effects of fetal calf serum, TGF alpha, and amiloride on 3H-Thymidine incorporation were also studied. Amiloride (1 mmol/L) and external Na+ removal decreased baseline pHi in both HEPES and KRB. In HEPES, cells recovered from an acid load (20 mmol/L NH4Cl) by an amiloride inhibitable Na+/H+ exchange. In KRB, an additional, DIDS-inhibitable, Na(+)- and HCO3- dependent, but Cl(-)-independent acid extruder (Na:HCO3 cotransport) was activated. No evidence was found for a Cl/HCO3 exchange acting as acid loader. Administration of EGF and TGF alpha, but not of IGF-II, induced a dose-dependent, amiloride-inhibitable increase in baseline pHi, together with an increase in Na+/H+ exchange activity, shifting to the right the JH/pHi curve. Finally, 3H-thymidine incorporation in Hep G2 cells, in the presence of FCS or TGF alpha, was strongly inhibited by amiloride. In conclusion, in Hep G2 cells, pHi is mainly regulated by Na+/H+ exchange, which activity can be stimulated by EGF and TGF alpha, but not by IGF-II. Administration of TGF alpha stimulates DNA synthesis, an effect that is blocked by amiloride, an inhibitor of Na+/H+ exchanger. These data suggest that Na+/H+ exchange activation may play a critical role in the growth of some hepatic tumors.
Surgeon Specialization and Use of Sentinel Lymph Node Biopsy for Breast Cancer
Authors: Tina W. F. Yen, Purushuttom W. Laud, Rodney A. Sparapani, Ann B. Nattinger
Journal: JAMA Surgery (2013)

Sentinel lymph node biopsy (SLNB) is the standard of care for axillary staging in patients with clinically node-negative breast cancer. It is not known whether SLNB rates differ by surgeon expertise. If surgeons with less breast cancer expertise are less likely to offer SLNB to these patients, this practice pattern could lead to unnecessary axillary lymph node dissections and lymphedema.To explore potential measures of surgical expertise (including a novel objective specialization measure: percentage of a surgeon's operations performed for breast cancer determined from Medicare claims) on the use of SLNB for invasive breast cancer.A population-based prospective cohort study was conducted in California, Florida, and Illinois. Participants included elderly (65-89 years) women identified from Medicare claims as having had incident invasive breast cancer surgery in 2003. Patient, tumor, treatment, and surgeon characteristics were examined.Type of axillary surgery performed.Of 1703 women who received treatment by 863 surgeons, 56.4% underwent an initial SLNB, 37.2% initial axillary lymph node dissection, and 6.3% no axillary surgery. The median annual surgeon Medicare volume of breast cancer cases was 6.0 (range, 1.5-57.0); the median surgeon percentage of breast cancer cases was 4.5% (range, 0.4%-100.0%). After multivariable adjustment of patient and surgeon factors, women operated on by surgeons with higher volumes and percentages of breast cancer cases had a higher likelihood of undergoing SLNB. Specifically, women were most likely to undergo SLNB if the operation was performed by high-volume surgeons (regardless of percentage) or by lower-volume surgeons with a high percentage of breast cancer cases. In addition, membership in the American Society of Breast Surgeons (odds ratio, 1.98; 95% CI, 1.51-2.60) and Society of Surgical Oncology (1.59; 1.09-2.30) were independent predictors of women undergoing an initial SLNB.Patients who receive treatment from surgeons with more experience with and focus on breast cancer are significantly more likely to undergo SLNB, highlighting the importance of receiving initial treatment by specialized providers. Factors relating to specialization in a particular area, including our novel surgeon percentage measure, require further investigation as potential indicators of quality of care.
The Ophthalmoscope in Kidney Disease.
Authors: Oren Oneal
Journal: JAMA (1895)

Wabash, Ind., Feb. 19, 1895. <h3>To the Editor:</h3> —"Advanced kidney disease is often first discovered by ophthalmoscopic examination." Illustrating the truth of the above item taken from a recent medical journal, I wish to report a case which came under my observation recently: C. M. was sent to me by Dr. K. to be fitted with glasses. He had been complaining of failing vision for about four weeks in right eye and for two weeks in left eye. Vision was equal to counting fingers at ten feet. No improvement with glasses. Ophthalmoscopic examination showed extensive patches of albuminuric retinitis in both eyes. I then questioned him about his general health, which he said was very good. Had not been sick and felt as well as usual. No trouble with kidneys as far as he knew. I sent him back to his family physician, Dr. K., with a letter, telling him
Priming of polymorphonuclear neutrophils by atrial natriuretic peptide in vitro.
Authors: C J Wiedermann, M Niedermühlbichler, H Braunsteiner, C J Widermann
Journal: Journal of Clinical Investigation (1992)

In ischemia-reflow states of coronary artery disease, the activation of PMN precedes the initiation of tissue damage. Release of atrial natriuretic peptide (ANP) from myocytes occurs within minutes after the onset of myocardial ischemia, which suggests a possible role of ANP in PMN activation. To investigate this possibility, we tested the effects of ANP on functions of PMN in vitro. ANP is a potent signal for priming the PMN respiration burst to secrete superoxide anion. Phorbol 12-myristate 13-acetate, opsonized zymosan, or FMLP could all be used as triggering stimuli to demonstrate the priming of PMN activation by ANP. Only ANP fragments 1-28 and 7-28 enhanced respiration burst activity but identical preparations of ANP fragments 13-18 or 1-11 failed to do so. This structure-activity relationship is typical of receptors for ANP found in other tissues. In addition, ANP stimulated the release of beta-glucuronidase From PMN triggered by FMLP. The observed inhibition by ANP of FMLP-stimulated chemotaxis of PMN may be due to their enhanced adhesiveness. These data show that a classic cardiac hormone is involved in regulating important functional activities of PMN. These data support the possibility that ANP could act as a preinflammatory substance in ischemia-reperfusion states and myocardial necrosis.
Estrogens, Progestogens and Breast Cancer
Authors: Somers H. Sturgis
Journal: New England Journal of Medicine (1969)

There is as yet no unanimity of medical opinion concerning the risks attending the use of oral drugs for contraception. Recently, one aspect of the controversy — the possible relation of these compounds to breast cancer — has been aired in the Journal. 1 2 3 Most authorities will agree that the definitive answer may have to wait until contraceptive pills have been used for 20 years or so; it is only 13 years since Rock, Pincus and Garcia4 presented the first report on their pharmacologic action. It may not be inappropriate to recall that in 1936 Dr. Hugh Auchincloss reported to a . . .