tbuckley/cabot-search huggingface dataset:
Hyperadrenocorticism in a Patient with Esophageal Squamous-Cell Carcinoma
Authors: Stephen Migueles
Journal: Annals of Internal Medicine (1998)

Letters15 January 1998Hyperadrenocorticism in a Patient with Esophageal Squamous-Cell CarcinomaStephen Migueles, MD, Susan Thompson, MD, and Sean McGrade, MDStephen Migueles, MDGeorgetown University Medical Center; Washington, DC 20007Search for more papers by this author, Susan Thompson, MDGeorgetown University Medical Center; Washington, DC 20007Search for more papers by this author, and Sean McGrade, MDGeorgetown University Medical Center; Washington, DC 20007Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-2-199801150-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The ectopic corticotropin syndrome in association with nonpancreatic gastrointestinal tract cancer is rare. We report an unusual case of hyperadrenocorticism in a patient with metastatic esophageal squamous-cell carcinoma.A 64-year-old man presented with a 3-month history of dysphagia and 11.35-kg weight loss. Physical examination was remarkable for a blood pressure of 160/98 mm Hg, cachexia, numerous ecchymoses, and globally diminished strength and reflexes. Abnormal laboratory values included a hematocrit of 0.34; a serum potassium level of 2.1 mEq/L, a chloride level of 86 mEq/L, a bicarbonate level of 42 mEq/L, and a glucose level of 264 mg/dL.... References1. Lohrenz FN, Custer GS. ACTH producing metastases from carcinoma of the esophagus. Ann Intern Med. 1965; 62:1017-22. Google Scholar2. Wajchenberg BL, Mendonca BB, Liberman B, Pereira MA, Carneiro PC, Wakamatsu A, et al. Ectopic adrenocorticotropic hormone syndrome. Endocrinology Review. 1994; 15:752-87. Google Scholar3. Coates PJ, Doniach I, Howlett TA, Rees LH, Besser GM. An immunocytochemical study of 18 tumours causing ectopic Cushing's syndrome. J Clin Pathol. 1986; 39:955-60. Google Scholar Author, Article, and Disclosure InformationAuthors: Stephen Migueles, MD; Susan Thompson, MD; Sean McGrade, MDAffiliations: Georgetown University Medical Center; Washington, DC 20007 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMolecular analysis and literature-based hypothesis of an immunonegative prostate small cell carcinoma causing ectopic ACTH syndrome 15 January 1998Volume 128, Issue 2Page: 157KeywordsAdrenocorticotropic hormoneBiosynthesisLesionsPeptide hormonesPotassiumReflexesResearch laboratoriesStainingThymusWeight loss ePublished: 15 August 2000 Issue Published: 15 January 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Mechanisms of allergen specific immunotherapy – T‐cell tolerance and more
Authors: M. Jutel, M. Akdis, K. Blaser, C. A. Akdis
Journal: Allergy (2006)

Specific immune suppression and induction of tolerance are essential processes in the regulation and circumvention of immune defence. The balance between allergen-specific T-regulatory (Treg) cells and T helper 2 cells appears to be decisive in the development of allergic and healthy immune response against allergens. Treg cells consistently represent the dominant subset specific for common environmental allergens in healthy individuals. In contrast, there is a high frequency of allergen-specific T helper 2 cells in allergic individuals. A decrease in interleukin (IL)-4, IL-5 and IL-13 production by allergen-specific CD4+ T cells due to the induction of peripheral T cell tolerance is the most essential step in allergen-specific immunotherapy (SIT). Suppressed proliferative and cytokine responses against the major allergens are induced by multiple suppressor factors, such as cytokines like IL-10 and transforming growth factor (TGF)-beta and cell surface molecules like cytotoxic T lymphocyte antigen-4, programmed death-1 and histamine receptor 2. There is considerable rationale for targeting T cells to increase efficacy of SIT. Such novel approaches include the use of modified allergens produced using recombinant DNA technology and adjuvants or additional drugs, which may increase the generation of allergen-specific peripheral tolerance. By the application of the recent knowledge in Treg cells and related mechanisms of peripheral tolerance, more rational and safer approaches are awaiting for the future of prevention and cure of allergic diseases.
Serologic study of human parvovirus B19 infection in pregnancy in Japan
Authors: N. Yaegashi, T. Niinuma, H. Chisaka, S. Uehara, K. Okamura, O. Shinkawa, A. Tsunoda, S. Moffatt, Kazuo Sugamura, A. Yajima
Journal: Journal of Infection (1999)
Evaluating the Clinical Accuracy of Two Continuous Glucose Sensors Using Continuous Glucose–Error Grid Analysis
Authors: William L. Clarke, Stacey Anderson, Leon Farhy, Marc Breton, Linda Gonder-Frederick, Daniel Cox, Boris Kovatchev
Journal: Diabetes Care (2005)

To compare the clinical accuracy of two different continuous glucose sensors (CGS) during euglycemia and hypoglycemia using continuous glucose-error grid analysis (CG-EGA).FreeStyle Navigator (Abbott Laboratories, Alameda, CA) and MiniMed CGMS (Medtronic, Northridge, CA) CGSs were applied to the abdomens of 16 type 1 diabetic subjects (age 42 +/- 3 years) 12 h before the initiation of the study. Each system was calibrated according to the manufacturer's recommendations. Each subject underwent a hyperinsulinemic-euglycemic clamp (blood glucose goal 110 mg/dl) for 70-210 min followed by a 1-mg.dl(-1).min(-1) controlled reduction in blood glucose toward a nadir of 40 mg/dl. Arterialized blood glucose was determined every 5 min using a Beckman Glucose Analyzer (Fullerton, CA). CGS glucose recordings were matched to the reference blood glucose with 30-s precision, and rates of glucose change were calculated for 5-min intervals. CG-EGA was used to quantify the clinical accuracy of both systems by estimating combined point and rate accuracy of each system in the euglycemic (70-180 mg/dl) and hypoglycemic (<70 mg/dl) ranges.A total of 1,104 data pairs were recorded in the euglycemic range and 250 data pairs in the hypoglycemic range. Overall correlation between CGS and reference glucose was similar for both systems (Navigator, r = 0.84; CGMS, r = 0.79, NS). During euglycemia, both CGS systems had similar clinical accuracy (Navigator zones A + B, 88.8%; CGMS zones A + B, 89.3%, NS). However, during hypoglycemia, the Navigator was significantly more clinically accurate than the CGMS (zones A + B = 82.4 vs. 61.6%, Navigator and CGMS, respectively, P < 0.0005).CG-EGA is a helpful tool for evaluating and comparing the clinical accuracy of CGS systems in different blood glucose ranges. CG-EGA provides accuracy details beyond other methods of evaluation, including correlational analysis and the original EGA.
THE NATURE AND PROGRESS OF MALIGNANT DISEASE.ORATION ON SURGERY AT THE FIFTY-SEVENTH ANNUAL SESSION OF THE AMERICAN MEDICAL ASSOCIATION, BOSTON, JUNE 5-8, 1906.
Authors: JOSEPH D. BRYANT
Journal: JAMA (1906)

My first words are words of thanks, profound and sincere thanks, addressed to my colleagues of the American Medical Association because of my estimation of the high honor conferred in inviting me to address you on this occasion. My first desire, the dominating desire of earnest appreciation, is that I may say something that will justify the choice of my colleagues and my presence before you. My first hope, the fond hope which I most cherish at this time, is that some one who may be influenced by what I shall say will gain in comfort and life thereby; for, be the gain but little, even then those who are accessory to my presence may claim acquittal because of it. Since it may not be known to all here present, I am prompted to say at once that, some time during the course of the meeting of this Association, an
Enzymatic degradation of cartilage by dialysed urine of rheumatoid patients.
Authors: M Bassiouni
Journal: Annals of the Rheumatic Diseases (1969)

In this study urine from patients with severe active rheumatoid arthritis has been investigated for enzymatic activity affecting cartilage. Material and MethodsUrine.-This was collected from eight female patients with severe and active rheumatoid arthritis (meeting ARA criteria), one of whom had juvenile rheumatoid arthritis.The erythrocyte sedimentation rate ranged from 30 to 90 mm. in the first hour (Westergren).The Waaler- Rose test was positive in five and negative in three cases.Urine was collected for control purposes from eight normal subjects, three males and five females, whose average age (31 years) was the same as that of the rheuma- toid patients.Cartilage.-Fibro-elasticcartilage was obtained from the ears of albino rats and hyaline cartilage from the nasal septa of cattle.appearance.x 1,000.
Manipulative Augmentation of Pericardial Rubs
Authors: Arthur J. Geiger
Journal: JAMA (1961)

To the Editor:—  For more than 2 decades I have been teaching and demonstrating 2 simple maneuvers that frequently elicit or augment the diagnostic friction sounds of pericarditis of various etiologies.  One maneuver is merely an extension of the well-known practice of having the patient lean forward; it is to place the patient in the knee-elbow or prone position during ausculation. Thus, an inaudible or merely suggestive pericardial rub often becomes intensified, probably by bringing about a closer and firmer contact between the epicardium, pericardium, and chest wall.  Another even simpler and more practical maneuver is to listen for the rub while the patient takes and holds a moderately deep breath. This is contrary to traditional teaching in physical diagnosis, in which auscultation during held expiration is conventionally advised. It has been possible on scores of occasions to demonstrate unequivocally that an otherwise inaudible or faint or single-phase rub (that
Reply to Sigurdur Gudjónsson, Wiking Månsson, Sten Holmäng and Fredrik Liedberg's Letter to the Editor re: Richard J. Sylvester, Willem Oosterlinck. An Immediate Instillation after Transurethral Resection of Bladder Tumor in Non–Muscle-Invasive Bladder Cancer: Has the Evidence Changed? Eur Urol 2009;56:43–5
Authors: Richard J. Sylvester, Willem Oosterlinck
Journal: European Urology (2009)
Maxillary Antral Cancers
Authors: Lars-Gunnar Larsson
Journal: JAMA (1972)

Cancer in the paranasal sinuses and nasal cavities in a relatively rare tumor disease, with an annual incidence of about one case per 100,000 inhabitants in Europe and the United States.<sup>1</sup>The majority of these tumors start in the mucous membrane of the maxillary antrum or the ethmoid labyrinth. A few cases originate from the nasal cavities, while primary cancers in the sphenoid and frontal sinuses are extremely rare. The age-specific incidence of the disease continuously increases with age; it is predominately a disease of the middle aged and aging. The only known etiologic factor of some importance in antral carcinoma is chronic sinusitis. Long-standing sinusitis causes a squamous cell metaplasia of the respiratory epithelium, which probably is the origin of most antral cancers. Some patients have a long history with signs of chronic sinusitis, prior to the signs of progressive tumor. Squamous cell carcinoma is the most frequent
The Brain in Fever
Authors: H. Sandwith
Journal: BMJ (1851)

As Englishmen we must honestly admit, in spite of our proud recol- lections of what English observation has achieved from the days of Sydenham downwardls, that the French have won imperishable laurels in the important field of Febrile Pathology.It is due, indeed, to the memory of Sir John Pringle to assert, that, even a hundred years ago, he caught a glimnpse of the doctrine that, when fever proves fatal, it mostly or often does so by the production of certain specific organic lesions.This truth, though crudely stated, is embodied in the asser- tion, that "1be examined ten patient-s who died of typhus, and came to the conclusion, that, when it proves fatal, it generally termidnates VOL.III.
Talking With Patients
Authors: Barry I. Liskow
Journal: JAMA (1973)

Eighteen years separate the first and second editions of this book. The 1955 volume was distinguished by a concise, sensible approach to talking effectively with, among others, crying, depressed, anxious, retarded, angry, and grieving patients. The new edition preserves its predecessor's format of a section on talking with adults and a section on talking with children, and has been expanded from 30 to 41 chapters and from 144 to 354 pages. Paradoxically, however, this 1973 edition, to a much greater extent than the first, is in the style of psychiatric volumes of the 1950s, when dogmatism often passed as science and moralism as wisdom. Hence, obese patients are "self-destructive," the chronic alcoholic demonstrates ego strength by "his single-minded determination to go his own way even if it kills him," guilt and shame regarding sex in adolescence are needed "to develop an adequate sense of social and personal responsibility," complex historical
sFLT1 in preeclampsia: trophoblast defense against a decidual VEGFA barrage?
Authors: S. Lee Adamson
Journal: Journal of Clinical Investigation (2014)

Preeclampsia, a life-threatening complication of human pregnancy, has a spectrum of clinical signs and is likely caused by an array of pathological mechanisms. However, elevated levels of soluble fms-like tyrosine kinase-1 (sFLT1) in the placenta and in the maternal circulation has emerged as a common finding in women with preeclampsia and likely is a causative factor in this disorder. In this issue of the JCI, Fan and colleagues provide experimental evidence from both humans and mice that suggests placental trophoblast cells overexpress sFLT1 in self defense against excessive VEGFA produced by maternal decidual cells. The authors' work thus implicates the decidual cells of the mother as the culprit responsible for increased placental expression of sFLT1, a VEGFA antagonist that enters the maternal circulation and consequently induces the clinical signs of preeclampsia.
Apolipoprotein E/C1 Locus Variants Modify Renal Cell Carcinoma Risk
Authors: Lee E. Moore, Paul Brennan, Sara Karami, Idan Menashe, Sonja I. Berndt, Linda M. Dong, Allison Meisner, Meredith Yeager, Stephen Chanock, Joanne Colt, Kendra Schwartz, Faith Davis, David Zaridze, Vsevolod Mattveev, Vladimir Janout, Hellena Kollarova, Vladimir Bencko, Marie Navratilova, Neonilia Szeszenia-Dabrowska, Dana Mates, Ivana Holcatova, Paolo Boffetta, Wong-Ho Chow, Philip S. Rosenberg, Nathaniel Rothman
Journal: Cancer Research (2009)

Lipid peroxidation is considered a unifying mechanistic pathway through which known risk factors induce renal cell carcinoma (RCC). We hypothesized that genes selected a priori for their role in lipid peroxidation would modify cancer risk. We genotyped 635 single nucleotide polymorphisms (SNP) in 38candidate genes in 777 Caucasian RCC cases and 1,035 controls enrolled in a large European case-control study. Top candidate SNPs were confirmed among 718 Caucasian cases and 615 controls in a second study in the United States. Two of the three SNPs (rs8106822 and rs405509) that replicated in the U.S. study were within a regulatory region of the APOE promoter. The OR for rs8106822 A>G variant was 1.22(AG) and 1.41(GG) (P(trend) = 0.01) in the European study, 1.05(AG) and 1.51(GG) (P(trend) = 0.03) in the U.S. study, and 1.15(AG) and 1.44(GG) (P(trend) = 0.001) among 1,485 cases and 1,639 controls combined. The rs405509 G>T variant was associated with risk in the European (OR, 0.87(TG); OR, 0.71(TT); P(trend) = 0.02), the U.S. (OR, 0.68(TG); OR, 0.71(TT); P(trend) = 0.02), and both studies combined (OR(TG), 0.79; OR(TT), 0.71; P(trend) = 0.001), as was the G-G haplotype (r(2) = 0.64; P= 4.7 x 10(-4)). This association is biologically plausible as SNP rs405509 was shown to modify protein binding and transcriptional activity of the APOE protein in vitro and is in linkage disequilibrium with key known variants defining the e2, e3, and e4 alleles that modify risk of atherosclerosis, Alzheimer's disease risk, and progression to AIDS. In two large case-control studies, our findings further define a functional region of interest at the APOE locus that increases RCC susceptibility.
Revision of the Code of Ethics.
Authors: None A Conservative Member.
Journal: JAMA (1893)

The coroner of Philadelphia has at last furnished the frightful example that the comic papers have long been instituting inquiry for.A boy, 13 years of age, who was said to be an inveterate cigarette smoker, who smoked con¬ stantly during his waking hours, was attacked by a violent headache one morning, and this was followed by severe convulsions, which terminated fatally.A verdict of " death from convulsions from excessive cigarette smoking" was rendered, according to the daily papers, which however fail to state whether or not any lesions were discovered in the brain at the post-mortem examination.AVithout the au¬ topsy it would seem that something would be required, even more potent than the authority of the coroner, to establish a positive diagnosis, or even a diagnosis by exclusion, of
Mitral valve prolapse: a consistent manifestation of type IV Ehlers-Danlos syndrome. The pathogenetic role of the abnormal production of type III collagen.
Authors: A S Jaffe, E M Geltman, G E Rodey, J Uitto
Journal: Circulation (1981)

To evaluate whether abnormal production of type III collagen, the characteristic biochemical feature of patients with the type IV Ehlers-Danlos syndrome, consistently predisposes to mitral valve prolapse, we evaluated the family of a proband with classic type IV Ehlers-Danlos syndrome. Production of type III collagen was assessed with the use of cultured skin fibroblasts. Mitral valve prolapse was detected by M-mode and two-dimensional echocardiography. Biochemical abnormalities in the production of type III collagen and echocardiographic findings of mitral valve prolapse were completely concordant. All patients with abnormal production of type III collagen had mitral valve prolapse and all subjects with normal production of type III collagen had entirely normal echocardiograms. Six of the eight patients with abnormal production of type III collagen had subtle cutaneous abnormalities. The consistent association of abnormal production of type III collagen and mitral valve prolapse in this family suggests that this abnormality of collagen may give rise to mitral valve prolapse.
Impaired Invariant Chain Degradation and Antigen Presentation and Diminished Collagen-Induced Arthritis in Cathepsin S Null Mice
Authors: Terry Y Nakagawa, William H Brissette, Paul D Lira, Richard J Griffiths, Nina Petrushova, Jeffrey Stock, John D McNeish, Susan E Eastman, Edward D Howard, Sally R.M Clarke, Edward F Rosloniec, Eileen A Elliott, Alexander Y Rudensky
Journal: Immunity (1999)
838-3 Safety and efficacy of glycoprotein IIb/IIIa receptor blockers in patients with chronic renal insufficiency undergoing contemporary percutaneous coronary intervention
Authors: Mauro Moscucci, Dean E Smith, Arthur Riba, Raj Goswami, Anthony DeFranco, Sanjaya Khanal, Michael O'Donnell, David Share, Kim A Eagle
Journal: Journal of the American College of Cardiology (2004)
Comparable Efficacy of Administration with Face Mask or Mouthpiece of Nebulized Budesonide Inhalation Suspension for Infants and Young Children with Persistent Asthma
Authors: MICHAEL MELLON, JEFFREY LEFLEIN, KAREN WALTON-BOWEN, MARIO CRUZ-RIVERA, SHERAHE FITZPATRICK, JOSEPH A. SMITH
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

A randomized, double-blind, placebo-controlled, parallel-group study including 481 children at 37 centers in the United States demonstrated the efficacy and safety of budesonide inhalation suspension in doses of 0.25 mg once daily, 0.25 mg twice daily, 0.5 mg twice daily, and 1.0 mg daily in infants and young children with persistent asthma. The retrospective analysis presented here compares the efficacy of treatment with the suspension administered through a face mask or mouthpiece. All patients receiving budesonide inhalation suspension via face mask or mouthpiece showed clinical improvements in nighttime and daytime asthma symptoms as compared with administration of a placebo. The improvements were of similar magnitude as those observed in an analysis of all patients treated. Improvements in nighttime asthma symptoms were statistically significant with budesonide at 0.25 mg daily (p = 0.040), 0.25 mg twice daily (p = 0.008), and 0.5 mg twice daily (p = 0.046) delivered by face mask. In patients using mouthpieces, nighttime asthma symptoms improved significantly in the 0.25-mg twice-daily (p = 0.005) and 1.0-mg daily (p = 0.035) groups. Patients receiving budesonide at 0.5 mg twice daily via a face mask improved significantly in daytime asthma symptoms (p = 0.009). The use of breakthrough medication was reduced in patients receiving budesonide via face masks or mouthpieces relative to placebo, and treatment was well tolerated in all study groups. This retrospective analysis suggests that nebulized budesonide inhalation suspension can be administered effectively by either face mask or mouthpiece to young children with persistent asthma.
Flattening Postprandial Blood Glucose Responses with Guar Gum: Acute Effects
Authors: Michael E McIvor, Charles C Cummings, Theresa A Leo, Albert I Mendeloff
Journal: Diabetes Care (1985)

It has been proposed that high-carbohydrate, high-fiber (HCF) diets might serve as useful therapeutic modality in non-insulin-dependent diabetes mellitus (NIDDM). One problem in evaluating clinical trials of this therapy is that, by their very nature, the trials cannot be double blinded. We have developed HCF and placebo granola-type bars using complex absorbable carbohydrate and guar gum fiber to circumvent this methodologic problem. The HCF bars, when consumed with an ad lib. diet, assure an HCF intake without imposing other dietary restrictions. To test the short-term efficacy of the bars, 9 normal adult volunteers, 2 women with impaired glucose tolerance, and 20 patients with NIDDM consumed the bars alone or with meals. Blood glucose responses when HCF bars were consumed alone were blunted when compared with the placebo response (P &amp;lt; 0.0005 to P &amp;lt; 0.002), with the most marked suppression occurring in the early postprandial period. In contrast, when the bars were consumed along with breakfast, HCF and placebo responses were virtually identical in the early postprandial period, but showed a progressively greater difference from 90 to 240 min (P &amp;lt; 0.02 to P &amp;lt; 0.0005). When consumed with lunch as well as breakfast, the HCF bars caused flattening of blood glucose responses during the late postprandial period after breakfast and maintained flattened responses during the early and late postprandial periods after lunch (P &amp;lt; 0.05 to P &amp;lt; 0.005). It is concluded that these HCF bars can be used to blunt postprandial blood glucose responses, in subjects with either normal or abnormal carbohydrate metabolism.