tbuckley/cabot-search huggingface dataset:
'What's in a Name?' The Paperwork Reduction Act
Authors: Michael E. DeBakey
Journal: JAMA (1990)

"Paperwork Reduction Act." Music to the ears of every American taxpayer. And certainly to physicians inundated by Medicare forms. Who could oppose legislation with such a noble name? Well, I could. Not because I advocate paperwork proliferation, but because a proposal within the House of Representatives to renew this Act (first enacted in 1980) contains a clause that would damage an institution that most physicians have long depended on for reliable information—the National Library of Medicine (NLM). This institution represents the largest and finest collection of biomedical publications, papers, and documents in the world. The quality of information products derived from the Library's databases will be at serious risk if HR 3695, The Paperwork Reduction and Federal Information Resources Management Act of 1989, is enacted. This Act, sponsored by Rep John Conyers, Jr, of Michigan, would prohibit the Library from entering into formal agreements with private vendors, thus effectively banning
Giant Parathyroid Adenoma With Atypical Ultrasonographic Image
Authors: Nikolaos F. Orfanos, Theodoros Mariolis-Sapsakos, Filotheos N. Orfanos, Nikolaos Goutas, Dimitrios Vlachodimitropoulos, Aristidis G. Antoniou
Journal: Clinical Nuclear Medicine (2007)

A 49-year-old woman with slightly increased serum calcium levels on random biochemical blood tests was found by Tc-99m MIBI scintigraphy to have a giant parathyroid adenoma with an atypical ultrasonographic image showing a homogenous mass with atypical vascularization. Surgical excision was carried out. The size of the adenoma did not correlate with the blood calcium levels.
REPORT OF CASES IN EVIDENCE OF ADVANCED THEORY OF SURGICAL IMPUNITY OF THE PERITONEAL VISCERA.Read in the Section on Surgery and Anatomy, at the Forty-fourth Annual Meeting of the American Medical Association.
Authors: JOHN E. LINK
Journal: JAMA (1893)

To the members of this Association I feel that I should make some explanation, if not apology, in presenting this work. I am possibly somewhat differently situated from the most of the prominent workers of the Surgical Section, and therefore from the environment of my location am able to draw some conclusions at variance with the experience of the city and hospital surgeon and teacher. There are, we may all know, two classes of surgeons radically different in their methods of doing good, the conservative and the bold or daring. And whilst I may have in some remarks before the Section as well as in printed articles seemed to imply that with regard to abdominal work I place myself with the latter, surely I do not wish to so stand. I am decidedly in favor of conservative means in all cases where delay is not hazardous, and surely I agree
Activity of CYP2E1 and CYP3A enzymes in adults with moderate alcohol consumption: A comparison with nonalcoholics
Authors: Suthat Liangpunsakul, Dhanashri Kolwankar, Amar Pinto, J. Christopher Gorski, Stephen D. Hall, Naga Chalasani
Journal: Hepatology (2005)

Alcohol consumption is known to induce hepatic CYP2E1 activity, but its effect on hepatic and intestinal CYP3A in humans is not known. We have conducted a study to compare the CYP2E1 and CYP3A activities in 20 individuals with moderate alcohol consumption and 20 gender-, race-. and body mass index (BMI)-matched nonalcoholics. Intravenous and oral midazolam (MDZ) clearances were used to measure the in vivo CYP3A activity, and chlorzoxazone (CHZ) oral clearance was used to assess in vivo CYP2E1 activity. Furthermore, we assessed the relationship between hepatic CYP2E1 and CYP3A activities and their messenger RNA (mRNA) expression in the peripheral lymphocytes. The systemic clearance (CL) of MDZ was not different between alcoholics (36.9 ± 12 L/hr) and nonalcoholics (36.6 ± 14.1; P = .9). The oral availability of MDZ was significantly lower in alcoholics than in the nonalcoholics (0.28 ± .09 vs. 0.38 ± .17, respectively, P = .03). The maximum serum concentration after oral midazolam dosing was significantly different between the 2 groups. CHZ CL was significantly higher in alcoholics than in nonalcoholics (31.5 ± 11.9 vs. 23.4 ± 8.7 L/hr, P < 0.05). CYP3A4 and CYP2E1 mRNA levels were not significantly different between the groups, and no correlation was observed between lymphocyte CYP mRNA and in vivo CYP activity. In conclusion, in individuals with moderate alcohol consumption, there was no alteration in the hepatic CYP3A activity, but the reduced midazolam oral bioavailability suggests that moderate alcohol consumption may cause intestinal CYP3A induction. Lymphocyte CYP2E1 and CYP3A4 mRNA levels did not correlate with CYP2E1 and CYP3A activities. (HEPATOLOGY 2005;41:1144–1150.)
Aspiration Pneumonia
Authors: John L. Cameron, George D. Zuidema
Journal: JAMA (1972)

In many clinical settings aspiration is probably the most common cause of pulmonary pathology. To support this thesis, there is ample circumstantial evidence in patients undergoing general anesthesia, in bedridden, acutely and chronically ill patients, in trauma victims, and in patients with tracheostomies. In many instances aspiration is occult and difficult to diagnose. A high index of suspicion is necessary. Every physician should take it upon himself to instruct the medical and allied medical personnel caring for his patients in the many small techniques and maneuvers that will make aspiration unlikely.
Changes in cholinergic parameters associated with failure of conotruncal septation in embryonic chick hearts after neural crest ablation.
Authors: M L Kirby, R S Aronstam, J J Buccafusco
Journal: Circulation Research (1985)

Cells from the neural crest over occipital somites migrate to the heart, where they give rise to parasympathetic postganglionic neurons as well as ectomesenchymal elements which contribute to conotruncal septation. With a microcautery needle, the neural crest over occipital somites was ablated bilaterally in chicken embryos at an early stage of development. Histological examination on incubation day 15 revealed conotruncal malformations, involving malformation or absence of the conotruncal septum in all embryos. Two peaks of embryo mortality were observed. One peak (incubation days 6-8) occurred at the same time as conotruncal septal closure; the second peak (incubation days 11-13) was concurrent with the onset of functional parasympathetic innervation. A disruption of parasympathetic innervation was indicated by: (1) a decrease in acetylcholinesterase staining, (2) a decrease (27%) in the number of ganglion cells in the conotruncus, (3) decreases in the acetylcholine content of atrium (31%) and ventricle (39%), and (4) a decrease (21%) in muscarinic acetylcholine receptor density on incubation day 15. Radiolabeled ligand-binding studies revealed no change in the affinity of cardiac muscarinic receptors for [3H]methylscopolamine (KD = 0.17-0.21 nM). Agonist-binding affinity and sensitivity to guanine nucleotides were similarly unaffected. The reasons for the limited extent of the parasympathetic lesion are unclear, but may involve recruitment of precursor cells from other regions of the neural crest, partial regeneration of the neural crest following surgical removal, or an alteration in the contribution of incoming sympathetic or preganglionic parasympathetic elements. No such plasticity was associated with neural crest contributions to the structural development of the conotruncus. Malformations were observed in all lesioned embryos.
Skin Ulcers Misdiagnosed as Pyoderma Gangrenosum
Authors: Roger H. Weenig, Mark D.P. Davis, Patrick R. Dahl, W.P. Daniel Su
Journal: New England Journal of Medicine (2002)

Pyoderma gangrenosum is a diagnosis of exclusion, and the misdiagnosis of pyoderma gangrenosum can result in substantial complications in patients who have other causes of severe cutaneous ulceration.
Factor X Deficiency in Primary Amyloidosis
Authors: Philip R. Greipp, Robert A. Kyle, E. J. Walter Bowie
Journal: New England Journal of Medicine (1979)

MANY patients with acquired factor X deficiency associated with primary amyloidosis have a severe bleeding disorder.1 2 3 4 A Because administered factor X is rapidly removed from circulation, concentrates of vitamin K and vitamin K-dependent factors rarely benefit these patients. We describe a patient with factor X deficiency due to infiltration of the spleen by amyloid. Splenectomy gave complete and long-lasting correction of factor X deficiency and the associated bleeding disorder.Case ReportA 49-year-old man presented in May, 1976, with abdominal pain, edema and dyspnea on exertion, all of which had lasted six weeks. A bullous, purpuric skin eruption had been . . .
The Effect of Standard- and High-Dose Epinephrine on Coronary Perfusion Pressure During Prolonged Cardiopulmonary Resuscitation
Authors: Norman A. Paradis
Journal: JAMA (1991)

We studied the effect of standard and high doses of epinephrine on coronary perfusion pressure during cardiopulmonary resuscitation in 32 patients whose cardiac arrest was refractory to advanced cardiac life support. Simultaneous aortic and right atrial pressures were measured and plasma epinephrine levels were sampled. Patients remaining in cardiac arrest after multiple 1-mg doses of epinephrine received a high dose of 0.2 mg/kg. The increase in the coronary perfusion pressures was 3.7 +/- 5.0 mm Hg following a standard dose, not a statistically significant change. The increase after a high dose was 11.3 +/- 10.0 mm Hg; this was both statistically different than before administration and larger than after a standard dose. High-dose epinephrine was more likely to raise the coronary perfusion pressure above the previously demonstrated critical value of 15 mm Hg. The highest arterial plasma epinephrine level after a standard dose was 152 +/- 162 ng/mL, and after a high dose, 393 +/- 289 ng/mL. Because coronary perfusion pressure is a good predictor of outcome in cardiac arrest, the increase after high-dose epinephrine may improve rates of return of spontaneous circulation.
Renal collecting duct epithelial cells regulate inflammation in tubulointerstitial damage in mice
Authors: Katsuhito Fujiu, Ichiro Manabe, Ryozo Nagai
Journal: Journal of Clinical Investigation (2011)

Renal tubulointerstitial damage is the final common pathway leading from chronic kidney disease to end-stage renal disease. Inflammation is clearly involved in tubulointerstitial injury, but it remains unclear how the inflammatory processes are initiated and regulated. Here, we have shown that in the mouse kidney, the transcription factor Krüppel-like factor-5 (KLF5) is mainly expressed in collecting duct epithelial cells and that Klf5 haploinsufficient mice (Klf5+/- mice) exhibit ameliorated renal injury in the unilateral ureteral obstruction (UUO) model of tubulointerstitial disease. Additionally, Klf5 haploinsufficiency reduced accumulation of CD11b+ F4/80(lo) cells, which expressed proinflammatory cytokines and induced apoptosis among renal epithelial cells, phenotypes indicative of M1-type macrophages. By contrast, it increased accumulation of CD11b+ F4/80(hi) macrophages, which expressed CD206 and CD301 and contributed to fibrosis, in part via TGF-β production--phenotypes indicative of M2-type macrophages. Interestingly, KLF5, in concert with C/EBPα, was found to induce expression of the chemotactic proteins S100A8 and S100A9, which recruited inflammatory monocytes to the kidneys and promoted their activation into M1-type macrophages. Finally, assessing the effects of bone marrow-specific Klf5 haploinsufficiency or collecting duct- or myeloid cell-specific Klf5 deletion confirmed that collecting duct expression of Klf5 is essential for inflammatory responses to UUO. Taken together, our results demonstrate that the renal collecting duct plays a pivotal role in the initiation and progression of tubulointerstitial inflammation.
Effects of Electronic Fetal-Heart-Rate Monitoring, as Compared with Periodic Auscultation, on the Neurologic Development of Premature Infants
Authors: Kirkwood K. Shy, David A. Luthy, Forrest C. Bennett, Michael Whitfield, Eric B. Larson, Gerald van Belle, James P. Hughes, Judith A. Wilson, Morton A. Stenchever
Journal: New England Journal of Medicine (1990)

In a multicenter, randomized clinical trial, we assessed the early neurologic development of 93 children born prematurely whose heart rates were monitored electronically during delivery and compared it with that of 96 children born prematurely whose heart rates were periodically monitored by auscultation. All the children were singletons with cephalic presentation, and all weighed ≤ 1750 g at birth. The mental and psychomotor indexes of the Bayley Scales of Infant Development (standardized mean score ±SD, 100±16) and a formal neurologic examination were administered at three follow-up visits (at 4, 8, and 18 months of age, corrected for gestational age).
Global health cannot be achieved without efforts to curb population growth
Authors: Robin Stott
Journal: BMJ (2011)

In slices from mouse cerebral cortex, histamine elicits in a concentration-dependent manner the hydrolysis of [<sup>3</sup>H]glycogen previously synthesized from [<sup>3</sup>H]glucose, a response mediated by H<sub>1</sub> receptors. Desensitization of this glycogenolytic response occurs when slices are incubated with 50 µM histamine and is characterized by a rightward shift of the concentration-response curve (EC<sub>50</sub> = 32 ± 1 µM instead of 4 ± 1 µM) without significant change in the maximal glycogenolysis. Desensitization occurs with a half-time of about 20 min, and the initial responsiveness is gradually recovered within 1 hr. Recovery is not impaired in the presence of cycloheximide, a protein synthesis inhibitor. Desensitization to the glycogenolytic action of histamine seems to be a selective process: (a) it results from stimulation of H<sub>1</sub> receptors, since 2-thiazolylethylamine, an H<sub>1</sub>-receptor agonist (but not dimaprit, an H<sub>2</sub>-receptor agonist) shares the desensitizing action of histamine; (b) only the glycogenolytic response to histamine is desensitized, whereas responsiveness to other glycogenolytic agents (noradrenaline, serotonin, adenosine, dibutyryl cyclic AMP) is not modified. Following exposure of slices to histamine, the binding of [<sup>3</sup>H]mepyramine to H<sub>1</sub> receptors is significantly modified. The change consists of a 20% decrease in the <i>B</i><sub>max</sub> of the [<sup>3</sup>H]antihistamine without significant change in either its <i>K<sub>d</sub></i> or the <i>K<sub>i</sub></i> of histamine.
Syk mediates airway contractility independent of leukocyte function
Authors: X. Wang, N. Khanna, J. Wu, K. Godri Pollitt, G. J. Evans, C.-W. Chow, J. A. Scott
Journal: Allergy (2015)

Background Syk, an immune regulatory tyrosine kinase, plays a role in inflammatory disease processes. We recently reported a role for epithelial expression of Syk in the airways hyper-responsiveness in response to air pollution in a mouse model of asthma. The aim of this study was to further investigate the role of Syk in airway contractility in response to methacholine (MCh) and particulate matter (PM) air pollutants, in the absence of underlying inflammation. Methods We used Sykflox/flox//rosa26CreERT2 conditional Syk knockout mice to evaluate respiratory mechanics and MCh responsiveness following PM exposure in vivo using the ventilator-based flexiVent® system. Results While total and differential cell counts in bronchoalveolar lavage fluid were similar between the Sykflox/flox and Sykdel/del mice, central airways respiratory resistance (RN) to MCh was significantly augmented following PM exposure between Syk-intact (Sykflox/flox) and Syk-deficient (Sykdel/del) mice (RN(max): 2.06 ± 0.29 vs. 1.29 ± 0.10, respectively; p < 0.05, n = 8–10/group). We employed live videomicroscopy to investigate changes in airway luminal diameter using ex vivo lung slices, which were devoid of circulating leukocytes. MCh reduced the airway luminal area of Sykflox/flox mice to 81.1 ± 1.4% of baseline, which was virtually abrogated in Sykdel/del mice (luminal area = 93.2 ± 0.5%, n = 5/group, p < 0.05). In response to PM exposure, Sykflox/flox airways contracted to 73.8 ± 2.7% of baseline luminal diameter, whereas Sykdel/del airways exhibited minimal contractility to PM and MCh (90.0 ± 1.3% of baseline, n = 5/group, p < 0.05). Conclusions These observations suggest that Syk mediates airway contractility in the normal and allergic airways, independent of its role and function in leukocytes, and supports a paracrine role for airway epithelial Syk in modulating airway smooth muscle activity.
STUDIES ON THE PHYSICAL AND CHEMICAL PROPERTIES OF THE VIRUS OF FOOT-AND-MOUTH DISEASE
Authors: Peter K. Olitsky, Louis Boëez
Journal: The Journal of Experimental Medicine (1927)

A strain of foot-and-mouth disease virus was recovered from a cow at the height of the disease, and was propagated through at least 261 passages in the guinea pig. Considerably over 2000 animals proved susceptible to the virus, and the virus could be transferred at will back to cattle and hogs, and then again returned to guinea pigs. No natural immunity was discovered in guinea pigs. Secondary lesions were easily and regularly induced, thus making this strain particularly favorable to experimental purposes. In general, the guinea pig may therefore be regarded as the animal of choice for laboratory studies. The guinea pig could be infected by different methods of injection in different sites, but constant and regular production of primary and secondary lesions-or generalization of the disease-followed intradermal "tunneling" in the manner described, combined with subcutaneous inoculation of the posterior hairless pads of full grown animals. As we have indicated, the virus was peculiarly epitheliotropic, which in turn gives support to the opinion that its portal of entry may be limited. The active agent could purify itself of chance concomitant bacteria in the first passages, in a susceptible animal-a character possessed by filter-passing viruses in general. The virus was active in dilutions of 1:10,000,000. This shows not only the minuteness of the active agent, but also the necessity for a change of technique from that employed with larger sized infectious agents. Apart from this, the dilution factor is important in interpreting mere preservation of the virus rather than multiplication, when only early successive subplants in culture experiments are positive. Furthermore, some samples of virus were not so active-a factor of twenty-five existed between the weakest and strongest samples among fifteen titrated. This indicates that comparative tests, as, for example, of survival in different media, should be made with the same specimen. In any case, the rate and energy of action of the virus were proportional to its concentration, thus differing from the behavior of certain enzymes. The incitant is not sedimented by centrifugation. Non-centrifugability, a property of some other filter-passing, infectious agents, is not an indication of the fluid character of the virus, as we have already explained. In view of the evidence presented and other tests to be reported later, failure of deposition is related to the minute size of the incitant. The method of centrifugation has also failed to remove "virucidal bodies" in the meaning of Frosch and Dahmen.
Diagnosis and Immunotherapy of Mould Allergy
Authors: H.‐J. Malling, S. Dreborg, B. Weeke
Journal: Allergy (1986)

Thirty‐three adult asthmatic patients suspected of mould allergy were investigated by in vitro and in order to tests in order to establish a specific diagnosis of asthma caused by the mould species Cladosporium . The patients were evaluated by daily symptom scores in the peak Cladosporium season, bronchial provocation test (BPT), skin prick test (SPT), RAST, histamine release from basophil granulocytes (HIST), and crossed radio‐immunoelectrophoresis (CRIE), and the results were scored as negative (score 0), equivocal (score 1) or positive (score 2). Based on daily symptom scores and the result of BPT the patients were classified as being manifest allergic (asthma) to Cladosporium (positive allergy), inconclusive or negative. Positive allergy was defined as asthma symptoms oscillating with the spore concentration and a BPT score 2 (positive at allergen concentration &lt; 10,000 BU). Negative allergy was defined as NO asthma symptoms and a negative BPT (score 0) and inconclusive in the case of symptoms and BPT sum of score 1‐3. According to the classification a final diagnosis (positive or negative) could be established in 85% of the patients. “False positive” tests were found: for BPT in 27%, SPT 18%, RAST 0%, HIST 18%, and CRIE 0%. The corresponding figures for “false negative” were; BPT 0%, SPT 0%, RAST 27%, HIST 18%, and CRIE 23%. The relative risk of being allergic in spite of a negative test result was 0 % for BPT and SPT, and 25‐30 % with RAST, HIST, and CRIE. In the case of positive test the risk was 90‐100%. Excluding BPT, SPT was found to be the optimal single test to predict/rule out clinical allergy. A stepwise combination of positive SPT and positive RAST was found exclusively in patients clinically evaluated as positive, and does not call for an additional BPT. Using a potent allergenic extract a negative SPT excluded clinically important allergy. The primary conclusion of the study, however, is that the final diagnosis of Cladosporium asthma could not be based on a positive BPT alone (due to “false positive”), but only on a combination of clinical symptoms during the spore season and a positive BPT.
Chronic Intermittent Hypoxia Induces Atherosclerosis
Authors: Vladimir Savransky, Ashika Nanayakkara, Jianguo Li, Shannon Bevans, Philip L. Smith, Annabelle Rodriguez, Vsevolod Y. Polotsky
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Rationale: Obstructive sleep apnea, a condition leading to chronic intermittent hypoxia (CIH), is associated with hyperlipidemia, atherosclerosis, and a high cardiovascular risk. A causal link between obstructive sleep apnea and atherosclerosis has not been established.Objectives: The objective of the present study was to examine whether CIH may induce atherosclerosis in C57BL/6J mice.Methods: Forty male C57BL/6J mice, 8 weeks of age, were fed either a high-cholesterol diet or a regular chow diet and subjected either to CIH or intermittent air (control conditions) for 12 weeks.Measurements and Main Results: Nine of 10 mice simultaneously exposed to CIH and high-cholesterol diet developed atherosclerotic lesions in the aortic origin and descending aorta. In contrast, atherosclerosis was not observed in mice exposed to intermittent air and a high-cholesterol diet or in mice exposed to CIH and a regular diet. A high-cholesterol diet resulted in significant increases in serum total and low-density lipoprotein cholesterol levels and a decrease in high-density lipoprotein cholesterol. Compared with mice exposed to intermittent air and a high-cholesterol diet, combined exposure to CIH and a high-cholesterol diet resulted in marked progression of dyslipidemia with further increases in serum total cholesterol and low-density lipoprotein cholesterol (124 ± 4 vs. 106 ± 6 mg/dl; p < 0.05), a twofold increase in serum lipid peroxidation, and up-regulation of an important hepatic enzyme of lipoprotein secretion, stearoyl-coenzyme A desaturase-1.Conclusions: CIH causes atherosclerosis in the presence of diet-induced dyslipidemia.