tbuckley/cabot-search huggingface dataset:
Metropolitan Free Hospital: Operation for the Cure of Stuttering
Authors: None Lucas
Journal: BMJ (1841)

OF STtITTEIIING. 16.Has been progressing favourably since last report.The limb was placed on its outer side the day before yesterday, and is now perfectly easy.22. The leg has been placed in pasteboard splints, and laid on its fibular side.Tolerably firm union has taken place, and the wound over the fibiula is slowly filling up.He experiences scarcely any pain in the leg.Appetite anid general health good.28. Has been gradually improving since last repott; the leg is becoming very firn; he can raise it from the bed without any assistanice.Jan. 6.Progressing favourably.19.Has been up the last two days.Considerable edema appears about the litnb after he has been up a shiort time.The upper wounid is not entirely healed.There is motion, though slight, of the ancle-joint.A pasteboard splint is applied on the fibular side with a roller.Feb. 2. He is able to walk on it with much more secu- rity, and it does not swell so muclh as before.It is now strapped uniformly with strips of soap-plaster.8. Gaining strength rapidly.15.The patient has left the hospital, the leg being quite firm, and enabling him to walk very well.
Randomized Comparison of Elective Stent Implantation and Coronary Balloon Angioplasty Guided by Online Quantitative Angiography and Intracoronary Doppler
Authors: Carlo Di Mario, Jeffrey W. Moses, Todd J. Anderson, Raoul Bonan, Toshiya Muramatsu, Abnash Chander Jain, Josè Suarez de Lezo, Seung Yun Cho, Morton Kern, Ian T. Meredith, David Cohen, Issam Moussa, Antonio Colombo
Journal: Circulation (2000)

Background —The purpose of this study was to compare long-term outcomes of coronary stenting in all lesions (elective stenting) or only in lesions with inadequate morphological and functional results after balloon angioplasty (guided PTCA). Methods and Results —Treatment of multivessel disease, with any lesion length and vessel size, was allowed provided that all lesions were suitable for stent implantation. Patients were randomized to elective stent implantation (n=370) or guided PTCA (n=365). An optimal PTCA result (residual diameter stenosis ≤35%, coronary flow reserve measured with a Doppler guidewire &gt;2.0, absence of threatening dissections) was achieved in 166 lesions (43%). The remaining 218 lesions underwent stent implantation (provisional stenting). Final residual diameter stenosis was lower in the elective and provisional stent groups (9.3% and 10.2%) than in the optimal PTCA group (24.8%, P &lt;0.00001). On an intention-to-treat analysis, the probability of ≥1 major adverse cardiac event at 12 months was 17.8% in the elective stenting group and 18.9% in the guided PTCA group (20.1% for optimal PTCA and 18.0% for the provisional stenting subgroup, P =NS). The incidence of repeat target lesion revascularization at 1 year was 14.9% in the elective stent group and 15.6% in the guided PTCA group (17.6% for optimal PTCA and 14.1% for the provisional stenting subgroup, P =NS). Conclusions —When balloon angioplasty is guided by online quantitative angiography and Doppler-derived coronary flow reserve, with provisional stenting reserved for suboptimal results, early and late clinical outcomes are comparable to those achieved by elective stenting of all patients.
Acute Coronary Syndrome Caused by a Mobile Mass in the Left Main Coronary Artery
Authors: Baris Ikitimur, Tevfik Gurmen, Ali Tabakan, Kaya Suzer
Journal: Journal of the American College of Cardiology (2010)

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Intracoronary thrombi represent an important aspect of the pathophysiology of acute coronary syndromes. Their presentation and management differ depending on the clinical presentation. We present a case with an unusual
Effects of antibiotic treatment in the subset of common-cold patients who have bacteria in nasopharyngeal secretions
Authors: L Kaiser, D Lew, B Hirschel, R Auckenthaler, A Morabia, A Heald, J Voegli, H Stalder, P Benedict, F Terrier, W Wunderli, L Matter, D Germann
Journal: The Lancet (1996)
Undergraduate clinical neurosciences programme development: A consumer-based evaluation
Authors: R F Gledhill
Journal: Journal of the Royal Society of Medicine (1987)

Intern responses to a questionnaire were used to evaluate an undergraduate clinical neurosciences programme. The data obtained were judged an authentic measure of instructional efficacy. Most interns rated themselves competent in performing the neurological examination but ill-equipped to interpret their findings and to manage effectively common problems, especially emergencies. Neurological diseases and the non-biomedical aspects of patient care were identified relatively infrequently as matters needing greater emphasis. Explanations for these findings may include a curriculum of traditional format, differences in teaching and assessing theoretical and practical competence, and the typical responsibilities of interns in an academic hospital. Intern evaluation of undergraduate clinical programmes can provide data useful to their development.
The extended psychological present
Authors: Philip N. Hineline
Journal: Behavioral and Brain Sciences (1995)

Abstract Portraying psychological process as extended over time in multiply overlapping scales is a conceptual advance that can be understood as analogous to our understanding of spatial relationships. There may be a residual contradiction, however, when Rachlin invokes “cost” in ways that seem to imply earlier conceptions. The roles of superimposed or conditionally related stimuli also remain to be addressed.
Reversal of reentry and acceleration due to double-wave reentry: Two mechanisms for failure to terminate tachycardias by rapid pacing
Authors: Lawrence H. Frame, Edward K. Rhee, Robert C. Bernstein, Hailing Fei
Journal: Journal of the American College of Cardiology (1996)

Objectives. We sought to demonstrate mechanisms by which rapid pacing can cause conduction block without terminating reentry. Background. Rapid pacing can fail to terminate or can accelerate tachycardias in patients. Mechanisms for these responses are poorly understood. Methods. We studied reentry in the canine atrial tricuspid ring and a left ventricular ring in vitro in 12 preparations. Activations were recorded from 10 sites around the ring, and monophasic action potentials were recorded from critical sites of block. Rapid pacing at cycle lengths that intermittently caused conduction block was performed at multiple sites. Results. Action potential alternans contributed to block of an orthodromic impulse during rapid pacing. When pacing continued for two stimuli after orthodromic block, a second episode of block could reverse the direction of tachycardia. Continued pacing at this site was likely to produce block of an antidromic impulse, which may initiate double-wave reentry. Double-wave reentry could be sustained or nonsustained. Its cycle length was 56% to 77% of the single-wave cycle length. The ratio of double-wave cycle length to single-wave cycle length was inversely correlated with the relative excitable gap (p < 0.01). Double-wave reentry can be a mechanism for persistent cycle length alteration during tachycardia. Conclusions. Successful termination of reentry by rapid pacing required block of an orthodromic impulse and stopping pacing within one stimulus after orthodromic block. Reversal of reentry makes the circuit resistant to termination from this site of pacing. Antidromic block can cause acceleration due to double-wave ree
Chagas' Disease — Can We Stop the Deaths?
Authors: James H. Maguire
Journal: New England Journal of Medicine (2006)

Nearly 100 years since its discovery by the Brazilian physician Carlos Chagas, the protozoan parasite Trypanosoma cruzi remains perhaps the most common cause of myocarditis worldwide. The lethality of Chagas' heart disease is undisputed, as the survival curves presented by Rassi et al. in this issue of the Journal illustrate with chilling clarity (pages 799–808). More than 10 million Latin Americans carry the parasite, and at least 1 million of them will die unless scientific and political breakthroughs lead to new strategies and tools for diagnosis, treatment, and increased access to medical care.1 Chagas' disease (American trypanosomiasis) afflicts impoverished people . . .
Glucocorticoid-Induced Ketoacidosis in Gestational Diabetes: Sequela of the Acute Treatment of Preterm Labor: A case report
Authors: A Bedalov, A Balasubramanyam
Journal: Diabetes Care (1997)

Pregnancy induces complex changes in energy metabolism, manifested clinically by insulin resistance, low fasting blood glucose levels, and proneness to ketosis. It is quite unusual for pregnant women who do not have type I diabetes to progress from ketosis to frank ketoacidosis, although this phenomenon is common in larger mammals. In the case described here, glucocorticoid administration in the setting of a prolonged fast triggered a metabolic cascade leading to ketoacidosis in a pregnant woman without type I diabetes. Other details of this illustrative case serve to synthesize several disparate observations regarding the pathogenesis of pregnancy ketoacidosis. Physicians should be aware of the potential for rapidly developing ketoacidosis with atypical biochemical and clinical features in pregnant women who are treated with high doses of glucocorticoids.
Intratumoral Versus Intraparenchymal Injection Technique for Lymphoscintigraphy in Breast Cancer
Authors: SUSANNE H. ESTOURGIE, OMGO E. NIEWEG, RENATO A. VALDÉS OLMOS, EMIEL J. TH. RUTGERS, BIN B.R. KROON
Journal: Clinical Nuclear Medicine (2003)

A 1.5-cm nonpalpable mass was detected in the upper outer quadrant of the left breast by screening mammography in a 55-year-old woman. The patient was scheduled for a sentinel node procedure, and lymphoscintigraphy was performed the day before surgery. Unintentionally, she received an intraparenchymal tracer injection 3 cm away from the malignant lesion instead of the intended intratumoral injection. Lymphoscintigraphy revealed two sentinel nodes in the axilla. A second dose of Tc-99m nanocolloid was injected the next day into the primary tumor through a catheter that had been inserted under ultrasound guidance the previous day. Once more, a lymphoscintigraphic image was obtained that showed additional sentinel nodes in two different regions outside the axilla. This observation supports the authors’ contention that lymphatic watersheds exist in the breast and highlights the importance of tracer administration into or close to the tumor.
Inactivation of the X-Chromosome
Authors: Charles J. Epstein
Journal: New England Journal of Medicine (1972)

IN its classic form, the hypothesis of X-chromosome inactivation holds that only one of the two X-chromosomes present in cells of female mammals is functional. The "decision" of which X-chromosome is to operate in a cell occurs quite early in embryogenesis and, once made, is irreversible for that cell and all its progeny. The net effect of the inactivation is to make the dosage of X-chromosomal genes (and, therefore, gene products) equal in male and female cells.Despite the apparent general validity of the inactivation hypothesis, it has been recognized from the beginning that certain observations are not easily reconciled . . .
The Medical Teacher
Authors: Jacqueline A. Noonan
Journal: JAMA (1982)

This is a new book, in paperback, written by experts in medical education from Australia with a few chapters from the United Kingdom and the United States and divided into five sections. The first section, concerned with "The Learner," reminds the teacher of the somewhat unique characteristics of medical students. They are relatively homogeneous with respect to intellectual ability, but may vary considerably in performance because of individual differences in perseverance, manual skills, and personality, to name a few, and also because of the teaching and examining methods employed. However, 95% of medical students are capable of learning to a high performance level if provided with appropriate opportunities. The second section is a brief one on "The Teacher," which discusses ways in which a teacher can gain feedback in teaching performances in order to decide which teaching skills need to be developed or improved. The longest section, "Methods," deals with
Tissue Doppler Imaging Is Superior to Strain Rate Imaging and Postsystolic Shortening on the Prediction of Reverse Remodeling in Both Ischemic and Nonischemic Heart Failure After Cardiac Resynchronization Therapy
Authors: Cheuk-Man Yu, Jeffrey Wing-Hong Fung, Qing Zhang, Chi-Kin Chan, Yat-Sun Chan, Hong Lin, Leo C.C. Kum, Shun-Ling Kong, Yan Zhang, John E. Sanderson
Journal: Circulation (2004)

A number of noninvasive techniques have been used to predict the effectiveness of cardiac resynchronization therapy (CRT) in heart failure patients, in particular left ventricular (LV) reverse remodeling. This study compared the relative predictive values of tissue Doppler imaging (TDI) and strain-rate imaging (SRI) parameters for LV reverse remodeling in patients who received CRT and examined for potential differences in ischemic (n=22) and nonischemic (n=32) heart failure.TDI and SRI were performed at baseline and 3-month follow-up. Eighteen parameters of intraventricular and interventricular asynchrony based on the time to peak myocardial contraction (Ts) and time to peak strain rate (Tsr) were compared, along with postsystolic shortening (PSS). Reverse remodeling with reduction of LV end-diastolic and end-systolic volumes and gain in ejection fraction (all P<0.001) was observed in the whole study population. The standard deviation of Ts of 12 LV segments (Ts-SD) is the most powerful predictor of reverse remodeling in both the ischemic (r=-0.65, P<0.001) and nonischemic (r=-0.79, P<0.001) groups. The PSS of 12 LV segments was a good predictor only for the nonischemic (r=-0.64, P<0.001) but not the ischemic (r=0.32, P=NS) group. However, parameters of SRI and interventricular asynchrony failed to predict reverse remodeling. By multiple regression analysis, independent parameters included Ts-SD in both groups (P<0.005) and PSS of 12 LV segments in the nonischemic group (P=0.03). The area of the receiver operating characteristic curve was largest for Ts-SD (0.94; CI=0.88 to 1.00).Ts-SD is the most powerful predictor of LV reverse remodeling and was consistently useful for ischemic and nonischemic heart failure. However, PSS is useful only for nonischemic pathogenesis, whereas the role of SRI parameters was not supported by the present study.
Transient Right-to-Left Shunt in Acute Pulmonary Embolism
Authors: PIERRE-DENIS BUFFAZ, JEAN-LUC CRACOWSKI, CAROLE WOODWARD, CHRISTOPHE CURA, JEAN-PIERRE CARAVEL, MICHEL COMET
Journal: Clinical Nuclear Medicine (1999)

A right-to-left shunt can be observed in the acute phase of massive pulmonary embolism. It is caused by increased pressure in the right atrium. This can explain the severity of hypoxemia, which cannot be corrected with oxygen administration. A right-to-left shunt should be considered in the setting of massive pulmonary embolism.
Reduction of Plasma Lipids, Lipoproteins, and Apoproteins by Dietary Fish Oils in Patients with Hypertriglyceridemia
Authors: B E Phillipson, D W Rothrock, W E Connor, W S Harris, D R Illingworth
Journal: New England Journal of Medicine (1985)

Dietary fish oils, which are rich in omega-3 fatty acids, have been reported to reduce plasma lipid levels in normolipidemic subjects. We examined the effects of fish oil in 20 hypertriglyceridemic patients: 10 with Type IIb hyperlipidemia and 10 with Type V. These patients were put on three diets differing primarily in fatty acid composition and fat content. The control diet contained a fatty acid mixture typical of a low-fat therapeutic diet (ratio of polyunsaturated to saturated fat, 1.4), the fish-oil diet contained omega-3 fatty acids, and the vegetable-oil diet was rich in the omega-6 fatty acid, linoleic acid. Each diet was followed for four weeks. In the Type IIb group, the fish-oil diet led to decreases in both plasma cholesterol (-27 per cent) and triglyceride (-64 per cent), as compared with the control diet. Very-low-density lipoproteins (VLDLs) were also reduced markedly. The vegetable-oil diet had much less effect. With fish oil, the Type V group had marked decreases in total cholesterol and triglyceride levels (-45 and -79 per cent, respectively). VLDL levels were dramatically lowered, as were apoprotein E levels. The vegetable-oil diet (unlike the fish-oil diet) produced a rapid and significant rise in plasma triglyceride levels. We conclude that fish oils and fish may be useful components of diets for the treatment of hypertriglyceridemia.
The kappa-carrageenase of the marine bacterium Cytophaga drobachiensis. Structural and phylogenetic relationships within family-16 glycoside hydrolases
Authors: T. Barbeyron, A. Gerard, P. Potin, B. Henrissat, B. Kloareg
Journal: Molecular Biology and Evolution (1998)

We report here cloning from the marine gliding bacterium Cytophaga drobachiensis of kappa-carrageenase, a glycoside hydrolase involved in the degradation of kappa-carrageenan. Structural features in the nucleotide sequence are pointed out, including the presence of an octameric omega sequence similar to the ribosome-binding sites of various eukaryotes and prokaryotes. The cgkA gene codes for a protein of 545 aa, with a signal peptide of 35 aa and a 229-aa-long posttranslationaly processed C-terminal domain. The enzyme displays the overall folding and catalytic domain characteristics of family 16 of glycoside hydrolases, which comprises other beta-1,4-alpha-1,3-D/L-galactan hydrolases, beta-1,3-D-glucan hydrolases (laminarinases), beta-1,4-1,3-D-glucan hydrolases (lichenases), and beta-1,4-D-xyloglucan endotransglycosylases. In order to address the origin and evolution of CgkA, a comprehensive phylogenetic tree of family 16 was built using parsimony analysis. Family-16 glycoside hydrolases cluster according to their substrate specificity, regardless of their phylogenetic distribution over eubacteria and eukaryotes. Such a topology suggests that the general homology between laminarinases, agarases, kappa-carrageenases, lichenases, and xyloglucan endotransglycosylases has arisen through gene duplication, likely from an ancestral protein with laminarinase activity.
Cardiac Denervation in Diabetic Neuropathy
Authors: PETER J. WATKINS
Journal: Annals of Internal Medicine (1980)

Measurement of heart rate variation during deep breathing has been used as a diagnostic test of autonomic function. Normal subjects have considerable heart rate variation that is accentuated during deep breathing; this variation is diminished or sometimes absent in diabetics with autonomic neuropathy. Recording heart rate variation during deep breathing is a good method for establishing the presence of autonomic neuropathy: All normal subjects have a score greater than 9, and autonomic neuropathy is probably absent if the score is greater than 12. The optimal breathing rate for this test is six breaths per minute in nondiabetics but is usually less in diabetics with autonomic neuropathy. The use of six breaths per minute as a standard, however, enhances the ability of the test to discriminate normal from neuropathic patients. Imparied heart rate variation can be the earliest sign of diabetic neuropathy and may precede the appearance of autonomic symptoms by several years. Severe autonomic neuropathy may be responsible for spontaneous respiratory arrest and unexplained sudden deaths, which are not rare among these patients.
Risks and Benefits of Direct-to-Consumer Genetic Testing Remain Unclear
Authors: Bridget M. Kuehn
Journal: JAMA (2008)

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Isolation, barrier properties and lipid analysis of stratum compactum, a discrete region of the stratum corneum
Authors: P.A. BOWSER, R.J. WHITE
Journal: British Journal of Dermatology (1985)

We have isolated the lowest region of human and pig stratum corneum as an integral layer which we have termed the stratum compactum. This preparation is resistant to disruption by enzymes, 6murea, Triton X-100 and solvents. Our evidence suggests that all cells of the stratum corneum may be equally permeable to aqueous soluble materials but that penetration of materials through the corneum depends on the state of cohesion between cells and of the organization of intercellular lipid species. As the cells move up towards the outside of the stratum corneum the cohesive forces are reduced due to desmosome degradation and lipid modifications with ultimate dyshesion and sloughing of individual cells.
Influence of morphine on the distal oesophagus and the lower oesophageal sphincter--a manometric study.
Authors: K Dowlatshahi, A Evander, B Walther, D B Skinner
Journal: Gut (1985)

Basal pressure and relaxation of the lower oesophageal sphincter (LOS) as well as amplitude, duration and propagation velocity of peristaltic waves in the distal third of oesophagus were measured in 15 healthy adults (nine men and six women). A highly standardised technique was used employing manometric equipment including a low-compliance pneumohydraulic infusion system and a triple lumen recording catheter. After establishment of baseline manometry values the catheter was positioned with its distal orifice in the lower oesophageal sphincter. In 10 subjects 0.2 mg/kg body weight of morphine sulphate was then injected subcutaneously. In five others equal volume of saline was given. The manometric data were analysed blindly. Repeated manometric evaluations were carried out 15, 30, 45, 60, and 75 minutes after the injection. Morphine increased slightly LOS-pressure and significantly (p less than 0.001) decreased LOS-relaxation, the maximal effect occurring 30 minutes after the injection. Amplitude of peristaltic waves increased slightly but insignificantly, whereas propagation velocity and duration were uninfluenced. The results of this study suggest that pharmacologic doses of morphine influence normal function of the LOS and possibly the distal oesophagus. The role of endogenous opiates in this respect, however, awaits further studies. It is suggested that abnormalities in opioid neurotransmission may explain some of the non-specific oesophageal motility disorders.