tbuckley/cabot-search huggingface dataset:
Surfer's Chest Knots
Authors: Charles K. Tashima
Journal: JAMA (1973)

<h3>To the Editor.—</h3> A variation of the usual surfer's nodule, previously reported, has been encountered and related to the use of shorter boards. A 47-year-old Hawaiian man was admitted for investigation of recently discovered polycythemia. Aside from a reddish hue to his dark brown pigmentation, there were no unusual findings, except for a round, soft, nontender, 5-cm subcutaneous mass over the anterolateral aspect of the lower part of the left hemithorax, with a less prominent nodule on the right. A small firm nodule was present on the dorsum of the left foot. This right-handed patient explained that these chest nodules were caused by lying on a surfboard. He surfed from 5 AM until noon on weekends. The nodules developed when he switched to the shorter seven-foot board, while the nodules of the feet diminished, since his feet were in contact less with the board. Surfer's nodules (201:134, 1967) or "knots"
Evidence That Human Cardiac Myocytes Divide after Myocardial Infarction
Authors: Antonio P. Beltrami, Konrad Urbanek, Jan Kajstura, Shao-Min Yan, Nicoletta Finato, Rossana Bussani, Bernardo Nadal-Ginard, Furio Silvestri, Annarosa Leri, C. Alberto Beltrami, Piero Anversa
Journal: New England Journal of Medicine (2001)

The scarring of the heart that results from myocardial infarction has been interpreted as evidence that the heart is composed of myocytes that are unable to divide. However, recent observations have provided evidence of proliferation of myocytes in the adult heart. Therefore, we studied the extent of mitosis among myocytes after myocardial infarction in humans.Samples from the border of the infarct and from areas of the myocardium distant from the infarct were obtained from 13 patients who had died 4 to 12 days after infarction. Ten normal hearts were used as controls. Myocytes that had entered the cell cycle in preparation for cell division were measured by labeling of the nuclear antigen Ki-67, which is associated with cell division. The fraction of myocyte nuclei that were undergoing mitosis was determined, and the mitotic index (the ratio of the number of nuclei undergoing mitosis to the number not undergoing mitosis) was calculated. The presence of mitotic spindles, contractile rings, karyokinesis, and cytokinesis was also recorded.In the infarcted hearts, Ki-67 expression was detected in 4 percent of myocyte nuclei in the regions adjacent to the infarcts and in 1 percent of those in regions distant from the infarcts. The reentry of myocytes into the cell cycle resulted in mitotic indexes of 0.08 percent and 0.03 percent, respectively, in the zones adjacent to and distant from the infarcts. Events characteristic of cell division--the formation of the mitotic spindles, the formation of contractile rings, karyokinesis, and cytokinesis--were identified; these features demonstrated that there was myocyte proliferation after myocardial infarction.Our results challenge the dogma that the adult heart is a postmitotic organ and indicate that the regeneration of myocytes may be a critical component of the increase in muscle mass of the myocardium.
THE COMPARATIVE RESULTS OF LITHOTOMY, LITHOLAPAXY AND LITHOTRITY IN ONE HUNDRED OPERATIONS FOR STONE.
Authors: EDMUND ANDREWS
Journal: JAMA (1889)

The new instruments and modified methods introduced by Bigelow, of Boston, for crushing and evacuating vesical calculi seemed at first dangerously severe. In litholapaxy one must often work with his instruments in the bladder for more than an hour, and it naturally impressed surgeons as a rash and perilous procedure. I confess to having felt strong fears in this direction, and many other surgeons were even more timid in the matter than myself. Prof. Paul F. Eve seems to have avoided the new plan almost entirely, and Prof. James R. Wood, of New York, shortly before his death, showed me his collection of vesical calculi, and informed me that he had just cut for stone the ninetieth time, and had never crushed in a single instance. However, experience soon showed that the bladder is far more tolerant of even a whole hour or more of Careful instrumentation, which thoroughly clears
Orthopaedic sports medicine, 2nd edn.
Authors: D Hughes
Journal: British Journal of Sports Medicine (2003)

Silence on clinical fundamentalsYour point about lifesaving hand washing to prevent diarrhoeal illness 1 is well made.I have found that the inattention you have noted to such clinical fundamentals in textbooks on sports medicine is mirrored by the absence of any notation, affirmative or otherwise, in many textbooks on pain, correlating the symptom (pain) with the physical sign (tenderness), a rudimentary clinical confirmation of the validity of pain, according to my clinical training in Ireland, that could distinguish malingering from a genuine complaint of pain, for example.Perhaps I have received a false impression but, if so, the utility of eliciting tenderness, a longstanding custom during physical examination, seems a mystery.In November 2002, I attended a conference in Florida on prescribing addictive drugs.None of the purportedly expert presenters mentioned the issue spontaneously.When I collared one of them after his lecture and enquired specifically about the point, he claimed that chronic, non-malignant pain and tenderness are usually ''dissociated''that is, a patient can suffer chronic, nonmalignant pain in the absence of tenderness of the painful part, on physical examination.This assertion seemed contrary to my own, admittedly anecdotal, experience over some 24 years.Furthermore, it would seem to (a) render chronic, non-malignant pain, and maybe all pain, unknowable and undetectable (except perhaps to the alleged sufferer, although nobody else can tell), (b) place the assessment of pain in the realm of ''pathological science'', 5 and (c) invalidate the very idea of regulation of narcotic drugs to ensure that the practitioner prescribe one only when it ''corresponds to the ailment''. 5 The silence on the subject in the medical literature seemed anomalous.A Boolean Pubmed search on the keywords ''pain'' and ''tenderness'' revealed no relevant articles.I examined all 114 textbooks on pain in the medical library of the University of Southern California (USC) and found two 2 3 that addressed the issue.
Effects of aerobic or resistance exercise and/or diet on glucose tolerance and plasma insulin levels in obese men.
Authors: B Rice, I Janssen, R Hudson, R Ross
Journal: Diabetes Care (1999)

OBJECTIVE: This study had two objectives. First, we examined whether the influence of diet combined with either aerobic (DA) (n = 10) or resistance (DR) (n = 10) exercise has effects on insulin and glucose levels that are different in obese men. Second, we tried to determine whether the combination of diet and exercise is associated with improvements in insulin and glucose levels that are greater than those associated with diet alone (DO) (n = 9). RESEARCH DESIGN AND METHODS: Insulin and glucose levels were measured after an overnight fast and a 75-g oral glucose challenge (OGTT). Visceral adipose tissue (AT), subcutaneous AT, and skeletal muscle were measured by magnetic resonance imaging (MRI) before and after treatment (16 weeks). RESULTS: Reductions in weight (12.4 +/- 3.8 kg) and in visceral (37 +/- 15.1%) and subcutaneous AT (24.3 +/- 8.6%) were not different between treatments (P &amp;gt; 0.05). Skeletal muscle was maintained in the DA and DR groups but was reduced (7.3 +/- 2.8%) in the DO group (P &amp;lt; 0.05). Independent of treatment, fasting glucose and OGTT glucose did not change (P &amp;gt; 0.05). However, fasting insulin, OGTT insulin, and the insulin-to-glucose ratio decreased within all treatments (P &amp;lt; 0.05). Reductions in the OGTT insulin area under the curve were greater (P &amp;lt; 0.05) within the DA (52 +/- 12%) and DR (42 +/- 17%) treatments than in the DO (20 +/- 15%) treatment. Collapsed across group, reductions in visceral AT were related to reductions in fasting and OGTT glucose (P &amp;lt; 0.05), whereas reductions in abdominal subcutaneous AT correlated with reductions in fasting insulin (P &amp;lt; 0.05). CONCLUSIONS: Weight loss induced by diet and aerobic or resistance exercise has similar positive effects on lowering fasting and OGTT insulin values that are greater than those with diet alone. Because changes in glucose and insulin were related to reductions in visceral and abdominal subcutaneous AT, we conclude that reduction in abdominal obesity consequent to diet and exercise-induced weight loss is important for attaining improvements in plasma insulin levels, observations that strengthen the concept that abdominal obesity has an important role in mediating insulin resistance.
Hepatocyte nuclear factor 1α: A key mediator of the effect of bile acids on gene expression
Authors: Diana Jung, Gerd A. Kullak-Ublick
Journal: Hepatology (2003)

Bile acids regulate the expression of genes involved in cholesterol homeostasis. They are ligands of the farnesoid X receptor, which induces small heterodimer partner (SHP)–1, a transcriptional repressor of bile acid synthetic enzymes. In cholestatic liver disease, hepatic bile acid concentrations are elevated and expression of the major Na+-independent bile acid uptake system, organic anion transporting polypeptide (OATP)–C (solute carrier gene family SLC21A6 ), is markedly decreased. Because the OATP–C gene is transcriptionally dependent on the hepatocyte nuclear factor (HNF) 1α, we hypothesized that bile acids decrease OATP–C expression through direct repression of HNF1α. To test this hypothesis, we studied the regulation of the human HNF1 α gene by bile acids. HNF1α expression in cultured hepatoma cells was decreased ˜50% after 12 hours' exposure to 100 μmol/L chenodeoxycholic acid (CDCA). Characterization of the human HNF1 α gene promoter identified a consensus bile acid response element that binds and is activated by HNF4α. Mutagenesis of the HNF4α site abolished baseline HNF1α promoter activity. The central mechanism by which bile acids repress HNF1α is decreased activation by HNF4α. SHP directly inhibits HNF4α–mediated transactivation of the HNF1α promoter in cotransfection assays. In addition, HNF4α nuclear binding activity is decreased by CDCA and the human HNF4 α gene promoter is repressed by CDCA through an SHP–independent mechanism. In conclusion, we show that repression of HNF1α is an important new mechanism by which bile acids regulate the expression of HNF1α–dependent genes in man. This explains the suppressive effect of bile acids on the OATP–C gene promoter, leading to decreased expression in cholestatic liver disease.
Effect of Lower Doses of Conjugated Equine Estrogens With and Without Medroxyprogesterone Acetate on Bone in Early Postmenopausal Women
Authors: Robert Lindsay, J. Christopher Gallagher, Michael Kleerekoper, James H. Pickar
Journal: JAMA (2002)

Lower-than-commonly-prescribed doses of conjugated equine estrogens (CEEs) with medroxyprogesterone acetate (MPA) improve vasomotor symptoms and vaginal atrophy, provide acceptable bleeding and lipid profiles, and afford endometrial protection. This lower-dose therapy's protection against loss of bone mineral density (BMD) associated with menopause has not been thoroughly investigated.To determine the effects of lower doses of CEEs only or CEEs-MPA on spine and hip BMD, total body bone mineral content (BMC), and biochemical markers of bone turnover in postmenopausal women.Two-year randomized, double-blind, placebo-controlled substudy of the Women's Health, Osteoporosis, Progestin, Estrogen trial, conducted at 19 US centers between August 1995 and October 2000.Eight hundred twenty-two healthy postmenopausal women aged 40 to 65 years who were within 4 years of their last menstrual period.Patients were randomly assigned to receive CEEs, 0.625; CEEs, 0.625 and MPA, 2.5; CEEs, 0.45; CEEs, 0.45 and MPA, 2.5; CEEs, 0.45 and MPA, 1.5; CEEs, 0.3; CEEs 0.3 and MPA, 1.5 (all doses in mg/d); or placebo for 2 years. All participants also received elemental calcium at 600 mg/d.Changes from baseline in spine and total hip BMD, total body BMC, and biochemical markers of bone turnover (serum osteocalcin and urinary cross-linked N-telopeptides of type I collagen), assessed at 6-month intervals and compared among treatment groups with a modified intention-to-treat approach.At 24 months, women assigned to all of the active treatment groups had significant gains from baseline (P<.001) in spine and hip BMD and total body BMC (except total body BMC in the group receiving CEEs, 0.3 mg/d). These changes were significantly different from those in the placebo group, in which losses of bone mass in spine and total body were evident over the course of the study (P<.001). The loss in hip BMD from baseline in the placebo group was significant at 18 (P =.02) but not at 24 months (P =.06). Osteocalcin and N-telopeptides of type I collagen were significantly reduced from baseline (P<.001) for all active treatment groups at all time points; no changes were found for the placebo group. For women treated with CEEs alone, the gains in spine BMD for the group taking CEEs, 0.625 mg/d, were significantly higher than those of the group taking CEEs, 0.3 mg/d (P =.02), but not the group treated with CEEs, 0.45 mg/d (P =.48).Doses of CEEs or CEEs-MPA lower than 0.625 mg/d effectively increase BMD and BMC in early postmenopausal women.
Evaluation of risk factors in the development of hepatocellular carcinoma in autoimmune hepatitis: Implications for follow-up and screening
Authors: Andrew D. Yeoman, Thawab Al-Chalabi, John B. Karani, Alberto Quaglia, John Devlin, Giorgina Mieli-Vergani, Adrian Bomford, John G. O'Grady, Phillip M. Harrison, Michael A. Heneghan
Journal: Hepatology (2008)

Hepatocellular carcinoma (HCC) has traditionally been considered a rare complication of cirrhosis secondary to autoimmune hepatitis (AIH), yet the true incidence remains unknown due to a lack of published data. Consequently, some professional guidelines do not mandate routine surveillance for HCC in this condition. Our aims were to evaluate the rate at which HCC develops among a large, prospectively obtained cohort of patients with AIH at a single center. Demographic, clinical, and laboratory indices associated with the development of HCC were also identified. HCC was discovered in 15 of 243 patients with AIH, all of whom had type 1 AIH equating to 1090 cases per 100,000 patient follow-up years. HCC occurred in the same proportion of females as males, 6.1% versus 6.4%, P = 0.95. HCC occurred more frequently in patients who had cirrhosis at presentation, 9.3% versus 3.4%, P = 0.048, or who had a variceal bleed as the index presentation of AIH, 20% versus 5.3%, P = 0.003. The median duration from time of confirmed cirrhosis to a diagnosis of HCC was 102.5 months, range 12-195 months. Median survival in patients whose HCC was diagnosed on surveillance was 19 months (range 6-36 months) compared with 2 months (range 0-14 months) for patients presenting symptomatically (P = 0.042).Cirrhosis in AIH is the sine qua non for HCC development, which subsequently occurs at a rate of 1.1% per year and affects men and women in equal proportions.
The effect of Percutaneous Mitral Balloon Valvuloplasty on Right Ventricular Functions in Mitral Stenosis: The Short and Mid Term Following
Authors: Sinan İnci, Mustafa Kemal Erol, Muhammet Hakan Taş, Eftal Murat Bakırcı, Hikmet Hamur, Şule Karakelleoğlu
Journal: Journal of the American College of Cardiology (2013)
FGFR3 Mutations Indicate Better Survival in Invasive Upper Urinary Tract and Bladder Tumours
Authors: Johanna M.M. van Oers, Ellen C. Zwarthoff, Ishtiaq Rehman, Abdel-Rahmene Azzouzi, Olivier Cussenot, Mark Meuth, Freddie C. Hamdy, James W.F. Catto
Journal: European Urology (2008)
How far will an account of ritualized behavior go in explaining cultural rituals?
Authors: Robert N. McCauley
Journal: Behavioral and Brain Sciences (2006)

The theory of ritualized behavior should offer insight about cultural rituals. Considering ritualized behaviors' scripted actions and both the frequent absence of anxiety and the routinization of many cultural rituals, questions remain about how much and what precisely gets explained. Among religious rituals, ritualized behaviors arise more strikingly in special agent rituals, but that might be because they usually include novices.
Associations of Pregnancy Complications With Calculated Cardiovascular Disease Risk and Cardiovascular Risk Factors in Middle Age
Authors: Abigail Fraser, Scott M. Nelson, Corrie Macdonald-Wallis, Lynne Cherry, Elaine Butler, Naveed Sattar, Debbie A. Lawlor
Journal: Circulation (2012)

The nature and contribution of different pregnancy-related complications to future cardiovascular disease (CVD) and its risk factors and the mechanisms underlying these associations remain unclear.We studied associations of pregnancy diabetes mellitus, hypertensive disorders of pregnancy, preterm delivery, and size for gestational age with calculated 10-year CVD risk (based on the Framingham score) and a wide range of cardiovascular risk factors measured 18 years after pregnancy (mean age at outcome assessment, 48 years) in a prospective cohort of 3416 women. Gestational diabetes mellitus was positively associated with fasting glucose and insulin, even after adjustment for potential confounders, whereas hypertensive disorders of pregnancy were associated with body mass index, waist circumference, blood pressure, lipids, and insulin. Large for gestational age was associated with greater waist circumference and glucose concentrations, whereas small for gestational age and preterm delivery were associated with higher blood pressure. The association with the calculated 10-year CVD risk based on the Framingham prediction score was odds ratio 1.31 (95 confidence interval, 1.11-1.53) for preeclampsia and 1.26 (95 confidence interval, 0.95-1.68) for gestational diabetes mellitus compared with women without preeclampsia and without gestational diabetes mellitus, respectively.Hypertensive disorders of pregnancy and pregnancy diabetes mellitus are independently associated with an increased calculated 10-year CVD risk. Preeclampsia may be the better predictor of future CVD because it was associated with a wider range of cardiovascular risk factors. Our results suggest that pregnancy may be an important opportunity for early identification of women at increased risk of CVD later in life.
Calcinosis of Childhood Determatomyositis with Glucoheptonate Angiogram
Authors: DAVID J. CZARNECKI, BRUCE A. SCHROEDER, JOHN R. STY
Journal: Clinical Nuclear Medicine (1987)

In childhood dermatomyositis, calcinosis occurs in skin, subcutaneous tissue, and muscle. These areas of calcinosis have been well evaluated with labeled phosphate compounds. Cutaneous ulceration and infection are frequent complications. The radionuclide angiogram is a very well known and sensitive method to demonstrate vascularity of a lesion. The common abdominal lesions demonstrating increased vascularity in pediatrics include abscess, cellulitis, hemangioma, arteriovenous malformation, and endocrine tumors. An abnormal vascular pattern can also be demonstrated in dermatomyositis. A case of a nine-year-old boy is presented.
Free radical generation by ultrasound in aqueous and nonaqueous solutions.
Authors: P Riesz, D Berdahl, C L Christman
Journal: Environmental Health Perspectives (1985)

The physical principles underlying the oscillatory behavior of minute gas bubbles in liquids exposed to ultrasound are reviewed. Results from mathematical analyses suggest that these oscillations sometimes become unstable leading to transient cavitation in which a bubble violently collapses during a single acoustic half-cycle producing high temperatures and pressures. The role that micronuclei, resonant bubble size, and rectified diffusion play in the initiation of transient cavitation is explained. Evidence to support these theoretical predictions is presented with particular emphasis on sonoluminescence which provides some non-chemical evidence for the formation of free radicals. Acoustic methods for conducting sonochemical investigations are discussed. In aqueous solutions transient cavitation initially generates hydrogen atoms and hydroxyl radicals which may recombine to form hydrogen and hydrogen peroxide or may react with solutes in the gas phase, at the gas-liquid boundary or in the bulk of the solution. The analogies and differences between sonochemistry and ionizing radiation chemistry are explored. The use of spin trapping and electron spin resonance to identify hydrogen atoms and hydroxyl radicals conclusively and to detect transient cavitation produced by continuous wave and by pulsed ultrasound is described in detail. The study of the chemical effects of cavitation in organic liquids is a relatively unexplored area which has recently become the subject of renewed interest. Examples of the decomposition of solvent and solute, of ultrasonically initiated free-radical polymerization and polymer degradation are presented. Spin trapping has been used to identify radicals in organic liquids, in polymer degradation and in the decomposition of organometallic compounds.
Lessons from the outbreak of food poisoning at Stanley Royd Hospital: what are health authorities doing now?
Authors: M Kapila, R Buttery
Journal: BMJ (1986)

The committee of inquiry into the outbreak of food poisoning at Stanley Royd Hospital identified serious deficiencies in the management of the outbreak and urged all health authorities to learn from the incident and prepare adequate plans for dealing with any future outbreaks. A survey of district health authorities in England showed that most authorities do not yet have a written plan or that their plans are incomplete and inadequate. The appreciable resistance to such planning suggests that most health authorities would be unable to deal with outbreaks of food poisoning effectively and efficiently.