tbuckley/cabot-search huggingface dataset:
Ronald James Bower
Authors: Donald Portsmouth
Journal: BMJ (2005)

​FormerFormer general practitioner Knowle, Solihull (b Southampton 1918; q Cambridge/St Bartholomew's Hospital, London, 1942), died on 4 April 2005 following a period of immobility caused by paraplegia resulting from spinal osteoarthritis.




Figure 1




After qualifying Ronald joined the Royal Army Medical Corps, serving with the 2nd Chindit expedition behind Japanese lines in Burma and then as commanding officer of a military hospital in India. In 1947 he joined a practice in Knowle, retiring in 1983. He also served as medical officer to a hospital for people with learning difficulties. Outside medicine Ronald's chief interest was in conservation and he was president of the Knowle Society for many years. Predeceased by his wife, Joan, he leaves four children and six grandchildren.
Poe: Defined as Schoolboy, but Definition as a Novelist Is Too Novel
Authors: Robert DiLallo
Journal: JAMA (1990)

<h3>To the Editor.—</h3> In the February 10, 1989, issue of<i>JAMA</i>, a discussion of "The Fall of the House of Usher" and porphyria misrepresented aspects of Edgar Allan Poe's life.<sup>1</sup>I will begin at the end of the article, the closing sentence of which begins, "However, as one of the greatest American novelists, Poe apparently observed..." Poe wrote only one novel in his 20-year career,<i>The Narrative of Arthur Gordon Pym</i>, published serially in 1837 and in July 1838 in New York as a book.<i>Pym</i>is not generally considered to be among Poe's best works, and, in any case, one novel does not a Dickens make.<sup>2,3</sup> Moreover, earlier in the last paragraph the authors attempt to tie Poe's years as a schoolboy in Britain, the malady of George III, and "The Fall of the House of Usher" into a neat package. Poe was born in 1809
Lesions of the Sacrum
Authors: Melvin L. Turner
Journal: JAMA (1981)

PRIMARY lesions of the sacrum are relatively uncommon. They frequently are accompanied by nonspecific symptoms such as low back pain and pelvic pressure. Large lesions may involve the sacral nerves and are often palpable on rectal examination. The diagnosis of an early lesion may prove difficult when vague symptoms are accompanied by subtle radiological findings. The curvilinear shape of the sacrum makes it difficult to evaluate on standard anteroposterior projections. A helpful adjunct is the distorted view of the sacrum, which is obtained with the tube angled 15 degrees cephalad and with the patient's hips flexed. This stretches or straightens out the sacrum, enhancing visualization. On frontal projections, the symmetry and osseous integrity of the sacral foramina should be carefully observed. Fecal material and bowel gas frequently overlie and obscure the sacrum, particularly when the sacral nerves are involved<sup>1</sup>(Fig 1, top left). The lateral view demonstrates the anterior border
Endoscopic Ultrasound Guided Fine Needle Aspiration of Malignant Pancreatic Lesions
Authors: M. S. Bhutani, R. H. Hawes, P. L. Baron, A. Sanders-Cliette, A. van Velse, J. F. Osborne, B. J. Hoffman
Journal: Endoscopy (1997)

Purpose: To evaluate the accuracy, safety, and clinical utility of endoscopic ultrasound (EUS) guided fine needle aspiration (FNA) of pancreatic masses.
Epinephrine-induced activation of LW-mediated sickle cell adhesion and vaso-occlusion in vivo
Authors: Rahima Zennadi, Benjamin J. Moeller, Erin J. Whalen, Milena Batchvarova, Ke Xu, Siqing Shan, Martha Delahunty, Mark W. Dewhirst, Marilyn J. Telen
Journal: Blood (2007)
Immunoblotting of streptococcal antigens in guttate psoriasis
Authors: A.G.McT. WILSON, I. CLARK, S.R. HEARD, D.D. MUNRO, J.D.T. KIRBY
Journal: British Journal of Dermatology (1993)

Guttate psoriasis may be precipitated by acute streptococcal infection, usually of the upper respiratory tract. We have studied the immune response to streptococci in 26 patients presenting with a first or recurrent episode of acute guttate psoriasis (AGP), using immunoblotting. Eighteen of 26 patients studied had a demonstrable response to a wide range of streptococcal antigens using this approach, compared with 14 of 26 patients who demonstrated a response using more conventional antistreptococcal antibody tests. Patients with AGP had a significantly higher antibody detection score using immunoblotting than did control subjects (P < 0.005). We conclude that immunoblotting is a useful technique in studying this condition and may be of benefit in exploring the immunopathogenesis of AGP.
Hepatocellular HLA display and B2 microglobulin serum values before and after treatment with α interferon (IFN) in chronic NANB hepatitis
Authors: M.A. Freni, A. Ajello, A. Spadaro, A. Fava, I. Calapristi, M.L. Resta, N. Alessi, O. Ferraù
Journal: Journal of Hepatology (1989)
S98 Ventilatory efficiency in pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension: physiological differences and implications for disease-specific end-points
Authors: Z. Zhai, K. Murphy, H. Tighe, C. Wang, M. Wilkins, S. Gibbs, L. S. Howard
Journal: Thorax (2010)

<h3>Background</h3> Measures of ventilatory efficiency during cardiopulmonary exercise testing (CPX), such as the V<sub>E</sub>/VCO<sub>2</sub> slope and ventilatory equivalent for CO<sub>2</sub> at anaerobic threshold (EqCO<sub>2</sub>_AT), are increasingly being used as prognostic markers in heart failure and pulmonary arterial hypertension (PAH). Little is known about whether these measures can be applied to all forms of PH, in particular chronic thromboembolic pulmonary hypertension (CTEPH), where thrombotic vascular occlusion may an impact on gas exchange through increased dead space fraction. <h3>Methods and results</h3> 127 patients, 77 with CTEPH and 50 with PAH, underwent incremental CPX. Ventilatory dead space fraction (V<sub>D</sub>/V<sub>T</sub>) measured at peak exercise with arterial blood gas analysis was higher in CTEPH than PAH (52.9 vs 41.8, p&lt;0.001).The V<sub>E</sub>/VCO<sub>2</sub> slope was higher in CTEPH patients than in PAH patients (50.7 vs 44.4, p=0.024) and was mirrored by similar changes in EqCO<sub>2</sub>_AT (47.7 vs 42.0 p=0.008). Multivariate analysis demonstrated disease subtype to be a powerful independent predictor of V<sub>D</sub>/V<sub>T</sub> (p&lt;0.001), V<sub>E</sub>/VCO<sub>2</sub> slope (p=0.003) and EqCO<sub>2</sub>_AT (p&lt;0.001). These three measures could distinguish between WHO functional classes I/II and III/IV in PAH, but not CTEPH (Abstract S98 Figure 1). As a result of increased ventilatory inefficiency in CTEPH, breathing reserve was lower at peak exercise compared with PAH (29.0 vs 38.8, p=0.003) despite similar peak VO<sub>2</sub> and heart rate reserves. <h3>Conclusion</h3> Significant differences in gas exchange exist between CTEPH and PAH, possibly due to differences in V<sub>D</sub>/V<sub>T</sub> as a result of vascular occlusion due to thromboembolic disease. These findings increase our understanding of the mechanisms of exercise limitation in subtypes of pulmonary hypertension, with increased dependence on gas exchange and ventilatory capacity in CTEPH. Furthermore these differences in gas exchange dissociate measures of ventilatory efficiency from disease severity in CTEPH. Caution should be applied in using common prognostic end-points from CPX in all forms of pulmonary hypertension.
Psychiatric Training Program for Nonpsychiatric Physicians
Authors: Leopold Bellak
Journal: JAMA (1963)

Postgraduate seminars in psychiatry for nonpsychiatric physicians are essential because psychiatry, although a basic medical science, has not been sufficiently taught to a majority of physicians now in practice. Also, the scarcity of psychiatrists makes it essential that other physicians be able to diagnose and treat patients with certain psychiatric problems. The development of community psychiatry has made it clear that psychiatry has a preventive medical function which must be exercised by all doctors. The experience here summarized, in the fourth year of teaching a year-long seminar to about 20 physicians at a time, indicates that the needs cited can be met. Lectures, seminars, supervised psychotherapeutic experience, consultations, and participation in the activities of a psychiatric division of a large general hospital seemed to offer a very useful training.
Radioimmunological determination of insulinlike growth factors I and II in normal subjects and in patients with growth disorders and extrapancreatic tumor hypoglycemia.
Authors: J Zapf, H Walter, E R Froesch
Journal: Journal of Clinical Investigation (1981)

Serum levels of immunoreactive insulinlike growth factors (IGF) I and II were determined by a modified IGF I and a new IGF II radioimmunoassay in normal children and adults, and in patients with acromegaly, isolated growth hormone deficiency, and extrapancreatic tumor hypoglycemia. Serum samples were gel filtered by a simple routine procedure at acidic pH to dissociate and separate IGF from the IGF carrier protein. Mean immunoreactive IGF I levels (+/- SD; corrected for crossreactivity of IGF II) were 193 +/- 58 ng/ml in normal adult subjects, 712 +/- 245 ng/ml in acromegalic patients and 24 +/- 14 ng/ml in patients with isolated growth hormone deficiency. The lack of growth hormone alone, irrespective of an otherwise normal hormonal status, appears to be responsible for the drastic decrease of IGF I levels. Oversecretion of growth hormone does not increase the levels of immunoreactive IGF II: mean levels (+/- SD; corrected for crossreactivity of IGF I) in normal and acromegalic subjects are virtually identical (647 +/- 126 and 641 +/- 189 ng/ml, respectively). Apparently, normal growth hormone levels stimulate IGF II production already maximally. However in growth hormone deficiency immunoreactive IGF II is significantly decreased (252 +/- 99 ng/ml). Thus, IGF II, like IGF I, is growth hormone dependent. But in contrast to IGF I, the growth hormone dependence of IGF II seems to become apparent only at subnormal growth hormone levels. In normal children IGF I is age dependent: it is low in newborn cord sera (51 +/- 20 ng/ml) and gradually rises into the adult range with increasing age. At the onset of and during puberty mean IGF I levels lie above prepubertal values. In contrast, IGF II levels in normal children are independent of age and pubertal stage beyond the first year of life, whereas newborns have significantly lower IGF II values. Hypoglycemia resulting from extrapancreatic tumors is not associated with increased immunoreactive IGF I or II levels. IGF I is decreased in most of the sera (mean level +/- SD:56 +/- 39 ng/ml) whereas IGF II lies in the normal range (556 +/- 195 ng/ml).
Phenotypic and Functional Characterization of Blood γδ T Cells in Sleep Apnea
Authors: Larissa Dyugovskaya, Peretz Lavie, Lena Lavie
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Hypoxia-induced lymphocyte dysfunction may be implicated in endothelial cell damage in obstructive sleep apnea (OSA) syndrome. gammadelta T cells' unique migration, cytotoxic features, and accumulation in atherosclerotic plaques are considered critical in cardiovascular disorders. We characterized the phenotype, cytokine profile, adhesion properties, and cytotoxicity of gammadelta T cells in patients with OSA and control subjects. The following is a summary of our major findings regarding OSA gammadelta T cells: (1) a significant increase in the expression of the inhibitory natural killer B1 receptors was found; (2) the intracellular content of proinflammatory cytokines tumor necrosis factor (TNF)-alpha and interleukin-8 was increased, and the content of the antiinflammatory cytokine interleukin-10 was decreased; (3) gammadelta T cells of patients with OSA adhered significantly more avidly to nonactivated endothelial cells in culture than those of control subjects; (4) L-selectin expression was higher; (5) anti-E/P-selectin antibodies and anti-TNF-alpha antibodies decreased the adhesion index of OSA gammadelta T lymphocytes/endothelial cells but not of control subjects; and (6) cytotoxicity of OSA gammadelta T lymphocytes against endothelial cells in culture was 2.5-fold higher than that of control subjects and could be prevented by pretreatment with anti-TNF-alpha. Collectively these data implicate gammadelta T lymphocyte function in atherogenic sequelae in OSA.
Uncoupling of PI3K from ErbB3 Impairs Mammary Gland Development but Does Not Impact on ErbB2-Induced Mammary Tumorigenesis
Authors: Hicham Lahlou, Thomas Müller, Virginie Sanguin-Gendreau, Carmen Birchmeier, William J. Muller
Journal: Cancer Research (2012)

Abstract The formation of ErbB2/ErbB3 heterodimers plays a critical role in ErbB2-mediated signaling in both normal mammary development and mammary tumor progression. Through 7 phosphoinositide 3-kinase (PI3K) phosphotyrosine-binding sites, ErbB3 is able to recruit PI3K and initiate the PI3K/AKT signaling pathway. To directly explore the importance of the ErbB3/PI3K pathway in mammary development and tumorigenesis, we generated a mouse model that carries a mutant ErbB3 allele lacking the seven known PI3K-binding sites (ErbB3Δ85). Mice homozygous for the ErbB3Δ85 allele exhibited an initial early growth defect and a dramatic impairment of mammary epithelial outgrowth. Although homozygous adult mice eventually recovered from the growth defect, their mammary glands continued to manifest the mammary outgrowth and lactation defects throughout their adult life. Interestingly, despite the presence of a profound mammary gland defect, all of the female ErbB3Δ85 mice developed metastatic ErbB2-induced mammary tumors secondary to mammary epithelial expression of an activated ErbB2 oncogene capable of compensatory PI3K signaling from both EGF receptor and ErbB2. Our findings therefore indicate that, although ErbB3-associated PI3K activity is critical for mammary development, it is dispensable for ErbB2-induced mammary tumor progression. Cancer Res; 72(12); 3080–90. ©2012 AACR.
The Dietary Fat—Breast Cancer Hypothesis: Is It Really Alive?
Authors: Don A. Evans
Journal: JAMA (1990)

<h3>To the Editor.—</h3> I found the proclamation by Schatzkin et al<sup>1</sup>that "The Dietary Fat—Breast Cancer Hypothesis is Alive" amusing. This idea has been tossed about for years, but little attention has been given to the presence of residual estrogen in the fat consumed. Cattle and hog breeders give beef and pork animals on the hoof high doses of diethylstilbestrol or other potent estrogens to increase the weight gain on the feed lot and thus increase marbling of select cuts. In their paragraph discussing biologic plausibility, several alternative mechanisms are proposed. Until the beef and pork fat sources are assayed for residual quantities of potent estrogens (given by hog and cattle breeders to improve the return on their feed), I will find it hard to regard these studies seriously. Perhaps Schatzkin and colleagues can direct me to the definitive study that allows them to set aside this rather
Vaccine: The Controversial Story of Medicine's Greatest Lifesaver
Authors: Arthur Allen, Michael Fitzpatrick
Journal: Journal of the Royal Society of Medicine (2007)

In his comprehensive survey of vaccination controversies past and present, Arthur Allen quotes US vaccine chief Walter Orenstein's recollection that ‘for those trained in pediatrics in the 1970s, Hib (Haemophilus influenzae type b) was a horror.’ It was indeed. I recall a mother whose infant died of Hib meningitis, secondary to an apparently trivial otitis media, within minutes of arriving in hospital. Already at an advanced stage of her second pregnancy, she promptly went into labour and had an uncomplicated delivery. The way her grief at the loss of one child overwhelmed her joy at the arrival of another is my enduring memory of the horror of Hib, which was still killing 60 children every year in Britain in the 1980s.

Thanks to the introduction of routine Hib immunization in 1992, this disease has now become a rarity. Yet, as Orenstein points out, when the immunization was introduced there was much uncertainty about its impact on the ecology of Haemophilus and the long term consequences. As he observes, some things are ‘only knowable in the long run;’ in the meantime, ‘we have to take our chances and then follow up.’ One of the themes of Allen's book is that this courageous and enterprising approach to vaccination policy—vindicated by its historic achievements in the conquest of disease—is now threatened by the contemporary climate of risk aversion.

Allen does not ignore the history of vaccine disasters. He includes the fiasco in the US military in 1942, when yellow fever vaccine contaminated with hepatitis B caused 100 deaths, and the mass vaccination against smallpox in New York in 1947 that caused six deaths (four more than the outbreak itself). In the Cutter incident in the 1950s, inadequately inactivated polio vaccine caused 164 cases of paralysis and 10 deaths. While acknowledging these failures, Allen pays tribute to immunization authorities—such as Henry Kempe and Bob Chen—who have campaigned to improve vaccine safety.

The great irony underlying current vaccination controversies is that, as vaccines have become more effective and safer than ever before, an anti-vaccine world view, reflecting a combination of nostalgia and cultural pessimism, has become more prevalent. Allen reports how one family with an autistic child described ‘going down the rabbit hole’ into a ‘spooky realm of herbalists and populist mavericks and—not to put too fine a point on it—conspiracy kooks, who view America as a toxic hell.’ Recognizing that parents' anger and inclination to blame vaccines reflect difficulties in coming to terms with their children's disabilities, Allen has himself bravely challenged anti-vaccine campaigners who have had such a damaging impact on the world of autism.

Allen concludes with Orenstein's prescient warning that a precautionary approach, reflecting corporate concerns about a low profit, high risk area of investment and government sensitivities to public anxieties, ‘could paralyze’ innovation in vaccines.
Advertising in the Secular Press.
Authors: J. F. Jenkins
Journal: JAMA (1898)

Tecumseh, Mich., March 10, 1898. <h3>To the Editor:</h3> —In these days of push, of progress, of smokeless gunpowder, of climbing to the pinnacle of fame by every available means, is it not right, yea, is it not the only certain method by which a young and ambitious medical graduate can lift himself bodily into the aerie of success, by advertising his wares in the secular press where he locates, and informing his patrons through the press of his undoubted ability after the following manner? Dr. Obediah Hayseed, assisted by Dr. Mossback and Dr. Falstaff of Rouge's Hollow, successfully removed a tumor from Mrs. George Gumbo. The patient is doing nicely. Is this not the proper method of becoming eminent with a single bound? Respectully yours,
Help and hope at the bottom of the pile
Authors: Henry McQuay
Journal: BMJ (2008)

The burden of chronic pain for those who have it and their families is substantial, says <b>Henry McQuay</b>, and these patients deserve better. <b>Dawn Stacey and colleagues</b> (doi: 10.1136/bmj.39520.701748.94) describe an example of quality improvement in practice for one group of people with chronic pain, those with osteoarthritis
Environmental and genetic risk factors and gene-environment interactions in the pathogenesis of chronic obstructive lung disease.
Authors: R Walter, D J Gottlieb, G T O'Connor
Journal: Environmental Health Perspectives (2000)

Current understanding of the pathogenesis of chronic obstructive pulmonary disease (COPD), a source of substantial morbidity and mortality in the United States, suggests that chronic inflammation leads to the airways obstruction and parenchymal destruction that characterize this condition. Environmental factors, especially tobacco smoke exposure, are known to accelerate longitudinal decline of lung function, and there is substantial evidence that upregulation of inflammatory pathways plays a vital role in this process. Genetic regulation of both inflammatory responses and anti-inflammatory protective mechanisms likely underlies the heritability of COPD observed in family studies. In alpha-1 protease inhibitor deficiency, the only genetic disorder known to cause COPD, lack of inhibition of elastase activity, results in the parenchymal destruction of emphysema. Other genetic polymorphisms have been hypothesized to alter the risk of COPD but have not been established as causes of this condition. It is likely that multiple genetic factors interacting with each other and with a number of environmental agents will be found to result in the development of COPD.
Sequencing of Endocrine Therapy in Postmenopausal Women with Advanced Breast Cancer
Authors: James N. Ingle
Journal: Clinical Cancer Research (2004)

The introduction of the nonsteroidal aromatase inhibitor (NS-AI) anastrozole as an alternative to tamoxifen for adjuvant therapy of women with resected hormone receptor-positive breast cancer has added a management category into which patients presenting with metastatic disease can be placed. There are now essentially three such categories: (a) tamoxifen sensitive (no prior AI); (b) tamoxifen resistant (no prior AI); and (c) NS-AI resistant (no prior tamoxifen). Well-conducted Phase III trials provide evidence for choosing first-line therapy for advanced disease in categories a and b. In tamoxifen-sensitive patients, one can choose either NS-AI, anastrozole, or letrozole. In tamoxifen-resistant patients, one can choose either of the NS-AIs, the steroidal AI exemestane, or the estrogen receptor down-regulator fulvestrant. The situation is quite different for patients in category c. There are no Phase III trials of agents in patients who have experienced disease progression on a NS-AI. Phase II data are available for exemestane and high-dose estrogens, and retrospective data are available for tamoxifen and fulvestrant. Additional clinical trials are needed to determine an optimal sequencing strategy.
Ketoconazole 2% shampoo in the treatment of tinea versicolor: A multicenter, randomized, double-blind, placebo-controlled trial
Authors: David S. Lange, Henry M. Richards, Joseph Guarnieri, John M. Humeniuk, Ronald C. Savin, Blas A. Reyes, Janet Hickman, David M. Pariser, Robert J. Pariser, Elizabeth F. Sherertz, Rachel M. Grossman, Elvira M. Gisoldi, Mark A. Klausner
Journal: Journal of the American Academy of Dermatology (1998)