tbuckley/cabot-search huggingface dataset:
SPECT Evaluation of Brain Perfusion Reserve by the Acetazolamide Test Using Tc-99m HMPAO
Authors: HIROSHI MATSUDA, SOTARO HIGASHI, KEIKO KINUYA, SHIRU TSUJI, JUNICHI NOZAKI, HISASHI SUMIYA, KINICHI HISADA, JUNKOH YAMASHITA
Journal: Clinical Nuclear Medicine (1991)

This report describes a new approach to the evaluation of brain perfusion reserve using Tc-99m HMPAO SPECT. Consecutive brain Tc-99m HMPAO SPECT studies before and after acetazolamide (Diamox) administration were performed within 30 minutes on 19 patients with significant vascular occlusive lesions. Thirteen patients showed decreased perfusion reserve and four patients maintained perfusion reserve in the affected vascular territories after Diamox administration, providing additional information to baseline Tc-99m HMPAO SPECT in 17 (89%) patients. Although flow augmentation post-Diamox was underestimated, possibly due to the nonproportionality of Tc-99m HMPAO activity to true blood flow, significant changes in the brain perfusion pattern were both visually and quantitatively determined using an image subtraction technique. This consecutive Tc-99m HMPAO SPECT technique seems to be of practical use for the evaluation of brain perfusion reserve and for the improvement of the sensitivity of detecting pathologic areas.
A Lecture on the Use of the Microphone in Sounding for Stone
Authors: H. Thompson
Journal: BMJ (1878)

Surgeon to the Hospital.GENTLEIMEN,--My object to-day is to show, as far as I can, hlow the microphone, a very recent invention of Professor Hughes, may be ap- plied to the operation of sounding for stone.But, in order to make myself perfectly clear to you, it will be necessary at the outset to define one single term, otherwise there is a chance of what I say being mis- understood.I mean the word "sound".This word, as we know, has a technical sense, and signifies the instrument lying before me, the sound; and
The Meaning of Criminal Insanity, by Herbert Fingarette, 271 pp, $10, University of California Press, 1972.
Authors: Seymour Pollack
Journal: JAMA (1972)

Recent years have seen increasing polarity between two positions in American psychiatry: one, emphasizing that psychiatry as a medical discipline should limit itself solely to medical ends, and the second, accepting as a social obligation the need for psychiatry to apply itself to legal objectives, specifically, the ends of criminal justice. The psychiatrist's involvement in the defense of criminal insanity stands as a beacon highlighting these two extreme positions; Herbert Fingarette, not a psychiatrist but a legal philosopher, has taken the second position. To Fingarette the essence of the social concept of responsibility is man's capacity for rational conduct, and he considers irrationality (substantial incapacity for rational conduct) due to mental illness to be the essence of criminal insanity for the purpose of exculpation from criminal responsibility. Irrationality, or loss of reason, signifies to Fingarette more than an intellectual defect; it is the loss of the very capacity for rational
Impaired Glucose Tolerance, Diabetes, and Cardiovascular Disease Risk Factor Profiles in the Elderly: The Honolulu Heart Program
Authors: Beatriz L Rodriguez, Jess David Curb, Cecil M Burchfiel, Boji Huang, Dan S Sharp, Guiqing Ye Lu, Wilfred Fujimoto, Katsuhiko Yano
Journal: Diabetes Care (1996)

OBJECTIVE The relationship between glucose tolerance status and other cardiovascular disease (CVD) risk factors was evaluated in a cohort of Japanese-American men (n = 3,741) ages 71–93 years who participated in the fourth examination of the Honolulu Heart Program in 1991–1993. RESEARCH DESIGN AND METHODS In this cross-sectional study, subjects were classified by reported diabetes and glucose tolerance status using questionnaires and the World Health Organization (WHO) criteria, respectively. RESULTS The prevalence of reported diabetes was 17%. Among the men who completed an oral glucose tolerance test and had no history of diabetes (n = 1,900), 23% were diagnosed as diabetic and 39% had impaired glucose tolerance (IGT) by WHO criteria. The CVD risk factor profiles of men with IGT and diabetes were significantly more adverse compared with men with normal glucose tolerance after adjustment for age. The rates of hypertension, mean levels of BMI, waist-to-hip ratio, triglycerides, and fasting insulin were higher in men with IGT and diabetes compared with normal subjects. Opposite trends were observed for HDL cholesterol. Two-hour insulin was significantly higher among men with IGT and previously undiagnosed diabetes. Men with known diabetes had a lower physical activity index and higher fibrinogen levels than normal subjects. No significant differences were observed for current smoking and alcohol intake. Differences in risk factor levels by glucose tolerance status remained after adjustment for age, physical activity, BMI, and waist-to-hip ratio. CONCLUSIONS These findings show that among elderly men of Japanese ancestry, impaired glucose tolerance and undiagnosed and known diabetes are highly prevalent, and these conditions are associated with adverse CVD factor profiles.
Prevention of Varicella by Zoster Immune Globulin
Authors: Philip A. Brunell, Avron Ross, Lawrence H. Miller, Betty Kuo
Journal: New England Journal of Medicine (1969)

Zoster immune globulin (ZIG) was found, in a double-blind study, to prevent varicella if a 2-ml dose was given to susceptible children within 72 hours of household exposure. Chicken pox developed in each of six households in the child who received human immune serum globulin, whereas no clinical manifestations appeared in his sibling who received ZIG. Moreover, none of the ZIG recipients had a rise in Varicella Zoster (V-Z) serum antibody after exposure, suggesting that infection had been prevented rather than modified. ZIG was prepared from plasma of patients convalescing from herpes zoster who had a V-Z complement-fixing antibody titer of 1:256 or higher. It may be useful in the prevention of varicella in children with cancer, children who are receiving steroid or antimetabolite therapy, newborn infants and susceptible adults.
Reply to Letter Regarding Article, “High-Sensitivity Troponin T Concentrations in Acute Chest Pain Patients Evaluated With Cardiac Computed Tomography”
Authors: James L. Januzzi, Quynh A. Truong, Asim A. Mohammed, Fabian Bamberg, John H. Nichols, Christopher L. Schlett, Udo Hoffmann, Hang Lee, John T. Nagurney, Mahir Karakas, Wolfgang Koenig
Journal: Circulation (2011)
The Care of Patients With Severe Chronic Pain in Terminal Illness
Authors: William T. McGivney
Journal: JAMA (1984)

The care of terminally ill patients with severe chronic pain should provide treatment that permits these patients to close their lives with dignity and purpose. Analgesics, both opioid and nonopioid, are available and when properly used can provide effective relief of pain for most terminally ill patients. It is incumbent on the physician and on all others who care for the dying patient with severe chronic pain to understand clearly the dynamics of the pain experience, the clinical pharmacology of analgesics, and the needs of the patient, family, and friends.This is a report of the discussions and recommendations of the "Conference on the Care of Patients With Severe Chronic Pain in Terminal Illness," sponsored by the American Medical Association and the Public Health Service, held on 28 January 1983 in Washington, D.C. Despite the availability of effective analgesic drugs, insufficient and improper medication has resulted in suffering and diminished quality of life for many terminally ill patients. This review describes the dynamics of pain, evaluates the pharmacologic activity of analgesics, and maintains that it is incumbent on physicians to understand these mechanisms as well as the needs of the patient and family in providing optimum terminal care.
Intermittent enteral feeding: the influence on respiratory and digestive tract colonization in mechanically ventilated intensive-care-unit patients.
Authors: M J Bonten, C A Gaillard, R van der Hulst, P W de Leeuw, S van der Geest, E E Stobberingh, P B Soeters
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

Continuous enteral feeding (CEF) has been associated with decreased gastric acidity, thereby stimulating gastric colonization and ventilator-associated pneumonia (VAP). Intermittent enteral feeding (IEF) could induce a temporary increase in gastric acidity and decrease the risk of VAP. We studied the influence of IEF (18 h/d) and CEF (24 h/d) on gastric and oropharyngeal colonization. Sixty patients were randomized to receive either IEF or CEF, and continuous intragastric pH monitoring was performed in 50 patients. Median intragastric pH levels were similar before enteral feeding was instituted (pH 2.5 for CEF and pH 2.4 for IEF), and median pH values increased slightly after institution of nutrition (NS). In patients receiving IEF, median pH decreased from 3.5 to 2.2 (p = 0.0002) when enteral feeding was discontinued. However, despite this, 80% of the patients in both study groups were colonized in the stomach after 7 d in study. In addition, colonization rates of the oropharynx and trachea, the incidence of VAP, and mortality were similar in both study groups. IEF was less well tolerated than CEF. We conclude that almost all patients receiving enteral feeding are colonized in the stomach with gram-negative bacteria. IEF resulted in a slight decrease in intragastric pH without influencing rates of colonization and infection of the respiratory tract.
Correction: Oncotic Pressure and Transudates
Authors: ROBERT S. ZOHLMAN
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 March 1973Correction: Oncotic Pressure and TransudatesROBERT S. ZOHLMAN, M.D.ROBERT S. ZOHLMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-78-3-461_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the October 1972 issue the article "Pleural Effusions: The Diagnostic Separation of Transudates and Exudates," by Light and colleagues (pp. 507-513), opens with a brief discussion of the cause of transudates and exudates. It states, "Increased plasma osmotic pressure or elevated systemic or pulmonary hydrostatic pressure are alterations that produce transudates."I am sure that they were misprinted and meant to say that decreased plasma osmotic pressure contributes to transudation. More precisely, it is a decrease in the plasma oncotic pressure that results in transudation. A change in osmotic pressure in the plasma will not cause... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Cardiovascular Research Institute School of Medicine University of California, San Francisco San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 March 1973Volume 78, Issue 3Page: 461-461KeywordsBlood plasmaOsmotic pressurePleural effusion ePublished: 1 December 2008 Issue Published: 1 March 1973 PDF downloadLoading ...
Non-accidental injury in children: two cases of concealment of self injury.
Authors: R Benians, P Goldacre
Journal: BMJ (1984)

Leptospirosis complicated by fatal intracerebral haemorrhageLeptospirosis is a potentially fatal bacterial disease that has tradi- tionally been associated with occupations such as mining and farming, in which the risk of contact with contaminated rodent urine is fairly high.'We describe a patient who contracted leptospirosis while on a walking holiday in the inner Hebrides.Despite early diagnosis and apparently successful initial treatment he died after a spontaneous intracerebral haemorrhage. Case reportA 39 year old man was transferred to Glasgow from Islay, an island in the inner Hebrides.He had collapsed while walking in the hills two days previously and had been admitted to the local hospital confused, dehydrated, and shocked.He was rehydrated and, on arrival in Glasgow, seemed well./~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~C oronal section of brain at level of the pulvinar of the thalamus, with unconnected haematomas in the midline of the corpus callosum and the white matter of the right parietal lobe.He began to vomit overnight and became jaundiced.Deepening jaundice was accompanied by diarrhoea, profuse vomiting, hiccups, calf muscle pains, iridocyclitis, and subconjunctival haemorrhages.Haemoglobin concentration, differential white cell count, erythrocyte sedimentation rate, coagulation screen, and fibrin degradation products were all normal.The platelet count was reduced to 69 x 109/1 but rose to 200 X 109/l one week after admission.Routine biochemical tests on the day after admission gave the following: urea 36 mmol/l (216 mg/100 ml), creatinine 643 jtmol/l (7 3 mg/100 ml), bilirubin 196 Jumol/l (11-5 mg/100 ml), digestive tract of mice during systemic antibiotic treatment.
Transient Sunitinib Resistance in Gastrointestinal Stromal Tumors
Authors: Raffaella Bracci, Elena Maccaroni, Stefano Cascinu
Journal: New England Journal of Medicine (2013)

Two patients are described in whom response to sunitinib as second-line therapy was followed by disease progression. After they received other treatments that did not work, reexposure to sunitinib led to partial responses in both patients.
Effect of Potassium on the Resting Length of Vascular Smooth Muscle of the Rabbit Aorta and its Response to I-Norepinephrine
Authors: JOHN A. BEVAN, J. V. OSHER
Journal: Circulation Research (1963)

Change in resting length, response to l -nor-epinephrine and tissue concentration of potassium of helical rabbit aorta strips have been investigated, following changes in concentration of extracellular potassium. Increase in potassium decreases resting length, increases sensitivity and slope of log dose - probit response curve: potassium decrease has opposite effects. Alterations in external potassium concentration have no effect on the maximum response to l -norepinephrine. A potassium range between 50% and 300% of normal was investigated. Results show that when the muscle shortened, following an increase in potassium in the presence of l -norepinephrine, the change in resting length due to a direct action of this ion was more important than changes in sensitivity to l -norepinephrine. It is suggested that sensitivity of muscle to l -norepinephrine may be related to the intra-cellular concentration of potassium.
Prognosis of patients discharged from a coronary care unit.
Authors: H C Smyllie
Journal: BMJ (1986)

Etude retrospective, sur 10 ans, de la survie de malades sortant d'unites de soins coronariens, avec ou sans infarctus aigu du myocarde (298). Peu de differences de mortalite pendant la 1ere annee; ensuite la mortalite «coronarienne» est moindre dans le groupe sans infarctus aigu, mais dans ce groupe la difference n'est pas significative entre les sous-groupes avec et sans ischemie
Giant appendiceal mucocele mimicking gastrointestinal stromal tumor of the cecum
Authors: T. Akaraviputh, A. Trakarnsanga, S. Pongprasobchai, W. Boonnuch
Journal: Endoscopy (2009)

A 54-year-old man presented with chronic abdominal pain and chronic diarrhea. He underwent a routine endoscopic examination. Colonoscopy demonstrated a huge submucosal tumor measuring 4.2 × 4.0 × 5.0 cm at the cecum ([Fig. 1]). Endoscopic ultrasonography (EUS) using a miniprobe revealed a 4-cm well-circumscribed, hypoechoic, homogeneous lesion arising from the fourth sonographic layer ([Fig. 2]), and the lesion was diagnosed as a large gastrointestinal stromal tumor (GIST) of the cecum. CT scan of the lower abdomen showed a cystic lesion compressing the cecum ([Fig. 3]). The patient underwent an exploratory laparotomy and the intraoperative finding was of a giant appendiceal mass ([Fig. 4]). Right hemicolectomy was performed and the pathological analysis confirmed a mucinous tumor of borderline malignancy with free surgical margins. The patient recovered well without any postoperative complications.
Further Experiences with Injured Bile Ducts
Authors: Frank H. Lahey
Journal: New England Journal of Medicine (1949)

EARLY in my surgical experience I became interested in the problem of injuries to the bile ducts and in 1923 wrote my first paper1 , 2 on this subject, dealing with the results obtained by transplanting completely external fistulas when common and hepatic ducts had been so injured and severed that all or practically all the bile was discharged externally. This operation was first proposed and employed on a patient by Dr. Hugh Williams at the Massachusetts General Hospital (Fig. 1).Since that time we in the clinic have had a continuing interest in the problem of the management of the patients . . .
Adenoviral vectors persist in vivo and maintain activated CD8+ T cells: implications for their use as vaccines
Authors: Nia Tatsis, Julie C. Fitzgerald, Arturo Reyes-Sandoval, Kimberly C. Harris-McCoy, Scott E. Hensley, Dongming Zhou, Shih-Wen Lin, Ang Bian, Zhi Quan Xiang, Amaya Iparraguirre, Cesar Lopez-Camacho, E. John Wherry, Hildegund C. J. Ertl
Journal: Blood (2007)
Abstract 645: DNA methylation marker discovery for the prediction of nodal metastases in head and neck cancer.
Authors: Martijn Clausen, Lieuwe J. Melchers, Leonie Bruine de Bruin, Mirjam F. Mastik, Lorian Slagter-Menkema, Harry J. Groen, Bert van der Vegt, Bernard F. Van der Laan, Tim De Meyer, Wim Van Criekinge, G Bea Wisman, Jan L. Roodenburg, Ed Schuuring
Journal: Cancer Research (2013)

Abstract Annually 650,000 new patients are diagnosed with Head and Neck cancer, making it the sixth most common cancer worldwide. The 5-year survival is only 60% due to inaccurate detection of nodal metastases in the cervical or submandibular region (N-status). Our goal is to find new DNA methylation markers in the primary tumor that predict nodal metastases to improve diagnostics and treatment. For biomarker discovery we used a new approach combining global methylation assessment, next generation sequencing, quantitative methylation and microarray expression profiling. Here we report the success of this new approach and the further validation of novel biomarkers. We performed MethylCap-Seq on DNA from 6 oral squamous cell carcinomas (OSCC) with nodal metastases (N+) and 6 OSCC without nodal metastases (N0) to measure global methylation levels. After comparison of the sequenced reads a list was composed of the 5000 most differentially methylated genes between the two groups. The most significantly differentially methylated genes were validated using Quantitative Methylation Specific PCR (QMSP) and Pyrosequencing on a independent series of 20 N+ and 20 N0 OSCC. In addition, the MethylCap-Seq methylation data was combined with microarray expression data of 696 genes for a N-status validation cohort containing 222 OSCC (Hoof et al.; J Clin Oncol. 2012 Oct 8). Based upon the assumption that hypermethylation is associated with downregulation of gene expression, we selected hypermethylated and downregulated genes distinguishing between the two groups. The effect of DNA methylation on gene expression will be measured by (Q)RT-PCR and immunohistochemistry on a N-status validation panel. The most promising methylation markers will be further validated by Pyrosequencing and QMSP on DNA of a N-status validation cohort containing 463 cases for which complete clinicopathological and follow-up data are available. These markers might contribute to better diagnosis, improved quality of life and may be associated with increased survival. This research was supported by the Center for Translational Molecular Medicine (project AIRFORCE). Citation Format: Martijn Clausen, Lieuwe J. Melchers, Leonie Bruine de Bruin, Mirjam F. Mastik, Lorian Slagter-Menkema, Harry J. Groen, Bert van der Vegt, Bernard F. Van der Laan, Tim De Meyer, Wim Van Criekinge, G Bea Wisman, Jan L. Roodenburg, Ed Schuuring. DNA methylation marker discovery for the prediction of nodal metastases in head and neck cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 645. doi:10.1158/1538-7445.AM2013-645
MAPK activation and apoptotic alterations in hearts subjected to calcium paradox are attenuated by taurine
Authors: Y XU, H SAINI, M ZHANG, V ELIMBAN, N DHALLA
Journal: Cardiovascular Research (2006)

The Ca2+ -paradox is an important phenomenon to study cell injury induced by Ca2+ -overload in myocardium. Although intracellular Ca2+ -overload acts as a trigger and modulator of cell death due to apoptosis under various pathophysiological conditions, the presence of apoptosis in hearts subjected to Ca2+ -paradox has not been demonstrated. Since taurine attenuates the changes in cardiac function due to Ca2+ -paradox, this study investigated the occurrence and mechanisms of apoptosis in Ca2+ -paradoxic hearts treated in the absence and presence of taurine.Ca2+ -paradox was induced by perfusing the isolated rat heart with Ca2+ -free medium for 5 min followed by reperfusion with Ca2+ -containing medium for 30 min. Apoptosis related signal transduction mechanisms were determined in Ca2+ -paradoxic hearts perfused with or without 10 mM taurine.Marked alterations in cardiac function and the presence of apoptosis were seen in Ca2+ -paradoxic hearts reperfused for 30 min. Unlike the total protein contents in hearts subjected to Ca2+ -paradox, the contents of phosphorylated p38 mitogen-activated protein kinase (MAPK), extracellular signal regulated kinase (ERK)1, ERK2 and c-jun amino-terminal kinase were increased by 125 +/- 8.6%, 296 +/- 14.3%, 213 +/- 8.5% and 133 +/- 4.2%, respectively vs. control. Caspase-3 and phosphorylated Bcl-2 contents were also increased by 193 +/- 10.2% and 134 +/- 5.0% vs. control whereas phosphorylated Bad and the ratio of Bcl-2/Bad were depressed by 32 +/- 10.8% and 0.23 +/- 0.5% vs. control in Ca2+ -paradoxic hearts. The apoptosis as seen in Ca2+ -paradoxic hearts reperfused for 30 min was not evident in hearts at 10 min Ca2+ -repletion but was similar to hearts subjected to 60 min Ca2+ -repletion. These changes in the apoptotic pathway in cardiomyocytes subjected to Ca2+ -paradox were prevented by taurine. Furthermore, taurine attenuated the KCl- or ATP-induced increase in intracellular concentration of Ca2+ in cardiomyocytes.This study suggests that cardiac dysfunction due to Ca2+ -paradox may be associated with apoptosis. In addition, the beneficial effects of taurine on cardiac function may be related to the attenuation of changes in MAPK and apoptotic signal transduction mechanisms in Ca2+ -paradoxic hearts.
Portal Hypertension in a Case of Acute Leukemia Treated with Antimetabolites for Ten Years
Authors: Andre D. Lascari, Robert L. Givler, Robert T. Soper, Lee Forest Hill
Journal: New England Journal of Medicine (1968)

HEPATIC toxicity due to antimetabolite therapy is a well known complication in the treatment of leukemia. To our knowledge, hepatic damage resulting in portal hypertension and hypersplenism has not been reported as a complication of such therapy.The case reported below describes portal hypertension with bleeding esophageal varices and hypersplenism in a child with a long-term survival with acute lymphocytic leukemia. The patient has been on continuous chemotherapy for the past 10 years, and at the time of this report the disease is still in remission.Case ReportA 6 1/2-year-old girl, previously well, was admitted to the hospital because . . .