tbuckley/cabot-search huggingface dataset:
Consequences of reocclusion after successful reperfusion therapy in acute myocardial infarction. TAMI Study Group.
Authors: E M Ohman, R M Califf, E J Topol, R Candela, C Abbottsmith, S Ellis, K N Sigmon, D Kereiakes, B George, R Stack
Journal: Circulation (1990)

To determine the clinical consequences of reocclusion of an infarct-related artery after reperfusion therapy, we evaluated 810 patients with acute myocardial infarction. Patients were admitted into four sequential studies with similar entry criteria in which patency of the infarct-related artery was assessed by coronary arteriography 90 minutes after onset of thrombolytic therapy. Successful reperfusion was established acutely in 733 patients. Thrombolytic therapy included tissue-type plasminogen activator (t-PA) in 517, urokinase in 87, and a combination of t-PA and urokinase in 129 patients. All patients received aspirin, intravenous heparin and nitroglycerin, and diltiazem during the recovery phase. A repeat coronary arteriogram was performed in 88% of patients at a median of 7 days after the onset of symptoms. Reocclusion of the infarct-related artery occurred in 91 patients (12.4%), and 58% of these were symptomatic. Angiographic characteristics at 90 minutes after thrombolytic therapy that were associated with reocclusion compared with sustained coronary artery patency were right coronary infarct-related artery (65% versus 44%, respectively) and Thrombolysis in Myocardial Infarction (TIMI) flow 0 or 1 (21% versus 10%, respectively) before further intervention. Median (interquartile value) degree of stenosis in the infarct-related artery at 90 minutes was similar between groups: 99% for reoccluded (value, 90/100%) compared with 95% for patent (value, 80/99%). Patients with reocclusion had similar left ventricular ejection fractions compared with patients with sustained patency at follow-up. However, patients with reocclusion at follow-up had worse infarct-zone function at -2.7 (value, -3.2/-1.8) versus -2.4 (SD/chord) (value, -3.1/-1.3) (p = 0.016). The recovery of both global and infarct-zone function was impaired by reocclusion of the infarct-related artery compared with maintained patency; median delta ejection fraction was -2 compared with 1 (p = 0.006) and median delta infarct-zone wall motion was -0.10 compared with 0.34 SD/chord (p = 0.011), respectively. In addition, patients with reocclusion had more complicated hospital courses and higher in-hospital mortality rates (11.0% versus 4.5%, respectively; p = 0.01). We conclude that reocclusion of the infarct-related artery after successful reperfusion is associated with substantial morbidity and mortality rates. Reocclusion is also detrimental to the functional recovery of both global and infarct-zone regional left ventricular function. Thus, new strategies in the postinfarction period need to be developed to prevent reocclusion of the infarct-related artery.
An Incidentally Detected Solitary Fibrous Tumor on 99mTc-Sestamibi Myocardial Perfusion Imaging
Authors: Qian Hua, Jianming Ni
Journal: Clinical Nuclear Medicine (2015)

A 55-year-old woman with a mild transient chest pain but normal laboratory examination results underwent 99mTc-sestamibi myocardial perfusion imaging. An abnormal nodular radioactive uptake, which appeared protruding from the anterior segments, was detected. This activity was later proved to be benign solitary fibrous tumor of pleura after histopathological examination after the surgical exploration.
Cases of Alleged Displacement of the Uterus: With Remarks
Authors: C. J. Gibb
Journal: BMJ (1871)

You see that in both instances we had to combat disorder of long standing under many unfavourable circumstances, and that success was obtained in each, not by excogitating some new and peculiar remedy, some antidoloric oil or drops, but by the steady pursuance of a rational method, involving simply the use of old well approved remedies.In both cases, improvement came very slowly; some weeks
The right to refuse necessary treatment
Authors: A. R. Holder
Journal: JAMA (1972)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Exercise Radionuclide Ventriculographic Responses in Hypertensive Patients with Chest Pain
Authors: Alan G. Wasserman, Richard J. Katz, P. Jacob Varghese, Roy H. Leiboff, George G. Bren, Sarah Schlesselman, Vijay M. Varma, Richard C. Reba, Allan M. Ross
Journal: New England Journal of Medicine (1984)

The effectiveness of exercise-treadmill testing in diagnosing coronary-artery disease in hypertensive patients is limited by a high rate of false positivity. Exercise radionuclide ventriculography, however, relies on different criteria (ejection fraction and wall motion), and we have evaluated this procedure in 37 hypertensive and 109 normotensive patients with chest pain, using coronary arteriography as an indicator of coronary disease. In the hypertensive cohort there was no difference in the ejection fraction at rest between the 17 patients with coronary disease and the 20 without it. Neither group had a significant mean (+/- S.E.M.) change in ejection fraction from rest to exercise (-1.9 +/- 2 and - 1.4 +/- 1 per cent, respectively). A wall-motion abnormality developed during exercise in 5 of the 17 hypertensive patients with coronary disease (29 per cent) and in 4 of the 20 without it (20 per cent) (P = not significant). In the normotensive cohort, however, the peak-exercise ejection fractions were significantly different. The 71 patients with coronary disease had a mean decrease of 3.6 +/- 1 per cent, in contrast to the patients without coronary disease, who had an increase of 6 +/- 1 per cent (P less than 0.001). An exercise-induced wall-motion abnormality was seen in 35 of the 71 patients with coronary disease (48 per cent), as compared with 3 of the 38 without it, (8 per cent) (P less than 0.001). We conclude that exercise radionuclide ventriculography is inadequate as a screening test for coronary atherosclerosis in hypertensive patients with chest pain.
Stumbling on the shoulders of giants
Authors: W. Muirhead
Journal: BMJ (2010)

“Could you talk me through what you’re doing as you go?” 

“So, I’m inspecting for any loss of the nail bed angle and looking for splinter haemorrhages. Now I’m pressing on the nail bed to measure the capillary refill time and checking for Quincke’s sign. (Could you turn your hands over, please?) I’m looking for any Janeway lesions that might be present, palpating for Osler’s nodes, feeling for any tendon xanthoma.

“Now I’m checking the rate, rhythm, and character of the pulse. (Do you have any pain in your shoulder?) And checking for Watson’s water-hammer pulse. I’m comparing both wrists for any radio-radial delay and (Is it ok if I check a pulse in your groin?) any radio-femoral delay. Normally at this point I would measure the blood pressure. Now I’m inspecting the eyes more closely, looking for xanthelasma, corneal arcus, and (Could you pull your eyelid down for me? Like this?) any conjunctival pallor. (Could you say “aargh,” please?) I’m looking inside …
Pituitary gonadotropin-releasing hormone receptors. Effects of castration, steroid replacement, and the role of gonadotropin-releasing hormone in modulating receptors in the rat.
Authors: M S Frager, D R Pieper, S A Tonetta, J A Duncan, J C Marshall
Journal: Journal of Clinical Investigation (1981)

To study the role of gonadotropin-releasing hormone (GnRH) receptors in the regulation of gonadotropin secretion, we used D-125I-alanine6 des glycyl10 GnRH ethylamide (D-125I-Ala analog), a nondegradable, superagonist GnRH analog to assess GnRH receptors on rat pituitary membranes. Receptor affinity in intact adult rats was 5.0 X 10(9) M-1 and was unchanged after castration in both sexes. Castration of adult male and female rats produced a twofold increase in GnRH binding capacity by 7 d and binding capacity remained elevated for the subsequent 14 d. GnRH receptor number rose more rapidly after castration in males than females, and the time-course of receptor rise was similar to the increase in serum gonadotropin levels. The increase in GnRH binding capacity was prevented by gonadal steroid replacement at the time of castration in both sexes. Injections of the GnRH analog, D-Ser6 (TBu) des Gly10 GnRH ethylamide for 4 d produced a 70% increase in GnRH receptor number in intact male rats and testosterone-replaced castrates. The same regimen, however, failed to increase the elevated receptor numbers present after castration. Administration of rabbit anti-GnRH serum concomitant with castration inhibited the rise in both GnRH receptor number and luteinizing hormone. The changes in pituitary GnRH receptors parallel previously demonstrated changes in hypothalamic secretion of GnRH. Thus, GnRH probably regulates its own receptor in vivo and gonadal steroids may influence pituitary GnRH receptors by changing hypothalamic GnRH secretion.
NIH and the Bodies Politic
Authors: Bernadine Healy
Journal: New England Journal of Medicine (1994)

In 1940, President Franklin Roosevelt, a polio victim who understood well the suffering and devastation caused by chronic illness, made what was then a long drive out to Bethesda, Maryland, to dedicate the campus of the new National Institutes of Health (NIH). When he made this trek, our nation was just recovering from the worst economic depression in its history and was fighting to stay out of World War II. Nevertheless, Roosevelt's mind was on the peacetime to come, on this nation's posterity, and as he stood on the NIH campus he told his audience, “We cannot be a strong . . .
Nonuniformity Artifact Mimicking Extracardiac Uptake on Rubidium-82 Myocardial Perfusion Image
Authors: Sameer Kale, Raghuveer Halkar, James Galt
Journal: Clinical Nuclear Medicine (2007)

Rest and stress rubidium-82 myocardial perfusion imaging is used effectively for assessment of coronary artery disease. Extracardiac uptake of Rb-82 can be seen in the gut, tumors, and vascular structures. However, artifacts caused by improper attenuation or nonuniformity may mimic extracardiac uptake. Here, extracardiac uptake noted in the anterobasal aspect of the heart in oblique slices was due to a nonuniformity artifact caused by failure of a photomultiplier tube as demonstrated in the fused transmission and emission image. It is necessary to check for artifacts when abnormal uptake is seen. Imaging after replacing the photomultiplier tube showed no artifact.
TCT-404 Regular Drug Eluting Stent versus Dedicated Bifurcation Paclitaxel-Eluting Stent in Coronary Bifurcation Treatment - 9-month Analysis of POLBOS Study
Authors: Robert J. Gil, Dobrin Vassilev, Jacek Bil, Adam Kern, Radoslaw Formuszewicz, Slawomir Dobrzycki
Journal: Journal of the American College of Cardiology (2013)
Abstract A33: Modeling clinical resistance to RAF inhibitors in an in vivo melanoma model provides insights into prevention of resistance
Authors: Meghna Das Thakur, Fernando Salangsang, Nancy Pryer, Martin McMahon, Darrin Stuart
Journal: Clinical Cancer Research (2012)

Abstract Small-molecule RAF inhibitors such as vemurafenib have demonstrated proof-of-concept that BRAFV600E is a key driver of proliferation and survival in melanoma, as evidenced by tumor regression and prolonged survival in patients in late stage clinical trials. Unfortunately, in many patients the tumor response can be short lived as resistance to the inhibitor rapidly develops. Understanding the mechanisms that underlie drug resistance will be critical to providing improved treatment options for these patients. Here we model the emergence of resistance to vemurafenib in an early passage primary human melanoma xenograft model, which recapitulates a more physiologically relevant microenvironment, genetic diversity, and selective pressure compared to in vitro models. The selection of resistance in vivo also provides the opportunity to model drug pharmacokinetics which better replicates the selective pressure observed in patients. Long-term continuous treatment of the homozygous BRAFV600E primary melanoma xenografts with RAF inhibitors resulted in the appearance of resistant tumors over the course of 4 to 6 weeks. Pharmacodynamic (PD) analysis of individual tumors indicated that the MAPK pathway is suppressed by the compounds in resistant tumors, although the degree and duration of suppression is less than in sensitive tumors. Furthermore, there is heterogeneity in the kinetics of pathway inhibition and recovery between tumors. Biochemical analyses indicate that BRAFV600E protein levels are upregulated across all resistant tumors and in some cases there is DNA amplification of the mutant BRAF. Taken together with the PD data, this suggests there is a great deal of tumor cell heterogeneity, and that tumors are able to rapidly adapt to the selective pressure being applied. Both in vivo drug withdrawal studies as well as in vitro analyses of tumor derived cell lines indicate that the resistant cells have become dependent on the presence of the inhibitor for their survival. Based on these observations it appears that resistant tumor cells are less fit than sensitive tumor cells in the absence of drug and therefore we tested an intermittent dosing regimen. Intermittent dosing (4 weeks on / 2 weeks off) of RAF inhibitors prevented the evolution of resistance for the duration of the study (4 months). These data could have significant implications in optimizing dose schedules to prevent the emergence of clinical resistance.
Alopecia areata: the need for guidelines and evidence-based dermatology
Authors: M.J. Sladden, S.P. MacDonald Hull, M.L. Wood, P.E. Hutchinson, A.G. Messenger
Journal: British Journal of Dermatology (2005)

Journal Article Alopecia areata: the need for guidelines and evidence‐based dermatology Get access M.J. Sladden, M.J. Sladden Department of Dermatology, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, U.K Search for other works by this author on: Oxford Academic Google Scholar S.P. MacDonald Hull, S.P. MacDonald Hull Department of Dermatology, Pontefract General Infirmary, Friarwood Lane, Pontefract WF8 1PL, U.K Search for other works by this author on: Oxford Academic Google Scholar M.L. Wood, M.L. Wood Department of Dermatology, Rotherham District General Hospital, Moorgate Road, Rotherham S60 2UD, U.K Search for other works by this author on: Oxford Academic Google Scholar P.E. Hutchinson, P.E. Hutchinson Department of Dermatology, Leicester Royal Infirmary, Infirmary Square, Leicester LE1 5WW, U.K Search for other works by this author on: Oxford Academic Google Scholar A.G. Messenger A.G. Messenger Department of Dermatology, Royal Hallamshire Hospital, Glossop Road, Sheffield S10 2JF, U.K. E‐mail: m.sladden@doctors.org.uk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 152, Issue 5, 1 May 2005, Pages 1086–1087, https://doi.org/10.1111/j.1365-2133.2005.06578.x Published: 01 May 2005
The Absorbency of Tampons
Authors: Esther R. Rome
Journal: JAMA (1988)

To the Editor.  —As members of the American Society of Testing and Materials Tampon Task Force, we would like to add some comments to the  EDITORIAL by Dr Wolfe entitled Dangerous Delays in Tampon Absorbency Warnings. 1 The Syngyna test that is used as the basis for the absorbency ratings exists in several versions, not one, as his article implies.  The standardization of this test was a point of contention between the manufacturers and the consumers on the task force because there is, was, and still are questions about the statistical validity of the analysis of test data presented to the task force. Since the demise of the task force in 1985, the manufacturers have agreed on an industry standard for the Syngyna test that is similar to the test proposed by the American Society of Testing and Materials and that continues to have the same flaws.  The values obtained
Clinical features and outcomes of gastric variceal bleeding: retrospective Korean multicenter data
Authors: Moon Young Kim, Soon Ho Um, Soon Koo Baik, Yeon Seok Seo, Soo Young Park, Jung Il Lee, Jin Woo Lee, Gab Jin Cheon, Joo Hyun Sohn, Tae Yeob Kim, Young Suk Lim, Tae Hyo Kim, Tae Hee Lee, Sung Jae Park, Seung Ha Park, Jin Dong Kim, Sang Young Han, Chang Soo Choi, Eun Young Cho, Dong Joon Kim, Jae Seok Hwang, Byoung Kuk Jang, June Sung Lee, Sang Gyune Kim, Young Seok Kim, So Young Kwon, Won Hyeok Choe, Chang Hyeong Lee, Byung Seok Kim, Jae Young Jang, Soung Won Jeong, Byung Ho Kim, Jae Jun Shim, Yong Kyun Cho, Moon Soo Koh, Hyun Woong Lee
Journal: Clinical and Molecular Hepatology (2013)

While gastric variceal bleeding (GVB) is not as prevalent as esophageal variceal bleeding, it is reportedly more serious, with high failure rates of the initial hemostasis (>30%), and has a worse prognosis than esophageal variceal bleeding. However, there is limited information regarding hemostasis and the prognosis for GVB. The aim of this study was to determine retrospectively the clinical outcomes of GVB in a multicenter study in Korea.The data of 1,308 episodes of GVB (males:females=1062:246, age=55.0±11.0 years, mean±SD) were collected from 24 referral hospital centers in South Korea between March 2003 and December 2008. The rates of initial hemostasis failure, rebleeding, and mortality within 5 days and 6 weeks of the index bleed were evaluated.The initial hemostasis failed in 6.1% of the patients, and this was associated with the Child-Pugh score [odds ratio (OR)=1.619; P<0.001] and the treatment modality: endoscopic variceal ligation, endoscopic variceal obturation, and balloon-occluded retrograde transvenous obliteration vs. endoscopic sclerotherapy, transjugular intrahepatic portosystemic shunt, and balloon tamponade (OR=0.221, P<0.001). Rebleeding developed in 11.5% of the patients, and was significantly associated with Child-Pugh score (OR=1.159, P<0.001) and treatment modality (OR=0.619, P=0.026). The GVB-associated mortality was 10.3%; mortality in these cases was associated with Child-Pugh score (OR=1.795, P<0.001) and the treatment modality for the initial hemostasis (OR=0.467, P=0.001).The clinical outcome for GVB was better for the present cohort than in previous reports. Initial hemostasis failure, rebleeding, and mortality due to GVB were universally associated with the severity of liver cirrhosis.
Safety and Efficacy of the Specific Endothelin-A Receptor Antagonist ZD4054 in Patients with Hormone-Resistant Prostate Cancer and Bone Metastases Who Were Pain Free or Mildly Symptomatic: A Double-Blind, Placebo-Controlled, Randomised, Phase 2 Trial
Authors: Nicholas D. James, Armelle Caty, Michael Borre, Bernard A. Zonnenberg, Philippe Beuzeboc, Thomas Morris, De Phung, Nancy A. Dawson
Journal: European Urology (2008)
Enhanced stimulus-secretion coupling in polyamine-depleted rat insulinoma cells. An effect involving increased cytoplasmic Ca2+, inositol phosphate generation, and phorbol ester sensitivity.
Authors: A Sjöholm, P Arkhammar, N Welsh, K Bokvist, P Rorsman, A Hallberg, T Nilsson, M Welsh, P O Berggren
Journal: Journal of Clinical Investigation (1993)

To extend previous observations on the role of polyamines in insulin production, metabolism, and replication of insulin-secreting pancreatic beta cells, we have studied the role of polyamines in the regulation of the stimulus-secretion coupling of clonal rat insulinoma cells (RINm5F). For this purpose, RINm5F cells were partially depleted in their polyamine contents by use of the specific ornithine decarboxylase inhibitor difluoromethylornithine (DFMO), which led to an increase in cellular insulin and ATP contents. Analysis of different parts of the signal transduction pathway revealed that insulin secretion and the increase in cytoplasmic free Ca2+ concentration ([Ca2+]i) after K(+)-induced depolarization were markedly enhanced in DFMO-treated cells. These effects were paralleled by increased voltage-activated Ca2+ currents, as judged by whole-cell patch-clamp analysis, probably reflecting increased channel activity rather than elevated number of channels per cell. DFMO treatment also rendered phospholipase C in these cells more sensitive to the muscarinic receptor agonist carbamylcholine, as evidenced by enhanced generation of inositol phosphates, increase in [Ca2+]i and insulin secretion, despite an unaltered ligand binding to muscarinic receptors and lack of effect on protein kinase C activity. In addition, the tumor promoter 12-O-tetradecanoylphorbol 13-acetate, at concentrations suggested to be specific for protein kinase C activation, evoked an increased insulin output in polyamine-deprived cells compared to control cells. The stimulatory effects of glucose or the cyclic AMP raising agent theophylline on insulin release were not increased by DFMO treatment. In spite of increased binding of sulfonylurea in DFMO-treated cells, there was no secretory response or altered increase in [Ca2+]i in response to the drug in these cells. It is concluded that partial polyamine depletion sensitizes the stimulus-secretion coupling at multiple levels in the insulinoma cells, including increased voltage-dependent Ca2+ influx and enhanced responsiveness to activators of phospholipase C and protein kinase C. In their entirety, our present results indicate that the behavior of the stimulus-secretion coupling of polyamine-depleted RINm5F insulinoma cells changes towards that of native beta cells, thus improving the usefulness of this cell line for studies of beta cell insulin secretion.
Fibroblast Growth Factor Homologous Factors Control Neuronal Excitability through Modulation of Voltage-Gated Sodium Channels
Authors: Mitchell Goldfarb, Jon Schoorlemmer, Anthony Williams, Shyam Diwakar, Qing Wang, Xiao Huang, Joanna Giza, Dafna Tchetchik, Kevin Kelley, Ana Vega, Gary Matthews, Paola Rossi, David M. Ornitz, Egidio D'Angelo
Journal: Neuron (2007)
James Noel McGalliard
Authors: David Wong
Journal: BMJ (2004)

Consultant ophthalmologist St Paul's Eye Unit, Royal Liverpool and Broadgreen University Hospital Trust (b 1956; q Queen's University, Belfast, 1981; DipOphth, FRCSI, FRCS Ed, FRCOphth), died from a heart attack on 19 December 2003.​2003.




Figure 1




James McGalliard decided to specialise in ophthalmology soon after qualifying. He performed his higher surgical training and specialised in vitreoretinal surgery at St Paul's Eye Unit in Liverpool, where in 1991 he was appointed consultant ophthalmologist. He served as clinical director at St Paul's for several years. He leaves a wife and three children.