tbuckley/cabot-search huggingface dataset:
Audit of amniocentesis from a district general hospital: is it worth it?
Authors: J J Wiener, A Farrow, S C Farrow
Journal: BMJ (1990)

OBJECTIVE--To audit all mid-trimester amniocenteses performed by obstetricians at a district general hospital to see whether experience improved the outcome. DESIGN--Retrospective review of medical records. SETTING--Royal Gwent Hospital, south Wales. SUBJECTS--All 469 amniocenteses carried out in 1985-7. OUTCOME MEASURES--Number of attempts at withdrawal of amniotic fluid; number with bloodstained liquor; and number of subsequent miscarriages, terminations, and congenital abnormalities. RESULTS--Of the 469 amniocenteses, 411 were performed by one obstetrician, and initial comparisons with those performed by the rest of the hospital team showed no significant differences in outcome of pregnancy. The main difference between the two groups was in the number of attempts at withdrawal of amniotic fluid and the number with bloodstained liquor. The single obstetrician failed to obtain amniotic fluid on 1% of occasions compared with 10% for the other operators by the end of the second attempt. The costs of carrying out the audit were considerable. The review of fewer than 500 case records cost the equivalent of 2000 pounds in staff time and took over 200 hours to complete, equivalent to 63 sessions of one person9s time. CONCLUSIONS--The audit was useful in that it provided information on complication rates, which could be compared with published data, and comparisons between obstetricians who perform large and small numbers of procedures. IMPLICATIONS--For an individual9s practice the monitoring of amniocentesis should not be continuously carried out and subsequent audits should tackle other common procedures. When an audit is attempted the health service should provide adequate support to clinicians for this purpose.
The Minnesota Rural Physician Redistribution Plan, 1971 to 1976
Authors: John E. Verby
Journal: JAMA (1977)

The Rural Physician Associate Program was developed by the University of Minnesota Medical School faculty in an attempt to meet the demands of the citizens of Minnesota to improve the distribution of primary physicians to rural areas. The program is offered to students who have completed 2 2/3 academic years of medical school. There were no regulations requiring the students' return to rural areas after completion of training. Thus far, 163 students have completed the program. Forty-three have continued in medical school and another 27 are in residency-training programs. Primary care residencies have been chosen by 68; another 31 have completed their medical education and are in rural practice. Of the 22 practicing in Minnesota, 21 have returned to rural communities.
Effect of Biphasic Shock Duration on Defibrillation Threshold With Different Electrode Configurations and Phase 2 Capacitances
Authors: Patrick N. Schauerte, Kathrin Ziegert, Matthias Waldmann, Friedrich A. Schöndube, Frank Birkenhauer, Karl Mischke, Marius Grossmann, Peter Hanrath, Christoph Stellbrink
Journal: Circulation (1999)

Background —The defibrillation threshold (DFT) may be affected by biphasic shock duration (BSD), electrode configuration, and capacitance. The upper limit of vulnerability (ULV) may be used to estimate the DFT. For different lead configurations and phase 2 capacitances, we investigated in 18 pigs whether the use of ULV may predict waveforms with lowest DFT. Methods and Results —DFT and ULV were determined by up-down protocols for 10 BSDs. ULVs were measured by T-wave scanning during ventricular pacing (cycle length 500 ms). In protocol 1 (n=6), a pectoral “active can” was combined with an electrode in the superior vena cava as common cathode and a right ventricle electrode as anode (AC+SVC). In protocol 2 and protocol 3 (n=6 each), only the “active can” was used as proximal electrode (AC). Capacitance was 150 μF during both phases in protocol 1 and protocol 3 but 150 μF (phase 1) and 300 μF (phase 2) in protocol 2. ULV and DFT demonstrated a linear correlation in each protocol ( r =0.78 to 0.84). Lowest DFTs were found at 10 ms for AC+SVC and at 14 ms for AC ( P &lt;0.001). At optimal BSDs, voltage DFTs did not differ significantly between AC (527±57 V) and AC+SVC (520±70 V). Switching capacitors for phase 2 in a way that reduced leading-edge voltage by 50% while doubling capacity did not change BSD for optimal voltage DFT but increased minimum DFT from 527±57 V to 653±133 V ( P =0.04). Conclusions —The BSD with lowest DFT is shorter for AC+SVC than for AC. There is no significant difference in voltage DFT between both at optimal BSD. A lower phase 2 capacitance reduces DFTs irrespective of BSD. Because strength-duration curves for DFT and ULV correlate for different BSDs, lead systems, and phase 2 capacitances, ULV determination may allow the prediction of waveforms with lowest DFT.
The molecular basis of human 3-methylcrotonyl-CoA carboxylase deficiency
Authors: Matthias R. Baumgartner, Shlomo Almashanu, Terttu Suormala, Cassandra Obie, Robert N. Cole, Seymour Packman, E. Regula Baumgartner, David Valle
Journal: Journal of Clinical Investigation (2001)

Isolated biotin-resistant 3-methylcrotonyl-CoA carboxylase (MCC) deficiency is an autosomal recessive disorder of leucine catabolism that appears to be the most frequent organic aciduria detected in tandem mass spectrometry–based neonatal screening programs. The phenotype is variable, ranging from neonatal onset with severe neurological involvement to asymptomatic adults. MCC is a heteromeric mitochondrial enzyme composed of biotin-containing α subunits and smaller β subunits. Here, we report cloning of MCCA and MCCB cDNAs and the organization of their structural genes. We show that a series of 14 MCC-deficient probands defines two complementation groups, CG1 and 2, resulting from mutations in MCCB and MCCA, respectively. We identify five MCCA and nine MCCB mutant alleles and show that missense mutations in each result in loss of function.
A CASE OF CHRONIC ECZEMA FOLLOWED BY FATAL GANGRENE
Authors: G. H. LANCASHIRE
Journal: British Journal of Dermatology (1910)

Journal Article A CASE OF CHRONIC ECZEMA FOLLOWED BY FATAL GANGRENE Get access G. H. LANCASHIRE, M.D. G. H. LANCASHIRE, M.D. Hon. Physician to the Manchester and Salford Hospital for Skin‐Diseases Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 22, Issue 7, 1 July 1910, Pages 215–221, https://doi.org/10.1111/j.1365-2133.1910.tb16628.x Published: 01 July 1910
Can transcutaneous recordings detect gastric electrical abnormalities?
Authors: B O Familoni, K L Bowes, Y J Kingma, K R Cote
Journal: Gut (1991)

The ability of transcutaneous recordings of gastric electrical activity to detect gastric electrical abnormalities was determined by simultaneous measurements of gastric electrical activity with surgically implanted serosal electrodes and cutaneous electrodes in six patients undergoing abdominal operations. Transient abnormalities in gastric electrical activity were seen in five of the six patients during the postoperative period. Recognition of normal gastric electrical activity by visual analysis was possible 67% of the time and with computer analysis 95% of the time. Ninety four per cent of abnormalities in frequency were detected by visual analysis and 93.7% by computer analysis. Abnormalities involving a loss of coupling, however, were not recognised by transcutaneous recordings. Transcutaneous recordings of gastric electrical activity assessed by computer analysis can usually recognise normal gastric electrical activity and tachygastria. Current techniques, however, are unable to detect abnormalities in electrical coupling.
Rhophilin-1 Is a Key Regulator of the Podocyte Cytoskeleton and Is Essential for Glomerular Filtration
Authors: Mark A. Lal, Ann-Charlotte Andersson, Kan Katayama, Ziejie Xiao, Masatoshi Nukui, Kjell Hultenby, Annika Wernerson, Karl Tryggvason
Journal: Journal of the American Society of Nephrology (2014)

Rhophilin-1 is a Rho GTPase-interacting protein, the biologic function of which is largely unknown. Here, we identify and describe the functional role of Rhophilin-1 as a novel podocyte-specific protein of the kidney glomerulus. Rhophilin-1 knockout mice were phenotypically normal at birth but developed albuminuria at about 2 weeks of age. Kidneys from severely albuminuric mice revealed widespread podocyte foot process effacement, thickening of the glomerular basement membrane, and FSGS-like lesions. The absence of any overt changes in the expression of podocyte proteins at the onset of proteinuria suggested that the primary cause of podocyte abnormalities in Rhpn1-null mice was the result of cell-autonomous, Rhophilin-1–dependent signaling events. In culture, Rhophilin-1 was detected at the plasma membrane leading edge of primary podocytes, where it elicited remodeling of the actin cytoskeleton network. This effect of Rhophilin-1 on actin cytoskeleton organization associated with inhibitory effects on Rho-dependent phosphorylation of the myosin regulatory light chain and stress fiber formation. Conversely, phosphorylation of myosin regulatory light chain increased in podocyte foot processes of Rhpn1−/− mice, implicating altered actinomyosin contractility in foot process effacement and compromised filtration capacity. Targeted deletion of RhoA in podocytes of Rhophilin-1 knockout mice exacerbated the renal injury. Taken together, our results indicate that Rhophilin-1 is essential for the integrity of the glomerular filtration barrier and that this protein is a key determinant of podocyte cytoskeleton architecture.
Abstract IA1: COP1: Tumor suppressor role revealed
Authors: Vishva M. Dixit
Journal: Cancer Research (2012)

Abstract Proto-oncogenes ETV1, ETV4, and ETV5 belong to the PEA3 family of ETS transcription factors and have been identified recently in prostate cancer chromosomal rearrangements that result in their overexpression. Little is known, however, about their post-translational regulation. Here we show that ETV1, ETV4, and ETV5 interact with the ubiquitin ligase COP1. COP1 together with its binding partner DET1 ubiquitinated ETV1, resulting in ETV1 proteasomal degradation. Importantly, we show that truncation of ETV1 by the TMPRSS2:ETV1 translocation found in prostate cancer removes its COP1 binding motif and thereby enhances its stability. Consistent with a critical role for COP1 in regulating PEA3 transcription factors, COP1 deficiency in primary mouse prostate cells produced prostate intraepithelial neoplasia in vivo. The relationship between COP1 and ETV1 was also evident in human prostate cancer samples where loss of COP1 expression correlated with elevated ETV1 protein. Citation Format: Vishva M. Dixit. COP1: Tumor suppressor role revealed [abstract]. In: Proceedings of the AACR Special Conference on Advances in Prostate Cancer Research; 2012 Feb 6-9; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2012;72(4 Suppl):Abstract nr IA1.
Radioiodine Dilution Due to Levothyroxine When Using Recombinant Human Thyroid-Stimulating Hormone
Authors: Herbert A. Klein
Journal: Clinical Nuclear Medicine (2011)

Following thyroidectomy, a patient with papillary thyroid carcinoma was found to have widespread radioiodine-avid metastatic lesions and was treated with I-131. When follow-up scanning was anticipated, his 24-hour urinary iodine was found to be 254 μg. Because of the interim development of moderate renal failure, he was considered to be a candidate for preparation using recombinant human thyroid-stimulating hormone (rhTSH), with continued administration of thyroid hormone. To decrease the dilution effect of nonradioactive iodine, levothyroxine was replaced with liothyronine, with a resultant decrease in 24-hour urinary iodine to less than 110 μg, followed by radioiodine imaging, dosimetry, and retreatment with I-131 for persistent, though improved disease. The dilution of radioiodine with nonradioactive iodine from any source may degrade image quality and reduce the effectiveness of therapy. The use of rhTSH has advantages in the evaluation and I-131 treatment of differentiated thyroid cancer. There is evidence that this approach results in a longer effective half-time of radioiodine in remnants, improved bone marrow dosimetry, and comparable remnant ablation efficacy as compared with hormone withdrawal. However, it entails continued administration of thyroid hormone, which is a source of nonradioactive iodine. Reduction of the nonradioactive iodine burden of levothyroxine by conversion to liothyronine warrants investigation as possibly enhancing the advantages of rhTSH.
Are Stentless Valves Superior to Modern Stented Valves?
Authors: Ayyaz Ali, James C. Halstead, Fay Cafferty, Linda Sharples, Fiona Rose, Richard Coulden, Evelyn Lee, John Dunning, Vincenzo Argano, Steven Tsui
Journal: Circulation (2006)

Background— It is presumed that stentless aortic bioprostheses are hemodynamically superior to stented bioprostheses. A prospective randomized controlled trial was undertaken to compare stentless versus modern stented valves. Methods and Results— Patients with severe aortic valve stenosis (n=161) undergoing aortic valve replacement (AVR) were randomized intraoperatively to receive either the C-E Perimount stented bioprosthesis (n=81) or the Prima Plus stentless bioprosthesis (n =80). We assessed left ventricular mass (LVM) regression with transthoracic echocardiography (TTE) and magnetic resonance imaging (MRI). Transvalvular gradients were measured postoperatively by Doppler echocardiography to compare hemodynamic performance. There was no difference between groups with regard to age, symptom status, need for concomitant coronary artery bypass surgery, or baseline LVM. LVM regressed in both groups but with no significant difference between groups at 1 year. In a subset of 50 patients, MRI was also used to assess LVM regression, and again there was no significant difference between groups at 1 year. Hemodynamic performance of the 2 valves was similar with no difference in mean and peak systolic transvalvular gradients 1 year after surgery. In patients with reduced ventricular function (left ventricular ejection fraction [LVEF] &lt;60%), there was a significantly greater improvement in LVEF from baseline to 1 year in stentless valve recipients. Conclusions— Both stented and stentless bioprostheses are associated with excellent clinical and hemodynamic outcomes 1 year after AVR. Comparable hemodynamics and LVM regression can be achieved using a second-generation stented pericardial bioprosthesis. In patients with ventricular impairment, stentless bioprostheses may allow for greater improvement in left ventricular function postoperatively.
Reducing the Risk of Gynecologic Cancer in the Lynch Syndrome
Authors: Kenneth Offit, Noah D. Kauff
Journal: New England Journal of Medicine (2006)

The first description of a kindred with hereditary nonpolyposis colorectal cancer (HNPCC) in 1925 was based on the family history of a woman who later died from endometrial cancer. On the basis of a detailed interview by Michigan pathologist Aldred Scott Warthin with this woman (his seamstress) and with other members of "Family G," Warthin described a large kindred with hereditary colorectal and endometrial cancers.1 Sixty-eight years later, Henry Lynch broadened the spectrum of hereditary cancers in the HNPCC syndrome to include ovarian cancer, transitional-cell cancer of the renal pelvis, and less often, stomach, small-intestine, pancreatic, and other types of . . .
Cytochrome P450 2C19 681G&gt;A Polymorphism and High On-Clopidogrel Platelet Reactivity Associated With Adverse 1-Year Clinical Outcome of Elective Percutaneous Coronary Intervention With Drug-Eluting or Bare-Metal Stents
Authors: Dietmar Trenk, Willibald Hochholzer, Martin F. Fromm, Ligia-Emilia Chialda, Andreas Pahl, Christian M. Valina, Christian Stratz, Peter Schmiebusch, Hans-Peter Bestehorn, Heinz Joachim Büttner, Franz-Josef Neumann
Journal: Journal of the American College of Cardiology (2008)
The Cerebrospinal Fluid in Rheumatoid Spondylitis
Authors: E. W. Boland, N. E. Headley, P. S. Hench
Journal: Annals of the Rheumatic Diseases (1948)

Abnormalities in the chemistry of cerebrospinal fluid in cases of rheumatoid arthritis and of rheuma- toid spondylitis have been reported: the total pro- tein may be increased in amount, and at times there may be abnormalities in the colloidal gold reaction.The present study was designed to determine how 195 p copyright.
THE EFFECTIVENESS OF COMMERCIAL DIPHTHERIA TOXOID IN ACTIVE IMMUNIZATION OF INFANTS
Authors: JOSEPH GREENGARD
Journal: JAMA (1933)

Diphtheria toxoid as an antigen for the production of active immunity has proved very effective. 1 The report of a series of 100 infants so treated was published in 1931. 2 In this group, 98 per cent were rendered negative to the Schick test; in these cases the production of immunity was quite rapid, the greatest proportion showing a negative Schick test within two weeks of the last dose of toxoid and complete immunity being produced in six weeks in practically all. In this group the technic of immunization consisted in the hypodermic injection of two 1 cc. doses of toxoid, spaced at a three weeks interval in thirty-six and at a one week interval in eighty-one. The group in which the short interval was used apparently showed just as good results as the one with the longer interval. A commercial toxoid was used, all of which was produced by
Distribution of 11 beta-hydroxysteroid dehydrogenase along the rabbit nephron.
Authors: J P Bonvalet, I Doignon, M Blot-Chabaud, P Pradelles, N Farman
Journal: Journal of Clinical Investigation (1990)

It has been recently proposed that 11 beta-hydroxysteroid dehydrogenase (11 beta-OHSD) is responsible for aldosterone tissue specificity. A 11 beta-OHSD deficiency has been invoked as a cause of the syndrome of apparent mineralocorticoid excess, and 11 beta-OHSD inhibition by liquorice has been invoked to explain the hypertension induced by this drug. Since the renal tubule is composed of aldosterone-sensitive and insensitive segments, we determined the distribution of 11 beta-OHSD along the rabbit tubule. Pools of tubular segments isolated by microdissection were incubated for 2 h at 37 degrees C in the presence of [3H]corticosterone (3H-B, 8.10(-9) M). Afterwards, the amounts of 3H-B and of the metabolite 11-dehydrocorticosterone (3H-A) were determined using HPLC analysis. In the proximal tubule, in either its convoluted or straight portion, and in the medullary thick ascending limb, the amount of 3H-A was 19.6 +/- 3.8% (n = 12), 17.9 +/- 3.4 (n = 8), and 15.0 +/- 2.2 (n = 4), respectively, of the sum of 3H-A + 3H-B. In the cortical ascending limb and the collecting tubule in its cortical and medullary parts, it was 74.7 +/- 6.8% (n = 4), 74.1 +/- 4.9 (n = 9) and 64.6 +/- 14.1 (n = 3), respectively. In both proximal and cortical collecting tubule, addition of carbenoxolone 8.10(-4) M, an inhibitor of 11 beta-OHSD, almost completely inhibited the conversion of 3H-B to 3H-A. Thus, 11 beta-OHSD activity was high in the aldosterone-sensitive segments, and low in the aldosterone-insensitive segments. These results strongly favor the hypothesis that 11 beta-OHSD is a key enzyme in mineralocorticoid tissue specificity along the rabbit nephron. They reinforce the notion that a defect in 11 beta-OHSD plays a major role in the syndrome of apparent mineralocorticoid excess and liquorice-induced hypertension.
Hypogammaglobulinaemia and arthritis.
Authors: J S Lawrence, J M Bremner, B M Ansell
Journal: Annals of the Rheumatic Diseases (1969)

Discussion.-PROF.I. M. Rorrr (Middlesex Hospital) suggested that any lymphocyte might become a "killer" if exposed to a non-specific stimulus such as an antigenantibody complex or aggrated gamma-globulin plus com- plement.DR. MACLENNAN agreed that this was a possible explanation.He produced experimental evidence which suggested that complement components were unlikely to play a significant part in his particular experiments.DR.M. K. JASANI (Horsham) asked if the increased cytotoxicity could be due to stimulation of lymphocytes by an antigen present in synovial fluid.DR. MACLENNAN thought that, in his series of experiments, this possibility could be excluded.
THE PATTERN OF EPIDERMOLYSIS BULLOSA IN THE TRANSVAAL BANTU
Authors: M. A. MENTER, I. M. PATZ
Journal: British Journal of Dermatology (1971)

Two main types of epidermolysis bullosa affecting the Bantu are described. The possible evolution of the albopapuloid variety as seen in 2 patients with the dominant dystrophic type is discussed. The presentation of an infant with localized absence of skin and subsequent epidermolysis bullosa letalis supports the hypothesis that epidermolysis bullosa letalis with congenital localized absence of skin represents an intra‐uterine phase of the disease.
The Phantom of Lactic Acidosis due to Metformin in Patients With Diabetes
Authors: Robert I. Misbin
Journal: Diabetes Care (2004)

Metformin is the only biguanide that is available in the U.S. Another biguanide, phenformin, had been used since the 1950s, but was declared an “imminent hazard” in 1976 because of lactic acidosis (1). At the time of its removal from the market, there had been 306 documented cases of phenformin-associated lactic acidosis (2), including 1 fatal and 2 nonfatal cases in the randomized controlled trial of the University Group Diabetes Program (3).

Metformin was marketed as Glucophage by Bristol-Myers Squibb in early 1995, with a boxed warning concerning the risk of lactic acidosis. Metformin had been used widely in Europe for several years, where it had been recognized that the risk of lactic acidosis from metformin was no greater than the risk of hypoglycemia from sulfonylureas (4).

Although the clinical utility of metformin had been recognized in the U.S. (5), its approval was undoubtedly delayed by the specter of phenformin and the lingering concern that metformin might also cause lactic acidosis. The eventual approval of metformin was unusually controversial. Crofford (6) predicted that metformin “will be widely used and will improve the outlook for many patients” with diabetes. But fear of lactic acidosis led the consumer advocacy group Public Citizen (7) to issue the warning: “Do not use Glucophage.”

Based on data from Sweden, it was estimated that the risk of lactic acidosis in patients taking phenformin was ∼10-fold higher than the risk in patients taking metformin. A later report from Sweden (9) concluded that discontinuing metformin in aging patients when they developed renal or cardiovascular disease could further reduce the risk of lactic acidosis. The labeling …
Physical Diagnosis Teaching
Authors: David H. Spodick
Journal: JAMA (1971)

Traditionally, physical diagnosis has been the stepchild of medical education, beneath the concern of ranking faculty members while limiting patient exposure to weekly quantums taught by isolated platoons of conscripted instructors of widely varying competence and commitment. Even the term "physical diagnosis" conjures up a series of bedside rituals, the choreography of which has been inflicted piecemeal upon green students with little relation to their clinical and social settings. It is indeed necessary to introduce the student to the practical aspects of the tools of his trade, but since we are evaluating people as well as gallbladders there is no reason to completely sever this from the integral approach to the patient. Teachinghospital patients must put up with so many trying acts of mercy in the course of a day as to make remarkable their toleration of additional intrusions by relays of strange interrogators intent upon both rehashing the story
The leukotriene B4 lipid chemoattractant receptor BLT1 defines antigen-primed T cells in humans
Authors: Sabina A. Islam, Seddon Y. Thomas, Christoph Hess, Benjamin D. Medoff, Terry K. Means, Christian Brander, Craig M. Lilly, Andrew M. Tager, Andrew D. Luster
Journal: Blood (2005)