tbuckley/cabot-search huggingface dataset:
Relationship between Ventricular Premature Contractions on Routine Electrocardiography and Subsequent Sudden Death from Coronary Heart Disease
Authors: F. DAVID FISHER, HERMAN A. TYROLER
Journal: Circulation (1973)

The association between ventricular premature contractions (VPC) on routine ECG and sudden death (SD) from coronary heart disease (CHD) during an ll-year period was examined in a historic prospective study of 1,214 white male factory workers, ages 35-69, in Canton, North Carolina. Prevalence of VPC was 92 (6.7%) increasing from 2% to 15% with age. Sixty of the 118 deaths were ascribed to CHD, 38 (63.3%) with 24-hour SD, and 27 (45%) with 1-hour SD. The relative risk of 1-hour SD for those with VPC was not increased (0.9); the risk of 24-hour SD was increased only minimally (1.3). Within the age band 50-59, the relative risk of 24-hour sudden death was 2.4 but the presence of other electrocardiographic abnormality carried the same increased risk. For the Canton population, using VPC on routine ECG as predictor of sudden death yielded no advantage over other ECG abnormalities.
Interleukin 6 secretion by monocytes and alveolar macrophages in systemic sclerosis with lung involvement.
Authors: B Crestani, N Seta, M De Bandt, P Soler, C Rolland, M Dehoux, A Boutten, M C Dombret, E Palazzo, M F Kahn
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Interleukin-6 (IL-6) has been involved in the pathogenesis of inflammatory and/or autoimmune diseases. We characterized the production of IL-6 by blood monocytes and alveolar macrophages (AM) in 11 patients with definite systemic sclerosis (SSc) with lung involvement and in eight normal control subjects. IL-6 levels were determined in serum, bronchoalveolar lavage (BAL) supernatants, monocytes, and AM cell culture supernatants using an ELISA kit. BAL cell analysis evidenced an alveolitis with hypercellularity and increased neutrophils and mast cells absolute counts. Serum and BAL IL-6 levels were low and similar in SSc and control groups. The monocytes of the group with SSc secreted more IL-6 than did the control group, both spontaneously (p = 0.01) and after LPS stimulation (p = 0.0007). Spontaneous secretion of IL-6 by AM tended to be higher in the SSc group than in the control group (p = 0.22). LPS-induced IL-6 secretion by AM was similar in both groups. Our study demonstrates that during SSc lung disease, spontaneous and stimulated IL-6 secretion by blood monocytes is increased, compared with secretion by healthy control subjects. By contrast, IL-6 secretion by AM is normal despite evidence of mild alveolitis.
More Than Just Reassurance on Tiotropium Safety
Authors: Christine R Jenkins
Journal: New England Journal of Medicine (2013)

Since its registration in 2002, a dry-powder formulation of tiotropium delivered by a HandiHaler inhalation device has consistently been recommended in clinical-practice guidelines as first-line maintenance bronchodilator therapy for chronic obstructive pulmonary disease (COPD). This recommendation is based on the efficacy of tiotropium in improving lung function, exercise capacity, and quality of life and in reducing moderate and severe COPD exacerbations.The safety reputation of tiotropium as delivered by dry-powder inhalation remained relatively unblemished until its successor, tiotropium delivered by a soft-mist Respimat inhaler, underwent clinical trials. Despite the clear efficacy of the Respimat formulation, post hoc pooled safety analyses . . .
WATER EXCHANGE OF COLLAGENOUS TISSUES AND OF GELATIN
Authors: Eugene L. Opie, Mary B. Rothbard
Journal: The Journal of Experimental Medicine (1953)

Water exchange of parenchymatous tissue, namely liver, kidney, or pancreas, occurs by osmosis, and the movement of water, as is well known, occurs in direct relation to the concentration of the surrounding solution. But the present work shows that the hydration of collagenous tissues, like that of gelatin, occurs in strong as well as in weak solutions of sodium chloride. The water intake of collagenous tissue in solutions of sodium chloride or of sucrose increases with increased density of the tissue and the sequence of changes is like that observed with gels of increasing gelatin content under the same conditions. Dense collagenous tissue, apparently impervious to the movement of water, exhibits a conspicuous ability to attract and hold it.
Guidelines on body recontouring after bariatric surgery are available
Authors: J. A. Dunne, R. Welbourn, M. Soldin
Journal: BMJ (2015)

Bucknor and colleagues rightly state that recently updated National Institute for Health and Care Excellence (NICE) guidelines for management of obesity did not include reconstructive body contouring surgery after massive weight loss.1 However, NICE accredited national commissioning guidelines for such surgery were published in 2014, to standardise referrals and avoid …
Calcification in the Left Upper Quadrant or "All That Glisters..."
Authors: William J. Otto
Journal: JAMA (1965)

<h3>Dr. Joseph T. Ferrucci, Jr.:</h3> A 47-year-old white man complained of intermittent right flank pain which radiated subcostally for several months prior to admission. There was no jaundice, dysuria, fever, or weight loss. He also had symptoms of arterial insufficiency in the left leg and complained of angina for which he took glyceryl trinitrate tablets. Physical examination revealed a mild elevation of the blood pressure: systolic, 160 mm Hg; diastolic, 100. There was neither a palpable mass nor tenderness in the abdomen. The pulses of the left leg were slightly decreased. Intravenous pyelography was performed (Fig 1). <h3>Discussion</h3><h3>Dr. Laurence L. Robbins:</h3> Dr. Mueller, what do you think about this examination? <h3>Dr. H. Peter Mueller:</h3> Consistently, through the entire examination, there is a density in the left upper quadrant which appears unrelated to the kidney and could very well represent an aneurysm of the celiac axis or the splenic artery.
Pargyline Treatment of Hypertension
Authors: Marvin Moser, White Plains, Bernard Brodoff, New Rochelle, Aaron Miller, Arthur G. Goldman
Journal: JAMA (1964)

Twenty-eight patients with hypertension have been treated with pargyline hydrochloride, a nonhydrazine amine oxidase inhibitor, alone or in combination with methyclothiazide, a thiazide diuretic. An excellent blood pressure response in elderly, less severely ill patients was noted following pargyline or combination therapy. In younger, more severly hypertensive patients, response was not universally satisfactory. Postural hypotension, impotence, and transient liver function abnormalities were noted in some of these patients. Further long-term studies with pargyline in the treatment of hypertensive disease appear to be warranted.
Liver transplantation for alcoholic liver disease: Evaluation of a selection protocol
Authors: A C Anand, B H Ferraz-Neto, P Nightingale, D F Mirza, A C White, P McMaster, J M Neuberger
Journal: Hepatology (1997)

We have used a formal transplant protocol to select patients with alcoholic liver disease (ALD) for transplantation. We retrospectively analyzed all the patients with ALD who were referred specifically for transplantation to our Liver Unit between 1987 and 1994. Patients were selected for liver transplantation if they had end-stage liver disease and had remained abstinent from the time they were medically advised to stop alcohol intake. Of the 180 patients referred for transplantation, 43 (none of whom were transplanted) had case records insufficiently complete for full analysis; this may bias the analysis. Of the remaining 137 patients, 39 were transplanted and 4 were awaiting transplantation at the time of analysis. Of the patients who were not accepted for transplantation, 13 died during the assessment, 7 were considered to be unlikely to survive the procedure, 29 were found to be medically unsuitable, 16 psychologically unsuitable, 7 patients refused the offer of transplantation, and an additional 19 either showed clinical improvement or were considered too well for transplantation. Special investigations, such as brain computerized tomography (CT) scan and echocardiograph, changed the clinical decision to transplant in only a small number of cases (4% and 5%, respectively). Nine of the transplanted patients died and the remaining were followed up for a median of 25 (range, 7-63) months. One year actuarial survival for the transplanted patients was 79%, for those considered too sick was 0%, for medically unsuitable patients was 44%, for psychologically unsuitable patients was 65% and for those considered too well was 94%. Only 5 of the transplanted patients (13%) reverted to drinking. The observed actuarial survival of nontransplanted patients was compared with the expected survival calculated by ‘the Beclere model.’ The observed actuarial survival in the nontransplanted groups was much better than anticipated from the Beclere model, which therefore, is not applicable to our patients. The proportional hazards regression analysis of our nontransplanted patients identified serum bilirubin, serum albumin, blood urea, ascites, and spontaneous bacterial peritonitis as factors significantly predictive of their probability of survival. Using a model based on these parameters, the expected survival of our transplanted patients was calculated. Although we applied the model to a different population, the observed actuarial survival in the transplanted patients was found to be better than their expected survival ( P &lt; or = .001). Our protocol was useful in selecting suitable patients with ALD for liver transplantation, which resulted in significant survival advantage with low recidivism rate.
Surgical Management of Chronic Obstructive Lung Disease
Authors: Eugene G. Laforet
Journal: New England Journal of Medicine (1972)

THERE is general if sometimes reluctant agreement that the emphysema-chronic-bronchitis complex in adults be designated chronic obstructive lung disease (COLD). To the casual observer surgery seems to offer little in the management of such an obviously "medical" disease. That it has a role, however circumscribed, is as much a reflection of the inadequacies of medical therapy as of the boundless optimism of the surgeon. What surgical maneuvers have been advocated in COLD, when are they applicable, and, in the light of present information, how effective are they? A convenient if not totally accurate classification might separate procedures that are designed . . .
A cluster of Pneumocystis carinii infections in children.
Authors: L E Fenelon, C T Keane, M Bakir, I J Temperley
Journal: BMJ (1985)

A cluster of Pneumocystis carinii infections in childrenPneumocystis canrnii pneumonia occurs almost exclusively in immuno- suppressed patients, particularly those being treated for acute lymphoblastic leukaemia.The mode of transmission of the organism is not clear.' Several hospital outbreaks have been reported, and animal to animal transmission has been documented, but convincing evidence is still lacking of person to person transmission.We present a cluster of children currently receiving the United Kingdom Acute Lymphoblastic Leukaemia eight (UKALL 8) regimen for acute lymphoblastic leukaemia who became seropositive for antipneumocystis antibody within a short space of time, providing further evidence for person to person transmission.
A Preferentially Segregated Recycling Vesicle Pool of Limited Size Supports Neurotransmission in Native Central Synapses
Authors: Vincenzo Marra, Jemima J. Burden, Julian R. Thorpe, Ikuko T. Smith, Spencer L. Smith, Michael Häusser, Tiago Branco, Kevin Staras
Journal: Neuron (2012)

At small central synapses, efficient turnover of vesicles is crucial for stimulus-driven transmission, but how the structure of this recycling pool relates to its functional role remains unclear. Here we characterize the organizational principles of functional vesicles at native hippocampal synapses with nanoscale resolution using fluorescent dye labeling and electron microscopy. We show that the recycling pool broadly scales with the magnitude of the total vesicle pool, but its average size is small (∼45 vesicles), highly variable, and regulated by CDK5/calcineurin activity. Spatial analysis demonstrates that recycling vesicles are preferentially arranged near the active zone and this segregation is abolished by actin stabilization, slowing the rate of activity-driven exocytosis. Our approach reveals a similarly biased recycling pool distribution at synapses in visual cortex activated by sensory stimulation in vivo. We suggest that in small native central synapses, efficient release of a limited pool of vesicles relies on their favored spatial positioning within the terminal.
Differential stability of control gene and fusion gene transcripts over time may hamper accurate quantification of minimal residual disease – a study within the Europe Against Cancer Program
Authors: V H J van der Velden, N Boeckx, M Gonzalez, M Malec, G Barbany, T Lion, E Gottardi, N Pallisgaard, E Beillard, W C J Hop, P G Hoogeveen, J Gabert, J J M van Dongen
Journal: Leukemia (2004)
Immunomodulatory effect of procainamide in man. Inhibition of human suppressor T-cell activity in vitro.
Authors: T Ochi, E A Goldings, P E Lipsky, M Ziff
Journal: Journal of Clinical Investigation (1983)

Procainamide (PA) induces the production of a number of autoantibodies in a high proportion of treated individuals and in some a syndrome closely resembling systemic lupus erythematosus. The mechanism underlying this action of PA is unclear. To examine the possibility that PA might induce autoantibody formation by altering normal immunoregulatory mechanisms, the action of this drug on an in vitro model of antibody formation in man was examined. PA was found to augment the generation of immunoglobulin-secreting cells (ISC) from human peripheral blood mononuclear cells (PBM) in response to pokeweed mitogen but had no effect on pokeweed mitogen-induced tritiated thymidine incorporation. When purified populations of B and T cells were used, PA enhanced the generation of ISC in B-cell cultures supported by untreated T cells but not by T cells treated with mitomycin C. These results indicate that PA augmented B-cell responses by inhibiting suppressor T-cell activity and not by augmenting helper T-cell or B-cell function. N-Acetyl-procainamide had no effect on the generation of ISC in this system. The effect of PA on concanavalin A (Con A)-induced suppressor cell activity was also examined to determine whether PA altered the generation or expression of suppressor T-cell function. PBM were cultured with 30 microgram/ml of Con A for 48 h to generate suppressor cells. When these were co-cultured with fresh PBM, the number of ISC generated was decreased by 58.1 +/- 3.4% (mean +/- SEM, n = 6). Cells that had been similarly incubated without Con A were not inhibitory. The addition of PA to the Con A-stimulated cultures inhibited the generation of suppressor cells as indicated by the fact that the response of fresh cells co-cultured with the Con A-stimulated cells was diminished by only 27.2 +/- 4.3%. In this system too, N-acetyl-procaimamide had no effect. By contrast, adding PA only to the co-culture of Con A-stimulated cells with fresh PBM had a less marked effect on suppressor cell function. These results indicate that the major action of PA is to inhibit the generation of suppressor T-cell activity. Such an effect may explain the capacity of this agent to induce autoantibody formation in treated individuals.
Electronic archive of 16 journals dating back 200 years is launched
Authors: Michael Cross
Journal: BMJ (2006)

Anyone wanting to read Alan Hodgkin and Andrew Huxley's 1952 paper proposing the ionic theory of nerve impulses no longer has to travel to a specialist scientific library. The paper, “Measurement of current-voltage relations in the membrane of the giant axon of Loligo ” (Journal of Physiology 1952;116:424-48), which put its authors on the way to a Nobel prize, is one of thousands now freely available online as part of an historic archive of 16 biomedical journals dating back nearly 200 years.

The backfiles archive—which will include the BMJ —was launched last week under an …
Massive Steroid Excretion and Hypocholesterolemia with an Adrenal Adenoma
Authors: STEVEN B. LEICHTER
Journal: Annals of Internal Medicine (1974)

A 48-year-old woman with mild hirsutism had extremely elevated urinary excretion of 17-ketosteroids (as high as 1555 mg per day). At operation, a large, benign adenoma was found. The case was unusual in that she had severe hypocholesterolemia that was first documented 2 years before surgery. Postoperatively, plasma cholesterol levels promptly returned to normal. It is proposed that the markedly elevated production of steroid substances by this tumor led to a massive diversion of plasma cholesterol, exceeding any compensatory increase in hepatic cholesterol synthesis. This consequence of steroid overproduction has hitherto been unrecognized.
Transmission of Non-A, Non-B Hepatitis
Authors: JAY H. HOOFNAGLE
Journal: Annals of Internal Medicine (1977)

In studies conducted in the early 1950s, sera from six asymptomatic blood donors, implicated in the transmission of viral hepatitis, were inoculated into 10 to 20 volunteers each. Five of these "implicated" donor sera transmitted clinically apparent hepatitis to the recipients. The stored serum samples from these studies have been reanalyzed using serologic markers for hepatitis B virus and hepatitis A virus infection. Two of the donor sera were hepatitis B surface antigen (HBsAg)-positive, and both transmitted hepatitis B virus infection to all susceptible recipients, half of whom showing clinical symptoms. The remaining three infectious donors were HBs-Ag-negative, yet were icterogenic to 10% to 47% of recipients. Testing of serum samples from these recipients with hepatitis showed no evidence of hepatitis B virus or hepatitis A virus infection. This study and other recent evidence suggest that there is a third type of human viral hepatitis--non-A, non-B hepatitis--which is due to a transmissible agent and may well be associated with a chronic carrier state.
Dominant recognition by human CD8+ cytotoxic T lymphocytes of dengue virus nonstructural proteins NS3 and NS1.2a.
Authors: A Mathew, I Kurane, A L Rothman, L L Zeng, M A Brinton, F A Ennis
Journal: Journal of Clinical Investigation (1996)

A severe complication of dengue virus infection, dengue hemorrhagic fever (DHF), is hypothesized to be immunologically mediated and virus-specific cytotoxic T lymphocytes (CTLs) may trigger DHF. It is also likely that dengue virus-specific CTLs are important for recovery from dengue virus infections. There is little available information on the human CD8+ T cell responses to dengue viruses. Memory CD8+CTL responses were analyzed to determine the diversity of the T cell response to dengue virus and to identify immunodominant proteins using PBMC from eight healthy adult volunteers who had received monovalent, live-attenuated candidate vaccines of the four dengue serotypes. All the donors had specific T cell proliferation to dengue and to other flaviviruses that we tested. CTLs were generated from the stimulated PBMC of all donors, and in the seven donors tested, dengue virus-specific CD8+CTL activity was demonstrated. The nonstructural (NS3 and NS1.2a) and envelope (E) proteins were recognized by CD8+CTLs from six, five, and three donors, respectively. All donors recognized either NS3 or NS1.2a. In one donor who received a dengue 4 vaccine, CTL killing was seen in bulk culture against the premembrane protein (prM). This is the first demonstration of a CTL response against the prM protein. The CTL responses using the PBMC of two donors were serotype specific, whereas all other donors had serotype-cross-reactive responses. For one donor, CTLs specific for E, NS1.2a, and NS3 proteins were all HLA-B44 restricted. For three other donors tested, the potential restricting alleles for recognition of NS3 were B38, A24, and/or B62 and B35.These results indicate that the CD8+CTL responses of humans after immunization with one serotype of dengue virus are diverse and directed against a variety of proteins. The NS3 and NS1.2a proteins should be considered when designing subunit vaccines for dengue.
Acute Intoxication with Desipramine
Authors: Peter Tchen, A. Dixon Weatherhead, Nelson G. Richards
Journal: New England Journal of Medicine (1966)

SINCE the introduction of imipramine there have been numerous reports about the ingestion of massive quantities of this drug. Some were fatal whereas other patients survived without sequelae.1 2 3 4 5 6 Desipramine, a metabolite of imipramine, has a rapid action that makes it the drug of choice when a prompt antidepressant response is desirable.Williams,7 in 1964, first described the effects of massive ingestion of desipramine (a total dose of 1150 mg.). The following case occurred two months after the drug became available in this country.Case ReportA 59-year-old woman with mild diabetes and labile hypertension had suffered from a manic-depressive psychosis . . .
MIXED LYMPHOCYTE CULTURE RESPONSES OF MICE
Authors: Janet M. D. Plate
Journal: The Journal of Experimental Medicine (1974)

Cellular responses in vitro to H-2D region histocompatibility antigens were demonstrated to be under the genetic control of two or three (P = 0.013) independently segregating loci. The H-2 region itself accounts for one of these loci, however, its activity appears to be dependent upon an association with other non-H-2-associated genetic information. The ability to stimulate a response and to respond to that stimulus are two separate genetic functions in certain MLR combinations. The stimuli in our studies were products of the H-2D region and cell donors must differ at that region in order for a response to occur. The control of the level of responses was determined by other genetic material. Differences at these "response loci" were not necessary for the induction of a proliferative response in the mixed lymphocyte cultures.
The Physician's Physiology and His Power of Healing
Authors: Charles D. Aring
Journal: JAMA (1976)

JUSTICE Cardozo said that there is an accuracy that defeats itself by overemphasis of details, and that one must permit oneself, quite advisedly and deliberately, a certain margin of misstatement. This rule applies not only in the legal profession; in medicine too, detail quite often conceals meaning. The human organism resists digital quantification and an excessively concrete approach tends to be self-defeating. An interesting observation in this vein was made by Samuel Butler in the late 19th century. The author of<i>Erewhon</i>(1872), who had more than a little insight into the human condition, entered the following in his<i>Notebooks</i>(chap 14): "A physician's physiology has much the same relation to his power of healing as a cleric's divinity has to his power of influencing conduct." A "refinement" that is generally less than helpful to the patient is the practice of admitting to the hospital the ordinary or nonurgent patient