tbuckley/cabot-search huggingface dataset:
Serum Potassium Levels and Myocardial Threshold of Excitability
Authors: Weldon J. Walker
Journal: JAMA (1974)

To the Editor.—  The electrocardiographic tracings or the title must be mislabeled in the article, Transvenous Pacemaker Failure Induced by Hyperkalemia, by O'Reilly, Murnaghan, and Williams (228:336, 1974), since the tracings show the pacemaker functioning best at highest potassium levels. The text is also confusing. The patient's pacemaker functioned intermittently, regardless of serum potassium levels and the use of numerous agents known to alter myocardial threshold, until it was removed. The removed pacemaker tested as normal. A replacement pacemaker also functioned intermittently. This patient apparently had such extensive endocardial fibrosis as to largely insulate the myocardium from a normal transvenous electrode. Hence, it was a poor case from which to draw conclusions concerning factors influencing myocardial excitability, and the authors' conclusions were contrary to those of most investigators.  Siebens et al 1 in 1953 demonstrated in dogs a parallel increase of myocardial responsiveness by increasing extracellular potassium levels from 3
Left Vocal-Cord Paralysis Associated with Hypertensive Heart Disease
Authors: William C. L. Diefenbach
Journal: New England Journal of Medicine (1949)

LEFT vocal-cord paralysis is frequently observed in various forms of intrathoracic disease, such as aortic aneurysm, mediastinal tumors, pleuritic thickening and pulmonary tuberculosis. A variety of cardiac lesions, including mitral stenosis, arteriosclerotic heart disease, congenital heart disease and aneurysms of the large vessels, may also produce this syndrome. Its occurrence in only a small percentage of cardiac conditions is not clear.Although a number of hypotheses have been proposed, the exact mechanism has not been elucidated. Ortner,1 in 1897, first described vocal-cord paralysis associated with heart disease, his 2 cases occurring in mitral stenosis. At autopsy an enlarged auricle was . . .
Is 8-mm More Effective Than 4-mm Tip Electrode Catheter for Ablation of Typical Atrial Flutter?
Authors: Chin-Feng Tsai, Ching-Tai Tai, Wen-Chung Yu, Yi-Jen Chen, Ming-Hsiung Hsieh, Chern-En Chiang, Yu-An Ding, Mau-Song Chang, Shih-Ann Chen
Journal: Circulation (1999)

Background —The prospective, randomized study comparing 4- with 8-mm tip electrodes for radiofrequency linear ablation of typical atrial flutter is not available. Methods and Results —A total of 104 consecutive patients with typical atrial flutter were randomly assigned to undergo radiofrequency linear ablation using a 4- (Group I, n=54) or 8-mm tip electrode (Group II, n=50) catheter (temperature-control model, preset 70°C). If complete bidirectional isthmus block could not be achieved after 5 pulses, the ablation catheter was changed to the other type; the maximal radiofrequency pulse number was limited to &lt;10 pulses. Complete or incomplete isthmus conduction block was assessed by activation sequence in a multielectrode Halo catheter during low lateral right atrial and proximal coronary sinus pacing. Before shifting to the other catheter type, the 8-mm electrode catheter achieved higher complete isthmus block rate (92% versus 67%, P &lt;0.05) with fewer pulses (2±1 versus 3±1, P &lt;0.05), shorter procedure time (24±15 versus 31±12 minutes, P &lt;0.05), and shorter fluoroscopic time (14±10 versus 23±15 minutes, P &lt;0.05). After 5 failed ablation pulses, 12 (67%) of 18 patients in group I attained complete isthmus block by using an 8-mm tip catheter, but none of 4 patients in group II achieved complete block by changing to a 4-mm tip catheter. Conclusions —The 8-mm tip electrodes are more effective than the standard 4-mm length electrodes in linear ablation for typical atrial flutter. This clinical benefit may be of particular value for some patients with broad and/or thick isthmus.
Innocent Cardiovascular Murmurs in the Adult
Authors: WALT F. WEAVER, COLIN H. M. WALKER
Journal: Circulation (1964)

One hundred young adults who were known to have had innocent murmurs as children were re-examined 16 or more years after the murmur was detected. In all individuals a murmur was again heard. Whether or not this was the same murmur could not be determined. While most (85 per cent) had the vibratory quality similar to the childhood vibratory innocent murmur, 87 per cent were audible at or above the third left intercostal space, a higher proportion than is usually found in children. The murmurs could be divided into three main groups: those maximum at the lower left sternal border (58 per cent), the pulmonary area (31 per cent), and the aortic area and neck (10 per cent). Only one was maximum at the apex. No true cardiorespiratory murmurs were heard. In this study the cardiac sounds and murmurs were faithfully reproduced by the taperecording equipment employed, thus supporting the view that this technic could be used in heart-screening programs but offers no advantage over simple auscultation.
Colonoscopic allergen provocation (COLAP): a new diagnostic approach for gastrointestinal food allergy.
Authors: S C Bischoff, J Mayer, J Wedemeyer, P N Meier, G Zeck-Kapp, B Wedi, A Kapp, Y Cetin, M Gebel, M P Manns
Journal: Gut (1997)

BACKGROUND: The clinical relevance of gastrointestinal food allergy in adults is largely unknown because the mechanisms are poorly understood and the diagnosis is difficult to confirm. AIMS: To improve the diagnostic means for confirming intestinal food allergy on an objective basis, a new colonoscopic allergen provocation (COLAP) test was developed. PATIENTS: The COLAP test was performed in 70 adult patients with abdominal symptoms suspected to be related to food allergy, and in five healthy volunteers. METHODS: During the COLAP test, the caecal mucosa was challenged endoscopically with three food antigen extracts, a buffer control, and a positive control (histamine). The mucosal weal and flare reaction was registered semiquantitatively 20 minutes after challenge, and tissue biopsy specimens were examined for mast cell and eosinophil activation. RESULTS: No severe systemic anaphylactic reactions were found in response to intestinal challenge. The COLAP test was positive to at least one food antigen in 54 of 70 patients (77%), whereas no reaction in response to antigen was found in healthy volunteers. Antigen induced weal and flare reactions were correlated with intestinal mast cell and eosinophil activation, as well as with patients9 history of adverse reactions to food, but not with serum concentrations of total or specific IgE or skin test results. CONCLUSION: The COLAP test may be a useful diagnostic measure in patients with suspected intestinal food allergy and may provide a new tool for the study of underlying mechanisms.
Evaluating Patient-Centered Outcomes in the Randomized Controlled Trial and Beyond: Informing the Future with Lessons from the Past
Authors: Christopher M. Booth
Journal: Clinical Cancer Research (2010)

Abstract In the era of molecular oncology, patients still define a useful therapy as one that allows them to live longer and helps them to live better. Although patient outcomes have clearly improved as a result of randomized controlled trials (RCT), it is critical that contemporary trials retain the perspective of these fundamental patient-centered outcomes. Trends in study design, results, and interpretation of oncology RCTs from the past provide a useful framework in which to consider how the research community may approach trial design in the future. Although the RCT remains the standard for establishing efficacy, this article also considers how population-based outcome studies can provide insight into effectiveness of new therapies and explores how the results of RCTs translate into benefit in the general population. Clin Cancer Res; 16(24); 5963–71. ©2010 AACR.
Developmental changes in the ultrastructure and sarcomere shortening of the isolated rabbit ventricular myocyte.
Authors: R Nassar, M C Reedy, P A Anderson
Journal: Circulation Research (1987)

Sarcomere shortening and ultrastructure of intact isolated myocytes from ventricles of three-week-old and adult rabbits were examined. Cells were fixed and embedded, and after measuring their sarcomere shortening in response to electrical stimulation, they were examined in serial thin sections by electron microscopy. This structure-function analysis showed that adult cells were significantly larger, had longer rest sarcomere lengths, greater amount and velocity of sarcomere shortening, greater velocity of reextension, and shorter contraction duration than immature cells. In immature myocytes, a thin outer shell of myofibrils enveloped a central mass of mitochondria and nuclei, but in adult cells, the cytoskeleton divided the cell into compartments with the mitochondria arranged around and interspersed among the myofibrils. The different arrangement of the organelles and the cytoskeleton at the two ages may account for the shorter rest sarcomere length in the young myocytes and may confer differing internal loads that contribute to their smaller amount and velocity of sarcomere shortening. The corbular and longitudinal sarcoplasmic reticulum were less demarcated in immature than in adult cells. Myocytes from both ages showed postextrasystolic potentiation, suggesting that the sarcoplasmic reticulum modulates calcium at both ages. Restitution of contractility between contractions, obtained by measuring sarcomere shortening of interpolated extrasystoles, was faster in immature than in adult cells and may reflect the structural differences in the sarcoplasmic reticulum. The developmental differentiation in the sarcoplasmic reticulum suggests that changes in compartmentalization of calcium and in the distribution of putative calcium-release sites contribute to the increased contractility of adult myocytes.
Cosmetic interventions need tighter controls to protect patients, review concludes
Authors: I. Torjesen
Journal: BMJ (2013)

The people and companies involved in surgical and non-surgical cosmetic interventions in England, including injection of dermal fillers and Botox, need to be more tightly regulated, the final report of a government commissioned review has said. And if things go wrong patients need to have a right of redress, it added.

The Department of Health commissioned the review, led by the NHS’s medical director, Bruce Keogh, last year, after serious problems arose with silicone breast implants made by the French company Poly Implant Prothese (PIP).1 

The review looked at the products used for surgical and non-surgical cosmetic procedures; the people who carry out the interventions; advertising; and the advice and support given to patients and consumers.2

It found that there is little or no regulation of non-surgical interventions such as injection of dermal fillers or Botox, despite their popularity. The review’s final report said that production of dermal fillers should be subject to the same controls …
Radial Artery Versus Saphenous Vein Patency Randomized Trial
Authors: Peter Collins, Carolyn M. Webb, Chee F. Chong, Neil E. Moat
Journal: Circulation (2008)

Background— Graft patency is a fundamental predictor of long-term survival after coronary artery bypass surgery. Left and right internal thoracic artery (arterial) graft patency has been shown to be superior to that of saphenous vein grafts. More recently, the radial artery has been used as an aortocoronary graft, but little is known about the midterm and long-term patency of this conduit. We performed a single-center prospective randomized trial comparing the angiographic patency of radial artery and saphenous vein aortocoronary bypass grafts at 5 years after surgery. Methods and Results— We enrolled 142 patients randomized at a single center to have either the radial artery or saphenous vein grafted to a stenosed branch of the native left circumflex coronary artery. The primary end point was angiographic graft patency 5 years postoperatively. At 5 years, 134 patients were alive and eligible for reangiography (5-year survival, 94.4%). Angiography was performed in 103 patients (77%); 98.3% of radial artery grafts and 86.4% of saphenous vein grafts were patent ( P =0.04). Graft narrowing occurred in 10% of patent radial artery grafts and 23% of patent saphenous vein grafts ( P =0.01). Conclusions— Radial artery aortocoronary bypass grafts to a stenosed branch of the circumflex coronary artery have an excellent patency rate at 5 years. This was significantly better than the patency rate for saphenous vein grafts and comparable to reported patency rates for internal thoracic artery grafts.
Infective Factors in Exacerbations of Bronchitis and Asthma
Authors: H. P. Lambert, H. Stern
Journal: BMJ (1972)

Infections of the respiratory tract were studied in a group of families each containing a patient with chronic bronchitis or with asthma. A wide variety of infective agents may be associated with exacerbations in susceptible subjects, but the types of organism to which patients are most at risk differ according to the family structure. Exacerbations in the susceptible subject are more likely to be related to viral infections when the family contains children than when it does not.Two patients with asthma experienced frequent respiratory infections, many of which provoked attacks of asthma.
Abstract 531: MiR-199a-5p is a biomarker for and regulator of epithelial-mesenchymal transition in triple-negative breast cancer patients
Authors: Vivian Y. Shin, Man T. Siu, John C. Ho, Ava Kwong
Journal: Cancer Research (2014)

Abstract Objectives: Triple-negative breast cancer (TNBC) accounts for 15-20% of all breast cancer, and is characterized by the absence of estrogen receptor, progesterone receptor and human epidermal growth factor receptor. The lack of targeted therapy is a major obstacle for treating against this aggressive subtype, hence the search of specific biomarkers may use as potential diagnostic marker and perhaps a therapeutic target for TNBC. Methods: Plasma samples from patients with TNBC and non-TNBC were recruited for miRNA profiling. By using miRCURY LNA array containing 730 miRNAs, we compared the differential miRNA expressions in plasma of patient with TNBC (n=5) and non-TNBC (n=5), as well as healthy controls (n=5). Selected miRNAs were further validated in an independent cohort (n=250) using real-time RT-PCR. Functional study of miRNA was also carried out in the cell lines. Results: Microarray data revealed miR-16, miR-21 and miR-199a-5p have differentially expression between TNBC and non-TNBC. We found that miR-16, miR-21 and miR-199a-5p were underexpressed in TNBC cases when compared with healthy controls. Moreover, post-operative expression levels of miR-16, miR-21 and miR-199a-5p were significantly increased than that of pre-operative plasma of TNBC. We then stratified the patients by TNM stage and associate with miRNA expression level. Plasma miR-199a-5p expression in TNBC patients had significant difference when compared with healthy controls (stage I, p&amp;lt;0.002; stage II, p&amp;lt;0.001; stage III, p&amp;lt;0.011). Transfection of miR-199a-5p mimic significantly reduced cell proliferation and restored the epithelial-mesenchymal transition (EMT) markers (E-cadherin, ZEB1 and TWIST2). Conclusions: Our data implicate that miR-199a-5p is a potential marker for discriminating TNBC cases and non-TNBC cases. The association of miR-199a-5p with EMT markers uncovers an important pathway in metastatic breast cancer. This study provides insights for the potential use of miRNA as diagnostic marker and targeted therapy for the treatment of TNBC. Citation Format: Vivian Y. Shin, Man T. Siu, John C. Ho, Ava Kwong. MiR-199a-5p is a biomarker for and regulator of epithelial-mesenchymal transition in triple-negative breast cancer patients. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 531. doi:10.1158/1538-7445.AM2014-531
Incidence of hiatus hernia and gastro-oesophageal reflux in 1030 prospective barium meal examinations in adult Nigerians.
Authors: O O Bassey, E E Eyo, G A Akinhanmi
Journal: Thorax (1977)

A prospective study to determine the incidence of hiatus hernia and gastro-oesophageal reflux in 1030 consecutive symptomatic adult Nigerian patients undergoing barium meal examination is reported. The results show a very low incidence of hiatus hernia (0-39%) and an equally low incidence of gastro-oesophageal reflux (2-2%) when compared with similar studies in Europe and America. There was a high incidence of duodenal ulcer (23-3%) and a low incidence of gastric ulcer (1-8%), the duodenal/gastric ulcer ratio of 12-1:1 being much higher than in Europe.
P83 Combined liver and kidney transplantation: a single centre experience
Authors: M. Smith, K. Rye, T. Haldane, B. Gunson, S. Bramhall, D. Mutimer
Journal: Gut (2011)

<h3>Introduction</h3> Combined liver kidney transplantation (CLKT) is an accepted approach to management of patients with dual organ pathology, but may be associated with significant additional post-operative morbidity and mortality in comparison with transplantation of either organ alone. <h3>Aim</h3> To analyse the experience of CLKT at a single centre. <h3>Method</h3> Retrospective analysis of all CLKTs performed at our centre between May 1994 and August 2010. Data collected included demographics, indications for CLKT, surgical techniques, post-transplant complications and patient/graft survival. <h3>Results</h3> Of 2130 liver transplants (LT) performed there were 24 CLKTs—12 male with median age 52 years, Child-Pugh score 7 and MELD 19. Indications for LT were polycystic liver disease 11 (46%), cirrhosis 7 (29%), hepatocellular carcinoma 2 (8%), recurrent PSC/PBC 3 (12%), oxalosis 1 (4%). The indications for kidney transplantation (KT) were polycystic kidney disease 10 (42%), calcineurin-inhibitor toxicity 4 (17%), chronic kidney graft failure 4 (17%), IgA nephropathy 3 (13%), diabetes 1 (4%), Type II hyperoxaluria 1 (4%), glomerulonephritis 1 (4%). Five patients had prior KT; four chronic graft failure, 1 calcineurin-inhibitor toxicity. 12 patients (50%) were dialysis-dependent pre-transplantation. During a median follow-up of 1223 days (IQR 550–2264 days) 5 patients died (overall survival 79.2%) with a median time from CLKT to death 947 days (range 4–2373 days). Causes of death: primary non-function of the liver (1), cardiac complications (2) and de novo cancer (2). Seven patients (29%) had at least one episode of histologically proven acute cellular rejection of the liver and 1 (4%) acute renal rejection. Cumulative 1, 3 and 5-year patient, liver graft and kidney graft survival were 96%, 85%, 75%; 86%, 79%, 62% and 91%, 85%, 75% respectively. 3 patients required further liver transplantation (2 hepatic artery thrombosis, 1 primary non-function). 13 patients required haemodialysis post-operatively. At 3-month follow-up, survivors had median creatinine and eGFR of 129 μmol/l and 48 ml/min respectively; 1 patient still required dialysis. At 1 year and 5 years median creatinine and eGFR were 134 μmol/l and 43 ml/min, 155 μmol/l and 38 ml/min respectively. 1 patient resumed haemodialysis 4640 days after CLKT and is on the waiting list for renal re-transplantation. <h3>Conclusion</h3> CLKT in this cohort had favourable outcomes with excellent patient and graft survival (both organs). Although the number of patients in our study is relatively few, 5-year kidney graft survival rates do not appear inferior to published data for patients undergoing renal transplantation alone.
Reflections on Skin Grafting in Hand Repairs
Authors: Bradford Cannon
Journal: JAMA (1967)

The hand is exposed to many hazards, some of which result in loss of skin. Recovery of normal function depends on prompt replacement of the protective skin cover with skin graft. With rare exceptions a split-thickness graft is chosen for primary closure following acute trauma. The graft is easily cut, insures a stable bearing surface, "takes" well, and leaves minimal scarring at the donor site. Elective incisions in the hand prior to skin grafting should not cross flexion creases; disfiguring or disabling scars should be avoided in selecting a donor site; and where possible the simplest, most expeditious method of repair will usually insure the best functional result.
The search for Samojloff: a Russian physiologist in times of change.
Authors: D M Krikler
Journal: BMJ (1987)

The names of Russian physicians do not often spring to mind when recalling the advances of the past century, though a quick glance discloses many contributions, including those of Anitschkow in the pathogenesis of arteriosclerosis, Korotkoff in the measurement of blood pressure, and Elie Metchnikoff, the bacteriologist. Few, however, realise that James Herrick's diagnosis of coronary occlusion in the living patient1 had been anticipated by two years by two physicians from Kiev, Obrastzow and Straschesko. Their original description in Russki Vrach was republished almost simultaneously in German and was cited by Herrick.2 Even before this, however, a Russian physiologist, Alexander Filipovich Samojloff, had written the first book on electro cardiography, which should have been easily accessible to Western physicians because it was written in German and had been issued by a leading German publisher.3 The book is not, however, listed in two important EngUsh bibliographies,45 though it and several other publications by Samojloff were cited by Western contemporaries, and his contributions are proudly acknowledged in the Soviet Union. Who was Samojloff and what was his role in Russian and indeed international physiology?
Radiation and Thyroid Neoplasia
Authors: WILLIAM M. MCCONAHEY
Journal: Annals of Internal Medicine (1976)

Comments and Corrections1 June 1976Radiation and Thyroid NeoplasiaWILLIAM M. MCCONAHEY, M.D., A. B. HAYLES, M.D.WILLIAM M. MCCONAHEY, M.D.Search for more papers by this author, A. B. HAYLES, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-6-749 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: It is now generally accepted that an association exists between external radiation administered to the head, neck, and upper thorax of infants, children, and adolescents and the subsequent development of neoplastic changes in the thyroid gland. Until recent years, external radiation was frequently administered to shrink an enlarged thymus or for the treatment of tonsillitis, adenoiditis, hearing loss, hemangioma, acne, tinea capitis, and other conditions. During the course of these treatments, the thyroid gland was exposed to scatter radiation. The use of external radiation therapy was then accepted practice, and its value was attested by many. Concern... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: WILLIAM M. MCCONAHEY, M.D.; A. B. HAYLES, M.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byRadiation and the thyroidManagement of thyroid nodules. I: History and physical examination, blood tests, x-ray tests, and ultrasonographyReactions to ionizing radiationThe Approach to the Irradiated ThyroidThe Thyroid 1 June 1976Volume 84, Issue 6Page: 749-750KeywordsAcneAdolescentsCandidaChildrenHearingInfantsRadiation therapyThoraxThymusThyroid ePublished: 1 December 2008 Issue Published: 1 June 1976 PDF downloadLoading ...