tbuckley/cabot-search huggingface dataset:
Biliary duct-to-duct anastomosis using magnets in a Billroth II gastrectomy patient
Authors: T. Tsuchiya, T. Itoi, A. Sofuni, F. Itokawa, D. Lee
Journal: Endoscopy (2013)

The usefulness of magnetic compression anastomosis (MCA) for biliary duct-to-duct anastomosis had been reported in patients with normal anatomy or after liver transplantation [1] [2] [3] [4]. Here we report a case of successful MCA for biliary duct-to-duct anastomosis, carried out in a 65-year-old woman who underwent Billroth II gastrectomy for pyloric stenosis at the age of 17 years. Regarding the patient's present condition, 2 years after liver central bisegmentectomy (with common bile duct preservation) for hepatoma, she developed hilar biliary obstruction. To treat this, we carried out posterior segmental branch percutaneous transhepatic biliary drainage (PTBD). As the patient refused re-operation, we carried out MCA. As described previously [1] [2] [3], we initially placed a 16-Fr PTBD tube to dilate the biliary tract, after which two 7-Fr plastic stents were placed up to the right hepatic bile duct using a colonoscope. Magnetic retrograde cholangiopancreatography (MRCP) and computed tomography (CT) revealed that the distance between the PTBD tube and the endoscopic biliary drainage tube was approximately 15 mm ([Fig. 1]). At 2 weeks after stent placement, we carried out MCA. A samarium cobalt rare-earth magnet was advanced in front of the papilla with a biopsy forceps using an oblique-viewing endoscope (XK240, Olympus, Tokyo, Japan). The magnet was then inserted up to the right hepatic duct under fluoroscopic guidance. Another magnet was advanced to the right hepatic duct via the PTBD route, and the two magnets were attracted towards each other ([Fig. 2 a]). The following day, the magnets were observed to be almost in total contact with each other ([Fig. 2 b]). After 1 month, the two approximating magnets were removed via the PTBD route and a 14-Fr internal fistula tube was placed ([Fig. 3]). To the best of our knowledge, this is the first report on successful MCA in a Billroth II gastrectomy patient. MCA may be beneficial for biliary duct-to-duct anastomosis in selected patients.
Antipili antibody affords protection against experimental ascending pyelonephritis.
Authors: F J Silverblatt, L S Cohen
Journal: Journal of Clinical Investigation (1979)

The ability of antipili antibody to prevent ascending urinary tract infection was investigated in rats. One group of rats was immunized passively with rabbit antisera to purified pili and challenged by intravesicular inoculation of 5 x 10(7) heavily piliated Escherichia coli. Only 2 of 14 immunized animals developed cortical abscesses as compared to 13 of 15 control rats given normal rabbit serum (P equals 0.0001). The mean log titer of bacteria in the kidneys of the immunized rats was 0.85 vs. 6.08 in the controls (P less than 0.005). A second group was actively immunized with pili. 3 of 16 immunized animals became infected as compared to 10 of 15 controls (P equals 0.01). The mean log titers were 2.13 and 4.54, respectively (P less than 0.01). A third group was passively immunized and challenged with a strain that had different O, K, and H antigens but shared pili antigens. Abscesses occurred in 4 of 15 immunized animals as compared to 13 of 15 controls (P equals 0.001). The mean log titers were 2.37 and 5.63, respectively (P less than 0.005). These results indicate that antipili antibody protects rats against ascending urinary tract infections.
A Novel Substrate-Based HIV-1 Protease Inhibitor Drug Resistance Mechanism
Authors: Monique Nijhuis, Noortje M van Maarseveen, Stephane Lastere, Pauline Schipper, Eoin Coakley, Bärbel Glass, Mirka Rovenska, Dorien de Jong, Colombe Chappey, Irma W Goedegebuure, Gabrielle Heilek-Snyder, Dominic Dulude, Nick Cammack, Lea Brakier-Gingras, Jan Konvalinka, Neil Parkin, Hans-Georg Kräusslich, Francoise Brun-Vezinet, Charles A. B Boucher
Journal: PLoS Medicine (2007)

HIV protease inhibitor (PI) therapy results in the rapid selection of drug resistant viral variants harbouring one or two substitutions in the viral protease. To combat PI resistance development, two approaches have been developed. The first is to increase the level of PI in the plasma of the patient, and the second is to develop novel PI with high potency against the known PI-resistant HIV protease variants. Both approaches share the requirement for a considerable increase in the number of protease mutations to lead to clinical resistance, thereby increasing the genetic barrier. We investigated whether HIV could yet again find a way to become less susceptible to these novel inhibitors.We have performed in vitro selection experiments using a novel PI with an increased genetic barrier (RO033-4649) and demonstrated selection of three viruses 4- to 8-fold resistant to all PI compared to wild type. These PI-resistant viruses did not have a single substitution in the viral protease. Full genomic sequencing revealed the presence of NC/p1 cleavage site substitutions in the viral Gag polyprotein (K436E and/or I437T/V) in all three resistant viruses. These changes, when introduced in a reference strain, conferred PI resistance. The mechanism leading to PI resistance is enhancement of the processing efficiency of the altered substrate by wild-type protease. Analysis of genotypic and phenotypic resistance profiles of 28,000 clinical isolates demonstrated the presence of these NC/p1 cleavage site mutations in some clinical samples (codon 431 substitutions in 13%, codon 436 substitutions in 8%, and codon 437 substitutions in 10%). Moreover, these cleavage site substitutions were highly significantly associated with reduced susceptibility to PI in clinical isolates lacking primary protease mutations. Furthermore, we used data from a clinical trial (NARVAL, ANRS 088) to demonstrate that these NC/p1 cleavage site changes are associated with virological failure during PI therapy.HIV can use an alternative mechanism to become resistant to PI by changing the substrate instead of the protease. Further studies are required to determine to what extent cleavage site mutations may explain virological failure during PI therapy.
Multiple Colonic Masses in a Young Woman
Authors: James J. Pollard, Robert A. Nebesar
Journal: JAMA (1964)

Dr. Luiz F. Mattoso: This 19-year-old, single, white female came to the outpatient department because of a missed menstrual period. At the Gynecology Clinic she was found to have a hemoglobin level of 7.7 gm and a hematocrit value of 31%. Because of this anemia she was admitted for diagnostic workup. The patient had enjoyed good health but had had episodes of diarrhea during the previous year and, usually, three bowel movements a day. She had noted dark stools and bright red blood on occasion. No weight loss had occurred. Her past medical history was otherwise not remarkable. Admission laboratory examination showed a hematocrit value of 34%; a white blood count of 10,000 with a normal differential; results negative to urinalysis and positive to the stool guaiac test; and a bromsulphalein retention of 5%. Roentgenograms of the chest and abdomen were taken on admission and both appeared to be normal.
Fukushima: lightening the darkness for next time
Authors: T. Delamothe
Journal: BMJ (2011)

The challenge now is to learn as much as possible about the medical effects of radiation



The BMJ ’s editorial board met in London last month, but one board member, Ryuki Kassai, wasn’t there. As head of the Department of Community and Family Medicine at Fukushima Medical University he was busy elsewhere. You can read his blogs at http://blogs.bmj.com/ and listen to his podcast at http://podcasts.bmj.com/ about facing the unimaginable triple whammy of earthquake, tsunami, and radiation leak.

Coastal towns near Fukushima now look like Hiroshima after the bomb, and Dr Kassai begins his first blog by quoting the writer Kenzaburo Oe’s Hiroshima Notes , about falling again into the darkness after having once known the light.

What surprised me was Dr Kassai’s claim that high quality, standardised, evidence based information on how to respond was lacking. “We experienced the disasters in Hiroshima and Nagasaki, but despite this there are many misunderstandings regarding radiation,” he wrote. “We need information on immediate, short, and long term effects of radiation, and interventions and strategies to alleviate the effects.”

But surely after the atomic bombs in Japan and the radiation leak in Chernobyl there was nothing much left to learn. And then I remembered a session I attended at the annual congress of the International Physicians for …
Peripheral Nerve Injuries — Diagnosis and Treatment
Authors: Svante Edshage
Journal: New England Journal of Medicine (1968)

NERVE suture is still a field of surgery in which results often fall short of goals. The difficulties in the evaluation of results have been elucidated by the methods for the examination of the regeneration of sensibility described by Moberg,1 , 2 who emphasizes the fact that evaluation should always be in terms of "functional recovery" and not "academic recovery."3 By academic recovery he means the kind of sensibility that is registered by needle and cotton-wool tests. These types of tests cannot differentiate paresthesia from useful sensibility. Paresthesia may under certain circumstances be regarded as an unuseful type of sensibility and should . . .
The molecular mechanisms that control thrombopoiesis
Authors: K. Kaushansky
Journal: Journal of Clinical Investigation (2005)

Our understanding of thrombopoiesis--the formation of blood platelets--has improved greatly in the last decade, with the cloning and characterization of thrombopoietin, the primary regulator of this process. Thrombopoietin affects nearly all aspects of platelet production, from self-renewal and expansion of HSCs, through stimulation of the proliferation of megakaryocyte progenitor cells, to support of the maturation of these cells into platelet-producing cells. The molecular and cellular mechanisms through which thrombopoietin affects platelet production provide new insights into the interplay between intrinsic and extrinsic influences on hematopoiesis and highlight new opportunities to translate basic biology into clinical advances.
Immune Thrombocytopenic Purpura — Let the Treatment Fit the Patient
Authors: James N. George, Sara K. Vesely
Journal: New England Journal of Medicine (2003)

Recognition of immune thrombocytopenic purpura is increasing because of the increasing frequency of routine blood counts that reveal unexpected thrombocytopenia. For patients who may have immune thrombocytopenic purpura, the essential decisions are whether to perform additional diagnostic studies and whether to initiate any treatment.The diagnosis of immune thrombocytopenic purpura is established only by ruling out other causes of thrombocytopenia. The patient's history, the findings on physical examination, the blood counts, and the findings on examination of the blood smear are usually sufficient.1,2 Examination of the blood smear is essential to rule out in vitro platelet clumping that can . . .
Secreted Lymphotoxin-α Is Essential for the Control of an Intracellular Bacterial Infection
Authors: Daniel R. Roach, Helen Briscoe, Bernardette Saunders, Malcolm P. France, Sean Riminton, Warwick J. Britton
Journal: The Journal of Experimental Medicine (2001)

Although the essential role of tumor necrosis factor (TNF) in the control of intracellular bacterial infection is well established, it is uncertain whether the related cytokines lymphotoxin-alpha (LTalpha3) and lymphotoxin-beta (LTbeta) have independent roles in this process. Using C57Bl/6 mice in which the genes for these cytokines have been disrupted, we have examined the relative contribution of secreted LTalpha3 and membrane-bound LTbeta in the host response to aerosol Mycobacterium tuberculosis infection. To overcome the lack of peripheral lymph nodes in LTalpha-/- and LTbeta-/- mice, bone marrow chimeric mice were constructed. LT-/- chimeras, which lack both secreted LTalpha3 and membrane-bound LTbeta (LT1beta2 and LT2beta1), were highly susceptible and succumbed 5 wk after infection. LTbeta-/- chimeras, which lack only the membrane-bound LTbeta, controlled the infection in a comparable manner to wild-type (WT) chimeric mice. T cell responses to mycobacterial antigens and macrophage responses in LTalpha-/- chimeras were equivalent to those of WT chimeras, but in LTalpha-/- chimeras, granuloma formation was abnormal. LTalpha-/- chimeras recruited normal numbers of T cells into their lungs, but the lymphocytes were restricted to perivascular and peribronchial areas and were not colocated with macrophages in granulomas. Therefore, LTalpha3is essential for the control of pulmonary tuberculosis, and its critical role lies not in the activation of T cells and macrophages per se but in the local organization of the granulomatous response.
Abstract 496: Adaptive response to chronic oxidative stress involves epithelial-mesenchymal transition in MCF-7 breast cancer cells
Authors: Prathap Kumar S. Mahalingaiah, Logeswari Ponnusamy, Kamaleshwar P. Singh
Journal: Cancer Research (2014)

Abstract Though the increased oxidative stress by endogenous and exogenous factors has been hypothesized as a potential mechanism for breast cancer growth and progression, but there is no direct mechanistic evidence for adaptation to ROS-induced toxicity by the breast cancer cells. Therefore the objective of this study was to evaluate effects of chronic oxidative stress on the growth, survival and tumorigenicity of MCF-7 breast cancer cells. MCF-7 cells were exposed to hydrogen peroxide (H202) induced oxidative stress for both acute (48 hrs) and chronic (3 months) period. Cell growth and viability were evaluated by cell count and MTT assay and were confirmed by cell cycle analysis. Expression of genes related to cell cycle, cell survival, and metastasis were measured by quantitative real-time PCR. Effect of oxidative stress on tumorigenic phenotype was determined in-vitro by soft agar assay. Results of cell count, MTT and cell cycle analysis revealed increased growth, and survival of MCF-7 cells that was chronically exposed to H2O2. This was further confirmed at molecular level by increased expression of cell cycle and cell survival genes, whereas down-regulation of apoptotic genes. Chronic oxidative stress also increased tumorigenic phenotype and metastatic potential of MCF-7 cells as revealed by increase in soft agar grown colonies and expression of metastasis related genes. Additionally, fibroblast-like appearance with down regulation of epithelial markers, whereas up-regulation of mesenchymal markers in cells with chronic exposure to oxidative stress further suggest that adaptation to chronic oxidative stress by MCF-7 cells involves epithelial to mesenchymal transition (EMT). Dysregulation of epigenetic regulatory genes expression also suggest potential role of epigenetic mechanism in increased survival and tumorigencity of breast cancer cells.The findings of this study for the first time provided direct evidence for involvement EMT and epigenetic changes in adaptation of MCF-7 breast cancer cells to chronic oxidative stress. Results of this study are also highly significant in understanding the mechanism for acquired resistance to chemotherapeutic drugs that are known to produce ROS in breast cancer cells. Citation Format: Prathap Kumar S. Mahalingaiah, Logeswari Ponnusamy, Kamaleshwar P. Singh. Adaptive response to chronic oxidative stress involves epithelial-mesenchymal transition in MCF-7 breast cancer cells. [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 496. doi:10.1158/1538-7445.AM2014-496
Combined Ventricular Systolic and Arterial Stiffening in Patients With Heart Failure and Preserved Ejection Fraction
Authors: Miho Kawaguchi, Ilan Hay, Barry Fetics, David A. Kass
Journal: Circulation (2003)

Heart failure with preserved ejection fraction (HF-nlEF) is common in aged individuals with systolic hypertension and is frequently ascribed to diastolic dysfunction. We hypothesized that such patients also display combined ventricular-systolic and arterial stiffening that can exacerbate blood pressure lability and diastolic dysfunction under stress.Left ventricular pressure-volume relations were measured in patients with HF-nlEF (n=10) and contrasted with asymptomatic age-matched (n=9) and young (n=14) normotensives and age- and blood pressure-matched controls (n=25). End-systolic elastance (stiffness) was higher in patients with HF-nlEF (4.7+/-1.5 mm Hg/mL) than in controls (2.1+/-0.9 mm Hg/mL for normotensives and 3.3+/-1.0 mm Hg/mL for hypertensives; P<0.001). Effective arterial elastance was also higher (2.6+/-0.5 versus 1.9+/-0.5 mm Hg/mL) due to reduced total arterial compliance; the latter inversely correlated with end-systolic elastance (P=0.0001). Body size and stroke volumes were similar and could not explain differences in ventricular-arterial stiffening. HF-nlEF patients also displayed diastolic abnormalities, including higher left ventricular end-diastolic pressures (24.3+/-4.6 versus 12.9+/-5.5 mm Hg), caused by an upward-shifted diastolic pressure-volume curve. However, isovolumic relaxation and the early-to-late filling ratio were similar in age- and blood pressure-matched controls. Ventricular-arterial stiffening amplified stress-induced hypertension, which worsened diastolic function, and predicted higher cardiac energy costs to provide reserve output.Patients with HF-lnEF have systolic-ventricular and arterial stiffening beyond that associated with aging and/or hypertension. This may play an important pathophysiological role by exacerbating systemic load interaction with diastolic function, augmenting blood pressure lability, and elevating cardiac metabolic demand under stress.
Homolateral Pyramidal Signs with Tumours of the Posterior Fossa
Authors: L. C. Oliver, J. R. Gibbs
Journal: BMJ (1952)

ANAEMIA BsrAt that time the pulse rose to 88.With the exception of one reading (at 9.30 p.m.) the pulse had not exceeded 84 prior to this last reading.She was well next day.The change was very gratifying.The blood counts before and after transfusion were: 1b Hb g./100 ml.,
Acid sphingomyelinase deficient mice: a model of types A and B Niemann–Pick disease
Authors: Kenichi Horinouchi, Shai Erlich, Daniel P. Perl, Klaus Ferlinz, Charles L. Bisgaier, Konrad Sandhoff, Robert J. Desnick, Colin L. Stewart, Edward H. Schuchman
Journal: Nature Genetics (1995)
ABORTIONS IN RUMANIA
Authors: S. Manuila
Journal: JAMA (1933)

<h3>To the Editor:</h3> —I was greatly surprised to read in the Bucharest letter (The Journal, September 2, p. 792) that the number of abortions registered in statistics is about 60,000 a year. I will not discuss the figure, although my associates and I are the only ones in Rumania who could be well aware of the actual number. I have no idea as to the number of abortions that take place here. Two expressions of a contradictory nature—"secret abortions" and "late statistical reports"—are used by the correspondent. The causes of death registered according to the International List give the following data for 1931 and 1932:
Effect of Antacid on Absorption of Enteric-Coated Aspirin
Authors: Stuart Feldman
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Modification of the gastrointestinal absorption of one drug by another may be an important factor in patients receiving multiple drug therapy, especially with the increasing use of over-the-counter medications. We report the influence of administration of antacids on the release of aspirin from an entericcoated formulation. Enteric-coated aspirin (Ecotrin) was administered to six healthy subjects (aged 21 to 32 years) with and without coadministration of a magnesium and aluminum hydroxide oral suspension (Maalox) in a crossover manner. At least one week separated each study. After an overnight fast and one hour prior to the administration of the aspirin, 15 ml of antacid suspension was taken with 85 ml of water. At the time of aspirin administration, 15 ml of antacid suspension was again administered with 85 ml ofwater. The control studies consisted of administration of 100 ml of water one hour prior to and concomitantly with
A genetic cause for skin lumps and diarrhoea
Authors: R P Arasaradnam, H Jarvis, G Waight, R Prajapati, O Adesanya, C Nwokolo
Journal: Gut (2009)

A 50-year-old man presented with a 4 month history of intermittent abdominal pain and diarrhoea associated with weight loss. The abdominal pain was occasionally severe and occurred with bloating and distension. He …
John Edgar Morison
Authors: Chris Morison, Denis Biggart
Journal: BMJ (2007)

John Edgar Morison was educated at Banbridge Academy and entered the medical faculty of Queen's University in 1929. After two years, and obtaining second place in the second medical examination, he transferred for one year to the faculty of science, obtaining the degree of bachelor of science with honours in physiology and biochemistry in 1932. He was awarded the Peel prize in philosophy in 1932. He graduated MB BCh BAO with honours and a first scholarship in 1935. He gained the MD gold medal in 1940 and DSc in 1951. He was also FRCPath, FRCOG ad eundem gradum, and was awarded an …
Family Tree Can Yield Lifesaving Knowledge for Patients at Risk for Hereditary Cancers
Authors: Teri Randall
Journal: JAMA (1992)

FOR MOST WOMEN, a 1 in 9 chance of developing breast cancer in a lifetime is a frightening prospect. Yet for a significant number of women, the odds are much higher than this. Women from certain families, in which breast cancer is an inherited autosomal dominant trait, face odds of 1 in 2. Between 4% and 9% of all breast cancers are believed to be dominantly inherited in the classic Mendelian sense. This may account for as many as 15 000 cases a year. Either parent can pass on the trait to the daughter. (The father would be an "obligate carrier.") The cancer typically occurs 15 to 20 years earlier than usual, bilaterally, or with tumors in other organs, particularly the ovaries. The idea that cancer can follow the classic laws of Mendelian genetics in certain families received a chilly reception from cancer researchers when it was first proposed several
The Surgical Management of Rheumatoid Arthritis
Authors: Leonard F. Peltier
Journal: JAMA (1968)

This book should have a wide circulation among orthopedists, physiatrists, and rheumatologists. It is not solely concerned with the indications for surgery and the technique of operations presently utilized in rehabilitating patients with rheumatoid arthritis, although it very adequately encompasses these subjects. There is special emphasis on the general principles of dealing with the patient and his disease. Well described are the techniques of recording the patient's condition so that changes resulting from progressing disease and treatment can be accurately evaluated. The programs of therapeutic exercise for the conservative management as well as for the postoperative rehabilitation are thoroughly elaborated—a feature that is often lacking in surgical monographs. After a discussion of the general principles of treatment, the special problems of individual joints are considered. The text reads easily; the illustrations are carefully chosen; the book is well printed. The author must be complimented on his well-balanced view of this
Intravascular ultrasound predictors of late recurrence after stent implantation in small coronary arteries
Authors: Ioannis Iakovou, George Dangas, Roxana Mehran, Gary S. Mintz, Alexandra J. Lansky, Milena G. Adamian, Makoto Hirose, Yoshio Kobayashi, Issam Moussa, Gregg W. Stone, Jeffrey W. Moses, Martin B. Leon
Journal: Journal of the American College of Cardiology (2003)