tbuckley/cabot-search huggingface dataset:
PMO-120 Kupffer cell derived interleukin (IL)-18 induces hepatic inflammation by promoting lymphocyte subsets recruitment on hepatic endothelial cells
Authors: E Liaskou, D Withers, E Humphreys, J C Shaw, L Tuohey, P Klenerman, D H Adams, Y H Oo
Journal: Gut (2012)

<h3>Introduction</h3> IL-18, known as interferon-γ inducing factor, is a potent pro-inflammatory cytokine implicated in liver allograft rejection, viral hepatitis and hepatocellular carcinoma progression, where it plays an important role in cell-mediated immune responses and inflammatory injury. We hypothesise that IL-18 promotes hepatic inflammation by supporting effector T cells migration across hepatic sinusoidal endothelium. In this study, we investigated the expression and cellular regulation of IL-18 secretion in the human liver and demonstrated a role in promoting T cell recruitment to the liver. <h3>Methods</h3> IL-18 mRNA expression levels were measured in normal and diseased human livers using QRT-PCR and tissue localisation assessed by immunohistochemistry and confocal microscopy. Human hepatic sinusoidal endothelial cells were treated with Il-18 in vitro and flow cytometry used to assess induction of adhesion molecules. The functional significance of these responses to IL-18 was investigated in flow based adhesion assays using IL-18 treated HSEC and CD4 and CD8 T cell subsets under physiological flow. <h3>Results</h3> IL-18 mRNA expression was significantly higher in liver tissue form patients with ALD (19-fold), PBC (7.6-fold) and seronegative hepatitis (30.6-fold) (p&lt;0.05) compared with normal liver. IL-18 protein expression was restricted to hepatic sinusoids where it colocalized with CD68<sup>+</sup> Kupffer cells, whereas CD31<sup>+</sup> endothelial cells were IL-18<sup>neg</sup>. HSEC stimulated with IL-18 lead upregulation of cell adhesion molecules ICAM-1 and VCAM-1 which translated into a 2.5-fold increase in their functional ability to recruit CD4 and CD8 T cells in flow-based adhesion assays. Total adhesion of CD4 and CD8 T cells was significantly (p&lt;0.05) reduced when ICAM-1, VCAM-1, and CXCR3 molecules were blocked or if G protein coupled receptors were inhibited with pertussis toxin (PTX). CD8 T cell adhesion was also dependent on vascular adhesion protein-1. <h3>Conclusion</h3> We report high IL-18 expression by Kupffer cells in inflammatory liver disease. The ability of IL-18 to enhance T cell recruitment via sinusoidal endothelium suggests it acts to promote lymphocyte recruitment during the development of chronic hepatitis and is thus a potential novel therapeutic target in inflammatory liver disease. <h3>Competing interests</h3> None declared.
Reduced concentrations of potassium, magnesium, and sodium-potassium pumps in human skeletal muscle during treatment with diuretics
Authors: I Dorup, K Skajaa, T Clausen, K Kjeldsen
Journal: BMJ (1988)

Animal studies have shown that potassium depletion induced by diuretics or potassium deficient fodder leads to a selective decrease in the concentrations of potassium and in the concentration of sodium-potassium pumps in skeletal muscle. In 25 patients who had received diuretics for 2-14 years the mean concentrations of potassium, magnesium, and sodium-potassium pumps were measured in skeletal muscle biopsy specimens and were significantly lower than in those from a group of age matched controls. The reductions in all three variables were significant in those patients receiving diuretics for arterial hypertension as well as in those being treated for congestive heart failure. In 14 patients the mean muscle potassium concentration was below the control range, but only one of those was hypokalaemic (3·4 mmol/l), and 13 were receiving potassium supplements. In 15 patients the mean muscle magnesium concentration was below normal, and the mean muscle potassium and magnesium concentrations showed a linear correlation. In 12 patients in whom the mean muscle potassium concentration was below 80 μmol/g wet weight there was a linear correlation between the cellular potassium:sodium ratio and the concentration of <sup>3</sup>H-ouabain binding sites indicating that potassium deficiency also leads to a down regulation of sodium-potassium pumps in human skeletal muscle. In spite of potassium supplements long term treatment with diuretics may lead to potassium and magnesium deficiencies, which are not detectable using the standard methods of serum analysis. The changes in concentrations of electrolytes and sodium-potassium pumps associated with treatment with diuretics may impair muscle function and potassium homoeostasis and interfere with the distribution of digitalis glycosides.
Surgeons condemn Lansley for misinformation on outcomes of knee operations
Authors: Z. Kmietowicz
Journal: BMJ (2012)

Organisations representing orthopaedic surgeons have written to the health secretary Andrew Lansley admonishing him for statements he made about the outcomes of knee surgery, which they say were misinformed and could have deterred patients from having operations and alarmed others about their prognosis.

The letter is a response to an interview with Mr Lansley in the Sunday Times on 29 January, in which he said, “An interesting case in point is knee surgery; the data has now come back demonstrating half of knee surgery doesn’t substantially change the outcome for patients: their mobility isn’t improved that much, nor their pain.”

Joe Dias, president of the British Orthopaedic Association, and Tim Wilton, president of the British Association for Surgery to …
Acute Pancreatitis after Double-Balloon Enteroscopy: An Old Pathogenetic Theory Revisited as a Result of Using a New Endoscopic Tool
Authors: M. J. Groenen, T. G. Moreels, H. Orlent, J. Haringsma, E. J. Kuipers
Journal: Endoscopy (2006)

Double-balloon enteroscopy is a novel technique for visualizing the entire small bowel. Complications have been reported relatively rarely in the small series published up until now. In this report we describe two patients who developed acute pancreatitis immediately after double-balloon enteroscopy, diagnosed on clinical, biochemical, and radiological grounds. In both patients the pancreatitis resolved with supportive care. Based on early studies on the pathogenesis of acute pancreatitis, we discuss the possible pathogenetic mechanism for pancreatitis arising as a complication of this novel endoscopic technique.
Misstatement Concerning Phylacogen
Authors: E. B. Edie
Journal: JAMA (1913)

<h3>To the Editor:</h3> —I wish to correct, through your columns, a statement which occurs in Parke, Davis and Company's Therapeutic Notes, Special Phylacogen Number, January, 1913. On page 56, it is said that Phylacogens were discussed at a meeting of the Fayette County Medical Society, Connellsville, Pa., June 18, 1912. On that date the physicians of Connellsville were invited by a local druggist to assemble in the parlors of the Arlington Hotel to hear a talk on "Serums and Vaccines." About a dozen attended and were plentifully supplied with cigars, beer and Phylacogen claims by one of Parke, Davis and Company's hired men. The Fayette County Medical Society held no meeting in June, 1912, and has at no time discussed Phylacogen or any other proprietary medicine. <h3>The Role of Prevention.</h3> —In the future of medicine, the mere removal of disease must play more and more a subordinate part. Most disease
Therapeutic effects of lysophosphatidylcholine in experimental sepsis
Authors: Ji-Jing Yan, Jun-Sub Jung, Jung-Eun Lee, Jongho Lee, Sung-Oh Huh, Hee-Sung Kim, Kyeong Cheon Jung, Jae-Young Cho, Ju-Suk Nam, Hong-Won Suh, Yung-Hi Kim, Dong-Keun Song
Journal: Nature Medicine (2004)
Does hepatitis C virus cause hepatocellular carcinoma?
Authors: Hubert E. Blum
Journal: Hepatology (1994)

Background and Methods. To detect potentially curable cases of hepatocellular carcinoma, outpatients with chronic hepatitis or compensated liver cirrhosis who were seen at the Center for Adult Diseases (Osaka, Japan) were examined periodically by means of ultrasonography and measurement of serum alpha-fetoprotein. Risk factors for hepatocellular carcinoma were identified with a Cox proportional-hazards model. Results. A total of 917 patients, 40 to 69 years old, were registered from May 1987 to March 1991. By the end of September 1991, liver cancer had developed in 54. The three-year cumulative risk of liver cancer was 12.5 percent for 240 patients with liver cirrhosis at enrollment and 3.8 percent for 677 patients with chronic hepatitis. Cox regression analysis showed that the risk of liver cancer was increased almost sevenfold in patients with hepatitis B surface antigen (rate ratio, 6.92; 95 percent confidence interval, 2.92 to 16.39) and fourfold in patients with hepatitis C antibody (rate ratio, 4.09; 95 percent confidence interval, 1.30 to 12.85). A high alpha-fetoprotein value at enrollment was also a risk marker for liver cancer. Conclusions. Patients with hepatitis C virus infection have a greatly increased risk of liver cancer. Further studies are required to clarify the roles of other risk factors, including drinking and smoking habits.
Recovering the Good Earth: China’s Growing Organic Market
Authors: David A. Taylor
Journal: Environmental Health Perspectives (2008)

A worker picks cucumbers at an organic farm near Beijing, 20 June 2008.Typically the fruits and vegetables grown here are exported; however, during the Olympic Games in August, the farm will supply produce to event caterers. People whose impressions of Chinese food exports are colored by reports of contaminated pet food or pesticide-laced dumplings might not expect China to have much of an organic market.They would be wrong.According to "The Greening of China's Food: Green Food, Organic Food, and Eco-labelling," a paper presented at the May 2008 Sustainable Consumption and Alternative Agri-Food Systems Conference, 28% of China's arable land-just over 34 million hectaresis devoted to "eco-foods," a designation that includes organic certification as well as China's unique "green" and "hazard-free" categories of food.In an increasingly global food market, unexpected opportunities for farmers around the world are opening in unlikely places, such as China's experiments with organic food.The world market for organic foods has soared, with sales growing by more than US$5 billion annually and doubling between 2000 and 2006, according to the International Federation of Organic Agriculture Movements (IFOAM), an umbrella organization based in Bonn, Germany.That international trend explains why China and other countries-despite relatively little domestic demand for organic food-have become big players in the organic market.Organic farming in China is largely an export-oriented industry, with the main products for both export and import being cereals, soybeans, and tea, followed by some vegetables, fruits and meat.Yet, although China has instituted several eco-food certification systems, reports of lax inspections persist."Regulation is an imperfect substitute for the accountability, and trust, built into a market in which food producers meet the gaze of eaters and vice versa," author Michael Pollan writes in his 2008 book In Defense of Food: An Eater's Manifesto.In situations where farmers and consumers can't meet face-to-face at the farmer's market, however, some form of inspection is all that's left to serve the interest of public health.How, then, is China adapting to secure the safety of its exports and the health of its own citizens?
PREDICTION OF OPTIMAL DEPLOYMENT ANGLE FOR TAVR: FEASIBILITY OF CT ANGIOGRAPHY AND NON–CONTRAST DYNACT IMAGE REGISTRATION BASED APPROACH AND ITS POTENTIAL IMPLICATION ON LIMITING CONTRAST VOLUME
Authors: Colin M. Barker, Ponraj Chinnadurai, Basel Ramlawi, Gouthami Chintalapani, Su Min Chang, Mohammed Al–Marzooq, C. Huie Lin, Julie Veasey, Faisal Nabi, Stephen Little, John Mahmarian, Michael Reardon, Neal Kleiman
Journal: Journal of the American College of Cardiology (2013)
Prevalence of Raynaud's phenomenon in a healthy Greek population
Authors: P. V Voulgari
Journal: Annals of the Rheumatic Diseases (2000)

Raynaud's phenomenon (RP) is comprised of repeated episodes of colour changes of the skin of digits on cold exposure or emotional stress. The prevalence of RP in the general population is variable fluctuating between 4%-15%, among surveys. The aim of this study was to estimate the prevalence of RP in a healthy working Greek population and to investigate the possible association of RP with various demographic, social and other factors.A total of 756 employees of the University Hospital of Ioannina was included in the study. They belong to the administrative (120 subjects), nursing and technical (a representative sample of 418 and 218 subjects, respectively) personnel. Five hundred subjects (111 men and 389 women) responded in a face to face interview based on a specially conformed questionnaire. The study began in November 1997 and was completed in March 1998.Twenty six subjects with RP (1 man and 25 women) were found. Their mean (SD) age was 32.73 (5.77) years. The prevalence of RP was 5.2% (0.9% in men and 6.4% in women). The sex ratio, male/female, was 1/7.1. An association between RP and migraine was found. However, there were no significant correlations of RP with smoking, alcohol and coffee consumption, dietary habits, occupational history and drug exposure. No social or other demographic parameters associated to RP frequency were found.The prevalence of RP (5.2%) in the population studied is relatively low compared with previous studies. RP focuses on the fourth decade of life and affects mainly women. There was no evidence of any correlation of RP with social, environmental or personal parameters while an association of RP with migraine was found. Geographical or genetic factors, or both, may be responsible for these results.
Addressing the Ethical, Legal, and Social Issues Raised by Voting by Persons With Dementia
Authors: Jason H Karlawish, Richard J Bonnie, Paul S Appelbaum, Constantine Lyketsos, Bryan James, David Knopman, Christopher Patusky, Rosalie A Kane, Pamela S Karlan
Journal: JAMA (2004)

This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance to enable persons with cognitive impairment to vote; and formulation of uniform and workable policies for voting in long-term care settings. In some instances, extrapolation from existing policies and research permits reasonable recommendations to guide policy and practice. However, in other instances, additional research is necessary.
Randomized Trial of Short- Versus Long-Course Radiotherapy for Palliation of Painful Bone Metastases
Authors: William F. Hartsell, Charles B. Scott, Deborah Watkins Bruner, Charles W. Scarantino, Robert A. Ivker, Mack Roach, John H. Suh, William F. Demas, Benjamin Movsas, Ivy A. Petersen, Andre A. Konski, Charles S. Cleeland, Nora A. Janjan, Michelle DeSilvio
Journal: JNCI Journal of the National Cancer Institute (2005)

Background: Radiation therapy is effective in palliating pain from bone metastases. We investigated whether 8 Gy delivered in a single treatment fraction provides pain and narcotic relief that is equivalent to that of the standard treatment course of 30 Gy delivered in 10 treatment fractions over 2 weeks. Methods: A prospective, phase III randomized study of palliative radiation therapy was conducted for patients with breast or prostate cancer who had one to three sites of painful bone metastases and moderate to severe pain. Patients were randomly assigned to 8 Gy in one treatment fraction (8-Gy arm) or to 30 Gy in 10 treatment fractions (30-Gy arm). Pain relief at 3 months after randomization was evaluated with the Brief Pain Inventory. The Wilcoxon–Mann–Whitney test was used to compare response to treatment in terms of pain and narcotic relief between the two arms and for each stratification variable. All statistical comparisons were two-sided. Results: There were 455 patients in the 8-Gy arm and 443 in the 30-Gy arm; pretreatment characteristics were equally balanced between arms. Grade 2–4 acute toxicity was more frequent in the 30-Gy arm (17%) than in the 8-Gy arm (10%) (difference = 7%, 95% CI = 3% to 12%; P = .002). Late toxicity was rare (4%) in both arms. The overall response rate was 66%. Complete and partial response rates were 15% and 50%, respectively, in the 8-Gy arm compared with 18% and 48% in the 30-Gy arm ( P = .6). At 3 months, 33% of all patients no longer required narcotic medications. The incidence of subsequent pathologic fracture was 5% for the 8-Gy arm and 4% for the 30-Gy arm. The retreatment rate was statistically significantly higher in the 8-Gy arm (18%) than in the 30-Gy arm (9%) ( P <.001). Conclusions: Both regimens were equivalent in terms of pain and narcotic relief at 3 months and were well tolerated with few adverse effects. The 8-Gy arm had a higher rate of re-treatment but had less acute toxicity than the 30-Gy arm.
Natalizumab plus Interferon Beta-1a for Relapsing Multiple Sclerosis
Authors: Richard A. Rudick, William H. Stuart, Peter A. Calabresi, Christian Confavreux, Steven L. Galetta, Ernst-Wilhelm Radue, Fred D. Lublin, Bianca Weinstock-Guttman, Daniel R. Wynn, Frances Lynn, Michael A. Panzara, Alfred W. Sandrock
Journal: New England Journal of Medicine (2006)

Interferon beta is used to modify the course of relapsing multiple sclerosis. Despite interferon beta therapy, many patients have relapses. Natalizumab, an alpha4 integrin antagonist, appeared to be safe and effective alone and when added to interferon beta-1a in preliminary studies.We randomly assigned 1171 patients who, despite interferon beta-1a therapy, had had at least one relapse during the 12-month period before randomization to receive continued interferon beta-1a in combination with 300 mg of natalizumab (589 patients) or placebo (582 patients) intravenously every 4 weeks for up to 116 weeks. The primary end points were the rate of clinical relapse at 1 year and the cumulative probability of disability progression sustained for 12 weeks, as measured by the Expanded Disability Status Scale, at 2 years.Combination therapy resulted in a 24 percent reduction in the relative risk of sustained disability progression (hazard ratio, 0.76; 95 percent confidence interval, 0.61 to 0.96; P=0.02). Kaplan-Meier estimates of the cumulative probability of progression at two years were 23 percent with combination therapy and 29 percent with interferon beta-1a alone. Combination therapy was associated with a lower annualized rate of relapse over a two-year period than was interferon beta-1a alone (0.34 vs. 0.75, P<0.001) and with fewer new or enlarging lesions on T(2)-weighted magnetic resonance imaging (0.9 vs. 5.4, P<0.001). Adverse events associated with combination therapy were anxiety, pharyngitis, sinus congestion, and peripheral edema. Two cases of progressive multifocal leukoencephalopathy, one of which was fatal, were diagnosed in natalizumab-treated patients.Natalizumab added to interferon beta-1a was significantly more effective than interferon beta-1a alone in patients with relapsing multiple sclerosis. Additional research is needed to elucidate the benefits and risks of this combination treatment. (ClinicalTrials.gov number, NCT00030966.).
CASE OF DOUBLE ANUS, VAGINA AND UTERUS
Authors: William A. Hinckle
Journal: JAMA (1928)

While congenital malformations of the pelvic organs are by no means a rarity, the case here reported is, I believe, extremely unusual. A woman, aged 62, had enjoyed normal health until recently. She was referred to me for certain rather indefinite bowel and rectal symptoms. After much persuasion I was permitted to make an examination which she had previously denied to others. Her reason for objecting was soon apparent. Externally I found two well developed anuses about three inches apart. Each had a well defined sphincter muscle over which the patient had fair control. There were two vaginas and two well developed clitorides. The labia majora on the outer sides were normal. The two on the inner aspects were fused into a sort of central perineal body. The organs on the left were better developed than those on the right. Defecation was usually through the left anus, though, when the movements were
Avoiding Bias in the Annualized Rate of Change of FEV<sub>1</sub>
Authors: Philip H. Quanjer, Jan P. Schouten, Martin R. Miller, Gregg Ruppel
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

reasonable to conclude that if PSR inhibition occurred at a higher PaCO2 during PLV than GV then pulmonary stretch must have been higher during PLV than GV. That is, PSR activity was inhibited during PLV at a higher pressure than during GV since PaCO2 was high during PLV. In addition, since the model studied by Sindelar and coworkers was a small lung lavage–injured cat (2.3 1.0 kg), it is unlikely that the impact of perfluorocarbons on dependent lung would be the same as in an adult human. The difference in the height of the lungs (about 3 to 4 cm vs. 15 to 20 cm) would result in marked differences in the effect of the perfluorocarbon on dependent alveoli. Considering the quantity of perfluorocarbon instilled in adult patients (30 ml/kg or about 2,250 ml, 75 kg adult) versus the studied cats (30 ml/kg or about 69 ml, 2.3 kg) and a perfluorocarbon density of 1.9, it is difficult to conceive that the most gravity-dependent alveolar pressure during both inspiration and expiration would be similar during GV and PLV at the same airway gas pressure. It is important to remember that, during PLV, gas ventilation is provided on top of the perfluorocarbon-filled lungs. It is true that with gas ventilation the perfluorocarbon spreads over a larger lung area. However, there is still a column of fluid on top of dependent alveoli that is pressurized by the gas ventilation. Overall, what is clearly needed is additional research into the use of perfluorocarbon-assisted ventilation and the mechanisms associated with both its beneficial and detrimental effects.
Concerning Pads upon the Finger Joints and their Clinical Relationships
Authors: A. E. Garrod
Journal: BMJ (1904)

On 4nother occasion a patient was seen with a small elastic swelling near the head of the right epididymis.It felt like one of the cysts which are so commonly met with in that situation, but it was not translucent.A small trochar and cannula were used to empty the supposititious cyst, butonlya little blood ran out, and the lumen of the trochar was partially blocked with a scrap of soft tissue.This was pronounced by the pathologist to be sarcomatous.The testicle was removed and a small sarcomatous tumour found in the body of the testis close to the head of the epididymis.In conclusion, you will remember when confronted with a young and ambiguous tumour to assume ain attitude of intel- lectual humility, and carefully eschew diagnostic omniscience and infallibility.For knowledge is of things we see.NOTE AND REFERENCE. 1 1 am told that Mr. Shaw has been timed to have the section ready in two minutes.