tbuckley/cabot-search huggingface dataset:
THE TREND OF SURGERY
Authors: J. TATE MASON
Journal: JAMA (1927)

Progress is the watchword of science. It would be stimulating to sketch the splendid developments in surgery during the past generations, the observations that transformed the science of surgery from a series of barbarous and hazardous experiments on suffering humanity to a comparatively safe and reliable method of overcoming disease and restoring health; but I shall confine what I have to say to a few observations based largely on my own experience. One cannot look back without a sense of pride and satisfaction to what has been accomplished during the past quarter of a century.  Speculation as to the future and occasionally the outlining of changes for the betterment of conditions as a whole are especially needed in the field of surgery where, many times, an operation is the ultimate effort on the part of the patient and surgeon to remedy a condition that has baffled other branches of medicine.
Weapons of mass destruction
Authors: Imre Loefler
Journal: BMJ (2004)

The agricultural revolution was the first quantum leap in manipulating the environment and the industrial revolution was the second. The medical revolution is the third. Domestication, the harnessing of stored energy, and the eradication of hostile species were necessary before man could invade all niches on earth and multiply. The securement of man's biosphere began with the battle against lion and bear and wolf. Now the biological enemies …
Risk for Colorectal Cancer in Persons With a Family History of Adenomatous Polyps
Authors: Thomas F. Imperiale, David F. Ransohoff
Journal: Annals of Internal Medicine (2012)

Background: The risk for colorectal cancer (CRC) is unclear for persons who have first-degree relatives with adenomatous polyps (adenomas). Purpose: To determine the validity of studies about this issue. Data Sources: MEDLINE and Cochrane databases from 1966 through 2011. Study Selection: Sequential review of titles, abstracts, and text from retrieved articles. Data Extraction: Study objective, study design, and numbers in study groups. Data Synthesis: Ten studies were identified that have been used to answer the question, “Does having a first-degree relative with an adenoma increase the risk for CRC?” We determined that they instead answer the question, “Does having a first-degree relative with CRC increase the risk for an adenoma?” We identified 2 additional studies that provide more relevant information. One study showed that the risk for CRC in persons who have first-degree relatives with adenomas is greater than the risk in persons who do not have first-degree relatives with adenomas (2.31% vs. 0.53%; relative risk, 4.36 [95% CI, 1.60 to 10.21]). The other study showed that the risk for CRC or large adenomas (≥1 cm) in persons who have first-degree relatives with large adenomas is greater than the risk in persons whose first-degree relatives do not have adenomas or CRC (8.3% vs. 4.2%; adjusted odds ratio, 2.27 [CI, 1.01 to 5.09]). Limitation: Even the 2 relevant studies have design problems that affect validity and generalizability. Conclusion: Most studies that are cited for the risk for CRC when relatives have adenomas do not address the issue. The 2 studies that do address the issue suggest an increased risk but have important methodological limitations. Properly designed studies are needed to measure the risk and identify the factors that modify it. Primary Funding Source: National Cancer Institute.
Deep Venous Thrombosis in Total Hip Replacement-Reply
Authors: Richard D. Sautter
Journal: JAMA (1984)

<h3>In Reply.—</h3> Dr Leeman is correct in calling attention to the variable that may confound results in deep venous thrombosis. The evidence is apparent that the type of anesthesia employed during total hip arthroplasty does influence the extent of postoperative deep venous thrombosis. We had no opportunity to evaluate this aspect as all the patients received a general anesthetic. I have one word of caution; elective total hip arthroplasty and emergency surgery for fractured hips are two separate problems. A significant number of patients who have suffered a fractured hip may have developed a deep venous thrombus before surgical intervention. Therefore, comparison between these two groups in regard to evidence of venous thrombosis is inappropriate. We thank Dr Leeman for his kind remarks and hope that he and his colleagues will find our suggested therapeutic regimen helpful.
A Nationwide Plan for Continuing Medical Education
Authors: Bernard V. Dryer
Journal: JAMA (1964)

THERE IS A STORY that tells of a wise old lady who had reached her last hours. Her best friend managed to arouse her long enough to ask: "Tell me, what's the answer?" The woman opened her eyes and said, "What is the question?" Defining the question has always been half the answer, and the question before us now concerns a nationwide plan for continuing medical education. The American Medical Association Board of Trustees has approved implementation of the plan, beginning on a pilot scale, using the monograph, "Lifetime Learning for Physicians" as a guide.<sup>1,2</sup> The objectives of this paper are at least three-fold: (1) to inform you of this nationwide plan if you do not know about it, (2) to add to your information if you do, (3) and to explore at least two misunderstandings—the first, that an authoritarian agency is being planned, and second, that a scheme
Mitogen activated protein kinases as targets for development of novel anti-inflammatory drugs
Authors: M Karin
Journal: Annals of the Rheumatic Diseases (2004)

Given the prevalence and debilitating nature of chronic inflammatory diseases there is a never ending quest for identification of novel targets for the rational development of anti-inflammatory drugs. Although the major signalling pathway that controls inflammation associated gene expression is the one leading to activation of transcription factor NF-kappaB, considerable attention has also been given to mitogen activated protein kinases (MAPKs) as likely targets for development of novel anti-inflammatory therapeutics. Indeed, inhibitors targeting these pathways have been developed and preliminary preclinical data suggest that they exhibit anti-inflammatory activity. This report focuses on the possible mechanisms through which such inhibitors may interfere with inflammation and discusses the pros and cons of targeting MAPKs in the treatment of chronic inflammatory disease.
[501] EFFICACY AND SAFETY OF PEG-IFN ALPHA-2b TREATMENT FOR 48 WEEKS IN ADULT THALASSAEMIC PATIENTS WITH CHRONIC HCV INFECTION
Authors: D. Kountouras, J. Koskinas, H. Berdoussi, N. Vgontza, M. Karagiorga, A. Lagiandreou, K. Kaligeros, E. Voskaridou, A. Archimandritis
Journal: Journal of Hepatology (2007)
Randomized Clinical Trial of Activated Protein C for the Treatment of Acute Lung Injury
Authors: Kathleen D. Liu, Joseph Levitt, Hanjing Zhuo, Richard H. Kallet, Sandra Brady, Jay Steingrub, Mark Tidswell, Mark D. Siegel, Graciela Soto, Michael W. Peterson, Mark S. Chesnutt, Charles Phillips, Ann Weinacker, B. Taylor Thompson, Mark D. Eisner, Michael A. Matthay
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Microvascular injury, inflammation, and coagulation play critical roles in the pathogenesis of acute lung injury (ALI). Plasma protein C levels are decreased in patients with acute lung injury and are associated with higher mortality and fewer ventilator-free days.To test the efficacy of activated protein C (APC) as a therapy for patients with ALI.Eligible subjects were critically ill patients who met the American/European consensus criteria for ALI. Patients with severe sepsis and an APACHE II score of 25 or more were excluded. Participants were randomized to receive APC (24 microg/kg/h for 96 h) or placebo in a double-blind fashion within 72 hours of the onset of ALI. The primary endpoint was ventilator-free days.APC increased plasma protein C levels (P = 0.002) and decreased pulmonary dead space fraction (P = 0.02). However, there was no statistically significant difference between patients receiving placebo (n = 38) or APC (n = 37) in the number of ventilator-free days (median [25-75% interquartile range]: 19 [0-24] vs. 19 [14-22], respectively; P = 0.78) or in 60-day mortality (5/38 vs. 5/37 patients, respectively; P = 1.0). There were no differences in the number of bleeding events between the two groups.APC did not improve outcomes from ALI. The results of this trial do not support a large clinical trial of APC for ALI in the absence of severe sepsis and high disease severity.
580 Predictive factors of sustained virological and histological response after combination antiviral therapy in transplanted patients with recurrent hepatitis C
Authors: S. Iacob, S. Beckebaum, V. Cicinnati, R. Iacob, L. Gheorghe, C. Gheorghe, I. Popescu, A. Frilling, M. Malago, G. Gerken, C. Broelsch
Journal: Journal of Hepatology (2006)
Arterial Stiffness and Endothelial Function in Patients With β-Thalassemia Major
Authors: Y.F. Cheung, Godfrey C.F. Chan, S.Y. Ha
Journal: Circulation (2002)

Background— Increased iron store has been linked to risk of cardiovascular disease. Structural alterations of arteries in β-thalassemia major patients and in vitro functional disturbance of vascular endothelial cells by thalassemic serum have been described. We sought to determine whether arterial stiffness and endothelial function are altered in vivo. Methods and Results— Thirty thalassemia patients (16 male) aged 22.2±7.4 years were recruited. Left ventricular (LV) mass and function were assessed echocardiographically. Carotid and brachioradial artery stiffness was assessed by stiffness index and pulse-wave velocity (PWV), respectively. Brachial artery endothelial function was assessed by vascular response to reactive hyperemia (flow-mediated dilation [FMD]) and sublingual glyceryl trinitrate. These indexes were compared with those of 30 age- and sex-matched controls. None of the patients had LV systolic or diastolic dysfunction. When compared with controls, patients had greater absolute (113.8±38.0 versus 109.0± 32.6 g, P =0.04) and indexed (82.4±17.5 versus 66.7±12.7 g/m 2 , P &lt;0.001) LV mass, carotid artery stiffness index (8.1±3.5 versus 5.5±1.6, P &lt;0.001), and brachioradial PWV (8.9±2.4 versus 7.9±1.7 m/s, P = 0.03). Their FMD was impaired (3.5±3.3% versus 8.8±3.9%, P &lt;0.001), whereas glyceryl trinitrate– mediated dilation was preserved (17.9±7.6% versus 16.3±6.1%, P =0.40). Both stiffness index and PWV correlated inversely with magnitude of FMD ( r =−0.40, P =0.03; r =−0.41, P =0.03) and positively with indexed LV mass ( r =0.50, P =0.005; r =0.40, P =0.027). Nonetheless, no significant correlation existed between ferritin level and carotid stiffness, PWV, or FMD. Conclusions— Increased arterial stiffness, endothelial dysfunction, and LV hypertrophy occur in patients with β-thalassemia major, which may result in reduction of mechanical efficiency of the heart.
Control of polyclonal immunoglobulin production from human lymphocytes by leukotrienes; leukotriene B4 induces an OKT8(+), radiosensitive suppressor cell from resting, human OKT8(-) T cells.
Authors: D Atluru, J S Goodwin
Journal: Journal of Clinical Investigation (1984)

We report that leukotriene B4 (LTB4), a 5-lipoxygenase metabolite of arachidonic acid, is a potent suppressor of polyclonal Ig production in pokeweed mitogen (PWM)-stimulated cultures of human peripheral blood lymphocytes, while LTC4 and LTD4 have little activity in this system. Preincubation of T cells with LTB4 in nanomolar to picomolar concentrations rendered these cells suppressive of Ig production in subsequent PWM-stimulated cultures of fresh, autologous B + T cells. This LTB4-induced suppressor cell was radiosensitive, and its generation could be blocked by cyclohexamide but not by mitomycin C. The LTB4-induced suppressor cell was OKT8(+), while the precursor for the cell could be OKT8(-). The incubation of OKT8(-) T cells with LTB4 for 18 h resulted in the appearance of the OKT8(+) on 10-20% of the cells, and this could be blocked by cyclohexamide but not by mitomycin C. Thus, LTB4 in very low concentrations induces a radiosensitive OKT8(+) suppressor cell from OKT8(-) cells. In this regard, LTB4 is three to six orders of magnitude more potent than any endogenous hormonal inducer of suppressor cells previously described. Glucocorticosteroids, which block suppressor cell induction in many systems, may act by inhibiting endogenous production of LTB4.
The effects of experimental tear film removal on corneal surface regularity and barrier function
Authors: Dilek Dursun, Dagoberto Monroy, Robert Knighton, Timo Tervo, Minna Vesaluoma, Kermit Carraway, William Feuer, Stephen C Pflugfelder
Journal: Ophthalmology (2000)

To evaluate corneal surface regularity and asymmetry, corneal thickness, barrier function, and contrast sensitivity after experimental removal of the precorneal tear layer.Prospective, clinic-based, nonrandomized (self-controlled) comparative trial.Six eyes of six healthy volunteers (three males, three females; age range, 29-40 years).A precorneal tear lesion was created by pressing a sterile Biopore (Millipore, Bedford, MA) Teflon membrane against the central cornea. Corneal topography with both the Topographic Modeling System (TMS-1; Computed Anatomy, Tomey Technology, Cambridge, MA) and the Orbscan (Orbscan Inc., Salt Lake City, UT) were performed before the lesion was created and 30 seconds, 1 hour, and 4 hours after the lesion was created. Surface regularity and surface asymmetry indices were evaluated by the TMS-1 topography system. Maximum and minimum keratometric readings, corneal fluorescein staining, contrast sensitivity, and corneal thickness were evaluated before and after the tear lesion. Cytologic membranes were stained for MUC4 mucin using an indirect immunofluorescent staining technique. Confocal microscopy was performed to evaluate the integrity of the corneal epithelium in two eyes. Analysis of variance with polynomial contrasts was used to examine time trends of the outcome variables.The change in corneal surface regularity and asymmetry indices, corneal thickness, permeability to fluorescein dye, and contrast sensitivity before and after the lesion was made were compared.The corneal epithelium in the area of the lesion showed intense fluorescein staining 30 seconds postlesion but appeared normal by 4 hours. Confluent, homogeneous staining for MUC4 mucin was observed on the membranes used to create the lesion in all cases. The surface regularity index measured with the TMS-1 increased after the lesion was created and decreased toward normal by 4 hours (P = 0.017). Corneal thickness measured by the Orbscan instrument significantly increased in the central (P = 0.001), superior (P = 0.006), inferotemporal (P < 0.001) and superotemporal (P = 0.001) cornea immediately following the lesion and returned to normal by 4 hours. The lesion caused a decrease in visual acuity at 6.30%, 4% and 2.5% contrast sensitivities 1 hour postlesion and these measurements returned to prelesion values by 4 hours (P = 0.085, P = 0.005, P = 0.043).The precorneal tear layer serves as a permeability barrier and is essential for maintaining a smooth quality optical surface.
Induction of toll-like receptors by Propionibacterium acnes
Authors: S. Jugeau, I. Tenaud, A.C. Knol, V. Jarrousse, G. Quereux, A. Khammari, B. Dreno
Journal: British Journal of Dermatology (2005)

The bacterium Propionibacterium acnes is involved in the induction and maintenance of the inflammatory phase of acne. Recent studies have found that keratinocytes express toll-like receptors (TLRs) implicated in immediate immunity. No studies have, to date, been carried out on the action of P. acnes upon TLR activation in keratinocytes.Focusing on the inflammatory phase of acne, to clarify the role of P. acnes in immediate immunity by inducing expression of TLR-2 and TLR-4 by keratinocytes. We also studied how the secretion and expression of matrix metalloproteinase (MMP)-9 is induced by P. acnes.The work was carried out on two levels: in vivo with the study of the expression of TLR-2 and TLR-4 proteins in biopsies of acne lesions and in vitro on cultured keratinocyte monolayers to study the modulating effects of P. acnes on the expression of TLR-2 and TLR-4 and also on the expression and secretion of MMP-9.Our findings reveal that in vivo TLR-2 and TLR-4 expression is increased in the epidermis of acne lesions. In vitro, an increase in TLR-2 and TLR-4 expression by human keratinocytes occurred in the first hours of incubation with bacterial fractions as well as an increase of the expression and secretion by the keratinocytes of MMP-9, which plays a role in inflammation.This work demonstrates that P. acnes induces TLR expression and that this mechanism could play an essential role in acne-linked inflammation. These receptors could be involved notably in acute acne.
Medical Student Radicals: Conflict and Resolution
Authors: JERROLD S. MAXMEN
Journal: American Journal of Psychiatry (1971)

The author describes activist medical students in terms of their core values—humanitarianism, moral integrity, and the desire for meaningful communication—and their primary psychological tasks—achieving cultural continuity and integration of their personalities. He discusses the conflicts they experience with their school administrations and the methods used to resolve them, and concludes that the roles of activist and student-physician are compatible.
Intron open reading frames as mobile elements and evolution of a group I intron
Authors: C. H. Sellem, L. Belcour
Journal: Molecular Biology and Evolution (1997)

Group I introns are proposed to have become mobile following the acquisition of open reading frames (ORFs) that encode highly specific DNA endonucleases. This proposal implies that intron ORFs could behave as autonomously mobile entities. This was supported by abundant circumstantial evidence but no experiment of ORF transfer from an ORF-containing intron to its ORF-less counterpart has been described. In this paper we present such experiments, which demonstrate the efficient mobility of the mitochondrial nad1-i4-orf1 between two Podospora strains. The homing of this mobile ORF was accompanied by a bidirectional co-conversion that did not systematically involve the whole intron sequence. Orf1 acquisition would be the most recent step in the evolution of the nad1-i4 intron, which has resulted in many strains of Podospora having an intron with two ORFs (biorfic) and four splicing pathways. We show that two of the splicing events that operate in this biorfic intron, as evidenced by PCR experiments, are generated by a 5'-alternative splice site, which is most probably a remnant of the monoorfic ancestral form of the intron. We propose a sequential evolution model that is consistent with the four organizations of the corresponding nad1 locus that we found among various species of the Pyrenomycete family; these organizations consist of no intron, an intron alone, a monoorfic intron, and a biorfic intron.
Does imaging the oesophagus, stomach and duodenum with the ESO 2 pillcam compare favourably with conventional video-endoscopy in patients with dyspepsia?
Authors: L. Marelli, L. Jackson, F. Jaboli, M. Hamilton, O. Epstein
Journal: Gut (2011)

<h3>Introduction</h3> Oesophageal capsule endoscopy (ESO 2) has been developed to image the oesophageal mucosa and compares with endoscopy (OGD).1 With a battery life of 30 min, the capsule transmits gastric and even duodenal images beyond its designated function. Trituration causes the capsule to tumble back and forth between fundus and antrum, before passing through the pylorus. With its fore and aft cameras providing a 312 degree field of vision, it is likely that ESO could visualise most, if not all the gastric mucosa. The authors9 aim was to compare accuracy of ESO versus OGD for detecting mucosal pathology in patients with uncomplicated dyspepsia and/or heartburn, and patient discomfort. <h3>Methods</h3> 50 consecutive outpatients, referred with dyspepsia and/or heartburn ingested an ESO 2 PillCam and underwent OGD 4 h later. ESO was reported independently by 2 experienced capsule readers and OGD was performed by an expert endoscopist, blinded to ESO results, and recorded on DVD. At the end of the study, a final report was agreed by 2 gastroenterologists viewing ESO and recorded OGD simultaneously, side by side, with biopsy results. This defined benchmark against which to judge the initial ESO and OGD reports. Each patient completed a questionnaire assessing ESO versus OGD discomfort. <h3>Results</h3> 50 patients (mean age 56±15; M/F: 17/33) had OGD, 35 without sedation. ESO was ingested by 49 patients (1 unable to swallow the capsule). The duodenum was visualised in 30 of 49 (61%). The final (benchmark) reports identified major pathology in 15 patients (6 Barretts, 1 pyloric channel ulcer, 5 oesophagitis, 6 erosive gastritis and 4 large hiatus hernia) and in 17 minor pathology (13 superficial gastritis, 10 small hiatus hernia and 4 hyperplastic fundal polyps). 17 patients had normal finding. Compared with the benchmark report, sensitivity and specificity of the initial report for major pathology was 93% and 100% for ESO and 87% and 100% for OGD. ESO failed to report 1 oesophagitis and OGD failed to detect 1 pyloric ulcer and 1 Barretts oesophagus. Sensitivity and specificity for minor pathology was 76% and 97% for ESO and 76% and 78% for OGD. ESO had reduced sensitivity for small hiatus hernia and OGD had poor specificity for superficial gastritis. Median patient discomfort (scale 0–10) was 0 for ESO and 4.5 for OGD. <h3>Conclusion</h3> This pilot study suggests that ESO provides an accurate and well-tolerated method to visualise oesophageal and gastric mucosa, and in 61%, duodenal mucosa. An ESO capsule programmed to broadcast for up to 2 h could offer a minimally invasive method for imaging the oesophagus, stomach and duodenum. Further studies are necessary to fully evaluate the role of capsule OGD in investigating foregut symptoms.
Axial cineangiography in congenital heart disease. Section II. Specific lesions.
Authors: L P Elliott, L M Bargeron, P R Bream, B Soto, G C Curry
Journal: Circulation (1977)

The value of axial cineangiography in several forms of congenital heart disease serves as an illustrated supplement to Section I. These techniques visualize defects in the entire ventricular and atrial septum. In persistent atrioventricular (A-V) canal, it is possible to visualize all parts of both septa, status of the A-V valves (two valves versus a common A-V valve), and if a common A-V valve, its degree of override. In tetralogy of Fallot, the bifurcation of the pulmonary trunk, entire ventricular septum and coronary arteries are vividly shown. The presence of true and confluent pulmonary arteries versus systemic or bronchial arteries in pseudotruncus is clearcut. In double outlet right ventricle or in transpositions with or without double outlet right ventricle, the mitral valve-semilunar valve relationships, the left ventricular outflow tract, subpulmonary region and a straddling tricuspid valve are well demonstrated. In asymmetric septal hypertrophy, biventricular angiography may be circumvented.
Familial cancer on a Scottish island.
Authors: R D Hill
Journal: BMJ (1976)

When the causes of death were determined in 18 relations of a child with Fanconi's anaemia 10 deaths were found to be due to carcinoma of various organs. Cases of osteogenic sarcoma, leukaemia, and Marfan's syndrome were also discovered among relatives. The family was from a remote community in the hebrides and there was considerable intermarriage. Suggestive evidence of heterozygosity was found by chromosome analysis.