tbuckley/cabot-search huggingface dataset:
Vasectomy in the surgery.
Authors: C G Brown
Journal: BMJ (1972)

This procedure would have two advan- tages.The first is that it would overcome many of the administrative difficulties, both on the ward and in the laboratory, which arise from the necessity of sending a plasma sample and request card to the laboratory on one day and the 24-hour urine sample with a second request card on the following day.If the plasma is taken when the collec- tion is completed, both specimens can be sent with a single request card.The second, perhaps less important, advantage is that with this procedure the change in creatinine clearance will be greater than with the conventional method should the plasma creatinine be rising or falling during the period of the urine collection.For example, if renal function were deteriorating and plasma creatinine rising the creatinine clear- ance would be lower if the plasma is taken at the end of the urine collection than if it is taken in the middle.There is no doubt that clinical biochemistry laboratories would welcome this change in procedure, and it appears to have no clinical disadvantages.-Weare, etc.,
Abstract 2297: Transcriptome profiling of invasion phenotype associated with epithelial-mesenchymal transition in esophageal cancer
Authors: Hsiao-Fang Li, Talun Peng, Ann-Joy Cheng
Journal: Cancer Research (2010)

Abstract The esophageal cancer (ESC) is one of the ten-leading cancers in Taiwan with highly metastatic potential. The aim of this study was to clarify relevant alterations of gene expression associated with the invasive phenotype of ESC. To reduce heterogeneity and to obtain data on genes specifically involved in invasive mechanism, we established a highly invasive ESC subline (CE48) through 10 passages of in vitro Matrigel selections. This subline exhibited increases of invasion and migration abilities with the ascending generations, in accompany of morphological alteration from epithelial type to mesenchymal type, suggesting an epithelial- mesenchymal transition (EMT) was occurred during this Matrigel selection. In support of this finding, five molecular EMT markers were also changed accordingly. Affymetrix cDNA microarray was used to compare the transcriptomes between the parental and the EMT-associated invasion subline. Heretical cluster and algorithmic analyses of the microarray dataset revealed that several functional pathways associated with these phenotypic alterations. On the other hand, 10 genes were examined for the potential differential expressions between parental and invasion subline by RT-PCR or western blot analysis. In which, TKT, FLNA, FN1, Gp96, Slug and IQGAP1 were found over-expressed in the invasion subline, suggesting a positive association in the regulation of EMT-associated invasion. Knockdown of TKT by siRNA further demonstrated suppression of cell invasion. Therefore, the EMT-associated invasion sublin and transcriptome profiling of the cells were determined. Results of this study provide molecular knowledge in the EMT-associated metastasis in ESC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 2297.
Disappearing teaspoons: Method of spoon surveillance was not adequate
Authors: David A Silver
Journal: BMJ (2006)

Good quality monitoring is crucial for informed choiceEditor-In accordance with the patient choice scheme, all 303 primary care trusts in England were obliged from January 2005 to offer patients a choice of at least two providers for cataract surgery. 1 The scheme allows patients to be involved in how, where, and when they are treated.Providers can be NHS trusts, diagnostic and treatment centres, or independent sector providers from the UK or overseas.By February 2005 13 000 extra operations had already been performed under the independent sector treatment programme. 2However, concern was raised about variations in clinical safety between different providers. 3 We sent a postal questionnaire to the leaders of patient choice for each of the primary care trusts in England asking how they monitor the quality of care from their providers.The table shows the replies from 125 trusts.The quality monitoring of providers by primary care trusts is poorly structured and variable.Who then should monitor standards and what variables should they use?Traditionally, NHS providers have used audit and clinical governance to measure their performance.Should it now be the role of the Strategic Health Authority, the provider, or the purchaser in the form of primary care trusts to monitor the product offered to the patient?Information technology exists to collect accurate data about adverse events in addition to visual acuity and refractive outcomes.The public expect that safe cataract care should be commissioned for them, 4 and robust methods of monitoring need to be agreed and implemented so that patients can make a truly informed choice.These decisions need to be made not only for cataract surgery but also for other elective procedures that will increasingly be made available to patients through the patient choice scheme.
LEPROSY IN KOREA
Authors: R. M. Wilson
Journal: JAMA (1926)

A study of 938 cases of leprosy has been made. The patients are all inmates of the leper colonies of Kwangju and Fusan. The facts presented below have been observed. <h3>INCIDENCE</h3> It has been estimated that there are from 5,000 to 20,000 lepers in Korea. Such a wide variance in the figures immediately indicates the difficulty of making an accurate census. It is easy for a leper to conceal his symptoms if he does not want to be discovered. Probably the only way of making an accurate estimate would be for a physician with leper assistants to journey through the country and treat the lepers as they find them. It has been observed that 4 per cent of the cases are in the father, 3 per cent in the mother, 0.029 per cent in the sister and 12 per cent in the brother. It is a common observation of
Four-year follow-up study in patients with angina pectoris and normal coronary arteriograms ("syndrome X")
Authors: D Opherk, G Schuler, K Wetterauer, J Manthey, F Schwarz, W Kübler
Journal: Circulation (1989)

In patients with typical stress-induced anginal pain, normal coronary arteries, and unimpaired left ventricular performance at rest ("syndrome X"), a reduced coronary dilatory capacity, abnormal lactate metabolism during stress, and reduction of left ventricular functional reserve have been described. A group of 40 patients with syndrome X was followed for several years to determine their long-term prognosis. In 27 patients pulmonary artery pressure and in 19 patients left ventricular ejection fraction were reassessed during rest and exercise approximately 4 years after the initial examination. In patients with stress-induced ST-segment depression, these variables did not change during the observation period. In patients with constant or rate-dependent left bundle branch block, however, there was significant deterioration of left ventricular performance during rest (pulmonary artery mean pressure, 16 +/- 3 vs. 17 +/- 4 mm Hg, p = NS; left ventricular ejection fraction, 62 +/- 5% vs. 55 +/- 5%, p less than 0.05) and exercise (pulmonary artery, 30 +/- 6 vs. 39 +/- 10 mm Hg, p less than 0.005; left ventricular ejection fraction, 59 +/- 6% vs. 49 +/- 5%, p less than 0.01). These findings suggest that in syndrome X two subgroups with distinctly different prognoses may be defined: In patients with stress-induced ST-segment depression during exercise, left ventricular performance remains well preserved; however, in patients with either constant or rate-dependent left bundle branch block, there is significant deterioration of left ventricular function within several years.
Sudden sinus slowing with junctional escape: a common mode of initiation of juvenile supraventricular tachycardia.
Authors: A M Levy, B J Bonazinga
Journal: Circulation (1983)

After noting bradycardia-induced supraventricular tachycardia (SVT) in two successive children with SVT, we analyzed Holter monitor recordings done on 66 children with suspected or proved SVT. Ten children had apparent reentry SVT. The most common mode of initiation (eight of 10 patients) was not premature atrial beats, but sudden sinus pause with a junctional escape beat (JEB), usually fused with the delayed sinus P wave, initiating the tachycardia. Electrophysiologic studies in five children who had this mode of initiation showed evidence of reentry in four, possibly by dual atrioventricular nodal (AVN) pathways. Since sudden sinus pause and JEB are relatively uncommon in adults, the disappearance of this phenomenon with age may be the most significant reason why children often have less tachyarrhythmia as they get older. Both propranolol and digoxin significantly increased the numbers of episodes of SVT in the three patients tested with serial Holter monitoring.
Declining Blood Lead Levels and Cognitive Change in Children
Authors: Michael Rabinowitz
Journal: JAMA (1993)

To the Editor.  —In study by Ruff et al 1 of the effect of declining lead levels on the cognitive abilities of children, some children in the study sample were found to be developmentally delayed during testing performed at the time of entrance into the study. And an even larger number of children were found to be in the range where they might be described as being at high risk for developmental delay.  Perhaps the majority of children in this study were of the age range, socioeconomic status, and cognitive performance level where they were likely to be eligible for early childhood education programs, and I would suspect that some study children were enrolled in such programs between the time they were enrolled in the lead study and their 6-month follow-up.  For those who are enrolled in such childhood enrichment programs, these children are being removed to a more relatively
Genetic alterations at the splice junction of p53 gene in human hepatocellular carcinoma
Authors: Hey-Chi Hsu, A-Min Huang, Po-Lin Lai, Wei-Ming Chien, Shian-Yang Peng, Shu-Wha Lin
Journal: Hepatology (1994)

The tumor-suppressor gene p53 may transactivate the transcription of genes that down-regulate cellular growth-related genes and may become oncogenic as a result of the production of mutant proteins or the loss of its protein expression. This study reports that alterations of the highly conserved consensus intervening sequences at the splice junctions may lead to the inactivation of the p53 gene. Analyses with the combined polymerase chain reaction and single-strand conformational polymorphism and direct DNA sequencing of DNAs amplified by means of asymmetric polymerase chain reaction demonstrated sequence alterations at the splice junctions of introns 5 and 7 in four human hepatocellular carcinomas, with a single base substitution at the splice junction in three and a 10-bp deletion starting from the dinucleotide AG of the acceptor site of intron 5 in the fourth. Restriction fragment length polymorphism analysis disclosed allele loss in all three informative cases. The p53 mRNA concentrations were remarkably reduced or undetectable in two hepatocellular carcinomas, whereas the two tumors (cases 2 and 3) that had single base changes at the acceptor site of intron 7 had both normal and abnormally sized p53 mRNAs. Immunocytochemistry failed to detect the wild-type and mutant p53 proteins in all four tumors. Western-blot analysis disclosed an abnormal, larger p53 protein of 55 kD in the tumor of case 3.(ABSTRACT TRUNCATED AT 250 WORDS)
Rock climbing: observations on heart rate and plasma catecholamine concentrations and the influence of oxprenolol.
Authors: E. S. Williams, P. Taggart, M. Carruthers
Journal: British Journal of Sports Medicine (1978)

Observations are presented on the electrocardiogram and plasma catecholamine concentrations of 11 healthy men monitored during two rock climbing ascents. A placebo was administered prior to the first climb and an oral dose of the beta blocking agent oxprenolol ("Trasicor") prior to the second. Mean heart rates were 166 (+/- 20.4 SD) and 120 (+/- 10.2) respectively. Median plasma adrenaline concentrations were 0.05 microgram/1 and 0.33 microgram/1 before and after the climbs following the placebo. No significant difference was observed in the adrenaline concentrations before and after climbing following oxprenolol, or of noradrenaline concentrations on either occasion. These results are interpreted as suggesting that this popular sport represents more an anxiety-type of psychological stress than a physical stress and as such is likely to increase moral fibre rather than muscle fibre.
Diabetes and Cardiovascular Disease
Authors: Rafael Bitzur
Journal: Diabetes Care (2011)

The prevalence of obesity and diabetes continues to increase rapidly in the U.S. and all over the world (1–3). Obesity and diabetes are major risk factors for cardiovascular diseases (CVDs), but despite the increase in their prevalence, there seems to be a continuous steady decline in death rates from coronary heart disease (CHD) and stroke (4). Moreover, cause-specific excess death associated with obesity has been declining despite the increase in obesity rates (5).

The reason behind this apparent paradox is probably a better control of other risk factors for CVD, such as cholesterol levels, hypertension, and smoking. Several trials demonstrated that more than half the decline in deaths from CHD in the last decades may be attributable to reductions in major risk factors (6). Of all risk factors, treating high cholesterol levels had the highest impact on the decline in CHD mortality (7). This is hardly surprising because the LDL cholesterol level is the strongest determinant of CHD risk, even in diabetic patients (8).

### Prevention of CHD in diabetic patients and the question of residual risk

Statins are the most effective agents in reducing the risk of CHD in diabetic patients, reducing the relative risk by about one-third (9,10). An analysis based on the UK Prospective Diabetes Study (UKPDS) risk engine demonstrated that even in the Steno-2 study, in which multifactorial intervention was used for the treatment of diabetes with an impressive reduction of both cardiovascular morbidity and mortality, lipid-lowering therapy accounted for more than 70% of CVD risk reduction (11). Actually, many more patients in the intensive therapy group achieved their cholesterol goal compared with the conventional therapy group (70 vs. 20%), while there was no difference between the groups in the attainment of their triglyceride goal (11). The main difference between the intensive and conventional treatment groups was in the use of statins (12 …
THE DIAGNOSIS OF EXOPHTHALMIC GOITER.
Authors: LEWELLYS F. BARKER
Journal: JAMA (1907)

The part assigned to me in this symposium is the diagnosis of this remarkable disease. What I shall have to say is based (1) on an analysis of the cases which have occurred in my wards at the Johns Hopkins Hospital during the past two years,<sup>1</sup>and (2) on a study of the bibliography of the subject.<sup>2</sup> It will be convenient to discuss (I) the character and significance of the individual signs and symptoms; (II) the diagnosis of the clinical syndrome, especially in its less obvious forms; (III) certain points in differential diagnosis, and (IV) the diagnosis of the indications and contraindications for surgical interference. On account of the necessity of brevity I am forced to limit the discussion to the features which I regard as most essential. <h3>I. THE CHARACTER AND SIGNIFICANCE OF THE INDIVIDUAL SIGNS AND SYMPTOMS.</h3> Besides the three cardinal symptoms—struma, tachycardia and exophthalmus—there are
Lymphoblastic response to autologous colon epithelial cells in ulcerative colitis in vitro
Authors: P. S. Hunt, S. Trotter
Journal: Gut (1973)

The blastic transformation <i>in vitro</i> of peripheral blood lymphocytes was measured by the 72-hour uptake of tritiated thymidine (<sup>3</sup>H-6-thymidine) in 23 patients with mucosal ulcerative colitis, three patients with acute Crohn9s colitis with rectal involvement, and seven normal subjects. The 23 patients with ulcerative colitis were subdivided into three groups, graded according to severity into seven with acute, severe, nine with active, chronic, and seven with quiescent disease. In the control cultures of lymphocytes without any added potential stimulant the uptake of <sup>3</sup>H-6-thymidine in the clinical subgroup of seven patients with acute, severe ulcerative colitis was significantly greater than in seven normal subjects (p&lt;0·01). This contrasted with a reduced uptake of <sup>3</sup>H-6-thymidine by lymphocytes from seven patients with acute severe colitis when compared with seven normal subjects after stimulation with phytohaemagglutinin-P (PHA-P) (p&lt;0·01). In further duplicate cultures of lymphocytes specifically stimulated by an equal number of viable autologous rectal epithelial cells, the uptake of <sup>3</sup>H-6-thymidine was significantly greater in seven patients with acute severe colitis when compared with seven normal subjects (p&lt;0·01). The results in three patients with acute Crohn9s colitis with rectal involvement showed no such evidence of lymphocyte sensitivity to autologous rectal epithelial cells and their uptake of <sup>3</sup>H-6-thymidine lay within the normal range. Evidence that the degree of lymphoblastic transformation was related to the clinical severity of ulcerative colitis was provided by the results obtained in the unstimulated and epithelial cell stimulant cultures. The uptake of <sup>3</sup>H-6-thymidine was directly related to the clinical severity of ulcerative colitis in the three subgroups studied. In addition, four of the seven patients with acute severe colitis were studied later in clinical remission. They were then found to have a significantly reduced uptake of <sup>3</sup>H-6-thymidine in response to autologous rectal epithelial cells (p &lt; 0·01).
Rheumatoid-susceptible alleles of HLA-DRB1 are genetically recessive to non-susceptible alleles in the progression of bone destruction in the wrists and fingers of patients with RA.
Authors: Y Toda, Y Minamikawa, S Akagi, H Sugano, Y Mori, H Nishimura, S Arita, Y Sugino, R Ogawa
Journal: Annals of the Rheumatic Diseases (1994)

To assess the relationship between HLA-DRB1 genotypes and the progression of bone destruction in Japanese patients with RA. The HLA-DRB1 alleles were determined by polymerase chain reaction and allele specific oligonucleotide probe techniques in 160 Japanese patients with RA. HLA-DR 0101, 0401, 0404, 0405, 1001 and 1402 were regarded as susceptible alleles of RA according to previous reports. Patients were classified into three groups (S/S, S/N and N/N group), based on the possession of two, one or no susceptible factor. The grading of radio-graphic changes in the wrists and fingers were evaluated by Larsen's criteria. The radiographic grades were first compared with the results of genotyping in the 160 cross sectional cases. A retrospective study was then conducted on a subgroup consisting of 57 cases taken from the 160 cases used for the cross sectional study. In the scatter diagram of the 160 cross sectional cases expressing the relationship between the stage of bone destruction and duration of RA, the regression line and the 95% confidence intervals separated the S/S group from the S/N and N/N groups in the early phase of development of bone destruction. In the retrospective study on the 57 cases the median years taken to development to stage V in the wrists after the onset of symptoms were 13.1 in the patients in the S/S group, 22.7 in the S/N group and 23.0 in the N/N group. The difference observed between the S/S and S/N group, and between the S/S and N/N group were statistically significant (p < 0.01), but that between the S/N and N/N groups was not. Thus the bone destruction in the wrists and fingers progressed more rapidly in the S/S group than in the S/N and N/N groups; and the rheumatoid susceptible alleles of HLA-DRB1 can be considered to be genetically recessive to the non-susceptible alleles in the progression of bone destructions in the wrists and fingers. Genotyping of HLA-DRB1 can be a useful prognostic marker in the early phase of RA.
Effect of dietary calcium on the colonic luminal environment.
Authors: G V Appleton, R W Owen, E E Wheeler, D N Challacombe, R C Williamson
Journal: Gut (1991)

Dietary supplementation with calcium may prevent the development of colorectal cancer. This mechanism may be related to fatty acid and bile salt chelation in the small bowel forming non-toxic calcium-soap compounds. Calcium may also act locally or systemically on the colonic mucosa. Faecal concentrations of free fatty acids and free bile acids were measured in 17 Sprague-Dawley rats (weighing 472 (39 g)) whose daily calcium intake had been trebled by enriching the chow and adding calcium lactate (24 g/l) to the drinking water. Mean (SEM) faecal concentrations of free bile acids were 33% less than in 19 controls (1.23 (0.15) v 1.82 (0.20) mg/g; p less than 0.001), whereas free fatty acid concentrations were 117% higher (14.68 (3.59) v 6.76 (2.41) mg/g; p less than 0.02). The 'direct' effect of calcium was assessed by organ culture of rat colonic explants in three different concentrations of calcium. Crypt cell production rate (measured by a stathmokinetic technique), which was (mean (SEM)) 4.80 (0.23) cells/crypt/h in control medium (Ca2+ = 2.14 mmol/l), fell by 43% when calcium concentration was doubled (p less than 0.05) and by a further 43% when the concentration was trebled (p less than 0.02). Calcium binds free fatty acids but not free bile acids intraluminally. Calcium has a direct antitropic action on colonic crypts.
Screening for Down's syndrome in the North East Thames region.
Authors: V Murday, J Slack
Journal: BMJ (1985)

The suggested strategies for a screening programme for Down9s syndrome by maternal serum alpha fetoprotein concentration were examined and tested on the experience of the North East Thames Regional. Screening by maternal serum alpha fetoprotein concentration may be used to identify pregnancies at increased risk, but this is useful only in women aged over 32 whose collective risk is greater than one in 200. The absolute probability of carrying babies with Down9s syndrome for individuals in this high risk group can then be calculated and used to decide whether further diagnosis by amniocentesis is desired.
Tobacco industry knowingly duped public with "low tar" brands
Authors: C. White
Journal: BMJ (2002)

the Institute for Public Policy Research recommends that personal care should be free, on the basis of equity and social justice.It says the inherited system is "flawed," and that the boundary between whether the state or the individual has to pay for care has become "arbitrary, often inconsistent, and difficult for people to understand."The policy has generated strong resentment, the report says, as it means that an elderly person in hospital has all costs paid while someone ill in a residential home must pay for personal care."The funding distinction between acute health care and long-term health care, and thus the difference in consequences for the individual of developing cancer or heart disease versus Alzheimer's or motor neurone disease is still starkly inequitable," the report argues.Although free personal care would be expensive, this should not drive the government's decision, the institute urges.It estimates that the cost of state funding would be around 0.3% of GDP by 2050, depending on demand and demographic changes.