tbuckley/cabot-search huggingface dataset:
Differences and Differentials
Authors: J. H. E. Bergin
Journal: BMJ (1964)

after pyloroplasty.This is one of several reasons why gastro-enterostomy should be avoided.In cases of severe dumping the gastro-enterostomy is probably best taken down and replaced by pyloroplasty.May I, too, comment on gastrostomy after vagotomy and pyloroplasty-referred to by Professor A. W. Kay (28 March, p. 822) ?Hendry taught me to use neither naso-gastric intubation nor gastrostomy after this opera- tion, nor to use a naso-gastric tube before operation.In over 200 cases I can confirm his teaching.There is no need whatever for any form of gastric suction after vagotomy and pyloroplasty.Fluids by mouth in the immediate post-operative period need not be severely restricted.With "tubeless " vag- otomy fluids and electrolytes are not with- drawn and do not, therefore, need to be replaced.Post-operative intravenous fluids, or even rectal fluids, are not routinely neces- sary, though in hot weather we give saline in the theatre to combat fluid loss there and to allay post-operative thirst.-Iam, etc.,
Proteolysis of the urokinase-type plasminogen activator receptor by metalloproteinase-12: implication for angiogenesis in fibrin matrices
Authors: Pieter Koolwijk, Nicolai Sidenius, Erna Peters, Cornelis F. M. Sier, Roeland Hanemaaijer, Francesco Blasi, Victor W. M. van Hinsbergh
Journal: Blood (2001)
Cutaneous leishmaniasis - treatment options in children
Authors: R.N. Matin
Journal: British Journal of Dermatology (2015)

Journal Article Cutaneous leishmaniasis – treatment options in children Get access R.N. Matin R.N. Matin Department of Dermatology Churchill Hospital Old Road Headington Oxford U.K Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 172, Issue 4, 1 April 2015, Pages 844–845, https://doi.org/10.1111/bjd.13660 Published: 01 April 2015
Pump-Probe Imaging Differentiates Melanoma from Melanocytic Nevi
Authors: Thomas E. Matthews, Ivan R. Piletic, M. Angelica Selim, Mary Jane Simpson, Warren S. Warren
Journal: Science Translational Medicine (2011)

Melanoma diagnosis is clinically challenging: the accuracy of visual inspection by dermatologists is highly variable and heavily weighted toward false positives. Even the current gold standard of biopsy results in varying diagnoses among pathologists. We have developed a multiphoton technique (based on pump-probe spectroscopy) that directly determines the microscopic distribution of eumelanin and pheomelanin in pigmented lesions of human skin. Our initial results showed a marked difference in the chemical variety of melanin between nonmalignant nevi and melanoma, as well as a number of substantial architectural differences. We examined slices from 42 pigmented lesions and found that melanomas had an increased eumelanin content compared to nonmalignant nevi. When used as a diagnostic criterion, the ratio of eumelanin to pheomelanin captured all investigated melanomas but excluded three-quarters of dysplastic nevi and all benign dermal nevi. Additional evaluation of architectural and cytological features revealed by multiphoton imaging, including the maturation of melanocytes, presence of pigmented melanocytes in the dermis, number and location of melanocytic nests, and confluency of pigmented cells in the epidermis, further increased specificity, allowing rejection of more than half of the remaining false-positive results. We then adapted this multiphoton imaging technique to hematoxylin and eosin (H&E)-stained slides. By adding melanin chemical contrast to H&E-stained slides, pathologists will gain complementary information to increase the ease and accuracy of melanoma diagnosis.
Methaqualone Abuse, The Quiet Epidemic
Authors: Emil F. Pascarelli
Journal: JAMA (1973)

Abuse of the nonbarbiturate hypnotic, methaqualone, has quietly reached the proportions of a countrywide epidemic among students and others. Methaqualone abusers, caught up in its "love drug" mystique and seeking a dissociative "high," are oblivious to many of its dangers. Experience in Europe and elsewhere indicates that the drug has a marked potential for producing dependence and causes a severe withdrawal syndrome. Overdose problems include a predisposition to cardiovascular complications and convulsions, and vomiting in the unconscious patient.
Flow cytometric analysis of peripheral blood lymphocytes in ulcerative colitis and Crohn's disease.
Authors: M Senju, F Hulstaert, J Lowder, D P Jewell
Journal: Gut (1991)

Using two colour immunofluorescence with fluorescein isothiocyanate and phycoerythrin labelled monoclonal antibodies, multi-parameter flow cytometry was used to examine the antigenic characteristics of peripheral blood lymphocytes in whole blood of patients with ulcerative colitis and Crohn's disease who were not taking immunosuppressive drugs. The numbers of CD4+ and CD8+ lymphocytes in patients with ulcerative colitis and Crohn's disease remained unchanged so that the CD4/CD8 ratio was the same as that of normal control subjects. In Crohn's disease there were many activated T cells (CD3+, CD25+). Although natural killer cells in active Crohn's disease were lower than in normal control subjects, cytotoxic T lymphocytes, as defined by CD3+, CD16+, did not differ in patients with inflammatory bowel disease compared with normal control subjects. For B cell subsets, there were differences in Leu-1+ B cells, Leu-8+ B cells, Fc epsilon R+B cells (Leu-16+, Leu-20+), and activated B cells (Leu-12+, Leu-21+) between patients with inflammatory bowel disease and normal control subjects. These differences are compatible with local activation of B cells in the inflamed colon.
Total Excision Biopsy for Primary Malignant Melanoma
Authors: Matthew N. Harris
Journal: JAMA (1973)

<h3>To the Editor.—</h3> There are few areas where a biopsy is more important or more readily performed than for lesions of the skin. Definitive therapy depends upon a correct diagnosis obtained by means of an adequate and representative biopsy sample. Any pigmented skin lesion that shows unexpected change should be regarded as a possible melanoma until proved otherwise. The unpigmented melanoma may be disarming in appearance and look much like granulation tissue or a pyogenic granuloma. Suspicion of melanoma should be aroused when a pigmented lesion increases in size, changes in color, exhibits pain, irritation or pruritus, becomes infected, bleeds, ulcerates, or becomes crusted. These changes are particularly common in light-skinned, freckled, blue-eyed individuals, but by no means is melanoma limited to this group. If the diagnosis of melanoma is suspected, it should be established, when possible, by total excision biopsy. Exceptions include lesions that are so large or so
US to require public disclosure of drug and device industry's financial ties to doctors
Authors: K. Epstein
Journal: BMJ (2012)

Later this year, the US government will probably require drug and medical device companies to start disclosing almost all financial relationships with doctors, including payments for research, consulting, speaking engagements, and even meals, under procedures published on 17 January.

Doctors who develop or assess a drug, receive royalty payments—or receive little more than breakfast or lunch during a visit from a device manufacturer’s representative—will have to file reports, subject to government auditing and inspections, that will be posted on a publicly searchable website in 2013.

Obama administration officials, health policy specialists, and some members of Congress, which in 2010 passed the Patient Protection and Affordable Care Act requiring such disclosure, say it will bring transparency and accountability to commonplace conflicts of interest.

Many studies (www.medpac.gov/chapters/Mar09_Ch05.pdf) have shown how the influence of manufacturers and their representatives can …
Immune-mediated loss of transgene expression in skin: implications for cutaneous gene therapy
Authors: Soosan Ghazizadeh, Richard S Kalish, Lorne B Taichman
Journal: Molecular Therapy (2003)

A clearer understanding of the immune-mediated loss of transgene from cutaneous epithelium is necessary for development of effective clinical gene therapy protocols for patients who carry null mutations in the target gene. We have used retrovirus-mediated transfer of lacZ to mouse skin as a model to investigate the mechanism of immune-mediated transgene loss in skin. Transduction of C57Bl/6 mouse skin resulted in elicitation of both humoral and cellular immune responses. Antibody responses did not play a major role in the loss of transgene. Infiltration of the transduced skin with CD4+ and CD8+ cells and induction of transgene-specific cytotoxic T lymphocytes implied a role for T-cell-mediated responses. Transduction of mice deficient in either major histocompatibility complex (MHC) class I or class II molecules resulted in transient transgene expression. Only in MHC−/− mice lacking expression of both class I and class II MHC molecules was persistent transgene expression seen. These data indicate a primary role for T-cell-mediated responses in the immune-mediated loss of transgene expression. Furthermore, CD4 and CD8 T cells have overlapping roles and either population can effectively eliminate transduced cells. Therefore, long-term cutaneous gene therapy may require development of strategies to interfere with activation or function of both T cell populations.
Carbon dioxide insufflation vs. conventional saline irrigation for peroral video cholangioscopy
Authors: S. Doi, I. Yasuda, M. Nakashima, T. Iwashita, K. Toda, T. Mukai, K. Iwata, T. Itoi, H. Moriwaki
Journal: Endoscopy (2011)

<b>Background and study aims:</b> Recent studies have evaluated the efficacy of peroral cholangioscopy (POCS) for diagnosis of biliary diseases. In order to obtain clear images with POCS, saline irrigation, which is performed to replace yellow bile, is carried out for an extended duration. The aim of this study was to evaluate the feasibility of replacing saline irrigation with CO<sub>2</sub> insufflation during POCS. <b>Patients and methods:</b> A total of 36 patients who had bile duct lesions and were due to undergo POCS were enrolled in the study. Of these patients, 18 underwent POCS using saline irrigation followed by CO<sub>2</sub> insufflation, and 18 patients underwent the reverse approach. The two methods were compared with regard to the time required to obtain a clear endoscopic image and the quality of the images. <b>Results:</b> The median time required to obtain a clear endoscopic image using CO<sub>2</sub> insufflation (5.0 min) was significantly shorter than that required for saline irrigation (22.5 min; <i>P</i> < 0.001). The quality of the endoscopic images obtained was similar in 27 cases. However, CO<sub>2</sub> insufflation provided better images in four cases that showed an abundance of mucin or biliary sludge, and saline irrigation was superior to CO<sub>2</sub> insufflation in five cases that showed severe stricture with bleeding and tall papillary lesions. <b>Conclusions:</b> CO<sub>2</sub> insufflation during POCS can reduce procedure time and simplify cholangioscopy. The overall image quality was similar to that obtained with conventional saline irrigation.
Visualization by Dynamic and Static Osseous Scintigraphy of Pelvic Chondrosarcoma in Multiple Hereditary Exostosis
Authors: ROBERTA L. JACKSON, JOSEP G. LLAURADO
Journal: Clinical Nuclear Medicine (1987)

Malignant degeneration to chondrosarcoma occurred in the left hemipelvis of a patient with multiple hereditary exostosis. Tc-99m HDP bone scintigraphy revealed markedly increased focal uptake in the areas of left superior pubic ramus, obturator foramen, and ischium with displacement of the urinary bladder. Of particular interest was the presence of vascularities seen in the flow and blood pool scintigrams. Following surgical exeresis, the gross appearance and histologic features of the tumor were identified as those of a low grade chondrosarcoma.
The renal tubular handling of aldosterone and its acid-labile conjugate
Authors: Murphy T. Scurry, Leroy Shear, Kevin G. Barry
Journal: Journal of Clinical Investigation (1968)

Stop-flow studies using infusions of aldosterone-(3)H or its (3)H acid-labile conjugate were done on five rhesus monkeys. The aldosterone-(3)H urine-to-plasma (U/P) ratio decreased in the same distal urine samples as sodium. The (3)H acid-labile conjugate U/P-to-inulin U/P ratio increased in the more proximal samples either with conjugate formed endogenously during aldosterone-(3)H infusions or with labeled conjugate infused alone. Aldosterone reabsorption occurred at a distal site in the renal tubule, and secretion of its acid-labile conjugate occurred at a proximal site.
Closing the gap. Report of the Carter Center Health Policy Consultation
Authors: W. H. Foege
Journal: JAMA (1985)

A NATIONAL consultation on health policy was held at The Carter Center of Emory University, Atlanta, Nov 26 through 28, 1984.<sup>1</sup>National leaders from private, public, voluntary, and academic institutions met with specialists from many health fields to recommend and develop priorities for interventions directed at unnecessary morbidity and mortality in the United States. The consultation was the second in a three-part, five-year health project of research, planning, and implementation known as "Closing the Gap," and was cochaired by former President Jimmy Carter and Edward N. Brandt, Jr, MD, Assistant Secretary for Health. Contributions appear in this issue from President Carter<sup>2</sup>and Dr Brandt.<sup>3</sup> Rather than seek technologic breakthroughs, the project seeks to focus national health policy on the "gap" represented by health problems that are unnecessary in light of knowledge that already is at hand. Consultants from various medical specialties conducted extensive investigations of the burden
Analgesics and Chronic Renal Disease
Authors: Edward B. Shaw
Journal: JAMA (1963)

To the Editor:—  The article and editorials in the May 11 issue ofThe Journal( 184 :435, 494) regarding the  of analgesics in chronic renal disease have certain amusing as well as dismaying overtones. The patient who consumes analgesic tablets in a dosage of 10 to 30 daily over a period of years will not profit from a warning on the label and scarcely deserves this protection. Labels recommending no more than six tablets in 24 hours and the avoidance of long-continued use will hardly meet the problem of the patient who over-works, consumes generous quantities of alcohol, smokes excessively, and then consumes excessive quantities of analgesics until the next cocktail hour. This is the real vicious circle which needs attention.  Almost without exception the drug which is introduced as highly effective and utterly without adverse reactions is eventually shown not to be devoid of side effects. The real
Effect of oestrogen on the sleep, mood, and anxiety of menopausal women.
Authors: J Thomson, I Oswald
Journal: BMJ (1977)

A double-blind controlled study of the effect of piperazine oestrone sulphate on sleep, depression, anxiety, and hot flushes was performed in 34 perimenopausal women. Half of the patients were given six weeks9 placebo followed by eight weeks9 oestrogen, and half remained on placebo throughout. Sleep was recorded electrophysiologically every week, and mood and anxiety were rated daily by means of visual analogue scales. Hot flushes were counted daily. Observer rating scales of anxiety and depression were complete at intervals. During the first month of active treatment the amount of intervening wakefulness in the first six hours of sleep decreased significantly more in the oestrone group than in those on placebo. Between the baseline period and the second treatment month the oestrone group showed a significantly greater decrease in the total amount of intervening wakefulness and in the frequency of awakenings. Their total amount of rapid eye movement sleep increased. Mood and anxiety improved and the number of hot flushes decreased to a similar degree in both groups. Although oestrogen did reduce the number of episodes of wakefulness in perimenopausal women complaining of insomnia, its effects on their psychological symptoms were little different to those of placebo.
Evaluation of Biocompatibility and Administration Site Reactogenicity of Polyanhydride‐Particle‐Based Platform for Vaccine Delivery
Authors: Lucas Huntimer, Amanda E. Ramer‐Tait, Latrisha K. Petersen, Kathleen A. Ross, Katherine A. Walz, Chong Wang, Jesse Hostetter, Balaji Narasimhan, Michael J. Wannemuehler
Journal: Advanced Healthcare Materials (2012)

Abstract Efficacy, purity, safety, and potency are important attributes of vaccines. Polyanhydride particles represent a novel class of vaccine adjuvants and delivery platforms that have demonstrated the ability to enhance the stability of protein antigens as well as elicit protective immunity against bacterial pathogens. This work aims to elucidate the biocompatibility, inflammatory reactions, and particle effects on mice injected with a 5 mg dose of polyanhydride nanoparticles via common parenteral routes (subcutaneous and intramuscular). Independent of polymer chemistry, nanoparticles more effectively disseminated away from the injection site as compared to microparticles, which exhibited a depot effect. Using fluorescent probes, the in vivo distribution of three formulations of nanoparticles, following subcutaneous administration, indicated migration away from the injection site. Less inflammation was observed at the injection sites of mice‐administered nanoparticles as compared to Alum and incomplete Freund's adjuvant. Furthermore, histological evaluation revealed minimal adverse injection site reactions and minimal toxicological effects associated with the administration of nanoparticles at 30 days post‐administration. Collectively, these results demonstrate that polyanhydride nanoparticles do not induce inflammation as a cumulative effect of particle persistence or degradation and are, therefore, a viable candidate for a vaccine delivery platform.
Unusual Pattern of Marrow Distribution Following Treatment of Aplastic Anemia
Authors: H DANIEL FAWCETT, BETTYE A. SAYLE, MARTIN L. NUSYNOWITZ, FRANK H. GARDNER
Journal: Clinical Nuclear Medicine (1989)

A 53 year-old female with aplastic anemia demonstrated decreased marrow activity with Indium-111 chloride. A repeat examination following treatment with etiocholanolone showed increased uptake in a multifocal patchy pattern. The differential diagonsis would include an unusual pattern of marrow regeneration, neoplastic disease and widespread inflammation/infection. A diagnosis of patchy marrow regeneration was made when a similar distribution of activity was demonstrated with Tc-99m sulfer colloid. Bone marrow biopsy showed a markedly hypocelluar marrow with a small island (20–30%) of erythroid marrow. Reticuloendotheliai cells were also present.
Enhancement of pain control with ketorolac tromethamine in patients with sickle cell vaso‐occlusive crisis
Authors: Elliott Perlin, Helga Finke, Oswaldo Castro, Sohail Rana, Jerome Pittman, Robert Burt, Carol Ruff, Dennis McHugh
Journal: American Journal of Hematology (1994)

Abstract Twenty one patients with sickle cell disease admitted to the hospital with the pain of vaso‐occlusive crisis (VOC) were treated by continuous IV infusion of ketorolac or normal saline for up to 5 days. All patients received supplemental IM injections of meperidine, 100 mg, as necessary, but not more frequently than every 3 hr. Over the 5 days the ketorolac treated patients (KT) required 33% less meperidine than did the placebo treated patients (PL), P = 0.04, and had significantly better pain relief as assessed by categorical, visual analog, and pain relief scales. By the end of 5 days infusions had been discontinued in six KT and one PL. The time to discontinuation of the infusion was significantly shorter in KT, ( P = 0.009). The median duration of hospital stay from the start of treatment was 3.3 days for KT and 7.2 days for PL, P = 0.027. Adverse events were mainly related to the digestive system. This study showed that continuous infusion of ketorolac significantly reduced total meperidine requirement and that the analgesia produced by this combination was superior to that produced by meperidine alone. Further evaluation of this drug in the management of sickle cell VOC is warranted. © 1994 Wiley‐Liss, Inc.
Psychopathology in Women and Men: Focus on Female Hormones
Authors: Mary V. Seeman
Journal: American Journal of Psychiatry (1997)

OBJECTIVE: The goal of this overview is to examine male/female differences in psychopathology in light of the known effects of gonadal steroids, especially estradiol, on neural function. METHOD: The epidemiology of specific psychopathological syndromes is highlighted with respect to male/female differences and discussed against the backdrop of recent neuroendocrine findings. RESULTS: A number of differences between the sexes in rates of illness and course of illness are documented, with Alzheimer's disease, schizophrenia, alcoholism, and mood and anxiety disorders each illustrating slightly different hormone-mediated risks and buffers. CONCLUSIONS: Estrogens are neuroprotective with respect to neuronal degeneration, growth, and susceptibility to toxins. The cyclic fluctuations of estrogens and progesterone enhance the response to stress, which confers susceptibility to depression and anxiety. (Am J Psychiatry 1997; 154:1641–1647)
Ectopic Expression of Vascular Cell Adhesion Molecule-1 as a New Mechanism for Tumor Immune Evasion
Authors: Ken-Yu Lin, Dan Lu, Chien-Fu Hung, Shiwen Peng, Lanqing Huang, Chunfa Jie, Francisco Murillo, Jesse Rowley, Ya-Chea Tsai, Liangmei He, Dae-Jin Kim, Elizabeth Jaffee, Drew Pardoll, T.-C. Wu
Journal: Cancer Research (2007)

Abstract Immune escape is an important reason why the immune system cannot control tumor growth, but how escape variants emerge during immunotherapy remains poorly understood. Here, we identify a new mechanism of tumor immune escape using an in vivo selection strategy. We generated a highly immune-resistant cancer cell line (P3) by subjecting a susceptible cancer cell line (P0/TC-1) to multiple rounds of in vivo immune selection. Microarray analysis of P0 and P3 revealed that vascular cell adhesion molecule-1 (VCAM-1) is up-regulated in the P3-resistant variant. Retroviral transfer of VCAM-1 into P0 significantly increased its resistance against a vaccine-induced immune response. Analysis of tumors showed a dramatic decrease in the number of tumor-infiltrating cluster of differentiation 8+ (CD8+) T cells in the tumors expressing VCAM-1. In vitro transwell migration assays showed that VCAM-1 can promote the migration of CD8+ T cells through its interaction with the α4β1 integrin. Site-directed mutagenesis of VCAM-1 at amino acid residues required for interaction with α4β1 integrin completely abolished the immune resistance conferred by VCAM-1 in vivo. Surface staining showed that most renal cell carcinomas (RCC) express VCAM-1, whereas an RCC that responded to vaccination was VCAM-1 negative. These data provide evidence that tumor expression of VCAM-1 represents a new mechanism of immune evasion and has important implications for the development of immunotherapy for human RCC. [Cancer Res 2007;67(4):1832–41]
Book: Complications: A Surgeon's Notes on an Imperfect Science
Authors: S. A Pai
Journal: BMJ (2002)

Atul Gawande Metropolitan Books, $24, pp 288 ISBN 080 506 3196 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> C omplications is a collection of essays about doubt and uncertainty in medicine. As well as being a surgeon, Atul Gawande is a staff writer on medicine and science at The New Yorker , and some of the essays in this volume have appeared before. For example, “When Doctors Make Mistakes,” which is a frank account of what often happens “behind the scenes,” was included in a collection of the “best American science and nature writing 2000,” … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif