tbuckley/cabot-search huggingface dataset:
An unusual cause of massive upper gastrointestinal bleeding: Dieulafoy's lesion within a giant midesophageal diverticulum
Authors: I. Turan, A. Ozturk, U. Akarca, O. Ozutemiz
Journal: Endoscopy (2008)

Midesophageal diverticula are usually asymptomatic and are often discovered incidentally during endoscopy performed for unrelated reasons. A small proportion present with life-threatening bleeding. We present here a first report of the massive arterial bleeding from Dieulafoy's lesion in a midesophageal diverticulum.
The Belgian Medical Crisis
Authors: C. Newton Peabody
Journal: JAMA (1964)

JULIUS CAESAR, in his commentaries on the three parts of Gaul, noted that "the Belgiums were the most courageous of them all." The conduct of the Belgian medical profession in the past few months lends strong support to that observation. The enactment of the Leburton law establishing a National Institute of Sickness and Disability Insurance (INAMI) forced the doctors and dentists to decide whether they or the politicians were better qualified to determine the character of organized medicine in their country. It is well known that the strike was used and that the medical body finally won its point. While the technical details of their victory are being determined, one might well examine the ethics of the strike, the strategy of the government, and the reason for the doctors' success. Without seeming to apologize for the strike, certain details of its execution should be better known. The American press did
Mental Symptoms in Cerebrospinal Meningitis
Authors: T. W. H. Weir, C. K. Vautier
Journal: BMJ (1942)

During the winter months of 1940-1 three male patients were admitted to this hospital suffering from abnormal mental symptoms which were subsequently found to be due to cerebrospinal meningitis.All these cases were certified before admission.Present wartime conditions, with evacuation, expanding war production, and the con- gregation in schools and halls of large parties of men and women engaged in civil defence (Underwood, 1940), have given rise to circumstances which are apt to encourage the development of infectious diseases.Among these occurs cerebrospinal fever, ,a disease whose spread by carriers is notoriously associated with overcrowding.Now, the fol- lowing three cases have a direct association with the war- time effort, and a description of them may prove of interest and perhaps of assistance to those in charge of the health and welfare of people living under such conditions, and be a guide to the best means of dealing with them.Case I A man aged 29.Employed as a labourer at War Office con- struction works.Slept in hut with other workers.Heavy drinker for several weeks prior to onset of illness.Noticed to be restless and excited two days before admission.Became more restless,.confused, violent, and abusive.RKgarded by fellow-workmen as suffering from alcoholic excitement.The doctor called in reported him as being restless and abusive, unable to recognize friends who were attempting to pacify him.Patient was certified and sent to the mental hospital.No history of cases of cerebrospinal fever in area where patient worked.Admitted to this hospital October 30, 1940.Well-developed patient.Mental state confused; restless, violent, and abusive.Resisted examination strongly.Axillary temperature and pulse rate normal.No neurological abnormality observed, nor was any rash present.Shortly after admission given morphine and hyoscine; became quieter and slept for a few hours.On October 31, pulse 120, temperature 101.6°F.; delirium more marked; was fairly quiet with sedatives.November 1.-Pulse 110, temperature 101.4'F. Restless and irritable.Patient noticed to be lying on side with head slightly drawn backwards.Neck rigidity present, with positive Kernig's sign.Brudzinski's sign was also elicited.A lumbar puncture
Antigen-specific activation, tolerization, and reactivation of the interleukin 4 pathway in vivo.
Authors: M Röcken, J Urban, E M Shevach
Journal: The Journal of Experimental Medicine (1994)

The outcome of immune responses critically depends on the pattern of lymphokines secreted by CD4+ T cells. CD4+ T cells may differentiate into interleukin 2 (IL-2) and interferon gamma secreting T helper 1 (Th1)-like cells or IL-4/IL-5/IL-10 secreting Th2-like cells. However, the mechanisms that regulate production of IL-4 or other T cell lymphokines in vivo remain unknown. We use the superantigen, Staphylococcus enterotoxin A (SEA), as a model antigen to characterize the signals that regulate the production of IL-4 in vivo. Induction of IL-4 in normal CD4+ T cells required stimulation with both antigen and IL-4. SEA-specific CD4+ T cells produced large amounts of IL-4 when restimulated within 10 d after in vivo priming. Repetitive application of both signals was required to prevent downregulation of IL-4 production. Although controversy exists regarding the susceptibility of Th2-like cells to tolerogenic signals, high doses of superantigen readily abolished the capacity to produce IL-4 in both naive T cells and in T cells already primed for IL-4 production. Infection with the nematode, Nippostrongylus brasiliensis, reversed the established T cell tolerance, whereas the signals which induced IL-4 production in normal T cells, antigen and IL-4, were not capable of reversing superantigen-specific tolerance in vivo. The major parameter that correlated with the capacity of parasitic infection to break tolerance was magnitude of the lymphoproliferation seen during the course of the infection. The capacity to activate or tolerize the IL-4 pathway in an antigen-specific fashion should prove useful in the design of antigen-specific therapies for autoimmune and allergic diseases.
NÆVUS OF EYELID, WITH EXTENSIVE SECONDARY CONJUNCTIVAL INVOLVEMENT.
Authors: G. ORAM RING
Journal: JAMA (1898)

I desire to present, somewhat briefly, the history of a case of absorbing interest, which is at present under my professional care, and which by reason of its serious character and great rarity, will form a proper subject for the consideration of the Section. On Feb. 13, 1897, through the courtesy of my friend, Dr. J. Cardeen Cooper, a female, M. M., aged 18 months, was referred to me for treatment of a nævus of the right upper eyelid. Dr. Cooper has very kindly furnished me with a history of the case, previous to the date of my examination, the child having first come under his observation in June, 1896, five months after birth. At that time there existed on the right upper lid a nævus of the size of a small shin bark, which the mother stated had grown in about two months, as at birth there had existed
Adenoviral Constructs Encoding Phosphorylation-Competent Full-length and Truncated Forms of the Human Retinoblastoma Protein Inhibit Myocyte Proliferation and Neointima Formation
Authors: Roy C. Smith, Ken N. Wills, Douglas Antelman, Harris Perlman, Lonn N. Truong, Kevin Krasinski, Kenneth Walsh
Journal: Circulation (1997)

Background The retinoblastoma (Rb) protein is a key cell-cycle regulator that controls entry into the S phase by modulating the activity of the E2F transcription factor. We analyzed the effects of full-length phosphorylation-competent and a mutant truncated form of human Rb for their effects on vascular smooth muscle cell (VSMC) proliferation and neointima formation. Methods and Results A number of mutant forms, both phosphorylation competent and incompetent, of human Rb protein were evaluated for their ability to inhibit E2F activity. The results of these assays indicated that a phosphorylation competent, amino-terminal–truncated Rb protein (Rb56) was a particularly potent inhibitor of E2F-mediated transcription relative to the full-length Rb construct (Rb110). Adenoviral constructs containing Rb56 or Rb110 expressed their respective Rb forms in VSMCs, as determined by Western immunoblot analysis, and were similar in their abilities to arrest the cell cycle, as determined by assays of 3 H-thymidine incorporation and by flow cytometric analyses. When examined for their effect on neointima formation after balloon injury of the rat carotid artery, both full-length and truncated forms of Rb inhibited formation of this VSMC-derived lesion. Conclusions These analyses revealed that the maintenance of high levels of phosphorylation-competent human Rb, either full-length or truncated forms, in VSMCs is an effective method of modulating the extent of intimal hyperplasia that occurs after balloon-induced vascular injury.
Brian John Chapman
Authors: N. Colledge, A. Elder, A. Coull
Journal: BMJ (2012)

Born in Edinburgh, Brian John Chapman attended Daniel Stewart’s School, where he was Dux. He then entered medical school at the University of Edinburgh, where he met his wife Dorothy. The couple spent a memorable student elective in South Africa, narrowly avoiding being charged by an elephant. They became engaged on their return, and he qualified BSc (2.1 in biochemistry) and MB ChB in 1981.

After house jobs, he was appointed to a senior house officer rotation in Edinburgh and initially explored a career in respiratory medicine. However, after diagnosing an elderly patient attending a respiratory clinic with Parkinson’s disease, he came to the attention of Roger Smith, a senior lecturer in geriatric medicine, who persuaded him to apply for a post in the specialty. Brian’s subsequent contribution has been …
Incomplete Duplication of the Esophagus: One Case
Authors: J. Gayá Cantallops, A. Obrador Adrover, J. Marcos Fernández, A. Ballesteros Fernández
Journal: Endoscopy (1981)

A single case of incomplete duplication of the esophagus is presented, which was fortuitously diagnosed in an asymptomatic older male. The endoscopic findings are described, and the various features of these esophageal anomalies discussed.
To opt in or opt out of electronic patient records?: Isle of Wight and Scottish projects are not opt out schemes
Authors: Paul R Cundy, Alan Hassey
Journal: BMJ (2006)

EDITOR—Watson and Halamka debate whether patients should have to opt in or out of the national electronic care record.1 However, the Isle of Wight and Scottish electronic emergency care summary models cannot be truly compared with that proposed for the NHS summary care record because patients …
RPN2 gene confers docetaxel resistance in breast cancer
Authors: Kimi Honma, Kyoko Iwao-Koizumi, Fumitaka Takeshita, Yusuke Yamamoto, Teruhiko Yoshida, Kazuto Nishio, Shunji Nagahara, Kikuya Kato, Takahiro Ochiya
Journal: Nature Medicine (2008)
Review shows no evidence that individualised herbal treatments are effective
Authors: Susan Mayor
Journal: BMJ (2007)

No good evidence exists that individually tailored prescriptions of a mixture of herbs are effective, concludes a systematic review published last week.

The study reviewed all available studies of individualised herbal medicine for any indication ( Postgraduate Medical Journal 2007;83:633-7). The researchers, from the Universities of Exeter and Plymouth, found only three randomised controlled trials out of 1300 studies they identified that they considered were of sufficient quality to draw meaningful conclusions. These three trials showed no convincing evidence of benefit. …
Subendocardial Infarction: Report of Six Cases and Critical Survey of the Literature
Authors: HAROLD D. LEVINE, RALPH V. FORD
Journal: Circulation (1950)

In the ordinary evolution of an acute myocardial infarct the electrocardiogram shows T wave (ischemia), RS-T segment ("current of injury") and QRS (death of muscle) changes. This paper presents a special group of cases of infarction in which only T wave and RS-T segment changes developed even when patients were observed over a considerable period. Therefore, the curves as such could not be considered diagnostic of myocardial infarction. The authors here describe a unique and intriguing group of cases of fatal myocardial infarction with electrocardiograms resembling those seen in stress tests for coronary insufficiency and showing rimlike subendocardial infarcts at postmortem.
Paul Broca: Founder of French Anthropology, Explorer of the Brain
Authors: Frank R. Freemon
Journal: JAMA (1993)

The modern physician finds the name Broca familiar: Broca's area, Broca's aphasia, the diagonal band of Broca, the great limbic lobe of Broca. Everyone interested in the history of medicine should be familiar with the life and career of Paul Broca (1824-1880), a key figure in the development of modern medical science. This excellent biography by Schiller was written in 1979 and is now reissued in paperback. Broca was born in the small village of Sainte-Foy-la-Grande in southwestern France. He obtained his medical education in Paris and began the long struggle up the French academic ladder. His career was surgery, but his interests encompassed the entire human condition. His early studies involved the microscopic examination of autopsies from cancer patients. He was the first to define clearly that cancer could spread via venous channels. Broca became interested in the anatomy of the human skeleton, particularly the skull. The French surgeon
The disturbance of epidermal barrier function in atopy patch test reactions in atopic eczema
Authors: M. GFESSER, J. RAKOSKI, J. RING
Journal: British Journal of Dermatology (1996)

Atopic eczema (AE) is a common skin disorder. Eczematous lesions showing macroscopic, microscopic and immunopathological resemblance to lesional AE can be induced by aeroallergens by epicutaneous testing (atopy patch test, APT). Altered epidermal barrier function, as determined by transepidermal water loss (TEWL), is a typical feature of patients with AE. The present investigation was performed to define the differences in the epidermal barrier function between positive APT reactions to aeroallergens and positive patch test reactions to contact allergens in AE patients. Allergen extracts from grass pollen, birch pollen, cat dander and house dust mite (Dermatophagoides pteronyssinus) were applied in large Finn chambers on Scanpor for 48 h on the clinically unaffected and untreated skin of the back, in 11 patients with AE. The same procedure was done with 27 contact allergens of a standard test battery. Test reactions were read and TEWL was measured after 48 and 72 h. Eight of the 11 patients developed positive APT reactions to D. pteronyssinus, two to cat dander and one to birch pollen. Seven of the 11 patients showed positive patch test reactions to nickel sulphate, two to potassium dichromate, one to thiuram-mix and one to paraphenylenediamine. Vehicle controls were negative. The TEWL of the positive APT reactions was significantly higher, both after 48 h (mean +/- standard deviation 10.0 +/- 6.5 g/m2h) and after 72 h (9.7 +/- 5.4 g/m2h) as compared with the control site (48/72h: 4.4 +/- 1.5/4.1 +/- 1.4 g/m2h) (P < 0.01). In contrast, TEWL of the positive patch test reactions to contact allergens (48/72 h: 5.4 +/- 2.2/5.4 +/- 1.9 g/m2h) was similar to that of the control site (48/72 h: 5.2 +/- 2.1/5.0 +/- 1.8 g/m2h) (not significant). The relative TEWL at 48 h and 72 h, expressed as the ratio between the positive patch test and the control site, was significantly higher in the positive APT reactions (48/72 h: 218.8 +/- 80.4%/232.0 +/- 85.9%) compared with positive patch test reactions to contact allergens (48/72 h: 102.1 +/- 12.0%/107.1 +/- 9.5%) (P < 0.01). It is concluded that the epidermal barrier function in AE patients is altered only in positive APT reactions, in contrast to positive patch test reactions to contact allergens. As a consequence of this aeroallergen-induced altered epidermal barrier function, further allergens can more easily penetrate the skin, inducing a vicious circle and perpetuating the eczematous lesions.
LAPTOP Study: A 24-Month Trial of Verteporfin Versus Ranibizumab for Polypoidal Choroidal Vasculopathy
Authors: Akio Oishi, Noriko Miyamoto, Michiko Mandai, Shigeru Honda, Toshiyuki Matsuoka, Hideyasu Oh, Mihori Kita, Tomoko Nagai, Nobuhiro Bessho, Mamoru Uenishi, Yasuo Kurimoto, Akira Negi
Journal: Ophthalmology (2014)
Arginase Inhibition Improves Endothelial Function in Patients With Coronary Artery Disease and Type 2 Diabetes Mellitus
Authors: Alexey Shemyakin, Oskar Kövamees, Arnar Rafnsson, Felix Böhm, Peter Svenarud, Magnus Settergren, Christian Jung, John Pernow
Journal: Circulation (2012)

Endothelial dysfunction plays an important role in the early development of atherosclerosis and vascular complications in type 2 diabetes mellitus. Increased expression and activity of arginase, metabolizing the nitric oxide substrate l-arginine, may result in reduced production of nitric oxide and thereby endothelial dysfunction. We hypothesized that inhibition of arginase activity improves endothelial function in patients with coronary artery disease (CAD) and type 2 diabetes mellitus.Three groups of subjects were included: 16 patients with CAD, 16 patients with CAD and type 2 diabetes mellitus (CAD+Diabetes), and 16 age-matched healthy control subjects. Forearm endothelium-dependent and endothelium-independent vasodilatation were assessed with venous occlusion plethysmography before and during intra-arterial infusion of the arginase inhibitor N(ω)-hydroxy-nor-l-arginine (nor-NOHA; 0.1 mg/min). Nor-NOHA was also coinfused with the nitric oxide synthase inhibitor (N(G)-monomethyl L-arginine). The expression of arginase was determined in the internal mammary artery of patients undergoing bypass surgery. Nor-NOHA markedly increased endothelium-dependent vasodilatation (up to 2-fold) in patients with CAD+Diabetes and CAD (P<0.001) but not in the control group. N(G)-monomethyl L-arginine completely inhibited the increase in endothelium-dependent vasodilatation induced by nor-NOHA. Endothelium-independent vasodilatation was slightly improved by nor-NOHA in the CAD+Diabetes group. Arginase I was expressed in vascular smooth muscle cells and endothelial cells, and arginase II was expressed in endothelial cells of patients with and without diabetes mellitus.Arginase inhibition markedly improves endothelial function in patients with CAD and type 2 diabetes mellitus suggesting that increased arginase activity is a key factor in the development of endothelial dysfunction.
Regenerative Potential of Cardiosphere-Derived Cells Expanded From Percutaneous Endomyocardial Biopsy Specimens
Authors: Rachel Ruckdeschel Smith, Lucio Barile, Hee Cheol Cho, Michelle K. Leppo, Joshua M. Hare, Elisa Messina, Alessandro Giacomello, M. Roselle Abraham, Eduardo Marbán
Journal: Circulation (2007)

Background— Ex vivo expansion of resident cardiac stem cells, followed by delivery to the heart, may favor regeneration and functional improvement. Methods and Results— Percutaneous endomyocardial biopsy specimens grown in primary culture developed multicellular clusters known as cardiospheres, which were plated to yield cardiosphere-derived cells (CDCs). CDCs from human biopsy specimens and from comparable porcine samples were examined in vitro for biophysical and cytochemical evidence of cardiogenic differentiation. In addition, human CDCs were injected into the border zone of acute myocardial infarcts in immunodeficient mice. Biopsy specimens from 69 of 70 patients yielded cardiosphere-forming cells. Cardiospheres and CDCs expressed antigenic characteristics of stem cells at each stage of processing, as well as proteins vital for cardiac contractile and electrical function. Human and porcine CDCs cocultured with neonatal rat ventricular myocytes exhibited biophysical signatures characteristic of myocytes, including calcium transients synchronous with those of neighboring myocytes. Human CDCs injected into the border zone of myocardial infarcts engrafted and migrated into the infarct zone. After 20 days, the percentage of viable myocardium within the infarct zone was greater in the CDC-treated group than in the fibroblast-treated control group; likewise, left ventricular ejection fraction was higher in the CDC-treated group. Conclusions— A method is presented for the isolation of adult human stem cells from endomyocardial biopsy specimens. CDCs are cardiogenic in vitro; they promote cardiac regeneration and improve heart function in a mouse infarct model, which provides motivation for further development for therapeutic applications in patients.
Psychiatrist suspended for undermining patients' trust in treatment
Authors: Owen Dyer
Journal: BMJ (2004)

A consultant child psychiatrist who sent letters to GPs questioning other psychiatrists' competence, and forwarded copies to their patients, has been suspended for 12 months by the General Medical Council for serious professional misconduct.

Dr Patrick Cosgrove was one of the pioneers of the use of methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The Citizens' Commission on Human Rights and Overload Network, the Scottish based advocacy group for patients with the condition, have both complained to the GMC about Dr Cosgrove, saying he was too ready to prescribe …
ABC of sexual health: A woman's sexual life after an operation
Authors: A. de Marquiegui, M. Huish
Journal: BMJ (1999)

Disfiguring and mutilating operations, especially of the face, breasts, genitals, and reproductive organs, often have a deleterious effect on a woman's self image and sexuality. Sociopsychological aspects of body image form a complex pattern of self knowledge and how one is perceived by others. The invasion of surgery invariably causes temporary or permanent changes, which may not be anticipated by women or may emerge only on discharge from hospital. Partners who adapt poorly to the new circumstances may also find it difficult to continue sexual activity, but an existing strong and intimate relationship encourages positive postoperative adjustment. Dealing with psychological and emotional states such as anxiety, fear, and depression about surgery is crucial to a woman and her partner. Medical teams should encourage women to discuss their worries, especially sexual anxieties, as problems become more entrenched and more difficult to treat over time. Postoperative surveys of women suggest that 28-50% wanted their doctor to address sexual difficulties. Rehabilitation is important in promoting adjustment and acceptance by facilitating the grieving process. Women who have a stoma as a result of chronic illness such as irritable bowel disorder, ulcerative colitis, and Crohn's disease often experience a better psychological and sexual outcome than do those who undergo emergency surgery for, say, cancer of the colon. Healthy adaptation to a stoma depends on preoperative and postoperative counselling and understanding by stoma nurses. Patients' greatest fears are loss of control, bad odour, noise, leaking or bursting bags, unsightliness, and their partner's feelings towards them. ### Factors affecting sexual function after an operation