tbuckley/cabot-search huggingface dataset:
Interobserver variability in the pathologic interpretation of endomyocardial biopsy results.
Authors: J G Shanes, J Ghali, M E Billingham, V J Ferrans, J J Fenoglio, W D Edwards, C C Tsai, J E Saffitz, J Isner, S Furner
Journal: Circulation (1987)

Controversy exists over the role of endomyocardial biopsy in evaluating patients with dilated cardiomyopathy, particularly in detecting myocarditis and in assessing prognosis. Interobserver variability, if high, could explain conflicting reports. To assess this possibility, we submitted biopsy specimens from 16 patients with dilated cardiomyopathy to seven cardiac pathologists. The same slides were independently reviewed by each and assessed for fibrosis, hypertrophy, nuclear changes on a 0 to 3+ scale, mean lymphocyte count per high-power field, and myocarditis. The prevalance of significant fibrosis ranged from 25% to 69%, hypertrophy from 19% to 88%, nuclear changes from 31% to 94%, and abnormal lymphocyte count from 0 to 38%. One or more pathologists diagnosed definite or possible myocarditis in 11 of the 16 patients. Of these 11 patients, three pathologists agreed about three and two pathologists agreed about five. Myocarditis was diagnosed by a single pathologist in three cases. We conclude that interobserver variability is high in interpreting biopsy specimens from patients with dilated cardiomyopathy and that quantitative and standardized methods are needed to increase diagnostic consistency.
A Guide to Drug Therapy in Renal Failure
Authors: William M. Bennett
Journal: JAMA (1974)

Five tables suggest maintenance dosage intervals for common drugs used in patients with renal insufficiency, based on data in the literature. If information about a particular drug is unavailable, emphasis is given to biological half-life, normal pharmacology, and creatinine clearance for modification of the usual dose schedules. Nephrotoxicity or adverse effects in patients with renal disease are noted and adjustments for concurrent dialysis suggested. (<i>JAMA</i>230:1544-1553, 1974)
Gyrate atrophy of the choroid and retina with hyperornithinemia: characterization of mutant liver L-ornithine:2-oxoacid aminotransferase kinetics.
Authors: I Sipilä, O Simell, J J O'Donnell
Journal: Journal of Clinical Investigation (1981)

Deficient activity of L-ornithine:2-oxoacid aminotransferase is associated with gyrate atrophy of the choroid and retina with hyperornithinemia, an autosomal recessive disease leading to blindness. Liver tissue from two patients contained trace activity of the enzyme. The Michaelis (Km) value of the mutant enzyme for ornithine was 200 mM, 50-fold higher than normal, but increasing the concentrations of alpha-oxoglutarate and pyridoxal 5'-phosphate to 10 times those giving maximal activity of the normal enzyme had no effect on the mutant enzyme. Substrate inhibition of the mutant could not be demonstrated at 1,000 mM ornithine concentration, whereas ornithine concentrations above 70 mM inhibited the normal enzyme. The data suggest that the abnormal L-ornithine:2-oxoacid aminotransferase in the two patients studied has an altered binding site for ornithine.
Spα<sup>1/65</sup> hereditary elliptocytosis in North Africa
Authors: N. Alloisio, D. Guetarni, L. Morlé, B. Pothier, M. T. Ducluzeau, A. Soun, P. Colonna, M. Clerc, N. Philippe, J. Delaunay
Journal: American Journal of Hematology (1986)

Abstract The Spα 1/65 variant of the spectrin has been recently described in black people with hereditary elliptocytosis (HE). The present study reports on a similar Spα 1/65 variant in nine North African persons belonging to four unrelated families. The abnormality was associated with a variable degree of elliptocytosis. In one case, red cell morphology was normal. In the nine carriers of the biochemical abnormality, the spectrin dimer self‐association was defective. The association constant was reduced: 0.65 to 1.7 × 10 5 M −1 (controls: 4.6 × 0.5 × 10 5 m M −1 (n = 21)); in six cases, there was a higher level of spectrin dimer in the low ionic strength extract at 4°C: 13.0 to 19.7% (controls: 6.4 ± 2.1% (n = 7)). Limited tryptic digests of spectrin from the nine persons revealed a decrease of the 80,000‐dalton α‐1 domain, and the concomitant appearance of a peptide with a molecular weight of 65,000 daltons and an isoelectric point ranging from 5.0 to 5.1. There was a correlation between the proportion of the 65,000‐dalton fragments, the defect of spectrin self‐association, and the extent of morphological alteration. This is the first large series concerning a spectrin abnormality in non‐black persons. In North Africa, cases of HE that are not due to a protein 4.1 defect have turned out so far to be associated with the Spα 1/65 variant.
STUDIES ON THE SENSITIZATION OF ANIMALS WITH SIMPLE CHEMICAL COMPOUNDS
Authors: Egon Macher, Merrill W. Chase
Journal: The Journal of Experimental Medicine (1969)

The fate of (14)C-labeled allergens injected intradermally into guinea pigs, namely picryl chloride (PCl*) and 2:4 dinitrochlorobenzene (DNCB*), was followed during the induction period of delayed hypersensitivity. Both chemicals were applied in a single injection into one ear in amounts that approached their minimal sensitizing doses (PCl, 0.25 microg; DNCB, 5.0 microg). Radioactivity in the various tissues was determined by liquid scintillation counting after combustion of tissues to CO(2) and H(2)O. The injected allergens seemed to leave the injection site in three phases. A large proportion of allergen escaped rapidly from the ear, about 50% within 3 hr in the case of PCl, within 15 min for DNCB, the difference probably reflecting their unequal reaction constants. Initially there was a "half-life" escape in 2.5 hr with injected dosage of 0.25 microg PCl and in 18 hr for 5.0 microg DNCB. This escape occurred via the regional veins and not via the lymphatics. Radioactive decomposition products of the allergens were already present in the urine within 3-4 hr. After 6-8 hr, the half-life time of escape lengthened to approximately 28 hr for both allergens used in their respective initial dosages, holding up to 2 days after which there occurred still further slowing; between 2 and 4 days the time was about 43 hr for PCl, much longer (72-88 hr?) for DNCB, apparently reflecting different physicochemical properties of this second fraction. Sensitization seemed to be connected with the portion that was present between 12 hr and 4 days of the induction period. It is not known how far the escape of radioactivity during this period may represent gradual hydrolysis of attached picryl and dinitrophenyl groupings, respectively, to form picric acid and dinitrophenol. Gradual accumulation of the second fraction in the regional lymph nodes could definitely be excluded. It was noted that no hypersensitivity arose and essentially no depot of radioactivity existed between 12 hr and 4 days when DNCB was injected in a dose of 0.25 microg, owing to its ready escape from the ear; but 20 times as much DNCB caused sensitization and provided about the same fixed depot as 0.25 microg of picryl chloride. After delayed hypersensitivity had been established, traces of radioactivity were still measurable at the site. This third fraction, probably representing a different coupling product, escaped at a very low rate and was traceable up through several weeks. No demonstrable radioactivity could be detected in thymus, spleen, and mesenteric nodes when examined at short intervals between (1/2) min and 17 days. In analogy with findings on transplantation "immunity" and with studies reported in the following paper, the induction of delayed hypersensitivity can be explained by encounters between lymphoid cells and the hapten complex which is found present in the local site for 4 days, in agreement with Medawar's concept of peripheral sensitization.
Bacterial agglutination studies with secretory IgA prepared from human gastrointestinal secretions and colostrum
Authors: D. B. L. McClelland, R. R. Samson, D. M. Parkin, D. J. C. Shearman
Journal: Gut (1972)

The function of human purified colostral and gastrointestinal IgA has been studied by its ability to agglutinate common gastrointestinal organisms. Agglutinating activity was unaffected by trypsin or acid but it was abolished rapidly by pepsin. Both colostral and gastrointestinal IgA agglutinated a wide range of enteric organisms. Variations in this activity occurred between different individuals, and between different gastrointestinal sites in the same individual. In preliminary studies, saliva and IgA prepared from gastric and jejunal secretions in patients with pernicious anaemia showed a more uniform agglutination pattern than IgA prepared from the same sites in other patients. The agglutinin activity of IgA prepared from a particular site may be determined by the bacterial flora at that site. Agglutination methods for assessing the function of gastrointestinal antibody may be of value in the study of the possible roles of antibodies in inflammatory bowel disease.
Secretion of biliary lipids in young Chilean women with cholesterol gallstones.
Authors: V Valdivieso, R Palma, F Nervi, C Covarrubias, C Severin, C Antezana
Journal: Gut (1979)

The early appearance of cholesterol gallstones is very common in Chile. To elucidate the mechanisms involved in this phenomenon, the size of the bile acid pool and the secretion of biliary lipids were studied in two groups of young women with normal weights and radiologically functioning gallbladders: nine with cholesterol gallstones and 14 healthy volunteers. The bile acid pool was similar in control and gallstone patients. The secretory rates of bile acids and phospholipids were comparable and significantly correlated in both groups. On the other hand, cholesterol output was higher in gallstone patients. In controls there was a significant correlation between the output of bile acids and cholesterol, but no correlation was found in the gallstone group. This study suggests that cholesterol hypersecretion into the bile is a major factor in the pathogenesis of cholesterol gallstone disease in young Chilean women with normal weights.
TCT-178 Atrial fibrillation in patients with aortic stenosis: is percutaneous left atrial appendage closure an option?
Authors: Akhil Parashar, Jasneet Devgun, Shikhar Agarwal, James Thomas, Apurva Patel, E. Murat Tuzcu, Amar Krishnaswamy, Samir Kapadia
Journal: Journal of the American College of Cardiology (2014)
Partial Gastrectomy for Duodenal Ulcer
Authors: Edward Landau, Mary E. Sullivan, Richard W. Dwight, Robert M. Donaldson
Journal: New England Journal of Medicine (1961)

THERE is a clinical impression that the results of operative therapy for duodenal ulcer vary, depending upon the original indication for surgical intervention. This concept, however, has not been adequately confirmed by a satisfactory study. Since most writers who compare different types of treatment for duodenal ulcer do not clearly separate patients according to the indication for which therapy is undertaken, it seemed important to examine the results when a single method of treatment for duodenal ulcer was carried out in patients in whom the indications for treatment were quite different. In the present study, therefore, the effects of subtotal . . .
Surgical waiting lists are not inevitable
Authors: R. J Motley
Journal: Journal of the Royal Society of Medicine (2004)

I contest Professor Black's conclusion that surgical waiting lists are inevitable (April 2004 JRSM1). Waiting lists are purely a function of an imbalance between supply and demand. If the availability of surgery, in terms of facilities and surgeons, exceeded demand, there would be no waiting list. Admittedly, a minority of patients might then undergo surgery for conditions which would have resolved spontaneously, but the majority would be appropriately treated and without delay. The proposal that surgeons with private practice contrive to maintain long NHS waiting lists is offensive to hard-working members of the medical profession. By what mechanism does Professor Black propose that these surgeons keep a long NHS waiting list? Do they not turn up for work when expected? This hackneyed explanation of long waiting lists is simply a political excuse for failing to provide adequate capacity in the NHS. However, in a publicly funded health service, few taxpayers would countenance a surplus of NHS surgeons sitting around waiting for patients. Far better the alternative—a reasonable wait for publicly funded surgery, and for those who wish to be treated at their convenience, a privately funded option.
Posterior Extensions of the Human Compact Atrioventricular Node
Authors: Shin Inoue, Anton E. Becker
Journal: Circulation (1998)

Background —Catheter ablation procedures have revived interest in the detailed anatomy of the specialized atrioventricular (AV) septal junctional area. The compact AV node usually is considered to have a blunt posterior end. The objective of this study was to reconstruct the human compact AV node in relation to the landmarks of Koch’s triangle, with emphasis on its posterior extension. Methods and Results —In 21 hearts obtained from autopsies, the AV nodal septal junctional area was removed en bloc, serially sectioned, and reconstructed. None of the hearts showed a blunt posterior ending of the compact AV node; 13 showed posterior extensions on both the right and left sides; 7 had a rightward posterior extension only; and 1 heart showed a single leftward extension. Hence, a rightward posterior extension was present in 20 of 21 hearts. Furthermore, in 16 of these 20 hearts, the rightward extension continued to the level of the coronary sinus ostium; in 7, the bundle extended beyond this anatomic landmark. The mean length of the right posterior extension was 4.4±2.0 mm; that of the leftward posterior extension was 1.8±0.9 mm. Superimposed onto the slope of the muscular AV septum, viewed from the right atrium, the rightward extension ran close to the tricuspid annulus with the leftward extension positioned superiorly. Conclusions —The human compact AV node contains rightward and leftward posterior extensions, with the right extension close to the tricuspid annulus. It is tempting to speculate that these extensions are involved in “slow pathway” conduction.
Ambiguity in the U.K. guidelines for the management of cutaneous melanoma
Authors: F.S. Ali, P. A.Harris, P.E.M. Butler
Journal: British Journal of Dermatology (2002)

Journal Article Ambiguity in the U.K. guidelines for the management of cutaneous melanoma Get access F.S. Ali, F.S. Ali Department of Plastic Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, U.K Correspondence: Miss Farida Ali E‐mail: faridaali71@aol.com faridaali71@aol.com Search for other works by this author on: Oxford Academic Google Scholar P. A.Harris, P. A.Harris Department of Plastic Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, U.K Search for other works by this author on: Oxford Academic Google Scholar P.E.M. Butler P.E.M. Butler Department of Plastic Surgery, Royal Free Hospital NHS Trust, Pond Street, London NW3 2QG, U.K Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 147, Issue 4, 1 October 2002, Pages 835–836, https://doi.org/10.1046/j.1365-2133.2002.505320.x Published: 01 October 2002
Inflicted Burns in Children— Forensic Recognition and Resolution
Authors: Gilbert E. Corrigan
Journal: JAMA (1980)

<h3>To the Editor.—</h3> The discovery by Hight et al (242:517, 1979), that 9% of the children treated at the Children's Hospital of Michigan had burns caused through felonious human assault, is no surprise to those physicians trained in forensic medicine. Our problem is to convince people in pediatric hospitals that the cases of children who die in their burn centers should be reported to the local forensic authorities and that formal medicolegal investigations be initiated. The fact is that the burned child is often denied his civil rights by those in charge of pediatric burn units. Their excuses include (1) the need for local in-house autopsy for proper surveillance of infection, (2) the loss of parental accord with the treating physician from the calling of the police authority into the case, (3) the lack of interest by hospital medical authorities because of the nihilistic view that even with an investigation nothing
Changes in Rates of Autopsy-Detected Diagnostic Errors Over Time
Authors: Kaveh G. Shojania, Elizabeth C. Burton, Kathryn M. McDonald, Lee Goldman
Journal: JAMA (2003)

Context Substantial discrepanies exist between clinical diagnoses and findings at autopsy. Autopsy may be used as a tool for quality management to analyze diagnostic discrepanies. Objective To determine the rate at which autopsies detect important, clinically missed diagnoses, and the extent to which this rate has changed over time. Data Sources A systematic literature search for English-language articles available on MEDLINE from 1966 to April 2002, using the search terms autopsy , postmortem changes , post-mortem , postmortem , necropsy , and posthumous , identified 45 studies reporting 53 distinct autopsy series meeting prospectively defined criteria. Reference lists were reviewed to identify additional studies, and the final bibliography was distributed to experts in the field to identify missing or unpublished studies. Study Selection Included studies reported clinically missed diagnoses involving a primary cause of death (major errors), with the most serious being those likely to have affected patient outcome (class I errors). Data Extraction Logistic regression was performed using data from 53 distinct autopsy series over a 40-year period and adjusting for the effects of changes in autopsy rates, country, case mix (general autopsies; adult medical; adult intensive care; adult or pediatric surgery; general pediatrics or pediatric inpatients; neonatal or pediatric intensive care; and other autopsy), and important methodological features of the primary studies. Data Synthesis Of 53 autopsy series identified, 42 reported major errors and 37 reported class I errors. Twenty-six autopsy series reported both major and class I error rates. The median error rate was 23.5% (range, 4.1%-49.8%) for major errors and 9.0% (range, 0%-20.7%) for class I errors. Analyses of diagnostic error rates adjusting for the effects of case mix, country, and autopsy rate yielded relative decreases per decade of 19.4% (95% confidence interval [CI], 1.8%-33.8%) for major errors and 33.4% (95% [CI], 8.4%-51.6%) for class I errors. Despite these decreases, we estimated that a contemporary US institution (based on autopsy rates ranging from 100% [the extrapolated extreme at which clinical selection is eliminated] to 5% [roughly the national average]), could observe a major error rate from 8.4% to 24.4% and a class I error rate from 4.1% to 6.7%. Conclusion The possibility that a given autopsy will reveal important unsuspected diagnoses has decreased over time, but remains sufficiently high that encouraging ongoing use of the autopsy appears warranted.
Paraproteins and bence jones protein
Authors: E. N. Wardle
Journal: BMJ (1967)

BJDIfURNALtions revealed that he is an alkaptonuric with moderate diabetes mellitus.The presence in his urine of homogentisic acid is confirmed by extraction' and chromato- graphic identification,2 and of glucose by osazone and Selivanoff's tests.Curiously enough, Clinistix failed to detect glucose in this urine.Further investigation has brought to light that this failure of Clinistix was due to the inhibition of peroxidase reaction by homogentisic acid.3This case seems to be the second to be reported from India since that of Bose et al.4 where diabetes mellitus and alkaptonuria are coexistent.-Weare, etc., B.
[772] LIPID ACCUMULATION IN HEPATOCYTES INDUCES ACTIVATION AND PRO-FIBROTIC GENE EXPRESSION IN HEPATIC STELLATE CELLS - A NEW IN VITRO MODEL TO STUDY FIBROGENESIS IN NASH
Authors: H. Wobser, C. Dorn, T. Weiss, C. Bollheimer, R. Buettner, J. Schoelmerich, C. Hellerbrand
Journal: Journal of Hepatology (2007)
Phenotypic characterization of kidney stone formers by endoscopic and histological quantification of intrarenal calcification
Authors: Michael P. Linnes, Amy E. Krambeck, Lynn Cornell, James C. Williams, Mark Korinek, Eric J. Bergstralh, Xujian Li, Andrew D. Rule, Cynthia M. McCollough, Terri J. Vrtiska, John C. Lieske
Journal: Kidney International (2013)
Mouse Model of Human Ovarian Endometrioid Adenocarcinoma Based on Somatic Defects in the Wnt/β-Catenin and PI3K/Pten Signaling Pathways
Authors: Rong Wu, Neali Hendrix-Lucas, Rork Kuick, Yali Zhai, Donald R. Schwartz, Aytekin Akyol, Samir Hanash, David E. Misek, Hidetaka Katabuchi, Bart O. Williams, Eric R. Fearon, Kathleen R. Cho
Journal: Cancer Cell (2007)
A comparison of three standard methods of identifying mast cells in endobronchial biopsies in normal and asthmatic subjects
Authors: L. G. Heaney, P. Leggett, P. Maxwell, H. Bharucha, M. Ennis
Journal: Allergy (1997)

Reported mast‐cell counts in endobronchial biopsies from asthmatic subjects are conflicting, with different methodologies often being used. This study compared three standard methods of counting mast cells in endobronchial biopsies from asthmatic and normal subjects. Endobronchial biopsies were obtained from atopic asthmatic subjects ( n = 17), atopic nonasthmatic subjects ( n =6), and nonatopic nonasthmatic control subjects ( n =5). After overnight fixation in Carnoy's fixative, mast cells were stained by the short and long toluidine blue methods and antitryptase immunohistochemistry and were counted by light microscopy. Method comparison was made according to Bland &amp; Altman. The limits of agreement were unacceptable for each of the comparisons, suggesting that the methods are not interchangeable. Coefficients of repeatability were excellent, and not different for the individual techniques. These results suggest that some of the reported differences in mast‐cell numbers in endobronchial biopsies in asthma may be due to the staining method used, making direct comparisons between studies invalid. Agreement on a standard method is required for counting mast cells in bronchial biopsies, and we recommend the immunohistochemical method, since fixation is less critical and the resultant tissue sections facilitate clear, accurate, and rapid counts.
Patients will be able to book appointments online and have phone consultations
Authors: O. Mashta
Journal: BMJ (2008)

Funding of general practices in England will be reformed to reward GPs for taking on new patients, a new Department of Health policy document says.

The new funding system will also improve choice for patients, says the report, which sets out the future direction for primary and community care in England as part of the government’s next stage review of the NHS.

The report says that primary care trusts will work with local GPs to open up closed lists, help expand practice boundaries (by paying allowances to expand practices, for example), and allow patients greater choice among existing and new practices.

Laurence Buckman, chairman of the BMA’s General Practitioners Committee, said, “Choice of …
Single Daily Dose of Antidepressants
Authors: Frank J Ayd
Journal: JAMA (1974)

In recent years, there has been a spate of articles on the failure of patients to take medicine as directed and the impact of this on therapeutic outcome. Many of these studies have been reviewed by Stewart and Cluff<sup>1</sup>and by Blackwell.<sup>2</sup>They disclose a disturbing rate of noncompliance ranging from 20% to 82%. In one study, individuals judged to be very unreliable were excluded.<sup>3</sup>Even with this restriction, 31% of the "reliable" patients took less than 70% of their medication. The magnitude of the patient noncompliance problem is even greater than the data indicate, because most of the methods for measuring compliance are limited to finding the extremes only—those who comply fully, or those who comply minimally or not at all. The majority of patients in compliance studies were taking divided doses of a single drug. A substantial number of patients today, however, are simultaneously taking