tbuckley/cabot-search huggingface dataset:
A Morphologic Study of Canine Hearts Subjected to Fibrillation, Electrical Defibrillation and Manual Compression
Authors: C. G. TEDESCHI, C. W. WHITE
Journal: Circulation (1954)

The pathologic effects on the heart of fibrillation, countershock and manual compression have been studied in canine hearts. Survival experiments have permitted evaluation of the permanence of the damage produced. Massage of the normally beating heart produced minimal nonspecific damage. Manual compression on the fibrillating heart was seen to elicit changes more severe than those observed after fibrillation alone, including occasional focal myocardial necrosis. Alternating-current countershock produced both epicardial and myocardial damage at the site of application of the electrodes. In view of their localization, these changes would not be expected to alter cardiac function appreciably. Comparable changes, but less severe in type, were found in the hearts of animals subjected to condenser discharge countershock. Padding of the electrodes with saline-soaked gauze did not appear to influence the degree of damage.
Emergency Polytetrafluoroethylene-Covered Stent Implantation to Treat Coronary Ruptures
Authors: Carlo Briguori, Takahiro Nishida, Angelo Anzuini, Carlo Di Mario, Eberhard Grube, Antonio Colombo
Journal: Circulation (2000)

Background —Coronary perforation is a life-threatening complication of percutaneous interventions. In the past few years, the implantation of covered stents has emerged as a strategy for treatment when the traditional conservative approach (ie, prolonged balloon inflation and reversal of anticoagulation) fails. Methods and Results —Since May 1997 (when polytetrafluoroethylene [PTFE]-covered stents were available at our institutions), 11 of the 12 consecutive patients who had coronary ruptures that were unsuccessfully sealed with prolonged balloon inflation and reversal of anticoagulation were treated with 12 PTFE-covered stents (PTFE group). The efficacy of the PTFE-covered stent was compared with that of noncovered stents, which were used to treat 17 perforations (non-PTFE group). One patient sustained a very distal perforation that was not suitable for covered stent sealing and underwent emergency surgery. All vessel ruptures treated with PTFE-covered stent implantation were successfully sealed. The time necessary to deploy the stent was 10±3 minutes (range, 4 to 15 minutes). All patients but one were discharged from the hospital and had an optimal early clinical outcome. One patient underwent emergency bypass surgery and died in the intensive care unit. The occurrence of cardiac tamponade and the necessity for emergency surgery was significantly lower in the PTFE group than in the non-PTFE group. At 14±4 months, the 10 discharged patients had not experienced any major adverse cardiac events. Conclusions —This preliminary study supports the utility of the PTFE-covered stent for the nonsurgical treatment of vessel ruptures.
Reproducibility of the French‐American‐British classification of acute Leukemia: The southwest oncology group experience
Authors: David R. Head, Richard A. Savage, Lizardo Cerezo, Catherine M. Craven, John N. Bickers, Robert Hartsock, Thomas A. Hosty, John H. Saiki, Henry E. Wilson, Francis S. Morrison, Charles A. Coltman, John J. Hutton
Journal: American Journal of Hematology (1985)

Abstract After initial French‐American‐British (FAB) diagnosis by a multiinstitutional Southwest Oncology Group panel, slides of acute leukemia cases were recirculated to panel members for second review. The reproducibility of the FAB classification is analyzed. The classification is reproducible in the 70% range in panel reviewer hands and allows remarkable reproducibility in the morphologic and cytochemical distinction of acute lymphoid leukemia (ALL) from acute myeloid leukemia (AML). The limitations of a morphologic and cytochemical classification of acute leukemia are discussed. A simplification of the FAB system, merging M1, M2, and M4 as M7, is proposed; this simplification improves the system's reproducibility.
Postsystolic shortening of acutely ischemic canine myocardium predicts early and late recovery of function after coronary artery reperfusion.
Authors: M Takayama, R M Norris, M A Brown, L C Armiger, J T Rivers, H D White
Journal: Circulation (1988)

Postsystolic shortening and thickening of ischemic and postischemic myocardium are well-recognized phenomena, but their significance is controversial. To discover whether postsystolic shortening and thickening might represent an active process and to establish their place as possible predictors of functional recovery during and after recovery from ischemia, we examined correlations in severely ischemic dyskinetic myocardial segments in 14 open-chest anesthetized dogs (90 minutes' ischemia, n = 9; 180 minutes' ischemia, n = 5) between the magnitudes of postsystolic shortening and thickening during ischemia and either the magnitudes of systolic shortening and thickening in the same segments before coronary occlusion or the magnitudes of shortening and thickening at 30-60 minutes and at 2-3 weeks after reperfusion. We found positive correlations between preocclusion shortening and postsystolic shortening (r = 0.44, n = 33 myocardial segments; p less than 0.02) and between preocclusion thickening and postsystolic thickening (r = 0.73, n = 13 segments; p less than 0.01), both measured at 5 minutes after onset of ischemia. Strong correlations were found also between postsystolic shortening and thickening measured immediately before reperfusion and systolic shortening and thickening measured after recovery at 2-3 weeks (r = 0.73, n = 28; p less than 0.001 for shortening; r = 0.79, n = 12; p less than 0.01 for thickening). Significant but less-exact correlations were found between postsystolic shortening and thickening measured immediately before reperfusion and early recovery of shortening and thickening at 30-60 minutes after reperfusion (during the "stunned myocardium" period). Postsystolic shortening and thickening persisted early after reperfusion in dogs that had had 90 minutes of ischemia, and this predicted further significant return of function at 2-3 weeks. However, dogs that had had 180 minutes of ischemia did not have postsystolic shortening or thickening during early recovery and showed no further return of function at 2-3 weeks. The magnitudes of postsystolic shortening and thickening immediately before reperfusion were better predictors of late return of function than the histological appearance of the ischemic segments at 2-3 weeks or the magnitude of their blood flow during ischemia (15 +/- 3 micron microspheres). From correlations made immediately before reperfusion with those at functional recovery after reperfusion, we conclude that postsystolic shortening and thickening of dyskinetic myocardial segments are markers of their potential for recovery.(ABSTRACT TRUNCATED AT 400 WORDS)
Futility: Another Way?
Authors: Samir K. Shah
Journal: Annals of Internal Medicine (2014)

Letters17 June 2014Futility: Another Way?Samir K. Shah, MDSamir K. Shah, MDFrom Cleveland Clinic, Cleveland, Ohio.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L14-5012-8 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Thanks to Dr. Lynn and Dr. Radwany, who wrote to offer practical suggestions for the future or to simply share their experiences.I agree wholeheartedly with Dr. Kassabian's point that a 0% success or survivability rate is not a reasonable criterion that can be endorsed by physicians. It is important to note, however, that this criterion is used by patients and families on occasion, and I have seen it become the source of much conflict between the patient and treating physicians. The corollary issue of uncertainty in medicine, specifically in prognostication, is an important one that is beyond ... Author, Article, and Disclosure InformationAffiliations: From Cleveland Clinic, Cleveland, Ohio.Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L14-0190. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFutility Samir K. Shah Futility Samir K. Shah Futility: Another Way? Joanne Lynn Futility: Another Way? Steven M. Radwany Futility: Another Way? Simon Kassabian Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Keyvan Ravakhah Futility: Another Way? Joanne Lynn Futility: Another Way? Simon Kassabian Futility: Another Way? Steven M. Radwany Metrics 17 June 2014Volume 160, Issue 12Page: 879KeywordsCardiac surgeryConflicts of interestDisclosureEmotionsForecastingPalliative careResidencySurgeons ePublished: 17 June 2014 Issue Published: 17 June 2014 Copyright & PermissionsCopyright © 2014 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Staff awareness of cost of anaesthetic drugs, fluids, and disposables
Authors: M J Fairbrass, A G Chaffe
Journal: BMJ (1988)

Staff awareness of cost of anaesthetic drugs, fluids, and disposables Recently reports have highlighted the cost of anaesthetic agents and how the cost ofgiving an anaesthetic has increased in real terms.'I Awareness by staff of the price of drugs, intravenous fluids, and equipment may influence their Mean (SD) price of items as estimated by anaesthetic staff Estimated price (£)
Bacterial translocation attenuates the systemic hemodynamic improvement produced by terlipressin in patients with cirrhosis
Authors: Georgios N. Kalambokis, Athanasia Mouzaki, Maria Rodi, Konstantinos Pappas, Epameinondas V. Tsianos
Journal: Hepatology (2011)

We read with interest the article by Bellot et al., who found an association between bacterial translocation (BT) and systemic hemodynamic derangement in patients with cirrhosis.1 BT worsens splanchnic arterial vasodilation in cirrhosis by stimulating nitric oxide (NO) production in the splanchnic vasculature, either directly or through the cytokine cascade.2 Indeed, intestinal decontamination reduces BT2 and serum NO levels,3 and improves systemic hemodynamics3 in patients with cirrhosis. However, increased NO synthesis could also adversely affect systemic hemodynamics by decreasing mesenterial arterial reactivity to endogenous4 or exogenous vasoconstrictors, such as terlipressin.5 We present preliminary data on the impact of BT on systemic hemodynamic effects of terlipressin in 17 patients with decompensated cirrhosis (male, n = 13; mean age = 52 ± 3 years; Child-Pugh score = 10.1 ± 0.5). Plasma endotoxin levels were detected by the Limulus amebocyte lysate chromogenic endpoint assay (Hycult biotech, Uden, the Netherlands) at baseline. Mean arterial pressure, cardiac output by Doppler ultrasound, and systemic vascular resistance (SVR) as the ratio mean arterial pressure/cardiac output were evaluated at baseline and 30 minutes after bolus intravenous administration of terlipressin (1 mg). SVR increased significantly after terlipressin (1768 ± 101 versus 1404 ± 91 dyn/second/cm−5; P < 0.001). Endotoxin levels were correlated inversely and significantly with baseline SVR values (r = −0.587; P = 0.01) and SVR changes after terlipressin (Fig. 1). Correlation between plasma endotoxin levels (in endotoxin units [EU]) and systemic vascular resistance changes (DSVR) after terlipressin infusion. Endotoxin is detectable in all patients6 whereas bacterial DNA is detectable in only 58% of patients with decompensated cirrhosis1 and was preferred as a marker of BT in our study. Furthermore, bacterial DNA was not correlated with systemic hemodynamics in the study by Bellot et al.1 The present results support the link between BT and systemic circulatory dysfunction in cirrhosis, suggesting that intestinal decontamination could enhance the hemodynamic effects of terlipressin and contribute to a decrease in rebleeding events in patients with variceal bleeding taking antibiotic prophylaxis.7 Georgios N. Kalambokis M.D.*, Athanasia Mouzaki M.D., Ph.D. , Maria Rodi M.D. , Konstantinos Pappas M.D. , Epameinondas V. Tsianos M.D., Ph.D.*, * First Division of Internal Medicine and Hepato-Gastroenterology Unit, Ioannina, Greece, Department of Cardiology, Medical School of Ioannina, Ioannina, Greece, Division of Hematology, Department of Internal Medicine, Medical School, University of Patras, Patras, Greece.
Application of Ultrasound
Authors: Gilbert Baum
Journal: JAMA (1974)

ULTRASONOGRAPHY is as great a medical advance as the discovery of the x-ray. Ultrasonography is noninvasive, the only physical modality that can produce an anatomical cross section of the internal soft tissues of the body without the use of contrast media or surgery. Under suitable conditions, structures as small as 0.1 mm may be observed at 15 mHz. Ultrasound is simply high-frequency sound waves that are nonionizing at the energy levels and exposure times used for diagnosis. Under these conditions, ultrasound does not alter the physiology of the observed tissues. After 15 years of use, there has not been a case of immediate, delayed, or cumulative injurious effects from ultrasonic energy levels employed in diagnostic ultrasonography. Repeated examinations may be carried out without hazard to the patient. Soft-tissue tumors can be visualized regardless of their radioactive isotope uptake or location. Radiolucent foreign bodies may be visualized, and their relationship to
Palliative Care of the Cancer Patient
Authors: Walter T. Murphy
Journal: JAMA (1968)

This 640 page book attempts to answer the question, What is needed to assist and to guide in the management of the advanced cancer patient? In some respects the book is successful. The shortcomings could be explained partially by the size of the volume and the fact that it is difficult for any editor to avoid redundancy, omissions, and contradictions when the chapters are written by 33 different authors representing anesthesiology, surgery, radiation therapy, internal medicine, pediatrics, neurology, neurosurgery, psychiatry, and nursing.  The best chapters are those which discuss perfusion, infusion, neurological complications and nursing care. The chapters pertaining to surgery are more technically complete and better illustrated than those dealing with irradiation. The latter modality could have been more thoroughly discussed and better illustrated in view of the fact that irradiation can accomplish spectacular palliation in many types of advanced cancer. The important use of systemic chemotherapy is barely
Gallium-67 and Pulmonary Complications of Amiodarone
Authors: MYRON L. LECKLITNER, DENNIS R. JOHNSON, JOHN J. HUGHES
Journal: Clinical Nuclear Medicine (1988)

A 66-year-old white man with amiodarone pneumonitis is presented. The diagnosis was made with the aid of Ga-67 imaging, which is a sensitive method of detecting amiodarone pulmonary toxicity in patients with symptomatic pulmonary infiltrates on chest radiographs. Ga-67 Imaging is especially useful in distinguishing amiodarone pneumonitis from congestive heart failure.
A novel capecitabine dosing schedule combined with bevacizumab is safe and active in patients with metastatic breast cancer: A phase II study
Authors: T. A. Traina, M. Theodoulou, U. Dugan, K. Feigin, S. Patil, C. Edwards, L. Norton, C. A. Hudis
Journal: Journal of Clinical Oncology (2008)

1101 Background: Capecitabine has activity in breast cancer and is usually dosed for 14 days (d) followed by a 7d rest (14 - 7). We described a mathematical method which predicts the optimal dosing schedule for C to be 7d followed by a 7d rest (7 - 7) (Norton et al, AACR 2005). Phase I study determined the MTD of C(7 - 7) to be higher than that for conventional dosing (Traina et al, accepted for publication JCO). We are now testing C(7 - 7) with bevacizumab (B) in the Phase II trial described below. Methods: Eligible patients (pts) have measurable, metastatic breast cancer (MBC), ECOG performance status (PS) <2 and normal organ function. Any number of prior chemotherapy (CRx) regimens is permitted. Pts with prior fluoropyrimidine or bevacizumab are excluded. Therapy (tx) consists of C (2,000mg BID, 7 - 7) and B (10mg/kg IV q2 weeks(wk)). Pts are evaluated for toxicity q2wk and for response q12wk. Cycle length: 4 wks. Primary endpoint: response rate (RR). Secondary endpoints: clinical benefit, TTP, PFS, toxicity. Using a mini-max, two-stage design, with alpha=10% and power=90% to discriminate between RR 10% and 25%, 27 pts will be enrolled to the first stage. If >2 pts respond, 13 additional patients will be enrolled. If >6/40 pts respond, then C(7 - 7) + B will be considered worthy of further study. If >11 pts experience Grade 3/4 capecitabine-related toxicity the trial will be stopped. Results: Fourteen pts are enrolled. Median (med) age 50.5 yrs (29–70), med ECOG performance status 0 (0–2), ER/PR(+) 11, HER2(+) 0, sites of MBC: bone(12), liver/lung(12), soft tissue(11). Prior tx: Adjuvant: CRx (10), hormone tx (6); MBC: CRx (0), hormone tx (7). 12 pts are evaluable for toxicity. After a med of 3 (0–7) cycles: 1 pt had grade 4 pulmonary embolism requiring discontinuation of B. All C dose modifications due to hand foot syndrome (HFS): grade 3=2 pts, grade 2=3pts. Six pts evaluable for response: PR=2, stable disease (SD) >6 mo =1, SD<6 mo=3. Conclusions: Combination capecitabine (7 - 7) and bevacizumab appears well tolerated and active. Additional safety and efficacy data is anticipated prior to this meeting. Supported in part by Roche and Genentech. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Hoffman-La Roche Roche Hoffman-La Roche Genentech, Roche Genentech, Roche
Integrating Global Gene Expression and Radiation Survival Parameters across the 60 Cell Lines of the National Cancer Institute Anticancer Drug Screen
Authors: Sally A. Amundson, Khanh T. Do, Lisa C. Vinikoor, R. Anthony Lee, Christine A. Koch-Paiz, Jaeyong Ahn, Mark Reimers, Yidong Chen, Dominic A. Scudiero, John N. Weinstein, Jeffrey M. Trent, Michael L. Bittner, Paul S. Meltzer, Albert J. Fornace
Journal: Cancer Research (2008)

Abstract The 60 cell lines of the National Cancer Institute Anticancer Drug Screen (NCI-60) constitute the most extensively characterized in vitro cancer cell model. They have been tested for sensitivity to more than 100,000 potential chemotherapy agents and have been profiled extensively at the DNA, RNA, protein, functional, and pharmacologic levels. We have used the NCI-60 cell lines and three additional lines to develop a database of responses of cancer cells to ionizing radiation. We compared clonogenic survival, apoptosis, and gene expression response by microarray. Although several studies have profiled relative basal gene expression in the NCI-60, this is the first comparison of large-scale gene expression changes in response to genotoxic stress. Twenty-two genes were differentially regulated in cells with low survival after 2-Gy γ-rays; 14 genes identified lines more sensitive to 8 Gy. Unlike reported basal gene expression patterns, changes in expression in response to radiation showed little tissue-of-origin effect, except for differentiating the lymphoblastoid cell lines from other cell types. Basal expression patterns, however, discriminated well between radiosensitive and more resistant lines, possibly being more informative than radiation response signatures. The most striking patterns in the radiation data were a set of genes up-regulated preferentially in the p53 wild-type lines and a set of cell cycle regulatory genes down-regulated across the entire NCI-60 panel. The response of those genes to γ-rays seems to be unaffected by the myriad of genetic differences across this diverse cell set; it represents the most penetrant gene expression response to ionizing radiation yet observed. [Cancer Res 2008;68(2):415–24]
A nation of Jack Sprats? Cholesterol program to stress dietary changes
Authors: C. Marwick
Journal: JAMA (1986)

THE NATIONAL CHOLESTEROL Education Program, mandated by the National Heart, Lung and Blood Institute's (NHLBI) Consensus Development Conference on Lowering Blood Cholesterol to Prevent Heart Attack, is under way. Although many technical details remain to be ironed out, it is becoming clear that the program will focus on teaching the merits of dietary, rather than pharmacologic, intervention. Initially, the program will be directed principally at those in the high-risk groups and at the physicians who may be caring for them. "This is the first line of attack. We have an obligation to do something for those who have a definite, accepted risk factor for coronary heart disease [CHD]," says NHLBI's James I. Cleeman, MD, coordinator of the program. In designing the study, investigators will be aided by data from a survey the NHLBI conducted earlier this year concerning the knowledge, attitudes, and practices of physicians and the public concerning elevated
INTERACTION BETWEEN BASELINE AND EARLY WORSENING OF RENAL FUNCTION AND EFFICACY OF RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM BLOCKADE IN PATIENTS WITH HEART FAILURE: INSIGHTS FROM VALSARTAN IN HEART FAILURE TRIAL
Authors: Anastasia Lesogor, Jay Cohn, Roberto Latini, Gianni Tognoni, Henry Krum, Barry Massie, Andrew Zalewski, Albert Kandra, Tsushung Hua, Claudio Gimpelewicz
Journal: Journal of the American College of Cardiology (2013)
Inaugural Address ON THE MEDICAL NEEDS OF INDIA: Delivered at the London School of Medicine for Women on October 1st, 1913
Authors: C. P. Lukis
Journal: BMJ (1913)

Monocytes/macrophages are critical early innate immune responders during murine CMV (MCMV) infection. It has been established that inflammatory monocyte/macrophages are released from the bone marrow and into the peripheral blood before entry into infected tissue sites. We previously reported a role for IFN-α/β in promotion of CCR2-mediated recruitment of monocyte/macrophages into the liver in response to MCMV infection. However, the mechanisms that support the migration of monocyte/macrophages from the bone marrow and into the peripheral blood under conditions of MCMV infection have not been elucidated. Herein, we demonstrate an accumulation of monocyte/macrophages in the bone marrow of MCMV-infected CCR2-deficient mice, whereas circulating monocyte/macrophages are profoundly diminished. The CCR2 ligands MCP-1, MCP-3, and MCP-5 are detected in bone marrow and in serum from MCMV-infected mice. Furthermore, bone marrow leukocytes from naive mice produce high levels of MCP-1 and MCP-5, and moderate levels of MCP-3, when stimulated with recombinant IFN-α in culture. We identify bone marrow F4/80<sup>+</sup> cells as major producers of MCP-1, MCP-3, and MCP-5. Moreover, induction of CCR2 ligands is dependent on IFN-α/β-mediated signals and MCMV infection. Taken together, the results reveal a critical role for inflammatory cytokines in stimulating production of CCR2-binding chemokines from F4/80<sup>+</sup> cells in the bone marrow, and they suggest that local production of chemokines supports monocyte/macrophage egress from the bone marrow into the blood during a virus infection.