tbuckley/cabot-search huggingface dataset:
Influence of Tumor Characteristics on the Accuracy of Endoscopic Ultrasonography in Staging Cancer of the Esophagus and Esophagogastric Junction
Authors: P. A. Heeren, H. L. van Westreenen, G. J. Geersing, H. M. van Dullemen, J. T. Plukker
Journal: Endoscopy (2004)

Background and Study Aims: Endoscopic ultrasonography (EUS) is the most accurate method of assessing the locoregional extent of cancer of the esophagus and esophagogastric junction. The aim of this study was to evaluate the influence of tumor-related factors such as length and location on the accuracy of EUS in staging these tumors. Patients and Methods: Between January 1997 and September 2002, 280 consecutive patients underwent preoperative EUS for staging cancer of the esophagus and esophagogastric junction. The influence of histopathology, the presence of Barrett's dysplasia or stenosis, and the location and length of the primary tumor on the accuracy of EUS for T, N, and M staging were studied. Results: The overall accuracy rates of EUS for assessing the T, N, and M stages were 73 %, 80 %, and 78 %, respectively. The influence of the tumor's histopathology and the presence of Barrett's dysplasia or stenosis was minimal. The accuracy of EUS was greater in tumors 5 cm or less in size than in tumors larger than 5 cm (82 % vs. 52 % for the T stage, P < 0.05; 88 % vs. 59 % for the N stage, P < 0.05; and 92 % vs. 56 % for the M stage, P < 0.001). The low accuracy of T staging in larger tumors may be due to the exclusion of patients with local unresectability or distant metastases. EUS was also significantly better in esophageal tumors, particularly for identifying celiac trunk metastases (93 % vs. 63 %; P < 0.001). Conclusions: The accuracy of EUS for staging esophageal cancer is lower in tumors larger than 5 cm and in esophagogastric junction tumors than in tumors 5 cm in size or less and in esophageal tumors. These findings should be considered when treatment decisions are being taken.
Improvement in Myocardial Function and Coronary Blood Flow in Ischemic Myocardium after Mannitol
Authors: James T. Willerson, Wm. John Powell, Timothy E. Guiney, James J. Stark, Charles A. Sanders, Alexander Leaf
Journal: Journal of Clinical Investigation (1972)

The purpose of this study was to evaluate the effect of hyperosmolality on the performance of, and the collateral blood flow to, ischemic myocardium. The myocardial response to mannitol, a hyperosmolar agent which remains extracellular, was evaluated in anesthetized dogs. Mannitol was infused into the aortic roots of 31 isovolumic hearts and of 15 dogs on right heart bypass, before and during ischemia. Myocardial ischemia was produced by temporary ligation of either the proximal or mid-left anterior descending coronary artery. Mannitol significantly improved the depressed ventricular function curves which occurred with left anterior descending coronary artery occlusion. Mannitol also significantly lessened the S-T segment elevation (epicardial electrocardiogram) occurring during myocardial ischemia in the isovolumic hearts and this reduction was associated with significant increases in total coronary blood flow (P < 0.005) and with increased collateral coronary blood flow to the ischemia area (P < 0.005).THUS, INCREASES IN SERUM OSMOLALITY PRODUCED BY MANNITOL RESULT IN THE FOLLOWING BENEFICIAL CHANGES DURING MYOCARDIAL ISCHEMIA: (a) improved myocardial function, (b) reduced S-T segment elevation, (c) increased total coronary blood flow, and (d) increased collateral coronary blood flow.
Tips for severe hepatorenal syndrome in non-transplant cirrhotics: a new option?!
Authors: KA Brensing, J Textor, J Perz, P Schiedermaier, P Raab, H Strunk, HU Klehr, HJ Kramer, U Spengler, H Schild, T Sauerbruch
Journal: Journal of Hepatology (1998)
The Long-Term Effects of Psychotherapy Added to Pharmacotherapy on Morning to Evening Diurnal Cortisol Patterns in Outpatients with Major Depression
Authors: Fei-Hsiu Hsiao, Guey-Mei Jow, Yu-Ming Lai, Yu-Ting Chen, Kuo-Chang Wang, Siu-Man Ng, Rainbow T.H. Ho, Cecilia L.W. Chan, Tsung-Tsair Yang
Journal: Psychotherapy and Psychosomatics (2011)

&lt;i&gt;Background:&lt;/i&gt; Psychotherapy added to pharmacotherapy results in greater improvement in clinical outcomes than does pharmacotherapy alone. However, few studies examined how psychotherapy coupled with pharmacotherapy could produce a long-term protective effect by improving the psychobiological stress response. &lt;i&gt;Methods:&lt;/i&gt; The researchers recruited 63 subjects with major depressive disorder (MDD) in an outpatient department of psychiatry at a general hospital. The randomly assigned subjects formed 2 groups: 29 in combined therapy (COMB) and 34 in monotherapy (MT). The COMB included 8 weekly body-mind-spirit group psychotherapy sessions added to pharmacotherapy. MT consisted of pharmacotherapy only. The outcome measures, collected at the subjects’ homes, included the Beck Depression Inventory II (BDI-II), the State Trait Anxiety Inventory (STAI) and salivary cortisol on awakening, 45 min after awakening, and at 12.00, 17.00 and 21.00 h. Evaluation of outcome measures was at baseline condition, and at months 2 (end of additional psychotherapy), 5 and 8. &lt;i&gt;Results:&lt;/i&gt; While the decreases in symptoms of depression were similar between COMB and MT (p &gt; 0.05), the reductions in anxiety state were greater in COMB than in MT during the 8-month follow-up (p &lt; 0.05). A steeper diurnal cortisol pattern more likely occurred in COMB than in MT in the 3 follow-up periods (p &lt; 0.05, p &lt;0.001 and p &lt; 0.01). &lt;i&gt;Conclusions:&lt;/i&gt; The superior outcomes of group psychotherapy added to pharmacotherapy for MDD outpatients could relate to decreasing the anxiety state and to producing long-term impacts on positive stress endocrine outcomes seen as a steeper diurnal cortisol pattern.
The new NHS. West Suffolk: a volcano under the wheat fields.
Authors: J Smith
Journal: BMJ (1991)

BMJ 1991;302:641-5 Piped Muzak and a notice proclaiming a commitment to quality and caring are not enough to transform an NHS waiting room into the lounge for Concorde. Yet the place is warm on a cold February day, the floors clean, the staff polite, the consultants willing to fit their days round patients. The place is West Suffolk district general hospital, the main acute unit for West Suffolk Health Authority, and the time barely a month away from the biggest transformation in the NHS since 1948. Clearly life is not going to change radically on 1 April. This is partly because the government has declared a smooth take off, but geography also limits the scope for change. People at all levels in the district like to characterise West Suffolk as a typical rural area?slow to change. Yet when you probe it's clear that much has already changed, and the district and its two units are probably better prepared than many for 1 April. This stems from a tradition of delegating authority to units, the fact that the district already runs a management accounting-clinical budgeting system, the piloting of contracts in the East Anglian region over the past few months, and the existence of good group practices that know a lot about where their patients go. And beyond next year managers and doctors are beginning to think in innovative ways of how they can make the system work. Views about what will happen to the NHS in West Suffolk show a remarkable uniformity, particularly about the key relation between the health authority and its district general hospital. Where managers and doctors differ is in their attitudes towards the changes ?the managers broadly optimistic, the consultants pessimistic.
CHRONIC THROMBOCYTOPENIC PURPURA HEMORRHAGICA CURED BY SPLENECTOMY
Authors: Ross Proctor
Journal: JAMA (1931)

Since Kaznelson, in 1916, performed the first splenectomy for purpura hemorrhagica there have been only 160 cases reported in the literature. It seems worth while to add another report to the series, especially as the duration of symptoms in this case is one of the longest on record.  The results of splenectomy have been brilliant in cases of purpura that are clear cut. Fortunately, all the cardinal signs were present: thrombocytopenia (highest count 10,000 after transfusion, usually none found); prolonged bleeding time (average, twenty minutes); nonretractile clot (none in twenty-four hours); positive capillary resistance test (showers of petechiae on the dependent parts even on merely standing), and a tendency to bleed from the mucous surfaces. It is interesting to note the rapid regeneration of blood when the acute hemorrhage was controlled. The dramatic change in the blood picture immediately after operation is noteworthy. The cessation of bleeding on clamping the
ASSOCIATION BETWEEN VERY LOW LEVELS OF BASELINE HIGH-DENSITY LIPOPROTEIN CHOLESTEROL AND INCREASED LONG-TERM MORTALITY IN MEDICALLY MANAGED ACUTE CORONARY SYNDROME PATIENTS
Authors: Emil Hagstrom, Matthew Roe, Gail Hafley, Megan Neely, Mandeep Sidhu, Eileen Brown, Dorairaj Prabhakaran, Harvey White, Paul Armstrong, Keith Fox, E. Magnus Ohman, William Boden
Journal: Journal of the American College of Cardiology (2014)
ENCEPHALO-MYELITIS IN VIRUS DISEASES AND EXANTHEMATA
Authors: H. M. Turnbull
Journal: BMJ (1928)

f'KTIM Bmes A 331 size, miiay, on tlie otlher lhanid, offer no obstacle to the passage -of tlihe caltheter, alnd it inav not eveni be felt as an obstructioll.
Postprostatectomy Target-Normal Structure Overlap Volume Differences Using Computed Tomography and Radioimmunoscintigraphy Images for Radiotherapy Treatment Planning
Authors: Andy Su, Michael J. Blend, Danny Spelbring, Russell J. Hamilton, Ashesh B. Jani
Journal: Clinical Nuclear Medicine (2006)

The purpose of this study was to analyze regions of uptake in normal structures on postprostatectomy radioimmunoscintigraphy (RIS) images by evaluating differences in the overlap volumes of prostate fossa clinical target volume (CTV) and planning target volume (PTV) using correlative computed tomography (CT) images.The electronic records of 13 patients who received external beam radiotherapy postprostatectomy and who underwent a vessel-based RIS/CT registration were reviewed. For each patient, the RIS-defined CTV (CTV(RIS)) was compared (in terms of the overlap volume with the surrounding bladder, rectum, pubic symphysis, and penile bulb) with the CT-defined CTV(pre) before this registration and also with CTV(post) (the final target volume used for treatment). Similar analyses were done for PTV(RIS), PTV(pre), and PTV(post) defined in each case to be the corresponding CTV + 1-cm margin.CTV(RIS) overlapped significantly more with the bladder, rectum, and symphysis, but not with the penile bulb, than did either the CTV(pre) or CTV(post). However, the corresponding PTV analyses revealed no significant differences between any of the overlap volumes of any of the PTVs with the bladder, rectum, and penile bulb, but did reveal a significant difference between the PTV(RIS) and PTV(post) overlap volumes with the symphysis compared with PTV(pre) overlap volumes with the symphysis.On RIS images, there appear to be areas of uptake in the bladder, rectum, and pubic symphysis but not the penile bulb; however, the dosimetric consequences of this uptake for radiation treatment planning are minimal on the bladder, rectum, and penile bulb, but require segmentation for dose reduction to the pubic symphysis.
Cardiac compliance and dimensions in carbon monoxide-induced cardiomegaly
Authors: D. G PENNEY, B. G BARTHEL, J. A SKONEY
Journal: Cardiovascular Research (1984)

Adult male rats inhaled 500 ppm CO continuously for 38 to 47 days to produce significant cardiomegaly. In a first experiment in which heart wall stiffness was examined, haematocrit rose 45.1% and the ratio of the sum of right ventricle (RV) and left ventricle (LV) to body weight (mg·g−1) increased from 2.69 to 3.34. Compliance (ml·mmHg−1) of CO LV's and RV's studied from 0 to 25 mmHg intraluminal pressure, was generally greater than that of LV's and RV's from controls at the same pressure. These differences were greater for RV's. There was no difference between control RV's and LV's at the same distending pressure. The differences between treated and control groups disappeared when compliance was normalised per g heart weight. In a second experiment in which heart dimensions were examined, haematocrit ratio increased 48.6% and 2V (RV + LV) to body weight ratio (mg·g−1) increased from 2.77 to 3.45. Atrial weight was also greater. LV apex to base length increased 6.4% and LV outside diameter increased 7.3 %. No significant differences in L V, RV or interventricular septum (S) thickness resulted from CO exposure, as measured at three sites in each, in four cross-sections of the heart between the apex and base. In general, LV wall was slightly thicker than S, while RV was about 35% that of LV. The findings suggest that chronic carboxyhaemoglobinaemia produces largely eccentric cardiomegaly, and that there is no intrinsic change in wall stiffness.
P2-13-01: Gene Profiling of Whole Blood May Identify Patients with BRCA Mutations.
Authors: LA Mina, Y Gokmen-Polar, C Goswami, AM Storniolo, L Li, S Badve, GW Sledge
Journal: Cancer Research (2011)

Abstract Background:The BRCA1 and the BRCA2 proteins play a role in DNA repair and confer genomic stability to the cell. Identifying BRCA mutation carriers has become an important tool for prevention as well as guiding therapy in cancer patients. We proposed to test the hypothesis that gene expression analysis of peripheral whole blood can reliably detect these mutations. Materials and methods: Following IRB approval, 10cc of blood was collected from 36 women (BRCA1 (n=8), BRCA2 (n=9), Hereditary breast cancer without BRCA (FAM) (n=7), sporadic breast cancer (SPO) (n=11)). 3 of BRCA1 and 5 of BRCA2 samples were from women without cancer. Following RNA extraction (using the method described by Beekman et al) and quality assessment, Illumina® Whole-Genome DASL™ microarray (Human Ref-8 BeadChips) analysis was performed. The raw data was normalized and analyzed using Partek® Genomic Suite. Differentially expressed genes were identified using ANOVA analysis. Geneset specific supervised analysis was performed to visualize the inherent similarities and differences in the gene expression amongst different groups for 1) DNA repair and 2) Immune-system-related genes. Ingenuity Pathway Analysis (IPA) was performed to interpret the data in the context of biological processes, pathways and networks. Results: Twenty-nine of the 87 immune-related genes were up-regulated in BRCA1 and BRCA2 groups compared to SPO or FAM groups; these included IL7R, CD53, CD2, CD48 and HLA-DRA. Twenty-five of the 79 DNA repair genes were up-regulated in BRCA1 and BRCA2; these included FANCC, RAD51L3, MSH2, MSH6 and PCNA. In IPA analysis, the comparison of BRCA1 vs. REST (BRCA2 + FAM + SPO) showed a strong immunologic signal, with the top altered biological processes including “Immunologic disease”, “Infection mechanism”, “Immune cell trafficking” and “cell-mediated immune response “. The top 5 canonical pathways also reflected a similar pattern and included “iCOS-iCOSL Signaling in T Helper Cells”, “OX40 Signaling Pathway”, “Calcium-induced T Lymphocyte”, “Apoptosis Regulation of IL-2 Expression in Activated and Anergic T Lymphocytes” and “Protein Ubiquitination Pathway”. When BRCA2 was compared with the REST (BRCA1 + FAM + SPO), a much weaker signal was noted with none of the canonical pathways being significantly altered. PAM analysis showed that a set of 16 genes could differentiate the BRCA patients from the rest with an error rate of 5%. Further validation of this geneset is being performed. Conclusion: Gene profiling in whole blood may offer an easy, reliable and inexpensive way to identify patients with BRCA mutation. Further studies are currently underway to validate our results in a larger patient population. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-13-01.
Cleft Uvula— (Case of Dr. Foster).
Authors: J. H. Davisson
Journal: JAMA (1894)

Los Angeles, Cal., Dec. 13, 1894. <h3>To the Editor:</h3> —TheJournalof December 8 contains the report of an interesting case of cleft uvula, by Dr. Hal Foster, of Kansas City. I say, cleft uvula, because it is a case of cleft uvula rather than double uvula. I have a similar, if not identical case, in a boy of 12 years, a native Californian. There is nothing in his voice to indicate the anomaly, neither is there any interference with deglutition. I can not believe the cleft in Dr. Foster's case has anything in particular to do with phonation, as the "fine" voice of his patient is in contrast with a rather coarse voice in my patient. The cleft is also complete in my case and does not involve other tissues or organs. The two rather long appendages frequently adhere but oftener separate and are carried outward and upward, until
The predictive value of combinations of different levels of brain natriuretic peptide and norepinephrine in the Val-HeFT trial
Authors: Inderiit S. Anand, Roberto Latini, Serge Masson, Dianne Judd, Aldo P. Maggioni, Robert Glazer, Tom Chiang, Philippe Lechat, Gianni Tognoni, Jay N. Cohn
Journal: Journal of the American College of Cardiology (2002)
Increasing Trends in Hospitalization for Atrial Fibrillation in the United States, 1985 Through 1999
Authors: Wendy A. Wattigney, George A. Mensah, Janet B. Croft
Journal: Circulation (2003)

Atrial fibrillation, the most common sustained disturbance of heart rhythm, is associated with a 5-fold increase in the incidence of ischemic stroke.The National Hospital Discharge Survey was used to estimate the annual number and prevalence of hospitalizations with atrial fibrillation among men and women 35 years of age or older. From 1985 through 1999, hospitalizations increased from 154 086 to 376 487 for a first-listed diagnosis and from 787 750 to 2 283 673 for any diagnosis. Prevalence was higher among successive age groups. Age-standardized prevalence was consistently higher among men than women. In 1999, essential hypertension, ischemic heart disease, congestive heart failure, and diabetes were prominent coexisting conditions. The number of male patients discharged home decreased from 77% to 63%, whereas the number of discharges to long-term care increased from 9% to 15%; the corresponding values for women were 72% to 56% and 15% to 23%. A slight increase in discharges to short-term care was indicated, whereas no trends were noted for in-hospital mortality.Hospitalizations for atrial fibrillation have increased dramatically (2- to 3-fold) in recent years. The public health burden of atrial fibrillation is enormous and expected to continue to increase over the next decades. Primary prevention of atrial fibrillation must be recognized and pursued as a complementary management strategy for reducing cardiovascular morbidity and mortality.
Tc-99m MIBI Uptake in a Bronchial Carcinoid Tumor
Authors: ALI S. ARBAB, KIYOSHI KOIZUMI, TAKAO ARAI, TSUTOMU ARAKI, KATSURA OZAWA, RYOICHI HASHIMOTO, AKIHIRO HEMMI
Journal: Clinical Nuclear Medicine (1996)

A 57-year-old woman had a bronchial carcinoid tumor. Tc-99m MIBI SPECT showed accumulation both on early and delayed images, but there was no activity in the tumor on delayed Tl-201 SPECT. Histopathology and electron microscopy showed carcinoid tumor without oncocytic features. Early uptake and retention of sestamibi in the tumor might be related to the vascularity as well as increased mitochondrial potential.
Diagnosis and Therapy of Coronary Artery Disease
Authors: Peter T. Kuo
Journal: JAMA (1980)

The complexity of coronary artery disease and its prevalence in our affluent society have stimulated experts in diverse disciplines to contribute a vast amount of new knowledge during the past decade. Dr Peter F. Cohn and the other contributors to<i>Diagnosis and Therapy of Coronary Artery Disease</i>have undertaken a most ambitious task in organizing and assimilating the many new developments in the field. Chapter after chapter, the reviewer is impressed by the comprehensiveness and lucidity of the coverage of this common—and perhaps the most important—cardiovascular disorder. In their discussion of this rapidly evolving subject, Dr Cohn and his contributors have made a special effort to present findings and opinions of other investigators and cardiologists on various aspects of the disease. But, at the same time, they do not hesitate to provide their own best opinion on a given issue based on their extensive clinical and research experiences. The book
Pathogenic antibodies inhibit the binding of apolipoproteins to megalin/gp330 in passive Heymann nephritis.
Authors: D Kerjaschki, M Exner, R Ullrich, M Susani, L K Curtiss, J L Witztum, M G Farquhar, R A Orlando
Journal: Journal of Clinical Investigation (1997)

Megalin/gp330 is an endocytic receptor that internalizes multiple ligands including apolipoproteins E (apo E) and B100 (apo B). Megalin is the main antigenic target in passive Heymann nephritis (pHN), where it binds circulating autoantibodies leading to the formation of subepithelial immune deposits (ID)-the hallmark of pHN. Apo E and apo B were found recently to accumulate within these IDs, and evidence was provided that their lipids may undergo peroxidation, causing glomerular basement membrane damage and proteinuria. Here we investigated if ID-forming antimegalin IgG can inhibit the binding and internalization of apo E-betaVLDL (very low density lipoprotein) by megalin, and lead to their accumulation within IDs. By immunoelectron microscopy, apo E and apo B were detected in clathrin-coated pits and multivesicular bodies of podocytes in control rats, suggesting that the uptake of lipoproteins is a constitutive function of the glomerular epithelium. When pHN was induced by intravenous injection of antimegalin IgG, apo E and apo B were found within IDs by immunofluorescence and immunoelectron microscopy. Bound antibodies eluted from glomeruli of rats with pHN were found to inhibit the binding and internalization of apo E-enriched betaVLDL by megalin. These results indicate that pHN-inducing antimegalin IgG is capable of interfering with the uptake of lipoproteins by megalin in vivo during the formation of IDs.
The new disease--"administration"?
Authors: D Meyers
Journal: BMJ (1975)

677 a mercury sphygmomanometer alone, 8% an aneroid one, and 29% both.The use of aneroid sphygmomanometers is rising among recently-qualified doctors.Of doctors qualified after 1964 39% used an aneroid one and 43% a mercury one, whereas only 25% of those
Cholesterol Solubility in Bile. EVIDENCE THAT SUPERSATURATED BILE IS FREQUENT IN HEALTHY MAN
Authors: R. Thomas Holzbach, Mitsuko Marsh, Monica Olszewski, Keith Holan
Journal: Journal of Clinical Investigation (1973)

The development and validation of a direct method for measuring maximum cholesterol solubility in bile is described. Application of this method to five large mammalian species, including man, produced a micellar zone significantly smaller than that previously reported. Further studies on in vitro model solutions patterned after bile confirmed this new micellar zone. Thus, direct evidence demonstrates that the micellar zone boundary derived in vitro from model solutions is applicable to human gallbladder bile. Using the present criteria, normal human bile, in contrast to bile from other mammalian species, is commonly supersaturated with cholesterol. A male-female difference in bile composition is not demonstrable despite the well-established female preponderance of cholelithiasis. Bile from patients with cholesterol cholelithiasis has a micellar zone similar to normals but differs compositionally in that there is a greater excess of cholesterol above saturation. We conclude that cholesterol supersaturation may be a necessary but not solely sufficient cause for gallstone formation.