tbuckley/cabot-search huggingface dataset:
Oncoplastic Surgery Using Laparoscopically Harvested Omental Flap: Results of 100 Patients.
Authors: H. Zaha
Journal: Cancer Research (2009)

Abstract Background: Indication of breast-conservation treatment (BCT) has been increased due to various oncoplastic techniques. The latissimus dorsi flap is one of the most commonly used techniques for partial breast reconstruction. The disadvantage of this technique is the presence of donor-site morbidity and deformity. Laparoscopically harvested omental flap (LHOF) may compensate for these disadvantages associated with the donor-site. The aim of this study was to access the safety and the efficacy of this procedure.Methods: Oncoplastic surgery using LHOF was applied to 100 patients who underwent either BCT or nipple-sparing mastectomy (NSM) between April 2002 and March 2009. The patients who underwent BCT had a large loss of breast tissue (more than 30% of breast tissue), and LHOFs were applied for partial breast reconstruction. All of omental flaps was laparoscopically harvested. The pedicled flap was extracted via a small subcutaneous tunnel created from the xiphoid process, and filled the dead space of a breast. Free flap was withdrawn from a small incision in the lower abdominal wall. Then microanastomoses between right gastroepiploic vessels and thracodorsal vessels were performed. The patients were followed-up for complications and cosmetic results.Results: 65 cases of BCT and 35 cases of NSM were included. The omental flaps were successfully harvested in 99 cases without conversion to open surgery (99%). Median operative time for harvesting the omental flap was approximately 1 hour. Morbidity associated with laparoscopy occurred in 8 cases (8%), which were 5 partial graft necroses, 2 vascular injuries of the gastroepiploic artery and one incisional hernia. Morbidities not associated with laparoscopy occurred in 9 cases (9%), which were two postoperative hematoma, 3 wound infections and 4 others. Cosmetic results were almost satisfactory, with a soft breast that was natural in appearance. Postoperative radiotherapy did not change the cosmetic outcome. Donor-site scars were minimal like those of laparoscopic cholecystectomy. However, in 17 patients (17%), the amount of omentum was found to be inadequate when applied for reconstruction after NSM. In 19 patients (19%), minor deformity or asymmetry of the reconstructed breast had occurred because of postoperative infectious complications or volume lack.Conclusion: Although there is a limit of volume, LHOF is safe procedure with minimal donor-site morbidity and deformity, and attractive autologous flap for partial breast reconstruction. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3120.
LPS inhibits endothelin-1-induced endothelial NOS activation in hepatic sinusoidal cells through a negative feedback involving caveolin-1
Authors: Walid S. Kamoun, Amel Karaa, Nicole Kresge, Sandra M. Merkel, Katarzyna Korneszczuk, Mark G. Clemens
Journal: Hepatology (2005)

During endotoxemia, liver microcirculation disruption is characterized by a hypersensitivity to the constrictor effects of endothelin 1 (ET-1). The shift of ET-1-mediated effects toward vasoconstriction may result from depressed ET-1-mediated vasodilation through decreased ET-1-induced nitric oxide (NO) production. We have previously shown that lipopolysaccharide (LPS) pretreatment abrogates ET-1-induced endothelial nitric oxide synthase (eNOS) translocation, but its effects on eNOS activation are yet to be determined. Our aim was to assess the effects of LPS on ET-1-mediated eNOS activation in hepatic sinusoidal endothelial cells (SECs) and to investigate the molecular mechanisms involved. SECs were treated with LPS (100 ng/mL) for 6 hours followed by 30 minutes ET-1 (10 nmol/L) stimulation. LPS significantly inhibited ET-1-mediated eNOS activation. This inhibition was associated with upregulation of Caveolin-1 (CAV-1) and a shift in ET-1-mediated eNOS phosphorylation from an activation (Ser1177) to an inhibition (Thr495). LPS treatment has been shown to induce ET-1 expression and secretion from endothelial cells. We therefore investigated the role of endogenous ET-1 in the inhibition of ET-1 activation of eNOS after LPS. Antagonizing ET-1 effects and blocking its activation in LPS pretreated SECs decreased the LPS-induced overexpression of CAV-1 as well as the inhibition of ET-1-induced NOS activity. Furthermore, 6 hours of ET-1 treatment exerted the same effects on eNOS activity, phosphorylation, and CAV-1 expression as LPS treatment. In conclusion, LPS-induced suppression of ET-1-mediated eNOS activation is ET-1 dependent and suggest a pivotal role of CAV-1 in eNOS induction inhibition under stress.
Thermoresponsive self-assembled elastin-based nanoparticles for delivery of BMPs
Authors: Paulo C. Bessa, Raul Machado, Sylvia Nürnberger, Daniela Dopler, Asmita Banerjee, António M. Cunha, J. Carlos Rodríguez-Cabello, Heinz Redl, Martijn van Griensven, Rui L. Reis, Margarida Casal
Journal: Journal of Controlled Release (2009)
Diabetic Acidosis Secondary to Steroid Therapy
Authors: Robert P. Blereau, M. Weingarten
Journal: New England Journal of Medicine (1964)

THE purpose of this communication is to report what we believe to be an uncommon complication of steroid therapy.Case ReportA 29-year-old Negro with pulmonary sarcoidosis had a family history including 1 cousin with diabetes. The fasting blood sugar in 1961 and in 1962 was normal (80 to 120 mg. per 100 ml.). A glucose tolerance test on February 1, 1963, revealed a blood sugar of 113 mg. per 100 ml. fasting, 151 mg. at 1/2 hour, 156 mg. at 1 hour, 113 mg. at 2 hours and 110 mg. at 3 hours after a meal. All specimens of . . .
Glucocorticoid exposure in late gestation permanently programs rat hepatic phosphoenolpyruvate carboxykinase and glucocorticoid receptor expression and causes glucose intolerance in adult offspring.
Authors: M J Nyirenda, R S Lindsay, C J Kenyon, A Burchell, J R Seckl
Journal: Journal of Clinical Investigation (1998)

Low birth weight in humans is predictive of insulin resistance and diabetes in adult life. The molecular mechanisms underlying this link are unknown but fetal exposure to excess glucocorticoids has been implicated. The fetus is normally protected from the higher maternal levels of glucocorticoids by feto-placental 11beta-hydroxysteroid dehydrogenase type-2 (11beta-HSD2) which inactivates glucocorticoids. We have shown previously that inhibiting 11beta-HSD2 throughout pregnancy in rats reduces birth weight and causes hyperglycemia in the adult offspring. We now show that dexamethasone (a poor substrate for 11beta-HSD2) administered to pregnant rats selectively in the last week of pregnancy reduces birth weight by 10% (P < 0.05), and produces adult fasting hyperglycemia (treated 5.3+/-0.3; control 4.3+/-0.2 mmol/ liter, P = 0.04), reactive hyperglycemia (treated 8.7+/-0.4; control 7.5+/-0.2 mmol/liter, P = 0.03), and hyperinsulinemia (treated 6.1+/-0.4; control 3.8+/-0.5 ng/ml, P = 0.01) on oral glucose loading. In the adult offspring of rats exposed to dexamethasone in late pregnancy, hepatic expression of glucocorticoid receptor (GR) mRNA and phosphoenolpyruvate carboxykinase (PEPCK) mRNA (and activity) are increased by 25% (P = 0.01) and 60% (P < 0.01), respectively, while other liver enzymes (glucose-6-phosphatase, glucokinase, and 11beta-hydroxysteroid dehydrogenase type-1) are unaltered. In contrast dexamethasone, when given in the first or second week of gestation, has no effect on offspring insulin/glucose responses or hepatic PEPCK and GR expression. The increased hepatic GR expression may be crucial, since rats exposed to dexamethasone in utero showed potentiated glucose responses to exogenous corticosterone. These observations suggest that excessive glucocorticoid exposure late in pregnancy predisposes the offspring to glucose intolerance in adulthood. Programmed hepatic PEPCK overexpression, perhaps mediated by increased GR, may promote this process by increasing gluconeogenesis.
Comprehensive characterization of IGHV3-21–expressing B-cell chronic lymphocytic leukemia: an Italian multicenter study
Authors: Riccardo Bomben, Michele Dal Bo, Daniela Capello, Dania Benedetti, Daniela Marconi, Antonella Zucchetto, Francesco Forconi, Rossana Maffei, Emanuela M. Ghia, Luca Laurenti, Pietro Bulian, Maria Ilaria Del Principe, Giuseppe Palermo, Mia Thorsélius, Massimo Degan, Renato Campanini, Anna Guarini, Giovanni Del Poeta, Richard Rosenquist, Dimitar G. Efremov, Roberto Marasca, Robin Foà, Gianluca Gaidano, Valter Gattei
Journal: Blood (2006)
A Survey of Physicians' Attitudes and Practices Regarding Erotic and Nonerotic Contact with Patients
Authors: SHELDON H. KARDENER, MARIELLE FULLER, IVAN N. MENSH
Journal: American Journal of Psychiatry (1973)

An anonymous questionnaire survey of a random sample of 460 physicians revealed that most psychiatrists, obstetrician-gynecologists, surgeons, internists, and general practitioners did not believe in the efficacy of or engage in nonerotic physical contact with their patients. Five to 13 percent of the respondents indicated that they engaged in erotic behavior with patients and five to 7.2 percent engaged in sexual intercourse specifically. The authors point out the need for greater openness and acceptance of discussion about and research in this highly sensitive and vital area.
Persistent Activation of the Fyn/ERK Kinase Signaling Axis Mediates Imatinib Resistance in Chronic Myelogenous Leukemia Cells through Upregulation of Intracellular SPARC
Authors: Nina Fenouille, Alexandre Puissant, Maeva Dufies, Guillaume Robert, Arnaud Jacquel, Mickaël Ohanna, Marcel Deckert, Jean-Max Pasquet, François-Xavier Mahon, Jill-Patrice Cassuto, Sophie Raynaud, Sophie Tartare-Deckert, Patrick Auberger
Journal: Cancer Research (2010)

Abstract SPARC is an extracellular matrix protein that exerts pleiotropic effects on extracellular matrix organization, growth factor availability, cell adhesion, differentiation, and immunity in cancer. Chronic myelogenous leukemia (CML) cells resistant to the BCR-ABL inhibitor imatinib (IM-R cells) were found to overexpress SPARC mRNA. In this study, we show that imatinib triggers SPARC accumulation in a variety of tyrosine kinase inhibitor (TKI)–resistant CML cell lines. SPARC silencing in IM-R cells restored imatinib sensitivity, whereas enforced SPARC expression in imatinib-sensitive cells promoted viability as well as protection against imatinib-mediated apoptosis. Notably, we found that the protective effect of SPARC required intracellular retention inside cells. Accordingly, SPARC was not secreted into the culture medium of IM-R cells. Increased SPARC expression was intimately linked to persistent activation of the Fyn/ERK kinase signaling axis. Pharmacologic inhibition of this pathway or siRNA-mediated knockdown of Fyn kinase resensitized IM-R cells to imatinib. In support of our findings, increased levels of SPARC mRNA were documented in blood cells from CML patients after 1 year of imatinib therapy compared with initial diagnosis. Taken together, our results highlight an important role for the Fyn/ERK signaling pathway in imatinib-resistant cells that is driven by accumulation of intracellular SPARC. Cancer Res; 70(23); 9659–70. ©2010 AACR.
Commentary: Models can be powerful tools for making decisions about effective and efficient health care
Authors: A. Shahani
Journal: BMJ (1996)

The appropriate way of increasing a risk pool is to extend it over time to enable a site to have a number of years to pay back any overspends.For other sites to take on this risk creates a problem of moral hazard.It undermines the underlying rationale of giving practices budgets, which is that they are responsible for the eco- nomic consequences of their decisions.Exceptional catastrophic risks-for example, forensic psychiatry-do not naturally form part of practice budgets.These risks ought to be shared with health authorities and financed by a general levy, with payments authorised by a committee representing con- tributors.In general, therefore, our analysis supports basing total purchasing sites on single practices.We are interested to see whether experience with total purchas- ing bears this out.We thank Brian Maynard Potts of South and West Devon
Outpatient appointments system.
Authors: S Cope
Journal: BMJ (1973)

tion of about I million there are some 34 school clinic sessions per week, and the hospitals, alceady full, just could not fit in the extra sessions.Fortunately all but four of these clinics are run by S.H.M.O.s or the equivalent who have also assistant sessions at the regional eye unit and our si subsidiary hospitals, so that an adequate re- lationship of the two services is obtained.-Iam, etc., JOHN PRIMROSE Romford, EssexPractice in the United States Sut,-I am a British paediatrician in the United States on a one year fellowship.Before he comes to the United States a hospital doctor needs the E.C.F.M.G. certificate.He may then be under the impression that no further qualifications are necessary during the course of a one-year stay here.Many doctors in the past have discovered on arrival in America that they cannot sur- vive on
Editorial: A call to recognize PCP
Authors: Z. Danilevicius
Journal: JAMA (1975)

We are tough and hardened men. The influence of Women's Liberation does not permit us to tip our hats to a lady. However, we respond to the smile of an innocent baby; and if ever compassion is felt in our hearts, it is especially poignant when we see a suffering or dying child. Our profession, dedicated to saving lives, has largely eliminated sentiment from our work. However, when a child's life is at stake, a physician will, with emotion, do all he can to save it. One of the worst, fastest-moving, and cruelest killers of children is<i>Pneumocystis carinii pneumonia</i>(PCP). This syndrome seldom develops in a strong, well-nourished child with an uncompromised immune system. However, children in the first year of life, who are malnourished or who have debilitating diseases or malignancy and whose immunologic status is compromised, are especially vulnerable. In the United States, the disease is less
Primary care research networks may herald new collaborations
Authors: Roger Jones, Adrian Eddleston, Gill Rowlands
Journal: BMJ (2005)

Family history of breast cancer Referral guidelines changed after acceptance of 10 minute consultationEditor-In their 10 minute consultation on family history of breast cancer Lucassen and Watson drew attention to the recently published guidelines from the National Institute for Clinical Excellence (NICE) on familial breast cancer. 1 2 It is unfortunate that the referral criteria were changed between the acceptance of this article in December 2003 and the final published guidelines in June 2004, which would result in the referral of the patient highlighted in the article for potential mammography screening, rather than for her reassurance.Women aged 40-49 years at moderate risk of breast cancer are entitled to annual mammograms. 2 The definition of moderate risk was based on a risk of at least 3% over the 10 year period from the age of 40 to 50.Available evidence, particularly from combined analyses of case-control studies of familial risks, 3 indicates that a woman reaches this category with a first degree relative (mother or sister) with breast cancer when younger than 40 years or two relatives on the same side of the family (one first degree and one second degree or two first degree) diagnosed at any age.The latter category differs from the draft NICE guidelines and previous referral criteria, which required that the two relatives be diagnosed at an average age of less than 60. 4 This age restriction was removed because it could not be justified on the basis of the available data.It should be noted, however, that referral on the basis of two elderly close relatives is likely to be restricted to the age groups of 30-49, with referral of only high risk groups (for example, two affected relatives diagnosed at an average age of less than 50 years) outside this age group.
A Possible Site of Action of Thyroid Hormone.
Authors: P. C. Johnson
Journal: Annals of Internal Medicine (1962)

s1 April 1962A Possible Site of Action of Thyroid Hormone.P. C. Johnson, M.D., F.A.C.P.P. C. Johnson, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-676_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptMammalian erythrocytes, being devoid of mitochondria but containing both the hexose monophosphate shunt pathway and the Embden-Meyerhof pathway of glucose oxidation, make convenient preparation for the study of the effects that thyroid hormone has on these two metabolic pathways. Certain enzymes of the hexose monophosphate shunt pathway have been shown to be increased in erythrocytes from thyroid-treated animals and in thyrotoxicosis.Using C-14 glucosein vitro, we have found that the hexose monophosphate shunt pathway of glucose oxidation is depressed to 27 ± 6% (mean ± SE) of normal in ten thyrotoxic individuals and three normal persons treated for two... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: P. C. Johnson, M.D., F.A.C.P.Affiliations: Houston, Tex. (CI) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 676-676KeywordsEnzymesGlucoseMetabolic pathwaysMitochondriaThyroidThyroid hormones ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
Tc-99m-DTPA Enema in Detection of Colon Interposition During Liver Scan
Authors: SHIV M. GUPTA, NILO E. HERRERA, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1981)

GUPTA, SHIV M. M.D.; HERRERA, NILO E. M.D.; SPENCER, RICHARD P. M.D.,Ph.D. Author Information
Harveian Lectures on the Mode of Death from Acute Intestinal Strangulation and Chronic Intestinal Obstruction
Authors: T. Bryant
Journal: BMJ (1884)

I PROPOSE, in the following lectures, to'bring before yo'd some points connected with abdominal surgery, and to consider, first, how death, is occasioned in initestinal strangulation and intussusception; and, secondly, how life is destroyed by intestinal obstruction.The pathological inquiry will be illustrated by cases,l and followed by some prac- tical conclusions.Hitherto, it has been the custom to place cases of strangulation of the bowel amongst those of obstruction, indee4, to consider them as only one of its forms; but there is, I am convinced, in this arrange- ment a grievous error; since, in strangula1ion of the intestine, obstruc- tion is only one of its symptoms, but not the cause of danger or of death ; whereas, in cases of intestinal obstriction, the obstruction is the prominent and dangerous feature, and from it, or it chiefly, the con- secutive changes are.brought about.From this proposed plan of procedure, you will see that the basis of the practical conclusions which I shall draw will be laid upon pathological knowledge, and that what is to be done to save or prolon-g life, will be educed from whatis known of the changes which tend towards its destruction.I do this, moreover, under the assured conviction that it is by this method alone that the scientific practice of surgical art is to be promoted.And, first of all, with reference to 'what is commonly called "acute intestinal obstruction," but which should be designated " in- testinal strangulation," is it true that patients die from the obstruc- tion-that is, from the arrest of the passage bf feeces along the intes- tinal tube ?ot is it more true that the obstruction is merely a symptom of some condition which, if not relieved, must bring about a fatal re- sult; fatal, however, not from obstruction to the passage of ieces through the lumen of the bowel, but from changes in the bowel itself.and the parts above ?I believe this latter observation to be correct, tend would adduce as proof the case of acute strangulated hernia relieved by operation or taxis, as the case may be, and in which the symptoms, however severe before its reduction, at once cease on this result being effected although, possibly, no action of the bowels may be obtained for two or three weeks subsequently, the want of action tot giving rise to any special symptoms.In fact, in this instance, as, in' all other cases of an acute or like nature, the symptoms are directly' dik the arrest of the circulation of the blood through the strangulafed'bowel, and hot
Cost-effectiveness of Interferon-α2b Treatment for Hepatitis B e Antigen-Positive Chronic Hepatitis B
Authors: John B. Wong
Journal: Annals of Internal Medicine (1995)

Objective: To estimate the cost-effectiveness of interferon-α2B for the treatment of patients with chronic hepatitis B infection who are positive for hepatitis B e antigen (HBeAg). Design: Meta-analysis of nine randomized, controlled trials and cost-effectiveness analysis, projecting the clinical and economic outcomes expected from changes in serologic markers of hepatitis B viral replication. Data Sources: MEDLINE search, expert panel opinion, hospital cost data, and adjusted physician charges. Patients: 552 patients with confirmed chronic hepatitis B infection who were positive for HBeAg. Intervention: Interferon-α2b. Measurements: Lifetime incidence of cirrhosis and hepatocellular carcinoma; life expectancy; quality-adjusted life expectancy; and costs and marginal cost-effectiveness ratios from a societal perspective. Results: Interferon-α2b increases the likelihood of becoming negative for HBeAg from 9.1% to 45.6% (difference, 36.5%; 95% CI, 23.7% to 49.2%) and of becoming negative for hepatitis B surface antigen from 1.7% to 7.7% (difference, 6.0%; CI, 2.8% to 9.3%) in the first year. For a 35-year-old person with chronic hepatitis B who is HBeAg positive, our analysis suggests that interferon-α2b will increase life expectancy by 3.1 years or 3.4 quality-adjusted life-years and will decrease projected lifetime costs, even if future savings are discounted; thus, interferon-α2b is the dominant strategy. Even with the model biased strongly in favor of standard care, the marginal cost-effectiveness ratio of interferon did not exceed $12 000 per life-year gained. Conclusions: Interferon-α2b should prolong life and lower costs for patients with chronic hepatitis B who are HBeAg positive.
Does the underprivileged area index work?
Authors: R Leavey, J Wood
Journal: BMJ (1985)

The underprivileged area index was developed by Jarman to identify areas with the greatest need for general practitioner services and where general practitioners were under the greatest pressure. We found that in wards that scored the worst on the underprivileged area index the doctor:patient ratios were the highest. We suggest that the index needs to be used with other indicators to identify variations in need in small areas.
Mass immunisation campaign against polio in Africa reports "high coverage"
Authors: J. Zarocostas
Journal: BMJ (2010)

Preliminary field assessments indicate that the synchronised mass immunisation campaign against polio launched on 26 October to reach 72 million children in 15 African countries is progressing well, international health officials have said.

Rod Curtis, a World Health Organization spokesman, told the BMJ on 1 November that experts are reporting “high coverage” of the target children under the age of 5 years in the Democratic Republic of the Congo, Liberia, and Mali.

However, initial assessments in Angola indicated that the campaign “was not a great improvement on past campaigns,” said Mr Curtis. An earlier campaign in the capital, Luanda—a key reservoir …