tbuckley/cabot-search huggingface dataset:
Dynamic nature of the aortic regurgitant orifice area during diastole in patients with chronic aortic regurgitation.
Authors: S C Reimold, S E Maier, K E Fleischmann, M Khatri, D Piwnica-Worms, R Kikinis, R T Lee
Journal: Circulation (1994)

BACKGROUND The effective aortic regurgitant orifice area varies with aortic pressure in animal models of acute aortic regurgitation. The purpose of this study was to determine whether the aortic regurgitant orifice area changes during diastole in patients with chronic aortic regurgitation. METHODS AND RESULTS Two-dimensional and Doppler echocardiography were performed immediately before and after magnetic resonance velocity mapping using a cine phase contrast sequence in 17 patients with chronic aortic regurgitation. ECG-gated continuous-wave Doppler velocity time integrals and magnetic resonance flow rates were measured 16 times per cardiac cycle. The mean aortic regurgitant orifice area (centimeters squared) was calculated by the continuity equation. The regurgitant orifice area was also determined for each diastolic acquisition interval. Changes in the regurgitant orifice area during diastole were modeled using an asymptotic exponential decay model to determine the static and dynamic components of the orifice. The regurgitant orifice area increased directly with regurgitant fraction (y[cm2] = 0.0072[cm2/%]*x[%]-0.0409[cm2]; r = .86, P &lt; .0001). In 15 of 17 (88%) patients, the regurgitant orifice area decreased during diastole. The dynamic component of the regurgitant orifice area decreased with increasing regurgitant fraction (y[%] = -0.98x[%]+96.9[%]; r = -.90, P &lt; .0001). There were no significant differences in heart rate, systolic or diastolic blood pressures, or continuous-wave Doppler velocity time integrals measured before or after the magnetic resonance examination. CONCLUSIONS The effective regurgitant orifice area decreases during diastole in patients with chronic aortic regurgitation. This phenomenon should be considered when evaluating aortic regurgitant severity.
Mortality follow-up of the 1942 epidemic of hepatitis B in the U.S. Army
Authors: James E. Norman, Gilbert W. Beebe, Jay H. Hoofnagle, Leonard B. Seeff
Journal: Hepatology (1993)

The hypothesis that adult infection with the hepatitis B virus in the United States leads to a carrier state with a high risk of primary liver cancer was tested in two ways: (a) a cohort mortality study of U.S. Army veterans given yellow fever vaccine contaminated with hepatitis B virus in 1942 and controls and (b) a case-control study comparing veterans with hepatocellular carcinoma in Veterans Affairs hospitals with matched controls with respect to receipt of contaminated vaccine in 1942. Three groups totaling 69,988 men were the subjects of the cohort study: group 1 comprised men hospitalized with hepatitis in 1942, group 2 comprised men subclinically infected in 1942 and group 3 comprised controls who entered service after the contaminated vaccine was discontinued. Hepatocellular carcinoma cases (n = 24) and control subjects (n = 63) derived from Veterans Affairs hospital discharge files were the subjects of the casecontrol study. Group comparisons of death rates from liver cancer were refined by expert review of records to select hepatocellular carcinoma from among all causes of death so diagnosed in the cohort study. Slightly excess mortality was found for hepatocellular carcinoma in group 2 (subclinical hepatitis B) but not for group 1 (overt hepatitis B) compared with group 3 (controls) (p = 0.08). Mortality from nonalcoholic chronic liver disease was less in group 2 than in group 3. In the case-control study, the relative risk for hepatocellular carcinoma conferred by receipt of contaminated vaccine was estimated as 3.3 (p = 0.06). We conclude from the cohort study that immunocompetent adult males rarely become carriers after hepatitis B virus infection, probably far less often than the frequently assumed rate of 5% to 10%. The small excess liver cancer mortality seen in the cohort study and the results of the case-control study are consistent, nevertheless, with the now well-established etiological role of hepatitis B virus infection in liver cancer. (HEPATOLOGY 1993;18:790-797).
The Relation of a Venous-Arteriolar Reflex to Transmural Pressure and Resistance in Small and Large Systemic Vessels
Authors: FRANCIS J. HADDY, ROBERT P. GILBERT
Journal: Circulation Research (1956)

Data are presented which indicate that, even in pressure ranges well above critical closing pressures, transmural pressure is an important factor in determining systemic vascular resistance but that a mechanism is present which actively limits these pressure changes in resistance when transmural pressure is varied on the venous side.
A STUDY OF THE STIGMATA OF DEGENERACY AMONG THE AMERICAN CRIMINAL YOUTH.
Authors: EUGENE S. TALBOT
Journal: JAMA (1898)

The present contribution results from studies on young criminals made during 1895-96 at the State reformatories at Pontiac, Ill., and Elmira, New York. The investigation concerns especially the stigmata of the head and face. The stature and weight were noted, but other anthropometric data were not specially considered, as measurements had to be entrusted to others. It was therefore deemed advisable to avoid as far as possible elements of error concomitant on extensive detailed anthropometry. Only simple measurements easily obtained with accuracy were made. Inasmuch as facial and cranial development are, as a rule, most directly co-related with moral and intellectual evolution it was deemed natural that they should furnish sufficient data for discussion in an article of the present scope. Since the inquiry dealt only with the physical stigmata of the head and face, the youngest inmates were, for obvious reasons (immature jaw and face development) excluded from consideration.
Smoking reduces insulin absorption from subcutaneous tissue.
Authors: P Klemp, B Staberg, S Madsbad, K Kolendorf
Journal: BMJ (1982)

Unusual cause of atrial fibrillationAtrial fibrillation is one of the most common arrhythmias and is caused most often by mitral stenosis, ischaemic heart disease, or thyrotoxicosis.It may also occur as a transient manifestation in the Wolff-Parkinson-White syndrome.More rarely there may be no detectable underlying lesion.We describe a patient who developed atrial fibrillation during the course of a chlamydia B infection, possibly due to complicating myocarditis.
Autosomal/Recessive Hypocalciuric Hypercalcemia
Authors: Andrew Dunn
Journal: Annals of Internal Medicine (1997)

Letters15 May 1997Autosomal/Recessive Hypocalciuric HypercalcemiaAndrew Dunn, MDAndrew Dunn, MDMount Sinai Medical Center, New York, NY 10029Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-10-199705150-00039 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The poem by Van Peenen [1] was an entertaining description of the varying manifestations of a genetic disease. However, it left me puzzled. Familial hypocalciuric hypercalcemia is a benign disorder that is inherited as an autosomal dominant trait [2]. It is commonly discovered during the evaluation of asymptomatic hypercalcemia.Is the author's stylish manner causing me to misinterpret the poem, or is the author describing the rare case of a child inheriting an autosomal dominant allele from each parent?References1. Van Peenen HJ. Autosomal/recessive (familial hypocalciuric hypercalcemia). Ann Intern Med. 1996; 125:7. Google Scholar2. Potts JT Jr. Diseases of the parathyroid gland and other hyper- and hypocalcemic disorders. In: Isselbacher KJ, Martin JB, Braunwald E, Fauci AS, Wilson JD, Kasper DL, eds. Harrison's Principles of Internal Medicine. 13th ed. New York: McGraw-Hill; 1994:2156-7. Google Scholar Author, Article, and Disclosure InformationAuthors: Andrew Dunn, MDAffiliations: Mount Sinai Medical Center, New York, NY 10029 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 1997Volume 126, Issue 10Page: 835KeywordsAllelesAutosomal dominant traitsGenetic diseasesHypercalcemia ePublished: 15 August 2000 Issue Published: 15 May 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Connexin43 mediates direct intercellular communication in human osteoblastic cell networks.
Authors: R Civitelli, E C Beyer, P M Warlow, A J Robertson, S T Geist, T H Steinberg
Journal: Journal of Clinical Investigation (1993)

We have examined cell coupling and expression of gap junction proteins in monolayer cultures of cells derived from human bone marrow stromal cells (BMC) and trabecular bone osteoblasts (HOB), and in the human osteogenic sarcoma cell line, SaOS-2. Both HOB and BMC cells were functionally coupled, since microinjection of Lucifer yellow resulted in dye transfer to neighboring cells, with averages of 3.4 +/- 2.8 (n = 131) and 8.1 +/- 9.3 (n = 51) coupled cells per injection, respectively. In contrast, little diffusion of Lucifer yellow was observed in SaOS-2 monolayers (1.4 +/- 1.8 coupled cells per injection, n = 100). Dye diffusion was inhibited by octanol (3.8 mM), an inhibitor of gap junctional communication. All of the osteoblastic cells expressed mRNA for connexin43 and connexin45, but not for connexins 26, 32, 37, 40, or 46. Whereas all of the osteoblastic cells expressed similar quantities of mRNA for connexin43, the poorly coupled SaOS-2 cells produced significantly less Cx43 protein than either HOB or BMC, as assessed by immunofluorescence and immunoprecipitation. Conversely, more Cx45 mRNA was expressed by SaOS-2 cells than by HOB or BMC. Thus, intercellular coupling in normal and transformed human osteoblastic cells correlates with the level of expression of Cx43, which appears to mediate intercellular communication in these cells. Gap junctional communication may serve as a means by which osteoblasts can work in synchrony and propagate locally generated signals throughout the skeletal tissue.
Prognostic Value of Ambulatory and Home Blood Pressures Compared With Office Blood Pressure in the General Population
Authors: Roberto Sega, Rita Facchetti, Michele Bombelli, Giancarlo Cesana, Giovanni Corrao, Guido Grassi, Giuseppe Mancia
Journal: Circulation (2005)

Background— Studies in hypertensive patients suggest that ambulatory blood pressure (BP) is prognostically superior to office BP. Much less information is available in the general population, however. Obtaining this information was the purpose of the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) study. Methods and Results— Office, home, and 24-hour ambulatory BP values were obtained in 2051 subjects between 25 and 74 years of age who were representative of the general population of Monza (Milan, Italy). Subjects were followed up for an average of 131 months, during which time cardiovascular and noncardiovascular fatal events were recorded (n=186). Office, home, and ambulatory BP values showed a significant exponential direct relationship with risk of cardiovascular or all-cause death. The goodness of fit of the relationship was greater for systolic than for diastolic BP and for night than for day BP, but its overall value was not better for home or ambulatory than for office BP. The slope of the relationship, however, was progressively greater from office to home and ambulatory BP. Home and night BP modestly improved the goodness of fit of the risk model when added to office BP. Conclusions— In the PAMELA population, risk of death increased more with a given increase in home or ambulatory than in office BP. The overall ability to predict death, however, was not greater for home and ambulatory than for office BP, although it was somewhat increased by the combination of office and outside-of-office values. Systolic BP was almost invariably superior to diastolic BP, and night BP was superior to day BP.
Unique Molecule May Aid Cartilage Repair
Authors: Rebecca Voelker
Journal: JAMA (2010)

people or to those already with multiple riskfactors,”Nissensaid.“Wearetalking about those individualswhoappear tobe at risk but who do not have a cholesterol level high enough to trigger treatment.” A key element to the FDA’s decision is the use of hsCRP to establish who among asymptomatic individuals qualifies for this statin therapy. James H. Stein, MD, professor of medicine at the University of Wisconsin School of Medicine in Madison, anticipates that physicians will use hsCRP as a tiebreaker in deciding whether or not to move on to medical therapy for certain patients. “If I end up with a JUPITER patient, I would do the standard risk panel,” Stain said. “If I determined they were at intermediate risk [based on the Framingham risk assessment] but they did not qualify for lipid therapy, I would do a CRP test and act on that if it was elevated.” A high hsCRP reading, as it relates to heart disease, tends to be associated with excess weight. Stein said he is concerned about “medication creep”—that physicians and patients will find it easier to opt for a daily pill over more onerous therapies involving lifestyle modification. “We should work on the lifestyle factor that directly affects CRP, and that is adiposity,” Stein said. The price of rosuvastatin, a proprietary drug that can cost an estimated $140 per month, may be too high for the patients whose insurance plans do not cover the medication or who are uninsured. Nissen and Stein said they believe rosuvastatin’s success in this asymptomatic population is probably a class effect, and they would consider substituting another statin for a patient who cannot afford the drug. But Thomas A. Pearson, MD, PhD, MPH, professor of community and preventive medicine at the University of Rochester Medical Center in New York, warned physicians against quickly seeking alternative statins. “I would be a defender of heterogeneity in our pharmacopeia for drugs within a class, and there is error on the part of third-party payers in saying all statins are the same,” Pearson said. For some, there is concern that the FDA’s expansion of indications for rosuvastatin has established a treatment guideline based on a single study; an action that goes against the accepted norms of having a group of leading researchers reviewing all of the evidence and then making recommendations. “Are you going to let the FDA write the cholesterol guidelines in a backdoor manner instead of the National Cholesterol Education Program?” asked Scott M. Grundy, MD, PhD, director of the Center for Human Nutrition at the University of Texas Southwestern Medical Center in Dallas, who chaired the most recent expert panel that published guidelines for lipid management. “The FDA ought to be very clear that these are not guidelines and represent a response to one clinical trial.”
Enteroscopy: Endangered by the Capsule?
Authors: B. S. Lewis
Journal: Endoscopy (2002)

Since the inception of endoscopic examinations, physicians have wanted to obtain direct visualization of the entire gut. Standard endoscopic and colonoscopic exams view only small amounts of the proximal and distal ends of the small bowel. Endoscopic examination of the entire small bowel has remained elusive. Push enteroscopy was the first step in the endoscopic evaluation of the intestine. Initially colonoscopes, both adult and pediatric, were used to evaluate the entire duodenum and proximal jejunum. On average, a 160 cm long instrument can be advanced 40 cm beyond the ligament of Treitz. Currently, 2.1 - 2.5 meter long push enteroscopes have greatly improved the depth of insertion and visualization of the small bowel and it is now possible to inspect the jejunum in its entirety. Examination of the distal small bowel has previously been achieved using sonde and rope-way techniques [1]. Both investigations are lengthy and quite uncomfortable, even painful. The medical community has largely abandoned these exams.
Impact of gestrinone on the course of asymptomatic endometriosis.
Authors: E J Thomas, I D Cooke
Journal: BMJ (1987)

A new drug, gestrinone, was subjected to the first double blind, randomised placebo controlled trial of any treatment of endometriosis. The disease deteriorated in eight (47%) of the 17 patients prescribed placebo (95% confidence limits 23% and 71%) compared with none of the 18 patients prescribed gestrinone (p = 0.002). There was a difference in elimination of the endometriosis in the gestrinone group compared with placebo but this was not statistically significant (p = 0.057). There was a significant difference in improvement of the disease in the gestrinone group compared with placebo (p = 0.004), confirming that gestrinone is an effective treatment of endometriosis. Endometriosis deteriorates in at least 23% of patients; as it is impossible to predict in whom this will happen, treatment appears to be warranted in all cases.
GAD-reactive CD4+ Th1 cells induce diabetes in NOD/SCID mice.
Authors: D Zekzer, F S Wong, O Ayalon, I Millet, M Altieri, S Shintani, M Solimena, R S Sherwin
Journal: Journal of Clinical Investigation (1998)

Although glutamic acid decarboxylase (GAD) has been implicated in IDDM, there is no direct evidence showing GAD-reactive T cells are diabetogenic in vivo. To address this issue, 3-wk-old NOD mice received two injections of purified rat brain GAD; one mouse rapidly developed diabetes 3 wk later. Splenocytes from this mouse showed a proliferative response to purified GAD, and were used to generate a CD4+ T cell line, designated 5A, that expresses TCRs encoding Vbeta2 and Vbeta12. 5A T cells exhibit a MHC restricted proliferative response to purified GAD, as well as GAD65 peptide 524-543. After antigen-specific stimulation, 5A T cells secrete IFNgamma and TNFalpha/beta, but not IL-4. They are also cytotoxic against NOD-derived hybridoma cells (expressing I-Ag7) that were transfected with rat GAD65, but not nontransfected hybridoma cells. Adoptive transfer of 5A cells into NOD/SCID mice produced insulitis in all mice. Diabetes occurred in 83% of the mice. We conclude that GAD injection in young NOD mice may, in some cases, provoke diabetes due to the activation of diabetogenic T cells reactive to GAD65 peptides. Our data provide direct evidence that GAD65 autoimmunity may be a critical event in the pathogenesis of IDDM.
Inhibition and subsequent enhancement of platelet responsiveness by prostacyclin in the rabbit. Relationship to platelet adenosine 3',5'-cyclic monophosphate.
Authors: M Vanderwel, R J Haslam
Journal: Journal of Clinical Investigation (1985)

Methods were developed for measuring changes in platelet sensitivity to a release-inducing stimulus and in platelet cyclic AMP in fresh whole blood samples from rabbits. These techniques permitted detection of the effects of exogenous and endogenous prostacyclin on circulating platelets. In these methods, rabbit platelets were labeled in vitro by incubation with [14C]serotonin and [3H]adenine and then transfused into other rabbits. Release of platelet [14C]serotonin by a standard dose of synthetic platelet-activating factor (40 pmol/ml) and the platelet cyclic [3H]AMP levels were then measured in citrated blood from the conscious animals within 2 min of arterial puncture. Bolus intravenous injections of prostacyclin (1-10 nmol/kg) caused concentration-dependent increases in platelet cyclic AMP after 2 min, which decreased approximately 75% by 5 min, and disappeared after 30 min. Significant inhibition of the platelet release reaction was detected 2 min but not 5 min after injection of 10 nmol of prostacyclin per kilogram. With lower doses, significant enhancement of the release of [14C]serotonin was observed after 5 min. Similar changes in platelet responsiveness and cyclic [3H]AMP were observed after release of endogenous prostacyclin by intravenous injection of angiotensin II (5 nmol/kg); inhibition of the release of [14C]serotonin after 2 min was followed by potentiation after 5 min, though platelet cyclic [3H]AMP remained above control values. In these experiments, the time course of the changes in platelet cyclic [3H]AMP correlated closely with values for blood prostacyclin obtained previously (Haslam, R.J., and M.D. McClenaghan, 1981, Nature [Lond.]., 292:364-366). Prostacyclin also had a biphasic effect on the release of [14C]serotonin when added to citrated blood in vitro, though both the increase in sensitivity to platelet-activating factor and the return of platelet cyclic [3H]AMP towards control values took place more slowly. At all times, addition of platelet-activating factor decreased platelet cyclic [3H]AMP towards but not below the control level observed in the absence of prostacyclin. Our results indicate that although transient increases in platelet cyclic AMP cause an immediate decrease in platelet responsiveness in vivo or in vitro, a period of enhanced platelet sensitivity follows as platelet cyclic AMP falls.
Computed Tomography Screening for Lung Cancer
Authors: Phillip M. Boiselle
Journal: JAMA (2013)

<h3>Importance</h3>Low-dose computed tomography (CT) screening was shown to reduce lung cancer–specific mortality in a large randomized trial of a high-risk population. The decision to pursue CT screening for lung cancer is a timely question raised by individuals at risk of lung cancer and by their health care practitioners.<h3>Objectives</h3>To discuss the evidence for use of chest x-rays and low-dose CT in screening for lung cancer; to describe potential benefits, harms, and uncertainties of CT screening; and to review current guidelines for CT screening.<h3>Evidence Review</h3>MEDLINE and the Cochrane Library were searched from 1984 to 2012. Additional citations were obtained from lists of references from select research and review articles on this topic. Evidence was graded using the American Hospital Association level of evidence guidelines.<h3>Findings</h3>Low-dose CT screening has been associated with a 20% reduction in lung cancer mortality in a large randomized controlled trial (National Lung Screening Trial [NLST]) of a high-risk population. Mortality data have not yet been reported for 5 other randomized controlled trials, and the sample sizes were too small to detect a meaningful difference in 2 other completed trials. A major risk of CT screening is a high false-positive rate, with associated risks and costs associated with follow-up CT scans and the potential for more invasive diagnostic procedures. Published guidelines for screening indicate a consensus that screening may be indicated for individuals who meet entry criteria for the NLST, but some guidelines expand their recommendations for screening beyond these criteria.<h3>Conclusions and Relevance</h3>Individuals at high risk of lung cancer who meet the criteria for CT screening in published guidelines should participate in an informed and shared decision-making process by discussing the potential benefits, harms, and uncertainties of screening with their physicians.