tbuckley/cabot-search huggingface dataset:
Papilla of Vater: Structure and Function
Authors: H. D. Allescher
Journal: Endoscopy (1989)

The papilla of Vater is involved in the regulation of bile flow (inhibition and facilitation) into the duodenum and the prevention of reflux into the bile and pancreatic duct system. These functions are achieved by a special muscular, neural and mucosal structure of the papilla of Vater. The mucosa of the papilla of Vater consists of a complicated system of mucosal folds which can function as an anti-reflux valve or might even participate in the regulation of bile outflow. The smooth muscle of the spincter of Oddi differs anatomically and embryologically from the surrounding duodenal muscle. It shows spontaneous electrical and mechanical activity acting independently from the duodenum but integrated into the overall function of the gastrointestinal tract by myogenic mechanisms, extrinsic and intrinsic nerves and circulating hormones. A spontaneous myogenic electrical activity propagates distally and leads to distally propagating phasic contractions. With endoscopic manometry in humans these phasic contractions as well as basal tone, bile duct pressure and pancreatic duct pressure can be measured. Changes of the basal tone and the phasic activity will alter the flow resistance thus regulating bile flow and inducing gallbladder filling. The most characteristic feature of the sphincter of Oddi is the inhibitory effect of cholecystokinin, which is a powerful contractor of the gallbladder, on the sphincter of Oddi motor activity. Cholecystokinin released in response to intra-duodenal fat and other nutrients might be the physiological stimulus of the increased bile flow post-prandially. The function of other hormones is still rather speculative and their physiological significance awaits further confirmation.
Electrolyte disturbances and cardiac failure with hypomagnesaemia in anorexia nervosa.
Authors: V Fonseca, C W Havard
Journal: BMJ (1985)

A 32 year old woman with anorexia nervosa was admitted to hospital with severe hypocalcaemia and hypokalaemia that was refractory to replacement treatment but that responded immediately to an infusion of magnesium. She also had congestive cardiac failure that responded to magnesium replacement. The mild hypomagnesaemia found in this patient was responsible for the refractory hypocalcaemia. Minor deficiencies of magnesium may cause severe hypocalcaemia and hypokalaemia that are refractory to replacement treatment. Prompt replacement of magnesium may prevent prolonged tetany, cardiac arrhythmias, and heart failure.
Homosexuality and the Physician
Authors: Philip H. Heersema
Journal: JAMA (1965)

There is in every individual, in some degree, an interest in and a potential of affection for members of his own sex as well as for the opposite sex. This potential is evidence of the universality of homosexuality. In the psychological sexual development of the individual there is a brief period, usually at the onset of puberty, that may properly be called a normal "homosexual" stage. Until recently, this crucial span of years has been relatively neglected in the field of psychiatric prevention and psychotherapy, and this neglect has undoubtedly complicated and obscured the treatment of homosexuality. For decades, the prevalent social attitude toward homosexuality has been one of contempt reinforced by many punitive measures. Recently we have witnessed a condoning, an accepting, and in some areas even a glorifying of the homosexual "way of life." These exaggerated attitudes, from persecution to glorification, as well as certain misconceptions of the
PTH-057 A Twin-Centre Randomized Trial of Increasing Clear Fluid Intake to Standard Moviprep Regimen in Adult Out-Patient Colonoscopy Improves Left Sided Bowel Cleansing &amp; Polyp Detection Rates: Abstract PTH-057 Table 1
Authors: S Pelitari, J K Dowman, K Glover, S Keen, A D Farmer
Journal: Gut (2013)

<h3>Introduction</h3> Inadequate bowel preparation for colonoscopy is associated with increased complication rates and a reduction in diagnostic yield. Low volume 2L polyethylene glycol and ascorbic acid (Moviprep, Norgine Pharmaceuticals) has been demonstrated to be non-inferior to other bowel cleansing agents but has greater patient tolerability (1). It is not known whether the addition of clear fluids to the standard regiment improves bowel cleansing with Moviprep. <h3>Methods</h3> All adult patients attending for routine out-patient colonoscopy at two secondary care sites were randomised to receive either standard 2L Moviprep (regimen 1) or standard 2L Moviprep with an extra 1.5L of clear fluid (regimen 2). Segmental, and overall, bowel cleansing was assessed by the colonoscopist, blinded to the randomisation, using the validated Harefield Scale (HS). The HS is an inverted Ottawa scale scored from 4 (colon empty and clean) to 1 (large amounts of irremovable residual faeces) in six colonic segments. <h3>Results</h3> 496 patients (252 females, mean age 59 years (range 22–90)) were included in an intention to treat analysis. The unadjusted completion rate was 95%. 246 patients were randomised to regimen 1 and 250 patients to regimen 2. Groups were similar in terms of demographics, indications for colonoscopy, presence of comorbidities and completion rates. <i>Table 1</i> details the segmental, and overall, scoring between groups. Polyp detection rates were significantly higher in the group who took extra fluid (odds ratio 0.57, 95% confidence interval 0.34–0.89, <i>p</i> = 0.01). <h3>Conclusion</h3> Increasing the volume of clear fluid intake with Moviprep improves cleansing in the distal colon and improves polyp detection rate. These data have important implications for clinical practise as upto 2/3rds of colorectal cancers arise in the left colon (2). Further research is now warranted to reproduce these findings in a larger cohort of patients. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> Marmo<i> et al.</i> Effective bowel cleansing before colonoscopy: a randomised study of split-dosage versus non-split dosage regimens of high-volume versus low-volume polyethylene glycol solutions, GIE 2010; 72(2):313–320. McCallion <i>et al.</i> Flexible sigmoidoscopy and the changing distribution of colorectal cancer: implications for screening, Gut 2001; 48(4):522–5.
Immunosuppression of Graves' Hyperthyroidism — Still an Elusive Goal
Authors: Wilmar M. Wiersinga
Journal: New England Journal of Medicine (1996)

Fifty years have passed since radioactive iodine and antithyroid drugs became available for the treatment of hyperthyroidism caused by Graves' disease. Despite the efficacy of both treatments, opinions still diverge widely as to which is better. A course of antithyroid-drug therapy requires prolonged daily treatment, but 40 to 50 percent of patients treated for a year remain euthyroid after therapy is discontinued. Therapy with iodine-131, on the other hand, is simple and fast (one dose usually suffices), but the treatment causes hypothyroidism in a large proportion of patients. In a survey of endocrinologists, 69 percent of the responding physicians in . . .
Tachyarrhythmia in yersinia arthritis.
Authors: T Lenz, F Keller
Journal: Annals of the Rheumatic Diseases (1984)

C4 deficiency, SLE, and Whipple's disease SIR, We read with interest the report of a patient with C4 deficiency, SLE, and Whipple's disease.'We would like to propose an alternative to the diagnosis of Whipple's disease in this case.There have been several recent publications highlighting the striking resemblance of the lesions of Mycobacterium avium-intracellulare infection to those of Whipple's disease.2PAS-positive macrophages are found in tissue infected by M. avium-intracellulare as well as in Whipple's disease; the bacillary bodies seen by electron microscopy in each condition are indistinguishable.4The authors postulate that complement deficiency, SLE itself, and steroid therapy all rendered their patient more susceptible to Whipple's disease.The same argument suggests M. avium-intracellulare infection.Since the special procedures required to culture this organism5 were not carried out, the diagnosis of Whipple's disease remains uncertain.An acid-fast stain, said to be negative in Whipple's disease and positive in M. avium-intracellulare infection,2 3 could be performed on tissues obtained at necropsy in this case.The results would be of great interest.
Evaluation of myocardial ischemia in Kawasaki disease by dobutamine stress signal-averaged ventricular late potentials
Authors: Yukiko Genma, Shunichi Ogawa, Jiakun Zhang, Masao Yamamoto
Journal: Cardiovascular Research (1997)

Objective: To determine the possibility of diagnosing myocardial ischemia from signal-averaged electrocardiographic late potentials (LPs) in patients with Kawasaki disease. Methods: Dobutamine stress LPs were obtained in 85 children with a history of Kawasaki disease (48 without coronary artery lesions, 19 with coronary artery lesions without myocardial ischemia, and 18 with myocardial ischemia). The infusion of dobutamine was started at 5 μg/kg/min, increased to 30 μg/kg/min. The presence of LPs was determined by the filtered QRS duration, the root mean square voltage during the last 40 ms, and the duration of the signal under 40 μV. Results: Among the children without coronary lesions, LPs were detected in 4.2% at rest and in 2.1% with dobutamine stress. Among the group with coronary lesions but without ischemia, LPs were found in 5.3% at rest and in 5.3% with stress. In the group with ischemia, LPs were present in 44.4% at rest and in 77.8% with stress. The sensitivity for myocardial ischemia was 72.7% at rest and 87.5% with stress (p<0.05), and the specificity was 86.5% at rest and 94.2% with stress. Conclusion: LPs associated with dobutamine stress testing are useful for identifying myocardial ischemia in children with Kawasaki disease, especially in those who cannot tolerate testing involving physical exercise.
Elevated furin levels in human cystic fibrosis cells result in hypersusceptibility to exotoxin A–induced cytotoxicity
Authors: Wojciech Ornatowski, Jens F. Poschet, Elizabeth Perkett, Jennifer L. Taylor-Cousar, Vojo Deretic
Journal: Journal of Clinical Investigation (2007)

Progressive pulmonary disease and infections with Pseudomonas aeruginosa remain an intractable problem in cystic fibrosis (CF). At the cellular level, CF is characterized by organellar hyperacidification, which results in altered protein and lipid glycosylation. Altered pH of the trans-Golgi network (TGN) may further disrupt the protein processing and packaging that occurs in this organelle. Here we measured activity of the major TGN endoprotease furin and demonstrated a marked upregulation in human CF cells. Increased furin activity was linked to elevated production in CF of the immunosuppressive and tissue remodeling cytokine TGF-beta and its downstream effects, including macrophage deactivation and augmented collagen secretion by epithelial cells. As furin is responsible for the proteolytic processing of a range of endogenous and exogenous substrates including growth factors and bacterial toxins, we determined that elevated furin-dependent activation of exotoxin A caused increased cell death in CF respiratory epithelial cells compared with genetically matched CF transmembrane conductance regulator-corrected cells. Thus elevated furin levels in CF respiratory epithelial cells contributes to bacterial toxin-induced cell death, fibrosis, and local immunosuppression. These data suggest that the use of furin inhibitors may represent a strategy for pharmacotherapy in CF.
Deceased-Donor Characteristics and the Survival Benefit of Kidney Transplantation
Authors: Robert M. Merion
Journal: JAMA (2005)

Context Transplantation using kidneys from deceased donors who meet the expanded criteria donor (ECD) definition (age Ն60 years or 50 to 59 years with at least 2 of the following: history of hypertension, serum creatinine level Ͼ1.5 mg/dL [132.6 µmol/L], and cerebrovascular cause of death) is associated with 70% higher risk of graft failure compared with non-ECD transplants.However, if ECD transplants offer improved overall patient survival, inferior graft outcome may represent an acceptable trade-off.Objective To compare mortality after ECD kidney transplantation vs that in a combined standard-therapy group of non-ECD recipients and those still receiving dialysis. Design, Setting, and PatientsRetrospective cohort study using data from a US national registry of mortality and graft outcomes among kidney transplant candidates and recipients.The cohort included 109 127 patients receiving dialysis and added to the kidney waiting list between January 1, 1995, and December 31, 2002, and followed up through July 31, 2004.Main Outcome Measure Long-term (3-year) relative risk of mortality for ECD kidney recipients vs those receiving standard therapy, estimated using time-dependent Cox regression models.Results By end of follow-up, 7790 ECD kidney transplants were performed.Because of excess ECD recipient mortality in the perioperative period, cumulative survival did not equal that of standard-therapy patients until 3.5 years posttransplantation.Long-term relative mortality risk was 17% lower for ECD recipients (relative risk, 0.83; 95% confidence interval, 0.77-0.90;PϽ.001).Subgroups with significant ECD survival benefit included patients older than 40 years, both sexes, non-Hispanics, all races, unsensitized patients, and those with diabetes or hypertension.In organ procurement organizations (OPOs) with long median waiting times (Ͼ1350 days), ECD recipients had a 27% lower risk of death (relative risk, 0.73; 95% confidence interval, 0.64-0.83;PϽ.001).In areas with shorter waiting times, only recipients with diabetes demonstrated an ECD survival benefit.Conclusions ECD kidney transplants should be offered principally to candidates older than 40 years in OPOs with long waiting times.In OPOs with shorter waiting times, in which non-ECD kidney transplant availability is higher, candidates should be counseled that ECD survival benefit is observed only for patients with diabetes.
Pathologist in G20 inquest admits there was a "compelling association" between push by policeman and heart attack
Authors: C. Dyer
Journal: BMJ (2011)

Freddy Patel, the pathologist who concluded that newspaper seller Ian Tomlinson died of natural causes at the anti-G20 summit protest on 1 April 2009, has told the London inquest into the death that he changed his postmortem report a year after he produced it.

Dr Patel’s first report, dated 6 April 2009, was produced before amateur video footage came to light, a week after the death, which showed Mr Tomlinson being struck on the leg with a baton and pushed to the ground by a police constable. The report found that the death was consistent with natural causes because Mr Tomlinson had coronary artery disease and could have died at any time.

Dr Patel …
Cytomegalovirus Transmission Among Homosexual Men
Authors: JAMES J. GOEDERT
Journal: Annals of Internal Medicine (1984)

Letters and Corrections1 January 1984Cytomegalovirus Transmission Among Homosexual MenJAMES J. GOEDERT, M.D., ROBERT J. BIGGAR, M.D.JAMES J. GOEDERT, M.D.Search for more papers by this author, ROBERT J. BIGGAR, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-1-156_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Mintz and coworkers (1), in their recent report of risk factors for cytomegalovirus infection, claim that of seven sexual practices investigated, only anal-receptive intercourse correlated with acquisition of infection. Because we have previously shown that cytomegalovirus is excreted in the seminal fluid of 15% of antibody-positive homosexual men (2), transmission through anal-receptive intercourse is conceivable. However, in their analysis of sexual practices, the authors made no attempt to control for age. Age has previously been shown by these authors (3) and ourselves (4) to be strongly related to cytomegalovirus infection in homosexual men.We have analyzed the...References1. MINTZ L, DREW W, MINER R, and BRAFF E. Cytomegalovirus infections in homosexual men: an epidemiologic study. Ann Intern Med. 1983;99:326-9. LinkGoogle Scholar2. BIGGAR R, ANDERSEN H, and EBBESEN P. Seminal fluid excretion of CMV in homosexual men related to immunosuppression. Br Med J. 1983;286:2010-2. CrossrefMedlineGoogle Scholar3. DREW W, MINTZ L, MINER R, SANDS M, and KETTERER B. Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis. 1981;143:188-92. CrossrefMedlineGoogle Scholar4. MELBYE M, BIGGAR R, EBBESEN P, ANDERSEN H, and VESTERGAARD B. Lifestyle and antiviral antibody studies among homosexual men in Denmark. Acta Pathol Microbiol Scand [B]. 1983. (In press). Google Scholar1. DREW W, MINTZ L, MINER R, SANDS M, and KETTERER B. Prevalence of cytomegalovirus infection in homosexual men. J Infect Dis. 1981;143:188-92. CrossrefMedlineGoogle Scholar2. MINTZ L, DREW W, MINER R, and BRAFF E. Cytomegalovirus infections in homosexual men: an epidemiological study. Ann Intern Med. 1983;99:326-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: JAMES J. GOEDERT, M.D.; ROBERT J. BIGGAR, M.D.Affiliations: Environmental Epidemiology Branch National Cancer Institute Bethesda, MD 20205 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAntiviral antibodies in the sera of homosexual men: Correlation with their lifestyle and drug usageAcquired immune deficiency syndrome: The causative agent and the evolving perspective 1 January 1984Volume 100, Issue 1Page: 156-156KeywordsCytomegalovirus infectionHomosexualsMedical risk factorsRisk management ePublished: 1 December 2008 Issue Published: 1 January 1984 PDF downloadLoading ...
Atlanto-axial subluxation in rheumatoid arthritis.
Authors: J A Mathews
Journal: Annals of the Rheumatic Diseases (1969)

Rheumatoid arthritis has a high morbidity but a low mortality.One cause of death in this disease is compression of the cervical cord following atlanto- axial subluxation.This makes the finding of atlanto-axial subluxation of great importance, although the relationship of small amounts of sub- luxation to symptoms and subsequent progress has not been established.Similarly, the importance of a chance finding of subluxation is uncertain.In this study, the entire rheumatoid population of a hospital clinic has been surveyed both clinically and radiologically to determine the incidence of this abnormality.Material 76 consecutive out-patients with rheumatoid arthritis were studied; they represented the population served by the hospital.Their disease satisfied the American Rheumatism Association criteria for rheumatoid arthritis.Seventy of the patients studied had at least one of the following additional features: positive rheumatoid factor tests, erosions, or nodules.Control subjects were selected from the physical medicine department clinics, the physiotherapy depart- ment, and the hospital beds.No person with headache or clinical evidence of rheumatoid arthritis was included in the control group.The 28 control subjects were matched with the rheumatoid patients for age and sex. MethodDetails of the apparent duration of the disease, of systemic steroid therapy, nodules, and radiological changes were recorded.Erosive changes were recorded as absent, present, or severe, the last if one or more bones in the hands or feet were seen in radiographs to be so eroded as to have an unrecognizable contour.Symp- toms referable to the cervical spine were enquired after, namely pain or stiffness in the head or neck either spontaneously or on movement, and paraesthesiae on *Paper read to the Heberden Society at a meeting held at Burgen- stock, Switzerland, in
Twenty one years of P19 cells: what an embryonal carcinoma cell line taught us about cardiomyocyte differentiation
Authors: M VANDERHEYDEN, L DEFIZE
Journal: Cardiovascular Research (2003)

Many different stem cell types have been shown to differentiate into cardiac muscle cells in vitro but P19 embryonal carcinoma (EC) cells were one of the first examples described and have been the most extensively characterized. P19 EC cells, isolated from an experimental embryo-derived teratocarcinoma in mice, are multipotent and can differentiate into cell types of all three germ layers. Because of their capacity to form cardiomyocytes however, they have been used to dissect the role of cardiac-specific transcription factors and upstream signalling pathways in cardiac cell differentiation. Furthermore, they have shed light on unique aspects of cardiac cell physiology during heart cell differentiation, including regulation of the proteins underlying the electrical and contractile systems. Here, we review studies on different subclones of P19 cells, and what they have taught us about cardiac differentiation and physiology.
Who Will Die in the ICU? APACHE II, ROC Curve Analysis, and, of Course, Cleone
Authors: Roy M. Poses
Journal: JAMA (1989)

<h3>To the Editor. —</h3> In a recent article, Kruse and colleagues<sup>1</sup>suggest that the prognostic predictions made by the Acute Physiology and Chronic Health Evaluation II (APACHE II) are no better than those of physicians in training and that therefore this model has little potential to improve clinical decision making for individual patients. They evaluated predictions using ROC curve analysis, which is an excellent method to assess ability to discriminate among patients with different outcomes.<sup>2</sup>However, they did not assess the reliability of the predictions, ie, the agreement between predicted and actual outcome rates. Reliability may not be a useful criterion for evaluating diagnostic tests, since it depends on pretest disease probability and the cutoff for test positivity. However, unless one can meaningfully define pretest disease probability and cutoff criteria for the mental processes people use to make judgments, reliability would seem to be an appropriate paradigm for
Stem cell assays in the evaluation of myelotoxicity
Authors: Aroop Mangalik, William A. Robinson
Journal: Environmental Health Perspectives (1981)

The concept and characteristics of different types of hematopoietic cells have been described. Hematopoietic stem cells are currently considered to exist in a variety of populations with different degrees of commitment towards a particular cell line. By a combination of animal studies and studies with hematopoietic disorders, the concept of dividing hematopoietic stem cells into uncommitted and committed types has emerged in the past several years. Uncommitted stem cells are capable of differentiation, under the proper stimulus, into either of the cell lines of the hematopoietic system. These cells form a resting population of cells with a low mitoitic rate and a long resting (G0) phase. The committed stem cells are partially differentiated and mature only into one type of cell. The committed stem cell population is relatively more active than the population of uncommitted stem cells. A variety of assays both in vivo and in vitro are currently available for the study of different hematopoietic stem cells. These assays are semiquantitative. The number of colonies of mature cells which develop after the infusion or plating of a population of cells containing the stem cells is proportional to the total number of cells infused. A variety of toxic as well as biological substances have been assayed in these systems and a quantitative depression of the number of colonies produced has been noted by a variety of workers. The degree of depression in the number of colonies varies with the agent in use and the type of assay employed. These studies have demonstrated that toxicity of chemicals on the hematopoietic stem cells can be studied with these in vitro and animal studies to give an assessment of their potential toxicity in the intact organism. The recent development of the Dexter two-layer liquid culture system has provided a new impetus to the research on the uncommitted stem cell in a variety of organisms.