tbuckley/cabot-search huggingface dataset:
Trephine Biopsy for Diffuse Lung Lesions.
Authors: S. J. Steel
Journal: Annals of Internal Medicine (1968)

s1 May 1968Trephine Biopsy for Diffuse Lung Lesions.S. J. Steel, M.R.C.P., D. P. Winstanley, M.R.C.P.S. J. Steel, M.R.C.P.Search for more papers by this author, D. P. Winstanley, M.R.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1186_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the past 5 years 96 lung biopsies have been performed with an air drill rotating at a speed of up to 15,000 rev/min. A specially designed trephine, 2.1 mm in bore, proved effective in obtaining adequate specimens from patients with diffuse lung lesions. With this method 89 out of 96 (93%) consecutive lung biopsies were successful in producing specimens of lung tissue for histological examination, and 81 (84%) of these biopsies were diagnostically significant. Conditions such as sarcoidosis, berylliosis, alveolar proteinosis, polyarteritis nodosa, and chronic diffuse interstitial pulmonary fibrosis were conclusively diagnosed. Complications were not serious, and the commonest... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: S. J. Steel, M.R.C.P.; D. P. Winstanley, M.R.C.P.Affiliations: London, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1186-1187KeywordsBiopsyLesionsLungsProteinsPulmonary fibrosisSarcoidosis ePublished: 1 December 2008 Issue Published: 1 May 1968 PDF downloadLoading ...
Reasoning in Medicine: An Introduction to Clinical Inference
Authors: Kevin Patrick
Journal: JAMA (1989)

<h3>Medical Decision Making, by Harold C. Sox, Jr, Marshal A. Blatt, Michael C. Higgins, et al, 406 pp, with illus, $24.95, Boston, Mass, Butterworths, 1988</h3> . As with many physicians, the seeds of my ability to reason clinically, though sewn during medical school, really only began to sprout in my internship. Through regular exposure to an Oslerian internist legendary in the community for his ability to assimilate clinical information and make appropriate judgments about diagnosis and treatment, I had the opportunity to comprehend in almost unspoken ways what the "art" of medicine was. My guess is that each one of our group of 12 interns took away from that year a somewhat different set of impressions of just exactly how this particular physician arrived at his almost magically insightful conclusions. And in all likelihood we have continued to whatever level of skill we now have with these biased perspectives acting as
Points: Influence of prophylactic photochemotherapy on incidence of relapse of psoriasis cleared initially with dithranol
Authors: P C M van de Kerkhof
Journal: BMJ (1984)

Choosing a practice SIR,-The last section in the paper by Dr Brian Beaumont and Dr Malcolm McCoubrie (10 March, p 761) gives a varied list of "practice progonistic signs," but unfortunately the authors do not state the significance of these qualities.We are a coffee drinking, Christmas party giving practice, devoid of drug firm goodies and with a smoking partner.Our trainee is confused as to whether these signs bode good or ill for the future.
Role of Microtubules in Low Density Lipoprotein Processing by Cultured Cells
Authors: Richard E. Ostlund, Barbara Pfleger, Gustav Schonfeld
Journal: Journal of Clinical Investigation (1979)

The effect of the microtubule inhibitor colchicine on the metabolism of 125I-low density lipoprotein (LDL) by cultured human skin fibroblasts and aortic medial cells was studied in vitro. Colchicine did not alter the binding of LDL to cell surface receptors. However, the rate of LDL endocytosis was reduced to 58% of that expected. Despite diminished endocytosis, LDL was found to accumulate within the cells to 165% of that expected, whereas the release of LDL protein degradation products into the medium was reduced to 34% of control, findings consistent with a reduced rate of intracellular LDL breakdown. Colchicine did not alter cell content of the acid protease which degrades LDL, nor did [3H]colchicine accumulate in lysosomal fractions. However, colchicine did alter the intracellular distribution of both fibroblast lysosomes and endosomes. After colchicine, lysosomes tended to accumulate in the perinuclear region, whereas endosomes were found at the cell periphery. These findings are consistent with the hypothesis that ingested LDL is less available to lysosomal enzymes in the presence of colchicine. The actions of colchicine appear to be a result of destruction of cell microtubules. Lumicolchicine, a mixture of colchicine isomers which (unlike the parent compound) does not bind to the subunit of microtubules, was without effect.
Stress-Response in Male Partners of Women Submitted to in vitro Fertilization and Embryo Transfer
Authors: M. Tarabusi, M.L. Matteo, A. Volpe, F. Facchinetti
Journal: Psychotherapy and Psychosomatics (2000)

In a previous work, we have reported the relationship between women and the outcome of in vitro fertilization and embryo transfer (IVF-ET). The goal of the present work is to evaluate the association between vulnerability to stress and treatment outcome in male partners of couples submitted to IVF-ET.The day of semen collection at the Assisted Reproduction Unit of the Department of Obstetrics and Gynecology, University of Modena, 45 subjects were submitted to Stroop Color Word Conflict, a task measuring the ability to cope with a cognitive stressor, involving the attentional and sympathoadrenal system. Systolic and diastolic blood pressure, as well as heart rate (HR), were measured at baseline, during the test and 10 min after the end of testing. The evidence of pregnancy (betahCG >250 mIU/ml 12 days after ET) is the main outcome measure; the couples were classed in either a 'success' or a 'failure' group.Thirteen couples became pregnant. Pregnancy progressed until term in 6 cases, while 7 cases showed only a preclinical evidence of pregnancy. Age, education, causes and duration of infertility were similar in the success and failure groups. No difference was found in the number and motility of spermatozoa both at baseline and after capacitation (a technique improving sperm motility). Moreover, the success group showed a higher number of both fertilized oocytes and embryos transferred compared with the failure group. The area under the curve of the cardiovascular parameters was calculated. The failure group showed a higher value for HR (50.6 +/- 36.7 of percent total change) than the success group (31.8 +/- 16.9; p = 0.006).The cardiovascular response to stress is a good correlate of success in infertile males submitted to the IVF-ET program.
AMPUTATIONS IN WAR
Authors: NORMAN T. KIRK
Journal: JAMA (1942)

Experiences in World War I demanded an order that no wound should be closed by primary suture. Even with the advent of the sulfonamide derivatives it is not believed that primary suture is safe in extremity surgery under war conditions. This was further proved by reports of infection which followed débridement, the application of sulfanilamide and primary closure of wounds at Pearl Harbor and by reports in the<i>Lancet</i>from experiences on the Libyan front. All wounds closed by primary suture or tightly packed were found grossly infected when the patients arrived at the base in Egypt. Methods of amputation might be classified as follows: The guillotine or open method: circular or flapless type; flap type. The closed type of amputation (amputations at site of election where flaps are fashioned and closed by primary suture). Repair of the guillotine stump: (a) Plastic closure. (b) Plastic resection. (c)
Comparison of On-Demand vs Planned Relaparotomy Strategy in Patients With Severe Peritonitis
Authors: Oddeke van Ruler, Cecilia W. Mahler, Kimberly R. Boer, E. Ascelijn Reuland, Hein G. Gooszen, Brent C. Opmeer, Peter W. de Graaf, Bas Lamme, Michael F. Gerhards, E. Philip Steller, J. W. Olivier van Till, Corianne J. A. M. de Borgie, Dirk J. Gouma, Johannes B. Reitsma, Marja A. Boermeester, for the Dutch Peritonitis Study Group
Journal: JAMA (2007)

In patients with severe secondary peritonitis, there are 2 surgical treatment strategies following an initial emergency laparotomy: planned relaparotomy and relaparotomy only when the patient's condition demands it ("on-demand"). The on-demand strategy may reduce mortality, morbidity, health care utilization, and costs. However, randomized trials have not been performed.To compare patient outcome, health care utilization, and costs of on-demand and planned relaparotomy.Randomized, nonblinded clinical trial at 2 academic and 5 regional teaching hospitals in the Netherlands from November 2001 through February 2005. Patients had severe secondary peritonitis and an Acute Physiology and Chronic Health Evaluation (APACHE-II) score of 11 or greater.Random allocation to on-demand or planned relaparotomy strategy.The primary end point was death and/or peritonitis-related morbidity within a 12-month follow-up period. Secondary end points included health care utilization and costs.A total of 232 patients (116 on-demand and 116 planned) were randomized. One patient in the on-demand group was excluded due to an operative diagnosis of pancreatitis and 3 in each group withdrew or were lost to follow-up. There was no significant difference in primary end point (57% on-demand [n = 64] vs 65% planned [n = 73]; P = .25) or in mortality alone (29% on-demand [n = 32] vs 36% planned [n = 41]; P = .22) or morbidity alone (40% on-demand [n = 32] vs 44% planned [n = 32]; P = .58). A total of 42% of the on-demand patients had a relaparotomy vs 94% of the planned relaparotomy group. A total of 31% of first relaparotomies were negative in the on-demand group vs 66% in the planned group (P <.001). Patients in the on-demand group had shorter median intensive care unit stays (7 vs 11 days; P = .001) and shorter median hospital stays (27 vs 35 days; P = .008). Direct medical costs per patient were reduced by 23% using the on-demand strategy.Patients in the on-demand relaparotomy group did not have a significantly lower rate of death or major peritonitis-related morbidity compared with the planned relaparotomy group but did have a substantial reduction in relaparotomies, health care utilization, and medical costs.http://isrctn.org Identifier: ISRCTN51729393.
Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia
Authors: Brooke K. Coombes, Leanne Bisset, Peter Brooks, Asad Khan, Bill Vicenzino
Journal: JAMA (2013)

Corticosteroid injection and physiotherapy, common treatments for lateral epicondylalgia, are frequently combined in clinical practice. However, evidence on their combined efficacy is lacking.To investigate the effectiveness of corticosteroid injection, multimodal physiotherapy, or both in patients with unilateral lateral epicondylalgia.A 2 × 2 factorial, randomized, injection-blinded, placebo-controlled trial was conducted at a single university research center and 16 primary care settings in Brisbane, Australia. A total of 165 patients aged 18 years or older with unilateral lateral epicondylalgia of longer than 6 weeks' duration were enrolled between July 2008 and May 2010; 1-year follow-up was completed in May 2011.Corticosteroid injection (n = 43), placebo injection (n = 41), corticosteroid injection plus physiotherapy (n = 40), or placebo injection plus physiotherapy (n = 41).The 2 primary outcomes were 1-year global rating of change scores for complete recovery or much improvement and 1-year recurrence (defined as complete recovery or much improvement at 4 or 8 weeks, but not later) analyzed on an intention-to-treat basis (P < .01). Secondary outcomes included complete recovery or much improvement at 4 and 26 weeks.Corticosteroid injection resulted in lower complete recovery or much improvement at 1 year vs placebo injection (83% vs 96%, respectively; relative risk [RR], 0.86 [99% CI, 0.75-0.99]; P = .01) and greater 1-year recurrence (54% vs 12%; RR, 0.23 [99% CI, 0.10-0.51]; P < .001). The physiotherapy and no physiotherapy groups did not differ on 1-year ratings of complete recovery or much improvement (91% vs 88%, respectively; RR, 1.04 [99% CI, 0.90-1.19]; P = .56) or recurrence (29% vs 38%; RR, 1.31 [99% CI, 0.73-2.35]; P = .25). Similar patterns were found at 26 weeks, with lower complete recovery or much improvement after corticosteroid injection vs placebo injection (55% vs 85%, respectively; RR, 0.79 [99% CI, 0.62-0.99]; P < .001) and no difference between the physiotherapy and no physiotherapy groups (71% vs 69%, respectively; RR, 1.22 [99% CI, 0.97-1.53]; P = .84). At 4 weeks, there was a significant interaction between corticosteroid injection and physiotherapy (P = .01), whereby patients receiving the placebo injection plus physiotherapy had greater complete recovery or much improvement vs no physiotherapy (39% vs 10%, respectively; RR, 4.00 [99% CI, 1.07-15.00]; P = .004). However, there was no difference between patients receiving the corticosteroid injection plus physiotherapy vs corticosteroid alone (68% vs 71%, respectively; RR, 0.95 [99% CI, 0.65-1.38]; P = .57).Among patients with chronic unilateral lateral epicondylalgia, the use of corticosteroid injection vs placebo injection resulted in worse clinical outcomes after 1 year, and physiotherapy did not result in any significant differences.anzctr.org Identifier: ACTRN12609000051246.
P232 MOLECULAR PHYLOGENETICS OF HEPATITIS C VIRUS (HCV) AS A TOOL TO UNDERSTAND THE HCV EPIDEMIC IN BRITISH COLUMBIA (BC), CANADA
Authors: A. Olmstead, M. Krajden, V. Montoya, J. Grebely, A.F.Y. Poon, P.R. Harrigan, J.B. Joy
Journal: Journal of Hepatology (2014)
PARANEOPLASTIC MYELOPATHY: ANTIBODIES AGAINST PROTEIN IN NORMAL SPINAL CORD AND UNDERLYING NEOPLASM
Authors: VikenL. Babikian, Kari Stefansson, MichaelE. Dieperink, BarryG.W. Arnason, LindaS. Marton, BarryE. Levy
Journal: The Lancet (1985)
David Lewis Crosby
Authors: B I Rees
Journal: BMJ (2009)

David Lewis Crosby performed the first renal transplant operation in Wales and established the principle of high dependency units in acute medical care.

He was born, bred, educated, and spent most of his professional life in Cardiff. After house jobs in Cardiff, he did his national service with the British Army on the Rhine as medical officer to the 77th Heavy Anti-Aircraft Regiment. David made the most of this time, enjoying the many varied experiences of army medical life and learning German to a standard that often surprised both German patients and visiting medical students.

He was casualty officer in Cardiff Royal Infirmary and registrar in general surgery in Swansea but realised that to improve his opportunities he needed research experience. He applied successfully for a post in the Peter Bent Brigham Hospital, Boston, …
Studies of the mechanism by which 3,5,3'- triiodothyronine stimulates 2-deoxyglucose uptake in rat thymocytes in vitro. Role of calcium and adenosine 3':5'-monophosphate.
Authors: J Segal, S H Ingbar
Journal: Journal of Clinical Investigation (1981)

The present experiments were designed to explore the mechanism whereby 3,5,3'-triiodothyronine (T3) stimulates the uptake of 2-deoxy-D-glucose (2-DG) in rat thymocytes in vitro. Addition of T3 evoked a transient, dose-related increase in cellular cyclic (c) AMP concentrations, evident within 5 min. followed soon by an increase in 2-DG uptake. The effects of T3 on both cAMP concentration and 2-DG uptake were dependent upon the presence of extracellular calcium. Epinephrine also induced a sequential increase in thymocyte cAMP concentration and 2-DG uptake. These responses were more prompt than those to T3, but were calcium independent. As with their combined effects on 2-DG uptake, T3 and epinephrine produced synergistic or additive effects on cellular cAMP concentration. Dibutyryl cAMP also stimulated 2-DG uptake, an effect that was more prompt than that of epinephrine, and like that of epinephrine, was calcium independent. Prior or simultaneous addition of L-alprenolol (10 microM), which, we have previously shown, blocks the effect of both T3 and epinephrine on 2-DG uptake, also blocked the increase in thymocyte cAMP concentration induced by these agents. In contrast, L-alprenolol failed to block the increase in 2-DG uptake produced by dibutyryl cAMP. On the basis of these observations we suggest that T3 increases 2-DC uptake in the rat thymocyte by increasing the cellular concentration of cAMP, which then acts to enhance sugar transport. The increase in 2-DC uptake induced by epinephrine is also mediated by an increase in cAMP concentration. The greater response of cellular cAMP concentration to T3 and epinephrine when added together than to either agent added alone may explain their synergistic action to increase 2-DG uptake. We suggest that these actions of T3 and epinephrine are both initiated at the level of the plasma membrane.
SELF-ASSESSMENT—QUESTION NO. 700
Authors: ROCER H. SMITH
Journal: Annals of Internal Medicine (1969)

Letters and Comments1 September 1969SELF-ASSESSMENT—QUESTION NO. 700ROCER H. SMITHROCER H. SMITHSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-71-3-669 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:The answer to Question #700 of the ACP's series (Ann. Intern. Med. 70: 750, 1969) is incorrect. The report of the Subcommittee of the American Heart Association inCirculation36: 980, 1967, describes the proper technique for recording indirect blood pressure. Correlation of this technique is found in many studies, including that by Freis and Sappington inCirculation38: 1085, 1968. As presented, there does not appear to be a correct answer among the letter-code choices. Moreover, the reference quoted to support the answer does not seem to describe the measurement of blood pressure.... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: MC Cardiology Service Department of the Army Headquarters Tripler Army Medical Center A.P.O. San Francisco, Calif. 96438 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 September 1969Volume 71, Issue 3Page: 669-669KeywordsBlood pressureHeart ePublished: 1 December 2008 Issue Published: 1 September 1969 PDF downloadLoading ...
INTRAMEDULLARY TUMOUR OF SPINAL CORD: TREATMENT BY LAMINECTOMY AND APPLICATION OF RADIUM
Authors: J. M. Clarke, R. G. P. Lansdown
Journal: BMJ (1914)

TiHE following case is; onle of intramedullary tuiimotur lItmbo-sacral region of cord, found irremovable operation, some weelis later treated by placing a tube containing 50riug.radium for twenty-two lhours in tlhe canal, witi the resuLlt of steady and progressive improvement miovement and sensatiotn in tlle previously paralysed limbs, until the onset of an actute cystitis with colti infec- tion wore otut tlhe patient's strengtlh and causedlher deatlh.History.Tlle patient, a single woman aged 26. was by ocecupation a typist, andlhad had no previouLs illness.In May, slhe lhad a curious itching feeling in tlle right tlhigh, followed June by pains inthe rigllt hiip and thigh causinglher limnp.At the -end of Jtune pains in the back, riglt lutmbar region, of sharp, slhooting clharacter came were increased by turning the head.In July tile pains superficial tenderness in the right leg were so severe atat she bandaged it to preventrub;bing with the clothes.From July 14th she could no longer to work, and took to bed for a nmonth.At this time shle couid walk without support.At the end of August clhanged over to the left hip and left the right numb."After further rest in September shle improved, anid pains were less, hut from this timeshle had difficulty great frequency in micturition, with burning pains in the6 bladder.Condition oni Adnission.Shec was senit to Bristol General Hospital by Dr.Mayes on October 11th, and in addition to bladder complained of pains like stitch in the back, stiffness and paiins in the legs, and inability to walk through being uniable to balance."She was in a very nervous state, and had Symptoms tlhyroidisM, evidenced by a symm etrical general nlarge.m ient of thyroid, which was soft, a rapid pulse fine tremor of the hands, and a moist skin; symptoims were present more or less thlroughout illness.
Purification of human lung leukotriene C4 synthase and preparation of a polyclonal antibody.
Authors: J F Penrose, J Spector, B K Lam, D S Friend, K Xu, R M Jack, K F Austen
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Leukotriene (LT) C4 synthase is an integral membrane protein that catalyzes the conjugation of LTA4 to reduced glutathione to form LTC4. LTC4 synthase has been cloned and characterized from transformed cell lines, but the protein has not been defined from a tissue source. LTC4 synthase was purified to homogeneity from human lung tissue, utilizing S-hexyl glutathione chromatography followed by LTC4 affinity chromatography. A greater than 100,000-fold purification with a yield of 8 to 25% (n = 4) was achieved. The purified LTC4 synthase migrated in sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) as an 18-kD protein, and its 19 N-terminal amino acid sequence is identical to that of purified LTC4 synthase from KG-1 myeloid cells or from expression cloning of a KG-1 library in COS cells. Using a rabbit polyclonal IgG raised against purified LTC4 synthase, SDS-PAGE immunoblotting of LTC4 synthase from human lung tissue, eosinophils, KG-1 cells, and platelets showed an 18-kD protein. Immunofluorescence staining of alveolar macrophages in human lung sections with the anti-LTC4 synthase IgG revealed LTC4 synthase to be largely perinuclear in distribution. Thus, LTC4 synthase, the biosynthetic enzyme responsible for the formation of cysteinyl LTs, is present in lung tissue in a form apparently identical to that of hematopoietic cells.
Treatment of Sickle Crisis
Authors: J. F. Desforges
Journal: New England Journal of Medicine (1971)

For over 20 years, the pathogenesis of sickling and of its clinical manifestations has intrigued hematologists and molecular biologists. A series of observations has unraveled some of the mystery of the sickling phenomenon. The substitution of valine for glutamic acid in the beta chain of S hemoglobin alters the structure of the molecule in such a way that, in the reduced state, the molecules stack up in parallel or helical arrangement to form the semicrystalline structure, or tactoid, first described by Harris.1 , 2 According to Murayama, this stacking takes place because the substituted valine alters the tertiary structure by forming a . . .
IGF-Binding Protein-1 Levels Are Related to Insulin-Mediated Glucose Disposal and Are a Potential Serum Marker of Insulin Resistance
Authors: Betty A. Maddux, Adelene Chan, Lawrence J. Mandarino, Ira D. Goldfine, Elena A. De Filippis
Journal: Diabetes Care (2006)

OBJECTIVE—IGF-binding protein (IGFBP)-1 is negatively regulated by insulin. We determined whether the measurement of IGFBP-1 in serum is a useful marker of insulin resistance. RESEARCH DESIGN AND METHODS—Twenty-three subjects underwent a euglycemic insulin clamp. Glucose disposal rates (M) were then correlated with measurements of IGFBP-1, fasting insulin levels, homeostasis model assessment (HOMA), and BMI. RESULTS—IGFBP-1 levels more strongly correlated with M (R = 0.73) than the other parameters such as BMI or HOMA. The level of this protein decreased in individuals who became more insulin sensitive by exercise training. CONCLUSIONS—These studies show a strong correlation between insulin sensitivity and the serum levels of IGFBP-1. These studies suggest, therefore, that measurement of this protein may be valuable in identifying those individuals with insulin resistance and those individuals who respond to interventional strategies.