tbuckley/cabot-search huggingface dataset:
Lesson of the week: Blunt orbital trauma
Authors: S B Holmes
Journal: BMJ (2000)

All blunt orbital trauma, regardless of severity, should be thoroughly investigated 

Orbital trauma is common and patients present to a variety of healthcare professionals depending on the type of injury. Clinical examination may reveal gross problems such as diplopia and enophthalmos, which may require radiological confirmation.

Most orbital injuries are minor and are managed conservatively. The consequences of an overlooked injury can have profound consequences, with persistent enophthalmos, diplopia, and orbital sepsis representing major morbidity when diagnosis and treatment are delayed.1 The incidence of isolated blow out fractures of the orbit is unknown. We identified 10 patients with such fractures from 170 patients with bony orbital injuries referred to our department over 20 months. We describe one of those patients.

A 13 year old boy was playing football with his friend when the ball was kicked into a neighbour's garden. They argued about who was to retrieve the ball, and the friend playfully punched the boy on the left orbit. Despite initial discomfort, he carried on playing.

Overnight the boy had minimal periorbital swelling, and the following morning he attended school as usual. He had been selected for the school basketball team but while …
THE MECHANISM RESPONSIBLE FOR THE HYPERCHOLESTEREMIA INDUCED BY TRITON WR-1339
Authors: Meyer Friedman, Sanford O. Byers
Journal: The Journal of Experimental Medicine (1953)

Injection of triton WR-1339 into rats leads to a rapid increase in the cholesterol, cholate, and various lipid fractions of their blood. The increase in cholesterol is confined to the blood itself. The cholesteremic effect of triton was not dependent upon a prior accumulation of cholate in plasma. The liver was found to be the source of the excess cholesterol but the rate of cholesterol synthesis, the excretion of cholate, and the cholesterol content of the liver were not changed by injection of triton. The cholesteremic effect of triton is not due to alteration in the intestinal excretion of cholesterol. Transfer of blood between "tritonized" and normal rats leads to a disappearance of the hypercholesteremia in the former and its appearance in the latter animals. The plasma proteins of rats injected with triton are markedly changed qualitatively. Heparin was found to inhibit the hypercholesteremic effect of triton. The hypercholesteremia following triton injection appears to be due to a fundamental physicochemical change in the plasma proteins produced by injection of this detergent.
SPONTANEOUS RUPTURE OF THE HEART WITH CONGENITAL SOLITARY KIDNEY
Authors: Magnus C. Petersen
Journal: JAMA (1927)

L. C., a married woman, aged 60, a nullipara, was a patient in the St. Peter State Hospital for seven years, being admitted, Feb. 17, 1920. On admission the physical examination revealed nothing abnormal except a slight increase in temperature which subsided in the course of a few days. Urinalysis showed a specific gravity of 1.035, a slight trace of albumin, and many pus cells. The blood Wassermann reaction was negative. She had many poorly systematized delusions of persecution and auditory hallucinations, to which she responded actively. During the stay in the hospital she was in good physical condition. Occasionally she would become very profane and threatening, but she was quiet the two weeks preceding death. On the forenoon of July 16, 1927, she was feeling well and joked with the other patients while, bathing. When stepping out from under the shower she suddenly fell forward, gasping for breath. She became cyanosed and lost
Comment on: Olsson et al. High Levels of Education Are Associated With an Increased Risk of Latent Autoimmune Diabetes in Adults: Results From the Nord-Trøndelag Health Study. Diabetes Care 2011;34:102–107
Authors: Peter T. Sawicki, Hilda Bastian
Journal: Diabetes Care (2011)

Olsson et al. (1) describe an association between high levels of education and an increased risk of autoimmune diabetes in adults. They propose “the hygiene hypothesis” as an explanation for their results indicating that childhood environment and a low prevalence of childhood infections might contribute to the evolution of autoimmune diabetes. We would like to draw the attention to …
Methylmercury Contamination of Laboratory Animal Diets
Authors: Bernard Weiss, Sander Stern, Elsa Cernichiari, Robert Gelein
Journal: Environmental Health Perspectives (2005)

In the midst of research focusing on the neurodevelopmental effects of mercury vapor in rats, we detected significant levels of mercury (30-60 ng/g) in the blood of nonexposed control subjects. We determined that the dominant form of the mercury was organic and that the standard laboratory chow we used in our vivarium was the source of the contamination. The dietary levels were deemed of potential biologic significance, even though they might have fallen below the limits of measurement specified by the supplier. All investigators employing animals in research must assess such potential contamination because dietary agents may alter a) conclusions based on intentionally administered doses, b) outcomes by interacting with other agents that are the primary focus of the research, and c) outcomes of research unrelated to the toxic effects of experimentally administered agents.
Effects of long-term ursodeoxycholate administration on expression levels of secretory low-molecular-weight phospholipases A and mucin genes in gallbladders and biliary composition in patients with multiple cholesterol stones
Authors: Masahito Kano, Junichi Shoda, Tatsuro Irimura, Tetsuya Ueda, Ryu Iwasaki, Tetsuya Urasaki, Yasushi Kawauchi, Toru Asano, Yasushi Matsuzaki, Naomi Tanaka
Journal: Hepatology (1998)

Group IIA phospholipase A2 (PLA2), a secretory low-molecular-weight PLA2, may play a critical role in the process of gallbladder mucosal inflammation in multiple cholesterol stones, which in turn may produce biliary pronucleating proteins as well as mucin. On the other hand, ursodeoxycholate (UDC) decreases biliary levels of various pronucleating proteins, possibly because of its membrane-protective effects on the inflamed gallbladder mucosa. To elucidate that beneficial effect of UDC, the expression levels of low-molecular-weight PLA2s, group IIA PLA2 (PLA2-IIA), and group V PLA2 (PLA2-V), and mucin core polypeptide genes in the gallbladders were studied for UDC-treated patients and untreated patients with multiple cholesterol stones. Furthermore, the results were correlated with alterations in biliary composition. With long-term administration of UDC, the PLA2-IIA protein mass (2.7 +/- 0.5 vs. 5.0 +/- 0.4 ng/mg x protein [mean +/- SEM]; P < .01) and steady-state mRNA level, as well as the PLA2-V mRNA level, were significantly decreased in the gallbladders, where the prostaglandin E2 (PGE2) level was concomitantly decreased (190.7 +/- 27.9 vs. 393.6 +/- 55.3 pg/mg x protein; P < .01). In the gallbladder bile, the immunoradiometrically determined PLA2-IIA levels were significantly decreased in the UDC-treated patients (43 +/- 4 ng/dL; P < .01) in comparison with untreated patients (78 +/- 6 ng/dL). Significant decreases were similarly found for total protein, mucin, and free arachidonate concentrations, as well as nucleation activity in the bile. The degree of the changes was found to be rather small in solitary stones. In contrast to the decreased mucin concentration, however, there were no significant changes in the expression levels of mucin core polypeptide genes (MUC1-MUC6) between the UDC-treated and untreated patients. Long-term UDC administration was observed to lower the increased PLA2-IIA protein mass and mRNA level, as well as the PLA2-V mRNA level, in the gallbladders of patients with multiple cholesterol stones, which in turn may be of therapeutic importance in improving the gallbladder mucosal inflammation. Effects of UDC on secretory low-molecular-weight PLA2s as inflammatory mediators may relate to the reported efficacy of UDC treatment in cholesterol gallstone disease.
Do oral corticosteroids reduce the severity of acute lower respiratory tract illnesses in preschool children with recurrent wheezing?
Authors: Avraham Beigelman, Tonya S. King, David Mauger, Robert S. Zeiger, Robert C. Strunk, H. William Kelly, Fernando D. Martinez, Robert F. Lemanske, Katherine Rivera-Spoljaric, Daniel J. Jackson, Theresa Guilbert, Ronina Covar, Leonard B. Bacharier
Journal: Journal of Allergy and Clinical Immunology (2013)
Abstract 5577: The role of age-related enhancements of IL-17 in prostate cancer initiation and progression
Authors: Alejandra De Angulo, Robert Faris, David Cavazos, Christopher Jolly, Linda A. deGraffenried
Journal: Cancer Research (2011)

Abstract Background: Age is the single greatest risk factor for prostate cancer development. As men pass age 40, their chance of developing prostate cancer increases exponentially each year. The mechanism by which age influences the risk of prostate cancer remains largely unknown, hindering the development of effective preventive approaches. While local events are known to contribute to age-related prostate tumorigenesis, the role of the aging immune system in prostate cancer development has been largely understudied. The aging process affects the adaptive cell-mediated immune response and at the same time there is a shift to a more inflammatory cytokine profile. Recent studies have shown that age-related enhancements of Th17 might contribute to changes in immune function and prostate cancer development. The age-related shift in T-lymphocyte cytokine profile and the enhancement of TH17 generation might be significant contributing factors to the association between age and prostate tumorigenesis. Methods: For our studies we have been using a unique animal model, the glycerol-3-phosphate acyltransferase-1 (GPAT-1) knock out mouse. The GPAT-1 KO young mouse T lymphocyte phenotype mimics old (&amp;gt; 18 m) wild type mice. Preliminary data suggested that cytokines secreted from the GPAT-KO aging mimic T-lymphocytes can promote activation of the STAT3/NF-kB pathways. In order to test if IL-17 was responsible for the strong induction of NF-kB and STAT3, we repeated previous experiments that measured the activation of NF-kB and STAT3, but supplemented the experimental sera and conditioned media with depleting antibodies to IL-17. Successful inhibition of the NF-kB and STAT3 pathways was assessed by Western Blot analysis. Conclusions: Depleting IL-17 in the GPAT-1 KO sera and conditioned media decreased NF-kB activity to the levels of the cells treated with wild-type sera. Sera from the old and GPAT-1 KO mice induced activation of downstream targets of IL-17. These results suggest that circulating factors from the GPAT-1 KO mice mimic those in aging mice and strongly induced signaling pathways involve in the development of prostate cancer. The age-related enhancements of IL-17 may play a key role in prostate cancer initiation and progression. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5577. doi:10.1158/1538-7445.AM2011-5577
PNEUMONIA SIMULATING SINUS THROMBOSIS
Authors: JEROME F. STRAUSS
Journal: JAMA (1926)

Reminiscent of the somewhat obsolete caution in the diagnosis of surgical appendicitis and its differentiation from a type of lobar pneumonia are the analogous situations arising as a personal experience with disconcerting frequency during the grip epidemic in Chicago, in the spring of 1925. I am well aware that this experience is only that of well marked clinical coincidence, and that in recording these notes nothing unusual in the component parts of the cases cited will be noted. The fact, however, that in each of the instances to be reported the patient was referred to me by men of broad medical experience as serious otologic cases requiring immediate and radical surgery prompts me to publish these abbreviated case histories as a contribution to the differential diagnosis of thrombosis of the lateral sinus, and as the possible prevention of serious error in the choice of procedure when this particular clinical picture
Impaired autophagy: A mechanism of mitochondrial dysfunction in anoxic rat hepatocytes
Authors: Jae-Sung Kim, Takashi Nitta, Dagmara Mohuczy, Kerri A. O'Malley, Lyle L. Moldawer, William A. Dunn, Kevin E. Behrns
Journal: Hepatology (2008)

Autophagy selectively removes abnormal or damaged organelles such as dysfunctional mitochondria. The mitochondrial permeability transition (MPT) is a marker of impaired mitochondrial function that is evident in hepatic ischemia/reperfusion (I/R) injury. However, the relationship between mitochondrial dysfunction and autophagy in I/R injury is unknown. Cultured rat hepatocytes and mouse livers were exposed to anoxia/reoxygenation (A/R) and I/R, respectively. Expression of autophagy-related protein 7 (Atg7), Beclin-1, and Atg12, autophagy regulatory proteins, was analyzed by western blots. Some hepatocytes were incubated with calpain 2 inhibitors or infected with adenoviruses encoding green fluorescent protein (control), Atg7, and Beclin-1 to augment autophagy. To induce nutrient depletion, a condition stimulating autophagy, hepatocytes were incubated in an amino acid–free and serum-free medium for 3 hours prior to onset of anoxia. For confocal imaging, hepatocytes were coloaded with calcein and tetramethylrhodamine methyl ester to visualize onset of the MPT and mitochondrial depolarization, respectively. To further examine autophagy, hepatocytes were infected with an adenovirus expressing green fluorescent protein–microtubule-associated protein light chain 3 (GFP-LC3) and subjected to A/R. Calpain activity was fluorometrically determined with succinyl-Leu-Leu-Val-Tyr-7-amino-4-methylcoumarin. A/R markedly decreased Atg7 and Beclin-1 concomitantly with a progressive increase in calpain activity. I/R of livers also decreased both proteins. However, inhibition of calpain isoform 2, adenoviral overexpression, and nutrient depletion all substantially suppressed A/R-induced loss of autophagy proteins, prevented onset of the MPT, and decreased cell death after reoxygenation. Confocal imaging of GFP-LC3 confirmed A/R-induced depletion of autophagosomes, which was reversed by nutrient depletion and adenoviral overexpression. Conclusion: Calpain 2–mediated degradation of Atg7 and Beclin-1 impairs mitochondrial autophagy, and this subsequently leads to MPT-dependent hepatocyte death after A/R.
Sirt3 blocks the cardiac hypertrophic response by augmenting Foxo3a-dependent antioxidant defense mechanisms in mice
Authors: Nagalingam R. Sundaresan, Madhu Gupta, Gene Kim, Senthilkumar B. Rajamohan, Ayman Isbatan, Mahesh P. Gupta
Journal: Journal of Clinical Investigation (2009)

Sirtuin 3 (SIRT3) is a member of the sirtuin family of proteins that promote longevity in many organisms. Increased expression of SIRT3 has been linked to an extended life span in humans. Here, we have shown that Sirt3 protects the mouse heart by blocking the cardiac hypertrophic response. Although Sirt3-deficient mice appeared to have normal activity, they showed signs of cardiac hypertrophy and interstitial fibrosis at 8 weeks of age. Application of hypertrophic stimuli to these mice produced a severe cardiac hypertrophic response, whereas Sirt3-expressing Tg mice were protected from similar stimuli. In primary cultures of cardiomyocytes, Sirt3 blocked cardiac hypertrophy by activating the forkhead box O3a–dependent (Foxo3a-dependent), antioxidant–encoding genes manganese superoxide dismutase (MnSOD) and catalase (Cat), thereby decreasing cellular levels of ROS. Reduced ROS levels suppressed Ras activation and downstream signaling through the MAPK/ERK and PI3K/Akt pathways. This resulted in repressed activity of transcription factors, specifically GATA4 and NFAT, and translation factors, specifically eukaryotic initiation factor 4E (elf4E) and S6 ribosomal protein (S6P), which are involved in the development of cardiac hypertrophy. These results demonstrate that SIRT3 is an endogenous negative regulator of cardiac hypertrophy, which protects hearts by suppressing cellular levels of ROS.
Learner-Centered Medical Education
Authors: Kenneth M. Ludmerer
Journal: New England Journal of Medicine (2004)

Medical students occupy a curious position in the history of the American medical school. Before World War II, the education of medical students was the central mission of medical schools, and undergraduate medical education remains their one unique mission. Yet after World War II, as medical faculties expanded their activities in graduate-level teaching, research, and patient care, the education of medical students became no more than a byproduct of the operation of academic health centers.1 The diminishing visibility of the medical student is not in itself harmful for medical education, provided that faculties take students and teaching seriously. However, from . . .
PENETRATING WOUND OF CHEST: THORACOTOMY: SUTURE OF PERICARDIUM
Authors: J. B. Haycraft
Journal: BMJ (1920)

the uiterus niineteen times during early pregnancy, does-not irecord a case of conservative Caesarean section.My five cases are given in Table B. In all of them contractions of the pelvis and the presence of fibtoids were the inidications for the operation.The five chiildren sur- vived; one motlher die(d owing to nmv failure to discover tlie infection of tlle tuim-nour.The case slhould lhave been treatedl by total abdomiinal lyvsterectomiiy.Ca68area;7:7 Section followved by Abdominal Hyltsterectomny.Landau performued the operation in twvo cases onilv; the mothers and onie clhild recovered; of the otlher child it was stated tllat it was a wvell-developed boy, but wlhetlher it survived or not is not m-entioned.My six cases are givenl in Table C.All the mothers recovered, and all the chiildren survived except one, which was dead before the operation was performed.Total hysterectomy, which was performed in five of the cases, is, in my opinion, preferable to amputatioIl in preg- nant as in non-pregnant cases, especially as it provides drainage anid repaoves the possibly infected cervix.Troell gives a! list of twenty cases (iucluding two of mine) operated on siu&e 1900, with two deaths.I am able to add three: more cases (Table C, Nos. 4 5, 6;), making twenty.thlree cases with two deatls.aIn the..p?t:periumn vaginal myomectomy is usually the best treatmenit for subumucous tumours even when tlley are infected or invert the utetus.It sliould usually be tried before resortinig to hysterectomy, which I have never found to be necessary.In infected subperitoneal or intiamjural tumours total abdominaL hysterectomy should be performned.
Hugh John Adolphus Coni
Authors: N. Coni, A. Douglas
Journal: BMJ (2008)

Hugh Coni was born in 1967 and educated at Charing Cross and Westminster Medical School, where he qualified in 1990. Halfway into his first house job, the backache which had plagued him since the age of 17 declared its hand when he developed acute retention on holiday in Florence, and he was found to have a pre-sacral Ewing’s sarcoma. Following chemotherapy and intensive radiotherapy, he resumed his career, doing house jobs in Norwich and …
MATHEMATICS AND MEDICINE
Authors: Levering Tyson
Journal: JAMA (1924)

<h3>To the Editor:</h3> —One of the students in the Home Study Department at Columbia, who is a practicing physician and who is taking one of our courses in mathematics, sent us a clipping from your issue of September 27, evidently an editorial, entitled "Medicine and Mathematics." This has interested us very much for the simple reason that this department at Columbia was organized primarily for service to individuals who wish to study certain subjects but who cannot conform to the demands of a formal academic curriculum. Busy professional men, such as physicians, might find the University Home Study course in mathematics exceedingly useful, and it occurred to me that perhaps some of your readers would be glad to know that Columbia University conducts a series of mathematics courses which can be used by the busy professional man in his spare moments.
Critical Care of the Cancer Patient
Authors: Joseph J. Bander
Journal: JAMA (1985)

Cancer, once a cause for social embarrassment, is now a socially acceptable disease. Cancer, along with its complications, once a condition that precluded admission to an intensive care unit, is now a leading cause of problems necessitating intensive care.<i>Critical Care of the Cancer Patient</i>, with contributions by specialists and subspecialists from Memorial Sloan-Kettering, one of the nation's premier cancer centers, arrives on the scene in a timely fashion. Many of the problems covered in this text are common to all patients in intensive care, but there is specific emphasis on failures of organ systems resulting from or directly related to cancer and its therapy. As with any multiauthored text, there is substantial variability, although the editors have successfully limited much duplicative discussion. The section on the complications of chemotherapy is remarkably brief, providing but an overview of agents and modalities of therapy. More detail, however, is provided in subsequent
Grinker's Neurology
Authors: G. R. Haase
Journal: JAMA (1977)

<i>Grinker's Neurology</i>has been one of a small group of well-esteemed neurological textbooks since it was first published in 1934. The present seventh edition has been edited and in good measure rewritten by Dr Nicholas Vick. The gratitude Dr Vick expresses to his wife for her patience is well deserved—a task of this order must have taken much of Dr Vick's time. A few vital statistics: the book has 1,086 pages, including a bibliography and an extensive index of 60 pages. There are nearly 400 illustrations as well as a small number of tables. The typesetting and book cover are pleasant. The weight of the book—more than 2 kg—precludes bedtime reading, and the price will unfortunately preclude personal ownership for many. The outline of the work follows certain conventions: an extensive first chapter introduces the neurological examination in which the reader is told how to perform the individual steps involved
Intestinal mucosal alterations in rats with carbon tetrachloride-induced cirrhosis: Changes in glycosylation and luminal bacteria
Authors: Sathish Kumar Natarajan, Prabhu Ramamoorthy, Simmy Thomas, Jayasree Basivireddy, Gagandeep Kang, Anup Ramachandran, Anna B Pulimood, K.A. Balasubramanian
Journal: Hepatology (2006)

Spontaneous bacterial peritonitis is a major cause of mortality after liver cirrhosis. Altered permeability of the mucosa and deficiencies in host immune defenses through bacterial translocation from the intestine due to intestinal bacterial overgrowth have been implicated in the development of this complication. Molecular mechanisms underlying the process are not well known. In order to understand mechanisms involved in translocation of bacteria, this study explored the role of oxidative stress in mediating changes in intestinal mucosal glycosylation and luminal bacterial content during cirrhosis. CCl4-induced cirrhosis in rats led to prolonged oxidative stress in the intestine, accompanied by increased sugar content of both intestinal brush border and surfactant layers. This was accompanied by changes in bacterial flora in the gut, which showed increased hydrophobicity and adherence to the mucosa. Inhibition of xanthine oxidase using sodium tungstate or antioxidant supplementation using vitamin E reversed the oxidative stress, changes in brush border membrane sugar content, and bacterial adherence. In conclusion, oxidative stress in the intestine during cirrhosis alters mucosal glycosylation, accompanied by an increased hydrophobicity of luminal bacteria, enabling increased bacterial adherence onto epithelial cells. This might facilitate translocation across the mucosa, resulting in complications such as spontaneous bacterial peritonitis. (HEPATOLOGY 2006;43:837–846.)