tbuckley/cabot-search huggingface dataset:
Maternal Outcome After Open Fetal Surgery
Authors: Michael T. Longaker
Journal: JAMA (1991)

A few fetal diseases may benefit from surgical treatment before birth, but hysterotomy and subsequent delivery by cesarean section pose a risk to the otherwise unaffected mother. To assess maternal risk of mortality, morbidity, and reproductive potential after fetal surgery, we reviewed our experience with 17 highly selected women who underwent fetal surgery. Fifteen of these procedures were performed for one of two congenital anomalies: severe bilateral hydronephrosis and congenital diaphragmatic hernia. There were no deaths or serious maternal injuries. In the 14 women who continued pregnancy after hysterotomy, uterine irritability and preterm labor were frequent complications, requiring early confinement in most cases. There has been no detectable effect on future fertility, as indicated by eight subsequent normal pregnancies. We conclude that hysterotomy for fetal surgery can be accomplished without unduly endangering the mother's life or her future reproductive potential. However, morbidity related to premature labor remains a serious problem, and our ability to control uterine contractions after hysterotomy remains the limiting factor in human fetal surgery.The authors describe their experience with 17 highly selected women who underwent hysterotomy for fetal surgery for complex anomalies and then cesarean delivery through the Fetal Treatment Program at the University of California, San Francisco. Maternal risk of mortality, morbidity, and reproductive potential after fetal surgery were assessed. There were no deaths or serious maternal injuries, although the 14 women who continued their pregnancies experienced uterine irritability and preterm labor followed by premature delivery. Seven of the 17 women had eight subsequent normal pregnancies. The authors conclude from their experience that hysterotomy for fetal surgery can be performed without endangering a woman's life or her future fertility. Uterine irritability and premature labor remain serious problems. The authors believe that now is the time to rigorously examine the efficacy, safety, and cost-effectiveness of fetal therapies before they become accepted treatment.
Correlation between G2m(n) immunoglobulin allotype and human antibody response and susceptibility to polysaccharide encapsulated bacteria.
Authors: D M Ambrosino, G Schiffman, E C Gotschlich, P H Schur, G A Rosenberg, G G DeLange, E van Loghem, G R Siber
Journal: Journal of Clinical Investigation (1985)

To determine whether genetic factors influence the human antibody response to polysaccharides, we correlated Ig allotypes with the concentrations of antibody to 14 bacterial capsular antigens in 130 actively immunized Caucasian adults. The 88 individuals possessing G2m(n), an allotype antigen of IgG2 subclass heavy chains, had significantly higher postimmunization antibody levels to Haemophilus influenzae type b (Hib) and 8 of 11 pneumococcal types (P less than 0.05) than the 42 lacking this antigen. For Hib, pneumococcus type 14, and meningococcus group C, an increased response was observed in IgG class but not in IgM or IgA classes of antibody. The G2m(n) positive individuals also had higher preimmunization antibody levels to most polysaccharide antigens. Total IgG2 concentrations were correlated with the mean postimmunization antibody concentrations to pneumococci (P = 0.005), but this correlation was independent of G2m(n) by multiple regression analysis. To determine if the lack of G2m(n) was associated with increased susceptibility to infection, we compared the frequencies of various Ig allotypes in 98 children infected with Hib and 98 matched controls. Caucasian children with Hib infections other than epiglottitis were significantly more likely to lack the G2m(n) allotype than controls (P less than 0.05). G2m(n) negative Caucasian children less than or equal to 18 mo old have a 5.1-fold higher risk of nonepiglottitic Hib infections than G2m(n) positive children (P less than 0.01). We conclude that allotypic variants of the gamma-2 heavy chain genes, or genes in linkage equilibrium with them, exert a regulatory influence on the caucasian antibody response to a variety of immunologically distinct bacterial polysaccharide antigens. Young Caucasian children of the low responder phenotype, i.e., those lacking the G2m(n) allotype, are genetically predisposed to Hib and perhaps other bacterial infections.
A quantitative analysis of hemodynamic effects of the right ventricle included in the circulation of the Fontan procedure.
Authors: M Nakazawa, H Katayama, Y Imai, K Nojima, T Nakanishi, H Kurosawa, A Takao, H Okuda
Journal: Circulation (1991)

Right heart hemodynamics were analyzed with a catheter-mounted velocity meter in seven patients after direct atrioventricular anastomosis for Fontan procedure (RV group) and were compared with those obtained in eight patients after direct atriopulmonary anastomosis (RA group).In the RV group, cardiac output was 2.7 +/- 0.6 l/min/m2; mean right atrial and pulmonary artery pressures were both 13 +/- 3 mm Hg; mean pulmonary artery wedge pressure was 7 +/- 5 mm Hg; left ventricular end-diastolic volume, determined angiographically, was 129 +/- 40% of normal; and its ejection fraction was 0.50 +/- 0.09. In the RA group, data were similar to those of the RV group except that right heart pressure were lower in the RV group, which was related to the preoperative condition of the pulmonary circulation. In the RV group, the fraction of ventricular forward flow of the total forward flow in the main pulmonary artery ranged from 0.21 to 0.46 and was not correlated with cardiac output or with any other parameter. The backward flow into the inferior vena cava at ventricular systole was greater than the atrial flow in two patients in whom cardiac output was less than 2.2 l/min/m2, whereas caval backward flow at atrial contraction was greater than ventricular flow in the other five patients, of whom four had a cardiac output greater than 3.1 l/min/m2.We conclude that the inclusion of right ventricle in the circulation of the Fontan procedure does not necessarily improve overall hemodynamics in most patients.
709-6 Preoperative Risk Stratification for Geriatric Patients Approaching Vascular Surgery: High Prevalence of Severe Coronary Artery Disease (CAD) Among Patients with Angina or Diabetes Mellitus
Authors: Sumita D. Paul, Norman R. Hertzer, Jess R. Young, Kim A. Eagle
Journal: Journal of the American College of Cardiology (1995)
Surgical Management of Vascular Disease
Authors: D. E. Strandness
Journal: JAMA (1992)

This is a large and very comprehensive text dealing specifically with the problems related to the management of vascular diseases. In the preface, the editors explain that existing texts do not address problems in a manner permitting use not only as practical guides for the treatment of everyday clinical problems but also as reference sources. In addition, the editors have enlisted the help of distinguished authors from all over the world. This does give the reader an international perspective not found in other large texts. However, as I read the contributions, there did not seem to be much in the way of differences of opinion as to how one should approach or treat patients with vascular disease. This undoubtedly reflects a fairly uniform approach to clinical problems by specialty, which is reassuring and indicates how far we have come in understanding the pathophysiology of vascular disease and how it should
HISTOLOGICAL AND SEROLOGICAL SEQUENCES IN EXPERIMENTAL HYPERSENSITIVITY
Authors: Clinton Van Zandt Hawn, Charles A. Janeway
Journal: The Journal of Experimental Medicine (1947)

1. Groups of normal rabbits were given, single intravenous injections of foreign proteins in doses of 1 gm. per kilo, bled at regular intervals for serologic studies, and sacrificed after varying lengths of time for pathological studies. The protein solutions used were of crystallized bovine serum albumin, bovine serum gamma globulin, and bovine serum. The experiments were planned, first, to correlate the sequence of pathological and immunological changes, and second, to compare the responses to two chemically and immunologically distinct plasma protein fractions and to the whole serum of the same species. 2. (a) The principal pathological lesions in rabbits given bovine serum were similar to those which have been previously observed following, the injection of horse serum and were characterized by widely dispersed but segmental acute inflammatory lesions of the arteries. These lesions were at their height 2 weeks after injection and showed marked repair at 4 weeks. (b) Crystallized bovine serum albumin produced lesions almost exclusively confined to the arteries which were at their height at 2 weeks, were healing at 3, and healed by 4 weeks. The lesions were less numerous and less intense than in animals given whole serum and were only found in some of the animals. (c) Bovine serum gamma globulin elicited quite different histologic sequences. The most striking lesions involved the glomeruli of the kidneys, and to a lesser degree, the heart. Lesions in the liver and joints were present but less conspicuous, and arterial lesions were rare and slight in degree. The lesions not only differed from those in rabbits given albumin in distribution but in timing, since they were most widespread and acute at 1 week and were healing at 2 weeks after injection. Moreover, lesions were observed in almost every animal. 3. Results of immunological studies were consistent with the interpretation that the pathological lesions were due to an antigen-antibody reaction in the tissues, as shown by the following: (a) Acute lesions were only observed when antigen was present and before antibody appeared in the circulation. (b) Healing of lesions was only observed (with one exception) when antigen had almost or completely disappeared from the circulation, usually with the appearance of antibody. (c) There was a correlation between the rapidity of evolution of the lesions and the rapidity with which the antigen disappeared from the circulation. (d) There was a rough correlation between the proportion of animals showing lesions and the proportion developing antibodies after the injection of a particular protein solution.
Ultrasound Diagnosis of Pericardial Effusion
Authors: Harvey Feigenbaum
Journal: JAMA (1965)

The differentiation between a large, dilated heart and pericardial effusion is essential but frequently difficult. The clinician must often resort to diagnostic procedures which offer some hazard to the patient. The use of reflected ultrasound was found to be a highly effective and simple method of making this differential diagnosis. In five dogs with artificially produced pericardial effusion it was noted that without pericardial fluid only one ultrasound echo was produced in the vicinity of the posterior heart wall. When fluid was introduced, one detected two echoes, one which moved with cardiac action, the posterior heart wall, and another which moved only with respiration, the pericardium. The space between the two signals represented the pericardial fluid. Subsequent clinical studies confirmed the accuracy, reliability, and simplicity of this diagnostic procedure.
O8.07 * HISTOLOGY, LOCALISATION, TREATMENT AND OUTCOME OF 339 CONSECUTIVE CHILDREN AND ADOLESCENTS WITH LOW GRADE GLIOMAS TREATED AT THE MEDICAL UNIVERSITY OF VIENNA BETWEEN 1993 AND 2012
Authors: I. Slavc, M. Chocholous, A. Woehrer, R. Heumesser, A. Azizi, C. Haberler, A. Peyrl, C. Dorfer, K. Dieckmann, T. Czech
Journal: Neuro-Oncology (2014)

Low grade gliomas (LGG) comprise a spectrum of different tumor entities corresponding to WHO grade I and II, including pilocytic astrocytoma, diffuse glioma and glioneuronal tumors. LGG in children differ in histologic distribution, molecular profile, localisation in the CNS and outcome from LGGs in adults. We report on a series of patients treated at a single center over 20 years. PATIENTS: Between 1993 and 2012, 339 consecutive patients with a median age of 8 years (range 4 months - 18 years, p25 = 3.7 years, p75 = 13.4 years) were treated at the Medical University of Vienna. 19.5% of the patients were <3 years of age at diagnosis. Gender distribution was equal. Tumors were associated with syndromes in 84 of the patients (NF1: n = 64, TSC: n = 17, and other: n = 3). Localisation was supratentorial midline in 112, cerebral hemispheres in 105, posterior fossa in 86, ventricular system in 27 and spinal in 9 patients. 66 patients with a median age of 4.4 years had optic pathway gliomas. RESULTS: Gross total resection was performed in 109, subtotal resection in 49, partial resection in 57, and biopsy in 22 patients. 83 patients had no surgery (patients with NF1, TSC, tectal glioma or tumors confined to the optic nerves and chiasm), and in the remaining the degree of resection was not evaluable. 37 patients had 2 tumor surgeries, 14 three, 5 four and one had 5 tumor surgeries during their course of disease. Histology was pilocytic astrocytoma in 122, pilomyxoid astrocytoma in 10, diffuse astrocytoma in 42, ganglioglioma in 30, subependymal giant cell astrocytoma in 17, oligoastrocytoma in 11, and other rarer histologies in the remaining patients. Twelve patients (3.5%) died and 84 patients (24.8%) had at least one event. After a median follow-up of 107 months (14-300) the 1-year overall survival (OS) was 100%, the 10-year OS 96.1 ± 1.2%, and the 20-year OS 95.3 ± 1.4%. Event-free survival (EFS) after 1 year was 92.9 ± 1.4%, after 10 years 73.8 ± 2.6% and after 20 years 67.9 ± 3.4%. CONCLUSION: While long term survival of children and adolescents with low grade gliomas is better than of adults, recurrence and death may occur even in WHO grade I tumors and regular surveillance MRI is recommended.
Mutations in the activin receptor–like kinase 1 gene in hereditary haemorrhagic telangiectasia type 2
Authors: D.W. Johnson, J.N. Berg, M.A. Baldwin, C.J. Gallione, I. Marondel, S.-J. Yoon, T.T. Stenzel, M. Speer, M.A. Pericak-Vance, A. Diamond, A.E. Guttmacher, C.E. Jackson, L. Attisano, R. Kucherlapati, M.E.M. Porteous, D.A. Marchuk
Journal: Nature Genetics (1996)
HORMONES OF THE ANTERIOR LOBE OF THE PITUITARY GLAND
Authors: E. C. Dodds, R. L. Noble
Journal: BMJ (1936)

<h3>Abstract</h3> <h3>Objectives</h3> The recent COVID-19 pandemic has disrupted mental healthcare delivery, with many services shifting from in- person to remote patient contact. We investigated the impact of the pandemic on the use of remote consultation and on the prescribing of psychiatric medications. <h3>Design and setting</h3> The Clinical Record Interactive Search tool (CRIS) was used to examine de-identified electronic health records (EHRs) of people receiving mental healthcare from the South London and Maudsley (SLaM) NHS Foundation Trust. Data from the period before and after the onset of the pandemic were analysed using linear regression, and visualised using locally estimated scatterplot smoothing (LOESS). <h3>Participants</h3> All patients receiving care from SLaM between 7<sup>th</sup> January 2019 and 20<sup>th</sup> September 2020 (around 37,500 patients per week). <h3>Outcome measures</h3> The number of clinical contacts (in-person, remote or non-attended) with mental healthcare professionals per week Prescribing of antipsychotic and mood stabiliser medications per week <h3>Results</h3> Following the onset of the pandemic, the frequency of in-person contacts was significantly reduced compared to that in the previous year (β coefficient: −5829.6 contacts, 95% CI −6919.5 to −4739.6, p&lt;0.001), while the frequency of remote contacts significantly increased (β coefficient: 3338.5 contacts, 95% CI 3074.4 to 3602.7, p&lt;0.001). Rates of remote consultation were lower in older adults than in working age adults, children and adolescents. Despite this change in the type of patient contact, antipsychotic and mood stabiliser prescribing remained at similar levels. <h3>Conclusions</h3> The COVID-19 pandemic has been associated with a marked increase in remote consultation, particularly among younger patients. However, there was no evidence that this has led to changes in psychiatric prescribing. Nevertheless, further work is needed to ensure that older patients are able to access mental healthcare remotely.
Immunologic response and factors affecting its assessment.
Authors: J A Moore, R E Faith
Journal: Environmental Health Perspectives (1976)

The potential harmful effects of toxic compounds on the developing immune system are discussed. This discussion is illustrated by results of studies of the effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on the developing immune system of Fischer rats. While this compound and several others have been shown to have immunosuppressive effects, the available data do not support routine evaluation of the consequence of chemical exposure to the developing immune system.
Cell–Matrix Contact Prevents Recognition and Damage of Endothelial Cells in States of Heightened Immunity
Authors: Heiko Methe, Elazer R. Edelman
Journal: Circulation (2006)

Autoimmunity may exacerbate vascular disease, particularly in the form of anti-endothelial cell (EC) antibodies. The increased morbidity of cardiovascular diseases in concert with diabetes mellitus, hypertension, and other systemic illnesses may reflect the increase presence and potency of these antibodies. Matrix-embedded ECs act as powerful regulators of vascular repair accompanied by significant reduction in expected systemic and local inflammation. We compared the immune response against free and matrix-embedded ECs in naïve mice and mice with heightened EC immune reactivity.Mice were presensitized to EC with repeated (days 0, 21, 35) subcutaneous injections of saline-suspended porcine EC (PAE) (5 x 10(5) cells). Controls received saline injections. On day 42, mice received 5 x 10(5) matrix-embedded or free PAEs. Circulating PAE-specific antibodies and effector T-cells were analyzed via flow cytometry, and xenoreactive lymphocytes via ELISPOT, 90 days after implantation. PAE-specific antibody-titers, frequency of CD4+-effector cells, and xenoreactive splenocytes were 2- to 4-fold lower (P<0.0001) when naïve mice were injected with matrix-embedded instead of saline-suspended PAEs. Though basal levels of circulating antibodies were significantly elevated after serial PAE injections (2210+/-341 mean fluorescence intensity, day 42) and almost doubled again 90 days after injection of a fourth set of free PAEs, antibody levels declined by half in recipients of matrix-embedded PAEs at day 42 (P<0.0001). Levels of CD4+-effector cells and xenoreactive splenocytes showed similar results.Implantation of free PAE elicits a significant immune response in naïve mice and even more pronounced in mice with predeveloped anti-endothelial immunity. Matrix-embedding protects xenogeneic ECs against immune reaction in naïve mice and to a similar extent in mice with heightened immune reactivity. Matrix-embedded EC might offer a promising approach for treatment of advanced cardiovascular disease.
Not different kinds, just special cases
Authors: David Danks
Journal: Behavioral and Brain Sciences (2010)

Machery's Heterogeneity Hypothesis depends on his argument that no theory of concepts can account for all the extant reliable categorization data. I argue that a single theoretical framework based on graphical models can explain all of the behavioral data to which this argument refers. These different theories of concepts thus (arguably) correspond to different special cases, not different kinds.
The Hormone-Induced Regulation of Contact-Dependent Cell-Cell Communication by Phosphorylation*
Authors: ROBERT B. STAGG, WILLIAM H. FLETCHER
Journal: Endocrine Reviews (1990)

THERE are a number of recent reviews on gap junctions and their ability to mediate contact-dependent cell-to-cell communication (1–11). Each of these articles has its own perspective on the biophysical, biochemical, and physiological roles of cell communication in various tissues and cell types. It is our intent to focus on the established and potential functions of intercellular communication, especially as they apply to endocrine or endocrine-responsive systems, and to correlate this with what is known about the regulation of cell communication. To do this coherently the structure of gap junctions is considered first, after which the concept of intercellular communication is introduced. Then the biochemistry and molecular biology of gap junctions are summarized. Finally, the apparent physiological significance of intercellular communication will be reviewed and related to emerging evidence on the regulation of this dynamic process. Until recently, studies of intercellular communication mainly involved the use of electron microscopy to evaluate morphological changes in gap junctional membranes after various treatments of cells or tissues or they relied on electrophysiological based approaches to examine alterations in cell-cell ionic coupling or fluorescent dye transfer. Because of the extreme technical demands of each of these experimental methods, only rarely were studies combining electron microscopy and electrophysiology performed (12).
Effects of body position, hyperinflation, and blood gas tensions on maximal respiratory pressures in patients with chronic obstructive pulmonary disease.
Authors: Y F Heijdra, P N Dekhuijzen, C L van Herwaarden, H T Folgering
Journal: Thorax (1994)

BACKGROUND--Inspiratory muscle strength in patients with chronic obstructive pulmonary disease (COPD) can be affected by mechanical factors which influence the length of the diaphragm, and by non-mechanical factors. The aim of the present study was to evaluate firstly the effects of body position on respiratory pressures and, secondly, to determine the relative contribution of age, body mass index (BMI), lung volumes, and arterial blood gas tensions to respiratory muscle strength. METHODS--Thirty male patients with stable COPD (mean FEV1 40.4% predicted) participated in the study. Maximal inspiratory and expiratory mouth pressures (PImax, PEmax) and maximal inspiratory transdiaphragmatic pressures (PDI) in the sitting and supine position, lung function, and arterial blood gas tensions were measured. RESULTS--Mean (SD) PImax in the sitting position was higher than in the supine position (7.1(2.3)kPa v 6.4(2.2)kPa respectively). In contrast, PDI in the sitting position was lower than in the supine position (10.0(3.5)kPa v 10.8(3.7)kPa respectively). PEmax was higher in the sitting position (9.3(3.0)kPa) than in the supine position (8.7(2.8)kPa). Significant correlations were found between inspiratory muscle strength on the one hand, and lung function parameters, BMI, and arterial blood gas tensions on the other. CONCLUSIONS--Inspiratory muscle strength in patients with COPD is influenced by mechanical factors (body position, lung volumes) and non-mechanical factors (BMI, FEV1, and blood gases). PImax and PEmax are lower in the supine position while, in contrast to healthy subjects, PDI is higher in the supine position than in the sitting position.