tbuckley/cabot-search huggingface dataset:
Lectures on Some Important Points in Connection with the Surgery of the Urinary Organs
Authors: H. Thompson
Journal: BMJ (1884)

tetanus, for a short time iniduces so much contracture onl undrugged muscle that, after discontinuing stimulation, the muscle remains con- siderably contracted, and the trace much above the line of repose for half an hour or even longer.Sodium-biesrbonate makes the muscle too like the muscle of tlle snail (Richet, loc.cit.) and the muscles of the forceps of the cray-fish, which, after a single excitation, relax very slowly.The p ' S Explanetion of Fig. 5.-Sodium-bicarbonate solution given as described in text.A. Contraction with break-shocks, the coil standing at 20 and 15.B. A con- traction excited with the coil at 0. Muscle of a snail, according to Richet, occupies an hour in becoming fully extended, and for the trace to recover its original position to the base-line; and he has seen fibrillary contractions in the snail- muscle follow a single excitation.Richet points out that the " secondary waves" and the contracture are not due to exhaustion, though any circumstance that causes exhaustion delays somewhat both contraction and relaxation.He finds it difficult to induce contracture in a fatigued muscle.My experiments show that the fibrillary contractions with delayed relaxation in both normal muscle, and muscles treated with sodium- bicarbonate, are not the result of fatigue nor of exhaustion ; that ex- haustion, indeed, induced by repeated excitations, soon obviates fibrillary contractions, and hastens the relaxation.For instance, in normal muscle, and in muscles under sodium-bicarbonate, the induction of contractions, especially with a strong excitation, diminishes, and at last extinguishes, the fibrillary contractions, and the delay in dilatation.And further, I many times destroyed the brain of a frog, and tied the heart ; and, after severalVdays' interval, when muscular contractility became very weak, I took muscle-tracings, but stimulation failed-to produce either fibrillary twitchings or delay in dilatation, or only to a scarcely appreciable extent.Many animals, as the rabbit, have two kinds of muscles, white muscles acting quickly, red muscles contracting and dilating more slowly.Sodium-bicarbonate then reduces the rate of quick acting mutscles to the level of red, slow acting muscles.Richet finds that the muscle of the tail of the cray-fislh contracts quickly, the muscle of the claw slowly.Sodium-bicai-bonate affects muscle just like veratria.Both agents produce fibrillary contractions ; both cause delay in tie muscular re-
The Broader View of Medical Ethics
Authors: Vernon H. Mark
Journal: JAMA (1979)

To the Editor.—  Mr Cousins' view of medical ethics is intriguing and even compelling, but I wonder if it automatically invests the doctor with undeserved wisdom. Of course, any  is free to influence any aspect of public life or policy as long as he does so in the role of a private citizen, but when he uses the mantle of physician to give his views special authority, especially as a moral or ethical champion, he may be misleading the public. Our country is full of self-anointed prophets, all too ready to advise the public on matters of national policy, international politics, and philosophical and religious matters. There is nothing in the standard medical curriculum that gives physicians a special insight into philosophy, religion, economics, or international politics. If he steps outside of the medical arena to argue such matters of public policy or national defense, he should not drag
Abstract 5529: Imaging and therapy with rituximab anti-CD20 immunotherapy in an animal model of central nervous system lymphoma
Authors: Leslie L. Muldoon, Seth J. Lewin, Edit Dosa, Michael A. Pagel, Nancy D. Doolittle, Edward A. Neuwelt
Journal: Cancer Research (2011)

Abstract Purpose: To evaluate monoclonal antibody (mAb) delivery, tumor volumetrics on magnetic resonance imaging (MRI), and efficacy in a rat model of central nervous system (CNS) lymphoma when delivery of rituximab and/or methotrexate to the brain was optimized with osmotic blood-brain barrier disruption (BBBD). Experimental Design: Female nude rats with intracerebral human MC116 B-cell lymphoma xenografts underwent baseline MRI and were randomized into five groups (n = 6/group): 1) BBBD saline control; 2) methotrexate with BBBD; 3) rituximab with BBBD; 4) rituximab and methotrexate with BBBD; and 5) intravenous rituximab. Tumor volumes were assessed by MRI at 1 week and rats were followed for survival. Results: BBBD increased delivery of 90Y-radiolabeled mAb in the CNS lymphoma model. Control rats showed 201 +/- 102% increase in tumor volume on MRI 1 week after entering the study and median 14 day survival (range 6-33). Tumor growth on MRI was slowed in the methotrexate treatment group, but survival time (median 7 days, range 5-12) was not different from controls. Among 17 evaluable rats treated with rituximab, 10 showed decreased tumor volume on MRI. All rituximab groups had increased survival compared to control, with a combined median of 43 days (range 20-60, P&amp;lt;0.001). There were no differences by route of delivery or combination with methotrexate. Conclusions: Rituximab was effective at decreasing tumor volume and improving survival in a CNS lymphoma model, and was not affected by combination with methotrexate or by BBBD. We suggest that rituximab warrants further study in human primary CNS lymphoma. 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 5529. doi:10.1158/1538-7445.AM2011-5529
Reply from Authors re: R. Houston Thompson. Partial Versus Radical Nephrectomy: The Debate Regarding Renal Function Ends While the Survival Controversy Continues. Eur Urol 2014;65:378–9
Authors: Emil Scosyrev, Edward M. Messing, Richard Sylvester, Steven Campbell, Hendrik Van Poppel
Journal: European Urology (2013)
Abstract 5364: Correlation of immune responses and overall survival in a phase II study of belagenpumatucel-L, an allogeneic tumor cell vaccine, in non-small cell lung cancer (NSCLC)
Authors: Daniel L. Shawler, Alex Tong, Lily Liu, Ewa Carrier, Charles S. Davis, John Nemunaitis, Habib Fakhrai
Journal: Cancer Research (2012)

Abstract This study examines the correlative/predictive value of cellular- and humoral-mediated immune response on the clinical responsiveness of patients who received belagenpumatucel-L, a therapeutic vaccine comprised of 4 TGF-β2 antisense gene-modified allogeneic non-small cell lung cancer (NSCLC) cell lines in a phase II clinical trial in which subjects with stage III/IV NSCLC received intradermal injections of the vaccine every 4-8 weeks. We performed assays of cellular (ELISPOT) and humoral (antibody ELISA) immunity on 36 subjects in the trial and correlated these data with the long term assessment of overall survival. All but one subject in the study showed an increase in immune reactivity in at least one of the cellular or humoral assays. Eleven subjects who demonstrated an aggregate increase in both cellular and humoral immune reactivity (positive by three of four criteria tested) had a median survival of 32.5 months (95% CI, 25.2 to 39.8). This was significantly better than the median survival of only 11.6 months (95% CI, 5.6 to 17.6) for the 25 subjects who showed an increase in one or none of the measured immune parameters (p=0.015, log-rank test). The demonstration of a statistically significant correlation between cellular and humoral immune responses and overall survival in subjects treated with belagenpumatucel-L suggest that both compartments of the immune system likely impact the clinical response and are important for the induction of clinically significant antitumor immunity by the vaccine. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5364. doi:1538-7445.AM2012-5364
Late diagnosis of frontal meningiomas presenting with psychiatric symptoms
Authors: R S Maurice-Williams, G Dunwoody
Journal: BMJ (1988)

A propos de 2 observations. Des troubles psychiques chez un adulte jeune jusque-la en bonne sante peuvent etre dus a une tumeur benigne (meningiome) du lobe frontal. Les cephalees, l'œdeme papillaire et les signes neurologiques focaux peuvent n'apparaitre qu'apres des mois ou des annees
Carbohydrate Intolerance and Lipemia
Authors: EDWIN L. BIERMAN
Journal: Annals of Internal Medicine (1968)

The association between carbohydrate intolerance and lipemic disorders has been described and a pathophysiological classification developed. There appears to be little evidence for a cause-and-effect relation between carbohydrate intolerance and endogenous lipemia (hypertriglyceridemia). One factor common to both, adiposity, may contribute to their frequent coexistence.
HLA-restricted, processing- and metabolism-independent pathway of drug recognition by human alpha beta T lymphocytes.
Authors: M P Zanni, S von Greyerz, B Schnyder, K A Brander, K Frutig, Y Hari, S Valitutti, W J Pichler
Journal: Journal of Clinical Investigation (1998)

T cell recognition of drugs is explained by the hapten-carrier model, implying covalent binding of chemically reactive drugs to carrier proteins. However, most drugs are nonreactive and their recognition by T cells is unclear. We generated T cell clones from allergic individuals specific to sulfamethoxazole, lidocaine (nonreactive drugs), and cef-triaxone (per se reactive beta-lactam antibiotic) and compared the increase of intracellular free calcium concentration ([Ca2+]i) and the kinetics of T cell receptor (TCR) downregulation of these clones by drug-specific stimulations. All drugs tested induced an MHC-restricted, dose- and antigen-presenting cell (APC)-dependent TCR downregulation on specific CD4(+) and CD8(+) T cell clones. Chemically nonreactive drugs elicited an immediate and sustained [Ca2+]i increase and a rapid TCR downregulation, but only when these drugs were added in solution to APC and clone. In contrast, the chemically reactive hapten ceftriaxone added in solution needed > 6 h to induce TCR downregulation. When APC were preincubated with ceftriaxone, a rapid downregulation of the TCR and cytokine secretion was observed, suggesting a stable presentation of a covalently modified peptide. Our data demonstrate two distinct pathways of drug presentation to activated specific T cells. The per se reactive ceftriaxone is presented after covalent binding to carrier peptides. Nonreactive drugs can be recognized by specific alphabeta+ T cells via a nonconventional presentation pathway based on a labile binding of the drug to MHC-peptide complexes.
Topical Analgesia for the Urethra
Authors: R. Bryce-Smith
Journal: BMJ (1955)

MEDICAL MEMORANDA~~MEIUJUM by 2 in.(5 cm.) at its greatest width.It was attached by its narrower extremity to the costal aspect of the vertebral border.The wider end bore rounded facets indicating the points of contact with the ribs.The pathological report stated that the specimen con- sisted of normal compact and cancellous bone, covered by a layer of hyaline cartilage at its wider end, and without any evidence of haemopoiesis or malignancy.The post-operative recovery was uneventful, a full range of painless movement, together with disappearance of the " winging" of the scapula, being obtained in eight weeks. COMMENTIn only two cases of the present collected series of 26 instances bf exostosis of the scapula were the exostoses found to be present at a site other than the medial angle or vertebral border.Du Mortier and Halpert (1934) believed the exostosis to grow from an accessory centre of ossification, but Lunardi (1934) thought it to be due to an over- growth of the epiphysis of the vertebral border.Treatment consisted in excision of the exostosis as close to the scapula as possible, and sometimes a portion of the scapula may need to be resected with it.The results of operation appear to be uniformly good, and even in cases in which winging has been present for many years, as in the case here described, correction of the deformity and return of full function is the rule.I wish to thank Mr. G. Hyman, under whose care this case was admitted and who performed the operation, for permission to publish and for encouragement and advice; and Dr.
'This added to my multiple myopia'
Authors: L. Irwig
Journal: BMJ (2003)

Ayear ago, at the age of 55, I was diagnosed as having normal-tension glaucoma. I had an upper visual field loss in both eyes—about 20% of the field in the right eye and about 30 % in the left eye, in which the area of loss was close to the centre of the visual field and therefore potentially threatened fixation. This added to my lifelong myopia, which I now know is a risk factor for glaucoma. Like many patients with a chronic condition, I read extensively about glaucoma after receiving the diagnosis. However, I had the advantage of epidemiological expertise, a special interest in screening and diagnosis,1 2 and a deep-seated belief in the importance of patient involvement in decision making.3 I will discuss issues that were important to me as a patient and that highlight potential improvement in management. Many of these points may be generalisable to other chronic conditions. Health care often involves a partnership between practitioner and patient sharing the best evidence, deciding how to make decisions, and incorporating patient preferences.4

Randomised trials show that pressure reduction by drugs, or trabeculoplasty by laser or surgery, will slow the loss of the visual field.5 6 Deciding whether to start treatment, and if so which treatment, depends on the extent to which the benefits outweigh the harm of adverse effects of treatment. If my visual field loss was stable rather than progressive, treatment would involve harm without any potential for benefit. Ophthalmological opinion was …
The Physician's Stake in Animal Research-Reply
Authors: James B. Wyngaarden
Journal: JAMA (1986)

<h3>In Reply.—</h3> Apparently, Dr Odell is unaware of a number of steps the National Institutes of Health (NIH) have taken to effect the activities he views as necessary. In June 1984, led by the NIH, the Public Health Service revised its guidelines for the care and use of laboratory animals. These new guidelines were prepared well before legislation requiring them (PL 99-158) was enacted, but the requirements are virtually identical. The guidelines were developed after extensive review of public comments, including many from persons Dr Odell would categorize as animal rights advocates. One of the requirements is that every institution have an animal care and use committee to review research proposals and to oversee animal facilities and research. Generally, at least one committee member must be an individual not on the payroll or otherwise affiliated with the institution. These requirements clearly address Dr Odell's concern that the general public have
Glycemic Control and Cardiovascular Disease — Should We Reassess Clinical Goals?
Authors: William T. Cefalu
Journal: New England Journal of Medicine (2005)

Improved glycemic control reduces the risks of early microvascular complications, such as retinopathy, nephropathy, and neuropathy, in patients with diabetes.1,2 Such patients also have a markedly increased risk of macrovascular complications — myocardial infarction and stroke — as compared with persons without diabetes, and cardiovascular disease is the chief cause of death among patients with either type 1 or type 2 diabetes.3,4 The increased risk appears to be only partially explained by traditional risk factors. Whereas we recognize that the development of atherosclerosis is multifactorial, there is substantial evidence linking chronic hyperglycemia to an increased risk of cardiovascular . . .
Screening Programs for Phenylketonuria in the Newborn
Authors: Robert A. MacCready
Journal: JAMA (1963)

<h3>To the Editor:—</h3> It occurred to me that a preliminary published note regarding the 10-month experience of Massachusetts in the nation-wide phenylketonuria (PKU) newborn screening project might be of value to physicians and health officers of other states. In the nation-wide program sponsored by the Children's Bureau, using the Guthrie bacterial inhibition assay on heel blood,<sup>1</sup>the Massachusetts Department of Public Health went far beyond the quota assigned to the state, and in mid-July, 1962, offered the program to all maternity hospitals in the state. With three cases discovered within the first 4 months of the program, participation grew rapidly, and by midwinter all maternity hospitals in the state, including the military hospitals with obstetrical services, were enrolled. In the large number of newborn babies tested to date, the filter-paper blood screening test has worked very well. We have not been unduly troubled with false-positive reactions, and the test
Triosephosphate isomerase deficiency: Repetitive occurrence of point mutation in amino acid 104 in multiple apparently unrelated families
Authors: Arthur Schneider, Beryl Westwood, Catherine Yim, Josef Prchal, Roger Berkow, Richard Labotka, Rajasekharan Warrier, Ernest Beutler
Journal: American Journal of Hematology (1995)

Abstract The molecular basis of triosephosphate isomerase (TPI) deficiency was studied in 3 patients from three separate families. In all 3 patients, genomic DNA directly sequenced after amplification by the polymerase chain reaction exhibited the point mutation TPI 315C amino acid 104 Glu→Asp. Although other mutations known to cause TPI deficiency have been restricted to single families, the amino acid 104 defect has now been described in nine apparently unrelated families throughout the world and is clearly the most frequently occurring form of the disorder. The basis of the repetitive occurrence of this mutation remains unexplained.
A Lecture ON INFECTIVE CYCLITIS IN RELATION TO PENETRATING WOUNDS OF THE EYEBALL: Delivered at the West London Post-Graduate College
Authors: P. Dunn
Journal: BMJ (1907)

Comparing cerebro-spinal with tuberculous meningitias the infrequency of paralytic squint and optic nearitis, and the -comparative frequency cf spasmodic squints and dis- sociated movements are somewhat strikiDg.It is probable also that defect or absence of vision without ophthalmo- scopic changes is more common than in the tuberculous form.With regard to prognosis, it is perhaps impossible to gather reliable data from such a limited series of cases, but the writer would express the opinion that retraction of the eyelids, corneal complications, absence of the pupil reflexes, true nystagmus, lid winking combined with jerky movements of the eyes, and optic neuritis, are among the symptoms of graver significance.The absence of ocular symptoms does not, of course, justify a favourable prognosis.In conclusion, the writer desires to express his special obligation to Drs.Maegregor, Connal, and McPhee for their assistance in carrying out these examinations.
Modulation of the natriuretic response to atrial natriuretic peptide by alterations in peritubular Starling forces in the rat.
Authors: R E Mendez, B R Dunn, J L Troy, B M Brenner
Journal: Circulation Research (1986)

The mechanisms underlying the natriuretic response to infusions of atrial natriuretic peptide (ANP) remain incompletely defined. By acting as renal vasodilators, atrial peptides may serve to alter peritubular capillary physical forces and favor a decrease in tubule solute reabsorption. Therefore, we studied the effects of known modifiers of intrarenal Starling forces on the natriuresis induced by infusion of intravenous hANP [4-28] (0.5 microgram/kg/min) in anesthetized, euvolemic Munich-Wistar rats. In the first series of studies, infusion of ANP resulted in a significant natriuresis, diuresis, and increase in inulin clearance and in a slight fall in systemic arterial pressure, as compared to vehicle infusion. Subsequent elevation of renal perfusion pressure by superimposition of angiotensin II infusion (0.1-0.2 microgram/kg/min i.v.) on continued ANP infusion resulted in marked further enhancement of natriuresis, independent of changes in glomerular filtration rate (GFR). In the second set of experiments, in which oncotic pressure in the postglomerular capillaries was elevated by hyperoncotic exchange transfusion, administration of ANP did not result in natriuresis, even though GFR increased by the same magnitude as that seen in isooncotic animals given ANP. These observations are consistent with the view that peritubular capillary hydraulic and oncotic pressures modulate the natriuretic and diuretic effects of ANP.
Sirolimus-based immunosuppression is associated with increased survival after liver transplantation for hepatocellular carcinoma
Authors: Christian Toso, Shaheed Merani, David L. Bigam, A.M. James Shapiro, Norman M. Kneteman
Journal: Hepatology (2009)

Liver transplantation is an important treatment option for selected patients with nonresectable hepatocellular carcinoma (HCC). Several reports have suggested a lower risk of posttransplant tumor recurrence with the use of sirolimus and a higher one with calcineurin inhibitors, but the selection of an ideal immunosuppression protocol is still a matter of debate. The aim of this study was to define the immunosuppression associated with the best survival after liver transplantation for HCC. It was based on the Scientific Registry of Transplant Recipients and included 2,491 adult recipients of isolated liver transplantation for HCC and 12,167 for non-HCC diagnoses between March 2002 and March 2009. All patients remained on stable maintenance immunosuppression protocols for at least 6 months posttransplant. In a multivariate analysis, only anti-CD25 antibody induction and sirolimus-based maintenance therapy were associated with improved survivals after transplantation for HCC (hazard ratio [HR] 0.64, 95% confidence interval [CI]: 0.45–0.9, P ≤ 0.01; HR 0.53, 95% CI: 0.31–0.92, P ≤ 0.05, respectively). The other studied drugs, including calcineurin inhibitors, did not demonstrate a significant impact. In an effort to understand whether the observed effects were due to a direct impact of the drug on tumor or more on liver transplant in general, we conducted a similar analysis on non-HCC patients. Although anti-CD25 induction was again associated with a trend toward improved survival, sirolimus showed a trend toward lower rates of survival in non-HCC recipients, confirming the specificity of its beneficial impact to cancer patients. Conclusion: According to these data, sirolimus-based immunosuppression has unique posttransplant effects on HCC patients that lead to improved survival. (HEPATOLOGY 2010.)