tbuckley/cabot-search huggingface dataset:
Trauma to the Liver
Authors: Charles H. Fuller
Journal: JAMA (1965)

The authors accumulated an extensive experience with war wounds of the liver during World War II and have maintained an active interest in the subject since then. Their contributions to the surgical literature, especially those of Madding, have been many and worthwhile, and include original research as well as clinical experience. In addition to their own experience, the authors make liberal use of the knowledge and learning of others, and properly acknowledge these contributions in the very adequate bibliographies at the end of each chapter. Since World War II many advances in the knowledge of liver anatomy, physiology, and management of liver wounds have made surgery on the liver for trauma more feasible and safer. The improved surgical mortality rates testify to this. These aspects are briefly but thoroughly covered. The book opens with a chapter on surgical anatomy of the liver, a subject still often grossly misrepresented in modern
MEPs criticise WHO over H1N1 pandemic advice
Authors: R. Watson
Journal: BMJ (2011)

The European parliament has launched a strong attack on the World Health Organization, accusing it of distorting the term “pandemic” during the H1N1 outbreak in 2009-10 and triggering a worldwide false alarm. That, in turn, gave rise to inappropriate and disproportionate public health decisions by European Union countries, members of the parliament claim.

The criticism comes in a report drafted by the French Green MEP Michele Rivasi evaluating management of H1N1 flu in 2009-10 in the European Union. The report was overwhelmingly adopted by the parliament’s public health committee on 25 January, with 58 votes in favour of the report, just two against, and one abstention.

It calls …
A NEW RECTAL SPECULUM.
Authors: N. H. HENDERSON
Journal: JAMA (1894)

While one would think after examining the various rectal specula now on the market that there would be no room for another, experience has demonstrated that there is. The new rectal speculum as shown in the cut below is sure to find a place in the hands of those who are giving attention to diseases of the rectum. By rotating handle, B, one-half, we completely close the opening, in which position the instrument should be when introduced. As will be observed, when the handle, B, is rotated directly over handle, A, we have a large opening, exposing almost onehalf of the caliber of the rectum. After introducing the speculum the handle, B, is to be rotated little or much, to expose little or much of the field as may be desired. In using the speculum in this way the plug is not necessary, but is only designed to be used
Sertraline as a first-line treatment for cholestatic pruritus
Authors: Marlyn J. Mayo, Iorna Handem, Sandra Saldana, Heidi Jacobe, Yonas Getachew, John A. Rush
Journal: Hepatology (2007)

Abstract Pruritus is frequently the most debilitating symptom of cholestatic liver diseases. Moreover, existing therapies are often ineffective. Recent small, retrospective case series reports suggest that serotonin reuptake inhibitors can improve pruritus. This study was undertaken to establish the dose of sertraline and to evaluate its efficacy for cholestatic pruritus. Twenty one subjects with chronic pruritus due to liver disease (including primary biliary cirrhosis, primary sclerosing cholangitis, chronic hepatitis C, and postnecrotic cirrhosis) initially underwent an open-label, dose escalation to determine the dose with optimal efficacy and tolerability. After a washout period, 12 of the subjects entered a randomized, double-blind, placebo-controlled trial. Participants quantified their pruritus using a 0-10 visual analog scale, and pruritus was assessed for distribution, timing, degree of disability, and physical evidence of scratching. The optimum sertraline dose (75-100 mg/day) was well tolerated. In the controlled portion of the study, itch scores improved in patients taking sertraline, but worsened in patients taking placebo ( P = 0.009). Changes in itch distribution, duration, direction, and physical evidence of scratching paralleled changes in the visual analog pruritus score. Conclusion: Sertraline seems to be an effective, well-tolerated treatment for pruritus due to chronic liver disease. These results suggest that serotonergic pathways are important in the perception of itch. (Hepatology 2007;45:666–674.)
Corticosteroids for acute chest syndrome in children with sickle cell disease: Variation in use and association with length of stay and readmission
Authors: Amy Sobota, Dionne A. Graham, Matthew M. Heeney, Ellis J. Neufeld
Journal: American Journal of Hematology (2009)

Acute chest syndrome (ACS) causes significant morbidity and mortality in sickle cell disease. The role of corticosteroids is unclear. The objectives of our study were to examine the variation between hospitals in their use of corticosteroids for ACS, describe characteristics associated with corticosteroids, and investigate the association between corticosteroids, length of stay, and readmission. We performed a retrospective examination of 5,247 hospitalizations for ACS between January 1, 2004, and June 30, 2008, at 32 hospitals in the Pediatric Health Information System database. We used multivariate regression to examine the variability in the use of corticosteroids adjusting for hospital case mix, identify factors associated with corticosteroid use, and evaluate the association of corticosteroids with length of stay and 3-day readmission rates controlling for propensity score. Corticosteroid use varied greatly by hospital (10-86% among all patients, 18-92% in patients with asthma). Treatment with corticosteroids was associated with comorbid asthma (OR 3.9, 95% CI: 3.2-4.8), inhaled steroids (OR 1.4, 95% CI: 1.1-1.7), bronchodilators (OR 3.2, 95% CI: 2.5-4.2), nitric oxide (OR 2.4, 95% CI: 1.2-5.0), oxygen (OR 2.3, 95% CI: 1.8-2.9), ICU (OR 1.7, 95% CI: 1.3-2.3), ventilation (OR 2.0, 95% CI: 1.4-2.8), APR-DRG severity level (OR 1.4, 95% CI: 1.2-1.6), and discharge year (OR 0.86, 95% CI: 0.80-0.92). Corticosteroids were associated with an increased length of stay (25%, 95% CI: 14-38%) and a higher 3-day readmission rate (OR 2.3, 95% CI: 1.6-3.4), adjusted for confounding. Hospitals vary greatly in the use of corticosteroids for ACS, even in patients with asthma. Clear evidence of the efficacy and toxicity of corticosteroid treatment in ACS may reduce variation in care.
338 STEATO-HEPATITIS HAS A STRONG IMPACT ON LIVER STIFFNESS MEASURED BY TRANSIENT ELASTOGRAPHY IN CHRONIC HEPATITIS C PATIENTS
Authors: V. Leroy, N. Sturm, J. Guéchot, E.S. Zafrani, A. Paris, J.L. Bosson, J.P. Zarski
Journal: Journal of Hepatology (2011)
Mechanism Initiating Ventricular Fibrillation Demonstrated in Cultured Ventricular Muscle Tissue
Authors: TOYOMI SANO, TOHRU SAWANOBORI
Journal: Circulation Research (1970)

Ventricular muscle strips of the rat embryo heart were used for tissue culture preparations without adding trypsin. Fibrillation-like arrhythmia was induced by adding aconitine or strophanthin, and the potentials were recorded with one or two microelectrodes. The tracing by one microelectrode was no different than tracings from fibrillating adult mammalian hearts. The size and shape of the action potential varied beat by beat, and its time of appearance was quite irregular and rapid. But, when tracings obtained simultaneously by two microelectrodes were compared, most of the action potentials were roughly synchronous and thus unlike adult cardiac fibrillation. This ruled out the possibility of multiple reentry or multifocal origin in this preparation. Because of the small size of the cultured tissue, reentry of the excitation wave probably could not occur, and the conclusion that fibrillation originated from a single focus is thus supported. Three varieties of the onset of fibrillation, i.e., gradual increase of tachycardia with progressively steeper slow diastolic depolarization, a prominent positive afterpotential followed by a negative afterpotential, and abortive action potentials superimposed on the repolarization of the preceding action potentials or on the negative afterpotential, supported the unifocal onset.
Acute Interstitial Nephritis Due to Drugs
Authors: ADAM L. LINTON
Journal: Annals of Internal Medicine (1980)

Acute interstitial nephritis due to drugs commonly presents as acute renal failure and may be commoner than is presently realized. Drugs implicated include not only methicillin and other penicillins but also diuretics and nonsteroidal anti-inflammatory agents. The mechanism of injury likely involves an immunologic disturbance, possibly a delayed hypersensitivity reaction. Differential diagnosis from other causes of acute renal failure may be difficult, but coincident evidence of an acute allergic reaction may help, as may the detection of eosinophils in the urine or avid uptake of 67Ga by the kidneys. Definitive diagnosis may require renal biopsy, which will reveal normal glomeruli and a patchy but usually heavy interstitial infiltrate with lymphocytes, plasma cells, and eosinophils. Diagnosis of acute interstitial nephritis is important, because withdrawal of the offending agent will usually result in rapid improvement in renal function, and steroid therapy may reduce residual chronic renal damage.
Renal vasoconstriction caused by short-term cholesterol feeding is corrected by thromboxane antagonist or probucol.
Authors: R Kaplan, H S Aynedjian, D Schlondorff, N Bank
Journal: Journal of Clinical Investigation (1990)

Recent studies indicate that short-term cholesterol feeding causes vascular hyperreactivity and/or increased tone in certain vascular beds. The present study in rats examined the effect of 3 wk of cholesterol-supplemented diet (CSD) on renal hemodynamics. We tested the hypothesis that LDL oxidized in vivo is causally related to increased renal vascular tone by adding the antioxidant drug probucol to the CSD (CSD + P). Micropuncture of surface nephrons in the CSD rats demonstrated that single nephron glomerular filtration rate (SNGFR) and single nephron afferent plasma flow (QA) were markedly lower than in normal rats, whereas glomerular capillary pressure (PGC), afferent arteriolar resistance (RA), and single nephron filtration fraction (SNFF) were higher. In the CSD + P animals, almost all of these hemodynamic abnormalities were absent. TXB2 and PGE2 were increased in proximal tubule fluid and urine in the CSD rats, but normal in the CSD + P group. Infusion of a TXA2 receptor antagonist into the suprarenal aorta of CSD rats caused a rapid return to normal of RBF (renal blood flow), GFR (glomerular filtration rate), SNGFR, QA, RA, PGC, and Kf (ultrafiltration coefficient). Our observations demonstrate that cholesterol feeding leads to renal vasoconstriction, which appears to be mediated largely by increased TXA2 production. The fact that probucol prevented the hemodynamic abnormalities as well as the increased TX production is consistent with the hypothesis that LDL oxidized in vivo initiates events leading to TX mediated vasoconstriction.
Nonspecific signals for B-cell localization and activation.
Authors: R M Franklin, R A Prendergast, A M Silverstein
Journal: The Journal of Experimental Medicine (1978)

Virgin, inactive mammary gland autografted to the anterior chamber of the rabbit eye remains free of lymphoid cells. Activation of the ectopic gland by systemic injection of chorionic gonadotropin results in maturation of the gland and milk production, accompanied by the immirgration of lymphocytes and their activati-n to Ig formation, predominantly of the IgA class. In the presence of antigen-induced intraocular inflammation, the activated gland is able to influence the Ig class of B cells in the neighboring ocular tissues. These data suggest that even nonlymphoid tissues may elaborate lymphocyte-homing and polyclonal B-cell activating factors which function independently of specific antigen.
COLORIMETRIC DETERMINATION OF REACTION OF BACTERIOLOGIC MEDIUMS AND OTHER FLUIDS
Authors: GEORGE D. BARNETT
Journal: JAMA (1918)

affected.Head and Campbell,6 in 1900, pathologically demonstrated the presence of micro-organisms in the nerve radicles involved, and contended that herpes zoster was an acute specific disease.This was later experimentally proved by Rosenow and Oftedahl,7 in their work on specific streptococci selection, by iso¬ lating streptococci from tonsils, pyorrheal abscesses, sputum and spinal fluid in man with herpes, and pro¬ ducing herpes, with corresponding ganglionic lesions, by animal inoculation with these strains of organisms.As to chickenpox, nothing has ever been definitely determined etiologically.Tyzzer,8 in a histopathologic study of chickenpox vesicles, found certain bodies enclosed in the nuclei and cytoplasm of the cells involved.These he considered typical of chickenpox, but he was unable to produce new lesions by their inoculation, and had to consider them as nonparasitic.Keysselitz and Mayer9 believed that the inclusion bodies of chickenpox were analogous to cytoryctes and that they were not in themselves definitely para¬ sites, but contained the infective virus.Very little else has been discovered.
Analysis of Mucosal Blood Hemoglobin Distribution in Gastric Ulcers by Computerized Color Display on Electronic Endoscopy
Authors: S. Tsuji, S. Kawano, N. Hayashi, M. Tsujii, T. Ogihara, T. Kamada, N. Sato
Journal: Endoscopy (1991)

A technique of computerized color display was used to analyze the mucosal blood hemoglobin distribution in patients with gastric ulcers. Using an electronic endoscope, red and green images (Vr and Vg) obtained separately from the electronic endoscopic image were transferred to an image analyzer and a computer. The mucosal hemoglobin content was calculated at each pixel of the image using the formula: index of hemoglobin content = 32[log2(Vr/Vg)]. Forty endoscopy examinations were performed in 15 patients with small ulcers (less than or equal to 1 cm) in the gastric angle and 5 normal subjects. The index of hemoglobin content ranged from 24 to 40 in the normal subjects. The index for the area around an active ulcer was mostly below 33. In cases of ulcers in the healing stage it increased to more than 40. The index was still above 40 in ulcer scars in the S1 stage, but within normal range in most of the mucosa in the S2 stage. Thus, the mucosal blood hemoglobin distribution can be assessed by computerized color analysis in patients with gastric ulcers at various stages.
The Cost of Marinol (Dronabinol)-Reply
Authors: Fred J. Hellinger
Journal: JAMA (1993)

<h3>In Reply.</h3> —The estimates for the daily cost of Marinol presented in my article differ from those presented by Dr Shepard primarily because of different assumptions about the amount of Marinol (a manufactured version of tetrahydrocannabinol, the principal active ingredient in marijuana) taken by persons with HIV. My estimate of the unit cost of Marinol is similar to Shepard's. I estimated that the cost of 2.5 mg of Marinol was $2.61. (This figure is obtained by dividing the weekly cost of taking 25 mg daily by seven [$26.14=$183/7] to derive an estimate of the cost of 25 mg and then dividing this figure by 10 to obtain an estimate of the cost of 2.5 mg.) The information provided by Shepard indicates that the average price of 2.5 mg of Marinol is $2.99 ($179.40/60). My estimate was derived from data provided by Stadtlander's Pharmacy, Pittsburgh, Pa, in February 1993, and the
Relationship between acetaldehyde levels and cell survival in ethanol-metabolizing hepatoma cells
Authors: Dahn L. Clemens, Andrew Forman, Thomas R. Jerrells, Michael F. Sorrell, Dean J. Tuma
Journal: Hepatology (2002)

We have created a number of recombinant Hep G2 cell lines, designated VA cells, that constitutively express alcohol dehydrogenase. Oxidation of ethanol by the VA cells results in the production and accumulation of acetaldehyde, and a dramatic increase in the nicotinamide adenine dinucleotide, reduced (NADH)/nicotinamide adenine dinucleotide (NAD + ) ratio (redox-state). It is believed that production of acetaldehyde, and the increase in the redox-state of hepatocytes, are responsible for many of the dysfunctions associated with alcoholic liver disease. When the VA cells were cultured in the presence of ethanol, we observed a dramatic reduction in cell accumulation. This reduction was more pronounced in cells that metabolized ethanol more efficiently. Inhibition of alcohol dehydrogenase activity abolished this reduction, demonstrating that ethanol oxidation was required for this dysfunction. Subsequent investigations indicated that this ethanol oxidation-mediated reduction in cell accumulation was the result of both cytotoxicity and impaired DNA synthesis. To dissociate the increase in the cellular redox-state from acetaldehyde production, VA cells were cultured in the presence of isopropanol. The oxidation of isopropanol results in similar redox changes, but the metabolic by-product of isopropanol oxidation is acetone. The metabolism of isopropanol by VA cells resulted in very little reduction in cell number. Furthermore, treatment of ethanol-metabolizing VA cells with the aldehyde dehydrogenase inhibitor, cyanamide, increased the levels of acetaldehyde and resulted in an additional reduction in cell number. In conclusion, these studies indicated that exposure to acetaldehyde caused cytotoxicity, as well as the ethanol oxidation-mediated reduction in cell number.
Reduction in experimental infarct size by recombinant human superoxide dismutase: insights into the pathophysiology of reperfusion injury.
Authors: G Ambrosio, L C Becker, G M Hutchins, H F Weisman, M L Weisfeldt
Journal: Circulation (1986)

To determine the importance of reperfusion injury and the ability of the free-radical scavenger recombinant human superoxide dismutase (h-SOD) to prevent it, open-chest dogs underwent 90 min of proximal circumflex coronary artery occlusion, and only at the moment of reperfusion received either h-SOD (400,000 IU bolus into the left atrium followed by a 300,000 IU iv infusion over 1 hr) or saline. After 48 hr the surviving animals were killed and measurements were made of the risk region (by postmortem angiography) and infarct size (by gross pathology). All measurements were made by investigators blinded to treatment given, and the code was broken only at the end of the study. Hemodynamic variables and collateral flow during ischemia were similar in the two groups. Infarct size in control animals (n = 8) averaged 22.4 +/- 3.1% of the left ventricle and 52.2 +/- 7.1% of the risk region, compared with 13.3 +/- 0.8% of the left ventricle and 33.6 +/- 2.1% of the risk region in h-SOD-treated dogs (n = 8) (p less than .05). Infarcts in treated animals were not only smaller, but also exhibited a distinctive "patchiness," suggesting protection along vascular distributions. Furthermore, analysis of the relationship between infarct size and collateral flow measured during ischemia in the two groups indicated that protection by h-SOD was greatest in animals with the lowest collateral flows. This study supports the concept that reperfusion of ischemic myocardium results in a separate component of cell damage, presumably linked to the generation of oxygen free radicals on reflow. Since the h-SOD preventable reperfusion component of injury was most pronounced in hearts with the most severe ischemia, scavenging of oxygen radicals at the time of reflow may offer a novel and particularly promising therapeutic approach for the protection of ischemic myocardium.
Poor uptake of hepatitis B vaccine in India has several causes, study finds
Authors: C. Travasso
Journal: BMJ (2013)

Poor management of vaccine stocks, poor record keeping, lack of staff training, and use of multidose vials were among the main reasons for low coverage of the hepatitis B vaccine in 10 states across India, researchers have found.

India is home to 11% of the world’s people with chronic hepatitis B and has between 100 000 and 200 000 deaths from hepatocellular carcinoma or cirrhosis each year. To tackle the disease, India introduced the hepatitis B vaccine across 10 states in …
Quantitative rotational tomography with 201Tl and 99mTc 2-methoxy-isobutyl-isonitrile. A direct comparison in normal individuals and patients with coronary artery disease.
Authors: J K Kahn, I McGhie, M S Akers, M N Sills, T L Faber, P V Kulkarni, J T Willerson, J R Corbett
Journal: Circulation (1989)

We tested the hypothesis that 99mTc 2-methoxy-isobutyl-isonitrile (99mTc MIBI), a new radiopharmaceutical for myocardial perfusion imaging, provides accurate noninvasive detection of coronary artery disease (CAD). Imaging in patients after exercise and at rest with 99mTc MIBI was compared with imaging after exercise and redistribution with 201Tl in 12 normal subjects and 38 patients with angiographic documentation of CAD (greater than or equal to 50% diameter stenosis). We used single-photon emission computed tomography (SPECT) and computer quantitation of regional tracer distribution. The quality of reconstructed images with 99mTc MIBI judged visually was superior to that of 201Tl in 88% of all studies performed and was comparable in the others. With the limits of normal as 2.5 SD below the mean of gender-matched normal volunteers, 201Tl SPECT identified 32 and 99mTc MIBI identified 36 patients with CAD (p = 0.2). 201Tl SPECT identified 45 of 75 (60%) and 99mTc MIBI identified 59 of 75 (79%) stenosed coronary arteries (p less than 0.05). The quantitative severity of perfusion defects was similar for the two tracers. 201Tl SPECT identified 104 reversibly ischemic myocardial segments compared with 134 with 99mTc MIBI (p less than 0.05). Thus, SPECT myocardial perfusion imaging with 99mTc MIBI and computer quantitation provides an accurate method for the noninvasive detection of significant coronary artery disease. Furthermore, image quality is generally superior to 201Tl, and reversibly ischemic myocardial segments may be better identified with 99mTc MIBI.
HDL proteomics: pot of gold or Pandora’s box?
Authors: Muredach P. Reilly, Alan R. Tall
Journal: Journal of Clinical Investigation (2007)

In this issue of the JCI, Vaisar et al. studied the proteome of HDL (see the related article beginning on page 746). They reveal, quite unexpectedly, that HDL is enriched in several proteins involved in the complement cascade, as well as in a variety of protease inhibitors, supporting the concept that HDL plays a role in innate immunity and in the regulation of proteolytic cascades involved in inflammatory and coagulation processes. The protein makeup of HDL also appears to be altered in patients with coronary artery disease. HDL proteomics is in its infancy, and preliminary findings will need to be confirmed using standardized approaches in larger clinical samples. However, this approach promises to better elucidate the relationship of HDL to atherosclerosis and its complications and could eventually help in the development of biomarkers to predict the outcome of interventions that alter HDL levels and functions.
Castration as a Treatment for Crime, not as a Punishment.
Authors: F. E. Daniel
Journal: JAMA (1896)

Austin, Texas, Jan. 21,1896. <h3>To the Editor:</h3> —In your editorial comments on my paper which was read at the recent meeting of the Chicago Medico-Legal Society (see issue of January 18), I regret to see that you misapprehend its entire trend and object. Surely, you did not read it. You convey the impression that its object was to advocate castration of<i>sexual perverts as a punishment</i>; whereas the subject of sexual perverts was scarcely alluded to, and I distinctly disclaimed, in the very first paragraph, all idea of punishment; deprecate further along, that our penal system is based upon the ancient idea of revenge, and that its chief end<i>seems to be punishment</i>. And, again, I say, "punishment should have no place in a civilized code." (You must have had in mind my paper on sexual perverts which was read at the Medico-Legal Congress in 1893.) Moreover, nothing was said