tbuckley/cabot-search huggingface dataset:
Primary non-Hodgkin lymphoma of the stomach: endoscopic pattern and prognosis in low versus high grade malignancy in relation to the MALT concept.
Authors: B G Taal, H Boot, P van Heerde, D de Jong, A A Hart, J M Burgers
Journal: Gut (1996)

BACKGROUND: Various histological classifications developed for nodal lymphomas failed to be of value in extranodal lymphomas. More recently, gastric lymphoma is considered to represent a distinctive group derived from mucosa associated lymphoid tissue (MALT). AIM: To study the prognostic value of malignancy grading based on the concept that most gastric lymphomas are of MALT origin, the endoscopic as well as clinical characteristics in 114 patients with primary gastric non-Hodgkin9s lymphoma were evaluated. RESULTS: In univariate analysis, patients with low grade lymphoma (n = 51) were younger, had less advanced stage, and less frequently bulky disease than those with high grade lymphoma (n = 63). In multivariate analysis weight loss and increased erythrocyte sedimentation rate were significantly less frequent in low grade (45% and 22%) compared with high grade lymphoma (75% and 53%). In low grade lymphoma endoscopic findings were often interpreted as a benign condition (27 of 51), in contrast with high grade lymphoma, where carcinoma was most frequently (37 of 63) suspected. In low grade lymphoma complete remission rate was 92%, and five year survival 75%, In high grade lymphoma results were significantly less favourable (p = 0.0001): complete remission in 68%, and a five year survival of 46%. CONCLUSION: Malignancy grading was strongly correlated with treatment outcome; endoscopically low grade lymphoma was often hard to distinguish from benign conditions, whereas high grade lymphoma often revealed carcinoma-like features.
Aetiological role of bacteria associated with reactive arthritis in pauciarticular juvenile chronic arthritis.
Authors: J Sieper, J Braun, E Doring, P Wu, J Heesemann, J Treharne, G Kingsley
Journal: Annals of the Rheumatic Diseases (1992)

The cause of juvenile chronic arthritis (JCA) is unknown. Pauciarticular JCA is the most common subtype and can be subdivided into early (type I) and late onset (type II) forms, the latter clinically resembling reactive arthritis.The cellular immune responses to bacteria associated with reactive arthritis in blood and synovial fluid from 39 children with pauciarticular JCA, three children with classical reactive arthritis, and two children with psoriatic arthritis were examined. Specific titres of antibodies to bacteria in serum samples were measured in all patients.A bacteria specific synovial cellular immune response was found in two of three (67%) patients with reactive arthritis and 14 of 28 (50%) patients with pauciarticular JCA type II but only in one of 11 (9%) patients with pauciarticular JCA type I and none in patients with psoriatic arthritis. Six patients responded specifically to Chlamydia trachomatis and 11 to Yersinia enterocolitica. Antigen specific lymphocyte proliferation correlated poorly with the specific antibody response.These findings suggest that bacteria with associated reactive arthritis may have a causative role in pauciarticular JCA type II but not in JCA type I.
Recombinant plasminogen activator inhibitor-1 reverses the bleeding tendency associated with the combined administration of tissue-type plasminogen activator and aspirin in rabbits.
Authors: D E Vaughan, P J Declerck, M De Mol, D Collen
Journal: Journal of Clinical Investigation (1989)

The major side effect of thrombolytic therapy is bleeding; however, the pathogenesis of this potential complication is not well understood. Accordingly, we examined the effects of aspirin and recombinant human tissue-type plasminogen activator (rt-PA) on serial template bleeding times and on hemostasis parameters in rabbits. The administration of intravenous aspirin (15 mg/kg) produced a slight prolongation in bleeding times, from 2.1 +/- 0.5 to 2.6 +/- 0.5 min (mean +/- SD, n = 26, P less than 0.01), whereas rt-PA (1 mg/kg per h for 2 h) lengthened the bleeding time from 2.4 +/- 0.3 to 3.2 +/- 0.6 min (n = 5, P = NS). Combination of aspirin with 0.5 mg/kg per h of rt-PA for 2 h prolonged the bleeding time from 2.5 +/- 0.4 to 6.2 +/- 0.9 min (n = 10, P less than 0.01), with an associated fibrinogen decrease of approximately 15%. The combination of aspirin with 1 mg/kg per h of rt-PA for 2 h prolonged the bleeding time from 3.0 +/- 0.3 to 8.3 +/- 1.4 min (n = 8, P less than 0.01) and simultaneously induced a decrease of plasma fibrinogen by approximately 40%. Virtually all animals treated with rt-PA and aspirin manifested a bleeding tendency, as evidenced by spontaneous rebleeding at sites of previously performed template bleeding times or oozing at the femoral venous catheterization site. Intravenous bolus injection of 1 mg/kg of guanidine hydrochloride-reactivated recombinant human plasminogen activator inhibitor-1 (rPAI-1) at the end of the rt-PA infusion resulted in complete reversal, within 5 min, of the prolongation of the bleeding time, and in a disappearance of the bleeding tendency. Nonreactivated rPAI-1 and tranexamic acid were significantly less potent in reversing the bleeding time prolongation. These findings indicate that aspirin and rt-PA given separately do not markedly affect the template bleeding time, but in combination induce a marked prolongation associated with a significant bleeding tendency. This bleeding time prolongation can be rapidly normalized by the administration of reactivated rPAI-1.
The Doctrine of Signatures: A Defense of Theory in Medicine
Authors: E. R. Priest
Journal: JAMA (1991)

Many clinicians don't see the sense in moral philosophy. Ethics especially seems too metaphysical and esoteric to be of any real use in daily practice, which is full of practical, needed-to-be-solved-yesterday problems. Asking good questions and raising dilemmas of theory do not seem to help. When a philosopher is expert in his or her own discipline, however, and learns medicine in the time-honored way— here, by watching and studying in the anatomy laboratories and hospital wards of Johns Hopkins—physicians should take note. First in 1938, and now in a second edition in 1991, Scott Buchanan uses "the doctrine of signatures" to tempt the philosophically malnourished medicine of today. The doctrine, generally credited to Paracelsus (1493-1541), suggested to the ancients that the form, color, or markings of plants indicated their appropriate medicinal use: eg, yellow substances would be helpful for the treatment of jaundice; the heart-shaped leaves of<i>Digitalis purpurea</i>would
Variceal Bleeding and Portal Hypertension: Much to Learn, Much to Explore
Authors: D. K. Bhasin, N. J. S. Malhi
Journal: Endoscopy (2002)

The newer diagnostic and therapeutic options continue to evolve and important developments have been made in the field of variceal bleeding and portal hypertension. A meeting was held at Baveno to update consensus on different terminologies in relation to portal hypertension. β-blockers continue to be the mainstay for primary prophylaxis of variceal bleeding, and endoscopic variceal ligation (EVL) is fast emerging as a strong contender. The role of vasoactive drugs in the management of variceal bleeding was assessed. Octreotide and terlipressin were shown to be as effective as sclerotherapy in achieving initial hemostasis, and octreotide was shown to be safe and efficacious in the prevention of rebleeding. EVL was superior to endoscopic sclerotherapy (EST) for obliteration of esophageal varices. Sequential and simultaneous ligation and sclerotherapy were more effective than ligation alone, in reducing the recurrence rate after variceal obliteration. For gastric varices, cyanoacrylate glue continues to be the first line of treatment, and band ligation is being assessed further. Bleeding ectopic varices were dealt by appropriate endoscopic means. Endosonography has developed strongly in the assessment of variceal eradication and prediction of variceal recurrence. Transjugular intrahepatic portosystemic shunting (TIPS) significantly reduces rebleeding rates compared to EVL.
The cell nucleus.
Authors: R A Laskey
Journal: BMJ (1987)

The cell nucleus is the information centre of the cell. It is responsible for copying highly selected regions of the genome into ribonucleic acid (RNA) and for supplying precisely regulated amounts of specific RNA molecules to the cytoplasm, where they are translated into proteins. In addition it must duplicate its entire structure every time the cell divides. This article considers how the nucleus is organised to perform the immensely complex task of selective information retrieval. Recently several different experimental approaches have elucidated how deoxyribonucleic acid (DNA) is organised in the nucleus and how specific regions of DNA are selected for expression at particular times and in particular cells of the body. One of the key problems in selective information retrieval in the nucleus becomes obvious if we consider how densely DNA is packed into the nucleus. Each chromosome consists of an individual double helix of DNA about 40 mm long by 2 nm wide packed into a nucleus of about 6 urn in diameter. The implications of these dimensions can be seen more clearly by a simple scale model enlarged one million times. On this scale the DNA in each chromosome would resemble thin string, 2 mm in diameter but 40 km long, and the total DNA in one nucleus would reach from London to Leningrad. Yet on the same scale this 1800 km of DNA must all be packaged into a nucleus of only 6 m diameter in such a way that specific regions must remain fully accessible for highly regulated expression. The answer to how such a densely packed structure can function in selective information retrieval lies in a precise three dimensional nuclear architecture. The contents of the nucleus are not just a randomly mobile solution but are highly organised into a hierarchy of ordered structures.
The Pre-Hospital Phase of Acute Myocardial Infarction
Authors: ARTHUR J. MOSS, SIDNEY GOLDSTEIN
Journal: Circulation (1970)

A prospective interview study of the hospital arrival time (HAT) was obtained on 160 patients, aged 28 to 87 years, who were admitted with acute myocardial infarctions to cardiac care units in two Rochester hospitals. The median time between the onset of acute coronary symptoms and the patient's arrival in a hospital emergency department was 3½ hours. The distribution of the HAT was trimodal: group I (early arrivals), less than 4 hours from onset of symptoms, median, 2 hours, n = 89; group II (mid-arrivals), 4 to 14 hours, median, 6 hours, n = 45; group III (late arrivals), greater than 14 hours, median, 27 hours, n = 26. Three intervals were defined: a decision time, an unaccounted for time, and a transportation time. In the entire population, the decision time consumed the major portion (51%) of the HAT, and the unaccounted for time 35% of HAT. The transportation time, whether by ambulance or car, averaged 25 min (14% of HAT), and it made up a diminishing percentage of the HAT in the longer arrival groups. The HAT in groups I, II, and III and the decision time in groups I and II were scrutinized with regard to demographic data, past medical history, pre-hospital factors, and hospital course. The findings suggest that the psychologic makeup of the patient is a major factor in the decision making process and thus, in the duration of the HAT.
Epidermoid Cysts Simulating Rheumatoid Nodules in the Olecranon Region
Authors: Joseph T. Wilson
Journal: JAMA (1970)

In four patients with rheumatic disease, a subcutaneous lesion in the olecranon region, which appeared to be a rheumatoid nodule clinically, proved to be an epidermoid cyst histologically. No pathogenetic relationships between the epidermoid cyst and the rheumatic disease were suggested. The biopsy findings must be interpreted with care, because, as illustrated in a fifth case, a degenerated rheumatoid nodule can be confused histologically with a ruptured epidermoid cyst.
Removal of Cerumen-Reply
Authors: Byron J. Bailey
Journal: JAMA (1984)

<h3>In Reply.—</h3> Regarding the use of high-pressure water irrigation to remove cerumen from the external auditory canal, I am willing to acknowledge both the importance of saving time and the comparative safety of irrigation when the patient has an intact, strong, and healthy tympanic membrane. I also agree that irrigation is a physician error in the presence of tympanotomy tubes but would point out that the error is more likely to occur when irrigation is used routinely than when foreign matter is removed with a cerumen loop or suction. Foreign material, of course, may prevent the examiner from visualizing the presence of the tube. My objection to routine, high-pressure irrigation is based on observation of iatrogenic otitis media in three categories of patients: (1) patients with a tympanotomy tube that is not seen because of foreign material in the external canal, (2) patients with an unsuspected tympanic membrane perforation, and
Therapeutic effect of PEGylated TNFR1-selective antagonistic mutant TNF in experimental autoimmune encephalomyelitis mice
Authors: Tetsuya Nomura, Yasuhiro Abe, Haruhiko Kamada, Hiroko Shibata, Hiroyuki Kayamuro, Masaki Inoue, Tomoyuki Kawara, Shuhei Arita, Takeshi Furuya, Takuya Yamashita, Kazuya Nagano, Tomoaki Yoshikawa, Yasuo Yoshioka, Yohei Mukai, Shinsaku Nakagawa, Madoka Taniai, Tsunetaka Ohta, Satoshi Serada, Tetsuji Naka, Shin-ichi Tsunoda, Yasuo Tsutsumi
Journal: Journal of Controlled Release (2009)
Queues for cure?
Authors: H. Hemingway, B. Jacobson
Journal: BMJ (1995)

Ten million people aged 60 and older live in England and Wales.Langman et al estimated that in this population 10 000 episodes of ulcer bleeding and 2000 ulcer perforations occur each year.8This yields an overall annual risk of bleeding of an ulcer of 1 in 1000 and of perforation of 1 in 5000; about a quarter of these episodes are associated with the use of non- steroidal anti-inflammatory drugs.8If the drugs in current use were replaced by those with the lowest relative risk then the number of episodes of upper gastrointestinal adverse events associated with the drugs would be halved.The incidence of adverse effects could be cut further if the lowest effective doses ofnon-steroidal anti-inflammatory drug were prescribed.8The strategy of minimising the use of non-steroidal anti- inflammatory drugs through rational prescribing contrasts with the implications of coprescribing antiulcer drugs.Two hundred deaths attributable to ulcers caused by non-steroidal anti-inflammatory drugs occur in Britain each year."If the 20 million prescriptions for these drugs issued each year in Britain are each assumed to be for, on average, one month's treatment then the cost of coprescribing misoprostol or ranitidine would range from £200m (misoprostol 400 ,ug daily) to £600m (ranitidine 150 mg twice daily).Even if these drugs were totally effective in preventing deaths from non- steroidal anti-inflammatory drugs (which they are not) the cost per life saved would be ,(1 m to £3m.What are the implications for managing elderly patients with chronic pain?Although pain in younger patients often has an inflammatory component, the contribution of acute inflammation to pain in elderly patients is unclear.Chronic pain is likely to be due principally to degenerative changes, and the inflammatory component is less important.The correct initial treatment for such patients is regular paracetamol or a standard compound analgesic such as co-codamol.The reluctance of some patients to take such treatment regularly is one factor that makes longer acting, but more toxic, non-steroidal anti-inflammatory drugs appear clinically more effective.In clinical trials non-steroidal anti- inflammatory drugs seem to offer additional benefit to
Cloning and characterization of complementary DNA for human tryptase.
Authors: J S Miller, E H Westin, L B Schwartz
Journal: Journal of Clinical Investigation (1989)

The amino acid sequence of human mast cell tryptase was determined from corresponding cDNA cloned from a lambda ZAP library made with mRNA derived from a human mast cell preparation. Tryptase is the major neutral protease present in human mast cells and serves as a specific marker of mast cells by immunohistologic techniques and as a specific indicator of mast cell activation when detected in biologic fluids. Based on nucleic acid sequence, human tryptase consists of a 244-amino acid catalytic portion of 27,423 D with two putative N-linked carbohydrate binding sites and a 30-amino acid leader sequence of 3,048 D. A His74, Asp120, Ser223 catalytic triad and four cystine groups were identified by analogy to other serine proteases. Regions of amino acid sequence that are highly conserved in serine proteases, in general, were conserved in tryptase. The catalytic portion of human tryptase had an 84% amino acid sequence similarity with that of dog tryptase; their leader sequences had a 67% similarity. Asp217 in the substrate binding pocket of human tryptase is consistent with a specificity for Arg and Lys residues at the site of cleavage (P1), whereas Glu245 is consistent with the known preference of human tryptase for substrates with Arg or Lys also at P3, analogous residues also being present in dog tryptase. Asp244, which is substituted for the Gly found in dog tryptase and in most serine proteases, is present in the putative substrate binding pocket and may confer additional substrate specificity on human tryptase for basic residues. Further studies now can be designed to elucidate these structure-function relationships.
Hyperreactivity to Nitrovasodilators in Forearm Vasculature Is Related to Autonomic Dysfunction in Insulin-Dependent Diabetes Mellitus
Authors: Sari Ma¨kimattila, Matti Ma¨ntysaari, Per-Henrik Groop, Paula Summanen, Antti Virkama¨ki, Anna Schlenzka, Johan Fagerudd, Hannele Yki-Ja¨rvinen
Journal: Circulation (1997)

Background The link between diabetes and vascular disease is poorly understood. Data regarding endothelial function in vivo in patients with insulin-dependent diabetes mellitus (IDDM) have been inconsistent with in vitro studies demonstrating hyperglycemia-induced impairments in endothelium-dependent vasodilation. Methods and Results We determined whether alterations in neural control of the vascular tone might contribute to blood flow responses to intrabrachial infusions of acetylcholine (ACh), sodium nitroprusside (SNP), and l - N -monomethyl-arginine (L-NMMA) in 22 men with IDDM (12 with normoalbuminuria, HbA 1c =8.6±0.3%; 10 with macroalbuminuria, HbA 1c =8.6±0.3%) and 11 matched normal men. Autonomic function was assessed from reflex vasoconstriction to cold, the blood pressure response to standing and hand grip, and heart rate variation, including spectral analysis, during controlled breathing, and the Valsalva maneuver. IDDM with macroalbuminuria exhibited hyperresponsiveness to both ACh and SNP compared with the patients with normoalbuminuria or normal subjects. Reflex sympathetic vasoconstriction to cold was severely impaired in the IDDM patients with macroalbuminuria (−19±6%) compared with normoalbuminuric patients (−39±5%, P &lt;.05) and normal subjects (−54±7%, P &lt;.001). The macroalbuminuric patients also had evidence of autonomic dysfunction during controlled and deep breathing tests and during the Valsalva maneuver. Within the group of IDDM patients, neither the urinary albumin excretion rate nor other parameters such as HbA 1c or serum cholesterol correlated with forearm blood flow during the vasoactive drug infusions. There were, however, significant inverse correlations between several measures of both sympathetic and parasympathetic autonomic functions and vascular hyperresponsiveness to SNP and ACh. For example, the Valsalva ratio was inversely correlated with the increase in blood flow in response to infusion of 3 ( r =−.74, P &lt;.001) and 10 ( r =−.73, P &lt;.001) μg/min SNP and 7.5 ( r =−.73, P &lt;.001) and 15 ( r =−.75, P &lt;.001) μg/min ACh. Conclusions These data are consistent with idea that altered neurotransmission is an important determinant of vascular reactivity of diabetic blood vessels to nitrovasodilators in vivo.
A Reevaluation of "Psychiatric Help" When Divorce Impends
Authors: CARL A. WHITAKER, MILTON H. MILLER
Journal: American Journal of Psychiatry (1969)

Psychotherapeutic intervention on one side or another in a marriage when divorce is being considered may serve to destroy the possibility of reconciliation. Despite the therapist's efforts to remain neutral, he inevitably finds himself thrust into the role of catalyst, judge, or "alternate mate." The authors suggest the inclusion of both partners, as well as children and perhaps other family members, in the therapeutic situation as one means of avoiding an outcome that may ultimately prove detrimental to all.
Bowel function measurements of individuals with different eating patterns.
Authors: G J Davies, M Crowder, B Reid, J W Dickerson
Journal: Gut (1986)

Bowel function was assessed in 51 subjects: 10 women and seven men who habitually consumed an omnivorous, vegetarian, or vegan diet. The subjects on these diets had a mean intake of fibre of 23 g, 37 g, and 47 g respectively. Mean transit times were variable and not significantly different between the groups. Vegans, however, had a greater frequency of defecation and passed softer stools. All measurements of bowel function were significantly correlated with total dietary fibre. As dietary fibre increased mean transit time decreased, stool frequency increased and the stools became softer. Men produced a greater quantity of softer, less formed faeces than women. During the luteal phase of the menstrual cycle women excreted harder stools and had a significantly longer mean transit time. The finding that mean transit time was more highly correlated with faecal form than any of the other bowel function measurements could be of practical importance.
Assessment of coronary arterial stenoses post-intervention by quantitative angiography versus intracoronary ultrasound in 13 patients undergoing balloon and/or laser coronary angioplasty
Authors: Kenneth Rosenfield, Wolfram Voelker, Douglas W. Losordo, K. Ramaswamy, Bernard D. Kosowsky, John O. Pastore, Jeffrey M. Isner
Journal: Journal of the American College of Cardiology (1991)
Transient acantholytic dermatosis
Authors: P. J. HEENAN, C. J. QUIRK
Journal: British Journal of Dermatology (1980)

SUMMARY A series of twenty-four cases of transient acantholytic dermatosis (TAD) is presented. All patients were male and their eruptions tended to be more persistent than those of previously reported cases. The epidermal changes included four patterns of acantholysis, of which the pemphigus-like pattern was associated with the more persistent eruptions. Although twenty-three of the twenty-four patients had other actinic-associated skin lesions, no direct relationship between the onset of TAD and episodes of excessive sun exposure was found. Oral vitamin A treatment has been effective in some cases.