tbuckley/cabot-search huggingface dataset:
Brief Chemotherapy and Involved Field Radiation Therapy for Limited-Stage, Histologically Aggressive Lymphoma
Authors: JOSEPH M. CONNORS
Journal: Annals of Internal Medicine (1987)

Study Objective: To determine the efficacy and toxicity of brief chemotherapy and involved field radiation therapy for treatment of limited-stage, histologically aggressive malignant lymphoma. Design: Single-arm prospective trial. Setting: Comprehensive cancer treatment center serving the entire population of British Columbia. Patients: Consecutive enrollment of 78 patients ranging in age from 21 to 82 years (median, 64) with limited-stage (no B symptoms, Ann Arbor stage I or II, tumors less than 10 cm in diameter), diffuse large cell, mixed or immunoblastic histologic characteristics of malignant lymphoma seen at our institution between May 1980 and December 1984. All eligible patients were evaluated for response and relapse-free and overall survival. Interventions: Chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) for three cycles followed by involved field radiation therapy to the original site of disease in a dose equivalent to 3000 cGy in ten fractions. Main Results: The complete response rate was 99% (77 of 78 patients). With a median follow-up off treatment of 30 months the actuarial relapse-free survival is 84% and the overall survival is 85%. No deaths due to toxicity occurred. Conclusions: Brief chemotherapy and involved field radiation therapy is highly successful treatment for patients with limited-stage, histologically aggressive malignant lymphoma. Toxicity of this approach is acceptable, even in the elderly. Staging laparotomy is not needed to select these patients. Future trials should incorporate more effective Chemotherapy programs.
REPORT OF CASE OF SPLENECTOMY, WITH ATTEMPTED SURGICAL CURE OF ASCITES DUE TO CIRRHOSIS OF THE LIVER.
Authors: T. N. RAFFERTY
Journal: JAMA (1900)

Mrs. T., an American and a widow, 31 years of age, consulted me on Aug. 6, 1899, with the following history: She began life, and has mostly lived, in a malarious district; and from the age of 8 to 17 she had chills frequently—none since. Her family history was good and no history of syphilis. She began menstruating at 16; it has been painless and regular. She was married at the age of 22, one year afterward had a miscarriage, supposed to be the result of a fall, and was in bed for three weeks, with fever; she was delirious part of the time. Her menses were irregular from that time, and ceased entirely four years ago, the patient then being 27 years of age. About six years ago she began to have dull pains in the left hypochondrium, but gave little attention to them until two or three years later, when
Cystic fibrosis presenting with periorificial dermatitis
Authors: Christopher P. Schmidt, Walter Tunnessen
Journal: Journal of the American Academy of Dermatology (1991)

A 2-week-old baby boy had a periorificial dermatitis that progressively worsened, as did his failure to thrive.Decreased serum zinc, proteins, and amino acids, as well as an increase in fecal fat, were noted.The child's dermatitis responded promptly to nutritional therapy.Sweat chloride levels were markedly elevated.The dermatitis, occasionally seen as a presenting feature ofcystic fibrosis, is most likely the result of malabsorption caused by pancreatic exocrine dysfunction.(
A Note on the Treatment of Rheumatoid Arthritis by Vaccines
Authors: G. A. Bannatyne, J. Lindsay
Journal: BMJ (1911)

Recurrence of sudden infant death syndrome (SIDS) is rare but may give rise to confusion and controversy because of the differential diagnoses of familial disease or covert homicide. We examine eight studies of recurrent SIDS published in English since 1970. These studies reported relative risks of recurrence, as compared with the population or with controls, ranging from 1.7 to 10.1. We assess the validity of the studies by three main criteria: accuracy of ascertainment, adequacy of investigation and matching of controls. We found that all the studies failed to meet these criteria, and we think that their flaws would have resulted mainly in overestimation of recurrence risk. We conclude that, although an increase in risk is probable on theoretical grounds, this risk cannot be quantified from the available evidence. We suggest that professionals should be cautious in their pronouncements on the chances of recurrence, and that parents who have lost a baby to SIDS can, with the exception of particularly vulnerable families, be reassured that the risk of recurrence is small.
A health service fit for a queen
Authors: Colin Brewer
Journal: BMJ (2013)

The British public doesn’t know much about medical care, but it knows what it likes, and that certainly includes a really good general practitioner who knows your medical and social history. Despite attempts by bureaucrats and the Shipman inquiry to bury him, Dr Finlay is alive and hugely popular in our collective imagination. And also in Buckingham Palace, where …
Effects of Elevated Glucose Concentrations on the Metabolism of the Aortic Wall
Authors: Anthony D. Morrison, Rex S. Clements, Albert I. Winegrad
Journal: Journal of Clinical Investigation (1972)

The effects of elevated glucose concentrations on the metabolism of the aortic wall were examined in a preparation of tubular segments of rabbit descending thoracic aorta comprised of intima and media only. Increased medium glucose concentrations (20-50 mm) resulted in increased aortic sorbitol and fructose concentrations and an increased rate of fructose release into the medium. This increased flux through the polyol pathway can be explained as a consequence both of an increased free intracellular glucose concentration and of the kinetic characteristics of the alditol: NADP oxidoreductase and the l-iditol: NAD oxidoreductase isolated and partially purified from rabbit thoracic aorta. Incubation with elevated glucose concentrations for 2 or more hr was also associated with a significant increase in the water content of the tissue without a significant increase in the inulin space. The oxygen uptake of the tissues incubated with elevated glucose concentrations was significantly reduced; this appears to result from a limitation imposed by oxygen diffusion at physiological oxygen tensions. A compensatory increase in glycolysis and an increase in the aortic lactate/pyruvate concentration ratio were also observed. The oxygen uptake and lactate production of tissue incubated with 50 mm glucose could be preserved at rates observed in tissue incubated with a physiological glucose concentration by the addition of 40 mm mannitol to the medium. Aortic intima and media from alloxan-diabetic rabbits also exhibit an increased water content and a decreased rate of oxygen uptake. These observations suggest that elevated ambient glucose concentrations result in significant alterations in the metabolism of aortic intima and media.
The Global Burden of Tuberculosis — Combating Drug Resistance in Difficult Times
Authors: Peter R. Donald, Paul D. van Helden
Journal: New England Journal of Medicine (2009)

Disturbingly, there were an estimated 500,000 cases of multidrug-resistant (MDR) tuberculosis in 2007, and 55 countries had reported cases of extensively drug-resistant (XDR) tuberculosis by the end of 2008. Dr. Peter Donald and Paul van Helden write that these figures highlight a potential threat to our ability to treat tuberculosis.
Limitations of multidetector computed tomography (MDCT)
Authors: E. D Nicol, J. Stirrup
Journal: BMJ (2008)

Haydar et al recommend wider adoption of multidetector computed tomography (MDCT) to investigate acute interscapular chest pain.1 Although the potential to confirm or exclude acute myocardial infarction, aortic dissection, aortitis, or acute pulmonary embolism in a single radiological study is highly appealing, they did not mention potential hazards or limitations.

Firstly, thorough clinical history and examination should, in most cases, allow determination …
Psychological Reactions in the Wounded
Authors: L. Minski
Journal: BMJ (1945)

BRiJTISH way be precipitated in a susceptible patient.It may be that the development of an acute glaucoma, which on rare occasions follows operation and which has previously been ascribed to premedication with atropine, may really have been due in whole or part to this phenomenon.It is necessary to point out that in this series of cases hyoscine and not atropine was used pre-operatively; all readings were taken with the Schi6tz tonometer, and in conscious patients gutt.holocaine 1 %0 was used as a local analgesic.SummaryThirteen cases of unilateral hypotony have been described follow- ing anaesthesia in a series of 300 cases.The aetiological factor has been shown to be the pressure exerted by the rim of a badly adjusted face-mask, and the importance of the choice of a correct size and shape of mask is stressed.The nature, length of operation, age and condition of the patient, and type of anaesthetic used, seem to play little or no part in the production of this unilateral hypotony, although pentothal sodium, which is known to cause a bilateral reduction in tension, no doubt tends to exaggerate the effects caused by pressure, as instanced by Cases 1, 12, and 13.The possibility of the occurrence of acute glaucoma in the affected eye should be borne in mind, as the lowered intraocular tension is followed by a rise above the normal which may last for some hours.We are indebted to Mr. C. H.
Noninvasive Evaluation of Coronary Sinus Anatomy and Its Relation to the Mitral Valve Annulus
Authors: Laurens F. Tops, Nico R. Van de Veire, Joanne D. Schuijf, Albert de Roos, Ernst E. van der Wall, Martin J. Schalij, Jeroen J. Bax
Journal: Circulation (2007)

Percutaneous mitral annuloplasty has been proposed as an alternative to surgical annuloplasty. In this respect, evaluation of the coronary sinus (CS) and its relation with the mitral valve annulus (MVA) and the coronary arteries is relevant. The feasibility of evaluating these issues noninvasively with multislice computed tomography was determined.In 105 patients (72 men, age 59+/-11 years), 64-slice multislice computed tomography was performed for noninvasive evaluation of coronary artery disease. Thirty-four patients with heart failure and/or severe mitral regurgitation were included. Three-dimensional reconstructions and standard orthogonal planes were used to assess CS anatomy and its relation with the MVA and circumflex artery. In 71 patients (68%), the circumflex artery coursed between the CS and the MVA with a minimal distance between the CS and the circumflex artery of 1.3+/-1.0 mm. The CS was located along the left atrial wall, rather than along the MVA, in the majority of the patients (ranging from 90% at the level of the MVA to 14% at the level of the distal CS). The minimal distance between the CS and MVA was 5.1+/-2.9 mm. In patients with severe mitral regurgitation, the minimal distance between the CS and the MVA was significantly greater as compared with patients without severe mitral regurgitation (mean 7.3+/-3.9 mm versus 4.8+/-2.5 mm, P<0.05).In the majority of the patients, the CS courses superiorly to the MVA. In 68% of the patients, the circumflex artery courses between the CS and the mitral annulus. Multislice computed tomography may provide useful information for the selection of potential candidates for percutaneous mitral annuloplasty.
Cytokine regulation of antigen-driven immunoglobulin production in filarial parasite infections in humans.
Authors: C L King, E A Ottesen, T B Nutman
Journal: Journal of Clinical Investigation (1990)

To define the immunoregulatory mechanisms underlying serum IgE levels found in patients with filariasis, we studied polyclonal IgE production by peripheral blood mononuclear cells (PBMC) from 15 patients with filarial infections, with a focus on the role of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) in the generation and regulation of the response. Spontaneous in vitro IgE production was elevated in 10 of the 15 patients (836-6,464 pg/ml; normals, less than 500 pg/ml). Addition of filarial parasite antigen to PBMC cultures significantly stimulated polyclonal IgE production in an antigen dose-dependent manner in 10 of 12 patients tested (P less than 0.001). The essential role of IL-4 in the generation of this response was demonstrated when simultaneous addition of anti-IL-4 completely inhibited antigen-stimulated IgE production in all 10 patients studied. An inhibitory role of endogenously produced IFN-gamma was also indicated when the addition of anti-IFN-gamma to the cultures significantly augmented filarial antigen-stimulated IgE production by 33-1,238% in these same patients. Addition of 10-1,000 U/ml of recombinant human IFN-gamma to PBMC completely inhibited parasite antigen-induced IgE production. This study demonstrates that filarial antigen-stimulated IgE production in patients with filariasis is mediated by IL-4 and down regulated by IFN-gamma and suggests that the amount of IgE produced depends on the relative quantity of IL-4 and IFN-gamma generated by parasite-specific T cells.
Dispersion of atrial refractoriness and atrial fibrillation vulnerability: relationship to anatomic site and basic cycle length
Authors: F.X. Roithinger, P.R. Steiner, M.R. Karch, D. Scholtz, M. Chin, C. Stillson, A. SippensGroenewegen, M.D. Lesh
Journal: Journal of the American College of Cardiology (1998)
Vascular incorporation of alpha-tocopherol prevents endothelial dysfunction due to oxidized LDL by inhibiting protein kinase C stimulation.
Authors: J F Keaney, Y Guo, D Cunningham, G T Shwaery, A Xu, J A Vita
Journal: Journal of Clinical Investigation (1996)

Excess vascular oxidative stress has been linked to impaired endothelium-dependent arterial relaxation in hypercholesterolemia. alpha-Tocopherol (AT) preserves endothelial function in hypercholesterolemia although the mechanism(s) for this protective effect is (are) not known. We examined the tissue-specific effects of AT on oxidized LDL (ox-LDL)-mediated endothelial dysfunction in male New Zealand White rabbits. Animals consumed chow deficient in (< 10 IU/kg) or supplemented with (1,000 IU/kg) AT for 28 d. Exposure of thoracic aortae from AT-deficient animals to ox-LDL (0-500 microg/ml) for 4 h produced dose-dependent inhibition of acetylcholine-mediated relaxation (P < 0.05) while vessels derived from animals consuming AT were resistant to ox-LDL-mediated endothelial dysfunction. Animals consuming AT demonstrated a 100-fold increase in vascular AT content and this was strongly correlated with vessel resistance to endothelial dysfunction from ox-LDL (R = 0.67; P = 0.0014). These results were not explained by an effect of AT on ox-LDL-mediated cytotoxicity by LDH assay or scanning electron microscopy. Vascular incorporation of AT did produce resistance to endothelial dysfunction from protein kinase C stimulation, an event that has been implicated in the vascular response to ox-LDL. Human aortic endothelial cells loaded with AT also demonstrated resistance to protein kinase C stimulation by both phorbol ester and ox-LDL. Thus, these data indicate that enrichment of vascular tissue with AT protects the vascular endothelium from ox-LDL-mediated dysfunction, at least in part, through the inhibition of protein kinase C stimulation. These findings suggest one potential mechanism for the observed beneficial effect of AT in preventing the clinical expression of coronary artery disease that is distinct from the antioxidant protection of LDL.
Failure of Exercise to Reduce Blood Pressure in Patients With Mild Hypertension
Authors: James A. Blumenthal
Journal: JAMA (1991)

--To assess the effects of physical exercise training on blood pressure in patients with mild hypertension.--Randomized controlled trial.--Hospital-based cardiac rehabilitation program.--Ninety-nine men and women with untreated mild hypertension (systolic blood pressure, 140 to 180 mm Hg; diastolic blood pressure, 90 to 105 mm Hg) were included in the volunteer sample.--Subjects were randomly assigned to a 4-month program of aerobic exercise training, strength and flexibility training, or to a waiting list control group.--The main outcome measures were systolic and diastolic blood pressures measured four times with a random zero sphygmomanometer on 3 separate days in a clinic setting.--After 4 months of exercise training, subjects in the aerobic exercise group did not exhibit greater reductions in blood pressure than subjects in the control group. We expected a differential decline of 5 mm Hg between the aerobic exercise and waiting list control groups and found a difference of -1.0 +/- 16 mm Hg and -1.2 +/- 10 mm Hg at alpha = .05 for systolic and diastolic blood pressure, respectively.--Moderate aerobic exercise alone should not be considered a replacement for pharmacologic therapy in nonobese patients with mild hypertension.
Analysis of HL-A antigens in patients with Hodgkin's disease and their families
Authors: John F. Forbes, Peter J. Morris
Journal: Journal of Clinical Investigation (1972)

The HL-A phenotypes of 127 patients with Hodgkin's disease have been determined. A very significant association has been found between Hodgkin's disease and two HL-A antigens, HL-A11 (P < 0.009), and W5 (P < < 0.0005). The families of 40 of these patients were genotyped for HL-A antigens. A normal mendelian segregation of the relevant antigen was found in all 12 families of HL-All positive patients and in 6 of 8 families of W5 positive patients. These findings suggest that certain Hodgkin's patients have a genetically determined susceptibility to their disease. It is postulated that this susceptibility could be due to linkage between HL-A genes and genes controlling immune responsiveness. Analysis of subgroups of Hodgkin's patients based on age, sex, and pathology suggests that these HL-A associations are most marked in certain subgroups.
Mutations in SLC6A19, encoding B0AT1, cause Hartnup disorder
Authors: Robert Kleta, Elisa Romeo, Zorica Ristic, Toshihiro Ohura, Caroline Stuart, Mauricio Arcos-Burgos, Mital H Dave, Carsten A Wagner, Simone R M Camargo, Sumiko Inoue, Norio Matsuura, Amanda Helip-Wooley, Detlef Bockenhauer, Richard Warth, Isa Bernardini, Gepke Visser, Thomas Eggermann, Philip Lee, Arthit Chairoungdua, Promsuk Jutabha, Ellappan Babu, Sirinun Nilwarangkoon, Naohiko Anzai, Yoshikatsu Kanai, Francois Verrey, William A Gahl, Akio Koizumi
Journal: Nature Genetics (2004)
Abstract A73: A bioengineered ovarian cancer microenvironment to assess protease-associated functions
Authors: Daniela Loessner, Simone C. Rizzi, Kathryn S. Stok, Viktor Magdolen, Dietmar W. Hutmacher, Judith A. Clements
Journal: Clinical Cancer Research (2013)

Abstract Cancer-associated proteases promote peritoneal dissemination and chemoresistance in malignant progression. In this study, kallikrein-related peptidases 4, 5, 6, and 7 (KLK4-7)-cotransfected ovarian cancer cells were embedded in a bioengineered three-dimensional (3D) microenvironment that contains RGD motifs for integrin engagement to analyse their spheroid growth and survival after chemotreatment. KLK4-7-cotransfected cells formed larger spheroids and proliferated more than controls in 3D, particularly within RGD-functionalized matrices, which was reduced upon integrin inhibition. In contrast, KLK4-7-expressing cell monolayers proliferated less than controls, emphasising the relevance of the 3D microenvironment and integrin engagement. In a spheroid-based animal model, KLK4-7-overexpression induced tumor growth after 4 weeks and intraperitoneal spread after 8 weeks. Upon paclitaxel administration, KLK4-7-expressing tumors declined in size and showed less metastatic outgrowth. KLK4-7-expressing spheroids showed 53% survival upon paclitaxel treatment, accompanied by enhanced chemoresistance-related factors; their survival was further reduced by combination treatment of paclitaxel with KLK (22%) or MAPK (6%) inhibition. The concomitant presence of KLK4-7 in ovarian cancer cells together with integrin activation drives spheroid formation and proliferation. Combinatorial approaches of paclitaxel and KLK/MAPK inhibition may be more efficient for late-stage disease than chemotherapeutics alone as these inhibitory regimens reduced cancer spheroid growth to a greater extent than paclitaxel alone. Citation Format: Daniela Loessner, Simone C. Rizzi, Kathryn S. Stok, Viktor Magdolen, Dietmar W. Hutmacher, Judith A. Clements. A bioengineered ovarian cancer microenvironment to assess protease-associated functions. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A73.
Graduate Primary Care Training: A Collaborative Alternative for Family Practice, Internal Medicine, and Pediatrics
Authors: A.H. Strelnick
Journal: Annals of Internal Medicine (1988)

The Residency Program in Social Medicine at Montefiore Medical Center is a collaborative, integrated training program for primary care pediatricians, internists, and family physicians within one interdisciplinary organization. Since 1970 we have trained more than 200 physicians, prepared them for board certification in their specialty, emphasized the psychosocial aspects and social determinants of health and illness, and shared a faculty, curriculum, and commitment to provide medical care for inner-city, underserved populations. We discuss the program's history and curriculum, administrative and academic structure, shared "crosstrack faculty units (psychosocial; social medicine; and research, education, and evaluation), and graduates' practice outcomes. The interdisciplinary character of the Residency Program in Social Medicine helps physicians successfully serve the underserved and exemplifies that interdisciplinary medical education succeeds when interdisciplinary health care teams are organized for optimal patient care. Only the federal government has the perspective and power to foster more interdisciplinary collaboration and strengthen primary care education in a period of shrinking resources.
Genomewide Linkage Analysis Identifies Novel Genetic Loci for Lung Function in Mice
Authors: Claudia Reinhard, Birgit Meyer, Helmut Fuchs, Tobias Stoeger, Gunter Eder, Franz Rüschendorf, Joachim Heyder, Peter Nürnberg, Martin Hrabé de Angelis, Holger Schulz
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Pulmonary function, including lung volumes and compliance, may be genetically determined, but few genetic polymorphisms have been identified that control these traits. We used an experimental approach and performed the first whole genome scan for pulmonary function in mice.To identify novel chromosomal regions contributing to lung function, quantitative trait locus linkage analysis was applied in N(2) backcross and F(2) intercross mice derived from two inbred strains-C3H/HeJ and JF1/Msf-with extremely divergent phenotypes.Significant linkages to total lung capacity with LOD (logarithm of the odds) scores up to 6.0 were detected on chromosomes 15 and 17, to dead space volume and lung compliance on chromosomes 5 and 15 (LOD scores higher than 4.0), to lung compliance also on chromosome 19 (LOD score of 5.8), and to diffusing capacity on chromosomes 15 and 17 (LOD scores up to 5.0). The region of interest on chromosome 17 near D17Mit133 contains a syntenic region to human chromosome 6q27, which was recently identified to be linked to lung function in humans. The identified intervals harbor valuable candidate genes, such as the relaxin1 and transforming growth factor beta receptor 3 gene, which revealed missense polymorphisms between the parental strains.The study provides evidence for linkage of different measures of lung function on murine chromosomes 5, 15, 17, and 19 and suggests novel candidate genes that may also affect the expression of human pulmonary function.