tbuckley/cabot-search huggingface dataset:
A better mousetrap
Authors: Adrian Reuben
Journal: Hepatology (2004)

A Better Mousetraplood spurts as from a geyser, and prompt action is required.With its familiar hiss, suction is applied, and an expanding redness comes into view, like a vermilion Carolina moon waxing in accelerated time.The knob is turned, and a satisfying muffled click is felt more than heard.Warily, the vacuum is released and the knuckle of once gushing mucosa, now ensnared with a shiny black rubber ring, recedes slowly from sight like the jettisoned stage of a spacecraft.Another bleeding varix, temporarily staunched only weeks ago with a styptic injection, has finally been successfully obliterated (Fig. 1) l .It seems a little surprising now that the occurrence of esophagogastric varices in cirrhosis and their propensity to bleed became widely appreciated only late in the history of hepatology, after the turn of the 20th century.2Although modern estimates do range widely, we know that the prevalence of varices in cirrhosis, their risk of bleeding and rebleeding and the consequent mortality, are all in the 20% to 80% range, depending upon the variables in the study and the particular stratification used.3Nonetheless, William Osler, who recognized the existence of esophageal varices4 and had himselfwitnessed a fatality therefrom,5 had personal experience of only two cases by the time he published his famous textbook in 1892, in which, forsooth, he also wrote that hemorrhage from gastric varices was seldom f a d 6 The existence of esophageal varices had actually been clearly established 50 years earlier, in 1840, by William Power of Maryland, who reported on the autopsy of a 50-year-old man of robust frame, intemperate habits, and deficient intelligence.7The patient, who died of gastrointestinal hemorrhage, was found to have "Varicose veins of the oesophagus" that Power had never met with before, nor had he found a similar case recorded.Power wondered, ". ..whether the presence ofvarices to such an extent, and death caused by their rupture, be not-something as yet unheard of in pathological anatomy."7Power's discovery was later confirmed in a report from France,8 but even so this was still the only experience of that entity for Friedrich Theodor von Frerichs, the founder of modern hepatology, by the time his own textbook was written.' Admittedly it was well nigh impossible then to diagnose in life the presence of varices-silent or otherwise-in the years before Adolf Kussmaul performed the first really practical esophagoscopy in Freiburg in 1868, using an ~ ~~~~
People with sickle cell disease need better services
Authors: L Dillner
Journal: BMJ (1994)

People with sickle cell disease and other haemoglobinopathies in Britain do not always get the best treatment, says a report from the Standing Medical Advisory Committee. Children suffering from these disorders are often not given penicillin prophylaxis to prevent pneumococcal infection, although this is one of the few interventions supported by research findings. The report, commissioned by the secretary of state for health, says that services are less than comprehensive, even in districts where these disorders are common.

About 5000 people in Britain have sickle cell disease; most of them are Afro-Caribbean. Thalassaemia, mostly of the beta type and in …
THE PATHOLOGY AND ETIOLOGY OF ARTHRITIS DEFORMANS.
Authors: THOMAS McCRAE
Journal: JAMA (1904)

In discussing this subject there are two courses open; one is to go over the various theories and ideas that have been put forth, the other is to dispense with tradition so far as we can and state as closely as possible the condition of our knowledge in regard to this subject to-day. It is perhaps well to state frankly that we are more likely to outline our ignorance than to state our knowledge, but we can at any rate determine the lines in which investigation is most likely to be profitable, because I take it that no one would be likely to say to-day that we had anything very firmly established in regard to the subject of this paper. Through bacteriologic work we have been able to limit certain forms of arthritis definitely. It would seem best to restrict the term
Characterization of B‐ and T‐cell responses and HLA‐DR4 binding motifs of the latex allergen Hev b 6.01 (prohevein) and its post‐transcriptionally formed proteins Hev b 6.02 and Hev b 6.03
Authors: M. Raulf‐Heimsoth, P. Rozynek, T. Brüning, H.‐P. Rihs
Journal: Allergy (2004)

Background: Multiple immunoglobulin E (IgE)‐binding proteins in natural rubber latex extracts have been identified. In the case of Hev b 6 a differentiation was made between the precursor protein prohevein (Hev b 6.01) and its two post‐transcriptionally formed proteins, the N‐terminal hevein (Hev b 6.02) and the C‐terminal domain (Hev b 6.03). All three components act as independent allergens. The aim of this study was a detailed analysis of the T‐cell responses and the IgE‐binding capacity of Hev b 6.01, Hev b 6.02 and Hev b 6.03 by using these allergens as recombinant maltose‐binding fusion (MBP) proteins and the usage of synthetic modified hevein peptides. Methods: Latex‐allergic health care workers (HCWs) suffering from rhinitis, conjunctivitis, contact urticaria and/or asthma with increased specific IgE‐antibodies to latex were tested for their IgE‐binding capacity and T‐cell reactivity (by proliferation response) to the recombinant MBP‐rHev b 6.01, MBP‐rHev b 6.02, MBP‐rHev b 6.03, to native Hev b 6.02, to modified hevein peptides and wheat germ agglutinin (WGA). For testing of the human leucocyte antigen (HLA) class II restriction of MBP‐rHev b 6.01 induced peripheral blood mononuclear cell (PBMC) responses, monoclonal antibodies against HLA‐DR, HLA‐DP or HLA‐DQ were added. Results: Seventeen of 18 (94%) serum samples from latex‐allergic HCWs had increased levels of specific IgE to MBP‐rHev b 6.01, 16 (89%) to MBP‐rHev b 6.02 and 13 (72%) to MBP‐rHev b 6.03. A significant difference existed between the specific IgE‐values of MBP‐rHev b 6.02 and MBP‐rHev b 6.03 ( P &lt; 0.01). Proliferation responses of PBMC of the same 18 latex‐allergic patients were positive for MBP‐rHev b 6.01 and MBP‐rHev b 6.03 in 83 and 67% of the tested PBMC suspension, whereas the proliferation responses induced with MBP‐rHev b 6.02 or native Hev b 6.02 were very low (5.6 and 22.2%). Sera from nine additional latex‐allergic patients showed specific IgE binding to the native Hev b 6.02, but none of these sera showed specific IgE binding to the modified Hev b 6.02‐peptides [whereby all eight cysteine residues were substituted by serine (C → S) or by alanine (C → A)]. Proliferation responses induced by the modified Hev b 6.02 peptides were not significantly different from that induced by Hev b 6.02. Potential HLA‐DR4Dw4(DRB1*0401)‐restricted T‐cell epitopes of Hev b 6.01 predicted by two computer algorithms were only found in the Hev b 6.03‐part of Hev b 6.01. Conclusion: In the Hev b 6.01 precursor the regions responsible for IgE binding and those for inducing the T‐cell proliferation responses are settled in different parts of the protein. The Hev b 6.02 domain is responsible for IgE binding and carries discontinuous B‐cell epitopes whereas Hev b 6.03 is a better inducer of a proliferation response and contains HLA‐DR4‐binding motifs.
Impact of genetic abnormalities on survival after allogeneic hematopoietic stem cell transplantation in multiple myeloma
Authors: G Schilling, T Hansen, A Shimoni, T Zabelina, J-A Simon-Perez, N C Gutierrez, W Bethge, P Liebisch, R Schwerdtfeger, M Bornhäuser, S Otterstetter, E M M Penas, J Dierlamm, F Ayuk, D Atanackovic, U Bacher, C Bokemeyer, A Zander, J S Miguel, A Nagler, N Kröger
Journal: Leukemia (2008)
An Automated Method for the Measurement of Ventricular Volume
Authors: MELVIN L. MARCUS, WILLIAM H. SCHUETTE, WILLARD C. WHITEHOUSE, JAMES J. BAILEY, D. LUKE GLANCY
Journal: Circulation (1972)

Several important indices of myocardial performance depend upon accurate and frequent measurement of ventricular volume. Studies employing such measurements have been limited because of the difficulty of manually measuring and calculating volumes frequently enough to obtain meaningful data. We, therefore, have developed an automated method for determination of ventricular volume in man. Left ventricular cineangiograms taken in the right anterior oblique position at 60 frames/sec are projected with a flickerless projector onto a Plumbicon television camera. A second television camera is used by a skilled operator for masking out noncontributory portions of the film and for shading selected areas to facilitate accurate recognition of the opacified chamber. An electronic video-tracking device then simultaneously determines the area and the maximum length of the opacified chamber in each cine frame. These data are recorded as analog signals on magnetic tape. Volumes are calculated by computer and plotted against time. When volumes determined by this automated method are compared with those obtained by manual planimetry, the correlation coefficient is 0.96. Aluminum prolate spheroids, left ventricular casts, and left ventricular cineangiograms were studied. This automated technic permits rapid and accurate measurement of ventricular volume in patients having diagnostic left ventriculograms.
Characterization of Gap Junction Channels in Adult Rabbit Atrial and Ventricular Myocardium
Authors: Sander Verheule, Marjan J. A. van Kempen, Pascal H. J. A. te Welscher, Brenda R. Kwak, Habo J. Jongsma
Journal: Circulation Research (1997)

For effective cardiac output, it is essential that electrical excitation spread rapidly throughout the atria and ventricles. This is effected by electrical coupling through gap junction channels at contact sites between myocytes. These channels form a low-resistance pathway between adjacent myocytes and consist of connexin proteins. The connexin family is a large multigene family, and the channels formed by different members of this family have distinct electrical and regulatory properties. We have studied gap junction channels between adult rabbit atrial and ventricular myocytes using immunocytochemical and electrophysiological methods. Gap junctions of ventricular myocytes were immunoreactive to antibodies directed against connexin43 (Cx43) and Cx45, but not to antibodies against Cx37 or Cx40. Gap junctions between atrial myocytes showed immunostaining with anti-Cx40, -Cx43, and -Cx45 antibodies, but not with anti-Cx37 antibody. Endocardial and endothelial tissue were labeled with both Cx37 and Cx40 antibodies. The conductance of rabbit myocardial gap junctions was measured using the double whole-cell voltage-clamp method. The average macroscopic junctional conductance, corrected for series resistance, of atrial and ventricular cell pairs did not differ significantly (169+/-146 and 175+/-147 nS, respectively), and both were at most only slightly sensitive to the applied transjunctional potential difference. The difference in connexin expression between atrial and ventricular myocytes was reflected in the distribution of single gap junction channel conductances. A single population of unitary channel conductances with an average of 100 pS was observed between ventricular myocyte pairs. In addition to this population, a population with an average conductance of 185 pS was present between atrial myocyte pairs. The observed difference in connexin expression between atrial and ventricular myocardium may enable differential regulation of conduction in these tissues.
Resistant Urinary Infections Resulting from Changes in Resistance Pattern of Faecal Flora Induced by Sulphonamide and Hospital Environment
Authors: K. Lincoln, G. Lidin-Janson, J. Winberg
Journal: BMJ (1970)

The faecal flora was studied in eight children admitted to hospital for treatment of a first urinary infection with sulphonamides. The original, sulphonamide-sensitive Escherichia coli organisms were found to disappear, to be replaced by other E. coli serotypes that were almost invariably resistant to sulphonamides. Some of these serotypes carried R-factors for multiple antibiotic resistance.Possibly some urinary infections with antibiotic-resistant organisms may be due to faecal organisms whose resistance has been changed by previous antibiotic treatment. Hence it is important to study the effects of individual antibiotics on the faecal flora.
Pitfalls in Medicine.--II
Authors: A. H. Douthwaite
Journal: BMJ (1956)

IHow often are we wrong?One searches in vain for precise information pointing to the error-proneness of physicians, surgeons, and general practitioners.Some indication of consultant fallibility is offered by Scandi-I navian analysis based on a thousand consecutive I necropsies.This reveals 67 completely faulty diagnoses and a higher number of incomplete assessments of the morbid processes during life.Carcinoma of the stomach and bacterial endocarditis in old people rank high in the list.Mistakes largely due to vagaries of disease rather than to faulty approach by the physician can be traced as a rule to unusual patterns of symptoms-less often to puzzling physical signs. Misleading Symptoms: Coronary Artery DiseaseRather surprisingly, perhaps, we find coronary artery dis- ease may present in such strange ways, or be mimicked so closely by other conditions, that it provides a formid- able pitfall even for those who devote themselves to diseases of the heart.A few case histories may be of interest.
A Fan for Snoring
Authors: ROBERT A. STEVEN
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 December 1973A Fan for SnoringROBERT A. STEVEN, M.D., F.A.C.P.ROBERT A. STEVEN, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-6-914_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The numerous references to snoring in the scientific and lay literatures attest to its wide prevalence and to the domestic unhappiness it causes. To date, no treatment of much value has been suggested, except the use of separate rooms. Hence this brief presentation.Seven years ago my wife and I spent a vacation in Santo Domingo. We had an air-conditioned room, and the conditioner was on through every night. After three nights my wife remarked that she had not been disturbed by my snoring and had slept better than she had for years. I decided then that... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT A. STEVEN, M.D., F.A.C.P.Affiliations: San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1973Volume 79, Issue 6Page: 914-914 ePublished: 1 December 2008 Issue Published: 1 December 1973 PDF downloadLoading ...
Adverse Influence of Systemic Vascular Stiffening on Cardiac Dysfunction and Adaptation to Acute Coronary Occlusion
Authors: David A. Kass, Akio Saeki, Richard S. Tunin, Fabio A. Recchia
Journal: Circulation (1996)

[corrected] Age is an independent risk factor for increased mortality from ischemic heart disease. Arterial stiffening with widening of the pulse pressure may contribute to this risk by exacerbating cardiac dysfunction after total coronary artery occlusion.To test the above hypothesis, 14 open-chest dogs underwent surgery in which the intrathoracic aorta was bypassed with a stiff plastic tube. Directing ventricular outflow through the bypass widened the arterial pulse pressure from 41 to 115 mm Hg at similar mean pressure and flow. Hearts ejecting into the native aorta (NA) exhibited only modest dysfunction after two minutes of mid-left anterior descending coronary artery occlusion. However, the same occlusion applied during ejection into the bypass tube (BT) induced far more severe cardiodepression (ie, systolic pressure fell by -41+/-10 mm Hg for BT versus -15+/-3 mm Hg for NA, and end-systolic volume rose by 15+/-3 versus 6+/-2 mL), with a threefold greater decline in ejection fraction. This disparity was not due to higher baseline work loads because total pressure-volume area was similar in both cases. Furthermore, marked increases in basal work load and wall stress induced by angiotensin II infusion (in four additional studies) did not reproduce this behavior. Although peak systolic chamber stress was greater with the BT, this did not increase systolic dyskinesis as measured in the central ischemic zone. However, the total mass of myocardium that was rendered severely ischemic (ie, flow reduced by > or = 80%) was twice as large with BT ejection, likely expanding the region of dyskinesis. This disparity may relate to altered phasic coronary flow during BT ejection, which displays marked enhancement of systolic flow and renders the heart more vulnerable to diminished mean and systolic perfusion pressures.Cardiac ejection into a stiff systemic vasculature augments cardiac dysfunction and ischemia due to coronary occlusion by tightening the link between cardiac systolic performance and myocardial perfusion. This may contribute to the higher mortality risk from ischemic heart disease due to age.
Improving Care of Patients With Hypertension-Reply
Authors: William B. Kannel
Journal: JAMA (1996)

In Reply.  —I agree with Dr Black's assertions about the state of physicians' control of existing hypertension in the general population. Hypertension is one of the most easily detected and corrected of the major risk factors for cardiovascular disease. Therefore, it is disappointing that we have not been able to bring the blood pressure of hypertensive patients under better control. However, in addition to correcting the barriers of poor understanding of the hazards and need for better long-term compliance in taking medications, there is an urgent need to implement more effective primary preventive measures. The incidence of new onset of hypertension remains unacceptably high. As monitored by the Framingham Study, hypertension incidence and prevalence have not shown any tendency to decline over decades of follow-up of the cohort. 1 Few diseases have been eradicated from populations by detecting and treating all those who already have it. We must attempt to shift
Straight hair associated with interferon alfa plus ribavirin in hepatitis C infection
Authors: S.W. Lanigan
Journal: British Journal of Dermatology (2003)

Sir, The striking photographs of patient 2 in the letter by Bessis et al.1 clearly caught the eye. Their patient, a 45‐year‐old white man with chronic hepatitis C, was described in the correspondence. I wonder for what purpose were the black rectangles superimposed over the patient's eyes? I feel confident that anyone knowing the patient would recognize him immediately from the photographs and be able to read confidential medical information concerning him. I feel there is often a tokenism (to which I have contributed in the past) to the black box obscuring the eyes, the purpose of which should be to preserve the patient's anonymity. In my experience this frequently fails, although not often as so obviously as in this example. Authors and editors should ensure that adequate attempts are made to conceal identifiable features or, as is becoming more common practice, to obtain the patient's consent before publishing their image.
Long-term results of five consecutive trials in childhood acute lymphoblastic leukemia performed by the ALL-BFM study group from 1981 to 2000
Authors: A Möricke, M Zimmermann, A Reiter, G Henze, A Schrauder, H Gadner, W D Ludwig, J Ritter, J Harbott, G Mann, T Klingebiel, F Zintl, C Niemeyer, B Kremens, F Niggli, D Niethammer, K Welte, M Stanulla, E Odenwald, H Riehm, M Schrappe
Journal: Leukemia (2009)
HIV vaccine partnerships offer hope to the developing world
Authors: H. Matthews
Journal: BMJ (1998)

The International AIDS Vaccine Initiative, based in New York, US, was established in 1996 to develop a safe and affordable AIDS vaccine. It is funded by a number of large foundations and charities, the British government, and the World Bank. The Initiative's first 2 large projects, 2 research programs into a vaccine against HIV, were launched last week. The programs cost $9 million and involve partnerships between British, American, and African researchers. The goal is to produce a vaccine against HIV which is effective against the viral strains prevalent in the developing world and affordable to the governments of the worst affected countries. Work on an AIDS vaccine is extremely important to the world, for only such a vaccine has any chance of ending the global epidemic. Any vaccine which is developed from the initiative's research efforts will be subject to unique agreements on intellectual property, which will allow its use at low cost in the developing world, where 95% of AIDS cases occur. One of the partnerships will begin phase 1 safety trials within 1 year.
A NEW CASE OF GRANULOMA ANNULARE
Authors: H. RADCLIFFE-CROCKER
Journal: British Journal of Dermatology (1902)

Journal Article A NEW CASE OF GRANULOMA ANNULARE Get access H. RADCLIFFE‐CROCKER H. RADCLIFFE‐CROCKER Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 14, Issue 8, 1 August 1902, Pages 307–310, https://doi.org/10.1111/j.1365-2133.1902.tb16458.x Published: 01 August 1902
A Variant of AESOP Syndrome (Adenopathy and Extensive Skin Patch Overlying a Plasmacytoma)
Authors: Franco Rongioletti, Alfredo Rebora
Journal: JAMA Dermatology (2013)

Glucocorticoids form the backbone of therapy, with additional immunosuppressive agents being required in most cases. Options for additional immunosuppressive therapy include cyclosporine, mycophenolate mofetil, cyclophosphamide, intravenous immunoglobulin, plasmapheresis, and rituximab. 2,3,5 It has been proposed that many of these adjuvant immunosuppressants increase the risk of developing a malignant neoplasm. While this potential increase in risk may be acceptable in a patient at average risk, in the present case, it added a layer of complexity in our patient with a p53 mutation. We opted to use cyclosporine as a steroid-sparing agent, and our patient subsequently continued taking cyclosporine as monotherapy with a good response. To our knowledge, this is the first reported case in English of treatment for PAMS in the setting of Li-Fraumeni syndrome. We recommend that an oncologist be involved in the choice of therapeutic agents for the treatment of PAMS in the setting of a p53 mutation.