tbuckley/cabot-search huggingface dataset:
Successful discontinuation of anticoagulation following eculizumab administration in paroxysmal nocturnal hemoglobinuria
Authors: Ashkan Emadi, Robert A. Brodsky
Journal: American Journal of Hematology (2009)

Langerhans cell histiocytosis following acute leukemia in an adultTo the editor: A 69-year-old man presents with cough and SOB approximately 3.5 years following diagnosis of a poorly differentiated acute lymphocytic leukemia (progenitor cell phenotype).By flow cytometry, the initial leukemia in 1998 was positive for HLA-DR, CD34, and CD45 and negative for lymphoid and myeloid markers including: CD3, CD5, CD7, CD19, CD10, CD20, CD13, CD33, CD11b, and CD14; CD1a and S-100 protein staining were not available on this sample.A pathologic diagnosis of a progenitor cell leukemia most suggestive of acute lymphocytic leukemia was made.The patient received induction therapy in November 1998 and achieved a complete remission.Consolidation therapy was discontinued after one cycle due to severe cytopenias.Maintenance therapy was discontinued after 6 months secondary to methotrexate-induced hepatoxicity.Approximately 3.5 years after the initial diagnosis, the patient presented with back pain and leg weakness and found to have a paraspinal mass with cord compression.He underwent surgical resection followed by consolidative radiation.The lesion (see Fig. 1) was composed of sheets of medium to large sized mitotically active cells with relatively abundant cytoplasm.Occasional multinucleated tumor giant cells were also identified.The cell nuclei were vesicular with irregular contour and occasional grooves.Considering the remote history of a lymphocytic leukemia and the morphologic features which raised the possibility of an epithelioid/dendritic cell neoplasm, a panel of immunohistochemical stains was used to characterize the lesion.The tumor cells were positive for vimentin, CD1a, S-100 protein, CD43 and focally for keratins, CD45, CD68, and lysozyme.Negative immunostains included EMA, Melan-A, CD3, CD20, CD21, CD35, Kappa and Lambda light chains, and MPO.Leder's histochemical stain was negative.Based on the morphology and the immunohistochemical profile, a diagnosis of a dendritic cell neoplasm most consistent with Langerhans cell sarcoma was rendered.Electron microscopic studies were not performed.Bone marrow biopsy revealed trilineage hematopoiesis with no evidence of leukemic involvement.Approximately 2 months later, he developed a similar soft tissue mass in the right upper chest extending into the right supraclavicular area.Radiation treatment resulted in a complete clinical response in the chest mass and he had no evidence of progression for 1 year.The patient then developed shortness of breath and fevers.A CXR showed a right
Targeting efficiency and biodistribution of biotinylated-EGF-conjugated gelatin nanoparticles administered via aerosol delivery in nude mice with lung cancer
Authors: Ching-Li Tseng, Steven Yueh-Hsiu Wu, Wen-Hsi Wang, Cheng-Liang Peng, Feng-Huei Lin, Chien-Cheng Lin, Tai-Horng Young, Ming-Jium Shieh
Journal: Biomaterials (2008)
The Sweet Contraceptive
Authors: Ira S. Schwartz
Journal: JAMA (1975)

<h3>To the Editor.—</h3> The lighthearted editorial by Dr. Henry T. Ricketts (231:392, 1975) concerning the potential of 5-thio-glucose as a male contraceptive prompted a verse in the same spirit: Five-thio in mice competes with D-Perhaps it can work for you and me. Within the testis it gums the works So spermatogenesis no longer works. No more hormones, IUDs, and the rest of that biz? Then hail 5-thio-glucose How sweet it is!
Thrombolytic therapy with streptokinase stimulates collagen breakdown.
Authors: K J Peuhkurinen, L Risteli, J T Melkko, M Linnaluoto, A Jounela, J Risteli
Journal: Circulation (1991)

BACKGROUND Plasmin is capable of degrading extracellular matrix components such as collagen in vitro. To evaluate the significance of this for in vivo conditions, we set out to study the effect of streptokinase, which acts by converting plasminogen to plasmin, on the serum concentrations of the amino-terminal propeptide of type III procollagen (PIIINP) and the carboxy-terminal propeptide of type I procollagen (PICP). METHODS AND RESULTS Twenty-three patients with suspected acute myocardial infarction were included in the study; 17 of them received thrombolytic therapy, and six were treated conservatively. PIIINP and PICP were assayed with radioimmunoassays. Kinetics of creatine kinase-MB release were determined to differentiate reperfusers from nonreperfusers. Composite curves of creatine kinase-MB release were constructed for different patient subgroups. During streptokinase infusion the serum concentrations of PIIINP increased rapidly, with a maximum mean increase of 50% (from 2.2 +/- 0.2 to 3.3 +/- 0.3 micrograms/l) in 45 minutes. A similar increase was also observed in two patients who received thrombolytic therapy but did not subsequently develop any myocardial infarction determined on the basis of enzyme release. The relative increase in PIIINP during streptokinase treatment was higher in those acute myocardial infarction patients with probable reperfusion than those with nonprobable reperfusion. Corresponding changes in PIIINP were not seen in the control group. Two days later there was a second increase in serum PIIINP for both patient groups. This change coincided with a similar increase in PICP. CONCLUSIONS We conclude that streptokinase, probably by activation of plasminogen to plasmin, stimulates the breakdown of type III collagen during thrombolytic therapy. This phenomenon may decrease the risk of rethrombosis of the affected artery if the exposed collagen is responsible for thrombosis formation, but it could also be involved in the development of hemorrhagic complications during thrombolytic therapy. The second increase in PIIINP levels probably indicates type III collagen synthesis of the infarcted area. This investigation represents a pilot study, and more studies on the effects of various thrombolytic agents on interstitial collagen metabolism are obviously needed.
Exogenous Reinfection in Tuberculosis
Authors: Paul E.M. Fine, Peter M. Small
Journal: New England Journal of Medicine (1999)

Tuberculosis, like all infectious diseases, involves exposure to a pathogen resulting in an asymptomatic period of incubation or latency that may progress to active disease. Unlike most other infectious diseases, tuberculosis involves a delay between infection and disease that is extremely variable, ranging from a few weeks to a lifetime. Therefore, the development of active tuberculosis in someone known to have been previously infected raises the question whether this represents a recrudescence of the initially infecting organism (endogenous reactivation) or a new strain of Mycobacterium tuberculosis (exogenous reinfection).For decades, this question has been central to a debate in which . . .
The Effect of Alcohol Intake on Insulin Sensitivity in Men
Authors: Renate R. Zilkens, Valerie Burke, Gerald Watts, Laurence J. Beilin, Ian B. Puddey
Journal: Diabetes Care (2003)

OBJECTIVE—Population data suggest that alcohol consumption may influence the risk of diabetes in a biphasic manner, but this has not been tested by any controlled interventions. The object of this study was to determine whether reducing alcohol intake in moderate-to-heavy drinkers (40–110 g/day) results in improvement in insulin sensitivity. RESEARCH DESIGN AND METHODS—A 4-week run-in period where subjects maintained their usual drinking pattern was followed by randomization to a two-way cross-over intervention study. In each of two 4-week treatment interventions, subjects either substituted their usual alcohol intake with a 0.9% alcohol beer or maintained their usual alcohol intake. At the end of each 4-week period, insulin sensitivity as determined by the low-dose insulin glucose infusion test and the homeostasis model assessment (HOMA) score, and biomarkers of alcohol consumption (γ-glutamyl transpeptidase [γ-GT] and HDL cholesterol) were measured. RESULTS—A total of 16 healthy men aged 51.0 ± 2.7 (mean ± SEM) years with a BMI of 26.4 ± 0.61 kg/m2 completed the study. There was a large reduction in alcohol intake (72.4 ± 5.0 vs. 7.9 ± 1.6 g/day, P &amp;lt; 0.001) and significant reductions in γ-GT (geometric mean 24.4 units/l [95% CI 19.7–30.2] vs. 18.6 units/l [15.5–22.2], P &amp;lt; 0.01) and HDL cholesterol (1.36 ± 0.07 vs. 1.13 ± 0.07 mmol/l, P &amp;lt; 0.001). There was no effect of alcohol on insulin sensitivity index (ISI), fasting insulin, glucose, or HOMA score. CONCLUSIONS—A substantial reduction in alcohol intake from 7.2 to 0.8 standard drinks per day in healthy men did not change insulin sensitivity as measured by ISI or HOMA score.
RUPTURE OF AN AORTIC ANEURISM IN A CHILD OF FOUR YEARS.
Authors: ROBERT N. WILLSON
Journal: JAMA (1907)

The following case is reported as of interest to the clinician as well as to the pathologist, especially in its bearing on the relation between hereditary syphilis and lesions of the heart and vessels in early life: <h3>Patient.</h3> —M. E., a male child, was born Oct. 19, 1903. He was the first child from the union of apparently healthy parents, born five years after their marriage. <h3>Family History.</h3> —Both father and mother are living, and both are 34 years of age. The father had the usual diseases of childhood, and hesitatingly denied having had a sore on the genitals, but admitted two distinct attacks of gonorrhea prior to marriage. At the age of 21 he began to experience convulsive seizures resembling epilepsy in all respects. He was treated for epilepsy by several neurologists in this city, but always with an increase in the number and severity of the attacks rather
Atrioventricular Dissociation in a Patient Receiving Clonidine
Authors: Patrick Abiuso
Journal: JAMA (1978)

<h3>To the Editor.—</h3> Recently Kibler and Gazes (238:1930, 1977) reported two cases of atrioventricular (AV) block associated with administration of clonidine hydrochloride. The only previously reported case was described by Yeh et al,<sup>1</sup>who described a patient with Wenkebach phenomena associated with clonidine use. We recently treated a patient with clonidine, and AV dissociation developed. <h3>Report of a Case. —</h3> A 38-year-old woman was admitted to the gynecological service at the Cooper Medical Center for evaluation of stress incontinence. Her previous diagnosis had been severe hypertension and nephrosclerosis. At the time of her admission, her blood pressure was elevated at 200/110 mm Hg despite various antihypertensives. She was given clonidine hydrochloride<sup>2</sup>at the time of admission, and dosage was gradually increased to 0.2 mg every eight hours orally. After approximately ten days of clonidine therapy, sinus bradycardia with AV dissociation developed unexpectedly. His's bundle electrography performed while he
Age-related prevalence of dermoscopy patterns in acquired melanocytic naevi
Authors: I. Zalaudek, S. Grinschgl, G. Argenziano, A.A. Marghoob, A. Blum, E. Richtig, I.H. Wolf, R. Fink-Puches, H. Kerl, H.P. Soyer, R. Hofmann-Wellenhof
Journal: British Journal of Dermatology (2005)

Based on the dermoscopic classification of acquired melanocytic naevi, six different dermoscopic types can be distinguished by morphology (globular, globular-reticular, globular-homogeneous, reticular, reticular-homogeneous, homogeneous) and by pigment distribution (uniform, central hyperpigmentation, central hypopigmentation, peripheral hyperpigmentation, peripheral hypopigmentation, multifocal hyper/hypopigmentation). It has been suggested that most individuals harbour one predominant dermoscopic type among their naevi.To evaluate whether the age of the patient influences the predominant naevus pattern observed in individuals with multiple acquired melanocytic naevi.Individuals were recruited from the pigmented skin lesion clinic in Graz between July 2000 and February 2001. Individuals with at least 10 melanocytic naevi were selected consecutively until a total of 10 individuals in each of five age groups was obtained. Age groups were: 0-15 years, 16-30 years, 31-45 years, 46-60 years and > 60 years. Digitized images of acquired melanocytic naevi, defined as benign melanocytic proliferations having a diameter of at least 5 mm with a macular component and which were not apparent within the first year of life, were evaluated by dermoscopic criteria. The associations of dermoscopic features as a function of patient age were analysed. We calculated absolute numbers and frequencies, given as percentages, as well as predominance of the dermoscopic types of naevi in the different age groups.Analysis of 1268 naevi revealed that the globular pattern predominated in the youngest age group. By contrast, the reticular and/or homogeneous patterns were increasingly exhibited in naevi from older individuals (older than 15 years). Uniform pigmentation was most common in melanocytic naevi in the youngest age group, while central hyperpigmentation was predominantly seen in the group of individuals aged 16-30 years.The predominance of dermoscopic types of melanocytic naevi varies according to the individual's age. Awareness of the age-related dermoscopic predominance of melanocytic naevi might allow more accurate recognition of dermoscopic patterns of melanocytic skin lesions that are unusual with respect to the individual's age. This observation may help in the early recognition of some 'banal'-appearing melanomas. Furthermore, the observations made in this study raise interesting questions regarding naevus evolution.
The credibility gap
Authors: C. Reid
Journal: BMJ (1998)

“No offence,” said the mother of the asthmatic child, “but you're a casualty doctor; I think my child ought to see a paediatrician.” A few years ago this might have been an understandable request, but times have changed — haven't they? I was tempted to ask her how she thought a junior doctor in paediatrics would be able to offer more than a specialist registrar in accident and emergency medicine with anaesthetic experience and advanced paediatric life support training.

Subsequently discovering that mum was a senior registrar in medicine at a neighbouring hospital brought home just how great a credibility problem our specialty still faces.

The credibility battle is fought every working day. Many doctors seem uncomfortable when a casualty officer wants to discuss the management of a clinical problem, which comes under “their” specialty, failing to acknowledge that emergent presentations happen to be “our” specialty. Other specialists are often quick to criticise accident and emergency management, but it is not …
Serial Hemodynamic Observations in Asymptomatic Children with Valvar Aortic Stenosis
Authors: WILLIAM F. FRIEDMAN, JAMES MODLINGER, JACOB R. MORGAN
Journal: Circulation (1971)

The natural history of valvar aortic stenosis in children is uncertain. This report analyzes serial clinical and catheterization data of nine initially asymptomatic children. The first hemodynamic study was performed at an average age of 6.8 years, and the follow-up study at an average age of 13.1 years. Cardiac indices and left ventricular enddiastolic pressures were consistently normal in all patients. The peak transvalvar pressure difference increased between the initial and final studies in seven out of nine patients. The gradient ranged from 15 to 40 mm Hg (mean 28.2) at the first study, and from 20 to 100 mm Hg (mean 61.6) at the most recent evaluation. Severe stenosis (gradient&gt; 50 mm Hg, normal cardiac output; or calculated orifice &lt;0.7 cm 2 /m 2 ) developed in five of nine patients during a 6.8 year average follow-up. The obstruction advanced from mild to moderate in two patients; mild obstruction was unchanged in the remaining two. While the onset of symptoms and changes in the electrocardiogram suggested the possibility of severe obstruction in two patients, there was a poor correlation between the presence of symptoms, the results of the electrocardiogram, the results of the chest X-ray, and the transvalvar pressure gradient in any individual patient. The results of this study suggest that a progressive increase in the severity of obstruction may occur commonly, even in young children, and support the application of serial hemodynamic study to routine patient management.
Prevalence and Prognostic Significance of the Presence of Esophageal Varices in Patients With Hepatocellular Carcinoma
Authors: Edoardo Giovanni Giannini, Domenico Risso, Roberto Testa, Franco Trevisani, Maria Anna Di Nolfo, Paolo Del Poggio, Luisa Benvegnù, Gian Ludovico Rapaccini, Fabio Farinati, Marco Zoli, Franco Borzio, Eugenio Caturelli
Journal: Clinical Gastroenterology and Hepatology (2006)
Comparative Trial of Nortriptyline and Amitriptyline in 100 Depressed Patients
Authors: JOE MENDELS
Journal: American Journal of Psychiatry (1968)

A double-blind trial was conducted on 100 depressed patients using amitriptyline and its derivative, nortriptyline. Scores obtained on the Hamilton Depression Scale were used as an index of change. Patients treated with nortriptyline responded significantly more rapidly than patients treated with amitriptyline, but there was no difference in response to the two drugs after six weeks of treatment.
ERYTHROPOIETIN RECEPTOR DEFICIENT MICE HAVE IMPAIRED CARDIAC ADAPTATION DURING VOLUNTARY EXERCISE
Authors: Willem-Peter T. Ruifrok, Laura M. Meems, B. Daan Westenbrink, Alexander H. Maass, Herman H. Sillje, Dirk J. van Veldhuisen, Wiek H. van Gilst, Rudolf A. de Boer
Journal: Journal of the American College of Cardiology (2010)
Organ Salvage Policies
Authors: Thomas H. Murray, Stuart J. Youngner
Journal: JAMA (1994)

Salvaging organs from the bodies of the newly dead is a project of great medical urgency and cultural significance. The Council on Ethical and Judicial Affairs of the American Medical Association (AMA) has recently completed two reports on possible changes in public policy intended to increase the supply of transplantable organs. One of these reports, dealing with policies known as mandated choice and presumed consent, appears in this issue ofTHE Journal.<sup>1</sup>The other report, on financial incentives, was adopted by the AMA House of Delegates and is AMA policy, though it is not published herein.<sup>2</sup> See also p 809. The two AMA reports share the same good intention. There are more people in desperate need of transplantable organs than there are organs available. Lives could be extended if more organs could be obtained. In the Council's judgment, two of the policies discussed—mandated choice and a form of financial
Tetanus, with Death Due to Aseptic Dural Sinus Thrombosis
Authors: Elbert T. Phelps
Journal: New England Journal of Medicine (1946)

THE following case of tetanus is reported because of several unusual features, one of which —aseptic dural sinus thrombosis — was apparently the cause of the fatal outcome.Case ReportP. G., a 6-year-old boy, entered the Elliot Hospital on September 1, 1945, with the chief complaint of difficulty in swallowing of 1 week's duration. Three weeks prior to entry, a wood splinter penetrated deep into the left anterior tibial area. Part of the splinter was removed and the wound was dressed at home. The patient was well until 1 week prior to admission, when a "frozen" expression appeared on . . .
Late renal failure due to prostatic outflow obstruction.
Authors: D. E. Neal, R. A. Styles
Journal: BMJ (1989)

This raises some important questions.Is it good for the profession to demand that pupils should decide on medicine at the age of 13?Is it really a requirement of medical education that pupils should be so engaged in theoretical science from such a tender age?Is it good for the profession to select students who have had an unbalanced education?Is it not important for doctors to have a grounding in the arts, humanities, technology, and creativity as well as science?Could someone concerned with selecting medical students please give me some answers, preferably before my son decides on his options after Easter?
Are Urban Mental Health Centers Worth It?
Authors: J. M. STUBBLEBINE, J. BARRY DECKER
Journal: American Journal of Psychiatry (1971)

On the basis of experience in San Francisco, the authors believe that the community mental health center offers a viable alternative to state hospital care for the mentally ill and is able to do this economically. The centers are functioning reasonably well and are growing in size and in range of tasks. However, serious problems remain, including the challenges of drug abuse, alcoholism, and childhood mental illness, as well as a wide range of organizational and administrative problems.
Gastrointestinal Metastasis of a Malignant Melanoma
Authors: J. Meyer-Burg, J. Treichel, U. Ziegler
Journal: Endoscopy (1973)

With modern gastroenterological methods (gastroscopy, laparoscopy, X-ray double contrast) the impressive intravital demonstration of metastases of a malignant melanoma of the stomach and of lymph nodes of the major omentum was successful.
Headache After Trivalent Inactivated Influenza Vaccine (TIV): Gender Differences and Severity
Authors: S. Kim-Delio, M.M. Klote, M.R. Nelson, W.W. Carr, R.D. Deguzman, C.P. Mikita, B.L. Martin, R.J.M. Engler
Journal: Journal of Allergy and Clinical Immunology (2007)
IN VIVO STUDIES IN C4-DEFICIENT GUINEA PIGS
Authors: Leonard Ellman, Ira Green, Francis Judge, Michael M. Frank
Journal: The Journal of Experimental Medicine (1971)

Guinea pigs with a genetically determined total deficiency of the fourth component of complement have been studied for various in vivo immunological functions. Passive cutaneous anaphylaxsis, contact and delayed hypersensitivity, and the cellular exudative response to a foreign body were normal. These animals also have normal direct and reverse passive Arthus reactions which suggest that they possess a mechanism to bypass C4 and directly activate late-acting complement components. This would appear to be an unequivocal demonstration of an alternate pathway in the complement sequence. Immune clearance of guinea pig erythrocytes sensitized with rabbit antibody was impaired in the deficient animals. Antibody production in C4-deficient animals was impaired for two of the three antigens studied.
Organ Transplantation in New England
Authors: Alan G. Birtch, Francis D. Moore
Journal: New England Journal of Medicine (1972)

IN a recent Journal report, the Massachusetts Department of Public Health described some aspects of kidney transplantation in Massachusetts.1 As we pass the 20th anniversary of the first human-kidney transplantation of the modern era,2 and the 10th anniversary of the first successful use of azathioprine for human-kidney transplantation (April 5, 1962),3 an expanded regional survey seems appropriate.Currently, eight hospitals in Boston are active in kidney transplant surgery, performing over 170 transplants during 1971 and over 635 during the past decade.These numbers may be considered in the light of the world experience, which is of remarkable extent considering the . . .
Posterior Fossa Mass in a 60-Year-Old Woman
Authors: Richard J. Steckel
Journal: JAMA (1965)

<h3>Dr. Richard Steckel:</h3> A 60-year-old woman entered the hospital with dizziness and difficulty in walking which had progressively worsened for three months. She had had an attack of vertigo, accompanied by tinnitus and nausea, ten years ago. A diagnosis of labyrinthitis had been made and her symptoms subsided spontaneously after three months. On the present admission her general physical examination was not remarkable. There was a fine rotary nystagmus on lateral gaze, and mild left cerebellar signs were present. Her speech was slow and slurred. She was unable to stand with her feet closer together than six inches, and she walked very cautiously. Plantar responses and deep tendon reflexes were normal. Urinalysis revealed 80 white blood cells. The twohour postprandial blood sugar was elevated slightly at 120 mg/100 cc. The blood bromide and barbiturate levels were within normal limits. The skull roentgenograms were within normal limits. A pneumoencephalogram was performed