tbuckley/cabot-search huggingface dataset:
Spontaneous preterm labour and delivery at under 34 weeks' gestation
Authors: M O Lobb, M E I Morgan
Journal: BMJ (1983)

The authors also make two unjustified con- clusions.Firstly, they suggest that response does not influence survival.This is contrary to their own results."The median survival time was longer than 41 months for patients with a partial remission, less than seven months for those with progressive disease, and 23 and 21 months respectively for patients with a minor response and no change (partial remission v minor response+no change v progressive disease: p< 0-0001)."The correlation between survival and response has been reported by others.2Finally, the authors state that cytotoxic drugs in older patients can have unpleasant side effects.Unpleasant side effects are an expected (if un- welcome) concomitant of cytotoxic chemotherapy in patients of all ages.Begg et al, in a retrospective analysis of patients treated in studies of the Eastern Cooperative Oncology Group, showed that older patients did not appear to be unduly susceptible to cytotoxic toxicity.6It is unfortunate, therefore, that a randomised prospective study with large numbers of patients should fail to provide meaningful answers because of unambitious study design and incomplete reporting.6C L SINOFF
Mechanism of sustained mechanical alternans. Effect of variations in ventricular billing volume.
Authors: D Adler, S Nikolic, E H Sonnenblick, E L Yellin
Journal: Circulation Research (1991)

This study investigations the phenomenon of sustained mechanical alternans (SMA) through the use of quantitative criteria. Discrete analysis is used to demonstrate that the hemodynamic variables during SMA are governed by a simple mathematical relation. The analysis shows that the value of the slope created by the two alternating beats on the stroke volume (SV)-end-diastolic volume (EDV) plane is gamma = (mu - 1) (1 + beta)/(mu - beta), where mu = SVs/SVw, and SVs and SVw denote the strong and weak beats, respectively, in the presence of one contractile state, and the beats associated with the higher and lower contractile states, respectively, in the presence of two alternating contractile states; beta = FVs/FVw, where FVs and FVw are the filling volumes after SVs and SVw, respectively. This equation is valid, whether SMA is exhibited in the presence of one or two contractile states and irrespective of the SV-EDV functional relation. Assuming constant afterload, a criterion based on this slope (gamma) is described to determine if SMA is caused by variations in EDV and FV. The slope of the SV-EDV curve in the presence of one contractile state (denoted as gamma) was determined directly (34 runs in eight dogs) by preventing FV in a beat, after a steady state, using a remote-controlled mitral valve. The slope gamma = 0.892 +/- 0.078 was found to agree with data in the literature. In 10 other dogs, mitral flow and aortic flow were measured in 55 series of SMA. In 51 series, gamma was greater than 1. Because the experimental slope in the presence of one contractile state, gamma, is smaller than or equal to 1, the possibility that one contractile state is involved in this series is rejected. On the other hand, when two contractile states are involved, the slope that the two successive beats create on the SV-EDV plane, gamma, is determined by connecting the two SV-EDV relations. This slope tends to be greater than 1. Thus, in these 51 series, SMA cannot be explained as a result of the Frank-Starling mechanism and variations in FV but as a result of two alternating contractile states. In the other four series, the value of gamma can be compatible either with the presence of one contractile state or with two alternating contractile states. This quantitative analysis enables the classification of the various types of SMA into subcategories with well-defined features. The quantitative analysis presented here shows that the common genesis of SMA is an alternating contractile state.
IODIZED OIL IN PULMONARY SUPPURATIONS AND ACID-FAST BACTERIA
Authors: W. L. Holman
Journal: JAMA (1928)

ABSTRACT To the Editor: —In a recent abstract of an article by E. R. Ware (California & West. Med. 28:356 [March] 1928; abstr. The Journal, April 28, p. 1409), the statement is made that  one case a cavity which was filled with iodized oil was thought to be nontuberculous. Following injection   appeared in the sputum. None had been found previously. I have not seen the original article and therefore do not know whether the tubercle bacilli were proved such by animal inoculation or not. In any case there is a source of error in staining for acid-fast bacteria after the use of such substances as iodized oil. I called attention to this in an article two years ago (An Error in Acid-Fast and Gram Staining Due to Petrolatum, Arch. Path. & Lab. Med. 1:390 [March] 1926). I have tried the effect of iodized oil on non-acid-fast
A case of diplopia and arm weakness
Authors: D K Sennik, D Suresh, E Goodall, R J M Lane
Journal: BMJ (2009)

A previously fit and well 84 year old woman presented with a three month history of worsening double vision. Her double vision was maximal on looking to the left and upwards. Her relatives had also noted “drooping” of her eyelids, which was worse on the right and most noticeable in the evenings. Three weeks previously her upper arms had become progressively weaker, to the extent that she was unable to lift her left hand above her head. The weakness was worse on exertion and improved after rest. Figures 1⇓ and 2⇓ show the patient attempting to look to the left ⇓ ⇓. Her cognitive function and tendon reflexes were normal, and she had no sensory signs.







### Short answers

### Long answers

#### 1 Clinical signs

Figures 1 and 2 show ptosis caused by weakness of the levator palpebrae muscles, which are innervated by the third cranial nerves. This is more pronounced on the right side. In both pictures, the patient has been asked to look to the left. In fig 2, when both eyelids are …
Transient Proteinuria in Emergency Medical Admissions
Authors: David B. Reuben, Tom J. Wachtel, Peter C. Brown, James L. Driscoll
Journal: New England Journal of Medicine (1982)

TRANSIENT proteinuria has been found to accompany various physiologic and pathologic states in which normal kidney function is preserved. The best studied of these states has been febrile proteinuria, but transient proteinuria without renal disease has been described with changes in posture, exposure to cold, emotional stress, adrenalin administration, abdominal operations, and congestive heart failure.1 , 2 Theoretically, other diseases involving similar pathophysiologic changes (e.g., diseases accompanied by severe emotional stress or by a hyperadrenergic state) may also be associated with transient proteinuria. To determine which medical illnesses are associated with transient proteinuria and how frequently this occurs, we have evaluated 313 . . .
Correlation of disease activity and drug therapy with the autologous mixed lymphocyte reaction in rheumatoid arthritis.
Authors: S M Cross, R A Hazelton
Journal: Annals of the Rheumatic Diseases (1985)

The response of peripheral blood lymphocytes (PBL) to autologous synovial fluid lymphocytes (SFL) from patients with rheumatoid arthritis and Reiter's syndrome was investigated in an autologous mixed lymphocyte reaction (AMLR). SFL were found to be poor responders but strong stimulators of autologous and allogeneic PBL compared with autologous PBL. The plastic-adherent (macrophage) cells from the SFL were found to be highly stimulatory to autologous PBL, particularly when the adherent cells were removed from the responding PBL. The stimulation of these PBL non-adherent cells by SFL adherent cells follows two main trends: either no stimulation, or higher stimulation than using unseparated SFL and PBL. Patients in the high stimulator group were taking non-steroidal anti-inflammatory drugs while those in the low responder group were taking, in addition, second-line drugs such as D-penicillamine or gold. Autologous serum was found to inhibit the AMLR and this is probably due to drug metabolites in patients' sera. Initial results show that the AMLR in individual patients is highly correlated, over time, with the erythrocyte sedimentation rate (ESR).
A pharmacokinetic model of inhaled methanol in humans and comparison to methanol disposition in mice and rats.
Authors: R A Perkins, K W Ward, G M Pollack
Journal: Environmental Health Perspectives (1995)

We estimated kinetic parameters associated with methanol disposition in humans from data reported in the literature. Michaelis-Menten elimination parameters (Vmax = 115 mg/L/hr; Km = 460 mg/L) were selected for input into a semi-physiologic pharmacokinetic model. We used reported literature values for blood or urine methanol concentrations in humans and nonhuman primates after methanol inhalation as input to an inhalation disposition model that evaluated the absorption of methanol, expressed as the fraction of inhaled methanol concentration that was absorbed (phi). Values of phi for nonexercising subjects typically varied between 0.64 and 0.75; 0.80 was observed to be a reasonable upper boundary for fractional absorption. Absorption efficiency in exercising subjects was lower than that in resting individuals. Incorporation of the kinetic parameters and phi into a pharmacokinetic model of human exposure to methanol, compared to a similar analysis in rodents, indicated that following an 8-hr exposure to 5000 ppm of methanol vapor, blood methanol concentrations in the mouse would be 13- to 18-fold higher than in humans exposed to the same methanol vapor concentration; blood methanol concentrations in the rat under similar conditions would be 5-fold higher than in humans. These results demonstrate the importance in the risk assessment for methanol of basing extrapolations from rodents to humans on actual blood concentrations rather than on methanol vapor exposure concentrations.
The Balance Between Research and Teaching in Medical Education
Authors: Lewis Thomas
Journal: JAMA (1968)

I shall begin by assuming a general agreement that the research and teaching functions of the modern medical school are out of balance with each other, and their imbalance is made even shakier by the increasing interposition, somewhere between them, of the expanding function of clinical service. It is with the problem of how to arrange these three harmoniously, so that each supports and balances the others, that Drs. Egeberg, Chapman, and I are concerned. We can all agree that the primary function of the medical school is the education of physicians. We can also agree, I believe, that in a profession in which the fundamental concepts are being changed so rapidly and completely by the advances in biomedical science, research must inevitably play an important role in the process of education. When we speak of research in the medical school, we had better be clear about what we mean,
Application of a new phased-array ultrasound imaging catheter in the assessment of vascular dimensions. In vivo comparison to cineangiography.
Authors: S E Nissen, C L Grines, J C Gurley, K Sublett, D Haynie, C Diaz, D C Booth, A N DeMaria
Journal: Circulation (1990)

Tomographic imaging techniques such as ultrasound can provide important information in the evaluation of vascular anatomy. Recent technical advances have permitted fabrication of a small (1.83 mm), phased-array, intravascular ultrasonic imaging catheter capable of continuous real-time, cross-sectional imaging of blood vessels. We used this imaging catheter to compare intraluminal ultrasound with cineangiography in the measurement of vascular dimensions in animals and to assess the intraobserver and interobserver variability of the technique. Segmental deformation of vessel anatomy was produced by stenoses created with a tissue ligature or by balloon dilation. The mean value for measurements of vessel diameter was 5.6 mm by cineangiography and 5.7 mm by intravascular ultrasound. The correlation between cineangiography and ultrasound was close (r = 0.98). Mean cross-sectional area by angiography was 28.8 mm2 and 29.6 mm2 (r = 0.96) by ultrasound. Percent diameter reduction produced by the stenoses averaged 48.4% by cineangiography and 40.1% by ultrasound, and the two methods correlated closely (r = 0.89). Correlation between cineangiography and ultrasound for vessel diameter and area before balloon dilation was closer (r = 0.92 and 0.88) than after balloon dilation (r = 0.86 and 0.81). This difference reflected an increase in measured vessel eccentricity following balloon dilation. These data demonstrate that intravascular ultrasound is an accurate and reproducible method for measurement of vascular diameter and cross-sectional area in vivo. Intravascular ultrasound is capable of accurately identifying and quantifying segmental deformation of vascular dimensions produced by either stenoses or balloon dilation.
Air embolism during neurosurgery. An evaluation of right-atrial catheters for diagnosis and treatment
Authors: J. D. Michenfelder
Journal: JAMA (1969)

During a seven-year period, 2,002 neurosurgical procedures were done with the patients in the sitting position. Forty episodes of air embolism were recognized in 32 of these patients and all but one episode occurred during surgery on the posterior cranial fossa. In 18 patients, a catheter had been previously placed in the right atrium (21 episodes) or superior vena cava (two episodes). In all of these, the diagnosis was confirmed by the aspiration of volumes of air varying from 2 to 400 ml. During eight of the episodes, volumes exceeding 10 ml of air were aspirated. This experience supports a recommendation for placement of a catheter in the right atrium prior to surgical procedures likely to be complicated by air embolism.
Determinants of Arsenic Metabolism: Blood Arsenic Metabolites, Plasma Folate, Cobalamin, and Homocysteine Concentrations in Maternal–Newborn Pairs
Authors: Marni Hall, Mary Gamble, Vesna Slavkovich, Xinhua Liu, Diane Levy, Zhongqi Cheng, Alexander van Geen, Mahammad Yunus, Mahfuzar Rahman, J. Richard Pilsner, Joseph Graziano
Journal: Environmental Health Perspectives (2007)

BackgroundIn Bangladesh, tens of millions of people have been consuming waterborne arsenic for decades. The extent to which As is transported to the fetus during pregnancy has not been well characterized.ObjectivesWe therefore conducted a study of 101 pregnant women who gave birth in Matlab, Bangladesh.MethodsMaternal and cord blood pairs were collected and concentrations of total As were analyzed for 101 pairs, and As metabolites for 30 pairs. Maternal urinary As metabolites and plasma folate, cobalamin, and homocysteine levels in maternal cord pairs were also measured. Household tube well–water As concentrations exceeded the World Health Organization guideline of 10 μg/L in 38% of the cases.ResultsWe observed strong associations between maternal and cord blood concentrations of total As (r = 0.93, p < 0.0001). Maternal and cord blood arsenic metabolites (n = 30) were also strongly correlated: in dimethylarsinate (DMA) (r = 0.94, p < 0.0001), monomethylarsonate (r = 0.80, p < 0.0001), arsenite (As+3) (r = 0.80, p < 0.0001), and arsenate (As+5) (r = 0.89, p < 0.0001). Maternal homocysteine was a strong predictor of %DMA in maternal urine, maternal blood, and cord blood (β = −6.2, p < 0.02; β = −10.9, p < 0.04; and β = −13.7, p < 0.04, respectively). Maternal folate was inversely associated with maternal blood As5+ (β = 0.56, p < 0.05), and maternal cobalamin was inversely associated with cord blood As5+ (β = −1.2, p < 0.01).ConclusionsWe conclude that exposure to all metabolites of inorganic As occurs in the prenatal period.
Renal involvement in human leptospirosis.
Authors: V. Sitprija
Journal: BMJ (1968)

During antibiotic treatment the first observation is a change in L.D.H. activity, followed about one day later by a change in D.N.A. concentration.This may indicate an initial inhibi- tion of disintegration of cellular elements in the sputum as the first effect of the antibiotic, followed later by a reduction in the absolute number of its cellular elements as a result of successful long-term therapy.The determination of L.D.H. activity has proved to be a valuable method of estimating the efficacy of antibiotic therapy in the treatment of infection in patients with chronic bronchitis.In the case of bacterial resistance developing during antibiotic therapy a rise in L.D.H. activity will occur before clinical deterioration, and thus allow time for a change to other appro- priate treatment.The separation of L.D.H. isoenzymes was performed to establish the origin of L.D.H. in bronchial secretions.It seems unlikely that L.D.H. is of bacterial origin, since the electrophoretic migration pattern of its fractions is identical with that of human serum.In uninfected bronchial secretions the L.D.H. isoenzymes resemble those found in normal serum, and it is possible that in this case they originate from that source.However, in infected sputum with a high L.D.H. activity the pattern of L.D.H. isoenzymes corresponds to that of leucocytes and probably mucosal cells. SummaryDetermination of lactic dehydrogenase activity (L.D.H.) in bronchial secretions is a simple method of differentiating between infected and uninfected chronic bronchitics.The values obtained correlate well with the results of the quantitative determination of deoxyribonucleic acid (D.N.A.) in the secre- tions.The D.N.A. content of sputum can easily be estimated semiquantitatively by fluorescent microscopy, and the results obtained by this method compare well with quantitative D.N.A. estimations.
Abstract 3465: DNA adducts of tobacco-specific nitrosamines in human pancreatic tissue resulting from pyridylhydroxybutylation and pyridyloxobutylation
Authors: Heike Eggert, Christopher W. Heppel, Oliver Peschel, Sebastian Kunz, Birkhild Giebe, Elmar Richter
Journal: Cancer Research (2010)

Abstract Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States. Whereas cigarette smoking is a well established important risk factor for pancreatic cancer, the contribution of smokeless tobacco consumption is still a matter of debate. The tobacco-specific nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) is the only known compound present in tobacco and tobacco smoke which induces pancreatic tumors in animal models. In rats, the major NNK metabolite 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), proved to be an even more potent pancreatic carcinogen. NNK and NNAL have been detected in pancreatic juice. However, activation of NNK and NNAL leading to pyridyloxobutyl (POB) and pyridylhydroxybutyl (PHB) DNA adducts, respectively, has not been proven in human pancreas. Determination of POB DNA adducts was achieved by acid hydrolysis of 4-hydroxy-1-(3-pyridyl)-1-butanone (HPB) from DNA after addition of [3,3,4,4-D4]-HPB as internal standard, derivatization with pentafluorobenzoyl chloride (PFBC) and quantification by gas chromatography/high resolution mass spectrometry with negative chemical ionization according to Heppel et al. (Anal Bioanal Chem 393:1525-30, 2009). POB DNA adducts could be easily detected in 8 of 11 pancreatic samples of sudden death victims from Germany at 2.95±1.08 fmol/µg DNA (mean±standard error; values below detection limit set at zero). Using [3,3,4,4-D4]-diol as internal standard, this analytical method also revealed the presence of PHB adducts in pancreatic DNA releasing 4-hydroxy-1-(3-pyridyl)-1-butanol (diol). However, because of massive peak broadening the PFBC ester of diol could not be quantified reliably. To improve the chromatographic resolution, the PFBC ester of diol was further derivatized according to Kao and Giese (Chem Res Toxicol 18:70-5, 2005) with pivalic anhydride to cap the secondary hydroxy group. The resulting tert-butyl esters of the PFBC esters of diol and [3,3,4,4-D4]-diol show excellent performance in capillary gas chromatography and allow quantification by single ion monitoring at the molecular masses of m/z 445.13 and m/z 449.16, respectively. In summary, the presence of POB and PHB DNA adducts in human pancreatic tissue has been clearly demonstrated for the first time. Further studies will show the specificity of these pancreatic DNA adducts for smoking and smokeless tobacco consumption and the correlation with other tobacco-specific biomarkers. Supported by a grant of the Institute for Science and Health, St. Louis, MO. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 3465.
Thoughts on the Clinton Health Plan
Authors: Steven A. Schroeder
Journal: Annals of Internal Medicine (1994)

Letters1 April 1994Thoughts on the Clinton Health PlanSteven A. Schroeder, MDSteven A. Schroeder, MDThe Robert Wood Johnson Foundation; Princeton, NJ 08543Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-7-199404010-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:It is difficult to disagree with Dr. Glusker's contention that health education is worthwhile. However, the United States probably devotes more energy to media coverage of health-related issues than does any other country. Despite some impressive recent declines in smoking prevalence and deaths from drunken driving, our national health indices still trail those of other developed countries. Whether health education could reduce expenditures is debatable. To the extent that education encourages healthier habits, it could at least postpone illness and disability and could perhaps even reduce medical care. To the extent that it stimulates diagnostic tests such as ... Author, Article, and Disclosure InformationAffiliations: The Robert Wood Johnson Foundation; Princeton, NJ 08543 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1994Volume 120, Issue 7Page: 622KeywordsAntigensCholesterolDisabilitiesHabitsHealth careMammographyMedical education Issue Published: 1 April 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Prevention of Endometrial Cancer
Authors: Ernest W. Page
Journal: JAMA (1977)

<h3>To the Editor.—</h3> It was a welcome relief to read Lipsett's article, "Estrogen Use and Cancer Risk" (237:1112), in which he supports the thesis that estrogens per se are not carcinogenic but are "preparative" for the development of cancer. There is little doubt that the cause of endometrial cancer is some carcinogenic agent (a virus or some other villain) that may well reach the endometrial surface initially as a "chance phenomenon." The important fact is that about ten years must now elapse, as shown by Gusberg<sup>1</sup>and others, before the earliest morphologic change eventuates in cancer. What chance does an endometrium have of developing malignant neoplasms if it is periodically shed, albeit incompletely, as in normal ovulatory cycles? The occurrence of such an event is exceedingly rare (less than 1% of endometrial carcinomas), and even then one wonders if the cancer did not arise in a persistent polyp. Hertig
A Rare Case of Follicular Dendritic Cell Sarcoma Involving Multiple Bones
Authors: Lei Jiang, Hui Tan, Weiguang Wang, YunFeng Cheng, Hongcheng Shi
Journal: Clinical Nuclear Medicine (2013)

A 36-year-old female patient with recurrent fever and abdominal pain for 20 days underwent a whole-body FDG PET/CT to detect the potential source of the fever. The images showed intense FDG uptake in multiple bones. Eventually, follicular dendritic cell sarcoma was diagnosed following the biopsy from the lesion in the left iliac bone.