tbuckley/cabot-search huggingface dataset:
Pseudoclonality in cutaneous pseudolymphomas: a pitfall in interpretation of rearrangement studies
Authors: A Böer, R Tirumalae, M Bresch, T M Falk
Journal: British Journal of Dermatology (2008)

Pseudoclonality is a well-known problem in the interpretation of rearrangement studies of lymph node biopsies. Recently, pseudoclonality has been demonstrated in skin lesions of borreliosis. Studies on pseudoclonality in cutaneous pseudolymphomas are lacking but pseudoclones may pose a risk for overinterpretation of such lesions as cutaneous lymphoma.To determine the frequency of pseudoclonality in cutaneous pseudolymphomas identified by clinicopathological correlation and follow up.Study of 30 lesions of pseudolymphomatous cutaneous infiltrates (including insect bite reactions, borrelial pseudolymphomas and pseudolymphomatous drug eruptions) by histopathology, immunophenotyping, T-cell receptor gamma rearrangement and IgH rearrangement.Seven infiltrates were B-cell pseudoclonal; four were T-cell pseudoclonal. Moreover, B-cell clonality was identified in four cases. Immunophenotyping demonstrated that B-cell pseudoclonality and B-cell clonality occurred when infiltrates were moderately dense and included only a minority of B lymphocytes. T-cell pseudoclonality also occurred mostly in moderately dense infiltrates.B-cell and T-cell pseudoclones are not uncommonly encountered in moderately dense pseudolymphomatous infiltrates (23% and 13%, respectively). B-cell clonality is seen occasionally in pseudolymphomatous infiltrates (13%), especially when they are sparse in B lymphocytes. Therefore, rearrangement studies cannot be interpreted without correlation with morphological patterns and immunophenotyping of infiltrates and they need to be confirmed by duplicate or triplicate tests in order to prevent overinterpretation.
Midwife led delivery is safer than a labour ward for low risk pregnancies, says NICE guidance
Authors: I. Torjesen
Journal: BMJ (2014)

Giving birth in a midwife led birthing unit or at home with the support of a midwife is safer than giving birth in a traditional hospital ward for women with straightforward, low risk pregnancies, an updated guideline from the National Institute for Health and Care Excellence (NICE) has said.

It added that a home birth is as safe for the baby as delivery in a midwife led unit or in a traditional labour ward under the supervision of obstetricians, provided the mother has a low risk pregnancy and has had at least one child before.1

The guideline said that women should be given information on …
Cold Erythema
Authors: Walter B. Shelley
Journal: JAMA (1962)

A 5-year-old boy reacted from infancy to cold stimuli with severe local pain, widespread erythema, and occasionally muscle spasm and collapse. In early life intractable constipation was also a feature. Physical examination and routine laboratory studies were normal as were specialized studies on serum and urine. The ice test produced pain and erythema without urticaria and was blocked by previous infiltration with procaine hydrochloride. Intradermal injections of histamine and bradykinin produced typical reactions; serotonin produced marked erythema without a wheal. Injected plasma from cold-incubated, autologous blood also resulted in marked erythema. Passive transfer tests were negative. Therapeutic trial with several classes of compounds offered only slight relief. It is felt that this cold sensitivity may be mediated by local serotonin release.
Implications of host pancreatic hormones in the restart of grafted liver
Authors: Tetsuya Kiuchi, Ernst R. Kuse, Karl J. Oldhafer, Burckhardt Ringe, Shogo Okamoto, Albrecht Bornscheuer, George Brabant, Yoshio Yamaoka, Rudolf Pichlmayr
Journal: Hepatology (1995)

Regulatory roles of insulin and glucagon in hepatic metabolism and function are well described. However, little is known about implications of host pancreatic hormones in primary function of grafted liver. This study aimed to investigate it in relation to hepatic mitochondrial function. Insulin, c-peptide, and glucagon in peripheral blood were monitored for 2 days in clinical liver transplantation by a continuous sampling technique to avoid influences of hormonal oscillation. In grafts with immediate function (n = 10), smooth increase of arterial ketone body ratio reflecting hepatic intramitochondrial redox state was accompanied by increased c-peptide and decreased glucagon, resulting in the increase of c-peptide/glucagon ratio. In other functioning grafts (n = 20), where ketone body ratio was rather lower, increased glucagon level, observed also during anhepatic phase, resulted in the slower increase of c-peptide/glucagon ratio. There were accompanied by increased free fatty acid and ketone body levels. In primary nonfunction (n = 4), rapid increase of c-peptide accompanied by hyperglycemia resulted in the accelerated increase of c-peptide/glucagon ratio, but ketone body ratio did not show any increase. Insulin/c-peptide ratio also showed a rapid increase. These findings suggest that the increase of insulin/glucagon ratio in portal blood, potentially influenced by recipient condition, is associated with the recovery of mitochondrial energy metabolism in survived hepatic grafts. However, this relationship does not work in failed grafts, where irreversible impairment of energy metabolism is attributed to graft itself.
IRF-4-Binding Protein Inhibits Interleukin-17 and Interleukin-21 Production by Controlling the Activity of IRF-4 Transcription Factor
Authors: Qinzhong Chen, Wen Yang, Sanjay Gupta, Partha Biswas, Paula Smith, Govind Bhagat, Alessandra B. Pernis
Journal: Immunity (2008)
Prognostic significance of the number of induced ventricular complexes during assessment of therapy for ventricular tachyarrhythmias.
Authors: C D Swerdlow, R A Winkle, J W Mason
Journal: Circulation (1983)

We analyzed 255 long-term trials of antiarrhythmic therapy, each of which had been evaluated at electrophysiologic study, to identify the maximum number of induced ventricular complexes consistent with the long-term efficacy of antiarrhythmic therapy. All patients had spontaneous and inducible sustained ventricular tachycardia or ventricular fibrillation. The incidence of therapeutic efficacy at 1 month and throughout follow-up was similar for trials in which zero, one, two, three, four, five, six to 10, and 11 to 15 complexes were induced, but significantly lower (p less than .001) for trials in which 16 or more complexes were induced. The cumulative incidence of efficacy at 1 year was 75 +/- 5% for 0 to 5 induced complexes, 72 +/- 11% for six to 10 complexes, 83 +/- 15% for 11 to 15 complexes, 42 +/- 10% for 16 complexes to 15 sec, and 48 +/- 6% for sustained ventricular tachycardia. At 1 year, the incidence of "sudden death-free" survival was higher for patients in trials that prevented initiation of sustained ventricular tachycardia than for those in trials that permitted initiation of sustained ventricular tachycardia (91 +/- 3% vs 75 +/- 6%; p = .01). The duration of the arrhythmia induced at therapy assessment was in the range of 11 to 20 complexes for only 4% of trials. Antiarrhythmic therapy is likely to be effective if as many as 15 complexes are induced at therapy assessment. The best cutoff, between 11 and 20 complexes, is difficult to identify because of the small fraction of trials in this range. Patients in whom initiation of sustained ventricular tachycardia is not prevented are at high risk for arrhythmia recurrence and sudden death.
FATAL ASPHYXIA DUE TO MASSIVE HEMOPTYSIS IN A CASE OF MITRAL STENOSIS
Authors: Harry J. Isaacs
Journal: JAMA (1953)

Hemoptysis is a well-known complication of stenosis of the mitral valve; however, the world literature contains but few reported cases of death following hemoptysis from this cause. In the following case a mechanism for the cause of death due to massive hemoptysis is clearly demonstrated. REPORT OF A CASE The patient, a 54-year-old Jewish linotype operator, was admitted to Mount Sinai Hospital on April 2, 1950, because of hemoptysis for the previous 24 hours. This episode, during which he coughed up several cupfuls of bright red blood, was the third or fourth and most serious he had had in the preceding five months. Fourteen years earlier, because of a chronic cough associated with dyspnea and chest pain that was diagnosed as bronchiectasis, he had moved to Arizona, where he did well medically. He returned to Chicago, and, except for the chronic cough, productive of small amounts of whitish or greenish
Cost-Effectiveness of Interferon-α and Conventional Chemotherapy in Chronic Myelogenous Leukemia
Authors: Michael W. Kattan, Yuji Inoue, Francis J. Giles, Moshe Talpaz, Howard Ozer, Francois Guilhot, Eliana Zuffa, Stephen L. Huber, J. Robert Beck
Journal: Annals of Internal Medicine (1996)

Objective: To compare the cost-effectiveness of interferon-α with that of hydroxyurea as initial therapy for patients with chronic myelogenous leukemia (CML) in the chronic phase. Design: A decision analysis and Markov model that described the natural history of the therapeutic process. The Markov model contained two treatment arms (interferon-α and hydroxyurea) and eight states of health (complete hematologic remission with cytogenetic response, complete hematologic remission without cytogenetic response, partial hematologic remission, chronic phase without hematologic remission, accelerated phase, blast crisis, bone marrow transplantation, and death). Probabilities, costs, and utilities were obtained from published clinical studies and clinical investigators. Measurement: Quality-adjusted years of life saved and costs and qualities discounted at 5% per year. Setting: University medical centers in North America and Europe. Patients: Meta-analysis of results from patients studied in clinical trials. Results: The model's predictions of median survival (69 months with interferon-α therapy and 58 months with hydroxyurea therapy) were derived from data in the recent literature. In patients 50 years of age, interferon-α improved life expectancy over hydroxyurea by approximately 18 months. The marginal cost-effectiveness of interferon-α (incremental discounted cost of interferon-α compared with that of conventional therapy) was $34 800 per quality-adjusted year of life saved. The model was sensitive to the monthly cost of interferon-α therapy (if the cost of interferon-α is reduced by one third, the cost-effectiveness becomes $19 300 per quality-adjusted year of life saved) but was not particularly sensitive to the costs associated with blast crisis or bone marrow transplantation. The other significant variable was quality of life during therapy with interferon-α; when this measure was varied from 70% to 100% of the quality of life during hydroxyurea therapy, cost-effectiveness changed from $123 200 to $25 620 per quality-adjusted year of life saved. When the quality of life associated with interferon-α was less than 62% of the quality of life associated with hydroxyurea, the discounted quality-adjusted life expectancy with interferon-α was less than that with hydroxyurea. Conclusion: Compared with hydroxyurea, interferon-α is, in most clinical scenarios, a cost-effective initial therapy for patients with chronic-phase CML who can tolerate the drug.
Phylogenetic evidence for recombination in dengue virus
Authors: E. C. Holmes, M. Worobey, A. Rambaut
Journal: Molecular Biology and Evolution (1999)

A split decomposition analysis of dengue (DEN) virus gene sequences revealed extensive networked evolution, indicative of recombination, among DEN-1 strains but not within serotypes DEN-2, DEN-3, or DEN-4. Within DEN-1, two viruses sampled from South America in the last 10 years were identified as recombinants. To map the breakpoints and test their statistical support, we developed a novel maximum likelihood method. In both recombinants, the breakpoints were found to be in similar positions, within the fusion peptide of the envelope protein, demonstrating that a single recombination event occurred prior to the divergence of these two strains. This is the first report of recombination in natural populations of dengue virus.
Bleeding in an Atonic Stomach Simulating Lower Gastrointestinal Bleeding on Technetium-99m RBC Scintigraphy
Authors: DAVID GROSHAR, JACQUELINE JERUSALMI,, MENAHEM LAM, SARA GIPS
Journal: Clinical Nuclear Medicine (1985)

Technetium-99m labeled red blood cell (Tc-RBC) scintigraphy has been used as a method in detecting and localizing gastrointestinal bleeding sites (1,2). We present a case of a bleeding atonic stomach simulating bleeding from the left colon.
Rationing: the debate we have to have
Authors: R. Smith
Journal: BMJ (1995)

Britain was transfixed last week by two stories that were primarily about the rationing of health care. In one case a court ruled that Cambridge Health Authority did not have to offer a second bone marrow transplant to a 10 year old child dying of leukaemia (p 0000). In the other case a man with a severe head injury was flown 320 km by helicopter to a neurosurgical unit because none of the many nearer units could take him (p 0000). The media were filled with these stories, and the debate over rationing exploded into life once again. Unfortunately—because the …
Pathophysiology of Gestation, vol 3; Fetal and Neonatal Disorders
Authors: Marietta Henry
Journal: JAMA (1974)

In early postnatal life, the physiological functions of infants undergo marked transitional changes that serve to adapt every system of the body to the external environment. When these changes are judged by either fetal or adult standards, they may often appear pathological. Yet, when analyzed in view of recent knowledge, they appear mere physiological adjustments to extrauterine life. The present volume of this series includes discussions of several important systems in the newborn period— circulation, respiration, bilirubin metabolism, and water, electrolyte, and acid-base balance. Also discussed are the endocrine system, nervous system, and immunological mechanisms. The excellent pattern of discussion makes it easier to understand these complex processes. Each chapter first presents the physiological processes required to adjust to intrauterine environment. Then the pathophysiological alterations that may occur are analyzed. Descriptions follow of the normal physiological changes happening immediately after clamping of the umbilical cord and initiation of breathing. Finally,
Liver Transplantation for Polycystic Liver Disease
Authors: William J Wall
Journal: New England Journal of Medicine (2007)

A 51-year-old woman with polycystic liver and kidney disease had undergone renal transplantation 21 years before presentation. She had no evidence of cerebrovascular malformations. Both her father and aunt also had polycystic kidney disease. After the renal transplantation, her liver had become progressively diseased and enlarged through cystic changes. Early satiety, malnutrition, and abdominal pain necessitated a liver transplantation. The recipient's weight at transplantation was 59 kg. A 9.1-kg liver (white arrow) was removed and replaced with a whole graft that was one tenth the weight of the diseased liver (black arrowhead). A large cyst at the dome of the . . .
The Rape of the Phallus —A Sequel
Authors: Mitchell Edson
Journal: JAMA (1965)

<h3>To the Editor:—</h3> It was noted in the naval hospital where the writer was stationed in 1962 that most of the patients with venereal and lower-urinary-tract infections were uncircumcised. In a four-year study from 1956 to 1960 in approximately 100 cases of epididymitis, where the status was recorded, twice as many were uncircumcised as circumcised. Of 54 patients admitted to a male urology ward, 19 were circumcised and 35 uncircumcised. Over the same period, in nonurologic admissions the ratio was reversed: 198 were circumcised and 93 were not. <i>W. K. C. M.</i>: I accept Dr. Edson's statistics completely, but not the inference he draws from them. Venereal disease is most prevalent in the lower socioeconomic groups, the same groups in which the vast majority of uncircumcised males are to be found. Tuberculosis, like the foreskin, is also most commonly found in the lower socioeconomic groups. We must be excused for
Postcholecystectomy Syndrome
Authors: GIUSEPPE RUBINI, MARIANO DIMONTE
Journal: Clinical Nuclear Medicine (1999)

Purpose The aim of this study was to compare the anatomic data obtained by magnetic resonance cholangiopancreatography (MRCP) with the functional data obtained by Tc-99m iminodiacetic acid (IDA) hepatobiliary imaging in patients with postcholecystectomy syndrome. MRCP provides good quality imaging of the biliary tract, highlighting walls and dilatation or stenosis of the biliary tract, stones in the cystic duct remnant, the pancreas, and the pancreatic ducts. Hepatobiliary imaging permits evaluation of hepatocellular function and the dysfunctional components of biliary obstruction. Methods MRCP showed biliary tract dilatation in four of five patients; this was associated with pathologic dilatation of the cystic duct and stenosis of the distal end of the common bile duct in three patients. Tc-99m IDA imaging showed hepatocellular functional changes (prolonged maximum concentration time and lower hepatic extraction fraction) in five of five patients, and delayed visualization of the hepatic duct and common bile duct in four patients. Intestinal passage of the radiopharmaceutical occurred in all patients only after a high-fat meal. Two patients had slow biliary emptying of Tc-99m IDA with normal results of MRCP. Results These data, together with the absence of structural changes in the biliary tract walls, suggest that sphincter of Oddi spasm during fasting causes slower passage, whereas the physiologic stimulation of a high-fat meal aids intestinal bile flow. Conclusion The combined study of the biliary tract by MRCP and Tc-99m IDA imaging yields an efficient and complete evaluation of the postcholecystectomy syndrome.
Immunologic Rejection of Human Cancer Transplanted with a Renal Allograft
Authors: Richard E. Wilson, Edward B. Hager, Constantine L. Hampers, Joseph M. Corson, John P. Merrill, Joseph E. Murray
Journal: New England Journal of Medicine (1968)

Metastatic carcinoma of the bronchus, inadvertently transferred to a patient when a kidney was transplanted from a cadaveric source, underwent immunologic rejection in the new host. This metastatic focus in and around the transplanted kidney did not appear until 18 months after the allograft was placed. When immunosuppressive therapy was discontinued, the previously functioning kidney was promptly rejected whereas tumor growth did not appear to be altered. After removal of the kidney, however, the residual cancer disappeared. The patient received a second kidney transplant nine months after removal of the first. There has been no evidence of further metastatic cancer despite resumption of a full program of immunosuppression.
Hepatotoxicity associated with use of D-penicillamine in rheumatoid arthritis.
Authors: J Rosenbaum, W A Katz, H R Schumacher
Journal: Annals of the Rheumatic Diseases (1980)

Two patients with rheumatoid arthritis developed evidence of hepatotoxicity while receiving D-penicillamine. Both recovered after withdrawal of the drug. These cases and a review of the literature suggested that hepatotoxicity, though rare, should be added to the list of adverse reactions to D-penicillamine.
Critical Care Gastroenterology
Authors: Phillip M. Berman
Journal: JAMA (1983)

<i>Critical Care Gastroenterology</i>is the expansion of material presented at a postgraduate course conducted by The University of South Florida College of Medicine. Critical care is broadly interpreted to include not only the management of emergencies, but less urgent clinical problems that require careful judgment in the determination and administration of medical or surgical therapy. The text provides a concise description of the pathophysiology pertinent to a variety of digestive system dysfunctions, followed by a therapeutic approach based on these principles. The authors are apologetic for the lack of improvement over the years in the treatment of hepatic failure and acute gastrointestinal bleeding, but they present the best advice that the humble gastroenterologist can provide. Helpful bedside diagnostic and therapeutic hints, often heard on teaching rounds, but difficult to document in print, are found throughout the book. Valuable data on drug dosages, tips on the insertion and management of the
Does the Metabolic Syndrome Exist?
Authors: Scott M. Grundy
Journal: Diabetes Care (2006)

In recent years, several organizations have proposed that the metabolic syndrome be introduced into clinical practice as a multidimensional risk condition for both atherosclerotic cardiovascular disease (ASCVD) and type 2 diabetes (rev. in 1). This proposal generally has been well received. Recently, however, Kahn et al. (2) questioned whether evidence for the existence and characteristics of the metabolic syndrome is sufficiently developed to support its inclusion in clinical practice. Several critical issues were broached in their article. The present commentary will attempt to briefly respond to the issues raised.

Five risk factors of metabolic origin (atherogenic dyslipidemia, elevated blood pressure, elevated glucose, a prothrombotic state, and a proinflammatory state) commonly cluster together (1). This aggregation is frequently observed in clinical practice, and it has been convincingly documented in prospective studies by cluster analyses (3). Risk factor clustering cannot be explained by chance occurrence alone. Thus, if the metabolic syndrome is defined as multiple risk factors that are metabolically interrelated, then the syndrome certainly exists.

The commonly observed aggregation of metabolic risk factors has gone by several different names: syndrome X, insulin resistance syndrome, pre-diabetes, metabolic syndrome, dysmetabolic syndrome, plurimetabolic syndrome, cardiometabolic syndrome, dyslipidemic hypertension, hypertriglyceridemic waist, and deadly quartet (1). No single term has been universally accepted, and terminology likely will continue to be a topic of some disagreement. Kahn et al. have misgivings regarding whether the clustering of risk factors deserves the name “syndrome,” although most investigators are accepting of it. Among the various names, “metabolic syndrome” is widely used and broadly accepted in both cardiovascular and diabetes fields. It is general and does not commit to a particular pathogenesis. Consequently, it is reasonable to employ the term because of precedent and common usage. The term appears to be at least as good as any of the alternatives.

For …
g-Protein Coupled Receptor Family C, Group 5, Member A ( gprc5a ) Expression Is Decreased in the Adjacent Field and Normal Bronchial Epithelia of Patients with Chronic Obstructive Pulmonary Disease and Non–Small-Cell Lung Cancer
Authors: Junya Fujimoto, Humam Kadara, Melinda M. Garcia, Mohamed Kabbout, Carmen Behrens, Diane D. Liu, J. Jack Lee, Luisa M. Solis, Edward S. Kim, Neda Kalhor, Cesar Moran, Amir Sharafkhaneh, Reuben Lotan, Ignacio I. Wistuba
Journal: Journal of Thoracic Oncology (2012)