tbuckley/cabot-search huggingface dataset:
Ejection fraction response to exercise in patients with chest pain and normal coronary arteriograms.
Authors: R J Gibbons, K L Lee, F Cobb, R H Jones
Journal: Circulation (1981)

In this study we describe the ejection fraction response to upright exercise using first-pass radionuclide angiocardiography in a group of 60 patients with chest pain, normal coronary arteriograms and normal resting ventricular function. A wide range of resting function (heart rate and ejection fraction) and exercise function (heart rate, ejection fraction, peak work load and estimated peak oxygen uptake) were measured. The ejection fraction response to exercise demonstrated wide variation, ranging from a decrease of 23% to an increase of 24%. Six of 22 clinical and radionuclide angiocardiographic variables (resting ejection fraction, peak work load, age, sex, body surface area and the change in end-diastolic volume index with exercise) were significant univariate predictors of the ejection fraction response to exercise. Multivariable analysis identified resting ejection fraction, the change in end-diastolic volume index with exercise and either sex or peak work load as variables that provided significant independent predictive information. These observations indicate that the ejection fraction response to exercise is a complex response that is influenced by multiple physiologic variables. The wide variation in this population suggests that the ejection fraction response to exercise is not a reliable test for the diagnosis of coronary artery disease because of its low specificity.
RT-31 * SURVIVAL OUTCOMES IN PATIENTS RECEIVING BOTH FRACTIONATED STEREOTACTIC RADIOTHERAPY AND BEVACIZUMAB FOR RECURRENT HIGH GRADE GLIOMA
Authors: J. Siglin, J. Palmer, C. Champ, H. Eldredge-Hindy, J. Glass, L. Kim, J. Evans, D. Andrews, M. Werner-Wasik, W. Shi
Journal: Neuro-Oncology (2014)

BACKGROUND: Fractionated stereotactic radiotherapy (FSRT) and bevacizumab (BEV) are commonly utilized treatments for recurrent high grade glioma (rHGG), yet robust outcomes data regarding the combination of these therapies is lacking. Furthermore, the optimal sequence of these regimens is not well defined. METHODS: Patients with WHO grade III (AA) or IV (GBM) glioma who received both BEV and re-irradiation with FSRT were retrospectively reviewed. Study endpoints included overall survival (OS) and median survival time (MST) from recurrence. Kaplan-Meier curves were generated utilizing a log-rank test with a p-value of ≤0.05 considered significant. RESULTS: 105 patients with rHGG (GBM = 79, AA = 26) received both BEV and FSRT. Patient characteristics at recurrence were as follows: Median KPS was 80 (range: 50-100); median age was 57; median time to recurrence was 10.8 months (mo) and 36.2% of patients had surgery for recurrence. The median time to second treatment modality was 6.2 mo for patients receiving BEV first and 5.5 mo for the FSRT first cohort. For all patients, median OS was 28.1 mo and MST from recurrence was 14.7 mo (25.2 mo and 13.8 mo for GBM only). In patients receiving FSRT first (n = 56), median OS and MST from recurrence were 35.1 mo and 16.3 mo respectively. In patients receiving BEV first (n = 50), median OS and MST from recurrence were 25.9 and 13.3 mo respectively. Sequencing FSRT prior to BEV at recurrence showed improvement in OS (p = 0.043) but only a trend for improvement in MST from recurrence (p = 0.116). CONCLUSIONS: The combination of FSRT and BEV for recurrent/progressive HGG provide promising results in terms of OS and survival from recurrence. Combining these treatment modalities appears to improve upon the historic outcomes of either treatment alone and sequencing FSRT as the initial treatment of recurrence may provide a survival benefit.
Carotid sinus reflexes during postural changes, naturally elicited fighting behaviour, and phases of sleep in the cat
Authors: A. D. BO, G. BACCELLI, G. CELLINA, F. FEA, A. FERRARI, A. ZANCHETTI
Journal: Cardiovascular Research (1985)

Reflex responses of mean blood pressure and of heart rate to either bilateral common carotid occlusion (CO) or unilateral carotid sinus dilatation (CSD) during rest and different behaviours have been compared in conscious cats. Unloading and loading the carotid sinus receptors elicited equal reflex responses both of mean blood pressure and of heart rate during control immobile behaviour (CO: + 34 ± 6 mmHg and + 35 ± 6 beats·min−1; CSD: -37 ± 4 mmHg and -52 ± 11 beats·min−1), standing on the hindlimbs (CO: + 36 ± 5 mmHg and + 29 ± 5 beats·min−1; CSD: - 40 ± 6 mmHg and -61 ± 10 beats·min−1), fighting against an attacking animal (CO: + 34 ± 5 mmHg and + 31 ± 5 beats·min−1; CSD: -37 ± 5 mmHg and -56 ± 10 beats·min−1), quiet wakefulness (CO: + 37 ± 5 mmHg and + 38 ± 4 beats·min−1; CSD: -34 ± 4 mmHg and -53 ± 8 beats·min−1) and synchronised sleep (CO: + 36 ± 5 mmHg and + 37 ± 4 beats·min−1; CSD: -36 ± 4 mmHg and -52 ± 6 beats·min−1). Desynchronised sleep was associated with an identical response to CSD (-30 ± 4 mmHg and - 51 ± 7 beats·min−1) but with a reduced (p<0.01) reflex response to CO (+ 18 ± 3 mmHg and + 19 ± 3 beats·min−1). These data indicate that carotid sinus baroreflexes largely maintain their ability to modulate pressure upwards and downwards when blood pressure has been reset at somewhat higher levels by standing and fighting and at somewhat lower levels by synchronised sleep. The selective depression of carotid occlusion responses during desynchronised sleep suggests a central or peripheral shift of the baroreflex stimulus-response curve or a selective central inhibition of the reflex response to baroreceptor unloading.
Acute Pain Treatment
Authors: John L. Zeller, Alison E. Burke, Richard M. Glass
Journal: JAMA (2008)

Acute Pain Treatment Pain is an unpleasant sensory and emotional experience usually arising from actual or potential tissue damage.Acute pain can be a difficult medical problem to diagnose and treat.It may be caused by many events or circumstances.Symptoms can last hours, days, or weeks and are commonly associated with tissue injury, inflammation, a surgical procedure, childbirth, or a brief disease process.Other types of pain may be classified as chronic (pain of long duration), neuropathic (pain resulting from damage to nerves), psychogenic (pain not due to visible signs of disease or injury), or cancer-related (effects of a malignant disease on the body).The January 2, 2008, issue of JAMA includes an article that identifies trends in the prescription of medicines to treat acute pain in US emergency departments.
DECIDUAL REACTION IN THE APPENDIX IN INTRA-UTERINE PREGNANCY
Authors: GEORGE W. OUTERBRIDGE
Journal: JAMA (1913)

One of the most interesting phenomena observed in connection with both normal and ectopic gestation is the occurrence at various locations outside the uterus of tissue having a histologic appearance nearly or quite identical with that of decidua. It has been conclusively shown that the normal, intra-uterine decidua represents nothing more nor less than a transformation of the endometrial stroma, as a result of which the majority of the connective-tissue cells have become much swollen, and have assumed a round, oval or more or less polygonal shape. The cytoplasm often contains vacuoles, probably of glycogen; the nuclei also are somewhat swollen and vesicular, and often occur two or three to a single cell. The cells lie close together, but are separated by fine fibrous trabeculae; scattered among them are usually seen a few small, deeply staining, unchanged connective-tissue cells, the whole structure presenting a very characteristic and, for the most
Analysis of Wnt Gene Expression in Prostate Cancer
Authors: Hanneng Zhu, Michal Mazor, Yoshiaki Kawano, Marjorie M. Walker, Hing Y. Leung, Kelly Armstrong, Jonathan Waxman, Robert M. Kypta
Journal: Cancer Research (2004)

Abstract The Wnt signaling pathway is aberrantly activated in many tumor types, including those of the prostate, in which β-catenin accumulates in cell nuclei and acts as a transcriptional coregulator for the androgen receptor. Because activating mutations in the β-catenin gene are rare in prostate cancer, we have looked for altered expression of other components of the Wnt signaling pathway in prostate cancer cells. Here we determined the expression levels of Wnt family genes in cultured human prostate cells and prostate cancer cell lines. We found that WNT11 expression is elevated in hormone-independent prostate cancer cell lines. Additional analysis indicated that WNT11 expression is also elevated in high-grade prostatic tumors and in hormone-independent xenografts. Growth of hormone-dependent LNCaP cells in hormone-depleted media led to increased WNT11 expression, which was repressed by the synthetic androgen R1881. This repression was inhibited by the antiandrogen bicalutamide, suggesting that androgens negatively regulate WNT11 expression through the androgen receptor. Expression of WNT11 inhibited androgen receptor transcriptional activity and cell growth in androgen-dependent cells but not in androgen-independent cells. WNT11 inhibited activation of the canonical Wnt pathway by WNT3A in HEK 293 cells and inhibited basal β-catenin/Tcf transcriptional activity in LNCaP cells. However, expression of stabilized β-catenin did not prevent the inhibition of androgen receptor transcriptional activity by WNT11. Our observations are consistent with a model in which androgen depletion activates WNT11-dependent signals that inhibit androgen-dependent but not androgen-independent cell growth.
Oxidized low density lipoproteins cause contraction and inhibit endothelium-dependent relaxation in the pig coronary artery.
Authors: B C Simon, L D Cunningham, R A Cohen
Journal: Journal of Clinical Investigation (1990)

The direct vasoactive effects of native and oxidatively modified low density lipoproteins as well as their effects on endothelium-dependent relaxations to 5-hydroxytryptamine were studied in isolated rings of pig right coronary artery. Slowly developing contractions were caused by native low density lipoproteins (100 micrograms protein/ml). The contractions were more pronounced in the absence than in the presence of the trace metal chelator, EDTA, and coincided with the formation of lipid peroxides during the response. The lipophilic antioxidant, butylated hydroxytoluene, prevented the oxidation of, and contraction to, native low density lipoproteins. Low density lipoproteins oxidized by exposure to copper contracted coronary arteries more rapidly with a threshold of only 1 micrograms protein/ml, but with a similar maximal contraction at 100 micrograms protein/ml. Superoxide dismutase inhibited the contraction to native low density lipoproteins, but not to oxidized low density lipoproteins. Catalase blocked contractions to both native and oxidized low density lipoproteins. Contractions to oxidized low density lipoproteins were unaffected by indomethacin, but were abolished by removal of the endothelium or by inhibitors of endothelium-derived relaxing factor. Oxidized low density lipoproteins but not native low density lipoproteins inhibited endothelium-dependent relaxations to 5-hydroxytryptamine. Thus, oxidized low density lipoproteins caused endothelium-dependent coronary artery contractions which are mediated by a hydroperoxide. Contractions to native low density lipoproteins are due to their oxidation in the organ chamber by the superoxide anion radical. Oxidized, but not native, low density lipoproteins impair normal endothelial cell vasodilator function in vitro. Oxidized low density lipoproteins, important in the pathogenesis of atherosclerosis, may directly contribute to the increased risk of vasospasm seen in hypercholesterolemia and atherosclerosis.
Role of nonallergic hypersensitivity reactions in children with chronic urticaria
Authors: I. Ehlers, B. Niggemann, C. Binder, T. Zuberbier
Journal: Allergy (1998)

Background IgE‐independent (pseudoallergic) reactions to food and food ingredients are common in a subgroup of adult patients with chronic urticaria, who have daily spontaneous occurrence of wheals. However, for children with chronic urticaria (duration longer than 6 weeks, no physical influence), no data on the importance of pseudoallergen‐induced chronic urticaria are available. Therefore, we investigated the role of nonallergic hypersensitivity to food in all children seen with chronic continuous urticaria i n our two clinics over the last 2 years (n = 16). Methods All patients were given a low‐pseudoallergen diet for 3 weeks followed by provocation with food rich in pseudoallergens. To identify the main eliciting agents, a subgroup of responders was exposed to food additives by double‐blind, placebo‐controlled food challenges. Results Pseudoallergen‐induced urticaria was diagnosed in 12 cases (75%). Reactions occurred mainly to coloring agents and preservatives, but also to monosodium glutamate and a sweetener (saccharin/cyclamate). Conclusions TTiese results confirm that nonallergic hypersensitivity reactions play a role in children with chronic urticaria, although the latter disease is rare at that age. In children, food additives, especially coloring agents and preservatives, appear to play a more important role in eliciting nonallergic hypersensitivity reactions than in adult patients, where naturally occurring pseudoallergens in fruits and vegetables are mainly responsible.
A Post-Graduate Lecture ON CARDIOLYSIS
Authors: R. M. Simon
Journal: BMJ (1912)

IN 1902 Brauer suggested tllat, in cases in which it was 1sp11pectcdt tha-t the free actioni of the heart was lhamperecd I)y adhesionis; of the pericardium to parts outside it, it would benefit the patient to remove some of the bony and cartilaginous framneworkl of tihe thorax.He supposed that thlc precordial pait of the chest wall woutld thereby b'eome more fle-xible aniid oppose less resistance to cardiac e-pr,insion.It is; probable.however, that the relief to the heart tlhtus given iiav lie less in the softenint, of tlle wall ;against wh-iich it l)eats thalni in tlle removal of tiglht and toulglh adhcsions to the fixed points like the ribs, and that lrelief imay be exp)ected fronm the removal of these ad hes~,io ns.Tihrce of hiis cases wvere operated on, and 17 in all.were recordedultp to 1908.No death occuirred as the result of operationi, andi( bnllit restulted in eaclh case.In 1908.Poynton' and Trotter brought the case of a p)ationt oni whiomi1 tlhe operation liad been perforimled before thm0 l"oyal Society of MAledicine, and were of opinion that the proceeding hia(d been justified by the improvement in the boy s conidition.It must be remembered that when thie opieration ha-s been -perforimed, it has beeni done to rlCiev-e srniptonis which lhave resisted all other illethods of trcatmClent, anid ofteni when, as in my own case, thc lati(lit hias, appearedI to be oni the ver y threshiold of deathi.Aniotler ea;s;e wvas, referred to at this meeting in whiich (leatil occuriired( thirce mi-ontlis after tihe operationi OWing to a freshi attaclk of pericarditis.From a surgical point of view the discussion lnarrowed itself down to the point whetier or no the wlhole periosteuimf of the ribs shiouild be reioved--the authors of the paper concluding that the aIniterlior pveliosteuimii only should be taken away, reossifi- cation under tihese cireuimstances niot being likely to ocLur.
Secretory Products From Epicardial Adipose Tissue of Patients With Type 2 Diabetes Mellitus Induce Cardiomyocyte Dysfunction
Authors: Sabrina Greulich, Bujar Maxhera, Guy Vandenplas, Daniella Herzfeld de Wiza, Konstantinos Smiris, Heidi Mueller, Jessica Heinrichs, Marcel Blumensatt, Claude Cuvelier, Payam Akhyari, Johannes B. Ruige, D. Margriet Ouwens, Juergen Eckel
Journal: Circulation (2012)

Background— Secreted factors from epicardial adipose tissue (EAT) have been implicated in the development of cardiomyocyte dysfunction. This study aimed to assess whether alterations in the secretory profile of EAT in patients with type 2 diabetes mellitus (DM2) affect contractile function and insulin action in cardiomyocytes. Methods and Results— Contractile function and insulin action were analyzed in primary adult rat cardiomyocytes incubated with conditioned media (CM) generated from explants of EAT biopsies obtained from patients without and with DM2. CM from subcutaneous and pericardial adipose tissue biopsies from the same patients served as the control. Cardiomyocytes treated with CM (EAT) from DM2 patients showed reductions in sarcomere shortening, cytosolic Ca 2+ fluxes, expression of sarcoplasmic endoplasmic reticulum ATPase 2a, and decreased insulin-mediated Akt-Ser473-phosphorylation as compared with CM from the other groups. Profiling of the CM showed that activin A, angiopoietin-2, and CD14 selectively accumulated in CM-EAT-DM2 versus CM-EAT in patients without DM2 and CM from the other fat depots. Accordingly, EAT biopsies from DM2 patients were characterized by clusters of CD14-positive monocytes. Furthermore, SMAD2-phosphorylation, a downstream target of activin A signaling, was elevated in cardiomyocytes treated with CM (EAT) from DM2 patients, and the detrimental effects of CM (EAT) from DM2 patients were partially abolished in cardiomyocytes pretreated with a neutralizing antibody against activin A. Finally, both recombinant activin A and angiopoietin-2 reduced cardiomyocyte contractile function, but only activin A reduced the expression of sarcoplasmic endoplasmic reticulum ATPase 2a. Conclusions— Collectively, our data implicate DM2-related alterations in the secretory profile of EAT in the pathogenesis of diabetes mellitus–related heart disease.
Synergistic Enhancement of Carboplatin Efficacy with Photodynamic Therapy in a Three-Dimensional Model for Micrometastatic Ovarian Cancer
Authors: Imran Rizvi, Jonathan P. Celli, Conor L. Evans, Adnan O. Abu-Yousif, Alona Muzikansky, Brian W. Pogue, Dianne Finkelstein, Tayyaba Hasan
Journal: Cancer Research (2010)

Metastatic ovarian cancer (OvCa) frequently recurs due to chemoresistance, highlighting the need for nonoverlapping combination therapies that mechanistically synergize to eradicate residual disease. Photodynamic therapy (PDT), a photochemistry-based cytotoxic modality, sensitizes ovarian tumors to platinum agents and biologics and has shown clinical promise against ovarian carcinomatosis. We introduce a three-dimensional (3D) model representing adherent ovarian micrometastases and high-throughput quantitative imaging methods to rapidly screen the order-dependent effects of combining benzoporphyrin-derivative (BPD) monoacid A-based PDT with low-dose carboplatin. 3D ovarian micronodules grown on Matrigel were subjected to BPD-PDT either before or after carboplatin treatment. We developed custom fluorescence image analysis routines to quantify residual tumor volume and viability. Carboplatin alone did not eradicate ovarian micrometastases at a dose of 400 mg/m2, leaving surviving cores that were nonsensitive or impermeable to chemotherapy. BPD-PDT (1.25 μmol/L·J/cm2) created punctate cytotoxic regions within tumors and disrupted micronodular structure. Treatment with BPD-PDT prior to low-dose carboplatin (40 mg/m2) produced a significant synergistic reduction [P<0.0001, analysis of covariance (ANCOVA)] in residual tumor volume [0.26; 95% confidence interval (95% CI), 0.19-0.36] compared with PDT alone (0.76; 95% CI, 0.63-0.92) or carboplatin alone (0.95; 95% CI, 0.83-1.09), relative to controls. This synergism was not observed with the reverse treatment order. Here, we demonstrate for the first time the use of a 3D model for micrometastatic OvCa as a rapid and quantitative reporter to optimize sequence and dosing regimens of clinically relevant combination strategies. This approach combining biological modeling with high-content imaging provides a platform to rapidly screen therapeutic strategies for a broad array of metastatic tumors.
Getting two new hip joints.
Authors: J Dunlop
Journal: BMJ (1984)

It was with a slight feeling of envy that I read Professor Rhodes's article Getting a new hip  in September 1983. -1 had played competitive tennis until my mid-40s, but over the next three to four years had increasing difficulty in walking. My gait was described affectionately by my husband as that of a ruptured duck. Doctors' symptoms are often decidedly non-textbook. After considering a variety of different referrals with my family doctor I came to the conclusion that if I was not suffering from multiple sclerosis my symptoms must have a hysterical basis. As time went on I could walk a diminishing distance each day; breakfast time was no problem, by lunch I was struggling, and the evenings became increasingly impossible. Recovery occurred during the night. This had the added disadvantage that when seen by my colleagues during meetings, at lunch time, etc, I did not seem too disabled. My poor family told another story. Matters came to a head in the spring of 1983 when I was unable to straighten up after interviewing a patient in the cells at the local police station. What the police thought of the duty psychiatrist I can only imagine. Another x ray and a visit to an orthopaedic surgeon showed absence of joint space in both hips?perhaps due to congenitally poor positioning?with bony changes on the left side: a joint replacement was suggested. It is interesting, yet somewhat traumatic, going through the emotional phases known to occur in patients facing major surgery. The relief when something concrete is found changes quickly to why me, why a doctor, why so young, and then you experience general recoil at the thought of two long scars?all television programmes seemed to portray leggy women with high cut bikinis at that time?together with the incorporation of lengths of metal and polyethylene sockets into your body. But when you cannot walk and modern surgery offers an escape there is no alternative. The above fears need to be faced and worked through. The anxiety state so common after emergency surgery results from the lack of time to do this.
Once-Daily Fluticasone Furoate∗ Nasal Spray (FFNS) Improves Quality of Life (QoL) in Subjects with Seasonal Allergic Rhinitis (SAR) during the mountain cedar pollen season ∗USAN approved name
Authors: J.H. van Bavel, T. Toler, A. Ellsworth, R. Stanford, E. Philpot
Journal: Journal of Allergy and Clinical Immunology (2007)
Dermatofibrosarcoma protuberans: a tumour of nestin-positive cutaneous mesenchymal stem cells?
Authors: K. Sellheyer, P. Nelson, D. Krahl
Journal: British Journal of Dermatology (2009)

There is an increasing body of evidence suggesting that malignancies arise from mutated stem cells, which has led to the formulation of the cancer stem cell hypothesis. It has also been suggested that cutaneous malignancies originate from a mutated stem cell. To date, mesenchymal tumours of the skin have not been the focus of the cancer stem cell hypothesis. A population of mesenchymal stem cells has recently been identified in the dermal compartment of the skin. These proposed stem cells are positive for the neuroepithelial stem cell marker nestin.To describe the expression pattern of nestin, a neuroepithelial stem cell protein, in dermatofibrosarcoma protuberans (DFSP).Immunohistochemical evaluation of DFSP with a monoclonal antibody against nestin was performed using standard techniques. For comparison we also analysed dermatofibromas (DF). In addition, we used antibodies against CD34 and Factor XIIIa; the proliferation marker Ki67 was also used.Strong immunoreactivity for nestin was found in DFSP whereas all DF cases were nestin-negative.We propose that DFSP may represent a clonal expansion of a nestin-positive mesenchymal stem cell which would put this tumour in line with other neoplasms for which the cancer stem cell hypothesis was formulated. We suggest the use of nestin as an additional marker for DFSP, especially in cases of negative immunoreactivity for CD34. Nestin may also be employed for margin evaluation of DFSP in micrographic (Mohs) surgery.