tbuckley/cabot-search huggingface dataset:
Assessment of myocardial salvage after ischemia and reperfusion using magnetic resonance imaging and spectroscopy.
Authors: C L Wolfe, M E Moseley, M G Wikstrom, R E Sievers, M F Wendland, J W Dupon, W E Finkbeiner, M J Lipton, W W Parmley, R C Brasch
Journal: Circulation (1989)

To test the hypothesis that contrast-enhanced magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) can differentiate reversible from irreversible myocardial injury, these modalities were used to study ischemia and reperfusion in a rat model. The presence of ischemia and reperfusion were confirmed with radiolabeled microspheres (n = 6). Groups of animals were subjected to either 16 (n = 17), 30 (n = 14), 60 (n = 11), or 90 (n = 14) minutes of left coronary artery (LCA) occlusion and 60 minutes reperfusion. After albumin-gadolinium (Gd)-DTPA injection, contrast-enhanced, T1-weighted, spin-echo proton images were acquired at baseline and every 16 minutes during LCA occlusion and reperfusion. In separate experiments, 31phosphorus (31P) spectra were acquired at similar time points during ischemia and reperfusion. After 16 minutes occlusion, normally perfused myocardium enhanced significantly compared with ischemic myocardium on MRI (104 +/- 7.9% vs. 61 +/- 11.0%, p less than 0.05, n = 5, mean +/- SEM, % of baseline value). MRS showed reduced phosphocreatine (PCr) and adenosine triphosphate (ATP) (58.8 +/- 2.4%, p less than or equal to 0.01; 81.4 +/- 2.4, p less than or equal to 0.01, n = 12). After 16 or 30 minutes ischemia, reflow resulted in uniform MRI signal intensity of the ischemic zone compared with normal myocardium (93.5 +/- 11.3 vs. 80.9 +/- 7.0, p = NS, n = 11, % of baseline value at 30 minutes reperfusion) and PCr recovery on MRS (94.3 +/- 4.0%, p = NS, n = 20, % baseline value at 30 minutes reflow). After 60 and 90 minutes ischemia, reflow resulted in marked enhancement of reperfused compared with normal myocardium on MRI (254.0 +/- 30.0 vs. 78.3 +/- 9.2, p less than or equal to 0.01, n = 10) and no recovery of PCr on MRS (64.1 +/- 3.0, p = NS, n = 14). Triphenyltetrazolium chloride (TTC) staining revealed transmural myocardial infarction (MI) in all hearts subjected to 60 or 90 minutes ischemia and reflow, and small nontransmural MIs in only 2/11 hearts subjected to 16 or 30 minutes ischemia and reperfusion. Thus, 1) MRI with albumin-Gd-DTPA is useful for identifying myocardial ischemia by enhancing the contrast between normally perfused and ischemic myocardia; 2) MRI with albumin-Gd-DTPA is useful for identifying reperfusion after myocardial ischemia; and 3) after reperfusion, reversible can be distinguished from irreversible myocardial injury by characteristic findings on MRI and MRS.
POSTURE STUDIES IN GYNECOLOGY
Authors: NORMAN F. MILLER
Journal: JAMA (1927)

Development and advance in our knowledge of obstetrics and gynecology have been among the outstanding achievements in the field of medicine in the past twenty-five years. Analysis of this advance will show that it has been confined chiefly to the more uncommon and unusual conditions. Among methods of treatment, the tendency toward conservatism is probably the most noteworthy recent advance. Diagnosis and diagnostic procedures have in general kept pace with this progress. On the whole, however, it would seem that the advance is more apparent than real, since we are still faced with most of the common gynecologic complaints which have existed unchanged for hundreds of years. Young women are still suffering from dysmenorrhea, menorrhagia, leukorrhea, backache, and vague pains in the sides, while older women have grown to look on these conditions as normal. Many physicians have come to consider these common complaints as more or less natural and
Prognosis for Gross Motor Function in Cerebral Palsy
Authors: Peter L. Rosenbaum, Stephen D. Walter, Steven E. Hanna, Robert J. Palisano, Dianne J. Russell, Parminder Raina, Ellen Wood, Doreen J. Bartlett, Barbara E. Galuppi
Journal: JAMA (2002)

ContextLack of a valid classification of severity of cerebral palsy and the absence of longitudinal data on which to base an opinion have made it difficult to consider prognostic issues accurately.ObjectiveTo describe patterns of gross motor development of children with cerebral palsy by severity, using longitudinal observations, as a basis for prognostic counseling with parents and for planning clinical management.DesignLongitudinal cohort study of children with cerebral palsy, stratified by age and severity of motor function and observed serially for up to 4 years during the period from 1996 to 2001.SettingNineteen publicly funded regional children's ambulatory rehabilitation programs in Ontario.ParticipantsA total of 657 children aged 1 to 13 years at study onset, representing the full spectrum of clinical severity of motor impairment in children with cerebral palsy.Main Outcome MeasuresSeverity of cerebral palsy, classified with the 5-level Gross Motor Function Classification System; function, formally assessed with the Gross Motor Function Measure (GMFM).ResultsBased on a total of 2632 GMFM assessments, 5 distinct motor development curves were created; these describe important and significant differences in the rates and limits of gross motor development among children with cerebral palsy by severity. There is substantial within-stratum variation in gross motor development.ConclusionsEvidence-based prognostication about gross motor progress in children with cerebral palsy is now possible, providing parents and clinicians with a means to plan interventions and to judge progress over time. Further work is needed to describe motor function of adolescents with cerebral palsy.
The afferent innervation of the heart.
Authors: Edwin F. Hirsch
Journal: JAMA (1963)

The subject material reviewed and then developed as a record of personal investigations concerns the afferent innervation of the hearts of humans, and of animals after vagotomy or extirpation of the spinal ganglia. In each of these three fields the author records observations on the afferent nervous plexus and the endings in the epicardium, the myocardium, and the endocardium. The Beilschowsky-Gros method was used, generally, as the tissue stain. Nonidez had reported in 1941 that the afferent fibers had greater affinity for silver nitrate. On this basis the afferent fibers were identified and distinguished from the efferent fibers by the author. The author identified two main groups of afferent endings, the diffuse and the compact, with and without specialized cells. They are chiefly brush and arborization forms, but others are glomerular- and "neuromuscular spindle"-type endings. The published descriptions do not include the efferent (motor) innervation of the heart. The text
Factors Influencing Treatment Utilization in African Psychotherapy
Authors: D. Awanbor
Journal: Psychotherapy and Psychosomatics (1985)

Two hundred subjects, 100 each from urban and rural areas of a Nigerian ethnic group were administered questionnaires and given interviews to determine variables shaping their preferred mode of treatment between traditional and Western forms of psychotherapy. Education was found to play an insignificant role among the present subjects as the educated literate subjects continue to indicate considerable interest for traditional treatment. Location was shown to have a significant effect on the treatment choice made by the subjects especially among the rural subjects. The implications of these findings for treatment provision are discussed.
Transjugular Intrahepatic Portosystemic Shunt or Sclerotherapy: Which Would You Choose?
Authors: Harold O. Conn
Journal: Annals of Internal Medicine (1998)

Letters15 February 1998Transjugular Intrahepatic Portosystemic Shunt or Sclerotherapy: Which Would You Choose?Harold O. Conn, MDHarold O. Conn, MDYale University; New Haven, CT 06510Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-4-199802150-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Drs. Marshall and King take exception to two of my opinions. First, they take issue with my statement that endoscopic sclerotherapy is the standard therapy for bleeding varices. They believe that endoscopic variceal ligation has already supplanted endoscopic sclerotherapy. Our disagreement is about the tense of the verb-“is” versus “was.” I have no doubt that endoscopic variceal ligation will supplant endoscopic sclerotherapy in the future, but the standard of care is defined as the treatment of choice now. The medical device industry standard for tracking such data indicates that of more than 38 000 patients who bled from ...References1. Levine RJ. Ethics and Regulations of Clinical Research. New Haven, CT: Yale Univ Pr; 1986. Google Scholar2. Freedman B. Equipoise and the ethics of clinical research. N Engl J Med. 1987; 317:141-5. Google Scholar Author, Article, and Disclosure InformationAuthors: Harold O. Conn, MDAffiliations: Yale University; New Haven, CT 06510 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCost-effectiveness analysis of transjugular intrahepatic portosystemic shunt (TIPS) versus endoscopic therapy for the prevention of recurrent esophageal variceal bleeding 15 February 1998Volume 128, Issue 4Page: 322KeywordsChildrenClinical trialsEjaculationEndoscopyForecastingHemorrhageLigation assaySurgeons ePublished: 15 August 2000 Issue Published: 15 February 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Is persistent polyclonal b lymphocytosis caused by epstein‐barr virus? A study with polymerase chain reaction and in situ hybridization
Authors: Kuan‐Chih Chow, Thomas E. Witzig, Chin‐Yang Li, Johnny Q. Nacilla
Journal: American Journal of Hematology (1992)

Abstract Previous reports of patients with persistent polyclonal B lymphocytosis have found associations with female sex, cigarette smoking, HLA‐DR7 phenotype, and moderate elevation of peripheral blood polyclonal B lymphocytes. The presence of binucleated cells and atypical lymphocytes in the peripheral blood of these patients was highly suggestive of a viral infection, such as with the Epstein‐Barr virus. We report a 47‐year‐old asymptomatic woman who was incidentally found to have persistent polyclonal B lymphocytosis and serum IgG against virus capsid antigen (VCA) and Epstein‐Barr virus (EBV)‐associated nuclear antigen (EBNA) of EBV. The presence of EBV was investigated in the peripheral blood lymphocytes from this patient by in situ hybridization and polymerase chain reaction methods. EBV DNA was demonstrated in the lympohcyte fraction by polymerase chain reaction, and it was further located in lymphoid cells by in situ hybridization. These results indicate that persistent polyclonal B lymphocytosis is strongly associated with EBV. © 1992 Wiley‐Liss, Inc.
Health and Economic Benefits of Increased β-Blocker Use Following Myocardial Infarction
Authors: Kathryn A. Phillips
Journal: JAMA (2000)

Contextβ-Blockers are underused in patients who have myocardial infarction (MI), despite the proven efficacy of these agents. New evidence indicates that β-blockers can have benefit in patients with conditions that have been considered relative contraindications. Understanding the consequences of underuse of β-blockers is important because of the implications for current policy debates over quality-of-care measures and Medicare prescription drug coverage.ObjectiveTo examine the potential health and economic impact of increased use of β-blockers in patients who have had MI.Design and SettingWe used the Coronary Heart Disease (CHD) Policy Model, a computer-simulation Markov model of CHD in the US population, to estimate the epidemiological impact and cost-effectiveness of increased β-blocker use from current to target levels among survivors of MI aged 35 to 84 years. Simulations included 1 cohort of MI survivors in 2000 followed up for 20 years and 20 successive annual cohorts of all first-MI survivors in 2000-2020. Mortality and morbidity from CHD were derived from published meta-analyses and recent studies. This analysis used a societal perspective.Main Outcome MeasuresPrevented MIs, CHD mortality, life-years gained, and cost per quality-adjusted life-year (QALY) gained in 2000-2020.ResultsInitiating β-blocker use for all MI survivors except those with absolute contraindications in 2000 and continuing treatment for 20 years would result in 4300 fewer CHD deaths, 3500 MIs prevented, and 45,000 life-years gained compared with current use. The incremental cost per QALY gained would be $4500. If this increase in β-blocker use were implemented in all first-MI survivors annually over 20 years, β-blockers would save $18 million and result in 72,000 fewer CHD deaths, 62,000 MIs prevented, and 447,000 life-years gained. Sensitivity analyses demonstrated that the cost-effectiveness of β-blocker therapy would always be less than $11,000 per QALY gained, even under unfavorable assumptions, and may even be cost saving. Restricting β-blockers only to ideal patients (those without absolute or relative contraindications) would reduce the epidemiological impact of β-blocker therapy by about 60%.ConclusionsOur simulation indicates that increased use of β-blockers after MI would lead to impressive gains in health and would be potentially cost saving.
Protective Role of Matrix Metalloproteinase-9 in Ozone-Induced Airway Inflammation
Authors: Hyoung-Kyu Yoon, Hye-Youn Cho, Steven R. Kleeberger
Journal: Environmental Health Perspectives (2007)

Exposure to ozone causes airway inflammation, hyperreactivity, lung hyper-permeability, and epithelial cell injury. An early inflammatory response induced by inhaled O(3) is characterized primarily by release of inflammatory mediators such as cytokines, chemokines, and airway neutrophil accumulation. Matrix metalloproteinases (MMPs) have been implicated in the pathogenesis of oxidative lung disorders including acute lung injury, asthma, and chronic obstructive pulmonary disease.We hypothesized that MMPs have an important role in the pathogenesis of O(3)-induced airway inflammation.We compared the lung injury responses in either Mmp7- (Mmp7(-/-)) or Mmp9-deficient (Mmp9(-/-)) mice and their wild-type controls (Mmp7(+/+), Mmp9(+/+)) after exposure to 0.3 ppm O(3) or filtered air.Relative to air-exposed controls, MMP-9 activity in bronchoalveolar lavage fluid (BALF) was significantly increased by O(3) exposure in Mmp9(+/+) mice. O(3)-induced increases in the concentration of total protein (a marker of lung permeability) and the numbers of neutrophils and epithelial cells in BALF were significantly greater in Mmp9(-/-) mice compared with Mmp9(+/+) mice. Keratinocyte-derived chemokine (KC) and macrophage inflammatory protein (MIP)-2 levels in BALF were also significantly higher in Mmp9(-/-) mice than in Mmp9(+/+) mice after O(3) exposure, although no differences in mRNA expression for these chemokines were found between genotypes. Mean BALF protein concentration and numbers of inflammatory cells were not significantly different between Mmp7(+/+) and Mmp7(-/-) mice after O(3) exposure.Results demonstrated a protective role of MMP-9 but not of MMP-7, in O(3)-induced lung neutrophilic inflammation and hyperpermeability. The mechanism through which Mmp9 limits O(3)-induced airway injury is not known but may be via posttranscriptional effects on proinflammatory CXC chemokines including KC and MIP-2.
Ankylosing spondylitis in north Jordan: descriptive and analytical study
Authors: A. Askari
Journal: Annals of the Rheumatic Diseases (2000)

A study of ankylosing spondylitis in Jordan, which has been under investigated in this region.Twenty two patients were studied according to standard methodology during a period of four years. Information on HLA, the presence of uveitis, cardiac disease, and peripheral arthritis was recorded. Other variables such as age, sex, employment, and level of disability were also recorded.The results reflected the characteristics of the illness and the impact of the disease on the patients and their quality of life and were consistent with the findings of other workers in the region.
Abstract 2763: Combination therapy of an acid-sensitive albumin-binding prodrug of doxorubicin (INNO-206) and an albumin-binding prodrug of methotrexate (AW054) that is cleaved by cathepsin B and plasmin induces complete remissions against pancreatic cancer <i>in vivo</i> (MiaPaca-2)
Authors: Felix Kratz, Samar S E E A Azab, Rainer Zeisig, Iduna Fichtner, Andre Warnecke
Journal: Cancer Research (2012)

Abstract Pancreatic cancer is the fourth most common cause of cancer death across the globe. Pancreatic cancer has a poor prognosis. For locally advanced and for metastatic disease, which collectively represent over 80 % of individuals, median survival is approximately 10 and 6 months, respectively. Gemcitabine and 5-fluorouracil that have been approved for this indication have a poor response rate with a benefit in overall survival for a small population of treated patients of up to 2 months on average. Thus there is an unmet medical need for treating this tumor indication more effectively. INNO-206, the (6-maleimidocaproyl)hydrazone of doxorubicin (DOXO-EMCH) is an albumin-binding prodrug of doxorubicin with acid-sensitive properties that has shown objective responses in a phase I study, and phase II studies are scheduled in sarcoma for 2011/2012 (see www.cytrx.com). For treating essentially chemoresistant pancreatic cancer, we preclinically investigated a combination of two albumin-binding prodrugs, i.e. the albumin-binding prodrug INNO-206 and an albumin-binding prodrug of methotrexate, AW054, that is cleaved by two proteases that are over-expressed in solid tumors, cathepsin B and plasmin. In the pancreatic carcinoma xenograft model MiaPaca-2 both INNO-206 and AW054 were administered simultaneously (i.v.) in a three weekly schedule at half the maximum tolerated dose (MTD) of the respective prodrug, i.e. 3 x 12 mg/kg for INNO-206 (doxorubicin equivalents) and 3 x 10 mg/kg (methotrexate equivalents). Compared to doxorubicin (dosed at the MTD of 3 x 6 mg/kg) or methotrexate (dosed at the MTD of 3 x 125 mg/kg) or the combination of the two free drugs (3 x 3 mg/kg for doxorubicin and 3 x 62.5 mg/kg for doxorubicin) which only showed moderate antitumor effects over control animals treated with saline, the combination of the two albumin-binding prodrugs produced complete remissions and an acceptable body weight loss of −13 %. Immunohistochemical staining with CD31 that makes up a large portion of endothelial cell intercellular junctions was moderate to good in control tumors indicating a sufficient vascularity for the albumin-bound forms of the prodrugs to accumulate in the tumor via the EPR effect. This encouraging in vivo result is an impetus for investigating further combinations of albumin-binding prodrugs with other anticancer agents. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2763. doi:1538-7445.AM2012-2763
Breaking the Mold: New Strategies for Fighting Aflatoxins
Authors: Charles W. Schmidt
Journal: Environmental Health Perspectives (2013)

Storage sheds like these Cameroonian corn cribs leave crops vulnerable to Aspergillus contamination.But contamination isn't always as obvious as it is on this ear of corn, and aflatoxin exposure can go undetected until health effects occur.Aid and development agencies are helping farmers learn how to spot and prevent Aspergillus.
A U.K. multicentre audit of the assessment and management of psoriasis in children
Authors: M.L. Lam, E. Burden-Teh, S.M. Taibjee, A. Taylor, S. Webster, S. Dolman, C. Jury, D. Caruana, S. Darne, A. Carmichael, S. Natarajan, T. McPherson, A. Moore, R. Katugampola, M. Kalavala, D. Al-Ismail, L. Richards, V. Jones, S. Batul Syed, M. Glover, J. Hughes, E. Anderson, B. Hughes, P. Babakinejad, R. Murphy
Journal: British Journal of Dermatology (2014)
Three cell cycle scientists win Nobel prize
Authors: G. Watts
Journal: BMJ (2001)

Two of the winners of the 2001 Nobel prize in physiology or medicine, announced on Monday, will have come as no surprise to students of this coveted award. Sir Paul Nurse, director of the Imperial Cancer Research Fund in London, and Dr Leland Hartwell, director of the Fred Hutchinson Cancer Research Center in Seattle, have both been hotly tipped for the past few years.

The third of the trio, Dr Tim Hunt, also of …
Endoscopic papillary balloon dilatation may preserve sphincter of Oddi function after common bile duct stone management: evaluation from the viewpoint of endoscopic manometry
Authors: H Sato, T Kodama, J Takaaki, Y Tatsumi, T Maeda, S Fujita, Y Fukui, H Ogasawara, S Mitsufuji
Journal: Gut (1997)

Endoscopic papillary balloon dilatation (EPBD) has been reported as a safe and effective alternative to endoscopic sphincterotomy in the management of common bile duct (CBD) stones; its effect on papillary function has yet to be elucidated.To investigate sphincter of Oddi (SO) motility before and after EPBD to determine its effect on SO function.The papillary function of 10 patients with CBD stones was studied using endoscopic manometry before and one week after EPBD. The manometric studies were repeated one month after EPBD in seven patients.One week after EPBD, CBD pressure, SO peak pressure, SO basal pressure, and SO frequency decreased significantly. One month after EPBD, however, all parameters increased although the increases in SO basal pressure and CBD pressure were not significant. There was no significant difference in values of any parameter before and one month after EPBD. No serious complications occurred.These data suggest at least partial recovery of papillary function one month after the procedure. EPBD seems to preserve papillary function in treatment of CBD stones; a longer term follow up study with SO manometry should be performed to clarify the effect of EPBD on SO function.
Ethics and Cost Containment-Reply
Authors: Dana E. Johnson
Journal: JAMA (1985)

In Reply.—  The purpose of my article was not gloomily to predict an inevitable erosion in the moral caliber of American medicine, but rather to outline potential problems that could occur given the rapid changes occurring in health care provision. Neither did I mean to imply that health care providers were unaware of the possible influence of fiscal restraint on ethical decision making nor minimize the programs that have been developed to address these issues directly. My implicit purpose was to encourage such introspective efforts. If the negative aspects of this situation appear emphasized, it is only because of my personal feeling that, in our rush to contain costs, we generally have paid more attention to the bottom line than we have to the possible effects of cost-cutting on patient care.  The salvation of American medicine may lie in providing more cost-effective care, but not at the expense of the
Antidiarrhoeal activity of loperamide: studies of its influence on ion transport across rabbit ileal mucosa in vitro.
Authors: S Hughes, N B Higgs, L A Turnberg
Journal: Gut (1982)

Loperamide is a well-established antidiarrhoeal agent with effects on gastrointestinal motility. We have now shown that the drug influences ion transport. In isolated rabbit ileal mucosa loperamide caused a dose-related fall in potential difference and short-circuit current and reduced the serosa to mucosa flux of chloride. The electrical effects were inhibited by naloxone (10(-6)M) suggesting that they were mediated by opiate receptors. Loperamide (10(-6)M) inhibited secretion provoked by heat stable and heat labile E. coli toxins and by prostaglandin E2. We conclude that loperamide is able to inhibit secretion mediated by cAMP or cGNP, and that this may be relevant to its antidiarrhoeal properties.