tbuckley/cabot-search huggingface dataset:
Electrophysiological Effects of Long, Linear Atrial Lesions Placed Under Intracardiac Ultrasound Guidance
Authors: Jeffrey E. Olgin, Jonathan M. Kalman, Michael Chin, Carol Stillson, Mark Maguire, Philip Ursel, Michael D. Lesh
Journal: Circulation (1997)

Background A curative atrial fibrillation procedure will most likely rely on creating transmural linear ablative lesions. However, it is currently unknown whether endocardial radiofrequency lesions can create lines of conduction block. Methods and Results In six pigs, intracardiac echocardiography was used to guide the positioning of multiple coil array catheters to bridge endocardial structures in three right atrial locations: (1) from the crista terminalis to the tricuspid annulus; (2) from the fossa ovalis to the crista terminalis; and (3) from the inferior vena cava to the tricuspid annulus. Once the catheter was positioned, linear lesions were made by radiofrequency energy applied sequentially to each of the four coils. After 15 days, the chest was opened and a 112-electrode epicardial plaque was positioned over the atrial free wall lesion to determine activation patterns. Three lesions were placed in each animal, with a mean procedure time of 47±11 minutes. Once adequate contact was determined by intracardiac echocardiography, a single series of radiofrequency application was required to achieve tissue heating (65±4°C) with a power of 21±10 W. Epicardial mapping demonstrated complete conduction block across the lesions in all animals, with split potentials and disparate activation times (64±16 ms) across the lesion. At autopsy, all lesions were discrete, continuous, and without evidence of charring. The lesions were within 0.3±0.5 mm of their targeted anatomic locations and measured 21±4 mm long and 2.8±0.6 mm wide. Histology revealed transmural fibrosis throughout the length of each lesion. Conclusions Linear lesions that are electrophysiologically transmural and continuous can be placed in the right atrium of normal pigs. With intracardiac echocardiography, adequate tissue contact over several coil electrodes can be ensured, resulting in short procedure times, efficient energy application, and accurate anatomically linked lesion placement.
Expression of Natural Cytotoxicity Receptors (NCR's) NKp30, NKp44, and NKp46 mRNA's and Proteins by a Variety of Hematopoietic and Non-hematopoietic Cells
Authors: B.I.S. Srivastava, M.D. Srivastava
Journal: Journal of Allergy and Clinical Immunology (2005)
Impact of White-Coat Hypertension on Microvascular Complications in Type 2 Diabetes
Authors: Caroline K. Kramer, Cristiane B. Leitão, Luís H. Canani, Jorge L. Gross
Journal: Diabetes Care (2009)

Eguchi et al. (1), in their response to our study (2), point out that microvascular damage associated with white-coat hypertension may be the cause of increased blood pressure responses to daily stressors. This is a very interesting and original interpretation; however, the direction of the cause-and-effect relation between microvascular disease and blood pressure response to exercise can only be …
Forgotten (Almost) but Not Gone, Tuberculosis Suddenly Looms Large on Domestic Scene
Authors: Marsha F. Goldsmith
Journal: JAMA (1990)

PREVENTABLE, curable, but largely forgotten—that's been an apt description of tuberculosis (TB) in the United States from the 1940s until recently. However, speakers in Boston at the first World Conference on Lung Health made it clear that for various reasons
Immunotherapy with partially purified and standardized tree pollen extracts
Authors: H. Ipsen, B. Schwartz, J.‐Å. Wihl, B. Nüchel Petersen, E. P. Munch, H. Janniche, H. Løwenstein
Journal: Allergy (1988)

Patients allergic to pollen from alder, birch and hazel were hyposensitized during a 3‐year period with either birch pollen extract alone ( n = 24) or a mixture of one or more of alder, birch and hazel pollen extracts ( n = 27). The effect of the treatment was evaluated by RAST and tandem crossed‐radioimmunoelectrophoresis (tandem‐CRIE). The patient' specific IgE response to the major allergens of alder (Aln g I), birch (Bet v I) and hazel (Cor a I and Cor a II), as measured by tandem‐CRIE, and the total specific IgE response, measured by RAST, decreased significantly ( P c &lt; 0.05) during immunotherapy, irrespective of the extract used during the treatment. There was no significant difference ( P c &lt; 0.05) between the two treatment groups. The results obtained indicate either that birch pollen extract alone is adequate in the treatment of the studied patient group or the patients had been sensitized towards birch pollen alone.
Respect for traditional medicine
Authors: P. B R Kolman
Journal: BMJ (1983)

serotype 3, biotype 4, has been isolated several times from patients, food handlers,2 pigs, and monkeys.3Other serotypes or biotypes of Y enterocolitica, which are ubiquitous soil and water saprophytes,4 are probably as frequent in the tropics as they are in the temperate zone.Recently, a biotype 1 strain of Y enterocolitica, isolated from the stools of an African, was submitted to our laboratory by Dr J Bogaerts from Kigali (Rwanda).
Failure of CT Sharing in a Large Municipal Hospital
Authors: John C. M. Brust, P. C. Taylor Dickinson, Edward B. Healton
Journal: New England Journal of Medicine (1981)

Abstract Harlem Hospital Center lacks computed tomography (CT) facilities. During 1979 it attempted to share the CT facilities of two other institutions. Retrospective analysis reveals that under this arrangement only a small percentage of Harlem patients needing CT obtained it. Among patients recommended for CT, 252 of 1528 without trauma and six of 342 with trauma received it. In some instances there were difficulties in moving patients between hospitals. If transportation had been optimal, however, the other hospitals, because of their own needs, would have been unable to provide Harlem Hospital with more than a third of the CT scans requested. Furthermore, even if unlimited opportunities for scanning had been available, patients whose need for CT seemed most urgent — the very ill — would have been unable to receive it; of 163 patients who died without receiving CT as recommended, 93 were too sick or deteriorating too rapidly to be moved to the CT facilities. We conclude that CT cannot be effectively shared by large acute-care hospitals. (N Engl J Med. 1981; 304:1388–93.)
Changes in flow and pressure due to rotation of a saphenous vein segment
Authors: A. GORDON, J. WILLIAMS, B. BUXTON
Journal: Cardiovascular Research (1975)

The effect of axial rotation on flow through and pressure gradient across saphenous vein segments was studied using 15 cadaver long saphenous veins. A significant reduction in flow occurred at a mean rotation of 25 degrees/cm and a significant increase in head loss across the segments occurred at a mean rotation of 23 degrees/cm. Collapse of the vein segments occurred at a mean rotation of 27 degrees/cm.
KNOWLEDGE-BASED LV DETECTION AND AUTOMATIC EF CALCULATION FOR GATED BLOOD POOL STUDIES
Authors: J. Oian, R. P. DeVito, M. W. Groch, W. D. Erwin, J. D. Treffert
Journal: Clinical Nuclear Medicine (1992)

Oian, J.; DeVito, R. P.; Groch, M. W.; Erwin, W. D.; Treffert, J. D. Author Information
Delayed‐type hypersensitivity to subcutaneous enoxaparin
Authors: J. Méndez, M. E. Sanchis, R. de la Fuente, R. Stolle, J. M. Vega, C. Martinez, A. Armentia, P. Sánchez, A. Fernández
Journal: Allergy (1998)

Background Enoxaparin and other low‐molecular‐weight heparins are widely used to prevent and treat thromboembolic disorders. Cutaneous reactions secondary to enoxaparin injections include delayed hypersensitivity skin reactions described as erythematous, infiltrated plaques at injection sites. We studied three cases of erythematous infiltrated plaques after enoxaparin injection in order to establish the allergenic importance of this low‐molecular‐weight heparin. Methods Patch tests were performed with sodium heparin, calcium heparin, calcium enoxaparin, and calcium nadroparin, A subcutaneous test with calcium heparin and an intravenous challenge test with sodium heparin were done, A punch biopsy was obtained from an erythematous plaque in one patient. Results Patch tests were negative to calcium heparin in all patients, positive t o enoxaparin and nadroparin in two patients, and positive to sodium heparin i n one patient. In two patients, the subcutaneous challenge test was positive, the intravenous challenge test was negative, and the histopathologic appearance of the biopsy resembled a delayed‐type hypersensitivity reaction. Conclusions TTiese cases provide evidence of type IV hypersensitivity and the possibility of crossed‐allergenicity among unfractionated heparin and low‐molecular‐weight heparins. We show that the subcutaneous challenge test is the most reliable diagnostic measure.
Contrasting effect of alpha/beta- and gamma-interferons on expression of macrophage Ia antigens.
Authors: K Inaba, M Kitaura, T Kato, Y Watanabe, Y Kawade, S Muramatsu
Journal: The Journal of Experimental Medicine (1986)

IFN-gamma is known to induce the expression of Ia antigens on macrophages. We found that murine IFN-alpha and -beta blocked the effects of IFN-gamma in a dose-dependent manner. The antagonistic effect of IFN-alpha and -beta was observed even when macrophages were prestimulated with IFN-gamma. These inhibitory effects of IFN-alpha or -beta were blocked by their respective antibodies. The block exerted by IFN-alpha/beta was similar whether Ia levels were monitored by immunofluorescence with anti-Ia mAb, or by stimulation of freshly sensitized, alloreactive T lymphoblasts. Adherent macrophage-rich populations from newborn mice were incapable of expressing Ia antigens following stimulation with IFN-gamma, and would inhibit the response of adult macrophages to this lymphokine. Addition of anti-IFN-beta mAb, but not anti-IFN-alpha allowed newborns' macrophages to express Ia in response to IFN-gamma, and ablated the suppressive activity toward adult cells. These results indicate that IFN-alpha and -beta, which can be produced in the course of self-defense responses and during ontogeny, may contribute to the down-regulation of macrophage Ia expression.
The Customer Approach to Patienthood
Authors: Charles D. Aring
Journal: JAMA (1975)

Large psychiatric walk-in clinics and community mental health centers have been swamped with patients whose orientations are worlds apart from the professionals who serve them. It has been a challenge to conduct these operations for the benefit of the clientele, composed mainly of poor people, communication being what it is. When at the same time there is responsibility for good teaching, the difficulty is compounded.  In the current issue of Archives of General Psychiatry 32:553-558, 1975), Lazare and co-workers have faced this challenge and report on the process of negotiation between clinician and patient in the initial psychiatric interview in a busy walk-in clinic. Dropout rates as high as 60% have been reported after the first interview in some of these clinics. The goal of these authors was to compensate for the social differential between patient and therapist, to render improved patient care, to improve staff morale, and to teach
Bioethics are difficult to balance
Authors: A. J Raja
Journal: BMJ (2003)

EDITOR—Singh and DePellegrin focus too narrowly on the Western notions of bioethics.1 According to them, doctors who permit images of war to be captured fail in their legal and ethical duty to protect their patients.

Bioethical codes may not be different around the world, but they have to be contextual. Preaching to doctors not to allow filming of injured people …
Polymorphism in the 5' flanking region of the human insulin gene. Relationships with noninsulin-dependent diabetes mellitus, glucose and insulin concentrations, and diabetes treatment in the Pima Indians.
Authors: W C Knowler, D J Pettitt, B Vasquez, P S Rotwein, T L Andreone, M A Permutt
Journal: Journal of Clinical Investigation (1984)

Variations in DNA sequences flanking the insulin gene were studied in relation to noninsulin-dependent diabetes mellitus (NIDDM) in 87 unrelated Pima Indians at least 35 yr of age. DNA was isolated from nuclei of peripheral blood leukocytes and digested with restriction endonucleases. Less variation in this region was found in Pima Indians than in other racial groups previously studied. Only two classes of alleles (classes 1 and 3) were found, and there was virtually no variation within classes. At least one class 3 allele was found in 47% of the 38 nondiabetic subjects and in 37% of the 49 with NIDDM (odds ratio = 0.65, P = 0.4, 95% confidence interval for the odds ratio = 0.25 to 1.67). Homozygosity for class 3 alleles, however, was found only in diabetics. There were no differences according to genotype in obesity, fasting or postload glucose or insulin concentrations, or in the relationships between insulin and glucose concentrations. 61% (11/18) of the diabetics with a class 3 allele were receiving drug treatment for diabetes compared with only 26% (8/31) of diabetics without a class 3 allele (P = 0.03). The insulin gene polymorphism probably plays no important role in the genesis of NIDDM in Pima Indians, nor does it influence the glucose or insulin concentrations or their relationship to each other, but the class 3 allele, especially when homozygous in this population, may influence the severity of the disease as indicated by need for drug treatment.
Case Report of a Serious Adverse Event Following the Administration of T Cells Transduced With a Chimeric Antigen Receptor Recognizing ERBB2
Authors: Richard A Morgan, James C Yang, Mio Kitano, Mark E Dudley, Carolyn M Laurencot, Steven A Rosenberg
Journal: Molecular Therapy (2010)

In an attempt to treat cancer patients with ERBB2 overexpressing tumors, we developed a chimeric antigen receptor (CAR) based on the widely used humanized monoclonal antibody (mAb) Trastuzumab (Herceptin). An optimized CAR vector containing CD28, 4-1BB, and CD3zeta signaling moieties was assembled in a gamma-retroviral vector and used to transduce autologous peripheral blood lymphocytes (PBLs) from a patient with colon cancer metastatic to the lungs and liver, refractory to multiple standard treatments. The gene transfer efficiency into autologous T cells was 79% CAR(+) in CD3(+) cells and these cells demonstrated high-specific reactivity in in vitro coculture assays. Following completion of nonmyeloablative conditioning, the patient received 10(10) cells intravenously. Within 15 minutes after cell infusion the patient experienced respiratory distress, and displayed a dramatic pulmonary infiltrate on chest X-ray. She was intubated and despite intensive medical intervention the patient died 5 days after treatment. Serum samples after cell infusion showed marked increases in interferon-gamma (IFN-gamma), granulocyte macrophage-colony stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-10, consistent with a cytokine storm. We speculate that the large number of administered cells localized to the lung immediately following infusion and were triggered to release cytokine by the recognition of low levels of ERBB2 on lung epithelial cells.
Roles of Arrest-Defective Protein 1225 and Hypoxia-Inducible Factor 1α in Tumor Growth and Metastasis
Authors: Mi-Ni Lee, Shi-Nai Lee, Se-Hee Kim, Bora Kim, Bo-Kyung Jung, Ji Hae Seo, Ji-Hyeon Park, Jae-Hoon Choi, Sun Hee Yim, Mi-Ran Lee, Jong-Gil Park, Ji-Young Yoo, Jeong Hun Kim, Seung-Taek Lee, Hwan-Mook Kim, Sandra Ryeom, Kyu-Won Kim, Goo Taeg Oh
Journal: JNCI Journal of the National Cancer Institute (2010)

Vascular endothelial growth factor A (VEGFA), a critical mediator of tumor angiogenesis, is a well-characterized target of hypoxia-inducible factor 1 (HIF-1). Murine arrest-defective protein 1A (mARD1A(225)) acetylates HIF-1alpha, triggering its degradation, and thus may play a role in decreased expression of VEGFA.We generated Apc(Min/+)/mARD1A(225) transgenic mice and quantified growth of intestinal polyps. Human gastric MKN74 and murine melanoma B16F10 cells overexpressing mARD1A(225) were injected into mice, and tumor growth and metastasis were measured. VEGFA expression and microvessel density in tumors were assessed using immunohistochemistry. To evaluate the role of mARD1A(225) acetylation of Lys532 in HIF-1alpha, we injected B16F10-mARD1A(225) cell lines stably expressing mutant HIF-1alpha/K532R into mice and measured metastasis. All statistical tests were two-sided, and P values less than .05 were considered statistically significant.Apc(Min/+)/mARD1A(225) transgenic mice (n = 25) had statistically significantly fewer intestinal polyps than Apc(Min/+) mice (n = 21) (number of intestinal polyps per mouse: Apc(Min/+) mice vs Apc(Min/+)/mARD1A(225) transgenic mice, mean = 83.4 vs 38.0 polyps, difference = 45.4 polyps, 95% confidence interval [CI] = 41.8 to 48.6; P < .001). The growth and metastases of transplanted tumors were also statistically significantly reduced in mice injected with mARD1A(225)-overexpressing cells than in mice injected with control cells (P < .01). Moreover, overexpression of mARD1A(225) decreased VEGFA expression and microvessel density in tumor xenografts (P < .04) and Apc(Min/+) intestinal polyps (P = .001). Mutation of lysine 532 of HIF-1alpha in B16F10-mARD1A(225) cells prevented HIF-1alpha degradation and inhibited the antimetastatic effect of mARD1A(225) (P < .001).mARD1A(225) may be a novel upstream target that blocks VEGFA expression and tumor-related angiogenesis.
Tumor necrosis factor/cachectin. Induction of hemorrhagic necrosis in normal tissue requires the fifth component of complement (C5).
Authors: J L Rothstein, T F Lint, H Schreiber
Journal: The Journal of Experimental Medicine (1988)

TNF induces hemorrhagic necrosis (HN) when injected into skin exposed to bacterial agents but not when injected into normal skin. In this paper, we present several lines of evidence suggesting that TNF requires the fifth component of complement (C5) to induce HN in skin exposed to bacteria. First, mouse strains that do not have C5 did not develop HN after injection of TNF and bacteria into skin. Second, plasma from C5-sufficient mice could correct the defect in these C5-deficient mice. Third, heating at 56 degrees C for 30 min inactivated the capacity of plasma to reconstitute C5-deficient mice. Fourth, CVF, which is known to inactivate complement, abrogated the capability of C5-sufficient mice to respond. Fifth, depleting plasma of hemolytic activity while generating C5a did not affect the capacity of the activated plasma to reconstitute C5-deficient mice. Finally, only the plasma fraction containing molecules of the size range of C5a reconstituted C5-deficient mice. These findings indicate that C5a and not the membrane attack complex is required for HN. Although we do not know through which mechanism C5a participates in the development of HN, we propose that the described HN response is related to a local defense mechanism in which TNF and C5a lead to the disruption of capillaries in the direct vicinity of bacteria. By this mechanism the rapid spread of bacteria or their products into the circulation is prevented. Such a tissue response is consistent with the known higher susceptibility of C5-deficient mice to bacterial infections and provides a model with which to search for the multiple steps involved in this important local defense mechanism.
Changing clinical picture of non-accidental injury to children.
Authors: J Jenkins, O P Gray
Journal: BMJ (1983)

The setting up of the South Glamorgan Area Review Committee and locally agreed procedures in 1974 has been associated with a considerable increase in observed moderately severe non-accidental injuries in children. The increase is in all age groups but is rising in older children. Most of the rise is likely to be due to increased community awareness. On the other hand, there has been a steady decrease in severe injuries, which may well be due to early recognition of minor or moderate injuries preventing the development of severe injuries.
Transmural gastric closure and NOTES – How far have we come?
Authors: M. Ryou, C. Thompson
Journal: Endoscopy (2009)

The ability to perform secure closure of transmural gastric defects will represent a significant milestone in the evolution of therapeutic gastrointestinal endoscopy. In 1958, the flexible fiberoptic endoscope was introduced by Larry Curtiss and Basil Hirschowitz as a diagnostic modality. Over the ensuing decades, an interventional focus gradually took shape – initially for more invasive diagnostic techniques, such as biopsies and polypectomies, but later encompassing hemostasis, pancreaticobiliary procedures (i. e., endoscopic retrograde cholangiopancreatography and sphincterotomies), fine needle aspirations under endoscopic ultrasound guidance, and endoscopic mucosal resection and endoscopic submucosal dissection for resection of early-stage cancers. However, this growing interventional focus was mostly confined to the gastrointestinal lumen.
Randomised study of n of 1 trials versus standard practice
Authors: J. Mahon, A. Laupacis, A. Donner, T. Wood
Journal: BMJ (1996)

<h3>Abstract</h3> <b>Objective</b>: To compare outcomes between groups of patients with irreversible chronic airflow limitation given theophylline by n of 1 trials or standard practice. <b>Design</b>: Randomised controlled study of n of 1 trials versus standard practice. <b>Setting</b>: Tertiary care centre outpatient department. <b>Subjects</b>: 31 patients with irreversible chronic airflow limitation who were unsure that theophylline was helpful after an open trial. <b>Interventions</b>: n Of 1 trials (single patient randomised multiple crossover comparisons of theophylline against placebo) followed published guidelines. For standard practice patients theophylline was stopped and resumed if their dyspnoea worsened; if their dyspnoea then improved theophylline was continued. For both groups a decision to continue or stop the drug was made within three months of randomisation. <b>Main outcome measures</b>: Exercise capacity as measured by six minute walking distance, quality of life as measured by the chronic respiratory disease questionnaire at baseline and six months after randomisation, and proportions of patients taking theophylline at six months. <b>Results</b>: 26 patients completed follow up. 47% fewer n of 1 trial patients than standard practice patients were taking theophylline at six months (5/14 versus 10/12; 95% confidence interval of difference 14% to 80%) without differences in exercise capacity or quality of life. <b>Conclusions</b>: n Of 1 trials led to less theophylline use without adverse effects on exercise capacity or quality of life in patients with irreversible chronic airflow limitation. These data directly support the presence of a clinically important bias towards unnecessary treatment during open prescription of theophylline for irreversible chronic airflow limitation. Confirmation in a larger study and similar studies for other problems appropriate for n of 1 trials are needed before widespread use of n of 1 trials can be advocated in routine clinical practice. <h3>Key messages</h3> Several common clinical problems suit n of 1 tri- als, including prescription of theophylline for irre- versible chronic airflow limitation, yet they are rarely used Among patients with chronic airflow limitation randomised to receive theophylline by an n of 1 trial or standard practice 47% fewer n of 1 trial patients were taking theophylline after six months without difference in exercise capacity or quality of life There seems to be a clinically important bias towards unnecessary treatment in standard prac- tice in this setting; n of 1 trials may limit this bias