tbuckley/cabot-search huggingface dataset:
OC-124 Centralisation of OG services in the west of Scotland: are we matching the outcomes of the UK national OG audit?
Authors: A Crumley, G Bryce, G Fullarton, C MacKay, C Craig, M Forshaw
Journal: Gut (2012)

<h3>Introduction</h3> The SAGOC report (1997–2000) highlighted the high morbidity and mortality of oesophageal and gastric resections in Scotland. Since then, centralisation into higher volume units has only slowly occurred in Scotland. The UK National Oesophago-Gastric Audit has not included data from Scotland and direct comparisons of outcomes have been lacking. The aim of this study was to assess the surgical outcomes following the establishment of a regional unit in 2007 relative to the outcomes of the National Oesophago-Gastric Audit 2010. <h3>Methods</h3> A prospective database (August 2007–December 2011) recorded the demographic details, treatment received, postoperative events and pathology outcomes for all patients undergoing oesophageal or gastric resections. The data were recorded into a Microsoft Excel database and wherever possible the same definitions were utilised as per the National Oesophago-Gastric Audit. <h3>Results</h3> 233 patients (males=174 (75%); median age = 66 years) underwent either oesophageal or gastric resections, predominantly for adenocarcinoma (88%). 67% of patients received preoperative chemotherapy. 125 patients underwent oesophagectomy: transthoracic (n=73), transhiatal (n=46), inoperable (n=6). 102 patients underwent gastrectomy: total (n=41), subtotal (n=49), inoperable/bypass (n=12). Six patients underwent wedge resections. 30 day and in-hospital mortality following oesophagectomy was 1.7% and 3.4% respectively, all in patients undergoing transthoracic oesophagectomy and most commonly due to respiratory complications. 30 day and in-hospital mortality following gastrectomy was 3.3% and 5.6% respectively, all in patients undergoing total gastrectomy and most commonly due to surgical complications. 33 patients (14.1%) were admitted to ICU most commonly for respiratory failure and following anastomotic leakage. 37 patients (17.8%) underwent reoperation including endoscopic interventions. Clinical and radiological anastomotic leaks were observed in 12% of oesophagectomies and 10% of gastrectomies. Longitudinal and circumferential margin involvement occurred in 2.6% and 26.3% of oesophageal resections respectively. Longitudinal margin involvement was seen in 11% of gastric resections. Median lymph node was 16 (range=3–54) for all resections. More than six lymph nodes were removed in all oesophageal resections. However, &lt;25 lymph nodes were removed in nearly 80% of gastric resections. <h3>Conclusion</h3> The results from this newly established regional unit compare favourably with the outcomes from National Oesophago-Gastric Audit. Significant differences were highlighted in the proportion of transhiatal resections, the absence of minimally invasive surgery and longitudinal margin involvement and lymph node yields for gastric cancer surgery. <h3>Competing interests</h3> None declared.
Clinical Interventions in Tobacco Control
Authors: Marc Manley
Journal: JAMA (1991)

SMOKING is the leading preventable cause of death in our country. Smoking kills 434 000 people a year, more than 1000 every day<sup>1</sup>; it accounts for about 85% of all lung cancer deaths, about 80% of all chronic obstructive pulmonary disease deaths, and 30% of all heart disease deaths. In addition, smoking costs this country $52 billion annually in health care and other costs.<sup>2</sup> In spite of the magnitude of this health hazard, most physicians have never received training in techniques to help patients stop smoking. Many physicians believe they are unprepared and unsuccessful in treating patients addicted to nicotine.<sup>3,4</sup>However, recent scientific evidence suggests that physicians can help smokers stop and thus reduce the incidence of smoking-related diseases. In 1989, the National Cancer Institute (NCI) used clinical trial results and consensus development to produce recommendations for physicians who treat patients
Fluoroscopically Guided Laser Lithotripsy of a Pancreatic Duct Stone
Authors: M. Maier, R. Jakobs, B. Kohler, J. F. Riemann
Journal: Endoscopy (1994)

A 54-year-old man with early stage chronic pancreatitis and an impacted ductal stone in the pancreatic head complicated by a 2 cm abscess was treated with pulsed dye laser lithotripsy using an automatic stone tissue differentiation system under fluoroscopic control. This system automatically switches off the laser on contact with tissue. The 0.25 mm quartz fiber introduced into the pancreatic duct via a 5 French teflon catheter delivered 165 out of 1000 pulses at contact with the stone (100 mJ, 10 Hz). Partial stone disintegration was achieved making mechanical stone removal possible which initially failed. No major side-effect occurred. This new laser with a stone detection system seems to render fluoroscopically guided laser lithotripsy in the pancreatic duct safer thus warranting further clinical trials.
Evidence for the stimulatory effect of resveratrol on Ca2+-activated K+ current in vascular endothelial cells
Authors: H Li
Journal: Cardiovascular Research (2000)

Objective: Resveratrol, a natural phytoalexin compound, is present in grapes and wine, and it can produce vasorelaxation. However, little is known of its mechanisms of action on ionic currents in endothelial cells. Methods: The effect of resveratrol on Ca2+-activated K+ currents in an endothelial cell line (HUV-EC-C) originally derived from human umbilical vein was investigated with the aid of the patch-clamp technique. Results: In the whole-cell configuration, resveratrol reversibly increased the amplitude of K+ outward currents. The increase in outward current caused by resveratrol was greatly inhibited by iberiotoxin (200 nM) or paxilline (1 μM), but not by glibenclamide (10 μM), tamoxifen (10 μM), or β-bungarotoxin (200 nM). Thus, this outward current is believed to be Ca2+-activated K+ current (IK(Ca)). In the inside-out configuration, bath application of resveratrol (30 μM) caused no change in the single-channel conductance, but increased the activity of large-conductance Ca2+-activated K+ (BKCa) channels. Resveratrol enhanced the channel activity in a concentration-dependent manner. The EC50 value for resveratrol-induced channel activity was 20 μM. The resveratrol-stimulated increase in the channel activity was independent of internal Ca2+. Resveratrol (30 μM) also shifted the activation curve of BKCa channels to less positive membrane potentials. The change in the kinetic behavior of BKCa channels caused by resveratrol in these cells is due to an increase in mean open time and a decrease in mean closed time. In a pancreatic islet endothelial cell line (MS1), resveratrol (30 μM) also increased the activity of intermediate-conductance KCa channels. Conclusions: These results provide evidence that in addition to the presence of antioxidative activity, resveratrol can also stimulate KCa channels in endothelial cells. The direct stimulation of these KCa channels by resveratrol may be responsible for its effect on the functional activities of endothelial cells.
Coarctation in the Elderly
Authors: M. V. BRAIMBRIDGE, A. YEN
Journal: Circulation (1965)

The clinical presentation and operative results have been assessed of a series of patients with coarctation over the age of 40, and have been compared with a larger group of all ages. Long-standing hypertension increased markedly the incidence of symptoms due to left ventricular strain and cerebral hypertension. There was little increase in symptoms due to poor peripheral blood flow and no case of subacute bacterial endarteritis. The preoperative systolic blood pressures, when related to the normal for the age and sex of the patient, were higher and the diastolic pressures lower than an average group but signs of left ventricular strain were more common. At operation the aortic narrowing was found to be of usual severity. Grafts were necessary because of poor anastomotic tissue rather than long narrow segments as in the larger group. The operative mortality was doubled in the elderly, due entirely to hemorrhage from friable aortas. Morbidity was increased as a result of pulmonary and pleural complications. Postoperative blood pressures were almost exactly comparable with those of the over-all group when related to normal for age and sex. Symptoms were usually relieved but there was relatively slight radiologic or electrocardiographic change. The operative mortality and morbidity are acceptable in view of the risks of inaction and the satisfactory results of operation in the survivors.
Normal Cells Control the Growth of Neighboring Transformed Cells Independent of Gap Junctional Communication and Src Activity
Authors: David B. Alexander, Hitoshi Ichikawa, John F. Bechberger, Virginijus Valiunas, Misao Ohki, Christian C. G. Naus, Takehiko Kunimoto, Hiroyuki Tsuda, W. Todd Miller, Gary S. Goldberg
Journal: Cancer Research (2004)

Abstract The growth of many types of cancer cells can be controlled by surrounding normal cells. However, mechanisms underlying this phenomenon have not been defined. We used a layered culture system to investigate how nontransformed cells suppress the growth of neighboring transformed cells. Direct physical contact between transformed and nontransformed cells was required for growth suppression of transformed cells in this system; communication by diffusible factors was not sufficient. However, significant gap junctional communication was not required, indicating that other intercellular junctions mediated this growth regulatory response. We also report that the Src kinase activity in transformed cells was not directly inhibited by contact with nontransformed cells. Instead, nontransformed cells increased the expression of serum deprivation-response protein and the transcription factor four and a half LIM domain 1 in tumor cells. In addition, these results suggest mechanisms by which normal cells may block Wnt signaling, inhibit insulin-like growth factor activity, and promote host recognition of neighboring tumor cells.
Experience in Renal Transplantation
Authors: William D. Kelly
Journal: JAMA (1964)

This absorbing book will undoubtedly be a classic in its field. The author clearly states his purpose in the preface: "... The primary objective... is not to recapitulate all previous experience with human renal transplantation but rather... to present a simple and practical analysis of those cases treated by this means at the University of Colorado Medical Center, in order to help define the indications, technical requirements, limitations, causes of failure and results at one institution." This the author and his collaborators do in a clear, well-illustrated, albeit at times redundant, manner. The book might be mistaken for a practical guide of the future to a well-established clinical field, were it not for the repeated admonitions of the author on the experimental nature of the subject. This is underscored by emphasis on the need for strong collateral research effort in the animal laboratory and is amply illustrated by the many
Designer Genes for Producing Drugs: Will They Wash?
Authors: Henry I. Miller
Journal: JAMA (1982)

Recombinant DNA technology is all the vogue these days. It is the subject of intense media and investor interest. It has lured tens of millions of dollars from industry to support academic research, spawned a seemingly endless succession of symposia examining every nuance of the technology, and fostered the development of a hundred "recombinant DNA companies" in a dozen countries. But those who are "bullish" on this new technology had best be prepared to be patient, at least for the short term; most of the prognostications made about this new area are almost surely overly optimistic. Even the authoritative and useful report by the Congress' Office of Technology Assessment,<i>Impacts of Applied Genetics</i>, recently hyperbolized that "the<i>immediate</i>direct economic impact of using genetic manipulation in the [pharmaceutical] industry, measured as sales, can be estimated in the billions of dollars, with the indirect impacts... reaching several times that value." This
CASE OF CESAREAN SECTION UNDER SPINAL ANESTHESIA.
Authors: S. R. HOPKINS
Journal: JAMA (1902)

A report of the following successful case is not presented because of anything particularly peculiar in the operation itself, but mainly in an attempt to show what appears to the author the superiority of spinal anesthesia over ether or chloroform in cases of Cesarean section, because of the relaxed condition of the uterine muscles likely to obtain with the patient anesthetized by either of the two latter methods. The patient, a primipara, 28 years old, of small stature, suffered in early childhood an attack of poliomyelitis anterior acuta, as a result of which the right side of the body failed to keep pace in a matter of growth and development with the left. The right arm is 4½ inches shorter than the left, and the right half of the pelvis is correspondingly small, which fact, together with the markedly kyphotic condition of the lumbo-sacral spine, was largely responsible for the
Novel somatic mutations in large granular lymphocytic leukemia affecting the STAT-pathway and T-cell activation
Authors: E I Andersson, H L M Rajala, S Eldfors, P Ellonen, T Olson, A Jerez, M J Clemente, O Kallioniemi, K Porkka, C Heckman, T P Loughran, J P Maciejewski, S Mustjoki
Journal: Blood Cancer Journal (2013)

T-cell large granular lymphocytic (T-LGL) leukemia is a clonal disease characterized by the expansion of mature CD3+CD8+ cytotoxic T cells. It is often associated with autoimmune disorders and immune-mediated cytopenias. Our recent findings suggest that up to 40% of T-LGL patients harbor mutations in the STAT3 gene, whereas STAT5 mutations are present in 2% of patients. In order to identify putative disease-causing genetic alterations in the remaining T-LGL patients, we performed exome sequencing from three STAT mutation-negative patients and validated the findings in 113 large granular lymphocytic (LGL) leukemia patients. On average, 11 CD8+ LGL leukemia cell-specific high-confidence nonsynonymous somatic mutations were discovered in each patient. Interestingly, all patients had at least one mutation that affects either directly the STAT3-pathway (such as PTPRT) or T-cell activation (BCL11B, SLIT2 and NRP1). In all three patients, the STAT3 pathway was activated when studied by RNA expression or pSTAT3 analysis. Screening of the remaining 113 LGL leukemia patients did not reveal additional patients with same mutations. These novel mutations are potentially biologically relevant and represent rare genetic triggers for T-LGL leukemia, and are associated with similar disease phenotype as observed in patients with mutations in the STAT3 gene.
Health care is paradox in India
Authors: Susheel Oommen John
Journal: BMJ (2005)

Modified Mediterranean diet and survival Evidence for diet linked longevity is substantialEditor-The EPIC-elderly cohort study was designed to investigate the association between a modified Mediterranean diet and longer life expectancy among an elderly subpopulation (older than 60) that is part of the larger EPIC (European Prospective Investigation into Cancer and Nutrition) cohort. 1 2 Focusing the attention on a sample with a more restricted age range seems to reinforce previous findings on diet linked longevity, but important risk factors were not taken into account in collecting the data.Total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and blood pressure are well known determinants of cardiovascular disease.The study's outcomes are expressed in term of mortality, and cardiovascular disease remains the most important of all causes of death.The benefits of a healthy eating pattern with respect to these variables have been shown. 3he same might not be sustained if the total EPIC cohort were considered (aged 20-85). 2 Have the authors considered any possible statistical gain from including these risk factors in the analysis when considering the younger subgroup?We believe that the conclusions for participants older than 60 are stronger if the risk of cardiovascular disease in men and women after the menopause is considered.In a world in which people eat mainly processed foods that are rich in saturated fats, the analysis is a warning to adopt a healthier dietary pattern and, broadly, lifestyle changes.
Medicine at the Periphery
Authors: John Lister
Journal: New England Journal of Medicine (1957)

ONE of the major effects of the National Health Service has been the upgrading of the peripheral hospitals, and it is a tribute to medicine at the periphery that Dr. W. A. Bourne, F.R.C.P., of Brighton, has been elected president of the Section of Medicine at the Royal Society of Medicine for the current year. Before the inception of the Health Service it would not be unfair to say that in many peripheral hospitals the standard of medical care compared unfavorably with that in the large centers. There were, of course, exceptions, and many provincial hospitals have long established reputations . . .
SNAREing Voltage-Gated K+ and ATP-Sensitive K+ Channels: Tuning β-Cell Excitability with Syntaxin-1A and Other Exocytotic Proteins
Authors: Yuk M. Leung, Edwin P. Kwan, Betty Ng, Youhou Kang, Herbert Y. Gaisano
Journal: Endocrine Reviews (2007)

The three SNARE (soluble N-ethylmaleimide-sensitive factor attachment protein receptor) proteins, syntaxin, SNAP25 (synaptosome-associated protein of 25 kDa), and synaptobrevin, constitute the minimal machinery for exocytosis in secretory cells such as neurons and neuroendocrine cells by forming a series of complexes prior to and during vesicle fusion. It was subsequently found that these SNARE proteins not only participate in vesicle fusion, but also tether with voltage-dependent Ca(2+) channels to form an excitosome that precisely regulates calcium entry at the site of exocytosis. In pancreatic islet beta-cells, ATP-sensitive K(+) (K(ATP)) channel closure by high ATP concentration leads to membrane depolarization, voltage-dependent Ca(2+) channel opening, and insulin secretion, whereas subsequent opening of voltage-gated K(+) (Kv) channels repolarizes the cell to terminate exocytosis. We have obtained evidence that syntaxin-1A physically interacts with Kv2.1 (the predominant Kv in beta-cells) and the sulfonylurea receptor subunit of beta-cell K(ATP) channel to modify their gating behaviors. A model has proposed that the conformational changes of syntaxin-1A during exocytosis induce distinct functional modulations of K(ATP) and Kv2.1 channels in a manner that optimally regulates cell excitability and insulin secretion. Other proteins involved in exocytosis, such as Munc-13, tomosyn, rab3a-interacting molecule, and guanyl nucleotide exchange factor II, have also been implicated in direct or indirect regulation of beta-cell ion channel activities and excitability. This review discusses this interesting aspect that exocytotic proteins not only promote secretion per se, but also fine-tune beta-cell excitability via modulation of ion channel gating.
Fish models for environmental carcinogenesis: the rainbow trout.
Authors: G S Bailey, D E Williams, J D Hendricks
Journal: Environmental Health Perspectives (1996)

Progress over the past 30 years has revealed many strengths of the rainbow trout as an alternative model for environmental carcinogenesis research. These include low rearing costs, an early life-stage ultrasensitive bioassay, sensitivity to many classes of carcinogen, a well-described tumor pathology, responsiveness to tumor promoters and inhibitors, and a mechanistically informative nonmammalian comparative status. Low-cost husbandry, for example, has permitted statistically challenging tumor study designs with up to 10,000 trout to investigate the quantitative interrelationships among carcinogen dose, anticarcinogen dose, DNA adduct formation, and final tumor outcome. The basic elements of the trout carcinogen bioassay include multiple exposure routes, carcinogen response, husbandry requirements, and pathology. The principal known neoplasms occur in liver (mixed hepatocellular/cholangiocellular adenoma and carcinoma, hepatocellular carcinoma), kidney (nephroblastoma), swim bladder (adenopapilloma), and stomach (adenopapilloma). Trout possess a complex but incompletely characterized array of cytochromes P450, transferases, and other enzymic systems for phase I and phase II procarcinogen metabolism. In general, trout exhibit only limited capacity for DNA repair, especially for removal of bulky DNA adducts. This factor, together with a high capacity for P450 bioactivation and negligible glutathione transferase-mediated detoxication of the epoxide, accounts for the exceptional sensitivity of trout to aflatoxin B1 carcinogenesis. At the gene level, all trout tumors except nephroblastoma exhibit variable and often high incidences of oncogenic Ki-ras gene mutations. Mutations in the trout p53 tumor suppressor gene have yet to be described. There are many aspects of the trout model, especially the lack of complete organ homology, that limit its application as a surrogate for human cancer research. Within these limitations, however, it is apparent that trout and other fish models can serve as highly useful adjuncts to conventional rodent models in the study of environmental carcinogenesis and its modulation. For some problems, fish models can provide wholly unique approaches.
Wielding the axe
Authors: D. Spence
Journal: BMJ (2009)

The axe is coming. But the NHS is considered sacrosanct and won’t face cuts in spending; other public sector workers will take our pain. Now, I would go to the barricades to defend the NHS, but this protectionist policy is wrong, driven not by reason but a populist eye cast towards the next election. The NHS needs to share the pain of the public sector and indeed to demonstrate solidarity with workers in the private sector, who rightly believe that we are overpaid, overpensioned, and overprotected. Sparing the NHS …
The Inelastic Sac-like Component Versus the Slow Time Constant Component of the Distribution of Ventilation by Stage of Respiratory Dysfunction.
Authors: A. W. Brody
Journal: Annals of Internal Medicine (1969)

s1 May 1969The Inelastic Sac-like Component Versus the Slow Time Constant Component of the Distribution of Ventilation by Stage of Respiratory Dysfunction.A. W. Brody, J. J. Navin, R. R. Stoughton, F. BartaA. W. BrodySearch for more papers by this author, J. J. NavinSearch for more papers by this author, R. R. StoughtonSearch for more papers by this author, F. BartaSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1097_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring rebreathing to determine the functional residual capacity (FRC) by the closed-circuit method, three tests of the distribution of ventilation may also be performed, provided instrumental response is rapid enough. Standards were measured in 115 normal subjects, and correlation with disease was made in 125 patients using the nitrogen meter. The Fowler single-breath test or a variant is performed on the first breath and is thought to become abnormal because of the increased proportion of slowly emptying alveoli; this test is quite sensitive to early changes in obstructive disease. The forced equilibrium expiration (FEE) at 2 min to 500 ml... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: A. W. Brody; J. J. Navin; R. R. Stoughton; F. BartaAffiliations: Omaha, Nebraska PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byStandards and significance for three tests of the distribution of ventilation 1 May 1969Volume 70, Issue 5Page: 1097-1097KeywordsAlveoli ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...