tbuckley/cabot-search huggingface dataset:
In-vivo microvascular imaging of early squamous-cell cancer of the esophagus by confocal laser endomicroscopy
Authors: K. Deinert, R. Kiesslich, M. Vieth, M. Neurath, H. Neuhaus
Journal: Endoscopy (2007)

We present the case of a 63-year-old man with an early esophageal squamous-cell cancer that was visualized and analyzed by fluorescein-aided confocal laser endomicroscopic imaging. Our findings indicate that endomicroscopy is readily able to provide images of microvessels and to differentiate between normal and abnormal tumor vessels. Endomicroscopy therefore has the potential to characterize microvascular changes in early squamous-cell cancer, suggesting that this technique might have major implications for optimizing treatment strategies in modern endoscopy.
The Case for Anticoagulant Therapy
Authors: IRVING S. WRIGHT
Journal: Circulation (1964)

In summary, the total world evidence suggests that in the absence of compelling contraindications and with the availability of satisfactory laboratory and clinical facilities, patients suffering with acute myocardial infarction should receive adequate anticoagulant therapy during the first month, and that the risk of reinfarction and death is reduced if this is continued for 1 to 2 years after the first month. More long-term studies should be conducted to evaluate this treatment for succeeding years. This form of therapy presents certain difficulties that must be weighed against the possible gains in deciding whether or not to continue it.
THE USE AND ABUSE OF EXPERT MEDICAL AND SURGICAL TESTIMONY AND SOME RECOMMENDATIONS FOR INCREASING THE VALUE OF SUCH TESTIMONY.
Authors: ROBERT MATHER
Journal: JAMA (1897)

Thus far I have generalized, and what I have said is quite as applicable to many other kinds of expert evidence as to medical and surgical testimony. But a railway lawyer, speaking to railway surgeons on such a topic as the present must be understood by his hearers as having in mind in everything he says the special class of cases in which both are so much and so often interested. While, therefore, my observations have been general in terms, they have, no doubt, come to your minds as having special and direct reference to personal injury cases. Certainly no other class of cases more frequently displays the abuse of expert medical and surgical testimony, or demonstrates more clearly the necessity for improving the method of procuring and presenting such testimony. No doubt it is within the repeated experience of each of you that ignorant or corrupt expert testimony has
Stehbens Hypothesis Revisited
Authors: Zenonas Danilevicius
Journal: JAMA (1975)

In 1958, Stehbens 1 postulated that vibrational injury of hemodynamic origin was a major factor in atherosclerosis and that the degenerative compensatory thickening of the intima was a consequence of mechanical fatigue of the vessel wall. Seventeen years later, to test this hypothesis, Stehbens 2 took sheep kept on a nonatherogenic diet and subjected them to long-term, experimental arteriovenous fistulas. The anastomosed sheep veins displayed extensive and severe phlebosclerosis histologically similar to that in man. Calcification and perivascular round-cell infiltration were also present. The lipid deposits, even in the sheep with low serum cholesterol levels, appeared identical to those in human atherosclerosis. Deposits of lipids macroscopically similar to those in humans could be demonstrated deep in the venous wall by the appropriate stains. The widespread hyalinization of intimal fibrous tissue, characteristic of human atherosclerosis but not of dietinduced lesions was also prominent in these sheep.  Stehbens admits that there may
The new expert panel
Authors: T. Greenhalgh
Journal: BMJ (1995)

<b>Aim:</b> The relative afferent pupillary defect (RAPD) is an important clinical sign of asymmetrical retinal ganglion cell and axonal damage. Although glaucoma essentially affects bilateral eyes, a subset of patients manifests asymmetrical glaucomatous optic neuropathy (GON), which exhibits an RPAD in the more advanced eyes. However, the degree to which axonal loss occurs before an RAPD is clinically detectable has not been substantiated. The purpose of this study is to assess the relationship between the depth of a clinically detectable RAPD and the reduction ratio of retinal nerve fiber layer (RNFL) thickness in the more advanced eyes relative to that in the contralateral less advanced eyes of patients with asymmetrical GON. <b>Methods:</b> Enrolled were 29 consecutive glaucoma patients with the clinically detectable RAPD. An RAPD was quantified by placing log-scaled neutral density filters over the less advanced eyes while performing the swinging flashlight test. Average RNFL thickness was determined using the Fast RNFL thickness programme of optical coherence tomography 3000. Correlation coefficient and Linear regression analyses were used in assessing the relationship between the RAPD and the ratio of RNFL thickness in the more advanced eyes relative to that in the less advanced. <b>Results:</b> RAPD ranged from 0.6 to 2.4 log units. The log-scaled RAPD had a statistically significantly inversed correlation with the average RNFL thickness ratio (r<sub>s</sub> = −0.729, p&lt;0.0001). Linear regression analysis found an equation that the average RNFL thickness ratio in the more affected eyes relative to that in the less advanced (%) = (0.827−0.169×RAPD (log units))×100 (R<sup>2</sup> = 0.557, p&lt;0.0001). <b>Conclusions:</b> When an RAPD is clinically detected, the RNFL thickness in the more advanced eyes was in average reduced to about 73% of that in the less advanced.
Abdominal Aortic Aneurysm
Authors: Paul W. Knowles
Journal: JAMA (1961)

THIS PAPER describes the successful excision of a massive aneurysm of the abdominal aorta and common iliac arteries in a patient 89 years of age. The size of the aneurysm and the advanced age of the patient have prompted this report. <h3>Report of a Case</h3> An 89-year-old male (born Dec. 8, 1870) was admitted to the Baltimore City Hospitals in May, 1960, because of progressive pain for 6 months in the right lower extremity. The pain, a shooting and stabbing one along the posterior thigh and leg, was worsened by standing or walking. The patient's health had been excellent. He was a vigorous man and prior to the onset of his present illness had walked 1 to 2 miles daily. There was no history of previous operations or serious illnesses. On physical examination the patient appeared younger than his stated age. The blood pressure was 162/104 mm. Hg. Scattered basilar
Secret filming of GPs was unethical and unwise
Authors: M. Ebdy
Journal: BMJ (2011)

Although the performance of some general practitioners is undeniably deficient, the ethics of the Dispatches programme using secret filming of GPs left much to be desired.1 Three doctors were pilloried. The first did indefensible things, the second made much more understandable errors, and the third (out of hours) was blamed for …
Paternally Inherited Proinsulin Mutations May Result in Earlier Onset of Monogenic Diabetes Mutation Identity Effect in Monogenic Diabetes
Authors: Wojciech Fendler, Maciej Borowiec, Karolina Antosik, Beata Jaroszewska-Swiatek, Ewa Szwalkiewicz-Warowicka, Maciej Malecki, Malgorzata Mysliwiec, Wojciech Mlynarski
Journal: Diabetes Care (2010)

Mutations within the human proinsulin gene ( INS ) have been reported to cause neonatal, maturity onset diabetes of the young (MODY), and antibody-negative idiopathic type 1 diabetes (1–3). However, because the expression of maternally or paternally transmitted INS-IGF2 alleles is different as a result of selective methylation (imprinting) (4), we surmised that the effect of INS mutations may depend on the origin of the mutated allele.

To verify this hypothesis, pairs comprising an affected child and parent carrying the same heterozygous INS mutation were studied. A literature search was performed and yielded eight relevant articles reporting heterozygous INS mutations in neonatal, MODY, or antibody-negative type 1 diabetes (supplementary Table 1, available in an online appendix at http://care.diabetesjournals.org/cgi/content/full/dc10-1142/DC1). We also included an unpublished case …
Voodoo in the General Hospital
Authors: Stephen C. Cappannari
Journal: JAMA (1975)

We have observed the case of a hexed patient that emphasizes the interplay between modern medical practice and the influence of a supernatural voodoo subculture. Psychosocial stresses involved in the patient's illness (regional enteritis) added to the complexity of the clinical problem. The presence of ambivalence in the patient and her mother concerning their systems of belief, and their unwillingness to accept totally the treatment modalities of either modern medicine or voodoo, probably prevented the patient's predicted death. (<i>JAMA</i>232:938-940, 1975)
Effect of protein kinase C inhibitors on cardioprotection by ischemic preconditioning depends on the number of preconditioning episodes
Authors: T Miura
Journal: Cardiovascular Research (1998)

Objectives: This study examined the possibility that the role of PKC and PC, and thus the response to PFC inhibitors, may differ depending on how many ischemic episodes are employed to precondition the heart. Methods: In the first series of experiments, myocardial infarct was induced by 30 min of coronary occlusion and 3 h of reperfusion in the rabbit. Infarct size was determined by tetrazolium staining and expressed as a percentage of area at risk (%IS/AR). Prior to the 30-min ischemia, rabbits were subjected to no PC, single PC (i.e., PC with an episode of 5 min ischemia/5 min reperfusion), and repetitive PC (2 cycles of 5 min ischemia/5 min reperfusion) with or without one of three treatments: polymyxin B (PolyB), staurosporine (Stauro), and 8-sulfophenylthephylline (SPT). In the second series of experiments, the rabbits received 5 min of coronary occlusion after repetitive PC with or without PolyB or Stauro treatment. Then, myocardial tissue in the ischemic region was sampled for assay of PKC activity. Untreated rabbits served as controls. Results: Single and repetitive PC limited %IS/AR to the same extent (%IS/AR=9.8±1.9 and 10.4±2.3, both p<0.05, vs. the control value of 44.5±3.4), and single PC was blocked by PolyB (%IS/AR=43.9±2.7) and Stauro (%IS/AR=31.5±3.2). Although the protocol of PolyB injection maintained the plasma PolyB level during sustained ischemia well above its Ki for PKC, this agent and also Stauro failed to abolish the protection by repetitive PC (%IS/AR=21.6±3.0 and 11.4±4.3, respectively). SPT, an adenosine receptor antagonist, not only blocked single PC (%IS/AR=44.4±4.4) but also attenuated protection by repetitive PC (%IS/AR=28.3±3.6). Infarct sizes in non-preconditioned hearts were not modified by PolyB, Stauro, or SPT. The ratio of membrane fraction PKC activity to cytosolic fraction PKC activity was elevated by repetitive PC plus 5 min ischemia, and this change in PKC was inhibited in hearts given PolyB and Stauro. Conclusions: In contrast to single PC, repetitive PC protects the heart against infarction even when PolyB and Stauro are administered to inhibit PKC during ischemic insult. This difference may be attributable to a PKC-independent mechanism, in which the adenosine receptor may be partly involved.
A CASE OF EXTRA-UTERINE PREGNANCY.
Authors: C. N. COOPER
Journal: JAMA (1884)

Mrs. C. consulted me in October, 1882, for what she supposed to be some uterine disease. She was English by birth, 39 years old, and the mother of four children. She had suffered three miscarriages. Her youngest child was four years old. I treated her nearly three months for subinvolution previous to her last pregnancy. For the past eight months her menstrual flow had been scant, and followed by a somewhat profuse leucorrhœa. She had no flow in September, but when she consulted me, had recently ceased from her October period, and was suffering from dragging pain, lassitude, etc. I found the os flabby and patulous, readily admitting the point of the index finger. The cervical canal seemed filled with tenacious mucus. The depth of the uterine cavity including the cervix was five inches. Three times each week for the first month, and twice each week for the second month,
Methanethiol Metabolism and Its Role in the Pathogenesis of Hepatic Encephalopathy in Rats and Dogs
Authors: Henk J. Blom, Robert A.F.M. Chamuleau, Jan Rothuizen, Nicolaas E.P. Deutz, Albert Tangerman
Journal: Hepatology (1990)

The metabolism of methanethiol was studied in rats. Administration of a noncomatogenic dose of methanethiol through inspired air or injection into the upper colon resulted in an elevation of the concentrations of methanethiol mixed disulfides in serum (protein-S-S-CH 3 and X-S-S-CH 3 , × yet unknown) and in urine (X-S-S-CH 3 . The concentrations of methanethiol mixed disulfides proved to be a relative measure of exposure to methanethiol. The levels of volatile sulfur compounds methanethiol, dimethylsulfide and dimethyldisulfide in the air expired by rats exposed to a noncomatogenic dose of methanethiol through the colon were also elevated. Rats with acute hepatic encephalopathy caused by liver ischemia also showed elevation of methanethiol mixed disulfide levels on challenge of methanethiol through the colon or inspired air, but to a significantly smaller extent than did the corresponding sham–operated rats. This suggests that the liver is at least partly responsible for formation of methanethiol mixed disulfides. No additional toxic effects were observed in the rats with ischemic livers on methanethiol exposition when compared with normal rats, suggesting that the liver does not play an essential role in methanethiol detoxification. Metabolism of methanethiol by blood to sulfate, for example, might be more important. In rats with acute hepatic encephalopathy caused by liver ischemia and in dogs suffering from hepatic encephalopathy resulting from chronic liver disease, large and significant increases in ammonia levels were measured. However, the mean levels of methanethiol mixed disulfides in rats and dogs with hepatic encephalopathy were not different from the mean normal levels in these animals. It is concluded that in these animal models of liver failure the role of methanethiol in the pathogenesis of hepatic encephalopathy is probably minor or insignificant.(HEPATOLOGY 1990; 11:682–689.)
The Relation between Blood Organic Acid Soluble Phosphate Fractions, Citric Acid, Protein Fractions, and Lipid Fractions in Atherosclerotic Heart Diseases and in Lipemias
Authors: SIDNEY P. GOTTFRIED, NATHAN H. FRIEDMAN, IRVING B. AKERSON, RUSSELL H. POPE, SALVATORE DI MAURO
Journal: Circulation (1954)

Blood organic acid soluble phosphate fractions and serum citric acid determinations were performed on 39 carefully chosen cases of atherosclerosis, in order to determine whether any abnormalities might be detected in the oxidative phosphorylation of glucose or in the Krebs tricarboxylic acid cycle, respectively. No differences were observed between a series of normal individuals and atherosclerotic patients. Likewise, serum protein fractionations determined chemically revealed no differences. Only the serum lipid fractions, the total lipids and total cholesterol in particular, were elevated in 60 per cent of the atherosclerotic patients as compared with the normal subjects.
Identification of predictive biomarker signatures in melanoma tumors associated with response to tumor-infiltrating lymphocyte (TIL) therapy
Authors: Jie Qing Chen, Caitlin Creasy, Carlos Antonio Torres Cabala, Suhendan Ekmekcioglu, Sourindra N Maiti, Jason Roszik, Cara Haymaker, Chantale Bernatchez, Patrick Hwu, Laszlo Radvanyi
Journal: Journal for ImmunoTherapy of Cancer (2013)

Meeting abstracts Adoptive cell therapy using expanded autologous TIL is a promising immunotherapy for metastatic melanoma. However, we still know relatively little about the types of T cells in TIL mediating tumor regression, and there have been no biomarker studies on the actual tumors used to
Author defends meta-analysis that was criticised
Authors: F. P Cappuccio
Journal: BMJ (1999)

EDITOR—In their continuous and compelling search for faults in published research, Davey Smith and Egger have written a letter about meta-analysis that is inaccurate.1 In their reference to a meta-analysis of observational data that I and colleagues did2 and the reanalysis that followed3 the authors commit …
Dialect Is Diagnostic
Authors: JOHN F. BURNUM
Journal: Annals of Internal Medicine (1984)

Folk medical language, as spoken in western Alabama, contains medical dialect terms that have an ancient lineage, with structure and meaning very similar to those of their earliest roots. The dialect has precise medical meanings and is used with astonishing accuracy by patients. Terms and phrases are often diagnostic as well as colorfully descriptive. An appreciation of medical dialect makes practice more fun, history taking and diagnosis easier, and lessens misunderstandings with patients. It sharpens the physician's senses to every level of what patients feel and say, verbal and otherwise. An appreciation of dialect heightens respect for patients and gives the physician a sense of continuity with cultures and ages past. Understanding and respect for medical dialect can be a powerful aid to patient care.
Nanoporous polyelectrolyte vaccine microcarriers. A formulation platform for enhancing humoral and cellular immune responses
Authors: Stefaan De Koker, Kaat Fierens, Marijke Dierendonck, Riet De Rycke, Bart N. Lambrecht, Johan Grooten, Jean Paul Remon, Bruno G. De Geest
Journal: Journal of Controlled Release (2014)
View from childhood.
Authors: N J McGivering
Journal: BMJ (1979)

with regard to relapse rate in spinal TB.Was it possible during this three months when streptomycin was effective that a surgical debridement of the tuberculous lesion would not only get rid of this dead poisonous tissue (which the body took years to eliminate) but also permit the large molecules of streptomycin to reach more readily the tuberculous focus ?Could one convert it to a largely vascularised area instead of one of dead tissue ?The role of streptomycin was most valuable in the confidence it gave one that there was unlikely to be any serious dissemination of tubercle bacilli as a result of surgical disturbance of the lesion, and this indeed proved the basis of a great advance in the treatment of bone and joint tuberculosis.
Evidence for Success of Behavior Modification in Weight Loss and Control
Authors: John P. Foreyt
Journal: Annals of Internal Medicine (1993)

Behavior modification applied to the treatment of obesity has evolved from the environmental control of eating behavior to a broader approach characterized by systematic manipulation of all factors associated with eating and exercise patterns. This approach has shown success in helping obese persons lose modest amounts of weight. The average length of treatment is 18 weeks, and the average weight loss is 9.9 kg. About 66% of these weight losses are maintained at 52 weeks of follow-up. Because obesity is a chronic condition with a substantial potential for relapse, longer-term treatments are needed. In the future, behavioral modification is likely to be further combined with other treatment methods.
Determinants and clinical significance of jugular venous valve competence.
Authors: J Fisher, F Vaghaiwalla, J Tsitlik, H Levin, J Brinker, M Weisfeldt, F Yin
Journal: Circulation (1982)

We studied the function of right internal jugular vein valves during cardiac catheterization in 32 patients and external jugular vein valves in vitro from 13 dogs. Patients with normal central venous pressure had competent valves during cough-induced transvalvular pressure gradients of 52.4 +/- 8.6 mm Hg. Ten of 15 patients with elevated central venous pressure had either incompetent or absent internal jugular valves, the latter occurring only in patients with long-standing, severe tricuspid regurgitation. During coughing, competent valves were also demonstrated in the left internal jugular and in the right and left subclavian veins. The excised canine valves were competent at a static transvalvular pressure of 81.8 +/- 3.7 mm Hg. Five of six excised valves remained competent during pulsatile transvalvular pressure of 64.8 +/- 1.9 mm Hg. Thus, thoracic inlet venous valves are usually competent during sudden increases in intrathoracic pressure. These valves may play an important role in establishing the extrathoracic arteriovenous pressure gradient necessary for forward blood flow during cardiopulmonary resuscitation and other states with high intrathoracic pressure.
THE NEUTRALIZATION TEST IN POLIOMYELITIS
Authors: John R. Paul, James D. Trask
Journal: The Journal of Experimental Medicine (1935)

In experiments devised to compare the neutralizing action of normal adult human sera on different strains of poliomyelitis virus, and to fill in certain gaps in our series of neutralization tests with different strains of virus on different types of cases in different age groups, we have made the following observations. 1. The difference between two human and two passage strains of the virus when tested by this method amounted to about 25 per cent, and there was less power in normal adult sera to neutralize human than passage strains of virus. 2. The differences between the two human strains amounted to 15 per cent, and between the two passage strains to 8 per cent, the last figure falling within the limits of the experimental error of the method. The extent to which these findings affect certain concepts with regard to the epidemiology of poliomyelitis based on passage strain neutralization experiments cannot be determined from the data presented in this paper, except that they more or less confirm the view previously derived from passage strain experiments, that 70 to 95 per cent of normal urban adults possess in their blood, substance which neutralizes poliomyelitis virus in a given amount. However, certain other indications appear when the present results are supplemented by those we have previously obtained (25). Primarily, we have found no relation between the clinical acquisition of poliomyelitis and the presence of substance in the serum which neutralizes a passage strain of poliomyelitis virus. With a passage strain the results seem rather to bear a closer relationship to age than to illness. With a human strain we have obtained results in which there is some evidence, shown only in the juvenile group, that acquisition of the clinical disease is accompanied by the appearance of antiviral properties in the blood.
Altitude-dependent changes of directional hearing in mountaineers.
Authors: M E Rosenberg, A J Pollard
Journal: British Journal of Sports Medicine (1992)

This study demonstrates apparent deterioration in the ability to localize sound associated with acute exposure to high altitude in ten subjects on three mountaineering expeditions. Furthermore, the auditory localization errors improved to sea level values after a period of acclimatization. Occurring at altitudes where overt neurological symptoms are not usually seen, impairment of sensory perception may explain the increase in accidental deaths associated with altitude exposure due to disorientation and misjudgment but before hypoxia is evident.