tbuckley/cabot-search huggingface dataset:
West Nile Virus Encephalomyelitis in Transplant Recipients
Authors: Roger N. Rosenberg
Journal: JAMA (2004)

BackgroundIn the 2003 West Nile virus (WNV) epidemic, Colorado reported more WNV cases than any other state, including an unprecedented number in organ transplant recipients.MethodsPhysicians caring for transplant recipients hospitalized with naturally acquired WNV encephalitis provided data to characterize the clinical symptoms, results of diagnostic studies, and outcomes.ResultsEleven transplant recipients were identified (4 kidney, 2 stem cell, 2 liver, 1 lung, and 2 kidney/pancreas). Seven were directly admitted to 1 of the 2 hospitals in the study, and 4 were referred to 1 of these centers from regional hospitals. All but 1 patient had a prodrome typical of WNV encephalitis in nonimmunosuppressed patients. Ten patients developed meningoencephalitis, which in 3 cases was associated with acute flaccid paralysis. One patient developed acute flaccid paralysis without encephalitis. Six patients had significant movement disorders including tremor, myoclonus, or parkinsonism. All patients had cerebrospinal fluid pleocytosis and WNV-specific IgM in the cerebrospinal fluid and/or serum. Cerebrospinal fluid cytologic studies (n = 5) showed atypical lymphocytes, some resembling plasma cells; however, flow cytometry (n = 3) showed that cells were almost exclusively of T-cell (not B-cell or plasma cell) lineage. Magnetic resonance images of the brain were abnormal in 7 of 8 tested patients, and electroencephalograms were abnormal in 7 of 7, with 2 showing periodic lateralized epileptiform discharges. Nine of 11 patients survived infection, but 3 had significant residual deficits. One patient died 17 days after admission, and autopsy findings revealed severe panencephalitic changes with multifocal areas of necrosis in the cerebral deep gray nuclei, brainstem, and spinal cord as well as diffuse macrophage influx in the periventricular white matter. A second patient died of complications of WNV encephalitis 6 months after hospital admission.ConclusionsNaturally acquired WNV encephalitis in transplant recipients shows diagnostic, clinical, and laboratory features similar to those reported in nonimmunocompromised individuals, but neuroimaging, electroencephalography, and autopsy results verify that these patients develop neurological damage at the severe end of the spectrum.
The Metabolic Organization of the Adult Human Liver: A Comparative Study of Normal, Fibrotic, and Cirrhotic Liver Tissue
Authors: L Racine-Samson, J Scoazec, A D'Errico, M Fiorentino, L Christa, A Moreau, C Roda, W F Grigioni, G Feldmann
Journal: Hepatology (1996)

Little is known about the alterations of metabolic organization of the human liver tissue in chronic liver diseases. We therefore compared the distribution of the following zonal metabolic markers in 10 samples of normal liver tissue, 10 samples of fibrotic tissue, and 22 samples of cirrhotic tissue: (a) the enzymatic activities of glucose-6-phosphatase (G6P), lactate dehydrogenase (LDH), succinate dehydrogenase (SDH), nicotinamide-adenine-dinucleotide-phosphate [NAPH] dehydrogenase (ND), beta-hydroxybutyrate dehydrogenase (HBDH), and glutamate dehydrogenase (GDH); (b) the protein glutamine synthetase (GLS); and (c) albumin messenger RNA (mRNA). The normal human hepatic lobule was characterized by the periportal predominance of G6P and SDH enzymatic activities and albumin mRNAs, the perivenous predominance of ND and GDH, the restriction of GLS to a small perivenous compartment, and the predominanc of beta-HBDH at the contact of both portal tracts and centrilobular veins. In fibrosis, the overall metabolic organization of the normal liver tissue was retained. The expression of periportal markers predominated around enlarged portal tracts and that of perivenous markers around residual centrilobular veins. GLS was constantly detected at the contact of centrilobular veins. In cirrhotic nodules, no zonation was observed for most enzymatic activities or for albumin. Only G6P usually predominated at the periphery of the nodules. GLS was constantly undetectable. No difference accordingly to the etiology of the underlying disease was observed. In conclusion, the normal human hepatic lobule presents a marked metabolic zonation, preserved in fibrotic lesions, but lost in cirrhotic nodules. The alterations of the metabolic organization observed in cirrhosis might contribute to the pathogenesis of some of the metabolic disorders associated with advanced liver disease.
CLINICAL CHARACTERISTICS AND SHORT-TERM OUTCOME OF PATIENTS WITH TAKOTSUBO CARDIOMYOPATHY AND CRITICAL CORONARY LESIONS: ARE THEY AN EXTREME OF THE CLINICAL SPECTRUM OF TAKOTSUBO CARDIOMYOPATHY?
Authors: Mario Previtali, Gabriele Crimi, Alberto Valbusa, Rita Camporotondo, Alberto Bartolini, Alessandra Repetto, Marco Rossi, Paolo Rubartelli, Francesco Chiarella, Luigi Oltrona Visconti
Journal: Journal of the American College of Cardiology (2012)
Behavioral Health Insurance Parity for Federal Employees
Authors: Howard H. Goldman, Richard G. Frank, M. Audrey Burnam, Haiden A. Huskamp, M. Susan Ridgely, Sharon-Lise T. Normand, Alexander S. Young, Colleen L. Barry, Vanessa Azzone, Alisa B. Busch, Susan T. Azrin, Garrett Moran, Carolyn Lichtenstein, Margaret Blasinsky
Journal: New England Journal of Medicine (2006)

To improve insurance coverage of mental health and substance-abuse services, the Federal Employees Health Benefits (FEHB) Program offered mental health and substance-abuse benefits on a par with general medical benefits beginning in January 2001. The plans were encouraged to manage care.We compared seven FEHB plans from 1999 through 2002 with a matched set of health plans that did not have benefits on a par with mental health and substance-abuse benefits (parity of mental health and substance-abuse benefits). Using a difference-in-differences analysis, we compared the claims patterns of matched pairs of FEHB and control plans by examining the rate of use, total spending, and out-of-pocket spending among users of mental health and substance-abuse services.The difference-in-differences analysis indicated that the observed increase in the rate of use of mental health and substance-abuse services after the implementation of the parity policy was due almost entirely to a general trend in increased use that was observed in comparison health plans as well as FEHB plans. The implementation of parity was associated with a statistically significant increase in use in one plan (+0.78 percent, P<0.05) a significant decrease in use in one plan (-0.96 percent, P<0.05), and no significant difference in use in the other five plans (range, -0.38 percent to +0.23 percent; P>0.05 for each comparison). For beneficiaries who used mental health and substance-abuse services, spending attributable to the implementation of parity decreased significantly for three plans (range, -201.99 dollars to -68.97 dollars; P<0.05 for each comparison) and did not change significantly for four plans (range, -42.13 dollars to +27.11 dollars; P>0.05 for each comparison). The implementation of parity was associated with significant reductions in out-of-pocket spending in five of seven plans.When coupled with management of care, implementation of parity in insurance benefits for behavioral health care can improve insurance protection without increasing total costs.
Radioimmunotherapy of B-Cell Lymphoma with [<sup>131</sup>I]Anti-B1 (Anti-CD20) Antibody
Authors: Mark S. Kaminski, Kenneth R. Zasadny, Isaac R. Francis, Adam W. Milik, Charles W. Ross, Scott D. Moon, Shelley M. Crawford, Jeanne M. Burgess, Neil A. Petry, Gregory M. Butchko, Stephan D. Glenn, Richard L. Wahl
Journal: New England Journal of Medicine (1993)

Many patients with non-Hodgkin's lymphomas are not cured by current therapies, and new approaches to treatment are needed. As part of an ongoing phase 1 study, we examined the effect of radioimmunotherapy with 131I-labeled B-cell-specific anti-CD20 monoclonal antibody in 10 patients with CD20-positive B-cell lymphomas in whom primary chemotherapy had failed.
Renal Hypertension Without Main Arterial Stenosis
Authors: Donald F. McDonald
Journal: JAMA (1968)

Hypertensive patients who had a small kidney unilaterally underwent renal function tests. Patients who did not have arteriographic evidence of renal arterial stenosis were subjected to nephrectomy when they had nonfunctioning or functionally ischemic kidneys. The test correctly predicted whether a cure would occur in three of three patients with pyelonephritis and in 14 of 15 with ischemic hypoplastic kidneys. Nephrectomy cured hypertension in seven of nine patients with nonfunction. A comparison of these results with the results in 50 patients with renal arterial stenosis indicates that the predictive value of renal funcion tests was greatest in hypertensive patients who had small kidneys without renal arterial stenosis.
Doxorubicin-Induced Cardiac Toxicity and Cardiac Rest Gated Blood Pool Imaging
Authors: Marta J. Aiken, Vijay Suhag, Carlos A. Garcia, Elmo Acio, Shari Moreau, Dennis A. Priebat, Shyam P. Chennupati, Douglas Van Nostrand
Journal: Clinical Nuclear Medicine (2009)

Anthracyclines are one of the most commonly used and potent chemotherapeutic agents. Doxorubicin (Adriamycin) is one common anthracycline used to treat many solid tumors including breast, sarcomas, gynecologic and hematological malignancies, such as leukemias and lymphomas. However, its use is often limited due to dose-dependent cardiotoxicity. As a result, patients receiving doxorubicin should have close monitoring of their left ventricular function. The gated cardiac blood pool (GBP) study is one of the most accurate and reproducible methods of assessing left ventricular function. This report presents an overview of (1) the incidence, clinical course, mechanisms, pathology, prevention, and monitoring of doxorubicin-induced cardiotoxicity (DIC), (2) the use of GBP studies in monitoring for DIC, and (3) 2 algorithms for the use of GBP studies in monitoring for DIC. This report concludes with a proposed algorithm for the use of GBP studies in DIC. With an understanding of DIC, GBP studies, and various algorithms, the interpreting physician may help the oncologist identify DIC earlier, more accurately, and before it becomes clinically apparent.
Segmentation and quantification of the aortic arch using joint 3D model-based segmentation and elastic image registration
Authors: Andreas Biesdorf, Karl Rohr, Duan Feng, Hendrik von Tengg-Kobligk, Fabian Rengier, Dittmar Böckler, Hans-Ulrich Kauczor, Stefan Wörz
Journal: Medical Image Analysis (2012)
Angiotensin II Type 2 Receptor Blockade Amplifies the Early Signals of Cardiac Growth Response to Angiotensin II in Hypertrophied Hearts
Authors: Jozef Bartunek, Ellen O. Weinberg, Minori Tajima, Susanne Rohrbach, Beverly H. Lorell
Journal: Circulation (1999)

Background —We have previously shown that the acute molecular growth response of new protein synthesis and protein kinase C activation in response to angiotensin II (Ang II) is altered in left ventricular (LV) hypertrophy compared with normal hearts. We have also shown an upregulation of Ang II type 2 (AT 2 ) receptors in hypertrophied hearts relative to controls. Activation of AT 2 receptors is proposed to counteract growth effects of AT 1 receptor in response to Ang II. Thus, we tested the hypothesis that in hypertrophied hearts, the AT 2 receptor mediates inhibitory effects on the new cardiac protein synthesis in response to acute Ang II stimulation. Methods and Results —Flaccid buffer-perfused adult normal and hypertrophied rat hearts were perfused with Ang II 10 −8 mol/L plus prazosin 10 −7 mol/L or Ang II plus the AT 2 blocker PD 123319 5×10 −7 mol/L. New protein synthesis was measured by the rate of [ 3 H]phenylalanine incorporation into the LV proteins. In normal hearts, Ang II (n=8) increased the rate of [ 3 H]phenylalanine incorporation by 74±27% ( P &lt;0.05 versus no drug). Treatment with PD123319 (n=8) did not increase protein synthesis compared with Ang II alone (32±11% versus Ang II alone, P =NS). In hypertrophied hearts, Ang II alone (n=6) increased the rate of [ 3 H]phenylalanine incorporation only by 23±13% ( P =NS versus no drug). In contrast, treatment with PD123319 (n=7) induced a 76±21% increase in new LV protein synthesis compared with Ang II alone ( P &lt;0.05). AT 2 receptor blockade in Ang II–stimulated hypertrophied hearts was associated with enhanced membrane protein kinase C translocation and reduced LV cGMP content. Conclusions —These data support the hypothesis that in adult hypertrophied rat hearts, inhibition of cardiac AT 2 receptors, which are upregulated in chronic LV hypertrophy, amplifies the immediate LV growth response to Ang II. This appears to be related to augmented Ang II–stimulated PKC activation and suppression of cGMP signaling.
Cholangioscopy using a new type of cholangioscope for the diagnosis of biliary tract disease: a case series
Authors: V. Cennamo, C. Luigiano, C. Fabbri, A. Maimone, F. Bazzoli, L. Ceroni, C. Morace, E. Jovine
Journal: Endoscopy (2012)

We present an initial report regarding the clinical usefulness of peroral cholangioscopy, using a new type of cholangioscope, the Polyscope. Peroral cholangioscopy was performed in four patients with strictures after orthotopic liver transplantation (OLT) which were suspected of being ischemic biliary lesions, in three with indeterminate biliary strictures, in three with suspected retained bile duct stones, and in two for evaluation of the intraductal spread of adenomatous tissue after an ampullectomy. In all cases peroral cholangioscopy was performed successfully without complications. On the basis of direct viewing and/or tissue sampling a correct diagnosis was reached in all cases: in all patients who underwent OLT the strictures were not ischemic; the indeterminate strictures were all benign; and, in patients with suspected stones, complete clearance was confirmed. Intraductal spread was confirmed in one patient and excluded in the other. In our experience, peroral cholangioscopy using a Polyscope is a safe and effective method for diagnosing bile duct lesions.
Rheumatoid Arthritis Refractory to Standard Therapy-Reply
Authors: Ronald L. Wilder
Journal: JAMA (1988)

In Reply.—  I thank Dr Nordstrom for noting the error in my article. He is absolutely correct that azathioprine must be reduced to about 25% of the usual dose when used with allopurinol. As noted in my article, the two drugs should probably not be used together. With regard to methotrexate, I do not think there is disagreement. Methotrexate therapy generally is discontinued temporarily when serum liver enzyme levels are elevated twofold to threefold. Once the serum enzyme levels normalize (unless other contraindications exist), drug therapy can be reinstituted, as indicated in my article, usually at a lower dose. One does not disregard elevations in serum liver enzyme levels just because they do not correlate with histopathology.
Amrinone increases ventricular contractility and diastolic compliance in endotoxemia.
Authors: H A Werner, M J Herbertson, K R Walley
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Systolic and diastolic dysfunction occur during human septic shock, and sensitivity to beta-adrenergic agents is reduced. We sought to determine whether amrinone, an inotropic agent independent of beta-receptors, increases left-ventricular contractility or diastolic compliance after endotoxin infusion. We measured left-ventricular volume (using a conductance catheter) and pressure (using a Millar catheter) before and after administering amrinone (4.5 mg/kg i.v., then 10 micrograms/kg/min) to six endotoxemic and seven control pigs. The slope of the end-systolic pressure-volume relationship, Ees, was used as the primary measure of contractility. Diastolic stiffness was characterized using stiffness parameters taken from pressure-volume relationships (k) and from pressure-volume strain relationships. Amrinone increased Ees from a median of 10.4 mm Hg/ml (interquartile range, 7.2 to 12.3) to 16.4 (13.7 to 18.6) (p < 0.05) in the endotoxin group (p < 0.05). Amrinone decreased diastolic stiffness (k) in the endotoxin group by 35 +/- 18% (p < 0.05). Amrinone did not significantly change Ees or k in the control group. Mean arterial pressure decreased after endotoxin infusion from 117 +/- 23 mm Hg to 76.5 +/- 14.9 mm Hg (p < 0.05), and decreased further after amrinone to 62.0 +/- 14.8 mm Hg (p < 0.05). We conclude that in this model of sepsis, amrinone may beneficially increase systolic contractility and diastolic compliance, but may dangerously decrease an already low mean arterial pressure.
The spectrum of adult B‐lymphoid leukemias with BCR‐ABL: Molecular diagnostic, cytogenetic, and clinical laboratory perspectives
Authors: Jeffery M. Klco, Friederike H. Kreisel, Barbara A. Zehnbauer, Shashikant Kulkarni, Anjum Hassan, John L. Frater
Journal: American Journal of Hematology (2008)

Abstract The Philadelphia (Ph) chromosome is characteristic of chronic myelogenous leukemia (CML), but it is also the most frequent cytogenetic abnormality in precursor B‐lymphoblastic leukemia (ALL) of adults. The vast majority of CML patients have a BCR‐ABL translocation that yields a 210 kD (p210) oncoprotein, whereas adult Ph‐positive ALL cases can present with either a p190 or a p210 oncoprotein, or both. Considering that 30% of the patients with CML that progress to blast crisis will have a lymphoblastic presentation, adults presenting with a p210 ALL may have either a de novo ALL or CML presenting for the first time in lymphoblastic phase. To identify the distinguishing features, cases of p190‐ALL, p210‐ALL, and lymphoblastic CML were compared. In spite of significant overlap between the three entities, a number of features were found to aid in their differentiation. p210‐ALL patients present at a younger age with blasts that frequently show loss of expression of CD34, whereas p190‐ALL patients present with marked increase in peripheral blast percentage. Interestingly, bone marrow findings characteristic of a myeloproliferative disorder are specific, but are not sensitive for lymphoblastic CML. This study suggests that despite the similarities between these leukemias, p190‐ALL, p210‐ALL, and lymphoblastic phase CML likely represent three distinct diseases. Am. J. Hematol., 2008. © 2008 Wiley‐Liss, Inc.
INTRA-ARTERIAL INFUSION—SIMPLIFIED TECHNIQUE
Authors: John E. Keet
Journal: JAMA (1952)

Halsted<sup>1</sup>was the first in this country to use the arterial route for blood replacement when, in 1883, he bled patients suffering from carbon monoxide poisoning via the radial artery and, after whipping the blood in air, replaced it through the same artery. Little further use of this route was made until 1939, when Colonel Sam Seeley suggested the technique to Kohlstaedt and Page.<sup>2</sup>Since then many excellent reports have appeared attesting to its effectiveness in shock therapy.<sup>3</sup>Many different techniques have been described, all either complicated or requiring expensive apparatus.<sup>4</sup>There has been a high incidence of circulatory disturbances of the arm and hand among the reported cases, and some authors feel that it is only justified as a life-saving measure.<sup>4b</sup> It is the purpose of this paper to present a simplified technique that has been found extremely effective and free of circulatory complications
Impaired CD95 expression predisposes for recurrence in curatively resected colon carcinoma: clinical evidence for immunoselection and CD95L mediated control of minimal residual disease
Authors: J Strater
Journal: Gut (2005)

Loss of CD95 expression in tumour cells occurs frequently in colon carcinoma and may be associated with disease progression. On the other hand, neo-expression of CD95L in tumour cells may contribute to immune evasion.We aimed at further exploring the functional role and prognostic significance of the CD95/CD95L death inducing system in colon carcinomas.CD95 and CD95L expression was examined by immunohistochemistry in 128 R0 resected UICC (International Union against Cancer) stage II/III colon carcinomas and correlated with disease free survival.CD95 expression in tumour cells was observed in only 30 carcinomas (23.4%) whereas the others had at least a minor subpopulation of CD95 negative cells. Loss of CD95 in tumour cells was related to adverse prognosis in uni- and multivariate analysis (p = 0.046 and p = 0.036, respectively). Tumour infiltrating lymphocytes (TIL) were the major source of CD95L in colon carcinomas. CD95L+TIL were present in 83% of cases whereas CD95L was found in tumour cells in only 12% of cases. Moreover, a high rate of CD95L+TIL correlated with prolonged disease free survival in patients with UICC stage II (p = 0.05) but not in those with stage III.Loss of CD95 in tumour cells may be an independent prognostic factor in colon carcinomas. The CD95L counterattack is not a relevant feature in colon carcinoma but CD95L+TIL may contribute to tumour control in the early stages of the disease, exerting a concurrent selection pressure in the direction of CD95 abrogation/resistance.
ETIOLOGY OF OROYA FEVER
Authors: Hideyo Noguchi, Henry R. Muller, Evelyn B. Tilden, Joseph R. Tyler
Journal: The Journal of Experimental Medicine (1929)

In the experiments here reported, definite verruga lesions, in which the presence of Bartonella bacilliformis was established by culture or by passage to rhesus monkeys, were produced in a dog and in a donkey by inoculation of cultures or monkey passage strains. The reaction induced in these animals was entirely local, however; blood cultures were sterile. Histologically, the lesions produced were similar to those obtained in monkeys by inoculation of Bartonella bacilliformis, except for the presence of a marked polynuclear leucocytic exudate. In another donkey a lesion histologically suggestive of verruga was produced, while in one donkey and a horse the results of inoculation were negative or indefinite. The intravenous injection of a filtrate or of heat-killed cultures of Bartonella bacilliformis into two donkeys was followed by the appearance of large, soft, subcutaneous swellings, on various parts of the body, not resembling in any way verruga lesions.
MYOCARDIAL BRIDGING DOES NOT INCREASE CARDIAC RISK IN PATIENTS WITH CHEST PAIN BUT NO OBSTRUCTIVE CORONARY DISEASE: A 64 SLICE CORONARY CT ANGIOGRAPHY STUDY
Authors: Ronen Rubinshtein, Tamar Gaspar, Basil S. Lewis, Abhiram Prasad, Nathan Peled, David A. Halon
Journal: Journal of the American College of Cardiology (2010)
An Introduction to the Haemoglobinopathies and the Methods Used for Their Recognition
Authors: Robert W. Kellermeyer
Journal: JAMA (1967)

This book offers the "core material" pertaining to hemoglobin structure and genetic abnormalities in a brief, well-written and accurate monograph. The author does an excellent job of concisely and clearly summarizing a field that is continuously altered by rapid advances in protein chemistry and genetics. Further, he tells you how this new knowledge is helpful in gaining a better understanding of the variable clinical syndromes associated with hemoglobinopathies. The methods section is only 16 pages, yet it includes an organized approach to the evaluation of a suspected hemoglobin abnormality. Those methods not presented in sufficient detail to perform directly are adequately referenced. The medical student would benefit from reading this, but the monograph is best suited for the resident physician receiving special training in hematology or for the practicing physician with an interest in hematology. The monograph offers the careful reader an opportunity to gain an excellent perspective of a