tbuckley/cabot-search huggingface dataset:
Effects of subanesthetic concentrations of enflurane on rat pregnancy and early development.
Authors: C D Strout, M L Nahrwold, M G Taylor, I S Zagon
Journal: Environmental Health Perspectives (1977)

Anesthetic pollutants in the operating room have been implicated in producing spontaneous abortion in exposed personnel and congenital malformations among their offspring. To test the effects of trace concentrations of enflurane on pregnancy, rats were exposed to two levels (10.7 and 63.7 ppm) of the anesthetic for 8 hr daily from days 1 to 19 of pregnancy. Litter sizes were not affected but birth weights of exposed offspring were slightly higher than controls. During lactation, cross-fostering studies were performed. Exposed offspring were housed with nonexposed mothers and vice versa to determine if exposure during pregnancy affected early development. Weights at 7, 14, and 21 days of age did not differ among the offspring in the lower dose experiment. Weights of the cross-fostered groups in the high dose experiment were decreased at day seven compared to controls. In the same experiment, exposed offspring housed with exposed mothers were heavier than controls on day 21 of lactation. The modest nature of these alterations suggests that enflurane has little or no gross effect on rat pregnancy and postnatal development.
Palatal muscle electromyogram activity in obstructive sleep apnea.
Authors: D M Carlson, E Onal, D W Carley, M Lopata, R C Basner
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Eight subjects (5 men, 3 women, ages 27 to 55) with obstructive sleep apnea syndrome (OSAS) were studied to quantify and compare electromyographic (EMG) activity of levator veli palatini (LVP) and palatoglossus (PG), two velopharyngeal muscles, and genioglossus (GG) during obstructive apnea cycles in non-rapid eye movement (NREM) sleep. EMG activity of three successive preapneic breaths, first and last apneic efforts, and three successive postapneic breaths was quantified for each muscle as peak phasic inspiratory EMG normalized as percent activity of the last preapneic breath. In all subjects, apnea onset coincided with simultaneous inspiratory EMG nadir of all three muscles (LVP = 63 +/- 40%, PG = 74 +/- 53%. GG = 83 +/- 48%. mean +/- SD activity of last preapneic breath). Apnea resolution did not occur until inspiratory EMG of all three muscles simultaneously reached maximal activity, at levels significantly greater than preapneic activity as well as activity of the last preapneic effort (LVP = 215 +/- 205%, PG = 227 +/- 240+, GG = 235 +/- 202%, mean +/- SD activity of last preapneic breath, p < 0.05, Fisher's partial least-squares difference [PLSD] test for each muscle). The presence or absence of electroencephalographic arousal at apnea resolution did not influence these patterns of EMG activity. Inspiratory recruitment of velopharyngeal as well as oropharyngeal muscles appears to be associated with upper airway patency during sleep in patients with OSAS.
COMBINED GASTRIC AND DUODENAL ULCER
Authors: Jacob Buckstein
Journal: JAMA (1925)

I am prompted to report this case because of its rare occurrence. In approximately 7,500 roentgenographic examinations of the gastro-intestinal tract in the last three years, there have been only three cases in which both the roentgen ray and surgical exploration demonstrated the presence of a combined gastric and duodenal ulcer in the same patient. The patient whose roentgenogram is shown was operated on by the late Dr. T. A. Smith, formerly director of surgery, Fourth Division, Bellevue Hospital. [Since the writing of the foregoing report, a fourth case, diagnosed as combined gastric and duodenal ulcer roentgenographically, has been verified at operation by Dr. John McCreery, visiting surgeon to Bellevue Hospital. This makes four such cases in more than 8,000 examinations.]
The Royal Malady
Authors: Lester S. King
Journal: JAMA (1965)

Even today the most serious consequences can result when a head of government becomes ill. However bad such disturbances can be in the 20th century, they were far more severe in the days when monarchs exerted greater power. In late-18th-century England the British government was in a period of evolution, wherein the role of a ministry was becoming more clearly worked out and the relations of the ministry, parliament, and the king were becoming better defined.  Factions abounded. King George III and his heir apparent were bitterly hostile, and different political parties aligned with one or the other. And in 1788 George III became ill, the victim of what we today would call manic depressive psychosis.  The disease developed gradually. The responsibility of the royal physicians was heavy. Would the king regain his sanity? Should he be declared incompetent and a regent appointed? The political significance was exciting, the legal
Spontaneous Closure of Physiologically Advantageous Ventricular Septal Defects
Authors: P. SYAMASUNDAR RAO, NORMAN J. SISSMAN
Journal: Circulation (1971)

The clinical and pathological features of two cases in which physiologically advantageous ventricular septal defects closed spontaneously are presented. The first patient, with tricuspid atresia, Type I(c), developed symptoms and signs of increasing systemic hypoxemia, decreasing pulmonary blood flow, and a systolic murmur of decreasing intensity. His ventricular septal defect, previously demonstrated angiocardiographically, could not be found at autopsy; it is presumed to have closed by fusion of its muscular rims with subsequent covering by endocardial proliferation. The second patient, with a double-outlet right ventricle, demonstrated progressive left ventricular enlargement and congestive failure despite increasing pulmonary vascular resistance. Postmortem examination showed that this defect was sealed by adherence of the septal leaflet of the tricuspid valve to the edges of the defect. Appreciation of the true nature of the changing anatomical situation would have resulted in more rational effective therapeutic approaches. The cases presented and review of pertinent literature contribute to more complete understanding of circumstances surrounding the spontaneous closure of ventricular septal defects.
Nature of glomerular dysfunction in pre-eclampsia
Authors: Richard A. Lafayette, Maurice Druzin, Richard Sibley, Geraldine Derby, Tahira Malik, Phil Huie, Catherine Polhemus, William M. Deen, Bryan D. Myers
Journal: Kidney International (1998)

Nature of glomerular dysfunction in pre-eclampsia. <h3>Background</h3> Pre-eclampsia is characterized by hypertension, proteinuria and edema. Simultaneous studies of kidney function and structure have not been reported. We wished to explore the degree and nature of glomerular dysfunction in pre-eclampsia. <h3>Methods</h3> Physiologic techniques were used to estimate glomerular filtration rate (GFR), renal plasma flow and afferent oncotic pressure immediately after delivery in consecutive patients with pre-eclampsia (PET; <i>N</i> = 13). Healthy mothers completing an uncomplicated pregnancy served as functional controls (<i>N</i> = 12). A morphometric analysis of glomeruli obtained by biopsy and mathematical modeling were used to estimate the glomerular ultrafiltration coefficient (K<sub>f</sub>). Glomeruli from healthy female kidney transplant donors served as structural controls (<i>N</i> = 8). <h3>Results</h3> The GFR in PET was depressed below the control level, 91 ± 23 versus 149 ± 34 ml/min/1.73m<sup>2</sup>, respectively (<i>P</i> < 0.0001). In contrast, renal plasma flow and oncotic pressure were similar in the two groups (<i>P</i> = NS). A reduction in the density and size of endothelial fenestrae and subendothelial accumulation of fibrinoid deposits lowered glomerular hydraulic permeability in PET compared to controls, 1.81 versus 2.58 × 10<sup>-9</sup> m/sec/PA. Mesangial cell interposition also curtailed effective filtration surface area. Together, these changes lowered the computed single nephron K<sub>f</sub> in PET below control, 4.26 versus 6.78 nl/min · mm Hg, respectively. <h3>Conclusion</h3> The proportionate (∼40%) depression of K<sub>f</sub> for single nephrons and GFR suggests that hypofiltration in PET does not have a hemodynamic basis, but is a consequence of structural changes that lead to impairment of intrinsic glomerular ultrafiltration capacity.
Ethical, as Well as Physiological, Questions Continue to Arise Over Athletes' Steroid Abuse
Authors: Virginia S. Cowart
Journal: JAMA (1989)

SWISS PSYCHIATRIST Carl Jung wrote that we become what we do, an observation that has timely relevance in the sports world. This is true both in the United States—where several troubled college sports programs face sanctions for unethical behavior and a number of individual athletes have had criminal charges filed against them— and internationally.  The situation is of particular interest to physicians because many of the recent incidents are associated with some type of drug use, most commonly alcohol, cocaine, and anabolic steroids. The ethical issues can be considered apart from their effects on health, although the deleterious health effects of alcohol and cocaine are well known.  While the long-term health effects of taking anabolic steroids have not been documented, many experts believe that physicians have an obligation to discourage their athlete patients from using these drugs, based on the available information on their short-term effects.  Confessional tales by athletes
Measures for detecting systemic bioactivity with inhaled and intranasal corticosteroids
Authors: B. J. Lipworth, J. R. Seckl
Journal: Thorax (1997)

Topical corticosteroids are now widely ac-corticosteroids. 1 The factors which determine School, Dundee DD1 cepted for use as first line preventative therapy glucocorticoid response at the receptor and 9SY, UK B J Lipworth in the treatment of inflammatory diseases of molecular level are complex, and probably exthe lower and upper respiratory tract -namely, plain the individual variation and tissue speci-Molecular Medicine asthma and rhinitis.Although there is some ficity in systemic response (fig 1).Centre, University of Edinburgh, Western disparity in the dose response relationship for It is important first of all to consider the General Hospital, anti-asthmatic efficacy and systemic activity of factors that determine systemic absorption of Edinburgh EH4 2XU, glucocorticoids between individuals, it has been inhaled and intranasal corticosteroids. 2 For UK J R Seckl shown that there is a dissociation in the dose inhaled corticosteroids such as budesonide, response relationship above 400 g/day in chilfluticasone propionate, and triamcinolone ace-Correspondence to: Dr B J Lipworth.dren and 800 g/day in adults, at which stage tonide there is a relatively high degree of hepatic
Murine double nullizygotes of the angiotensin type 1A and 1B receptor genes duplicate severe abnormal phenotypes of angiotensinogen nullizygotes.
Authors: S Tsuchida, T Matsusaka, X Chen, S Okubo, F Niimura, H Nishimura, A Fogo, H Utsunomiya, T Inagami, I Ichikawa
Journal: Journal of Clinical Investigation (1998)

Rodents are the unique species carrying duplicated angiotensin (Ang) type 1 (AT1) receptor genes, Agtr1a and Agtr1b. After separately generating Agtr1a and Agtr1b null mutant mice by gene targeting, we produced double mutant mice homozygous for both Agtr1a and Agtr1b null mutation (Agtr1a-/-; Agtr1b-/-) by mating the single gene mutants. Agtr1a-/-, Agtr1b-/- mice are characterized by normal in utero survival but decreased ex utero survival rate. After birth they are characterized by low body weight gain, marked hypotension, and abnormal kidney morphology including delayed maturity in glomerular growth, hypoplastic papilla, and renal arterial hypertrophy. These abnormal phenotypes are quantitatively similar to those found in mutant mice homozygous for the angiotensinogen gene (Agt-/-), indicating that major biological functions of endogenous Ang elucidated by the abnormal phenotypes of Agt-/- are mediated by the AT1 receptors. Infusion of Ang II, AT1 blockers, or an AT2 blocker was without effect on blood pressure in Agtr1a-/-; Agtr1b-/- mice, indicating that AT2 receptor does not exert acute depressor effects in these mice lacking AT1 receptors. Also, unlike Agt-/- mice, some Agtr1a-/-; Agtr1b-/- mice have a large ventricular septum defect, suggesting that another receptor such as AT2 is functionally activated in Agtr1a-/-, Agtr1b-/- mice.
Clinical diagnosis of wheezing in early childhood
Authors: L. C. Martinati, A. L. Boner
Journal: Allergy (1995)

Wheezing is one of the most common symptoms of respiratory disease in childhood, Epidemiologic studies from various countries have shown that 10-15'\, of infants in the first year of life and up to 25",, of children under 5 years of age present to their physician with wheezing respiratory illness (40,67).The majority of infants and young children with recurrent wheezy, lower respiratory tract symptoms are very likely to have asthma, regardless of age of onset, evidence of atopic disease, precipitating causes, or frequency of wheezing (71), Since asthma in infancy can be confused with various other conditions which produce similar signs and symptoms, and physiologic changes, the initial evaluation of a wheezing infant should aim at the exclusion of alternative diagnoses." SitMioiniPc: C\s[.ir.sj nostic procedures in infants with recurrent chronic 8 F.iiiiKMo :iiiu' C\M.iitus,^ respirator) s)niptiMi!s are the//^'K'rc(Y//>?/e.vr (5-TU) B'.'ivficpuinion.,!^ cvspL-ii.... and tlic s u c'cit chloride h"^! since w heezing may be the
Multilobated non‐hodgkin lymphoma of B‐cell type: Leukemization and multiorganic involvement
Authors: F. Millá, J. Juncà, A. Flores, J. C. Lorenzo, J. Andreu, J. J. Navas
Journal: American Journal of Hematology (1989)

Abstract A case of multilobated non‐Hodgkin lymphoma (Pinkus' lymphoma) is presented. Its clinical manifestations (extreme leukemization) and immunological characteristics are stressed.
Quantitative Myocardial Cytokine Expression and Activation of the Apoptotic Pathway in Patients Who Require Left Ventricular Assist Devices
Authors: Emma J. Birks, Najma Latif, Virginia Owen, Christopher Bowles, Leanne E. Felkin, Anthony J. Mullen, Asghar Khaghani, Paul J.R. Barton, Julia M. Polak, John R. Pepper, Nicholas R. Banner, Magdi H. Yacoub
Journal: Circulation (2001)

Molecular mechanisms underlying the deterioration of patients undergoing LV assist device (LVAD) implantation remain poorly understood. We studied the cytokines tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta and IL-6 and the terminal stage of the apoptotic pathway in patients with decompensating heart failure who required LVAD support and compared them with patients with less severe heart failure undergoing elective heart transplantation.Myocardial and serum samples from 23 patients undergoing LVAD implantation were compared with those from 36 patients undergoing elective heart transplantation. Myocardial TNF-alpha mRNA (1.71-fold; P<0.05) and protein (3.43+/-0.19 versus 2.95+/-0.10 pg/mg protein; P<0.05) were elevated in the LVAD patients. Immunocytochemistry demonstrated TNF expression in the myocytes. Serum TNF-alpha was also elevated (12.5+/-1.9 versus 4.0+/-0.4 pg/mL; P<0.0001) in the LVAD patients. IL-6 mRNA (2.57-fold higher; P<0.005) and protein (27.83+/-9.35 versus 4.26+/-1.24 pg/mg protein; P<0.001) were higher in the LVAD candidates, as was serum IL-6 (79.3+/-23.6 versus 7.1+/-1.6 pg/mL; P<0.0001). Interleukin-1beta mRNA expression was 9.78-fold higher in the LVAD patients (P<0.001). iNOS mRNA expression was similar to that in advanced heart failure patients and was not further elevated in the LVAD patients. Levels of procaspase-9 (8.02+/-0.91 versus 6.16+/-0.43 oligodeoxynucleotide [OD] units; P<0.01), cleaved caspase-9 (10.02+/-1.0 versus 7.34+/-0.40 OD units; P<0.05), intact and spliced DFF-45 (4.58+/-0.75 versus 2.84+/-0.23 OD units; P<0.05) were raised in LVAD patients, but caspase-3 and human nuclease CPAN were not.Elevated TNF-alpha, IL-1beta, and IL-6 and alterations in the apoptotic pathway were found in the myocardium and elevated TNF-alpha and IL-6 in serum of deteriorating patients who required LVAD support. These occurrences may have therapeutic implications and influence the timing of LVAD insertion.
Long-term effects of carvedilol in idiopathic dilated cardiomyopathy with persistent left ventricular dysfunction despite chronic metoprolol
Authors: Andrea Di Lenarda, Gastone Sabbadini, Luca Salvatore, Gianfranco Sinagra, Luisa Mestroni, Bruno Pinamonti, Dario Gregori, Fulvio Ciani, Aureo Muzzi, Silvio Klugmann, Fulvio Camerini
Journal: Journal of the American College of Cardiology (1999)
The relationship between acid secretion after augmented histamine stimulation and the histology of the gastric mucosa
Authors: O. A. A. Bock, W. C. D. Richards, L. J. Witts
Journal: Gut (1963)

Augmented histamine tests and gastric mucosal biopsies were performed on 97 patients. The amount of acid secreted was closely correlated with the histological appearances of the gastric mucosa. There was a striking difference between the acid secretion of patients with normal biopsies and patients with superficial gastritis. Achlorhydria was not present in patients with normal biopsies. An occasional patient with gastric atrophy will be found to secrete small amounts of acid.
Patient safety team of the year
Authors: N. Hawkes
Journal: BMJ (2015)

Improving patient safety is a never ending quest. The shortlist for The BMJ Award for Patient Safety Team exemplifies how varied are the ways in which safety can be improved and outcomes bettered, says <b>Nigel Hawkes</b>. Two projects sought to enhance medical skills at the bedside to detect the deteriorating patient, two to reduce risks associated with innovation in treatments and in drug dispensing, and one to improve care of broken hip, a common misadventure of elderly people that too often leads to death.
Fiberduodenoscopic Observation on the Dynamics of the Duodenal Papilla
Authors: T. Kozu, I. Oi, S. Suzuki, T. Takemoto
Journal: Endoscopy (1970)

Through the experience of fiberduodenoscopy, the endoscopic aspects on the dynamics of the duodenal papilla is reported here. Characteristic appearance of the duodenal papilla is hemispherical protrusion on the longitudinal fold associated with proximal preputium-like circular folds and distal frenulum-like longitudinal folds. Color of the papilla varies case by case from reddish to pale, pearly white. The arrangement of the villi on the surface of the papilla seems to be different from surrounding mucosa. The appearance of the papilla is classified into three types; papillar type, hemispherical type and flat type. There may be transition from one type to another in the same case during observation. The accessory papilla can also be detected endoscopically if any. After stimulation with pancreozymin, thick bile flows out of the orifice. The dynamics of bile excretion are reported. During the phase of excretion, a valvular protrusion from inside of the orifice is sometimes observed, which is supposed to be the septum in the ampulla.
End of life strategy offers home nursing care for 24 hours a day
Authors: S. Mayor
Journal: BMJ (2008)

All NHS trusts in England must provide rapid response community nurses and palliative care outreach services round the clock to enable people who want to die at home to receive the care they need, a 10 year strategy review recommended this week.

The strategy—the first of its kind—sets out the new services, changes to existing services, and training and standards required to improve care for adults approaching the end of their lives. It aims to increase the number of people able to die in their own homes. Surveys of the general public show that between half and three quarters of people would prefer to die at home, but only about 18% currently do so.

Alan Johnson, the secretary of …
Evaluation of acoustic rhinometry in a nasal provocation test with allergen
Authors: M. Ganslmayer, F. Spertini, M.‐H. Terrien, A. Leimgruber, F. Rahm, B. Mosimann
Journal: Allergy (1999)

Background: The objective was to validate acoustic rhinometry (AR) in a nasal challenge with allergen. Methods: Nasal response to allergen provocation was based on clinical and symptom scores, cross‐sectional changes of the nasal mucosa as measured by AR with the Rhinoklack ® system, and peak nasal inspiratory flow (PNIF), in atopic and nonatopic volunteers. Results: After allergen challenge, mean variation in minimal cross‐sectional area (ΔMCA), as measured by AR, or in peak nasal inspiratory flow (ΔPNIF) in nonatopic volunteers, was −0.4±14.3% and 5.2±15.7%, respectively, compared to baseline. This allowed the determination of a reaction threshold of −29% for ΔMCA and of −26% for ΔPNIF. All but one of the 30 atopic patients reached the AR reaction threshold, whereas all patients reached the PNIF reaction threshold. AR and PNIF closely correlated with clinical and symptom scores for nasal congestion, since there was no significant difference at reaction threshold between both methods. Conclusions: In an allergen provocation test, AR appears to be as specific and sensitive as peak nasal inspiratory flow, with the advantage of being independent of the patient's active cooperation. Discrepancies between both methods emphasize the role of nasal cavity anatomy in measuring nasal congestion by AR.
Midkine gene transfer after myocardial infarction in rats prevents remodelling and ameliorates cardiac dysfunction
Authors: Arihiro Sumida, Mitsuru Horiba, Hisaaki Ishiguro, Hiroharu Takenaka, Norihiro Ueda, Hiroaki Ooboshi, Tobias Opthof, Kenji Kadomatsu, Itsuo Kodama
Journal: Cardiovascular Research (2009)

We have previously reported that therapy with midkine (MK) has a protective effect in mouse models of myocardial infarction (MI) and ischemia/reperfusion. The underlying mechanism was proved to be anti-apoptosis and prevention of left ventricular (LV) remodelling following angiogenesis. Here we investigated the effects of overexpression of MK by adenoviral gene transfer on cardiac function and remodelling in an experimental rat MI model. MI was created in male Wistar rats. Adenoviral vectors encoding mouse MK (AdMK) or β-galactosidase (AdLacZ; as controls) were injected in myocardium at the onset of MI. One week after injection, in vivo adenoviral gene expression was assessed by western blot and histological analysis. After echocardiographic analysis at 4 weeks and haemodynamic analysis at 6 weeks after MI, AdMK animals had better cardiac function compared with AdLacZ animals. Heart weight (HW) and relative HW of AdMK animals were not different from sham-operated animals after 6 weeks, pointing to a very potent effect in the prevention of ischemic cardiomyopathy. In histological studies at 6 weeks after MI, AdMK animals had less fibrosis in the non-infarcted myocardium and higher vascular density in the border-zone area compared with AdLacZ animals. AdMK animals had strongly upregulated levels of phosphorylated extracellular signal-regulated kinase, Akt, PI 3-kinase, and Bcl-2, whereas the level of Bax was downregulated compared with AdLacZ animals. Overexpression of MK prevents LV remodelling and ameliorates LV dysfunction by anti-apoptotic and pro-angiogenic effects. MK gene transfer may provide a new therapeutic modality in ischemic cardiomyopathy and ischemic heart failure.