tbuckley/cabot-search huggingface dataset:
A CASE OF BRAIN TUMOR.
Authors: JULIUS GRINKER
Journal: JAMA (1905)

<h3>Patient.</h3> —M. M., a Lithuanian laborer, aged 28, entered Cook County Hospital March 14, 1905, and was assigned to the care of Dr. Kuh. The following April he came under my service and remained under my observation until April 28, when a transfer to the surgical side was recommended. Dr. Schroeder performed an operation May 4, 1905, and the patient died May 5, 1905. <h3>History.</h3> —Family and personal history are negative and syphilis is denied. He states that his habits were always good and that he never sustained an injury. Three weeks previous to admission the patient began to complain of severe headaches, which were constant and generalized. At about the same time spells of vomiting appeared which seemed to have no relation to the gastric functions. A feeling of nausea always accompanied these vomiting spells, but sometimes there was nausea without vomiting. Somewhat later in the course of the
1130 HEPATIC REGULATION OF THE INSULIN-LIKE GROWTH FACTOR (IGF) SYSTEM BY ACUTE HYPOXIA IN CHILDREN
Authors: C.E. Martinelli, R.J. Custódio, V.I.C. Custódio, C.A. Scrideli, M.C. Cervi, P. Cupo, A.L.C. Martinelli
Journal: Journal of Hepatology (2010)
Balancing Efficacy and Toxicity in Kidney-Transplant Immunosuppression
Authors: Alan B. Leichtman
Journal: New England Journal of Medicine (2007)

Although protocols differ among transplantation centers, most immunosuppressive strategies for kidney-transplant recipients are built on two core practices: delivery of immunosuppression in two phases, usually termed induction and maintenance, and the concurrent use of several immunosuppressive medications that work at various sites in the cell cycle and have nonoverlapping toxic effects. In general, the induction phase involves the initial use of the same oral immunosuppressive medications that are prescribed at lower doses during long-term maintenance. Induction doses are reduced during the first 2 to 4 months after transplantation until maintenance levels are achieved. Induction may also include the administration of . . .
Biology of the Major Psychoses: A Comparative Analysis
Authors: Barry I. Liskow
Journal: JAMA (1976)

American psychiatry has been evolving over the past 20 years from a basically philosophical discipline with few ties to academic medicine into a scientifically based medical specialty. The field is complex and must cope with the basic issue of what constitutes a diagnosis as well as highly technical issues such as the localization of a specific neurochemical in a specific part of the brain. This volume lucidly highlights this complexity in relation to the psychoses, a concept cutting across many psychiatric conditions. The book is divided into five sections, all of which concern efforts to establish the validity and reliability of the concept of psychosis. Data from such diverse disciplines as electrophysiology, psychopharmacology, neurochemistry, and genetics are presented alone and in combinations in the attempt to find the common elements, if any, linking the psychoses. The 27 authors who contributed to this volume are aware of the need to delineate
Perforated Duodenal Ulcer Complicating Prednisone Therapy
Authors: Vance Fentress, Paul Firnschild, William S. Reveno
Journal: New England Journal of Medicine (1956)

OUT of a group of 18 arthritic patients treated with prednisone (Meticorten) we have encountered 3 with peptic ulcers; 1 of these, in whom a perforation developed, is the subject of this report. Peptic ulcer as a complication of prednisone therapy has previously been reported,1 as has 1 case of massive hematemesis from peptic ulcer in a patient with the nephrotic syndrome treated with prednisone.1 , 2 Bollet et al.1 have also noted the healing of peptic ulcers in 2 patients on a rigid ulcer regimen without reduction in prednisone dosage. There has not been, to our knowledge, a previously published report . . .
672 ATAXIA TELANGIECTASIA MUTATED PLAYS A PIVOTAL ROLE ON THE CELL SURVIVAL IN HEPATOMA VIA SUPPRESSING ENDOPLASMIC RETICULUM STRESS
Authors: S. Fujimaki, Y. Matsuda, A. Sanpei, M. Yano, S. Ohkoshi, T. Wakai, Y. Shirai, S. Hirano
Journal: Journal of Hepatology (2011)
Lack of Health Effects of Long-term Exposure to 2,3,7,8-Tetrachlorodibenzo-p-Dioxin
Authors: Anthony C. Allison
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Regarding the potential health hazard of 2,3,7,8-tetrachlorodibenzo-<i>p</i>-dioxin (TCDD) in industrial wastes, an epidemiologic comparison between exposed and non-exposed groups from Quail Run, Mo, recently published inThe Journal,<sup>1</sup>identified no consistent differences in medical history, physical examination findings, serum and urinary chemistry study results, and neurological test results. The subclinical differences in liver function test results reported are of dubious significance. However, since the authors suggested that long-term exposure to TCDD may be associated with depressed cell-mediated immunity, we wish to focus our comments on the immunologic data. A major point made is that the exposed group had a higher frequency of anergy and relative anergy than the control group. Skin tests for delayed-type hypersensitivity are notoriously subject to reader bias, especially in the hands of inexperienced readers, such as those used in this study. Observations made by two of the four readers were
Time course of changes in porcine myocardial phospholipid levels during ischemia. A reassessment of the lysolipid hypothesis.
Authors: N A Shaikh, E Downar
Journal: Circulation Research (1981)

This study was performed to determine the early and delayed metabolic effects of myocardial ischemia on the major membrane phospholipids and to reassess the potential role of lysophospholipids in the genesis of malignant dysrhythmias induced by ischemia. Samples taken from in situ hearts before ant at various intervals up to 40 minutes after abrupt ligation of LAD were extracted by the classical Folch technique with modifications to avoid artifactual lysophospholipid production and losses. Following thin layer chromatography of lipid extracts, phospholipid fractions were quantified by phosphorus estimation and lysophospholipids by a more sensitive method employing gas liquid chromatography. The total phospholipid content with the exception of lysophospholipids remained essentially constant throughout the early phases of acute ischemia, but fell by 6 and 14% after 8 and 24 ours, respectively. At 8 minutes, lysophospholipid levels n ischemic myocardium were significantly increased by 60% compared to pre-occlusion controls in the ischemic zone and by 25% in post-occlusion controls. They changed little thereafter. The molecular species of lysophospholipids remained unchanged throughout the period of ischemia studied. The mole fraction of other phospholipids as well as their fatty acyl and aldehyde profiles also were unchanged. Despite significant elevations in lysophospholipids levels, their absolute quantities were very small (0.6% of total phospholipid P) and 15-fold smaller than that reported in vitro to simulate electrophysiological manifestation of ischemia. However, such small amounts in vivo, if produced in the microenvironment of certain membrane-bound enzymes along with acidosis, hypoxia, and fatty acids, could be potentially deleterious to cell functions.
Protecting Severely Abused and Neglected Children
Authors: M S Jellinek, J M Murphy, S Bishop, F Poitrast, D Quinn
Journal: New England Journal of Medicine (1990)

Physicians are required by law to report all cases of suspected child abuse and neglect to a state social service agency. For all reported cases, but especially those of the most severely mistreated children, there is an assumption that the child will be rescued. The reporting physician expects that the child will be safe from further harm and that the child's long-term development will become the highest priority. Initially, those expectations are supported by the flurry of activity that includes completing paperwork, speaking with a social worker, and providing evidence through the medical record or testifying in a preliminary hearing. . . .
Decreased Skin Turgor
Authors: Cornelia de Vries Feyens, Cornelis P C de Jager
Journal: New England Journal of Medicine (2011)

A 61-year-old man with a vasoactive intestinal polypeptide-secreting neuroendocrine tumor (VIPoma) and diarrheal fluid losses exceeding 10 liters per day was transferred to the intensive care unit with severe volume depletion. On physical examination, the blood pressure was 54/30 mm Hg, and there was sinus tachycardia of 156 beats per minute. His total enteric fluid loss was 17 liters in the first 2 days after admission. The patient was also noted to have severely decreased skin turgor. Skin that was pinched over his anterior leg (Panel A) continued to be tented even after 10 minutes (Panel B). In patients with . . .
Mucopolysaccharides of whole human spleens in generalized amyloidosis.
Authors: T Bitter, H Muir
Journal: Journal of Clinical Investigation (1966)

Amyloidosis is a morphological concept (2) the diagnosis of which has been based on histo- logical critera (3)."Primary" and "secondary" amyloidosis and the forms of amyloidosis seen in conjunction with familial Mediterranean fever (FMF) and myeloma are all grouped under one name because of morphological similarities, although it is not certain that they represent a single disease.Electron microscopy has, however, revealed characteristic fibrils in all forms of amy- loidosis (4-6).Some of the stains that are taken up by amyloid material suggest that it may con- tain mucopolysaccharides (MPS) (7).Never- theless, chemical investigations have not previously shown any marked increase in extractable metachromatic material (8) nor in uronic acid (9) or sulfate-containing compounds (10), al- though heparan sulfate has been isolated from a few amyloid-bearing organs (11,12).The pur- pose of the present study was a systematic chemical investigation of the MPS in an extended se- ries of cases and controls that has not hitherto been carried out. MethodsTwenty patients with primary and secondary amyloidosis were collected, including one after myeloma and one after FMF.Table I gives some clinical findings and the distribution of amyloid in the spleens.The degree of in- filtration was assessed arbitrarily as follows: + = par- tial, ++ = subtotal, and +++ = total replacement by amyloid.The kidneys were also infiltrated with amyloid *
Prolactin and Breast Cancer
Authors: David L. Kleinberg
Journal: New England Journal of Medicine (1987)

The fact that pregnancy lowers long-term basal prolactin secretion has lead to the suggestion that low prolactin levels, which by inference may occur after pregnancy at an early age, may protect against breast cancer. There is evidence that prolactin is a co-carcinogen in rodent mammary cancer, but aspects of rodent mammary gland biology may not be applicable to humans. Research in primates suggests that some factor from the pituitary is required for breast cancer, although it is neither prolactin nor growth hormone. similarly, one experiment has been reported that some pituitary factor may potentiate estrogen in promoting growth of human breast cancer cells in cell culture. Treatment of human breast cancer with prolactin-lowering drugs, however, is ineffective. Removal of the pituitary os effective in treating human breast cancer, and furthermore, persons without mature breast tissue, such as women with Turner's syndrome or men, have a very low incidence of breast cancer. Overall, the evidence linking prolactin to breast cancer is insufficient to warrant use of prolactin-lowering ergot drugs as a preventive measure in those at risk of breast cancer.
TCT-601 Real-world experience of the polymer-free rapamycin-eluting YUKON-Choice stent: five-year results from a prospective registry
Authors: Marc-Alexander Ohlow, Hubertus von Korn, Ahmed Farah, Jörg Fuhrmann, Yu Jiangtao, Oliver Gunkel, Matthias Schreiber, Bernward Lauer
Journal: Journal of the American College of Cardiology (2012)
Noninvasive quantification of muscarinic receptors in vivo with positron emission tomography in the dog heart.
Authors: J Delforge, M Janier, A Syrota, C Crouzel, J M Vallois, J Cayla, J P Lançon, B M Mazoyer
Journal: Circulation (1990)

The in vivo quantification of myocardial muscarinic receptors has been obtained in six closed-chest dogs by using positron emission tomography. The dogs were injected with a trace amount of 11C-labeled methylquinuclidinyl benzilate (MQNB), a nonmetabolized antagonist of the muscarinic receptor. This was followed 30 minutes later by an injection of an excess of unlabeled MQNB (displacement experiment). Two additional injections of unlabeled MQNB with [11C]MQNB (coinjection experiment) and without [11C]MQNB (second displacement experiment) were administered after 70 and 120 minutes, respectively. This protocol allowed a separate evaluation of the quantity of available receptors (B'max) as well as the association and dissociation rate constants (k+1 and k-1) in each dog. The parameters were calculated by using a nonlinear mathematical model in regions of interest over the left ventricle and the interventricular septum. The average value of B'max was 42 +/- 11 pmol/ml tissue, the rate constants k+1, k-1, and Kd were 0.6 +/- 0.1 ml.pmol-1.min-1, 0.27 +/- 0.03 ml.pmol-1.min-1, and 0.49 +/- 0.14 pmol.ml-1, respectively, taking into account the MQNB reaction volume estimated to 0.15 ml/ml tissue. Although [11C]MQNB binding would appear irreversible, our findings indicate that the association of the antagonist is very rapid and that the dissociation is far from negligible. The dissociated ligand, however, has a high probability of rebinding to a free receptor site instead of escaping into the microcirculation. We deduce that the positron emission tomographic images obtained after injecting a trace amount of [11C]MQNB are more representative of blood flow than of receptor density or affinity. We also suggest a simplified protocol consisting of a tracer injection of [11C]MQNB and a second injection of an excess of cold MQNB, which is sufficient to measure B'max and Kd in humans.
Too much medicine: the challenge of finding common ground
Authors: H. Macdonald, E. Loder
Journal: BMJ (2015)

Imprecise terminology and lack of evidence based solutions are hampering progress 



MALCOLM WILLETT

Over the past few decades a “global, progressive, and activist health movement” has coalesced that broadly aims to “challenge the selling of sickness” and confront the problem of “too much medicine” in all its forms.1 2 There is consensus within this movement that far too often patients are injured by unnecessary or excessive medical care, and that too much medicine fuels waste and rising healthcare costs. The BMJ’s Too Much Medicine campaign (www.bmj.com/too-much-medicine) and this special theme issue aim to shed further light on the problem.

But what is too much medicine and who gets to decide? The phrase itself is a catchall term used to describe a variety of problems, including overdiagnosis, overtreatment, and medicalisation. It works well for advocacy, say Stacey Carter and colleagues in their article (doi:10.1136/bmj.h869), because it is broad and inclusive.3 More precise definitions, though, are needed for specific …
Dermal injection of immunocytes induces psoriasis.
Authors: T Wrone-Smith, B J Nickoloff
Journal: Journal of Clinical Investigation (1996)

Establishing direct and causal relationships among the confederacy of activated cell types present in psoriasis has been hampered by lack of an animal model. Within psoriatic plaques there are hyperplastic keratinocytes, infiltrating immunocytes, and activated endothelial cells. The purpose of this study was to determine if psoriasis is primarily a disorder of keratinocytes or the immune system. Using a newly developed experimental system in which full-thickness human skin is orthotopically transferred onto severe combined immunodeficient mice, autologous immunocytes were injected into dermis, and the resultant phenotype characterized by clinical, histologic, and immunophenotypic analyses. Engraftment of samples included both uninvolved/ symptomless (PN) skin removed from patients with psoriasis elsewhere, or from healthy individuals with no skin disease (NN skin). In 10 different experiments involving 6 different psoriasis patients, every PN skin was converted to a full-fledged psoriatic plaque skin by injection of autologous blood-derived immunocytes. In all but one psoriatic patient, the immunocytes required preactivation with IL-2 and superantigens to convert PN skin into psoriatic plaque skin. In every case, resultant plaques were characterized by visible presence of flaking and thickened skin, loss of the granular cell layer, prominent elongation of rete pegs with a dermal angiogenic tissue reaction, and infiltration within the epidermis by T cells. Lesional skin displayed 20 different antigenic determinants of the psoriatic phenotype. None of the four NN skin samples injected with autologous immunocytes converted to psoriatic plaques. We conclude that psoriasis is caused primarily by the ability of pathogenetic blood-derived immunocytes to induce secondary activation and disordered growth of endogenous cutaneous cells including keratinocytes and vascular endothelium.
Surgical Case-Histories From the Past
Authors: Ira M. Rutkow
Journal: JAMA (1995)

It was said of the renowned surgeon John Chalmers DaCosta that his keen wit, dry humor, and mordant expression made him one of the best-known after-dinner speakers in Philadelphia. The mere announcement "DaCosta will speak" guaranteed large attendance. Having recently been privileged to hear Harold Ellis, CBE, emeritus chairman of the Department of Surgery at the Charing Cross and Westminster Medical School, London, England, regale an American dinner audience with his story of Queen Caroline's (wife of King George II) umbilical hernia, I attest that Ellis is the DaCosta of his generation. I listened as Ellis enthralled the audience with his unique raconteurship What transfixed me was Ellis' use of surgical history as the foundation for his overall message of understanding change in modern society. I have since wondered, from what sources did Ellis receive his historical material? Was there some expatriate writer from Letterman or Leno who decided to
Clinton seeks heavy fines for breaching research ethics
Authors: F. Charatan
Journal: BMJ (2000)

President Clinton is to ask Congress for authority to levy fines of up to $250000 (£156000) on medical researchers who violate federal rules on human research, and up to $1m on the universities that employ them.

Donna Shalala, Department of Health and Human Services secretary, said on 23 May: “The explosion in biomedical research has brought new challenges as more researchers are becoming involved in commercial ventures that may create new ethical dilemmas. Today's actions …
Tyrosine Phosphorylation Controls Internalization of CTLA-4 by Regulating Its Interaction with Clathrin-Associated Adaptor Complex AP-2
Authors: Tooru Shiratori, Shoichiro Miyatake, Hiroshi Ohno, Chiaki Nakaseko, Kaichi Isono, Juan S Bonifacino, Takashi Saito
Journal: Immunity (1997)
Drugs Five Years Later
Authors: MARTIN ROSMAN
Journal: Annals of Internal Medicine (1973)

Azathioprine is approved by the FDA for use as an adjunct for the prevention of renal homotransplantation rejection. Some recently published papers have reported that this drug has been used in various "autoimmune" disorders. Although more controlled studies are required to determine the precise role of this drug for these conditions, clearly, azathioprine is a valuable steroid-sparing agent and has specific beneficial effects in rheumatoid arthritis and systemic lupus erythematosus. Its use remains investigational, since it is not approved by the FDA for these disorders. Further, the physician should carefully consider whether the benefits derived from its use in chronic disease outweigh both the short-term toxicity of infection and bone-marrow suppression and the potential long-term hazards of malignant transformation and genetic damage.
Evaluation of the patient with hepatitis B
Authors: Yaron Rotman, Thomas A. Brown, Jay H. Hoofnagle
Journal: Hepatology (2009)

Abstract The initial evaluation of a patient with hepatitis B virus infection should attempt to assess the disease activity and stage in the context of the known natural history of this infection and to properly assess the needs for treatment and surveillance. In addition to a medical history and focused physical examination, the initial evaluation usually requires serological, biochemical, and virological tests to confirm the diagnosis as well as an imaging study to establish a baseline for future monitoring. A liver biopsy is generally not needed but can provide useful information on prognosis, need for surveillance for hepatocellular carcinoma (HCC), and whether to recommend therapy. Follow-up monitoring is aimed at determining disease progression, development of complications, and reassessing the need for treatment. Monitoring frequency should be determined based on the activity and stage of disease. Initiation of screening for HCC should be based on age, race, sex, family history, and stage and duration of disease. The current recommended method of screening and surveillance for HCC is by ultrasonography and alpha-fetoprotein measurements every 6–12 months. Prospective studies are needed to evaluate the role of longitudinal application of noninvasive assays of fibrosis, such as serum fibrosis markers and transient elastography. Better biomarkers and imaging modalities are needed for early detection of HCC. Finally, studies are needed to better refine the indications and to balance the risks and benefits of antiviral therapy. (Hepatology 2009;49:S22–S27.)