tbuckley/cabot-search huggingface dataset:
Coding of clinical diagnoses. Persevere with Korner system.
Authors: B Panayiotou
Journal: BMJ (1993)

Non-steroidal anti-inflammatory drug (NSAID) therapy is associated with delayed gastroduodenal ulcer healing. In rats the degree of angiogenesis (new vessel formation) within the ulcer bed correlates strongly with the extent and speed of ulcer healing and may be inhibited by NSAIDs. This study therefore assessed the vascularity of 38 antral gastric ulcers immunohistochemically, using CD31 a vascular endothelial cell marker, in 17 patients taking NSAIDs and 19 control patients. In the superficial granulation tissue NSAID therapy was associated with a significant reduction in the median number of capillaries (13.5 (IQR: 9.5-18) v 23.5 (14-31) (p &lt; 0.005)), number of vessel buds (6 (4-12.5) v 17 (12-23) (p &lt; 0.05)), and maximum vessel diameter (29 (20.75-30.75) v 33.75 (24-45) (p &lt; 0.05)) when compared with controls. In deep granulation tissue NSAID therapy was similarly associated with a significant reduction in the number of capillaries (9 (6.5-12) v 14 (9-19.25) (p &lt; 0.04)), number of vessel buds (5 (3.5-8.5) v 13 (7-16.5) (p &lt; 0.01)), and maximum vessel diameter (23 (18-20.5) v 33 (21.5-45) (p &lt; 0.02)). There were no differences in vascularity in the adjacent glandular mucosa. Impairment of angiogenesis may be an important mechanism of NSAID related delayed ulcer healing.
Controlled trials: the 1948 watershed
Authors: R. Doll
Journal: BMJ (1998)

Important scientific advances seldom occur out of the blue but can be seen in retrospect to have been the culmination of processes that have built up over the years. This was certainly true of the introduction of the new method of conducting clinical trials, first reported in 1948, that has played such a major part in the progress of clinical medicine in the last half century. When I qualified in medicine in 1937, new treatments were almost always introduced on the grounds that in the hands of professor A or in the hands of a consultant at one of the leading teaching hospitals, the results in a small series of patients (seldom more than 50) had been superior to those recorded by professor B (or some other consultant) or by the same investigator previously. Under these conditions variability of outcome, chance, and the unconscious (leave alone the conscious) in the selection of patients brought about apparently important differences in the results obtained; consequently, there were many competing new treatments. The treatment of peptic ulcer was, perhaps, more susceptible to claims of benefit than most other chronic diseases; so that in 1948, when I began to investigate it, I was soon able to prepare a list of treatments beginning with each letter of the alphabet. Standard treatments, for their part, tended to be passed from one textbook to another without ever being adequately evaluated.

### Summary points

Claims of therapeutic benefit are often misleading unless there are concurrent control groups

When treatments are allocated to alternate patients there is a risk of bias in the selection of patients

Randomly allocating individuals after entry into a trial eliminates bias and provides a proper estimate of random error

Randomisation can be done within strata of the likely response to treatment, if clinicians can define the strata …
APPL1 Potentiates Insulin-Mediated Inhibition of Hepatic Glucose Production and Alleviates Diabetes via Akt Activation in Mice
Authors: Kenneth K.Y. Cheng, Miguel A. Iglesias, Karen S.L. Lam, Yu Wang, Gary Sweeney, Weidong Zhu, Paul M. Vanhoutte, Edward W. Kraegen, Aimin Xu
Journal: Cell Metabolism (2009)
High-Resolution Computed Tomography Imaging of Airway Disease in Infants with Cystic Fibrosis
Authors: Tanya M. Martínez, Conrado J. Llapur, Tamica H. Williams, Cathy Coates, Richard Gunderman, Mervyn D. Cohen, Michelle S. Howenstine, Osama Saba, Harvey O. Coxson, Robert S. Tepper
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

The development of early lung disease in patients with cystic fibrosis (CF) remains poorly defined.
Long-Term Outcome and Impact of Surgery on Adults With Coronary Arteries Originating From the Opposite Coronary Cusp
Authors: Richard A. Krasuski, Dari Magyar, Stephen Hart, Vidyasagar Kalahasti, Richard Lorber, Robert Hobbs, Gosta Pettersson, Eugene Blackstone
Journal: Circulation (2011)

Background— An anomalous coronary artery from the opposite sinus of Valsalva may increase sudden death risk in children and young adults, and surgical intervention is often recommended. The impact of this lesion when recognized in the adult and its management are ill defined. Methods and Results— We reviewed 210 700 cardiac catheterizations performed over a 35-year period at a single institution and identified 301 adults with an anomalous coronary artery from the opposite sinus of Valsalva, either anomalous right coronary artery from the left cusp or anomalous left main coronary artery from the right cusp. Patients were stratified by the pathway of the anomalous artery and the chosen treatment. Among the 301 patients with anomalous coronary artery from the opposite sinus of Valsalva (0.14% of the cohort), 79% had anomalous right coronary artery from the left cusp, and 18% had an interarterial course (IAC). Patients with IAC were younger (52±13 versus 59±13 years; P =0.001) and more likely to undergo surgical intervention (52% versus 27%; P &lt;0.001), but mortality was not increased with IAC. Among the 54 patients with IAC, 28 underwent surgical repair with no perioperative deaths. Patients evaluated since 2000 were significantly more likely to be referred for surgery ( P =0.004). Surgical patients were more likely to have abnormal stress tests (90% versus 43%; P =0.01) and had more extensive atherosclerosis but less diabetes mellitus (0% versus 23%; P =0.01). Long-term survival at 10 years appeared similar in both groups. Conclusions— In this single-center cohort study of patients with an anomalous coronary artery from the opposite sinus of Valsalva, surgical management appears to have been favored recently. Despite no perioperative mortality, a positive impact on long-term survival was not observed. The impact of surgery in older adults with anomalous coronary arteries arising from the opposite coronary sinus with IAC deserves further study.
An autoreactive antibody from an SLE/HIV-1 individual broadly neutralizes HIV-1
Authors: Mattia Bonsignori, Kevin Wiehe, Sebastian K. Grimm, Rebecca Lynch, Guang Yang, Daniel M. Kozink, Florence Perrin, Abby J. Cooper, Kwan-Ki Hwang, Xi Chen, Mengfei Liu, Krisha McKee, Robert J. Parks, Joshua Eudailey, Minyue Wang, Megan Clowse, Lisa G. Criscione-Schreiber, M. Anthony Moody, Margaret E. Ackerman, Scott D. Boyd, Feng Gao, Garnett Kelsoe, Laurent Verkoczy, Georgia D. Tomaras, Hua-Xin Liao, Thomas B. Kepler, David C. Montefiori, John R. Mascola, Barton F. Haynes
Journal: Journal of Clinical Investigation (2014)

Broadly HIV-1-neutralizing antibodies (BnAbs) display one or more unusual traits, including a long heavy chain complementarity-determining region 3 (HCDR3), polyreactivity, and high levels of somatic mutations. These shared characteristics suggest that BnAb development might be limited by immune tolerance controls. It has been postulated that HIV-1-infected individuals with autoimmune disease and defective immune tolerance mechanisms may produce BnAbs more readily than those without autoimmune diseases. In this study, we identified an HIV-1-infected individual with SLE who exhibited controlled viral load (<5,000 copies/ml) in the absence of controlling HLA phenotypes and developed plasma HIV-1 neutralization breadth. We collected memory B cells from this individual and isolated a BnAb, CH98, that targets the CD4 binding site (CD4bs) of HIV-1 envelope glycoprotein 120 (gp120). CH98 bound to human antigens including dsDNA, which is specifically associated with SLE. Anti-dsDNA reactivity was also present in the patient's plasma. CH98 had a mutation frequency of 25% and 15% nt somatic mutations in the heavy and light chain variable domains, respectively, a long HCDR3, and a deletion in the light chain CDR1. The occurrence of anti-dsDNA reactivity by a HIV-1 CD4bs BnAb in an individual with SLE raises the possibility that some BnAbs and SLE-associated autoantibodies arise from similar pools of B cells.
PTENα, a PTEN Isoform Translated through Alternative Initiation, Regulates Mitochondrial Function and Energy Metabolism
Authors: Hui Liang, Shiming He, Jingyi Yang, Xinying Jia, Pan Wang, Xi Chen, Zhong Zhang, Xiajuan Zou, Michael A. McNutt, Wen Hong Shen, Yuxin Yin
Journal: Cell Metabolism (2014)
Urea secretion by the straight segment of the proximal tubule.
Authors: S Kawamura, J P Kokko
Journal: Journal of Clinical Investigation (1976)

Studies utilizing in vitro microperfusion were designed to examine whether urea is actively or passively transported across superficial and juxtamedullary straight segments of rabbit proximal tubules. With perfusate and bath solutions containing 1 mM urea and electrolytes similar to normal plasma, the efflux (lumen-to-bath) isotopic permeability (X 10(-5) cm s-1) of superficial segments was 1.37 +/- 0.16 and of juxtamedullary segments was 2.14 +/- 0.20. In the same tubules, the influx (bath-to-lumen) isotopic permeability was 3.70 +/- 0.35 in superficial segments and 4.75 +/- 0.37 in juxtamedullary segments. Despite net water movement in the opposite direction (0.5 nl mm-1 min-1), the influx rate was significantly higher than the efflux rate of urea in both groups. With a low perfusion rate (2 nl/min) and equivalent specific activities of [14C]urea in bath and perfusate, the collected-to-perfused ratio of [14C]urea, corrected for volume marker change, was 1.07 +/- 0.01 in superficial and 1.09 +/- 0.01 in juxtamedullary nephrons, thus indicating net secretion in both segments. In separate studies urea influx was inhibited by hypothermia (decrease from 37 degrees to 28 degrees C), by phloretin (0.1 mM in bath), by cyanide (1 mM), but not by probenecid (0.2 mM). In each case the inhibition was highly significant and reversible. These data suggest that urea is actively secreted by the straight segments of both the superficial and juxtamedullary proximal tubules. These segments may, therefore, contribute significantly to the high urea concentration found at the bend of Henle's loop by micropuncture.
Changes in distribution and activity of glutamine synthetase in carbon tetrachloride-induced cirrhosis in the rat: Potential role in hyperammonemia
Authors: Rolf Gebhardt, Jürg Reichen
Journal: Hepatology (1994)

Cirrhosis induced in rats by carbon tetrachloride was used to study alterations in the activities and lobular distribution of carbamoylphosphate synthetase and glutamine synthetase. Specific activity of carbamoylphosphate synthetase in cirrhotic subjects was decreased to 70% of controls. Staining was homogeneous within micronodular areas, but varied from area to area and generally showed a decreased intensity. Specific activity of glutamine synthetase and the size of the glutamine synthetase-positive area were decreased to 20% and less of controls. Glutamine synthetase-positive hepatocytes were rare and scattered at the periphery of nodular areas and within fibrous septa, the normal association with the central veins being widely lost. Rarely, complete micronodules showed a slight homogeneous staining for glutamine synthetase. Arginase activity was not affected, whereas glutaminase activity was enhanced by 50%. Serum levels of ammonia were elevated more than 2-fold and those of glutamine by 30%. In contrast, urea levels tended to be slightly diminished. Serum ammonia levels showed a clear negative correlation with the specific activity of glutamine synthetase and the size of the glutamine synthetase-positive area. Furthermore, blood urea levels correlated with the sum of ammonia and glutamine concentrations, but not with each of these substrate concentrations alone. These data suggest that the changes in activity and distribution of glutamine synthetase contribute to hyperammonemia in cirrhosis. Despite a reduced activity of the initial enzyme of the urea cycle, urea synthesis is not diminished accordingly. This may be due to an enhanced flux caused by the elevated blood level of ammonia and an increased hydrolysis of glutamine, because of higher levels of glutaminase.
Sterilization of Anesthesia Apparatus
Authors: Charles H. Meeks
Journal: JAMA (1967)

THE importance of sterilization of anesthesia equipment and the relationship between contaminated equipment and subsequent infection has not been established. It has been recommended that since anesthesia equipment is exposed to a heavily contaminated area of the body meticulous care should be exercised in the handling and sterilization of apparatus.<sup>1</sup>Other workers, however, have either failed to detect significant contamination in a considerable part of the apparatus<sup>2</sup>or have concluded that it was unlikely that cross-infection would occur.<sup>3-5</sup> Sterilization of anesthesia equipment presents a rather difficult problem. Although certain items can apparently be sterilized by satisfactory techniques, bulky rubber items do not lend themselves to these techniques, and, in addition, must be processed in considerable quantity to meet the demands of a busy operating schedule. Germicides which are effective against certain organisms under certain conditions may be unsatisfactory under other conditions. Chemicals which have been found to
Clinical and Pathological Aspects of Cystic Disease of the Renal Medulla.
Authors: M. B. Strauss
Journal: Annals of Internal Medicine (1962)

s1 April 1962Clinical and Pathological Aspects of Cystic Disease of the Renal Medulla.M. B. Strauss, M.D., F.A.C.P.M. B. Strauss, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-699 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSufficient data are now available concerning ten patients to characterize the clinical and pathological findings in this disorder. In none was the urinary sediment abnormal, and albuminuria was either absent or minimal.Six of the patients, aged eight to 18 years, presented with severe anemia of obscure etiology. The unexpected finding of azotemia led to further investigation which revealed hyposthenuria refractory to vasopressin, acidosis, hypocalcemia, hyperphosphatemia, hyperphosphatasia, roentgenologic evidence of bone disease, and an inability to conserve sodium chloride. Hypertension was absent. The anamnesis disclosed long-standing polyuria and nocturia that had never been considered unusual or abnormal. Survival, once diagnosis... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: M. B. Strauss, M.D., F.A.C.P.Affiliations: Boston, Mass. (CS) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1962Volume 56, Issue 4Page: 699-699KeywordsAnemiaBoneEtiologyHypertensionHypocalcemiaRenal diseasesSodium chlorideVasopressin ePublished: 1 December 2008 Issue Published: 1 April 1962 PDF downloadLoading ...
In vitro and in vivo testing and correlation for oral controlled/ modified release dosage forms. report of the 2nd workshop held December 1988, Washington, DC. U.S.A.
Authors: Jerome P. Skelly, Gordon L. Amidon, William H. Barr, Leslie Z. Benet, James E. Carter, Joseph R. Robinson, Vinod P. Shah, Avraham Yacobi
Journal: Journal of Controlled Release (1990)
Management of Clinical Tetanus
Authors: Stephen N. Cohen
Journal: JAMA (1968)

To the Editor:—  The article Tetanus ( 204 :614, 1968) contains statements and recommendations which should be challenged.  First, the author has confused aluminum phosphate adsorbed toxoid with alum toxoid. These materials have similar uses but are not identical.  Second, a recommendation that oxytetracycline be administered to patients as prophylaxis against possible tetanus in the place of antitoxin of animal origin (if human hyperimmune globulin is not available) is not justifiable. Tetracycline-resistant clostridia have been reported, and certainly tetracycline could not be relied upon to penetrate into poorly vascularized areas likely to harbor the development of Clostridium tetani . Penicillin, which might penetrate because of the higher levels which can be safely attained is the antibiotic of choice for the eradication of clostridia, but if the patient needs antitoxin, antibiotics are no suitable substitute.  Third, the daily administration of equine or bovine antitoxin may perhaps increase the incidence or severity of serum sickness
Mutual Antagonism of Wilms’ Tumor 1 and β-Catenin Dictates Podocyte Health and Disease
Authors: Lili Zhou, Yingjian Li, Weichun He, Dong Zhou, Roderick J. Tan, Jing Nie, Fan Fan Hou, Youhua Liu
Journal: Journal of the American Society of Nephrology (2014)

Activation of β-catenin, the intracellular mediator of canonical Wnt signaling, has a critical role in mediating podocyte injury and proteinuria. However, the underlying mechanisms remain poorly understood. Here, we show that β-catenin triggers ubiquitin-mediated protein degradation of Wilms' tumor 1 (WT1) and functionally antagonizes its action. In mice injected with adriamycin, WT1 protein was progressively lost in glomerular podocytes at 1, 3, and 5 weeks after injection. Notably, loss of WT1 apparently did not result from podocyte depletion but was closely associated with upregulation of β-catenin. This change in WT1/β-catenin ratio was accompanied by loss of podocyte-specific nephrin, podocalyxin, and synaptopodin and acquisition of mesenchymal markers Snail1, α-smooth muscle actin, and fibroblast-specific protein 1. In vitro, overexpression of β-catenin induced WT1 protein degradation through the ubiquitin proteasomal pathway, which was blocked by MG-132. WT1 and β-catenin also competed for binding to common transcriptional coactivator CREB-binding protein and mutually repressed the expression of their respective target genes. In glomerular miniorgan culture, activation of β-catenin by Wnt3a repressed WT1 and its target gene expression. In vivo, blockade of Wnt/β-catenin signaling by endogenous antagonist Klotho induced WT1 and restored podocyte integrity in adriamycin nephropathy. These results show that β-catenin specifically targets WT1 for ubiquitin-mediated degradation, leading to podocyte dedifferentiation and mesenchymal transition. Our data also suggest that WT1 and β-catenin have opposing roles in podocyte biology, and that the ratio of their expression levels dictates the state of podocyte health and disease in vivo.
Current Management of Acute Cutaneous Wounds
Authors: Adam J. Singer, Alexander B. Dagum
Journal: New England Journal of Medicine (2008)

The primary goal in the management of wounds is to achieve rapid healing with optimal functional and cosmetic results. In this review, the authors summarize the current treatments for lacerations, including abrasions, skin tears, puncture wounds, and bite wounds, and for burns. A video demonstrates techniques for the application of topical skin adhesives and surgical tapes, as well as for the irrigation of wounds and the treatment of subungual hematomas.
Green tea polyphenols block the anticancer effects of bortezomib and other boronic acid–based proteasome inhibitors
Authors: Encouse B. Golden, Philip Y. Lam, Adel Kardosh, Kevin J. Gaffney, Enrique Cadenas, Stan G. Louie, Nicos A. Petasis, Thomas C. Chen, Axel H. Schönthal
Journal: Blood (2009)
James George Duncan
Authors: A. W Reid
Journal: BMJ (2003)

Consultant radiologist in administrative charge Glasgow Royal Infirmary 1969-85 (b Cluny, Aberdeenshire, 1922; q Aberdeen 1945; FRCP Glas, FRCS Ed, FRCR), d 16 September 2002.

After national service with the Royal Air Force in India, James trained in radiology and in 1956 was appointed consultant radiologist at the Royal Infirmary in Edinburgh. Following a spell as a visiting professor of radiology, at Strong Memorial Hospital, Rochester, New York, in 1969 he was appointed consultant radiologist in administrative charge at Glasgow Royal Infirmary. James was one of the early exponents of cross-sectional imaging, established a general ultrasound service, and in 1978 installed Scotland's first whole body computed tomographic scanner. He leaves a wife, Doris; a daughter; and two grandchildren.
767 EXPRESSION OF TLR4, NFκB SUBUNIT P65 AND C2 PROTEASOME SUBUNIT PROTEINS ARE INCREASED IN SKELETAL MUSCLE OF PATIENTS WITH CIRRHOSIS DUE TO ALCOHOLIC LIVER DISEASE
Authors: A.L. Selby, E.A. Wilkes, P.J. Atherton, K. Smith, M.J. Rennie, A.S. Austin
Journal: Journal of Hepatology (2009)
Total and Allergen Specific IgE Levels in Children Positively Correlate with CD4 + CD25 + CD127lo/- T Regulatory cells.
Authors: K.A. Burmeister, C. Tisler, L. Salazar, C.M. Seroogy, M. Evans, R. Gangnon, R. Lemanske, J. Gern
Journal: Journal of Allergy and Clinical Immunology (2009)
Absorption of Vitamin B12 in Pernicious Anaemia: IV. Administration into Buccal Cavity, into Washed Segment of Intestine, or after Partial Sterilization of Bowel
Authors: C. C. Ungley
Journal: BMJ (1950)

BmDINsRNAL 915 but by the fifteenth were back to their former level.The marrow was still megaloblastic.
<i>Helicobacter pylori</i>: the African enigma
Authors: I SEGAL, R ALLY, F SITAS, A R P WALKER
Journal: Gut (1998)

Editor,—A major advance in gastroenterology was the discovery that Helicobacter pylori causes chronic active gastritis, and is associated with duodenal ulcers and with gastric cancer. In an international study on 17 populations from 13 countries, it was concluded that there is a roughly six-fold risk of gastric cancer in populations with 100% H pylori infection.1 2 In Africa, a puzzling feature is that although there is a very high prevalence of the infection, associated …
Removal of Asymptomatic Impacted Wisdom Teeth
Authors: Marvin J. Scheer
Journal: JAMA (1984)

<h3>To the Editor.—</h3> I appreciated reading the discussion of Dr Laskin<sup>1</sup>on removal of asymptomatic impacted wisdom teeth. However, some important points need to be focused on. (1) Increased morbidity associated with age is associated with almost all surgeries and is not an indication for early prophylactic surgery. (2) Apparently there are no projective studies that demonstrate that prophylactic removal of asymptomatic impacted third molars is associated with lower morbidity.<sup>2,3</sup> It is difficult to understand how it can be standard to recommend that a significant portion of the population be subjected to a surgical procedure that has a substantial morbidity without knowledge of the value of the surgery. Cardiovascular surgeons have to prove that coronary bypass surgery is associated with lower morbidity and mortality; ear, nose, and throat surgeons have to prove that tonsil and adenoidectomy or myringotomy tube placement are associated with a significant decrease in morbidity.