tbuckley/cabot-search huggingface dataset:
The Diagnosis of Ventricular Tachycardias
Authors: David H. Spodick
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Morady and colleagues<sup>1</sup>make a solid contribution in dispelling the misconception that hypotension necessarily accompanies wide QRS tachycardias. Their term "wide-complex" was quite apropos, since the interpretation "ventricular tachycardia" is never quite certain except in an electrophysiological study. One can always have preexisting bundle-branch block or nodal (junctional) rhythm with an aberrant QRS complex. In the absence of ventriculoatrial conduction, a useful marker of ventricular tachycardia is atrioventricular dissociation. An often neglected clinical sign of this during ventricular tachycardia is the occurrence of intermittently intense Korotkoff's sounds while the blood pressure is being taken. Because atrioventricular dissociation produces occasional critical timing of atrial systole with improved ventricular function, there will be occasional intense first heart sounds and Korotkoff's sounds heard when the cuff is inflated above the systolic level.
Pregnancy in Penicillamine-Treated Patients with Wilson's Disease
Authors: I. Herbert Scheinberg, Irmin Sternlieb
Journal: New England Journal of Medicine (1975)

UNTIL specific treatment with D-penicillamine became available for Wilson's disease, successful pregnancy was a rare occurrence except in patients who remained asymptomatic well into adult life.1 2 3 4 5 In the symptomatic young women amenorrhea and spontaneous abortions were frequent complications, and the neurologic and psychiatric disturbances of the disorder reduced the probability of marriage. Treatment with D-penicillamine6 has dramatically altered the course of this illness so that a normal reproductive life is the rule rather than the exception. In this study we attempt to resolve a dilemma created on one hand, by the necessity of continued therapy and, on the other, by . . .
Ocular prostheses and contact lenses. II--Contact lenses.
Authors: C S Bailey, R J Buckley
Journal: BMJ (1991)

Although public awareness of contact lenses seems to be increasing, the number of people wearing them remains uncertain.A population survey in 1988 indi- cated that about 4% of the population of the United Kingdom aged between 16 and 60 were wearing lenses regularly-that is, about 2-32 million people.Most wearers have lenses for cosmetic reasons; they are usually people with mild ametropia who prefer not to wear spectacles.A smaller number of people are unable to attain satisfactory vision with glasses and can see adequately only with the aid of contact lenses.This group tends to be managed from hospital contact lens units and includes people with the following conditions: * Severe ametropia-In very long or short sighted people spectacles may be mechanically and optically unacceptable * Severe anisometropia-Patients would experience intolerable aniseikonia with glasses.This group includes patients with unilateral aphakia * Severe regular astigmatism -Patients experience dis-
Facilitating gastrotomy closure during natural-orifice transluminal endoscopic surgery using tissue anchors
Authors: J. Trunzo, L. Cavazzola, B. Elmunzer, B. Poulose, M. McGee, S. Schomish, J. Ponsky, J. Marks
Journal: Endoscopy (2009)

Reliable and secure closure of the gastrotomy after natural-orifice transluminal endoscopic surgery (NOTES) remains a critical step for widespread acceptance and use of this mode of surgery. We describe a novel method for gastrotomy closure using endoscopic tissue anchors.A standard upper endoscopy and wire placement as used for percutaneous endoscopic gastrostomy placement was performed in five pigs. Prior to gastrotomy, four tissue anchors were placed in four quadrants (1 cm away from the wire). A 12-mm gastrotomy was created endoscopically using a combination of needle-knife and balloon dilation. After transgastric peritoneoscopy, the sutures were approximated using a device knotting element. One additional pair of sutures was placed after evaluation of the gastric closure. The animals underwent in vivo contrast fluoroscopy, methylene blue instillation, and bursting pressure studies for assessment of the closure site.All animals studied showed complete sealing of the gastrotomy site without evidence of leak on fluoroscopic imaging or at final postmortem intragastric methylene blue instillation. Improved insufflation ability following gastrotomy was also noted using this technique, which enhanced overall visualization during the closure.Positioning tissue anchors prior to creating a NOTES gastrotomy was a feasible and reliable method to perform gastric closure. Follow-up survival studies will be warranted to support these preliminary findings.
Variants of bcl-2 specific siRNA for silencing antiapoptotic bcl-2 in pancreatic cancer
Authors: M Ocker
Journal: Gut (2005)

<b>Background and aims:</b> Pancreatic cancer remains a devastating diagnosis with only limited therapeutic options. Specific inhibition of expression of target genes has become possible using small interfering (si) RNAs. We therefore investigated how far siRNA specific for bcl-2 may serve as a therapeutic option for pancreatic cancer in vitro and in vivo. <b>Methods:</b> siRNAs targeting two different regions in the bcl-2 gene were transfected to YAP C and DAN G pancreatic carcinoma cells and human foreskin fibroblasts. Permutations were generated by changing 3′ and 5′ overhangs and varying the length of the paired RNA duplex. Transfection efficacy was determined using FITC labelled siRNAs and fluorescence microscopy. Cell survival and apoptosis were quantified at 24–120 hours. Pancreatic cancer xenografts in male nude mice were treated intraperitoneally with siRNAs daily for 24 days. siRNA pharmacokinetics in vivo were assessed using radioactively labelled siRNAs. Total protein and RNA were extracted for western Blot analysis and quantitative polymerase chain reaction. <b>Results and conclusions:</b> bcl-2 specific siRNAs specifically inhibited expression of the target gene in vitro and in vivo. Antiproliferative and proapoptotic effects were observed in tumour cells but not in fibroblasts or non-malignant tissues. siRNA permutations and diverse overhangs influenced gene silencing efficacy. siRNA was quickly distributed to all organs and excreted via the kidney and liver. bcl-2 specific siRNA is a promising adjunctive treatment for pancreatic carcinoma.
Exercise testing in asymptomatic or minimally symptomatic aortic regurgitation: relationship of left ventricular ejection fraction to left ventricular filling pressure during exercise.
Authors: C A Boucher, R A Wilson, D J Kanarek, A M Hutter, R D Okada, R R Liberthson, H W Strauss, G M Pohost
Journal: Circulation (1983)

Exercise radionuclide angiography is being used to evaluate left ventricular function in patients with aortic regurgitation. Ejection fraction is the most common variable analyzed. To better understand the rest and exercise ejection fraction in this setting, 20 patients with asymptomatic or minimally symptomatic severe aortic regurgitation were studied. All underwent simultaneous supine exercise radionuclide angiography and pulmonary gas exchange measurement and underwent rest and exercise measurement of pulmonary artery wedge pressure (PAWP) during cardiac catheterization. Eight patients had a peak exercise PAWP less than 15 mm Hg (group 1) and 12 had a peak exercise PAWP greater than or equal to 15 mm Hg (group 2). Group 1 patients were younger and more were in New York Heart Association class I. Group 1 patients also had a higher mean rest ejection fraction (0.64 +/- 0.08 vs 0.49 +/- 0.13, p less than 0.01, higher exercise ejection fraction (0.63 +/- 0.10 vs 0.40 +/- 0.18, p less than 0.01), lower end-systolic volume (38 +/- 13 vs 79 +/- 36 ml/m2, p less than 0.01) and higher peak oxygen uptake (24.9 +/- 5.1 vs 16.6 +/- 4.9 ml/kg/min, p less than 0.01) than group 2 patients. However, the two groups had similar cardiothoracic ratios, changes in ejection fractions with exercise, and rest and exercise regurgitant indexes. Using multiple regression analysis, the best correlate of the exercise PAWP was peak oxygen uptake (r = -0.78, p less than 0.01). No other measurement added significantly to the regression. When peak oxygen uptake was excluded, rest and exercise ejection fraction also correlated significantly (r = -0.62 and r = -0.60, respectively, p less than 0.01). Patients with asymptomatic or minimally symptomatic severe aortic regurgitation have a wide spectrum of cardiac performance in terms of the PAWP during exercise. The absolute rest and exercise ejection fraction and the level of exercise achieved are noninvasive variables that correlate with exercise PAWP in aortic regurgitation, but the change in ejection fraction with exercise by itself is not.
Depletion of Carcinoma-Associated Fibroblasts and Fibrosis Induces Immunosuppression and Accelerates Pancreas Cancer with Reduced Survival
Authors: Berna C. Özdemir, Tsvetelina Pentcheva-Hoang, Julienne L. Carstens, Xiaofeng Zheng, Chia-Chin Wu, Tyler R. Simpson, Hanane Laklai, Hikaru Sugimoto, Christoph Kahlert, Sergey V. Novitskiy, Ana De Jesus-Acosta, Padmanee Sharma, Pedram Heidari, Umar Mahmood, Lynda Chin, Harold L. Moses, Valerie M. Weaver, Anirban Maitra, James P. Allison, Valerie S. LeBleu, Raghu Kalluri
Journal: Cancer Cell (2014)
Bone marrow of patients with active multiple myeloma: Angiogenesis and plasma cell adhesion molecules LFA-1, VLA-4, LAM-1, and CD44
Authors: Angelo Vacca, Michela Di Loreto, Domenico Ribatti, Rita Di Stefano, Gennaro Gadaleta‐Caldarola, Giuseppe Iodice, Daniela Caloro, Franco Dammacco
Journal: American Journal of Hematology (1995)

Abstract Bone marrow plasma cells and stromal cells in multiple myeloma (MM) have been shown to be capable of releasing cytokines with angiogenic properties. Plasma cells can also express adhesion molecules controlling their adhesive interactions with endothelial cells. In the present study, we have evaluated by immunohistochemistry the extent of angiogenesis in the bone marrow of: a) 51 patients with active and non‐active MM; b) 25 patients with monoclonal gammopathy of undetermined significance (MGUS). Plasma cells were investigated by flow cytometry for the expression of the adhesion molecules LFA‐1, VLA‐4, LAM‐1, and CD44. The results showed that, while angiogenesis was very low or absent in patients with MGUS and non‐active MM, it increased markedly in those with active MM. The highest detectability of plasma cell adhesion molecules, except LAM‐1, was also found in these patients. The functional significance of these findings is unknown. Their consistent occurrence in the bone marrow of active myeloma patients, however, strongly suggests that more frequent adhesive interactions between plasma cells and their microvasculature underlie tumor dissemination.
THE TREATMENT OF ACUTE TRAUMATIC CRANIOCEREBRAL INJURIES
Authors: A. S. MACLAIRE
Journal: JAMA (1926)

In presenting such a subject as the treatment of acute traumatic craniocerebral injuries, just as great a difficulty lies in the selection of a descriptive term to include the entire field as in the universal acceptance of a uniform, proper treatment in this condition. The term fractured skull no longer conveys the true significance of the injury in that no provision has been made for the possible associated trauma of the intracranial contents. To employ the term acute brain injuries also bears the same objectionable defect in clarifying the picture by omitting the state of the calvarium. Thus, it appears to me that the term craniocerebral not only is descriptive but also covers every contingency possible in head injuries. In attempting to discuss a rational procedure for the proper treatment of acute brain and skull injuries, one is immediately confronted with the existence of many diversified methods of treatment in
N‐terminal proBNP and mortality in hospitalised patients with heart failure and preserved vs. reduced systolic function: data from the prospective Copenhagen Hospital Heart Failure Study (CHHF)
Authors: V. Kirk, M. Bay, J. Parner, K. Krogsgaard, T.M. Herzog, S. Boesgaard, C. Hassager, O.W. Nielsen, J. Aldershvile, H. Nielsen
Journal: European Journal of Heart Failure (2004)
Transthoracic ventricular defibrillation in adults.
Authors: N P Campbell, S W Webb, A A Adgey, J F Pantridge
Journal: BMJ (1977)

A prospective study of the energy required for transthoracic ventricular defibrillation in adults showed that in 42 (81%) out of 52 episodes of ventricular fibrillation shocks of 100 watt-seconds (Ws) of stored energy were successful. Out of 233 episodes, 222 (95%) were converted by 200 W s shocks. Among patients in whom primary ventricular fibrillation occurred within one hour of the onset of acute myocardial infarction, 200 W s shocks were successful in 40 (98%) out of 41 episodes. When low-energy shocks failed, a stored energy of 400 W s invariably succeeded. The need for large and expensive defibrillators that store more than 400 W s and are less readily available is therefore questioned.
Pseudoaneurysm of the Left Ventricle: an Unusual Echocardiographic Presentation
Authors: KENNETH H. DAVIDSON
Journal: Annals of Internal Medicine (1977)

Echocardiography showed a large anterior chamber communicating with the left ventricular cavity through the interventricular septum in a patient with a previous left ventricular aneurysmectomy. At postmortem examination this chamber proved to be an 11-cm diameter pseudoaneurysm that opened into the left ventricle through a 3-cm orifice. A review of the literature showed 67 cases of histologically proven left ventricular pseudoaneurysm, most of which occurred after myocardial infarction and cardiac surgery. Twenty-six of 32 left ventricular pseudoaneurysms were successfully operated upon. Among 35 patients with pseudoaneurysms not operated upon, rupture was a cause of death in 11.
RISKS OF HIV INFECTION IN THE HEALTH CARE SETTING
Authors: Victoria J. Fraser, M.D, William G. Powderly, M.D., F.R.C.P.I
Journal: Annual Review of Medicine (1995)

▪ Abstract Health care workers exposed to blood and body fluids have a low but measurable risk of occupational infection with human immunodeficiency virus (HIV). This risk is related to the prevalence of HIV among patients, the frequency of exposure to infected blood, and the method of exposure. The magnitude of risk is thus difficult to assess for any given situation, although the overall risk following percutaneous exposure is approximately 0.3%. Risk can be reduced by paying close attention to infection control procedures and by minimizing risky procedures. Exposure management should include preexposure education and immediate postexposure care and counseling. Chemoprophylaxis is widely used despite doubts as to its effectiveness, and much research is clearly needed to develop more effective prophylaxis. For patients, the risk of nosocomial acquisition of HIV remains extremely low and can be minimized by strict adherence to proper infection control procedures.
X-ray Experience During Pregnancy
Authors: Morton L. Brown
Journal: JAMA (1967)

On the basis of a recent national survey, the estimated medical x-ray visit rate during pregnancy was 26 per 100 women. The x-ray experience of pregnant women is significantly less than that of all women between the ages of 15 and 44 in the general population. Of the medical x-ray examinations during pregnancy, approximately 21% occurred during the first trimester, 25% during the second trimester, and 54% during the third trimester. Practically all abdominal examinations related to pregnancy were done during the third trimester, whereas chest and other medical x-ray examinations were more evenly distributed over the three trimesters. Medical x-ray examination rates were highest for primiparous women and for those having high order births.
Cytokine levels and inflammatory responses in developing late-phase allergic reactions in the skin
Authors: Burton Zweiman, Allen P. Kaplan, Lijuan Tong, Anne R. Moskovitz
Journal: Journal of Allergy and Clinical Immunology (1997)

Background: Cytokines could play roles in the attraction of leukocytes into sites of IgE-mediated late-phase reactions (LPR) or in the activation of such cells at the sites. Previous studies found increased release of IL-6, IL-1, and granulocyte-macrophage colony–stimulating factor into skin chambers overlying allergen-challenged sites, mainly after 6 hours when LPR are already well-developed. Objective: To compare levels of several cytokines with inflammatory responses in skin chambers overlying developing LPRs. Methods: Skin chambers were appended to denuded blister bases in 15 sensitive subjects, then challenged over a 5-hour period with pollen allergens (Ag) or buffer control (B). Levels of several chemotactic cytokines, eosinophil cationic product (released from eosinophils), and lactoferrin (released from neutrophils) were measured and leukocyte accumulation was assessed. Results: Levels of the chemokines IL-8, RANTES, and monocyte chemotactic protein-1 (but not IL-1, IL-6, or granulocyte-macrophage colony–stimulating factor) were significantly higher at Ag-challenge sites than at B-challenge sites. IL-5 was not detected. In individual chamber fluids at Ag-challenge sites, (1) IL-8 levels correlated strongly with levels of lactoferrin but not with eosinophil cationic protein levels; (2) RANTES levels correlated with numbers of eosinophils but not with eosinophil cationic protein levels; and (3) levels of monocyte chemotactic protein-1 correlated weakly with histamine released after the first hour. Conclusions: During LPRs developing during the first 5 hours of Ag challenge, there is increased local release of several chemokines, which could play roles in the observed attraction and subsequent activation of leukocytes and continued histamine release observed at such sites. (J Allergy Clin Immunol 1997;100:104-9.)
Predictors of Smoking Cessation after Coronary Artery Bypass Graft Surgery: Results of a Randomized Trial with 5-Year Follow-up
Authors: Nancy A. Rigotti
Journal: Annals of Internal Medicine (1994)

Objective: To test the efficacy of a smoking cessation program for inpatients recovering from coronary artery bypass graft surgery and to identify predictors of cessation. Design: Randomized, controlled clinical trial. Setting: Postoperative cardiac surgery unit of a large teaching hospital. Patients: Patients scheduled for coronary artery bypass surgery by participating surgeons between 1 July 1986 and 1 July 1987 who had smoked 1 or more packs of cigarettes in the 6 months before admission. Of 120 eligible patients, 93 enrolled and 87 were discharged alive. All survivors were followed for at least 1 year; 94% were followed for a median of 5.5 years. Intervention: A three-session, nurse-delivered behavior modification program using a videotape and face-to-face counseling was compared to usual care. Measurements: Smoking status was assessed six times in the year after surgery and 5.5 years after surgery. Self-reported nonsmoking was validated by saliva cotinine assay 1 and 5.5 years after surgery. Results: No statistically significant differences were found between control (n = 43) and intervention (n = 44) groups at baseline. One and 5.5 years after hospital discharge, validated continuous nonsmoking rates were identical in intervention and control groups (51% at 1 year; 44% at 5.5 years). Multiple logistic regression identified four factors that were independently associated with nonsmoking for 1 year: fewer than 3 previous attempts to quit (odds ratio, 7.4; 95% CI, 1.9 to 29.1); more than 1 week of preoperative nonsmoking (odds ratio, 10.0; CI, 2.0 to 50.2); definite intention to quit smoking (odds ratio, 12.0; CI, 2.6 to 55.1); and no difficulty not smoking in the hospital (odds ratio, 9.6; CI, 1.8 to 52.2). Nonsmoking for 5.5 years was independently associated with two of these factors: fewer than three previous attempts to quit and intention to quit smoking after surgery. Cessation was not related to demographic factors, daily cigarette consumption, disease severity, hospital course, social support, or beliefs and attitudes. Conclusions: Even without specific intervention, nearly one half of smokers quit for 5 years after coronary artery bypass surgery. A short inpatient education program did not increase this rate. Future efforts should target the time after discharge and focus on increasing motivation in patients who have repeatedly failed to quit.
Extensive Troponin I and T Modification Detected in Serum From Patients With Acute Myocardial Infarction
Authors: Ralf Labugger, Lenny Organ, Christine Collier, Dan Atar, Jennifer E. Van Eyk
Journal: Circulation (2000)

Cardiac troponin I and T (cTnI and cTnT) are specific biochemical serum markers for acute myocardial infarction (AMI). However, cTnI diagnostic assays are plagued by difficulties, resulting in >/=20-fold differences in measured values. These discrepancies may result from the release of the numerous cTnI modification products that are present in ischemic myocardium. The resolution of these discrepancies requires an investigation of the exact forms of cTnI present in the bloodstream of patients after myocardial injury.A western blot-direct serum analysis protocol was developed that allowed us to detect intact cTnI and a spectrum of up to 11 modified products in the serum from patients with AMI. For the first time, we document both a cTnI degradation pattern and the existence of phosphorylated cTnI in serum. The number and extent of these modifications reflect patterns similar to the time profiles of the routine clinical serum markers of total creatine kinase, creatine kinase-MB, and cTnI (determined by ELISA). Data from in vitro experiments, which were undertaken to study the degradation of human recombinant cTnI and cTnT when spiked in serum, indicate that some modification products present in patient serum existed in the myocardium and that recombinant cTnI alteration dramatically reduces the detectability of cTnI by the Immuno1 assay over time (our assay was unaffected).This pilot study defines, for the first time, what forms of cTnI and cTnT appear in the bloodstream of AMI patients, and it clarifies the lack of standardization between different cTnI diagnostic assays.