tbuckley/cabot-search huggingface dataset:
Preoperative Partitioning of Pulmonary Vascular Resistance Correlates With Early Outcome After Thromboendarterectomy for Chronic Thromboembolic Pulmonary Hypertension
Authors: Nick H.S. Kim, Pierre Fesler, Richard N. Channick, Kirk U. Knowlton, Ori Ben-Yehuda, Stephen H. Lee, Robert Naeije, Lewis J. Rubin
Journal: Circulation (2003)

Pulmonary thromboendarterectomy (PTE) is the preferred treatment for chronic thromboembolic pulmonary hypertension (CTEPH), but persistent pulmonary hypertension after PTE, as a result of either inaccessible distal thrombotic material or coexistent intrinsic small-vessel disease, remains a major determinant of poor outcome. Conventional preoperative evaluation is unreliable in identifying patients at risk for persistent pulmonary hypertension or predicting postoperative hemodynamic outcome. We postulated that pulmonary arterial occlusion pressure waveform analysis, a technique that has been used for partitioning pulmonary vascular resistance, might identify CTEPH patients with significant distal, small-vessel disease.Twenty-six patients underwent preoperative right heart catheterization before PTE. Pulmonary artery occlusion waveform recordings were performed in triplicate. Postoperative hemodynamics after PTE were compared with preoperative partitioning of pulmonary vascular resistance derived from the occlusion data. Preoperative assessment of upstream resistance (Rup) correlated with both postoperative total pulmonary resistance index (R2=0.79, P<0.001) and postoperative mean pulmonary artery pressure (R2=0.75, P<0.001). All 4 postoperative deaths occurred in patients with a preoperative Rup <60%.Pulmonary arterial occlusion pressure waveform analysis may identify CTEPH patients at risk for persistent pulmonary hypertension and poor outcome after PTE. Patients with CTEPH and Rup value <60% appear to be at highest risk.
Allergy and Immunity
Authors: D. Harley
Journal: BMJ (1938)

Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case–control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM<sub>2.5</sub>) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM<sub>2.5</sub> exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM<sub>2.5</sub>, significant association between GDM and nitrogen dioxide (NO<sub>2</sub>) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NO<sub>x</sub>) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO<sub>2</sub>) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO<sub>2</sub>, NO<sub>x</sub>, and SO<sub>2</sub>, and the second trimester exposure of PM<sub>2.5</sub> with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
High prevalence of hyperuricaemia and gout in an urbanised Micronesian population.
Authors: P Z Zimmet, S Whitehouse, L Jackson, K Thoma
Journal: BMJ (1978)

The prevalence of hyperuricaemia and gout was investigated in the Micronesian inhabitants of the highly urbanised central Pacific island of Nauru. Sixty-four per cent of men and 60% of women aged 20 years and over had hyperuricaemia--the highest prevalence rates yet reported for a population. The hyperuricaemia in men was accompanied by a high prevalence of clinical gout (6.9%). While the hyperuricaemia is probably genetic, the high prevalence of gout may be related to the environmental change from the traditional island style of living to one of almost complete Westernisation.
Urinary incontinence in women.
Authors: E P Arnold, A D Brown, J R Webster, P H Worth, A M Jequier, C P Bates, C G Whiteside, R T Warwick
Journal: BMJ (1972)

dialysis and non-dialysis group were com- parable for age and sex and whether the apparent differences in small numbers of patients was statistically significant.We studied the immediate effect of dialysis and found no significant difference in the peak acid output measured in the same 14 patients before and after dialysis,2 but on reviewing our data we find that the basal acid output was significantly reduced after dialysis (P<O.05).The peak acid output measures the parietal cell mass and perhaps its sensitivity to pentagastrin, but the changes in basal acid output, though less reproduceable, may reflect the changes in urea and electrolytes produced by dialysis.-Iam, etc.,
The kinetics of immunoglobulin synthesis by pokeweed mitogen stimulated peripheral blood lymphocytes in multiple myeloma
Authors: Edward R. George, Harvey J. Cohen
Journal: American Journal of Hematology (1979)

Abstract As a means of investigating the immunoglobulin (Ig) deficiency in multiple myeloma, the effects of pokeweed mitogen (PWM) on morphologic transformation and concomitant immunoglobulin synthesis and secretion kinetics were studied in peripheral blood lymphocytes (PBL) of normals and patients with myeloma. Lymphocyte Ig production kinetics, both in the unstimulated state and after five days of culture with PWM, were evaluated by 3 H‐leucine incorporation. B‐lymphocytes were found to be decreased by EC3 rosetting in the myeloma patients studied. In addition their lymphocytes had a mean of 30% transformation compared to 53% for normals (P &lt; 0.005). After five days of mitogen stimulation in culture, myeloma PBL failed to show the rise in intracellular Ig production seen in normal PBL under similar conditions. Thus, myeloma patients were found to have decreased numbers of EC3 rosetting B‐cells, decreased morphologic transformation rate in response to mitogenic stimulation, and failure to increase intracellular Ig after mitogenic stimulation. Possible etiologic mechanisms for the decreased Ig production are discussed.
Studies of the Mitral Valve
Authors: IAN E. RUSTED, CHARLES H. SCHEIFLEY, JESSE E. EDWARDS
Journal: Circulation (1956)

Knowledge of the structural changes in the commissures, cusps, and chordae tendineae is important to the understanding of the pathologic physiology of mitral stenosis and its surgical correction. Study of 70 hearts with mitral stenosis disclosed that a frequent cause of the obstruction was commissural fusion or shortening of the chordae tendineae or both. In a small percentage of hearts, mitral stenosis appeared to result principally from rigidity of the valvular leaflets. Measurements of the various components of the mitral valve in normal hearts have been given in a previous paper. In this communication, comparable measurements for these structures in 50 hearts with mitral stenosis are presented.
Mitral Leaflet Adaptation to Ventricular Remodeling
Authors: Miguel Chaput, Mark D. Handschumacher, J. Luis Guerrero, Godtfred Holmvang, Jacob P. Dal-Bianco, Suzanne Sullivan, Gus J. Vlahakes, Judy Hung, Robert A. Levine
Journal: Circulation (2009)

Ischemic mitral regurgitation is caused by systolic traction on the mitral leaflets related to ventricular distortion. Little is known about how chronic tethering affects leaflet area, in part because it cannot be measured repeatedly in situ. Recently, a new method for 3D echocardiographic measurement of mitral leaflet area was developed and validated in vivo against sheep valves, later excised. Clinical studies (n=80) showed that mitral leaflet area increased by >30% in patients with inferior myocardial infarction and dilated cardiomyopathy versus normal; greater adaptation independently predicted less mitral regurgitation. This study explored whether mitral valve area changes over time within the same heart with ischemic mitral regurgitation.Twelve sheep were studied at baseline and 3 months after inferior myocardial infarction by 3D echocardiography; 6 were untreated and 6 were treated initially with an epicardial patch to limit left ventricular dilation and mitral regurgitation. Untreated sheep developed left ventricular dilation at 3 months, with global dysfunction (mean+/-SD ejection fraction, 24+/-10% versus 44+/-10% with patching, P=0.02) and moderate mitral regurgitation (vena contracta, 5.0+/-1.0 versus 0.8+/-1.0 mm, P<0.0002). In untreated sheep, total diastolic leaflet area increased from 13.1+/-1.3 to 18.1+/-2.5 cm(2) (P=0.0001). In patched sheep, leaflet area at 3 months was not significantly different from baseline sheep values (13.0+/-1.1 versus baseline, 12.1+/-1.8 cm(2), P=0.31).Mitral valve area, independent of systolic stretch, increases over time as the left ventricular remodels after inferior myocardial infarction. This increase, however, fails to compensate adequately for tethering to prevent mitral regurgitation. Understanding the mechanism of valve adaptation can potentially suggest new biological and surgical therapeutic targets.
Clinical Use of the Anticoagulant Phenylindanedione
Authors: FREDERICK W. PRESTON, WM. R. O'CONNOR, CHARLES E. THOMPSON, ELDIS N. CHRISTENSEN
Journal: Circulation (1952)

Phenylindanedione is an anticoagulant similar in action to the coumarin series of compounds. Like dicumarol, it is effective orally, acts by lowering blood prothrombin content, and its administration is controlled by daily blood prothrombin determinations. A study of the effective dosage, rapidity of action, cumulative effect and hemorrhagic complications produced by this drug shows that it is a practical anticoagulant for clinical use and has certain advantages over dicumarol.
Points: Shingles: a belt of roses from Hell
Authors: R Mulroy
Journal: BMJ (1979)

This would perhaps bring home to the DHSS the extent to which the consultants are financ- ing the Health Service by running their own cars.I personally as a consultant manage to run one mini.My wife wonders why I spend all this money running a car for the sake of the NHS when she never has the use of it.I feel that the time has come now for my wife to have the use of our car and to insist that the hospital provides transport when it is needed.
Normal Erythrocyte Uroporphyrinogen I Synthase in a Kindred with Acute Intermittent Porphyria
Authors: PERTTl MUSTAJOKI
Journal: Annals of Internal Medicine (1981)

The diagnosis of acute intermittent porphyria was made in 10 members of a large kindred because of increased excretion of porphobilinogen and δ-aminolevulinic acid in the urine but normal fecal porphyrins. Erythrocyte uroporphyrinogen I synthase activity was normal in all nine subjects in whom it was measured. No hematologic or other cause was found that could secondarily have raised low activity to normal, suggesting that the Porphyric subjects may have had no enzyme abnormality in their erythrocytes. On the other hand, in 49 other Finnish patients with acute intermittent porphyria who were unrelated to the kindred, erythrocyte uroporphyrinogen I synthase activity was low. In acute intermittent porphyria there may be two variants, in one of which the enzyme defect is not expressed in the erythrocytes.
The Increasing Insurance Problem
Authors: W. R. Hudson
Journal: JAMA (1973)

To the Editor.—  In response to the letter from Dr. George R. Ruiz inThe Journal(223:1391, 1973), I, too, decry the role played by insurance companies in establishing fees. Unfortunately, I see no simple solution. Insurance underwriting is a complex business, and medicine is a complex profession. As Chairman of the Blue Shield Committee of the North Carolina Medical Society, I have frequent opportunities to look at both sides of the coin. Insurance companies feel, not without reason, that procedural related fees are necessary for accurate underwriting purposes. In truth, physicians themselves demonstrate considerable variance among their fees for a given procedure. As pointed out by Dr. Ruiz, there may be legitimate reasons for this. However, if one sits on an adjudication committee one notes that every uterus is the biggest, every gallbladder the most demanding, and every appendix is retrocecal. Fees based on operating time invariably penalize the
Osteocalcin regulates murine and human fertility through a pancreas-bone-testis axis
Authors: Franck Oury, Mathieu Ferron, Wang Huizhen, Cyrille Confavreux, Lin Xu, Julie Lacombe, Prashanth Srinivas, Alexandre Chamouni, Francesca Lugani, Herve Lejeune, T. Rajendra Kumar, Ingrid Plotton, Gerard Karsenty
Journal: Journal of Clinical Investigation (2013)

The osteoblast-derived hormone osteocalcin promotes testosterone biosynthesis in the mouse testis by binding to GPRC6A in Leydig cells. Interestingly, Osteocalcin-deficient mice exhibit increased levels of luteinizing hormone (LH), a pituitary hormone that regulates sex steroid synthesis in the testes. These observations raise the question of whether LH regulates osteocalcin's reproductive effects. Additionally, there is growing evidence that osteocalcin levels are a reliable marker of insulin secretion and sensitivity and circulating levels of testosterone in humans, but the endocrine function of osteocalcin is unclear. Using mouse models, we found that osteocalcin and LH act in 2 parallel pathways and that osteocalcin-stimulated testosterone synthesis is positively regulated by bone resorption and insulin signaling in osteoblasts. To determine the importance of osteocalcin in humans, we analyzed a cohort of patients with primary testicular failure and identified 2 individuals harboring the same heterozygous missense variant in one of the transmembrane domains of GPRC6A, which prevented the receptor from localizing to the cell membrane. This study uncovers the existence of a second endocrine axis that is necessary for optimal male fertility in the mouse and suggests that osteocalcin modulates reproductive function in humans.
Hepatitis B virus pre-S gene-encoded antigenic specificity and anti-pre-S antibody: Relationship between anti-pre-S response and recovery
Authors: Agata Budkowska, Pascal Dubreuil, Francis Capel, Jacques Pillot
Journal: Hepatology (1986)

A solid-phase radioimmunoassay involving specific antibody was developed for determination of the pre-S gene-encoded epitopes of hepatitis B virus and anti-pre-S antibody in sera of hepatitis B patients. The reaction for pre-S determinants associated with HBsAg was quantitatively inhibited by soluble, polymerized human serum albumin, and the lower limit of the assay was about 1.6 ng of HBsAg per ml. Continuous expression of pre-S-coded antigenic sites on HBsAg particles in chronic hepatitis B patients seropositive for HBeAg or anti-HBe shows that these determinants may be considered as a marker of chronicity during hepatitis B virus infection. The anti-pre-S antibody was determined by inhibition of the reaction for pre-S determinants. This antibody, different from anti-HBs, was detected during HBsAg antigenemia in patients recovering from acute type B hepatitis, before anti-HBs response. Kinetics of synthesis of anti-pre-S antibody in the course of acute type B hepatitis, followed by elimination of HBsAg and recovery, suggest the possible role of this antibody in the immunological clearance of infective hepatitis B virus particles.
Misinterpretation of Signs of Retinal Detachment
Authors: Simmons Lessell
Journal: New England Journal of Medicine (1967)

THE purpose of this report is to alert physicians to the danger of confusing the symptoms and signs of retinal detachment with those of brain or optic-nerve disease. Such misinterpretation results in a delay in therapy and may cause the patient to be subjected to unnecessary, expensive and dangerous diagnostic procedures.Although small retinal detachments may be asymptomatic, most patients complain of a blur in the field of vision. Clusters of "floaters" or flashes of light frequently herald the onset of the disorder. Pain is rarely noted. Externally, the eye looks unremarkable. The visual acuity remains normal unless the macula . . .
Prognostic Factors in Upper Urinary Tract Urothelial Carcinomas: A Comprehensive Review of the Current Literature
Authors: Giovanni Lughezzani, Maximilian Burger, Vitaly Margulis, Surena F. Matin, Giacomo Novara, Morgan Roupret, Shahrokh F. Shariat, Christopher G. Wood, Richard Zigeuner
Journal: European Urology (2012)
Simplified method for measuring compliance of superficial veins
Authors: C. Nachev, J. Collier, B. Robinson
Journal: Cardiovascular Research (1971)

A new method for assessing the compliance of superficial veins has been developed which depends on the estimation of the diameter of the vein at a standard congesting pressure by an optical technique. The method is reproducible and compares satisfactorily with a standard plethysmography technique; it is suitable for making repeated measurements of peripheral venous compliance in both normal subjects and seriously ill patients, and can also be employed in pharmacological studies.
RESEARCHERS AND CLINICIANS
Authors: John R. Herman
Journal: JAMA (1965)

Wanted: To head clinical department at large medical school. Man in his thirties who has made significant research contributions in his field and has had wide clinical and surgical experiences. To teach, run an active in-patient department, and to publish papers several times a year." Obviously exaggerated, but this search, varied only slightly from place to place, is being carried out all over the United States and in many other countries. Leaving aside the factors of age and the time needed for clinical experience, in these days of tremendous advances in scientific methodology, it is almost impossible for the clinician to be a laboratory man as well. Generally the lab man wants to be a full-time research man and has neither the time nor desire to do clinical work. Medical schools and university hospitals attached to the schools are of tremendous importance to the future of medicine. The prime goals
Ampicillin in the Treatment of Granuloma Inguinale
Authors: Maurice A. Thew
Journal: JAMA (1969)

Four cases of granuloma inguinale occurred in which ampicillin was administered orally. All lesions healed, including those seen in one patient in whom the recurrence of lesions had occurred following prolonged tetracycline hydrochloride therapy. This is the first known report of ampicillin being used in the treatment of granuloma inguinale.
Optimal resources for the examination and endovascular treatment of the peripheral and visceral vascular systems. AHA Intercouncil report on peripheral and visceral angiographic and interventional laboratories.
Authors: J F Cardella, W J Casarella, J A DeWeese, G M Dorros, J E Gray, B T Katzen, J H Laragh, D C Levin, V M Marx, E L Nickoloff
Journal: Circulation (1994)
Death receptor chews up bone
Authors: Amy Maxmen
Journal: The Journal of Experimental Medicine (2008)

Autoimmunity fought in the cortexIn the best-case scenario, self-attacking T cells are ousted before they have a chance to leave the thymus.That essential process, which eliminates autoreactive thymocytes from the get-go, is known to occur in the thymic medulla.Now, on page 2575, McCaughtry et al. provide solid evidence that this elimination also occurs in the thymic cortex.Although immunologists have reported T cell deletion in the cortex before, their results were made ambiguous by the transgenic mice models they used.These mice expressed T cell receptors specific for a self-peptide earlier in development than they are normally expressed.One fear was that those T cells were being deleted before they had a chance to migrate into the medulla.To quell that concern, McCaughtry's team generated a transgenic mouse in which the receptors are turned on at the appropriate time.Turns out, the earlier models were correct.T cells reacting to ubiquitous self-antigens were deleted in the cortex alone, before entering the medulla.Furthermore, the medulla-based transcription factor AIRE, which mediates T cell deletion, did not seem to be required in the cortical deletions.Local dendritic cells, however, were needed.Without them, a large fraction of autoreactive T cell clones survived.The locale of T cell deletion may depend on the antigen involved.Tissue-specific self-antigens are produced only in the medulla, whereas ubiquitous self-antigens, such as house-keeping peptides and the antigen recognized in the authors' mouse model, are widespread and can be handled in the cortex, at the site of first encounter.Now that the question of location has been settled, future studies can focus on learning how cortical dendritic cells control T cells gone awry.
Myosin isoenzymes of vascular smooth and cardiac muscle in the spontaneously hypertensive and normotensive male and female rat: a comparative study.
Authors: I Morano, M Gagelmann, A Arner, U Ganten, J C Rüegg
Journal: Circulation Research (1986)

Cardiac hypertrophy in hypertensive subjects, its biochemical markers, and functional consequences are of great clinical importance but still unclear. We observed a shift of the ventricular isomyosin of adult spontaneously hypertensive (H) rats of both sexes to the V3 form and a decreased myofibrillar ATPase activity in the H animals when compared to normotensive (N) controls. Compared to the male H rats, age-matched female H animals revealed a lower blood pressure, the same or even an elevated magnitude of cardiac hypertrophy, a different ventricular isomyosin pattern, and a higher myofibrillar ATPase activity. In female H rats the V1 and V3 isomyosins were equally distributed (35% V1 and 35% V3), but in male H animals the V3 was predominant (24% V1 and 45% V3). The Ca2+-regulated Mg2+-dependent myofibrillar ATPase of the rat ventricle correlated positively with the amount of V1 when measured at pCa 5 (maximum activation). At submaximum Ca2+-concentrations (pCa 6.9-5.9) the myofibrillar ATPase activities were not changed with the proportion of V1. The cooperativity of the Ca2+-activation of the myofibrillar ATPase increased with increasing amount of V1 (Hill-coefficient 3.7 with 100% V1) and decreased with increased proportion of V3 (Hill-coefficient 1.3 at 45% V3). Two myosin isoenzymes were detected in the aorta of rats, a slow migrating (S2) and a fast migrating (S1) form having both a higher mobility than the ventricular isomyosins. Only one band was observed in the portal vein, which revealed the same mobility as S2. Hypertension did not change the appearance of these vascular smooth muscle isomyosins neither in male nor in female animals.
The metabolic syndrome
Authors: J. B Meigs
Journal: BMJ (2003)

May be a guidepost or detour to preventing type 2 diabetes and cardiovascular disease 

Type 2 diabetes mellitus is becoming extremely common; its prevalence worldwide is expected to reach 5-7.6% by 2025.1 Atherosclerotic cardiovascular disease is the principal cause of death, disability, and excess healthcare costs in diabetes. Cardiovascular disease may already be present at the time when diabetes is diagnosed,w1 and patients with diabetes are more likely than their non-diabetic counterparts to die from a first event of cardiovascular disease.w2 These realities point to prevention of type 2 diabetes as the route to prevention of its costliest complications. The close association of type 2 diabetes with cardiovascular disease led to the hypothesis that the two arise from a common antecedent;w3 this concept has been codified by the World Health Organization and others as “the metabolic syndrome.”2

The diagnosis of the metabolic syndrome in patients might hold promise for enhanced prevention of diabetes and cardiovascular disease. However, substantial uncertainties remain about the clinical definition of the syndrome and whether risk factor clusters collectively indicate a discrete, unifying disorder. Most importantly, it is unclear whether diagnosing …