tbuckley/cabot-search huggingface dataset:
Continuous positive airway pressure breathing in the postoperative management of the cardiac infant
Authors: A. D. Crew, P. I. Varkonyi, L. G. Gardner, Q. L. A. Robinson, E. Wall, P. B. Deverall
Journal: Thorax (1974)

<b>Crew, A. D., Varkonyi, P. I., Gardner, L. G., Robinson, Q. L. A., Wall, E., and Deverall, P. B. (1974).</b><i>Thorax</i>, <b>29</b>, 437-445. <b>Continuous positive airway pressure breathing in the postoperative management of the cardiac infant.</b> Continuous positive airway pressure with spontaneous ventilation was used in the postoperative period following palliative or corrective surgery for congenital heart defects in a group of children of less than 3 years of age. After stabilization of the cardiovascular state, continuous positive airway pressure breathing (CPAP) was shown to be a suitable alternative to continuous positive pressure ventilation (CPPV). A statistically significant increase in PaO<sub>2</sub> was observed on changing from CPPV to CPAP. A statistically significant decrease in PaO<sub>2</sub> and increase in pulmonary venous admixture was observed after discontinuing the positive airway pressure and allowing the patient to breathe at ambient pressure. We would recommend CPAP as an intermediate manoeuvre in the withdrawal of ventilatory support as it introduces a smoothness and stability into patient management régimes which was previously lacking. Careful selection of apparatus is necessary as the airway pressure should be truly continuous and steady. In neonates the dead space of the system should be reduced to a minimum; CPAP alternating with periods on CPPV may be necessary for some time after cardiovascular stability has been attained.
Sample size for beginners.
Authors: C D Florey
Journal: BMJ (1993)

The common failure to include an estimation of sample size in grant proposals imposes a major handicap on applicants, particularly for those proposing work in any aspect of research in the health services. Members of research committees need evidence that a study is of adequate size for there to be a reasonable chance of a clear answer at the end. A simple illustrated explanation of the concepts in determining sample size should encourage the faint hearted to pay more attention to this increasingly important aspect of grantsmanship.
Contribution of systemic venous hypertension to the development of pulmonary edema in dogs.
Authors: W C Miller, W W Simi, D L Rice
Journal: Circulation Research (1978)

Systemic venous hypertension (SVH) is a frequent finding in pulmonary edema. To study the possible contributory or even causal role of SVH in pulmonary edema, a dog model was developed in which balloon catheters were placed in the left and right atria. Inflation of the left atrial balloon produced a tendency to pulmonary edema by causing pulmonary venous hypertension (PVH) (pulmonary artery wedge pressure of 20 mmHg). Inflation of the right atrial balloon produced SVH (central venous pressure of 15 mm Hg). After 2 hours, dogs with SVH with or without PVH demonstrated a greater amount of lung fluid accumulation (P less than 0.01) compared to controls or PVH alone. There was no significant difference in lung water in SVH dogs with or without PVH. Pulmonary blood flow was not significantly different between the experimental groups, each of which was less than control. Impairment of pulmonary lymphatic flow is one possible mechanism producing the worsening edema; however, bronchial venous hypertension or neurogenic reflexes cannot be excluded. We conclude that the contribution of systemic venous hypertension to the development of pulmonary edema may have therapeutic implications.
Incidence of vitreoretinal pathologic conditions within 24 months after laser in situ keratomileusis
Authors: J.Fernando Arevalo, Ernesto Ramirez, Enrique Suarez, Julian Morales-Stopello, Rafael Cortez, Gema Ramirez, George Antzoulatos, Javier Tugues, Jorge Rodriguez, Dario Fuenmayor-Rivera
Journal: Ophthalmology (2000)
THE GLOMERULAR MESANGIUM
Authors: S. Michael Mauer, David E. R. Sutherland, Richard J. Howard, Alfred J. Fish, John S. Najarian, Alfred F. Michael
Journal: The Journal of Experimental Medicine (1973)

A mechanism of immune glomerular injury is described based on the fixation of antibody (Ab) to an antigen (Ag) that has localized in the glomerular mesangium. Rabbits were given, intravenously (i.v.), aggregated human IgG (AHIgG) or albumin (AHSA) and 10 h later, when the Ag by immunofluorescent microscopy was present in the mesangium, a kidney was removed and transplanted into a normal rabbit. The recipient then received, i.v., rabbit anti-HIgG or anti-HSA. Within minutes of Ab infusion, glomeruli of the donor kidney had polymorphonuclear (PMN) infiltration that over the next few hours became marked and was associated with glomerular cell swelling. At 24 h a decrease in PMN's and early mesangial proliferation was seen. By 3 days there was marked mesangial hypercellularity and increased mesangial matrix. Within minutes after Ab administration rabbit IgG, C3, and fibrin were seen in the glomerular mesangium. There was a fall in complement titer by 1 min after Ab infusion that was due to complement consumption by the donor kidney. Complement then returned to normal levels by 48 h. Significant glomerular injury did not occur (a) in the recipient's own kidney, (b) from Ag administration and transplantation without recipient Ab administration, or (c) from transplantation and Ab administration without prior Ag administration. These studies demonstrated that Ag localized in the glomerular mesangium can react with circulating Ab and complement resulting in severe glomerular injury.
Preserved Endothelium-Dependent Vasodilation in Coronary Segments Previously Treated With Balloon Angioplasty and Intracoronary Irradiation
Authors: Manel Sabaté, I. Patrick Kay, Willem J. van der Giessen, Angel Cequier, Jurgen M. R. Ligthart, Joan Antoni Gómez-Hospital, Stéphane G. Carlier, Veronique L. M. A. Coen, Johannes P. A. Marijnissen, Alexander J. Wardeh, Peter C. Levendag, Patrick W. Serruys
Journal: Circulation (1999)

Background —Abnormal endothelium-dependent coronary vasomotion has been reported after balloon angioplasty (BA), as well as after intracoronary radiation. However, the long-term effect on coronary vasomotion is not known. The aim of this study was to evaluate the long-term vasomotion of coronary segments treated with BA and brachytherapy. Methods and Results —Patients with single de novo lesions treated either with BA followed by intracoronary β-irradiation (according to the Beta Energy Restenosis Trial-1.5) or with BA alone were eligible. Of these groups, those patients in stable condition who returned for 6-month angiographic follow-up formed the study population (n=19, irradiated group and n=11, control group). Endothelium-dependent coronary vasomotion was assessed by selective infusion of serial doses of acetylcholine (ACh) proximally to the treated area. Mean luminal diameter was calculated by quantitative coronary angiography both in the treated area and in distal segments. Endothelial dysfunction was defined as a vasoconstriction after the maximal dose of ACh (10 −6 mol/L). Seventeen irradiated segments (89.5%) demonstrated normal endothelial function. In contrast, 10 distal nonirradiated segments (53%) and 5 control segments (45%) demonstrated endothelium-dependent vasoconstriction (−19±17% and −9.0±5%, respectively). Mean percentage of change in mean luminal diameter after ACh was significantly higher in irradiated segments ( P =0.01). Conclusions —Endothelium-dependent vasomotion of coronary segments treated with BA followed by β-radiation is restored in the majority of stable patients at 6-month follow-up. This functional response appeared to be better than those documented both in the distal segments and in segments treated with BA alone.
Impact of Intranasal Insulin on Insulin Antibody Affinity and Isotypes in Young Children With HLA-Conferred Susceptibility to Type 1 Diabetes
Authors: Samppa J. Ryhänen, Taina Härkönen, Heli Siljander, Kirsti Näntö-Salonen, Tuula Simell, Heikki Hyöty, Jorma Ilonen, Riitta Veijola, Olli Simell, Mikael Knip
Journal: Diabetes Care (2011)

Despite promising results from studies on mouse models, intranasal insulin failed to prevent or delay the development of type 1 diabetes in autoantibody-positive children with HLA-conferred disease susceptibility. To analyze whether the insulin dose was inadequate to elicit an immunomodulatory response, we compared the changes observed in insulin antibody (IA) affinity and isotypes after treatment with nasal insulin or placebo.Ninety-five children (47 in the placebo group and 48 in the insulin group of the total of 224 children randomized for the trial) with HLA-conferred susceptibility to type 1 diabetes derived from the intervention arm of the Finnish Type 1 Diabetes Prediction and Prevention study were included in these analyses. Blood samples drawn before or at the beginning of the treatment and after treatment for 3 and 6 months were analyzed for IA affinity and isotype-specific IAs (IgG1-4, IgA, IgM, and IgE).IgG3- and IgA-IA levels (P = 0.031 and 0.015, respectively) and the number of IgG3-IA-positive subjects (P = 0.022) were significantly higher at 6 months after the initiation of the treatment in the insulin group. No significant differences were observed between the two groups in IA affinity or other IA isotypes.The insulin dose administered induced a modest change in the IA isotype profile. The lack of impact of nasal insulin on IA affinity implies that the immune response of study subjects was already mature at the beginning of the intervention.
A pilot study of combination therapy with interferon-α-2a and 5-fluorouracil in metastatic carcinoid and malignant endocrine pancreatic tumours
Authors: M.J. Hughes, D.J. Kerr, J. Cassidy, M. Soukop, K. McGregor, N. Blackburn, H. Yosef, S.B. Kaye
Journal: Annals of Oncology (1996)
Analysis of Mlsc genetics. A novel instance of genetic redundancy.
Authors: R Abe, M Foo-Phillips, R J Hodes
Journal: The Journal of Experimental Medicine (1989)

The identity of the self determinants involved in the selection of the T cell repertoire has been a matter of considerable interest. In addition to the apparent critical role of MHC gene products, accumulated experimental results indicate the importance of non-MHC gene products in T cell repertoire selection. In particular, murine Mlsa and Mlsc determinants have been shown to be highly stimulatory to allogeneic T cells and to be involved in the negative selection (elimination) of self-reactive T cells expressing selected TCR V beta segments. In this work, a unique phenomenon of genetic redundancy is described in the control of Mlsc expression: Mlsc appears to be controlled by at least two unlinked loci, and the product of either one of these loci is sufficient to evoke Mlsc-specific T cell response and to act as a ligand in the deletion of self Mlsc-reactive V beta 3+ T cells. Based on these findings, we propose a possible explanation for the fact that Mls-like genes or gene products have not been identified in other species such as man.
Screening of nineteen unrelated families with generalized resistance to thyroid hormone for known point mutations in the thyroid hormone receptor beta gene and the detection of a new mutation.
Authors: K Takeda, S Balzano, A Sakurai, L J DeGroot, S Refetoff
Journal: Journal of Clinical Investigation (1991)

Generalized resistance to thyroid hormone (GRTH) is a syndrome characterized by impaired tissue responsiveness to thyroid hormone. Two distinct point mutations in the hormone binding domain of the thyroid hormone receptor (TR) beta have recently been identified in two unrelated families with GRTH. One, Mf, involves a replacement of the normal glycine-345 for arginine in exon 7 and another, Mh, replaces the normal proline-453 for histidine in exon 8. To probe for the presence of the Mf and Mh defect in 19 unrelated families with GRTH, we applied separate polymerase chain reactions using allele-specific oligonucleotide primers containing the normal and each of the two mutant nucleotides at the 3'-position. A total of 24 affected subjects and 13 normal family members were studied. The mode of inheritance was dominant in 13 families, was unknown in 5 families, and was clearly recessive in 1 family in which only the consanguineous subjects were affected. Primers containing the substitutions specific for Mf and Mh amplified exons 7 and 8, respectively, only in affected members of each of the two index families. Primers containing the normal sequences amplified exons 7 and 8 of the TR beta gene in all subjects except affected members of one family. In this family with recessively inherited GRTH, neither exon could be amplified using any combinations of primers and DNA blot revealed absence of all coding exons. These results indicate a major deletion of the TR beta gene, including both DNA and hormone binding domains. Since heterozygous members of this family are not affected, the presence of a single normal allele is sufficient for normal function of the TR beta. These data also support the hypothesis that in the dominant mode of GRTH inheritance the presence of an abnormal TR beta interferes with the function of the normal TR beta. Distinct mutations are probably responsible for GRTH in unrelated families.
Genioglossus Activity in Children with Obstructive Sleep Apnea during Wakefulness and Sleep Onset
Authors: Eliot S. Katz, David P. White
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

A prominent role for upper airway neuromuscular control mechanisms in the pathophysiology of pediatric obstructive sleep apnea syndrome (OSAS) is suggested by the observation that obstruction does not occur during wakefulness and is infrequently seen during non-REM sleep. Using a custom intraoral surface electrode to record genioglossal activity (genioglossal electromyography [EMGgg]), normalized with a maximal maneuver, we studied 10 children with OSAS and 6 normal control subjects to determine EMGgg activity during (1) wakefulness, (2) the sleep onset period, and (3) stable non-REM sleep. We observed that the EMGgg activity in patients with OSAS compared with control subjects was significantly greater during wakefulness (3.6 ± 1.8 vs. 1.6 ± 1.8% maximum, p < 0.05) and had a greater decline during the early and late sleep onset period (p < 0.05). During stable non-REM sleep, EMGgg remained below the wakeful baseline in all normal control subjects but increased above the baseline in four of the patients with OSAS. We speculate that the increased EMGgg activity during wakefulness represents a reflex-driven neuromuscular compensation for an anatomically compromised airway. Furthermore, the larger decline in EMGgg at sleep onset observed in patients with OSAS is consistent with the relative loss of this reflex. Finally, the return of EMGgg activity above baseline in patients with severe OSAS suggests that some chemical or mechanical compensatory mechanisms remain active during stable non-REM sleep in children.
Combination of IFNa2b and isoprinosine in treatment of CHC: A pilotstudy
Authors: N. Osna, E. Hagina, N. Viulgert, A. Sochnev, V. Kuse, G. Silonova, L. Viksna, A. Zvirbliena, M. Mauricas, L. Balciuniene, A. Ambrozaitis, S.W. Schalm
Journal: Journal of Hepatology (2000)
Silence on clinical fundamentals
Authors: E N Grosch
Journal: British Journal of Sports Medicine (2003)

Silence on clinical fundamentalsYour point about lifesaving hand washing to prevent diarrhoeal illness 1 is well made.I have found that the inattention you have noted to such clinical fundamentals in textbooks on sports medicine is mirrored by the absence of any notation, affirmative or otherwise, in many textbooks on pain, correlating the symptom (pain) with the physical sign (tenderness), a rudimentary clinical confirmation of the validity of pain, according to my clinical training in Ireland, that could distinguish malingering from a genuine complaint of pain, for example.Perhaps I have received a false impression but, if so, the utility of eliciting tenderness, a longstanding custom during physical examination, seems a mystery.In November 2002, I attended a conference in Florida on prescribing addictive drugs.None of the purportedly expert presenters mentioned the issue spontaneously.When I collared one of them after his lecture and enquired specifically about the point, he claimed that chronic, non-malignant pain and tenderness are usually ''dissociated''that is, a patient can suffer chronic, nonmalignant pain in the absence of tenderness of the painful part, on physical examination.This assertion seemed contrary to my own, admittedly anecdotal, experience over some 24 years.Furthermore, it would seem to (a) render chronic, non-malignant pain, and maybe all pain, unknowable and undetectable (except perhaps to the alleged sufferer, although nobody else can tell), (b) place the assessment of pain in the realm of ''pathological science'', 5 and (c) invalidate the very idea of regulation of narcotic drugs to ensure that the practitioner prescribe one only when it ''corresponds to the ailment''. 5 The silence on the subject in the medical literature seemed anomalous.A Boolean Pubmed search on the keywords ''pain'' and ''tenderness'' revealed no relevant articles.I examined all 114 textbooks on pain in the medical library of the University of Southern California (USC) and found two 2 3 that addressed the issue.
Concurrence of sarcoidosis and aortitis: case report and review of the literature
Authors: V Weiler
Journal: Annals of the Rheumatic Diseases (2000)

Takayasu arteritis (TA) is a rare manifestation of systemic large vessel vasculitis which affects predominantly the aorta and its main branches, but often remains unrecognised owing to delayed diagnosis and non-characteristic clinical features. Sarcoidosis, too, is a systemic inflammatory disease which can affect virtually any organ system. Reports about the coincidence of both diseases have appeared. The case presented here is characterised by a significant time lag between detection of TA and appearance of clinical signs of sarcoidosis. The woman, now 39 years old, had erythema nodosum, circumscript alopecia, and recurrent uveitis, which dated back to 1980 and was attributed to sarcoidosis. At least 12 years later aortic valve insufficiency with progressive cardiac failure developed. Histology performed at the time of aortic valve prosthesis in 1997 disclosed a diagnosis of TA, which was confined to the aortic root. Incidentally, sarcoidosis was diagnosed in adjacent lymph nodes. A thorough check up failed to detect further manifestations of TA; thus, possibly, the patients had aortitis similar to, but not identical with, TA. Several related cases previously reported are discussed, suggesting that both diseases may be inherently related as they are characterised by certain non-specific, immunoinflammatory abnormalities. This case report suggests that the prevalence of TA, or related forms of arteritis, may be higher than expected and should be considered, especially in younger patients with non-characteristic cardiovascular symptoms and suspected systemic inflammatory disease. Moreover, the association with sarcoidosis in this and other previously described cases suggests that the two diseases may be related and that TA or TA-like vasculitis may even be a complication of sarcoidosis.
Overall prognosis with current treatment of infertility
Authors: J. A. Collins
Journal: Human Reproduction Update (2004)

Few reports provide pregnancy or birth rates for large groups of infertile couples having a comprehensive range of treatments. This model utilizes published evidence about diagnosis, treatment, the duration of treatment and the proportion of couples receiving treatment. Assisted reproduction technology treatment (ART) utilization was set arbitrarily at three levels: 3, 10 or 50% of the couples that had no live birth after conventional treatment. For each diagnosis and treatment the model estimated total live births, singleton live births and multiple live births per 10 000 couples. The overall live birth rate with non-ART treatment would be 37%, involving 3725 live births, of which 3478 (93%) would be singleton and 247 (7%) would be multiple. With ART utilization at 3, 10 and 50% of couples with persistent infertility in each diagnostic category, live birth rates were 39, 43 and 47% respectively, with 8, 10 and 12% multiple births. The corresponding utilization of ART would be 244, 813 and 1481 ART cycles per 106 population per annum. Typical management of infertility would fall short of 50% live births even with extensive utilization of ART. Underlying unknown untreatable factors remain barriers to greater overall success in the treatment of infertility.
Effects of monomethylfumarate on dendritic cell differentiation
Authors: N.H.R. Litjens, M. Rademaker, B. Ravensbergen, H.B. Thio, J.T. van Dissel, P.H. Nibbering
Journal: British Journal of Dermatology (2005)

Fumaric acid esters (FAE) are effective against psoriasis vulgaris and monomethylfumarate (MMF) is believed to be the most bioactive metabolite of this medication. Earlier we found that the beneficial effects of FAE medication are accompanied by a downregulation of type 1 cytokine production by T-helper (Th) lymphocytes, which are important as they maintain a type 1 cytokine [interferon (IFN)-gamma, interleukin (IL)-2] environment in the skin lesions of psoriasis vulgaris patients and once maximal beneficial effects are obtained type 2 cytokine production is also decreased. In vitro MMF selectively induced type 2 cytokine production by primed Th lymphocytes, whereas type 1 cytokine production by and profileration of T lymphocytes were unaffected.As dendritic cells (DCs) present in these skin lesions play a key role in the activation of Th lymphocytes, we investigated the effects of MMF on monocyte-derived DC differentiation.Monocytes were differentiated into immature (i) DCs by cytokines with or without MMF. To establish whether these cells were differentiated into iDCs, we analysed the expression of cell surface molecules on these cells and the capacity to capture antigens using flow cytometry. Next, we determined whether these MMF-incubated (MMF-)iDCs could be matured by lipopolysaccharide (LPS) and whether MMF affected this responsiveness as well. For this purpose we measured cytokine production by these LPS-stimulated cells (MMF-DCs) using enzyme-linked immunosorbent assays as well as their ability to activate naive Th lymphocytes.The presence of MMF during the differentiation of monocytes into iDCs resulted in cells that retained low levels of CD14 and hardly expressed CD1a. Upon maturation, these MMF-iDCs upregulated CD83 and costimulatory molecules and HLA-DR on their surface, indicating that these cells respond to LPS, albeit less than control iDCs. In addition, in response to LPS, MMF-iDCs did not decrease the capacity to capture antigens when compared with control iDCs. MMF-DCs hardly produced IL-12p70 and IL-10 and low levels of tumour necrosis factor (TNF)-alpha, whereas IL-8 produced by MMF-DCs and control DCs did not differ. Moreover, MMF-DCs were less able to induce IFN-gamma production by naive Th lymphocytes compared with control DCs. The production of IL-4 and IL-10 by naive Th lymphocytes cocultured with MMF-DCs did not differ from that by T cells cocultured with control DCs.MMF inhibited the monocyte-derived DC differentiation resulting in cells that cannot be appropriately matured to DCs. Consequently, these MMF-DCs are less effective than control DCs in stimulating type 1 cytokine, but not type 2 cytokine production, in Th lymphocytes. This general immunomodulatory effect may in part explain the beneficial effects of FAE therapy in psoriasis.