tbuckley/cabot-search huggingface dataset:
Wave Transmission in the Pulmonary Arterial System in Disease in Man
Authors: STUART R. REUBEN
Journal: Circulation Research (1970)

Pulmonary capillary blood flow was measured by the nitrous oxide-body plethysmograph technique in 21 patients with valvular heart disease or pulmonary thromboembolism during routine diagnostic cardiac catheterization. The studies were performed with a high-frequency phonocardiogram recorded from the pulmonary area to indicate the pulmonary valve opening at the beginning of right ventricular ejection. The pulmonary artery to capillary flow conduction time was measured from the time of pulmonary valve opening to the foot of the pulmonary capillary flow pulse. The conduction time was greater than 160 msec when the pulmonary artery pressure was normal. The fall in the conduction time in disease indicated elevated pulmonary arterial pulse wave velocity and this correlated well with the level of pulmonary arterial pressure (correlation coefficient 0.92, P &lt; 0.001). This suggests that there is a reduced pulmonary arterial distensibility in the chronic pulmonary hypertension of valvular heart disease and thromboembolic disorders.
Hearing loss in Grand Prix motorcyclists: occupational hazard or sports injury?
Authors: A W McCombe, J Binnington
Journal: British Journal of Sports Medicine (1994)

The prevalence of noise-induced hearing loss (NIHL) in current motorcycle grand prix racers was investigated. A total of 44 riders was randomly recruited and underwent interview, otological examination and pure tone audiometry. The median age was 28 (range 18-37) years and median racing experience was 10 (range 2-21) years. Twenty riders (45%) had hearing losses greater than expected for age matched controls. Not surprisingly this hearing deficit tended to increase with racing experience (r = 0.5, t = 2.51, 19 d.f., P &lt; 0.05). Only 17 riders (39%) were regular users of earplugs and only nine had used them for most of their racing careers. There is a need to raise awareness to this problem and increase the use of earplugs to avoid NIHL in grand prix motorcyclists.
Cideb, an ER- and Lipid Droplet-Associated Protein, Mediates VLDL Lipidation and Maturation by Interacting with Apolipoprotein B
Authors: Jing Ye, John Zhong Li, Yang Liu, Xuanhe Li, Tianshu Yang, Xiaodong Ma, Qing Li, Zemin Yao, Peng Li
Journal: Cell Metabolism (2009)
Biventricular Pacing Decreases Sympathetic Activity Compared With Right Ventricular Pacing in Patients With Depressed Ejection Fraction
Authors: Mohamed H. Hamdan, Jason D. Zagrodzky, Jose A. Joglar, Clifford J. Sheehan, Karthik Ramaswamy, Jeffrey F. Erdner, Richard L. Page, Michael L. Smith
Journal: Circulation (2000)

Background —Although there have been few studies in which the hemodynamic effects of right ventricular (RV) and left ventricular (LV) pacing were compared with those of biventricular (BV) pacing, the autonomic changes during these different pacing modes remain unknown. We hypothesized that BV pacing results in improved hemodynamics and a decrease in sympathetic nerve activity (SNA) compared with single-site pacing. Methods and Results —Thirteen men with a mean ejection fraction of 0.28±0.7 were enrolled in the study. Arterial blood pressure (BP), central venous pressure (CVP), and SNA were recorded during 3 minutes of right atrial (RA)-RV, RA-LV, and RA-BV pacing at a rate 10 beats faster than sinus rhythm. BP was greater during LV (151±7/85±3 mm Hg) and BV (151±6/85±3 mm Hg) pacing than during RV pacing (146±7/82±3 mm Hg) ( P &lt;0.05). There were no differences in CVP among all pacing modes ( P =0.27). SNA was significantly less ( P &lt;0.02) during both LV (606±35 U) and BV (582±41 U) pacing compared with RV pacing (685±32 U) ( P &lt;0.02). Although not statistically significant ( P =0.08 to 0.14), there was a trend for patients with a narrow QRS to have a lower mean BP and higher SNA during LV pacing than during BV pacing ( r =0.42 to 0.49). Conclusions —LV-based pacing results in improved hemodynamics and a decrease in SNA compared with RV pacing in patients with LV dysfunction regardless of the QRS duration.
In Vivo Blockade of Tumor Necrosis Factor-α Accelerates Functional Endothelial Recovery After Balloon Angioplasty
Authors: Kevin Krasinski, Ioakim Spyridopoulos, Marianne Kearney, Douglas W. Losordo
Journal: Circulation (2001)

Background Tumor necrosis factor-α (TNF) is expressed locally in arteries at sites of balloon injury. In vitro studies have shown that TNF inhibits cell cycle progression and induces apoptosis in endothelial cells. Accordingly, we performed a series of experiments to test the hypothesis that inhibiting TNF could accelerate endothelial recovery after angioplasty. Methods and Results TNF soluble receptor (TNFsr) has been shown to neutralize the actions of TNF in vitro and in vivo. Sprague-Dawley rats received TNFsr versus control IgG through an intraperitoneal injection. De-endothelializing balloon injury was then performed, and animals were killed after 1 week to evaluate re-endothelialization (Evans blue dye staining) and after 2 weeks to evaluate re-endothelialization and endothelial function. At both time points, blockade of TNF using TNFsr resulted in an increase in re-endothelialization, as measured as absolute area and percent area re-endothelialized. TNFsr also accelerated functional endothelial recovery, which manifest as an increase in nitric oxide production. Neointimal thickening was also shown inhibited. Conclusions In vivo blockade of TNF accelerates functional endothelial recovery after barotraumatic de-endothelializing injury. These findings suggest that locally expressed TNF acts to inhibit functional endothelial recovery after angioplasty and that transient blockade of TNF may improve the long-term success of angioplasty.
Constitutive integrin activation on tumor cells contributes to progression of leptomeningeal metastases1
Authors: Dieta Brandsma, Laurien Ulfman, Jaap C. Reijneveld, Madelon Bracke, Martin J.B. Taphoorn, Jaap Jan Zwaginga, Martijn F.B. Gebbink, Hetty de Boer, Leo Koenderman, Emile E. Voest
Journal: Neuro-Oncology (2006)

Leptomeningeal metastases are a serious neurological complication in cancer patients and associated with a dismal prognosis. Tumor cells that enter the subarachnoid space adhere to the leptomeninges and form tumor deposits. It is largely unknown which adhesion molecules mediate tumor cell adhesion to leptomeninges. We studied the role of integrin expression and activation in the progression of leptomeningeal metastases. For this study, we used a mouse acute lymphocytic leukemic cell line that was grown in suspension (L1210-S cell line) to develop an adherent L1210 cell line (L1210-A) by selectively culturing the few adherent cells in the cell culture. beta1, beta2, and beta3 integrins were in a constitutively high active state on L1210-A cells and in a low, but inducible, active state on L1210-S cells. Expression levels of these integrins were comparable in the two cell lines. Static adhesion levels of L1210-A cells on a leptomeningeal cell layer were significantly higher than those of L1210-S cells. All mice that were injected intrathecally with L1210-A cells died rapidly of leptomeningeal leukemia. In contrast, 45% long-term survival was seen after intrathecal injection of mice with L1210-S cells. Our data indicate that constitutive integrin activation on leukemic cells promotes progression of leptomeningeal leukemia by increased tumor cell adhesion to the leptomeninges. We argue that an aberrantly regulated inside-out signaling pathway underlies constitutive integrin activation on the adherent leukemic cell population.
A Systematic Approach to Risk Stratification and Intervention Within a Managed Care Environment Improves Diabetes Outcomes and Patient Satisfaction
Authors: Charles M. Clark, James W. Snyder, Robert L. Meek, Linda M. Stutz, Christopher G. Parkin
Journal: Diabetes Care (2001)

OBJECTIVE—To determine whether a comprehensive diabetes management program that included risk stratification and social marketing would improve clinical outcomes and patient satisfaction within a managed care organization (MCO). RESEARCH DESIGN AND METHODS—The 12-month prospective trial was conducted at primary care clinics within a MCO and involved 370 adults with diabetes. Measurements included 1) the frequency of dilated eye and foot examinations, microalbuminuria assessment, blood pressure measurement, lipid profile, and HbA1c measurement; 2) changes in blood pressure, lipid levels, and HbA1c levels; and 3) changes in patient satisfaction. RESULTS—Complete data are reported for the 193 patients who had been enrolled for 12 months; life table analysis is reported for all patients who remained enrolled at the study’s end as well as for a comparative control group of 623 patients. For the 193 patients for whom 12-month data were available, the number of patients in the low-risk category (HbA1c &amp;lt;7%) increased by 51.1%. A total of 97.4% of patients with an HbA1c &amp;gt;8% at baseline had a change in treatment regimen. Patients at the highest risk for coronary heart disease (LDL &amp;gt;130 mg/dl) decreased from 25.4% at baseline to 20.2%. Patients with a blood pressure &amp;lt;130/85 mmHg increased from 23.8 to 44.6%. Of these patients, 63.0% had changes in medication. Patients and providers expressed significant increases in satisfaction with the program. CONCLUSIONS—The program was successful in initiating the recommended changes in the diabetic therapeutic regimen, resulting in improved glycemic control, increased monitoring/management of diabetic complications, and greater patient and provider satisfaction. These results should have great significance in the design of future programs in MCOs aimed at improving the care of people with diabetes and other chronic diseases.
Unilateral wheeze caused by pseudomembranous aspergillus tracheobronchitis in the immunocompromised patient.
Authors: R C Tait, B R O'Driscoll, D W Denning
Journal: Thorax (1993)

Abstract Unilateral wheeze in the immunocompromised patient with unremitting fever may be the first localising sign of aspergillus tracheobronchitis. Two such cases are presented.
Intestinal gas dynamics: mechanisms and clinical relevance
Authors: F Azpiroz
Journal: Gut (2005)

Patients with functional gut disorders, irritable bowel disease, and related syndromes frequently attribute their symptoms to intestinal gas. While patients are usually convinced of their interpretation, the doctor has few arguments to confirm or refute it, and in this context intestinal gas has become a myth. Studies of intestinal gas dynamics have demonstrated subtle dysfunctions in intestinal motility. Hopefully, extension of these studies may help both in the classification of patients complaining of gas symptoms based on pathophysiological mechanisms, and in identification of objective markers to test mechanistically oriented treatment options.
Effects of sucralfate on acute and late bowel discomfort following radiotherapy of pelvic cancer.
Authors: R Henriksson, L Franzén, B Littbrand
Journal: Journal of Clinical Oncology (1992)

PURPOSE Radiotherapy, a cornerstone in the management of pelvic cancer, is accompanied by intestinal reactions. Therefore, we investigated the possible effects of sucralfate, an aluminium hydroxide complex of sulfated sucrose used in the treatment of gastric ulcer, in preventing radiation-induced diarrhea and bowel discomfort in patients treated with curative intention for pelvic cancer with external radiotherapy. PATIENTS AND METHODS The study was double-blind and placebo-controlled and included 70 patients with carcinoma in the prostate or urinary bladder without distant metastases (T1-4No1xMo) and a performance status of greater than or equal to 90% on the Karnofsky scale. Radiotherapy was conventionally delivered with high-energy photons (four-field technique, the total dose 64 Gy, 2 Gy daily, total treatment time 5 to 6 weeks). Dose granules of sucralfate or placebo were dispensed to each patient 2 weeks after radiation started and continued for 6 weeks. All analyses were performed blindly. RESULTS The frequency of defecation and stool consistency were significantly improved by sucralfate. Fourteen patients in the placebo group and three in the sucralfate group required symptomatic therapy with loperamide. One year later, the patients in the sucralfate group displayed significantly less problems with frequency of defecation, mucus, and blood in the stools compared with the placebo group. There was also a lower intake of loperamide and the weight decrease was less pronounced in the sucralfate group. There was no evidence of adverse effects associated with the use of sucralfate. CONCLUSION It is suggested that sucralfate can be of beneficial value in diminishing bowel discomfort during treatment and, most importantly, sucralfate also reduces the late bowel disturbances that follow radiotherapeutic treatment of pelvic malignancies. The earlier proposed mechanisms of action (eg, protection of denuded mucosa, cytoprotective properties, binding bile acids) seem adequate to explain the present effects of sucralfate.
Inadequate Treatment for Major Depression Both Before and After Attempted Suicide
Authors: K H Suominen, E T Isometsä, M M Henriksson, A I Ostamo, J K Lönnqvist
Journal: American Journal of Psychiatry (1998)

Objective:The authors' goal was to investigate the treatment received by suicide attempters with major depression before and after the index attempt.Method:Forty-three patients with current unipolar DSM-III-R major depression were identified in a diagnostic study from a systematic sample of suicide attempters in Helsinki. All were comprehensively interviewed and investigated after the attempt, and their treatment was ascertained from psychiatric and other health care records and follow-up interviews. Results:During the month just before the suicide attempt, seven (16%) of the patients had received antidepressants in adequate doses, seven had received weekly psychotherapy, and none had received ECT. Although almost all of the patients complied with the recommended aftercare following the suicide attempt, after 1 month only seven (17%) were receiving antidepressants in adequate doses, nine (22%) were receiving weekly psychotherapy, and none had been given ECT.Conclusions:It seems that few suicide attempters with major depression receive adequate treatment for depression before the suicide attempt and that, despite their well-known high risk for suicide, the treatment situation is not necessarily any better after the attempt. These findings suggest that the recognition of depression and the quality of treatment received for major depression among suicide attempters should be investigated and improved to prevent suicide. Am J Psychiatry 1998; 155: 1778-1780
Effects of combined inspiratory muscle and cycle ergometer training on exercise performance in patients with COPD
Authors: T Wanke, D Formanek, H Lahrmann, H Brath, M Wild, C Wagner, H Zwick
Journal: European Respiratory Journal (1994)

Cycle ergometer training plays an important role in the rehabilitation of patients with chronic obstructive pulmonary disease (COPD), but the usefulness of specific inspiratory muscle training as part of pulmonary rehabilitation remains uncertain. To determine whether inspiratory muscle training could intensify the known beneficial effects of cycle ergometer training on exercise performance in these patients, we compared the effect of an 8 week inspiratory muscle training combined with cycle ergometer training with that of an 8 week cycle ergometer training alone on inspiratory muscle performance and general exercise capacity. Patients were randomly assigned to the two training groups; 21 patients received additional inspiratory muscle training (Group 1) and 21 did not (Group 2). Maximal sniff assessed oesophageal and transdiaphragmatic pressures served as parameters for global inspiratory muscle strength and diaphragmatic strength, respectively. The duration for which the patient could breathe against a constant inspiratory pressure load was used as an index of inspiratory muscle endurance. Exercise capacity was determined by an incremental symptom-limited cycle ergometer test. After the training period, inspiratory muscle performance improved significantly in the patients with inspiratory muscle training, but not in those without. Both training regimens increased maximal power output and oxygen uptake, but this improvement was significantly greater in the patients with inspiratory muscle training than in those without.(ABSTRACT TRUNCATED AT 250 WORDS)
The role of mean inspiratory effort on daytime sleepiness
Authors: Z. Pelin, D. Karadeniz, L. Öztürk, E. Gözükirmizi, H. Kaynak
Journal: European Respiratory Journal (2003)

This study has investigated the role of average maximum inspiratory effort in excessive daytime sleepiness in patients with obstructive sleep apnoea syndrome (OSAS) and upper airway resistance syndrome (UARS). Fifteen patients diagnosed with UARS and 32 patients with OSAS, with &gt;5.5 h total sleep time (TST) during 8 h of nocturnal polygraphic recordings, were included in the study. Demographical data, polysomnographical data and data about daytime sleepiness, including Epworth sleepiness scale (ESS) and multiple sleep latency test (MSLT), were evaluated. In order to compute the average maximum inspiratory effort from oesophageal pressure ( P oes ) measurements, maximum P oes was obtained from 20 representative obstructive respiratory events (obstructive apnoeas, hypopnoeas or flow limitations) for each sleep stage in both supine and side positions. From P oes measurements during sleep, the increase in P oes (Δ P oes ) during respiratory events was also calculated. The average maximum P oes , Δ P oes , respiratory disturbance index (RDI) and arousal index were significantly correlated with ESS in OSAS patients. In patients with UARS, the only significant correlation was obtained between average maximum P oes and ESS. The MSLT score did not show any significant correlation with arousal index, number of stage variations, RDI, average P oes , Δ P oes , minimum oxygen saturation ( S a,O 2 ) and percentage of TST with an S a,O 2 &lt;90% in both UARS and OSAS patients. The results of multiple regression analysis showed that average maximum P oes correlates best with the variance in ESS for OSAS patients. In conclusion, the data from this study indicate the possible important role of average inspiratory effort in determining subjective sleepiness in both obstructive sleep apnoea syndrome and upper airway resistance syndrome patients.
Stroke without dissection from a neck holding manoeuvre in martial arts
Authors: M O McCarron, J Patterson, R Duncan
Journal: British Journal of Sports Medicine (1997)

Carotid artery trauma is a known cause of stroke in young people. The vessel may occlude, dissect or shower thrombotic emboli into intracranial vessels. This paper reports the use of single photon emission computed tomography (SPECT) imaging in a 29 year old man who developed an embolic stroke after neck holding manoeuvres at a martial arts class. Awareness of the potential consequences of these procedures is matched by the need for rapid and accurate diagnosis of stroke now that thrombolytic and neuroprotective treatments are emerging, which are effective only within a short time window.
The role of orthotopic liver transplantation in the management of sclerosing cholangitis
Authors: None Jonathan, None Harrison, Paul McMaster
Journal: Hepatology (1994)

Our recommendations are to manage asymptomatic patients with biannual clinical and biochemical follow-up examinations. Symptomatic non-cirrhotic patients who have diffuse SC should be enrolled in trials addressing the efficacy of medical therapy such as UDCA. Patients with diffuse disease and cirrhosis of the liver should be considered for liver transplantation. Symptomatic patients with a dominant stricture should first undergo rigorous investigation to rule out CCA. Disease in those noncirrhotic patients who are deemed to have benign strictures should initially be managed by means of dilation or surgical excision, although careful monitoring and review will be needed because most will continue with progressive disease, eventually showing signs of portal hypertension and cirrhosis. Patients with dominant strictures and cirrhosis should be considered for orthotopic liver transplantation. Liver transplantation in experienced units now offers more than 80% of patients a full and effective rehabilitation, with more than 75% alive at 5 yr. A progressive, advancing decompensating cholestatic disorder with an increasing risk of underlying malignancy can be stopped, giving the patient a high quality of life. More than half of patients report an improvement in the symptoms of their inflammatory bowel disease.
Prognostic value of micrometastases in sentinel lymph nodes of patients with breast carcinoma: a cohort study
Authors: P.D. Gobardhan, S.G. Elias, E.V.E. Madsen, V. Bongers, H.J.M. Ruitenberg, C.I. Perre, T. van Dalen
Journal: Annals of Oncology (2008)
Evolution of recurrent herpes simplex lesions. An immunohistologic study.
Authors: A L Cunningham, R R Turner, A C Miller, M F Para, T C Merigan
Journal: Journal of Clinical Investigation (1985)

We performed immunoperoxidase stains on skin biopsies taken from nine patients with recurrent peripheral herpes simplex lesions at 12 h to 6 d after onset of signs of symptoms to phenotype the inflammatory infiltrate, to detect cells producing interferons alpha and gamma, and to locate herpes simplex virus antigen-containing cells. Viral glycoprotein antigen was located in the nuclei and cytoplasm of necrotic epidermal cells, often within vesicles, in biopsies taken between the first and third day. Histologically, biopsies of all stages showed intradermal focal perivascular and diffuse mononuclear inflammatory infiltrates. The cells constituting the infiltrates were predominantly T lymphocytes with lesser numbers of histiocytes; Leu 7+ (most natural killer/killer) cells and B cells were rare in the biopsy specimens. Leu 3a+ ("helper") T lymphocytes predominated in both subepidermal and perivascular regions of early lesions (12-24 h). Tissue helper/suppressor ratios ranged from 6.3 to 3.4 compared with 1.9-1.0 in blood. In later lesions (after 2 d), monocytes/macrophages were more prominent in tissue sections and the helper/suppressor ratios (2.3-2.5) more nearly approximated those of blood (1.6-2.7). The negative correlation of tissue ratios with time was significant (P less than or equal to 0.02). A large proportion of the infiltrated T lymphocytes expressed DR antigens. There was also diffuse strong DR expression on epidermal cells in five cases (all of two or more days). In six biopsies, scattered macrophages and small cells, presumably lymphocytes, demonstrated cytoplasmic or membrane staining for a substance which copurifies with interferon gamma. We identified such stained cells within vessels, suggesting that these cells circulate. Gamma interferon might have an important role within the herpetic lesions, possibly inducing macrophage activation and cytotoxic T lymphocytes and increasing DR expression on monocyte and epidermal cells.