tbuckley/cabot-search huggingface dataset:
Developing the medical mind
Authors: C. Gray
Journal: BMJ (1998)

Lifelong learning should include doctors too. Happily, “The evidence suggests that humans everywhere on the planet see, talk and think about objects and people the same basic way.”(1) Reassuringly, this must apply to doctors also. And excitingly, the neurobiology of the mind has leapt forwards lately. Pinker's superb book tells all in a racy style. The medical mind is merely a special case and its owner rather ordinary in human terms. But, as humans, there is great scope for development. Are you sitting comfortably?

“Feather-footed through the plashy fens passes the questing vole.”(2) All questing creatures have brains made of nervous tissues acting as Turing machines. Even tiny insect and bird brains can navigate and can transfer information. Larger brains, such as those of us mighty mammals, are universes of billions of smaller computational units: “demons” in the jargon. These operate on bits of data received from sense organs, held in various memory files, and shared to different extents. There is no single homunculus watching a screen within - rather, there is a jostling bazaar of mental organs, modules, and demons competing for data and attention. The awesome features of the human brain are its powerful visual interpretation, enormous memory, and symbolic coding for thought and language. Think on this as you stroll into your next postgraduate examination. Its weaknesses are the tiny focus of attention and the episodic spurts of consciousness.

The mind is explained by natural selection. We evolved to meet the challenges of the African savannahs: long grass, large animals, and competing tribes. Mental mechanisms which conveyed advantage survived, which means the modern medical mind is strong on detecting fierce animals, recognising friends and relations, and defending its own territory: all are used in the clinical jungle.

We are apes with attitude because primates happened …
Abstract LB-428: Upregulation of serum amyloid A1 (SAA 1) gene is associated with ulcerative colitis-related colon cancer
Authors: Michael W. Schaffer, Joan C. Smith, Tanusri Ghosh Roy, Harold L. Moses, Samuel E. Adunyah, Amosy E. M'Koma
Journal: Cancer Research (2011)

Abstract Purpose: Ulcerative colitis (UC)-associated colon cancer is frequently diagnosed in an advanced stage. SAA1 is a secreted protein made in the liver and circulates in low levels in blood. SAA1 gene is expressed in colon carcinomas and is a chemoattractant with induction of migration, adhesion, and tissue infiltration of monocytes and Polymorphnuclear-leucocytes (PMN-L). Methods: Laser capture microdissection of colonic submucosa from UC (n=8), Crohn's colitis (CC) (n=8)), and normal (NL, n=8) samples was performed. The submucosal mRNA was extracted using the PicoPure(TM) RNA Isolation Kit. Comprehensive gene expression analysis of the pooled mRNA from each group was then performed using the Affymetrix GeneChip® Gene 1.0 ST Array System. Statistical comparisons of UC vs. CC and NL as well as CC versus UC and NL were performed (Wilcoxon Rank Test). To detect changes for UC, we compared UC to CC and UC to NL; and for CC, we compared CC to UC and CC to NL. Results: Analysis of all UC vs. CC and NL controls showed 28,869 genes which were represented on the array by 26 probes spread across the full length of each gene. When compared UC vs. CC and NL SAA1 remained the most upregulated gene showing a 56.8-folds and 91.3-folds (p&amp;lt; 0.0001) over expression. Conclusion: Microarray assessments show significantly overexpression of SAA1 in UC specimens. SAA1 has a role in local inflammation in the microenvironment of malignant tissue and is expressed in colon carcinomas. Our finding may potentially facilitate and validate the SAA1 as a new early predictive clinical marker and a unique target for designing novel selective inhibitors for therapeutic intervention of UC-associated CRC. Acknowledgement: 3U54CA091408–09S1 (MMC-VICC partnership) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr LB-428. doi:10.1158/1538-7445.AM2011-LB-428
A4.06 Mobilisation of joint-resident mesenchymal stromal cells for articular cartilage regeneration
Authors: A Khalil-Khan, T Baboolal, O Wall, E Jones, D McGonagle
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background and objectives</h3> Microfracture is a recognised procedure used to treat isolated cartilage injuries or defects, in which bone marrow mesenchymal stromal cells (BM-MSCs) are thought to migrate into the created blood clot, leading to subsequent cartilage repair via fibrocartilage formation. The discovery of MSCs in the synovium<sup>1</sup> and synovial fluid (SF)<sup>2</sup> provides a potential mechanism for repairing cartilage'from the top down' via their migration and homing to the microfracture site, however SF-MSCs are usually lost with joint irrigation. The purpose of this work was threefold; first to test the hypothesis that SF-MSCs&nbsp;can be replaced, and also their numbers further increased by synovial mechanical agitation, second that these cells were capable of rapid adhesion to clots and third that the clot composition influenced MSC migration. <h3>Materials and methods</h3> Ex-vivo mechanical agitation of the human superficial synovium and <i>in vivo</i> intraoperative agitation of the synovium&nbsp;of patients undergoing arthroscopy were performed with the use of cytology brush. Colony-forming unit-fibroblast (CFU-F) assay was performed to quantify released MSCs. Adhesion to clots was studied by comparing Platelet Rich Plasma (PRP), Whole Blood (WB) and White clots (WC). Migration studies were performed using passage 2/4 synovial MSCs in trans-well migration assay. MSC migration was compared between PRP&nbsp;and pooled human Platelet Lysate (hPL). <h3>Results</h3> Ex-vivo agitating of the synovium compared to irrigation alone increased MSC number 2.7-fold (n = 10, <i>p</i> = 0.002). Intraoperative arthroscopic agitation of the synovium replaced SF-MSCs (lost following irrigation), resulting in a 6-fold increase over irrigation alone (n = 9, <i>p</i> = 0.002). Released synovial MSC adhesion to clots was observed within 30 min with no difference between clot compositions. Released synovial MSCs demonstrated a trend for a better migration towards hPL compared to PRP. <h3>Conclusions</h3> Synovial MSCs can be released by mechanical means in vivo and these cells were capable of migration and rapid adherence to a relevant biological scaffold. Thus providing a rationale for one stage MSC augmentation by synovial brushing in combination with microfracture, as a strategy for cost effective joint repair. <h3>References</h3> De Bari, <i>et al</i>. Arthritis Rheum. 2001 Jones <i>et al.</i> Arthritis Rheum. 2004
GW25-e1095 Cardiac Electrical Activity Improved by Overexpression of the Sarcoplasmic Reticulum Ca 2+ -ATPase in Rat Myocardial Failure After Myocardial Infarction Evaluated by Microelectrode Arrays Technology
Authors: Fan Ping, Guo Yujun, Wang Hongli, Hou Yuemei
Journal: Journal of the American College of Cardiology (2014)
Renal Changes in Gout
Authors: Josiah Brown, G. Kenneth Mallory
Journal: New England Journal of Medicine (1950)

THE association of renal dysfunction with gout has been stressed from the earliest writings on this disease. Garrod,1 in 1863, stated that, "Even in slighter forms and early stages of gout, the renal organs become seriously impaired." He remarked on the frequency of albuminuria, especially in chronic stages of the disease. More recent studies by Schnitker and Richter,2 Coombs,3 Kinell and Haden4 and Hench5 give an incidence of renal impairment in gout ranging from 22 to 82 per cent. An almost equal number of patients have albuminuria without functional change. Urate gravel or stones were passed by 11 to 23 . . .
Abstract 619: Flavokawain A inhibits urinary bladder carcinogenesis in the UPII-SV40T transgenic mouse bladder cancer model.
Authors: Zhongbo Liu, Xuesen Li, Shuman liu, Xia Xu, Xuejiao Tian, Anne R. Simoneau, Xue-Ru Wu, Xiaolin Zi
Journal: Cancer Research (2012)

Abstract The UPII-SV40T transgenic model of the mouse bladder reproduces a precursor to recurrent and invasive Transitional Cell Carcinoma (TCC): carcinoma in situ (CIS). This model therefore is useful for testing the potential of agents for preventing bladder cancer recurrence. Flavokawain A is the predominant chalcone identified from the kava plant. We have recently shown that flavokawain A exhibited strong growth inhibitory effects on human bladder cancer cell lines both in vitro in cell cultures and in vivo in a xenograft mouse model. In this study, we examine whether flavokawain A can also inhibit bladder cancer development in the UPII-SV40T transgenic model. The transgenic mice were identified through genotyping using Southern blotting analysis. Both heterozygous and homozygous UPII-SV40T mice were fed orally with vehicle control or 6 g flavokawain A /kg food for 9 months starting at 6 weeks of age. More than 54% control food- fed male mice died of ureter obstruction and nephrohydrosis within 10.5 months of age, while more than 67% of mice fed with 6g flavokawain A /kg food survived beyond 10.5 months of age. The mean bladder weight of male transgenic mice that were fed with 6g flavokawain /kg food for 9 months decreased by about 46% compared to those fed with vehicle control diet (mean bladder weights for vehicle control versus flavokawain A treatments are 0.2031±0.016 versus 0.1108±0.02565, P=0.0037). The mean bladder weights of female transgenic mice that were fed with 6g flavokawain /kg food for 9 months decreased by 31% compared to those fed with vehicle control diet (mean bladder weights for vehicle control versus flavokawain A treatments are 0.0466±0.0052 versus 0.03225±0.004689, p=0.0556). Mouse pathology analysis revealed that vehicle control treated mice exhibited poorly differentiated transitional cell carcinoma in the bladder, while that flavokawain A treated mice presented well differentiated tumors in the bladder. The bladder tissues from flavokawain A treated mice showed a decreased number of Ki67 positive cells compared to those in vehicle control treated mice, which suggested that flavokawain A inhibited cell proliferation in vivo in bladder tumors. These results suggested a potential of flavokawain A in preventing the recurrence of non-muscle invasive urinary bladder cancer by treating CIS. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 619. doi:1538-7445.AM2012-619
Abstract P5-13-07: Hormone Levels in the OPTION Trial Show No Ovarian Protection by Goserelin in Adjuvant Chemotherapy for Early Breast Cancer — An Anglo-Celtic Collaborative Group and NCRN Trial
Authors: R Leonard, D Adamson, R Anderson, R Ballinger, G Bertelli, R Coleman, L Fallowfield, C Keerie, M McLinden, J Mansi, G Thomas, A. Yellowlees
Journal: Cancer Research (2010)

Abstract Non-randomised data suggest a protective benefit on ovarian function for using GnRH analogues to suppress menses during chemotherapy. However there have been no published randomised clinical trials to date that confirm this protection indicated by recovery of menstrual function. Observational data suggest that patient age and cumulative dose of alkylating agent or selection and intensity of dose other agents such as anthracyclines or taxanes are also important variables that determine the risk of chemotherapy-induced premature ovarian failure (POF). This trial in premenopausal women has tested the effect of goserelin (G) given randomly before and during adjuvant chemotherapy in premenopausal women with breast cancer. Any standard regimen was allowed but women were randomised in 2 strata, under 40 yrs and over 40 yrs at diagnosis. 227 patients were recruited by end December 2009, and 173 met the criteria for 1 year follow-up for this analysis; 140 patients of these 173 patients had provided adequate data on menstrual bleeding; 87 patients were aged under 40 and 53 patients were aged over 40 at the time of chemotherapy. Cessation of menstruation during chemotherapy was defined as at least two consecutive cycles with no menstrual bleeding since the previous cycle. Additionally, prior to the final cycle of chemotherapy, there had to be no return of menstrual bleeding. Of those patients who had ceased periods during chemotherapy, those with no further menstrual bleeding at 12 months follow up were deemed to have reached menopause. Patients were randomised to receive G or no G at start of chemotherapy. Primary endpoint was recovery of menses at 12 months from start of chemotherapy. Secondary endpoints included quality of life, oestrogen/LH/FSH levels at start and completion and at 12 months along with anti-mullerian hormone (AMH, as an indicator of impending ovarian failure). Endocrine data over time showed a close correlation with menses in that both measures indicated no protective effect in the treatment group. There was no significant difference with respect to POF when all patients were considered. However there was a trend to poorer recovery of menstrual function at 12 months in the under-40 yrs group who had G with 34.7% having POF in the G treated group and 15.8% in the chemotherapy only treated group (P ≥0.05). This is mirrored by the oestrogen data which show an incomplete recovery at 12 months of oestrogen in the G group compared with controls although a complete recovery at 24 months. LH and FSH levels showed appropriate suppression by G and thereafter similar levels to controls. Early follow up data on the hormone levels shows no difference between the treatment groups. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P5-13-07.
O137 4-PHENYLBUTYLATE AMELIORATES LIVER FIBROSIS IN PATIENTS WITH PROGRESSIVE FAMILIAL INTRAHEPATIC CHOLESTASIS (PFIC) TYPE 2 AND PRURITUS IN PATIENTS WITH PFIC TYPE 1
Authors: Y. Hasegawa, H. Kondou, S. Naoi, K. Bessho, M. Ukitsu, M. Sasaki, T. Tsunoda, A. Inui, H. Nagasaka, Y. Miyoshi, H. Hayashi
Journal: Journal of Hepatology (2014)
The Levels of Methionine Determined Byamino Acid Profiling Correlate with Thedegree of Methylation in Colon Cancertissues
Authors: Takayama Yuji, Muto Yuta, Suzuki Koichi, Kato Takaharu, Ichida Kosuke, Fukui Taro, Saito Masaaki, Tsujinaka Shingo, Kamiyama Hidenori, Sasaki Junichi, Horie Hisanaga, Kiyozaki Koichi, Rikiyama Toshiki
Journal: Annals of Oncology (2014)
AB0594 Pulmonary Artery Aneurysms (PAA) in Behcet's Disease (BD): A Review of the Literature:
Authors: S. Celik
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> PAA secondary to BD is a rare condition but also is the leading cause of mortality. It is not usually investigated in BD unless there is a specific complaint. Although there have been increasing numbers of case reports on PAA from the countries in which it is common, total case numbers published, treatment modalities used and prognosis in the literature to date are not documented. <h3>Objectives</h3> To review the literature based on the cases with PAA and BD. <h3>Methods</h3> The countries which have over four million people from each continent were chosen (n=128). A PubMed search for "BD, PAA and the country name" was conducted and 18 countries with BD and PAA were identified. The full texts of articles (n=76) were obtained from these countries and the data including gender, age, treatment modalities and mortality rates were collected. When more than 5 cases were presented, it was accepted as case series. <h3>Results</h3> There were a total of 191 cases (171 Male, 20 Female). The mean age of patients was 32±10. These have been published between 1981 and 2012. There were 82 case reports and 8 case series in total. The case series were reported from Turkey (n=7) and France (n=1). The most of the cases were from Turkey (n=135) (71%). One hundred eleven patients (58%) were treated with immunosuppressive therapy. The biologic treatment was only used in two (1%) patients from UK and USA. In 17 (9%) patients, embolization was chosen and it was more commonly used in patients from France. Forty one (22%) patients underwent surgery and it was more common in Iran, Israel and Tunisia. Of the 191 patients, 59 (31%) patients died and the death in 18 (31%) patients was related to the surgery (table). <h3>Conclusions</h3> PAA is a rare condition and it is mostly reported as case reports from the countries where BD is more commonly found. Although the treatment modalities chosen could be different among the countries, the immunosuppressive treatment is the most common treatment used. The surgery carries out a high mortality risk. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6064
Extracorporeal shock wave lithotripsy as a rescue for a trapped stone basket in the pancreatic duct
Authors: Liang-Hao Hu, Ting-Ting Du, Zhuan Liao, Wen-Bin Zou, Bo Ye, Zhao-Shen Li
Journal: Endoscopy (2014)

A 45-year-old woman was admitted to our department because of intermittent upper abdominal pain in the previous 2 years. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a greatly dilated pancreatic duct with multiple radiopaque stones, which confirmed the diagnosis of chronic pancreatitis ([Fig. 1 a, b]).
TCT-688 One Year Results of Tanscatheter Aortic Valve Therapy for Failed Surgical Bioprostheses - PARTNER II Valve-in-Valve Registry
Authors: Rakesh M Suri, John Webb, Michael Mack, Danny Dvir, Jonathon A Leipsic, Lowell F Satler, Kevin Greason, Darshan Doshi, Raj Makkar, Vinod Thourani, Lars Svensson, Todd Dewey, Augusto Pichard, Craig Smith, Martin Leon
Journal: Journal of the American College of Cardiology (2014)
Abstract P6-05-14: Estrogen-induced genes in ductal carcinoma in situ(DCIS): their comparison with invasive ductal carcinoma.
Authors: A Ebata, T Suzuki, K Takagi, Y Miki, Y Onodera, Y Nakamura, F Fujishima, K Ishida, M Watanabe, K Tamaki, T Ishida, N Ohuchi, H Sasano
Journal: Cancer Research (2012)

Abstract It is well known that estrogens play important roles in both the pathogenesis and development of invasive ductal carcinoma (IDC) of human breast. However, molecular features of estrogen actions have remained largely unclear in pure ductal carcinoma in situ (pDCIS), regarded as a precursor lesion of many IDCs. This is partly due to the fact that gene expression profiles of estrogen-responsive genes have not been examined in pDCIS. Therefore, we first examined the profiles of estrogen-induced genes in estrogen receptor (ER)-positive pDCIS and DCIS (DCIS-c) and IDC (IDC-c) components of IDC cases (n = 4, respectively) by microarray analysis. Estrogen-induced genes identified in this study were tentatively classified into three different groups in the hierarchical clustering analysis, and 33% of the genes were predominantly expressed in pDCIS rather than DCIS-c or IDC-c cases. Among these genes, the status of MYB (c-MYB), RBBP7 (RbAp46) and BIRC5 (survivin) expression in carcinoma cells was significantly higher in ER-positive pDCIS(n = 53) than that in ER-positive DCIS-c (n = 27) or IDC-c (n = 27) by subsequent immunohistochemical analysis of the corresponding genes (P &amp;lt; 0.0001, P = 0.03 and P = 0.0003, respectively). In particular, the status of c-MYB immunoreactivity was inversely (P = 0.006) correlated with Ki-67 in the pDCIS cases. These results suggest that expression profiles of estrogen-induced genes in pDCIS may be different from those in IDC, and c-MYB, RbAp46 and survivin may play particularly important roles among estrogen induced genes in ER-positive pDCIS. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P6-05-14.
Aortic Dilatation with Bicuspid Aortic Valve
Authors: Angela E Lin, Siddharth Prakash, Dianna M Milewicz
Journal: New England Journal of Medicine (2014)

Aortic Dilatation with Bicuspid Aortic ValveTo the Editor: In their review on thoracic aortic dilatation associated with bicuspid aortic valve, Verma and Siu (May 15 issue) 1 do not mention the increased prevalence of bicuspid aortic valve and its strong association with aortic dilatation and dissection in women with Turner's syndrome. 2This sex-chromosome disorder, which is caused by the loss of all or part of one X chromosome, affects approximately 1 in 2000 live-born females and approximately 80,000 women in the United States.The prevalence of bicuspid aortic valve in Turner's syndrome (approximately 1 in 3) is much greater than that in the general population and is frequently accompanied by other cardiovascular complications, such as dilatation or coarctation of the thoracic aorta. 3Its presence also increases the risk of aortic dissection and occurs more frequently, at younger ages, and during pregnancy in patients with Turner's syndrome. 4,5 Investigation of bicuspid aortic valve in patients with Turner's syndrome may provide generalizable insights into the contribution of X chromosome genes to bicuspid aortic valve in men, in whom increased susceptibility to bicuspid aortic valve may be due in part to a reduced dose of X chromosome genes.The unique association among bicuspid aortic valve, aortic disease, and Turner's syndrome is clearly important.
F-18 FDG Accumulation in Mucinous Cystic Neoplasm of Pancreas
Authors: Motohiro Sato, Takashi Hiyama, Keiko Kato, Takuro Shirasu, Fuyo Yoshimi, Hideo Nagai, Hitoaki Saito, Tatsuo Iijima
Journal: Clinical Nuclear Medicine (2010)

We report a case of mucinous cystic neoplasm which showed FDG accumulation in its cyst wall. MRI revealed that this tumor had repeated intracystic hemorrhage. Inhomogeneous FDG accumulation was found in the cyst wall. The epithelium was focally denuded and ovarian-like stroma with macrophage migration, which phagocytosed red blood cells, and fibrosis were recognized on histopathological examination. These histopathological findings suggested that FDG accumulates not in the monolayer epithelium but in ovarian-like stroma with macrophage migration and fibrosis. Macrophage migration and fibrosis were considered to have contributed to FDG accumulation in this mucinous cystic neoplasm.