tbuckley/cabot-search huggingface dataset:
Postural changes in left ventricular and mitral valvular dynamics in the systolic click - late systolic murmur syndrome.
Authors: M EFontana, C FWooley, R FLeighton, R PLewis
Journal: Circulation (1975)

Marked changes in the auscultatory pattern with posture have been noted in patients with mid-systolic clicks and/or late systolic murmurs (MSC-LSM). MSC tend to move earlier in systole and LSM become longer and often louder when patients assume upright posture. Systolic prolapse of the mitral leaflets with mild regurgitation account for MSC-LSM; earlier and greater prolapse with more and prolonged regurgitation associated with a reduced left ventricular volume (LVV) in the upright position would explain the auscultatory changes. Twenty-two patients with MSC-LSM were studied supine and at 45 degrees head-up tilt, recording intracardiac pressures, cardiac outputs, systolic time intervals, and performing LV cineangiography. Systolic prolapse of one or both mitral leaflets was demonstrated in all patients. Left ventricular end-diastolic and end-systolic volumes both decreased significantly at 45 degrees in all sixteen technically satisfactory studies. Greater mitral prolapse was noted upright in 12 of 14 stud...
The myxomatous mitral valve and sudden death.
Authors: EChesler, R AKing, J EEdwards
Journal: Circulation (1983)

The clincopathologic features of 14 cases of sudden death attributable to dysrhythmias associated with the myxomatous mitral valve are described. The patients were 14-59 years old (mean 27 +/- 11 years). Eleven were female and three male. Of the seven ECGs available, none showed prolongation of the QT interval, but two showed repolarization abnormalities. The material was classified according to the degree of prolapse in the pathologic specimen. When obvious prolapse was found, the expected auscultatory findings had been documented. In three cases there was minimal prolapse, casting some doubt on the hypothesis that traction on the papillary muscles or diastolic dumping of the leaflets may be implicated in the pathogenesis of the dysrhythmias. In one of the cases with minimal prolapse there was a strong family history of sudden death. Endocardial friction lesions were present in 11 cases, including two of the three with minimal prolapse. In five cases there was a thrombotic lesion in the angle between the...
Shall The Journal be Removed to Washington?
Authors: T. R. Luff
Journal: JAMA (1891)

I thought he must be suffering from a dislocation, and asked him to allow me to examine the joint.I did not give him ether in the reduction of it.I told him we would first break up the adhesions if he was willing to stand it.He agreed to this, and after the adhesions were broken up, the dislo¬ cation was reduced very readily.I did not give an anaesthetic.Another case, a man fell from a moving train, falling on his shoulder and simply stated to the physician that he had fallen off the train and struck his shoulder.The physician did not look for a dislocation.It was allowed to go for about ten days.So that I think it is always necessary to inquire carefully, and in some cases to use an anaesthetic when in doubt.
Sensitivity of end-systolic pressure-dimension and pressure-volume relations to the inotropic state in humans.
Authors: K MBorow, ANeumann, JWynne
Journal: Circulation (1982)

The value for the slope of the left ventricular (LV) end-systolic pressure-dimension and pressure-volume relations has been proposed as a quantitative measure of the LV inotropic state. This measure of LV inotropic state is attractive because it is independent of preload and incorporates afterload. To investigate the sensitivity of the slope of these relations to alterations in contractile state, 10 normal subjects were studied using M-mode echocardiographic, phonocardiographic and indirect carotid pulse recordings during infusion of methoxamine to alter end-systolic pressure and during infusion of dobutamine (5 micrograms/kg/min) to increase LV inotropic state. Heart rate was maintained within a narrow range for each subject. End-systolic volume was calculated from end-systolic echocardiographic dimension by standard methods. End-systolic pressure was estimated from the dicrotic notch pressure determined from a calibrated carotid pulse recording; peak systolic pressure was also measured. Regardless of th...
Hypothyroidism delays ischemia-induced contracture and adenine nucleotide depletion in rat myocardium.
Authors: L SCarter, R AMueller, E ANorfleet, F BPayne, L SSaltzman
Journal: Circulation Research (1987)

Isolated perfused paced hearts from rats rendered hypothyroid by chronic administration of propylthiouracil have a delayed onset of ischemia-induced myocardial contracture in contrast to hearts from control rats. In addition, the time to reach maximum contracture is delayed, and the magnitude of the contracture pressure is reduced. Preischemia myocardial adenosine triphosphate (ATP) values in the hypothyroid rat hearts are similar to those of control, but the rate of decrease in ATP is slower in the hearts of hypothyroid rats. Thus, it appears that in the hypothyroid state the development of ischemic contracture is associated with a slower fall of ATP.
Epstein–Barr Virus Induces Adipocyte Dedifferentiation to Modulate the Tumor Microenvironment
Authors: Shu-Chen Liu, Ngan-Ming Tsang, Po-Ju Lee, Yun-Hua Sui, Chen-Han Huang, Tzu-Tung Liu
Journal: Cancer Research (2021)

Abstract The most frequent location of metastatic EBV+ nasopharyngeal carcinoma (NPC) is the bone marrow, an adipocyte-dominant region. Several EBV-associated lymphoepithelioma-like carcinoma (LELC) types also grow in the anatomical vicinity of fat tissues. Here we show that in an adipose tissue-rich tumor setting, EBV targets adipocytes and remodels the tumor microenvironment. Positive immunoreactivity for EBV-encoded early antigen D was detected in adipose tissue near tumor beds of bone marrow metastatic NPC. EBV was capable of infecting primary human adipocytes in vitro, triggering expression of multiple EBV-encoded mRNA and proteins. In infected adipocytes, lipolysis was stimulated through enhanced expression of lipases and the AMPK metabolic pathway. The EBV-mediated imbalance in energy homeostasis was further confirmed by increased release of free fatty acids, glycerol, and expression of proinflammatory adipokines. Clinically, enhanced serum levels of free fatty acids in patients with NPC correlated with poorer recurrence-free survival. EBV-induced delipidation stimulated dedifferentiation of adipocytes into fibroblast-like cells expressing higher levels of S100A4, a marker protein of cancer-associated fibroblasts (CAF). IHC analyses of bone marrow metastatic NPC and salivary LELC revealed similar structural changes of dedifferentiated adipocytes located at the boundaries of EBV+ tumors. S100A4 expression in adipose tissues near tumor beds correlated with fibrotic response, implying that CAFs in the tumor microenvironment are partially derived from EBV-induced dedifferentiated adipocytes. Our data suggest that adipose tissue serves as an EBV reservoir, where EBV orchestrates the interactions between adipose tissues and tumor cells by rearranging metabolic pathways to benefit virus persistence and to promote a protumorigenic microenvironment. Significance: This study suggests that Epstein–Barr virus hijacks adipocyte lipid metabolism to create a tumor-promoting microenvironment from which reactivation and relapse of infection could potentially occur.
Prostaglandin control of the renal circulation in response to hypoxemia in the fetal lamb in utero.
Authors: R WMillard, HBaig, S FVatner
Journal: Circulation Research (1979)

We studied the effects of 10-minute periods of hypoxemia in unanesthetized fetal lambs in utero instrumented for measurements of arterial pressure and renal and iliac blood flows. Fetal hypoxemia, induced by delivering a hypoxic gas mixture to the ewe, was characterized by a reduction in fetal PaO2 from 20.1 +/- 1.4 to 8.8 +/- 1.0 mm Hg (mean +/- SE). The fetus responded with bradycardia and persistent vasoconstriction in the iliac bed throughout the 10-minute period. In contrast, renal resistance rose significantly only at the end of the hypoxemic period. After 5-7 minutes of hypoxemia, when iliac flow had fallen by 40 +/- 4% and iliac resistance had risen by 86 +/- 13%, renal flow and resistance were not changed significantly from control; in fact, we found that renal flow rose substantially at this time in several fetal lambs. After blockade of prostaglandin synthesis with either indomethacin or meclofenamate, renal flow fell after 5-7 minutes of hypoxemia by 36 +/- 5%. The reduction in renal flow and ...
Verapamil in the management of supraventricular tachyarrhythmias occurring after a recent myocardial infarction.
Authors: FHagemeijer
Journal: Circulation (1978)

In 16 patients, a sustained supraventricular tachyarrhythmia occurring less than 72 hours after the first symptom of an acute myocardial infarction was treated with titrated doses of verapamil. The drug was given intravenously in 1 mg increments every minute under continuous monitoring of electrocardiogram and blood pressure. Endpoints for the administration of verapamil were the following: reversion to sinus rhythm; a ventricular rate slower than 100/min; hypotension; a pulmonary capillary wedge pressure rising above 15 mm Hg; signs of intolerance; a maximum dose of 20 mg. Reversion to sinus rhythm was observed in 7/8 patients in atrial flutter and in 1/8 patients in atrial fibrillation; in all the ventricular rate could be slowed below 100/min without untoward effects.
Two-dimensional echocardiographic assessment of vegetative endocarditis.
Authors: B WGilbert, R SHaney, FCrawford, JMcClellan, H AGallis, M LJohnson, J AKisslo
Journal: Circulation (1977)

Real-time, two-dimensional echocardiography was used to document the presence and assess the size and location of vegetative lesions of the cardiac valves and chambers in seven patients with bacterial endocarditis. Anatomic correlation (surgical or autopsy) was accurate in all patients. Two-dimensional echocardiography was shown to be of particular value in determining morphologic characteristics of the lesions since this technique provides spatial information concerning moving cardiac structures. The results of two-dimensional echocardiography were most helpful in determining selected aspects of the clinical care provided for each patient. These data demonstrate that real-time, two-dimensional echocardiography, in combination with M-mode imaging techniques, may be of great potential value in the detection of vegetative endocarditis. Furthermore, reliable assessment of lesion size and location may, in time, become a valuable method for following the morphologic changes that occur in vegetative lesions, an...
Radiation Therapy in the Treatment of Hodgkin's Disease--Do You See What I See?
Authors: D. L. Longo
Journal: JNCI Journal of the National Cancer Institute (2003)

Controversy isanintegral part of nearlyall major progress inscience and medicine. One exception isthe development of anactive therapy where no previous therapy was effective. A fieldgenerally has no problem adopting a novel active treatment.However, when newer approaches are found that are either saferor more effective or both,they sometimes have trouble displac-ing an established approach.And so it iswith theroleof radia-tion therapy inthe treatment of Hodgkin’s disease.Historically, radiation therapy was the first curative therapyfor Hodgkin’s disease. Technicalinnovations inradiation equip-ment and clever designs of radiation fields broughtustothepoint where patients without B symptoms and withdisease lo-calized to one sideof the diaphragm could have theHodgkin’sdisease permanently eradicated in 80%–85% of cases. Patientswith B symptoms and with more advanceddisease fared con-siderably worse.In the 1960s and 1970s, genuine advances were made incombination chemotherapy programs that were first tested andconfirmed to be active inthe group of patients who could not beoptimally treatedbyradiation therapy, namelythose withBsymptoms and advanceddisease. Theefficacy of chemotherapyinadvanced-stage disease was comparabletotheefficacy ofradiation therapy in early-stage disease such that bythe 1980s,stage was no longer a prognostic factor. Subsequently, theche-motherapy programs were testedin patients usually treated withradiation therapy and were found to beatleast as effective asradiation therapy at eliminating theHodgkin’s disease.As patients began to survive longer after the successful treat-ment of theirHodgkin’s disease, other problems occurredinthese treated patients at a greater frequency than one wouldexpect in an age-matched population that had not been treatedfor Hodgkin’s disease. Fortunately, substantial numbers oflong-term survivors were producedbyradiation therapy andby com-bination chemotherapy, so it was possible to ascertainwhichproblems were related to theunderlying disease and which wererelated to treatment. For example, an increased risk of B-celllymphoma, often involving the gastrointestinal tract, was notedin patients treated with radiation therapy, chemotherapy, or both
Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation.
Authors: MEnriquez-Sarano, A JTajik, H VSchaff, T AOrszulak, K RBailey, R LFrye
Journal: Circulation (1994)

BACKGROUNDLeft ventricular dysfunction is a frequent cause of death after successful surgical repair of mitral regurgitation. The role of preoperative echocardiographic left ventricular variables in the prediction of postoperative survival and thus their clinical implications remain uncertain.METHODS AND RESULTSThe survival of 409 patients operated on between 1980 and 1989 for pure, isolated, organic mitral regurgitation and with a preoperative echocardiogram (within 6 months of operation) was analyzed. The overall survival was 75% at 5 years (90% of expected), 58% at 10 years (88% of expected), and 44% at 12 years (73% of expected). Operative mortality was 6.6% and markedly improved from 1980 to 1984 (10.7%) to 1985 to 1989 (3.7%). Multivariate analysis showed that age (P = .0003), date of operation (P = .003), and functional class (P = .016) but not left ventricular function were predictors of operative mortality. In the most recent period (1985 to 1989), operative mortality was 12.3% in patients age 75...
Comparison of echocardiographic and necropsy measurements of ventricular wall thicknesses in patients with and without disproportionate septal thickening.
Authors: B JMaron, W LHenry, W CRoberts, S EEpstein
Journal: Circulation (1977)

In several patients with asymmetric septal hypertrophy (ASH) diagnosed by echocardiography (septal-free wall thickness ratios greater than or equal to 1.3), we have discovered marked discrepancies between the echocardiographic and necropsy measurements of wall thicknesses that led to uncertainty regarding the actual cardiac diagnosis. To resolve these apparent incongruities, the echocardiograms and hearts of 17 patients with cardiac disease were studied. Six of nine patients with abnormal septal-free wall ratios greater than or equal to 1.3 during life had septal-free wall ratios that were not diagnostic of disproportionate septal thickening at necropsy. Such discrepancies may be explained as follows: 1) echocardiographic measurements during life were made in diastole (as per convention), but measurements at necropsy were made in hearts that appeared to have been in the systolic phase of the cardiac cycle; 2) the left ventricular free wall thickens considerably more than the ventricular septum in systole,...
Thrombin receptor 14-amino acid peptide mediates endothelial hyperadhesivity and neutrophil adhesion by P-selectin-dependent mechanism.
Authors: YSugama, A BMalik
Journal: Circulation Research (1992)

Thrombin cleaves its receptor at arginine-41, resulting in the generation of a new receptor NH2-terminus with the sequence SFLLRNPNDKYEPF. This peptide (TRP-14) may signal a variety of thrombin's responses. We examined the effects of TRP-14 in inducing endothelial cell hyperadhesivity and neutrophil (PMN) adhesion to endothelial cell monolayers. Human umbilical vein endothelial cells (HUVECs) challenged with TRP-14 (10(-4) to 10(-5) M) produced concentration-dependent increases in endothelial adhesivity to PMN. In contrast, position 1 to 2 inverted peptide (FSLLRNPNDKYEPF) did not induce the response. The adhesion response was transient; that is, PMN adhesion increased within 15 minutes and decreased by 75 minutes after TRP-14 challenge of HUVECs. The transient endothelial adhesiveness paralleled the time course of P-selectin expression. TRP-14-induced release of P-selectin from intracellular stores may be a critical determinant of the response since treatment of endothelial cells with anti-P-selectin mon...
Thromboembolic and bleeding complications in patients with mechanical heart valve prostheses.
Authors: S CCannegieter, F RRosendaal, EBriët
Journal: Circulation (1994)

BACKGROUNDPatients with mechanical heart valve prostheses may experience valve thrombosis and subsequent systemic embolism for which they are treated with oral anticoagulant therapy. It is essential to know reliable estimates of the risks and benefits of this therapy in order to answer a number of clinical questions rationally. We sought to obtain more precise estimates of the risks and benefits by combining the data from individual studies by using meta-analysis.METHODS AND RESULTSWe searched for studies in which the incidences were reported of embolic or bleeding complications in patients with mechanical heart valve prostheses. They were collected from the Medline and Current Contents database and by cross-references between 1970 and 1992. Since most studies vary greatly in many respects, we used a number of inclusion criteria, thus selecting comparable studies of acceptable quality only. The influence of antithrombotic therapy, valve position, and valve type was analyzed by univariate and by multivaria...
Stimulus-response curve of the renal baroreceptor: effect of converting enzyme inhibition and changes in salt intake.
Authors: E RFarhi, J RCant, W CPaganelli, V JDzau, A CBarger
Journal: Circulation Research (1987)

We investigated the effect of converting enzyme inhibition (CEI) on the relationship between renal perfusion pressure (RPP) and steady-state plasma renin activity (PRA) in uninephrectomized conscious dogs on normal-salt (80 meq Na+/day) and low-salt (10 meq Na+/day) diets. Stimulus-response curves for the renal baroreceptor were determined by measuring the steady-state PRA while the RPP was lowered and then held constant by an inflatable cuff placed around the renal artery. On each diet the control stimulus-response curve can be described by two lines intersecting at a threshold pressure; in the higher pressure range PRA is relatively insensitive to changes in RPP, while in the lower pressure range PRA is very responsive to changes in RPP. On the normal-salt diet CEI significantly increases the sensitivity of PRA to RPP in the responsive range without affecting the threshold pressure itself or the values of PRA at pressures greater than the threshold pressure. On the low-salt diet CEI also increases the s...
Unique resistance to guanethidine-induced chemical sympathectomy of spontaneously hypertensive rats: a resistance overcome by treatment with antibody to nerve growth factor.
Authors: E MJohnson, R AMacia
Journal: Circulation Research (1979)

The chronic administration of high doses of guanethidine to rats produces complete destruction of the peripheral sympathetic nervous system. In a study of the effect of guanethidine-induced sympathectomy on the development of hypertension is spontaneous hypertensive rats (SHR, Okomoto strain), only a partial sympathectomy could be produced as assessed by biochemical parameters (tyrosine hydroxylase activity in ganglia and tissue norepinephrine concentrations) and by evaluation of response to stimulation of vasomotor outflow in pithed rat preparations. Other strains of rats (Sprague-Dawley, American Wistar, Kyoto Wistar) were uniformly sensitive to guanethidine sympathectomy. The resistance to guanethidine was not due to a lower accumulation of guanethidine in the neurons of SHR. Addition to the guanethidine treatment of low doses of antibody to nerve growth factor (NGF), which itself produced only a modest sympathectomy, resulted in an almost complete sympathectomy. SHR did not become hypertensive when sy...
FACTS AND OPINIONS RELATING TO TUBERCULOSIS, WITH COMMENTARIES
Authors: H. Anceli
Journal: BMJ (1853)

Tuberculous Diseases, there may be some surprise that I should so soon again urge the subject upon the attention of the profession.There have subsequently appeared several important statistical reports, and some interesting papers and monographs; and my work has been reviewed by all the more influential medical, and some literary periodical journals, eliciting the discussion of certain disputed points.I have carefully collated such of these as have been brought under my notice, with a view to ascertain the facts and opinions they contain, and how far they tend to confirm or to correct the principles and practice inculcated in my own book; and, since it will impose on me very little additional labour, I purpose, in a few papers, to lay the results of this investigation bfore the readers of the AsSOCIATION JOURINAL.The present paper will embrace, mainly, statistical facts: and I commence with the statistics of tuberculous diseases in London, for the year 1852, from the Registrar-General's Sumnmiary of the Cauwes of Death, very recently distributed.My work on tuberculosis contains similar records as late as the.termination of the year 1851.The population of London, as estimated in this report, to the middle of the year, was 2,420,619; the total deaths were 54,213.The following table shows the deaths from tuberculous diseases: TABLE I.
Recognition of residual postoperative shunts by contrast echocardiographic techniques.
Authors: L MValdes-Cruz, D RPieroni, J MRoland, J PShematek
Journal: Circulation (1977)

A bedside echocardiographic technique was used to detect and localize residual intracardiac shunts in 26 patients who had surgical repair of septal defects. Contrast echocardiography was performed through central venous and left atrial monitoring catheters at the same time as cardiogreen dye curves. Indicator dilution confirmed residual atrial defects in ten patients and ventricular defects in five. Contrast echocardiography indicated the presence and level of shunting in all 15 patients. Temporary flow through newly implanted septal patches was detected and differentiated from shunting across a true residual defect. The contrast echocardiographic technique using injections through the central venous and left atrial catheters as described detects and localizes right-to-left and left-to-right shunting. It is a safe and reliable method to evaluate residual intracardiac defects postoperatively.
In vitro study of the influence of radial wall motion on wall shear stress in an elastic tube model of the aorta.
Authors: MKlanchar, J MTarbell, D MWang
Journal: Circulation Research (1990)

The purpose of this study was to determine the influence of radial motion of an arterial wall on the shear stress that flowing blood imposes on the wall (wall shear stress). Wall shear stress is known to influence endothelial cell function and may play a role in atherogenesis, but its magnitude and distribution in the circulation are not well understood. To simulate arterial wall motion, we used both straight and curved rubber tubing models in a mock circulatory system incorporating a variable impedance element distal to the model aorta. Wall shear rate was measured with a hot-film anemometer probe mounted flush on the tubing wall and free to move with the wall. Wall shear stress was determined as the product of wall shear rate and viscosity. By changing the distal impedance element, we determined the influence of the (temporal) phase angle between pressure and flow, or equivalently, tube diameter and flow, on wall shear stress. We observed a fivefold increase in peak wall shear stress and the onset of in...