tbuckley/cabot-search huggingface dataset:
OC-069 Outcomes of endoscopic resection of complex colorectal lesions referred to a tertiary institution after failed attempts at resection or extensive manipulation
Authors: A Emmanuel, S Gulati, M Burt, B Hayee, A Haji
Journal: Gut (2017)

Introduction  Substantial manipulation or sampling of large colorectal lesions prior to endoscopic resection can have significant effects on the feasibility and outcomes of endoscopic treatment. Failed attempts at resection and extensive sampling of lesions prior to referral to a specialist centre are common in western practice. However, there are few data defining the scope of the problem and the effects on outcomes following endoscopic resection. We examined the effect of significant prior manipulation on the feasibility and outcomes of endoscopic resection of complex colorectal neoplasms in a UK tertiary referral centre.  Method  Patients who underwent endoscopic resection of colorectal lesions≥2 cm were included. Lesions were assessed with magnification chromoendoscopy supplemented by colonoscopic ultrasound. A lesion specific approach was used to decide on resection technique. Patients were grouped according to whether they had previous failed attempts at resection, heavy manipulation (≥6 biopsies or tattoo into the lesion), or minimal sampling only (  Results  Endoscopic resection was performed for 408 large colorectal lesions (EMR n=327, ESD n=43, hybrid procedures using ESD n=38). Mean lesion size was 55.6 mm +/-30.7 mm. 216 (53%) lesions had been subjected to failed attempts at resection or heavy manipulation prior to referral. In 92 lesions (23%), an average of 1.5 (range 1–6) previous attempts at resection had been made, including 54 attempts at transanal surgical resection in 21 cases. A further 124 lesions (30%) had been extensively sampled or tattooed. Initial endoscopic resection was deemed successful in 97% of cases after previous failed attempts, 96% of cases with prior heavy manipulation and 97% of other cases (p=0.68). En bloc resection was possible in fewer patients with previous attempts at resection (14%, 31% and 42% respectively, p  Conclusion  After failed attempts at resection, patients have lower en bloc resection rates and higher recurrence rates. Nevertheless, specialist management in a dedicated tertiary unit results in successful, organ preserving endoscopic treatment of these extremely challenging lesions in 89% of cases with low complication rates.  Disclosure of Interest  None Declared
Anatomical configuration of the His bundle and bundle branches in the human heart.
Authors: G KMassing, T NJames
Journal: Circulation (1976)

The relationships among the His bundle, the origin of both bundle branches, and the interventricular (IV) septum were examined histologically in 32 human hearts, and the entire bundle branch systems were delineated in 13 of these. The His bundle in five hearts traversed the right IV septal crest, and the LBB origin was a very narrow stem (maximum 1.5 mm in cross-section) crossing from right to left through the inferior margin of the membranous septum. Proximal LBB anatomy was extremely variable, demonstrating multiple fiber groups which fanned out over the entire left septal surface. The LBB did not divide into two discrete divisions without multiple interconnections. The RBB formed an obtuse angle with the His bundle in 27 of 32 hearts. In those five hearts with right-sided His bundles, the right bundle branch was a direct continuation. The clinical, electrophysiologic, and electrocardiographic implications of these anatomical observations are discussed.
Vasopressin causes endothelium-dependent relaxations of the canine basilar artery.
Authors: Z SKatusic, J TShepherd, P MVanhoutte
Journal: Circulation Research (1984)

The effect of synthetic 8-arginine vasopressin (vasopressin) was studied in isolated canine basilar, left circumflex coronary, and femoral arteries of the dog. Vascular rings with and without endothelium were suspended for isometric tension recording in physiological salt solution. The removal of the endothelium was confirmed by the absence of relaxations induced by either thrombin (basilar arteries) or acetylcholine (coronary and femoral arteries). In the basilar artery, vasopressin induced concentration-dependent inhibition of myogenic tone. In basilar and coronary arteries, the hormone caused concentration-dependent relaxations during contractions evoked by prostaglandin F2 alpha. In femoral arteries, vasopressin caused contraction. After removal of the endothelium, the inhibitory responses to vasopressin were abolished in basilar arteries and significantly reduced in left circumflex coronary arteries. The contractions of femoral arteries were not affected by endothelium removal. The V1-vasopressinergi...
Stimulation of pulmonary vagal afferent C-fibers by lung edema in dogs.
Authors: A MRoberts, JBhattacharya, H DSchultz, H MColeridge, J CColeridge
Journal: Circulation Research (1986)

In anesthetized, open-chest dogs we examined the effect of pulmonary edema on the firing frequency of afferent vagal fibers arising from the lung. We recorded impulses from slips of the cervical vagus nerves and infused isotonic Krebs-Henseleit solution (20% of body weight) intravenously to increase net filtration pressure in the lung microvasculature. Measurement of extravascular lung water (6.0 +/- 0.4 g/g dry lung), and morphological examination of lung tissue (revealing various degrees of perivascular and peribronchial cuffing) confirmed that edema was present. At the end of the infusion when the lungs were congested (lung microvascular pressure, 37 cm water) and edematous, the impulse frequency of pulmonary and bronchial C-fibers and rapidly adapting receptors had increased 5-6 times. The only significant change in slowly adapting receptor activity was an increase during deflation. When lung water was still elevated but lung microvascular pressure had been restored to control by withdrawal of blood, ...
The effect of pericardium on the end-systolic pressure-segment length relationship in canine left ventricle in acute volume overload.
Authors: MKanazawa, KShirato, KIshikawa, TNakajima, THaneda, TTakishima
Journal: Circulation (1983)

The effect of the pericardium on the end-systolic pressure-segment length relationship in the left ventricle was examined with an ultrasonic miniature gauge in open-chest dogs. In 12 dogs, blood was infused until left ventricular (LV) end-diastolic pressure reached about 20 mm Hg, and then the pericardium was opened widely. In the other 12 dogs a pericardiectomy was performed without blood infusion. Stroke volume was measured in six dogs in the former group and in seven dogs in the latter group. After blood infusion, LV systolic, end-systolic, and end-diastolic pressures increased from 120 +/- 14 to 162 +/- 16 mm Hg (mean +/- SD), from 106 +/- 13 to 146 +/- 17 mm Hg, and from 8 +/- 2 to 19 +/- 2 mm Hg, respectively (all p less than .01). End-systolic and end-diastolic segment lengths increased from 8.9 +/- 2.1 to 10.6 +/- 2.2 mm and from 11.6 +/- 2.5 to 14.9 +/- 2.7 mm, respectively (both p less than .01). After pericardiectomy, the segments were further lengthened by 8.9 +/- 4.4% and by 10.0 +/- 6.2%, re...
Importance of collateral circulation for prevention of left ventricular aneurysm formation in acute myocardial infarction.
Authors: THirai, MFujita, HNakajima, HAsanoi, KYamanishi, AOhno, SSasayama
Journal: Circulation (1989)

The effect of preexistent coronary collateral perfusion on the prevention of left ventricular aneurysm formation was examined in 47 patients undergoing an intracoronary thrombolysis within 6 hours after the onset of a first acute anterior myocardial infarction. Left ventricular aneurysm formation and wall motion were analyzed with cineventriculography. A left ventricular aneurysm was determined as well-defined demarcation of the infarcted segment from normally contracting myocardium. In 25 patients with successful thrombolysis (group A), a left ventricular aneurysm was observed in one patient (4%) during the chronic stage of infarction. In 10 patients who had a significant collateral circulation to the infarct-related coronary artery and unsuccessful reperfusion (group B), the left ventricular aneurysm was observed in only one patient (10%). In the remaining 12 patients with unsuccessful recanalization in the absence of a significant collateral perfusion (group C), there was a higher incidence (seven of 1...
Physical Activity and Cognitive Function in Alzheimer Disease—Reply
Authors: Nicola T. Lautenschlager
Journal: JAMA (2009)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Overestimation of infarct size by quantitative two-dimensional echocardiography: the role of tethering and of analytic procedures.
Authors: TForce, AKemper, LPerkins, MGilfoil, CCohen, A FParisi
Journal: Circulation (1986)

Analyses of regional left ventricular systolic wall motion or thickening overestimate infarct size. We used quantitative two-dimensional echocardiographic analysis of systolic thickening and contrast two-dimensional echocardiography to evaluate causes for that overestimation. The following possibilities were considered: tethering, defined as dysfunction of contrast-enhancing myocardium adjacent to ischemic or contrast-negative regions, and the role of standard center of mass analysis algorithms, which may overestimate wall motion abnormalities because of the axis shift produced by simultaneous systolic expansion of the ischemic segment and systolic contraction of the nonischemic segment. In the short-axis view in 12 animals, the echo contrast defect (ECD) occupied 32 +/- 7% of the left ventricular circumference. Extent of dysfunction by the center of mass analysis was 39 +/- 5% of the left ventricular circumference and correlation with ECD size was .68 (SEE = 5.2%). Thus 8 +/- 6% of the circumference of...
Influence of dietary fat, apolipoprotein E phenotype, and sex on plasma lipoprotein levels.
Authors: M MCobb, HTeitlebaum, NRisch, JJekel, AOstfeld
Journal: Circulation (1992)

BACKGROUNDThe Western diet, sex, and apolipoprotein (Apo) E polymorphism have been implicated as codeterminants of lipid levels.METHODS AND RESULTSIn a retrospective analysis, we evaluated the combined impact of dietary fat, sex, and Apo E phenotype on lipoprotein levels in 67 subjects fed two contrasting, metabolically controlled diets: one a Western diet, with a low polyunsaturated to saturated (P:S) fatty acid ratio and the other a therapeutic diet, with a high P:S ratio. The high P:S diet compared with P:S diet exerted a far stronger predictive influence on lipoprotein concentrations than Apo E phenotype, sex, or the latter two factors combined. Apo E phenotype alone was associated with a stepwise increase in low density lipoprotein cholesterol (LDL-C), such that 3/2 less than 3/3 less than 4/3 on either the low or the high P:S diets. On the low P:S diet only, sex was shown to be a significant predictor of high density lipoprotein cholesterol (HDL-C) levels, with women greater than men, and the ...
Ergonovine-induced myocardial ischemia: no role for serotonergic receptors?
Authors: S BFreedman, SChierchia, LRodriguez-Plaza, RBugiardini, GSmith, AMaseri
Journal: Circulation (1984)

Because ergonovine appears to produce coronary contractions by a serotonergic (5-HT) mechanism, we attempted to prevent ergonovine-induced ischemia in patients with vasospastic angina by pretreatment with ketanserin, a new selective 5-HT blocker. We studied seven patients with consistently positive results of ergonovine testing (ST segment elevation in three and ST segment depression in four). Ergonovine testing was performed before and after a bolus of 10 mg of ketanserin (all patients) and infusion of 2 to 4 mg/hr for 8 hr (six patients). To assess 5-HT blockade during ketanserin infusion, the constrictor response of hand veins to 5-HT was tested before and after ketanserin. Despite evidence of 5-HT blockade in hand veins, ergonovine-induced ischemia was not prevented by ketanserin in any patient, and there was no significant change in the dose of ergonovine required to provoke ischemia. In one patient, four spontaneous episodes of ST segment elevation occurred during infusion of ketanserin. The plasma ...
Left main coronary artery stenosis: the influence of aortocoronary bypass surgery on survival.
Authors: LCampeau, FCorbara, DCrochet, RPetitclerc
Journal: Circulation (1978)

A retrospective study was carried out in 114 unoperated and 197 operated patients having left main coronary artery (LMCA) stenosis greater than or equal to 50%. Including the operative mortality of 9.1%, survival at seven years was significantly greater following pure aortocoronary bypass graft surgery, 77.5% as compared to 48.5% for the unoperated patients (P less than 0.01). The surgical mortality was significantly less during the last five years (1972-1976), 6.2% as compared to 17% during 1969-1971 (P less than 0.025). The three year survival in patients operated since 1972 was 90.2% as compared to 60.4% for unoperated patients. Survival remained significantly higher in the operated patients when studied as subsets on the basis of the severity of the LMCA stenosis (less than 70% as opposed to greater than or equal to 70%), and on the extent of associated obstructive disease of major coronary arteries (0-1 versus 2-3 arteries). It was significantly higher, however, only in operated patients with associa...
Balloon dilation angioplasty of hypoplastic and stenotic pulmonary arteries.
Authors: J ELock, W RCastaneda-Zuniga, B PFuhrman, J LBass
Journal: Circulation (1983)

Balloon dilation angioplasty (BDA) was attempted in seven children with either stenosis or hypoplasia (a narrowing greater than 1 cm long extending past the lung hilum) of both right and left pulmonary arteries (PAs). In two of these seven, the procedure could not be performed because of technical difficulties. In each of the remaining five children (1 1/2-16 years old), the right ventricular (RV) pressure was greater than 2/3 left ventricular pressure, main PA pressure was greater than 60 mm Hg, and previous operative attempts to relieve RV outflow obstruction, including the branch PA obstruction, were unsuccessful. BDA was performed in only one PA in each patient, and was considered successful if the pressure gradient decreased, angiographic diameter increased and the percentage of blood flow directed to the dilated lung increased. BDA was successful in all five children: RV pressure fell from 104 +/- 42 to 80 +/- 30 mm Hg (p less than 0.05), the gradient across the obstruction fell from 61 +/- 51 to 32...
Digoxin-quinidine interaction in patients with chronic renal failure.
Authors: P EFenster, W DHager, DPerrier, J RPowell, P EGraves, U FMichael
Journal: Circulation (1982)

We evaluated the effect of quinidine on digoxin pharmacokinetic in six patients with severe renal failure. Quinidine reduced the total body clearance of digoxin from 1.87 to 1.06 l/hour (p less than 0.001), and prolonged the digoxin half-life of elimination from 5.20 to 9.61 days (p less than 0.01). The digoxin volume of distribution was unchanged. Renal clearance of digoxin was negligible; thus, the decrease in total body clearance was due to a decrease in the nonrenal clearance of digoxin. The mean trough serum concentrations of quinidine ranged from 1.0 to 3.0 micrograms/ml. We conclude that in patients with chronic renal failure, the dose of digoxin should be decreased by 50% if quinidine therapy is initiated.
Ouabain. A stimulator of atrial natriuretic peptide secretion and its mechanism of action.
Authors: R JSchiebinger, E JCragoe
Journal: Circulation Research (1993)

Ouabain increases atrial natriuretic peptide (ANP) secretion. When isolated superfused rat left atria were paced at 2 Hz, ouabain at concentrations of 50, 100, and 200 microM increased ANP secretion by 2.0 +/- 0.3-, 3.2 +/- 0.5-, and 4.2 +/- 0.5-fold, respectively. In this study, we examine the mechanism of ouabain-stimulated ANP secretion using the dose of 100 microM. To determine whether calcium played a role, atria were superfused with the calcium antagonist lanthanum. Superfusion with 2 mM LaCl3 completely inhibited ouabain-stimulated secretion, suggesting that calcium influx and/or sarcoplasmic reticulum (SR) calcium release provide essential sources of calcium for the stimulatory pathway. To determine the contribution of calcium from the SR, atria were superfused with ryanodine, an agent that depletes the SR of calcium. Superfusion with 1 microM ryanodine inhibited ouabain-stimulated secretion by 47%. Inhibition of Na+,K(+)-ATPase allows sodium to accumulate in the cell. A rise in intracellular sodi...
Interleukin-2-induced lung injury. The role of complement.
Authors: RRabinovici, M DSofronski, PBorboroglu, A MSpirig, L MHillegas, JLevine, JVernick, S MScesney, NFeuerstein, GFeuerstein
Journal: Circulation Research (1994)

Pulmonary edema and sepsis-like syndrome are grave complications of interleukin-2 (IL-2) therapy. Recent animal studies have suggested IL-2-induced microvascular injury as the underlying mechanism. Since complement factors have been shown to mediate increased vascular permeability in diverse conditions that lead to pulmonary injury and recombinant human IL-2 is known to activate the complement system in patients undergoing IL-2 therapy, we hypothesized that complement factors play a pivotal role in the development of increased vascular permeability after IL-2 treatment. To test this hypothesis, we evaluated the capacity of recombinant soluble human complement receptor type 1 (sCR1, BRL 55730), a new highly specific complement inhibitor, to attenuate IL-2-induced lung injury in the rat. Recombinant human IL-2 (intravenously for 60 minutes) at 10(6) U per rat (n = 4) elevated lung water content (37 +/- 6%, P < .05), myeloperoxidase activity (162 +/- 49%, P < .05), and serum thromboxane B2 (30 +/- 1 pg/100 m...
Detection and characterisation of extracellular vesicles in exhaled breath condensate and sputum of COPD and severe asthma patients
Authors: Donatella Lucchetti, Giuseppe Santini, Luigi Perelli, Claudio Ricciardi-Tenore, Filomena Colella, Nadia Mores, Giuseppe Macis, Andrew Bush, Alessandro Sgambato, Paolo Montuschi
Journal: European Respiratory Journal (2021)

<b>Small and medium extracellular vesicles, identified and characterised in exhaled breath condensate and induced sputum supernatants, might provide pathophysiological insights and novel biomarkers in severe asthma and COPD patients</b>https://bit.ly/3fiTnXY
Effect of regional ischemia on the left ventricular end-systolic pressure-volume relationship of isolated canine hearts.
Authors: KSunagawa, W LMaughan, KSagawa
Journal: Circulation Research (1983)

We studied the effects of regional ischemia on the left ventricular isovolumic end-systolic pressure-volume relationship (ESPVR) in six excised, blood-perfused canine ventricles. We created different extents of regional ischemia by ligating various branches of the coronary arteries while keeping the coronary arterial pressure constant (80 mm Hg). The extent of regional ischemia (Rm) relative to the total mass of the left ventricular myocardium was determined by regional myocardial blood flow measured by the radioactive microsphere technique. With regional ischemia, the ESPVR shifted rightward without significant change in slope in the physiologic end-systolic pressure range. In the subphysiological end-systolic pressure range, however, its slope became lower than control. In order to quantify the degree of the rightward shift, we measured the extrapolated volume axis intercept (Vo) by fitting a straight line to the ESPVR in the physiological range under control and ischemic conditions. The shift in Vo (de...
Alteration of contractile function and excitation-contraction coupling in dilated cardiomyopathy.
Authors: GHasenfuss, L AMulieri, B JLeavitt, P DAllen, J RHaeberle, N RAlpert
Journal: Circulation Research (1992)

Myocardial failure in dilated cardiomyopathy may result from subcellular alterations in contractile protein function, excitation-contraction coupling processes, or recovery metabolism. We used isometric force and heat measurements to quantitatively investigate these subcellular systems in intact left ventricular muscle strips from nonfailing human hearts (n = 14) and from hearts with end-stage failing dilated cardiomyopathy (n = 13). In the failing myocardium, peak isometric twitch tension, maximum rate of tension rise, and maximum rate of relaxation were reduced by 46% (p = 0.013), 51% (p = 0.003), and 46% (p = 0.018), respectively (37 degrees C, 60 beats per minute). Tension-dependent heat, reflecting the number of crossbridge interactions during the isometric twitch, was reduced by 61% in the failing myocardium (p = 0.006). In terms of the individual crossbridge cycle, the average crossbridge force-time integral was increased by 33% (p = 0.04) in the failing myocardium. In the nonfailing myocardium, th...
Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study.
Authors: R ASchatz, D SBaim, MLeon, S GEllis, SGoldberg, J WHirshfeld, M WCleman, H SCabin, CWalker, JStagg
Journal: Circulation (1991)

Stenting of native coronary arteries with a balloon-expandable stent was attempted in 226 patients after elective angioplasty. Delivery of the device was successful in 213 (94%) of the patients. Of these, 39 received aspirin and dipyridamole only (group 1) and 174 received aspirin, dipyridamole, and warfarin for 1-3 months (group 2). There was no abrupt closure (less than or equal to 1 day) or perioperative death in either group. In-hospital or perioperative complications in group 1 compared with group 2 were as follows: subacute closure (1-14 days), seven (18%) patients versus one (0.6%) patient, respectively, p less than 0.0001; myocardial infarction, five (13%) patients versus one (0.6%) patient, respectively; condition requiring urgent bypass surgery, one (2.5%) patient versus no patients, respectively. Thus, the incidence of major complications such as death, myocardial infarction, or a condition requiring urgent bypass surgery was 15% in group 1 and 0.6% in group 2. Clinical follow-up revealed that ...