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SSX cancer testis antigens are expressed in most multiple myeloma patients: co-expression of SSX1, 2, 4, and 5 correlates with adverse prognosis and high frequencies of SSX-positive PCs. J Immunother 2006; 28:564-75. [PMID: 16224274 DOI: 10.1097/01.cji.0000175685.36239.e5] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Cancer testis antigens (CTAs) are tumor-specific antigens that may be useful targets for cancer vaccines. Here, CTA expression was examined in multiple myeloma (MM), a B-cell cancer characterized by malignant plasma cells (PCs) in the bone marrow (BM), and monoclonal gammopathy of undetermined significance (MGUS), a condition that can progress to MM. We screened a panel of patient BMs at different stages of malignancy for CTA expression by reverse transcription polymerase chain reaction RT-PCR. Here, SSX (synovial sarcoma, X chromosome) emerged as a promising candidate for an MM vaccine, having a profile similar to currently studied CTA, NY-ESO-1, and MAGE. SSX1, 2, 4, and 5 expression was studied further in 114 MM (total SSX, 61% of patients; SSX1, 42%; SSX2, 23%; SSX4, 38%; SSX5, 35%), 45 MGUS (total SSX, 24% of patients; SSX1, 9%; SSX4, 20%), and 12 control (0/12, 0%) subjects. Several expression patterns were observed, the most predominant being co-expression of SSX1, 2, 4, and 5 (called group A expression, in 20% of MM), which correlated with reduced survival (P=0.0006). Of the four genes, SSX2 had the strongest association with reduced survival (P=0.0001). SSX protein expression ranged from 13.5% of PCs in an SSX1/SSX4 co-expressor to as high as 88% of PCs in group A expressor, exceeding reported frequencies of NY-ESO-1 and MAGE in MM. In single PCs from group A patients, we detected variable degrees of SSX co-expression, emphasizing the heterogeneity of CTA expression within tumor cell populations. These results demonstrate that SSX is a frequently expressed CTA in MM and highlight its potential as an MM vaccine candidate.
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Intraclonal homogeneity of clonotypic immunoglobulin M and diversity of nonclinical post-switch isotypes in multiple myeloma: insights into the evolution of the myeloma clone. Clin Cancer Res 2002; 8:502-13. [PMID: 11839670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
PURPOSE The transformation status and role of clonotypic pre-switch IgM in the evolution of malignant post-switch multiple myeloma (MM) cells is unclear. In this study, we determined the differentiation stage within the B lineage of clonotypic cells from malignant and nonclinical isotype pools by analyzing the frequency and intraclonal diversity of members within each isotype pool. RESULTS Immunoglobulin VDJ transcripts were amplified from peripheral blood cells of seven patients with a hemi-nested reverse transcription-PCR with complementarity determining region 1 (CDR1)-specific and constant region primers. Of the 1951 clones screened by patient CDR2/3-specific PCR, 356 of these were sequenced. Intraclonal homogeneity was observed in pre-switch transcripts from four of four informative patients. Transcripts from the IgM pool were relatively frequent in two of four informative patients. Cellular limiting dilution analysis indicated 0.4-25% of peripheral blood mononuclear cells expressed clonotypic IgM for 6 of 15 samples tested. By contrast, significant intraclonal diversity was observed in the nonclinical IgA pool of 1 patient. A genealogical tree of IgA sequences was constructed showing ongoing clonal diversification from sequences with close homology to the germ-line V gene to those resembling the PC sequence. Furthermore, some clones exhibited complete homology with tumor VDJ sequence, plus extra mutations, suggestive of a parallel clonal arm that remains responsive to an antigenic stimulus. CONCLUSIONS Detection of intraclonal diversity in the post-switch nonclinical isotype pool suggests that remnants of the parent B-cell clone coexist with malignant clonal precursors. The presence of intraclonal homogeneity in the pre-switch IgM pool supports the idea that pre-switch MM cells play a role in malignant events within the MM clone.
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A comparison of two techniques for manual ventilation of the lungs by non-anaesthetists: the bag-valve-facemask and the cuffed oropharyngeal airway (COPA) apparatus. Anaesthesia 2001; 56:756-9. [PMID: 11493238 DOI: 10.1046/j.1365-2044.2001.02090.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In order to evaluate the possible role of the cuffed oropharyngeal airway during cardiopulmonary resuscitation, we compared its use by non-anaesthetists with the bag-valve-facemask technique of providing ventilation. A group of anaesthetic nurses and operating department practitioners were asked to manually ventilate the lungs of 40 patients undergoing elective surgery following the induction of general anaesthesia with neuromuscular blockade. Ventilation was first attempted using the bag-valve-facemask technique and then using the appropriate size cuffed oropharyngeal airway and self-inflating bag. Ventilation was clinically adequate in 32/40 (80%) patients using the bag-valve-facemask and in 38/40 (95%) patients using the cuffed oropharyngeal airway. Measured expired tidal volumes were greater using the cuffed oropharyngeal airway than with bag-valve-facemask ventilation in two-thirds of patients, despite a higher incidence of audible air leak. Successful ventilation was achieved using the cuffed oropharyngeal airway in seven of the eight patients in whom bag-valve-facemask ventilation was inadequate. The cuffed oropharyngeal airway may offer an effective method of providing ventilation during cardiopulmonary resuscitation by non-anaesthetic hospital staff, particularly when attempted ventilation using a bag-valve-facemask technique is proving ineffective.
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Magnesium sulphate for pre-eclampsia and a sudden bradycardia. Br J Anaesth 2000; 85:327-8. [PMID: 10992853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
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Abstract
A 76-year-old woman sustained inadvertent perforation of her posterior bladder wall during transurethral resection of a bladder tumour. In the immediate postoperative period, she developed life-threatening respiratory failure following the formation of a large, unilateral pleural effusion. After therapeutic drainage, biochemical analysis of the effusion revealed that it had a high concentration of glycine. The fluid used for intra- and postoperative bladder irrigation had leaked from the perforated bladder and collected in the pleural cavity. This type of hydrothorax complicating endoscopic urological surgery has not been described previously.
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Palacos and peanut oil. Anaesthesia 1999; 54:1233-4. [PMID: 10712187 DOI: 10.1046/j.1365-2044.1999.01236.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
We studied the frequency with which treatment was withdrawn in intensive care patients and the primary reason for reaching the decision. The medical records of patients having had active treatment withdrawn between August 1992 and February 1996 inclusive were reviewed. Patients were classified into an imminent death group consisting of those expected to die, a qualitative group who had treatment withdrawn on quality of life considerations and a lethal conditions group who had associated disease that precluded long-term survival. There were 1745 patients admitted, of whom 338 (19.4%) died in ICU. In 220 patients death followed the withdrawal of treatment (12.6% of all ICU admissions), 203 dying on ICU (60% of ICU deaths) and a further 17 soon after discharge to a ward. The primary reason for treatment withdrawal was imminent death in 45% of patients, qualitative considerations in 50% and lethal conditions in 5%. The reason varied significantly depending on the patient's age. Treatment is withdrawn commonly in ICU, the primary reason being quality of life considerations as often as because death is the expected outcome.
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Abstract
Ecstasy is an illegal recreationally used drug. A case of a young woman who had taken this drug and was found to have a spontaneous pneumomediastinum is reported. The association of spontaneous pneumomediastinum with drug abuse is discussed. The possible mechanism for this complication of Ecstasy, which has not been previously reported, is discussed.
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The Southern Society for Clinical Investigation at 50: the end of the beginning. Am J Med Sci 1996; 311:248-53. [PMID: 8659550 DOI: 10.1097/00000441-199606000-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Medical research, past, present, and future. ALABAMA MEDICINE : JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1995; 65:6-9. [PMID: 7484670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Research and health care reform. Am J Med Sci 1995; 309:249-51. [PMID: 7733139 DOI: 10.1097/00000441-199530950-00002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Iodine: maintenance of optimal intake. Endocr Pract 1995; 1:100-1. [PMID: 15251603 DOI: 10.4158/ep.1.2.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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14
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The future of the VA. Centralization, costs, politics, and presentism. JAMA 1995; 273:667-8. [PMID: 7844880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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A good lab profile is part of a good physical exam. ALABAMA MEDICINE : JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1994; 64:15-8. [PMID: 7976974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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'That we might learn....'. ALABAMA MEDICINE : JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1991; 60:27-9. [PMID: 2021088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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University of Alabama School of Medicine. Policy on impaired students and faculty with special reference to substance abuse. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1988; 25:84-90. [PMID: 3344930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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National priorities and influence. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1987; 24:373. [PMID: 3661901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Blood transfusion complications: leukoagglutinin reactions. Obstet Gynecol 1985; 65:78S-80S. [PMID: 3974980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Blood transfusions performed earlier in the 20th century were often accompanied by significant complications. Today, with an increased knowledge of blood type compatibility, the majority of risks have been eliminated. However, hazards still remain. The authors report on a potentially fatal pulmonary disorder caused by transfusions involving leukoagglutinins. This phenomenon apparently occurs with an increased risk in parous women and patients who have had multiple transfusions.
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Doomsday: Friday the 13th of November, 1987 or Out of gas, the end of the world is coming. ALABAMA MEDICINE : JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1985; 54:20-4, 26-7. [PMID: 3969847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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General Clinical Research Center. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1984; 21:1. [PMID: 6388387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Medical education in Alabama: Part I, the early years. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1982; 51:22-9. [PMID: 7045261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Tomorrow is already here: physician manpower in Alabama. The medical pedisolane in action. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1979; 16:239-58. [PMID: 546232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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How to get into medical school. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1978; 48:8-11. [PMID: 690531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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A memo from James A. Pittman, Jr., M.D. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1978; 15:89-90. [PMID: 637265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Herrman Blumgart and medical school-V.A. hospital affiliation. N Engl J Med 1977; 297:65. [PMID: 325409 DOI: 10.1056/nejm197707072970126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Curved-jaw needle holder. ARCHIVES OF SURGERY (CHICAGO, ILL. : 1960) 1977; 112:98. [PMID: 318831 DOI: 10.1001/archsurg.1977.01370010100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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How many doctors? JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1976; 46:38-9, 51, 56. [PMID: 1003057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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How many doctors? JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1976; 6:38-9, 51,6. [PMID: 1031439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Primary, secondary, and tertiary medical care. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1976; 45:31, 47. [PMID: 1031176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Quality of medical education and quality health care. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1975; 45:65. [PMID: 1236353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Competition, cooperation, and the patient. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1975; 47:18-20, 25. [PMID: 1236178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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The University of Alabama Medical Education Program: expansion of the system. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1975; 12:119-60. [PMID: 1147169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Continuing medical education. Excerpts from speech. JOURNAL OF THE MEDICAL ASSOCIATION OF THE STATE OF ALABAMA 1974; 43:447 passim. [PMID: 4813088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Varieties of hypothyroidism. THE MEDICAL ANNALS OF THE DISTRICT OF COLUMBIA 1973; 42:435-9. [PMID: 4204300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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RIA: an historical note. Clin Chem 1973; 19:793. [PMID: 4197250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Stimulation of TSH release and glucose oxidation in pituitaries from thyroidectomized rats by thyrotropin releasing factor (TRF). THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1973; 10:270-7. [PMID: 4203687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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A nomenclature for tests of thyroid hormones in serum: report of a committee of the American Thyroid Association. J Clin Endocrinol Metab 1972; 34:884-90. [PMID: 5012498 DOI: 10.1210/jcem-34-5-884] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Metabolism of 2-thiouracil in pyrimidine pathways leading to nucleotide synthesis. PROCEEDINGS OF THE SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE. SOCIETY FOR EXPERIMENTAL BIOLOGY AND MEDICINE (NEW YORK, N.Y.) 1972; 139:1292-7. [PMID: 5023327 DOI: 10.3181/00379727-139-36350] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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46
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Direct evaluation of pituitary thyrotopin reserve utilizing synthetic thyrotopin releasing hormone. J Clin Endocrinol Metab 1971; 33:573-81. [PMID: 4999252 DOI: 10.1210/jcem-33-4-573] [Citation(s) in RCA: 119] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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47
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The effect N-ethylmaleimide on peptide hormone lacking a disulfide bridge. THE ALABAMA JOURNAL OF MEDICAL SCIENCES 1971; 8:419-23. [PMID: 4333347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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48
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Mediastinum scanning with 75Se-selenomethionine. J Nucl Med 1971; 12:644-5. [PMID: 5571891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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50
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