bluuebunny/crossref_metadata_2025_split huggingface dataset:
Genome-Wide Association Study Identifies a Possible Susceptibility Locus for Endometrial Cancer
Authors: Long Jirong , Zheng Wei , Xiang Yong-Bing , Lose Felicity , Thompson Deborah , Tomlinson Ian , Yu Herbert , Wentzensen Nicolas , Lambrechts Diether , Dörk Thilo , Dubrowinskaja Natalia , Goodman Marc T. , Salvesen Helga B. , Fasching Peter A. , Scott Rodney J. , Delahanty Ryan , Zheng Ying , O'Mara Tracy , Healey Catherine S. , Hodgson Shirley , Risch Harvey , Yang Hannah P. , Amant Frederic , Turmanov Nurzhan , Schwake Anita , Lurie Galina , Trovik Jone , Beckmann Matthias W. , Ashton Katie , Ji Bu-Tian , Bao Ping-Ping , Howarth Kimberly , Lu Lingeng , Lissowska Jolanta , Coenegrachts Lieve , Kaidarova Dilyara , Dürst Matthias , Thompson Pamela J. , Krakstad Camilla , Ekici Arif B. , Otton Geoffrey , Shi Jiajun , Zhang Ben , Gorman Maggie , Brinton Louise , Coosemans An , Matsuno Rayna K. , Halle Mari K. , Hein Alexander , Proietto Anthony , Cai Hui , Lu Wei , Dunning Alison , Easton Douglas , Gao Yu-Tang , Cai Qiuyin , Spurdle Amanda B. , Shu Xiao-Ou 
Published: June 2012

Abstract
Background: Genome-wide association studies (GWAS) have identified more than 100 genetic loci for various cancers. However, only one is for endometrial cancer.
Methods: We conducted a three-stage GWAS including 8,492 endometrial cancer cases and 16,596 controls. After analyzing 585,963 single-nucleotide polymorphisms (SNP) in 832 cases and 2,682 controls (stage I) from the Shanghai Endometrial Cancer Genetics Study, we selected the top 106 SNPs for in silico replication among 1,265 cases and 5,190 controls from the Australian/British Endometrial Cancer GWAS (stage II). Nine SNPs showed results consistent in direction with stage I with P &lt; 0.1. These nine SNPs were investigated among 459 cases and 558 controls (stage IIIa) and six SNPs showed a direction of association consistent with stages I and II. These six SNPs, plus two additional SNPs selected on the basis of linkage disequilibrium and P values in stage II, were investigated among 5,936 cases and 8,166 controls from an additional 11 studies (stage IIIb).
Results: SNP rs1202524, near the CAPN9 gene on chromosome 1q42.2, showed a consistent association with endometrial cancer risk across all three stages, with ORs of 1.09 [95% confidence interval (CI), 1.03–1.16] for the A/G genotype and 1.17 (95% CI, 1.05–1.30) for the G/G genotype (P = 1.6 × 10−4 in combined analyses of all samples). The association was stronger when limited to the endometrioid subtype, with ORs (95% CI) of 1.11 (1.04–1.18) and 1.21 (1.08–1.35), respectively (P = 2.4 × 10−5).
Conclusions: Chromosome 1q42.2 may host an endometrial cancer susceptibility locus.
Impact: This study identified a potential genetic locus for endometrial cancer risk. Cancer Epidemiol Biomarkers Prev; 21(6); 980–7. ©2012 AACR.
Converting Epidemiologic Studies of Cancer Etiology to Survivorship Studies: Approaches and Challenges
Authors: Berrington de González Amy , Morton Lindsay M. 
Published: June 2012

Abstract
There are nearly 12 million cancer survivors living in the United States, and the number continues to rise with ongoing improvements in treatment and screening. Assuring the long-term health of these patients poses both clinical and public health concerns. Survivorship research covers multiple aspects of life after a cancer diagnosis, including quality of life, acute and late effects of cancer treatment and mortality. Answering these questions requires a wide array of data, including information on the outcomes of interest, treatment history, and lifestyle. One potentially efficient approach to studying late effects and survivorship is to convert or extend existing epidemiologic studies of cancer etiology. In this article, we evaluate the different potential approaches for doing this and the challenges this entails. Our evaluation highlights the combinations of research topic and design most likely to succeed. We show that any question that relates to the existing information including prediagnosis lifestyle factors or genetics (if samples are available) could be efficiently studied, with an appropriate design. On the other hand, most, though not all converted studies would be ill-suited to the evaluation of the effect of treatment and postdiagnosis lifestyle changes. In terms of endpoints, hard outcomes including mortality and second cancers are more likely to be available within the existing study framework than other morbidities or quality of life. In light of the costs and time required to build new cohorts, appropriately leveraging the existing studies offers an important opportunity to gain new insights into cancer survivorship for both clinicians and patients. Cancer Epidemiol Biomarkers Prev; 21(6); 875–80. ©2012 AACR.
Residential Radon Exposure, Histologic Types, and Lung Cancer Risk. A Case–Control Study in Galicia, Spain
Authors: Barros-Dios Juan Miguel , Ruano-Ravina Alberto , Pérez-Ríos Mónica , Castro-Bernárdez Margarita , Abal-Arca Jose , Tojo-Castro Marta 
Published: June 2012

Abstract
Background: Lung cancer is an important public health problem, and tobacco is the main risk factor followed by residential radon exposure. Recommended exposure levels have been progressively lowered. Galicia, the study area, has high residential radon concentrations. We aim (i) to assess the risk of lung cancer linked to airborne residential radon exposure, (ii) to ascertain whether tobacco modifies radon risk, and (iii) to know whether there is a lung cancer histologic type more susceptible to radon.
Methods: A hospital-based case–control design was conducted in two Spanish hospitals. Consecutive cases with histologic diagnosis of lung cancer and controls undergoing trivial surgery not tobacco-related were included. Residential radon was measured using standard procedures. Results were obtained using logistic regression.
Results: Three hundred and forty-nine cases and 513 controls were included. Radon exposure posed a risk even with a low exposure, with those exposed to 50 to 100 Bq/m3 having an OR of 1.87 [95% confidence interval (CI), 1.21–2.88] and of 2.21 (95% CI, 1.33–3.69) for those exposed to 148 Bq/m3 or more. Tobacco increased appreciably the risk posed by radon, with an OR of 73 (95% CI, 19.88–268.14) for heavy smokers exposed to more than 147 Bq/m3. Less frequent histologic types (including large cell carcinomas), followed by small cell lung cancer, had the highest risk associated with radon exposure.
Conclusions: The presence of airborne radon even at low concentrations poses a risk of developing lung cancer, with tobacco habit increasing considerably this risk.
Impact: Public health initiatives should address the higher risk of lung cancer for smokers exposed to radon. Cancer Epidemiol Biomarkers Prev; 21(6); 951–8. ©2012 AACR.
Association between Reproductive Factors and Urinary Estrogens and Estrogen Metabolites in Premenopausal Women
Authors: Fortner Renée T. , Hankinson Susan E. , Schairer Catherine , Xu Xia , Ziegler Regina G. , Eliassen A. Heather 
Published: June 2012

Abstract
Background: Little is known about relationships among reproductive factors, estrogens and estrogen metabolites (jointly referred to as EM), and estrogen metabolism patterns.
Methods: In a cross-sectional analysis, we examined the associations of age at menarche, menstrual cycle length and regularity, parity, age at first and last birth, breastfeeding, and duration of and time since use of oral contraceptives with mid-luteal phase urinary EM in a sample of 603 premenopausal women, ages 33 to 51 years, within the Nurses' Health Study II (NHSII). Fifteen individual urinary EMs were measured with liquid chromatography/tandem mass spectrometry (LC/MS-MS) and analyzed both individually and in metabolic pathways.
Results: Compared with women with extremely regular cycles, those with irregular cycles had lower levels of total EM (percent difference = 24%; Ptrend = 0.01), estradiol (23%; Ptrend = 0.02), and 16-hydroxylation pathway EM (32%; Ptrend &lt; 0.01). Longer menstrual cycles were associated with higher levels of estrone (percent difference ≥32 vs. &lt;26 days: 25%; Ptrend = 0.03), estradiol (24%; Ptrend = 0.01), and 16-hydroxylation pathway EM (22%; Ptrend = 0.02). Among parous women, older age at first birth was associated with lower 16-hydroxylation pathway EM (percent difference age at first birth &gt;35 vs. ≤25 years: 20%; Ptrend = 0.02). The other reproductive factors were not statistically significantly associated with individual urinary EM or EM pathways.
Conclusions and Impact: These data, based on a LC/MS-MS assay with high specificity and precision, provide an initial, comprehensive evaluation of the associations between reproductive factors and estrogen metabolism patterns. Cancer Epidemiol Biomarkers Prev; 21(6); 959–68. ©2012 AACR.
Serum Lipid Levels in Normal Persons
Authors: LEWIS LENA A. , OLMSTED FREDERICK , PAGE IRVINE H. , LAWRY ELEANOR Y. , MANN GEORGE V. , STARE FREDRICK J. , HANIG MARTIN , LAUFFER MAX A. , GORDON TAVIA , MOORE FELIX E. 
Published: June 2012

Measurements of S
f
12-20, S
f
20-100, and total serum cholesterol made on 10,690 men and 3,404 women are reported and the relation of lipid level to race, source, age, sex, blood pressure, and weight is described. Distributions for men 40 to 59 are reported in detail.

The groups studied, while not selected as representative of the population at large, were remarkably similar in their lipid levels. The lipid levels of only 2 of the 33 groups—Los Angeles and the prisoners—differed significantly from the average. No convincing explanation for either of these exceptions was discovered.
The data in this study were mainly from a white population. Data for nonwhites came primarily from 2 aberrant groups and were too meager to allow a clear characterization of lipid levels. The levels for nonwhites from these 2 sources were closer to those of the white members of these groups than to the levels of the general population.

Cholesterol levels for men and women were found to be about the same at age 20. For both sexes the level rises with age but at first the rise is much greater for men than women. Above age 50, however, the level is higher for women than men and the level for women continues to rise after that age—at least within the age series for this study. The level for men reaches a peak at age 55, after which it declines. The relation of age and sex with lipid level for S
f
12-20 and S
f
20-100 appeared to be similar to that for cholesterol.

Correlations of lipid levels with blood pressure and weight were positive but very low. Hypertension or obesity, however, is associated with some elevation of lipid levels.

S
f
20-100 was found to be the most sensitive of the 3 lipid measures to sex and race differences. In the age group 40 to 59 it was the only one that exhibited a definite race and sex differential. In addition, it had the highest correlation with weight and with blood pressure.
Interference Dissociation
Authors: MILLER RALPH , SHARRETT RICHARD H. 
Published: June 2012

Contradirectional interference results when 2 stimuli arising in different foci in any part of the heart spread in opposite directions toward each other. Interference dissociation is defined as that type of dissociation which is due to repetitive contradirectional interference.
The electrocardiograms of 12 cases have been selected for analysis to illustrate many of the important features of interference dissociation.
The various centers between which dissociation may theoretically occur are listed for reference. This series includes examples of dissociation due to interference between the following pairs of rhythms: Normal sinus rhythm and A-V nodal rhythm, normal sinus rhythm and multifocal idioventricular rhythms, sinus tachycardia and paroxysmal ventricular tachycardia, paroxysmal atrial tachycardia with block and idioventricular rhythm, simultaneous dissociated paroxysmal A-V nodal and ventricular tachycardias, and normal sinus rhythm and A-V nodal rhythm in the presence of the Wolff-Parkinson-White syndrome.
Interference may occur at any level between the points of origin of the 2 rhythms, and the most common sites of interference are illustrated diagrammatically.
Interference at the upper end of the A-V junction is of particular importance, and a clear understanding of isolated interference in this region is of help in resolving some of the more difficult problems of dissociation. For this reason the concept of the zone of potential interference is introduced. This is the time interval in the cardiac cycle during which interference between an A-V nodal, or ventricular, and oncoming S-A beat may be anticipated. Certain important deductions are derived from theoretical considerations of the zone of potential interference.
The various mechanisms leading to the onset and termination of interference dissociation are described, and the rates of the dissociated rhythms are compared.
Aberrancy of the ventricular response to A-V nodal impulses is discussed. This phenomenon is ascribed to uneven spread of the excitation wave from an eccentrically located focus, due to the fact that in the A-V node longitudinal is faster than horizontal transmission.
Ventricular and atrial captures are considered in detail. Of particular interest is the occasional occurrence of both types of capture in the same case. This paradox is explained on the basis of either intermittent retrograde block or simultaneous bidirectional conduction through the A-V node in the presence of functional longitudinal dissociation. The relationship of other forms of heart block to interference dissociation is pointed out. Heart block predisposes to, and frequently complicates, interference dissociation.
A differential diagnosis between interference dissociation and other disturbances of rhythm is presented.
Interference dissociation is one of the most complex arrhythmias and familiarity with all its possible variations is essential to the correct interpretation of any given tracing.
Current Concepts on the Management of Shock
Authors: WEIL MAX H. 
Published: June 2012

In the handling of a patient with shock it is essential to identify the underlying cause in order to plan rational treatment. On the basis of information presently available, the specific causes of shock have been classified into 6 groups: hypovolemia, cardiac failure, bacteremia, hypersensitivity, neurogenic factors, and obstruction to blood flow. Treatment was discussed with reference to these groups.
Vasopressor agents are helpful in most instances of shock related to cardiac failure, bacteremia, and hypersensitivity. They usually are contraindicated in shock due to vascular obstruction and in hypovolemic shock until optimal replacement of fluid has been achieved. Recent studies have indicated that metaraminol may be the pressor amine of choice because it is therapeutically effective, simple to administer, without risk of injury to skin and subcutaneous tissues, and available for injection without additional fluid (thus especially suitable for patients with renal failure).
Rigorous attention to the fluid and electrolyte state is of special importance. In the presence of acidosis, the response to vasopressor agents is greatly diminished. The use of molar solution of sodium lactate to re-establish this responsiveness has met with limited success and seems worthy of trial in selected cases.
Adrenocortical hormones may be of striking benefit in shock due to bacteremia or hypersensitivity when an overwhelming response to inflammation threatens life. These drugs may be used also to augment the effectiveness of vasopressor drugs. Relatively little risk is involved, provided that the periods of employment are short and that antibiotics are used concurrently.
The indications for the use of digitalis glycosides in shock are the same as at other times, and their routine use is of no proved benefit and may be injurious. Atropine is of value when excessive vagal activity with bradycardia produces or complicates the hypotensive state.
Chlorpromazine is of no proved worth in the treatment of shock, and possible benefits achieved with anticoagulants are not established as yet. Preliminary observations suggest that hypothermia may be of some value. The head-down position provides only transient benefit in patients with shock, and its prolonged or routine use may delay recovery.
Anesthesia in Patients with Heart Disease
Authors: VANDAM LEROY D. , BURNAP THOMAS K. 
Published: June 2012

Anesthesia for the patient with heart disease has become increasingly safer with the passage of years due to a better knowledge of the physiology of heart disease and of the pharmacologic action of anesthetic agents themselves. There are few statistics to support the clinical impression that patients with cardiac disease tolerate anesthesia and surgery well but reports are not lacking. The difficulty in gathering statistics lies in an inability to compare results in comparable groups of patients. Anesthesia is but a small part of the total operative experience. The patient with serious heart disease usually undergoes a relatively long period of preoperative preparation. When ready, he is given preanesthetic medication and is subjected to the administration of an anesthetic. The surgical operation is superimposed on these preliminary events. Subsequently, convalescence with its many physiologic adjustments completes the surgical experience.
Anesthetic problems may originate in any of the aforementioned phases of the operative experience. These problems have been briefly reviewed. The most important factor in minimizing the problems of anesthesia itself is the skill and knowledge with which the anesthetic agents are chosen and administered rather than the actual pharmacologic and physiologic effects of the agents themselves. On a background of thorough medical preperation safe anesthesia for the patient with heart disease consists of the careful selection of preanesthetic medication, flawless technic, and use of minimal quantities of anesthetic agents and adjuncts. Despite the attainment of these goals, circulatory and respiratory problems will be encountered. These may be related to the heart disease itself, to medical preparation, pharmacologic side effects, and to a multitude of undesirable respiratory and circulatory reflexes. The latter in turn reside in anesthetic and surgical manipulation. Knowledge of these factors enables the internist to understand the problems of anesthesia and to prepare the patient for the operative experience.
Transposition of the Pulmonary Veins
Authors: GUNTHEROTH WARREN G. , NADAS ALEXANDER S. , GROSS ROBERT E. 
Published: June 2012

The seriousness of incomplete transposition of the pulmonary veins has probably been underestimated in the past.
Data on 11 patients is presented, including 10 with associated atrial septal defects. Common symptoms were dyspnea, fatigability, and frequent respiratory infections. Examination revealed no cyanosis, widely split second sound, soft systolic murmur and middiastolic murmur at the apex. One third demonstrated a presystolic murmur of medium pitch. The electrocardiographic and radiographic features were characteristic of atrial septal defects. There were no specific vascular shadows in any of our patients. Catheterization data were also characteristic of atrial septal defects. There was an inverse relationship between the right atrial pressure and systemic index. Anomalous pulmonary veins were entered during the right heart catheterization in 6 of the 10 patients catheterized.
Seven patients have had atrioseptopexy to close the septal defect and to direct the blood from the anomalously draining veins into the newly enlarged left atrium. An eighth patient had repair and shift of the atrial septum by means of open heart surgery through a pump oxygenator. This approach will probably prove optimal for future operations.
The Effectiveness of Long-Term Treatment of Malignant Hypertension
Authors: DUSTAN HARRIET P. , SCHNECKLOTH ROLAND E. , CORCORAN A. C. , PAGE IRVINE H. 
Published: June 2012

A survey is reported of the courses of 84 patients who presented the syndrome of malignant hypertension and who have been under treatment with potent antihypertensive drugs.
Among these, 70 per cent survived 1 year of observation, 50 per cent 3 years, 33 per cent 5 years, and 26 per cent 6 years. These survival rates represent substantial therapeutic gains over survival rates in the untreated series of Keith, Wagener, and Barker.
The reported first-year survival rate is weighted by the untoward complication of hexamethonium pneumonitis, and current survival is greater than in the estimate presented.
Other causes of death are (1) rapidly or (2) delayed or slowly progressive renal failure and (3) complications of atherosclerosis. The first is usually associated with poor control of blood pressure. It seems merely an attenuation of the usual course of malignant hypertension. The syndrome of delayed or slowly progressive renal failure is associated with diffuse occlusive fibrous intimal hyperplasia of major renal arteries. Among the complications of atherosclerosis, cerebral hemorrhage was the most common and was associated with poor control of blood pressure level, while myocardial infarction, the next most common, was not. It may be that the coronary arteries, like the renal, are subject to progressive occlusive disease in some patients with treated malignant hypertension. It is not clear whether this process represents a continuation in vessels larger than arterioles, of a basic vascular disease or a delayed response on the part of the arteries to preexisting severe hypertension.
Survival is improved in patients who undertake treatment before malignant hypertension has caused extensive vascular damage. Patients who present themselves for treatment with evidences of severe renal damage generally do not survive for long periods. However, several such have maintained active lives for many months and years. Hence treatment should be withheld only in the most desperate circumstances.
Cardiac Rupture due to Metastases from a Carcinoma of the Antrum
Authors: SINGER DONALD H. , CZERNOBILSKY BERNARD , STEINBERG LESTER A. 
Published: June 2012

The case is described of a 70-year-old white man with a primary anaplastic carcinoma of the right maxillary antrum, and with widespread visceral dissemination, including metastases to the heart. Myocardial rupture was noted to have occurred through one of the metastatic lesions. To the best of our knowledge this is the fourth instance of rupture as a sequel to tumorous infiltration of the heart.
Among the metastases were one or more to a clear-cell adenoma of the left kidney. This instance of metastasis of "cancer to cancer" is the second case of this rare condition in the recent autopsy material of the Beth Israel Hospital.