tbuckley/cabot-search huggingface dataset:
The prognostic impact of stage and performance status on surgically resected non-small cell lung cancer
Authors: Mesut Bayraktaroglu, Engin Aynaci, Pinar Yildiz
Journal: European Respiratory Journal (2012)

In our study, pathological stage and Eastern Cooperative Oncology Group (ECOG) performance status were assessed in surgically resected non-small cell lung cancer (NSCLC) patients. The aim was to determine the effects of tumor stage and performance status on overall survival and disease-free survival in our cases.   METHODS:  148 consecutive patients (mean age 57.9±8.29 years, min 36 max 76) were included in this study. 12 (%8.1) patients were women and 136 (%91.9) were men. Each patient was staged according to the TNM classification.   RESULTS:  ECOG performance status was related with both mean survival and disease-free survival time (respectively p=0.011 and p=0.044). 148 patients were grouped by using 1997 TNM and 2009 IASLC staging systems. According to survival analysis, disease-free survival was not related with stage but mean survival analysis revealed that stage 3 cases had significantly worse survival compared to stage 1 cases (p=0.005).   CONCLUSION:  According to our results, survival was significantly worse in stage 3 patients and patients with poor performance status.
Identification of driver mutations in tumor specimens from 1,000 patients with lung adenocarcinoma: The NCI’s Lung Cancer Mutation Consortium (LCMC).
Authors: M. G. Kris, B. E. Johnson, D. J. Kwiatkowski, A. J. Iafrate, I. I. Wistuba, S. L. Aronson, J. A. Engelman, Y. Shyr, F. R. Khuri, C. M. Rudin, E. B. Garon, W. Pao, J. H. Schiller, E. B. Haura, K. Shirai, G. Giaccone, L. D. Berry, K. Kugler, J. D. Minna, P. A. Bunn
Journal: Journal of Clinical Oncology (2011)

CRA7506 The full, final text of this abstract will be available in Part II of the 2011 Annual Meeting Proceedings, distributed onsite at the Meeting on June 4, 2011, and as a supplement to the June 20, 2011, issue of Journal of Clinical Oncology.
Long-acting beta 2-adrenoceptor agonists: a new perspective in the treatment of asthma
Authors: CG Lofdahl, KF Chung
Journal: European Respiratory Journal (1991)

New long-acting beta 2-adrenoceptor agonists, formoterol and salmeterol, may soon appear in several European countries for treatment of asthma. This review examines currently available information and compares the basic pharmacology and describes the clinical effects of these new drugs. The long duration of bronchodilation seen in clinical studies seems to be similar, whereas in isolated tissues there might be a difference in the binding characteristics to the beta 2-adrenoceptor. Long-acting beta 2-agonists could have an inhibitory effect on inflammatory events related to asthma, but the clinical relevance of these effects is not clear at present. Long-term studies up to one year with both new drugs have not shown any unexpected side-effects, and no tachyphylaxis to beta-adrenoceptor stimulation has been reported. Patients appear to strongly prefer the new drugs compared to the short-acting beta 2-agonists. The potential place for these drugs in the treatment of asthma is discussed and some pitfalls pointed out. It is likely that the long-acting beta 2-agonists will be beneficial to many asthmatic patients.
The effects of early prone position on inflammatory response and mortality in porcine model of massive gastric aspiration
Authors: Qian Xiao, Yanling Wang, Ying Wu, Lijuan Xing
Journal: European Respiratory Journal (2014)

Background Aspiration of gastric contents, a common complication in critically ill patient, is a common cause of acute lung injury (ALI)/acute respiratory distress syndrome (ARDS), which leads high mortality.

Objectives To test the effects of early prone position on mortality in porcine after massive gastric aspiration and explore the possible mechanism.

Methods Twelve female healthy pigs were anesthetized and mechanically ventilated. Massive gastric aspiration model was created by ejecting 7ml/kg gastric contents fluids (pH=1 hydrochloric acid solution to dilute 40mg/ml gastric particles). They were randomly divided into the supine position group(SP)or prone position group(PP). Oxygenation (PaO2/FiO2), intrapulmonary shunt index (Qs/Qt), and the number of death were observed hourly for a total of 6 hours after aspiration. Interleukin-6 was measured in serum, and immunohistochemistry was performed to study interleukin-6 expression in the lung tissue.

Results All 6 animals in SP group died within 6 hours after aspiration, while only one died in PP group (χ2=7.071, P <0.01). The PaO2/FiO2 level in PP group was significantly higher than that in SP group ( P <0.01), and the trend of lower Qs/Qt was found in PP group than that in SP group ( P <0.05). The serum level of interleukin-6 in PP group was significantly lower than that in SP group ( P <0.01), and interleukin-6 expression decreased in PP group compared with SP group ( P <0.05).

Conclusions Early Prone position can improve oxygenation and intrapulmonary shunt, reduce inflammatory response and mortality rate in massive gastric aspiration.

Key words Prone position; Gastric aspiration; Mortality; Interleukin-6.
Endoscopic ultrasound-guided real-time fine-needle aspiration biopsy of the pancreas in cancer patients with pancreatic lesions.
Authors: D O Faigel, G G Ginsberg, J S Bentz, P K Gupta, D B Smith, M L Kochman
Journal: Journal of Clinical Oncology (1997)

BACKGROUND Endoscopic ultrasound (EUS) is an important new tool in the staging of pancreatic malignancies. Using new curved linear-array instruments, real-time fine-needle aspiration biopsy (RTFNA) of pancreatic lesions can be performed. METHODS Forty-five patients with pancreatic lesions (22 males and 23 females) underwent staging with the Olympus EUM-20 (Olympus America Corp, Melville, NY) followed by EUS-RTFNA with the Pentax FG-32PUA (Pentax-Precision Instrument Corp, Orangeburg, NY) and the 22-gauge GIP needle (GIP Medizin Technik, Grassau, Germany). RESULTS EUS tumor stages were as follows: TO, n = 1; T1, n = 8; T2, n = 9; and T3 n = 27. Aspiration attempts were unsuccessful in four patients (two technical failures and two inadequate specimens). The remaining 41 lesions (mean size, 3.3 cm) were aspirated under EUS guidance (median passes, three) and the cytologic diagnoses were 25 definite adenocarcinoma, five suspicious for adenocarcinoma (three subsequently confirmed and two clinical course consistent with adenocarcinoma), and 11 negative for malignancy. Of 11 negatives, two were found to have adenocarcinoma, seven were confirmed benign at surgery (four cystadenomas and three inflammatory), one had a benign pseudocyst, and one had abundant inflammatory cells on RTFNA and follow-up time greater than 12 months with computed tomographic (CT) scans consistent with resolving inflammation. There were no false-positive RTFNAs. There were no procedure-related complications. Among those with diagnostic EUS-RTFNA (91%), the sensitivity for malignancy (confirmed plus suspicious) was 94% and negative predictive value 82%. CONCLUSION EUS-guided RTFNA is a safe and accurate method for performing pancreatic biopsy. It should be considered in patients with suspected pancreatic malignancies in whom a tissue diagnosis is required or when other modalities have failed. EUS-RTFNA allows for local staging and tissue diagnosis in one procedure.
Breast Cancer in Adolescents and Young Adults: A Review With a Focus on Biology
Authors: Jill R. Tichy, Elgene Lim, Carey K. Anders
Journal: Journal of the National Comprehensive Cancer Network (2013)

Breast cancer is a substantial contributor to adolescent and young adult (AYA) malignancies, defined as a diagnosis of cancer between the ages of 15 and 39. In the United States, 6.6% of breast cancer cases are diagnosed among women younger than 40 years. When breast cancer occurs in AYAs, it typically has a worse prognosis and more-aggressive phenotype; higher proportions of high-grade and later-stage tumors; lower estrogen receptor positivity; and, in some studies, higher expression of HER2. Age-specific differences in the biology of AYA breast cancer have been explored in large-scale genomic studies with mixed results. Although some studies suggest that AYA breast cancer has a unique biology, others have shown that its aggressive nature is the result of higher frequencies of aggressive breast cancer subtypes among younger patients. More recently, stromal-related gene signatures have shown prognostic significance in AYA breast cancer, suggesting that differences in microenvironment may account for age-specific differences in breast cancer behavior. Although general principles for selecting cytotoxic and targeted agents are similar between AYAs and the general breast cancer population, endocrine therapy choices in the adjuvant and metastatic settings vary by pre- and postmenopausal status. The role of ovarian suppression remains controversial and is reviewed. The AYA population is a unique group of patients who need individualized care, including considerations of hereditary breast cancer predispositions, future fertility, and the effect of therapy on immediate and long-term quality of life, all of which require coordinated multidisciplinary care. This article addresses the epidemiology, genetics, and management of breast cancer in AYA women and highlights unique medical issues important to this population.
Involvement of Endothelial Apoptosis Underlying Chronic Obstructive Pulmonary Disease–like Phenotype in Adiponectin-null Mice
Authors: Kaori Nakanishi, Yoshito Takeda, Satoshi Tetsumoto, Takeo Iwasaki, Kazuyuki Tsujino, Hanako Kuhara, Yingji Jin, Izumi Nagatomo, Hiroshi Kida, Sho Goya, Takashi Kijima, Norikazu Maeda, Tohru Funahashi, Iichiro Shimomura, Isao Tachibana, Ichiro Kawase
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Chronic obstructive pulmonary disease is frequently complicated with comorbidities, such as cardiovascular disease, osteoporosis, and body weight loss, but the causal link remains unclear.To investigate the role of adiponectin in the pathogenesis of chronic obstructive pulmonary disease and its potential use in therapy.Adiponectin localization and dynamics in the lung were analyzed in an elastase-induced emphysema model. Next, the lung of adiponectin-knockout mice, extrapulmonary effects, and the underlying mechanism were investigated. Finally, we tested whether exogenous adiponectin could ameliorate the emphysematous change in adiponectin-knockout mice.Adiponectin expression in lung vasculature and plasma concentration of adiponectin were reduced after elastase-instillation. Notably, adiponectin-knockout mice showed progressive alveolar enlargement and increased lung compliance. They further exhibited not only systemic inflammation, but also extrapulmonary phenotype, such as body weight loss, fat atrophy, and osteoporosis. Moreover, endothelial apoptosis was enhanced in the lungs of adiponectin-knockout mice, as evidenced by caspase-3 activity. Consistent with this, expressions of vascular endothelial growth factor receptor-2 and platelet endothelial cell adhesion molecule-1 on endothelial cells were decreased in the adiponectin-knockout mice. Finally, adenovirus-mediated adiponectin supplementation ameliorated the emphysematous phenotype.Adiponectin-knockout mice develop progressive chronic obstructive pulmonary disease-like phenotype with systemic inflammation and extrapulmonary phenotypes. Hypoadiponectinemia could thus play a critical role in the progression of chronic obstructive pulmonary disease and concomitant comorbidities through endothelial dysfunction. Together, adiponectin could be a novel target for chronic obstructive pulmonary disease therapy.
NCCN Guidelines Implementation in the Multidisciplinary Merkel Cell Carcinoma Program at the University of Michigan
Authors: Jennifer L. Schwartz, Sandra L. Wong, Scott A. McLean, James A. Hayman, Christopher D. Lao, Jeffrey H. Kozlow, Kelly M. Malloy, Carol R. Bradford, Marcus L. Frohm, Douglas R. Fullen, Lori Lowe, Christopher K. Bichakjian
Journal: Journal of the National Comprehensive Cancer Network (2014)

Merkel cell carcinoma (MCC) is a rare malignancy of the skin, and prospective randomized clinical studies on management and treatment are very limited. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for MCC provide up-to-date, best evidence-based, and consensus-driven management pathways with the purpose of providing best care and outcomes. Multidisciplinary management with consensus treatment recommendations to individualize patient care within the framework of these guidelines is optimal. The University of Michigan multidisciplinary MCC program uses NCCN Guidelines in the management and treatment of its patients. This article discusses 4 patient presentations to highlight the implementation of the NCCN Guidelines for MCC at the University of Michigan.
The mother's smoking during pregnancy influences on endothelial dysfunction in newborns
Authors: Ann Khotsenko
Journal: European Respiratory Journal (2011)

Smoking during pregnancy is a risk for dangerous consequences. Smoking causes increased chances for miscarriage, growth restriction, preterm birth, and health problems in the future.  The aim of the investigation was to reveal effect of mother9s tobacco smoking during pregnancy on endothelial dysfunction in newborn.  127 children born from mothers - smokers were examined. The control group was consisted of 32 healthy babies born from never smoking parents. A level of thiocyanate (a marker of passive smoking) was determined in a blood serum by spectrophotometry method. Levels of S-nitrosothiols and endotheline-1 were determined in blood serum by spectrophotometry and enzyme immunoassay methods respectively for the estimation of the endothelium dysfunction.  The levels of thiocyanate were 8,64±0,52 mg/l (high level – I group) and 3,75±0,21mg/l (low level – II group) in serum of babies born from mothers – smokers. The level of thiocyanate was 1,03±0,07mg/l in control group. The levels of S-nitrosothiols were 2,37±0,16 fmol/ml in I group (P1  The tobacco derivatives came through placenta from mother-smoker to fetus. The endothelial dysfunctions are characterised by the decreasing of vasodilatator S-nitrosothiols and increasing of vasoconstrictor endotheline-1 level in newborn depended from level of thiocyanate.
Late-breaking abstract: Surfactant protein D (SP-D) as a biomarker for mortality: A study in elderly Danish twins
Authors: Helle Wulf Johansson, Mikael Thinggaard, Qihua Tan, Kaare Christensen, Uffe Holmskov, Grith Lykke Sørensen
Journal: European Respiratory Journal (2011)

Background:  SP-D is synthesized and secreted into the airspaces of the lung by alveolar and bronchiolar epithelial cells. Systemic measurements of SP-D are previously demonstrated to predict survival in patients with idiopatic pulmonary fibrosis and ALI/ARDS. However, SP-D may be a general indicator of pulmonary health status and associate to mortality in the general population.   Aim:  To investigate the association between higher serum SP-D levels and mortality in normal Danes.   Methods:  A total of 689 twins (234 males and 455 females) provided blood samples during a six month period in a survey (LSADT) performed in 1997. During a 13-year follow-up period 181 (77%) men died and 292 (64%) women died. SP-D serum levels were measured by ELISA technique.   Results:  Survival analysis was performed and SP-D levels were adjusted to age, smoking and BMI. SP-D levels were positively and significantly correlated to mortality in females. At the end of January 2010, there were 84 male twin pairs (39 MZ and 45 DZ) and 160 female twin pairs (73 MZ and 87 DZ) in which at least one twin had died. There was no evidence of an association between increasing intra-pair difference in log transformed SP-D and mortality in males. In contrast, intrapair analyses in females showed that the twin with the highest SP-D level had a higher risk of dying than the co-twin (OR=1.66, p=0.047). Adjusting this analysis with intrapair difference in smoking (packyear) and BMI did not affect this association (OR=1.75, p=0.040).   Conclusion:  The study indicates that circulating SP-D levels may be a biomarker to track the pulmonary health status and to forecast mortality in the elderly women.
Abstract 13127: Type 2 Diabetic Obese db/db Mice Are Refractory to Myocardial Ischemic Postconditioning Due to Deficiency of Leptin Receptors
Authors: Shu-Guang Zhu, Lei Xi, Rakesh C Kukreja
Journal: Circulation (2010)

Background: Since the first description of ischemic postconditioning (PostC) in dog model, this clinically relevant cardioprotective modality has been confirmed by numerous investigators in many sp...
Concomitant Chemoradiotherapy as Primary Therapy for Locoregionally Advanced Head and Neck Cancer
Authors: Everett E. Vokes, Merrill S. Kies, Daniel J. Haraf, Kerstin Stenson, Marcy List, Rod Humerickhouse, M. Eileen Dolan, Harold Pelzer, Laura Sulzen, Mary Ellyn Witt, Yi-Ching Hsieh, Bharat B. Mittal, Ralph R. Weichselbaum
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To achieve locoregional control of head and neck cancer, survival, and organ preservation using intensive concomitant chemoradiotherapy. PATIENTS AND METHODS: This study was a phase II trial of chemoradiotherapy with cisplatin 100 mg/m 2 every 28 days, infusional fluorouracil 800 mg/m 2 /d for 5 days, hydroxyurea 1 g orally every 12 hours for 11 doses, and radiotherapy twice daily at 1.5 Gy/fraction on days 1 through 5 (total dose, 15 Gy). Five days of treatment were followed by 9 days of rest, during which time patients received granulocyte colony-stimulating factor. Five cycles (three with cisplatin) were administered over 10 weeks (total radiotherapy dose, ≤ 75 Gy). Adjuvant chemoprevention with retinoic acid and interferon alfa-2A was offered. RESULTS: Seventy-six patients were treated (stage IV, 93%; N2, 54%; N3, 21%). At a median follow-up of 38 months, the 3-year progression-free survival is 72%, locoregional control 92%, systemic control 83%, and overall survival 55%. Toxicities included mucositis (grade 3, 45%; grade 4, 12%), neutropenia (grade 4, 39%), and thrombocytopenia (grade 4, 53%). Surgery at the primary site was performed in 13 patients, and 39 had neck dissection. A majority of patients declined adjuvant chemoprevention. Pharmacokinetic parameters were not prognostic of tumor control. Quality of life declined during treatment but returned from good to excellent by 12 months after treatment. CONCLUSION: Intensive concomitant chemoradiotherapy leads to high locoregional control and survival rates with organ preservation and a reversal of the historical pattern of failure (distant &gt; locoregional). Surgery after concomitant chemoradiotherapy is feasible. Compliance with adjuvant chemoprevention is poor. Identification of less toxic regimens and improved distant disease control emerge as important future research goals.
Clinical relevance of respiratory pathogens in patients hospitalised with acute exacerbations of chronic obstructive pulmonary disease
Authors: Karine Clearie, Soong Tan, Thomas Gillespie, Sandra Watson, Karon Carson, Andrew Smith
Journal: European Respiratory Journal (2013)

Rationale : Acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) are associated with substantial acute morbidity, mortality, and cost.   Aims : To assess the impact of viral / bacterial infection on length of hospitalization, and to determine whether any routinely used clinical markers can differentiate causes of exacerbations during hospital admission.   Methods : All patients admitted to Wishaw General hospital over a 6-month period with AECOPD were included prospectively. Clinical history and demographics, chest radiograph, serum inflammatory markers and attempted collection of viral throat gargles and sputum for microbiology were obtained during hospital admission with AECOPD.   Results : There were 199 COPD exacerbation episodes in 166 patients Complete data for sputum and virology were available in 77. The mean length of stay in patients with bacterial infection (n=13) was 5.6 (3.5 – 7.8) vs. 5.4 (3.8 – 7.0) for viral (n=14), 3.3 (1.0 – 5.6), for viral/ bacterial co-infection (n=6), and 6.1 (4.2 – 8.0) for non-infective exacerbations (n=44) (P=0.64). There were no significant differences in terms of peak WCC or the presence of consolidation on CXR between the four groups. Peak CRP was significantly higher in bacterial infections than non-infective exacerbation, but did not discriminate bacterial from viral infections. Symptoms were poor discriminators of underlying infection.   Conclusion : Length of stay in hospital in patients with acute exacerbations of COPD is not affected by positive virology or microbiology. Neither routine blood tests nor clinical symptoms can be used to differentiate between causes of exacerbation.
Prediction of Response to Preoperative Chemotherapy in Adenocarcinomas of the Esophagogastric Junction by Metabolic Imaging
Authors: Wolfgang A. Weber, Katja Ott, Karen Becker, Hans-Joachim Dittler, Hermann Helmberger, Norbert E. Avril, Günther Meisetschläger, Raymonde Busch, Jörg-Rüdiger Siewert, Markus Schwaiger, Ulrich Fink
Journal: Journal of Clinical Oncology (2001)

Preoperative chemotherapy in patients with gastroesophageal cancer is hampered by the lack of reliable predictors of tumor response. This study evaluates whether positron emission tomography (PET) using fluorine-18 fluorodeoxyglucose (FDG) may predict response early in the course of therapy.Forty consecutive patients with locally advanced adenocarcinomas of the esophagogastric junction were studied by FDG-PET at baseline and 14 days after initiation of cisplatin-based polychemotherapy. Clinical response (reduction of tumor length and wall thickness by > 50%) was evaluated after 3 months of therapy using endoscopy and standard imaging techniques. Patients with potentially resectable tumors underwent surgery, and tumor regression was assessed histopathologically.The reduction of tumor FDG uptake (mean +/- 1 SD) after 14 days of therapy was significantly different between responding (-54% +/- 17%) and nonresponding tumors (-15% +/- 21%). Optimal differentiation was achieved by a cutoff value of 35% reduction of initial FDG uptake. Applying this cutoff value as a criterion for a metabolic response predicted clinical response with a sensitivity and specificity of 93% (14 of 15 patients) and 95% (21 of 22), respectively. Histopathologically complete or subtotal tumor regression was achieved in 53% (eight of 15) of the patients with a metabolic response but only in 5% (one of 22) of the patients without a metabolic response. Patients without a metabolic response were also characterized by significantly shorter time to progression/recurrence (P =.01) and shorter overall survival (P =.04).PET imaging may differentiate responding and nonresponding tumors early in the course of therapy. By avoiding ineffective and potentially harmful treatment, this may markedly facilitate the use of preoperative therapy, especially in patients with potentially resectable tumors.
&lt;italic&gt;H-2&lt;/italic&gt; Expression on a Teratocarcinoma-Derived Cell Line, TerC&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: David B. Searls, Michael Edidin
Journal: JNCI Journal of the National Cancer Institute (1982)

The murine teratocarcinoma-derived cell line TerC, previously thought to lack products of the major histocompatibility locus H-2, was shown to express low levels of K- and D-end H-2 specificities with the use of a sensitive cytotoxic assay. The assay, based on the ability of antibody and complement to inhibit uptake of the thymidine analogue [125I]5-iodo-2'-deoxyuridine, detected appropriate public and private specificities, as demonstrated with the use of oligospecific antisera and by absorption analyses. A series of clone of TerC varied only slightly in H-2 expression, and there was no tendency for expression to increase with time in culture; thus the low levels of H-2 were not the result of a differentiating subpopulation.