tbuckley/cabot-search huggingface dataset:
Morphine-Augmented Cholescintigraphy with a False-Negative Result and an Apparent Ectopic Gallbladder
Authors: ERIC C. BOUREKAS, RICHARD H. TUPLER, ELLIOTT H. TURBINER
Journal: Clinical Nuclear Medicine (1992)

Morphine-augmented cholescintigraphy has been shown to be a highly sensitive and specific means of evaluating acute cholecystitis. False-negative results do occur infrequently, however, and such a case is reported. In addition, this case initially demonstrated an apparent ectopic gallbladder, and thus anomalies in location of the gallbladder will be discussed.
Peripheral Vascular Disease
Authors: D.E. Strandness, J. F. Eidt
Journal: Circulation (2000)

There is little doubt that one of the greatest advances in the field of peripheral arterial disease was our ability to visualize problems wherever they occurred. This was possible because of the development of arteriography. One of the dramatic developments that made this possible was the observation by Forsmann1 in 1929 that a catheter could be threaded through a peripheral vein into the right heart. He also suggested the possibility of injecting a contrast agent through the catheter for imaging purposes. Because of this contribution, he was awarded the Nobel prize in 1953. Seldinger2 in 1953 pushed this concept even further by showing that it was possible to replace an intra-arterial needle with a catheter that could be manipulated within the arterial system.

These developments, along with the realization that arteries could be replaced, led to many of the early advances. One of the first methods used to replace segments of abdominal aorta was the use of homografts. Dubost et al3 in 1952 reported the replacement of an aortic aneurysm with a homograft. This procedure was rapidly followed by similar efforts in the United States by Julian et al4 and Debakey et al.5 These homografts were initially used for the treatment of abdominal aortic aneurysms but did have serious problems related to size, according to the anatomy of the patient and late breakdown of the grafts themselves.6 Once it became obvious that arterial homografts were not an answer to the problem of arterial replacement, development of alternative methods moved ahead rapidly. Vorhees et al7 in 1952 reported the first application of an artificial prosthetic device for arterial replacement. This led to the development of other prosthetic materials such as Dacron, Teflon, and polytetrafluoroethylene.8 These grafts were and still are in widespread use …
Meningococcal Prophylaxis-Reply
Authors: Malcolm S. Artenstein
Journal: JAMA (1975)

In Reply.—  Dr Eickhoff presents a cogent argument for the use of rifampin prophylaxis when meningococcal disease has been diagnosed in one member of a family. Indeed, a number of authorities hold the same opinion. However, in the absence of proved (controlled) efficacy of the drug in preventing meningococcaldisease, the controversy becomes merely a matter of divergent opinions based on circumstantial evidence. Minocycline was the choice of some until the recent reports of serious side reactions. I am tempted to predict, therefore, that rifampin, which has immunosuppressive effects and inhibits RNA and DNA polymerases, will eventually be considered too hazardous a drug to be used for a purpose of unproved benefit.
Costs of Positive Tests-Reply
Authors: David S. Bachman
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Dr. Riley recently commented upon the waste of time and money expended by physicians in obtaining haircuts (<b>214</b>:1890, 1970). This is one affliction that many of the younger doctors have conquered: we just let our hair grow. Additional comments include the following: (1) that of Lester S. Saferstein, MD of Kansas City: The house staff solution to this dilemma was to engage a barber for four haircuts of the staff session bridge players during the game. (2) If the reading time of 2 minutes for this epic contribution were multiplied by 200,000 doctors... A. W. Freireich, MD, Malverne, NY. (3) A home haircutting set can be purchased for under $10. complete with electric clippers. James C. Cobey, MD, New York. (4) I suggest electric clippers with plastic attachments. This idea occurred to me in 1951 when we quit shaving rats and had a surplus clipper... John
PD5-2-6: Hypofractionated stereotactic body radiotherapy in patients with peripherally or centrally located medically inoperable stage I or isolated recurrent non-small cell lung cancer
Authors: Joe Y. Chang, Peter Balter, Zhongxing Liao, Kara M. Bucci, Mary F. McAleer, Qiuan Yang, Lei Dong, Jack A. Roth, James D. Cox, Ritsuko Komaki
Journal: Journal of Thoracic Oncology (2007)
A Novel Strategy for the Discovery of MHC Class II–Restricted Tumor Antigens: Identification of a Melanotransferrin Helper T-Cell Epitope
Authors: Till A. Röhn, Annette Reitz, Annette Paschen, Xuan D. Nguyen, Dirk Schadendorf, Anne B. Vogt, Harald Kropshofer
Journal: Cancer Research (2005)

Abstract CD4+ helper T cells play a critical role in orchestrating host immune responses, including antitumor immunity. The limited availability of MHC class II–associated tumor antigens is still viewed as a major obstacle in the use of CD4+ T cells in cancer vaccines. Here, we describe a novel approach for the identification of MHC class II tumor-associated antigens (TAAs). By combining two-dimensional liquid chromatography and nanoelectrospray ionization tandem mass spectrometry, we developed a highly sensitive method for the detection of human leukocyte antigen (HLA)-DR–associated peptides of dendritic cells upon exposure to necrotic tumor cells. This approach led to the identification of a novel MHC class II–restricted TAA epitope derived from melanotransferrin. The epitope stimulated T cells derived from melanoma patients and healthy individuals and displayed promiscuity in HLA-DR restriction. Moreover, the same peptide was also presented by MHC class II–positive melanoma cells. This strategy may contribute to increase the number of tumor epitopes presented by MHC class II molecules and may support the development of more efficacious vaccines against cancer.
Abstract 1741: Quantitative Real-Time PCR analysis of SPARCL1 and SPARC expression in colorectal cancer tissues
Authors: Rania Georges, Hassan Adwan, Carl C. Schimanski, Martin R. Berger
Journal: Cancer Research (2010)

Abstract The SPARC family of proteins comprises 10 members, which share structural similarities in one or more protein domains. SPARC-like protein 1 (SPARCL1; also known as hevin) and SPARC are two important family members, which have been found to be involved in various tumors. The relationship between these two molecules and colorectal cancer and its liver metastasis has not yet been fully studied and understood. cDNA microarray was used to analyze the expression profiles of 22523 genes in CC531 rat colon adenocarcinoma cells. Briefly, 2 × 106 CC531 were injected into the portal vein of male Wag/Rij rats to grow in the liver. The tumor cells were then re-isolated from rat livers at different time points (after 3, 6, 9, 14 and 21 days). SPARCL 1 and SPARC were among the genes, which were up-regulated in the re-isolated metastatic cells as compared to control CC531 cells grown in vitro, especially on days 3 (two- and nine-fold for SPARCL1 and SPARC) and 6 (four- and eleven-fold for SPARCL1 and SPARC) following tumor implantation. These results motivated us to analyze the expression of these two genes in 65 colorectal cancer tissues taken from patients in different UICC tumor stages (I, n=11; II, n=23; III, n=17; IV, n=14). A mixture of 10 mucosa samples was taken for comparison as normal control. Quantitative real time-PCR results showed that SPARCL1 mRNA was significantly down-regulated in 44 samples (68%) with these levels being on average fourfold lower (0.24 ± 0.21) than those in normal mucosa. Normal levels were found in 18 samples (28%), and up-regulated levels were detected in only 3 samples (4%) with these levels being on average threefold higher than those in normal mucosa (3.0 ± 1.1). No correlation between this down- or up-regulation and tumor stage could be found. In contrast to the results for SPARCL1, SPARC showed an almost consistent up-regulation in 60 of the tumor samples (92%). The average level of SPARC up-regulation was higher than that of SPARCL1 (6.5 fold higher than in normal mucosa). It is worth noting here that in those 21 samples, in which SPARCL1 mRNA was not down-regulated, SPARC expression was on average twofold higher (13fold higher than in normal mucosa) than the average expression level of all samples. These results suggest a relationship between the two family members, but it is still not clear, whether they have opposing or complementary functions in the context of tumor initiation and progression. More studies should be performed to uncover the possible role of these proteins in the course of colorectal cancer and its liver metastasis. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1741.
THE EFFECT OF ROTATIONAL ATHERECTOMY ON COMPLEX CALCIFIED CORONARY LESIONS: SERIAL OPTICAL COHERENCE TOMOGRAPHY STUDY
Authors: Nobuhiko Maejima, Kiyoshi Hibi, Masaaki Konishi, Noriaki Iwahashi, Kengo Tsukahara, Yoshio Tahara, Masami Kosuge, Toshiaki Ebina, Satoshi Umemura, Kazuo Kimura
Journal: Journal of the American College of Cardiology (2014)
Paging Dr Parris
Authors: J. O. Drife
Journal: BMJ (2001)

August. High summer and mid silly season. With parliament in recess, Britain's heavyweight political commentators have gone on holiday and the media have turned to trivia. Newspaper readers, grateful at first, soon tire of pap. They begin to long for autumn, when the journalists will sharpen their knives again.

For medical politicians, however, autumn never comes. One of the delights of being on the General Medical Council or, I daresay, the BMA …
Abstract P3-05-03: HER2-CONNECT® pathologist-assisted image analysis algorithm for HER2 IHC interpretation improves correlation with HER2 FISH results
Authors: DV Miller, H Stender, T Kristensen, RK Min, J Isaac, J Hansen, J Seaman, M Grunkin, M Vyberg
Journal: Cancer Research (2013)

Abstract Background: HER2 testing by immunohistochemistry (IHC) is prone to inter-observer variability and subjective interpretation. Pathologist-assisted digital image analysis is recommended in the CAP/ASCO guidelines to improve interpretive consistency. As a quality benchmark, HER2 IHC results should correlate with HER2 fluorescence in-situ hybridization (FISH) in &amp;gt;95% of positive and negative cases. HER2-CONNECT® (Visiopharm, Hoersholm Denmark) is a digital analysis algorithm that scores stained membrane interconnectivity rather than relying solely on staining of individual cells. As such, it can be thought of as a surrogate for the so-called “chickenwire” pattern characteristic of true HER2 positive tumors. In this study we applied HER2-CONNECT® analysis with pathologist quantitative interpretation (HC+PQI) to a set of breast tumors with known HER2 FISH status to assess concordance. Design: Breast carcinoma tissue sections previously stained with HER2 IHC (HercepTest) and interpreted manually were retrospectively re-submitted for HC+PQI. These included core and excisional biopsies from primary and metastatic sites. Fixation times were documented within recommended guidelines. HER2 FISH (PathVysion) was performed on all cases. Using connectivity scores on a scale of 0 - 1.0 from the analyzed regions, a pathologist determined the overall% of HER2 positive tumor cells in the sample (since HER2-CONNECT reports connectivity, but not tumor cell quantitation) and reported a final score per CAP/ASCO guidelines (&amp;lt;10% = 1+, 10-30% = 2+, &amp;gt;30% = 3+). Results: 190 cases comprised the analysis set, including 77 3+, 73 2+, and 40 0/1+ as scored in the original reports. 66 cases were HER2 FISH amplified (64/77, 83% of the original 3+ cases and 2/73, 2.7% of 2+ cases) and 6 cases were FISH equivocal. None of the 0/1+ cases were HER2 FISH amplified. Using HC+PQI, the new scores were 67 3+, 68 2+, and 55 1+. Correlation between HC+PQI and HER2 FISH was 95.5% (64/67) for 3+/amplified and 100% (55/55) for &amp;lt;2+/nonamplified (overall concordance 97.5%). Using FISH as the gold standard, the HC+PQI interpretation reduced the false positive rate from 13% (15/108) to 3% (4/108). 17 of 63 HER2 nonamplified samples originally scored 2+ were changed to 1+ on HC+PQI (i.e. reduction of FISH testing by 27% (17/63)). Conclusions: Relative to the original report scores, HC+PQI improved correlation with HER2 FISH and reduced the overall number of 2+ results (potentially reducing the number of FISH tests required). These data also objectively highlight the importance of the “chickenwire” pattern in positive result interpretation for HER2. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-05-03.
Clopidogrel Loading Dose Adjustment According to Platelet Reactivity Monitoring in Patients Carrying the 2C19*2Loss of Function Polymorphism
Authors: Laurent Bonello, Sébastien Armero, Omar Ait Mokhtar, Julien Mancini, Philippe Aldebert, Noémie Saut, Nathalie Bonello, Paul Barragan, Stéphane Arques, Marie-Paule Giacomoni, Caroline Bonello-Burignat, Marie-Noelle Bartholomei, Françoise Dignat-George, Laurence Camoin-Jau, Franck Paganelli
Journal: Journal of the American College of Cardiology (2010)
Immune deficiency and multiple viral warts: a possible variant of the Wiskott-Aldrich syndrome
Authors: A.D. ORMEROD, A.Y. FINLAY, A.G. KNIGHT, N. MATHEWS, J.M. STARK, J. GOUGH
Journal: British Journal of Dermatology (1983)

A patient with combined humoral and cell-mediated immune deficiency is reported with several features of the Wiskott-Aldrich syndrome but without eczema or platelet dysfunction. Underlying immune deficiency should be considered in patients who present with widespread viral warts.
A New Carbohydrate-iron Haematinic for Intramuscular Use
Authors: D. F. Cappell, H. E. Hutchison, E. B. Hendry, H. Conway
Journal: BMJ (1954)

In recording the clinical trial of an unsuccessful intra muscular iron preparation (Goldberg and Hutchison, 1953) attention was drawn to the valuable, though limited, field of usefulness of intravenous iron therapy and to the wider applicability of intramuscular iron, could a suitable preparation be elaborated. The desiderata were that the preparation should be an effective haematinic freely absorbed from the tissues and non-irritating. Our recent experience with a new dextran-iron complex ( imferon) has convinced us that it is highly satisfactory for intramuscular use, and we present a preliminary account of our findings.
Points: Family history of congenital hydrocephalus
Authors: J. Lorber
Journal: BMJ (1984)

September, p 591) confirmed brain death in the usual way before resuscitation was finally abandoned after four hours.The usual tests of brain death are tests of brain stem function.These tests should be preceded by essential preconditions and necessary exclusions.An essential precondition is irremediable structural brain damage.A necessary exclusion is acute intoxication.'In their patient neither of these criteria was satisfied.Their patient had not responded to intensive resuscitation and had remained hypotensive and anuric.As there had been no recovery and no prospect of recovery it may have been reasonable to discontinue resuscita- tion.It is not possible to use tests of brain death to support this decision as it was impossible to meet the currently accepted preconditions and exclusions which are required to give the tests validity.
Low perforin expression of early differentiated HCV-specific CD8+ T cells limits their hepatotoxic potential
Authors: Juandy Jo, Bertram Bengsch, Bianca Seigel, Sibylle J. Rau, Julia Schmidt, Emmanuel Bisse, Peter Aichele, Ulrike Aichele, Lars Joeckel, Cathy Royer, Karine Sá Ferreira, Christoph Borner, Thomas F. Baumert, Hubert E. Blum, Volker Lohmann, Richard Fischer, Robert Thimme
Journal: Journal of Hepatology (2012)
Glucocorticosteroids rapidly inhibit allergen‐induced expression of E‐selectin <i>in vitro</i> in a mucosal model of allergic rhinitis
Authors: C. Rudack, C. Bachert
Journal: Allergy (2000)

Background: Transendothelial migration of cells to sites of inflammation is a hallmark of the allergic reaction. The adhesion cascade involves the initial expression of the adhesion molecule E‐selectin on endothelial cells. The aim of the study was to determine the efficacy of a 30‐min preincubation of the glucocorticosteroids (GCS) fluticasone, prednisolone, and fluocortin butyl on allergen‐ and interleukin (IL)‐1β‐induced E‐selectin expression in allergic rhinitis. Methods: Freshly taken nasal inferior turbinate mucosa of 19 subjects with allergic rhinitis was cut into small cubes and preincubated for 30 min with prednisolone ( n =6), fluticasone ( n =5), and fluocortin butyl ( n =3) in different concentrations, followed by allergen exposure at a concentration of 1000 BU/ml for 1 and 2 h. Additionally, fluticasone‐preincubated tissues were exposed to recombinant human rhIL‐1β ( n =5) at a concentration of 2 pg/ml. The expression of E‐selectin was assessed by immunohistochemistry (APAAP technique) and computerized image evaluation. Results: In this model, E‐selectin expression was significantly upregulated by allergen and rhIL‐1β within 1 and 2 h. After 30‐min preincubation with prednisolone and fluocortin butyl at drug concentrations of 10 −8 mol/l, we found a significant (≥50%) reduction of the E‐selectin expression after 1 and 2 h. Allergen‐induced E‐selectin expression was nearly abolished at concentrations of 10 −5 (prednisolone) and 10 −4 mol/l (fluocortin butyl). Fluticasone significantly inhibited E‐selectin expression by ≥50% at concentrations of 10 −14 and 10 −12 mol/l after 1 and 2 h, and abolished E‐selectin induction at concentrations of 10 −12 and 10 −10 mol/l, respectively. Exposure of mucosal cubes to rhIL‐1β ( n =5) also induced rapid upregulation of E‐selectin expression, an effect which could be only partially suppressed by fluticasone preincubation at concentrations of 10 −10 mol/l. Conclusions: Allergen‐induced E‐selectin expression is significantly and rapidly inhibited by GCS preincubation, fluticasone being more potent than prednisolone and fluocortin butyl. We suggest that this rapid effect is mainly indirect, possibly by inhibition of allergen‐induced cytokine release.
NHS should learn lessons from mental health services, says report
Authors: J. Wise
Journal: BMJ (2014)

The transformation of mental health services in England over the past 30 years provides important lessons for those trying to develop community based alternatives to hospital care, a report from the King’s Fund says.1

Mental health services have changed from a model of acute and long term care based in large institutions to one in which most care is now provided in community settings by multidisciplinary mental health teams.

Service Transformation: Lessons from …
Corrigendum to “EAU Guidelines on Assessment and Nonsurgical Management of Urinary Incontinence” [Eur Urol 2012;62:1130–42]
Authors: Malcolm G. Lucas, Ruud J.L. Bosch, Fiona C. Burkhard, Francisco Cruz, Thomas B. Madden, Arjun K. Nambiar, Andreas Neisius, Dirk J.M.K. de Ridder, Andrea Tubaro, William H. Turner, Robert S. Pickard
Journal: European Urology (2013)
Association Between Prolonged Graft Ischemia and Primary Graft Failure or Survival Following Lung Transplantation
Authors: Joshua C. Grimm, Vicente Valero, Arman Kilic, Jonathan T. Magruder, Christian A. Merlo, Pali D. Shah, Ashish S. Shah
Journal: JAMA Surgery (2015)

The effect of prolonged graft ischemia (≥6 hours) on outcomes following lung transplantation is controversial.To evaluate the effect of prolonged total graft ischemia times on long-term survival rates and the development of primary graft failure (PGF) following lung transplantation.In this retrospective study, the United Network for Organ Sharing database was queried for adult patients who underwent lung transplantation from May 1, 2005, through December 31, 2011. Primary stratification by the presence of prolonged graft ischemia was performed. Kaplan-Meier estimates at 1 and 5 years were used to compare survival in the 2 cohorts. A multivariable Cox proportional hazards regression model was constructed to identify predictors of 1- and 5-year mortality. A risk-adjusted predictive model for the development of PGF was formulated in a similar fashion.The primary outcome of interest was 1- and 5-year survival. Secondary outcomes included PGF and other postoperative events, such as renal failure, biopsy-proven rejection, and stroke.Of the 10,225 patients who underwent lung transplantation, 3127 (30.6%) had allografts exposed to prolonged ischemia. There was no difference in survival at 1 (83.6% [95% CI, 82.3%-84.9%] vs 84.1% [95% CI, 83.3%-85.0%]; P = .41) or 5 (52.5% [95% CI, 51.0%-54.0%] vs 53.5% [95% CI, 51.3%-55.6%]; P = .82) years between patients who received grafts that were or were not exposed to ischemia that lasted 6 hours or more, respectively. Prolonged graft ischemia did not independently predict 1- or 5-year mortality or the development of PGF (odds ratio, 1.11; 95% CI, 0.88-1.39; P = .37). Furthermore, prolonged ischemia did not independently predict 1-year (hazard ratio, 1.09; 95% CI, 0.97-1.22; P =.15) or 5-year (hazard ratio, 1.05; 95% CI, 0.98-1.14; P =.18) mortality or the development of PGF (odds ratio, 1.11; 95% CI, 0.88-1.39; P =.37).No association was found between prolonged total graft ischemia times and primary graft failure or survival following lung transplantation. Given the scarcity of organs and the paucity of suitable recipients, prolonged ischemia time should not preclude transplantation. It is, therefore, reasonable to consider extending the accepted period of ischemia to more than 6 hours in certain patient populations to improve organ use.
Distinct delayed T‐cell response to <i>β</i>‐methasone and penicillin‐G in the same patient
Authors: E. Scala, M. Giani, S. Pastore, S. Pallotta, E. C. Guerra, L. Pirrotta, M. L. Locanto, A. Frezzolini, O. De Pità, P. Puddu
Journal: Allergy (2003)

Background: Multiple drug allergy syndrome is a clinical condition characterized by reactions against more than one different class of, both pharmacologically and structurally, unrelated drugs. Scanty data are available to date about a multiple drug delayed hypersensitivity syndrome. Our aim was to report the case of a delayed reaction to both β ‐methasone ( β ‐MT) and penicillin‐G (pen‐G) occurring in the same patient, and analyse β ‐MT‐ and pen‐G‐specific T‐cell Lines (TCLs) with regard to their specificity, phenotype and cytokine profile. Methods: We generated two drug‐specific TCLs from biopsies at the site of positive intradermal reactions, and analysed their immunophenotype, T‐cell receptor Vβ (TCR‐V β ) domains expression and cytokine profile. Results: We demonstrated the specificity of the T cells isolated from positive intradermal test reactions to pen‐G and β ‐MT through the strict dose‐dependent proliferation in response to drug‐pulsed autologous antigen presenting cells. Fluorescence activated cell sorter (FACS) analysis revealed a predominance of CD4+ cells in the inflammatory cell infiltrate of intradermal test with β ‐MT, while a predominance of CD8+ T cells in the site of delayed reaction to pen‐G was found. The drug specific CD4+ and CD8+ T cells were heterogeneous, with regard to TCR‐V β usage. CD8+ pen‐G‐TCL displayed a preferential T helper 2 (Th2) profile, while a substantially heterogeneous pattern of cytokine production characterized specific β ‐MT TCL. Conclusion: The study describes the coexistence in the same patient of a delayed hypersensitivity to both penicillin G and β ‐MT, driven, respectively, by pen‐G‐specificTh2‐skewed CD8+ and β ‐MT specificTh0 CD4+ T cells. This case further support the existence of a multiple drug allergy syndrome also for delayed hypersensitivity.