tbuckley/cabot-search huggingface dataset:
Abstract P4-16-09: Dosimetric feasibility and acute toxicity in a prospective trial of ultra-short course accelerated partial breast irradiation (APBI) using a multi-lumen balloon brachytherapy device
Authors: AJ Khan, FA Vicini, S Brown, BG Haffty, T Kearney, R Dale, DW Arthur
Journal: Cancer Research (2012)

Abstract Background: Shorter courses of APBI with novel fractionation schedules are being investigated; a large randomized trial from Europe has recently shown the safety and efficacy of a single-fraction adjuvant approach (with limited follow-up). We designed a prospective trial to identify and address the potential radiobiological and logistical limitations of single-fraction, intraoperative APBI. Methods: We designed a single-arm, multi-institutional, prospective phase II trial that sequentially treats three cohorts of women (each n=30) with three progressively hypofractionated schedules. Eligible women were age ≥ 50 years with unifocal invasive or in situ tumors ≤ 3.0 cm, excised with negative margins, and with negative lymph nodes and positive hormone-receptors. Using a reference schedule of 60 Gy delivered in 2 Gy fractions, and assuming tumor parameters: a/b = 4 Gy; a = 0.27 Gy-1, and repopulation parameters of: Teff = 26 days; delay time = 0 days, the reference tumor BED is ∼ 86 Gy4. We began with a schedule of 4 fractions of 7 Gy delivered twice-daily using a Contura MLB multi-lumen device. We defined very conservative dosimetric criteria for acceptability: maximum skin and rib dose to not exceed 100% of prescription dose, and V150 and V200 to not exceed 40 cc and 10 cc, respectively. Subsequent schedules are 3 fractions of 8.25 Gy and 2 fractions of 10.25 Gy, both delivered over 2 days. The primary endpoint is to exclude a local failure rate exceeding 10% with the upper limit of a 95% confidence interval. Results: A total of 30 patients have been enrolled at the 7 Gy × 4 fractions dose-level and followed for a minimum of 6 months. The median skin dose as a percent of prescription dose (PD) was 84% (40–100) and the median rib dose was 71% (16–119). 96% of the PTV_eval received a median of 95% of PD (range 85–103). The V150 (range 14–48cc) and V200 (range 0–29cc) criteria were met in all cases. One breast infection occurred and was treated; 2 cases of symptomatic fat necrosis and 2 cases of symptomatic seromas occurred. No acute toxicities greater than CTCAE grade 2 have been observed. Conclusion: Short-course APBI is dosimetrically feasible using the Contura MLB and appears to be tolerable in terms of acute toxicities. Our approach is based on well-defined radiobiological parameters and allows for an abbreviated course of treatment that is guided by full pathological review and the ability to objectively achieve and validate acceptable dosimetric criteria in each case. We have opened enrollment to the next schedule of 8.25 Gy for three fractions. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-16-09.
A Universal Scaling Law to Predict the Efficiency of Magnetic Nanoparticles as MRI T2‐Contrast Agents
Authors: Quoc L. Vuong, Jean‐François Berret, Jérôme Fresnais, Yves Gossuin, Olivier Sandre
Journal: Advanced Healthcare Materials (2012)

Magnetic particles are very efficient Magnetic Resonance Imaging (MRI) contrast agents. In the recent years, chemists have unleashed their imagination to design multi-functional nanoprobes for biomedical applications including MRI contrast enhancement. This study is focused on the direct relationship between the size and magnetization of the particles and their nuclear magnetic resonance relaxation properties, which condition their efficiency. Experimental relaxation results with maghemite particles exhibiting a wide range of sizes and magnetizations are compared to previously published data and to well-established relaxation theories with a good agreement. This allows deriving the experimental master curve of the transverse relaxivity versus particle size and to predict the MRI contrast efficiency of any type of magnetic nanoparticles. This prediction only requires the knowledge of the size of the particles impermeable to water protons and the saturation magnetization of the corresponding volume. To predict the T2 relaxation efficiency of magnetic single crystals, the crystal size and magnetization obtained through a single Langevin fit of a magnetization curve is the only information needed. For contrast agents made of several magnetic cores assembled into various geometries (dilute fractal aggregates, dense spherical clusters, core-shell micelles, hollow vesicles), one needs to know a third parameter, namely the intra-aggregate volume fraction occupied by the magnetic materials relatively to the whole (hydrodynamic) sphere. Finally a calculation of the maximum achievable relaxation effect and the size needed to reach this maximum is performed for different cases: maghemite single crystals and dense clusters, core-shell particles (oxide layer around a metallic core) and zinc manganese ferrite crystals.
Diagnosis of pigmented skin lesions by dermoscopy: web-based training improves diagnostic performance of non-experts
Authors: G. Pagnanelli, H.P. Soyer, G. Argenziano, R. Talamini, R. Barbati, L. Bianchi, E. Campione, I. Carboni, A.M. Carrozzo, M.S. Chimenti, I.DE Simoni, V. Falcomata, I.filipe Neto, F. Francesconi, A. Ginebri, J. Hagman, G.C. Marulli, F. Palamara, A.P. Vidolin, P. Piemonte, R. Soda, S. Chimenti
Journal: British Journal of Dermatology (2003)

Dermoscopy has been shown to enhance the diagnosis of melanoma. However, use of dermoscopy requires training and expertise to be effective.To determine whether an Internet-based course is a suitable tool in teaching dermoscopy, and to evaluate the diagnostic value of pattern analysis and diagnostic algorithms in colleagues not yet familiar with this technique.Sixteen colleagues who were not experts in dermoscopy were asked to evaluate the dermoscopic images of 20 pigmented skin lesions using different diagnostic methods (i.e. pattern analysis, ABCD rule, seven-point checklist and Menzies' method), before and after an Internet-based training course on dermoscopy. Mean +/- SEM sensitivity, specificity and diagnostic accuracy, and kappa (kappa) intraobserver agreement were evaluated for each diagnostic method before and after training for the 16 participants. Differences between mean values were assessed by means of two-tailed Wilcoxon rank-sum tests.There was a considerable improvement in the dermoscopic melanoma diagnosis after the Web-based training vs. before. Improvements in sensitivity and diagnostic accuracy were significant for the ABCD rule and Menzies' method. Improvements in sensitivity were also significant for pattern analysis, whereas the sensitivity values were high for the seven-point checklist in evaluations both before and after training. No significant difference was found for specificity before and after training for any method. There was a significant improvement in the kappa intraobserver agreement after training for pattern analysis and the ABCD rule. For the seven-point checklist and Menzies' method there was already good agreement before training, with no significant improvement after training.We demonstrated that Web-based training is an effective tool for teaching dermoscopy.
Gene Transfer of Human Guanosine 5′-Triphosphate Cyclohydrolase I Restores Vascular Tetrahydrobiopterin Level and Endothelial Function in Low Renin Hypertension
Authors: Jie-Sheng Zheng, Xiang-Qun Yang, Keith J. Lookingland, Gregory D. Fink, Christian Hesslinger, Gregory Kapatos, Imre Kovesdi, Alex F. Chen
Journal: Circulation (2003)

We recently reported that arterial superoxide (O2-) is augmented by increased endothelin-1 (ET-1) in deoxycorticosterone acetate (DOCA)-salt hypertension, a model of low renin hypertension. Tetrahydrobiopterin (BH4), a potent reducing molecule with antioxidant properties and an essential cofactor for endothelial nitric oxide synthase, protects against O2--induced vascular dysfunction. However, the interaction between O2- and BH4 on endothelial function and the underlying mechanisms are unknown.The present study tested the hypothesis that BH4 deficiency due to ET-1-induced O2- leads to impaired endothelium-dependent relaxation and that gene transfer of human guanosine 5'-triphosphate (GTP) cyclohydrolase I (GTPCH I), the first and rate-limiting enzyme for BH4 biosynthesis, reverses such deficiency and endothelial dysfunction in carotid arteries of DOCA-salt rats. There were significantly increased arterial O2- levels and decreased GTPCH I activity and BH4 levels in DOCA-salt compared with sham rats. Treatment of arteries of DOCA-salt rats with the selective ETA receptor antagonist ABT-627, NADPH oxidase inhibitor apocynin, or superoxide dismutase (SOD) mimetic tempol abolished O2- and restored BH4 levels. Basal arterial NO release and endothelium-dependent relaxations were impaired in DOCA-salt rats, conditions that were improved by apocynin or tempol treatment. Gene transfer of GTPCH I restored arterial GTPCH I activity and BH4 levels, resulting in reduced O2- and improved endothelium-dependent relaxation and basal NO release in DOCA-salt rats.These results indicate that a BH4 deficiency resulting from ET-1-induced O2- via an ETA/NADPH oxidase pathway leads to endothelial dysfunction, and gene transfer of GTPCH I reverses the BH4 deficiency and endothelial dysfunction by reducing O2- in low renin mineralocorticoid hypertension.
Long-term results of Dana-Farber Cancer Institute ALL Consortium protocols for children with newly diagnosed acute lymphoblastic leukemia (1985–2000)
Authors: L B Silverman, K E Stevenson, J E O'Brien, B L Asselin, R D Barr, L Clavell, P D Cole, K M Kelly, C Laverdiere, B Michon, M A Schorin, C L Schwartz, E W O'Holleran, D S Neuberg, H J Cohen, S E Sallan
Journal: Leukemia (2009)
Market-Driven Health Care: Who Wins, Who Loses in the Transformation of America's Largest Service Industry
Authors: Jesse S. Hixson
Journal: JAMA (1997)

Regina Herzlinger, who holds a Harvard Business School chair, writes about restructuring the health care service sector in the same consumer-friendly way that has successfully transformed American industry over the last two decades. She has both a prediction and a prescription for the health care sector. The author's prediction is twofold. First, the failure of the health care sector to keep pace with the remainder of the service industry in adopting a consumer orientation makes it increasingly anachronistic. For the most part, the health industry still treats consumers as though their time were worthless and they were ignorant about available choices. Unlike other sectors of the service industry, health care providers have done little to adapt to consumers' increasing knowledge, demand for information, ability to make their own decisions, and the increasing opportunity cost of their time. Health care financing and delivery institutions will face increasing pressure to respond to
Criteria and Guidelines for Reforming the U.S. Health Care System
Authors: S M Shortell, W J McNerney
Journal: New England Journal of Medicine (1990)

It would be tempting to suggest that the U.S. health care system is now in disarray were it not for the fact that it has never really been otherwise. There is increasing anger and frustration among employers, consumers, uninsured people, payers, and providers, all of whom are struggling with what are perceived to be competing demands to contain costs while trying to improve productivity, increase quality, and expand access to services. Clearly, our health care system needs more comprehensive strategies to address the multiple needs of different groups.We do not lack for new ideas or alternative models. In the . . .
Emergency Management of Acute Pulmonary Edema
Authors: RONALD F. GROSSMAN
Journal: Annals of Internal Medicine (1976)

Editorial Notes1 April 1976Emergency Management of Acute Pulmonary EdemaRONALD F. GROSSMAN, M.D., ARNOLD ABERMAN, M.D., F.R.C.P.(C)RONALD F. GROSSMAN, M.D.Search for more papers by this author, ARNOLD ABERMAN, M.D., F.R.C.P.(C)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-84-4-488_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptRecent studies on acute pulmonary edema secondary to left ventricular failure (1, 2) have shed new light on the accompanying metabolic and ventilatory abnormalities and have reopened old questions and controversies concerning the appropriate management. Although the standard teaching in both cardiology and respiratory textbooks has been that patients with acute pulmonary edema (unless they are desperately ill) have respiratory alkalosis and no metabolic disturbances, the majority, in fact, may have lactic acidosis (3) and a large minority, perhaps as many as 30%, may have carbon dioxide retention (1, 2). The lactic acidosis is no doubt a reflection of perfusion...References1. ABERMANFULOP AM: The metabolic and respiratory acidosis of acute pulmonary edema. Ann Intern Med 76:173-184, 1972 LinkGoogle Scholar2. AVERYSAMETSACKNER WPM: The acidosis of pulmonary edema. Am J Med 48:320-324, 1970 CrossrefMedlineGoogle Scholar3. FULOPHOROWITZABERMAN MMA: Lactic acidosis in pulmonary edema due to left ventricular failure. Ann Intern Med 79 180-186, 1973 LinkGoogle Scholar4. MATTARWEILSHUBIN JMH: Cardiac arrest in the critically ill. Am J Med 56:162-168, 1974 CrossrefMedlineGoogle Scholar5. LESCHCARANOSOSMULHOLLAND MCJ: Controlled study comparing ethacrynic acid to mercaptomerin in treatment of acute pulmonary edema. N Engl J Med 279:115-122, 1968 CrossrefMedlineGoogle Scholar6. DIKSHITVYDENFORRESTER KJJ: Renal and extrarenal hemodynamic effects of furosemide in congestive heart failure after acute myocardial infarction. N Engl J Med 288:1087-1090, 1973 CrossrefMedlineGoogle Scholar7. NIXON P: Pulmonary oedema with low left ventricular diastolic pressure in acute myocardial infarction. Lancet 2:146-147, 1968 CrossrefMedlineGoogle Scholar8. GRINER P: Treatment of acute pulmonary edema: conventional or intensive care? Ann Intern Med 77:501-506, 1972 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mount Sinai Hospital Toronto, Ontario Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAcute Alveolar Edema 1 April 1976Volume 84, Issue 4Page: 488-488KeywordsCarbon dioxideEdemaLactic acidosisVentilators Issue Published: 1 April 1976 PDF downloadLoading ...
Children From Romania: Testing for Tuberculosis-Reply
Authors: Margaret K. Hostetter
Journal: JAMA (1993)

<h3>In Reply.</h3> —Dr Jameson's letter highlights some of the controversial issues in the diagnosis and management of tuberculin reactors, especially when testing is performed after BCG vaccination. Among the patients in our study, 41 of 65 Romanian children had been vaccinated with BCG prior to their arrival in the United States. Of the 20 vaccinated children who did not receive tuberculin testing as a part of their initial medical evaluation, two had no induration on subsequent testing by their private physicians, two refused tuberculin testing, one had received BCG vaccine 10 months prior to the clinic visit, and 15 had received BCG vaccine within the antecedent 2 to 3 months and exhibited moist, unhealed BCG vaccination sites. The pediatric literature provides ample precedent that tuberculin testing within 6 months of BCG vaccination elicits induration of at least 5 mm in 60% of children and greater than 10 mm in 30%<sup>1</sup>;
The Future for Physician Assistants
Authors: JAMES F. CAWLEY
Journal: Annals of Internal Medicine (1983)

Physician assistants were intended to be assistants to primary care physicians. Physicians in private practice have only moderately responded to the availability of these professionals. Cutbacks in the numbers of foreign medical graduates entering American schools for graduate medical education, concern for overcrowding in some specialties, and the economic and clinical capabilities of physician assistants have lead to new uses for these persons. Physician assistants are employed in surgery and surgical subspecialties; in practice settings in institutions such as medical, pediatric, and surgical house staff; and in geriatric facilities, occupational medicine clinics, emergency rooms, and prison health systems. The projected surplus of physicians by 1990 may affect the use of physician assistants by private physicians in primary care.
A Homologue of CROC-1 in a Ciliated Protist (Sterkiella histriomuscorum) Testifies to the Ancient Origin of the Ubiquitin-conjugating Enzyme Variant Family
Authors: Eduardo Villalobo, Loïc Morin, Clara Moch, Rachel Lescasse, Michelle Hanna, Wei Xiao, Anne Baroin-Tourancheau
Journal: Molecular Biology and Evolution (2002)

Resting cysts of Sterkiella histriomuscorum (Ciliophora, Oxytrichidae) have been shown to contain messenger RNA, one of which codes for a protein significantly similar to CROC-1. CROC-1 is a human regulatory protein capable of transactivating the promoter of c-fos and belongs to a newly characterized family of ubiquitin-conjugating enzyme (E2) variants (UEV). We have determined the corresponding macronuclear gene sequence, which is the first protistan UEV sequence available. The phylogenetic analysis indicates the deep separation and solid clustering of all the UEV sequences within the E2 tree showing the ancient origin of these regulatory genes and their high structural conservation during evolution. Furthermore, overexpression of the ciliate UEV is able to rescue the Saccharomyces cerevisiaemms2 null mutant from killing by DNA damaging agents, implying that the UEV family proteins are functionally conserved. In S. histriomuscorum, expression of UEV is correlated with the growth of the cells as transcripts are present in excysting and vegetative cells but are rapidly down-regulated during starvation. These data support the high conservation of the UEV family in eukaryotes, and a regulatory role of the gene is discussed in relation to known functions of UEVs. This analysis may promote the search for homologues of other regulatory genes (metazoan regulators of differentiation) in ciliates.
Identification of inflammatory and proresolving lipid mediators in bone marrow and their lipidomic profiles with ovariectomy and omega‐3 intake
Authors: Raewyn C. Poulsen, Katherine H. Gotlinger, Charles N. Serhan, Marlena C. Kruger
Journal: American Journal of Hematology (2008)

Newly described lipoxygenase (LOX)-generated lipid mediators, that is, resolvins and protectins as well as lipoxins, are both anti-inflammatory and proresolving. We aimed to determine whether these lipid mediators are present in bone marrow and whether their lipidomic profiles are altered following ovariectomy or dietary supplementation with eicosapentaenoic acid (EPA) or docosahexaenoic acid (DHA) ethyl esters. Female rats were ovariectomised or sham-operated. Shams and one ovariectomised group received a diet devoid of omega-3 long-chain polyunsaturated fatty acids. The remaining ovariectomised rats received either 0.5 g EPA or DHA ethyl ester/kg body weight/day for 4 months. Bone marrow was analyzed using both GC to determine fatty acid composition and mediator lipidomics by LC/MS/MS profiling for the presence of LOX-pathway lipid mediators derived from arachidonic acid (AA), EPA, and DHA. LOX-derived products including lipoxins, resolvin D1, resolvin E1, and protectin D1 were identified in bone marrow by the presence of diagnostic ions in their corresponding MS-MS spectra. The proportion of AA relative to DHA and of AA-derived relative to DHA-derived mediators in bone marrow was higher in ovariectomised compared to sham-operated rats. DHA or EPA ethyl ester supplementation increased the percentage of DHA and EPA in bone marrow and increased the proportion of LOX mediators biosynthesized from DHA or EPA, respectively. Given the potent bioactivities of the lipoxins, resolvins, and protectins, the presence and changes in profile postovariectomy and with EPA and DHA ethyl ester supplementation may be of interest in bone marrow function and as a potential source of these mediators in vivo.
Levodopa, Involuntary Movements and Fusaric Acid
Authors: Ismael Mena
Journal: JAMA (1971)

<h3>To the Editor.—</h3> Levodopa is now generally accepted as the most effective therapy for the symptoms of parkinsonism<sup>1-4</sup>although it can induce involuntary movements which can mar some of its most dramatic responses.<sup>1</sup>In our hands, control of these movements without cancellation of the therapeutic effects has been achieved for minutes only, following injections of apomorphine.<sup>5</sup>Since all other attempts to control these movements have invariably caused reemergence of parkinsonism, we have proposed that the underlying mechanisms are unknown.<sup>6</sup> This situation called for the formulation of a hypothesis which might at least lead to novel experiments. Our hypothesis is presently this: Since levodopa generates cerebral dopamine as a necessary step in its therapeutic action,<sup>6</sup>the norepinephrine synthesized from dopamine might be causing the involuntary movements. The synthesis of cerebral norepinephrine from administered levodopa proceeds as follows: levodopa becomes decarboxylated widely in the brain to generate
IL-1β inhibition in autoimmune inner ear disease: can you hear me now?
Authors: Steven D. Rauch
Journal: Journal of Clinical Investigation (2014)

Clinical vignette: A 51-year-old man with right-sided sudden hearing loss presents to the otology clinic. He has a 4-year history of episodic vertigo of several hours' duration and fluctuating, progressive sensorineural hearing loss in his left ear. The vertigo attacks have not occurred for the last 18 months, and the left ear hearing is consistently poor. The patient's right ear hearing has dropped in the last 36 hours. MRI imaging of brain and temporal bone are normal. A 2-week "burst and taper" of oral prednisone is administered with no effect. Over the next 3 months, serial audiograms show rapidly progressive loss of threshold and word recognition scores on the right side. A trial of high-dose prednisone (60 mg/d for 30 days) results in full recovery of the right ear hearing and substantial improvement in the left ear. As the prednisone dose is slowly tapered over several months, the hearing drops again.
The Delivery of Mental Health Services to Children in a Prepaid Medical Care Program
Authors: SIDNEY S. GOLDENSOHN, RAYMOND FINK, SAM SHAPIRO
Journal: American Journal of Psychiatry (1971)

A New York prepaid group practice plan offered mental health services to children under age 15 during a 24-month demonstration period. On an annualized rate basis, the psychiatric consultation rate was 12.6 per 1.000 enrollees and the treatment start rate was 8.6 per 1,000. The average number of services per patient during the first 12 months was 14.5. Among the children receiving treatment, 39 percent had another family member who was also in treatment.