tbuckley/cabot-search huggingface dataset:
Does early identification of low-grade glioma growth impact outcome?
Authors: M. C. Chamberlain
Journal: Neuro-Oncology (2014)

See the letter by Pallud and Duffau, on pages 1295–1296.

Dr Pallud and colleagues represent a vanguard research team in understanding glioma growth by serial anatomic MRI and the use of their novel radiographic methodology, that is, the determination of the velocity of diametric expansion (VDE) by ellipsoid approximation.1 Several issues, however, temper enthusiasm for the incorporation of this radiographic method of low-grade glioma (LGG) growth into routine clinical practice as the authors suggest.

Firstly this method has never been assessed and validated in a prospective clinical trial, requirements that for example have been fulfilled for response assessment of high-grade gliomas using the Macdonald and RANO criteria.2,3 If treatment of LGG is to be determined by a VDE analysis, a prospective trial showing the benefit of this approach is relevant compared with the current standard practice of altering therapy at time of radiographic enhancement and presumed glioma de-differentiation to a higher grade or enlargement of the tumor by >25% as assessed by fluid attenuated inversion recovery or T2-weighted MRI.4

Secondly, routine clinical practice, at least in the United States, only rarely after radiographic demonstration of a presumed LGG follows patients with serial MRI. Rather these patients more often undergo resective surgery and after pathological and molecular assessment are considered for further therapy, most often radiotherapy (RT), particularly in the high risk LGG subgroup.5 The recently reported and data-mature RTOG 9802 trial demonstrated a significant survival benefit in patients studied defined as high risk (age >40 y or incompletely resected LGG) with the combined use of RT and PCV (procarbazine, lomustine, and vincristine) chemotherapy.6 This practice-changing RTOG study suggests that the majority of patients with LGG benefit from combined modality treatment in the up-front setting, a marked contrast to the watch and wait serial MRI assessment of Pallud et al.

Thirdly, this author is unaware of any data that indicate that treating radiographic progressive disease or a so-called more growth-aggressive LGG as defined by Pallud et al (VDE > 8 mm/y by serial MRI) results in an improved outcome with respect to either survival (overall or progression free) or quality of life. Clearly the intent is to introduce more aggressive therapy (RT or chemotherapy) to alter outcome in a clinically meaningful manner, but it is uncertain if earlier treatment affects overall outcome in progressive LGG. Any benefit of earlier treatment may arguably be explained by a lead-time bias.

Pallud and colleagues are to be congratulated for continuing their efforts to define LGG based upon radiological growth characteristics and I look forward to their further research in this regard.
Outcomes after Transplantation of Cord Blood or Bone Marrow from Unrelated Donors in Adults with Leukemia
Authors: Mary J. Laughlin, Mary Eapen, Pablo Rubinstein, John E. Wagner, Mei-Jei Zhang, Richard E. Champlin, Cladd Stevens, Juliet N. Barker, Robert P. Gale, Hillard M. Lazarus, David I. Marks, Jon J. van Rood, Andromachi Scaradavou, Mary M. Horowitz
Journal: New England Journal of Medicine (2004)

Data regarding the outcome of cord-blood transplantation in adults are scant, despite the fact that these grafts are increasingly used in adults.
We and I
Authors: Frank DeCicco
Journal: JAMA (2008)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
The Mount Fuji Sign
Authors: Josef G Heckmann, Oliver Ganslandt
Journal: New England Journal of Medicine (2004)

A 53-year-old woman was admitted because of progressive right-sided hemiparesis and aphasia. A computed tomographic (CT) scan of the brain revealed a space-occupying supratentorial lesion. A biopsy through a burr hole led to the histologic diagnosis of primary B-cell lymphoma of the central nervous system. Systemic treatment with corticosteroids and methotrexate was initiated, resulting in clinical stabilization. Six weeks later, the patient became disoriented and lethargic. A second CT scan of the brain showed a massive accumulation of air that was compressing the frontal lobes, a condition called the Mount Fuji sign. Dark-to-black areas in the frontal region were caused . . .
The interaction of sodium nitroprusside with human endothelial cells and platelets: nitroprusside and prostacyclin synergistically inhibit platelet function.
Authors: R I Levin, B B Weksler, E A Jaffe
Journal: Circulation (1982)

Sodium nitroprusside (NP) is a potent vasodilator that also inhibits platelet aggregation. To test the hypothesis that NP causes both of these effects by altering the balance between prostacyclin (PGI2) produced by endothelial cells and thromboxane A2 (TXA2) produced by platelets, we incubated each of these cell types with NP for 5 minutes and assayed the PGI2 and TXA2 produced. NP at pharmacologically achieved doses (0.01--30 micrograms/ml) inhibited platelet aggregation and resultant TXA2 synthesis in a dose- and time-dependent manner (p less than 0.001). The inhibition was not dependent on cAMP production, external calcium concentration, or suppression of TXA2 synthesis. NP did not alter the production of PGI2 by cultured human endothelial cells as measured by radioimmunoassay for 6-Keto-PGF1 alpha, the stable hydrolysis product of PGI2. However, supernates of NP-treated endothelial cells containing low, noninhibitory concentrations of NP unexpectedly inhibited platelet aggregation. This inhibition of platelet aggregation was due to synergy between PGI2 (0.1--3 nM) and NP (p interaction less than 0.03). The synergistic inhibition by NP and PGI2 of platelet aggregation and TXA2 synthesis in vivo may explain some of the beneficial actions of NP in the treatment of hypertension and congestive heart failure.
Antineutrophil cytoplasmic autoantibodies in patients with systemic sclerosis
Authors: S. AKIMOTO, O. ISHIKAWA, T. TAMURA, Y. MIYACHI
Journal: British Journal of Dermatology (1996)

Perinuclear type of antineutrophil cytoplasmic antibodies (p-ANCA) have been found in patients with periarteritis nodosa, Churg-Strauss arteritis, or pauci-immune idiopathic crescentic glomerulonephritis. Recently, the association of p-ANCA and normotensive renal failure, in patients with systemic sclerosis (SSc), was reported. We have studied the incidence of p-ANCA in patients with SSc and have investigated its relationship to clinical and laboratory findings. Sera from 77 patients with SSc were examined by the indirect immunofluorescence (IIF) test, employing an ethanol-fixed human neutrophil and enzyme-linked immunosorbent assay, using purified myeloperoxidase (MPO) as an antigen (MPO-ELISA). The sera from seven patients (9.1%) were p-ANCA positive, by both IIF and MPO-ELISA. One patient died from systemic necrotizing angiitis but the remaining six patients have shown no symptoms of systemic vasculitis or of renal involvement. There was a tendency for patients positive for p-ANCA (anti-MPO antibody) to also be positive for other autoantibodies, such as anti-Sc1-70 antibody, anti-centromere antibody, anti-microsome antibody, anti-thyroglobulin antibody and rheumatoid factor. Although the incidence of p-ANCA (anti-MPO antibody) is low in patients with SSc, and its clinical significance in SSc needs further investigations, this could be a serological marker for certain symptoms in SSc.
B‐Cell leukemia‐lymphoma with striking resemblance to burkitt lymphoma in a 70‐year‐old woman
Authors: Michael T. Shaw, Charles Palmer, John M. Yuhas, Armin Rembe, Gerald Robertson, Arthur D. Bankhurst
Journal: American Journal of Hematology (1978)

Abstract A 70‐year‐old woman developed acute leukemia and a serum IgM spike. She entered complete remission with an adriamycin, vincristine, cytosine arabinoside, and prednisone combination. Bone marrow remission was maintained with intermittent cytosine arabinoside; however, she developed large skin nodules which partly remitted following adriamycin, vincristine, cyclophosphamide, and prednisone combination. They very rapidly recurred, and she died soon after. Autopsy revealed extensive tumor in the abdomen, pelvis, and thoracic cavity, but no bone marrow involvement. Histology revealed a “starry sky” appearance. Cytology showed undifferentiated cells with vacuolated cytoplasm resembling Burkitt lymphoma cells. Peroxidase and esterase stains were negative. There was strong pyroninophilia and the periodic acid‐Schiff reaction showed granular activity in the cytoplasm. Electron microscopic appearances also resembled Burkitt lymphoma. Cytogenetic studies were normal, with no Ph 1 chromosome. Immunofluorescence demonstrated surface IgM and a little IgA. 3 H‐thymidine incorporation was high, indicating rapid growth. Dibutyral cyclic adenosine monophosphate (cAMP) stimulated growth, which was further evidence of the lymphoid origin of the tumor. The close resemblance of this tumor to Burkitt lymphoma emphasizes the difficulties in systematically classifying the lymphomas.
p53 Mutations and hepatitis B virus: Cofactors in hepatocellular carcinoma
Authors: Betty L. Slagle
Journal: Hepatology (1995)

We studied 80 hepatocellular carcinomas from three continents for p53 gene (TP53) mutations and hepatitis B virus (HBV) sequences. p53 mutations were frequent in tumors from Mozambique but not in tumors from South Africa, China, and Germany. Independent of geographic origin, most tumors were positive for HBV sequences. X gene coding sequences of HBV were detected in 78% of tumors, whereas viral sequences in the surface antigen- and core antigen-encoding regions were present in less than 45% of tumors. These observations indicate that hepatocellular carcinomas are genetically heterogeneous. Mozambican-type of hepatocellular carcinomas are characterized by a high incidence of p53 mutations related to aflatoxins. In other tumors, the rarity of p53 mutations combined with the frequent presence of viral X gene coding sequences suggests a possible interference of HBV with the wild-type p53 function.
Telemedicine in developing countries
Authors: S. M Edworthy
Journal: BMJ (2001)

Clinical review p 557 

The advent of modern communication technology has unleashed a new wave of opportunities and threats to the delivery of health services.1 Telemedicine, a broad umbrella term for delivery of medical care at a distance, has reached around the world, and now health professionals can communicate faster, more widely, and more directly with clients and colleagues, no matter where they are.2 Telemedicine may in fact have a more profound impact on developing countries than on developed ones.

Satellite stations in Uzbekistan, wireless connections in Cambodia, and microwave transmission in Kosova have shown that the low bandwidth internet can reach into remote areas, some of them with troubled political situations and uncertain economic environments. It has been more difficult and costly to implement broad bandwidth applications in these locations. Nevertheless, with the internet come email, websites, chatlines, multimedia presentations, and occasional opportunities for synchronous communication via internet phones and videoconferencing. Each of these communication vehicles provides an opportunity for medical education and medical care, not to mention collegial support.3 Of course, they …
Leukemia-associated antigen-specific T-cell responses following combined PR1 and WT1 peptide vaccination in patients with myeloid malignancies
Authors: Katayoun Rezvani, Agnes S. M. Yong, Stephan Mielke, Bipin N. Savani, Laura Musse, Jeanine Superata, Behnam Jafarpour, Carol Boss, A. John Barrett
Journal: Blood (2007)
Institutional care and elderly people.
Authors: J G Evans
Journal: BMJ (1993)

only small biopsy specimens can be obtained, and only in special circumstances.Tissue obtained at surgery to correct residual squint after the thyroid eye disease is quiescent is unlikely to further our understanding of the acute phase of the disease.The same problems apply to tissue obtained at necropsy from patients with a history of thyroid eye disease.Considerable efforts have been made to identify specific interactions between the immunoglobulins of patients with thyroid eye disease and orbital muscle membranes usually of porcine origin.Even in studies on human eye muscle membranes the results have not been consistent, probably because of methodological problems.'Immunoblotting, a cruder technique for identifying antigens, has recently shown that a 64 kd protein might be an autoantigen related to thyroid eye disease,"' and this protein has been cloned and sequenced."Perros and Kendall-Taylor have recently shown that immunoglobulins that bind to porcine eye muscle membranes increase the growth of a monoclonal porcine myoblast culture.'2This is the first report of a direct effect of immunoglobulins from patients with thyroid eye disease on an orbital tissue, and the work needs repeating with myoblasts from human extraocular muscles.At this stage the question of whether thyroid eye disease results from autoimmune disturbance remains open.The best hopes of furthering our understanding must lie with work on the functional role of the recently sequenced 64 kd protein in orbital muscle and on the growth promoting properties of the ophthalmopathic immunoglobulins de- scribed by Perros and Kendall-Taylor.
Environmental transport and transformation of automotive-emitted lead.
Authors: W T Piver
Journal: Environmental Health Perspectives (1977)

The use of a mass balance equation assists in clarifying the contribution of automotive-emitted lead to the regional and global problems of the distribution of this element, by taking into account the physicochemical transformation processes operating on the lead during its transport along the various environmental pathways. The technical factors which govern the emission of such lead from automobile engines and which affect its subsequent dispersion through the environment are described.
Distinct and Nonredundant In Vivo Functions of TNF Produced by T Cells and Macrophages/Neutrophils
Authors: Sergei I. Grivennikov, Alexei V. Tumanov, Dmitry J. Liepinsh, Andrei A. Kruglov, Boris I. Marakusha, Alexander N. Shakhov, Takaya Murakami, Ludmila N. Drutskaya, Irmgard Förster, Björn E. Clausen, Lino Tessarollo, Bernhard Ryffel, Dmitry V. Kuprash, Sergei A. Nedospasov
Journal: Immunity (2005)
Suicidal Adolescents and Children
Authors: A. Schrut
Journal: JAMA (1964)

Suicidal adolescents and children represent 0.5% to 3% of all suicides. A study of 31 adolescents and children seen at the Los Angeles Suicide Prevention Center or in private psychiatric practice revealed a peculiar type of self-destructive tendency in 15 patients. In these 15, chiefly adolescents, the suicide attempt was the ultimate in a series of various self-destructive acts. Arousing parental concern and thereby reducing anxiety and feelings of helplessness resulted in a paradoxical situation in which a natural biological drive for survival has become perversely involved with a drive toward self-destruction.
Science, medicine, and the future: Molecular assessment of cancer
Authors: C. Caldas
Journal: BMJ (1998)

The recent announcement of cancer as the main cause of death in the United Kingdom comes at the end of two decades of exciting advances in understanding the basic biology of human tumours. It is now established that the development of neoplasia is due to accumulated genetic alterations in somatic cells. Identifying cell populations that share specific genetic alterations from samples of saliva, sputum, urine, stool, and blood is likely to be become a routine method of screening populations for common cancers. Genetic assessment will also be used to stage tumours and detect micrometastases. The correlation of specific profiles of genetic alterations with clinical outcome will help define prognosis more accurately and enable clinicians to target treatment more effectively.

The major discovery in cancer biology has been that tumorigenesis is a multistep process associated with accumulated genetic alterations in somatic cells. The progression of a tumour through preneoplasia to frank neoplasia and then invasion and metastasis is the result of successive rounds of clonal expansion of somatic cells that acquire a selective growth advantage as a result of mutations in genes that control cellular proliferation and death.1 Mutations result either in the activation of oncogenes, which promote cellular proliferation or inhibit cell death, or in the inactivation of tumour suppressor genes, which inhibit proliferation or promote cell death. To become a cancer cell, a normal cell needs to accumulate at least five or six of these mutations.1

Mutations occur at a higher rate in cancer cells because their genetic material (chromosomes or DNA) is intrinsically unstable.1 This genetic instability seems to be a “property” of cancer cells.1

Colorectal carcinoma is the best studied example of the genetic alterations that underlie human cancer.2 A normal mucosal cell with inactivation of a tumour suppressor gene called APC …
M144, a Murine Cytomegalovirus (Mcmv)-Encoded Major Histocompatibility Complex Class I Homologue, Confers Tumor Resistance to Natural Killer Cell–Mediated Rejection
Authors: Erika Cretney, Mariapia A. Degli-Esposti, Eloise H. Densley, Helen E. Farrell, Nick J. Davis-Poynter, Mark J. Smyth
Journal: The Journal of Experimental Medicine (1999)

Until now, it has been unclear whether murine cytomegalovirus (MCMV)-encoded protein m144 directly regulates natural killer (NK) cell effector function and whether the effects of m144 are only strictly evident in the context of MCMV infection. We have generated clones of the transporter associated with antigen processing (TAP)-2–deficient RMA-S T lymphoma cell line and its parent cell line, RMA, that stably express significant and equivalent levels of m144. In vivo NK cell–mediated rejection of RMA-S-m144 lymphomas was reduced compared with rejection of parental or mock-transfected RMA-S clones, indicating the ability of m144 to regulate NK cell–mediated responses in vivo. Significantly, the accumulation of NK cells in the peritoneum was reduced in mice challenged with RMA-S-m144, as was the lytic activity of NK cells recovered from the peritoneum. Expression of m144 on RMA-S cells also conferred resistance to cytotoxicity mediated in vitro by interleukin 2–activated adherent spleen NK cells. In summary, the data demonstrate that m144 confers some protection from NK cell effector function mediated in the absence of target cell class I expression, but that in vivo the major effect of m144 is to regulate NK cell accumulation and activation at the site of immune challenge.
Respiratory Syncytial Virus in Epidemic Bronchiolitis of Infants
Authors: B. R. Sandiford, B. Spencer
Journal: BMJ (1962)

A survey has been made of 1,230 cases of acute bronchiolitis of infancy occurring in a children's hospital over an eight-year period.It is postulated that bronchiolitis is an acute infection of the whole respiratory tract in babies, caused by the viruses of the common cold, and that secondary infection of some degree is almost inevitable.It is suggested that this dual mechanism of infection applies in other illnesses and other age groups.The clinical features consist of signs of infection of the upper respiratory tract followed by persistent cough and marked bronchospasm.There are often crepitations at the lung bases and there may be cyanosis and restless- ness.The signs vary with the stage of the illness, and it is suggested that acute bronchiolitis cannot be separated clinically from bronchopneumonia in infancy.The acute phase of bronchiolitis seldom lasts for more than a week, but cough and wheeze can persist for another fortnight.The suggested plan of treatment emphasizes the need for broad-spectrum antibiotics in all cases.Some babies can be treated at home, and one of the main incjications for admission to hospital is the need for oxygen therapy.The mortality during the period under discussion has been 5.5%.This includes many babies with serious congenital abnormalities.Three out of four babies admitted with bronchiolitis are under 6 months of age, and the death rate is highest in this age group.There is no significant morbidity in infants who recover, and second attacks are rare.Tables giving details of age, mortality, radiological findings, and treatment are presented.We wish to record our appreciation of the work done by the medical and nursing staffs of this hospital in the management of these sick babies, and we wish to thank Miss B. D. Stuart for her secretarial assistance.
Cardioprotective Medication Is Associated With Improved Survival in Patients With Peripheral Arterial Disease
Authors: Harm H.H. Feringa, Virginie H. van Waning, Jeroen J. Bax, Abdou Elhendy, Eric Boersma, Olaf Schouten, Wael Galal, Radosav V. Vidakovic, Marco J. Tangelder, Don Poldermans
Journal: Journal of the American College of Cardiology (2006)
The Yield of Flexible Sigmoidoscopy and Double-Contrast Barium Enema in the Diagnosis of Neoplasms in the Large Bowel in Patients with a Positive Hemoccult Test
Authors: J. Kewenter, H. Brevinge, B. Engarås, E. Haglind
Journal: Endoscopy (1995)

Background and Study Aims: In an ongoing screening study of 68 306 patients for early detection of colorectal cancer, those with a positive Hemoccult II test (H2) were examined with a flexible sigmoidoscope (60 cm) (FS) and double-contrast barium enema (DCE). The aim of this study was to compare the results of FS and DCE examinations in the rectum and the sigmoid colon, and to evaluate the benefit of DCEs.
GASTRIC ULCERCLINICAL, PATHOLOGICAL AND SURGICAL PHASES.
Authors: A. H. CORDIER
Journal: JAMA (1903)

The invasion of the domain of internal medicine by the modern surgeon has been one meeting no little opposition, as the battle of words in medical societies and articles in journals will attest, yet this onward march of the application of proper surgical principles continues. With true surgical principles applied to internal organs, with actual demonstrations of the results claimed by such procedures by the surgeon, the practitioner is willing to accept these procedures and to recommend them. Only a few years ago pelvic hematocele found a place in every text-book and was treated from a medical standpoint, some cases recovering, but many dying; to-day ectopic gestation with ruptured tube has replaced the hematocele pathology, and proper surgery saves the majority of these cases. Postmortems on cases dead from internal bleeding from ruptured tubes, and surgical operations on the living revealed the true pathology in these cases. The propor management