tbuckley/cabot-search huggingface dataset:
Defining Experimental Therapy — A Third-Party Payer's Dilemma
Authors: L N Newcomer
Journal: New England Journal of Medicine (1990)

A young Maryland mother discovered that she had relapsed only six months after receiving adjuvant chemotherapy for breast cancer. Assessing her poor prognosis, the woman's oncologist recommended high-dose chemotherapy with autologous bone marrow transplantation. Her insurer, Blue Cross and Blue Shield of Virginia, denied coverage for the treatment, citing a clause in the policy that excluded "experimental" therapy. After hearing the case, a federal judge ordered the insurer to pay for the treatment, stating that the policy did not specify the criteria that defined a treatment as experimental.1 This case is representative of a dilemma for third-party payers. The majority . . .
SHORT-TERM USE OF CORTICOTROPIN AS ADJUNCTIVE THERAPY
Authors: William S. Reveno
Journal: JAMA (1952)

As experience with corticotropin (ACTH) accumulates, it is becoming increasingly apparent that its greatest usefulness is less as a cure in disease states than as an antitoxic agent, bolstering the defense mechanism and promoting remission. This quality may assert itself by the liberation of substances that absorb toxins by strengthening the cell membrane to prevent entry of damaging agents or by preventing disorganization of enzymatic processes within the cell itself. Bacterial growth is not inhibited, and specific antibody formation is neither accelerated nor arrested. The action may be presumed to be mainly one of blocking the action of toxins and allowing an adequate build-up of the defensive processes. Viewed in this light, the potentialities of the short-term use of corticotropin for conditions in which there is poor response to other therapy becomes readily evident. Systemic infections, shock states, and acute toxemias, when the patient is overwhelmed or floundering, may be
20-hour combination chemotherapy in advanced breast cancer.
Authors: J H Goldie, L A Price
Journal: BMJ (1977)

Case reportA 59-year-old woman with severe multiple sclerosis was admitted for the management of a decubitus ulcer over the mid-sacral area.This included spraying the base of the ulcer daily with 1-2 ml of bovine soluble insulin (insulin injection BP, 20 units/ml).She was turned two-hourly, given a high- protein diet and all possible nursing care.Her general condition deteriorated suddenly 3-4 hours after her insulin treatment.Her mental state changed and she became restless, aggressive, and disorientated.She was flushed and sweating, though afebrile.Her pulse was 110 beats/min and blood pressure 120/70 mm Hg.The only abnormal physical sign was a positive Babinski response on the left side.An electrocardiogram was within normal limits.During the next hour her condition deteriorated further and she became comatose and unresponsive to deep pain.Dextrostix showed a blood glucose concentration of less than 2 5 mmol/l (45 mg/100 ml) and urinary sugar concentration at this time was 12 mmol/l (20 mg/ 100 ml). 100 ml of 500o' dextrose intravenously resulted in total physical and mental recovery within 10 minutes.We are grateful to Dr Bridget T Hill of the Imperial Cancer Research Fund for several helpful discussions on the clinical application of cell cycle kinetics during the preparation of the paper.
Alpha Interferon for Induction of Remission in Hairy-Cell Leukemia
Authors: Jorge R. Quesada, James Reuben, John T. Manning, Evan M. Hersh, Jordan U. Gutterman
Journal: New England Journal of Medicine (1984)

We treated seven patients who had progressive hairy-cell leukemia with daily doses of 3 million units of partially pure alpha (leukocyte) interferon by the intramuscular route. Three patients had a complete remission, and four had a partial remission, according to strict criteria for a response. After treatment, bone-marrow aspirates showed an absence of leukemia cells in three patients and 5 per cent or fewer in three others. Normalization of subnormal peripheral-blood values occurred in six of six patients with anemia, in seven of seven with granulocytopenia, and in four of four with thrombocytopenia. Remissions have been maintained for over 6 to over 10 months. Alpha interferon appears to be highly effective in patients with hairy-cell leukemia. (N Engl J Med 1984; 310:15–8.)
A retrospective comparison of autologous and unrelated donor hematopoietic cell transplantation in myelodysplastic syndrome and secondary acute myeloid leukemia: a report on behalf of the Chronic Leukemia Working Party of the European Group for Blood and Marrow Transplantation (EBMT)
Authors: H K Al-Ali, R Brand, A van Biezen, J Finke, M Boogaerts, A A Fauser, M Egeler, J-Y Cahn, R Arnold, H Biersack, D Niederwieser, T de Witte
Journal: Leukemia (2007)
Biliary Tract Disease In Navajo Indians
Authors: Byron D. Danielson
Journal: JAMA (1968)

<h3>To the Editor:—</h3> In the article, "Biliary Tract Disease Among the Navajos," by Brown and Christensen (<b>202</b>:1050, 1967), there were two unverified conclusions. The average age of the male patients in the study was 56.8 and that of female patients 39.9 years. Colcock and Perey (<i>Surg Gyn Obstet</i><b>117</b>:529, 1963) stated that the average age of white male and female patients with biliary tract disease in their study was 53.7 and 53.4 years, respectively. The female-to-male ratio of patients with biliary tract disease in the Navajo group was about four to one, while that in the white population from various sources is about two to one (<i>Surg Gyn Obstet</i><b>85</b>:776, 1947;<i>Surg Gyn Obstet</i><b>101</b>:161, 1955). From this information was concluded the following: (1) biliary tract disease occurs at a younger age in the general Navajo population as compared to the white population, and (2) the
Syk-Dependent Cytokine Induction by Dectin-1 Reveals a Novel Pattern Recognition Pathway for C Type Lectins
Authors: Neil C. Rogers, Emma C. Slack, Alexander D. Edwards, Martijn A. Nolte, Oliver Schulz, Edina Schweighoffer, David L. Williams, Siamon Gordon, Victor L. Tybulewicz, Gordon D. Brown, Caetano Reis e Sousa
Journal: Immunity (2005)
Emergency endovascular stent graft repair for acute blunt thoracic aortic injury: a retrospective case control study
Authors: Christophe Broux, Frédéric Thony, Olivier Chavanon, Vincent Bach, Rachid Hacini, Christian Sengel, Dominique Blin, Pierre Lavagne, Pierre Girardet, Claude Jacquot
Journal: Intensive Care Medicine (2006)
A novel role of the CX3CR1/CX3CL1 system in the cross-talk between chronic lymphocytic leukemia cells and tumor microenvironment
Authors: E Ferretti, M Bertolotto, S Deaglio, C Tripodo, D Ribatti, V Audrito, F Blengio, S Matis, S Zupo, D Rossi, L Ottonello, G Gaidano, F Malavasi, V Pistoia, A Corcione
Journal: Leukemia (2011)
Clinical Phonocardiography
Authors: Morton E. Tavel
Journal: JAMA (1968)

Phonocardiography, in conjunction with external pulse tracings, can often be decisive in the diagnosis of idiopathic hypertrophic subaortic stenosis (IHSS). This disease has been recognized with considerable frequency in recent years,<sup>1</sup>and it is incumbent upon the clinician to familiarize himself with its various manifestations. Idiopathic hypertrophic subaortic stenosis is characterized by hypertrophy of the entire left ventricle with particular involvement of the interventricular septum in the region of the outflow tract. Subaortic obstruction is a dynamic process, and the stenosis occurs only after the left ventricle has contracted sufficiently to bring into approximation the thickened walls of its outflow tract. For this reason, the stenosis may vary in severity from time to time, and maneuvers which increase the vigor of ventricular contraction or which enhance left-ventricular emptying will increase the subaortic obstruction. As a result of the subaortic stenosis, a midsystolic, crescendodecrescendo (diamond-shaped) murmur is produced which is
Endoscopic fluorescence detection of low and high grade dysplasia in Barrett's oesophagus using systemic or local 5-aminolaevulinic acid sensitisation
Authors: E Endlicher, R Knuechel, T Hauser, R M Szeimies, J Schölmerich, H Messmann
Journal: Gut (2001)

Barrett's oesophagus is associated with an increased risk of cancer. As dysplasia is not visible during routine endoscopy, random biopsies in the four quadrants every 1-2 cm are recommended. Endoscopic fluorescence detection (EFD) after sensitisation with 5-aminolaevulinic acid (5-ALA) with different modes and concentrations was assessed to optimise the technique for detection of dysplasia or early cancers. 5-ALA is converted intracellularly to protoporphyrin IX which accumulates in malignant tissue and can be detected by typical red fluorescence after illumination with blue light.In 47 patients with Barrett's oesophagus, 10 with known dysplasia, 58 fluorescence endoscopies were performed after sensitisation with different concentrations of 5-ALA given orally (5, 10, 20, 30 mg/kg) or locally (500-1000 mg) by spraying the mucosa via a catheter. EFD was performed 4-6 hours after systemic and 1-2 hours after local sensitisation using a special light source delivering white or blue light. A total of 243 biopsies of red fluorescent (n=113) and non-fluorescent areas (n=130) were taken.In three patients, two early cancers and dysplasia, not visible during routine endoscopy, were detected by EFD. Thirty three biopsies revealed either low or high grade dysplasia. Sensitivity for detection of dysplastic lesions ranged from 60% after local sensitisation with 500 mg to 80%, 100%, and 100% after systemic application of 5-ALA 10, 20, and 30 mg/kg, respectively. However, specificity was best for local sensitisation (70%) while systemic administration revealed values between 27% and 56%. Using 5 mg/kg, no red fluorescence in dysplastic lesions was found. No severe side effects were noted.EFD is a promising tool to detect non-visible dysplastic lesions in Barrett's oesophagus using 5-ALA sensitisation. A randomised controlled study is now indicated to compare the efficacy of EFD with the standard technique of four quadrant random biopsies.
Sidestream tobacco smoke exposure acutely alters human nasal mucociliary clearance.
Authors: R Bascom, J Kesavanathan, T K Fitzgerald, K H Cheng, D L Swift
Journal: Environmental Health Perspectives (1995)

Nasal mucociliary clearance (NMC) is a biomarker of nasal mucosal function. Tobacco smokers have been shown to have abnormal NMC, but the acute effect of environmental tobacco smoke (ETS) on nonsmokers is unknown. This study evaluated acute tobacco smoke-induced alterations in NMC in 12 healthy adults. Subjects were studied on 2 days, separated by at least 1 week. Subjects underwent a 60-min controlled exposure at rest to air or sidestream tobacco smoke (SS) (15 ppm CO) in a controlled environmental chamber. One hour after the exposure, 99mTc-sulfur colloid was aerosolized throughout the nasal passage and counts were measured with a scintillation detector. Six out of 12 subjects showed more rapid clearance after smoke exposure than after air exposure, and 3/12 had rapid clearance on both days. However, substantial decreases in clearance occurred in 3/12 subjects, all of whom had a history of ETS rhinitis. In two subjects, more than 90% of the tracer remained 1 hr after tracer administration (2 hr after smoke exposure). Understanding the basis for biologic variability in the acute effect of tobacco smoke on NMC may advance our understanding of pathogenesis of chronic effects of ETS.
Talking about a revolution
Authors: D. Spence
Journal: BMJ (2010)

Medicine is glamorous. Overheard hushed voices talk about how clever we are: white coats, serious expressions, high pay, and respect. So medicine can be a draw for the vain, motivated by status not duty. But medicine is harsh, full of late nights, uncertainty, doubt, and blame. Even evidence based medicine informs but the merest part of our work, just a plastic tarpaulin in the wild storms of clinical practice. Medicine is a job of attitude not bookish learning, of emotion not logic. We still select …
LYMPHOCYTE TRANSFORMATION FOLLOWING B.C.G. VACCINATION
Authors: I. SARKANY, HEATHER HALES
Journal: British Journal of Dermatology (1968)

Journal Article LYMPHOCYTE TRANSFORMATION FOLLOWING B.C.G. VACCINATION Get access I. SARKANY, I. SARKANY Department of Dermatology, Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar HEATHER HALES HEATHER HALES Department of Dermatology, Royal Free Hospital, London, W.C.I Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 80, Issue 1, 1 January 1968, Pages 29–34, https://doi.org/10.1111/j.1365-2133.1968.tb11902.x Published: 01 January 1968 Article history Accepted: 05 September 1967 Published: 01 January 1968
Abstract P4-09-08: HOXB9, a gene promoting tumor angiogenesis and proliferation, is significantly associated with poor clincal outcomes in ER-positive breast cancer patients
Authors: H Seki, T Hayashida, H Jinno, M Takahashi, K Suzuki, M Kaneda, H Hara, M Osaku, F Asanuma, Y Yamada, M Mukai, Y Kitagawa
Journal: Cancer Research (2012)

Abstract Background: Studies have suggested that HOXB9 expression in breast cancer cells promotes cellular invasiveness, metastatic ability, and tumor neovascularization in the surrounding tissue in in vitro and in vivo assays. These findings imply that HOXB9 overexpression may alter tumor-specific cell fates and the tumor stromal microenvironment, contributing to breast cancer progression (Hayashida et al., PNAS 2010). We previously reported that clinical outcomes were significantly decreased in HOXB9-positive patients (Seki et al., Ann Surg Oncol. 2012). In this study, it was demonstrated that HER2 type and basal-like breast cancers were more associated with HOXB9 positivity than the luminal type. Therefore, it is required to identify more detail clinicopathological features most likely to be associated with HOXB9 overexpression. We investigated the correlation between HOXB9 overexpression and clinicopathological variables, and clinical outcomes in estrogen receptor (ER)-positive breast cancer patients. Patients and methods: A consecutive series of 118 ER-positive breast cancer patients who underwent surgical treatment were examined. HOXB9 expression was analyzed immunohistochemically using the anti-human HOXB9 polyclonal antibody. Immunostaining of Ki-67 and CD31 were also performed to evaluate tumor proliferation and angiogenesis. Results: The median age was 59 years and median observation period was 62 months. Of 118 tumor specimens immunostained for HOXB9, 49 specimens (41.5%) were positive staining. Univariate logistic regression revealed high nuclear grade (p &amp;lt; 0.001), lymph node metastasis (p = 0.019), the number of micro vessel density (p &amp;lt; 0.001) and the Ki-67 ratio (p = 0.019) as significant variables associated with HOXB9 positive. The disease-free survival (DFS) was significantly decreased in HOXB9-positive patients (HR = 4.262, 95% CI = 1.531 — 11.869, p = 0.006) A Multivariate analysis indicated that HOXB9 expression was the only independent prognostic factor for DFS (HR = 3.380 95% CI=1.160 — 9.849, p = 0.026). Conclusions: Our results suggest that HOXB9 expression promoting the cellular proliferation and the angiogenesis in tumor microenvironment is a significant prognostic factor for clinical outcomes in ER-positive breast cancer patients. Further study might help to determine the application of anti-angiogenic therapy for metastatic ER-positive breast cancer patients. Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P4-09-08.
Differences in the Effect of Cigarette Smoking on Endothelial Function in Chinese and White Adults
Authors: Kam S. Woo
Journal: Annals of Internal Medicine (1997)

Background: The prevalence of coronary artery disease in southern China is approximately one fifth that in "westernized" countries, even though approximately 70% of Chinese men smoke cigarettes and Chinese women have substantial passive exposure to cigarette smoke. Objectives: Endothelial dysfunction is an early event in atherosclerosis and occurs in young white active and passive smokers; we compared endothelial physiology in healthy young Chinese and white smokers and nonsmokers. Patients: 144 healthy adults who were 16 to 45 years of age: 72 Chinese persons in a village in southern China and 72 white persons in Australia and England who were matched for exposure to cigarette smoke. Each ethnic group comprised 36 controls (lifelong nonsmokers with no regular exposure to cigarette smoke; 16 men and 20 women) and 36 active or passive smokers (15 men and 21 women). Measurements: Arterial endothelial function was tested with high-resolution external vascular ultrasonography, and brachial artery diameter was measured at rest, after flow increase (which causes endothelium-dependent dilatation), and after administration of sublingual nitroglycerin (an endothelium-independent dilator). Results: Endothelium-dependent dilatation was similar in Chinese (7.9%) and white (8.4%) nonsmokers (P > 0.2). Among white persons, endothelium-dependent dilatation was lower in active or passive smokers (3.9%) than in nonsmokers (8.4%) (P < 0.001). Among Chinese persons, dilatation was not significantly lower in active or passive smokers (7.3%) than in nonsmokers (7.9%) (P > 0.2). Dilatation was higher in Chinese active or passive smokers (7.3%) than in white active or passive smokers (3.9%) (P < 0.001). Dilatation responses to nitroglycerin were similar in all groups (P = 0.17). Conclusion: Young Chinese adults have less evidence of arterial endothelial dysfunction than young white adults with similar direct or indirect exposure to cigarette smoke.
Estrogens in unexpected places: possible implications for researchers and consumers.
Authors: D Feldman, A Krishnan
Journal: Environmental Health Perspectives (1995)

Estrogenic activity originating in unexpected places was encountered on three occasions during an investigation of whether Saccharomyces cerevisiae synthesized estrogens. In each instance, estradiol found in the conditioned yeast culture medium originated from an exogenous source and was not synthesized by the yeast. In the first instance, yeast grown in the laboratory showed a time-dependent increase in estradiol in the conditioned medium. However, the culture medium supplement Bacto-peptone was found to contain large amounts of estrone. When added to yeast cultures in the form of YPD medium (yeast extract, Bacto-peptone, and dextrose), S. cerevisiae converted the estrone to estradiol leading to the accumulation of estradiol over time. In the second instance, commercially purchased S. cerevisiae grown in a molasses medium exhibited substantial amounts of estradiol. However, corn and beet molasses contained sufficient estrone and estradiol to account for the findings. As in the first instance, the yeast converted the estrone into estradiol. In the third instance, autoclaving culture medium in polycarbonate plastic flasks was found to cause an estrogenic substance to be added to the medium, whether yeast were present or not. It was determined that the autoclaving process leached bisphenol-A (BPA) out of the polycarbonate plastic. BPA was shown to bind to estrogen receptors and to induce estrogenic activity, including stimulation of MCF-7 breast cancer-cell proliferation and induction of the expression of progesterone receptors. The three instances highlight potential problems for investigators who might inadvertently add estrogens to experimental systems confounding their results. The BPA findings raise concerns about the possible addition of this estrogenic molecule to the food supply since polycarbonate plastic is used in myriad applications in the packaging of food and beverages. Although we are unaware of the substantial contamination of food products with BPA, we believe this possibility should be carefully investigated.
Intramucosal stercolith of colon
Authors: C.-M. Tai, K.-J. Lin, C.-T. Lee, C.-H. Tu, D.-S. Perng, H.-P. Wang
Journal: Endoscopy (2007)

A 27-year-old woman underwent colonoscopy because of chronic constipation and a family history of colon cancer. Colonoscopy revealed a 1.2-cm yellowish sessile lesion with transparent overlying mucosa, at the descending colon (Figure [1 a]). The mass was firm in consistency. After a mucosal defect was created using a biopsy forceps, a yellowish mass was extruded that spontaneously separated into two fragments (Figure [1 b]). Endoscopic mucosal resection was done to remove residual mucosa.
Medical Education 2006
Authors: Robert M. Golub
Journal: JAMA (2006)

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