tbuckley/cabot-search huggingface dataset:
Implications of Mass Automated Instruments on Medical Practice
Authors: R R Grams
Journal: Annual Review of Medicine (1976)

The clinical laboratory is in a stage of change which has been the direct result of an influx of technology and the current demand for lower costs and increased productivity. There is no significant trend anticipated in the future which would forestall this particular process. The practicing physician can anticipate a fairly marked reduction in the cost of individual tests and, likewise, a marked increase in the amount of available information. There will be a larger clerical function involved in the review of such information along with a series of relevant problems related to the actual size of the new data base. One of the most significant problems related to this increase in numerical reporting will be the statistical problem of the "abnormal-normal." Statistical misclassification must be considered with each abnormal test and a specific approach must be taken to these tests to minimize the inconvenience to the patient. It is recommended that any unsuspected abnormal test(s) that is discovered be repeated as a single test(s) through a reference method. Reordering of the test battery or screen will only offer another possibility for statistical misinterpretation. If the test on isolated evaluation does appear abnormal, then this should call for the routine evaluation of this particular condition. Multivariate statistical analysis could eliminate this probability dilemma, yet is presently experimental and is not in routine use within any clinical setting. We can look forward to the evolution of such a process through the mechanism of a hospital and laboratory communication system which will allow the physician to work with an evaluation process capable of handling these large volumes of numbers (22). Such programs are on the horizon and should be anticipated within the next five years in some of the larger centers that have this new instrumentation.
Sensitivity to the MEK inhibitor E6201 in melanoma cells is associated with mutant BRAF and wildtype PTEN status
Authors: Sara A Byron, David C Loch, Candice L Wellens, Andreas Wortmann, Jiayi Wu, John Wang, Kenichi Nomoto, Pamela M Pollock
Journal: Molecular Cancer (2012)

Abstract Background Melanoma is the most lethal form of skin cancer, but recent advances in molecularly targeted agents against the Ras/Raf/MAPK pathway demonstrate promise as effective therapies. Despite these advances, resistance remains an issue, as illustrated recently by the clinical experience with vemurafenib. Such acquired resistance appears to be the result of parallel pathway activation, such as PI3K, to overcome single-agent inhibition. In this report, we describe the cytotoxicity and anti-tumour activity of the novel MEK inhibitor, E6201, in a broad panel of melanoma cell lines (n = 31) of known mutational profile in vitro and in vivo . We further test the effectiveness of combining E6201 with an inhibitor of PI3K (LY294002) in overcoming resistance in these cell lines. Results The majority of melanoma cell lines were either sensitive (IC50 &lt; 500 nM, 24/31) or hypersensitive (IC50 &lt; 100 nM, 18/31) to E6201. This sensitivity correlated with wildtype PTEN and mutant BRAF status, whereas mutant RAS and PI3K pathway activation were associated with resistance. Although MEK inhibitors predominantly exert a cytostatic effect, E6201 elicited a potent cytocidal effect on most of the sensitive lines studied, as evidenced by Annexin positivity and cell death ELISA. Conversely, E6201 did not induce cell death in the two resistant melanoma cell lines tested. E6201 inhibited xenograft tumour growth in all four melanoma cell lines studied to varying degrees, but a more pronounced anti-tumour effect was observed for cell lines that previously demonstrated a cytocidal response in vitro . In vitro combination studies of E6201 and LY294002 showed synergism in all six melanoma cell lines tested, as defined by a mean combination index &lt; 1. Conclusions Our data demonstrate that E6201 elicits a predominantly cytocidal effect in vitro and in vivo in melanoma cells of diverse mutational background. Resistance to E6201 was associated with disruption of PTEN and activation of downstream PI3K signalling. In keeping with these data we demonstrate that co-inhibition of MAPK and PI3K is effective in overcoming resistance inherent in melanoma.
F-18 FDG PET of Foreign Body Granuloma
Authors: Kanae Kawai Miyake, Yuji Nakamoto, Yoshiki Mikami, Koichi Ishizu, Tsuneo Saga, Tatsuya Higashi, Kaori Togashi
Journal: Clinical Nuclear Medicine (2010)

Retained textiles with foreign body granulomatous reaction can form mass-mimicking soft tissue tumors, which may cause diagnostic, clinical, and medicolegal problems. In this study, we present 3 cases of foreign body granuloma by retained textiles, and demonstrate FDG PET findings with detailed pathologic correlation. We also provide a review of previous literatures.Three patients (all females; age range, 48-61 years) with histopathologic diagnosis of mass-forming foreign body granuloma caused by retained textiles were retrospectively studied. They underwent an FDG PET scan in our institute. The mass was located in the abdominopelvic cavity in all cases. The time interval between the prior surgery and the PET acquisition was 11 months, 15 or 19 years, and 26 years, respectively.Intense FDG uptake with a ring-shaped pattern was observed in 2 cases, while no uptake in 1 case. Microscopically, 2 with ring-shaped FDG uptake showed a cellular foreign body reaction peripherally, and artificial textile fibers and acellular eosinophilic amorphous materials in the central portion. In the one without FDG uptake, the mass was composed of mainly necrotic debris surrounding by a thick layer of well-formed collagen fibers. In previous case reports describing the accumulation of FDG in foreign body granulomas, 9 of 10 cases showed intense FDG uptake with a ring-shaped pattern.The ring-shaped pattern of FDG uptake seems to well characterize pseudotumor with foreign body granulomas. However, the pattern of FDG accumulation in retained textile with foreign body granulomas may vary due to histologic features.
Crude Penicillin Filtrate for Local Treatment
Authors: J. M. Alston
Journal: BMJ (1944)

scopic antero-posterior and lateral views and then, if necessary, oblique views.Posterior fractures involving the anterior clinoid process may be elucidated by taking an axial view of the optic foramen where the outer boundary is formed by the anterior clinoid process.Cases 9 and 10 were of the type described as a " block " fracture.The central naso-frontal block of bone was detached by two lateral fissures through the ethmoids in the one case and through the temporal and frontal bones in the other.Spinial Puncture.-Ibelieve that all patients with a head injury should have a spinal puncture.In the case of these anterior fossa fractures, examination of the spinal fluid may give warning of meningitis, and also it will check the presence of blood if there has been any doubtful nose-bleeding.Meningitis.-Meningitis itself may confirm the diagnosis.Case 6 showed no fracture in the original films, but the history of five recurrent attacks of pneumococcal meningitis was accepted as con- firmation of a dural tear, and a stereoscopic film revealed a hairline crack in the frontal sinus.Case 3 developed mild meningitisheadache, neck rigidity, pyrexia, and 10 cells per c.mm.-on the 25th day after injury.This was controlled in a few days by sulphadiazine therapy.On the 46th day he complained of a " running cold in the head," and was observed to have a profuse C.S.F.rhinorrhoea.It may be mentioned, by the way, that, though frank meningitis is diagnosed clinically by delirium, pyrexia, neck rigidity, and spinal fluid containing several thousand cells per c.mm., I cannot remember a case in which an organism could be recovered from the spinal fluid after sulphadiazine therapy had been instituted.
Complications of Pediatric Surgery
Authors: Robert J. Touloukian
Journal: JAMA (1982)

For surgeons, complications are a fact of life. Thoughtful assessment and discussion of each complication at the weekly hospital morbidity and mortality conference is directed at early detection and treatment. These discussions often provide the basis for modifications in management that improve the care of patients and the results of many surgical procedures. DeVries and Shapiro address this issue in a new multiauthored book encompassing subjects in general pediatric surgery and pediatric neurosurgery, orthopedics, and urology in 37 chapters. The text is clearly written and well illustrated, providing useful information for both generalists and pediatric surgeons. Organization of the contents is a bit confusing, since chapters on specific organs, such as the esophagus, are mixed with others on specific disorders, such as biliary atresia, necrotizing enterocolitis, and Wilms' tumor. While most conditions are covered in varying detail, many chapters have excessively long and nonessential descriptions of etiology and diagnosis, which
Treatment of Tropical Ulcers
Authors: M. Zwierz
Journal: BMJ (1950)

<h3>Objective:</h3> To evaluate the association of performance in cognitive domains executive function and memory with incident coronary heart disease and stroke in older participants without dementia. <h3>Methods:</h3> We included 3,926 participants (mean age 75 years, 44% male) at risk for cardiovascular diseases from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER) with Mini-Mental State Examination score ≥24 points. Scores on the Stroop Color-Word Test (selective attention) and the Letter Digit Substitution Test (processing speed) were converted to <i>Z</i> scores and averaged into a composite executive function score. Likewise, scores of the Picture Learning Test (immediate and delayed memory) were transformed into a composite memory score. Associations of executive function and memory were longitudinally assessed with risk of coronary heart disease and stroke using multivariable Cox regression models. <h3>Results:</h3> During 3.2 years of follow-up, incidence rates of coronary heart disease and stroke were 30.5 and 12.4 per 1,000 person-years, respectively. In multivariable models, participants in the lowest third of executive function, as compared to participants in the highest third, had 1.85-fold (95% confidence interval [CI] 1.39–2.45) higher risk of coronary heart disease and 1.51-fold (95% CI 0.99–2.30) higher risk of stroke. Participants in the lowest third of memory had no increased risk of coronary heart disease (hazard ratio 0.99, 95% CI 0.74–1.32) or stroke (hazard ratio 0.87, 95% CI 0.57–1.32). <h3>Conclusion:</h3> Lower executive function, but not memory, is associated with higher risk of coronary heart disease and stroke. Lower executive function, as an independent risk indicator, might better reflect brain vascular pathologies.
GONOCOCCUS INFECTION AS A CAUSE OF BLINDNESS, VULVOVAGINITIS AND ARTHRITIS.
Authors: J. CLIFTON EDGAR
Journal: JAMA (1907)

<h3>CAUSE OF BLINDNESS.</h3> The most important of the causes of blindness with which we have to do is that resulting from a gonococcus infection of the eyes of the child at birth. Important— first, because it is the most common cause of blindness; second, because it affects the young child and a long lifetime of blindness may follow; and third, because it is preventable and curable in practically every case receiving proper care, and because it is one of the most dangerous maladies to vision when treatment is neglected or delayed. It is a veritable world plague. It occurs everywhere and no country has yet succeeded in getting it completely under control. So widespread is blindness resulting from it that Magnus, who has made careful statistical studies concerning it, says that out of 2,528 cases, of all ages, of complete blindness in Germany 10.88 per cent. were due to this
Peer Review in Graduate Education
Authors: Bery Engebretshen
Journal: New England Journal of Medicine (1977)

Although few topics in medicine today share the interest generated by peer review, the impression is that programs to assure quality of health care have been received within the medical profession less than enthusiastically. Perhaps, if we look at the education of physicians-in-training, we can gain some insights. It seems incongruous that members of house staffs are given the responsibility for decision making in dealing with people whose body parts are malfunctioning, but at the same time are given no responsibility for the malfunctioning of themselves or their peers. Just as didactic presentation or philosophical discussions are not accepted as . . .
REFERRAL RATE FOR PULMONARY VALVE REPLACEMENT IN ADULTS WITH PULMONARY STENOSIS WHO HAVE UNDERGONE CHILDHOOD VALVOTOMY: A SINGLE ADULT CONGENITAL HEART CENTER&amp;apos;S EXPERIENCE
Authors: Daniel S. O&apos;Connor, Philip Green, Gregg Rosner, Jonathan Ginns, Marlon Rosenbaum
Journal: Journal of the American College of Cardiology (2012)
Emergency adult-to-adult living-donor liver transplantation for acute liver failure in a hepatitis B virus endemic area
Authors: Soo Jung Park, Young-Suk Lim, Shin Hwang, Nae Yun Heo, Han Chu Lee, Dong Jin Suh, Eunsil Yu, Sung Gyu Lee
Journal: Hepatology (2009)

The outcomes of patients with acute liver failure (ALF) vary greatly according to etiology. Emergency adult-to-adult living-donor liver transplantation (adult LDLT) would help address the shortage of available organs for patients with ALF, especially in hepatitis B virus (HBV)-endemic areas. We analyzed a prospective database of 110 consecutive adult patients with ALF. ALF was defined as sudden development of severe coagulopathy and encephalopathy within 26 weeks of onset of symptoms. In about 90% of patients, ALF was caused by etiologies that usually result in poor outcomes, including HBV infection (37%). Three cases (3%) were associated with acetaminophen overdose. Of the 99 patients listed for emergency liver transplantation, four (4%) underwent deceased-donor liver transplantation (DDLT), and 40 (40%) underwent adult LDLT. The 1-year survival rate of adult LDLT patients was 85%. Of the 55 patients listed but not transplanted, 45 (82%) died within a median of 7 days (range, 1-90 days). Multivariate analysis showed that adult LDLT (hazard ratio [HR] 0.10, P &lt; 0.01) and DDLT (HR 0.12, P = 0.04) were associated with decreased mortality, whereas older age (HR 1.03, P = 0.01) and higher Model for End-stage Liver Disease (MELD) (HR 1.03, P = 0.04) was associated with increased mortality of patients. There was no living donor mortality. Eight (17.8%) and three (6.7%) living donors experienced grade 1 and 2 complications, respectively. Conclusion: Emergency adult LDLT can be performed expeditiously and safely for patients with ALF, and greatly improves the survival rate. As the window during which transplantation is possible is limited, emergency adult LDLT should be considered one of the first-line treatment options in patients with ALF, especially in regions in which ALFs are caused by etiologies associated with poor outcome and the supply of organs is severely limited. (Hepatology 2010.)
Erythema Nodosum Leprosum Reaction of Leprosy Causing the Double Stripe Sign on Bone Scan Case Report
Authors: FREDERICK L. DATZ
Journal: Clinical Nuclear Medicine (1987)

Leprosy is a disease that is widely distributed in underdeveloped tropical regions, with cases also occurring in the United States. The bone scan findings in a patient with leprosy who had developed a reactional state of the disease, erythema nodosum leprosum, are presented. His scan showed bilaterally symmetrical double stripe signs involving the distal tibias, similar to those seen in hypertrophic osteoarthropathy. Physicians should be aware that this reactive phase of leprosy can also produce the double stripe sign.
Total volume paracentesis decreases variceal pressure, size, and variceal wall tension in cirrhotic patients
Authors: D Kravetz
Journal: Hepatology (1997)

It has been suggested that ascites is a risk factor for variceal bleeding in cirrhotic patients. However, no data of total volume paracentesis (TVP) effects on variceal hemodynamics has yet been published. The aim of this study was to investigate the effects of TVP on variceal pressure, size, and tension in cirrhotic patients. Before sclerotherapy, 18 cirrhotic patients with grade II esophageal varices were studied. The following measurements were performed on 12 patients at basal condition and after TVP: inferior vena cava pressure, esophageal pressure (EP), and intravariceal pressure (IVP) by direct punction and variceal size at endoscopy. The same measurements were performed at basal condition and 1 hour later without TVP on the other 6 patients used as a control group. Variceal pressure gradient (VPG) and variceal wall tension (WT) were calculated. Paracentesis and intra-abdominal pressure were obtained with a direct punction. No demographic differences were observed between both groups. Paracentesis produced a significant reduction of IVP (from 25.6 +/- 2.4 to 17.9 +/- 2.1 mm Hg, means +/- SEM, -30%, P < .05), VPG (from 16.6 +/- 2.4 to 10.8 +/- 1.4 mm Hg, -35%, P < .05). TVP also reduced variceal size (from 9 +/- 0.3 to 5.6 + 0.4 mm, -38%, P < .05) and WT (from 75.3 +/- 11.6 to 30 +/- 4.7 mm Hg. mm, -60%, P < .05). Intra-abdominal pressure decreased from 18 +/- 2.2 to 4 +/- 0.9 mm Hg (P < .05), and IVC decreased from 15.5 +/- 2.4 to 5.7 +/- 1.5 mm Hg (P < .05). No significant differences were observed in mean arterial pressure and heart rate. The mean ascitic fluid removed was 8 +/- 0.71 L. No significant difference between measurements was observed in the control group. Our results show that TVP significantly decreases variceal pressure and tension. These results suggest that ascites removal can be useful in the treatment of variceal bleeding in cirrhotic patients.
Abstract 1050: Force-Endurance: A Novel Method to Assess Skeletal Muscle Training Effects in Heart Failure Patients
Authors: Stephan Gielen, Marcus Sandri, Norman Mangner, Carolin Kleinecke, Irina Kozarez, Sandra Erbs, Robert Hoellriegel, Rainer P Hambrecht, Gerhard C Schuler
Journal: Circulation (2009)
Characterization of the Cyclooxygenase-2 Promoter in an Adenoviral Vector and Its Application for the Mitigation of Toxicity in Suicide Gene Therapy of Gastrointestinal Cancers
Authors: Masato Yamamoto, Ramon Alemany, Yasuo Adachi, William E. Grizzle, David T. Curiel
Journal: Molecular Therapy (2001)

The application of adenoviral molecular chemotherapy for systemic malignant disease using herpes simplex virus thymidine kinase has been limited by ectopic transgene expression in the liver due to the vector hepatotropism. The aim of this study was to mitigate this hepatotoxicity using the promoter of cyclooxygenase-2, inactive in liver but active in many gastrointestinal cancers. To analyze the specificity of transgene expression driven by cyclooxygenase-2 (cox-2) promoters, promoters of two different lengths were incorporated into adenoviral vectors to drive luciferase expression. The specific cytocidal effect and in vivo toxicity were analyzed with thymidine kinase expression vectors. The specificity of the cox-2 promoter was well preserved in the adenoviral vector. In vivo, the cox-2 promoter (−1432/+59) showed very little activity in the liver but attained high activity, comparable to that of the cytomegalovirus promoter, in cyclooxygenase-2-positive subcutaneous tumors. The cox-2 promoter-driven thymidine kinase-expressing vectors showed a cytocidal effect specifically in cyclooxygenase-2-positive cells. When mice were treated with the thymidine kinase-expressing vector and ganciclovir, the cox-2 promoter successfully mitigated the fatal hepatotoxicity, which was observed with the cytomegalovirus promoter-driven vector. The cox-2 promoter successfully mitigated the adverse effects of adenoviral suicide gene therapy by minimizing transgene expression in the liver.
The Novel HSP90 Inhibitor, IPI-493, Is Highly Effective in Human Gastrostrointestinal Stromal Tumor Xenografts Carrying Heterogeneous <i>KIT</i> Mutations
Authors: Giuseppe Floris, Raf Sciot, Agnieszka Wozniak, Thomas Van Looy, Jasmien Wellens, Gavino Faa, Emmanuel Normant, Maria Debiec-Rychter, Patrick Schöffski
Journal: Clinical Cancer Research (2011)

KIT activity is crucial for gastrointestinal stromal tumors (GIST). Imatinib (IMA) and sunitinib (SUN) are very effective KIT-inhibitors in patients with advanced GIST but have no curative potential. We evaluated the efficacy of the novel HSP90 inhibitor IPI-493 alone, or in combination with IMA or SUN in GIST xenografts with KIT mutations.Nude mice (n = 98) were grafted bilaterally with human GIST carrying KIT exon 11 (GIST-PSW), KIT exon 9 (GIST-BOE), or double, KIT imatinib-sensitive exon 11 and imatinib-resistant exon 17 mutations (GIST-48). Mice were divided into six treatment groups and dosed orally for 15 days as follows: (i) control group, sterile water; (ii) IMA alone; (iii) SUN alone; (iv) IPI-493 alone; (v) IPI-493+IMA; and (vi) IPI-493+SUN.Treatment with IPI-493 resulted in tumor growth stabilization, variable proliferation arrest, induction of apoptosis and necrosis, and downregulation of KIT and its signaling cascade, especially in the GIST-BOE model. Significant reduction of vessel density was observed with IPI-493 treatment, and was equal to SUN treatment in GIST-PSW and GIST-BOE xenografts. IPI-493 treatment effects were enhanced in combination with TKIs, especially with IPI-493+SUN. In our hands, IPI-493 showed dose-dependent liver damages.When administered as a single agent in a xenograft model, the HSP90 inhibitor IPI-493 has consistent antitumor activity and induces KIT downregulation in GISTs with heterogeneous KIT mutations. IPI-493 synergizes with TKIs that are commonly used for the treatment of advanced or IMA-resistant GIST. The antitumor response of IPI-493 is particularly enhanced in combination with SUN.
Goseki histological grading of gastric cancer is an important predictor of outcome.
Authors: I G Martin, M F Dixon, H Sue-Ling, A T Axon, D Johnston
Journal: Gut (1994)

TNM (tumour, node, metastases) staging has thus far been the most important guide to prognosis in patients with gastric cancer. Histological grading, in contrast, has not provided any additional information. Recently a novel grading system based on tubular differentiation and mucus production has been proposed, which was correlated with patterns of tumour spread found at necropsy. This study set out to assess its value as a determinant of survival after gastric resection. In a consecutive series of 211 patients who had potentially curative resection for gastric cancer, five histological grading systems were assessed: the Lauren type, the WHO type, degree of differentiation, the type of tumour border, and the lymphocytic response to the tumour and compared with the Goseki grading (I-IV). When T and N stage were taken into account, using Cox's proportional hazards model, only the Goseki grading added further to the ability to predict survival. The proportional hazards ratios were: node negative v node positive 6.5 T1 v T3 2.45; Goseki I v Goseki IV 3.1. Five year survival of patients with mucus rich (Goseki II and IV) T3 tumours was significantly worse than that of patients with mucus poor (Goseki I and III) T3 tumours (18% v 53%, p < 0.003). Goseki grading identifies subgroups of patients with a poorer prognosis than is predicted by TNM staging alone. It could prove useful in the selection of patients for adjuvant therapy after potentially curative resection for gastric cancer.