tbuckley/cabot-search huggingface dataset:
Colonic Polyps in Asymptomatic Patients
Authors: Jerry Drexler
Journal: Annals of Internal Medicine (1989)

Letters and Corrections1 May 1989Colonic Polyps in Asymptomatic PatientsJerry Drexler, MDJerry Drexler, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-110-9-747 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor: Achkar and Carey (1) showed that a small polyp in the rectosigmoid, whether hyperplastic or neoplastic, is 1.6 to 2.4 times more likely to indicate the proximal presence of an adenomatous rather than a hyperplastic polyp. They therefore suggest that a full colonoscopy be done in cases where a polyp of any size or histologic type is found at proctosigmoidoscopy.Unfortunately, such a recommendation would be disasterously expensive and poorly productive if followed to the letter. Rigid proctosigmoidoscopy in asymptomatic patients over age 45 yields diminutive polyps (defined as a mucosal excrescence) 5mm or less in size...References1. AchkarCarey EW. Small polyps found during fiberoptic sigmoidoscopy in asymptomatic patients. Ann Intern Med. 1988;109:880-3. LinkGoogle Scholar2. Drexler J. Asymptomatic polyps of the colon and rectum. III. Proximal and distal polyps relationships. Arch Intern Med. 1971; 127:466-9. CrossrefMedlineGoogle Scholar3. Knoerschild H. Growth rate and malignant potential of colonic polyps. Surg Forum. 1963;14:137-8. MedlineGoogle Scholar4. Arthur J. Structure and significance of metaplastic nodules in the rectal mucosa. J Clin Path. 1968;21:735-43. CrossrefMedlineGoogle Scholar5. Pagtalunan R. The histopathology of diminutive polyps of the large intestine. Surg Gynecol Obstet. 1965;120:1259-65. MedlineGoogle Scholar1. AchkarCarey EW. Small polyps found during fiberoptic sigmoidoscopy in asymptomatic patients. Ann Intern Med. 1988;109:880-3. LinkGoogle Scholar2. StoltenbergKirtleyCulp PDK. Are diminutive colorectal polyps clinically significant? [Abstract]. Gastrointest Endosc. 1988;34:172. Google Scholar3. AnsherLewisO'Keiffe AJD. Hyperplastic colonic polyps as a marker for adenomatous polyps [Abstract]. Gastroenterology. 1986;90:1328. Google Scholar4. BlueSivakAchkar MME. Colonoscopy as treatment of all polyps found at screening sigmoidoscopy [Abstract]. Gastrointest Endosc. 1988;34:193. Google Scholar5. Drexler J. Asymptomatic polyps of the colon and rectum. Arch Intern Med. 1971;127:466-9. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Los Angeles, CA 90034 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1989Volume 110, Issue 9Page: 747-748KeywordsColonoscopy Issue Published: 1 May 1989 PDF DownloadLoading ...
Leishmania major-specific, CD4+, major histocompatibility complex class II-restricted T cells derived in vitro from lymphoid tissues of naive mice.
Authors: A H Shankar, R G Titus
Journal: The Journal of Experimental Medicine (1993)

Several studies indicate that the outcome of experimental murine cutaneous leishmaniasis caused by Leishmania major (Lm) is determined by immunological events occurring shortly after infection. These events lead to outgrowth of either protective CD4+ T cells in the C57BL/6 mouse, which cures, or exacerbative cells in the BALB/c mouse, which succumbs to disease. Potential factors influencing the outgrowth of protective or exacerbative T cells include antigen-presenting cells (APC), cytokines, and parasite antigens. An in vitro system, in which one could precisely control the factors shaping early events in the T cell response to Lm, would be very useful. To this end, we have examined the in vitro response of naive lymphocytes to Lm promastigotes. The data presented here show that Lm-specific CD4+ T cell receptor alpha/beta + T cells can be generated in vitro from spleen and lymph node cell populations of naive mice. Furthermore, they can be obtained from the CD44low (unprimed) population of T lymphocytes, indicating that in vitro priming occurs. The ability to generate these T cells is dependent on the presence of live parasites and is not due to a parasite-derived nonspecific T cell mitogen. Restimulation, as assayed by proliferation, requires APC bearing syngeneic I-A. Optimal restimulation of the in vitro derived T cells is achieved only when live promastigotes are used. The T cells do not proliferate in response to a frozen-and-thawed lysate of promastigotes, yet they exhibit mild reactivity to lysates prepared from heat-shocked promastigotes. Furthermore, they do not recognize two predominant antigens on the promastigote surface, lipophosphoglycan and gp63. T cells derived in vitro with Lm show crossreactivity with live L. donovani, less crossreactivity with live L. mexicana, and no crossreactivity with live Bacillus-Calmette-Guerin or live Brugia malayi microfilariae. Finally, these early T cells, whether derived from healing C57BL/6 or nonhealing BALB/c mice, produce interleukin 2 (IL-2), IL-4, and interferon gamma.
On the Vaporisation of Chloroform, Ether, and Ethyl-Bromide, at Different Temperatures
Authors: W. Squire
Journal: BMJ (1882)

8. The cells of Langerhans are only nerve-cells, either belonging to the ganglia (Merlhel's) or to the subepidermic plexus, which have also been dragged into the epidermis, and broken off there. 9. Taking the ordinary hair-nerve apparatus as a standard, we find that its elements may hypertrophy, as shown in the feeler-hairs; or atrophy, as shown in the organ of Eimer in the mole, and in the touch bodies and Pacinian bodies. 10.The organ of Eimer represents the nerve-apparatus-of a hairfollicle,.from which the hairs have been, in former generations, dragged out by the action of the digging hands of the mole.[i.The forked tactile elements of the aborted hair-follicle may be- come transformed into Pacinian bodies, which are indeed their homo- logues and are true tactile nerve-endings.
Short- and Medium-Term Outcomes After Transcatheter Pulmonary Valve Placement in the Expanded Multicenter US Melody Valve Trial
Authors: Doff B. McElhinney, William E. Hellenbrand, Evan M. Zahn, Thomas K. Jones, John P. Cheatham, James E. Lock, Julie A. Vincent
Journal: Circulation (2010)

Background— Transcatheter pulmonary valve placement is an emerging therapy for pulmonary regurgitation and right ventricular outflow tract obstruction in selected patients. The Melody valve was recently approved in the United States for placement in dysfunctional right ventricular outflow tract conduits. Methods and Results— From January 2007 to August 2009, 136 patients (median age, 19 years) underwent catheterization for intended Melody valve implantation at 5 centers. Implantation was attempted in 124 patients; in the other 12, transcatheter pulmonary valve placement was not attempted because of the risk of coronary artery compression (n=6) or other clinical or protocol contraindications. There was 1 death from intracranial hemorrhage after coronary artery dissection, and 1 valve was explanted after conduit rupture. The median peak right ventricular outflow tract gradient was 37 mm Hg before implantation and 12 mm Hg immediately after implantation. Before implantation, pulmonary regurgitation was moderate or severe in 92 patients (81% with data); no patient had more than mild pulmonary regurgitation early after implantation or during follow-up (≥1 year in 65 patients). Freedom from diagnosis of stent fracture was 77.8±4.3% at 14 months. Freedom from Melody valve dysfunction or reintervention was 93.5±2.4% at 1 year. A higher right ventricular outflow tract gradient at discharge ( P =0.003) and younger age ( P =0.01) were associated with shorter freedom from dysfunction. Conclusions— In this updated report from the multicenter US Melody valve trial, we demonstrated an ongoing high rate of procedural success and encouraging short-term valve function. All reinterventions in this series were for right ventricular outflow tract obstruction, highlighting the importance of patient selection, adequate relief of obstruction, and measures to prevent and manage stent fracture. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00740870.
FDG PET/CT Imaging of a Gastric Fistula
Authors: Klaus Strobel, Alfred Zippelius, Thomas F. Hany
Journal: Clinical Nuclear Medicine (2007)

Development of a fistula is a rare complication after gastric perforation. We present a case of a 64-year-old woman with stage IV B-cell non-Hodgkin lymphoma which infiltrated the stomach wall. After operation for gastric perforation the patient further developed a gastroabdominal fistula. PET/CT was performed for therapy control after 6 cycles of chemotherapy. It is well known that FDG PET/CT is a sensitive modality to detect infection and inflammation. With the help of the anatomic CT information the course of the fistula could be exactly evaluated. PET/CT may be a helpful tool in imaging of patients with suspicion for abdominal fistulas.
Importance of viruses and Legionella pneumophila in respiratory exacerbations of young adults with cystic fibrosis.
Authors: J Efthimiou, M E Hodson, P Taylor, A G Taylor, J C Batten
Journal: Thorax (1984)

From January to April 1980 46 young adults with cystic fibrosis were studied for evidence of infection with a wide variety of microorganisms, including viruses and Legionella pneumophila. Two groups of patients were investigated: a "deteriorated" group of 24 patients who had experienced an increase in lower respiratory tract symptoms and fall in lung function values in the course of one month before the start of the study and a "stable" group of 22 patients with no such deterioration. All serological tests were repeated at one month and then one year after the beginning of the study. A fourfold rise in titres of antibodies to various viruses, Mycoplasma pneumoniae, and Coxiella burnetii was obtained in seven (29%) of the deteriorated group but in only one (4.5%) of the stable group (p less than 0.05). One other patient showed a fourfold rise in L pneumophila antibody titre (on the basis of the indirect fluorescent antibody test), which was accompanied by a respiratory illness consistent with legionnaires9 disease. Eight of the 46 patients (17.4%) had demonstrable titres of antibody against L pneumophila (1/32 or above).
A Critical Evaluation of Methods of Monitoring Diabetic Control
Authors: Robert Tattersall, Simon Walford, Ian Peacock, Edwin Gale, Simon Allison
Journal: Diabetes Care (1980)

Patients with insulin-treated diabetes need to be actively involved in their own treatment. We have found that measurement of blood rather than urinary glucose by our diabetic patients leads to greater understanding and enthusiasm as well as to better control of blood glucose. Home blood glucose monitoring is complementary to rather than a substitute for measurement of hemoglobin A1. The latter provides an objective index of long-term control that is of more use to the doctor than to the patient. The former gives the patient information that enables him to master his own disease from day to day.
Aberrant expression of RasGRP1 cooperates with gain-of-function NOTCH1 mutations in T-cell leukemogenesis
Authors: T Oki, J Kitaura, N Watanabe-Okochi, K Nishimura, A Maehara, T Uchida, Y Komeno, F Nakahara, Y Harada, T Sonoki, H Harada, T Kitamura
Journal: Leukemia (2011)
Genetic Modification of T Cells Redirected toward CS1 Enhances Eradication of Myeloma Cells
Authors: Jianhong Chu, Shun He, Youcai Deng, Jianying Zhang, Yong Peng, Tiffany Hughes, Ling Yi, Chang-Hyuk Kwon, Qi-En Wang, Steven M. Devine, Xiaoming He, Xue-Feng Bai, Craig C. Hofmeister, Jianhua Yu
Journal: Clinical Cancer Research (2014)

Our goal is to test whether CS1 could be targeted by chimeric antigen receptor (CAR) T cells to treat multiple myeloma (MM).We generated a retroviral construct of a CS1-specific CAR and engineered primary human T cells expressing the CAR. We then tested the capacity of CS1-CAR T cells to eradicate human MM tumor cells in vitro, ex vivo, and in vivo using orthotopic MM xenograft mouse models.In vitro, compared with mock-transduced T cells, upon recognizing CS1-positive MM cells, CS1-CAR-transduced T cells secreted more IFN-γ as well as interleukin (IL)-2, expressed higher levels of the activation marker CD69, showed higher capacity for degranulation, and displayed enhanced cytotoxicity. Ectopically forced expression of CS1 in MM cells with low CS1 expression enhanced recognition and killing by CAR T cells. Ex vivo, CS1-CAR T cells also showed similarly enhanced activities when responding to primary MM cells. More importantly, in orthotopic MM xenograft mouse models, adoptive transfer of human primary T cells expressing CS1-CAR efficiently suppressed the growth of human MM.1S and IM9 myeloma cells and significantly prolonged mouse survival.CS1 is a promising antigen that can be targeted by CAR-expressing T cells for treatment of MM.
Outcome of Deferred Initial Therapy in Mantle-Cell Lymphoma
Authors: Peter Martin, Amy Chadburn, Paul Christos, Karen Weil, Richard R. Furman, Jia Ruan, Rebecca Elstrom, Ruben Niesvizky, Scott Ely, Maurizio DiLiberto, Ari Melnick, Daniel M. Knowles, Selina Chen-Kiang, Morton Coleman, John P. Leonard
Journal: Journal of Clinical Oncology (2009)

Treatment of mantle-cell lymphoma (MCL) is nonstandardized, though patients are commonly treated immediately at diagnosis. Because data on observation, or "watch and wait," have not been previously reported, we analyzed the outcome of deferred initial therapy.Inclusion criteria in this retrospective analysis were a diagnosis of MCL between 1997 and 2007 and known date of first treatment. Hospital and research charts were reviewed for prognostic and treatment-related information. Date of death was derived from hospital records and confirmed using an online Social Security death index.Of 97 patients with MCL evaluated at Weill Cornell Medical Center, 31 patients (32%) were observed for more than 3 months before initial systemic therapy, with median time to treatment for the observation group of 12 months (range, 4 to 128 months). The observation group (median follow-up, 55 months) had a median age of 58 years (range, 40 to 81 years). Prognostic factors in assessable patients included advanced stage (III/IV) in 75%, elevated lactate dehydrogenase in 25%, and intermediate- or high-risk Mantle Cell International Prognostic Index in 54%. Better performance status and lower-risk standard International Prognostic Index scores were more commonly present in those undergoing observation. Although time to treatment did not predict overall survival in a multivariate analysis, the survival profile of the observation group was statistically superior to that of the early treatment group (not reached v 64 months, P = .004).In selected asymptomatic patients with MCL, deferred initial treatment ("watch and wait") is an acceptable management approach.
Evidence to be given to the public must be presented accurately and fairly
Authors: H. C Irving
Journal: BMJ (1997)

Prescribing antidepressants in general practiceWhat is an effective dose?Editor-What should be the advised dosage of a tricyclic antidepressant for major depression?In his editorial Tony Kendrick quotes a recommended dose of a typical tricyclic antidepressant, amitriptyline, as 125 mg daily. 1 This dosage is at the higher end of the range of dosages quoted for all tricyclic antidepressants in the British National Formulary.If followed it would have major implications for the prescribing habits of general practitioners.The recommended dosage for amitriptyline for major depression is quoted from a consensus statement published in the BMJ in 1992. 2 The source of this recommendation is a double blind placebo controlled trial of amitriptyline among depressed patients in general practice. 3 In this trial patients given the active drug received amitriptyline 75 mg daily by the end of the first week, amitriptyline 100 mg during the second week, and amitriptyline 125-175 mg, depending on improvement, during the remaining four weeks of the study.The median dose of amitriptyline given over the six week study period was 125 mg.It is the median tolerated dose.Figure 1 in the paper by Hollyman et al clearly shows a response to treatment in the first two weeks, when the lower dose of amitriptyline was given. 3 Kendrick discusses the results of several investigations into the effectiveness of antidepressants at different dosages.Similar investigations have been used to develop the dose range of every prescribable antidepressantfor example, Kerihuel and Dreyfus reviewed 34 randomised clinical trials of lofepramine. 4 In the papers reviewed the concentration of lofepramine giving a clinical response ranged from 105 mg to 210 mg, which is equivalent to 75-150 mg amitriptyline.The principle that more severe cases of major depression require higher doses of antidepressants is also valid.It also holds true for newer selective serotonin reuptake inhibitors.For example, a study of prescribing patterns across 23 381 prescriptions shows that a prescription for higher than the initial dose was required in 6.8% of patients taking fluoxetine, 21.1% of patients taking paroxetine, and 51% of patients taking sertraline. 5
An Immunofluorescence Test to Detect Serum Antibodies to Giardia lamblia
Authors: GOVINDA S. VISVESVARA
Journal: Annals of Internal Medicine (1980)

We used an indirect immunofluorescence test with Giardia lamblia trophozoites as antigen to detect anti-G. lamblia antibodies in serum. Seventy-one patients and control subjects were studied in a blinded protocol. Titers in 29 of 30 patients with symptomatic giardiasis (1:16 to 1:1024) did not overlap titers in 19 healthy control subjects (1:2 to 1:4); titers in 15 patients with hookworm, Entamoeba histolytica, or intestinal bacterial overgrowth were 1:16 or less Absorption of giardiasis patients' sera with G. lamblia trophozoites but not with E. histolytica, Trichomonas vaginalis, or Escherichia coli reduced the titers to, or nearly to, control values. Titers in individual sera were 93.9% reproducible within a fourfold or less dilution. Our results indicate that G. lamblia, an intestinal parasite often regarded as noninvasive, induces a systemic antibody response. The indirect immunofluorescence test for anti-G. lamblia antibodies is specific and reproducible; it may be useful in epidemiologic and immunologic studies of giardiasis.
Abstract P6-06-34: Comparing recurrence risk scores derived from 4 immunohistochemistry stains (IHC4) versus oncoType DX
Authors: DV Miller, TA Jensen, AD Covington, R Rosenthal, JM Avent, J Hansen, L Peck, PD Wise, MO Leavitt, JC Wallentine, B Rowley
Journal: Cancer Research (2013)

Abstract Background: Prognostically relevant biomarkers in breast cancers can be assayed using nucleic acid (e.g. OncoType DX) or protein based (e.g. immunohistochemistry (IHC)) detection stratagies. Nucleic acid tests measure many more markers compared to immunohistochemistry, but are weighted heavily for ER, PR, and HER2 in their prognostic scoring algorithms. Recent data suggest that a panel of 4 IHC stains (IHC4) may have equivalent prognostic ability to multigene assays. The aim of this study was to retrospectively compare IHC4 scores to OncoType DX recurrence scores in a large cohort of patients in our statewide health system. Methods: Formalin-fixed paraffin-embedded breast cancer samples previously submitted for OncoType DX testing between 2008 and 2011 were obtained and sections stained for ER, PR, HER2, and Ki67 (the IHC4 staining panel). Stained slides were scanned digitally and scored using customized pathologist assisted image analysis algorithms (Leica Biosystems Aperio, Vista CA). The resulting data were used in the modified “Magee Equation 3” (Klein et al. Mod Pathol. 2013. PMID: 23503643) to calculate an IHC4 recurrence score on a numerically comparable scale to that used in the OncoType score. The IHC4 and Oncotype DX scores were directly compared for concordance and correlation. Results: 280 breast cancer samples comprised the study cohort. The mean (median) IHC4 score was 20.13 (19), range: 11-42. The mean (median) OncoType score was 18.48 (16), range: 0-75. Using cut-offs of 0-17 for low risk, 18-30 for intermediate risk, and &amp;gt;30 for high risk, the concordance data is shown in Table 1. Comparison of scores from IHC4 and OncoType by Risk Category OncoType RS LowIntermedHigh Low80201IHC4 RSIntermed816819 High029RS = Recurrence Score Pearson's correlation coefficient for the entire set was 0.6669. The overall concordance was 56.1%; one-step discordance 43.6%; and two-step discordance: 0.3%. Eliminating the intermediate scores, the concordance was 98.8%. Conclusions: Reasonable agreement was seen between risk scores derived by IHC4 and OncoType DX. Only one discrepancy among 280 scores would have resulted in a different treatment recommendation (low risk by IHC4 and high risk by OncoType). If the IHC4 score is clearly high or low, one would not expect a dramatically different result from Oncotype DX, and the Oncotype DX test may not be needed. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P6-06-34.
Anal cancer rates quadruple among UK women in past 40 years
Authors: J. Wise
Journal: BMJ (2014)

The rate of anal cancer in women has risen steeply since the mid-1970s, from 0.4 per 100 000 to 1.8 per 100  000 in 2009-11, according to new UK figures.1 Cancer Research UK’s figures show that cases of anal cancer in men have also risen, from 0.4 per 100 000 in 1975-77 to 1.2 per 100 000 in 2009-11.

In 2011 there were 1175 new cases of anal cancer in the United Kingdom: 414 in men and 761 in women, giving a male:female ratio …
Penile Metastasis From Rectal Cancer by PET/CT
Authors: Mohammed Fahad Alzayed, Giovanni Artho, Ayoub Nahal, Marc Hickeson
Journal: Clinical Nuclear Medicine (2014)

It is extremely rare for rectal tumors to metastasize to the penis, and when it occurs, it is associated with poor prognosis. The appearance of penile metastasis from rectal primary tumor on PET imaging has not been widely reported. We report a case of a 70-year-old man with previous history of treated stage III adenocarcinoma of the rectum 26 months ago. The restaging 18F-FDG PET/CT scan demonstrated a hypermetabolic mass at the base of his penile shaft. This lesion was confirmed on core biopsy to be a metastatic adenocarcinoma of colorectal origin consistent with the known primary rectal tumor.