tbuckley/cabot-search huggingface dataset:
Neurogenic Tumors of the Chest
Authors: Philip L. Schiffman
Journal: JAMA (1977)

NEUROGENIC tumors are rarely seen in the chest. We report three cases that illustrate the several ways these tumors can present in the chest. The first case demonstrates a benign tumor presenting as an extrapleural mass, a location unusual even for this unusual tumor. The second case demonstrates a primary malignant tumor of the lung, and the third a malignant tumor that metastasized to the lung.  Report of Cases  Case 1.—  A 31-year-old man was referred for the evaluation of an abnormal chest roentgenogram obtained two years ago for immigration purposes. The extrapleural lesion was roentgenographically unchanged at the time of referral. The patient was asymptomatic and denied chest pain, dyspnea, cough, or weight loss. He had a history of extensive travel, including Asia and Latin America.  Physical examination results were normal. Skin tests were mumps, positive; purified protein derivative (PPD), 5 TU, doubtful; coccidioidin, negative; histoplasmin, negative. Chest roentgenograms
Molecular Targeting of Platelet-Derived Growth Factor B by Imatinib Mesylate in a Patient With Metastatic Dermatofibrosarcoma Protuberans
Authors: Brian P. Rubin, Scott M. Schuetze, Janet F. Eary, Thomas H. Norwood, Sohail Mirza, Ernest U. Conrad, James D. Bruckner
Journal: Journal of Clinical Oncology (2002)

Dermatofibrosarcoma protuberans is caused by activation of the platelet-derived growth factor B (PDGFB) receptor, a transmembrane tyrosine kinase. We investigated the response of dermatofibrosarcoma protuberans to the tyrosine kinase inhibitor imatinib mesylate.A patient with unresectable, metastatic dermatofibrosarcoma protuberans received imatinib mesylate (400 mg bid). Response to therapy was assessed by [18F]fluorodeoxyglucose (FDG) positron emission tomography, magnetic resonance imaging, and histopathologic and immunohistochemical evaluation.The patient was treated for 4 months with imatinib mesylate. The hypermetabolic uptake of FDG fell to background levels within 2 weeks of treatment, and the tumor volume shrank by over 75% during the 4 months of therapy, allowing for resection of the mass. There was no residual viable tumor in the resected specimen, indicating a complete histologic response to treatment with imatinib mesylate.Imatinib mesylate is highly active in dermatofibrosarcoma protuberans. The dramatic response seen in this patient demonstrates that inhibition of PDGFB receptor tyrosine kinase activity can significantly impact viability of at least one type of solid tumor.
Severe Early-Onset Polyneuropathy in Insulin-Dependent Diabetes Mellitus
Authors: G Said, C Goulon-Goeau, G Slama, G Tchobroutsky
Journal: New England Journal of Medicine (1992)

The pathophysiologic features of diabetic neuropathy, a common and disabling long-term complication of diabetes mellitus, are poorly understood. We studied five patients, 22 to 34 years old, in whom an uncommonly severe symmetric polyneuropathy developed soon after the onset of insulin-dependent diabetes. Their autonomic function and nerve conduction were studied, and sural-nerve biopsy specimens were examined by light and electron microscopy. Other causes of neuropathy were carefully excluded.
Expression of Neurotensin and NT1 Receptor in Human Breast Cancer: A Potential Role in Tumor Progression
Authors: Frédérique Souazé, Sandra Dupouy, Véronique Viardot-Foucault, Erik Bruyneel, Samir Attoub, Christian Gespach, Anne Gompel, Patricia Forgez
Journal: Cancer Research (2006)

Abstract Emerging evidence supports neurotensin as a trophic and antiapoptotic factor, mediating its control via the high-affinity neurotensin receptor (NT1 receptor) in several human solid tumors. In a series of 51 patients with invasive ductal breast cancers, 34% of all tumors were positive for neurotensin and 91% positive for NT1 receptor. We found a coexpression of neurotensin and NT1 receptor in a large proportion (30%) of ductal breast tumors, suggesting a contribution of the neurotensinergic signaling cascade within breast cancer progression. Functionally expressed NT1 receptor, in the highly malignant MDA-MB-231 human breast cancer cell line, coordinated a series of transforming functions, including cellular migration, invasion, induction of the matrix metalloproteinase (MMP)-9 transcripts, and MMP-9 gelatinase activity. Disruption of NT1 receptor signaling by silencing RNA or use of a specific NT1 receptor antagonist, SR48692, caused the reversion of these transforming functions and tumor growth of MDA-MB-231 cells xenografted in nude mice. Our findings support the contribution of neurotensin in human breast cancer progression and point out the utility to develop therapeutic molecules targeting neurotensin or NT1 receptor signaling cascade. These strategies would increase the range of therapeutic approaches and be beneficial for specific patients. (Cancer Res 2006; 66(12): 6243-9)
Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome?
Authors: C. J. Fowler, T. J. Christmas, C. R. Chapple, H. F. Parkhouse, R. S. Kirby, H. S. Jacobs
Journal: BMJ (1988)

A potential association between abnormal electromyographic activity--that is, decelerating bursts and complex repetitive discharges--of the urethral sphincter and difficulty in voiding was examined in 57 women with urinary retention. Abnormal electromyographic activity was found in 33. Ultrasonography of the ovaries in 22 of the 33 women showed that 14 had polycystic ovaries. Of the other eight women, two had had oophorectomies, one had shrunken ovaries and ovarian failure, and one had previously undergone oophorectomy and the other ovary could not be seen; in one neither ovary could be seen, and three had ovaries of normal appearance, although two of these women were taking the contraceptive pill. Thirteen of the group had endocrine symptoms and signs characteristic of the polycystic ovary syndrome. Videocystometrography in 17 of the women who were examined by ultrasonography showed low flow rates and high residual volumes of urine after micturition in 12 women who could void, the other five having chronic urinary retention. A speculative hypothesis for the observed association of impaired voiding, abnormal electromyographic activity of the urinary sphincter, and polycystic ovaries is advanced, based on the relative progesterone deficiency that characterises the polycystic ovary syndrome. Progesterone stabilises membranes, and its depletion might permit ephaptic transmission of impulses between muscle fibres in the muscle of the urethral sphincter, giving rise to the abnormal electromyographic activity. This may impair relaxation of the sphincter, resulting in low flow rates of urine, incomplete emptying of the bladder, and, finally, urinary retention.
Why we need a clinical trial for vitamin K
Authors: J M Slattery
Journal: BMJ (1994)

model has facilitated rather than hindered the introduction of expensive drugs in our hospital.Other measures (the formulary, generic prescribing, purchase contracts, appropriate management practices, drug utilisation review programme) continue to be aggressively pursued to ensure the best value for money.These were not enough, however, to accommodate all requests for new drugs.We concede that the model has not been formally validated, but it is being used successfully in several other Australian hospitals.The legal implications are real ones and will need to be addressed by individual institutions, but they are not different in principle from the problems arising from imposing waiting lists (probably universally practised and accepted as a "fact of life"), which can result in substantial siiffering and even death.
Small-intestinal cancer arising from heterotopic pancreas
Authors: K. Fujita, K. Hirakawa, T. Matsumoto, K. Amano, S. Yanai, S. Fujioka, Y. Himeno, K. Motoyama, Y. Nakashima, M. Iida
Journal: Endoscopy (2008)

We report on a case of jejunal cancer arising from heterotopic pancreas, as depicted by small-bowel radiography and double balloon endoscopy.
AN IMMUNIZATION PROGRAM
Authors: J. P. Leake
Journal: JAMA (1928)

<h3>To the Editor:</h3> —The problem offered by the query from Pennsylvania (The Journal, January 7, p. 51) relative to immunization of nurses is an interesting one in practical immunology, and in part, at least, is not infrequently presented to the physician. Carrying out the same general order as that given inThe Journal, and with the same number of visits to the physician (seventeen), the following scheme would serve to give the most favorable days for observation and for reading the various reactions: Day zero: Schick test on the right upper arm and control on the left upper arm, using the flexor surface 2 inches above the fold of the elbow. Day 2: (Two days later): Smallpox vaccination on the left upper arm over the insertion of the deltoid muscle (not on the leg). Day 3: Dick test on the right forearm, control on the left forearm, using the flexor
Autonomic dysfunction in systemic sclerosis: the site of damage.
Authors: P H Dessein, R F Gledhill
Journal: Annals of the Rheumatic Diseases (1989)

association between the diseases.'6 This association has been described previously in non-English publications, however.'" There are some diseases which could explain both the pulmonary and systemic involvement similar to the one seen in these patients,7`9 but these were reasonably ruled out in our patients on the basis of clinical features, special studies, and histological findings.As immunological phenomena play an important part in polyarteritis nodosa and idiopathic pulmonary fibrosis a common immunopathological link between the two dis- eases may exist.It is more probable, however, in view of the rarity of the association that the joint occurrence of these two uncommon diseases is simply coincidental.Further reports of new cases might help to determine whether this association is real or not.
The Physician as Learner: Linking Research to Practice
Authors: Marc S. Nelson
Journal: JAMA (1995)

Although medical students might think that the process of learning how to be a physician ends when they finish medical school, those who have been in practice know that, in fact, the learning process never stops. With the publication of this book, the authors have provided a wonderful resource for members of the health care professions who are involved in the process of continuing medical education (CME) for practicing physicians. The size and scope of medical education in North America is enormous. Interestingly, given the importance of CME, very little has been written on the subject. Although this book often raises more questions than it answers, it provides much useful information. The book comes as a result of two conferences held in Banff, Alberta, and Beaver Creek, Colo, that focused on important issues and questions in CME. The book has three parts. The first focuses on physicians as learners. It
Unusual Presentation of Focal Nodular Hyperplasia
Authors: GHANSHYAM KALANI, ROLDAN MARTINEZ
Journal: Clinical Nuclear Medicine (1995)

We report an unusual case of focal nodular hyperplasia presenting as a large tumor-like mass extending to the gastric pylorus. This showed increased activity on hepatobiliary imaging. Focal nodular hyperplasia usually develops in women of childbearing age (1). Although it may manifest clinically with vague abdominal pain and fullness, it typically is identified incidentally (1). The etiology of FNH remains unknown. However, regression has been documented after the discontinuation of oral contraceptives. Pathologically, the lesion consists of a nodular mass, frequently containing a central stellate scar with radiating fibrous septations (2). Histologic examination reveals an abnormal arrangement of hepatocytes, Kupffer cells, and bile ducts (2). Nuclear imaging reveals uptake of Tc-99m SC in 70% of cases because of the presence of Kupffer cells (3). Although rarely reported, two cases of hepatoblastoma showing uptake of Tc-99m SC have been noted in children (4). However, no known cases of hepatoblastoma have been reported to demonstrate both Tc-99m SC and HIDA uptake. These findings also assist in excluding hepatic adenomas from further clinical consideration (5,6). Sonographic evaluation reveals a nonspecific appearance, ranging from hypoechoic to hyperechioc (7). The size of individual lesions ranges from 1 cm to 20 cm, with multiple lesions being reported in 13% of cases (7). CT evaluation typically demonstrates a homogeneous mass of slightly decreased density, which becomes iso—to—hyperdense with intravenous contrast administration (7). A central fibrous scar is infrequently demonstrated on CT or ultrasound (3). This case emphasizes the potential of FNH to appear as a large tumor with extra-hepatic extension. It also supports the role of nuclear imaging when evaluating the etiology of a mass identified on CT or ultrasound.
Diagnostic Value of Esophageal Studies in Patients with Angina-like Chest Pain and Normal Coronary Angiograms
Authors: Ole Frobert
Journal: Annals of Internal Medicine (1996)

Objective: To study 1) variations in esophageal motility and pH values and 2) electrocardiographic ST-segment changes in patients with angina-like chest pain but normal coronary angiograms. Design: Cross-sectional study. Setting: Tertiary cardiologic referral center. Patients: 63 consecutive patients referred to the study center over a 3-year period and 22 healthy controls. Patients were grouped according to the results of exercise electrocardiography: normal response to exercise (n = 28) and ischemic response to exercise (n = 35). Measurements: 1] 24-hour three-channel esophageal manometry and two-channel pH monitoring, 2) provocation testing with intravenous edrophonium chloride and esophageal acid perfusion, and 3) Holter electrocardiography conducted during the first two tests. In conventional time-weighted analyses, values during periods of pain and the 2 minutes before pain developed were compared with baseline values. Results: Regardless of the outcome of exercise testing, no differences were seen in 24-hour esophageal variables between patients and controls. Forty-six patients had a total of 248 spontaneous episodes of chest pain. Only minor differences were seen between baseline and the prepain and pain periods. Edrophonium chloride provocation and acid perfusion caused chest pain in 9 patients (14%) and 10 patients (16%), respectively. Esophageal monitoring variables did not differ between patients with a positive response to one or both provocation tests (n = 16 [25%]) and controls and did not change between baseline and the prepain or pain periods. Forty-eight ST-segment depressions were recorded on Holter monitoring in 16 patients (25%), but these depressions were associated with one prepain period and four pain periods. No ST-segment changes were seen during esophageal provocation testing. Conclusions: The rationale for routine esophageal investigations in this patient group is questionable.
Localization of Tc-99m MDP in Neuroblastoma Metastases to the Liver and Lung
Authors: LEONARD P. CONNOLLY, DAVID A. BLOOM, HARRY KOZAKEWICH, FREDRIC A. HOFFER, S. TED TREVES
Journal: Clinical Nuclear Medicine (1996)

Localization of skeletal tracer in a neuroblastoma primary is common but localization in extraskeletal metastatic sites has not received recognition. Tc-99m MDP concentration in hepatic or pulmonary metastases was noted in three of ten patients with such metastases. Lesion size appears to be important for demonstrating these metastases with Tc-99m MDP. This was particularly true for hepatic metastases, which were identified only when they were 5 cm or greater in diameter.
Reversibility of Glucocorticoid-lnduced Osteopenia
Authors: Y LITVIN, S HAGE, R CATANE, T HORNE
Journal: Clinical Nuclear Medicine (1982)

*From the Department of Endocrinology and Metabolism, Hadassah University Hospital, Jerusalem, Israel †From the Department of Oncology, Hadassah University Hospital, Jerusalem, Israel ‡From the Department of Medical Biophysics and Nuclear Medicine, Hadassah University Hospital, Jerusalem, Israel
Nuclear Imaging in a Patient With Praecox Lymphedema
Authors: SHIH-CHUAN TSAI, CHIA-HUNG KAO, WAN-YU LIN, SHYH-JEN WANG
Journal: Clinical Nuclear Medicine (1996)

A 42-year-old woman had progressive swelling with pain and vesicle formation on both lower extremities for more than 20 years. Lymphoscintigraphy of both lower extremities showed dermal back flow in the right lower extremity and no evidence of lymph flow in the left lower extremity 1 hour after subcutaneous injection of tracer and these findings persisted after 4 hours. These findings indicate abnormal lymphatic drainage in both lower extremities with total occlusion on the left side. A Tc-99m albumin venogram also was performed and showed marked venous collateral circulation in the left lower extremity.
Life Expectancy After Treatment for Systolic Hypertension
Authors: Steven Coca
Journal: JAMA (2012)

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Assessment of the clinically relevant change in pain for patients with sciatica
Authors: B Giraudeau
Journal: Annals of the Rheumatic Diseases (2004)

The visual analogue scale (VAS) is widely used for pain assessment. However, the minimum clinically relevant change remains a debated question, even with regard to the method of assessment. On the one hand, considering intra-individual change in acute pain, Todd et al suggested a crude change of 13 mm (for a 100 mm VAS) to discriminate between reporting a little less or a little more pain.1 In the study of Farrar et al the best cut off points were estimated at −20 mm (for a crude change) or −33% (for a relative change) to best discriminate between patients who require a rescue opioid dose or not.2 Similar results were also derived when considering patient self appreciation of improvement in chronic pain.3 On the other hand, Redelmeier et al suggested focusing on interindividual change …
Relation of Concentrations of Bacteria and Bacterial Antigen in Cerebrospinal Fluid to Prognosis in Patients with Bacterial Meningitis
Authors: William E. Feldman
Journal: New England Journal of Medicine (1977)

Previous investigators have shown that patients with meningitis who have relatively large amounts of bacterial antigen in cerebrospinal fluid are more likely to have neurologic sequelae,1 subdural effusions,2 prolonged fever3 , 4 or greater morbidity and mortality5 than patients with lower amounts.Although these workers considered the levels of bacterial antigen related to the concentrations of bacteria, no direct evidence was available since concentrations of bacteria were not measured. Recently, I reported preliminary data showing that antigen levels in cerebrospinal fluid of 15 patients were significantly (P<0.017) related to concentrations of bacteria.6 From these data, I hypothesized that concentrations of bacteria were . . .
Iatrogenic Aspects of Digitalis Intoxication
Authors: Alfred Soffer
Journal: JAMA (1965)

It is, unfortunately, common practice to instruct the young physician to "push digitalis to the point of toxicity." Pursuance of such a regimen invites disaster because approximately half of the lethal dose has been administered when toxicity appears. It is probable that the physician's bag contains no drug which even approximates such a treacherously narrow difference between toxic and lethal dosages. Incidence of cardiac poisoning caused by this agent has not diminished; indeed, by prolonging the life span, patients with advanced cardiomegaly survive to reach the point when the physician more often encounters the baffling challenge of digitalis intolerance. Many misconceptions concerning dosage are honored by decades of falacious repetition, but there are also misinterpretations of recent vintage. Perhaps the most common error occurs because of the comforting but inaccurate concept that purified glycosides such as digoxin are uniquely "safe." Standard recommendations for parenteral digitalization may often be precariously close
Single Transit Non-Gated Radionuclide Angiocardiography for Assessing Left Ventricular Wall Motion and Ejection Fraction
Authors: RICHARD W. MYERS
Journal: Clinical Nuclear Medicine (1976)

Radionuclide techniques to assess both left ventricular wall motion and ejection fraction have previously required EKG gating, non-diffusible radiopharmaceuticals and extended equilibrium data collection periods. We have validated a new technique for assessing left ventricular function that produces end-diastolic and end-systolic images from analysis of precordial scintillation camera data obtained during the first transit of a 15mCi intravenous bolus of 99 mTc and which requires neither EKG gating nor the use of a non-diffusible tracer. Initially, a high temporal resolution image file was constructed. The time-activity curve from the left ventricular region of interest gave the familiar sawtooth pattern representing filling and emptying. Events occuring at the times corresponding to maxima were summed to give an end-diastolic image while those corresponding to minima for the same cycles were summed to give an end-systolic image. The ejection fraction was calculated from the left ventricular net integral counts (ED-ES) corrected for background. In 20 patients scintigraphic ejection fraction showed good correleation with ejection fraction from contrast angiography (r=.87, p<.001). All nine patients with localized anglographic wall-motion abnormalities were correctly identified by comparing end-diastolic and end-systolic images displayed as life-size, hard-copy reproductions. Minor degrees of diffuse wall-motion abnormalities were not detectable. We conclude that this method accurately assesses left ventricular ejection fraction and segmental wall-motion abnormalities.
The hyperimmunoglobulinaemia E and recurrent infections syndrome in an adult.
Authors: J P L'Huillier, P H Thoreux, P Delaval, B Desrues, E Le Gall, J Kernec, J F Delambre
Journal: Thorax (1990)

A 27 year old white woman with a history of chronic eczema and episodes of serious infection of the chest, skin, and bone presented with acute respiratory failure. She was found to have a spontaneous right pneumothorax and a pneumatocele in the left upper lobe. Despite a left upper lobectomy she was left with chronic respiratory failure, bullous lung disease, and bilateral bronchiectasis. The hyperimmunoglobulinaemia E and recurrent infections syndrome was diagnosed only in adult life.