tbuckley/cabot-search huggingface dataset:
Pulmonary Carcinosarcoma
Authors: Tzyy-Ling Chuang, Chun-Liang Lai, Shu-Mei Chang, Yuh-Feng Wang
Journal: Clinical Nuclear Medicine (2012)

We present a case of pulmonary carcinosarcoma. The patient is a 31-year-old man with a history of infectious mononucleosis in whom a right lung mass was found. His age is lower than the mean age at which pulmonary carcinosarcoma is usually reported. Chest CT scan showed a lobulated 29-mm mass in the right upper lung and multiple hypervascular liver nodules. FDG PET/CT showed increased FDG uptake in the right upper lung nodule (SUVmax, 4.1). However, the hepatic radiouptake showed only background activity. The liver nodules were stable at the 1-year follow-up period and were suggestive of hemangiomas.
The Role of HER1-HER4 and EGFRvIII in Hormone-Refractory Prostate Cancer
Authors: Joanne Edwards, Pamela Traynor, Alison F. Munro, Catherine F. Pirret, Barbara Dunne, John M.S. Bartlett
Journal: Clinical Cancer Research (2006)

Abstract Purpose: The role of the type I receptor tyrosine kinase (HER) family in progression of prostate cancer is controversial. Breast cancer studies show that these receptors should be investigated as a family. The current study investigates expression of HER1-HER4 and EGFRvIII in matched hormone-sensitive and hormone-refractory prostate tumors. Experimental Design: Immunohistochemical analysis was used to investigate protein expression of HER1-HER4, EGFRvIII, and phosphorylated Akt (pAkt) in matched hormone-sensitive and hormone-refractory prostate tumors. Results: Surprisingly, high HER2 membrane expression in hormone-sensitive tumors was associated with an increased time to biochemical relapse (P = 0.0003), and this translated into longer overall survival (P = 0.0021). Consistent with other studies, HER4 membrane expression in hormone-sensitive tumors was associated with longer time to biochemical relapse (P = 0.042), and EGFRvIII membrane expression was associated with shorter time to biochemical relapse (P = 0.015). An increase in pAkt expression was associated with reduced survival (P = 0.0098). Multivariate analysis showed that HER2 was an independent positive predictive marker of time to relapse in hormone-sensitive prostate tumors (P = 0.014). In contrast, high HER2 expression in hormone-refractory tumors was associated with decreased time to death from biochemical relapse (P = 0.039), and EGFRvIII nuclear expression was associated with decreased time to death from biochemical relapse and decreased overall survival (P = 0.02 and P = 0.005). Conclusion: These results suggest that the HER family may have multiple roles in prostate cancer, and that expression of the proteins alone is insufficient to predict the biological response that they may elicit.
Federal board seeks to reduce toll from general aviation accidents
Authors: Phil Gunby
Journal: JAMA (1984)

"The standards for occupant protection in general aviation [noncommercial] aircraft have remained essentially unchanged for about the last 30 years," says the National Transportation Safety Board. So the five-member Washington, DC, board is in the midst of a multiyear project to deal with the problem. What concerns the board, as well as many physicians, is that more than 21,000 persons were killed or seriously injured in 41,319 general aviation accidents over a ten-year period beginning in 1972. About one third of these accidents were not classified as severe, such as hard or gear-up landings or nosing-over after landing, and the board says most of the deaths and serious injuries in those "nonsevere" accidents could have been avoided. Reporting on the first phase of its study project, the board says "some preliminary findings indicate that problems may exist concerning the adequacy of seat and restraint [lap and shoulder belts] certification and
Positive End-Expiratory Pressure in Refractory Hypoxemia
Authors: EZALIA I. LEFTWICH
Journal: Annals of Internal Medicine (1973)

Positive end-expiratory pressure was used in 15 patients with severe hypoxemia because we could not attain an arterial Po2 of 50 mm Hg or greater with intermittent positive-pressure ventilation and an inspired O2 concentration of 50% or less. Before the institution of positive end-expiratory pressure, arterial Po2 levels ranged from 22 to 76 mm Hg, with inspired O2 concentrations of 40% to 100%. In all but one patient positive end-expiratory pressure, using inspired O2 concentrations of 30% to 50%, resulted in arterial Po2 levels ranging from 60 to 219 mm Hg. Measurements of central venous pressure, arterial blood pressure, pulse rate, and urine output showed no deleterious changes from this procedure. Positive end-expiratory pressure seems to effectively achieve adequate arterial Po2 levels without the use of potentially toxic inspired O2 concentrations, in patients with otherwise refractory hypoxemia. It apparently prevents alveolar collapse during expiration, thus improving ventilation-perfusion relationships.
Vascular free radical release. Ex vivo and in vivo evidence for a flow-dependent endothelial mechanism.
Authors: F R Laurindo, M de A Pedro, H V Barbeiro, F Pileggi, M H Carvalho, O Augusto, P L da Luz
Journal: Circulation Research (1994)

Mechanisms underlying production of vascular free radicals are unclear. We hypothesized that changes in blood flow might serve as a physiological stimulus for endothelial free radical release. Intact isolated aortas from 45 rabbits were perfused with the spin trap alpha-phenyl-N-tert-butylnitrone (PBN, 20 mmol/L) and formed radical adducts detected by electron paramagnetic resonance spectroscopy (EPR). Sequential perfusion at 2, 7.5, and 12 mL/min changed cumulative vascular PBN radical adduct yields, respectively, from 3.2 +/- 0.9 to 4.1 +/- 0.7 (P &lt; .05) and 7.0 +/- 1.5 (P &lt; .005) pmol/mg with endothelium and from 3.6 +/- 1.6 to 3.8 +/- 1.4 and 2.2 +/- 0.8 pmol/mg without endothelium (P = NS). In endothelialized aortas, superoxide dismutase (SOD) completely blocked flow-induced free radical production, whereas inactivated SOD, indomethacin, and the nitric oxide synthetase antagonist nitro-L-arginine methyl ester (L-NAME) had no effect; relaxations to acetylcholine remained unchanged with higher flows. To assess the role of flow on in vivo radical production, femoral arterial plasma levels of the ascorbyl radical, a stable ascorbate oxidation product, were measured by direct EPR in 56 other rabbits. Ascorbyl levels were assessed at baseline (30.2 +/- 0.7 nmol/L) and at peak-induced iliac flow changes. Flow increases from 25% to 100% due to saline injections through an extracorporeal aortic loop induced significant dose-dependent increases in ascorbyl levels (n = 5). In addition, after papaverine bolus injections, flow increased by 114 +/- 8% versus baseline, and ascorbyl levels increased by 5.4 +/- 0.7 nmol/L (n = 31, P &lt; .001); similar results occurred with adenosine, isoproterenol, or hyperemia after 30-second occlusions (P &lt; .05, n = 4 or 5 in each group). Active SOD completely blocked papaverine-induced ascorbyl radical increase, despite preserved flow response (delta ascorbyl = 0.02 +/- 1.6 nmol/L, P = NS); inactivated SOD, catalase, indomethacin, and L-NAME had no effect. Blood flow decreases of 65% to 100% due to phenylephrine or 60-second balloon occlusions were accompanied by an average decrease of 4.4 nmol/L (P &lt; .05) in ascorbyl levels. No change in ascorbyl signal was observed when rabbit blood alone was submitted to in vitro flow increases through a tubing circuit. Thus, increases in blood flow trigger vascular free radical generation; such a response seems to involve endothelium-derived superoxide radicals unrelated to cyclooxygenase or nitric oxide synthetase activities. This mechanism may contribute to explain vascular free radical generation in physiological or pathological circumstances.
Stenotrophomonas maltophilia – The most worrisome threat among unusual non-fermentative gram-negative bacilli from hospitalized patients: A prospective multicenter study
Authors: Vincent Fihman, Alban Le Monnier, Stephane Corvec, Francoise Jaureguy, Jacques Tankovic, Hervé Jacquier, Etienne Carbonnelle, Emmanuelle Bille, Marina Illiaquer, Vincent Cattoir, Jean-Ralph Zahar
Journal: Journal of Infection (2012)
Transcatheter Aortic Valve Replacement Using a Self-Expanding Bioprosthesis in Patients With Severe Aortic Stenosis at Extreme Risk for Surgery
Authors: Jeffrey J. Popma, David H. Adams, Michael J. Reardon, Steven J. Yakubov, Neal S. Kleiman, David Heimansohn, James Hermiller, G. Chad Hughes, J. Kevin Harrison, Joseph Coselli, Jose Diez, Ali Kafi, Theodore Schreiber, Thomas G. Gleason, John Conte, Maurice Buchbinder, G. Michael Deeb, Blasé Carabello, Patrick W. Serruys, Sharla Chenoweth, Jae K. Oh
Journal: Journal of the American College of Cardiology (2014)
Chemokine (C-C motif) receptor 2 mediates mast cell migration to abdominal aortic aneurysm lesions in mice
Authors: Jie Zhang, Huimei Chen, Li Liu, Jiusong Sun, Michael A. Shi, Galina K. Sukhova, Guo-Ping Shi
Journal: Cardiovascular Research (2012)

AimsMast cells participate importantly in abdominal aortic aneurysms (AAAs) by releasing inflammatory cytokines to promote vascular cell protease expression and arterial wall remodelling.Mast cells accumulate in AAA lesions during disease progression, but the exact chemokines by which mast cells migrate to the site of vascular inflammation remain unknown.This study tested the hypothesis that mast cells use chemokine (C-C motif) receptor 2 (CCR2) for their accumulation in experimental mouse AAA lesions. Methods and resultsWe generated mast cell and apolipoprotein E double-deficient (Apoe -/ -Kit W-sh/W-sh ) mice and found that they were protected from angiotensin II (Ang II) chronic infusion-induced AAAs compared with Apoe -/ -littermates.Using bonemarrow derived mast cells (BMMC) from Apoe -/ -mice and CCR2 double-deficient (Apoe -/ -Ccr2 -/ -) mice, we demonstrated that Apoe -/ -Kit W-sh/W-sh mice receiving BMMC from Apoe -/ -Ccr2 -/ -mice, but not those from Apoe -/ -mice, remained protected from AAA formation.Adoptive transfer of BMMC from Apoe -/ -mice into Apoe -/ -Kit W-sh/W-sh mice also increased lesion content of macrophages, T cells, and MHC class II-positive cells; there was also increased apoptosis, angiogenesis, cell proliferation, elastin fragmentation, and medial smooth muscle cell loss.In contrast, adoptive transfer of BMMC from Apoe -/ -Ccr2 -/ -mice into Apoe -/ -Kit W-sh/W-sh mice did not affect these variables. ConclusionsThe increased AAA formation and associated lesion characteristics in Apoe -/ -Kit W -sh/W -sh mice after receiving BMMC from Apoe -/ -mice, but not from Apoe -/ -Ccr2 -/ -mice, suggests that mast cells use CCR2 as the chemokine receptor for their recruitment in Ang II-induced mouse AAA lesions.
The natural history of milk allergy in an observational cohort
Authors: Robert A. Wood, Scott H. Sicherer, Brian P. Vickery, Stacie M. Jones, Andrew H. Liu, David M. Fleischer, Alice K. Henning, Lloyd Mayer, A. Wesley Burks, Alexander Grishin, Donald Stablein, Hugh A. Sampson
Journal: Journal of Allergy and Clinical Immunology (2012)
AT-36PANOBINOSTAT IN COMBINATION WITH BEVACIZUMAB FOR RECURRENT GLIOBLASTOMA AND ANAPLASTIC GLIOMA
Authors: Eudocia Lee, David Reardon, David Schiff, Jan Drappatz, Alona Muzikansky, Sean Grimm, Andrew Norden, Lakshmi Nayak, Rameen Beroukhim, Mikael Rinne, Andrew Chi, Tracy Batchelor, Kelly Hempfling, Christine McCluskey, Katrina Smith, Sarah Gaffey, Brendan Wrigley, Keith Ligon, Jeffrey Raizer, Patrick Wen
Journal: Neuro-Oncology (2014)

Bevacizumab is frequently used to treat recurrent high-grade gliomas, but responses are generally not durable. Panobinostat is a histone deacetylase inhibitor with anti-neoplastic and anti-angiogenic effects in glioma models and may work synergistically with bevacizumab. We conducted a multicenter phase II trial of panobinostat in combination with bevacizumab. Two cohorts were enrolled: one with recurrent glioblastoma (GBM) as the primary study and one with recurrent anaplastic glioma (AG) as the exploratory study. Patients received oral panobinostat 30 mg 3 x per week, every other week, in combination with bevacizumab 10 mg/kg every other week. The primary endpoint was PFS6 in the GBM cohort and the study was powered to discriminate between a 35% and 55% PFS6 rate (85% power at an alpha level of 0.07). At planned interim analysis, 13 of the first 21 patients accrued to the GBM cohort had progressed within 6 months of initiating study treatment. The GBM cohort did not meet criteria for continued accrual and was closed early. In the GBM cohort, PFS6 rate was 30.4%, median PFS 5 months, median OS 9 months. Accrual in the AG cohort continued to completion and a total of 15 patients were enrolled. In the AG cohort, PFS6 rate was 46.7%, median PFS 7 months, median OS 17 months. The most common grade 3 or 4 toxicities in the GBM arm were hypophosphatemia (12.5%), thrombocytopenia (12.5%), lymphopenia (8.3%), neutropenia (8.3%), and ALT elevation (8.3%). In the AG arm, the most common toxicities were thrombocytopenia (20.0%) and hypophosphatemia (13.3%). Although reasonably well-tolerated, this phase II study of panobinostat and bevacizumab in recurrent GBM did not meet criteria for continued accrual and the GBM cohort of the study was closed. In the recurrent AG cohort, the PFS6 rate was similar to historical controls. Updated data will be presented.
S41 Looking Beyond The Pleura - A Systematic Review Of Thoracic Ultrasonography To Diagnose Lung Consolidation In Respiratory Failure
Authors: J. Corcoran, P. Wallbridge, N. Rahman, S. Mallett, M. Hew
Journal: Thorax (2014)

<h3>Background and method</h3> The use of thoracic ultrasound (TUS) by physicians is increasingly commonplace in light of recent BTS guidelines and changes to training curricula. At its simplest, TUS enhances patient safety during interventions through the identification of pleural fluid and underlying structures. However, TUS training documents in the UK (Royal College of Radiologists) and US (American College of Chest Physicians) acknowledge a need for the ultrasonographer to recognise features of underlying lung, including consolidation. Pneumonia leading to respiratory failure is a common cause of admission to medical and intensive care units worldwide and associated with significant morbidity and mortality, particularly when diagnosis is delayed. Diagnosis can be challenging and existing tools (clinical examination, CXR or CT) have their recognised flaws. TUS may be an alternative solution, offering patients a bedside investigation that provides clinicians with instant feedback to inform treatment decisions. We searched MEDLINE, EMBASE and the Science Citation Index Expanded (inception to October 2013) for studies relating to the diagnostic use of TUS in adults with acute respiratory failure due to radiographic consolidation, focusing on studies using CT as their reference standard. Two reviewers independently extracted data from eligible studies and assessed study quality using QUADAS-2. <h3>Results</h3> Three cohort studies, all based in an ICU setting, with a total of 134 participants met inclusion criteria. Two studies were at high risk of potential bias, whilst the third had limitations of applicability. The reported sensitivity (0.91 to 1.00) and specificity (0.78–1.00) of TUS in expert hands for CT-detected consolidation was superior to that for CXR (sensitivity 0.38 and 0.68; specificity 0.89 and 0.95). Outside the inclusion criteria, a number of studies of patients with consolidation but no respiratory failure also suggested TUS might have greater diagnostic sensitivity than CXR. <h3>Conclusion</h3> TUS remains, at present, a technology with limited evidence to support a front-line role in the assessment of patients with respiratory failure to detect lung consolidation. However, the evidence available is promising and well-designed clinical studies are necessary to ascertain whether TUS can influence relevant outcomes for patient benefit.
125I-8-L-arginine vasopressin binding to human mononuclear phagocytes.
Authors: L H Block, R Locher, W Tenschert, W Siegenthaler, T Hofmann, E Mettler, W Vetter
Journal: Journal of Clinical Investigation (1981)

The binding of vasopressin to human circulating blood cells was examined. Direct binding studies with preparations of single cell types indicated that the mononuclear phagocyte system is almost entirely responsible for binding of the hormone. Binding of 125I-8-L-arginine vasopressin (AVP) (40 pM) in the presence of excess unlabeled hormone was saturable (2.8 +/- 0.4 fmol/2 x 10(6) cells per ml), was linear with cell number, was dependent upon the concentration of the radioligand used, and was reversible. Binding equilibrium was achieved in 30--40 min at 22 degrees C. Scatchard analysis of binding at this time showed an apparent dissociation constant of 25 +/- 0.21 pM, providing an estimate of 640 +/- 80 sites/cell. Pretreatment of the cells with cytochalasin B, an agent that can block phagocytosis, did not modify radioligand binding, which indicates that 125I-AVP uptake by the cells is due to binding and not to endocytosis. Specificity of vasopressin-sensitive sites on mononuclear phagocytes was demonstrated with a series of vasopressin analogues with various degrees of antidiuretic potency, and with peptide hormones that bind to specific receptors on circulating blood cells but that lack antidiuretic activity. AVP (40 pM) elevated the intracellular level of cyclic AMP from 137 +/- 8.6 to 350 +/- 20.5 pmol/mg cell protein. The binding affinities of the various analogues were correlated with their ability to stimulate intracellular cyclic AMP synthesis (Lys8-vasopressin less than deamino(8-D-Arg)-vasopressin less than oxytocin).
Complete atrioventricular block in patients with atrioventricular discordance.
Authors: J C Huhta, J D Maloney, D G Ritter, D M Ilstrup, R H Feldt
Journal: Circulation (1983)

Although patients with atrioventricular (AV) discordance (corrected transposition) have abnormal conduction pathways and may spontaneously develop high-grade AV block, no quantitative assessment of the risk of this happening is available. We reviewed the data on 107 patients with AV discordance ages 2-76 years (mean 22 years) at follow-up. Eighty-two patients (77%) had a ventricular septal defect, 57 (53%) had pulmonary stenosis, 35 (34%) had tricuspid insufficiency and 24 (23%) had dextrocardia. Twenty-three patients (22%) had complete AV block. This condition was present in four patients at birth and developed in 19 patients at ages 4 months to 53 years (mean 18.1 years). Nine of these patients had permanent pacemaker implantation, four at the onset of complete block and five an average of 11 years later. Nine patients have AV block but no pacemaker. One patient died suddenly. Detailed data analysis showed that with increasing follow-up the risk of natural onset AV block continued at a rate of approximately 2% per year after diagnosis. The presence of an intact ventricular septum made AV block more likely. We conclude that patients with AV discordance are at risk of developing complete AV block throughout their lives. With increasing age, this risk is approximately constant and is probably not significantly increased by corrective or palliative surgery if acute surgical AV block does not occur. Pacemaker implantation is not necessary in some children with spontaneous AV block.
Emergency cancer patients receive poor care
Authors: Alex Vass
Journal: BMJ (2001)

Patients with cancer in Britain, especially those presenting as an emergency, are not receiving equal access to high quality cancer services, a report published last week has said.

According to the charity National Confidential Enquiry into Perioperative Deaths, cancer patients are being managed in units and centres with different caseloads and levels of experience. Some caseloads are so low, the report said, that “it is doubtful whether clinicians are able to maintain clinical skills.”

The report, which covers most parts of Britain except Scotland, found that most cancer patients who died in hospital within 30 days of surgery had been admitted either urgently or …
Digitalis in the Sick Sinus Syndrome
Authors: TOBY R. ENGEL, STEPHEN F. SCHAAL
Journal: Circulation (1973)

The effect of digitalis in patients with sinoatrial node dysfunction was studied. Atrial pacing studies were performed while His bundle electrograms were recorded in fourteen patients with sinus bradyeardia, syncope, or related symptoms. Measurements were repeated after 0.01 mg/kg ouabain, followed in some by 1 mg atropine. Ouabain produced a significant shortening of sinoatrial recovery time, but no significant change in heart rate. Atropine normalized sinoatrial recovery times in most patients. This study demonstrates that digitalis causes an increase in automaticity in the sick sinus syndrome as reflected by a shortened sinoatrial recovery time. The efficacy of contemplated therapeutic agents in sick sinus syndrome can be evaluated by rapid atrial pacing. When clinically indicated, digitalis may be used for congestive heart failure or tachyarrhythmias in the sick sinus syndrome in the absence of significant A-V conduction disease.
Evaluating Patients With Arthritis of Recent Onset
Authors: Hani S. El-Gabalawy, Paul Duray, Raphaela Goldbach-Mansky
Journal: JAMA (2000)

Inflammatory synovitis of recent onset poses a diagnostic and prognostic challenge to primary care physicians and rheumatologists. A lack of understanding of the underlying etiologic and pathogenic processes limits the ability to distinguish forms of arthritis that follow a benign, self-limiting course from forms that proceed to an aggressive, erosive disease requiring intensive immunosuppressive therapy. It is estimated that between 30% and 40% of patients presenting with early synovitis have disease that remains unclassified. Using data from a cohort of patients with early synovitis and reviewing current literature, we discuss investigational approaches toward a new classification of patients with early synovitis. Although a lack of understanding of this heterogeneous clinical syndrome has led clinicians to take a largely empirical approach to treatment thus far, the evolving awareness of disease predisposition at a genetic level and the expanding ability to specifically manipulate biological pathways may ultimately change the approach to this clinical problem. JAMA. 2000;284:2368-2373.
Determinants of sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy.
Authors: D Levy, S B Labib, K M Anderson, J C Christiansen, W B Kannel, W P Castelli
Journal: Circulation (1990)

Numerous electrocardiographic criteria, which are largely dependent on fixed voltage thresholds, have been proposed for the diagnosis of left ventricular hypertrophy (LVH). Electrocardiographic criteria for LVH were examined in 4,684 subjects of the Framingham Heart Study who underwent echocardiographic study for LVH. Echocardiographic LVH was detected in 290 men (14.2%) and 465 women (17.6%). Electrocardiographic features of LVH were present in 2.9% of men (60/2,042) and 1.5% of women (39/2,642). The overall sensitivity of the electrocardiographic diagnosis of LVH was 6.9%, whereas specificity was 98.8%. Sensitivity of the electrocardiogram (ECG) for LVH was marginally lower in women than in men (5.6% vs. 9.0%, p = 0.075). Obesity was inversely associated with sensitivity (p less than 0.05, both sexes combined, sex-adjusted). Smoking was also inversely related to sensitivity (p = 0.001, both sexes combined, sex-adjusted). In contrast, sensitivity of the ECG increased with age (p less than 0.001, both sexes combined, sex-adjusted). These findings suggest that electrocardiographic detection of LVH can be improved by incorporating information about noncardiac factors that impact on electrocardiographic sensitivity for LVH, presumably by attenuating QRS voltage. New strategies that take into consideration sex, age, smoking status, and obesity might improve the sensitivity of the ECG without diminishing specificity.