tbuckley/cabot-search huggingface dataset:
OT-01 * EFFECTIVENESS OF PERFUSION AND DIFFUSION IMAGING FOR GRADING PEDIATRIC BRAIN TUMORS
Authors: T. Kelly, M. Prah, S. Jogal, M. Maheshwari, S. Lew, K. Schmainda
Journal: Neuro-Oncology (2015)

PURPOSE: To prospectively evaluate the effectiveness of perfusion MRI (pMRI) and diffusion MRI (DWI/ADC) measurements in distinguishing slow-growing low-grade (LG) from fast-growing high-grade (HG) pediatric brain tumors. Brain tumors in children differ significantly from adult. Therefore, testing the utility of pMRI and DWI values as biomarkers for grading pediatric brain tumors is essential. MATERIALS AND METHODS: Following IRB approval, 40 children with new brain tumors who had signed consent and assent were prospectively recruited. MRI exams with severe artifact, lesions too small for accurate diagnosis or those that did not fall under a WHO category were excluded. Thirty-four children with untreated tumors remained (16M/18F, ages 0-23yrs). Perfusion imaging was added to the routine clinical MRI. DWI and ADC images were part of the routine clinical exam. Surgically resected tumors were classified as LG (WHO I/II) or HG (WHO III/IV). Pilocytic astrocytomas (PA) and pilocytic optic-pathway gliomas (OPG) were grouped together because they behave differently than other LG lesions. Non-tumor (NT) lesions were also evaluated. Using serial imaging, stable and non-resectable lesions were classified as LG, whereas rapidly enlarging lesions were classified as HG. Based on these criteria there were HG (n = 4), LG (n = 18), PA + OPG (n = 8), and NT (n = 4). Perfusion normalized (nRCBV) and standardized (sRCBV) relative cerebral blood volume and normalized cerebral blood flow (nRCBF) were calculated. RESULTS: The sRCBV is statistically different for HG vs LG (p = 0.022), but not for nRCBV or nRCBF. ADC can distinguish HG from PA + OPG (p = 0.012) and HG from LG (p = 0.035); however, when sRCBV and ADC are combined, there is greater statistical power for distinguishing these tumor categories (HG vs LG: p = 0.0029; HG vs PA + OPG: p = 0.0095). CONCLUSIONS: The results of this study represent the first step toward developing an imaging biomarker that will allow us to subclassify pediatric brain tumors and tailor therapy to each child.
Virtual Colonoscopy — Promising, but Not Ready for Widespread Use
Authors: John H. Bond
Journal: New England Journal of Medicine (1999)

Three-dimensional computed tomographic (CT) colography, or “virtual colonoscopy,” is a promising new imaging method. The technique combines the use of rapid helical CT with computer software capable of rendering images of the whole colon. Using a conventional workstation and a dynamic display of images, a radiologist conducts virtual examinations of the bowel, simulating the way endoscopists view the colon. This method is being promoted by some as a noninvasive screening test for colorectal neoplasia.Virtual colonoscopy has a number of advantages over conventional colonoscopy. With virtual colonoscopy, the examination is performed without sedation in less time than conventional colonoscopy and . . .
Bacteraemia in Human Brucellosis
Authors: W. Ganado, W. Bannister
Journal: BMJ (1960)

These are possibly incomplete forms of Behcet's syndrome, but it is not known at present how many cases of recurrent orogenital ulceration ultimately develop iritis, the third symptom of Behcet's triad.Laboratory tests in two patients showed evidence of a systemic disturbance, while the third was found to have discoid lupus erythematosus.The herpes neutralization tests were carried out by Mr.
Marked hypodiploidy in blast phase chronic myelogenous leukemia: Report of a case and review of the literature
Authors: Michael L. Cibull, Mark E. Thompson, Linda Smith, C. Darrell Jennings, Michael A. Doukas, Edward J. Pavlik, Deborah E. Powell
Journal: American Journal of Hematology (1987)

Abstract The emergence of a near‐haploid clone of cells in blast phase chronic myelogenous leukemia is an unusual event. We report such a case and review eight other cases described in the English literature. The significance of the substantial loss of genetic material is discussed as is the phenotypic and genotypic heterogeneity observed in this group of patients.
A polymorphism in the delta-aminolevulinic acid dehydratase gene may modify the pharmacokinetics and toxicity of lead.
Authors: C M Smith, X Wang, H Hu, K T Kelsey
Journal: Environmental Health Perspectives (1995)

Associations between the presence of a constitutional variant of delta-aminolevulinic acid dehydratase (ALAD-2) and lead concentrations in blood and bone, as well as between this allele and indices of kidney function, were investigated among 691 members of a construction trade union. The average blood lead level in this group was 7.78 micrograms/dl. No significant difference was observed in blood lead concentration in ALAD-2 carriers compared to those homozygous for the more common ALAD-1 allele (7.78 +/- 3.62 micrograms Pb/dl vs. 7.73 ( +/- 3.48 micrograms Pb/dl, respectively; p = 0.73). Bone lead was measured in a subset of 122 of the study subjects. Patella minus tibia lead concentrations for each individual averaged 3.35 +/- 11.99 micrograms Pb/g bone mineral in ALAD-1 homozygotes and 8.62 +/- 9.47 micrograms Pb/g bone mineral in ALAD-2 carriers (p = 0.06). Comparisons of blood urea nitrogen (BUN) and uric acid by genotype indicated elevated levels among ALAD-2 individuals (p = 0.03 and 0.07, respectively). In logistic regression models accounting for other variables potentially associated with BUN and uric acid levels, BUN was significantly associated with blood lead levels (p = 0.01). Associations of BUN and uric acid levels with ALAD-2 were of borderline statistical significance in these models (p = 0.06 and 0.07). Taken together, these results suggest that the ALAD-2 genotype may influence the pharmacokinetic distribution and chronic renal toxicity of lead, perhaps due to differential binding of lead to the variant protein.
Nobel prize is awarded for studies of intracellular transport mechanisms
Authors: G. Watts
Journal: BMJ (2013)

The 2013 Nobel prize for medicine or physiology has been awarded to one German and two US cell biologists for their exploration of the mechanisms by which hormones, neurotransmitters, and other such materials are transported in tiny vesicles through the cell to their point of delivery.

The three winners are Randy W Schekman, born in 1948 and based in the University of California at Berkeley, James E Rothman, born in 1950 and working at Yale University, and Thomas C Sudhof, born in 1955 in Gottingen, Germany, and now at Stanford University.

Daniel Davis, professor of immunology at Manchester University’s Collaborative Centre for Inflammation Research and author of a new …
You<i>Can</i>Teach an Old Dog New Tricks
Authors: T C Merigan
Journal: New England Journal of Medicine (1990)

Clinical trials of a new treatment are undertaken in three phases. Phase I trials are designed to test the safety of the new treatment, phase II to test its efficacy, and phase III to compare it with standard treatment in a large number of patients selected to be as homogeneous as possible. The protocol is developed before the trial begins, and there are usually no changes in it, including entry criteria and end points, as the trial progresses. Thus, for good scientific reasons, clinical trials are designed to be rather formal and rigid.But all that is changing. In the . . .
Histiocytic Bone and Joint Disease
Authors: B. M. Ansell, E. G. L. Bywaters
Journal: Annals of the Rheumatic Diseases (1957)

Progress.-By1956, the serum bilirubin was unchanged (9-5 g. per cent.) and the xanthomata were disappearing, but the cholesterol was 1,500 mg. per cent.Now, in addition to osteoporosis, erosions were noted on the 503 copyright.
Comparison of a Tranquilizer and a Psychic Energizer
Authors: Stanley J. Geller
Journal: JAMA (1960)

Seventy-five hyperactive, poorly integrated children were divided into groups of 25 for a comparative study of the effects of two drugs on their behavior. One group received a psychic energizer (deanol) in doses of 50 mg. twice daily; the second received a sedative (trimeglamide) in doses of 250 mg. twice daily; the third received a placebo. Systematic observations were made before and after the period of medication. Analysis of the results showed that deanol generally increased the child's power of concentration as manifested in integrative tasks such as puzzle-solving. Trimeglamide generally alleviated tantrums and diffuse hyperactivity. The placebo group did not manifest either of these effects. The author suggests the concomitant use of these two drugs in overly aggressive, emotionally disturbed children.
Abstract 4333: Optical diagnostic system with Raman spectroscopy for gastric cancer
Authors: Hiroyuki Konno, Toshiki Kawabata, Okazaki Shigetoshi, Iino Ichirota, Takeshi Uehara, Tomohiko Setoguchi, Hirotoshi Kikuchi, Masayoshi Yamamoto, Manabu Ohta, Kinji Kamiya
Journal: Cancer Research (2010)

Abstract Background. Raman spectroscopy (RAS) is one of the available optical techniques, and the Raman spectrum for each molecule and tissue is characteristic and specific. We reported the usefulness of a Raman spectrum as a novel diagnostic modality for gastric cancer by using the biopsied specimens on 100th Annual Meeting. We present here the advanced data of RAS by using resected specimen of gastric cancers to clarify the possibility of endoscopic application of RAS for the real-time diagnosis of the gastric cancer. Methods. Without any pretreatment, the fresh specimens were measured with a near-infrared multichannel Raman spectroscopic system with an excitation wavelength of 1064nm, and Raman spectra specific for the specimens were obtained. A principal component analysis (PCA) was performed to distinguish gastric cancer and non-neoplastic tissue, and a discriminant analysis was used to evaluate the accuracy of the gastric cancer diagnosis. We reported sensitivity of RAS was 66%, specificity was 73%, and accuracy was 70%, respectively, by using 251 fresh biopsy specimens of gastric carcinoma and non-neoplastic mucosa. In the present study, we examined the Raman spectrum of the resected specimen of gastric cancers to clarify the clinical usefulness of RAS during endoscopy, because Raman spectrum during endoscopy is obtained from whole layer of stomach. Raman spectrum from mucosal side were obtained at 213 points (81 cancer points and 132 non-cancer points) by using 10 resected specimen (12 lesions). Results. Raman spectrum in the cancer points clearly differed from those for on-neoplastic points, especially at around 1644cm−1, as well as those observed in biopsied specimens. Analysis with PCA demonstrated that sensitivity was 72%, specificity was 78%, and accuracy was 76%. Interestingly, in the advanced gastric cancers, specificity was increased to 92% resulting that accuracy was also increased to 88%. Furthermore, the comparison between cancer points and non-cancer points without atrophy demonstrated that sensitivity was 89%, specificity was 86%, and accuracy was 88%. Conclusions. RAS with a 1064-nm excitation wavelength is useful for gastric cancer diagnosis. Raman diagnostic system may be improved according to the development of both systemic instruments and analytical methods. And in the near future, RAS makes possible real-time diagnosis of gastric cancer during endoscopy. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4333.
A 79-Year-Old Musician With Asymptomatic Carotid Artery Disease
Authors: Louis R. Caplan
Journal: JAMA (1995)

Dr DALEY: Mr C, a 79-year-old married professional classical musician with a history of cardiovascular and peripheral vascular disease, was noted to have asymptomatic carotid bruits in March 1995. He is active as a teacher and performer. He is insured by Medicare and carries supplemental Medigap insurance.  In 1989, Mr C underwent coronary artery bypass grafting for progressive anginal symptoms. Angina recurred in December 1994, and cardiac catheterization revealed diffuse three-vessel coronary artery disease with patent grafts. In recent months his angina has abated with medical therapy.  His risk factors for atherosclerosis include a total cholesterol level of 6.18 mmol/L (239 mg/dL), a family history of coronary artery disease, and a history of smoking cigarettes 20 years ago. Current medications include amlodipine besylate, 5 mg daily; terazosin hydrochloride, 5 mg daily, for mild symptoms of prostatic hypertrophy; and one enteric coated aspirin daily. Hypercholesterolemia is managed by diet, although until
Many ways to awareness: A developmental perspective on cognitive access
Authors: Carroll E. Izard, Paul C. Quinn, Steven B. Most
Journal: Behavioral and Brain Sciences (2007)

Abstract Block's target article makes a significant contribution toward sorting the neural bases of phenomenal consciousness from the neural systems that underlie cognitive access to it. However, data from developmental science suggest that cognitive access may be only one of several ways to access phenomenology. These data may also have implications for the visual-cognitive phenomena that Block uses to support his case.
"Rheumatoid nodules" and lymphoma!
Authors: P A Courtney, G D Wright, M B Finch
Journal: Annals of the Rheumatic Diseases (1998)

A 63 year old woman presented with painful, stiff hands. There was swelling of the hands, ankles and feet but no systemic upset. On examination there was soft tissue thickening of the proximal interphalangeal (PIP) and metacarpal phalangeal (MCP) joints of the hands with pitting oedema of the hands, feet and lower legs. The remainder of the examination was unremarkable. The following investigations were negative or normal. Full blood count and differential, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), rheumatoid factor, nuclear antibody profile, thyroid function. Serological investigation for parvovirus B19 was negative. Radiographs of the hands revealed soft tissue swelling but no erosions.

During the following six months the patient developed synovitis of PIP joints and wrists (fig 1) with bilateral dorsal sheath effusions (fig2). Multiple firm nodules were noted on both elbows and forearms measuring up to 1 cm (fig 2) and she developed symptoms …
Accountability in the NHS: whose head on the block?
Authors: R. Klein
Journal: BMJ (1976)

From time to time horror stories about waste, inefficiency, and incompetence in government departments or public servicqs hit the head- lines.Almost invariably their source is either the Comptroller and Auditor General or the Public Accounts Committee of the House of Commons.The former is responsible, with his staff of some 400 people, for checking the accounts of all government spending departments.The latter is responsible for following up these inquiries by summoning and cross- examining relevant civil servants.Between them, the activities of the Comptroller and Auditor General and of the Public Accounts Committee provide a unique insight into the processes of government, by forcing the officials responsible to explain their miscalculations and mistakes.It is therefore worth analysing in some detail the two most recent reports which have dealt with the spending record of the National Health Service: that published by the Comptroller and Auditor General at the beginning of this year' and the subsequent inquiry by the Public Accounts Committee.2For the second of these reports in particular provides a rare and revealing glimpse of how the top decision-makers at the Department of Health and Social Security perceive the structure of responsibility and accountability within the NHS.Small change of public expenditure
Role of transcription-coupled DNA repair in susceptibility to environmental carcinogenesis.
Authors: P C Hanawalt
Journal: Environmental Health Perspectives (1996)

Susceptibility to environmental carcinogenesis is the consequence of a complex interplay between intrinsic hereditary factors and actual exposures to potential carcinogenic agents. We must learn the nature of these interactions as well as the genetic defects that confer enhanced risk. In some genetic diseases an increased cancer risk correlates with a defect in the repair or replications of damaged DNA. Examples include xeroderma pigmentosum (XP), ataxia telangiectasia, Fanconi's anemia, and Bloom's syndrome. In Cockayne's syndrome the Specific defect in transcription-coupled repair (TCR) does not predispose the patients to the sunlight-induced skin cancer characteristic of XP. The demonstration of TCR in the XP129 partial revertant of XP-A cells indicates that ultraviolet (UV) resistance correlates with repair of cyclobutane pyrimidine dimers in active genes. Repair measured as an average over the genome can be misleading, and it is necessary to consider genomic locations of DNA damage and repair for a meaningful assessment of the biological importance of particular DNA lesions. Mutations in the p53 tumor suppressor gene are found in many human tumors. TCR accounts for the resulting mutational spectra in the p53 gene in certain tumors. Li-Fraumeni syndrome fibroblasts expressing only mutant p53 are more UV-resistant and exhibit less UV-induced apoptosis than normal human cells or heterozygotes for mutations in only one allele of p53. The p53-defective cells are deficient in global excision repair capacity but have retained TCR. The loss of p53 function may lead to greater genomic instability by reducing the efficiency of global DNA repair while cellular resistance may be assured through the operation of TCR and the elimination of apoptosis.
Parathyroid Function in Patients with Pheochromocytoma
Authors: SAM S. MILLER
Journal: Annals of Internal Medicine (1975)

Serum calcium, serum immunoreactive parathyroid hormone (PTH), and plasma immunoreactive calcitonin were measured in 12 patients with catecholamine-secreting tumors. Only two patients had high serum calcium and immunoreactive PTH concentrations (one also had high basal immunoreactive calcitonin); in both, the hypercalcemia persisted after removal of their pheochromocytomas but was corrected by removal of hyperplastic parathyroid glands and medullary thyroid carcinomas. Of the 10 patients with normal serum calcium and immunoreactive PTH concentrations, 2 had high immunoreactive calcitonin concentrations and medullary thyroid carcinomas alone were found. Our results suggest that [1] hypercalcemia occurs infrequently in patients with pheochromocytoma, [2] chronic circulating catecholamine excess does not cause increased immunoreactive PTH or immunoreactive calcitonin secretion in patients with pheochromocytoma, and [3] the parathyroid disease in patients with pheochromocytoma is a genetically determined component of multiple endocrine neoplasia.
To Die or Not to Die
Authors: Steven W. Hetts
Journal: JAMA (1998)

The death of cells in tissues of humans and other multicellular organisms is neither always abnormal nor always detrimental. Although necrosis ensues at the sites of massive cellular injury, most cells in the body die through a more subtle, noninflammatory, energy-dependent form of cell death called apoptosis. The number of cells in tissues is determined by the homeostatic balance between proliferation of new cells and death of senescent cells; the rates of proliferation and apoptosis vary widely from tissue to tissue. Recent research into the molecular mechanisms of apoptosis has revealed that apoptosis is a genetically programmed process that can become deranged when the components of the cellular apoptotic machinery are mutated or present in inappropriate quantities. Dysregulation of apoptosis is associated with the pathogenesis of a wide array of diseases: cancer, neurodegeneration, autoimmunity, heart disease, and other disorders. Products of genes involved in the regulation and execution of apoptosis are potentially excellent targets for diagnosis and therapeutic intervention in disease processes, and they offer renewed hope for cures and treatments for a wide array of maladies.
Beta blockade, diuretics, and salt restriction for the management of mild hypertension: a randomised double blind trial.
Authors: T M Erwteman, N Nagelkerke, J Lubsen, M Koster, A J Dunning
Journal: BMJ (1984)

Ninety four patients with mild hypertension (average supine diastolic blood pressure (phase V) 95-110 mm Hg) were allocated at random to receive restriction of dietary sodium (maximum allowed 70 mmol(mEq)/24 h) or a normal diet. In addition, they received in random order 25 mg chlorthalidone, 200 mg metoprolol (slow release), and a fixed combination of these two drugs. Each drug treatment was given for four weeks and alternated with four weeks of placebo. Forty four patients were allocated to sodium restriction (group 1) and 50 to normal diet (group 2). The mean 24 hour urinary sodium excretion in group 1 was 74 (SD 31) mmol(mEq)/24 h, and in group 2 132 (51) mmol/24 h. Compared with the screening blood pressure the average decrement of the supine blood pressure in group 1 was 16.0/8.6 mm Hg with placebo, 21.7/11.5 mm Hg with the diuretic, 28.5/17.8 mm Hg with the beta blocker, and 28.9/18.4 mm Hg with the combined agent; in group 2 these values were 13.3/6.1, 20.3/9.7, 21.3/12.9, and 29.4/16.8 mm Hg, respectively. There was a sharp decrease of the average potassium concentration during chlorthalidone and combination treatment periods (average value 3.3 mmol(mEq)/1). These results suggest that moderate salt restriction used as sole treatment has a limited though demonstrable blood pressure lowering effect but that when it is used as an adjuvant to beta blocker treatment its value is greatly enhanced.
Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program
Authors: Allen Kachalia
Journal: Annals of Internal Medicine (2010)

Background: Since 2001, the University of Michigan Health System (UMHS) has fully disclosed and offered compensation to patients for medical errors. Objective: To compare liability claims and costs before and after implementation of the UMHS disclosure-with-offer program. Design: Retrospective before–after analysis from 1995 to 2007. Setting: Public academic medical center and health system. Patients: Inpatients and outpatients involved in claims made to UMHS. Measurements: Number of new claims for compensation, number of claims compensated, time to claim resolution, and claims-related costs. Results: After full implementation of a disclosure-with-offer program, the average monthly rate of new claims decreased from 7.03 to 4.52 per 100 000 patient encounters (rate ratio [RR], 0.64 [95% CI, 0.44 to 0.95]). The average monthly rate of lawsuits decreased from 2.13 to 0.75 per 100 000 patient encounters (RR, 0.35 [CI, 0.22 to 0.58]). Median time from claim reporting to resolution decreased from 1.36 to 0.95 years. Average monthly cost rates decreased for total liability (RR, 0.41 [CI, 0.26 to 0.66]), patient compensation (RR, 0.41 [CI, 0.26 to 0.67]), and non–compensation-related legal costs (RR, 0.39 [CI, 0.22 to 0.67]). Limitations: The study design cannot establish causality. Malpractice claims generally declined in Michigan during the latter part of the study period. The findings might not apply to other health systems, given that UMHS has a closed staff model covered by a captive insurance company and often assumes legal responsibility. Conclusion: The UMHS implemented a program of full disclosure of medical errors with offers of compensation without increasing its total claims and liability costs. Primary Funding Source: Blue Cross Blue Shield of Michigan Foundation.