tbuckley/cabot-search huggingface dataset:
Identification of Incidental Hepatic Malignancy as Photopenic Defect on 99mTc-Sestamibi Myocardial Perfusion Imaging
Authors: Charles J. Hardebeck, Charles Herman, Alex Auseon
Journal: Clinical Nuclear Medicine (2013)

A 63-year-old male patient undergoing cardiac SPECT examination was incidentally found to have a large, photopenic (tracer-deficient) region in the right lobe of the liver. Follow-up abdominal CT scan demonstrated a corresponding large (7.8 cm × 6.9 cm), hypodense hepatic lesion. Subsequent CT-guided biopsy revealed metastatic carcinoma of uncertain primary source.
Recent advances: Oncology
Authors: M. H N Tattersall, H. Thomas
Journal: BMJ (1999)

Cancer is an increasing cause of morbidity and mortality in most countries. It has recently overtaken heart disease as the commonest cause of death in the United Kingdom. “Breakthroughs” in cancer research are reported regularly in the media. Some reports are based on new results that show potential for improved treatments, but others are premature or publicity seeking, and the motivation behind them is questionable. The public has high expectations that basic science cancer research will translate into improved cancer cures and care. Yet awareness and understanding of the clinical trials that are essential in establishing the effectiveness of new treatments is limited. Recruitment to randomised clinical trials evaluating new cancer treatments is often slow, partly because people are convinced that all new treatments are likely to be an improvement and partly because of unease about the process of randomisation. Better public education about categories of evidence in relation to health interventions might contribute to speedier and more appropriate evaluation of promising treatments.

Public confidence that cancer care in the United Kingdom is optimal has been shaken by reports that outcomes for some common cancers differ in countries in western Europe, and that survival rates in Britain for 18 of 25 cancer types studied are poorer than in most other European countries.1,2 Better than average outcomes were seen in Switzerland, Finland, and Holland. These reports, together with evidence that cancer survival rates differ within a country according to the pattern of care, prompted review of the provision of care for cancer patients in the United Kingdom and in parts of Australia.3–6 Optimal organisation of cancer care might achieve appreciable gains. In the case of breast cancer, this could amount to a 5% improvement in the survival rate at five years. Such a gain would be viewed as a major breakthrough if it were the result of a new treatment.


In this article we discuss five important recent advances in oncology. Four advances are related to the organisation of care, and are as important, in terms of a deliverable improved outcome, as any recent research findings or new treatments. These four advances are: the multidisciplinary cancer treatment team; supportive care for cancer patients; definition of treatment goals; and the status of clinical trials. In addition, we discuss the exciting treatment advances in areas other than radiation therapy and cytotoxic chemotherapy. 


Recent advances


Multidisciplinary treatment teams specialising in specific organ sites have been recognised as being important for optimal cancer care and for improving outcome


The organisation and delivery of supportive care to patients with cancer has improved


Treatment goals are more clearly defined


Public awareness and understanding of the clinical trials that are driving clinical research has increased


Research has started on potential treatments such as matrix metalloproteinase inhibitors, gene therapy, and cancer vaccines
Reaction of the myocardium to cryosurgery: electrophysiology and arrhythmogenic potential.
Authors: G J Klein, L Harrison, R F Ideker, W M Smith, J Kasell, A G Wallace, J J Gallagher
Journal: Circulation (1979)

The acute and chronic electrophysiological effects of a cryolesion produced in the left ventricle were studied in six dogs. All dogs had frequent ventricular premature beats (VPB) and five of six dogs had ventricular tachycardia during the first 4 days after the cryolesion; only one of the six dogs continued to have VPBs after 1 week, and this dog had identical VPBs before the creation of the cryolesion. Neither control dog had VPBs. Two additional dogs underwent epicardial and transmural mapping studies immediately after production of a cryolesion. VPBs in these animals were shown to originate at the border of the cryolesion. Epicardial activation sequence during normal sinus rhythm was not altered by the chronic cryolesion. The border zone of the chronic cryolesion was sharply demarcated with normal potentials recorded outside of the lesion and "extrinsic" potentials recorded within.
Extranuclear Functions of ER Impact Invasive Migration and Metastasis by Breast Cancer Cells
Authors: Dimple Chakravarty, Sujit S. Nair, Bindu Santhamma, Binoj C. Nair, Long Wang, Abhik Bandyopadhyay, Joseph K. Agyin, Darrell Brann, Lu-Zhe Sun, I-Tien Yeh, Francis Y. Lee, Rajeshwar Rao Tekmal, Rakesh Kumar, Ratna K. Vadlamudi
Journal: Cancer Research (2010)

Abstract The molecular basis of breast cancer progression to metastasis and the role of estrogen receptor (ER) signaling in this process remain poorly understood. Emerging evidence suggests that ER participates in extranuclear signaling in addition to genomic functions. Recent studies identified proline-, glutamic acid–, and leucine-rich protein-1 (PELP1) as one of the components of ER signalosome in the cytoplasm. PELP1 expression is deregulated in metastatic breast tumors. We examined the mechanism and significance of ER-PELP1–mediated extranuclear signals in the cytoskeletal remodeling and metastasis. Using estrogen dendrimer conjugate (EDC) that uniquely activate ER extranuclear signaling and by using model cells that stably express PELP1 short hairpin RNA (shRNA), we show that PELP1 is required for optimal activation of ER extranuclear actions. Using a yeast two-hybrid screen, we identified integrin-linked kinase 1 (ILK1) as a novel PELP1-binding protein. Activation of extranuclear signaling by EDC uniquely enhanced E2-mediated ruffles and filopodia-like structures. Using dominant-negative and dominant-active reagents, we found that estrogen-mediated extranuclear signaling promotes cytoskeleton reorganization through the ER-Src-PELP1-phosphoinositide 3-kinase-ILK1 pathway. Using in vitro Boyden chamber assays and in vivo xenograft assays, we found that ER extranuclear actions contribute to cell migration. Collectively, our results suggest that ER extranuclear actions play a role in cell motility/metastasis, establishing for the first time that endogenous PELP1 serves as a critical component of ER extranuclear actions leading to cell motility/invasion and that the ER-Src-PELP1-ILK1 pathway represents a novel therapeutic target for preventing the emergence of ER-positive metastasis. Cancer Res; 70(10); 4092–101. ©2010 AACR.
Continuation of anakinra despite the development of a pruritic rash in an otherwise refractory case of adult-onset Still’s disease: Figure 1
Authors: S Vordenbäumen, B Ostendorf, O Sander, J Richter, M Schneider
Journal: Annals of the Rheumatic Diseases (2009)

The human recombinant IL-1 receptor antagonist anakinra is used in rheumatoid arthritis,1 systemic lupus erythematosus2 and adult-onset Still’s disease (AOSD).3–5 Various side effects of mild to moderate severity including injection-site reactions,1 4 erythema and pruritus are known.1

We report the case of a 57-year-old male patient with Italian ancestry and chronic, long-standing AOSD. The patient presented himself in 1997 with daily high-spiking fevers up to 40°C, a faint rash, arthralgias, myalgias and splenomegaly of 15 cm. Ferritin was 2733 μg/l, C-reactive protein (CRP) was 12,4 mg/dl, white blood cell count was 42 000/μl. Antinuclear antibodies and antineutrophil cytoplasmic antibodies …
Efficacy and safety of calcipotriol plus betamethasone dipropionate scalp formulation compared with calcipotriol scalp solution in the treatment of scalp psoriasis: a randomized controlled trial
Authors: K. Kragballe, V. Hoffmann, J.P. Ortonne, J. Tan, P. Nordin, S. Segaert
Journal: British Journal of Dermatology (2009)

Current topical therapies for scalp psoriasis are difficult or unpleasant to apply, resulting in decreased adherence and efficacy.To compare the efficacy and safety of once-daily treatment with a combination of calcipotriol 50 microg g(-1) plus betamethasone 0.5 mg g(-1) (as dipropionate) (Xamiol; LEO Pharma A/S, Ballerup, Denmark) and twice-daily calcipotriol 50 microg mL(-1) scalp solution in patients with scalp psoriasis.This 8-week, multicentre, randomized, investigator-blind, parallel-group study compared two-compound calcipotriol/betamethasone scalp formulation with calcipotriol scalp solution in patients with moderately severe scalp psoriasis. Primary efficacy outcome was the proportion of patients who achieved 'clear' or 'minimal' disease severity according to investigator's global assessment of disease severity at week 8. Secondary efficacy outcomes and adverse events were also evaluated. Relapse and rebound were assessed in an 8-week, post-treatment observation phase.In total, 207 patients received the two-compound scalp formulation and 105 patients received calcipotriol scalp solution. The proportion of patients with 'clear' or 'minimal' disease at week 8 was significantly greater in the two-compound scalp formulation group (68.6%) than in the calcipotriol scalp solution group (31.4%; P < 0.001). Improvement was more rapid with the two-compound scalp formulation than with calcipotriol scalp solution. Further evidence of the superiority of the two-compound scalp formulation over the scalp solution was demonstrated through greater improvements in clinical signs and fewer adverse events.A once-daily combination of calcipotriol plus betamethasone dipropionate was significantly more effective and better tolerated than twice-daily calcipotriol scalp solution in the treatment of scalp psoriasis.
Does This Patient Have a Mole or a Melanoma?
Authors: John D. Whited, James M. Grichnik
Journal: JAMA (1998)

Lifetime risk for malignant melanoma has increased from 1 in 1500 in the United States in 1930 to 1 in 75 projected for the year 2000. Because the tumor's thickness at excision is the primary prognostic determinant, early detection through the history and physical examination can play an important role in the patient's clinical course. Two checklists have been developed as diagnostic aids, the ABCD (A indicates asymmetry; B, border irregularity; C, irregular color; and D, diameter >6 mm) and the revised 7-point checklists. These checklists should be interpreted with some discretion, but 2 studies have found the sensitivity for the ABCD checklist to be 92% (95% confidence interval [CI], 82%-96%) and 100% (95% CI, 54%-100%); 1 study found the specificity to be 98% (95% CI, 95%-99%). The revised 7-point checklist has been reported to have a sensitivity of 79% (95% CI, 70%-85%) to 100% (95% CI, 94%-100%) and specificity of 30% (95% CI, 21%-39%) to 37% (95% CI, 28%-46%). Physicians' global assessments for detecting the presence or absence of melanoma are estimated to have a specificity of 96% to 99%, while sensitivity ranges widely from 50% to 97%. Nondermatologists' examinations appear to be less sensitive than examinations performed by dermatologists.
Detection of Tricuspid Insufficiency by Portable Nuclear Probe Monitoring Over the Liver
Authors: HOLLEY M. DEY, PETER SCHULMAN, VIVIENNE E. SMITH, MOZAFFARREDDIN K. KARIMEDDINI, RICHARD P. SPENCER
Journal: Clinical Nuclear Medicine (1983)

A case is presented in which a portable nuclear scintillation probe was used to detect tricuspid regurgitation. An electrocardiographically–gated scintigraphic collection obtained over the liver was correlated with findings from contrast echocardiography and jugular venous pulse tracings. The nuclear probe may provide a simple means for the detection of tricuspid insufficiency. It remains to be determined if quantification of severity will be possible.
Spontaneous Necrotizing Fasciitis
Authors: David L. Galbut
Journal: JAMA (1977)

NECROTIZING fasciitis is an uncommon but severe clinical infection. It was reported in the literature more than 100 years ago as "hospital gangrene."<sup>1</sup> Necrotizing fasciitis is the preferred nomenclature because the essential characteristic is superficial or deep fascial necrosis, with extensive undermining of surrounding tissue.<sup>2,3</sup> Necrotizing fasciitis is most frequently found in lower extremities. It is also found in the upper extremities and in the abdomen.<sup>2,3</sup>Necrotizing fasciitis of the extremity is usually caused by external injury, which may be so minor as to go unnoticed by the person. Abdominal-wall necrotizing fasciitis is generally a postoperative complication.<sup>2,3</sup>Occult diverticulitis has been found, in rare instances, with lower-extremity necrotizing fasciitis.<sup>4</sup>To our knowledge, spontaneous abdominal-wall necrotizing fasciitis secondary to occult diverticulitis has not been reported in the English literature. <h3>Report of a Case</h3> A 71-year-old woman was admitted to Columbia-Presbyterian Medical Center in August 1976 with
427 CONTINUED HEAVY TRANSMISSION OF HCV IN A NEEDLE EXCHANGE PROGRAM THAT IS ASSOCIATED WITH MINIMAL TRANMISSION OF HIV. A NINE YEAR LONGITUDINAL COHORT STUDY
Authors: A. Widell, M. Alanko, L. Flamholc, H. Jacobssen, V. Molnegren, P. Björkman
Journal: Journal of Hepatology (2009)
To Teach Them This Art
Authors: William E. Lotterhos
Journal: JAMA (1966)

If Hippocrates could return today from Olympus and visit any one of the 88 accredited medical schools, he would, more likely than not, express enthusiastic approval of the curricula and general scientific attainment. His reaction  the state of the art, on the other hand, might be less than enthusiastic, and it may be logically supposed that his disappointment would be profound.  In this era of diagnosis by computer, automated hospitals, closed-circuit television, and chemotherapeutic miracles, the failure and possible obliteration of the art of medicine are the prices being exacted in the purchase of scientific advancement. Nobody wants  return  the horse and buggy doctor or  the ridiculous caricature of the bearded saint by the child's bedside, but he had his good points. In the 19th century, Pasteur admonished us to cure some,  relieve many, and  comfort all. The character and organization of medical services
1001-26 Local Dissolution of Intracoronary Thrombus with Urokinase Using the Dispatch™ Catheter: Clinical Studies
Authors: Joseph F. Mitchel, Daniel B. Fram, Jeffrey A. Hirst, Francis J. Kiernan, Charles Primiano, Adel M. Eldin, David D. Waters, Raymond G. McKay
Journal: Journal of the American College of Cardiology (1995)
Dual-Phase 99mTc Sestamibi Scintigraphy With Neck and Thorax SPECT/CT in Primary Hyperparathyroidism
Authors: Renaud Ciappuccini, Julia Morera, Pierre Pascal, Jean-Pierre Rame, Natacha Heutte, Nicolas Aide, Emmanuel Babin, Yves Reznik, Stéphane Bardet
Journal: Clinical Nuclear Medicine (2012)

To assess the diagnostic value of dual-phase (99m)Tc sestamibi scintigraphy with neck and thorax single-photon emission computed tomography/computed tomography (SPECT/CT) in patients with primary hyperparathyroidism, and to analyze the relationships between SPECT/CT data and serum calcium or parathyroid hormone (PTH) concentrations.(99m)Tc sestamibi scintigraphy was performed in 94 consecutive patients. Images included early and delayed planar neck images and delayed neck and thorax SPECT/CT. Scintigraphy was scored positive or negative.Fifty-nine sestamibi studies (63%) were positive. SPECT/CT demonstrated a single focus in 56 patients, in usual parathyroid sites in 80% of cases and in unusual sites in the remaining 20% (retrotracheal area, 7%; intrathyroidal, 9%; mediastinum, 4%), and double foci in 3. Serum calcium values were higher in patients with a positive scintigraphy than in those with a negative scintigraphy (2.80 vs. 2.66 mmol/L, P = 0.001) with similar figures for serum PTH values (129 vs. 107 pg/mL, P = 0.0649). In patients with a measurable parathyroid adenoma on integrated CT scan (n = 43), the greatest axial diameter of the adenoma was correlated to serum calcium (r = 0.405, P < 0.0071) or PTH concentrations (r = 0.589, P < 0.0001). Fifty-four patients underwent surgery, 45 with a positive, and 9 with a negative preoperative scintigraphy, resulting in a sensitivity of 92% (95% CI: 80-98) and a specificity of 83% (95% CI: 36-100).Dual-phase (99m)Tc sestamibi scintigraphy with SPECT/CT enables to identify a parathyroid adenoma in about two-thirds of patients with primary hyperparathyroidism and allows the surgeon to plan appropriate surgery. The likelihood of scintigraphy to be positive is affected by calcium or PTH concentrations.
Medical Student Abuse-Reply
Authors: Donna Rosenberg
Journal: JAMA (1984)

<h3>In Reply.—</h3> We wish to thank those who responded to our COMMENTARY regarding medical student abuse. Dr Nielsen has a number of opinions that are the opposite of ours. Although some might agree with him, we do not feel that medical student abuse as we defined it is ever acceptable. The abuse to which many students are exposed may be endurable, might even be inevitable, and is often forgotten. But students who are fortunate enough to avoid being abused are not worse off; they are better off. We do not consider medical students to be children (or childlike). As a group, medical students include some of the finest men and women we know. The medical profession should make sure that more of them remain that way.
Brainstem hemorrhage in descending transtentorial herniation (Duret hemorrhage)
Authors: Paul M. Parizel, Smitha Makkat, Philippe G. Jorens, Özkan Özsarlak, Patrick Cras, Johan W. Van Goethem, Luc van den Hauwe, Jan Verlooy, Arthur M. De Schepper
Journal: Intensive Care Medicine (2001)
Gastric clearance of serum albumin in normal man and in certain gastroduodenal disorders
Authors: A. Brassinne
Journal: Gut (1974)

Serum albumin gastric loss was estimated from the measurement of non-dialysable radioactivity of the gastric juice after intravenous injection of radioiodinated serum albumin (RISA). Immunochemical quantitation of serum albumin was performed in some of the samples. In the control group, the mean gastric clearance of albumin was 1·71 ml per hour with a range of 0·41 to 4·41 ml per hour. This represented a gastric loss of 1·9 gram of albumin per day and 11% of the daily degradation of albumin. There was no significant change in the gastric albumin loss after stimulating the gastric secretion. No significant difference in the gastric albumin leakage was found between normal subjects and patients with gastric or duodenal ulcer. In pernicious anaemia albumin loss into the stomach was greater (mean: 3·72 ml per hour; SD 1·52 ml) than in the normal group and accounted for the greater albumin fractional catabolic rate. This fact had never been proved before. In both patients with giant rugae of the gastric mucosa the gastric clearance of serum albumin was also increased. It is concluded first that albumin is not secreted by the chief and parietal cells of the mucosa and probably passes through the gastric wall between the cells of the mucosa, perhaps during the exfoliation of the surface epithelial cells, and secondly that the stomach is one of the sites of serum albumin breakdown, a fact that supports the view that the gastrointestinal tract plays a major role in the catabolism of serum albumin.
137 DOUBLE STRANDED DNA BREAKS ARE A MECHANISM FOR TUMOR FORMATION AT A CHRONIC LIVER INFLAMMATORY STATE
Authors: H. Barash, E. Gross, A. Israel, N. Corchia, T. Ben-Moshe, O. Pappo, E. Pikarsky, D. Goldenberg, I. Vlodavsky, E. Galun, R. Abramovitch
Journal: Journal of Hepatology (2008)
Making the fur fly
Authors: T. Dalrymple
Journal: BMJ (2008)

Here is a question for lovers of arcane and useless knowledge: which Germanophone authors with a medical background first published on the neuroanatomy of fish? The answer is Sigmund Freud, and, before him, Georg Buchner.

Buchner (1813-37) died at the same age as Keats, though from typhus rather than tuberculosis, and never qualified as a doctor but intended to do so and came from a family whose medical lineage stretched back two centuries. His brother, Ludwig, did qualify as a doctor and wrote a militantly materialist philosophical tract, Kraft und Stoff ( Force and Matter ), which was famous in its time and which exerted a great influence on the Russian revolutionary movement of the second half of the …
Induction of plasminogen activator inhibitor type 1 in murine lupus-like glomerulonephritis
Authors: Solange Moll, Pierre-Alain Menoud, Thierry Fulpius, Yves Pastore, Satoru Takahashi, Liliane Fossati, Jean-Dominique Vassalli, André-Pascal Sappino, Jürg A. Schifferli, Shozo Izui
Journal: Kidney International (1995)
Treatment of Residual Renal Calculi with Renacidin
Authors: K. Somasundaram, H. B. Eckstein
Journal: BMJ (1966)

Preliminary CommunicationsDBAITSH 91and now fluoresced deep emerald green.The nucleoli could no longer be identified and there was apparent loss of the chromatin material of the nucleus, which normally stains green and now assumed a deep opaque orange colouration.These changes became progressively more pronounced with time, to ultimate death of the cell and ghost-appearance after 40 to 44 hours.At a concentration of 5 parts per million of aflatoxin B, no obvious changes in the cultures were apparent until 20 to 24 hours' exposure, when the cytopathic changes described above rapidly took place.Control preparations with and without the diluent, dimethyl formamide, remained healthy and normal in appearance throughout the experiments.The acute effects of the aflatoxins on human liver cells merit further study of these substances as well as examination of the other naturally occurring hepatotoxins.-Investigation of the biochemical mechanisms involved is now in progress in our laboratory.
Gender and the Extent of Coronary Atherosclerosis, Plaque Composition, and Clinical Outcomes in Acute Coronary Syndromes
Authors: Alexandra J. Lansky, Vivian G. Ng, Akiko Maehara, Giora Weisz, Amir Lerman, Gary S. Mintz, Bernard De Bruyne, Naim Farhat, Gary Niess, Ivana Jankovic, Dana Lazar, Ke Xu, Martin Fahy, Patrick W. Serruys, Gregg W. Stone
Journal: JACC. Cardiovascular imaging (2012)