tbuckley/cabot-search huggingface dataset:
Abstract P6-10-05: Bilateral Breast Cancer: A Comparative Study with Unilateral Breast Cancer
Authors: Y-m Lee, S-H Ahn
Journal: Cancer Research (2010)

Abstract Background The clinical significance of bilateral breast cancer is unclear and its influence on prognosis is controversial, whether contralateral breast cancer occurs synchronous or metachronous. Our purpose is to assess the impact of bilateral breast cancer on prognosis and compared it to unilateral breast cancer. Methods We included 9,327 patients who diagnosed breast cancer and treated at Asan Medical Center from 1990 to 2007. Bilateral breast cancer was classified as synchronous in patients with a second breast cancer diagnosed within 6 months after the first breast cancer and as metachronous if the second breast cancer occurred more than 6 months after the first. To compare clinical features, we used more advanced-stage tumor in synchronous cases and the first tumor in metachronous cases. The follow-up cut-off date of this study was December 2009 and median value of follow-up was 59 months. This study was performed by medical records review retrospectively. Results 117 (1.3%) had synchronous breast cancer and 114 (1.2%) had metachrnous breast cancer. Except menopausal status, there were no significant differences for clinical features between the patients with unilateral breast cancer and synchronous bilateral breast cancer. Patients with bilateral metachronous breast cancer were significantly younger at the time of first diagnosis and had more often a highly increased familial risk. And women who developed metachronous cancer underwent more often mastectomy for their first tumor. Patients with synchronous (74.2%) or metachronous bilateral breast cancer (77.7%) had the same risk of death from breast cancer as patients with unilateral breast cancer. (82.7%) (10 years overall survival, p=0.703) Also, disease-free survival was no difference between these three groups. But when we analyzed disease-free survival according to recurrence pattern, patients with metachronous breast cancer had a higher risk of loco-regional recurrence, significantly, compared with other groups. Conclusion Patients with metachronous breast cancer developed more loco-regional recurrence than patients with unilateral disease or synchronous disease, but this recurrence didn't affect overall survival. Bilaterality of breast cancer is not associated with impaired overall survival. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-10-05.
TT-virus infection in north american blood donors, patients with fulminant hepatic failure, and cryptogenic cirrhosis
Authors: Michael Charlton, Philip Adjei, John Poterucha, Nizar Zein, Breanndan Moore, Terry Therneau, Ruud Krom, Russell Wiesner
Journal: Hepatology (1998)

A novel DNA virus, TT-virus (TTV), has been reported in patients with non-A-G posttransfusion hepatitis in Japan. We sought to determine whether TTV infection occurs in North American blood donors and to further determine the prevalence of TTV infection in several groups of patients with liver disease, including patients with cryptogenic cirrhosis and idiopathic fulminant hepatic failure. TTV infection was sought by detection of TTV DNA in serum by polymerase chain reaction (PCR) using primers generated from a conserved region of the TTV genome. Blood donors, patients with cryptogenic cirrhosis, idiopathic fulminant hepatic failure, and patients with other forms of advanced liver disease with and without a history of parenteral exposures were studied. TTV infection was present in 1% (1 of 100) of blood donors, 15% (5 of 33) of patients with cryptogenic cirrhosis, 27% (3 of 11) of patients with idiopathic fulminant hepatic failure, 18% (2 of 11) of patients with a history of exposure to blood products, and 4% (1 of 25) of patients without parenteral risk factors. For all patients tested, a history of prior exposure to blood products was associated with an increased risk of TTV infection (relative risk, 4.5; 90% confidence intervals, 0.6-43.9). We conclude that TTV infection is present among North American blood donors and is common in patients with liver disease, including cryptogenic cirrhosis and fulminant hepatic failure. Further studies are required to determine the role of TTV in the pathogenicity of acute and/or chronic liver disease.
Prospective identification of patients with amyloid heart disease by two-dimensional echocardiography.
Authors: G L Nicolosi, D Pavan, C Lestuzzi, C Burelli, F Zardo, D Zanuttini
Journal: Circulation (1984)

The purpose of this study was to determine whether changes in myocardial wall echogenicity that suggest amyloid disease could be prospectively identified by a qualitative analysis of two-dimensional echocardiographic images. Two thousand seventy-eight consecutive echocardiograms obtained over a 14 month period were prospectively analyzed. The myocardial walls of 30 patients showed multiple, discrete, small highly refractive echoes; amyloid disease was not known or suspected in any of them. It was recommended that all 30 patients undergo gingival biopsy to confirm the diagnosis and biopsy was performed in 15 patients. The recommendation for biopsy was made only on the basis of two-dimensional echocardiographic images and was independent of findings regarding thickness of the walls or the dimensions of the cardiac chambers. Results of biopsy were positive in 11 patients and negative in four. We conclude that qualitative evaluation of two-dimensional echocardiographic images can identify changes in myocardial wall echogenicity that correlate with a result of gingival biopsy positive for amyloidosis. In patients who have a typical myocardial texture by two-dimensional echocardiography and a positive gingival biopsy result, cardiac amyloidosis should be strongly suspected.
AMPUTATION AT THE KNEE-JOINT.
Authors: W. H. BUECHNER
Journal: JAMA (1896)

The first mention of the removal of the leg at the knee-joint dates back to 1581, when such an amputation was made by Fabricius Hildanus. The method then seems to have been lost until 1764, when it was again brought to light by Hoin and indorsed by Petit and Brasdor. It was not, however, until Velpeau popularized it in 1830 that it began to approach the place which it now holds in the domain of surgery. The first American operation by this method was that of Dr. Nathan Smith in 1824. Considerable difference may be found in the nomenclature of this subject. Disarticulation at the knee is called both by that name and by that of amputation; while to designate amputation through the femur, the names condylar, transcondylar and intracondylar amputation are employed. Ashhurst, in his International Encyclopedia of Surgery, says: "By amputation at the knee-joint is meant a pure
Fibrinolysin (Human) in Large Therapeutic Doses
Authors: Michael A. Polacek
Journal: JAMA (1965)

In recent years, mixtures of plasmin and streptokinase, known as fibrinolysin, have been available for the treatment of thromboembolic disorders.<sup>1-7</sup>In terms of dosage and efficacy, the use of this agent for treatment of the infrequent but sometimes catastrophic postoperative complications of thromboembolic disease remains controversial.<sup>8</sup>Since such complications may occur in the early postoperative period, it would be useful to have some information regarding the effect of this agent in bleeding and healing in surgical wounds. Reduction of plasma fibrinogen levels results in prolongation of clotting time and consequently may lead to poor hemostasis and subsequent problems in wound-healing.<sup>9-10</sup>Fibrinolysins produced in humans have already been identified in bleeding diathesis in surgical patients, although the dehiscence of suture lines has not yet been reported. Since there are frequent indications for postoperative therapy with fibrinolysin (human) and its effect on wound-healing has not yet been investigated, one
Role of the stress-activated protein kinases in endothelin-induced cardiomyocyte hypertrophy.
Authors: G Choukroun, R Hajjar, J M Kyriakis, J V Bonventre, A Rosenzweig, T Force
Journal: Journal of Clinical Investigation (1998)

The signal transduction pathways governing the hypertrophic response of cardiomyocytes are not well defined. Constitutive activation of the stress-activated protein kinase (SAPK) family of mitogen-activated protein (MAP) kinases or another stress-response MAP kinase, p38, by overexpression of activated mutants of various components of the pathways is sufficient to induce a hypertrophic response in cardiomyocytes, but it is not clear what role these pathways play in the response to physiologically relevant hypertrophic stimuli. To determine the role of the SAPKs in the hypertrophic response, we used adenovirus-mediated gene transfer of SAPK/ERK kinase-1 (KR) [SEK-1(KR)], a dominant inhibitory mutant of SEK-1, the immediate upstream activator of the SAPKs, to block signal transmission down the SAPK pathway in response to the potent hypertrophic agent, endothelin-1 (ET-1). SEK-1(KR) completely inhibited ET-1-induced SAPK activation without affecting activation of the other MAP kinases implicated in the hypertrophic response, p38 and extracellular signal-regulated protein kinases (ERK)-1/ERK-2. Expression of SEK-1(KR) markedly inhibited the ET-1-induced increase in protein synthesis. In contrast, the MAPK/ERK kinase inhibitor, PD98059, which blocks ERK activation, and the p38 inhibitor, SB203580, had no effect on ET-1-induced protein synthesis. ET-1 also induced a significant increase in atrial natriuretic factor mRNA expression as well as in the percentage of cells with highly organized sarcomeres, responses which were also blocked by expression of SEK-1(KR). In summary, inhibiting activation of the SAPK pathway abrogated the hypertrophic response to ET-1. These data are the first demonstration that the SAPKs are necessary for the development of agonist-induced cardiomyocyte hypertrophy, and suggest that in response to ET-1, they transduce critical signals governing the hypertrophic response.
Coronary circulatory failure and thromboxane A2 release during coronary occlusion and reperfusion in anaesthetised dogs
Authors: M. TANABE, Z.-I. TERASHITA, S. FUJIWARA, N. SHIMAMOTO, N. GOTO, K. NISHIKAWA, M. HIRATA
Journal: Cardiovascular Research (1982)

Attempts were made to demonstrate release of vasoactive substances from the heart during coronary occlusion (for 60 min) and reperfusion (for 60 min), and to clarify the pathophysiological significance of them. Vasoactive substances were detected by superfusion of rabbit aortic and dog coronary arterial strips with great coronary venous blood. Plasma thromboxane (TX) B2 was radioimmunologically assayed. Gradually developing, sustained contraction of both vascular strips was noted during coronary occlusion and reperfusion, while a transient contraction in rabbit aortic and relaxation in dog coronary arterial strips were seen immediately after reperfusion. The TXB2 released into the great coronary venous blood significantly increased during occlusion and reperfusion. Indomethacin treatment of the dog abolished the sustained contraction of both vascular strips and TXB2 release. The transient contraction of rabbit aorta after reperfusion was inhibited by phenoxybenzamine. Reactive hyperaemia following a 60 min occlusion was significantly depressed, as compared with that following 30 s to 30 min occlusion, and the depression was alleviated by indomethacin and imidazole. These results suggest that catecholamine(s) and TXA2 are released during coronary occlusion and reperfusion, and that the latter might be responsible for the coronary circulatory failure during reperfusion of irreversibly damaged myocardium.
Canadian doctors fear for freedom to practise
Authors: D Spurgeon
Journal: BMJ (1994)

Doctors in Canada are worried that their freedom to practise medicine will be severely restricted under new proposals from provincial and territorial health ministers. At a meeting in Halifax, Nova Scotia, the ministers decided that within a year each province must complete a plan that will identify how many doctors are needed within each area of the country.

The plan will be worked out with the collaboration of medical schools and doctors' professional bodies, but even so doctors are worried that …
IMPACT OF PLAQUE COMPOSITION ON PERIPROCEDURAL MYOCARDIAL INFARCTION: AN IMAP INTRAVASCULAR ULTRASOUND STUDY
Authors: Jae-Sik Jang, Han-Young Jin, Jeong-Sook Seo, Tae-Hyun Yang, Dae-Kyeong Kim, Dong-Soo Kim
Journal: Journal of the American College of Cardiology (2012)
Th17 blockade reduces the itch
Authors: Hema Bashyam
Journal: The Journal of Experimental Medicine (2007)

The red scaly skin of patients with psoriasis is caused by a complex circuit of inflammatory cells and cytokines. Zaba et al. (page 3183) now find that switching off one type of T helper (Th) cell is enough to break the circuit and heal the lesions.






Figure 1

TNF (green) stimulates dendritic cells (red) that cause psoriasis-like lesions (top). Lesions can be relieved by a TNF blocker (bottom).




Th1 cells that secrete interferon (IFN)-γ were initially thought to be the main villains within psoriatic plaques—build-ups of overproliferating skin cells. In animal models of psoriasis, IFN-γ thickens plaques by further increasing the proliferation of skin cells and enhancing their production of chemokines that recruit inflammatory cells.

But cytokines other than IFN-γ may be more to blame. Inhibitors of tumor necrosis factor (TNF)—originally given to patients to treat Crohn's disease and other inflammatory illnesses—have been shown to alleviate psoriasis- like lesions. How they work, however, was unclear.

Zaba et al. now find that blocking TNF prevents psoriasis by inactivating Th17 cells. Th17 cells are normally activated by TNF-stimulated dendritic cells (DCs) and induce epithelial cell proliferation by secreting IL-22. But fewer DCs and lower levels of IL-22 were found in treated plaques, which disappeared after two weeks of treatment with the TNF blocker.

Immediate relief from psoriasis might thus be made possible by getting rid of Th17 cells. Future studies might therefore benefit from focusing on Th17 cells rather than on Th1 cells, which survive in the plaques weeks longer than Th17 cells but fail to perpetuate disease.
Informed Consent for Tests for Prostate Cancer
Authors: Kenneth G. Marshall
Journal: JAMA (1995)

<h3>To the Editor.</h3> —The article by Dr Litwin and colleagues<sup>1</sup>makes it clear that significant morbidity is associated with all modalities of managing localized prostate cancer, including surgery, radiation, and observation. Is there any way of avoiding this? A conceptually simple method would be to give the patient the opportunity of completely opting out of the prostate cancer case-finding process. The rationale for this is straightforward. First, in the absence of controlled prospective studies, it is unknown whether any case-finding procedure for prostate cancer decreases mortality.<sup>2,3</sup>Second, the detection of a prostatic nodule on digital rectal examination (DRE) or the finding of an abnormal prostate-specific antigen (PSA) level results in a cascade of events that entail psychological and physical morbidity and sometimes even death. Were we to accept this approach, we would present each patient with the data required for him to give informed consent for a DRE
Require imaging guidance
Authors: D M Nichols, A G F Aitken
Journal: BMJ (1995)

EDITOR,—We were amused by Guy Vautier and colleagues' efforts to justify the continued use of blind liver biopsies and by their assertion that “the ideal biopsy may be one that is performed in the ward by the gastroenterologist using ultrasonographic guidance.”1 We believe that this is an issue in which the …
The role of letters in reviewing research
Authors: G N Kalla
Journal: BMJ (1994)

unknown referee as any evidence of these could then be referred back to the referee's institution.The bench test of a piece of research is its shelf life: will it still be of interest or relevant in 10 years' time?This test could equally well apply to negative findings.Many important discoveries throughout history have initially been considered to be unacceptable on religious or cultural grounds.As the ultimate peer reviewer is the wider medical audience, the medical referee should perhaps just
PEPFAR in Transition — Implications for HIV Care in South Africa
Authors: Ingrid T. Katz, Ingrid V. Bassett, Alexi A. Wright
Journal: New England Journal of Medicine (2013)

With the U.S. government halving the budget for the President's Emergency Plan for AIDS Relief in South Africa by 2017, the country is transitioning to full ownership of its HIV program. Will the move jeopardize the health of 1.7 million South Africans being treated for HIV?
Phenformin-Induced Lactic Acidosis in an Older Diabetic Patient
Authors: Filippo Luca Fimognari, Ruggero Pastorelli, Raffaele Antonelli Incalzi
Journal: Diabetes Care (2006)

A 73-year-old man with diabetes presented with upper-abdominal pain and nausea. He also had a history of hypertension, a pace-maker implant, and peripheral arterial disease treated with amputation of his left leg. His therapy included ticlopidine, enalapril, omeprazole, and 2 mg glibenclamide/30 mg phenformin b.i.d. The patient was alert and cognitively intact. Blood pressure and heart rate were 120/70 mmHg and 70 bpm, respectively. Radiographs of the chest and abdomen and an abdominal ultrasound study were normal. Laboratory tests disclosed a severe lactic acidosis (pH 6.8, pCO2 14.1 mmHg, pO2 108 mmHg, HCO3 4.9 mmol/l, lactate 21 mmol/l, and …
Fungus Diseases and Their Treatment
Authors: Thomas P. Kugelman
Journal: JAMA (1965)

This well-written and handsomely illustrated volume should prove of great value to those interested in the clinical aspects of medical mycology. In emphasis it differs somewhat from other current texts in that approximately half of the book is devoted to the superficial mycoses and a third to a discussion of the antifungal antibiotics. It is outstanding in its comprehensive and up-to-date coverage of the pharmacology, toxicology, and therapeutic uses of nystatin, amphotericin B, and griseofulvin.  The superficial and deep mycoses are each allotted one or more separate chapters. Special prominence is given to candidiasis, whose many manifestations and implications the authors discuss with exceptional clarity and authority. Coverage of the systemic mycoses is adequate but relatively brief, and readers seeking more detail will find the numerous references quite helpful.  The book's chief shortcoming is its failure to cover some of the technical aspects of isolation, identification, and species characteristics of
Fibrositis and the Chronic Fatigue Syndrome
Authors: Charles Pritchard
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 June 1988Fibrositis and the Chronic Fatigue SyndromeCHARLES PRITCHARD, M.D.CHARLES PRITCHARD, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-6-906_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Primary fibrositis should be included in any discussion of a fatigue syndrome and may be extremely difficult to distinguish from the chronic fatigue syndrome as defined by Holmes (1). It is a waxing and waning state of nonrestorative sleep, myalgias, specific tender points, and weather- and stress-induced exacerbations from which secondary causes, such as connective tissue, endocrine, neoplastic, and drug-related disorders, have been excluded (2, 3). In fact, fibrositis will meet both of the major and eight of the minor criteria of the chronic fatiguesyndrome depending on how one defines "new" in the major criteria.Those of...References1. HOLMES G, KAPLAN J, and GANTZ N. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988;108:387-9. LinkGoogle Scholar2. CAMPBELL S, CLARK S, and TINDALL E. Clinical characteristics of fibrositis. Arthritis Rheum. 1983;7:817-24. CrossrefGoogle Scholar3. YUNIS M, MASI A, and CALABRO J. Primary fibromyalgia (fibrositis): clinical study of 50 patients with matched normal controls. Semin Arthritis Rheum. 1981;11:151-71. CrossrefMedlineGoogle Scholar4. CARO X, WOLFE F, and JOHNSTON W. A Controlled and blinded study of immunoreactant deposition at the dermal-epidermal junction of patients with primary fibrositis syndrome. J Rheumatol. 1986;13:1086-92. MedlineGoogle Scholar5. MOLDOFSKY H, SCARISBRICK P, and ENGLAND R. Musculoskeletal symptoms and non-REM sleep disturbance in patients with "fibrositis syndrome"and healthy subjects. Psychosom Med. 1975;37:341-51. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: CHARLES PRITCHARD, M.D.Affiliations: Temple University Philadelphia, PA 19140 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byChronic Fatigue Syndrome: A ConundrumPrimary fibromyalgia and the chronic fatigue syndromeA Report–Chronic Fatigue Syndrome: Guidelines for Research 1 June 1988Volume 108, Issue 6Page: 906-906KeywordsChronic fatigue syndromeConnective tissueDrugsFatigueFibromyalgiaMyalgiaSleep ePublished: 1 December 2008 Issue Published: 1 June 1988 PDF downloadLoading ...
Jean Eileen Lawrie (nee Grant)
Authors: J. Husband, C. Williams
Journal: BMJ (2010)

Dr Jean Lawrie CBE MBBS was a remarkable woman who, during a career which spanned over 50 years, championed change for medical women and helped to establish their place in a man’s world. Through her endeavours women doctors can now enjoy a successful and rewarding career as well as assuming the responsibilities of family life. Indeed there are a number of women still practising medicine today who owe Dr Lawrie an enormous debt of gratitude for her wise counsel, personal encouragement, and support in the early days of their careers when the struggle to maintain a professional working life was daunting and the path ahead was far from clear.

Jean Lawrie subsequently played a key role in influencing government policy to introduce flexible and part-time training and to develop the retainer scheme which enabled women doctors to keep their hand in over the years when family commitments were too demanding to pursue an active career. Her vision for women in medicine was realised though her characteristically indomitable spirit and resolute determination to overcome any obstacles that stood in her way, however overwhelming. These exceptional qualities, which made Jean Lawrie a superb leader in the world of medical politics, were also …