tbuckley/cabot-search huggingface dataset:
Is More Intensive Surveillance Really a Good Idea for High-Risk Patients With Colorectal Cancer?
Authors: Craig C. Earle
Journal: Journal of Clinical Oncology (2014)

The American Society of Clinical Oncology's updated colorectal cancer surveillance guideline 1 provides, as always, rational, judicious guidance.However, I am concerned about the qualifying statement that "for patients at higher risk of recurrence, providers may want to consider more frequent interval testing." 1(p4468) Although on the surface it may seem reasonable, the evidence does not support this approach.Studies have consistently shown that patients with the highest risk of recurrence, especially because of node positivity, are the least likely to be cured with metastasectomy. [2]3][4][5] Increased intensity of surveillance in high-risk disease will more often detect the tip of the iceberg of metastases and result in subjecting more patients to noncurative surgeries.The qualifying statement encourages or at least justifies the overuse of expensive, unnecessary tests that may result in harm to patients.
Thermal Latency in Radiofrequency Ablation
Authors: Fred H.M. Wittkampf, Hiroshi Nakagawa, William S. Yamanashi, Shinobu Imai, Warren M. Jackman
Journal: Circulation (1996)

Background Progression of unintentionally induced atrioventricular delay is occasionally observed directly after termination of radiofrequency delivery in the vicinity of the atrioventricular node. We postulated that the application of a radiofrequency pulse may result in a tissue temperature rise that continues after the pulse. Methods and Results Using the thigh muscle preparation, 5-, 10-, 20-, and 30-second pulses were applied at 30 to 40 W via a standard 4-mm tip electrode with 10-g contact pressure. Forty-one undisturbed pulses were delivered while recording intramural temperatures at 2-, 4-, and 7-mm depth. Maximal “thermal latency” was observed with the shortest pulse duration and at greatest depth. With 5-second applications, tissue temperature at 7-mm depth peaked 11.6 seconds after termination of radiofrequency delivery and stayed above end-of-pulse value as long as 34.5 seconds after the pulse. The additional rise in tissue temperature was 2.9°C. If only recordings within the lesion border zone were considered, the duration of latency was maximal with 10-second pulses: an additional gain in tissue temperature of 3.4°C was observed 6.4 seconds after the pulse while tissue temperature stayed above end-of-pulse value during 18.3 seconds. Conclusions With relatively short applications, tissue temperature continues to rise after termination of radiofrequency delivery. This “thermal latency” may result in lesion growth after the pulse and may so explain the incidentally observed progression of conduction block after short pulses in the vicinity of the atrioventricular node. It also may explain the apparent discrepancy between lesion growth rate and intramural temperature rise studies.
Exercise training in patients with severe left ventricular dysfunction. Hemodynamic and metabolic effects.
Authors: M J Sullivan, M B Higginbotham, F R Cobb
Journal: Circulation (1988)

We studied the effects of exercise training in patients with chronic heart failure attributed to left ventricular dysfunction (ejection fraction, 24 +/- 10%). Twelve ambulatory patients with stable symptoms underwent 4-6 months of conditioning by exercising 4.1 +/- 0.6 hr/wk at a heart rate corresponding to 75% of peak oxygen consumption. Before and after training, patients underwent maximal bicycle exercise testing with direct measurement of central hemodynamic, leg blood flow, and metabolic responses. Exercise training resulted in a decrease in heart rate at rest and submaximal exercise and a 23% increase in peak oxygen consumption from 16.8 +/- 3.8 to 20.6 +/- 4.7 ml/kg/min (p less than 0.01). Heart rate, arterial lactate, and respiratory exchange ratio were unchanged at peak exercise after training. Maximal cardiac output tended to increase from 8.9 +/- 2.7 to 9.9 +/- 3.2 1/min and contributed to improved peak oxygen consumption in some patients, although this change did not reach statistical significance (p = 0.13). Rest and exercise measurements of left ventricular ejection fraction, left ventricular end-diastolic volume, and left ventricular end-systolic volume were unchanged. Right atrial, pulmonary arterial, pulmonary capillary wedge, and systemic arterial pressures were not different after training. Training induced several important peripheral adaptations that contributed to improved exercise performance. At peak exercise, systemic arteriovenous oxygen difference increased from 13.1 +/- 1.4 to 14.6 +/- 2.3 ml/dl (p less than 0.05). This increase was associated with an increase in peak-exercise leg blood flow from 2.5 +/- 0.7 to 3.0 +/- 0.8 l/min (p less than 0.01) and an increase in leg arteriovenous oxygen difference from 14.5 +/- 1.3 to 16.1 +/- 1.9 ml/dl (p = 0.07). Arterial and femoral venous lactate levels were markedly reduced during submaximal exercise after training, even though cardiac output and leg blood flow were unchanged at these workloads. Thus, ambulatory patients with chronic heart failure can achieve a significant training effect from long-term exercise. Peripheral adaptations, including an increase in peak blood flow to the exercising leg, played an important role in improving exercise tolerance.(ABSTRACT TRUNCATED AT 400 WORDS)
HbA1c 5·7–6·4% and impaired fasting plasma glucose for diagnosis of prediabetes and risk of progression to diabetes in Japan (TOPICS 3): a longitudinal cohort study
Authors: Yoriko Heianza, Shigeko Hara, Yasuji Arase, Kazumi Saito, Kazuya Fujiwara, Hiroshi Tsuji, Satoru Kodama, Shiun Dong Hsieh, Yasumichi Mori, Hitoshi Shimano, Nobuhiro Yamada, Kinori Kosaka, Hirohito Sone
Journal: The Lancet (2011)
Differential expression of cyclooxygenase-2 (COX-2) in human bile duct epithelial cells and bile duct neoplasm
Authors: Nobuyasu Hayashi, Hirofumi Yamamoto, Nobuaki Hiraoka, Keizo Dono, Yasuhiro Ito, Jiro Okami, Motoi Kondo, Hiroaki Nagano, Koji Umeshita, Masato Sakon, Nariaki Matsuura, Shoji Nakamori, Morito Monden
Journal: Hepatology (2001)

It is well known that chronic inflammatory conditions involving the bile ducts predispose to the development of bile duct carcinoma, although the relationship between chronic inflammation and malignant transformation is unclear. In this study, by combining immunohistochemistry and computer imaging techniques, we quantified and compared the cyclooxygenase-2 (COX-2) protein expression levels of epithelial cells according with their histopathological backgrounds. This technique revealed that the highest levels of COX-2 were expressed in bile duct carcinoma cells, mainly in cytoplasm, and the expression pattern was homogenous and abundant. Moderate levels of COX-2 protein expression were also observed in noncancerous epithelial cells with inflammatory reaction, but the staining intensity was heterogeneous among the positive cells exhibiting inflammation. In contrast, only scattered weak reactivity of COX-2 protein was observed in the noncancerous bile duct epithelial cells without inflammatory reaction. Moreover, bile duct epithelial cells in primary sclerosing cholangitis (PSC) showed very strong expression of COX-2 protein, that was comparable with carcinoma cells. On the other hand, primary biliary cirrhosis (PBC) epithelial cells showed moderate levels of COX-2 expression. In addition, specific COX-2 inhibitors, JTE-522 and NS-398, directly inhibited the growth of 4 bile duct carcinoma and 1 gall bladder carcinoma cell lines that expressed COX-2 protein, in vitro. These data suggest that COX-2 expression might regulate carcinogenesis of bile duct epithelial cells in inflammatory regions and tumor progression in this cancer. The data also suggest that COX-2 selective inhibitors might have therapeutic effects not only on bile duct carcinoma, but other hepatobiliary carcinomas.
Incidence of serious complications of corticosteroid therapy in respiratory disease: A retrospective survey of patients in the Brompton Hospital
Authors: H. C. Smyllie, C. K. Connolly
Journal: Thorax (1968)

A retrospectively controlled study is described of mortality and serious morbidity in 550 patients treated with corticosteroids and 499 controls. The overall incidence of side-effects was similar in both groups, but gastro-intestinal bleeding, diabetes, and mental disturbance early in treatment occurred more frequently in the corticosteroid group. Other individual side-effects did not occur significantly more often than in the controls, but there was an overall increased frequency of complications with increased dose, and also an increased mortality with increase in the maintenance dose. Gastro-intestinal bleeding was not related to a past or present chronic peptic ulcer, and was not commoner in treated patients. Reactivation of tuberculosis and exacerbation of mental disturbance did not occur. Weight gain occurred in 29% of patients, but appeared to be related closely to a satisfactory response to treatment. Hypertension occurred in 4% of the treated group. Overall mortality in the two groups was similar. Mortality due specifically to corticosteroids was difficult to assess: two patients died of haematemesis and three died with severe asthma during withdrawal of treatment, but there was no increase in mortality following physical stress in the treated series. Sudden death in asthmatics was not more frequent in corticosteroid-treated patients. All seven control patients who died suddenly with asthma were middleaged. Increase in duration of treatment was not associated with increased risk. Indeed the long-term, low-dose group had a lower incidence of complications than the rest and a mortality similar to that of the controls. A trial of corticosteroids for less than one month carried no risk in 41 patients.
Human Kallikrein 8 Protein Is a Favorable Prognostic Marker in Ovarian Cancer
Authors: Carla A. Borgoño, Tadaaki Kishi, Andreas Scorilas, Nadia Harbeck, Julia Dorn, Barbara Schmalfeldt, Manfred Schmitt, Eleftherios P. Diamandis
Journal: Clinical Cancer Research (2006)

Abstract Human kallikrein 8 (hK8/neuropsin/ovasin; encoded by KLK8) is a steroid hormone–regulated secreted serine protease differentially expressed in ovarian carcinoma. KLK8 mRNA levels are associated with a favorable patient prognosis and hK8 protein levels are elevated in the sera of 62% ovarian cancer patients, suggesting that KLK8/hK8 is a prospective biomarker. Given the above, the aim of the present study was to determine if tissue hK8 bears any prognostic significance in ovarian cancer. Using a newly developed ELISA, hK8 was quantified in 136 ovarian tumor extracts and correlated with clinicopathologic variables and outcome [progression-free survival (PFS); overall survival (OS)] over a median follow-up period of 42 months. hK8 levels in ovarian tumor cytosols ranged from 0 to 478 ng/mg total protein, with a median of 30 ng/mg. An optimal cutoff value of 25.8 ng/mg total protein (74th percentile) was selected based on the ability of hK8 values to predict the PFS of the study population and to categorize tumors as hK8 positive or negative. Women with hK8-positive tumors most often had lower-grade tumors (G1), no residual tumor after surgery, and optimal debulking success (P &amp;lt; 0.05). Univariate and multivariate analyses revealed that patients with hK8-positive tumors had a significantly longer PFS and OS than hK8-negative patients (P &amp;lt; 0.05). Kaplan-Meier survival curves further confirmed a reduced risk of relapse and death in women with hK8-positive tumors (P = 0.001 and P = 0.014, respectively). These results indicate that hK8 is an independent marker of favorable prognosis in ovarian cancer.
Atrial Fibrillation after Cardiac Surgery
Authors: William H. Maisel, James D. Rawn, William G. Stevenson
Journal: Annals of Internal Medicine (2001)

Purpose: To review the epidemiology, mechanisms, complications, predictors, prevention, and treatment of atrial fibrillation following cardiac surgery. Data Sources: MEDLINE search of English-language reports published between 1966 and 2000 and a search of references of relevant papers. Study Selection: Clinical and basic research studies on atrial fibrillation after cardiac surgery. Data Extraction: Relevant clinical information was extracted from selected articles. Data Synthesis: Atrial fibrillation occurs in 10% to 65% of patients after cardiac surgery, usually on the second or third postoperative day. Postoperative atrial fibrillation is associated with increased morbidity and mortality and longer, more expensive hospital stays. Prophylactic use of β-adrenergic blockers reduces the incidence of postoperative atrial fibrillation and should be administered before and after cardiac surgery to all patients without contraindication. Prophylactic amiodarone and atrial overdrive pacing should be considered in patients at high risk for postoperative atrial fibrillation (for example, patients with previous atrial fibrillation or mitral valve surgery). For patients who develop atrial fibrillation after cardiac surgery, a strategy of rhythm management or rate management should be selected. For patients who are hemodynamically unstable or highly symptomatic or who have a contraindication to anticoagulation, rhythm management with electrical cardioversion, amiodarone, or both is preferred. Treatment of the remaining patients should focus on rate control because most will spontaneously revert to sinus rhythm within 6 weeks after discharge. All patients with atrial fibrillation persisting for more than 24 to 48 hours and without contraindication should receive anticoagulation. Conclusions: Atrial fibrillation frequently complicates cardiac surgery. Many cases can be prevented with appropriate prophylactic therapy. A strategy of rhythm management for symptomatic patients and rate management for all other patients usually results in reversion to sinus rhythm within 6 weeks of discharge.
Hysterical Psychosis: The Cross-Cultural Evidence
Authors: L. L. LANGNESS
Journal: American Journal of Psychiatry (1967)

While the term "hysterical psychosis" appears to have been used in the literature on cross-cultural psychopathology partly because of nosological difficulties, the author feels that it may describe a widely distributed type of abnormal behavior. He believes the hysterical psychoses are particularly amenable to interdisciplinary research.
Quick fixes for quicksilver.
Authors: W C Holton
Journal: Environmental Health Perspectives (1998)

Mercury pollution is a persistent and increasing problem in the environment. Along with some natural sources of the metal, major man-made sources of mercury pollution include incinerators, fossil fuel plants, and municipal sewage systems. The EPA estimated that in 1989, approximately 643,000 kg of mercury was discarded as municipal solid waste, with 84% of it landfilled.
Fasting enhances mucosal antigen specific B cell responses in rheumatoid arthritis
Authors: C Trollmo, M Verdrengh, A Tarkowski
Journal: Annals of the Rheumatic Diseases (1997)

To evaluate the influence of fasting on the antigen specific immune responsiveness in patients with rheumatoid arthritis and healthy volunteers.Seven rheumatoid arthritis patients and 17 healthy volunteers were immunised perorally or parenterally with influenza virus vaccine after a three to six day long period of total energy deprivation (water fast). The subsequent antigen specific antibody mediated immune response was recorded in the blood at the single cell level by the ELISPOT method.Short term starvation induced an enhanced antigen specific mucosa derived B lymphocyte response in rheumatoid arthritis patients and healthy volunteers. In contrast, the systemic B cell responses were not significantly altered by a total energy deprivation.Short term starvation increases the mucosa derived B cell responsiveness, while systemic responsiveness is largely unaffected. The similar pattern of response in rheumatoid arthritis patients and healthy volunteers indicates that fasting alters the mucosal immune response independently of medical treatment.
CONCUSSION OF THE BRAIN
Authors: ALFRED REGINALD ALLEN
Journal: JAMA (1910)

In this day and generation a justification is desirable when a single case is reported. This is particularly in order when the case is one of cerebral concussion. Nevertheless, on account of the extraordinary symptom-complex and course of the case in question, I offer no apology for its presentation.  History.—  August 6, 1910, E. D., male, aged 6½ weight 49 pounds, in robust health, fell while running on the porch, striking the left side of his head. The time of the accident was about 4 p. m. Judging from the position of the echymosis, which was very slight, the point of impact must have been about 4 cm. above and 2 cm. behind the external canthus of the left eye.  I saw the child within ten minutes of the accident. The nurse said that after he fell he got upon his feet immediately, crying lustily. He was very pale, and
Gemcitabine plus erlotinib followed by capecitabine versus capecitabine plus erlotinib followed by gemcitabine in advanced pancreatic cancer: final results of a randomised phase 3 trial of the ‘Arbeitsgemeinschaft Internistische Onkologie’ (AIO-PK0104)
Authors: Volker Heinemann, Ursula Vehling-Kaiser, Dirk Waldschmidt, Erika Kettner, Angela Märten, Cornelia Winkelmann, Stefan Klein, Georgi Kojouharoff, Thomas C Gauler, Ludwig Fischer von Weikersthal, Michael R Clemens, Michael Geissler, Tim F Greten, Susanna Hegewisch-Becker, Oleg Rubanov, Gerold Baake, Thomas Höhler, Yon D Ko, Andreas Jung, Sascha Neugebauer, Stefan Boeck
Journal: Gut (2012)

This paper presents a case for allocating health care resources so as to maximise Quality Adjusted Life Years (QALYs). Throughout parallels are drawn with the grounds for adopting utilitarianism. QALYs are desirable because they are essential for human flourishing and goal-attainment. In conditions of scarcity the principle of QALY maximisation may involve unequal treatment of different groups of people; and it is argued that this is not objectionable. Doctors in their dealings with patients should not be continually consulting the principle (though it can sometimes be useful); instead by following existing ethical codes more QALYs will be produced overall. In the formulation of policy, however, the principle should be applied in a thoroughgoing way and, if it is, it will not have some of the counterintuitive consequences it may have in interpersonal situations.
Venous ulceration and free radicals
Authors: T. Cheatle
Journal: British Journal of Dermatology (1991)

Journal Article Venous ulceration and free radicals Get access T. Cheatle T. Cheatle Department of surgery, University College and Middlesex School of Medicine, The Middlesex Hospital, London WIN 8AA, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 124, Issue 5, 1 May 1991, Page 508, https://doi.org/10.1111/j.1365-2133.1991.tb00641.x Published: 01 May 1991
Simultaneous Humoral and Cellular Immune Response against Cancer–Testis Antigen NY-ESO-1: Definition of Human Histocompatibility Leukocyte Antigen (HLA)-A2–binding Peptide Epitopes
Authors: Elke Jäger, Yao-Tseng Chen, Jan W. Drijfhout, Julia Karbach, Mark Ringhoffer, Dirk Jäger, Michael Arand, Hisashi Wada, Yuji Noguchi, Elisabeth Stockert, Lloyd J. Old, Alexander Knuth
Journal: The Journal of Experimental Medicine (1998)

A growing number of human tumor antigens have been described that can be recognized by cytotoxic T lymphocytes (CTLs) in a major histocompatibility complex (MHC) class I–restricted fashion. Serological screening of cDNA expression libraries, SEREX, has recently been shown to provide another route for defining immunogenic human tumor antigens. The detection of antibody responses against known CTL-defined tumor antigens, e.g., MAGE-1 and tyrosinase, raised the question whether antibody and CTL responses against a defined tumor antigen can occur simultaneously in a single patient. In this paper, we report on a melanoma patient with a high-titer antibody response against the “cancer–testis” antigen NY-ESO-1. Concurrently, a strong MHC class I–restricted CTL reactivity against the autologous NY-ESO-1–positive tumor cell line was found. A stable CTL line (NW38-IVS-1) was established from this patient that reacted with autologous melanoma cells and with allogeneic human histocompatibility leukocyte antigen (HLA)-A2−, NY-ESO-1–positive, but not NY-ESO-1–negative, melanoma cells. Screening of NY-ESO-1 transfectants with NW38-IVS-1 revealed NY-ESO-1 as the relevant CTL target presented by HLA-A2. Computer calculation identified 26 peptides with HLA-A2–binding motifs encoded by NY-ESO-1. Of these, three peptides were efficiently recognized by NW38-IVS-1. Thus, we show that antigen-specific humoral and cellular immune responses against human tumor antigens may occur simultaneously. In addition, our analysis provides a general strategy for identifying the CTL-recognizing peptides of tumor antigens initially defined by autologous antibody.
The Role of Thymus in Transplantation Resistance Induced by Polyoma Virus
Authors: R. C. Ting, L. W. Law
Journal: JNCI Journal of the National Cancer Institute (1965)

Mice were thymectomized at 3 days of age and then were given injections of polyoma virus 1 to 2 weeks later. Most of the thymectomized mice gained weight at the same rate as the intact controls and produced polyoma hemagglutinin-inhibiting antibodies with titers as high as did their intact littermates. When these virus-infected mice were challenged with a syngeneic polyoma-virus-induced tumor 4 weeks later, most of the thymectomized mice failed to develop resistance against the challenge, whereas most of their intact littermates resisted the growth of the tumor. Thymectomized mice, which were implanted with Millipore diffusion chambers containing thymus and then infected with polyoma virus, also failed to develop transplantation resistance after challenge. However, thymus grafting did restore transplantation resistance to thymectomized mice, provided virus inoculation was given 4 weeks after grafting.