tbuckley/cabot-search huggingface dataset:
Limb-sparing surgery without radiotherapy based on anatomic location of soft tissue sarcoma.
Authors: A Rydholm, P Gustafson, B Rööser, H Willén, M Akerman, K Herrlin, T Alvegård
Journal: Journal of Clinical Oncology (1991)

From 1980 through 1986, 119 patients with soft tissue sarcomas of the extremities were referred to our tumor center either before surgery (n = 78) or immediately after incisional biopsy or marginal excision (n = 41). The tumors were classified according to anatomic location at admittance as subcutaneous (n = 40), intramuscular (n = 30), and extramuscular tumors (n = 49). Open biopsy was omitted in 75 of the 78 patients referred before surgery; the preoperative diagnosis was based on physical and radiographic findings and fine-needle aspiration cytology. The surgical intention for subcutaneous tumor was to obtain a wide margin, which required a cuff of fat tissue around the tumor and inclusion of the deep fascia beneath the tumor. A wide margin for an intramuscular tumor implied no open biopsy and an unbroken muscle fascia or thick muscle cuff around the tumor (primary myectomy). The 70 patients with subcutaneous and intramuscular tumors were all treated by local surgery. A wide margin was obtained in 56 patients who were not given radiotherapy. During a median follow-up of 5 years (range, 3.5 to 10 years), four of these 56 patients--47 of whom had high-grade malignant tumors--had a local recurrence. We conclude that routine combination of limb-sparing surgery with adjuvant radiotherapy is not necessary in patients with soft tissue sarcoma. Two thirds of soft tissue sarcomas of the extremities are primarily subcutaneous or intramuscular tumors, the majority of which can be treated by local surgery without local adjuvant therapy with a local recurrence rate of less than 10%, irrespective of malignancy grade.
Abstract 13157: Acute Coronary Syndrome without Chest Pain in Young Adults
Authors: Nadia Khan, Meytal Avgil, Mark Eisenberg, Igor Karp, Roxanne Pelletier, Colleen Norris, Stella Daskalopoulou, Kaberi Dasgupta, George Thanassoulis, Avi Shimony
Journal: Circulation (2012)

Background: Women with acute coronary syndrome (ACS) are more likely to present without chest pain compared to men, but underlying reasons for atypical presentation remain unclear. We evaluated soc...
Abstract 14156: Assessment of Pulmonary Arterial Pressure in Children with Congenital Heart Disease by Velocity-Encoded Cine Magnetic Resonance Imaging
Authors: Masaya Sugimoto, Hiroki Kajino, Aya Kajihama, Kouichi Nakau, Hiroshi Azuma
Journal: Circulation (2012)

Background:Children with congenital heart disease (CHD) often exhibit increased pulmonary blood flow (Qp) and pulmonary hypertension. It has been recently reported that the maximal change in the fl...
Comparison of survival between the American Joint Committee on Cancer (AJCC) six and seven lung cancer staging systems in a resection cohort.
Authors: C. Wang, L. E. Miller, R. A. Ramirez, M. T. Chi, M. Ul-Haq, R. A. Arteta-Bulos, A. Farooq, J. W. Allen, A. B. Weir, H. Cole, T. O'Brien, R. U. Osarogiagbon
Journal: Journal of Clinical Oncology (2011)

e17513 Background: The AJCC 7 lung cancer staging system was developed from a large international dataset. Unlike AJCC 6, AJCC 7 was less insistent on surgical staging, which is more accurate than clinical staging. AJCC 7 is more elaborate, moved some patients from their previous T and M categories, and assigned some patients to new stage groups. We examined the effect of these changes on a surgical cohort. Methods: Analysis was done for all curative-intent lung cancer resections in Memphis, TN from 1/1/04–12/31/09, excluding those with pre-operative therapy and those with no lymph nodes. Patients were assigned into AJCC 6 and 7 TNM groups. Survival was estimated by the Kaplan-Meier method. Survival curves were compared by the log-rank test. Results: Comparative stage grouping of the 1,125-patient cohort is shown in the table. The T or M category changed for 8% of patients: 53 (4%) to a higher, 47 (4%) to a lower category; 52% of the changes were from T2 to T3, 40% T4 to T3, 7% from M1 to T4 and 1% from T4 to M1. With combination of the TNM categories, 9% of patients moved to a higher, and 12% to a lower, stage. The greatest shift was a 230% increase in stage IIA patients and a 93% decrease in IIIB. The 5-year survival rates (AJCC 6 v 7) were: IA 65% for both; IB 50 v 52; IIA 39 v 39; IIB 32 v 42; IIIA 26 v 28; IIIB 45 v 0; IV 31 v 57. Although the difference in survival curves within each system as a whole was significant, (p<0.0001 for both), there was overlap in survival curves between AJCC 6 IB/IIA, IIB/IIIB/IIIA; this occurred between IIA/IIB in AJCC 7. Conclusions: The AJCC 7 staging system is more discriminatory of survival. The large increase in the stage IIA population did not significantly change the survival statistics, and reassignment of patients with “resectable” stage IIIB disease to a lower stage seems appropriate. Survival of resected stage IV patients was surprisingly good, suggesting that most of these patients (with a satellite lesion in the contralateral lung) probably had multiple primary tumors. AJCC 6 # patients AJCC 7 # patients IA IB IIA IIB IIIA IIIB IV Total AJCC 6 IA 413 0 0 0 0 0 0 413 IB 0 244 59 34 0 0 0 337 IIA 0 0 53 0 0 0 0 53 IIB 0 0 63 67 10 0 0 140 IIIA 0 0 0 0 95 0 0 95 IIIB 0 0 0 25 38 5 2 70 IV 0 0 0 0 7 0 10 17 Total AJCC 7 413 244 175 126 150 5 12 1,125
Adjuvant docetaxel chemotherapy with abbreviated hormonal therapy in patients with high-risk prostate cancer
Authors: N. Colocci, C. R. King, J. D. Brooks, H. S. Gill, J. C. Presti, S. Srinivas
Journal: Journal of Clinical Oncology (2007)

15589 Background: We conducted a pilot adjuvant docetaxel and abbreviated androgen deprivation study (ADT) in patients with high-risk localized prostate cancer. Study objectives were to evaluate toxicity, feasibility of 6 months of ADT and 3 months of docetaxel treatment, and incidence of serum PSA relapse at 2 years compared to historical controls. Methods: Eligible patients had radical prostatectomy or radiation therapy for high-risk disease (pathologic node positive disease, capsule involvement, extra-capsular extension, seminal vesicle involvement, positive surgical margins, Gleason score = 8, clinical stage T2c or T3, serum PSA &gt;20, or pre-op PSA &gt; 15 plus any high-risk feature). Patients were treated with taxotere 35 mg/m 2 weekly 3 out of every 4 weeks for 3 months, and an LHRH analog for 6 months concurrently. In this high-risk cohort, we estimated the risk of PSA recurrence to be as high as 65% in 2 years. To detect a reduction in recurrence rates after surgery or radiation by 40% at a power of 80% and a 2-sided alpha of 0.05, a total of 21 patients were needed in this pilot Phase II study. Results: Twentyone patients were enrolled between 9/04–9/05. The median age was 59.5 years (48–72). Ten patients had a radical prostatectomy and 11 had radiation therapy. All patients received 6 months of LHRH analog therapy. Median pre- treatment PSA was 9.5 ng/ml (4–120). Mean Gleason grade was 8 (7–9); 65% of the patients had &gt;50% biopsies positive. Treatment was well tolerated. Acute toxicity included 1 grade IV hyperglycemia. There was 1 dose reduction and 1 treatment delay. One patient had grade III elevation in serum AST which was transient. Grade I/II toxicities were common and included fatigue, diarrhea, insomnia, and pedal edema. Median follow up is 20 months. Five patients have relapsed. One (of 11) patients treated with radiation has relapsed with metastatic bone disease at 9 months. Four (of 10) patients who underwent prostatectomy have had a serologic relapse at 14, 14, 17 and 21 months, respectively. Conclusions: These data suggest that adjuvant weekly taxotere with abbreviated course of ADT is feasible and well tolerated. In this pilot trial, at a median follow up of 20 months, 23% of patients have relapsed. Longer follow up is required and is ongoing. No significant financial relationships to disclose.
MODELS FOR THE STUDY OF THE CONTRACTION OF MUSCLE AND OF CELL PROTOPLASM
Authors: Wilhelm Hasselbach, Annemarie Weber
Journal: Pharmacological Reviews (1955)

The contraction of both muscle and cell models is the result of the reaction of the contractile protein with ATP. The contraction may be studied by observation of the change in shape in the case of the cell models, of the superprecipitation of actomyosin gels, and of the unloaded shortening of actomyosin threads of glycerol-extracted fibres. It may also be studied by determining the tensionproduced by a model under isometric conditions, or by measuring the work done by a model. The extent of the contraction or the final tension, as well as the rate of shortening, may be investigated. It must be borne in mind that conditions affecting contraction have been shown to influence these reactions in a different way. Decrease of the Mg++ concentration, for instance, markedly affects the velocity of contraction of a muscle model, but has much less effect on the extent.  The contraction depends in a complex way on the active concentrations of the factors and cofactors of the system, such as actomyosin, ATP, Mg ++ , ionic strength and pH. Any change influencing the concentration of one of them will indirectly affect the process ( e.g.,  EDTA, hexametaphosphate, fluoride, etc.). Interpretation of the marked difference in the effects of various concentrations of ATP is complicated by the importance of the diameter of the models. A model containing a core which is free of ATP will develop a lower tension, or shorten more slowly, than will a thinner model. In a solution with a high concentration of ATP, the outer part of the model might react to a superoptimal concentration of ATP, while the center has not been reached by ATP.  The complexity of the reaction is also demonstrated in the behaviour of the enzymatic activity. With increasing ionic strength, the enzyme changes from a Mg ++ -activated to a Mg ++ -inhibited form. When, at low ionic strength, the actomyosin enzyme is present in its Mg ++ -activated form, contraction is inhibited by Ca ++  if its concentration increases far above that of Mg ++ .  The presence of the relaxing factors drastically changes the reaction of the system in that concentrations of ATP and Mg ++  which otherwise produce contraction bring about relaxation. While the addition of an ion, such as Ca ++  in low concentrations, has no influence on the contraction of pure actomyosin, calcium ion in the presence of a relaxing factor initiates contraction.  As previously stated, some substances act by altering the effective concentration of the components of the system, others attack the sulfhydryl groups, or the amino groups, thereby modifying the contraction. In addition, several other substances, e.g., urea, compounds containing sulfonic groups, have been found to influence contraction of the muscles reversibly by, as yet, unknown mechanisms.
Abstract 14676: Insufficient Papillary Muscle Contraction is Involved in Late Systolic Mitral Valve Prolapse: Quantitative Echocardiographic Study with Speckle Tracking Analysis
Authors: Hiroshi Kuwaki, Masaaki Takeuchi, Jeong Yoon Jang, Byng Joo Sun, Yun Jeong Kim, Mai Iwataki, Kyoko Otani, Junko Funatsu, Nobuhiko Haruki, Hidetoshi Yoshitani, Jae Kwan Song, Robert A Levine, Yutaka Otsuji
Journal: Circulation (2012)
Who will be patients' advocate if doctors assume the rationing role?
Authors: P. De Zulueta
Journal: BMJ (1996)

EDITOR,—The case of child B has important implications for patients seeking expensive potentially lifesaving treatment within the current economic climate.1 The Court of Appeal's decision was disappointing but unsurprising. The master of the rolls made it clear that the courts are not the forum for making decisions on the allocation of resources in health care (no doubt he could envisage the floodgates opening to scores of disappointed patients). What is surprising, however, is that he assumed that the decision making …
High rate of symptoms is seen five years after gastric bypass surgery for obesity
Authors: Susan Mayor
Journal: BMJ (2016)

Although most people report feeling better after gastric bypass surgery for obesity, the majority still have symptoms five years after their procedure and nearly a third need a further hospital stay, a study has shown.1

Researchers surveyed 2238 patients who underwent Roux en Y gastric bypass surgery for obesity from January 2006 to December 2011 in central Denmark and compared the patients’ self reported wellbeing and symptoms with 89 controls matched for sex and body mass index. Just under two thirds (1429; …
Dynamic pathophysiology in stable COPD patients with severely reduced exercise capacity
Authors: Ryoji Maekura, Toru Hiraga, Keisuke Miki, Seigo Kitada, Kenji Yoshimura, Yoshitaka Tateishi
Journal: European Respiratory Journal (2011)

Introduction: The survival prognosis of COPD patients with severely reduced exercise capacity is extremely poor. However, the dynamic pathophysiology of these patients, including sympathetic activation and lactic acidosis, remains to be accurately established. Thus, we performed this study to clarify the differences in the dynamic pathophysiology of four COPD patient groups classified according to their exercise capacity.

Methods: Ninety-one COPD patients (82 males, 9 females; average age, 69.7±6.8 years) underwent incremental CPET using a cycle ergometer. During CPET, we measured the patient levels of arterial blood gases, lactate, and catecholamines.

Results: We found that the pathophysiology of the COPD patients was different among the groups. Patients with severely reduced exercise capacity (peak oxygen uptake < 654 ml/min) were characterized by the following: (i) exercise-induced rapid decrease of arterial oxygen pressure (PaO2-slope: -7.8±7.0 mmHg/100 ml); (ii) sympathetic activation at low-grade workload (plasma norepinephrine level, 1.4±0.94 ng/ml at 20 W); (iii) little change in lactic acidosis; (iv) a limitation in the increase of ventilation; and (v) impaired gas exchange. The norepinephrine increase exhibited during exercise was significantly correlated (r = 0.94±0.08) with the dyspnoea ratings.

Conclusions: The COPD pathophysiology significantly varied among patients with different exercise capacities. Patients with lower exercise capacity suffered from severe gas exchange disorder, sympathetic overactivation, and ventilatory disturbance during exercise. CPET should consistently be performed to assess the factors that contribute to exercise limitation in COPD patients.
Ovarian and Papillary-Serous Peritoneal Carcinoma: Pilot Study With Thalidomide
Authors: N. Abramson, P. K. Stokes, Mathew Luke, Alan R. Marks, Jeffrey M. Harris
Journal: Journal of Clinical Oncology (2002)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2002.20.4.1147 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11844842 Ovarian and Papillary-Serous Peritoneal Carcinoma: Pilot Study With Thalidomide N. AbramsonxN. AbramsonSearch for articles by this author , P. K. StokesxP. K. StokesSearch for articles by this author , Mathew LukexMathew LukeSearch for articles by this author , Alan R. MarksxAlan R. MarksSearch for articles by this author , Jeffrey M. HarrisxJeffrey M. HarrisSearch for articles by this author Show More Baptist Cancer Institute, Baptist Medical Center, Jacksonville, FL https://doi.org/10.1200/JCO.2002.20.4.1147 First Page Full Text PDF Figures and Tables © 2002 by American Society of Clinical Oncology
Phase II study of paclitaxel, cisplatin, and 5-FU combination chemotherapy in patients with advanced gastric cancer
Authors: S. Cho, H. Shim, S. Lee, J. Ahn, D. Yang, Y. Kim, C. Park, J. Lee, I. Chung, H. Kim
Journal: Journal of Clinical Oncology (2007)

15052 Background: Taxane has been used widely in advanced gastric cancer, but toxicities are problematic. To avoid the bone marrow suppression, docetaxel could be replaced paclitaxel to reduce bone marrow suppression and to improve the efficacy, we planned to augmentation of the dose intensity. This phase II study evaluated the efficacy and safety of combination chemotherapy with paclitaxel, cisplatin, and 5-fluorouracil (5-FU) in advanced gastric cancer. Methods: Patients with histologically confirmed gastric adenocarcinoma, ECOG PS = 2, at least one measurable lesion and adequate organ functions were eligible. Paclitaxel (175 mg/m 2 ) and cisplatin (75 mg/m 2 ) were given as a 1-h intravenous infusion on day 1, followed by 5-FU (750 mg/m 2 ) as a 24-h continuous infusion for 5 days. This cycle was repeated every 3 weeks. Results: Forty-five eligible patients (median age 56 years) were treated in this way. Of the 41 patients in whom efficacy was evaluable, an objective response rate (ORR) was seen in 20 (48.8%), a complete response in two, and a partial response in 18 patients. The median time to progression was 6.9 months (95% CI, 5.86–7.94), and the median overall survival was 13.1 months (95% CI, 8.83–17.37). The main hematological toxicity was neutropenia and greater than grade 3 neutropenia was observed in 67 cycles (25%). Febrile neutropenia developed in three patients (7.3%). The major non-hematological toxicities were asthenia and peripheral neuropathy, but grade 3 or 4 toxicity was not seen. Conclusions: The combination chemotherapy with paclitaxel, cisplatin, and 5-FU is a promising regimen, and was well tolerated in patients with advanced gastric cancer. No significant financial relationships to disclose.
PDAC subtypes
Authors: Gemma K. Alderton
Journal: Nature reviews. Cancer (2015)

Growth rates and tumour evolutionWaclaw et al. sought to understand how tumours expand and become heterogeneous.First, they modelled expansion and tumour cell growth in a metastatic lesion and showed that stochastic growth most closely followed histopathological findings of metastatic lesions.Furthermore, they found that cell motility, and thus dispersal, within the tumour was important for determining cell division rates.Surprisingly, their data predict that without dispersal it could take 8 years for one cell to grow into one billion cells, whereas this would be 2 years for tumour growth involving dispersal.Next, they simulated tumour growth and mutation rates in response to therapy, and they showed that tumour cells that are able to migrate are likely to regrow more quickly.Finally, their model was also able to predict features of primary tumour growth that are observed histologically.Therefore, tumour cell migration within a tumour may expose cells to new environments that affect their fitness and thus their ability to divide.
Prospective analysis of prognosis in oncology patients with acute renal failure according to different organ failures
Authors: J. Lavilla, J. L. Perez-Gracia, A. Gurpide, N. Garcia-Fernandez, J. M. Lopez-Picazo, D. Pujante, A. Chopitea, A. P. Hernandez, J. Garcia-Foncillas, S. Martin-Algarra
Journal: Journal of Clinical Oncology (2005)

8150 Background: Acute Renal Failure (ARF) is a frequent cause of morbidity and mortality in cancer patients. The objective of this prospective study was to evaluate prognosis of ARF in these patients in relation to the presence of different organ failures. Methods: Cancer patients with ARF (>20% creatinine increase over baseline) were assessed. We collected clinical data (ARF etiology, underlying disease) and the commonly used renal prognostic score Liaño‘s Individual Severity Index (ISI). Statistical analysis was performed with SPSS 9.0 (chi-square, ANOVA, multiple regression analysis and logistic regression). Results: From January 1996 to April 2003, 444 patients were assessed. Mean age was 58 years and 65% were men. Distribution by tumor type was: genitourinary (34%), lung (13%), gastrointestinal (12%), skin (10%), breast (10%) and others (22%). Mortality rate was 19% and the main death causes were cardiovascular (60%) and respiratory diseases (23%). Renal replacement therapy was required in 19% and 25% had no renal recovery. Among variables included in ISI the following had prognostic influence in survival: oliguria (p=0.015; OR 2.61 [CI95% 1.2–5.6]), jaundice (p<0.001; OR 5.31 [CI95% 2.57–10.96]) and coma (p<0.001; OR 22.71 [CI95% 4.34–118.8]). Coma was the only independent variable (p<0.001; OR 53.2 [CI95% 22.4–126.38]). In patients without coma, survival corelated with need of mechanical ventilation (p<0.001; OR 8.02 [CI95% 3.6–18.4]), oliguria (p<0.001 OR 3.72 CI95% 1.84–7.52) and jaundice (p<0.001; OR 4.58 [CI95% 2.29–9.15]). The only independent variable was need of mechanical ventilation (p<0.001; OR 19.32 [CI95% 10.07–37.08]). In patients with jaundice, mortality rate was 51%; 34% required renal replacement therapy; and 40% had no renal recovery. In patients requiring mechanical ventilation mortality rate was 70%; 79% required renal replacement therapy; and 49% had no renal recovery. Conclusions: In cancer patients with ARF the presence of oliguria, coma, jaundice and mechanical ventilation, as defined in the ISI prognostic score, were associated with a worsened prognosis. Adequate preventive measures, early diagnosis and management are crucial in these patients. No significant financial relationships to disclose.
Neoadjuvant gemcitabine, erlotinib, and hypofractionated radiation therapy for potentially resectable pancreatic cancer: A pilot study
Authors: H. R. Cardenes, E. G. Chiorean, S. Perkins, J. DeWitt, C. M. Schmidt, P. Crowell, M. Yip-Schneider, N. Zyromski, H. Cramer, T. Howard
Journal: Journal of Clinical Oncology (2008)

15578 Background: Evaluation of feasibility and toxicity of neoadjuvant Gemcitabine, Erlotinib and hypofractionated radiotherapy in patients with potentially resectable pancreatic cancer (PC) and its effect on EGFR expression, cell proliferation and angiogenesis. Methods: Ten patients were enrolled in the study and received two weeks of Erlotinib, 100 mg/day/day), Gemcitabine (300 mg/m2/week) and hypofractionated Radiotherapy (3000 cGy, 10 fractions). Fresh tissue samples or paraffin blocks from preoperative FNA and postoperative surgical specimens were used for immunohistochemical (IHC) markers [EGFR, Ki67, Factor VIII and Apoptag]. Results: Mean patient age 61 years (range 49–72), 60% KPS ≥ 90%. One patient developed liver metastasis prior to surgery; another had surgery delayed due to hepatic abscess. The evaluable population included eight subjects completing the protocol. Preoperative staging: one IB, two IIA, five IIB patients. Extent of resection: six R0; 2 R2. Preoperative CTC grade 3–4 toxicities: liver dysfunction, nausea and vomiting and neutropenia, each in 1 patient. No adverse toxicities prevented any subject from surgical resection. Postoperative CTC grade 3 toxicities: hematological, 3 patients; 1 patient delayed gastric empting. There were no pathological complete responses. Two patients were downstaged; no changes in stage in 6 patients. No patients experienced progression at the time of surgery. Seven of 8 evaluable patients are still alive. Three patients developed liver metastasis and are receiving chemotherapy. Median follow up 10.7 months (range: 6.0–19.5). EGFR, Ki67 and Factor VIII expression in tumor cells was detectable in all surgical specimens. Only 5 patients had sufficiently cellular FNA cell blocks prior to therapy to make possible comparisons of correlates. In all cases, EGFR and Ki67 were increased in the surgical specimens relative to pre-treatment. FVIII was only evaluated in the surgical specimens. Conclusions: Neoadjuvant Gemcitabine, Erlotinib and hypofractionated radiotherapy is feasible and well tolerated. EGFR, Ki67 and Factor VIII expression in all surgical specimens make them valuable therapeutic targets in the adjuvant setting. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Genentech