tbuckley/cabot-search huggingface dataset:
Loop-and-let-go technique for a bleeding, large sessile gastric gastrointestinal stromal tumor (GIST)
Authors: A. Arezzo, M. Verra, A. Miegge, M. Morino
Journal: Endoscopy (2011)

A 77-year-old woman was admitted for syncope followed by melena. She was under oral anticoagulant therapy for atrial fibrillation. An urgent upper endoscopy revealed active oozing of blood from an ulcer crater on the surface of a 3.5-cm, sessile submucosal tumor at the gastric fundus. Endoscopic hemostasis was achieved by epinephrine injection and application of hemoclips ([Fig. 1]). Although surgical gastric wedge resection is considered the gold standard treatment for such lesions ≥ 2 cm in size, since the patient presented a high risk for general anaesthesia and recurrent bleeding as well as the need of further anticoagulant therapy, we were forced to consider endoscopic treatment. Endoscopic snare resection and submucosal dissection are associated with a significant risk of perforation [1]. Endoscopic band ligation technique has been described as effective for smaller lesions [2]. Another alternative, the endoloop technique, has also been recently reported as potentially effective, provided the loop is tightened around the base of the lesion, which results in tissue strangulation and slow mechanical transection of a gastrointestinal stromal tumor (GIST), that is, ischemic necrosis followed by spontaneous sloughing [3].
Ventricular Fibrillation during Carotid-Sinus Stimulation
Authors: Richard L. Porus, Frank I. Marcus
Journal: New England Journal of Medicine (1963)

CAROTID-sinus stimulation has proved to be an invaluable diagnostic and therapeutic tool. The response of a number of arrhythmias to its application is virtually diagnostic, and in paroxysmal atrial and nodal tachycardias, its use often results in the return of normal sinus rhythm.1 It may help to confirm the clinical impression of arteriosclerotic heart disease by the decrease in anginal pain that often follows carotid-sinus massage.2 Pulmonary edema has been reported to respond to its use.3 The transient slowing of the heart rate produced by carotid-sinus stimulation simplifies detection of heart sounds and murmurs.Reports of untoward neurologic effects of . . .
Abstract 1572: Influence of apc and med12 mutations on embryonic liver development in zebrafish: a potential model for investigating the role of Mediator in Wnt/β-catenin-dependent cancers.
Authors: Chamille J. Lescott, Eric Glasgow
Journal: Cancer Research (2013)

Abstract Mutations in adenomatus polyposis coli (APC) result in overactive Wnt signaling and have been linked to colon cancer and hepatoblastoma in humans. Therefore, the Wnt pathway is an attractive target for developing cancer therapeutics. APC directs β-catenin degradation; thus, APC loss results in β-catenin accumulation and an increase in β-catenin-induced transcription. Heterozygous apc mutant zebrafish present enlarged livers at 3 days post-fertilization, and as adults they are predisposed to tumor development. Recently, the Mediator co-activator complex component, Med12, was linked to Wnt signaling. Without med12, canonical Wnt/β-catenin signaling is significantly impaired. We hypothesized that heterozygous med12 mutants will have smaller livers due to a decrease in Wnt activity. Moreover, a reduction in Wnt/β-catenin signaling due to lower levels of Med12 in double heterozygous med12;apc mutant embryos will be sufficient to rescue the large liver phenotype observed in heterozygous apc mutant embryos. In situ hybridization with lfabp probe confirmed the increased liver size in apchu745/+ embryos and showed smaller livers in med12y82/+ embryos. Importantly, the med12y82/+ mutation rescued the large liver phenotype of apchu745/+ embryos. The data suggest that med12 and apc genetically interact to regulate liver development. This interaction between med12 and apc is also likely to also play a role in the development and progression of Wnt/β-catenin-dependent cancers. Therefore, rescue of liver hyperplasia in apc mutants may serve as a model for developing anti-cancer drugs targeting WNT/β-catenin signal transduction through its interaction with MED12. Citation Format: Chamille J. Lescott, Eric Glasgow. Influence of apc and med12 mutations on embryonic liver development in zebrafish: a potential model for investigating the role of Mediator in Wnt/β-catenin-dependent cancers. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1572. doi:10.1158/1538-7445.AM2013-1572 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.
Plasmodium knowlesi infection imported to Germany, January 2013
Authors: A Bart, J J van Hellemond, P J van Genderen, T Van Gool
Journal: Eurosurveillance (2013)

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AB0488 Antimalarials in the Treatment of Systemic Lupus Erythematosus in Denmark - A Nationwide Register Based Cohort Study
Authors: J.C. Nørgaard
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Background</h3> Evidence based international guidelines for the treatment of systemic lupus erythematosus (SLE) recommend anti-malarias (AMs) are taken by all SLE patients irrespective of disease activity. Only few studies have investigated the use of AMs among newly diagnosed patients with SLE. <h3>Objectives</h3> To analyze prescription patterns of AMs in newly diagnosed SLE patients in Denmark for the years 2000 -2011. <h3>Methods</h3> Using The Danish Prescription Register (DNPR) we conducted a nationwide Danish cohort study including all patients with a first time diagnosis of SLE (The Danish National Registry of Patients (NPR)). We used Kaplan-Meier estimates to compute the cumulative probability of starting AM treatment within a year and Cox regression analysis to compare time to treatment between patient groups. <h3>Results</h3> AMs were prescribed to 37.7% of the newly diagnosed SLE patients within the first year of follow-up. Approximately 20% did not receive any treatment. Women were more likely than men to start AM (adjusted HR of 1.26 (95% CI 1.06-1.50)). Patients diagnosed with SLE between in 2005-2011 were more likely to start treatment than patients diagnosed in 2000-2004 (HR of 1.33 (95% CI 1.17-1.51)). Patients with renal disease were less likely to start AM treatment than patients without this condition (adjusted HR of 0.67 (95% CI 0.56-0.83)). Current users of prednisolone were more likely to start AM treatment than non-users ((adjusted HR 1.93 (95% CI 1.68-2.23). <h3>Conclusions</h3> Our results showed that more Danish SLE patients should be prescribed AMs, especially patients with renal disease, to be in agreement with evidence based international guidelines. <h3>Acknowledgements</h3> For making this project possible, we wish to thank the following institutions: Institute of Clinical Medicine, Aarhus University. Department of Rheumatology, Aarhus University Hospital. Department of Clinical Epidemiology, Aarhus University Hospital and Gigtforenningen. There were no conflicts of interest. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.2951
Serum Immunoglobulins in the Nephrotic Syndrome
Authors: Joseph Giangiacomo, Thomas G. Cleary, Barbara R. Cole, Philip Hoffsten, Alan M. Robson
Journal: New England Journal of Medicine (1975)

To assess immunologic factors in the pathogenesis of idiopathic minimal-change nephrotic syndrome (INS), serum immunoglobulin concentrations were measured in 37 children with this syndrome and compared with those found in 36 with nephrotic syndrome secondary to chronic glomerulonephritis (CGN). Serum IgG and IgA levels were significantly reduced in nephrotic patients with either INS or CGN, IgG averaging 18.5 and 25.9 per cent of normal (P less than 0.001) and IgA 59.8 and 44.1 per cent of normal (P less than 0.01) respectively. Values increased after treatment of INS with prednisone, but mean values remained low. Serum IgM concentrations in INS averaged more than twice normal before, during, and after successful treatment with steroids. Patients with CGN did not have equivalent elevations of serum IgM. Thus, the primary defect in INS may be immunologic and could consist of deficiency in the T-cell function that mediates conversion of IgM synthesis to IgG synthesis.
PTH-028 Is Flexible Sigmoidoscopy ever Enough? an Audit of the Rates of Proximal Disease During Colonoscopy
Authors: S Macdonald, S Radhakrishnan, E Seward
Journal: Gut (2013)

<h3>Introduction</h3> There is debate about appropriate initial endoscopic investigation of patients with symptoms suggestive of colorectal cancer. Thompson (2008) proposed that for patients without iron deficiency anaemia or abdominal mass; Flexible Sigmoidoscopy (FS) should be first line with further colonoscopy only if significant distal colonic disease was detected. A proximal cancer miss rate of 1:500 patients over 60 years and 1:3000 below this age was reported. It was argued that this approach would significantly reduce costs and burden on patients. However Lieberman (2000) reported 2.7% of asymptomatic patients screened with colonoscopy had proximal neoplasms without distal disease. We have applied the Thompson criteria to our unit’s colonoscopy data to establish the rate of disease, both neoplastic and other, proximal to the splenic flexure which would have been missed by performing FS alone. <h3>Methods</h3> All colonoscopies performed in our unit over 2 months were examined and those which met the Thompson criteria for FS were included. The procedure and pathology reports were reviewed and the number with proximal but without distal disease, and type of pathology was established. Adenoma with low grade dysplasia (LGD) was the minimum classification for neoplasm. <h3>Results</h3> 342 colonoscopies were reviewed and 200 met the Thompson criteria for FS. 17 (8.5%) patients had proximal disease without distal disease, of which 9 (53%) were neoplastic and 8 (47%) had significant other disease (87.5% inflammatory). Of the 82 patients &gt; 60 years, it was found that 10 (12.1%) had significant disease, of which 8 (80%) were neoplastic (6 tubular adenoma with LGD, 2 tubulovillous adenoma with LGD). Of the 118 &lt; 60 years, 7 (5.9%) had significant disease (85% inflammatory) and 1 (15%) neoplastic. <h3>Conclusion</h3> 4.5% of patients who would have had a FS using Thompson criteria were found to have a proximal neoplasm. This is considerably higher than initially reported and more in keeping with data from colonoscopic bowel screening. When examined by age, nearly 1:10 patients over 60 years would have had a missed proximal neoplasm. This rate was 1:100 for those who were under 60 years. A considerable volume of proximal non-neoplastic disease, mainly inflammatory, would also be missed with FS examination (1:20 patients under 60 years). This study supports the use of colonoscopy for first line investigation of all patients with symptoms suggestive of colorectal cancer. <h3>Disclosure of Interest</h3> None Declared. <h3>References</h3> Lieberman MD, Weiss DG, Bond JH,<i> et al.</i> Use of colonoscopy to screen asymptomatic adults for colorectal cancer.<i> The New England Journal of Medicine</i> 2000; 343: 162–168. Thompson MR, Flashman KG, Wooldrage K, <i>et al.</i> Flexible sigmoidoscopy and whole colonic imaging in the diagnosis of cancer in patients with colorectal symptoms. <i>British Journal of Surgery</i>; 95:1140–1146.
Abstract 425: Fractionated radiation-induced tumor suppressor microRNAs in human prostate carcinoma cells.
Authors: C. Norman Coleman, Molykutty John-Aryankalayil, Adeola Y. Makinde, Sanjeewani T. Palayoor
Journal: Cancer Research (2013)

Abstract To understand the role of microRNAs (miRNA) in regulation of radiation-induced gene expression and to help define potential radiation-inducible targets, miRNA expression was studied in wild type p53 LNCaP and p53-mutated PC3 and DU145 cells. We have previously investigated the changes in the molecular profiles of tumor cells that were exposed to single dose (SD) versus fractionated radiation (MF) in vitro, and identified immune and stress response pathways that were induced by fractionated but not single dose radiation. Methods: Cells were exposed to 5Gy and 10Gy either as SD or MF radiation radiation. Microarray analyses were done using human Agilent miRNA Microarray Kit (V2). Data were analyzed using Gene Spring software. Validation of the miRNA expression and gene expression of miRNA targets was evaluated by real-time RT-PCR analysis. Target filter analysis of differentially expressed miRNAs (&amp;gt;1.5 fold change and p value&amp;lt;0.05) and their mRNA targets were done. Results: Microarray analyses revealed that radiation differentially expressed 84, 68 and 8 miRNAs with high confidence (&amp;gt;1.5fold change, p&amp;lt;0.05) in LNCaP, PC3 and DU145 cells, respectively. MF radiation affected more miRNAs than SD radiation in all cell lines. In LNCaP and PC3 cells, MF radiation upregulated tumor suppressor microRNAs miR-34a, miR-200, miR-135, miR-221 and let7. Baseline expression of miR-34a was markedly reduced in PC3 cells and DU145 cells compared to LNCaP cells. However, miR-34a was upregulated by fractionated irradiation in LNCaP and PC3 cells, but not in DU145 cells. RT_PCR analysis of 22 experimentally verified miR-34a targets, showed distinct expression patterns in PC3 and LNCaP cells 6 and 24 hours after radiation. An inverse correlation of NOTCH1, E2F5 and MDM4 expression was observed in PC3 cells 6 and 24 hours after MF but not in LNCaP cells. On the other hand, IFNB1 showed an inverse correlation only in LNCaP cells. Majority of the differences in the expression patterns of miR-34a targets were at 24 hours after MF. Conclusion: Differences in the miRNA expression exist between cell lines and after varying radiation regimens. Among the three prostate carcinoma cell lines, tumor suppressor miRNAs are upregulated after MF radiation in LNCaP and PC3 cells. Currently, we are in the process of modulating miRNAs and their targets to examine their effects on radio sensitivity. This work was supported by the Intramural Research Program of the NIH, NCI, CCR. Citation Format: C. Norman Coleman, Molykutty John-Aryankalayil, Adeola Y. Makinde, Sanjeewani T. Palayoor. Fractionated radiation-induced tumor suppressor microRNAs in human prostate carcinoma cells. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 425. doi:10.1158/1538-7445.AM2013-425
P1250 CHARACTERIZATION AND MANAGEMENT OF HEPATIC AND RENAL CYST INFECTION PATIENTS – A MULTICENTER RETROSPECTIVE STUDY
Authors: M.A. Lantinga, T.J.G. Gevers, R.G.L. de Sévaux, W.J.G. Oyen, J.W. de Fijter, D. Soonawala, M. Salih, E. Meijer, R.T. Gansevoort, J.P.H. Drenth
Journal: Journal of Hepatology (2014)
Feasibility and Incremental Benefit of Puffed-Cheek 18F-FDG PET/CT on Oral Cancer Patients
Authors: Chih-Yung Chang, Bang-Hung Yang, Ko-Han Lin, Ren-Shyan Liu, Shyh-Jen Wang, Wei-Jen Shih
Journal: Clinical Nuclear Medicine (2013)

The complexity of small oral cavity and intimate apposition of the oral cavity mucosal surfaces make CT identification of obvious masses difficult. Puffed-cheek CT improves the evaluation of oral cavity lesions. We used the puffed-cheek maneuver with 18F-FDG PET/CT scans to determine the feasibility and accuracy in clinical practice and to identify any benefits.Twenty-two patients with oral cancer were included. They were instructed to perform the puffed-cheek maneuver after a conventional 18F-FDG PET/CT scan. Two physicians reviewed the puffed-cheek and conventional 18F-FDG PET/CT images and achieved consensus about the cancer extent, location, and dental artifacts before classifying and grading the oral cancers. Dichotomous results of localized or extended cancer and artifact grading scores from the puffed-cheek and conventional 18F-FDG PET/CT methods were compared using McNemar test and the Wilcoxon signed-rank test. P < 0.05 was considered significant.The puffed-cheek maneuver with 18F-FDG PET/CT was practical and had incremental benefits. The conventional 18F-FDG PET/CT classified 12 patients correctly as having localized or extended cancer, and the puffed-cheek 18F-FDG PET/CT classified 21 patients correctly. Puffed-cheek 18F-FDG PET/CT found a synchronous skip cancer and provided detailed cancer delineation. This method might reduce the effects of dental artifacts without undesirable muscular FDG uptake.Puffed-cheek PET/CT is feasible in the current clinical setting and can improve the delineation of oral cancer extent and location, with a potential benefit of reducing dental artifacts.
Abstract 595: Single adenovirus-mediated simultaneous expression of p53 and the artificial microRNAs targeting anti-apoptotic p53 target genes
Authors: Masashi Idogawa, Yasushi Sasaki, Kohzoh Imai, Yasuhisa Shinomura, Takashi Tokino
Journal: Cancer Research (2010)

Abstract Gene transfer involving p53 is viewed as a potentially effective cancer therapy, but does not result in a good therapeutic response in all human cancers. Several p53 target genes have an inhibitory effect on p53-mediated apoptosis. Therefore, if the induction of these genes by p53 is selectively suppressed, the therapeutic effectiveness would be improved. In previous study, we constructed a replication-deficient recombinant adenovirus that encoded co-cistronic p53 and artificial microRNAs (miRNAs) targeting p21, a representative p53 target gene which have an anti-apoptotic effect, resulting in p53 expression and the suppression of p21 induction simultaneously. In colorectal and hepatocellular carcinoma cells, infection with the adenovirus vector augmented apoptosis and suppressed tumor growth as compared to an adenovirus that expressed p53 alone in vitro and in vivo. In this study, we additionally inserted miRNA sequences targeting other anti-apoptotic genes such as MDM2 to the vector and evaluated the therapeutic effectiveness of p53 expression in combination with the suppression of several anti-apoptotic p53 target genes. Infection with the vector suppressed the induction of anti-apoptotic target genes and induced apoptosis more efficiently in cancer cells. These results suggest that adenovirus-mediated transduction of p53 and miRNAs targeting anti-apoptotic p53 target genes is useful for therapy of human cancers. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 595.
A Retrospective Analysis of Risk Factors of Central Nervous System Metastases in Operable Breast Cancer: Different Survival by Biological Subtype and Ki67 Overexpression.
Authors: M. Ishihara, H. Mukai, M. Onozawa, K. Nihei, T. Shimada, N. Wada, S. Nagai
Journal: Cancer Research (2009)

Abstract Background: New agents have improved systemic disease control, but the control of central nervous system (CNS) metastases is still insufficient. The identification of factors that may predispose to CNS metastases may help lead to earlier detection possibly to improvement in disease management.Methods: Patients (pts) with metastatic who were diagnosed with clinical stage I-III primary breast cancer at National Cancer Center Hospital East from January 2003 to December 2005 were screened. All pts with CNS metastases were identified by CT or MRI. Cox proportional hazards models were fitted to find risk factors of CNS metastases. Factors included age, menopausal status, clinical stage, T stage, histological grade, lymphovascular invasion, hormone and HER2 status, and Ki67 (at least 30% tumor cells positive). Survival was calculated by the Kaplan-Meier method.Results: Median follow-up from operation was 53.5 months. Of 591 breast cancer pts, 76 pts (12.9%) relapsed. Seventeen pts (2.9%) developed CNS metastases; 5 pts developed as the first recurrence site. Multivariable analysis indicated the higher risk for developing CNS metastases were triple negative (TN) tumors (HR 5.532, 95% CI 1.445-21.180, p=0.013) and Ki67 overexpression (HR 3.906, 95% CI 1.179-12.939, p=0.026). There were no statistically significant differences in other factors. CNS metastasesCumulative incidence of CNS metastases (4 yrs)Median duration to CNS metastases (Months)Overall survival (4 yrs)Disease free survival (4 yrs)TN9.7% (9/93 pts)9.4%11.378.5%73.3%HER2 positive3.7% (4/107 pts)4.4%20.391.0%84.9%Others1.0% (4/391 pts)0.8% (p&amp;lt;0.0001)24.197.5% (p&amp;lt;0.0001)92.4% (p&amp;lt;0.0001) Ki67 ≥30%8.6% (12/140 pts)9.4%12.382.4%75.0%Ki67 &amp;lt;30%1.1% (5/446 pts)0.7% (p&amp;lt;0.0001)23.996.7% (p&amp;lt;0.0001)92.0% (p&amp;lt;0.0001) Discussion: In our analysis, TN or Ki67 overexpression breast cancer showed earlier CNS metastases and shorter overall survival. In case of these tumors, there is higher probability for early detection of limited CNS metastatic involvement. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6053.
1088 RATES AND PREDICTORS OF SUSTAINED VIROLOGICAL RESPONSE AND RELAPSE IN ITALIAN NAIVE MONO-INFECTED CHRONIC HEPATITIS C PATIENTS TREATED WITH PEGINTERFERON ALFA/RIBAVIRIN: PROPHESYS 2 FINAL ANALYSIS
Authors: A. Ascione, G. Carosi, A. Mangia, M. Puoti, A. Orlandini, C. Coppola, M. Schmitz, C. Golotta, M. Rizzetto
Journal: Journal of Hepatology (2012)
AB0516 Characteristics and treatment response of patients with axial spondyloarthritis (axspa) starting with sulfasalazine (ssz) or tnf-inhibitor (tnfi) as the first dmard.
Authors: K. M. Fagerli, D. van der Heijde, M. S. Heiberg, E. Rødevand, A. Wierød, K. Mikkelsen, S. Kalstad, T. K. Kvien, E. Lie
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> In the current recommendations for ankylosing spondylitis, SSZ is considered a treatment option in patients (pts) with peripheral disease (1), although it is widely accepted, and recently confirmed (2), that TNFi is superior to SSZ. <h3>Objectives</h3> Characterize baseline differences in pts with axSpA who received TNFi or SSZ as their 1<sup>st</sup> DMARD, and secondly, to compare the response to TNFi between pts who were DMARD naïve to those who had previously received SSZ. <h3>Methods</h3> Data is from NOR-DMARD, a Norwegian multicentre observational study of pts receiving DMARDs. DMARD-naive pts with a clinical diagnosis of axSpA (ICD-10: M45, M46.1, M46.8 or M46.9) starting SSZ or a TNFi were included. Among the SSZ-pts, those who later switched to a TNFi were identified. Selected outcome measures were patient global, SF-6D and ASDAS, BASDAI and ASAS responses. For comparisons independent t-test, Mann-Whitney U test, and Chi-square test were used. <h3>Results</h3> We included 181 pts receiving SSZ as their 1<sup>st</sup> DMARD, of whom 66 later switched to a TNFi, and 543 pts receiving a TNFi as 1<sup>st</sup> DMARD. Pts receiving SSZ as their 1<sup>st</sup> DMARD were younger, more often female, had shorter disease duration and more swollen joints, but had similar disease activity (table). At start of TNFi in the SSZ-switchers, disease duration and activity were similar to those who received TNFi as their 1<sup>st</sup> DMARD (except more joint swelling). Response to TNFi was similar in the two groups (table). <h3>Conclusions</h3> The use of SSZ did not seem to delay treatment with TNFi, as disease duration and activity was similar in those receiving TNFi as 1<sup>st</sup> DMARD and those who had first received SSZ, nor did response to TNFi appear to be impaired by prior SSZ-use. <h3>References</h3> Braun J <i>et al.</i> Ann Rheum Dis 2011;70:896–904. Braun J e<i>t al</i>. J Rheumatol 2012;39:836-40. <h3>Disclosure of Interest</h3> None Declared