tbuckley/cabot-search huggingface dataset:
BMET-30ACCURACY OF SCREENING FOR BRAIN METASTASES WITH WHOLE-BODY FDG PET IN INITIAL STAGING OF NON-CENTRAL NERVOUS SYSTEM MALIGNANCY
Authors: Rutvij Shah, Jason Johnson, Eric Rohren, Dawid Schellingerhout
Journal: Neuro-Oncology (2015)

BACKGROUND: Fluorodeoxyglucose (FDG) positron emission tomography (PET) is often used in the initial staging of non-CNS primaries to detect distant metastases. Previous studies suggested moderate sensitivity in detecting brain metastasis; however, samples sizes were small to modest. We chose to evaluate FDG-PET in a larger sample of patients to better assess the sensitivity in detecting brain metastases. METHODS: We retrospectively evaluated 172 adult patients with a variety of non-CNS primaries undergoing FDG-PET of the whole body (from vertex to at least mid-thigh) and MRI of the brain with a maximum interval of 30 days. Studies were acquired between January-2010 to March-2015. The presence of brain metastases for each imaging method was assessed. We excluded primary CNS malignancies, lymphoma, H&N primaries(except melanoma) and test intervals greater than 30 days. No patients were treated with surgery, radiation or chemotherapy in between the studies. Statistical analysis was done by Pearson chi-square test. RESULTS: Of 172 patients majority were: non-small cell(65) and small cell(23) lung carcinoma, melanoma(39), breast(13), unknown primaries(4) and renal cell carcinoma (3). PET and MRI revealed 47 and 75 cases with brain metastasis respectively. Overall sensitivity and specificity of PET in detecting brain metastases with the reference of MRI brain was 54.7% and 93.8% respectively. PPV and NPV of PET were 87.2% (95%CI: 74.8%- 94%) and 72.8% (64.4%-79.8%) respectively. Pre-test probability (prevalence) was 43.6% and accuracy of the PET was 76.7%. Pearson chi-square test is 50.06 and it is statistically significant with p-value < 0.00001. Pearson correlation coefficient between tests is 0.54. CONCLUSION: Sensitivity of FDG-PET in our evaluation is 54.7% sensitivity for brain metastasis compared to MRI brain. Our finding is similar to previously reported sensitivities. More sensitive screening FDG-PET protocols need to be employed (such as dedicated brain table position and/or MR/PET registration) to rely on FDG-PET as a screening method for the brain.
First case of bacteremic liver abscess caused by an ST260-related (ST1861), hypervirulent Klebsiella pneumoniae
Authors: Fabio Arena, Teresa Spanu, Lucia Henrici De Angelis, Flora Marzia Liotti, Marco Maria D'Andrea, Giulia Menchinelli, Flavio De Maio, Gian Maria Rossolini
Journal: Journal of Infection (2016)
Enhancement of Urethan Tumorigenesis in Mouse Lung by Butylated Hydroxytoluene2
Authors: Hanspeter Witschi, Diane Williamson, Simon Lock
Journal: JNCI Journal of the National Cancer Institute (1977)

Intraperitoneal injection of the antioxidant butylated hydroxytoluene (BHT) produces cell proliferation in mouse lungs within 2-4 days. We examined whether the presence of an increased number of proliferating lung cells would influence urethan tumorigenesis. Male Swiss-Webster mice were treated with 1 mg urethan/g before, during, or after BHT-stimulated cell growth in the lung. The number of pulmonary tumors found 13-15 weeks later was not different in BHT-treated mice compared to that in controls. On the other hand, repeated stimulation of cell growth after urethan treatment enhanced tumorigenesis. Male Swiss-Webster and A/J mice were given a single dose of urethan (1 mg/g) and, beginning 7 days later, weekly injections of BHT or corn oil. Repeated injections of BHT significantly increased the yield of lung tumors in both strains. Weekly injections of BHT into mice pretreated with 0.9% NaCl reduced the number of spontaneous pulmonary adenomas.
BMET-35CERITINIB IN ALK+ NSCLC METASTATIC TO BRAIN AND/OR LEPTOMENINGES: THE ASCEND-7 STUDY
Authors: Patrick Yung Wen, Fabrice Barlesi, Erin M. Bertino, Dong-Wan Kim, Martin J. van den Bent, Heather Wakelee, Pilar Cazorla Arratia, Junwu Shen, Fabrice Branle, Laura Q. Chow
Journal: Neuro-Oncology (2015)
GENO-29MUTATIONAL DIVERSITY UNDERLYING TELOMERE MAINTENANCE MECHANISMS IN AN APPRECIABLE FRACTION OF ADULT GLIOMAS
Authors: Juhi Ojha, Margaret Wrensch, Melike Pekmezci, Helen Hansen, Terri Rice, Lucie McCoy, Nils Madsen, Tarik Tihan, Mitchel Berger, Susan Chang, Michael Prados, Joseph Wiemels, Kyle Walsh, John Wiencke
Journal: Neuro-Oncology (2015)

Somatic alterations in the TERT promoter and in ATRX facilitate telomere maintenance and permit glial cells to escape replicative senescence. We assessed the mechanism of telomere maintenance in 452 infiltrative adult gliomas (WHO Grades II-IV) from the UCSF Adult Glioma Study. Hotspot mutations in the TERT promoter were detected by Sanger sequencing, while ATRX mutations were identified by immunohistochemistry. In total, 267 gliomas were classified as “TERT-mutated” (59%), 127 as “ATRX-mutated” (28%), and 58 as “TERTwt/ATRXwt” (13%). To identify the mechanism of telomere maintenance in these 58 TERTwt/ATRXwt gliomas, we designed a custom-sequencing panel targeting 36 genes with known roles in telomere biology. Parallel high-depth sequencing was performed, covering introns, exons and 15kb flanking regions on 5′ and 3' ends. Ten TERTwt/ATRXwt glioma specimens and matched-normal controls have been sequenced to-date, to an average depth of 250X. In 2 cases we identified a missense mutation of ATRX (p.R2197C and p.H1767D). In-silico functional analyses predict these to be highly-damaging mutations. This was confirmed by FISH, which revealed the presence of the Alternative Lengthening of Telomeres (ALT) phenotype. These ATRX mutations are located in a helicase ATP-binding and a helicase C-terminal domain, respectively, and likely lead to the expression of a non-functional ATRX protein that appears wild-type by IHC. We also identified a subclonal TERT C250T mutation in a 47 year-old glioblastoma patient with no IDH mutation. A fourth case had several somatic alterations of potential interest, including a highly clonal mutation in the Regulator of Telomere Elongation Helicase 1 (RTEL1) gene. Results from the first ten TERTwt/ATRXwt gliomas are promising and suggest a greater diversity of mutation types than can be revealed through simple Sanger sequencing or immunohistochemistry. Extension of these preliminary findings to a larger number of TERTwt/ATRXwt glioma cases is ongoing.
OC-084 Clinical significance of anorectal excitatory reflex (rectal contraction) in controls and patients with faecal incontinence
Authors: K Elgendy, A Farag
Journal: Gut (2015)

<h3>Introduction</h3> <h3>Aim </h3> To study the response of the rectum to the voluntary squeeze of anal sphincters in normal controls in comparison with patients with faecal incontinence. <h3>Method</h3> Lower rectal diameter and intrarectal pressures are recorded during rest and squeeze by lateral view evacuation proctography (defecography) and anorectal manometry in 35 normal controls and in 35 patients with faecal incontinence. <h3>Results</h3> 26 and 27 out of 35 patients in each group were males, with average age of 39 years old. There is highly significant difference in resting rectal pressure (RRP) and squeeze rectal pressure (SRP) and resting rectal diameter (RRD) and squeeze rectal diameter (SRD) in normal controls (p &lt; 0.01). There is also significant correlation between the change in rectal diameter and rectal pressure (p = 0.02). No significant different in RRD and SRD in group of patients complaining of faecal incontinence (p = 0.095), with no correlation between the change in rectal pressure and diameter (0.0727). There is no significant difference in RRP (p = 0.169). There is highly significant difference in SRP (p &lt; 0.01), change in rectal pressure (p &lt; 0.01) and change in rectal diameter (p &lt; 0.01). There was delay in the rectal pressure of average of 1.1 sec (0.5–1.4) between the squeeze and rectal pressure, suggestive of retrograde anorectal wave. <h3>Conclusion</h3> The rectal contraction during squeeze (rather than inhibitory, as suggested before) may allow retrograde evacuation of the rectum and delayed defecation in normal controls. This act is weak in incontinence group which may contribute to pathophysiology in those patients. <h3>Disclosure of interest</h3> None Declared.
Differential Sensitivity of Metastatic Versus Nonmetastatic Mammary Tumor Cells to Macrophage-Mediated Cytostasis&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: K Yamashina, A Fulton, G Heppner
Journal: JNCI Journal of the National Cancer Institute (1985)

Sensitivity to macrophage-mediated cytostasis was determined with 4 tumor cell lines derived from a single, spontaneously arising mouse mammary tumor. Cytostasis was measured in a 48-hour [3H]thymidine-incorporation assay with the use of maleic vinyl ether (pyran) fraction 2 (MVE-2)-elicited peritoneal macrophages as effector cells. Metastatic tumor lines 66 and 410.4 were less sensitive than nonmetastatic lines 67 and 168. Pretreatment of tumor cells with indomethacin for 24 hours before assay increased the cytostatic sensitivity of the metastatic tumor lines but did not affect that of the non metastatic tumor lines. Addition of 100 ng lipopolysaccharide (LPS)/ml to the assay mixture of MVE-2-primed macrophages and tumor cells or pretreatment of macrophages with LPS markedly lessened the differences in cytostatic sensitivity among the metastatic and non metastatic lines. Pretreatment of tumor cells with indomethacin plus addition of LPS during the effector phase of the assay completely abrogated differences in sensitivity. These results suggest that differences in sensitivity of metastatic versus nonmetastatic tumor cells to macrophage cytostasis are due to both tumor cell (prostaglandin) and effector cell (activation state) factors.
Contribution of Lead to Hypertension with Renal Impairment
Authors: Vecihi Batuman, Elaine Landy, John K. Maesaka, Richard P. Wedeen
Journal: New England Journal of Medicine (1983)

Hypertension of unknown cause is generally termed "essential." Because hypertension has long been considered a possible complication of lead poisoning and the EDTA lead-mobilization test has proved to be a sensitive indicator of excessive body stores of lead, we used this test to evaluate cumulative past lead absorption in 48 men diagnosed as having essential hypertension. Patients who had hypertension with reduced renal function (i.e., serum creatinine level greater than 1.5 mg per deciliter [133 mumols per liter]) had significantly larger amounts of mobilizable lead than did patients who had hypertension without renal impairment. The increase in mobilizable lead was not due to the renal disease itself, since 22 control patients without a history of essential hypertension but with comparable renal impairment from known causes excreted significantly less lead chelate during the three-day test. These data suggest that lead may have an etiologic role in the renal disease of some patients usually designated as having "essential" hypertension.
Lymphangitis after Self-Administration of Lipopolysaccharide
Authors: Neeraj K. Surana, Joseph W. St. Geme
Journal: New England Journal of Medicine (2005)

To the Editor: Acute lymphangitis is caused most often by Streptococcus pyogenes and occasionally by a range of other bacteria.1 We describe a patient in whom acute lymphangitis developed, with no evidence of infection. The patient was a 27-year-old medical student who was working in the laboratory and was resuspending membranes isolated from lysed Escherichia coli when he accidentally stabbed his left index finger with a contaminated needle. Within an hour, he noted pain and swelling in his left hand. Over the next several hours, tenderness in his left arm and axilla developed, and then red streaks extending from the . . .
Treatment and Prophylaxis of Pulmonary Embolism by Vein Interruption
Authors: Marion Lee Connerley, John H. L. Heintzelman
Journal: New England Journal of Medicine (1949)

FOR the years 1944 and 1945, an average of 1 to 3 patients died each month at the United States Naval Hospital, Chelsea, Massachusetts, as a result of pulmonary embolism. The diagnosis in 17 of these patients was substantiated by autopsy. It therefore became apparent that some form of treatment must be instituted in an attempt to reduce the toll claimed by this scourge of surgical procedure in New England. In an effort to obtain some useful data that might be a contribution to this problem in general, a regime consisting of interruption of femoral, iliac or inferior-vena-cava venous pathways . . .
Challenge of China’s rural health
Authors: Jun Han, Meng-Chao Wu, Tian Yang
Journal: BMJ (2016)

Rural health has been sacrificed for economic prosperity 

Although China has created an economic miracle over the past 30 years, the resulting adverse effects have become a thorny problem for the entire nation. People living in rural areas, where mortality remains substantially higher than in urban areas, have been hardest hit.

One of the main reasons is the rising tide of industrialisation and urbanisation that drives factories and other sources of pollution from urban areas to rural areas, seriously contaminating the water, air, and land and threatening the health of rural residents.1 Tuberculosis, malaria, bird flu, and other infectious diseases have staged a comeback in some rural areas, and the incidence of various malignancies keeps rising.1 One report identifies 459 official and unofficial “cancer villages” across 29 of the 31 provincial administrative units …
Screening for depression in geriatric medical patients
Authors: J T Okimoto, R F Barnes, R C Veith, M A Raskind, T S Inui, W B Carter
Journal: American Journal of Psychiatry (1982)

Depression, a common and treatable psychiatric disorder in later life, is often overlooked in geriatric medical patients. The authors evaluated the validity of two self-rating depression scales, the Zung Self-Rating Depression Scale and the Popoff Index of Depression, for 55 elderly patients. They compared these ratings with the diagnosis assigned by a psychiatrist who was blind to scale results and who interviewed these patients using DSM-III criteria. The two scales correctly classified 80% and 69% of the subjects, respectively. The authors identify six items from the two scales that may serve as a simple screening instrument for the detection of depression in geriatric medical patients.
Zomepirac Sodium in the Treatment of Primary Dysmenorrhea Syndrome
Authors: Penny Wise Budoff
Journal: New England Journal of Medicine (1982)

Zomepirac sodium was compared with placebo for relief of primary dysmenorrhea syndrome in a double-blind, crossover study of 47 patients. The agents were taken in three separate crossovers during six menstrual periods. Abdominal cramping and 25 other symptoms of dysmenorrhea syndrome were evaluated daily. Zomepirac was significantly more effective than placebo in relieving 12 of 13 primary symptoms and 6 of 13 associated symptoms (P less than or equal to 0.05). While taking zomepirac, patients were able to continue normal activities on a significantly higher proportion of days (P less than 0.001) and required supplemental analgesics significantly less often (P less than 0.001). Zomepirac was well tolerated by these patients. Gastrointestinal disturbances accounted for the largest proportion of adverse effects from either agent. These results indicate that zomepirac gave excellent relief of the symptoms of dysmenorrhea in this study population.
Treatment of Short Stature in Children and Adolescents with Human Pituitary Growth Hormone (Raben)
Authors: Lester F. Soyka, Alan Ziskind, John D. Crawford
Journal: New England Journal of Medicine (1964)

THE availability of an active, growth-promoting hormone, extracted from human pituitary glands, has added a potent, useful and in fact unique substance to the physician's therapeutic armamentarium. Since the original preparation by Li and his coworkers1 and by Raben2 its growth-promoting effectiveness in hypopituitary dwarfs has been amply confirmed.3 4 5 6 7 As with all new agents it was hoped that human growth hormone (HGH, or somatotropin) would prove itself useful in a wide range of growth and metabolic disorders. Short stature is a common problem in pediatrics.8 It is a field in which many proposed therapies have proved to be valueless or . . .
Limitations of Lymph Node Counts as a Measure of Therapy
Authors: Scott M Gilbert, Brent K Hollenbeck
Journal: Journal of the National Comprehensive Cancer Network (2009)

For several cancers, the number of lymph nodes removed during surgery is associated with survival. Observational studies supporting this association have prompted considerable debate regarding the extent of lymphadenectomy, and in some dieases, absolute lymph node counts have been suggested as a measure of the quality of cancer care. However, for most cancers, lymph node counts may not directly influence survival in a causal manner. In fact, several randomized clinical trials addressing the question in lung, gastric, and pancreatic cancers have not shown more extensive lymph node dissections to be linked with improved survival. Despite this negative evidence, however, lymph node counts have remained a target process in quality initiatives. Misinterpretation of the evidence may be driving some of the pressure to broadly implement more extended lymph node dissections. As a process for more accurate disease staging and as a potential marker for the completeness of surgery, lymph node counts are likely linked to quality, at least indirectly. However, a causal association between lymph node counts (and extented lymphadenectomy) and survival is tenuous and has not been supported by high-level evidence.
PTU-239 Safety of laparoscopic peritoneal lavage for diverticulitis: outcomes from a dedicated emergency surgery service
Authors: K Rhodes, D Jenkins, S Qiu, E Tan, N Behar
Journal: Gut (2015)

<h3>Introduction</h3> A dedicated emergency surgery service allows for faster accumulation of experience in procedures that are otherwise infrequent; laparoscopic peritoneal lavage (LPL) of perforated diverticulitis is one such procedure. We describe our experience with LPL in a series of consecutive patients treated by such service. <h3>Method</h3> Data was collected on 28 consecutive patients undergoing this novel technique in our unit between 2011 and 2014; this was analysed on an intention to treat basis. Outcomes assessed included morbidity, mortality and requirement of further interventions. All patients requiring surgery underwent initial laparoscopy based on our management algorithm. <h3>Results</h3> Of the 28 patients included in the study, there was a male:female ratio of 1.5:1 and a mean age of 57 years. Overall 4 patients required conversion to open Hartmann’s procedure for Hinchey grade IV. Of the remaining 24 patients, 8 (33%) were classified Hinchey grade I, 9 (38%) as grade II and 7 (29%) as grade III. Concomitant small bowel obstruction was relieved laparoscopically in 6 (25%) patients undergoing LPL and in 2 (50%) patients requiring a Hartmann’s procedure. <b>Early results (within 30 days):</b>All 8 Hinchey I patients resolved with intravenous antibiotics and intra-operative drain insertion. Of the Hinchey II and III patients, 3 (19%) required early re-intervention for pelvic abscess formation, all amenable to interventional radiological (IR) drainage. One Hinchey II patient subsequently required resection, despite IR drainage, at 1 week post LPL (failure rate 4%). 30-day mortality was 0% across all Hinchey grades. <b>Late results (Median follow up 26 months):</b>A further 4 of 23 (17%) patients required resection; 2 of these were for malignancy. Only 2 of 19 (11%) patients remaining re-presented with diverticulitis. All patients who underwent Hartmann’s for Hinchey grade IV required further operative procedures: 2 emergency and 2 elective. Mortality was 14% across all Hinchey grades. <h3>Conclusion</h3> Laparoscopy with a view to washout on an intention to treat basis appears safe, across all Hinchey grades of diverticulitis. LPL also allows laparoscopic relief of small bowel obstruction in patients presenting with this complication of diverticulitis. Further radiological drainage after LPL in this study appears safe although 1 of 3 patients progressed to a Hartmann’s procedure. Based on our findings of subsequent malignancy in two patients, we would advise timely post-operative colonoscopy and follow up in all patients. <h3>Disclosure of interest</h3> None Declared.
Markers of recurrence and predictors of clinical behavior of granulosa cell ovarian tumors
Authors: V. B. Nossov, P. E. Schwartz, F. Tavassoli
Journal: Journal of Clinical Oncology (2004)

5114 Background: Granulosa cell tumors are rare ovarian cancers that can be associated with significant morbidity and mortality. Little is known about prognostic markers of these tumors. We attempted to identify some of the molecular markers that can be used to determine candidates for postoperative chemotherapy to prevent recurrence. Methods: 33 cases were retrieved from the files of Yale Tumor Registry over a period of 12 years from 1992 to 2003. The patients ranged from 6 to 84 years of age, with a median age of 51 years. Conventional prognostic factors (age, tumor size, mitotic activity, capsular invasion and histologic pattern) were assessed. Morphological assessment identified 3 juvenile type, and 30 adult type tumors. A total of 9 cases with metastatic or recurrent disease were identified. A few novel markers were evaluated in the tumors with and without recurrence as well as in the recurrent and metastatic tumors. Imunohistochemical staining for inhibin, cERB B4, ER beta, EGFR and Cyclin D2 was performed. The histological and morphological characteristics of the granulosa cell tumors with and without recurrence and/or metastasis were correlated with the immunohistochemical findings for possible association between the expression of a specific tumor immunoprofile or marker expression and tumor behavior. Results: Positive inhibin staining was obtained only in adult type of GCT, almost exclusively in the primary site, and correlated with more advanced age (>47 y.o.). We did not find a correlation between inhibin expression and tumor size. The mitotic index did not correlate with recurrence or inhibin staining. Conclusions: Current data suggests that inhibin could be a predictor for favorable tumor behavior. Testing tumor samples for cERB B4, cylin D2, EGFR may help to establish a stronger correlation between the presence of certain markers and tumor recurrence. No significant financial relationships to disclose.
Malignant Lymphoreticular Tumors Induced by Trypan Blue and Transplanted in Inbred Rats
Authors: Theodore Gillman, A. Marion Kinns, Richard C. Hallowes, John B. Lloyd
Journal: JNCI Journal of the National Cancer Institute (1973)

Rats from 5-different strains received subcutaneous injections of 10 mg trypan blue dissolved in water once every 14 days. Tumors of the reticuloendothelial system developed in rats of 3 strains. In an inbred strain of Wistar rats, 19 of 20 had tumors after doses of more than 120 mg dye. Tumors were predominantly in lymph nodes and liver but also in the thymus and kidney and occasionally in the spleen, adrenal, lung, and ovary. During tumor induction, hyperplastic histiocytes in lymph nodes were probably derived from endothelium. The tumors were composed of pleomorphic histiocytes, some binucleate and resembling the Reed-Sternberg cells of human lymphomas. The tumors were transplantable within the same inbred strain, and 1 line was maintained for more than 40 passages. The morphology of the transplantable tumors was identical to that of the primary donor tumor. The distribution of transplanted tumors depended on whether inoculation was subcutaneous or intraperitoneal.