tbuckley/cabot-search huggingface dataset:
PWE-332 A pilot randomised controlled trial using objective video assessment to investigate the impact of the interval between long-course chemoradiotherapy and resection of advanced rectal cancer upon technical performance of surgery
Authors: J Foster, S Falk, P Ewings, B Williams-Yesson, G Hanna, N Francis
Journal: Gut (2015)

<h3>Introduction</h3> The optimal time to perform rectal cancer resection following long-course chemoradiotherapy (CRT) remains unclear. Many surgeons now elect to operate after a longer interval than the 6–8 weeks that was generally considered standard practice over the last decade. A longer interval may allow more precise surgery by allowing the radiation-induced inflammation to settle. The aim of this pilot multi-centre randomised controlled trial (RCT) was to evaluate the impact of the interval between CRT and surgery upon the technical complexity of the surgery. It was proposed that if a significant difference in complexity was found in this pilot study then progression to a large multi-centre RCT investigating the impact of the CRT-surgery interval upon rate of R0 resection would be indicated. <h3>Method</h3> Patients with rectal cancer requiring long-course CRT were recruited from seven centres between June 2012 and May 2014. Consenting patients were randomised to have surgery after an interval of either 6 weeks or 12 weeks following completion of long-course CRT. Expert interviews were used to generate a structured checklist describing the technical steps of the operation and a list of potential errors of the technical performance that may occur. Operations were video-recorded and unedited videos were analysed by a blinded research fellow against the structured checklist using an objective methodology to identify technical errors enacted. Additionally, the operating surgeons completed visual analogue scales to document their perception of the complexity of the procedure. Data were also collected on radiological downstaging, clinical outcomes to 30-days post-operation, quality of life, and pathological specimen completeness. <h3>Results</h3> Thirty one patients were enrolled into the study: 15 were randomised to a 6-week interval and 16 patients to 12-weeks. Four patients in the 6-week arm and two in the 12-week arm did not undergo surgery. Additionally, one patient in each arm was found to have unresectable disease at the time of surgery. Amongst the 23 patients who underwent resection there was no difference in frequency of errors identified per case between trial arms (p = 0.401), nor a difference in surgeon-reported complexity. No mortalities occurred. Other outcomes were similar between groups. <h3>Conclusion</h3> Objective video assessment of technical performance of surgery has been successfully used within the context of a pilot multi-centre RCT. The timing to surgery has no significant impact on error frequency between a 6-week or 12-week CRT-surgery interval. <h3>Disclosure of interest</h3> None Declared.
Prognostic factors for survival in patients with advanced renal cell carcinoma treated with recombinant interleukin-2
Authors: P.A. Palmer, J. Vinke, T. Philip, S. Negrier, J. Atzpodien, H. Kirchner, R. Oskam, C.R. Franks, H. Von der Maase, N. Thatcher, C. Jasmin, S. Fossa, M. Symann, L. Israel, G. Nagel, G. Stoter, C. Rugarli, O. Eremin, A. Iacone, F. Cleton, J. Janssens, None Willems, L. Bergmann, W. West, R. Oldham, R. Dillman, P. Wiernik, C. Coltman, A. Raynor, J. Doroshow, D. Parkinson, E. Gallignoni, P. Guillou, M. Gore, C. Keen, T. Roberts, A. Harris, M. Fordham, P. Harper, M. Cornbleet, P. Selby, B. Hancock, N. Bleehan, S. Harland, C. Rowland, M. Ostrowski, T. Hamblin, P. Veitch, M. Sokal, P. Abrams, R. Oliver, H. Bodenstein, P. Czygan, P. de Mulder, J. Wils
Journal: Annals of Oncology (1992)
Specific-Gravity Determination Fact or Fancy?
Authors: John T. Calambos, E. Garland Herndon, Gladys H. Reynolds
Journal: New England Journal of Medicine (1964)

THE clinical value of the urinary specific gravity is unchallenged by the thousands who routinely perform it as part of every urinalysis. The claim that it differentiates transudate from exudate in serous effusion made by textbooks on laboratory diagnoses has been questioned by many physicians in whose hands this procedure has been more often misleading than helpful. Therefore, a closer look at the information obtained by the measurement of the specific gravity as it is being performed in clinical laboratories — is justified.Precision of the DeterminationA single urine specimen was placed in 2 cylinders, and 2 new calibrated . . .
T-Cell Lineage of a Friend Virus-Induced Lymphatic Leukemia in Athymic Rats&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: Marc I. Lorber, Peter J. Dawson
 6, Michael R. Loken, John M. Ely, A. Howard Fieldsteel, Frank W. Fitch
Journal: JNCI Journal of the National Cancer Institute (1983)

Athymic (rnu/rnu) and euthymic rats inoculated with the Friend virus-associated lymphatic leukemia virus developed lymphocytic leukemia. Neoplastic cells from these animals were evaluated by means of indirect immunofluorescence and flow cytofluorometry with monoclonal antibodies Ox-1, Ox-7, and W3/25, which react with surface antigens present on normal rat lymphoid cell populations. Lymphoid cells from leukemic animals revealed characteristic alterations in cell surface fluorescence profiles when compared to normal, healthy controls. Athymic and euthymic leukemic rats were similar in that many cells from both the spleen and bone marrow had markers on the cell surface normally found on thymocytes but not on mature peripheral lymphocytes. These studies provided evidence supporting the presence of T-lineage lymphocytes in the athymic rat. Further, this population of early or “pre”-T-lymphocytes included the predominant leukemia cell type induced by the Friend virus-associated lymphatic leukemia virus.
Lumbar Sympathectomy for Arteriosclerosis of the Lower Extremities
Authors: Edward A. Edwards, Chilton Crane
Journal: New England Journal of Medicine (1951)

MEDICAL therapy has been disappointing in the painful and disabling effects of arteriosclerosis of the lower extremities. In the past fifteen years an increasing number of patients have been subjected to the operation of lumbar sympathectomy in an effort to improve results. The present report, which is an analysis of 100 patients with arteriosclerosis subjected to this operation, is presented to add to the evidence, already in the literature,1 2 3 4 5 6 7 8 9 10 of the value of the procedure in this disease.It is hoped that this analysis will aid in answering certain questions that arise when this operative treatment is proposed for the . . .
NCO-14PRE-TREATMENT HIPPOCAMPAL VOLUME PREDICTS NEUROCOGNITIVE FUNCTION (NCF) FOR PATIENTS TREATED WITH HIPPOCAMPAL AVOIDANCE WHOLE BRAIN RADIOTHERAPY (HA-WBRT) FOR BRAIN METASTASES: SECONDARY ANALYSIS OF NRG ONCOLOGY/RTOG 0933
Authors: Clifford Robinson, Stephanie Pugh, Joseph Bovi, Vinai Gondi, Minesh Mehta, Tammie Benzinger, Christopher Owen, Simon Lo, Vijayananda Kundapur, Paul Brown, Alexander Sun, Steven Howard, Albert DeNittis, Lisa Kachnic
Journal: Neuro-Oncology (2015)

BACKGROUND: RTOG 0933 demonstrated reduced risk of NCF decline in patients with brain metastases treated with HA-WBRT versus historical controls treated with standard WBRT. Hippocampal volume (HV) derived from high resolution MRI (HR-MRI) is an established predictor of NCF in Alzheimer's disease. We assessed associations of HV with NCF of patients enrolled on RTOG 0933. METHODS: HV (-Left, -Right, -Total) was calculated from (1) the submitted treatment structure file and (2) independent processing of baseline HR-MRI with validated software (FreeSurfer, FS). HV was correlated with baseline and 4 month NCF scores (Hopkins Verbal Learning Test-Revised (HVLT-R) Total Recall (TR), Immediate Recognition (IR), and Delayed Recall (DR)) using Pearson correlation. Comparisons between deteriorated and non-deteriorated patients were made using Wilcoxon. RESULTS: 39 of the 42 evaluable patients for the RTOG 0933 primary endpoint had hippocampal contours. All 42 had HR-MRIs, but only 21 were processable by FS due to scan quality. HVs from FS were larger than plan contours (median HV-Total 7.2 vs. 5.5 cc), though were significantly correlated (ρ = 0.68, p = 0.001). Larger FS HV-Total and HV-Right were significantly correlated with improved baseline HVLT-R TR (ρ = 0.46/p = 0.04, ρ = 0.51/p = 0.02, respectively) and DR (ρ = 0.46/p = 0.04, ρ = 0.49/p = 0.03, respectively) but not IR. Plan contour HV was not correlated with baseline HVLT-R though there was a trend for HV-Left with 4 month HVLT-R TR (ρ = 0.29/p = 0.07). There were no significant associations between HV and HVLT deterioration or change from baseline to 4 months. CONCLUSIONS: Baseline HV calculated from automatic segmentation of the hippocampus is significantly associated with baseline NCF. HV is not correlated with deterioration in NCF, though analysis is limited by few events and analyzable patients. The importance of HV will be explored further in two developing NRG trials. This project was supported by grants U10CA21661, U10CA180868, U10CA180822, U10CA37422 and UG1CA189867 from the National Cancer Institute (NCI).
Toxicities and response of concurrent chemoradiotherapy for stage IIB-IIIB cervical cancer.
Authors: D. Tran, H. C. Nguyen, A. K. Nguyen, T. T. A. Cung, H. M. Nguyen
Journal: Journal of Clinical Oncology (2010)

e15549 Background: Cervical cancer is the most common cancer in women in Vietnam. Concurrent chemoradiotherapy (CCRT) has been proved survival benefit and emerged as the standard treatment of locally advanced cervical cancer. However, it significantly increases early toxicities. This study evaluated the acute toxicities and responses of CCRT in treatment of stage IIB-IIIB cervical cancer in Vietnam. Methods: From November 2006 to December 2007, 60 patients with stage IIB-IIIB cervical cancer were treated by CCRT. EBRT consisted of 40 Gy/20 fractions, followed by 10 Gy boost to the parametrium and intracavitary HDR brachytherapy 7 Gy to point A/fraction/week in 3 fractions. Chemotherapy with cisplatin 40 mg/m2/weekly for 6 cycles started by the first day of EBRT. Results: All the patients completed treatment protocol. Grade 3-4 leukopenia, neutropenia, and thrombocytopenia were 40%, 33.3%, 8.3% respectively. 19 cases (31.7%) had renal toxicity (grade 1: 16 cases, grade 2: 2 cases, and grade 3: 1 case). Grade 3-4 toxicities increased sharply after the fourth cycle of chemotherapy. Mean overall treatment time is 72 days. 15 patients (25%) had to delay treatment mainly due to hematologic toxicity (10/15 cases). The overall response rate was 96.7% (complete response: 81.7%; partial response: 15%). Conclusions: CCRT is relatively high hematologic toxicities and high response rate. This study pointed out the relationship between the risk of toxicities and number of chemotherapy cycles. CCRT with 5 cycles of chemotherapy would decrease toxicities and overall treatment time. No significant financial relationships to disclose.
Predictive factors for metastasis in patients (pts) with gastric cancer
Authors: S. Kilickap, O. Dizdar, H. Harputluoglu, S. Aksoy, S. Yalcin
Journal: Journal of Clinical Oncology (2007)

15056 Background: Determination of patients (pts) with early stage disease who have a high risk for developing metastatic disease is crucial. We investigated the risk factors associated with metastases development in pts with operable gastric cancer. Patients and Methods: In this retrospective study, pts with stage I-III and non-metastatic stage IV gastric cancer diagnosed between 1990 and 2006 were evaluated. The medical records of all pts including patient characteristics, laboratory results, histopathological examinations, were reviewed. Logistic regression methods were used to determine the risk factors for developing metastasis and to calculate odds ratios (OR) with 95% confidence intervals (CI). Results: 184 pts (70% male, 30% female) were analyzed. The mean age ± standard deviation was 56.5±11.9. The mean age of female were higher than male (p=0.014). At the time of diagnosis, 13.6% of the pts had stage I, 19.0% had stage II, 53.3% had stage III, and 14.1% had non-metastatic stage IV disease. The tumors were distally localized in 80% of the cases. Median follow-up period was 35 months. During follow up, 51 pts developed metastases. Median time to metastases development was 14 months. Overall survival was shorter in pts who developed metastasis than those who did not. (20 months vs. not reached, respectively, p=0.002). In univariate analyses, stage (p=0.020), tumor localization (p=0.006), extracapsular lymphatic extension (ELE) (p&lt;0.001), the number of metastatic lymph nodes (p=0.001), CEA level (p&lt;0.001), lymphovascular invasion (LVI) (p=0.001), and perineural invasion (p=0.007) were associated with metastasis development. In multivariate analysis, elevated CEA levels (p=0.009; OR: 2.8; CI 95%: 1.29–6.19), LVI (p=0.041; OR: 2.2; CI 95%: 1.03–4.64) and ELE (p=0.029; OR: 2.3; CI 95%: 1.09–4.78) were associated with increased risk of metastasis development while distal localization (p=0.038; OR: 0.42; CI%: 0.18–0.95) was associated with decreased risk in pts with gastric cancer. Discussion: In pts with early stage or locally advanced gastric cancer, elevated CEA levels, LVI, proximal localization and ELE were associated with increased risk of developing metastasis. Aggressive treatment options and closer follow up should be considered for pts with these risk factors. No significant financial relationships to disclose.
Abstract 13249: Effect of Underlying Coronary Atherosclerosis on the Effectiveness of Three Dimensional Guided High Mechanical Index Impulses and Intravenous Microbubbles in Treating Acute Coronary Thromboses
Authors: Thomas R Porter, John Lof, Shunji Gao, Shelby Kutty, Feng Xie
Journal: Circulation (2010)

Although animal models have demonstrated that guided high mechanical index (MI) impulses from a diagnostic transducer improve microvascular recanalization in acute ST segment elevation myocardial i...
Successful less-invasive endoscopic treatment for bile leakage from choledochojejunostomy site using short-type single-balloon enteroscopy
Authors: Kazumasa Nagai, Kei Yane, Akio Katanuma, Kuniyuki Takahashi, Toshifumi Kin, Hajime Yamazaki, Hiroyuki Maguchi
Journal: Endoscopy (2016)

Bile leakage from the choledochojejunostomy site is usually treated by percutaneous transhepatic biliary drainage (PTBD) or reoperation [1] [2]. To date, there have been no reports on endoscopic treatment for bile leakage from the choledochojejunostomy site. Recently, balloon enteroscopy was developed and used to perform endoscopic retrograde cholangiopancreatography (ERCP) in patients with surgically altered gastrointestinal anatomy [3] [4] [5]. To the best of our knowledge, this is the first case report of balloon enteroscopy-assisted ERCP for bile leakage from the choledochojejunostomy site following transcatheter arterial embolization (TAE).
Sphingosine-1-phosphate/sphingosine-1-phosphate receptor 1 signaling is required for migration of naive human T cells from the thymus to the periphery
Authors: Rachel S. Resop, Marc Douaisi, Joshua Craft, Loes C.M. Jachimowski, Bianca Blom, Christel H. Uittenbogaart
Journal: Journal of Allergy and Clinical Immunology (2016)
Mother-to-Child Transmission of<i>Burkholderia pseudomallei</i>
Authors: Floor C. Abbink, Jurgen M. Orendi, Arnout J. de Beaufort
Journal: New England Journal of Medicine (2001)

To the Editor: Rai et al. (Dec.14 issue) 1 report the results of a long-term, multicenter, randomized trial comparing fludarabine with chlorambucil in previously untreated patients with advanced chronic lymphocytic leukemia (CLL).In their study the treatments were repeated monthly for a maximum of 12 cycles unless patients had progressive disease, a complete remission, or a response that plateaued over two months of treatment.The hematologic toxicity of fludarabine is well established, and most prior studies have reported that fludarabine can be given for a maximum of six cycles. [2]3][4][5] In our experience, we have not been able to administer more than eight cycles of fludarabine therapy because of severe and prolonged myelosuppression.Rai et al. have not stated how many patients were able to receive 12 cycles of fludarabine, the median number of cycles of fludarabine administered, or the median number of courses of fludarabine needed to induce a complete remission.
Normalization of Triglycerides in Type IV Hyperlipoproteinemia Fails to Correct Low Levels of High-Density-Lipoprotein Cholesterol
Authors: Joseph L. Witztum, Mary Ann Dillingham, William Giese, Joyce Bateman, Connie Diekman, Elaine Kammeyer Blaufuss, Stuart Weidman, Gustav Schonfeld
Journal: New England Journal of Medicine (1980)

High-density-lipoprotein (HDL) cholesterol protects against coronary heart disease, and ways to raise low HDL values are being sought. Cross-sectional population surveys have shown that HDL cholesterol is inversely related to plasma triglycerides, yet to our knowledge no longitudinal studies have shown that a decrease in elevated triglycerides will raise depressed HDL levels. We therefore used dietary therapy to lower the triglyceride levels of 29 men with Type IV hyperlipoproteinemia and evaluated the effects on HDL-cholesterol levels. Despite a reduction in triglyceride levels from 697±90 to 333±37 mg per deciliter (P<0.01), Initially low HDL-cholesterol values did not change (29±1 to 30±1 mg per deciliter). Even in a subgroup of 12 men whose triglyceride levels fell to normal (from 670±99 to 170±7, P<0.01) and whose weight and triglycerides remained stable for two years, HDL cholesterol remained unchanged (29±1 vs. 32±1). The persistently low HDL-cholesterol level in the presence of normalization of triglycerides suggests that depressed HDL cholesterol may be an independent metabolic abnormality in Type IV hyperlipoproteinemia. (N Engl J Med. 1980; 303:907–14.)
Pyomyositis Complicating Acute Bacterial Endocarditis in an Intravenous Drug User
Authors: Tze Shien Lo, Mary G. Mooers, Larry J. Wright
Journal: New England Journal of Medicine (2000)

To the Editor: Gryfe et al. (Jan.13 issue) 1 report that microsatellite instability in colorectal cancer is independently predictive of a favorable outcome.We have some concern about this conclusion, since the tumors with microsatellite instability were more frequently localized (59 percent, vs. 38 percent of those with microsatellite stability) and since the 10-year survival at each Dukes' stage did not differ significantly between patients with microsatellite instability and those with microsatellite stability (Fig. 2B,2C,2D, and 2E in the article).The authors state that in a multivariate analysis, microsatellite status was found to be "significantly and independently" associated with survival.In our opinion, however, we still need clear evidence in a univariate analysis of a survival advantage at each Dukes' stage.
The Advantage of Measuring Stimulated as Compared with Spontaneous Growth Hormone Levels in the Diagnosis of Growth Hormone Deficiency
Authors: Susan Rogers Rose, Judith Levine Ross, Mercedes Uriarte, Kevin M. Barnes, Fernando G. Cassorla, Gordon B. Cutler
Journal: New England Journal of Medicine (1988)

To clarify the relative usefulness of measuring stimulated as compared with spontaneous growth hormone levels in the diagnosis of growth hormone deficiency, we studied 54 short prepubertal children — 23 with growth hormone deficiency identified by stimulation tests and 31 with idiopathic short stature who had normal responses to growth hormone stimulation. Growth hormone levels were measured in plasma samples obtained every 20 minutes for either 12 or 24 hours. The results were compared with those in 46 normal prepubertal children. Children with growth hormone deficiency had significantly lower mean 24-hour growth hormone levels (1.0 μg per liter; range, 0.5 to 1.8) than normal children (2.8 μg per liter; range, 0.8 to 5.8; P<0.001). However, the diagnostic usefulness of the spontaneous growth hormone test was inferior to that of the stimulation tests, since it identified only 57 percent of the children with growth hormone deficiency identified by the stimulation tests. In the remaining children with growth hormone deficiency, spontaneous growth hormone levels were within the normal range. Children with idiopathic short stature had a normal mean 24-hour level of growth hormone (3.0 μg per liter; range, 1.1 to 6.7). No child in this group had low levels of spontaneous growth hormone secretion. We conclude that the measurement of the spontaneous secretion of growth hormone in prepubertal short children had lower sensitivity and offered no diagnostic advantage over stimulation tests. Our data do not support the routine measurement of spontaneous growth hormone secretion in the diagnosis of growth hormone deficiency. (N Engl J Med 1988; 319:201–7.)
The Rise of the Practice of Internal Medicine as a Specialty
Authors: Reginald Fitz
Journal: New England Journal of Medicine (1950)

IN 1865,1 the first meeting of the American Medical Association after any war was held in Boston and was a happy occasion. The official point of assembly for the delegates was the chamber of the House of Representatives at the State House (Fig. 1); there were welcoming speeches by His Excellency the Governor and His Honor the Mayor, a program of serious medical papers and a great deal of enjoyable entertainment with accompanying collations, balls and concerts. The final event was an evening trip along Boston Harbor on the steamship Rose Standish, concluded by a clambake and a triumphal . . .
Chronic Unilateral Pulmonary-Artery Thrombosis
Authors: Kenneth M. Moser, P. Gregg Rhodes, Charles C. Hufnagel
Journal: New England Journal of Medicine (1965)

ACUTE, massive pulmonary embolism — always an event of major clinical concern and interest — has received increased attention in recent years as improved technics for accomplishing emergency embolectomy have been developed.1 2 3 In contrast, chronic, massive, pulmonary arterial thromboembolism has attracted less diagnostic and therapeutic enthusiasm. This disparity is undoubtedly related to the less dramatic clinical picture of chronic thromboembolism, the ease with which it masquerades as or is masked by diverse cardiopulmonary disorders and the concept that it is not amenable to surgical correction.4 5 6 7 In the past, chronic, massive thromboembolic pulmonary-artery occlusion has been recognized chiefly at the . . .