tbuckley/cabot-search huggingface dataset:
Synthetic Thyrotropin-Releasing Hormone
Authors: Michael S. Anderson, Cyril Y. Bowers, Abba J. Kastin, Don S. Schalch, Andrew V. Schally, Peter J. Snyder, Robert D. Utiger, John F. Wilber, Alfred J. Wise
Journal: New England Journal of Medicine (1971)

Abstract Synthetic thyrotropin-releasing hormone (TRH) was administered by single intravenous injection to 79 healthy male volunteers and seven patients with secondary hypothyroidism. Plasma thyrotropin (TSH), growth hormone (GH), luteinizing hormone (LH), follicle-stimulating hormone (FSH) and cortisol concentrations were measured before and after TRH administration. In the normal subjects, the mean base-line TSH concentration was 4.5 μU per milliliter. Plasma TSH rose promptly to a peak of 14.0 μU per milliliter 30 minutes after TRH injection. No rises were observed in the other plasma hormones measured. In the patients with secondary hypothyroidism, TRH failed to elevate TSH. No evidence of toxicity and no serious side effects were seen after TRH administration. TRH is a potent and nontoxic stimulator of TSH release in man and is a useful diagnostic compound in testing pituitary TSH reserve. The availability of TRH now makes possible the recognition of hypothalamic hypothyroidism.
Use of 18F-FDG PET/CT Imaging for Evaluation of Patients With Primary Splenic Lymphoma
Authors: Sellam Karunanithi, Punit Sharma, Shambo Guha Roy, Beth Vettiyil, Atul Sharma, Sanjay Thulkar, Chandrasekhar Bal, Rakesh Kumar
Journal: Clinical Nuclear Medicine (2014)

Primary splenic lymphoma (PSL) is a rare disease, and its management differs from other splenic malignancies. The purpose of the present study was to evaluate the role of 18F-FDG PET/CT in patients with PSL.We retrospectively evaluated the data of 17 patients with PSL (median age, 46 years; range, 3-64) who had undergone 50 18F-FDG PET/CT studies. Of the 50 PET/CTs, 15 were done for primary diagnosis/staging and 35 were done for restaging. PET/CT images were evaluated both qualitatively and quantitatively [maximum standardized uptake value (SUVmax)]. Combination of clinical/imaging follow-up and/or histopathologic diagnosis was taken as reference standard.Of the total 50 F-FDG PET/CT studies, 27 studies (54%) were positive and 23 (46%) were negative for disease. PET/CT was true positive in 25 studies, true negative in 22 studies, false positive in 2 studies, and false negative in 1 study. Overall, per study-based sensitivity was 96.2%, specificity was 91.7%, and accuracy was 94%. In those studies performed for diagnosis/staging (15/50), PET/CT was true positive in all 15, with an accuracy of 100%. In those studies performed for restaging (35/50), sensitivity was 90.9%, specificity was 91.7%, and accuracy was 91.4%. No significant difference was seen in the accuracy of PET/CT between staging and restaging groups (P=0.601). On 18F-FDG PET/CT, splenic involvement was seen in 24 studies, lymph nodal involvement in 5 studies, liver involvement in 3 studies, and bone marrow involvement in 1 study. More than one site of disease was seen in 9 PET/CT studies. On semiquantitative analysis, the overall mean splenic lesion SUVmax was 6.9±7.9 (median, 4.6; range, 1.3-29). The mean value of ratio of SUVmax of splenic lesions and SUVliver was 4.4±5.5 (median, 2.4; range, 0.9-24.2). On comparison of areas under the curve, the mean value of ratio of SUVmax of splenic lesions and SUVliver was found to be superior to SUVmax alone for this differentiation of involvement from normal spleen (P=0.018).18F-FDG PET/CT seems useful in patients with primary splenic lymphoma and shows high diagnostic accuracy.
SP0185 How to Treat Psoriatic Arthritis
Authors: H. Marzo-Ortega
Journal: Annals of the Rheumatic Diseases (2014)

<h3></h3> Psoriatic arthritis (PsA) is a complex and heterogeneous disease in which environmental, and other factors interact resulting in disease in genetically susceptible individuals. PsA can occur in up to 40% of individuals with skin psoriasis leading to significant morbidity and mortality and enormous costs to healthcare systems. Recent advances in knowledge of disease pathogenesis in PsA have come from the use of biologic drugs in the treatment of PsA and skin psoriasis. However, despite good efficacy and safety profile, these drugs have not proven curative. In addition a substantial proportion of affected individuals may lose response to these agents, or develop side effects. The joint intervention of rheumatology and dermatology professionals in the management of these multifaceted diseases may lead to more optimal disease control and improve outcomes. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.6349
Non-Sentinel Lymph Node Status of Patients with T1/T2 Breast Cancer and Micrometastasis in the Sentinel Lymph Node.
Authors: R. Reitsamer, S. Glueck, C. Menzel, F. Peintinger
Journal: Cancer Research (2009)

Abstract Background: Micrometastatic disease in the sentinel lymph node is still an indication for complete axillary lymph node dissection. To further reduce morbidity in breast cancer patients the omission of complete axillary lymph node dissection in patients with micrometastasis in the sentinel lymph node would be desirable.Methods: We retrieved our data-base and looked for the non-sentinel lymph node status in patients with micrometastasis in the sentinel lymph node.Patients with primary T1/T2 breast cancer and sentinel lymph node biopsy were examined for their sentinel lymph node status. Patients with a micrometastasis in the sentinel lymph node, who received a complete axillary lymph node dissection were eligible for evaluation. Patients with a micrometastisis in the sentinel lymph node, who did not receive complete axillary lymph node dissection and patients after primary systemic therapy were excluded.Results: 103 patients were eligible for evaluation. All patients had micrometastases (0,2 to 2,0mm) in the sentinel lymph nodes. In total 15/103 patients (14.6%) had a further metastasis in one or two non-sentinel lymph nodes. 8/103 patients (7.8%) had one macrometastasis in a non-sentinel lymph node with sizes from 2.1mm to 5.0mm. 3/103 patients (2.9%) had a micrometastasis in two non-sentinel lymph nodes and 4/103 patients (3.9%) had one micrometastasis in one non-sentinel lymph node.Mean age of the patients was 57 years, 34 (33%) being premenopausal and 69 (67%) being postmenopausal. 22 patients (21.4%) received immediate axillary dissection after sentinel lymph node biopsy, but 81 patients (78.6%) had a secondary axillary lymph node dissection after the final pathological report. In 19 patients (18.4%) the micrometastasis in the sentinel lymph node could be detected by frozen sections, in 77 patients (74.8%) by serial sections at 250µm in the paraffin embedded sentinel lymph node and in 22 patients (21.4%) by immunohistochemistry only.Discussion: As long as we are lacking reliable methods for predicting the non-sentinel lymph node status for patients with micrometastases in the sentinel lymph node, and as long as the impact of micrometastases in the axilla are subject of debate, axillary lymph node dissection should be performed after sentinel lymph node biopsy with micrometastases in the sentinel lymph node. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 1034.
The Treatment of Meningitis Due to<i>Haemophilus influenzae</i>with Streptomycin
Authors: Louis Weinstein
Journal: New England Journal of Medicine (1946)

INFECTIONS with Haemophilus influenzae in children constitute a serious problem. In adults, because of the presence of large amounts of potent bactericidal antibodies in the blood, this organism is much less frequently an instigator of disease processes.1 During the pandemic of influenza in 1918, however, there were many cases in which the hemophilic organism was isolated from the lungs. It therefore appears that the normally present humoral protection against H. influenzae may break down under certain conditions and that this type of infection may be of great importance in all age groups. In children, there is no part of the . . .
Abstract 5541: Molecular diagnostic tests to augment cytomorphologic diagnosis of lung cancer
Authors: Jiyoun Yeo, Erin L. Crawford, Jill Zyrek-Betts, Sadik A. Khuder, Bradley Austermiller, James C. Willey
Journal: Cancer Research (2012)

Abstract Morphologic analysis of cytology samples obtained by transthoracic needle aspiration (TTNA) is one of the primary methods for diagnosing bronchogenic carcinoma. However, across multiple studies the false negative rate for cytomorphological analysis ranges from 0.2-0.3, and among those diagnosed with lung cancer, the false positive rate for diagnosing the sub-class of small cell carcinoma averages 0.09. These false results lead to additional invasive diagnostic studies and delay treatment. In an effort to augment accuracy and utility of cytopathologic evaluation of TTNA lung samples, we measured the previously reported c-myc x E2F-1/p21WAF1/CIP1 (p21 hereafter) gene expression index in cDNA samples from 78 non-malignant lung tissues and 57 lung cancer tissues. Using the optimal cut-off value, this test correctly classified 72/78 non-malignant and 50/57 malignant samples for a correct classification rate of 90% (95% CI 83.6% - 94.3%), sensitivity of 88%, and specificity of 92%. A CDKN2C/FOSL1 test for distinguishing non-small cell lung cancer (NSCLC) from small cell lung cancer (SCLC) had a PPV of 100% with 63% sensitivity. In order to optimize the robustness and utility of these tests, we developed qPCR methods that enable simultaneous measurement of each target gene and reference gene transcript relative to a known number of internal standard competitive template (CT) molecules using two-color flurometric analysis on real-time platform. For each gene, the native template was quantified with a sequence-specific FAM-labeled probe and the CT was quantified with a sequence-specific Quasar670 labeled probe. Results for each gene thus far demonstrate excellent linearity (R2 &amp;gt; 0.99, slope 1.0 +/- 0.05), relative accuracy (variance &amp;lt; 0.2), signal-to-analyte response (1.0 +/- 0.05) and precision (CV &amp;lt; 30%) over six orders of magnitude, and reliable detection of as few as 10 molecules. Assessing both the c-myc x E2F-1/p21 index and the CDKN2C/FOSL1 test promises to augment cytomorphologic diagnosis of bronchogenic carcinoma in TTNA samples biopsy samples. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 5541. doi:1538-7445.AM2012-5541
Traumatic Aneurysm of the Thoracic Aorta
Authors: Laurence K. Groves
Journal: New England Journal of Medicine (1964)

AS medicine develops, and its progress affords new diagnostic and therapeutic technics, it is fascinating to see the emergence of pathologic entities that have always been present but have not been fully appreciated for want of effective therapy. An excellent example of this is the traumatic aneurysm of the thoracic aorta. Resectional surgery of the aorta is a development of the last decade. When one thinks of aneurysms of the thoracic aorta one naturally thinks of degenerative vascular diseases grouped under the general heading of arteriosclerosis in addition to one infectious disease, syphilis. My personal experience with aneurysms of the . . .
A Study of the Status of Clinical Cancer Research in the United States (1990)
Authors: E. J Freireich
Journal: JNCI Journal of the National Cancer Institute (1991)

This study has confirmed a continuing decrease in the quality and quantity of young physicians entering academic careers in clinical oncology research, defined as cancer research requiring a clinician-patient interaction. Two major contributing factors were identified: the training programs and the research environment. The primary problems for the trainees were the financial insecurity of embarking on an academic career and the poor academic status of their role models in clinical cancer research. The problems regarding the environment of academic oncology and oncology research relate primarily to the strong and widespread perception that grant proposals for clinical oncology research are at a competitive disadvantage with proposals for cancer research in the laboratory. The study results yielded two basic recommendations. The first recommendation is to improve training for clinical cancer research and to implement unique funding mechanisms for trainees. Because physicians devote 3-10 years to clinical training, a minimum of 10 years of clinical research is needed for a clinician to compete effectively as a principal investigator in the R01 and P01 grant areas. The second recommendation is to develop peer review mechanisms that allow clinical research proposals to compete within a pool restricted to proposals in this category. The consensus in the study was that when programs in clinical research and laboratory research are in competition, the clinical proposals have a lower success rate. The problem appears to rest with the fact that the reviewers are frequently from disciplines other than clinical research and, more importantly, that clinical research proposals fare badly in competition against laboratory research proposals even when they are reviewed by appropriate peers. Implementation of this recommendation will require development of a clinical oncology research study section in the Division of Research Grants at the National Institutes of Health to review R01 grant proposals for innovative clinical cancer research, providing an academic environment that would enable the clinical investigator, through increased success in obtaining grants, to be a positive role model for the young physician/scientist.
PP-020 A prospective study of fibroblast growth factor 19 in patients with chronic diarrhoea and possible bile acid malabsorption
Authors: S Pattni, T Dew, J R F Walters
Journal: Gut (2010)

<h3>Introduction</h3> Chronic diarrhoea resulting from excess bile acids in the colon (“bile acid malabsorption”, BAM) is usually diagnosed by the selenium homocholic acid taurine (SeHCAT) test and responds to bile acid sequestrants. Other tests for BAM including serum levels of 7α-hydroxy-4-cholesten-3-one are not widely available. Our group suggested that disordered negative feedback inhibition by Fibroblast Growth Factor 19 (FGF19), produced by the ileum, of hepatic bile acid synthesis results in an excess of bile acids entering the colon, causing bile acid diarrhoea. We aim to examine further the role of FGF19 in a larger group of patients with chronic diarrhoea. <h3>Methods</h3> 62 patients have been prospectively recruited with chronic diarrhoea. All patients had routine investigations for chronic diarrhoea to exclude other causes and all had SeHCAT tests. Three different patient groups were defined according to the diagnosis based on SeHCAT results: SeHCAT &lt;15% and no other cause (primary BAM, n=21); SeHCAT &lt;15% and secondary BAM (n=13); normal SeHCAT, &gt;15% (n=28). All patient demographics and symptoms were recorded and fasting blood samples for FGF19 were collected and available in 54 patients. Serum FGF19 was quantified by ELISA using a commercially available kit. <h3>Results</h3> Fasting FGF19 levels were significantly lower in patients with primary and secondary BAM compared with the chronic diarrhoea group with normal SeHCAT results (medians 160 vs 139 vs 276 pg/ml, p &lt; 0.001). The majority of patients with primary BAM had SeHCAT retention of 5–10%. There was no significant difference in patient9s age, gender, ethnicity, number of bowel movements per day or night, duration of diarrhoea, and stool consistency (Bristol Stool Chart) between the groups. The BMI was significantly higher in patients with abnormal SeHCAT values (27 vs 23.5, p&lt;0.04). Faecal incontinence and urgency were more prevalent symptoms in these patients (50% vs 21%, p&lt;0.03 and 94% vs 71%, p&lt;0.03, respectively). Reported steatorrhoea, abdominal pain and bloating were features in both groups but no significant differences were noted. <h3>Conclusion</h3> This study confirms that serum levels of an easily measurable hormone, FGF19, are significantly reduced in patients with bile acid diarrhoea, and are not affected by chronic diarrhoea per se. These patients also have a higher BMI. Other symptoms such as faecal incontinence, urgency abdominal pain, bloating and steatorrhoea are also common findings in these patients. These results provide further evidence that there is a disruption of a homeostatic mechanism in the control of bile acid synthesis with an overproduction of bile acids leading to chronic watery diarrhoea.
Abstract 1155: Promoter CpG island hypermethylation of Decoy Receptor 1 (DCR1) is associated with poor response to irinotecan in colorectal cancer.
Authors: Linda JW Bosch, Geert Trooskens, Petur Snaebjornsson, Josien C. Haan, Lorraine Pelosof, Miriam Koopman, Jolien Tol, Joost Louwagie, Luc Dehaspe, Bauke Ylstra, Henk Verheul, Manon van Engeland, Iris D. Nagtegaal, James G. Herman, Cornelis JA Punt, Wim van Criekinge, Beatriz Carvalho, Gerrit A. Meijer
Journal: Cancer Research (2013)

Abstract Background Heterogeneity in the biology of colorectal cancer (CRC) is associated with variable responses to standard chemotherapy. We aimed to identify DNA hypermethylated genes as predictive biomarkers for irinotecan treatment of patients with metastatic CRC. Material and Methods The presence of DNA methylation for a selected panel of 22 genes was assessed by methylation specific PCR (MSP) on primary tumors of 185 patients with metastatic CRC treated with first-line capecitabine (CAP, n=90) or a combination of capecitabine and irinotecan (CAPIRI, n=95) in the phase III CAIRO trial. Methylation status of each gene was correlated to progression free survival (PFS) by treatment regimen. Genes for which methylation status associated with response to irinotecan, were validated in 166 patients treated with first-line CAP (n=78) or CAPIRI (n=88). Results Decoy Receptor 1 (DCR1) was identified as a novel hypermethylated gene in CRC. In CAPIRI treated patients, DCR1 methylation was correlated to a shorter PFS compared to patients with unmethylated DCR1 (hazard ratio [HR]=0.4 (95%CI =0.3-0.7), p = 0.0009). In patients with methylated DCR1 PFS did not improve with CAPIRI treatment, compared to treatment with CAP (discovery set: HR=0.8 (95%CI=0.5-1.3, p=0.4); validation set: HR=1.1 (95%CI 0.7-1.7, p=0.6)), in contrast to patients with unmethylated DCR1 (discovery set: HR=2.5 (95%CI 1.7-3.3, p=0.00004); validation set: HR=1.7 (95%CI 1.1-2.0, p=0.004)). Conclusion CRC patients with methylated DCR1 did not benefit from adding irinotecan to capecitabine therapy, indicating that DCR1 methylation status may guide selecting metastatic CRC patients for irinotecan-based therapy. Citation Format: Linda JW Bosch, Geert Trooskens, Petur Snaebjornsson, Josien C. Haan, Lorraine Pelosof, Miriam Koopman, Jolien Tol, Joost Louwagie, Luc Dehaspe, Bauke Ylstra, Henk Verheul, Manon van Engeland, Iris D. Nagtegaal, James G. Herman, Cornelis JA Punt, Wim van Criekinge, Beatriz Carvalho, Gerrit A. Meijer. Promoter CpG island hypermethylation of Decoy Receptor 1 (DCR1) is associated with poor response to irinotecan in colorectal cancer. [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 1155. doi:10.1158/1538-7445.AM2013-1155
The Performance of Contrast-Enhanced FDG PET/CT for the Differential Diagnosis of Unexpected Ovarian Mass Lesions in Patients With Nongynecologic Cancer
Authors: Jeong Won Lee, Jae-Hoon Lee, Arthur Cho, Mijin Yun, Jong Doo Lee, Young Tae Kim, Won Jun Kang
Journal: Clinical Nuclear Medicine (2014)

This study aimed to evaluate the diagnostic accuracy of contrast-enhanced FDG PET/CT for unexpected ovarian lesions in patients with nongynecologic cancers.The present retrospective study was approved by the hospital institutional review board. We enrolled 72 nongynecologic cancer patients (33 colorectal cancer, 20 breast cancer, and 19 gastric cancer) who showed unexpected ovarian lesions on contrast-enhanced FDG PET/CT and subsequently underwent surgical resection of the ovarian lesions. The SUVmax values of the ovarian lesions were compared according to the histopathological results, and the accuracy of PET/CT was evaluated.A total of 103 ovarian lesions were surgically resected from 72 patients (64 ovarian lesions were metastases, 21 were benign, and 18 were malignant primary ovarian cancer). SUVmax among the 3 groups were different (P < 0.0001). Using a cutoff SUVmax of 2.5, the sensitivity, specificity, and accuracy of PET/CT for detecting malignant ovarian lesions were 80.5%, 81.0%, and 80.6%, respectively. Detection rates of PET/CT for colorectal, breast, and gastric cancer metastases, as well as primary ovarian cancers were 91.4%, 83.3%, 47.8%, and 100.0%, respectively. Using contrast-enhanced CT findings with SUVmax, the sensitivity, specificity, and accuracy of contrast-enhanced FDG PET/CT were improved to 95.1%, 76.2%, and 91.3%, respectively (P = 0.003).Conventional FDG PET/CT showed moderate diagnostic accuracy for the detection of malignant ovarian lesions mainly due to low detection rate in gastric cancer metastases. The PET/CT detection rate of malignant ovarian lesions can be improved using contrast-enhanced CT findings with FDG uptake measurement.
Which Type Cesarean Section?
Authors: Roy J. Heffernan, Charles Leavitt Sullivan
Journal: New England Journal of Medicine (1948)

ABDOMINAL delivery may be accomplished in one of three ways: by the classic technic, by the low-segment operation or by some form of extraperitoneal cesarean section. It is not possible to compare absolutely the safety of the various procedures because of the variance in skill of individual operators and hospital equipment and also because the results reported by individual operators and clinics are not standardized so far as the condition of the patient at the time a particular technic was chosen for abdominal delivery is concerned.The classic method results in the highest morbidity and mortality because the uterine incision . . .