tbuckley/cabot-search huggingface dataset:
Use of Indium-111–Labeled Hepatocytes to Determine the Biodistribution of Transplanted Hepatocytes Through Portal Vein Infusion
Authors: NICOLAAS I. BOHNEN, MARTIN CHARRON, JORGE REYES, WENDY RUBINSTEIN, STEPHEN C. STROM, DENNIS SWANSON, RICHARD TOWBIN
Journal: Clinical Nuclear Medicine (2000)

Purpose Hepatocyte transplantation is useful for ex vivo gene therapy and liver repopulation. Methods for hepatic reconstitution were recently developed, but hepatocyte transplantation systems must be optimized. The authors report their experience with In-111 oxyquinolone labeling of a test dose of hepatocytes (108 cells) for noninvasive assessment of the biodistribution of transplanted hepatocytes in a 5-year-old child with ornithine transcarbamoylase deficiency. Materials and Methods Donor hepatocytes (approximately 108) were radiolabeled using a commercially available In-111 oxyquinolone solution (specific activity of 1 mCi/ml). Results The overall labeling efficiency was 36.4%. A final dose of approximately 290 μCi of the In-111–labeled hepatocytes in 10 ml serum-free phosphate-buffered saline was infused percutaneously into the portal vein approximately 2.5 hours after their preparation. The study was performed 3 hours before cell transplantation (109 cells). Quantitative analysis of the biodistribution of In-111–labeled hepatocytes indicated that cells were predominantly localized in the liver immediately after portal vein–infused transplantation. The predominant hepatic distribution was persistent for as long as 7 days after the procedure, with an average liver-to-spleen ratio of 9.5 to 1. No significant pulmonary radiotracer uptake was present. Conclusion These results indicate that In-111 labeling of hepatocytes is useful for the short-term noninvasive analysis of the biodistribution of transplanted hepatocytes.
Late diagnosis of Henoch-Schönlein purpura following detection of jejunal ischemia on conventional endoscopy
Authors: E. Kim, B. Park, J. Lim, S. Jung
Journal: Endoscopy (2012)

A 40-year-old man was admitted to our hospital for acute-onset, colicky abdominal pain and vomiting. He had undergone gastrojejunostomy for gastric ulcer bleeding 18 years ago. On physical examination, the patient appeared dehydrated and his abdomen was soft and diffusely tender without peritoneal signs. Laboratory investigations revealed a leukocyte count of 14 890/mm3 with 91 % in segment form. The initial computed tomography (CT) scan of the abdomen showed focal concentric wall thickening of the jejunum in the left upper abdomen ([Fig. 1]). Enteritis was suspected and the patient was managed with bowel rest, intravenous fluid replacement, and antibiotics. After 7 days, the patient reported slight reduction of the abdominal pain, however, the inflammatory indices were gradually deteriorating (white blood cell count: 27 230/mm3 and C-reactive protein: 11.9 mg/dL). A follow-up CT scan showed markedly aggravated wall thickening and extension of the inflamed area of the jejunum ([Fig. 2]). Endoscopic examination demonstrated severe segmental ischemia in the efferent loop of the jejunum ([Fig. 3]).
Androgens and the Evolution of Male-Gender Identity among Male Pseudohermaphrodites with 5α-Reductase Deficiency
Authors: Julianne Imperato-McGinley, Ralph E. Peterson, Teofilo Gautier, Erasmo Sturla
Journal: New England Journal of Medicine (1979)

To determine the contribution of androgens to the formation of male-gender identity, we studied male pseudohermaphrodites who had decreased dihydrotestosterone production due to 5 alpha-reductase deficiency. These subjects were born with female-appearing external genitalia and were raised as girls. They have plasma testosterone levels in the high normal range, show an excellent response to testosterone and are unique models for evaluating the effect of testosterone, as compared with a female upbringing, in determining gender identity. Eighteen of 38 affected subjects were unambiguously raised as girls, yet during or after puberty, 17 of 18 changed to a male-gender identity and 16 of 18 to a male-gender role. Thus, exposure of the brain to normal levels of testosterone in utero, neonatally and at puberty appears to contribute substantially to the formation of male-gender identity. These subjects demonstrate that in the absence of sociocultural factors that could interrupt the natural sequence of events, the effect of testosterone predominates, over-riding the effect of rearing as girls.
A Randomized Trial of Treatment Options for Alcohol-Abusing Workers
Authors: Diana Chapman Walsh, Ralph W. Hingson, Daniel M. Merrigan, Suzette Morelogk Levenson, L. Adrienne Cupples, Timothy Heeren, Gerald A. Coffman, Charles A. Becker, Thomas A. Barker, Susan K. Hamilton, Thomas G. McGuire, Cecil A. Kelly
Journal: New England Journal of Medicine (1991)

Employee-assistance programs sponsored by companies or labor unions identify workers who abuse alcohol and refer them for care, often to inpatient rehabilitation programs. Yet the effectiveness of inpatient treatment, as compared with a variety of less intensive alternatives, has repeatedly been called into question. In this study, anchored in the work site, we compared the effectiveness of mandatory in-hospital treatment with that of required attendance at the meetings of a self-help group and a choice of treatment options.
Robert Matthew Hay McMinn
Authors: M. Philip
Journal: BMJ (2012)

Robert Matthew Hay McMinn (“Bob”) died after a long and distinguished career as one of the foremost human anatomists of his generation, with several bestselling publications to his name. His major work was the publication in 1977 of A Colour Atlas of Human Anatomy, in collaboration with the photographer Ralph Hutchings. A totally new concept in anatomy teaching, this book showed life sized colour photographs of actual dissections of real bodies, rather than the usual line drawings with red arteries, blue veins, and yellow nerves that had been the somewhat dull, unrealistic fare for medical students until then. A modest and unassuming man, Bob was amazed by its success; it rapidly became one of the standard anatomical texts not only for medical students, but also for artists, sculptors and anyone interested in the human form. Rumour has it that it was even regarded by some as a desirable coffee table ornament. Revised over the years to include more clinical emphasis, the book is now in its sixth edition, has been translated into over 30 languages and has sales of several million wordwide.

With the …
PTU-104 Single Centre Management of Pyogenic Liver Abscesses: Surprisingly Poor but Mortality Still Low
Authors: A Puri, M Bhuva, F Sampaziotis, B Macfarlane
Journal: Gut (2013)

<h3>Introduction</h3> Untreated, pyogenic liver abscesses have a mortality approaching 100%. Three admissions in a week sparked interest in the best management of this condition. Although common, no comprehensive management guidelines could be found, prompting further review into how well this condition was managed locally <h3>Methods</h3> Retrospective analysis of all patients admitted to Watford Hospital between 2006 and 2011 with a diagnosis of pyogenic liver abscess. Data was collected to evaluate use of cultures, radiological intervention (aspiration or drain insertion), source of infection, investigation for cause, follow up and outcome <h3>Results</h3> Fourty four admissions were identified: 39 patients with 5 re-admissions. Mean age was 62 yrs, 59% male, 41% female. Eleven patients were managed by the Gastro team. Assumption of source was made on CT imaging results: 46% presumed portal translocation (most diverticular disease), 36% biliary, 18% unidentified. Blood cultures were taken in 24 patients (42% positive). Abscess aspirates were taken in 33 cases, sent for culture in 30 (50% positive). Presumed biliary or unidentified sources grew gramme negative organisms in 12/13 cases. Presumed portal sources grew gramme positives in 7/8 and anaerobes 1/8. Abscess size was &lt; 3 cm in 5 cases (incl. 2 readmissions). Four received anitbiotics (Abc) alone:resolution in 3/4, 1/4 no follow up. One was managed to resolution with Abc and aspiration. Mean length of stay was 11 days. In 6 patients the abscess was 3–5 cm. In this group, 1 patient with malignancy died, 1 treated successfully with Abc alone. The remaining 4 were treated with Abc and aspiration: 1/4 resolution, 1/4 readmitted, 2/4 no follow up. Mean length of stay 15 days. Thirty three patients had abscesses &gt; 5 cm (incl. 3 readmissions). Nineteen were treated with Abc and drainage: 2/19 had underlying malignancy and died, 6/19 resolution, 3/19 readmitted, 7/19 no follow up, 1/19 referred to surgery. Of the remaining fourteen, 3/14 had Abc alone (2 resolved, 1 patient with two readmissions no follow up), 1/14 a readmission referred for surgery and 10/14 Abc and aspiration. Outcome in these ten: 1/10 mutiple aspiration, 2/10 drain insertion, 1/10 surgical referral, 1/10 readmitted, 1/10 partial response, 3/10 no follow up, 1/10 resolution. Mean length of stay in &gt; 5 cm group : 27 days. Overall in all patients: investigation for cause limited to 3 colonoscopies and 1 ERCP, follow up inadequate in 15 (38%), mortality 8%. <h3>Conclusion</h3> Management of this serious condition was remarkably poor, with limited use of cultures, inconsistant radiologic intervention, no search for cause, and scanty follow up. Despite this confirmed mortality was just 8%.Guidelines for future management have been drawn up including recommendation that all patients are looked after by the Gastro team. <h3>Disclosure of Interest</h3> None Declared
Percutaneous flexible endoscopic necrosectomy for a retroperitoneal abscess
Authors: Vivek Kumbhari, Andrew Storm, Alan Tieu, Payal Saxena, Ahmed Messallam, Mohamad Zein, Alba Azola, Mouen Khashab, Patrick Okolo
Journal: Endoscopy (2014)

Increasing evidence supports endoscopic transluminal retroperitoneal debridement for the management of walled-off pancreatic necrosis [1] [2]. However, this approach is not feasible for cavities that do not approximate the gastrointestinal lumen. Yamamoto et al. recently demonstrated a method of percutaneous endoscopic necrosectomy (PEN) requiring 11 procedures [3]. We demonstrate an alternative, more efficient method using PEN plus daily irrigation with hydrogen peroxide to efficiently manage a retroperitoneal abscess.
P5-23-03: Breast Cancer in Elderly Treatment Algorithm – A New Approach To Optimize the Management of Breast Cancer in Older Patients.
Authors: M Tahir, R Pretorius, T Robinson, R Walker, A Stotter
Journal: Cancer Research (2011)

Abstract Background: Elderly patients have been receiving a sub-standard treatment for early breast cancer when compared to younger age group patients. A higher percentage of them are being treated with primary endocrine therapy (PET) based on the premise that they may not survive surgery or live long enough to benefit from it. In clinical practice, however, there is no validated assessment in place to assess their surgical risk or estimate their life expectancy. This study aimed to optimize the treatment of early breast cancer in older patients using comprehensive geriatric assessment (CGA). It tested the hypothesis that CGA could be used to predict 2-year survival in older breast cancer patients. Based on that a treatment algorithm was devised which could be used to recommend whether PET or surgery plus endocrine treatment would be best indicated in individual patients. Methods: The study included women &amp;gt;70 years of age with early breast cancer, seen in a dedicated Leicester clinic between 04/2005 and 04/2007. All patients had comprehensive assessment including documentation of co-morbidities, Mini-mental state examination (MMSe), Geriatric depression score (GDS), Activities of daily living (ADL), Instrumental activities of daily living (IADL) and American society of anesthesiologist score (ASA). Analysis was performed to find components of the CGA that were helpful in predicting 2-year survival in these patients. Results: 123 patients were included; age range was 70–94 (median-82). Twenty-two patients died within 2-years. Logistic regression analysis found MMSe, ADL, and ASA score to have an independent association with 2-year survival. A statistically significant correlation (p-value 0.000) was found between the dichotomized combined-score of these components and 2-year survival. Breast Cancer in Elderly Treatment Algorithm (BCETA) was devised using the scores of these three components. Patients who scored one or higher (high-risk group), were found to have &amp;lt;48% two-year survival; those, who scored zero (low-risk group), have &amp;gt;86% chance of two-year survival. The overall accuracy for the algorithm was 81%. Conclusion: Breast Cancer in Elderly Treatment Algorithm is a new and systematic approach to optimize the management of breast cancer in elderly patients. It is helpful in identifying high-risk patients with expected short-survival who may benefit from PET, if their cancer is hormone receptor positive. Patients with predicted longer life expectancy (low-risk) may be recommended standard treatment. A prospective study is ongoing at Leicester research clinic to validate the results. BREAST CANCER IN ELDERLY TREATMENT ALGORITHM Name: Hospital No: DOB: Address: Diagnosis: COMPREHENSIVE GERIATRIC ASSESSMENT TOTAL BCETA SCORE Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-23-03.
THU0407 Determinants of Exclusive Bone Loss at the Spine or Hip
Authors: T. Banks, M. Bukhari
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> A diagnosis of osteoporosis is achieved by demonstration of bone loss at either the hip or spine using bone densitometry. A subset of patients have bone loss at only one of these sites. Risk factors for osteoporosis are well known but it is unknown whether patients with exclusive bone loss at either site could be predicted. The relationship between exclusive bone loss and fracture has not been established. <h3>Objectives</h3> To determine whether patients with bone loss exclusively at the spine or the hip have different predictors and whether they correlate with prevalent fractures. <h3>Methods</h3> Patients referred to a district general hospital in North West England for bone densitometry between June 2004 and September 2010 were identified as either having osteoporosis (T score &lt;-2.5) of either the spine or the hip but not both. Risk factors for osteoporosis were assessed and groups were compared before and after adjustment for age and gender using a logistic regression model. Risk factors identified include body mass index (BMI), steroid use, smoking history, rheumatoid arthritis (RA), alcohol excess, history of fracture, family history and maternal hip fracture. <h3>Results</h3> Results are summarised in table 1. There were 711 patients with bone loss at the hip (OPHIP) and 1467 with bone loss at the spine (OPSPINE). Continuous variables are expressed as mean(standard deviation), dichotomous variables are expressed as a percentage. Results are shown before and after adjusting for the differences in age and gender between the two groups. After adjustment, the OPHIP group were shorter, heavier and had a higher prevalence of RA, steroid users and smokers. There were no statistically significant differences between the groups in prevalence of fracture at the femur(p 0.27, OR 9.28, CI 0.59, 6.67), pelvis (p 0.28, OR 1.74, CI 0.64, 4.72), forearm(p 0.94 OR 0.99, CI 0.79, 1.25), rib(p 0.22 OR 0.70, CI 0.4, 1.24), humerus(p 0.86, OR 1.04, CI 0.65, 1.66), spine (p 0.80, OR 0.96, CI 0.7, 1.10) or tibia/fibula (p 0.07, OR 1.38, CI 0.97, 1.96). <h3>Conclusions</h3> We have identified several variables (height, weight, smoking status and history of rheumatoid arthritis and steroid use) which may be used to predict the site of bone loss. There was no difference between the two groups in prevalence of fracture or fracture at specific sites. Further investigation into determinants of exclusive bone loss at these sites is warranted. Use of the hip only as a predictor of fracture appears valid. <h3>Disclosure of Interest</h3> None Declared
Spina Bifida in Infants of Women Treated with Carbamazepine during Pregnancy
Authors: Franz W. Rosa
Journal: New England Journal of Medicine (1991)

SHORTLY after Robert and Guibaud reported in 19821 an association between the use of valproic acid during pregnancy by women with seizure disorders and the occurrence of spina bifida in their offspring, carbamazepine was also implicated, on the basis of 12 cases of spina bifida among 60 infants with birth defects after exposure to carbamazepine in utero.2 , 3 Jones et al. recently reported the outcomes of pregnancy in a cohort of 56 women taking carbamazepine, on the basis of the data from the California Teratogen Registry.4 This study included a case of spina bifida. In follow-up correspondence, Jones et al. mentioned . . .
Case 19-1997
Authors: Ferdinand J. Venditti, Michael R. Pins
Journal: New England Journal of Medicine (1997)

Presentation of CaseA 57-year-old man was admitted to the hospital because of progressive edema and exertional dyspnea.The patient had been well until eight weeks earlier, when he was admitted to this hospital because of recurrent chest pain. An electrocardiogram showed a normal rhythm at a rate of 69, with poor R-wave progression in the right precordial leads, and elevated ST segments, with a tendency toward biphasic T waves, in leads V3 through V5. A radiograph of the chest revealed patchy air-space disease in the right lower lobe consistent with pneumonia; the cardiac silhouette was normal. . . .
IT-24 * DEVELOPMENT OF A NOVEL AUTOLOGOUS DENDRITIC CELL / ALLOGENEIC GLIOBLASTOMA LYSATE VACCINE PROTOCOL
Authors: I. Parney, T. Peterson, M. Gustafson, A. Dietz
Journal: Neuro-Oncology (2014)

BACKGROUND: Dendritic cell (DC) vaccines for glioblastoma (GBM) are promising but significant conceptual shortcomings may have limited their clinical efficacy. First, most trials have not employed optimal DC culture techniques resulting in large numbers of immature (immunosuppressive) DC's. Second, most have used autologous tumor lysate. While highly personalized, this limits vaccine availability and precludes antigen-specific response testing. Finally, GBM-mediated immunosuppression has been largely unaddressed. We have developed a novel DC vaccine protocol that addresses these issues. METHODS: The ability of standard DC culture techniques to produce mature (CD83+) DC's from healthy donors' and GBM patients' CD14+ monocytes was assessed. An optimized technique using GBM patients' monocytes was developed. A library of human Good Manufacturing Practices (GMP) GBM cell lines was established using a novel platelet lysate supplement. Immature/mature glioneuronal markers and tumor-associated antigens (TAA's) were assessed by western blot. Finally, multicolor FACS immunophenotyping of 120 leukocyte surface markers in 5mL whole blood was established. RESULTS: Standard culture techniques produce >90% mature (CD83+) DC's from healthy donor monocytes but < 60% CD83+ DC's from GBM patients' monocytes (P<0.001). A modified technique including platelet lysate produces >90% mature DC from GBM patients. Seven GMP-compatible GBM cell lines have been developed with clonigenic karyotypic abnormalities, immature (nestin) and some mature (GFAP, olig2, β-tubulin) glioneuronal marker expression, and expression of multiple TAA's. Our 120 marker panel produces comprehensive, reproducible immunophenotyping. CONCLUSION: We have developed a DC vaccination strategy that optimizes DC maturity, utilizes renewable GBM cell lines with established TAA expression profiles, and allows comprehensive immunophenotyping to identify responding/non-responding patient populations. Based on these studies, we have initiated a phase I clinical trial (MC1272; IND#15233) of autologous DC / allogeneic tumor lysate in newly diagnosed adult GBM patients that enables multiple vaccinations in most GBM patients with extensive immunophenotyping and TAA-specific response testing.
Abstract 4010: Significant roles of p120 catenin and MUC1 in promoting invasive behavior of pancreatic cancer cells
Authors: Xiang Liu, Chunhui Yi, Michael A. Hollingsworth
Journal: Cancer Research (2011)

Abstract Pancreatic cancer is highly lethal in part because the tumors have metastasized at the time of diagnosis. We are investigating the hypothesis that interactions between the cell surface mucin MUC1 and p120 catenin (p120ctn) modulate cell adhesion, invasion and metastatic properties of pancreatic cancer cells. MUC1 is overexpressed in pancreatic cancer and is known to modulate the invasive and metastatic properties of tumor cells by influencing cell surface adhesion properties directly and by signaling through the MUC1 cytoplasmic tail that reprogram transcription of invasion and metastasis associated genes. Downregulation or mislocalization of p120ctn is correlated with high grade and poor survival in human pancreatic cancer. E-cadherin, which is normally stabilized by p120 catenin in the cell membrane, is frequently lost or downregulated in various human cancers, resulting in the emergence of malignant characteristics, such as loss of epithelial morphology, and gain of invasiveness and metastatic potential. We hypothesized that MUC1 competed with binding of E-cadherin to p120ctn, which enhanced E-cadherin internalization, thus promoting epithelial to mesenchymal transition (EMT). We report here that several p120 catenin isoforms are expressed in human pancreatic cancer and that MUC1 cytoplasmic tail interacts with armadillo repeats of p120ctn. Overexpression of MUC1 resulted in alterations in expression of different p120ctn isoforms, increased nuclear localization of p120ctn, and a decrease in p120ctn association with E-cadherin, as detected by western blotting, co-immunoprecipitations, and confocal microscopy analysis of Capan1 and MIAPACA-2 pancreatic cancer cell lines. Our data support the hypothesis that MUC1 overexpression decreases the association of p120 catenin with E-cadherin, which increases E-cadherin turn over. We also detected colocalization of MUC1 and p120ctn in the nucleus, raising the possibility that this association constitutes a novel signaling pathway mediated by MUC1 and p120ctn that contribute to the reprograming of gene expression during EMT, invasion and metastasis. This research provides novel insight that enable opportunities to develop an effective therapy to prevent pancreatic tumor invasion and metastasis. Supported by grant R01CA57362 from the NCI. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4010. doi:10.1158/1538-7445.AM2011-4010