tbuckley/cabot-search huggingface dataset:
Brain metastases in locally advanced NSCLC treated with radical radiotherapy (RT) in a single institution
Authors: O. Hansen, K. H. Hansen, A. Stolberg-Rohr, P. Sorensen
Journal: Journal of Clinical Oncology (2007)

18107 Background: Brain metastases (BM) is a major problem in NSCLC. To evaluate the influence on survival in locally advanced NSCLC treated with radical RT, a retrospective analyses was performed of the patients treated at our institution. Methods: From June 1995 to Dec. 2003 200 patients with non-resectable NSCLC stage IIB-IIIAB received radical 3-D conformal radiotherapy with a planned dose =60Gy/30 F. Data on brain metastases were retrospectively obtained from the patient files. All patients were followed to death except in few cases in which data was obtained from other hospitals. End points were occurrence of BM and BM free survival (BM-RFS). A Cox multivariate analysis was performed including possible prognostic factors. Results: Stage at RT: IIB 8 (4%), IIIA 66(33%), IIIB+recurrent disease 126 (63%). Male/female ratio was 126 /74. The median survival was 15.5 months. The 2 yrs. survival was 34%. 42 (21%) cases of BM were observed. The median time to BM was 8.5 ms. with 86% occurring within 2 yrs. In 28 (67%) of the cases BM was the first site of failure, and in 10 (24%) BM remained the only site of failure. More women than men experienced BM 25 (34%) vs. 17 (14%), p= 0.0013. The survival after diagnosis of BM was 2.8 ms. The patients having BM as and these had better prognosis then patients experiencing BM at a later stage 5.3 vs 1.9 ms. (p&lt;0.0001). The prognosis after BM as first failure were no worse than patients having other sites as first distant failure (3.6 ms, p=0.3). In a Cox multivariate analysis only female gender was associated with poorer BM-RFS while use of neoadjuvant chemotherapy, adeno.-histologi, age, stage at RT, and performance status at RT were insignificant factors. Conclusions: A significant number of cases with locally advanced NSCLC experienced BM especially in females. The survival after diagnosis of BM as first failure were no worse than patients experiencing other distant sites as first failure. The results indicates a that PCI should be considered to this group of patients No significant financial relationships to disclose.
Membranous Nephropathy and a TAP1 Gene Polymorphism
Authors: Dominique Chevrier, Magali Giral, Veronique Braud, Jean-Paul Soulillou, Jean-Denis Bignon
Journal: New England Journal of Medicine (1994)

To the Editor: Membranous glomerulopathy, which is characterized by immune-complex deposits on the epithelial side of the glomerular basement membrane, is one of the most frequent forms of glomerulopathy. The mechanisms responsible for abnormal antibody responses and immune-complex catabolism in this disease are unknown. Nevertheless, an association between membranous nephropathy and the HLA-DR3 class II antigen has been described1. Recently, two “new” genes (TAP1 and TAP2) have been mapped within the HLA class II region2. Each of these genes codes for a transmembrane protein located within the membrane of the endoplasmic reticulum. The noncovalent association of these two . . .
Successful Treatment of Orthostatic Hypotension with 9-Alpha-Fluorohydrocortisone
Authors: Roger B. Hickler, George R. Thompson, Lay M. Fox, James T. Hamlin
Journal: New England Journal of Medicine (1959)

THERE is direct evidence that the postural hypotension attending primary autonomic insufficiency results from a failure of the sympathetic-nerve endings to release nor-epinephrine in response to a gravitational stress.1 , 2 Attempts at treatment of this condition with a host of pressor substances, supplementary sodium chloride, desoxycorticosterone, vasopressin and mechanical appliances (elastic stockings, abdominal binders and so forth) have been reported.3 4 5 6 7 It is the purpose of this report to describe the successful treatment with 9-alpha-fluorohydrocortisone of the postural hypotension of a patient severely disabled with primary autonomie insufficiency. A method is described to indicate that the basic defect was not altered despite . . .
P115 Outcomes of sleep studies and targeted therapies in patients with Myotonic Dystrophy: a cohort study
Authors: SD West, KN Anderson, J Hughes, A Atalaia, SV Baudouin, H Lochmuller
Journal: Thorax (2015)

<h3></h3> Patients with myotonic dystrophy (DM) have complex respiratory and neurological disease. Sleepiness is common. We describe a prospective cohort study of patients with DM and response to sleep treatments. <h3>Methods</h3> DM patients with daytime sleepiness or symptoms of respiratory failure were referred to the Regional Sleep Centre. They were admitted overnight for sleep study and respiratory assessment. If there was central hypoventilation causing respiratory failure, or obstructive sleep apnoea (OSA), they were offered non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) respectively. People without sleep disordered breathing with daytime sleepiness were assessed for modafinil, an alerting drug. <h3>Results</h3> From May 2011 to May 2015, 120 people with DM had investigations. Mean age was 47 (SD 13, range 18–74), mean BMI 28 kg/m<sup>2</sup> (7, 16–53) and mean Epworth Sleepiness Score 13 (5, 2–24). Mean Muscular Impairment Rating Scale was 3.85 (0.7, 2–5). Mean FEV1 was 70% predicted (SD 22), FVC 68% predicted (27), with a &gt;15% supine fall in FVC in 18%. PI max, PE max or SNIP were below 50% predicted in 73% of people. In this cohort, 32 people (27%) had raised CO<sub>2</sub> &gt;6.2 mmHg; NIV was trialled and provided at home in 29 (90% of those in whom it was indicated). Twelve people (37%) have continued this, 17 (53%) have returned it. Twenty one people (18%) were found to have OSA and 19 commenced CPAP (90% of those in whom it was indicated). This was continued by seven people (33%) and returned by 12 (57%). Thirty seven people (31%) found to have no evidence of significant sleep-disorderd breathing were assessed for modafinil. Twenty seven people (73% of those in whom this was indicated) attended clinic for this: 16 (43%) had good effect from modafinil and continue on it, 8 (22%) had no effect or intolerance; in three (8%) it was not prescribed. Thirty people (25% of total cohort) had no sleep disordered breathing and required no further input. <h3>Conclusions</h3> DM is a heterogeneous disorder, with varying BMI, sleepiness, muscular and respiratory impairment. Overall, only 35% of the total cohort gained benefit from CPAP, NIV or modafinil and continued with this therapy.
β-Adrenergic Blockade in Diuretic-Treated Patients with Essential Hypertension
Authors: Emmanuel L. Bravo, Robert C. Tarazi, Harriet P. Dustan
Journal: New England Journal of Medicine (1975)

The influence of beta-adrenergic blockade (160 mg per day of propranolol for four weeks) on plasma renin activity, plasma volume, and arterial pressure was explored in 20 patients with essential hypertension with hyper-reninemia from long-term diuretic therapy. In 15 of these patients renin activity remained elevated (range, 3.1 to 23.0 ng per milliliter). Plasma volume was unchanged in eight, increased in 11 and reduced in one. In 17 subjects mean arterial pressure decreased by more than 10 mm Hg, but these impressive reductions could not be explained by quantitative changes in either renin activity (r equals 0.1) or plasma volume (r equals 0.1). These data suggest that suppression of plasma renin activity by beta-adrenergic blockade is not attainable during diuretic therapy and is not the major factor responsible for the antihypertensive action of propranolol.
Detection of Measles Virus RNA in Lymphocytes from Peripheral-Blood and Brain Perivascular Infiltrates of Patients with Subacute Sclerosing Panencephalitis
Authors: Jean-Guy Fournier, Marc Tardieu, Pierre Lebon, Olivier Robain, Gérard Ponsot, Shmuel Rozenblatt, Michel Bouteille
Journal: New England Journal of Medicine (1985)

Original Article from The New England Journal of Medicine — Detection of Measles Virus RNA in Lymphocytes from Peripheral-Blood and Brain Perivascular Infiltrates of Patients with Subacute Sclerosing Panencephalitis
Abstract 332: Extracellular matrix stiffness regulates metabolic state in metastatic, but not quiescent, breast carcinoma cells
Authors: Brett A. Morris, Brian Burkel, Suzanne Ponik, Kevin Eliceiri, Julio Aguirre-Ghiso, John Condeelis, James Castracane, Patricia J. Keely
Journal: Cancer Research (2015)

Abstract Increased breast density is associated with a 4-6 fold increased risk of developing breast cancer, and is associated with an increase in deposition of extracellular matrix (ECM) proteins, most abundantly collagen I. Collagen, like other ECM proteins, plays a structural role fundamental to tissue organization. High levels of collagen deposition correspond with a stiffer ECM, which is emerging as an important regulator of cell proliferation and tumor progression. Our previously reported microarray implicated changes in mammary epithelial cell metabolism in response to increased matrix stiffness, consistent with the expanding role of the ECM in tumor cell signaling. Here we report that increased matrix stiffness regulates the expression of pyruvate dehydrogenase kinase 1, a key regulator between lactic acid production and pyruvate entry into the mitochondria, in highly metastatic 4T1 breast carcinoma cells. Interestingly, we do not observe this same metabolic regulation in quiescent (dormant) 4T07 tumor cells of the same lineage. These alterations in protein expression correlated to changes in cellular NADH metabolism observed by several independent approaches, including metabolic flux analysis and quantitative imaging fluorescence lifetime microscopy. Thus, we find that alterations in collagen stiffness cause metabolic shifts between oxidative phosphorylation and aerobic glycolysis in highly metastatic cells, but not in quiescent cells. These findings identify stiffness of the ECM as an important regulator of metabolic state, and further identify quiescence as a dominant trait that is not overcome by ECM stiffness. Citation Format: Brett A. Morris, Brian Burkel, Suzanne Ponik, Kevin Eliceiri, Julio Aguirre-Ghiso, John Condeelis, James Castracane, Patricia J. Keely. Extracellular matrix stiffness regulates metabolic state in metastatic, but not quiescent, breast carcinoma cells. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 332. doi:10.1158/1538-7445.AM2015-332
Management of Atopic Dermatitis
Authors: Sarah L. Stein, Adam S. Cifu
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Life events and the course of bipolar disorder
Authors: A Ellicott, C Hammen, M Gitlin, G Brown, K Jamison
Journal: American Journal of Psychiatry (1990)

The authors examined the impact of life stress on the course of bipolar disorder over a 2-year period in a group of 61 outpatients. The patients were followed prospectively with ongoing assessments of stressful life events, symptoms, levels of maintenance medication, and compliance with treatment regimens. As predicted, survival analyses indicated a significant association between life events and relapse or recurrence of the disorder. These effects could not be explained by differences in levels of medication or compliance. Further research is recommended to examine which specific subgroups of bipolar patients are most susceptible to stress.
Case 38-1979
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Norman G. Levinsky, Nicholas J. Robert
Journal: New England Journal of Medicine (1979)

Presentation of CaseA 22-year-old man was admitted to the hospital because of a question of drug ingestion.He was reported to be a frequent abuser of illicit drugs, which included phencyclidine, lysergic acid and methaqualone, but there was no history of intravenous injections or of previous admissions to the hospital. During the month before entry he remained at home with his parents and was not known to associate with providers of drugs.Five days before admission he began to vomit repeatedly and complained of abdominal pain. Four days later he appeared improved but depressed. He ate very little and . . .
The Hepatic Hilar Lymphatics of Man
Authors: Archie H. Baggenstoss, James C. Cain
Journal: New England Journal of Medicine (1957)

NUMEROUS observations during the course of studies on the pathogenesis of experimental ascites have suggested that the hepatic lymphatics play an important part.1 2 3 4 In these studies ascites was produced by constriction of the inferior vena cava above the liver, and tremendous dilatation of the capsular lymphatics and the lymphatics in the hepatoduodenal ligament was observed. The question whether such changes occur in man has never been adequately investigated. It has been shown that the deep lymphatics of the liver follow the course of the portal veins and bile ducts and drain toward the hilus of the liver.2 , 5 , 6 It is generally . . .
Comparison of Procoagulant Activities in Extracts of Normal and Malignant Human Tissue&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: S G Gordon, J J Franks, B J Lewis
Journal: JNCI Journal of the National Cancer Institute (1979)

Cancer procoagulant A (CPA) was originally described in extracts of tumor tissue, but whether this represented a quantitative and/or a qualitative difference from procoagulant activity in normal tissue extracts was not clear. Procoagulant activity was quantitated in extracts of 12 matched normal and malignant human tissue samples from the large intestine, breast, lung, and kidney. The specific activity of procoagulants in the tumor extracts was not greater than that in the extracts of normal tissue. Two enzymatic characteristics of CPA that distinguish it from tissue thromboplastin are its inhibition by diisopropylfluorophosphate (DFP) and its lack of dependence on factor VII. These specific tests were used to evaluate qualitative differences between procoagulants from normal and malignant intestinal tissues. In the paired normal and malignant tissue extracts, all tumor samples were inhibited by DFP and were active in factor VII-depleted bovine plasma (F7D-BP). In contrast, the extracts of normal tissue were insensitive to DFP and, except for one extract, were inactive in F7D-BP. Four of 9 other tumor extracts (44%) were positive for both of these tests for CPA, whereas the other 5 extracts were positive for only one of the two tests. The results suggest that extracts of normal and malignant tissues contained similar levels of procoagulant. However, malignant tissue contained a procoagulant enzymatically different from normal tissue thromboplastin. Furthermore, most of the malignant tissue extracts seemed to contain little or no thromboplastin.
Suspected Palytoxin Inhalation Exposures Associated with Zoanthid Corals in Aquarium Shops and Homes — Alaska, 2012–2014
Authors: Ali K. Hamade, Sandrine E. Deglin, Joe B. McLaughlin, Jonathan R. De, Sara M. Handy, Ann M. Knolhoff
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

On August 12, 2014, an Anchorage hospital notified the Alaska Section of Epidemiology (SOE) that a middle-aged male resident of Anchorage (patient A) had arrived in the emergency department with possible palytoxin exposure. Patient A complained of a bitter metallic taste, fever, weakness, cough, and muscle pain 7-8 hours after introduction of live zoanthid coral into his home aquarium. Palytoxin, a potent toxin known to produce the reported effects, is contained in zoanthid marine corals.
Blood Ammonia during Bleeding from Esophageal Varices in Patients with Hepatosplenic Schistosomiasis
Authors: Kenneth S. Warren, Gilberto Rebouças
Journal: New England Journal of Medicine (1964)

HEPATIC coma1 , 2 is responsible for a significant proportion of the high case fatality rate occurring during episodes of bleeding esophageal varices in patients with cirrhosis of the liver.1 2 3 4 The etiology of coma in such cases has been related to the marked elevation of peripheral blood ammonia concentrations occurring during and immediately after the hemorrhages.5 , 6 Patients with hepatosplenic schistosomiasis, however, are said to suffer a relatively low case fatality during episodes of hematemesis, and the development of hepatic coma is supposedly rare.7 8 9 To elucidate the reasons for these differences, arterial and venous ammonia concentrations were measured during episodes of bleeding esophageal . . .
Increased Plasma Histamine Concentrations after Food Challenges in Children with Atopic Dermatitis
Authors: Hugh A. Sampson, Patricia L. Jolie
Journal: New England Journal of Medicine (1984)

Thirty-three patients with atopic dermatitis underwent double-blind placebo-controlled food challenges for evaluation of the role of histamine in hypersensitivity to food. After suspect foods were eliminated for 10 days, oral challenges were performed with up to 8 g of dehydrated food. A total of 35 positive challenges elicited symptoms that were cutaneous (31), gastrointestinal (17), nasal (8), and respiratory (6) within 10 to 90 minutes. Forty-one food challenges were negative, and all 60 placebo challenges were negative. Only the group of patients with positive food challenges had a significant mean (±S.E.M.) rise in the plasma histamine concentration, from 296±80 pg per milliliter before challenge to 1055±356 after challenge (P<0.001). Rises in plasma histamine that were seen after these positive oral food challenges implicate mast-cell or basophil mediators in the pathogenesis of food allergy, including cutaneous changes in patients with atopic dermatitis. (N Engl J Med 1984; 311:372–6.)
Indicators of Prognosis in Node-Negative Breast Cancer
Authors: Helgi Sigurdsson, Bo Baldetorp, Åke Borg, Mats Dalberg, Mårten Fernö, Dick Killander, Håkan Olsson
Journal: New England Journal of Medicine (1990)

Measures of the proliferative activity of tumor cells have prognostic value in patients with node-negative breast cancer. We studied 367 women in southern Sweden who had undergone surgical resection for such cancer. Tumor specimens were analyzed with DNA flow cytometry in order to estimate both the DNA content (ploidy) and the fraction of cells in the synthetic phase of the cell cycle (S phase). The median duration of follow-up was four years; 28 percent of the patients received adjuvant therapy, usually with tamoxifen (n = 83).
Prostate cancer treated with radiotherapy with or without androgen deprivation: The importance of the PSA nadir within 12 months
Authors: A. Pollack, A. L. Hanlon, E. M. Horwitz, S. J. Feigenberg, R. G. Uzzo
Journal: Journal of Clinical Oncology (2004)

4569 Background: The nadir in PSA after prostate cancer treatment with 3D conformal radiotherapy (RT) may take years to occur; it is these kinetics which limit the clinical application of this highly significant predictor of outcome. In this report the value of the nadir PSA within 12 months of completing RT (nadir PSA12) was determined for patients treated with RT alone or RT plus androgen deprivation (AD). Methods: Between 5/1989–11/1999, 997 men received RT alone and 153 received RT+AD (median duration of AD 3 mo; range 1–23 mo; 127 men received ≤6 mo). The median follow-up from the completion of all treatment was 59 mo and 67 mo for the RT alone and RT+AD groups. The median RT doses were 76 Gy (range 63–84 Gy) and 77 Gy (range 64–82 Gy) for the RT alone and RT+AD groups. Multivariate analysis (MVA) via Cox proportional hazards regression was used to determine the association of nadir PSA12 to biochemical failure (BF; ASTRO definition), distant metastasis (DM) and overall mortality (OM). Results: The median nadir PSA12s were 1.3 (range <0.1–177.0) and 0.3 ng/ml (range <0.1–9.1) in the RT alone and RT+AD groups. For those who received RT alone, nadir PSA12 was significantly related in the MVAs to BF (p=0.0005), DM (p<0.0001) and OM (p<0.0001), independently of the other significant covariates of RT dose (continuous), T-stage (T1/T2ab vs T2c/T3), Gleason score (2–6 vs 7 vs 8–10) and initial pre-RT PSA (iPSA; continuous) for BF and all but iPSA for DM and OM. For those who received RT+AD, nadir PSA12 was significantly related to BF (p=0.0003) and DM (p<0.0001), independently of the other significant covariates of RT dose and T-stage for BF and Gleason score for DM; there were not enough events to run an MVA for OM. A nadir PSA12 of >2 ng/ml was associated with 5 yr BF, and DM rates of 36% and 8% for RT alone and 100% and 50% for RT+AD. The 5 yr OM rate for those with a nadir PSA12 >2 ng/ml after RT alone was 8%. Conclusions: Nadir PSA12 was a strong independent predictor of eventual BF, DM and OM, providing meaningful early information that may prove useful in directing additional treatment, especially for those who received RT+AD. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration AstraZeneca