tbuckley/cabot-search huggingface dataset:
Correlation between FDG PET/CT and the expression of Ki-67, MMP-2, micro-vessel density (MVD), and pathological grading in squamous cell carcinoma of the esophagus
Authors: L. Liu, Y. Huang, J. Guo, Z. H. Wang, D. G. Song
Journal: Journal of Clinical Oncology (2009)

e15556 Background: Variable uptake of 18FDG has been noticed in positron emission tomography (PET) studies of patients with esophageal squamous cell carcinoma (ESCC). The aim of the present study was to determine if 18 F-FDG PET/CT standardized uptake value (SUV) could quantitatively reflect tumor proliferation, invasion and angiogenesis, and to reveal the relationship between SUV and pathological grading of ESCC. Methods: Preoperative PET scans were performed in 47 patients with histologically proven ESCC. 18FDG uptake was semiquantitatively measured by SUV.Tumour sections were HE stained to determine the pathological grading,and were stained by immunohistochemistry for proliferation marker (Ki67), invasion marker (MMP-2), and angiogenic marker (CD34). The correlations between FDG SUVmax and Ki67 expression, MMP-2 expression, corresponding MVD were statistically analysed respectively. Results: Among all the 47 cases,there were 13 well- differentiated squamous cell tumors, 16 moderately differentiated tumors and 18 poorly differentiated tumors,45 of 47 tumors revealed FDG. accumulation in primary tumor foci confirmed by subsequently histopathologically. The mean FDG SUVmax value was 12.504 ± 6.805. Average Ki-67 index was (7.837±29.798) %, average MMP-2 index was (71.551%±27.126) % and average MVD was (18.429±9.603) accordingly. The SUV and Ki-67 index, MMP-2 index were positively correlated (r=0.581,0.594), and it was not correlated with MVD(P&gt;0.05). The mean SUV of well-differentiated, moderately differentiated and poorly differentiated tumors were 9.787±1.477, 12.313±0.479, 15.053±2.147 respectively, and a significant difference could be determined between them by statistical analysis(P=0.000). Conclusions: A significant positive correlation is demonstrated between FDG PET/CT SUV and Ki-67 index, MMP-2 index of the primary ESCC. SUV could reflect proliferation and invasion potential of tumor. However, there is no significant correlation between SUV and MVD, thus it could not reflect tumor angiogenesis in ESCC. To some extent, SUV could reflect pathologic grading of ESCC. No significant financial relationships to disclose.
Human Neutrophil-Mediated Cytotoxicity to Tumor Cells&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: T L Gerrard, D J Cohen, A M Kaplan
Journal: JNCI Journal of the National Cancer Institute (1981)

The role of human neutrophils as effector cells in host resistance to neoplasia was investigated. Neutrophil cytotoxicity was quantitated in an in vitro assay measuring release of [3H]thymidine from prelabeled human tumor cells. Neutrophils were consistently cytotoxic and cytostatic to the adherent tumor lines T24 (a transitional cell carcinoma of the bladder), LR (melanoma), and simian virus 40-transformed WI-38 VA 13 fibroblasts and to the nonadherent lymphoid tumor lines K562, Raji, and CEM. Maximum cytolysis and cytostasis occurred at 72 hours. Neutrophils were selectively cytotoxic for tumor cells and generally did not kill normal human fibroblasts. Selected protease inhibitors did not inhibit neutrophil cytotoxicity and neutrophil lysates were ineffective in killing tumor targets.
Treatment of Hypoparathyroid Patients with Chlorthalidone
Authors: Robert H. Porter, Brian G. Cox, David Heaney, Thomas H. Hostetter, Bobby J. Stinebaugh, Wadi N. Suki
Journal: New England Journal of Medicine (1978)

In an effort to maintain normal serum calcium levels without inducing hypercalciuria, we treated seven hypoparathyroid patients for up to 25 months with chlorthalidone, a thiazide-like sulfonamide diuretic, plus a salt-restricted diet, without added vitamin D. Mean 24-hour calcium excretion decreased from 179 to 88 mg (P<0.001), and mean serum calcium increased from 8.2 to 9.3 mg per deciliter (P<0.05). Diuretic therapy or moderate salt restriction alone was not as effective as combined therapy. Beneficial effects were sustained for as long as therapy was maintained. The rise in serum calcium, which involves the filterable and ionized fractions, cannot be due entirely to reduced excretion and may in part be explained by increased intestinal absorption. Oral chlorthalidone plus a low salt diet appears to be an effective alternative to vitamin D in the maintenance therapy of at least some patients with hypoparathyroidism. (N Engl J Med 298:577–581, 1978)
P191 Survival in patients with chronic type 2 respiratory failure: a comparison of obesity hypoventilation syndrome, COPD and overlap syndrome
Authors: A Jothieswaran, M Mascareno, S Bokhari, N Chaudhry, TW Felton, AM Bentley
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Home non-invasive ventilation (NIV) is established for the treatment for patients with obesity-related type 2 respiratory failure. Long-term outcomes for the use of NIV in patients with chronic hypercapnic COPD and “overlap syndrome” are less certain. Our objective was to compare the long-term survival of patients with obesity hypoventilation syndrome (OHS), COPD and overlap syndrome who were established on NIV. <h3>Methods</h3> All patients with a diagnosis of COPD, OHS and overlap syndrome were identified retrospectively from a patient database. Overlap syndrome was defined as COPD and either OHS or obstructive sleep apnoea resulting in chronic type 2 respiratory failure. The diagnosis was defined at the time NIV was established from medical assessment and respiratory physiology. All patient data was anonymised. A Kaplan-Meier survival analysis was performed. Median survival was estimated for each of the three groups. Survival was compared using Mantel-Cox test, Gehan-Breslow-Wilcoxon test and Log-rank test. <h3>Results</h3> In total 463 patients were established on NIV. NIV was initiated on 158 patients with COPD (51% female, 49% male, mean age at set up 66 years), 269 patients with OHS (46% female, 54% male, mean age 62 years) and 36 patients with overlap syndrome (48% female, 52% male, mean age 66 years). The Kaplan-Meier survival curves for the three groups are shown. A clinically and statistically significant difference in survival was observed between the three groups (p &lt; 0.0001). Patients with COPD had the worst long term survival compared with patients with OHS and the overlap syndrome. The median survival was 49 months for patients with COPD, 92 months for patients with overlap syndrome and 141 for patients with OHS. <h3>Conclusion</h3> Evidence for domiciliary NIV in patients with OHS is well established. There is emerging evidence to support with use of NIV in patients with chronic hypercapnic COPD and low body mass index. Patients with overlap syndrome are a heterogeneous group representing a spectrum from predominately COPD to predominately OHS. Further studies are required to establish if patients with overlap syndrome benefit from NIV and to identify potentially modifiable risk factors associated with a poor outcome.
Where Have All the Primary Care Applicants Gone?
Authors: Jack M. Colwill
Journal: New England Journal of Medicine (1992)

NOT all aspects of the 1960s can be viewed with nostalgia. Nevertheless, many people have such feelings for the deep social concern of the times. During the 1960s Congress implemented Medicare and Medicaid and also initiated primary care programs for underserved rural and inner-city populations. Convictions about a shortage of physicians led first to an expansion in the size of medical school classes and then to a recognition that more primary care physicians were needed. With state and federal support, residency training in family practice expanded rapidly during the 1970s,1 followed by the introduction of primary care tracks in internal . . .
The Nutritional Status of Civilians Rescued from Japanese Prison Camps
Authors: Allan M. Butler, Julian M. Ruffin, Marion M. Sniffen, Mary E. Wickson
Journal: New England Journal of Medicine (1945)

SEVERAL thousand United States citizens interned in Japanese prison camps in the Philippines from the latter part of December, 1941, to the middle of February, 1945, received diets that progressively became so inadequate as to result in marked nutritional deficiencies. The turmoil at the time of release and the exigencies pertaining between that time and embarkation for the United States prevented a systematic appraisal of the nutritional status of these persons during that period. The arrival of these citizens in West Coast ports, however, provided a momentary opportunity to make an appraisal not only of the deficiencies suffered from the . . .
Metabolic Effects of Somatostatin in Maturity-Onset Diabetes
Authors: William V. Tamborlane, Robert S. Sherwin, Rosa Hendler, Philip Felig
Journal: New England Journal of Medicine (1977)

To examine the effects of prolonged infusions of somatostatin in maturity-onset diabetes, we administered five-hour infusions to eight patients. This infusion resulted in a 45 to 55 per cent decline in plasma insulin and glucagon. Plasma glucose initially fell by 20 to 25 mg per 100 ml, but later rose despite continuing hypoglucagonemia. After five hours, plasma glucose concentration was 45 to 50 mg per 100 ml higher than that observed with saline infusion (P<0.001). The degree of hyperglycemia and plasma insulin levels correlated inversely at completion of the infusion (P<0.01). In addition, somatostatin resulted in a fivefold increase in β-hydroxybutyrate and a 40 to 45 per cent rise in branched-chain amino acids (P<0.005). Our findings suggest that glucagon is not essential for the development and maintenance of fasting hyperglycemia. Furthermore, accentuation by somatostatin of hyperglycemia, hyperketonemia and hyperaminoacidemia in maturity-onset diabetes argues against its use in patients with residual insulin secretion. (N Engl J Med 297:181–183, 1977)
Alterations of Red-Cell Glycolytic Intermediates and Oxygen Transport as a Consequence of Hypophosphatemia in Patients Receiving Intravenous Hyperalimentation
Authors: Susan F. Travis, Harvey J. Sugerman, Robert L. Ruberg, Stanley J. Dudrick, Maria Delivoria-Papadopoulos, Leonard D. Miller, Frank A. Oski
Journal: New England Journal of Medicine (1971)

Abstract Within seven to 10 days after initiation of  intravenous hyperalimentation with solutions lacking added inorganic phosphate, five of eight adults were found to be significantly hypophosphatemic (serum inorganic phosphate less than 1 mg per 100 ml). Associated with this hypophosphatemia was a decrease in erythrocyte glucose-6-phosphate, fructose-6-phosphate, 3-phosphoglyceric acid, 2-phosphoglyceric acid, phosphoenolpyruvate, 2,3-diphosphoglycerate and adenosine triphosphate, and a marked increase in the concentration of total triosre phosphates. The reduction in 2,3-diphosphoglycerate and adenosine triphosphate was accompanied by a striking increase in the red cell's affinity for oxygen. In an additional patient studied prospectively, the changes in erythrocyte metabolism were initially manifested by a slight rise in the total triose phosphates, which was rapidly followed by alterations similar to those described above. These findings suggest that in vivo red-cell glucose metabolism is c...
The Affordable Care Act: Where Are We Now? An NCCN Roundtable
Authors: Christian G. Downs, Liz Fowler, Michael Kolodziej, Lee H. Newcomer, Mohammed S. Ogaily, W. Thomas Purcell, John C. Winkelmann, Clifford Goodman
Journal: Journal of the National Comprehensive Cancer Network (2014)

The Affordable Care Act (ACA) is a transformational event for health care in the United States, with multiple impacts on health care, the economy, and society. Oncologists and other health care providers are already experiencing many changes—direct and indirect, anticipated and unanticipated. A distinguished and diverse panel assembled at the NCCN 19th Annual Conference to discuss the early phase of implementation of the ACA. The roundtable touched on early successes and stumbling blocks; the impact of the ACA on contemporary oncology practice and the new risk pool facing providers, payers, and patients; and some of the current and future challenges that lie ahead for all.
Case 36-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, John A. Mills, Harold F. Dvorak
Journal: New England Journal of Medicine (1970)

Presentation of CaseA 45-year-old man was admitted to the hospital because of dyspnea.For 20 years he had experienced mild attacks of asthma, limited to the summer months. Eleven months before admission diabetes and hypertension were found. Tolazamide was given for two weeks, and a diet was prescribed; he lost 9 kg in weight and thereafter regulated the diabetes with diet alone. Sodium restriction and oral medication were prescribed for hypertension but were omitted six months later when the blood pressure was found to be normal. Seven months before entry he was admitted to another hospital because of palpitation. . . .
BCR-ABL transcript analysis of patients (pts) with imatinib-resistant or -intolerant chronic myeloid leukemia in chronic phase (CML-CP) treated with nilotinib.
Authors: D. Kim, G. Saglio, G. Martinelli, Y. Shou, A. M. Stein, R. C. Woodman, H. Kantarjian, T. P. Hughes, J. P. Radich, A. Hochhaus
Journal: Journal of Clinical Oncology (2010)

6567 Background: CML patients with different types of BCR-ABL transcript may vary in disease prognosis and responses to therapy. An analysis was conducted to investigate the correlation between BCR-ABL transcript type and responses to nilotinib in the second-line setting. Methods: CML-CP pts (n = 321) with imatinib resistance or intolerance were included. In order to determine if transcript type influenced response dynamics, BCR-ABL transcript types were analyzed in 301/321 (94%) of pts. In addition, the BCR-ABL transcript dynamics were modeled as previously described (Stein et al. Blood. 2009;114(22):209). Results: Median nilotinib exposure was 561 days. The majority of pts (95%) were observed to have typical b3a2 (63%) and b2a2 (32%) BCR-ABL transcript types; 3% of pts had both typical transcripts and 2% had atypical transcripts (e1a2, e19a2, b3a3). The incidence of BL mutations was higher in patients with b3a2 transcripts compared with b2a2 (46% vs. 32%, p = 0.03). Response to nilotinib was similar regardless of transcript type (Table). A two-sample χ2 test of the four endpoints (CHR, CyR, MMR, and PFS) did not show a significant difference (p > 0.05) between the b2a2 and b3a2 populations. Modeling results demonstrated no statistically significant difference in the response dynamics between the major BCR-ABL transcript types. Conclusions: These data suggest that nilotinib is effective in patients with all BCR-ABL transcript types including those with atypical transcripts. Patients with typical b3a2 and b2a2 transcripts have similar patterns of response to nilotinib. Best response to nilotinib by transcript type Number Hematologic response, % Cytogenetic response, % Molecular response, % Event-freesurvival, % Transcript type n CHR CCyR PCyR MMR EFS b2a2 95 87.4 44.2 13.7 16.8 58.3 b3a2 190 80.5 34.2 10.0 15.3 51.4 b2a2 + b3a2 10 90.0 50.0 20.0 10.0 71.4 e1a2 2 100.0 0 50.0 — 100.0 e19a2 2 50.0 0 0 — 0 b3a3 2 100.0 100.0 0 — 100.0 p value: comparing b2a2 vs. b3a2 using χ2 2-sample test 0.15 0.09 0.73 0.34 Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Bristol-Myers Squibb, MSD, Novartis, Wyeth Novartis Bristol-Myers Squibb, Celgene, MSD, Novartis Bristol-Myers Squibb, Genzyme, Novartis, Wyeth
Case 20-2011
Authors: Edward T. Ryan, Lawrence C. Madoff, Mary Jane Ferraro
Journal: New England Journal of Medicine (2011)

A 30-year-old man was seen in the emergency room of this hospital because of the acute onset of diarrhea 2 days after his return from a trip to the Caribbean. He was afebrile, and the diarrhea was watery without blood. A diagnostic test was performed.
The Widening Sphere of Influence of HOXB7 in Solid Tumors
Authors: Maria Cristina Errico, Kideok Jin, Saraswati Sukumar, Alessandra Carè
Journal: Cancer Research (2016)

Strong lines of evidence have established a critical role for the homeodomain protein HOXB7 in cancer. Specifically, molecular and cellular studies have demonstrated that HOXB7 is a master regulatory gene, capable of orchestrating a variety of target molecules, resulting in the activation of several oncogenic pathways. HOXB7 overexpression correlates with clinical progression and poor outcome of cancer patients. Specific inhibition of HOXB7 is particularly relevant in cancers still lacking effective therapies, such as tamoxifen-resistant breast cancer and melanoma. Mechanistic studies are providing additional targets of therapy, and biomarker studies are further establishing its importance in early diagnosis and prognosis. Cancer Res; 76(10); 2857-62. ©2016 AACR.
FLUID VOLUME BALANCE BETWEEN PULMONARY INTRAVASCULAR SPACE AND EXTRAVASCULAR SPACE IN DOGS
Authors: Junpei Iinuma, Michio Arakawa, Yo Yasuda, Kenjiro Kambara, Hidetaka Miyazaki, Takashi Segawa, Senri Hirakawa
Journal: Circulation (1986)

We aimed to study the agreement of estimates of the pulmonary blood volume by the double indicator dilution method and the direct destructive method and the fluid volume balance between the pulmonary intravascular and extravascular spaces. We employed the double indicator dilution method using heat and indocyanine green, with a single injection (into the right atrium) and double sampling technique, that is from the pulmonary artery trunk (PAT) and the aortic root (Ao). With this method, we simultaneously determined the pulmonary extravascular water volume (PEWV), defined as the extravascular lung thermal volume estimated in Ao (LTVAo), and the pulmonary blood volume (PBV) from PAT to the left atrium (LA) (PBVPAT-LA). Dogs were divided into groups: a group without intervention (n = 16), a group loaded with dextran (n = 12) and a group loaded with alloxan (n = 7). When all groups were included, PBVPAT-LA (ml/kg) = 1.02 X PBVdirect(g/kg) + 0.96, n = 35, r = 0.83 where PBVdirect means the blood contents from the pulmonary artery bifurcation to the pulmonary vein measured by the direct destructive method. We substantiated the validity of the use of the double indicator dilution method. In studying the fluid volume balance, based on the results of the direct destructive method, the pulmonary intravascular-extravascular fluid volume ratio (intra/extra) was 1.3 +/- 0.3 (mean +/- SD) in the control state, implying that the interstitium in the lung is relatively dry. As overt pulmonary edema developed by dextran infusion, the ratio exponentially decreased to 1.0 +/- 0.1 (p less than 0.01). The behavior of the fluid volume balance in question (intra/extra), studied with the double indicator dilution method, was essentially similar to that analyzed by the direct destructive method.
Changes in Plasma Lipids and Lipoproteins during Isotretinoin Therapy for Acne
Authors: Susan Bershad, Ardon Rubinstein, James R. Paterniti, Ngoc-Anh Le, Susana C. Poliak, Bruce Heller, Henry N. Ginsberg, Raul Fleischmajer, W. Virgil Brown
Journal: New England Journal of Medicine (1985)

Abnormalities in plasma lipids are a recognized side effect of isotretinoin therapy for nodulocystic acne. We studied 60 patients during 20 weeks of isotretinoin therapy, to measure changes in plasma lipids and lipoproteins, to compare plasma lipid responses in men and women, and to determine whether there are alterations in levels of lipoprotein lipase or hepatic triglyceride lipase that could explain the development of isotretinoin-induced hypertriglyceridemia. Mean triglyceride levels rose in men and women, with maximum mean increases of 46.3 mg per deciliter (P<0.0001) and 52.3 mg per deciliter (P<0.002), respectively. The maximum level was reached by 4 weeks of therapy in men but not until the 12th week in women. Nine of 53 patients (17 per cent) completing 20 weeks of isotretinoin therapy acquired hypertriglyceridemia, with values of 200 to 600 mg per deciliter. Both men and women had significant increases in mean plasma levels of cholesterol and low-density-lipoprotein cholesterol and decreases in mean levels of high-density-lipoprotein cholesterol. There were no significant changes in mean levels of lipoprotein lipase or hepatic triglyceride lipase. Plasma lipid and lipoprotein levels returned to base line by eight weeks after discontinuation of the drug. If sustained over a long period, the change in the ratio of low-density-lipoprotein cholesterol to high-density-lipoprotein cholesterol that we observed, from 2.4 to 3.0 (P<0.0001), would predict an increased risk of cardiovascular disease. (N Engl J Med 1985; 313: 981–5.)
Predicting which patients will be discharged against medical advice: a pilot study
Authors: P Steinglass, C E Grantham, M Hertzman
Journal: American Journal of Psychiatry (1980)

Studies of patients signing out against medical advice (AMA) from a psychiatric service have been retrospective and inconsistent or contradictory in their findings. The authors report findings from a prospective study in which data from a brief structured interview of patients at the time of admission were used to predict subsequent AMA behavior. They achieved 80% accuracy. Critical variables centered around the nature of the "treatment contract" as perceived by the patient: AMA patients never intended to stay in the hospital for more than a few days.
Muscle Proteolysis Induced by a Circulating Peptide in Patients with Sepsis or Trauma
Authors: George H. A. Clowes, Barbara C. George, Claude A. Villee, Calvin A. Saravis
Journal: New England Journal of Medicine (1983)

Accelerated proteolysis of muscle is characteristic in patients with trauma or sepsis, but its cause is not well understood. Using rat muscle in vitro, we developed a bioassay to compare the proteolytic activity of plasma from 50 patients with trauma or sepsis with that of plasma from 14 normal volunteers and from 15 patients who had undergone "clean" elective surgical procedures. The mean proteolytic activity in the plasma of patients with trauma or sepsis was found to be 190 +/- 8.0 per cent of the control value (rat muscle incubated in medium alone), whereas the activity in normal plasma was 124 +/- 4.5 per cent (P less than 0.001). The activity in the plasma of patients who had undergone elective surgery was slightly elevated at 142 +/- 2.5 per cent (P less than 0.005). In 25 of the patients with trauma or sepsis the rate of amino acid release from one leg was measured by subtracting the concentration of tyrosine plus phenylalanine in the femoral artery plasma from that in the femoral vein; this rate correlated well with the bioactivity of the plasma in the bioassay system (r = 0.67, P less than 0.001). By means of ultrafiltration and chromatography, the plasma factor inducing proteolysis was isolated and found to be a peptide, probably containing sialic acid, with a chain of 33 amino acids and a molecular weight of approximately 4274 daltons.
Chronic Meningitis Associated with Histoplasma Endocarditis
Authors: Herbert J. Gerber, Fred W. Schoonmaker, Martha D. Vazquez
Journal: New England Journal of Medicine (1966)

ENDOCARDITIS due to Histoplasma capsulatum is rare. To our knowledge only 16 documented cases have been reported in the literature.1 Histoplasmosis is responsible for approximately a third of all reported cases of fungal endocarditis.2 , 3 The purpose of this paper is to present a case of histoplasma endocarditis that was undetected clinically.Case ReportA 59-year-old married retired Air Force sergeant from Tennessee entered the hospital on May 6, 1965. He had been well until August, 1964, when he had a thromboembolectomy of the left iliac artery at another hospital after a short history of leg pain and swelling. Subsequently, he . . .