tbuckley/cabot-search huggingface dataset:
A Simple Discriminatory Test for Upper Gastrointestinal Hemorrhage
Authors: William V. McDermott
Journal: New England Journal of Medicine (1957)

THE proper management of a patient with acute upper gastrointestinal hemorrhage depends upon the prompt localization of the source. In the experience at this hospital, about a third of the patients with this type of hemorrhage proved to be bleeding from esophageal varices.1 If this diagnosis could be established or eliminated, the problem would be greatly simplified. Both direct esophagoscopy and roentgenologic visualization of the upper gastrointestinal tract are frequently unsatisfactory or even impossible in the patient with continuing massive hemorrhage. Tests of liver function, such as the percentage of bromsulfalein retention, have proved unreliable (Fig. 1).Recent studies from . . .
Angiokeratoma Corporis Diffusum Universale (Fabry's Disease) in Two Brothers
Authors: J. E. Bethune, P. L. Landrigan, C. D. Chipman
Journal: New England Journal of Medicine (1961)

ANGIOKERATOMA corporis diffusum universale, or Fabry's disease, was regarded as a dcrmatologie curiosity until a description by Ruiter and Pompen1 from the Netherlands in 1939 suggested that it was a progressive systemic disorder. Since Fabry's2 original paper in 1898 about 35 cases have been described. The first case report in North America was published in 1955,3 and since then 4 more have been recorded.4 It is apparent from a review of the cases reported that a characteristic clinical pattern of progressive disease develops. At about the time of puberty in males, skin lesions that are only slowly progressive appear on . . .
An Immunoglobulin (IgG) Inhibitor of Polymorphonuclear Leukocyte Motility in a Patient with Recurrent Infection
Authors: Neil Kramer, H. Daniel Perez, Ira M. Goldstein
Journal: New England Journal of Medicine (1980)

We isolated from the serum of a patient with recurrent skin infections an IgG immunoglobulin that irreversibly inhibits the random motility and chemotactic responsiveness of polymorphonuclear leukocytes. Although the patient's leukocytes behaved like normal cells with respect to adherence, phagocytosis, degranulation, and generation of the superoxide anion, they did not migrate normally toward standard chemotactic stimuli. Normal human polymorphonuclear leukocytes behaved similarly after incubation with the patient's serum. Inhibition of motility was not associated with cyutotoxicity. Inhibitory activity could be removed completely from the patient's serum by treatment with either agarose-bound anti-human IgG or Sepharose-bound staphylococcal protein A. Exposure of normal polymorphonuclear leukocytes to as little as 1.25 microgram per milliliter (0.00125 g per liter) of the patient's purified IgG caused significant inhibition of random motility and chemotactic responsiveness (P < 0.01). Thus, IgG immunoglobulins can inhibit leukocyte motility specifically and irreversibly, and thereby adversely affect host defenses against invading microorganisms.
Randomized controlled trial of comparing gastrectomy (Gx) plus chemotherapy (CTX) with CTX alone in advanced gastric cancer (AGC) with a single non-curable factor: JCOG 0705/KGCA01 study (REGATTA).
Authors: Han-Kwang Yang, Toshimasa Tsujinaka, Kenichi Nakamura, Young Woo Kim, Masanori Terashima, Sang Uk Han, Yoshiaki Iwasaki, Woo Jin Hyung, Akinori Takagane, Byung-Joo Park, Kazumasa Fujitani, Seokyung Hahn, Mitsuru Sasako, Yung-Jue Bang
Journal: Journal of Clinical Oncology (2015)

200 Background: The prognosis of AGC with non-curable factors is poor. Chemotherapy is the standard-of-care for those patients. However, literatures suggest that Gx may improve patients' survival. Based on these, we conducted an international randomized trial to test the role of Gx in AGC with a single non-curable factor. This trial was performed in Japan, Korea, and Singapore. Methods: Eligibility criteria included histologically proven gastric adenocarcinoma, cT1-3, presence of a single non-curable factor confined to either liver (H1), peritoneum (P1), or para-aortic lymph node (16a1/b2) confirmed by both CT scan and laparoscopy/laparotomy, no other distant metastasis, aged 20-75, and PS 0-1. Eligible patients were randomized to Gx followed by CTX or CTX alone. Gx with D1 lymph node dissection was recommended without resection of metastatic lesions. CTX regimen was S-1 80 mg/m2/day on days 1-21 plus CDDP 60 mg/m2 on day 8 repeated every 5 weeks. The primary endpoint was overall survival (OS). The planned sample size was 165 cases per arm, with one-sided alpha of 5%, and an 80% power detecting a 2y-survival difference of 10% (20% with CTX alone vs. 30% with Gx and CTX). Results: Between Feb 2008 and Aug 2013, 175 patients (95 in Japan, 80 in Korea) were randomized. 89 pts were randomized to Gx and CTX, and 86 pts were randomized to CTX alone. The first interim analysis was performed in Sep 2013, with 37% (110/294) of the planned events observed, and JCOG DSMC recommended early termination of the trial based on the overall futile effect. In the updated analysis in Dec 2014 with a median follow-up period of 14.5 months, the 2y-OS were 25.1 (95% CI: 16.2 to 34.9) % with Gx followed by CTX and 31.7 (95% CI: 21.7 to 42.2) % with CTX alone (p = 0.68). However, subgroup analyses suggested gastrectomy might be beneficial especially for patients with L lesion or cN2/N3. Conclusions: In all randomized patients, Gx followed by CTX has no survival benefit over CTX alone for AGC patients with a single non-curable factor. There is a room to re-evaluate the additional gastrectomy confined to the patients in whom distal gastrectomy suffices for tumor resection. Clinical trial information: UMIN000001012.
Abstract #LB-115: Epigenetic study of serine protease PRSS23 in breast cancer proliferation regulated by estrogen receptor-\#945;
Authors: Hau Chan, Yu Lin, Shing Chang, Kuan Lin, Yung Chuang
Journal: Cancer Research (2009)

Serine protease 23 (PRSS23) is a novel member of the trypsin S1 superfamily. Recent transcript profiling studies have shown that PRSS23 may involve in cancer invasion. Interestingly, its mRNA level is found to be significantly elevated in MCF7, which is an estrogen receptor-\#945; positive (ER\#945;+) breast cancer cell line. In our previous study, PRSS23 was found to be transported into the cell nucleus in vitro. Thus, we hypothesized that PRSS23 may be a nuclear effecter of estrogen signaling in breast cancer proliferation. To test our hypothesis, we first surveyed PRSS23 expression in both types of the breast cancer cell lines (ER\#945;+:MCF7, BT-474, T-47D / ER\#945;-:MD-MB-231, MCF10A, Hs.578t), and three other non-breast cancer cell lines. Our results indicated that PRSS23 expression matched with the ER\#945; expression in at least three breast cancer cell lines, which include MCF7, BT474, and T47D. We then performed immunohistochemical assay to confirm the presence of PRSS23 in breast cancers at protein level using a custom polyclonal antibody. The positive identification led us to analyze the promoter binding region of PRSS23 and revealed an upstream estrogen responsive element (ERE), whose transcription regulatory function was subsequently validated by ChIP assay and ERE luciferase reporter assay in MCF7 and HEK293T. In another co-IP assay, we found PRSS23 may affect chromatin assembly in the breast cancer cell line. Last but not the least, PRSS23 was found to highly expressed in clinical ER\#945;+ breast cancer tissues as expected. Taken together, our finding supports the hypothesis that PRSS23 expression is under direct ERE regulation. It strongly implied that PRSS23 may participate in the cell cycle control of all ER\#945;+ breast cancers. Thus, we believe PRSS23 might serve as a prognostic marker for breast cancer in the clinical setting. It may also become a novel target for breast cancer therapy development.  Keywords  PRSS23; breast cancer; estrogen receptor \#945;; cell proliferation   Citation Information:  In: Proc Am Assoc Cancer Res; 2009 Apr 18-22; Denver, CO. Philadelphia (PA): AACR; 2009. Abstract nr LB-115.
Sleep and treatment prediction in endogenous depression
Authors: D J Kupfer, D G Spiker, P A Coble, J F Neil, R Ulrich, D H Shaw
Journal: American Journal of Psychiatry (1981)

The prediction of clinical response in depression has been based primarily on clinical symptoms and history. Recently, psychobiologic measures have been used to increase the accuracy of clinical prediction. In 34 drug-free patients with primary endogenous depression treated with amitriptyline, the application of EEG-monitored sleep criteria alone was more significant than clinical status alone in the prediction of clinical response. Prolonged REM latency and reduced difficulty in sleep onset following the administration of amitriptyline were the main sleep variables contributing to this prediction equation. These data suggest a strong relationship between clinical outcome and psychobiologic profile in patients with endogenous depression after a "pharmacologic probe" with a tricyclic antidepressant.
S82 Survival of HIV-infected patients admitted to the intensive care unit
Authors: A. G. Adlakha, M. Pavlou, D. Walker, A. J. Copas, S. Batson, S. G. Edwards, M. Singer, R. F. Miller
Journal: Thorax (2010)

Background Several studies from USA and Europe have suggested the outcome for HIV-infected patients admitted to the intensive care unit (ICU) has improved, concurrent with both the introduction of highly active antiretroviral therapy (HAART) and improved management of respiratory failure. This study examined outcomes and prognostic factors for HIV-infected patients admitted to our ICU over a 10-year period. Methods Retrospective study of HIV-infected adults admitted to a UK University-affiliated hospital ICU between January 1999 and March 2009. Information collected included patient demographics, receipt of HAART (no patient began HAART while on the ICU), reason for ICU admission and hospital course. Outcomes were survival to ICU and hospital discharge. Comparison was made against outcomes for general medical patients admitted to the same ICU. Multivariate analysis was used to assess prognostic factors. Results 192 HIV-infected patients had 222 admissions to the ICU. Among these 192 patients, 116 required mechanical ventilation and 43 renal replacement therapy. Their ICU admission was due to an HIV-associated diagnosis in 113 patients; 37 patients had Pneumocystis pneumonia. Survival to ICU discharge and hospital discharge was 78% and 70%, respectively, compared with 75% and 68% among 2065 general medical patients admitted to the ICU on 2274 occasions over the same time period. HIV infection was newly diagnosed (on this hospital admission) in 42 patients; among this group ICU and hospital survival was 69% and 57%, respectively. Factors associated with ICU survival were age (OR=0.97, 95%CI 0.93 to 1.00, per 10 year increase), haemoglobin (OR=1.33, 95%CI 1.07 to 1.65, for an increase of 1 g/dl), APACHE II score (OR=0.56, 95%CI 0.39 to 0.90, per 10 unit increase), receipt of HAART (OR=2.88, 95%CI 1.29 to 6.42) and need for mechanical ventilation (OR=0.18, 95%CI 0.07 to 0.43). Conclusions In the era of HAART the outcome from ICU for HIV-infected patients was comparable to that among general medical patients. These data infer neither HIV infection itself, nor an HIV-associated diagnosis should preclude referral to the ICU. The poorer outcome among those with newly diagnosed HIV infection underscores the need to encourage HIV testing outside of Genitourinary Medicine clinics.
Prevention of Acute Graft Rejection by the Prostaglandin E<sub>1</sub>Analogue Misoprostol in Renal-Transplant Recipients Treated with Cyclosporine and Prednisone
Authors: M Moran, M F Mozes, M S Maddux, S Veremis, C Bartkus, B Ketel, R Pollak, C Wallemark, O Jonasson
Journal: New England Journal of Medicine (1990)

Original Article from The New England Journal of Medicine — Prevention of Acute Graft Rejection by the Prostaglandin E1 Analogue Misoprostol in Renal-Transplant Recipients Treated with Cyclosporine and Prednisone
T-cell Landscape in a Primary Melanoma Predicts the Survival of Patients with Metastatic Disease after Their Treatment with Dendritic Cell Vaccines
Authors: Angela Vasaturo, Altuna Halilovic, Kalijn F. Bol, Dagmar I. Verweij, Willeke A.M. Blokx, Cornelis J.A. Punt, Patricia J.T.A. Groenen, J. Han J.M. van Krieken, Johannes Textor, I. Jolanda M. de Vries, Carl G. Figdor
Journal: Cancer Research (2016)

Tumor-infiltrating lymphocytes appear to be a predictor of survival in many cancers, including cutaneous melanoma. We applied automated multispectral imaging to determine whether density and distribution of T cells within primary cutaneous melanoma tissue correlate with survival of metastatic melanoma patients after dendritic cell (DC) vaccination. CD3(+) T cell infiltration in primary tumors from 77 metastatic melanoma patients was quantified using the ratio of intratumoral versus peritumoral T-cell densities (I/P ratio). Patients with longer survival after DC vaccination had stronger T-cell infiltration than patients with shorter survival in a discovery cohort of 19 patients (P = 0.000026) and a validation cohort of 39 patients (P = 0.000016). I/P ratio was the strongest predictor of survival in a multivariate analysis including M substage and serum lactate dehydrogenase level. To evaluate I/P ratio as a predictive biomarker, we analyzed 19 chemotherapy-treated patients. Longer survival times of DC-vaccinated compared with chemotherapy-treated patients was observed for high (P = 0.000566), but not low (P = 0.154) I/P ratios. In conclusion, T-cell infiltration into primary melanoma is a strong predictor of survival after DC vaccination in metastatic melanoma patients who, on average, started this therapy several years after primary tumor resection. The infiltration remains predictive even after adjustment for late-stage prognostic markers. Our findings suggest that the I/P ratio is a potential predictive biomarker for treatment selection. Cancer Res; 76(12); 3496-506. ©2016 AACR.
Improvement in Glucose Tolerance and Insulin Resistance in Obese Subjects Treated with Troglitazone
Authors: John J. Nolan, Bernhard Ludvik, Patricia Beerdsen, Mary Joyce, Jerrold Olefsky
Journal: New England Journal of Medicine (1994)

Troglitazone decreases insulin resistance and hyperglycemia in patients with non-insulin-dependent diabetes mellitus (NIDDM), but its effects on subjects without diabetes are not known.
Forensic Pathology — A Specialty in Trouble
Authors: Cyril H. Wecht
Journal: New England Journal of Medicine (1977)

The specialty of forensic pathology has become seriously understaffed in recent years, and its outlook is bleak. Of about 350,000 licensed physicians in the United States, some 10,000 are pathologists. Although miniscule by comparison, the current number of 354 Board-certified forensic pathologists could probably handle today's work load if they all practiced their specialty full-time; yet more than half devote all or part of their time to hospital pathology. About half the forensic work in this country is done by pathologists who have not received formal training in forensic pathology. Board-certified forensic pathologists are required by law in a minority . . .
CHAMBER: A Regional Performance Improvement CME Initiative for Breast Cancer Health Care Providers
Authors: Linda M. Sutton, Joseph Geradts, Erika P. Hamilton, Kathleen A. Havlin, Gretchen G. Kimmick, P. Kelly Marcom, Neil L. Spector, Melanie Watson, Daniel U. Rabin, Theodore O. Bruno, Amanda Noe, Stacy Miller, Chitra Subramaniam, Sherry Layton, Katherine Grichnik
Journal: Journal of the National Comprehensive Cancer Network (2015)

CHAMBER was a regional educational initiative for providers of care to patients with HER2+ breast cancer. The study goals were to (1) enhance testing for HER2/neu overexpression in patients with invasive breast cancer; (2) increase the appropriate use of targeted therapy for patients with HER2+ breast cancer; and (3) enhance patients' coping ability. This Performance Improvement Continuing Medical Education (PI-CME) initiative included clinical practice assessment, educational activities, and reassessment. Chart review revealed a high rate of HER2 testing (98%) before and after education. Targeted therapy for patients with HER2+ breast cancer declined after the program (from 96% to 61%), perhaps attributable to an increase in awareness of medical reasons to avoid use of targeted therapy. Assessment for patients' emotional coping ability increased after education (from 55% to 76%; P=.01). Rates of testing for HER2 amplification and assessment of emotional well-being after education were consistent with ASCO Quality Oncology Practice Initiative benchmark values. Documentation of actions to address emotional problems remained an area for improvement.
Hypothermia — Its Use in Severe Carbon Monoxide Poisoning
Authors: Thomas V. Craig, William Hunt, Robert Atkinson
Journal: New England Journal of Medicine (1959)

CLINICAL hypothermia has been used recently, with success, in a wide variety of conditions having in common Central-nervous-system hypoxia and edema. Reports have appeared in the literature regarding the protection of laboratory animals from carbon monoxide intoxication by the use of deep hypothermia.1 Encouraged by these reports, we made use of hypothermia in the treatment of severe carbon monoxide poisoning in a young man whose prognosis appeared hopeless. This is a report on the dramatic response of a patient to cooling.Case ReportAn 18-year-old man was taken to the hospital in a coma by the police emergency squad.One . . .
Further Evidence Relating Mitral-Valve Prolapse to Cerebral Ischemic Events
Authors: Henry J. M. Barnett, Derek R. Boughner, D. Wayne Taylor, Paul E. Cooper, William J. Kostuk, Peter M. Nichol
Journal: New England Journal of Medicine (1980)

Echocardiography demonstrates prolapse of the mitral valve in at least 5 per cent of the population. Since some observations have linked this condition to stroke, we studied its incidence in two groups of patients with cerebral ischemia. The older group contained 141 patients over 45 years of age (mean, 64.7 years) who had transient ischemia or partial stroke. Prolapse was found in eight (5.7 per cent) of these patients and in 10 (7.1 per cent) of 141 age-matched controls. The second group contained 60 patients who had transient ischemia or partial stroke and were under 45 years old (mean 33.9 years). Prolapse was detected in 24 patients (40 per cent) but in only five (6.8 per cent) of 60 age-matched controls (mean age, 33.7 years). The odds ratio, 9.33, was highly significant (P less than 0.001). In six of the 24 patients there were other potential causes for cerebral ischemia leaving 18 whom the only recognizable potential cause was a prolapsing mitral valve (odds ratio, 7.00; P less than 0.001). This study suggests that this entity has a role in cerebral ischemia, at least in younger patients. (N Engl J Med 302:139-144, 1980).
Low Leukocyte Counts with Blast Cells in Cerebrospinal Fluid of Children with Newly Diagnosed Acute Lymphoblastic Leukemia
Authors: Hazem H. Mahmoud, Gaston K. Rivera, Michael L. Hancock, Robert A. Krance, Larry E. Kun, Frederick G. Behm, Raul C. Ribeiro, John T. Sandlund, William M. Crist, Ching-Hon Pui
Journal: New England Journal of Medicine (1993)

Treatment of the central nervous system is crucial to the successful treatment of acute lymphoblastic leukemia in children. The intensity and timing of the therapy are based on the presence or predicted risk of central nervous system leukemia as assessed according to criteria that remain controversial.The clinical importance of leukemic blast cells detected in cerebrospinal fluid at the time of diagnosis was evaluated in 351 children with acute lymphoblastic leukemia in a randomized trial of intensive chemotherapy. All patients received intrathecal chemotherapy during the first year. Patients considered to be at high risk of relapse because of their clinical and cytogenetic features also received cranial irradiation and intrathecal chemotherapy one year after remission. Patients were considered to have central nervous system leukemia at diagnosis if they had at least 5 leukocytes per microliter of cerebrospinal fluid, with leukemic blast cells apparent in cytocentrifuged preparations, or cranial-nerve palsy; they received additional intrathecal injections of chemotherapeutic agents and cranial irradiation. Patients were retrospectively classified on the basis of cerebrospinal fluid findings: 291 patients had no detectable blast cells, 42 had fewer than 5 leukocytes per microliter and blast cells, and 18 had central nervous system leukemia as defined above. The clinical characteristics and outcomes of treatment in these groups were analyzed.The five-year probability of survival free of relapses confined to the central nervous system in patients with detectable blast cells and fewer than 5 leukocytes per microliter of cerebrospinal fluid was lower than in patients without blast cells (mean [+/- SE], 87 +/- 13 vs. 96 +/- 2 percent), but was not different from the probability in patients with central nervous system leukemia at diagnosis. All such isolated relapses of leukemia in patients with detectable blast cells occurred during the first year of treatment, before scheduled cranial irradiation. In a multivariate analysis, the presence of cerebrospinal fluid blast cells with fewer than 5 leukocytes per microliter was independently related to the risk of relapse confined to the central nervous system.Patients with leukemic blast cells in their cerebrospinal fluid are at increased risk for central nervous system relapse when cranial irradiation is delayed. Such patients require intensified central nervous system treatment early in the course of therapy.
Scientific Fraud and International Research
Authors: Raymond P. Abratt, Daniel A. Vorobiof, Louis Goedhals, Bernado Rappaport, Paul Ruff, Coenraad F. Slabber
Journal: Journal of Clinical Oncology (2001)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2001.19.15.3592 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11481373 Scientific Fraud and International Research Raymond P. AbrattxRaymond P. AbrattSearch for articles by this author , Daniel A. VorobiofxDaniel A. VorobiofSearch for articles by this author , Louis GoedhalsxLouis GoedhalsSearch for articles by this author , Bernado RappaportxBernado RappaportSearch for articles by this author , Paul RuffxPaul RuffSearch for articles by this author , Coenraad F. SlabberxCoenraad F. SlabberSearch for articles by this author Show More Groote Schuur Hospital and University of Cape Town, Cape TownSandton Oncology Clinic, JohannesburgUniversity of Free State, BloemfonteinMedical Oncology Centre, Rosebank, JohannesburgUniversity of Witwatersrand, JohannesburgUniversity of Pretoria, Pretoria, South Africa https://doi.org/10.1200/JCO.2001.19.15.3592 First Page Full Text PDF Figures and Tables © 2001 by American Society of Clinical Oncology
Aplastic Anemia Treated with Bone-Marrow Transfusion from an Identical Twin
Authors: M. Moreno Robins, Ward D. Noyes
Journal: New England Journal of Medicine (1961)

THE essential function of the bone marrow is to provide circulating cellular elements by a continual process of proliferation and maturation. In aplastic anemia, regardless of the underlying etiology, this function is drastically impaired. Presently available therapy is directed toward supporting the patient through the resulting period of granulocytopenia, thrombocytopenia and anemia until spontaneous recovery of the marrow occurs. Of great interest in this disease are the studies of repopulation of the marrow cavity by proliferation of transfused marrow cells from a donor, but this has had limited application because of immunologic barriers. In the case reported below, a patient . . .