Abstract:
OBJECTIVE:To develop an early diagnostic test for pancreatic cancer based on the identification of K-ras mutations in pure pancreatic juice collected during endoscopic retrograde pancreatography. DESIGN:Prospective study with masked comparison. The standard criteria for the diagnosis of pancreatic cancer were pancreatography or surgery (or both) and histopathology, with follow-up ranging from 6 to 40 months. SETTING:Referral center. PATIENTS:24 patients with no pancreatic disease (group 1); 29 patients with nontumoral pancreatic disease (group 2); and 22 patients with pancreatic tumor (group 3). Endoscopic ductal aspiration of cells or brush cytology was done on patients having endoscopic retrograde pancreatography for diagnostic or therapeutic reasons. MAIN OUTCOME MEASURE:Confirmation of mutation rates in patients with pancreatic cancer. RESULTS:K-ras gene analysis was done by polymerase chain reaction-mediated restriction fragment length polymorphism analysis and direct sequencing. All patients from groups 1 and 2 (n = 53) had a normal sequence for the K-ras 12th codon (group 1, 0% [95% CI, 0% to 14%]; group 2, 0% [CI, 0% to 12%]). Mutations were seen in 17 of the 22 patients in group 3 (77% [CI, 55% to 92%]). Two of the 17 had no evidence of pancreatic cancer when K-ras was first studied. One had chronic abdominal pain and the other presented with acute pancreatitis. Both were initially free of any pancreatic mass, but they developed tumors 18 and 40 months, respectively, after the K-ras mutations were identified. CONCLUSION:Identification of K-ras mutations in samples of pancreatic juice may be useful in differentiating between pancreatic cancer and noncancerous pancreatic diseases. K-ras mutation can precede clinical evidence of pancreatic cancer, but the clinical implications of this finding need further study.
journal_name
Ann Intern Medjournal_title
Annals of internal medicineauthors
Berthélemy P,Bouisson M,Escourrou J,Vaysse N,Rumeau JL,Pradayrol Ldoi
10.7326/0003-4819-123-3-199508010-00005subject
Has Abstractpub_date
1995-08-01 00:00:00pages
188-91issue
3eissn
0003-4819issn
1539-3704journal_volume
123pub_type
临床试验,杂志文章abstract::Physicians treating patients with chronic rheumatoid arthritis spend a considerable amount of time dealing with the psychological and social aspects of the disease. The patients' reaction to the disease can be related to age, experience, personality, and environment at work and at home. Common problems include loss of...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-3-344
更新日期:1982-03-01 00:00:00
abstract::Levels of circulating platelet aggregates and plasma beta-thromboglobulin reflect the degree of platelet activation in vascular injury and repair. Both values were evaluated in 38 patients with scleroderma and 18 control subjects matched for age, sex, and race. Circulating platelet aggregates (expressed as percentage ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-5-610
更新日期:1982-05-01 00:00:00
abstract:PURPOSE:It is currently unknown whether intensive insulin treatment of diabetes decreases the risk for cardiovascular complications by lowering glucose levels or increases the risk by postulated direct atherogenic effects. This article reviews published data from two long-term, randomized clinical trials that compared ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-124-1_part_2-199601011-00005
更新日期:1996-01-01 00:00:00
abstract::One half of 42 subjects treated for painful shoulders received classic acupuncture, and one half received a placebo in which the needles did not penetrate the skin. Half of each of these groups was treated in a positive setting to encourage the subject, and half in a negative setting designed to keep encouragement at ...
journal_title:Annals of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.7326/0003-4819-84-4-381
更新日期:1976-04-01 00:00:00
abstract::Arteriohepatic dysplasia (Alagille's syndrome) is presumed to be one of the familial intrahepatic cholestatic syndromes, all of which present with neonatal jaundice or failure to thrive, or both. We report the findings in five patients with this syndrome, four of whom have been followed into adulthood. In addition to ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-91-4-520
更新日期:1979-10-01 00:00:00
abstract::As a result of important advances in medical imaging, the oral cholecystogram is no longer the primary test of gallbladder function and anatomy. Real-time ultrasonography and cholescintigraphy, both highly sensitive and specific tests, are the two major methods for assessing gallbladder pathology. Oral cholecystograph...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-109-9-722
更新日期:1988-11-01 00:00:00
abstract::Tissues from guinea pigs inoculated intraperitoneally with the Legionnaires' disease (LD) bacterium were studied with light, immunofluorescent, and electron microscopy. The principal gross lesion was diffuse peritonitis of varying severity. Microscopically, the peritonitis of covered by a mixed inflammatory infiltrate...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-90-4-671
更新日期:1979-04-01 00:00:00
abstract:OBJECTIVE:To determine whether a noninvasive method for evaluating contrast-enhancing brain lesions in patients with the acquired immunodeficiency syndrome (AIDS) can accurately differentiate between lymphoma and nonlymphoma diagnoses. This method is based on Toxoplasma serologic testing and positron emission tomograph...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-123-8-199510150-00005
更新日期:1995-10-15 00:00:00
abstract::Prothrombin complex concentrates are used in the treatment of the congenital bleeding disorders associated with Factors II, VII, IX, and X deficiencies. They have also been extensively used to treat acquired coagulation abnormalities secondary to vitamin K deficiency, warfarin ingestion, and various types of liver dis...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-84-6-683
更新日期:1976-06-01 00:00:00
abstract::In September 1978, cases of hepatitis B in two patients treated by the same dentist led to investigation of a dental practice in Baltimore, Maryland. The dentist had had acute hepatitis B in June 1978 and had remained positive for hepatitis B surface antigen and hepatitis B e antigen over the ensuing 6 months. He had ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-95-2-133
更新日期:1981-08-01 00:00:00
abstract::A platelet transfusion from a blood group O donor, immunized 1 month before with Pneumovax, caused a hemolytic reaction in a blood group A recipient. Forty-five of 59 group O donors (76%) and all of nine group B donors immunized with Pneumovax had a fourfold or higher anti-A response. Half of the anti-A antibody in hi...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-96-5-580
更新日期:1982-05-01 00:00:00
abstract::Therapy of pulmonary hypertension is limited by the low potency and adverse effects of current pulmonary vasodilators. The hemodynamic effects of nitroglycerin in human pulmonary hypertension are not known. We administered nitroglycerin to nine patients with chronic pulmonary hypertension. Nitroglycerin increased card...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-99-1-9
更新日期:1983-07-01 00:00:00
abstract:BACKGROUND:The incidence of esophageal adenocarcinoma is increasing rapidly. Gastroesophageal reflux is a strong risk factor for this disease. The increase in incidence of esophageal adenocarcinoma coincided with the introduction of medications that promote reflux by relaxing the lower esophageal sphincter (LES), such ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-133-3-200008010-00007
更新日期:2000-08-01 00:00:00
abstract::Neuroblastoma, the second commonest solid tumor in children, is a neoplasm of the peripheral autonomic nervous system that usually occurs before children are 6 years old. Therapy of localized tumor (clinical stage I and II) and of a special form of metastatic tumor (clinical stage IV-S) is usually successful, but trea...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-97-6-873
更新日期:1982-12-01 00:00:00
abstract:BACKGROUND:Screening can detect prostate cancer at earlier, asymptomatic stages, when treatments might be more effective. PURPOSE:To update the 2002 and 2008 U.S. Preventive Services Task Force evidence reviews on screening and treatments for prostate cancer. DATA SOURCES:MEDLINE (2002 to July 2011) and the Cochrane ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-155-11-201112060-00375
更新日期:2011-12-06 00:00:00
abstract:BACKGROUND:New tests, such as magnetic resonance imaging (MRI) and electron-beam computed tomography (CT), are being developed for the diagnosis of coronary artery disease. OBJECTIVE:To determine the conditions that a new test must meet to be a cost-effective alternative to established imaging tests. DESIGN:Decision ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-131-9-199911020-00008
更新日期:1999-11-02 00:00:00
abstract:BACKGROUND:Increased prevalence of adolescent obesity requires effective treatment options beyond behavior therapy. OBJECTIVE:To see whether sibutramine reduced weight more than placebo in obese adolescents who were receiving a behavior therapy program. DESIGN:12-month, 3:1 randomized, double-blind trial conducted fr...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.7326/0003-4819-145-2-200607180-00005
更新日期:2006-07-18 00:00:00
abstract:STUDY OBJECTIVE:To critically assess original studies evaluating the role of preoperative pulmonary function testing in predicting postoperative outcomes. DESIGN:MEDLINE search of English-language articles from 1966 to 1987 using the following medical subjects headings respiratory function tests, lung, lung diseases, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,meta分析
doi:10.7326/0003-4819-112-10-763
更新日期:1990-05-15 00:00:00
abstract::Clinicians can use data to improve daily clinical practice. This paper offers eight principles for using data to support improvement in busy clinical settings: 1) seek usefulness, not perfection, in the measurement; 2) use a balanced set of process, outcome, and cost measures; 3) keep measurement simple (think big, bu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-128-6-199803150-00007
更新日期:1998-03-15 00:00:00
abstract::Intensive care is one of the largest, most expensive, and complex components of U.S. health care. Errors and the resulting adverse events are, however, common in intensive care units (ICUs). Theories about errors in high-risk environments, developed by aviation and other industries, provide insight into why ICUs are p...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-140-12-200406150-00013
更新日期:2004-06-15 00:00:00
abstract:BACKGROUND:Hypertension often persists after adrenalectomy for primary aldosteronism. OBJECTIVE:To determine factors associated with resolution of hypertension after adrenalectomy for primary aldosteronism. DESIGN:Retrospective cohort study. SETTING:Tertiary care referral center in Rochester, Minnesota. PATIENTS:Al...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-135-4-200108210-00010
更新日期:2001-08-21 00:00:00
abstract::The following principles of appropriate antibiotic use for adults with acute pharyngitis apply to immunocompetent adults without complicated comorbid conditions, such as chronic lung or heart disease, and history of rheumatic fever. They do not apply during known outbreaks of group A streptococcus.1. Group A beta-hemo...
journal_title:Annals of internal medicine
pub_type: 指南,杂志文章,实务指引
doi:10.7326/0003-4819-134-6-200103200-00019
更新日期:2001-03-20 00:00:00
abstract::The Hospital Readmissions Reduction Program (HRRP) has penalized hospitals with higher 30-day readmission rates more than $3 billion to date. Clinicians and policy experts have raised concerns that the 30-day readmission measure used in this program provides an incomplete picture of performance because it does not cap...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/M20-3486
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To assess factors related to consensus among community physicians regarding appropriate screening intervals for eight cancer screening procedures for which guidelines have been published. DESIGN:Interviews were conducted with a national random sample of 3436 physicians in family practice, internal medicine, ...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-120-7-199404010-00012
更新日期:1994-04-01 00:00:00
abstract::Diabetes mellitus is classified into two major categories: type I, which is insulin dependent, and type II, which is not. Insulin resistance in type II diabetes may be related to impaired receptor binding in some forms of the disorder. In the past, diabetes in pregnant women resulted in high rates of maternal and infa...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-96-5-635
更新日期:1982-05-01 00:00:00
abstract:STUDY OBJECTIVE:To assess respiratory muscle fatigue in acute respiratory failure in patients with chronic obstructive pulmonary disease and evaluate its influence on weaning patients from mechanical ventilation. DESIGN AND PATIENTS:We studied the time course of tracheal occlusion pressure (P0.1) and high-to-low ratio...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-108-6-800
更新日期:1988-06-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of tests done in the year before elective surgery that might substitute for preoperative screening tests and to determine the frequency of test results that change from a normal value to a value likely to alter perioperative management. DESIGN:Retrospective cohort analysis of compu...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-113-12-969
更新日期:1990-12-15 00:00:00
abstract::In 1993, the Clinical Efficacy Assessment Subcommittee began evaluation of new topics and reevaluation of previous guidelines on common screening tests, which were published in Annals of Internal Medicine between 1988 and 1990 and republished as a collection in 1991 (Eddy DM, ed. Common Screening Tests. Philadelphia: ...
journal_title:Annals of internal medicine
pub_type: 杂志文章,评审
doi:10.7326/0003-4819-122-12-199506150-00008
更新日期:1995-06-15 00:00:00
abstract:BACKGROUND:Health care-associated infections from invasive medical devices in the intensive care unit (ICU) are a major threat to patient safety. Most published studies of ICU-acquired infections have come from industrialized western countries. In a Centers for Disease Control and Prevention (CDC) National Nosocomial I...
journal_title:Annals of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.7326/0003-4819-145-8-200610170-00007
更新日期:2006-10-17 00:00:00
abstract::Between 1978 and 1985, the number of active internists in the United States increased from 64,000 to 91,000, and by 1998 the number will have increased to 141,000. This growth represents an increase of 121% for a 20-year period, during which time the population of the United States is expected to increase only 19%. Th...
journal_title:Annals of internal medicine
pub_type: 杂志文章
doi:10.7326/0003-4819-107-1-93
更新日期:1987-07-01 00:00:00