Pub Date : 2010-06-14DOI: 10.3138/9781442661813-052
S. Croft
{"title":"Tale of a T-shirt","authors":"S. Croft","doi":"10.3138/9781442661813-052","DOIUrl":"https://doi.org/10.3138/9781442661813-052","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"19 1","pages":"244-250"},"PeriodicalIF":0.7,"publicationDate":"2010-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80631859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Cell Phones and Cancer: A Short Communication.","authors":"T. Soeyonggo, Shelly Wang","doi":"10.5015/UTMJ.V87I3.1242","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1242","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"49 1","pages":"125-129"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85104596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dr. Robert N. Gryfe is a colorectal surgical oncologist at Mount Sinai and Princess Margaret Hospitals and researcher at Mount Sinai’s Samuel Lunenfeld Research Institute. Dr. Gryfe's clinical practice specializes in the management of patients with colon and rectal cancer and hereditary cancer syndromes. His research laboratory investigates the genetic determinants of colorectal cancer risk, prognosis and response to chemotherapy.
Robert N. Gryfe博士是Mount Sinai和Princess Margaret Hospitals的结直肠外科肿瘤学家，Mount Sinai ' s Samuel Lunenfeld Research Institute的研究员。Gryfe博士的临床实践专长于结肠癌、直肠癌和遗传性癌症综合征患者的管理。他的研究实验室研究结直肠癌风险、预后和化疗反应的遗传决定因素。
{"title":"An Interview with Dr. Robert N. Gryfe, Surgical Oncologist","authors":"C. Woodford","doi":"10.5015/UTMJ.V87I3.1264","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1264","url":null,"abstract":"Dr. Robert N. Gryfe is a colorectal surgical oncologist at Mount Sinai and Princess Margaret Hospitals and researcher at Mount Sinai’s Samuel Lunenfeld Research Institute. Dr. Gryfe's clinical practice specializes in the management of patients with colon and rectal cancer and hereditary cancer syndromes. His research laboratory investigates the genetic determinants of colorectal cancer risk, prognosis and response to chemotherapy.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"75 1","pages":"133-135"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82292550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcification occasionally occurs in Hodgkin’s lymphoma after therapy due to tissue necrosis. Rarely, calcification may be detected prior to treatment. This likely represents a dystrophic process when bulky tumours outgrow their blood supply. Due to this rare presentation, pre treatment calcified Hodgkin’s lymphoma is often mistaken for germ cell tumours on imaging. It is thus important to include Hodgkin’s lymphoma in the differential of this presentation. We present such a case of pre-treatment calcification of Hodgkin’s lymphoma in a young male and discuss the incidence, pathophysiology and imaging findings.
{"title":"Calcification of Untreated Mediastinal Hodgkin's Lymphoma: A Case Report","authors":"C. Rivest, M. Ianni, E. Haider","doi":"10.5015/UTMJ.V87I3.1238","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1238","url":null,"abstract":"Calcification occasionally occurs in Hodgkin’s lymphoma after therapy due to tissue necrosis. Rarely, calcification may be detected prior to treatment. This likely represents a dystrophic process when bulky tumours outgrow their blood supply. Due to this rare presentation, pre treatment calcified Hodgkin’s lymphoma is often mistaken for germ cell tumours on imaging. It is thus important to include Hodgkin’s lymphoma in the differential of this presentation. We present such a case of pre-treatment calcification of Hodgkin’s lymphoma in a young male and discuss the incidence, pathophysiology and imaging findings.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"213 1","pages":"148-149"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78000665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Glioblastoma, the most common and aggressive adult brain malignancy, is characterized by the presence of morphologically diverse neural cell types that differ in their ability to form and maintain tumours. The marked resistance of this cancer to conventional treatments has sparked attempts to identify therapeutically targetable cellular populations. Defined pools of tumour initiating cells have already been identified in other malignancies, i.e., leukemia. Like normal stem cells, these “cancer stem cells†(CSCs) have extensive self renewal capacity and multipotency; however, the origin of the CSC remains elusive. Recently, a small percentage of quiescent, undifferentiated, multipotent cells termed neural stem cells (NSCs) were found in the hippocampus, subâ€ventricular zone (SVZ), and olfactory bulb of the adult human brain. Since their discovery, it has been hypothesized that NSCs may act as a depot of tissueâ€specific stem cells in the brain that may be transformed into CSCs. The purpose of this essay is to critically review the literature to demonstrate that oncogenic mutations in NSCs allow them to become CSCs in glioblastomas, in light of the advantages and flaws of existing experimental models. Insights into the mechanism of CSC formation in the brain may allow for the optimization of current therapeutic approaches, as pathways in NSC-->CSC formation will provide opportunities to specifically target this notoriously treatmentâ€resistant malignancy.
{"title":"Does Glioblastoma arise from Oncogenic Transformation of Neural Stem Cells into Cancer Stem Cells","authors":"S. Jeimy","doi":"10.5015/UTMJ.V87I3.1247","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1247","url":null,"abstract":"Glioblastoma, the most common and aggressive adult brain malignancy, is characterized by the presence of morphologically diverse neural cell types that differ in their ability to form and maintain tumours. The marked resistance of this cancer to conventional treatments has sparked attempts to identify therapeutically targetable cellular populations. Defined pools of tumour initiating cells have already been identified in other malignancies, i.e., leukemia. Like normal stem cells, these “cancer stem cells†(CSCs) have extensive self renewal capacity and multipotency; however, the origin of the CSC remains elusive. Recently, a small percentage of quiescent, undifferentiated, multipotent cells termed neural stem cells (NSCs) were found in the hippocampus, subâ€ventricular zone (SVZ), and olfactory bulb of the adult human brain. Since their discovery, it has been hypothesized that NSCs may act as a depot of tissueâ€specific stem cells in the brain that may be transformed into CSCs. The purpose of this essay is to critically review the literature to demonstrate that oncogenic mutations in NSCs allow them to become CSCs in glioblastomas, in light of the advantages and flaws of existing experimental models. Insights into the mechanism of CSC formation in the brain may allow for the optimization of current therapeutic approaches, as pathways in NSC-->CSC formation will provide opportunities to specifically target this notoriously treatmentâ€resistant malignancy.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"9 1","pages":"155-160"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79251088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The textbook, CanMEDS Physician Health Guide: A Practical Handbook for Physician Health and Well-being, recently published by The Royal College of Physicians and Surgeons of Canada sheds light on the depth and scope of the CanMEDS competencies and how they relate to the personal health and the well-being of the medical doctor. This text is the latest addition to a growing library of College publications which serve as professional development resources pertaining to the CanMEDS roles. This particular text has developed a conceptual framework of physician health and evaluates and proposes concise strategies to address personal health issues that any medical student, resident or attending may encounter throughout his career.
{"title":"CanMEDS Physician Health Guide: A Practical Handbook for Physician Health and Well-being","authors":"Kenneth Vandewark","doi":"10.5015/UTMJ.V87I3.1262","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1262","url":null,"abstract":"The textbook, CanMEDS Physician Health Guide: A Practical Handbook for Physician Health and Well-being, recently published by The Royal College of Physicians and Surgeons of Canada sheds light on the depth and scope of the CanMEDS competencies and how they relate to the personal health and the well-being of the medical doctor. This text is the latest addition to a growing library of College publications which serve as professional development resources pertaining to the CanMEDS roles. This particular text has developed a conceptual framework of physician health and evaluates and proposes concise strategies to address personal health issues that any medical student, resident or attending may encounter throughout his career.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"4 1","pages":"190-191"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80540256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Is that lung cancer I smell in your breath","authors":"T. Yung","doi":"10.5015/UTMJ.V87I3.1244","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1244","url":null,"abstract":"","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"60 1","pages":"122-123"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88327170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thyroid cancer is the most common endocrinological malignancy worldwide and its incidence is increasing faster than for any other cancer. The majority of this increase has been in well differentiated thyroid carcinoma (WDTC) which comprises 90% of all thyroid malignancies. Recent advances in the diagnosis, surgical treatment, and long-term monitoring have enhanced the detection of primary and recurrent disease, as well as treatment modalities. These developments have prompted institutions to revise their guidelines on the management of thyroid disorders. In the diagnosis of thyroid nodules, recommendations have been made regarding initial evaluation, use of TSH and radionuclide studies, clinical and ultrasound criteria for fine-needle aspiration biopsy (FNAB), and the interpretation of FNAB results. Thyroidectomy (removal of gross thyroid tissue) and lymph node dissection have been established as efficacious initial therapies to reduce disease recurrence although the extent of surgical resection is hotly debated. Following surgical therapy, appropriate use of radioactive iodine (RAI) therapy to destroy microscopic disease is discussed, including its controversial use in low-risk patients. Guidelines for long-term management include recommendations on the use of TSH suppression therapy, surveillance of recurrent disease using ultrasound and serum thyroglobulin, and the treatment of recurrent/metastatic disease. Here, we review the recent developments and recommendations in the management of WDTC.
{"title":"Thyroid Cancer: Latest Approaches to Canada's Fastest Growing Cancer","authors":"A. Vaisman, Steven Orlov, J. Yip, D. Orlov","doi":"10.5015/UTMJ.V87I3.1234","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1234","url":null,"abstract":"Thyroid cancer is the most common endocrinological malignancy worldwide and its incidence is increasing faster than for any other cancer. The majority of this increase has been in well differentiated thyroid carcinoma (WDTC) which comprises 90% of all thyroid malignancies. Recent advances in the diagnosis, surgical treatment, and long-term monitoring have enhanced the detection of primary and recurrent disease, as well as treatment modalities. These developments have prompted institutions to revise their guidelines on the management of thyroid disorders. In the diagnosis of thyroid nodules, recommendations have been made regarding initial evaluation, use of TSH and radionuclide studies, clinical and ultrasound criteria for fine-needle aspiration biopsy (FNAB), and the interpretation of FNAB results. Thyroidectomy (removal of gross thyroid tissue) and lymph node dissection have been established as efficacious initial therapies to reduce disease recurrence although the extent of surgical resection is hotly debated. Following surgical therapy, appropriate use of radioactive iodine (RAI) therapy to destroy microscopic disease is discussed, including its controversial use in low-risk patients. Guidelines for long-term management include recommendations on the use of TSH suppression therapy, surveillance of recurrent disease using ultrasound and serum thyroglobulin, and the treatment of recurrent/metastatic disease. Here, we review the recent developments and recommendations in the management of WDTC.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"15 1","pages":"161-165"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87556131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 56-year-old woman presented to her family physician with a 2-month history of dizziness, palpitations, dyspnea on exertion,and episodic chest discomfort. Initial investigations revealed amild pancytopenia. Two days later, she presented to emergencywith a low-grade fever (37.8oC), left-sided chest discomfort, andweakness. She denied any infectious or bleeding symptoms andhad no significant past medical history, including no medications. On examination, the patient had no lymphadenopathy, andher cardiac, respiratory, and abdominal examinations were unre-markable, with no hepatosplenomegaly. Her investigationsrevealed a pancytopenia (see Table 1). On the basis of her neu -tropenia and low-grade fever, she was admitted for intravenousantibiotics and work-up of her pancytopenia.In hospital, her pancytopenia persisted; her counts reached anadir of hemoglobin (Hgb) 46 g/L, platelets (Plt) 16 X 10
一名56岁女性向家庭医生就诊，有2个月的头晕、心悸、用力时呼吸困难和间歇性胸部不适病史。初步调查显示轻度全血细胞减少症。两天后，患者出现低烧(37.8℃)、左侧胸部不适和虚弱。她否认有任何感染或出血症状，没有明显的既往病史，包括没有服用药物。检查时，患者无淋巴结病变，心脏、呼吸和腹部检查无明显异常，无肝脾肿大。她的检查显示有全血细胞减少症(见表1)。根据她的新肌减少症和低烧，她被静脉注射抗生素并检查了她的全血细胞减少症。在医院里，她的全血细胞减少症持续存在;血红蛋白(Hgb) 46 g/L，血小板(Plt) 16 X 10
{"title":"Acute Panmyelosis with Myelofibrosis: An Unusual Cause of Pancytopenia","authors":"E. Tseng, F. Moid, J. Blondal, Jerry M Maniate","doi":"10.5015/UTMJ.V87I3.1235","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1235","url":null,"abstract":"A 56-year-old woman presented to her family physician with a 2-month history of dizziness, palpitations, dyspnea on exertion,and episodic chest discomfort. Initial investigations revealed amild pancytopenia. Two days later, she presented to emergencywith a low-grade fever (37.8oC), left-sided chest discomfort, andweakness. She denied any infectious or bleeding symptoms andhad no significant past medical history, including no medications. On examination, the patient had no lymphadenopathy, andher cardiac, respiratory, and abdominal examinations were unre-markable, with no hepatosplenomegaly. Her investigationsrevealed a pancytopenia (see Table 1). On the basis of her neu -tropenia and low-grade fever, she was admitted for intravenousantibiotics and work-up of her pancytopenia.In hospital, her pancytopenia persisted; her counts reached anadir of hemoglobin (Hgb) 46 g/L, platelets (Plt) 16 X 10","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"89 1","pages":"153-154"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90609664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vision impairment is one of the leading causes of morbidity in the elderly population. Major causes of vision loss include presbyopia, cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. A vision screening program has the potential to identify millions of adults at risk for vision loss and vision-related co-morbidities. Previous guidelines in the 1990s recommended routine visual acuity screening by primary care physicians. However, subsequently published data have demonstrated a lack of effectiveness in quality-of-life outcomes with current screening strategies, likely due to the low sensitivity of the screening tests. Until further studies establish the accuracy of any vision test in predicting visual function, routine vision screening in the elderly in the primary care setting is not warranted. The introduction of other vision tests into the screening protocol, including low contrast VA assessment, stereoptic testing, and visual field testing, warrants further investigation and cost-benefit evaluation.
{"title":"Vision Screening in the Elderly: Current Literature and Recommendations","authors":"Y. Chen, Mary Thomas","doi":"10.5015/UTMJ.V87I3.1237","DOIUrl":"https://doi.org/10.5015/UTMJ.V87I3.1237","url":null,"abstract":"Vision impairment is one of the leading causes of morbidity in the elderly population. Major causes of vision loss include presbyopia, cataract, age-related macular degeneration, glaucoma, and diabetic retinopathy. A vision screening program has the potential to identify millions of adults at risk for vision loss and vision-related co-morbidities. Previous guidelines in the 1990s recommended routine visual acuity screening by primary care physicians. However, subsequently published data have demonstrated a lack of effectiveness in quality-of-life outcomes with current screening strategies, likely due to the low sensitivity of the screening tests. Until further studies establish the accuracy of any vision test in predicting visual function, routine vision screening in the elderly in the primary care setting is not warranted. The introduction of other vision tests into the screening protocol, including low contrast VA assessment, stereoptic testing, and visual field testing, warrants further investigation and cost-benefit evaluation.","PeriodicalId":41298,"journal":{"name":"University of Toronto Medical Journal","volume":"31 1","pages":"166-169"},"PeriodicalIF":0.7,"publicationDate":"2010-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72717798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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