Acute Respiratory Distress due to Thymoma in a Patient Treated with TK Inhibitor: A Case Report and Review of the Current Treatment Options

Thymic malignancies are rare intrathoracic tumors that may be aggressive and difficult to treat in advanced stage. Surgery is the cornerstone of the management of thymomas: it is significant for the definite histopathological diagnosis and staging, and in most cases, it constitutes the first step of the treatment strategy. For patients with primary unresectable thymomas, the multimodal treatment schedule nowadays includes neoadjuvant chemotherapy, extensive surgery, adjuvant radiotherapy, and in some cases, adjuvant chemotherapy. A patient with a history of stage III COPD and an undiagnosed thoracic mass was admitted to the intensive care unit with acute respiratory distress. A radiologic evaluation by CT scan revealed a mass of 13 cm in diameter at the mediastinum. Fine needle aspiration was performed and revealed a thymoma. Due to poor performance status, the patient was not able to undergo surgery. He refused to be treated with neither chemotherapy nor radiotherapy, but due to EGFR overexpression, treatment with TK inhibitor was suggested. Fine needle aspiration biopsy is commonly used to identify metastasis to the mediastinum. However, it is less often employed as a primary diagnostic tool for tumors, particularly thymic neoplasms. The use of targeted therapies for the treatment of thymic malignancies has been described in the literature. Over the past years, significant efforts have been made to dissect the molecular pathways involved in the carcinogenesis of these tumors. Insights have been obtained following anecdotal clinical responses to targeted therapies, and large-scale genomic analyses have been conducted

The influence of English colonization on culture of Australians

Several lignite samples were collected from boreholes of the Amynteo opencast lignite mine, northern Greece. Organic geochemical characteristics were investigated with the help of various analytical techniques, comprising Gas Chromatography (GC) and Gas-chromatography-Mass Spectrometry (GC-MS), Fourier Transform Infrared Spectroscopy (FTIR), solid-state Nuclear Magnetic Resonance (NMR) and Electron Paramagnetic Resonance (EPR) spectroscopy, petrographical measurements as well as determination of bulk parameters. In the low rank (Rr = 0.21%) Amynteo lignites, huminite is the most abundant maceral group, inertinite has relatively low percentages and liptinite concentrations are rather high. Carbon Preference Index (CPI) reveals the predominance of odd-numbered, long-chained aliphatic hydro-carbons, which is related to a higher terrestrial plant input. The Pr/Ph ratio suggests that reducing conditions were persistent during peatification. Gymnosperm biomarkers such as isoprimarane, abietane, phyllocladane and sandaracopimarane, as well as angiosperm indicators (lupane) and hopanoid compounds with bacterial origin were identified. Analyses of the aromatic fractions revealed the presence of naphthalene, alkyl benzenes and phenols, pyrene, cadalene, cadinane, fluoranthene and dibenzofurane. Based on the FTIR analysis, aliphatic and oxygen containing structures were prevailed over the aromatic moieties. The intensity of the mineral bands was preferentially increased in the FTIR spectra of insoluble material. According to NMR analysis, the aliphatic carbons (0-50 ppm) have higher proportions comparing to aromatic carbons (100-160 ppm). The aromaticity fraction is low (fa = 0.32), as expected for these low rank coals. The presence of free organic radicals and Fe3+ and Mn2+ paramagnetic ions was revealed by EPR. In summary, the combined application of complementary analytical techniques allowed a deep inside into the geochemical characteristics of Amynteo lignites

Searching for a heavy Higgs boson via the H --> l nu jj decay mode at the CERN LHC

The discovery of a heavy Higgs boson with mass up to m_H = 1 TeV at the CERN LHC is possible in the H--> W^+W^- --> l nu jj decay mode. The weak boson scattering signal and backgrounds from t\bar tjj and from W+jets production are analyzed with parton level Monte Carlo programs which are built on full tree level amplitudes for all subprocesses. The use of double jet tagging and the reconstruction of the W invariant mass reduce the combined backgrounds to the same level as the Higgs signal. A central mini-jet veto, which distinguishes the different gluon radiation patterns of the hard processes, further improves the signal to background ratio to about 2.5:1, with a signal cross section of 1 fb. The jet energy asymmetry of the W --> jj decay will give a clear signature of the longitudinal polarization of the W's in the final event sample.Comment: 23 pages (with 7 embedded figures), Revtex, uses epsf.sty. Z-compressed postscript version also available at http://phenom.physics.wisc.edu/pub/preprints/1997/madph-97-1017.ps.Z or at ftp://phenom.physics.wisc.edu/pub/preprints/1997/madph-97-1017.ps.

Management of Sigmoid Volvulus Avoiding Sigmoid Resection

Acute sigmoid volvulus is typically caused by an excessively mobile and redundant segment of colon with a stretched mesenteric pedicle. When this segment twists on its pedicle, the result can be obstruction, ischemia and perforation. A healthy, 18-year-old Caucasian woman presented to the emergency department complaining of cramping abdominal pain, distention, constipation and obstipation for the last 72 h, accompanied by nausea, vomiting and abdominal tenderness. The patient had tympanitic percussion tones and no bowel sounds. She was diagnosed with acute sigmoid volvulus. Although urgent resective surgery seems to be the appropriate treatment for those who present with acute abdominal pain, intestinal perforation or ischemic necrosis of the intestinal mucosa, the first therapeutic choice for clinically stable patients in good general condition is considered, by many institutions, to be endoscopic decompression. Controversy exists on the decision of the time, the type of definitive treatment, the strategy and the most appropriate surgical technique, especially for teenagers for whom sigmoid resection can be avoided

Searching for H --> tau tau in weak boson fusion at the LHC

Weak boson fusion is a copious source of intermediate mass Higgs bosons at the LHC. The additional very energetic forward jets in these events provide for powerful background suppression tools. We analyze the $H \to \tau\tau$ decay mode for the Standard Model Higgs boson. A parton level analysis of the dominant physics backgrounds (mainly $Z \to \tau\tau$ and Drell-Yan production of $\tau$'s) and of reducible backgrounds (from $W+$ jet and $b\bar{b}$ production in association with two jets and subsequent leptonic decays) demonstrates that this channel allows the observation of $H \to \tau\tau$ in a low background environment, yielding a significant Higgs signal with an integrated luminosity of about 30 fb$^{-1}$. The weak boson fusion process thus allows direct measurement of the $H\tau\tau$ coupling.Comment: 32 pages, Revtex, uses epsf.sty, 6 postscript figures. Opposite sign charge requirement for tau candidates added for reducible backgrounds; cuts for two figures explained more clearly in text; typos correcte

A method for identifying H -> tau tau -> e mu pTmiss at the CERN LHC

Weak boson fusion promises to be a copious source of intermediate mass Higgs bosons at the LHC. The additional very energetic forward jets in these events provide for powerful background suppression tools. We analyze the subsequent H -> tau tau -> e mu pTmiss decay for Higgs boson masses in the 100-150 GeV range. A parton level analysis of the dominant backgrounds demonstrates that this channel allows the observation of H -> tau tau in a low-background environment, yielding a significant Higgs boson signal with an integrated luminosity of order 60 fb^-1 or less, over most of the mass range. We also restate a No-Lose Theorem for observation of at least one of the CP-even neutral Higgs bosons in the MSSM, which requires an integrated luminosity of only 40 fb^-1.Comment: 21 pages, 10 embedded PS figs; additional comments on b-jet veto in tt~ backgrounds; to be published in Phys Rev