Laparoscopic versus open resection for appendix carcinoid

Background: Since an increasing number of appendectomies are performed via laparoscopy, it is crucial to determine the impact of this approach on appendix carcinoid (AC) outcome. The goal of this study was to compare results of laparoscopic (LAP) versus open (OP) appendectomy for AC according to intend to treat approach. Methods: A retrospective review (1991-2003) identified 39 patients (median age, 36 years; range, 12-83) treated by laparoscopy (LAP) or laparotomy (OP) for AC in a single institution. Follow-up was complete for all patients (median, 67 months; range, 4-132). Results: Most cases had associated acute appendicitis (64%). Median carcinoid size was 1.1 cm (range, 0.3-5) and 0.4 cm (range, 0.2-3) in the LAP and OP groups, respectively. LAP and OP were performed in 21 (54%) and 18 (46%) patients, respectively. Surgical margins were positive in two patients in the LAP group and one patient in the OP group (p = 0.6). Right colectomies were performed for AC >2 cm in five patients after LAP and in four patients after OP (p = 0.9). Actuarial 5-year survival rates were 100 and 94% in the LAP and OP groups, respectively (p = 0.2). Two patients died in the OP group, one due to metastatic carcinoid and the other due to metachronous colorectal cancer. Synchronous or metachronous colorectal carcinomas developed in six patients (15%). Conclusion: Laparoscopic appendectomy is a safe procedure for AC, with carcinologic and long-term results similar to those of conventional appendectomy. Thus, pre- or per-operative suspicion of AC is not a contraindication to LAP. Prognosis of AC appears more dependent on carcinoid malignant potential or associated tumors. Risk for developing colorectal adenocarcinoma is high in AC patients and warrants follow-up of all patients with colonoscopic screenin

Hydrochemical properties of deep carbonate aquifers in the SW German Molasse basin

Background The Upper Jurassic (Malm) limestone and the Middle Triassic Muschelkalk limestone 18 are the major thermal aquifers in the southwest German alpine foreland. The aquifers 19 are of interest for production of geothermal energy and for balneological purposes. Methods Hydrochemical data from several hundred wells within two deep limestone aquifers in the Molasse basin of SW Germany have been compiled, examined, validated, and analyzed with the aim to characterize the fluids and to investigate the origin of the fluid properties. Results The hydrochemical properties of the two aquifers differ in several aspects. The total amounts of dissolved solids (TDS) are much higher within the Upper Muschelkalk aquifer than within the Upper Jurassic. Water composition data reflect the origin and hydrochemical evolution of deep water. Rocks and their minerals control the chemical signature of the water. With increasing depth, the total of dissolved solids increases. In both aquifers, the water evolves to a NaCl-dominated fluid regardless of the aquifer rock. Discussion The salinity of the aquifers has different sources. In the case of the Upper Muschelkalk, it is linked to deep circulation systems, while the hydrochemical properties in the Upper Jurassic developed due to changing overburden and hydraulic potential

Optical study of the electronic phase transition of strongly correlated YbInCu_4

Infrared, visible and near-UV reflectivity measurements are used to obtain conductivity as a function of temperature and frequency in YbInCu_4, which exhibits an isostructural phase-transition into a mixed-valent phase below T_v=42 K. In addition to a gradual loss of spectral weight with decreasing temperature extending up to 1.5 eV, a sharp resonance appears at 0.25 eV in the mixed-valent phase. This feature can be described in terms of excitations into the Kondo (Abrikosov-Suhl) resonance, and, like the sudden reduction of resistivity, provides a direct reflection of the onset of coherence in this strongly correlated electron system.Comment: 4 pages, 3 figures (to appear in Phys. Rev. B

Gravitational Waves in Open de Sitter Space

We compute the spectrum of primordial gravitational wave perturbations in open de Sitter spacetime. The background spacetime is taken to be the continuation of an O(5) symmetric instanton saddle point of the Euclidean no boundary path integral. The two-point tensor fluctuations are computed directly from the Euclidean path integral. The Euclidean correlator is then analytically continued into the Lorentzian region where it describes the quantum mechanical vacuum fluctuations of the graviton field. Unlike the results of earlier work, the correlator is shown to be unique and well behaved in the infrared. We show that the infrared divergence found in previous calculations is due to the contribution of a discrete gauge mode inadvertently included in the spectrum.Comment: 17 pages, compressed and RevTex file, including one postscript figure fil

Spin-gap effect on resistivity in the t-J model

We calculate the spin-gap effect on dc resistivity in the t-J model of high-$T_{\rm c}$ cuprates by using the Ginzburg-Landau theory coupled with a gauge field as its effective field theory to get $\rho(T) \propto T \{1-c\:(T^* -T)^d \}$, where $T^*$ is the spin-gap onset temperature. By taking the compactness of massive gauge field into account, the exponent $d$ deviates from its mean-field value 1/2 and becomes a nonuniversal $T$-dependent quantity, which improves the correspondence with the experiments.Comment: 4 pages, REVTeX format, 2 eps-figure

Holographic analysis of diffraction structure factors

We combine the theory of inside-source/inside-detector x-ray fluorescence holography and Kossel lines/x ray standing waves in kinematic approximation to directly obtain the phases of the diffraction structure factors. The influence of Kossel lines and standing waves on holography is also discussed. We obtain partial phase determination from experimental data obtaining the sign of the real part of the structure factor for several reciprocal lattice vectors of a vanadium crystal.Comment: 4 pages, 3 figures, submitte

Thermal expansion, heat capacity and magnetostriction of RAl3_3 (R = Tm, Yb, Lu) single crystals

We present thermal expansion and longitudinal magnetostriction data for cubic RAl3 (R = Tm, Yb, Lu) single crystals. The thermal expansion coefficient for YbAl3 is consistent with an intermediate valence of the Yb ion, whereas the data for TmAl3 show crystal electric field contributions and have strong magnetic field dependencies. de Haas-van Alphen-like oscillations were observed in the magnetostriction data of YbAl3 and LuAl3, several new extreme orbits were measured and their effective masses were estimated. Zero and 140 kOe specific heat data taken on both LuAl3 and TmAl3 for T < 200 K allow for the determination of a CEF splitting scheme for TmAl3

Simulation of Increased Nitrogen Deposition to a Montane Forest Ecosystem: Partitioning of the Added 15N

Abstract. Nitrogen (N) was added over two years to a spruce-dominated (Picea abies) montane forest at Alptal, central Switzerland. A solution of ammonium nitrate (NH4NO3) was frequently sprinkled on the forest floor (1500 m2) to simulate an additional input of 30 kg N ha-1 yr-1 over the ambient 12 kg bulk inorganic N deposition. The added nitrogen was labelled with 15NH415NO3 during the first year. Results are compared to a control plot. Neither the trees nor the ground vegetation showed any increase in their N content. Only 4.1 % of N in the ground vegetation came from the N addition. Current-year needles contained 11 mg N g-1 dry weight, of which only 2 % was from labelled N; older needles had approximately half as much 15N. The uptake from the treatment was therefore very small. Redistribution of N also took place in the trunks: 1 to 2-year-old wood contained 0.7 % labelled N, tree rings dating back 3 to 14 years contained 0.4%. Altogether, the above-ground vegetation took up 12 % of the labelled N. Most 15N was recovered in the soil: 13 % in litter and roots, 63 % in the sieved soil. Nitrate leaching accounted for 10%. Factors thought to be influencing N uptake are discussed in relation to plant use of N and soil conditions

A Global Analog of Cheshire Charge

It is shown that a model with a spontaneously broken global symmetry can support defects analogous to Alice strings, and a process analogous to Cheshire charge exchange can take place. A possible realization in superfluid He-3 is pointed out.Comment: 24 pages (figures 1-4 included as uu-encoded tar files), CALT-68-1865 (Revised version: an expression (eq. 17) for global charge density is corrected; some typos and sign mismatches are removed.

Estradiol and testosterone levels in patients undergoing partial hepatectomy - A possible signal for hepatic regeneration?

In five adult male patients undergoing a 40-60% partial hepatectomy, serum sex hormone levels before and after hepatic resection were determined. Blood was drawn immediately prior to each surgical procedure and at specified time points postoperatively. Compared to hormone levels found prior to surgery, following major hepatic resection, estradiol levels increase at 24 and 48 hr, while testosterone levels decline, being significantly reduced at 96 and 144 hr. These data demonstrate that adult males who undergo a 40-60% partial hepatectomy experience alterations in their sex hormone levels similar to those observed in male rats following a 70% hepatectomy. These changes in sex hormone levels have been associated in animals with an alteration of the sex hormone receptor status of the liver that is thought to participate in the initiation of the regenerative response. These studies suggest, but do not prove, that in man, as in the case of the rat, sex hormones may participate in the initiation of or at least modulate in part the regenerative response that occurs following a major hepatic resection. © 1989 Plenum Publishing Corporation