Role of Adjuvant Multimodality Therapy After Curative-Intent Resection of Ampullary Carcinoma

Importance: Ampullary adenocarcinoma is a rare malignant neoplasm that arises within the duodenal ampullary complex. The role of adjuvant therapy (AT) in the treatment of ampullary adenocarcinoma has not been clearly defined. Objective: To determine if long-term survival after curative-intent resection of ampullary adenocarcinoma may be improved by selection of patients for AT directed by histologic subtype. Design, setting, and participants: This multinational, retrospective cohort study was conducted at 12 institutions from April 1, 2000, to July 31, 2017, among 357 patients with resected, nonmetastatic ampullary adenocarcinoma receiving surgery alone or AT. Cox proportional hazards regression was used to identify covariates associated with overall survival. The surgery alone and AT cohorts were matched 1:1 by propensity scores based on the likelihood of receiving AT or by survival hazard from Cox modeling. Overall survival was compared with Kaplan-Meier estimates. Exposures: Adjuvant chemotherapy (fluorouracil- or gemcitabine-based) with or without radiotherapy. Main outcomes and measures: Overall survival. Results: A total of 357 patients (156 women and 201 men; median age, 65.8 years [interquartile range, 58-74 years]) underwent curative-intent resection of ampullary adenocarcinoma. Patients with intestinal subtype had a longer median overall survival compared with those with pancreatobiliary subtype (77 vs 54 months; P = .05). Histologic subtype was not associated with AT administration (intestinal, 52.9% [101 of 191]; and pancreatobiliary, 59.5% [78 of 131]; P = .24). Patients with pancreatobiliary histologic subtype most commonly received gemcitabine-based regimens (71.0% [22 of 31]) or combinations of gemcitabine and fluorouracil (12.9% [4 of 31]), whereas treatment of those with intestinal histologic subtype was more varied (fluorouracil, 50.0% [17 of 34]; gemcitabine, 44.1% [15 of 34]; P = .01). In the propensity score-matched cohort, AT was not associated with a survival benefit for either histologic subtype (intestinal: hazard ratio, 1.21; 95% CI, 0.67-2.16; P = .53; pancreatobiliary: hazard ratio, 1.35; 95% CI, 0.66-2.76; P = .41). Conclusions and relevance: Adjuvant therapy was more frequently used in patients with poor prognostic factors but was not associated with demonstrable improvements in survival, regardless of tumor histologic subtype. The value of a multimodality regimen remains poorly defined

Caenorhabditis elegans N-glycan Core β-galactoside Confers Sensitivity towards Nematotoxic Fungal Galectin CGL2

The physiological role of fungal galectins has remained elusive. Here, we show that feeding of a mushroom galectin, Coprinopsis cinerea CGL2, to Caenorhabditis elegans inhibited development and reproduction and ultimately resulted in killing of this nematode. The lack of toxicity of a carbohydrate-binding defective CGL2 variant and the resistance of a C. elegans mutant defective in GDP-fucose biosynthesis suggested that CGL2-mediated nematotoxicity depends on the interaction between the galectin and a fucose-containing glycoconjugate. A screen for CGL2-resistant worm mutants identified this glycoconjugate as a Galβ1,4Fucα1,6 modification of C. elegans N-glycan cores. Analysis of N-glycan structures in wild type and CGL2-resistant nematodes confirmed this finding and allowed the identification of a novel putative glycosyltransferase required for the biosynthesis of this glycoepitope. The X-ray crystal structure of a complex between CGL2 and the Galβ1,4Fucα1,6GlcNAc trisaccharide at 1.5 Å resolution revealed the biophysical basis for this interaction. Our results suggest that fungal galectins play a role in the defense of fungi against predators by binding to specific glycoconjugates of these organisms

An historical address delivered before the citizens of Springfield in Massachusetts at the public celebration, May 26, 1911, of the two hundred and seventy-fifth anniversary of the settlement; with five appendices, viz: Meaning of Indian local names, The cartography of Springfield, Old place names in Springfield, Unrecorded deed of Nippumsuit, Unrecorded deed of Paupsunnuck,

"The memories of the civil war; an historical address delivered before the E. K. Wilcox post of the Grand army of the republic, December 24, 1891": p. 92-100.Mode of access: Internet

"First 50 years of YMCA movement : including sketch of training schools" by Charles H. Burrows (1894)

The book titled "First 50 years of YMCA movement : including sketch of training schools" is written by Charles H. Barrows, the third president of the International YMCA Training School, now known as Springfield College, in 1894. The book talks about the history of the Young Men's Christian Association, its development in 50 years, and the rationale to build training schools, including Springfield College, for YMCA. This book is the typewritten version of the original version, which is handwritten by Charles Barrows.From 1893 to 1896, Charles Henry Barrows served as the third president of the International YMCA Training School, now known as Springfield College. He was one of the college’s original founders and served on the board of trustees for thirty-four years. During his presidency, Barrows built a gymnasium and the Administration building. During his service to the college, he also helped secure bequests and gifts for the endowment and frequently served as a legal adviser

"First 50 Years of YMCA Movement Including Sketch of Training Schools" by Charles H. Barrows (1894)

This manuscript titled "First 50 years of YMCA movement : including sketch of training schools" is written by Charles H. Barrows, the third president of the International YMCA Training School, now known as Springfield College, in 1894. The manuscript talks about the history of the Young Men's Christian Association, its development in 50 years, and the rationale to build training schools, including Springfield College, for YMCA. This manuscript has been transcribed into a printed version, and this is the original version.From 1893 to 1896, Charles Henry Barrows served as the third president of the International YMCA Training School, now known as Springfield College. He was one of the college’s original founders and served on the board of trustees for thirty-four years. During his presidency, Barrows built a gymnasium and the Administration building. During his service to the college, he also helped secure bequests and gifts for the endowment and frequently served as a legal adviser