Pancreatic Resections for Advanced M1-Pancreatic Carcinoma: The Value of Synchronous Metastasectomy

Background. For M1 pancreatic adenocarcinomas pancreatic resection is usually not indicated. However, in highly selected patients synchronous metastasectomy may be appropriate together with pancreatic resection when operative morbidity is low. Materials and Methods. From January 1, 2004 to December, 2007 a total of 20 patients with pancreatic malignancies were retrospectively evaluated who underwent pancreatic surgery with synchronous resection of hepatic, adjacent organ, or peritoneal metastases for proven UICC stage IV periampullary cancer of the pancreas. Perioperative as well as clinicopathological parameters were evaluated. Results. There were 20 patients (9 men, 11 women; mean age 58 years) identified. The primary tumor was located in the pancreatic head (n = 9, 45%), in pancreatic tail (n = 9, 45%), and in the papilla Vateri (n = 2, 10%). Metastases were located in the liver (n = 14, 70%), peritoneum (n = 5, 25%), and omentum majus (n = 2, 10%). Lymphnode metastases were present in 16 patients (80%). All patients received resection of their tumors together with metastasectomy. Pylorus preserving duodenopancreatectomy was performed in 8 patients, distal pancreatectomy in 8, duodenopancreatectomy in 2, and total pancreatectomy in 2. Morbidity was 45% and there was no perioperative mortality. Median postoperative survival was 10.7 months (2.6–37.7 months) which was not significantly different from a matched-pair group of patients who underwent pancreatic resection for UICC adenocarcinoma of the pancreas (median survival 15.6 months; P = .1). Conclusion. Pancreatic resection for M1 periampullary cancer of the pancreas can be performed safely in well-selected patients. However, indication for surgery has to be made on an individual basis

Nanogranular MgB2 thin films on SiC buffered Si substrates prepared by in-situ method

MgB2 thin films were deposited on SiC buffered Si substrates by sequential electron beam evaporation of B-Mg bilayer followed by in-situ annealing. The application of a SiC buffer layer enables the maximum annealing temperature of 830 C. The Transmission Electron Microscopy analysis confirms the growth of a nanogranular MgB2 film and the presence of a Mg2Si compound at the surface of the film. The 150-200 nm thick films show a maximum zero resistance critical temperature TC0 above 37 K and a critical current density JC ~ 106 A/cm2 at 11K.Comment: 7 pages, 6 figures, submitted to Applied Physics Letter

Indications and Early Outcomes for Total Pancreatectomy at a High-Volume Pancreas Center

Background. This study aimed to analyse the most common current indications for total pancreatectomy (TP) at a high-volume pancreas center. Method. Prospectively collected data on indications and short-term outcome of all TP's performed from January 2004 until June 2008 were analysed. Results. The total pancreatectomies (TP) were 63, i.e., 6.7% of all pancreatic procedures (n = 948). Indications for TP were classified into 4 groups: tumors of advanced stage, n = 23 (36.5%), technical problems due to soft pancreatic tissue, n = 18 (28.6%), troubles due to perioperative surgical complications, n = 15 (23.8%), and therapy-resistant pain due to chronic pancreatitis, n = 7 (11.1%). Surgical complications occurred in 23 patients (36.5%). The mortality in elective TP was 6.25%. Median postoperative stay was 21 days. Mortality, morbidity and the other perioperative parameters differed substantially according to the indication for pancreatectomy. Conclusion. Total pancreatectomy is definitely indicated for a limited range of elective and emergency situations. Indications can be: size or localisation of pancreatic tumor, trouble, technical diffuculties and therapy-refractory pain in chronic pancreatitis. A TP due to perioperative complications (troubles) after pancreatic resections is doomed by extremely high morbidity and mortality and should be avoided

Studies of resistance switching effects in metal/YBa2Cu3O7-x interface junctions

Current-voltage characteristics of planar junctions formed by an epitaxial c-axis oriented YBa2Cu3O7-x thin film micro-bridge and Ag counter-electrode were measured in the temperature range from 4.2 K to 300 K. A hysteretic behavior related to switching of the junction resistance from a high-resistive to a low-resistive state and vice-versa was observed and analyzed in terms of the maximal current bias and temperature dependence. The same effects were observed on a sub-micrometer scale YBa2Cu3O7-x thin film - PtIr point contact junctions using Scanning Tunneling Microscope. These phenomena are discussed within a diffusion model, describing an oxygen vacancy drift in YBa2Cu3O7-x films in the nano-scale vicinity of the junction interface under applied electrical fields.Comment: To be published in Applied Surface Science

Spin-dependent effective interactions for halo nuclei

We discuss the spin-dependence of the effective two-body interactions appropriate for three-body computations. The only reasonable choice seems to be the fine and hyperfine interactions known for atomic electrons interacting with the nucleus. One exception is the nucleon-nucleon interaction imposing a different type of symmetry. We use the two-neutron halo nucleus 11Li as illustration. We demonstrate that models with the wrong spin-dependence are basically without predictive power. The Pauli forbidden core and valence states must be consistently treated.Comment: TeX file, 6 pages, 3 postscript figure

Effect of crystallographic anisotropy on the resistance switching phenomenon in perovskites

Resistance switching effects in metal/perovskite contacts based on epitaxial c-axis oriented Y-Ba-Cu-O (YBCO) thin films with different crystallographic orientations have been studied. Three types of Ag/YBCO junctions with the contact restricted to (i) c-axis direction, (ii) ab-plane direction, and (iii) both were designed and fabricated, and their current-voltage characteristics have been measured. The type (i) junctions exhibited conventional bipolar resistance switching behavior, whereas in other two types the low-resistance state was unsteady and their resistance quickly relaxed to the initial high-resistance state. Physical mechanism based on the oxygen diffusion scenario, explaining such behavior, is discussed.Comment: The final version was published in Journal of Applied Physics (2012

FHIR-DHP: A standardized clinical data harmonisation pipeline for scalable AI application deployment

Background Increasing digitalisation in the medical domain gives rise to large amounts of healthcare data which has the potential to expand clinical knowledge and transform patient care if leveraged through artificial intelligence (AI). Yet, big data and AI oftentimes cannot unlock their full potential at scale, owing to non-standardised data formats, lack of technical and semantic data interoperability, and limited cooperation between stakeholders in the healthcare system. Despite the existence of standardised data formats for the medical domain, such as Fast Healthcare Interoperability Resources (FHIR), their prevalence and usability for AI remains limited.Objective We developed a data harmonisation pipeline (DHP) for clinical data sets relying on the common FHIR data standard.Methods We validated the performance and usability of our FHIR-DHP with data from the MIMIC IV database including > 40,000 patients admitted to an intensive care unit.Results We present the FHIR-DHP workflow in respect of transformation of “raw” hospital records into a harmonised, AI-friendly data representation. The pipeline consists of five key preprocessing steps: querying of data from hospital database, FHIR mapping, syntactic validation, transfer of harmonised data into the patient-model database and export of data in an AI-friendly format for further medical applications. A detailed example of FHIR-DHP execution was presented for clinical diagnoses records.Conclusions Our approach enables scalable and needs-driven data modelling of large and heterogenous clinical data sets. The FHIR-DHP is a pivotal step towards increasing cooperation, interoperability and quality of patient care in the clinical routine and for medical research