Early Hepatocellular Carcinoma: Transplantation versus Resection: The Case for Liver Resection

The optimal surgical treatment of hepatocellular carcinoma on well-compensated cirrhosis is controversial. Advocates of liver transplantation cite better long-term survival, lower risk of recurrence, and the ability of transplantation to treat both the HCC and the underlying liver cirrhosis. Transplantation, however, is not universally available to all appropriate-risk candidates because of a lack of sufficient organ donors and in addition suffers from the disadvantages of requiring a more complex pre- and postoperative management associated with risks of inaccessibility, noncompliance, and late complications. Resection, by contrast, is much more easily and widely available, avoids many of those risks, is by many accounts as effective at achieving similar long-term survival, and still allows for safe, subsequent liver transplantation in cases of recurrence. Here, arguments are made in favor of resection being easier, safer, simpler, and comparably effective in the treatment of HCC relative to transplantation, and therefore being the optimal initial treatment in cases of hepatocellular carcinoma on well-compensated cirrhosis

Hereditary Pancreatic and Hepatobiliary Cancers

Hereditary etiologies of pancreatic and hepatobiliary cancers are increasingly recognized. An estimated >10% of pancreatic and increasing number of hepatobiliary cancers are hereditary. The cumulative risk of hereditary pancreatic cancer ranges from measurable but negligible in cystic fibrosis to a sobering 70% in cases of hereditary pancreatitis. Candidates for pancreatic cancer surveillance are those with a risk pancreatic cancer estimated to be >10-fold that of the normal population. Screening for pancreatic cancer in high-risk individuals is typically performed by endoscopic ultrasound and should begin at least 10 years prior to the age of the youngest affected relative. Disease states known to be associated with increased risk of hepatocellular cancer include hereditary hemochromatosis, autoimmune hepatitis, porphyria, and α1-antitrypsin deficiency, with relative risks as high as 36-fold. Although much less is known about hereditary bile-duct cancers, Muir-Torre syndrome and bile salt export pump deficiency are diseases whose association with hereditary carcinogenesis is under investigation

Colorectal Liver Metastases

The diagnosis and management of CRLM is complex and requires a multidisciplinary team approach for optimal outcomes. Over the past several decades, the 5-year survival following resection of CRLM has increased and the criteria for resection have broadened substantially. Even patients with multiple, bilateral CRLM, previously thought unresectable, may now be candidates for resection. Two-stage hepatectomy, repeat curative-intent hepatectomy, and even selected resection of extrahepatic metastases have further increased the number of patients who may be treated with curative intent. Multiple liver-directed therapies exist to treat unresectable, incurable patients with adequate survival benefit and morbidity rates

Cancer Surgery in the Elderly

The proportions both of elderly patients in the world and of elderly patients with cancer are both increasing. In the evaluation of these patients, physiologic age, and not chronologic age, should be carefully considered in the decision-making process prior to both cancer screening and cancer treatment in an effort to avoid ageism. Many tools exist to help the practitioner determine the physiologic age of the patient, which allows for more appropriate and more individualized risk stratification, both in the pre- and postoperative periods as patients are evaluated for surgical treatments and monitored for surgical complications, respectively. During and after operations in the oncogeriatric populations, physiologic changes occuring that accompany aging include impaired stress response, increased senescence, and decreased immunity, all three of which impact the risk/benefit ratio associated with cancer surgery in the elderly

A Molecular Line Survey around Orion at Low Frequencies with the MWA

The low-frequency sky may reveal some of the secrets yet to be discovered. Until recently, molecules had never been detected within interstellar clouds at frequencies below 700 MHz. Following the pilot survey toward the Galactic center at 103-133 MHz with the Murchison Widefield Array, we surveyed 400 deg2centered on the Orion KL nebula from 99 to 170 MHz. Orion is a nearby region of active star formation and known to be a chemically rich environment. In this paper, we present tentative detections of nitric oxide and its isotopologues, singularly deuterated formic acid, molecular oxygen, and several unidentified transitions. The three identified molecules are particularly interesting, as laboratory experiments have suggested that these molecules are precursors to the formation of amines

Physical Science Day: Design, Implementation, and Assessment

Physical Science Day at The University of Texas–Pan American (UTPA), in collaboration with the Edinburg Consolidated Independent School District, has been designed, developed and implemented to address an identified fundamental shortcoming in our educational process within this primarily (90+%) Hispanic serving border region. Physical Science Day overcomes the lack of knowledge about what physics is by raising youth awareness of physics as the foundation of science, engineering and technology disciplines, through activities including hands-on laboratory experiments, career orientation, and higher educational student and graduated student testimonials. Thus, Physical Science Day encourages, attracts, and enables more Hispanic youth towards science, technology and engineering disciplines in higher education. Pre- and post-survey results showed that Physical Science Day is effective at increasing student knowledge about physics, physical science, and chemistry programs, raising awareness of broad career opportunities, as well as for stimulating youth interest towards studying such disciplines at UTPA

Composite signet-ring cell/neuroendocrine carcinoma of the stomach with a metastatic neuroendocrine carcinoma component: a better prognosis entity

<p>Abstract</p> <p>Background</p> <p>Mixed (composite) exocrine-neuroendocrine cell carcinomas are defined as an intimate admixture of neoplastic glandular exocrine and neuroendocrine cell types. Although gastric adenocarcinoma containing a small number of neuroendocrine cells is a relatively frequent occurrence, gastric neoplasms containing equal proportions of both cell types are rare.</p> <p>Case Presentation</p> <p>We present a case of composite exocrine (signet-ring cell)-neuroendocrine cell carcinoma, in which the neoplastic signet-ring cell exocrine and neuroendocrine constituents occurred in fairly equivalent amounts, whereas only the neuroendocrine carcinoma portion of the tumor represented the metastatic component. Light microscopy, immunohistochemical and electron microscopic findings are described, and the literature is reviewed.</p> <p>Conclusion</p> <p>This study confirms the ability of pluripotent precursor cells to differentiate into either adenocarcinoma or neuroendocrine tumor and, justifying the designation of composite exocrine-neuroendocrine cell carcinoma as the appropriate classification for this tumor. The protracted clinical course further supports the notion that composite signet-ring cell/neuroendocrine carcinoma tumors behave relatively less aggressively than the pure forms of the former cell type.</p

Head--on Collision of Two Unequal Mass Black Holes

We present results from the first fully nonlinear numerical calculations of the head--on collision of two unequal mass black holes. Selected waveforms of the most dominant l=2, 3 and 4 quasinormal modes are shown, as are the total radiated energies and recoil velocities for a range of mass ratios and initial separations. Our results validate the close and distant separation limit perturbation studies, and suggest that the head--on collision scenario is not likely to produce an astrophysically significant recoil effect.Comment: 5 pages, 3 figure