Rupture and intra-peritoneal bleeding of a hepatocellular carcinoma after a transarterial chemoembolization procedure: a case report

Deposited according publisher policy posted on Sherpa/RoMEO November 16, 2011. Updated version of CC Attribution 2.0 assigned -- CC Attribution 3.0 with international jurisdiction.YesFunding provided by the Open Access Authors Fund

Identification of prognostic inflammatory factors in colorectal liver metastases

BACKGROUND: The modified Glasgow Prognostic Score (mGPS) has been reported to be an important prognostic indicator in a number of tumor types, including colorectal cancer (CRC). The features of the inflammatory state thought to accompany elevated C-reactive protein (CRP), a key feature of mGPS, were characterized in patients with colorectal liver metastases. Additional inflammatory mediators that contribute to prognosis were explored. METHODS: In sera from 69 patients with colorectal liver metastases, a panel of 42 inflammatory mediators were quantified as a function of CRP levels, and as a function of disease-free survival. Multivariate statistical methods were used to determine association of each mediator with elevated CRP and truncated disease-free survival. RESULTS: Elevated CRP was confirmed to be a strong predictor of survival (HR 4.00, p = 0.001) and recurrence (HR 3.30, p = 0.002). The inflammatory state associated with elevated CRP was comprised of raised IL-1β, IL-6, IL-12 and IL-15. In addition, elevated IL-8 and PDGF-AB/BB and decreased eotaxin and IP-10 were associated with worse disease-free and overall survival. CONCLUSIONS: Elevated CRP is associated with a proinflammatory state. The inflammatory state is an important prognostic indicator in CRC liver metastases. The individual contributions of tumor biology and the host to this inflammatory response will require further investigation. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/1471-2407-14-542) contains supplementary material, which is available to authorized users

A Pair of Compact Red Galaxies at Redshift 2.38, Immersed in a 100 kpc Scale Ly-alpha Nebula

We present Hubble Space Telescope (HST) and ground-based observations of a pair of galaxies at redshift 2.38, which are collectively known as 2142-4420 B1 (Francis et al. 1996). The two galaxies are both luminous extremely red objects (EROs), separated by 0.8 arcsec. They are embedded within a 100 kpc scale diffuse Ly-alpha nebula (or blob) of luminosity ~10^44 erg/s. The radial profiles and colors of both red objects are most naturally explained if they are young elliptical galaxies: the most distant yet found. It is not, however, possible to rule out a model in which they are abnormally compact, extremely dusty starbursting disk galaxies. If they are elliptical galaxies, their stellar populations have inferred masses of ~10^11 solar masses and ages of ~7x10^8 years. Both galaxies have color gradients: their centers are significantly bluer than their outer regions. The surface brightness of both galaxies is roughly an order of magnitude greater than would be predicted by the Kormendy relation. A chain of diffuse star formation extending 1 arcsec from the galaxies may be evidence that they are interacting or merging. The Ly-alpha nebula surrounding the galaxies shows apparent velocity substructure of amplitude ~ 700 km/s. We propose that the Ly-alpha emission from this nebula may be produced by fast shocks, powered either by a galactic superwind or by the release of gravitational potential energy.Comment: 33 pages, 9 figures, ApJ in press (to appear in Jun 10 issue

Lifshitz critical point in the cuprate superconductor YBa2Cu3Oy from high-field Hall effect measurements

The Hall coefficient R_H of the cuprate superconductor YBa2Cu3Oy was measured in magnetic fields up to 60 T for a hole concentration p from 0.078 to 0.152, in the underdoped regime. In fields large enough to suppress superconductivity, R_H(T) is seen to go from positive at high temperature to negative at low temperature, for p > 0.08. This change of sign is attributed to the emergence of an electron pocket in the Fermi surface at low temperature. At p < 0.08, the normal-state R_H(T) remains positive at all temperatures, increasing monotonically as T \to 0. We attribute the change of behaviour across p = 0.08 to a Lifshitz transition, namely a change in Fermi-surface topology occurring at a critical concentration p_L = 0.08, where the electron pocket vanishes. The loss of the high-mobility electron pocket across p_L coincides with a ten-fold drop in the conductivity at low temperature, revealed in measurements of the electrical resistivity $\rho$ at high fields, showing that the so-called metal-insulator crossover of cuprates is in fact driven by a Lifshitz transition. It also coincides with a jump in the in-plane anisotropy of $\rho$, showing that without its electron pocket the Fermi surface must have strong two-fold in-plane anisotropy. These findings are consistent with a Fermi-surface reconstruction caused by a unidirectional spin-density wave or stripe order.Comment: 16 pages, 13 figures, see associated Viewpoint: M. Vojta, Physics 4, 12 (2011

A phase II experience with neoadjuvant irinotecan (CPT-11), 5-fluorouracil (5-FU) and leucovorin (LV) for colorectal liver metastases

<p>Abstract</p> <p>Background</p> <p>Chemotherapy may improve survival in patients undergoing resection of colorectal liver metastases (CLM). Neoadjuvant chemotherapy may help identify patients with occult extrahepatic disease (averting unnecessary metastasectomy), and it provides <it>in vivo </it>chemosensitivity data.</p> <p>Methods</p> <p>A phase II trial was initiated in which patients with resectable CLM received CPT-11, 5-FU and LV for 12 weeks. Metastasectomy was performed unless extrahepatic disease appeared. Postoperatively, patients with stable or responsive disease received the same regimen for 12 weeks. Patients with progressive disease received either second-line chemotherapy or best supportive care. The primary endpoint was disease-free survival (DFS); secondary endpoints included overall survival (OS) and safety.</p> <p>Results</p> <p>35 patients were accrued. During preoperative chemotherapy, 16 patients (46%) had grade 3/4 toxicities. Resection was not possible in 5 patients. One patient died of arrhythmia following surgery, and 1 patient had transient liver failure. During the postoperative treatment phase, 12 patients (55%) had grade 3/4 toxicities. Deep venous thrombosis (DVT) occurred in 11 patients (34%) at various times during treatment. Of those who underwent resection, median DFS was 23.0 mo. and median OS has not been reached. The overall survival from time of diagnosis of liver metastases was 51.6 mo for the entire cohort.</p> <p>Conclusion</p> <p>A short course of chemotherapy prior to hepatic metastasectomy may serve to select candidates best suited for resection and it may also direct postoperative systemic treatment. Given the significant incidence of DVT, alternative systemic neoadjuvant regimens should be investigated, particularly those that avoid the use of a central venous line.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov NCT00168155.</p

Bostonia: The Boston University Alumni Magazine. Volume 11

Founded in 1900, Bostonia magazine is Boston University's main alumni publication, which covers alumni and student life, as well as university activities, events, and programs

The ambivalent shadow of the pre-Wilsonian rise of international law

The generation of American international lawyers who founded the American Society of International Law in 1906 and nurtured the soil for what has been retrospectively called a “moralistic legalistic approach to international relations” remains little studied. A survey of the rise of international legal literature in the U.S. from the mid-19th century to the eve of the Great War serves as a backdrop to the examination of the boosting effect on international law of the Spanish American War in 1898. An examination of the Insular Cases before the US Supreme Court is then accompanied by the analysis of a number of influential factors behind the pre-war rise of international law in the U.S. The work concludes with an examination of the rise of natural law doctrines in international law during the interwar period and the critiques addressed.by the realist founders of the field of “international relations” to the “moralistic legalistic approach to international relation

Highly Accurate Diagnosis of Pleural Tuberculosis by Immunological Analysis of the Pleural Effusion

Pleural TB is notoriously difficult to diagnose due to its paucibacillary nature yet it is the most common cause of pleural effusions in TB endemic countries such as The Gambia. We identified both cellular and soluble biomarkers in the pleural fluid that allowed highly accurate diagnosis of pleural TB compared to peripheral blood markers. Multi-plex cytokine analysis on unstimulated pleural fluid showed that IP-10 resulted in a positive likelihood ratio (LR) of 9.6 versus 2.8 for IFN-γ; a combination of IP-10, IL-6 and IL-10 resulted in an AUC of 0.96 and positive LR of 10. A striking finding was the significantly higher proportion of PPD-specific IFN-γ+TNF-α+ cell population (PPD-IGTA) in the pleural fluid compared to peripheral blood of TB subjects. Presence of this pleural PPD-IGTA population resulted in 95% correct classification of pleural TB disease with a sensitivity of 95% and specificity of 100%. These data suggest that analysis of the site of infection provides superior diagnostic accuracy compared to peripheral blood for pleural TB, likely due to the sequestration of effector cells at this acute stage of disease

A decade of experience with injuries to the gallbladder

Article deposited according to publisher policy posted on SHERPA/RoMEO, 05/08/2010.YesFunding provided by the Open Access Authors Fund