The term "carcinoid" is a misnomer: the evidence based on local invasion

<p>Abstract</p> <p>Background</p> <p>Since Oberndorfer proposed the term "carcinoid" in 1907, over 100 years have passed. This attractive term was initially proposed for 6 cases of his own experience with 12 submucosal lesions in the small intestine.</p> <p>Oberndorfer summarized the characteristic features of these lesions as follows: (1) small in size and often multiple, (2) histologically undifferentiated with a suggestion of gland-formation, (3) well-defined without any tendency to infiltrate the surroundings, (4) no metastases, and (5) apparently slow-growing reaching no significant size with a seemingly harmless nature.</p> <p>Review</p> <p>This article stresses the malignant nature of "carcinoid" on the basis of local invasion prior to metastases in the first two sessions, (1) with Oberndorfer's original diagram, and (2) with an experimental observation on extraglandular microcarcinoid in a form of "budding".</p> <p>Next, (3) a statistical comparison between a carcinoid group and a non-carcinoid ordinary carcinoma group is introduced on metastasis rates at an early stage with two prescribed factors of the depth of invasion restricted within the submucosa (sm-lesion) and a small tumor size category of 1 cm to 2 cm: the carcinoid group exhibited metastasis rates higher than those in the ordinary carcinoma group when calculated in the stomach and rectum.</p> <p>In the author's experience, "carcinoids" are malignant not only in the gastrointestinal tract but also in the other sites on the basis of local invasion.</p> <p>Lastly, (4) discussion on the terminology of "carcinoid" as a misnomer is carried out.</p> <p>Adequate terms referring to the entity of this malignant tumor group are discussed. One of the most adequate and brief terms for "carcinoid" that is included now in neuroendocrine tumor group would be "endocrinocarcinoma" as per the author's proposal, followed by NEC (neuroendocrinocarcinoma) or GEC (gut endocrinocarcinoma).</p> <p>Conclusion</p> <p>The term "carcinoid" is a misnomer that can be confirmed on the basis of local invasion prior to metastases. "No metastases without local invasion" is not of a negligible importance.</p

An investigation into the sample preparation procedure and analysis of cyanoacrylate adhesives using capillary electrophoresis

In this study, the trace acid profile of cyanoacrylate adhesives was studied using capillary electrophoresis. Liquid–liquid extraction was employed as the sample preparation step before separation by capillary electrophoresis. The solubility of the adhesives was investigated using various organic solvents, e.g. hexane and dichloromethane, and chloroform was determined to be the optimum solvent as it enabled the full dissolution of the adhesive. A comprehensive stability study was performed over a 3-year period and results indicate that the adhesives were stable for 2 years after which their stability and performance degraded

Re-thinking uk transport emissions – Getting to the 2050 targets

Transport is a complex system, integral to national and international structure and without which society cannot function. At the same time, transport is a significant contributor to global greenhouse gas emissions. In the UK a step change is required in the transport sector to achieve the legally binding reduction targets of the Climate Change Act 2008. Following the UK government’s 2013 review of carbon dioxide emissions from infrastructure, this paper looks at the country’s present and projected transport emissions in the context of the transport status quo and plans for growth. It argues there is an urgent need to rebalance the transport modal mix, with all modes integrated into a seamless transport system with smart interfacing between them. Drivers for behavioural change are also essential.Engineering and Physical Sciences Research CouncilThis is the final version of the article. It first appeared from ICE Publishing via https://doi.org/10.1680/jcien.15.0007

Greenhouse gas considerations in rail infrastructure in the UK

Transportation-related greenhouse gas (GHG) emissions account for an increasing proportion of total emissions in the UK and globally. The provision of rail transit is popularly proposed to reduce transport GHG emissions, but the provision of new infrastructure is itself GHG intensive. Understanding of the GHG emissions impact of rail projects is limited and very few longitudinal studies have been carried out. Existing assessments are often limited both in their scope and the factors considered. A holistic understanding of GHG impacts must include an assessment of capital GHG emissions, operational energy and maintenance as well as an assessment of ridership mode shift and mode share impacts and the relationship between transit infrastructure and land use. This paper explores rail infrastructure projects and their associated GHG emissions. Guidance is given on the aspects of rail planning, design and construction that must be considered to more fully understand the associated GHG impacts.The authors would like to thank The Commonwealth Scholarship Commission in the UK for the scholarship funding that facilitated this work

Fabric anisotropy & DEM informed two-surface hyperplasticity: constitutive formulation, asymptotic states & experimental validation

In geotechnical analysis continuum idealisations of the bulk material still provide the most appropriate approach for engineers designing large-scale structures. In this area, the most successful framework for describing the behaviour of soils is Critical State (CS) soil mechanics. However, the findings from discrete element method (DEM) analysis, such as the uniqueness of the CS, can provide invaluable information in the development such models. This paper details the key concepts behind a two-surface hyperplasticity model (?) whose development was informed by recent DEM findings on the uniqueness of the CS. Asymptotic states of the model will be confirmed and the DEM-continuum-experimental loop will be closed through comparison of the developed model with experimental data on coarse-grained particulate media. This will demonstrate, that providing the previous stress history is accounted for, the proposed model is suitable for a variety of particulate media

Safety and Efficacy of Everolimus in Adult Patients with Neuroendocrine Tumors

Neuroendocrine tumors (NETs) consist of a diverse family of tumors which are derived from the neuroendocrine system. Most NETs are well or moderately differentiated tumors with a relatively indolent growth pattern. However, these tumors can cause significant clinical disease due to release of functional products that mediate the carcinoid syndrome and other diverse sequela. They also can grow progressively and cause symptoms from local invasion or distant metastasis. NETs are optimally treated with surgery and somatosatin analogs (SSA’s) to control symptoms but are relatively insensitive to systemic chemotherapy. As a result, patients with advanced unresectable NETs have a poor prognosis. In 2011, two targeted therapies, sunitinib and everolimus were approved in the subset of progressive pancreatic NETs (pNETs). Everolimus is an oral inhibitor of the growth stimulatory mTOR pathway. In Phase 2 trials in NETs and pNETs, everolimus was well tolerated and associated with some response and widespread disease stabilization. In follow-up, randomized Phase 3 trials, everolimus was compared to placebo. In the RADIANT-2 trial, everolimus and a somatostatin analog were used in patients with functional NETs and treatment was associated with an an improvement in progression-free survival (PFS). In the RADIANT-3 trial, patients with pNET were randomized to receive everolimus or placebo along with best supportive care. Everolimus was again associated with improvement in PFS compared to placebo and it has been approved by the FDA for patients with progressive pNET. Everolimus is associated with frequent low grade toxicity but is also notable for increased rates of infection as well as non-infectious pneumonitis. mTOR inhibition with everolimus represents a significant advance in the treatment of advanced neuroendocrine tumors

Capillary electrophoresis-mass spectrometry analysis of trehalose-6-phosphate in Arabidopsis thaliana seedlings

Trehalose-6-phosphate (T6P) is an intermediate in the plant metabolic pathway that results in trehalose production. T6P has been shown to inhibit the sucrose nonfermenting-1-related protein kinase 1, which is a major regulator of metabolism. The quantitation of T6P has proven difficult due to the complexity of the plant matrix and the low abundance of T6P in plant tissues. The aim of this work was to develop a quantitation method for T6P present in Arabidopsis tissues, with capillary electrophoresis (CE) coupled to electrospray ionization-mass spectrometry (MS) with a sheath liquid (SL) interface. The CE-MS method was first optimized with respect to T6P signal intensity and separation of isomers by studying the composition of the background electrolyte (BGE) and SL. The use of triethylamine (TEA) in the BGE was favorable, providing separation of T6P from sucrose-6-phosphate and minimizing ionization suppression. Replacing ammonium acetate with TEA enhanced T6P signal intensities more than four times. The optimized method allowed quantification of T6P in plant extracts with good linearity (r2 > 0.99) within a biologically relevant concentration range. The limit of quantification was 80 nM in Arabidopsis extracts, corresponding to 33 pmol/g plant fresh weight. The CE-MS method was applied to the determination of T6P in seedlings from wild type (WT) Arabidopsis and mutants lacking the trehalase AtTRE1, tre1-1, challenged with trehalose or sorbitol. T6P accumulation in tre1-1 plants grown on sorbitol was about twice the level of T6P found in WT. CE-MS is shown to be a fast and reliable technique to analyze phosphodisaccharides for seedling extracts. The low sample volume requirement of CE and its direct MS coupling makes it an attractive alternative for anion-exchange liquid chromatography–MS

Classification of tumours

Tumours are classified according to the most differentiated cells with the exception of carcinomas where a few tumour cells show neuroendocrine differentiation. In this case these cells are regarded as redifferentiated tumour cells, and the tumour is not classified as neuroendocrine. However, it is now clear that normal neuroendocrine cells can divide, and that continuous stimulation of such cells results in tumour formation, which during time becomes increasingly malignant. To understand tumourigenesis, it is of utmost importance to recognize the cell of origin of the tumour since knowledge of the growth regulation of that cell may give information about development and thus possible prevention and prophylaxis of the tumour. It may also have implications for the treatment. The successful treatment of gastrointestinal stromal tumours by a tyrosine kinase inhibitor is an example of the importance of a correct cellular classification of a tumour. In the future tumours should not just be classified as for instance adenocarcinomas of an organ, but more precisely as a carcinoma originating from a certain cell type of that organ

Quasi-stationary States of Two-Dimensional Electron Plasma Trapped in Magnetic Field

We have performed numerical simulations on a pure electron plasma system under a strong magnetic field, in order to examine quasi-stationary states that the system eventually evolves into. We use ring states as the initial states, changing the width, and find that the system evolves into a vortex crystal state from a thinner-ring state while a state with a single-peaked density distribution is obtained from a thicker-ring initial state. For those quasi-stationary states, density distribution and macroscopic observables are defined on the basis of a coarse-grained density field. We compare our results with experiments and some statistical theories, which include the Gibbs-Boltzmann statistics, Tsallis statistics, the fluid entropy theory, and the minimum enstrophy state. From some of those initial states, we obtain the quasi-stationary states which are close to the minimum enstrophy state, but we also find that the quasi-stationary states depend upon initial states, even if the initial states have the same energy and angular momentum, which means the ergodicity does not hold.Comment: 9 pages, 7 figure

Comparative simulation study of colloidal gels and glasses

Using computer simulations, we identify the mechanisms causing aggregation and structural arrest of colloidal suspensions interacting with a short-ranged attraction at moderate and high densities. Two different non-ergodicity transitions are observed. As the density is increased, a glass transition takes place, driven by excluded volume effects. In contrast, at moderate densities, gelation is approached as the strength of the attraction increases. At high density and interaction strength, both transitions merge, and a logarithmic decay in the correlation function is observed. All of these features are correctly predicted by mode coupling theory