Prognostic factors affecting survival after surgical resection of gastrointestinal stromal tumours: a two-unit experience over 10 years

BACKGROUND: Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal neoplasm of the gastrointestinal (GI) tract which has only been recently described based on their specific immunohistochemistry and the presence of particular KIT-related mutations which potentially make them targets for tyrosine kinase inhibition. METHODS: Sixty-one patients (29 M; 32 F, median age 60 years; range: 23–86 years) between June 1994 and March 2005, were analyzed from two allied institutions. Patient, tumour, and treatment variables were analyzed to identify factors affecting survival. RESULTS: Of the 61 patients, 55 (90%) underwent complete surgical resection of macroscopic disease. The 5-year overall survival (OS) rate in the 61 patients was 88% and the 5-year disease-free survival (DFS) in the 55 cases completely resected was 75%. Univariate analysis revealed that R0 resection was strongly associated with a better OSrate (p < 0.0001). Likewise, univariate analysis also showed high mitotic count of > 10 mitoses/per 50 HPF was a significant variable in worse prognosis for OS (≤ 10 mitoses/per 50 HPF 95% 5-year OS vs. > 10 mitoses/per 50 HPF 74% 5-year OS, respectively; p = 0.013). On subsequent multivariate analysis, only high mitotic count remained as a significant negative prognostic variable for OS (p = 0.029). Among patients resected for cure, there were 8 recurrences during follow-up. The mean time to recurrence was 21 ± 10 months (range: 4–36 months). Univariate analysis revealed that mitotic count of > 10 mitoses per 50 high power fields, intratumoural necrosis, and pathological tumour size (> 10 cm in maximal diameter) significantly correlated with DFS (p = 0.006, 0.002 and 0.02, respectively), with tumour necrosis and high mitotic count remaining as independent predictive variables affecting prognosis on subsequent multivariate analysis. CONCLUSION: Most GISTs are resectable with survival principally dependent upon mitotic count and completeness of resection. Future metabolic and genetic analyses will define the role of and resistance to induction or postoperative adjuvant targeted kinase inhibition therapy

Seasonal patterns of gonadal development and condition index of Dendostrea sandvicensis

Very little information is available on the Hawaiian Oyster Dendostrea sandvicensis in regards to its biology and physiology. Efforts were made to better understand the active reproductive season of this oyster by studying the population located in He'eia fish pond in Kaneohe Bay, O`ahu. This study focused on the condition index (CI) and gonadal developmental stage trends, measured from monthly oyster tissue samples from January to December 2009. The relationship between CI and temperature was examined. Results suggest CI is not related to temperature. Further analysis defined a positive correlation for CI and temperature during summer but not in winter. Ranges in CI values were higher in summer than in winter. D. sandvicensis experience a tropical reproductive cycle, as trends related to the gonadal stage indicate. January to March is dominated by maturing gonads. From April to October there is a rise and then steady decline of empty gonads indicating an active reproduction season. From November to December a rise in mature gonads indicate readiness for reproduction and recovery. Empty gonads are present through out the year indicating reproduction happens throughout the year, and peaks in beginning of summer

Maturation, Spawning and Larval Rearing Techniques of Pacific Yellowtail, Seriola mazatlana

Techniques for maturation, spawning and larval rearing of Pacific yellowtail, Seriola mazatlana, were developed in Ecuador during the last five years. Using the methodology described in this paper, we were able to obtain continuous and sustainable year-round spawning of both wild and captive reared broodstock fish in maturation tanks. After collection from the wild and acclimation for about one year at the hatchery facilities, one group of twelve broodstock fish was producing about 400, 000 fertilized eggs twice a week over a 18-month period. Another group of ten wild broodstock fish spawned 4, 500, 000 fertilized eggs per month from February to October, 1997. Similar results were achieved with a third group of twelve wild caught broodstock fish in another commercial hatchery in Ecuador. During 1997, 50 months after hatching, we were able to get a hatchery grown group of brood fish (first generation in captivity) to spawn about 200, 000 fertilized eggs twice a week in captivity. Larval husbandry was conducted using three different techniques: intensive, semiintensive and extensive. Results have been highly variable. Depending upon the egg quality from the different batches, survival rates ranging from 0-70% were achieved throughout larval rearing of Seriola until metamorphosis. High mortalities of fingerlings and early juveniles after metamorphosis have been lowering the average survival rates through the juvenile stage to 0.5-2.0%. Epitheliocystis has been shown to be the most important disease to occur during early developmental stages. Epizootics of this disease have caused mass mortalities of fingerlings. Other factors directly or indirectly related to the high mortality rates observed are broodstock nutrition, variability in egg quality among different batches, larval nutrition, weaning from live feeds onto artificial diets, as well as high levels of cannibalism after metamorphosis. Commercial production of Pacific yellowtail in Ecuador and other Latin American countries has been hampered exclusively by high mortalities of fingerlings and early juveniles. All other technicalities related to their aquaculture are thought to be mastered. The technological feasibility of Pacific yellowtail aquaculture has been proven. The commercial, economical viability of the operation remains uncertain

Discoteca-Pub para jóvenes mayores con experiencia “Mis Tiempos”

TesisLa siguiente tesis presenta un plan de negocios para implementar una discoteca pub dirigido a personas de la tercera edad, donde podrán disfrutar con personas de su generación escuchando y bailando música de sus tiempos. Se escogió este tema debido a que en el mercado actual no existe un lugar de diversión exclusivo para ellos. Según la investigación realizada hay un gran entusiasmo en las personas, ya que disponen de mayor tiempo y dinero para divertirse al tener menores responsabilidades. Es por ello que este proyecto se ofrece a personas mayores de 55 años de edad, proveniente de los niveles socio-económicos A y B, que viven en los distritos de Lima Moderna. En base al análisis estratégico del macro entorno, se determinó que las condiciones económicas, políticas, sociodemográficas y jurídico-legales son en su mayoría favorables para poner en marcha este negocio. De otro lado, según nuestro análisis del sector, se puede afirmar que las fuerzas del mercado se presentan con baja intensidad lo cual deriva en una débil competitividad. En lo que respecta al entorno específico, se pudo corroborar que los posibles competidores son pocos y ninguno presenta todos los atributos que el público objetivo desea. El producto que se ofrecerá para satisfacer las necesidades del mercado, se ha elaborado en base a los atributos valorados por este segmento, como: ritmos y géneros musicales acorde a su generación, tragos y piqueos preferidos, servicio de transporte, bar en ruta, estacionamiento y/o valet parking, servicio médico de emergencia y ambientación acorde a la época de los años ´50, ´60 y ´70s. El local contará con dos ambientes donde se podrá transitar libremente: un Pub donde se pueda conversar y una Discoteca donde nuestros clientes podrán gozar de shows en vivo. La ventaja competitiva diferencial de esta propuesta es “ofrecer un lugar de diversión innovador, diferente, exclusivo para los jóvenes mayores con experiencia, que les permita sentir la magia del ayer escuchando y bailando música de sus tiempos”. Esta propuesta se apoya en actividades que han sido cuidadosamente planificadas para ser eficaces, teniendo los recursos necesarios que garanticen su ejecución. Asimismo se contará con socios claves para desarrollar alianzas de mutuo beneficio. Por otro lado, la relación con nuestros clientes será cercana, porque buscaremos mantener contacto dentro y fuera del local a través de canales tradicionales y digitales, a fin de que sientan identificados con esta propuesta y puedan convertirse en futuros fans de nuestro negocio. Debido al nivel de demanda detectada en nuestra investigación, se estima que existe en el mercado un aproximado de 235 mil personas que podrían ser nuestros potenciales consumidores. Como consecuencia de este estudio, se proyecta una ocupabilidad del 85% en el primer año y una tendencia creciente hasta llegar al 98% en el cuarto año de operación. Finalmente, las fuentes de ingreso de este negocio son el cobro del cover (entrada) y la venta de piqueos y bebidas a los clientes. Consecuentemente y considerando los principales criterios de evaluación se puede afirmar que nuestro proyecto es viable dado que se obtuvo los siguientes resultados: Valor Actual Neto (VAN) de S/.536,670, Tasa Interna de Retorno (TIR) de 45.60%. y un período de recuperación de 3.33 años, confirmando que el negocio es una alternativa de inversión rentable