Results of combined treatment of anaplastic thyroid carcinoma (ATC)

<p>Abstract</p> <p>Background</p> <p>Anaplastic thyroid carcinoma (ATC) is among the most aggressive human malignancies. It is associated with a high rate of local recurrence and with poor prognosis.</p> <p>Methods</p> <p>We retrospectively reviewed 44 consecutive patients treated between 1996 and 2010 at Leon Berard Cancer Centre, Lyon, France. The combined treatment strategy derived from the one developed at the Institut Gustave Roussy included total thyroidectomy and cervical lymph-node dissection, when feasible, combined with 2 cycles of doxorubicin (60 mg/m2) and cisplatin (100 mg/m2) Q3W, hyperfractionated (1.2 Gy twice daily) radiation to the neck and upper mediastinum (46-50 Gy), and then four cycles of doxorubicin-cisplatin.</p> <p>Results</p> <p>Thirty-five patients received the three-phase combined treatment. Complete response after treatment was achieved in 14/44 patients (31.8%). Eight patients had a partial response (18.2%). Twenty-two (50%) had progressive disease. All patients with metastases at diagnosis died shortly afterwards. Thirteen patients are still alive. The median survival of the entire population was 8 months.</p> <p>Conclusion</p> <p>Despite the ultimately dismal prognosis of ATC, multimodality treatment significantly improves local control and appears to afford long-term survival in some patients. There is active ongoing research, and results obtained with new targeted systemic treatment appear encouraging.</p

Vulvar basal cell carcinoma

Vulva is an uncommon localization for basal cell carcinomas. We report three cases and review the literature. There is often a long delay before patients seek medical attention for these lesions. Moreover the clinical aspect is often indistinctive and misleading. The gross polymorphism of vulvar neoplasms therefore calls for biopsy of any suspicious areas. Surgical excision or Moh's chemotherapy are the treatments of choice for vulvar basal cell carcinomas. The recurrence rate remains quite high even when the lesion looks completely resected

Multipath Spanners

This paper concerns graph spanners that approximate multipaths between pair of vertices of an undirected graphs with n vertices. Classically, a spanner H of stretch s for a graph G is a spanning subgraph such that the distance in H between any two vertices is at most s times the distance in G. We study in this paper spanners that approximate short cycles, and more generally p edge-disjoint paths with p&gt; 1, between any pair of vertices. For every unweighted graph G, we construct a 2-multipath 3-spanner of O(n 3/2) edges. In other words, for any two vertices u, v of G, the length of the shortest cycle (with no edge replication) traversing u, v in the spanner is at most thrice the length of the shortest one in G. This construction is shown to be optimal in term of stretch and of size. In a second construction, we produce a 2-multipath (2, 8)-spanner of O(n 3/2) edges, i.e., the length of the shortest cycle traversing any two vertices have length at most twice the shortest length in G plus eight. For arbitrary p, we observe that, for each integer k � 1, every weighted graph has a p-multipath p(2k−1)-spanner with O(pn 1+1/k) edges, leaving open the question whether, with similar size, the stretch of the spanner can be reduced to 2k − 1 for all p&gt; 1

Diagnostic Performance of Transesophageal Echocardiography and Cardiac Computed Tomography in Infective Endocarditis

Background: Multimodality imaging is essential for infective endocarditis (IE) diagnosis. The aim of this work was to evaluate the agreement between transesophageal echocardiography (TEE) and cardiac computed tomography (CT) findings in patients with surgically confirmed IE. Methods: Sixty-eight patients (mean age 63 ± 2 years) with a definite diagnosis of left-side IE according to the modified European Society of Cardiology Duke criteria, on both native and prosthetic valves, underwent TEE and cardiac CT before surgery. The presence of valvular (vegetations, erosion) and paravalvular (abscess, pseudoaneurysm) IE-related lesions were compared between both modalities. Perioperative inspection was used as reference. Results: TEE performed better than CT in detecting valvular IE-related lesions (TEE area under the curve [AUCTEE] = 0.881 vs AUCCT = 0.720, P =.02) and was similar to CT with respect to paravalvular IE-related lesions (AUCTEE = 0.830 vs AUCCT = 0.816, P =.835). The ability of TEE to detect vegetation was significantly better than that of CT (AUCTEE = 0.863 vs AUCCT = 0.693, P =.02). The maximum size of vegetations was moderately correlated between modalities (Spearman's rho = 0.575, P &lt;.001). Computed tomography exhibited higher sensitivity than TEE for pseudoaneurysm detection (100% vs 66.7%, respectively) but was similar with respect to diagnostic accuracy (AUCTEE = 0.833 vs AUCCT = 0.984, P =.156). Conclusions: In patients with a definite diagnosis of left-side IE according to the modified European Society of Cardiology Duke criteria, TEE performed better than CT for the detection of valvular IE-related lesions and similar to CT for the detection of paravalvular IE-related lesions