Spin-current vortices in current-perpendicular-to-plane nanoconstricted spin-valves

The charge and spin diffusion equations taking into account spin-flip and spin-transfer torque were numerically solved using a finite element method in complex non-collinear geometry with strongly inhomogeneous current flow. As an illustration, spin-dependent transport through a non-magnetic nanoconstriction separating two magnetic layers was investigated. Unexpected results such as vortices of spin-currents in the vicinity of the nanoconstriction were obtained. The angular variations of magnetoresistance and spin-transfer torque are strongly influenced by the structure geometry.Comment: 11 pages, 5 figure

Volumetric Enhancing Tumor Burden at CT to Predict Survival Outcomes in Patients with Neuroendocrine Liver Metastases after Intra-arterial Treatment

Purpose: To investigate whether liver enhancing tumor burden (LETB) assessed at contrast-enhanced CT indicates early response and helps predict survival outcomes in patients with multifocal neuroendocrine liver metastases (NELM) after intra-arterial treatment.Materials and Methods: This retrospective study included patients with NELM who underwent intra-arterial treatment with transarterial embolization (TAE) or chemoembolization (TACE) between April 2006 and December 2018. Tumor response in treated NELM was evaluated by using the Response Evaluation Criteria in Solid Tumors (RECIST) and modified RECIST (mRECIST). LETB was mea-sured as attenuation 2 SDs greater than that of a region of interest in the nontumoral liver parenchyma. Overall survival (OS); time to unTA(C)Eable progression, defined as the time from the initial treatment until the time when intra-arterial treatments were considered technically unfeasible, either not recommended by the multidisciplinary tumor board or until death; and hepatic and whole-body progression-free survival (PFS) were evaluated using multivariable Cox proportional hazards analyses, the Kaplan-Meier method, and log-rank test.Results: The study included 119 patients (mean age, 60 years +/- 11 [SD]; 61 men) who underwent 161 treatments. A median LETB change of -25.8% best discriminated OS (83 months in responders vs 51 months in nonresponders; P = .02) and whole-body PFS (18 vs 8 months, respectively; P < .001). A -10% LETB change best discriminated time to unTA(C)Eable progression (32 months in re-sponders vs 12 months in nonresponders; P < .001) and hepatic PFS (18 vs 8 months, respectively; P < .001). LETB change remained independently associated with improved OS (hazard ratio [HR], 0.56), time to unTA(C)Eable progression (HR, 0.44), hepatic PFS (HR, 0.42), and whole-body PFS (HR, 0.47) on multivariable analysis. Neither RECIST nor mRECIST helped predict patient outcome. Conclusion: Response according to LETB change helped predict survival outcomes in patients with NELM after intra-arterial treat-ments, with better discrimination than RECIST and mRECIST

Gastric Juvenile Polyposis with High-Grade Dysplasia in Pachydermoperiostosis

Pachydermoperiostosis (PDP) is the primary form of hypertrophic osteoarthropathy. It is a very rare disease consisting of pachydermia, digital clubbing and radiologic periostosis. Various digestive symptoms in PDP are seen in 11–49% of patients and juvenile polyps may be found at gastric endoscopy. We report here the history of a patient with PDP who was referred for assessment of severe anemia. Endoscopy of the upper digestive tract showed multiple polyps of the stomach with two huge lesions exhibiting foci of high-grade dysplasia. This observation suggests that PDP can be considered as a precancerous condition of the stomach and systematic screening using endoscopy should be considered in these patients

Unravelling the pharmacologic opportunities and future directions for targeted therapies in gastro-intestinal cancers part 2: Neuroendocrine tumours, hepatocellular carcinoma, and gastro-intestinal stromal tumours.

Until the 1990s, cytotoxic chemotherapy has been the cornerstone of medical therapy for gastrointestinal (GI) cancers. Better understanding of the cancer cell molecular biology has led to the therapeutic revolution of targeted therapies, i.e. monoclonal antibodies or small molecule inhibitors directed against proteins that are specifically overexpressed or mutated in cancer cells. These agents, being more specific to cancer cells, were expected to be less toxic than conventional cytotoxic agents. However, their effects have sometimes been disappointing, due to intrinsic or acquired resistance mechanisms, or to an activity restricted to some tumour settings, illustrating the importance of patient selection and early identification of predictive biomarkers of response to these therapies. Targeted agents have provided clinical benefit in many GI cancer types. Particularly, some GI tumours are considered chemoresistant and targeted therapies have offered a new therapeutic base for their management. Hence, somatostatin receptor-directed strategies, sorafenib, and imatinib have revolutioned the management of neuroendocrine tumours (NET), hepatocellular carcinoma (HCC), and gastrointestinal stromal tumours (GIST), respectively, and are now used as first-line treatment in many patients affected by these tumours. However, these agents face problems of resistances and identification of predictive biomarkers from imaging and/or biology. We propose a comprehensive two-part review providing a panoramic approach of the successes and failures of targeted agents in GI cancers to unravel the pharmacologic opportunities and future directions for these agents in GI oncology. In this second part, we will focus on NET, HCC, and GIST, whose treatment relies primarily on targeted therapies

Laparoscopic versus Open Pancreatectomy in 102 Solid Pseudopapillary Neoplasm Showed Similar Outcome and Survival

Purpose: Pancreatic solid pseudopapillary neoplasm (PSPPN) is a rare tumor, mostly affecting a working young population, who could benefit a laparoscopic approach (LA) for complete resection. We report the largest single-center comparative cohort study between the LA versus the open approach (OA). Method: Between 2001 and 2021, 102 patients (84 % female, median age: 30) underwent pancreatectomy for SPPN and were all included in this retrospective study. Demographic, perioperative and pathological data were collected. The population was divided in two groups, LA being compared to OA regarding early and the long-term results. Results: Forty patients underwent resection by LA and 62 by te OA. There were no significant differences regarding age, gender, BMI, ASA score, symptomatic presentation and tumor size between groups. A preoperative biopsy under endoscopic ultrasound was performed in 45 patients (44%) without difference between both groups. Pancreatic head locations were less frequently observed in LA (30% vs 54%, p=0.013). Pancreatoduodenectomy (PD) was less frequently done by LA (25% vs 53%, p=0.004) and distal pancreatectomy (DP) was more frequently done by LA (40% vs 16%, p=0.003). There was no conversion in case of LA. LA was associated with lower operating time (170 vs 255 min, p=0.0005), intraoperative blood loss (100 vs 200 ml, p=0.002), and hospital stay (15 vs 20 days, p=0.03). There was no difference in the early outcome and one death (1%) was observed after PD by LA. The lymph node count was lower in the LA group (4 vs 11, p=0.0001), but the rate of lymph node invasion was low in both groups (3% vs 2%, p=0.752). In subgroup analysis by surgical procedure, PD by LA was associated with lower median blood loss (180 versus 200ml, p=0.034) and a lower number of harvested lymph nodes (11 vs 15, p=0.02). DP, by LA was associated with lower median tumor size on imaging (40 versus 80mm, p=0.048), shorter operative duration (135 versus 190min, p=0.028), and less complications according the median comprehensive complication index score (0 versus 8.7, p=0.048). After a median follow-up of 60 months, two recurrences (2%) were observed and unrelated to the approach. Conclusion: Laparoscopic approach for SPPN appears to be safe with advantages on morbidity without risk of recurrence. Furthermore, this approach should be promoted regarding the parietal and esthetic advantages in young female patients

Antiproliferative Systemic Therapies for Metastatic Small Bowel Neuroendocrine Tumours

Neuroendocrine neoplasms (NENs) are a heterogeneous group of malignancies with rising incidence and prevalence. Outcome and therapy of small bowel neuroendocrine tumours (SBNETs) is variable, depending on the grade, differentiation, tumour burden, as well as the site of the tumour origin. Because of this, multidisciplinary approach is essential. Large randomized clinical trials, with somatostatin analogues (PROMID, CLARINET) or with peptide receptor radionuclide therapy (PRRT) with 177-lutetium (NETTER-1 trial) as well as the mammalian target of rapamycin inhibitor (mTOR) everolimus (RADIANT trials), represent milestones for the medical management of unresectable grade 1 and 2 SBNETS over the last decade. Novel therapies, such as tyrosine kinase inhibitors (TKI), are on the cutting edge. However, multiple unsolved questions remain. This review provides a comprehensive review of the main systemic therapeutic options for advanced SBNETs and discusses the latest guideline recommendations for palliative treatment