347 research outputs found

    Resection of the liver for colorectal carcinoma metastases - A multi-institutional study of long-term survivors

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    In this review of a collected series of patients undergoing hepatic resection for colorectal metastases, 100 patients were found to have survived greater than five years from the time of resection. Of these 100 long-term survivors, 71 remain disease-free through the last follow-up, 19 recurred prior to five years, and ten recurred after five years. Patient characteristics that may have contributed to survival were examined. Procedures performed included five trisegmentectomies, 32 lobectomies, 16 left lateral segmentectomies, and 45 wedge resections. The margin of resection was recorded in 27 patients, one of whom had a positive margin, nine of whom had a less than or equal to 1-cm margin, and 17 of whom had a greater than 1-cm margin. Eighty-one patients had a solitary metastasis to the liver, 11 patients had two metastases, one patient had three metastases, and four patients had four metastases. Thirty patients had Stage C primary carcinoma, 40 had Stage B primary carcinoma, and one had Stage A primarycarcinoma. The disease-free interval from the time of colon resection to the time of liver resection was less than one year in 65 patients, and greater than one year in 34 patients. Three patients had bilobar metastases. Four of the patients had extrahepatic disease resected simultaneously with the liver resection. Though several contraindications to hepatic resection have been proposed in the past, five-year survival has been found in patients with extrahepatic disease resected simultaneously, patients with bilobar metastases, patients with multiple metastases, and patients with positive margins. Five-year disease-free survivors are also present in each of these subsets. It is concluded that five-year survival is possible in the presence of reported contraindications to resection, and therefore that the decision to resect the liver must be individualized. © 1988 American Society of Colon and Rectal Surgeons

    Gyrokinetic turbulence: a nonlinear route to dissipation through phase space

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    This paper describes a conceptual framework for understanding kinetic plasma turbulence as a generalized form of energy cascade in phase space. It is emphasized that conversion of turbulent energy into thermodynamic heat is only achievable in the presence of some (however small) degree of collisionality. The smallness of the collision rate is compensated by the emergence of small-scale structure in the velocity space. For gyrokinetic turbulence, a nonlinear perpendicular phase mixing mechanism is identified and described as a turbulent cascade of entropy fluctuations simultaneously occurring at spatial scales smaller than the ion gyroscale and in velocity space. Scaling relations for the resulting fluctuation spectra are derived. An estimate for the collisional cutoff is provided. The importance of adequately modeling and resolving collisions in gyrokinetic simulations is biefly discussed, as well as the relevance of these results to understanding the dissipation-range turbulence in the solar wind and the electrostatic microturbulence in fusion plasmas.Comment: iop revtex style, 14 pages, 1 figure; submitted to PPCF; invited talk for EPS Conference on Plasma Physics, Crete, June 2008; Replaced to match published versio

    Finishing the euchromatic sequence of the human genome

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    The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

    First-Forbidden Beta Decay

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