Long-term disease-free survival of patients with radically resected thymomas: relevance of cell-cycle protein expression

BACKGROUND. Despite radical Surgical resection, thymomas often recur. The objective of the current retrospective Study was to investigate the prognostic relevance of the expression of cell-cycle proteins in these neoplasms to formulate a possible therapeutic Surveillance strategy for the prevention of recurrence. METHODS. The authors retrospectively reviewed the main clinicopathologic factors, including the World Health Organization (WHO) classification, of patients with thymoma who had undergone radical surgical resection. Specimens were studied using immunohistochemistry and the expression of cell-cycle proteins (i.e., p21, p27, and p53) was assessed. Univariate and multivariate analysis of predicting survival prognostic factors were performed. RESULTS. The authors analyzed 88 patients with thymoma who underwent radical surgical resection at the study institution. According to the Masaoka staging system, 41 patients had Stage I disease, 31 patients had Stage II disease, and 16 patients had Stage III disease. There were 24 tumor recurrences (27.3%), 4 of which were local, 16 of which were distant intrathoracic, and 4 of which were extrathoracic. The second radical resection provided a disease-free Survival rate that was similar to the first. Only Masaoka stage (P=0.001), WHO classification (P=0.001), high expression of p53 (P=0.03), and low expression of p21 (P=0.02) and p27 (P=0.001) were found to he correlated with a reduced disease-free survival. Low p27 expression was found to be the most significant predictive factor of a short disease-free Survival (P=0.001), especially when associated with low p21 expression and high p53 expression (P=0.0001). CONCLUSIONS. Long-term disease-free survival in thymoma patients treated with radical surgical resection Was found to be correlated with Masaoka stage, WHO classification, and expression of cell-cycle proteins, with the latter found to be the most significant predictive factor. Functional cooperation between cell-cycle proteins might constitute another level of regulation in tumor growth. More careful surveillance should be adopted whenever there is negative cell-cycle protein expression. (c) 2005 American Cancer Society

Transxiphoid hand-assisted videothoracoscopic surgery

BACKGROUND: We have performed transxiphoid hand-assisted videothoracoscopy since 1995 to allow manual palpation in bilateral lung metastasectomy. This approach was extended to other thoracoscopic procedures requiring a handport. No extensive report about early and late results has yet been published. METHODS: We retrospectively reviewed the first 100 consecutive patients undergoing transxiphoid hand-assisted videothoracoscopy. Acute and chronic postoperative pain, respiratory function, patient's satisfaction score (1 to 5), quality of life (Short Form-36), and survival rate were evaluated. RESULTS: Seventy-four patients had lung metastases, 5 had primary lung cancers, 16 had benign nodules, and 5 had Morgani's hernia. Five patients needed conversion to thoracotomy, whereas 7 successfully underwent a second transxiphoid operation. Sixty-five metastatic patients were bilaterally explored, 44 were without radiologic evidence of contralateral lesions, discovering 23 occult metastases and 10 patients with occult contralateral disease. A total of 207 minimal resections and 11 lobectomies were performed. Mean operative time was 103 +/- 35 minutes. We had no intraoperative mortality or major complications. Thirty-day postoperative morbidity documented arrhythmia (n = 4) and acute pneumonia (n = 4). Visual Analogue Scale pain, C-reactive protein, fibrinogen, and serum interleukin-6, -8, and -10 normalized within 72 hours. Respiratory function and most of the Short Form-36 domains recovered within 3 months. Six-month mean patient satisfaction score was 4.0 +/- 0.8. Three- and 5-year survival rates for metastatic patients were 52% and 43%, respectively. Mean disease-free interval was 12 +/- 5.8 months. CONCLUSIONS: Transxiphoid hand-assisted videothoracoscopy proved a good alternative to conventional approaches, and provided rapid recovery without affecting the survival rate in those patients with metastatic lesions. We recommend it whenever a handport during video-assisted procedure is required

Swift-XRT 6-year monitoring of the ultraluminous X-ray source M33-X8

The long term evolution of ULX with their spectral and luminosity variations in time give important clues on the nature of ULX and on the accretion process that powers them. We report here the results of a Swift-XRT 6-year monitoring campaign of the closest example of a persistent ULX, M33 X-8, that extends to 16 years the monitoring of this source in the soft X-rays. The luminosity of this source is a few 10^39 erg/s, marking the faint end of the ULX luminosity function. We analysed the set of 15 observations collected during the Swift monitoring. We searched for differences in the spectral parameters at different observing epochs, adopting several models commonly used to fit the X-ray spectra of ULX. The source exhibits flux variations of the order of 30%. No significant spectral variations are observed along the monitoring. The average 0.5-10 keV spectrum can be well described by a thermal model, either in the form of a slim disk, or as a combination of a Comptonized corona and a standard accretion disk.Comment: 6 pages, 4 figures, 2 tables. Paper published in A&

Temporal features of LS I +61∘^{\circ}303 in hard X-rays from the Swift/BAT survey data

We study the long-term spectral and timing behaviour of LS I +61$^{\circ}$303 in hard X-rays (15--150 keV) using $\sim$10 years of survey data from the $Swift$ Burst Alert Telescope (BAT) monitor. We focus on the detection of long periodicities known to be present in this source in multiple wavelengths. We clearly detect three periods: the shorter one at 26.48 days is compatible with the orbital period of the system; the second, longer, periodicity at 26.93 days, is detected for the first time in X-rays and its value is consistent with an analogous temporal feature recently detected in the radio and in the gamma-ray waveband, and we associate it with a modulation caused by a precessing jet in this system. Finally, we find also evidence of the long-term periodicity at $\sim$1667 d, that results compatible with a beat frequency of the two close, and shorter, periodicities. We discuss our results in the context of the multi-band behaviour of the physical processes of this source.Comment: 5 pages, 8 figures. Published in MNRA

Effects of lung volume reduction surgery for emphysema on glycolipidic hormones

BACKGROUND: Pulmonary emphysema is associated with cachexia and disregulation of the hormones regulating the glycolipid metabolism, insulin resistance, and altered substrate utilization. This study aimed at identifying the effects of lung volume reduction surgery (LVRS) on glycolipidic hormones compared to respiratory rehabilitation (RR). METHODS: Thirty-three patients with moderate-to-severe emphysema who were undergoing video-assisted thoracoscopic LVRS were compared to 31 similar patients who refused the operation and followed a standardized RR program. All patients were evaluated before and 12 months after treatment for respiratory function, body composition, glycolipidic hormones, metabolic parameters, and insulin resistance, which was calculated using the homeostatic model assessment index for insulin resistance (HOMA-IR). These groups were compared to a matched healthy control population. RESULTS: Only after LVRS significant improvements were obtained in respiratory function (FEV1, +25.2%; p<0.0001; residual volume, -19.5%; p<0.0001), metabolic parameters (total cholesterol, +13.1%; p<0.01; high-density lipoprotein cholesterol, +11.2%; p<0.01; triglycerides, +18.4; p<0.001; nonesterified fatty acid, -19.7%; p<0.001), and body composition (fat-free mass [FFM], +6.5%; p<0.01; fat mass [FM], +11.9%; p<0.01). The leptin/FM ratio (-6.1%; p<0.01) and resistin/FM ratio (-5.6%; p<0.01) decreased, whereas the adiponectin/FM ratio (+6.9%; p<0.01) and ghrelin (+9.2%; p<0.01) increased, together with reductions in glycemia (-8.8%; p<0.01), insulin level (-20.4%; p<0.001), and HOMA-IR (-27.2%; p<0.0001). The decrement in residual volume was correlated with increment of FFM (rho=-0.49; p<0.02), FM (rho=-0.55; p<0.009), and ghrelin (rho=-0.52; p<0.01), and also with decreases in leptin corrected for FM (rho=0.50; p<0.02) and, marginally, HOMA-IR (rho=0.35; p=0.07). CONCLUSIONS: After LVRS, glycolipidic hormone levels and nutritional status significantly improved, along with insulin resistance reduction and more physiologic utilization of substrates. Correlations between residual volume and body composition as well as glycolipidic hormone levels suggest that postoperative recovery in respiratory dynamics may induce favorable clinical changes when compared to RR

Quality of life after tailored combined surgery for stage I non-small-cell lung cancer and severe emphysema

Background. We analyzed the early and long-term quality of life changes occurring in 16 patients undergoing tailored combined surgery for stage I non-small-cell lung cancer (NSCLC) and severe emphysema. Methods. Mean age was 65 +/- 5 years. All patients had severe emphysema with severely impaired respiratory function and quality of life. Tumor resection was performed with sole lung volume reduction (LVR) in 5 patients, separate wedge resection in 3 patients, segmentectomy in 2 patients, and lobectomy in 6 patients. A bilateral LVR was performed in 5 patients. Quality of life was assessed at baseline and every 6 months postoperatively by the Short-form 36 (SF-36) item questionnaire. Results. Mean follow-up was 44 +/- 21 months. All tumors were pathologic stage I. There was no hospital mortality nor major morbidity. Significant improvements occurred for up to 36 months in the general health (p = 0.02) domain and for up to 24 months in physical functioning (p = 0.02), role physical (p = 0.005), and general health (P = 0.01) SF-36 domains. Associated improvements regarded dyspnea index (-1.3 +/- 0.6) forced expiratory volume in one second (+0.28 +/- 0.2L), residual volume (-1.18 +/- 0.5L) and 6-minute-walking test distance (+86 +/- 67 m). Actuarial 5-year survival was similar to that of patients with no cancer undergoing LVRS during the same period (68% vs 82%, p = not significant). Conclusions. Our study suggests that selected patients with stage I NSCLC and severe emphysema may significantly benefit from tailored combined surgery in terms of long-term quality of life and survival. (Ann Thorac Surg 2003;76:1821-7

Autonomous 3D geometry reconstruction through robot-manipulated optical sensors

Many industrial sectors face increasing production demands and the need to reduce costs, without compromising the quality. The use of robotics and automation has grown significantly in recent years, but versatile robotic manipulators are still not commonly used in small factories. Beside of the investments required to enable efficient and profitable use of robot technology, the efforts needed to program robots are only economically viable in case of large lot sizes. Generating robot programs for specific manufacturing tasks still relies on programming trajectory waypoints by hand. The use of virtual simulation software and the availability of the specimen digital models can facilitate robot programming. Nevertheless, in many cases, the virtual models are not available or there are excessive differences between virtual and real setups, leading to inaccurate robot programs and time-consuming manual corrections. Previous works have demonstrated the use of robot-manipulated optical sensors to map the geometry of samples. However, the use of simple user-defined robot paths, which are not optimized for a specific part geometry, typically causes some areas of the samples to not be mapped with the required level of accuracy or to not be sampled at all by the optical sensor. This work presents an autonomous framework to enable adaptive surface mapping, without any previous knowledge of the part geometry being transferred to the system. The novelty of this work lies in enabling the capability of mapping a part surface at the required level of sampling density, whilst minimizing the number of necessary view poses. Its development has also led to an efficient method of point cloud down-sampling and merging. The article gives an overview of the related work in the field, a detailed description of the proposed framework and a proof of its functionality through both simulated and experimental evidences

Cytokines and chemokines production by mononuclear cells from parturient women after stimulation with live Toxoplasma gondii

AbstractToxoplasma gondii is an obligate intracellular parasite that can cause variable clinical symptoms or can even be asymptomatic in immunocompetent individuals. More severe symptoms are observed in immunocompromised patients and congenital transmission of the parasite has been reported. The objective of this study was to evaluate the response of peripheral blood mononuclear cells (PBMC) in parturient and non-pregnant women exposed to live tachyzoites of T. gondii strain RH or ME49. PBMC were isolated from parturient and non-pregnant women with negative or positive serology for toxoplasmosis and cultured with live tachyzoites of the two T. gondii strains for 24 h. Next, the cell culture supernatants were collected and levels of CCL2, CCL5, IL-6, IL-10, IL-12, and TNF-α produced by PBMC after tachyzoite exposure were measured. Live tachyzoite forms of T. gondii significantly inhibited the synthesis of CCL2 in seropositive parturient women, whereas a stimulatory effect on CCL5 was observed in seronegative parturient women. Cells from T. gondii-seronegative non-pregnant women produced significantly higher levels of TNF-α and IL-12, demonstrating the proinflammatory profile induced by the presence of the parasite in culture. The results suggest that the immunomodulation seen during pregnancy contributes to the development of an environment that facilitates escape of the parasite from the immune response