153 research outputs found
Experience With Radical Resection in The Management of Proximal Bile Duct Cancer
Multiple surgical and nonsurgical approaches have been advocated for the treatment of proximal bile duct
cancer. However, survival appears longest when a resection can be performed. Fifteen patients treated at a
university center were managed with an aggressive surgical approach. Resection of the tumor was
performed in 13 of 15 patients (87%). Of the patients undergoing resection, major hepatic resection was
performed in 8 (62%), while excision of vessels with reconstruction was performed in 5 (38%). Eleven of
the 13 resected patients (85%) were discharged from the hospital. Clinical symptoms of recurrent disease
occurred between 3 and 36 months after surgery in 7 patients, 6 of whom have died. Three other patients
are alive at 5, 21, and 36 months without clinical evidence of recurrence. There was no correlation between
the completeness of resection and the duration of disease-free survival
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Clinical and serological features of systemic sclerosis in a multicenter African American cohort: Analysis of the genome research in African American scleroderma patients clinical database.
Racial differences exist in the severity of systemic sclerosis (SSc). To enhance our knowledge about SSc in African Americans, we established a comprehensive clinical database from the largest multicenter cohort of African American SSc patients assembled to date (the Genome Research in African American Scleroderma Patients (GRASP) cohort).African American SSc patients were enrolled retrospectively and prospectively over a 30-year period (1987-2016), from 18 academic centers throughout the United States. The cross-sectional prevalence of sociodemographic, clinical, and serological features was evaluated. Factors associated with clinically significant manifestations of SSc were assessed using multivariate logistic regression analyses.The study population included a total of 1009 African American SSc patients, comprised of 84% women. In total, 945 (94%) patients met the 2013 American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) classification criteria for SSc, with the remaining 64 (6%) meeting the 1980 ACR or CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) criteria. While 43% were actively employed, 33% required disability support. The majority (57%) had the more severe diffuse subtype and a young age at symptom onset (39.1 ± 13.7 years), in marked contrast to that reported in cohorts of predominantly European ancestry. Also, 1 in 10 patients had a severe Medsger cardiac score of 4. Pulmonary fibrosis evident on computed tomography (CT) chest was present in 43% of patients and was significantly associated with anti-topoisomerase I positivity. 38% of patients with CT evidence of pulmonary fibrosis had a severe restrictive ventilator defect, forced vital capacity (FVC) ≤50% predicted. A significant association was noted between longer disease duration and higher odds of pulmonary hypertension, telangiectasia, and calcinosis. The prevalence of potentially fatal scleroderma renal crisis was 7%, 3.5 times higher than the 2% prevalence reported in the European League Against Rheumatism Scleroderma Trials and Research (EUSTAR) cohort.Our study emphasizes the unique and severe disease burden of SSc in African Americans compared to those of European ancestry
Transverse spin dependence of pp total cross‐sections
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87331/2/72_1.pd
Multiplicity fluctuations in nuclear collisions at 158 A GeV
System size dependence of multiplicity fluctuations of charged particles
produced in nuclear collisions at 158 A GeV was studied in the NA49 CERN
experiment. Results indicate a non-monotonic dependence of the scaled variance
of the multiplicity distribution with a maximum for semi-peripheral Pb+Pb
interactions with number of projectile participants of about 35. This effect is
not observed in a string-hadronic model of nuclear collision HIJING.Comment: Presented at "Focus on Multiplicity", 17-19 of June, Bari, Ital
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<i>HLA</i> and autoantibodies define scleroderma subtypes and risk in African and European Americans and suggest a role for molecular mimicry
Systemic sclerosis (SSc) is a clinically heterogeneous autoimmune disease characterized by mutually exclusive autoantibodies directed against distinct nuclear antigens. We examined HLA associations in SSc and its autoantibody subsets in a large, newly recruited African American (AA) cohort and among European Americans (EA). In the AA population, the African ancestry-predominant HLA-DRB1*08:04 and HLA-DRB1*11:02 alleles were associated with overall SSc risk, and the HLA-DRB1*08:04 allele was strongly associated with the severe antifibrillarin (AFA) antibody subset of SSc (odds ratio = 7.4). These African ancestry-predominant alleles may help explain the increased frequency and severity of SSc among the AA population. In the EA population, the HLA-DPB1*13:01 and HLA-DRB1*07:01 alleles were more strongly associated with antitopoisomerase (ATA) and anticentromere antibody-positive subsets of SSc, respectively, than with overall SSc risk, emphasizing the importance of HLA in defining autoantibody subtypes. The association of the HLA-DPB1*13:01 allele with the ATA+ subset of SSc in both AA and EA patients demonstrated a transancestry effect. A direct correlation between SSc prevalence and HLA-DPB1*13:01 allele frequency in multiple populations was observed (r = 0.98, P = 3 × 10−6). Conditional analysis in the autoantibody subsets of SSc revealed several associated amino acid residues, mostly in the peptide-binding groove of the class II HLA molecules. Using HLA α / β allelic heterodimers, we bioinformatically predicted immunodominant peptides of topoisomerase 1, fibrillarin, and centromere protein A and discovered that they are homologous to viral protein sequences from the Mimiviridae and Phycodnaviridae families. Taken together, these data suggest a possible link between HLA alleles, autoantibodies, and environmental triggers in the pathogenesis of SSc
Electric charge fluctuations in central Pb+Pb collisions at 20, 30, 40, 80 and 158 AGeV
Results are presented on event-by-event electric charge fluctuations in
central Pb+Pb collisions at 20, 30, 40, 80 and 158 AGeV. The observed
fluctuations are close to those expected for a gas of pions correlated by
global charge conservation only. These fluctuations are considerably larger
than those calculated for an ideal gas of deconfined quarks and gluons. The
present measurements do not necessarily exclude reduced fluctuations from a
quark-gluon plasma because these might be masked by contributions from
resonance decays.Comment: 19 pages, 8 figure
Omega and Antiomega production in central Pb+Pb collisions at 40 and 158 AGeV
Results are presented on Omega production in central Pb+Pb collisions at 40
and 158 AGeV beam energy. Given are transverse-mass spectra, rapidity
distributions, and total yields for the sum Omega+Antiomega at 40 AGeV and for
Omega and Antiomega separately at 158 AGeV. The yields are strongly
under-predicted by the string-hadronic UrQMD model and are in better agreement
with predictions from a hadron gas models.Comment: 5 papes, 4 figures, 1 table, updated figure 4 and table 1. Final
version, including some editorial changes, as published in PR
Report from NA49
The most recent data of NA49 on hadron production in nuclear collisions at
CERN SPS energies are presented. Anomalies in the energy dependence of pion and
kaon production in central Pb+Pb collisions are observed. They suggest that the
onset of deconfinement is located at about 30 AGeV. Large multiplicity and
transverse momentum fluctuations are measured for collisions of intermediate
mass systems at 158 AGeV. The need for a new experimental programme at the CERN
SPS is underlined.Comment: invited talk presented at Quark Matter 2004, 10 page
System-size dependence of strangeness production in nucleus-nucleus collisions at sqrt{s_{NN}}=17.3 GeV
Emission of pi, K, phi and Lambda was measured in near-central C+C and Si+Si
collisions at 158 AGeV beam energy. Together with earlier data for p+p, S+S and
Pb+Pb, the system-size dependence of relative strangeness production in
nucleus-nucleus collisions is obtained. Its fast rise and the saturation
observed at about 60 participating nucleons can be understood as onset of the
formation of coherent partonic subsystems of increasing size.Comment: Phys.Rev.Lett in print; version2: changes made according to the
request of the referee
System size dependence of strange particle yields and spectra at sqrt(s)=17.3 GeV
Yields and spectra of strange hadrons (K+, K-, phi, Lambda and Antilambda) as
well as of charged pions were measured in near central C+C and Si+Si collisions
at 158 AGeV beam energy with the NA49 detector. Together with earlier data for
p+p, S+S and Pb+Pb reactions the system size dependence can be studied.
Relative strangeness production rises fast and saturates at about 60
participating nucleons; the net hyperon spectra show an increasing shift
towards midrapidity for larger colliding nuclei. An interpretation based on the
formation of coherent systems of increasing volume is proposed. The transverse
mass spectra can be described by a blast wave ansatz. Increasing flow velocity
is accompanied by decreasing temperatures for both kinetic and chemical freeze
out. The increasing gap between inelastic and elastic decoupling leaves space
for rescattering.Comment: 8 pages, 6 figures, Proceedings of the Hot Quarks 2004 worksho
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