A Case of Primary Squamous Cell Carcinoma of the Liver Arising in a Solitary Cyst

A case of primary squamous cell carcinoma in a pre-existing hepatic cyst is presented. A review of the literature suggests that this rare type of liver tumor tends to arise from solitary, nonparasitic cysts, lined with squamous epithelium. Effective therapy is not available, the prognosis is grave

Analysis for the Design of a Sustainable Housing Complex in Haiti

This paper presents sustainable strategies for the design of a prototype sustainable housing complex in tropical climate that applies specifically to Haiti. The tropical climate zone is hot and humid with abundant rainfall and luxuriant vegetation growth. Despite its beautiful environment most of the countries in this zone are undeveloped and poverty manifests itself in different faces especially in poor housing condition. In this study, the history, geography, and culture of Haiti are analyzed in the context of family unit, community, and economic aspects. The climate conditions are also investigated in the context of residents’ comfort and energy savings. The construction materials appropriate for Haiti climate are explored. Rainwater harvesting and gray water reuses are discussed. Finally, sustainable design principles are proposed. Sustainable housing design refers to a strategy to plan and build a housing complex that uses efficient energy and water management while minimizing the overall adverse health and environmental problems. This means keeping the conventional comfort and environment conditions in housing by using natural sources of energy, like sun and wind, to provide natural heating, cooling, ventilation, lighting, and water management while contributing to a responsible natural resources use. The proposed guiding principles target to be utilized for the design of sustainable housing complex in Haiti located in a tropical climate

Impact of non-axillary sentinel node biopsy on staging and treatment of breast cancer patients

The purpose of this study was to evaluate the occurrence of lymphatic drainage to non-axillary sentinel nodes and to determine the implications of this phenomenon. A total of 549 breast cancer patients underwent lymphoscintigraphy after intratumoural injection of 99mTc-nanocolloid. The sentinel node was intraoperatively identified with the aid of intratumoural administered patent blue dye and a gamma-ray detection probe. Histopathological examination of sentinel nodes included step-sectioning at six levels and immunohistochemical staining. A sentinel node outside level I or II of the axilla was found in 149 patients (27%): internal mammary sentinel nodes in 86 patients, other non-axillary sentinel nodes in 44 and both internal mammary and other non-axillary sentinel nodes in nineteen patients. The intra-operative identification rate was 80%. Internal mammary metastases were found in seventeen patients and metastases in other non-axillary sentinel nodes in ten patients. Staging improved in 13% of patients with non-axillary sentinel lymph nodes and their treatment strategy was changed in 17%. A small proportion of clinically node negative breast cancer patients can be staged more precisely by biopsy of sentinel nodes outside level I and II of the axilla, resulting in additional decision criteria for postoperative regional or systemic therapy

Survival and biomarker analyses from the OpACIN-neo and OpACIN neoadjuvant immunotherapy trials in stage III melanoma

Neoadjuvant ipilimumab plus nivolumab showed high pathologic response rates (pRRs) in patients with macroscopic stage III melanoma in the phase 1b OpACIN () and phase 2 OpACIN-neo () studies(1,2). While the results are promising, data on the durability of these pathologic responses and baseline biomarkers for response and survival were lacking. After a median follow-up of 4 years, none of the patients with a pathologic response (n = 7/9 patients) in the OpACIN study had relapsed. In OpACIN-neo (n = 86), the 2-year estimated relapse-free survival was 84% for all patients, 97% for patients achieving a pathologic response and 36% for nonresponders (P < 0.001). High tumor mutational burden (TMB) and high interferon-gamma-related gene expression signature score (IFN-gamma score) were associated with pathologic response and low risk of relapse; pRR was 100% in patients with high IFN-gamma score/high TMB; patients with high IFN-gamma score/low TMB or low IFN-gamma score/high TMB had pRRs of 91% and 88%; while patients with low IFN-gamma score/low TMB had a pRR of only 39%. These data demonstrate long-term benefit in patients with a pathologic response and show the predictive potential of TMB and IFN-gamma score. Our findings provide a strong rationale for a randomized phase 3 study comparing neoadjuvant ipilimumab plus nivolumab versus standard adjuvant therapy with antibodies against the programmed cell death protein-1 (anti-PD-1) in macroscopic stage III melanoma

Roles of glial cells in synapse development

Brain function relies on communication among neurons via highly specialized contacts, the synapses, and synaptic dysfunction lies at the heart of age-, disease-, and injury-induced defects of the nervous system. For these reasons, the formation—and repair—of synaptic connections is a major focus of neuroscience research. In this review, I summarize recent evidence that synapse development is not a cell-autonomous process and that its distinct phases depend on assistance from the so-called glial cells. The results supporting this view concern synapses in the central nervous system as well as neuromuscular junctions and originate from experimental models ranging from cell cultures to living flies, worms, and mice. Peeking at the future, I will highlight recent technical advances that are likely to revolutionize our views on synapse–glia interactions in the developing, adult and diseased brain

Specific Lymphocyte Stimulation by Purified, Heat-inactivated Hepatitis-B Antigen

The ability of purified, heat-inactivated hepatitis-B antigen (HBAg) to stimulate sensitized lymphocytes in vitro was investigated with the lymphocyte stimulation test on lymphocytes from three groups of individuals. Stimulation was minimal in the lymphocytes of two out of 15 normal controls, whereas lymphocytes from nine out of 12 patients who had recovered from hepatitis B showed stimulation, as did lymphocytes from five out of 12 laboratory technicians who had been regularly exposed to HBAg but who had no history of hepatitis or signs of it in the previous two years. No differences were observed in the responses to phytohaemagglutinin of lymphocytes from persons in the three groups. HBAg and HBAg inactivated by heat were shown in immunodiffusion to be immunologically identical. Inactivated HBAg stimulated antibody production in guinea-pigs. These findings suggest that not only humoral but also cell-mediated immunity might be induced by vaccination with purified, heat-inactivated HBAg

High incidence of in-transit metastases after sentinel node biopsy in patients with melanoma

BACKGROUND: The occurrence of in-transit metastases in patients with a tumour-positive sentinel node varies greatly between centres and it has been suggested that the incidence is high in this patient group. METHODS: The incidence of in-transit metastases in 61 patients who had lymph node dissection because of a tumour-positive sentinel node was compared with that in 60 patients who had palpable nodal metastases dissected. RESULTS: The incidence of in-transit metastases was 23 per cent in patients with a positive sentinel node and 8 per cent in those with palpable nodes (P = 0.027). CONCLUSION: Sentinel node biopsy was associated with a higher risk of in-transit metastases. This finding does not support the routine use of sentinel node biopsy in the management of melanom