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

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

SHIELD: Comparing Gas and Star Formation in Low Mass Galaxies

We analyze the relationships between atomic, neutral hydrogen (HI) and star formation (SF) in the 12 low-mass SHIELD galaxies. We compare high spectral (~0.82 km/s/channel) and spatial resolution (physical resolutions of 170 pc - 700 pc) HI imaging from the VLA with H\alpha and far-ultraviolet imaging. We quantify the degree of co-spatiality between star forming regions and regions of high HI column densities. We calculate the global star formation efficiencies (SFE, $\Sigma_{\rm SFR}$ / $\Sigma_{\rm HI}$), and examine the relationships among the SFE and HI mass, HI column density, and star formation rate (SFR). The systems are consuming their cold neutral gas on timescales of order a few Gyr. While we derive an index for the Kennicutt-Schmidt relation of N ~ 0.68 $\pm$ 0.04 for the SHIELD sample as a whole, the values of N vary considerably from system to system. By supplementing SHIELD results with those from other surveys, we find that HI mass and UV-based SFR are strongly correlated over five orders of magnitude. Identification of patterns within the SHIELD sample allows us to bin the galaxies into three general categories: 1) mainly co-spatial HI and SF regions, found in systems with highest peak HI column densities and highest total HI masses, 2) moderately correlated HI and SF regions, found in systems with moderate HI column densities, and 3) obvious offsets between HI and SF peaks, found in systems with the lowest total HI masses. SF in these galaxies is dominated by stochasticity and random fluctuations in their ISM

SHIELD: Neutral Gas Kinematics and Dynamics

We present kinematic analyses of the 12 galaxies in the "Survey of HI in Extremely Low-mass Dwarfs" (SHIELD). We use multi-configuration interferometric observations of the HI 21cm emission line from the Karl G. Jansky Very Large Array (VLA) to produce image cubes at a variety of spatial and spectral resolutions. Both two- and three-dimensional fitting techniques are employed in an attempt to derive inclination-corrected rotation curves for each galaxy. In most cases, the comparable magnitudes of velocity dispersion and projected rotation result in degeneracies that prohibit unambiguous circular velocity solutions. We thus make spatially resolved position-velocity cuts, corrected for inclination using the stellar components, to estimate the circular rotation velocities. We find circular velocities <30 km/s for the entire survey population. Baryonic masses are calculated using single-dish HI fluxes from Arecibo and stellar masses derived from HST and Spitzer imaging. Comparison is made with total dynamical masses estimated from the position-velocity analysis. The SHIELD galaxies are then placed on the baryonic Tully-Fisher relation. There exists an empirical threshold rotational velocity <15 km/s, below which current observations cannot differentiate coherent rotation from pressure support. The SHIELD galaxies are representative of an important population of galaxies whose properties cannot be described by current models of rotationally-dominated galaxy dynamics

Star formation in quasar hosts and the origin of radio emission in radio-quiet quasars

This article has been accepted for publication in Monthly Notices of the Royal Astronomical Society following peer review. The version of record [Nadia L. Zakamska, et al., 'Star formation in quasar hosts and the origin of radio emission in radio-quiet quasars', MNRAS, 455(4): 4191-4211, first published online December 4, 2015, is available online via doi: 10.1093/mnras/stv2571 Published by Oxford University Press on behalf of the Royal Astronomical Society. Copyright 2015 The AuthorsRadio emission from radio-quiet quasars may be due to star formation in the quasar host galaxy, to a jet launched by the supermassive black hole, or to relativistic particles accelerated in a wide-angle radiatively driven outflow. In this paper, we examine whether radio emission from radio-quiet quasars is a byproduct of star formation in their hosts. To this end, we use infrared spectroscopy and photometry from Spitzer and Herschel to estimate or place upper limits on star formation rates in hosts of ∼300 obscured and unobscured quasars at z < 1. We find that low-ionization forbidden emission lines such as [Ne II] and [Ne III] are likely dominated by quasar ionization and do not provide reliable star formation diagnostics in quasar hosts, while polycyclic aromatic hydrocarbon (PAH) emission features may be suppressed due to the destruction of PAH molecules by the quasar radiation field. While the bolometric luminosities of our sources are dominated by the quasars, the 160 μm fluxes are likely dominated by star formation, but they too should be used with caution. We estimate median star formation rates to be 6–29 M yr−1, with obscured quasars at the high end of this range. This star formation rate is insufficient to explain the observed radio emission from quasars by an order of magnitude, with log (Lradio, obs/Lradio, SF) = 0.6–1.3 depending on quasar type and star formation estimator. Although radio-quiet quasars in our sample lie close to the 8–1000 μm infrared/radio correlation characteristic of the star-forming galaxies, both their infrared emission and their radio emission are dominated by the quasar activity, not by the host galaxy.Peer reviewedFinal Published versio

Community-based prevention leads to an increase in condom use and a reduction in sexually transmitted infections (STIs) among men who have sex with men (MSM) and female sex workers (FSW): the Frontiers Prevention Project (FPP) evaluation results

<p>Abstract</p> <p>Background</p> <p>India has an estimated 2.0 million to 3.1 million people living with HIV; it has the highest number of HIV-positive people in Asia and ranks third in the world. The Frontiers Prevention Project (FPP) was implemented in 2002 to conduct targeted prevention intervention geared towards female sex workers (FSW) and men who have sex with men (MSM) in the state of Andhra Pradesh (AP). This paper reports the overall changes in behaviour and STI outcomes between 2003/4 and 2007 and also describes the changes attributed to the FPP.</p> <p>Methods</p> <p>The evaluation used two cross-sectional surveys among MSM and FSW at 24 sites in AP. Surveys were implemented using a similar methodology. Univariate analyses were conducted by comparing means: baseline vs. four-year follow-up and FPP vs. non-FPP. For both MSM and FSW, random and fixed-effects logit regression models at the site level were estimated for <it>condom use with last partner</it>, <it>syphilis sero-positivity </it>and <it>HSV 2 sero-positivity</it>. In addition, for FSW we estimated models for <it>condom use with regular partner</it>, and for MSM we estimated models for <it>condom use with last female partner</it>.</p> <p>Results</p> <p>Among MSM, fixed-effects analysis revealed that FPP was positively correlated with the probability of <it>condom use with last female sexual partner </it>and negatively correlated with the individual probability of <it>sero-positivity to syphilis and HSV 2</it>. Among FSW, the FPP intervention was significantly correlated with increased <it>condom use with regular partners </it>and with lower probability of <it>STI sero-positivity</it>.</p> <p>Discussion</p> <p>Important changes in behaviours related to an increase in prevention activities translated to reductions in STI sero-prevalence in AP, India. In contrast with non-FPP sites, the FPP sites experienced an intense community approach as part of the FPP intervention, and the general increase in condom use and its effect on STI sero-prevalence reflected the efficacy of these intense prevention activities focused on key populations in AP.</p

Co-activation: its association with weakness and specific neurological pathology

BACKGROUND: Net agonist muscle strength is in part determined by the degree of antagonist co-activation. The level of co-activation might vary in different neurological disorders causing weakness or might vary with agonist strength. AIM: This study investigated whether antagonist co-activation changed a) with the degree of muscle weakness and b) with the nature of the neurological lesion causing weakness. METHODS: Measures of isometric quadriceps and hamstrings strength were obtained. Antagonist (hamstring) co-activation during knee extension was calculated as a ratio of hamstrings over quadriceps activity both during an isometric and during a functional sit to stand (STS) task (using kinematics) in groups of patients with extrapyramidal (n = 15), upper motor neuron (UMN) (n = 12), lower motor neuron (LMN) with (n = 18) or without (n = 12) sensory loss, primary muscle or neuromuscular junction disorder (n = 17) and in healthy matched controls (n = 32). Independent t-tests or Mann Witney U tests were used to compare between the groups. Correlations between variables were also investigated. RESULTS: In healthy subjects mean (SD) co-activation of hamstrings during isometric knee extension was 11.8 (6.2)% and during STS was 20.5 (12.9)%. In patients, co-activation ranged from 7 to 17% during isometric knee extension and 15 to 25% during STS. Only the extrapyramidal group had lower co-activation levels than healthy matched controls (p < 0.05). Agonist isometric muscle strength and co-activation correlated only in muscle disease (r = -0.6, p < 0.05) and during STS in UMN disorders (r = -0.7, p < 0.5). CONCLUSION: It is concluded that antagonist co-activation does not systematically vary with the site of neurological pathology when compared to healthy matched controls or, in most patient groups, with strength. The lower co-activation levels found in the extrapyramidal group require confirmation and further investigation. Co-activation may be relevant to individuals with muscle weakness. Within patient serial studies in the presence of changing muscle strength may help to understand these relationships more clearly

Synthesis and hyperpolarisation of eNOS substrates for quantification of NO production by 1H NMR spectroscopy

Hyperpolarization enhances the intensity of the NMR signals of a molecule, whose in vivo metabolic fate can be monitored by MRI with higher sensitivity. SABRE is a hyperpolarization technique that could potentially be used to image nitric oxide (NO) production in vivo. This would be very important, because NO dysregulation is involved in several pathologies, including cardiovascular ones. The nitric oxide synthase (NOS) pathway leads to NO production via conversion of l-arginine into l-citrulline. NO is a free radical gas with a short half-life in vivo (≈5s), therefore direct NO quantification is challenging. An indirect method - based on quantifying conversion of an l-Arg- to l-Cit-derivative by 1H NMR spectroscopy - is herein proposed. A small library of pyridyl containing l-Arg derivatives was designed and synthesised. In vitro tests showed that compounds 4a-j and 11a-c were better or equivalent substrates for the eNOS enzyme (NO2 - production=19-46μM) than native l-Arg (NO2 - production=25μM). Enzymatic conversion of l-Arg to l-Cit derivatives could be monitored by 1H NMR. The maximum hyperpolarization achieved by SABRE reached 870-fold NMR signal enhancement, which opens up exciting future perspectives of using these molecules as hyperpolarized MRI tracers in vivo

Vascular clamping in liver surgery: physiology, indications and techniques

This article reviews the historical evolution of hepatic vascular clamping and their indications. The anatomic basis for partial and complete vascular clamping will be discussed, as will the rationales of continuous and intermittent vascular clamping