Successful surgical management of an extrahepatic biliary cystadenocarcinoma

Extrahepatic bile duct cancer is an uncommon disease, and few cases are curable by surgery. We report a case of extrahepatic biliary cystadenocarcinoma (BCAC) associated with atrophy of the left hepatic lobe. A 54-year old male was admitted with painless obstructive jaundice and a hepatic palpable mass noticed one month before presentation. Liver functions tests were consistent with cholestatic damage and serum carbohydrate antigen 19.9 (CA 19-9) was increased before treatment. Magnetic resonance imaging (MRI) disclosed dilatation of the left hepatic bile duct with irregular wall thickening close to the hepatic confluence, and atrophy of left hepatic lobe. The patient was submitted to en bloc extended left hepatectomy with resection of caudate lobe, hilar lymphadenectomy, and suprapancreatic biliary tree resection. All surgical margins were grossly negative, and postoperative course was uneventful, except for a minor bile leak. The patient was discharged on the 15th postoperative day; he is alive without tumor recurrence one year after primary therapy. Although technically challenging, extended en bloc resection is feasible in adults with extrahepatic BCAC and can improve survival with acceptable and manageable morbidity

Inspiratory fraction and exercise impairment in COPD patients GOLD stages II-III

The inspiratory-to-total lung capacity ratio or inspiratory fraction (inspiratory capacity (IC)/total lung capacity (TLC)) may be functionally more representative than traditional indices of resting airflow limitation and lung hyperinflation in patients with chronic obstructive pulmonary disease (COPD).In the present retrospective study, a comparison was made of the individual performance of post-bronchodilator IC, IC/TLC and forced expiratory volume in one second (FEV1) in predicting a severely reduced peak oxygen uptake (V'o(2); < 60% predicted) in 44 COPD patients Global Initiative for Chronic Obstructive Lung Disease stages II-III (post-bronchodilator FEV1 ranging from 31-79% pred).Patients with lower IC/TLC values (<= 0.28) showed increased lung volumes and reduced exercise capacity as compared with other subjects. Following a multiple linear regression analysis, only IC/TLC and FEV1 remained as independent predictors of V'o(2) (r(2)=0.33). A receiver operating characteristic (ROC) curve analysis revealed that an IC/TLC <= 0.28 had the highest specificity (89.6%), positive predictive value (80%) and overall accuracy (86.3%) in identifying patients with V'o(2)< 60% pred. in addition, the area under the ROC curve tended to be higher for IC/TLC than IC.In conclusion, post-bronchodilator total lung capacity-corrected inspiratory fraction provides useful information in addition to forced expiratory volume in one second and inspiratory capacity, to estimate the likelihood of chronic obstructive pulmonary disease patients to present with severely reduced maximal exercise capacity.Universidade Federal de São Paulo, Paulista Sch Med, Pulm Funct & Clin Exercise Physiol Unit, Resp Div,Dept Med,EPM, BR-04020050 São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Sch Med, Pulm Funct & Clin Exercise Physiol Unit, Resp Div,Dept Med,EPM, BR-04020050 São Paulo, BrazilWeb of Scienc

Bi-Large Neutrino Mixing See-Saw Mass Matrix with Texture Zeros and Leptogenesis

We study constraints on neutrino properties from texture zeros in bi-large mixing See-Saw mass matrix and also from leptogenesis. Texture zeros may occur in the light (class a)) or in the heavy (class b)) neutrino mass matrices. Each of these two classes has 5 different forms which can produce non-trivial three generation mixing with at least one texture zero. We find that two types of texture zero mass matrices in both class a) and class b) can be consistent with present data on neutrino masses, mixing and produce the observed baryon asymmetry of the universe. None of the neutrinos can have zero masses with the lightest of the light neutrinos having a mass larger than about 0.039 eV for class a) and 0.002 eV for class b). In these models although CKM CP violating phase vanishes, non-zero Majorana phases, however, can exist and play an important role in producing the observed baryon asymmetry in our universe through leptogenesis mechanism. The requirement of producing the observed baryon asymmetry can further distinguish different models and also restrict the See-Saw scale to be in the range $10^{12}\sim 10^{15}$ GeV.Comment: 21 pages, 7 figures revised version, some references added, to be submitted to PR

Extracellular vesicles from oral squamous carcinoma cells display pro- and anti-angiogenic properties

BackgroundA new intercellular communication mode established by neoplastic cells and tumor microenvironment components is based on extracellular vesicles (EVs). However, the biological effects of the EVs released by tumor cells on angiogenesis are not completely understood. Here, we aimed to understand the biological effects of EVs isolated from two cell lines of oral squamous cell carcinoma (OSCC) (SCC15 and HSC3) on endothelial cell tubulogenesis. MethodsOSCC-derived EVs were isolated with a polymer-based precipitation method, quantified using nanoparticle tracking analysis and verified for EV markers by dot blot. Functional assays were performed to assess the angiogenic potential of the OSCC-derived EVs. ResultsThe results showed that EVs derived from both cell lines displayed typical spherical-shaped morphology and expressed the EV markers CD63 and Annexin II. Although the average particle concentration and size were quite similar, SCC15-derived EVs promoted a pronounced tubular formation associated with significant migration and apoptosis rates of the endothelial cells, whereas EVs derived from HSC3 cells inhibited significantly endothelial cell tubulogenesis and proliferation. ConclusionThe findings of this study reveal that EVs derived from different OSCC cell lines by a polymer-based precipitation method promote pro- or anti-angiogenic effects.Peer reviewe