Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) procedure for colorectal liver metastasis

Since first described, Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) has garnered boisterous praise and fervent criticism. Its rapid adoption and employment for a variety of indications resulted in high perioperative morbidity and mortality. However recent risk stratification, refinement of technique to reduce the impact of stage I and progression along the learning curve have resulted in improved outcomes. The first randomized trial comparing ALPPS to two stage hepatectomy (TSH) for colorectal liver metastases (CRLM) was recently published demonstrating comparable perioperative morbidity and mortality with improved resectability and survival following ALPPS. In this review, as ALPPS enters the thirteenth year since conception, the current status of this contentious two stage technique is presented and best practices for deployment in the treatment of CRLM is codified

A Generalized Diffusion Tensor for Fully Anisotropic Diffusion of Energetic Particles in the Heliospheric Magnetic Field

The spatial diffusion of cosmic rays in turbulent magnetic fields can, in the most general case, be fully anisotropic, i.e. one has to distinguish three diffusion axes in a local, field-aligned frame. We reexamine the transformation for the diffusion tensor from this local to a global frame, in which the Parker transport equation for energetic particles is usually formulated and solved. Particularly, we generalize the transformation formulas to allow for an explicit choice of two principal local perpendicular diffusion axes. This generalization includes the 'traditional' diffusion tensor in the special case of isotropic perpendicular diffusion. For the local frame, we motivate the choice of the Frenet-Serret trihedron which is related to the intrinsic magnetic field geometry. We directly compare the old and the new tensor elements for two heliospheric magnetic field configurations, namely the hybrid Fisk and the Parker field. Subsequently, we examine the significance of the different formulations for the diffusion tensor in a standard 3D model for the modulation of galactic protons. For this we utilize a numerical code to evaluate a system of stochastic differential equations equivalent to the Parker transport equation and present the resulting modulated spectra. The computed differential fluxes based on the new tensor formulation deviate from those obtained with the 'traditional' one (only valid for isotropic perpendicular diffusion) by up to 60% for energies below a few hundred MeV depending on heliocentric distance.Comment: 8 pages, 6 figures, accepted in Ap

Antioxidative potential of a combined therapy of anti TNFα and Zn acetate in experimental colitis.

AIM: To evaluate whether combination therapy with anti-tumour necrosis factor α (TNFα) antibody and Zn acetate is beneficial in dextran sodium sulphate (DSS) colitis. METHODS: Colitis was induced in CD1-Swiss mice with 5% DSS for 7 d. The experimental mice were then randomised into the following subgroups: standard diet + DSS treated (induced colitis group); standard diet + DSS + subcutaneous 25 μg anti-TNFα treated group; Zn acetate treated group + DSS + subcutaneous 25 μg anti-TNFα; standard diet + DSS + subcutaneous 6.25 μg anti-TNFα treated group and Zn acetate treated group + DSS + subcutaneous 6.25 μg anti-TNFα. Each group of mice was matched with a similar group of sham control animals. Macroscopic and histological features were scored blindly. Homogenates of the colonic mucosa were assessed for myeloperoxidase activity as a biochemical marker of inflammation and DNA adducts (8OH-dG) as a measure of oxidative damage. RESULTS: DSS produced submucosal erosions, ulcers, inflammatory cell infiltration and cryptic abscesses which were reduced in both groups of mice receiving either anti-TNFα alone or combined with zinc. The effect was more pronounced in the latter group (vs Zn diet, P < 0.02). Myeloperoxidase activity (vs controls, P < 0.02) and DNA adducts, greatly elevated in the DSS fed colitis group (vs controls, P < 0.05), were significantly reduced in the treated groups, with a more remarkable effect in the group receiving combined therapy (vs standard diet, P < 0.04). CONCLUSION: DSS induces colonic inflammation which is modulated by the administration of anti-TNFα. Combining anti-TNFα with Zn acetate offers marginal benefit in colitis severity

Endothelin receptors (version 2019.4) in the IUPHAR/BPS Guide to Pharmacology Database

Endothelin receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on Endothelin Receptors [24]) are activated by the endogenous 21 amino-acid peptides endothelins 1-3 (endothelin-1, endothelin-2 and endothelin-3)

Endothelin receptors in GtoPdb v.2023.1

Endothelin receptors (nomenclature as agreed by the NC-IUPHAR Subcommittee on Endothelin Receptors [24]) are activated by the endogenous 21 amino-acid peptides endothelins 1-3 (endothelin-1, endothelin-2 and endothelin-3)

Kolmogorov-Sinai entropy in field line diffusion by anisotropic magnetic turbulence

The Kolmogorov-Sinai (KS) entropy in turbulent diffusion of magnetic field lines is analyzed on the basis of a numerical simulation model and theoretical investigations. In the parameter range of strongly anisotropic magnetic turbulence the KS entropy is shown to deviate considerably from the earlier predicted scaling relations [Rev. Mod. Phys. {\bf 64}, 961 (1992)]. In particular, a slowing down logarithmic behavior versus the so-called Kubo number $R\gg 1$ ($R = (\delta B / B_0) (\xi_\| / \xi_\bot)$, where $\delta B / B_0$ is the ratio of the rms magnetic fluctuation field to the magnetic field strength, and $\xi_\bot$ and $\xi_\|$ are the correlation lengths in respective dimensions) is found instead of a power-law dependence. These discrepancies are explained from general principles of Hamiltonian dynamics. We discuss the implication of Hamiltonian properties in governing the paradigmatic "percolation" transport, characterized by $R\to\infty$, associating it with the concept of pseudochaos (random non-chaotic dynamics with zero Lyapunov exponents). Applications of this study pertain to both fusion and astrophysical plasma and by mathematical analogy to problems outside the plasma physics. This research article is dedicated to the memory of Professor George M. ZaslavskyComment: 15 pages, 2 figures. Accepted for publication on Plasma Physics and Controlled Fusio

Coronary Thrombolysis with Intravenous Streptokinase in the Anesthetized Dog: A Dose-Response Study

ABSTRAC

Muon excess at sea level from solar flares in association with the Fermi GBM spacecraft detector

This paper presents results of an ongoing survey on the associations between muon excesses at ground level registered by the Tupi telescopes and transient solar events, two solar flares whose gamma-ray and X-ray emissions were reported by, respectively, the Fermi GBM and the GOES 14. We show that solar flares of small scale, those with prompt X-ray emission classified by GOES as C-Class (power $10^{-6}$ to $10^{-5}$ W m$^2$ at 1 AU) may give rise to muon excess probably associated with solar protons and ions emitted by the flare and arriving at the Earth as a coherent particle pulse. The Tupi telescopes are within the central region of the South Atlantic Anomaly (SAA), which allows particle detectors to achieve a low rigidity of response to primary and secondary charged particles ($\geq 0.1$ GV). Here we argue for the possibility of a "scale-free" energy distribution of particles accelerated by solar flares. Large and small scale flares have the same energy spectrum up to energies exceeding the pion production, the difference between them is only the intensity. If this hypothesis is correct, the Tupi telescope is registering muons produced by protons (ions) whose energy corresponds to the tail of the spectrum. Consequently the energy distribution of the emitted protons has to be a power law spectrum, since power law distributions are characterized as scale free distributions. The Tupi events give support to this conjecture.Comment: 24 pages, 10 figure