344 research outputs found

    Impact of tumor size on outcomes after anatomic lung resection for stage 1A non–small cell lung cancer based on the current staging system

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    ObjectiveAnatomic segmentectomy may achieve results comparable to lobectomy for early-stage non–small cell lung cancer. The 7th edition of the AJCC Cancer Staging Handbook stratified the previous T1 tumor designation into T1a and T1b subsets, which still define stage 1A node-negative non–small cell lung cancer. We are left to hypothesize whether this classification may aid in directing the extent of surgical resection. We retrospectively reviewed our anatomic segmentectomy and lobectomy management of stage 1A non–small cell lung cancer to determine differences in survival and local recurrence rates based on the new stratification.MethodsWe performed a retrospective review of 429 patients undergoing resection of pathologically confirmed stage 1A non–small cell lung cancer via lobectomy or anatomic segmentectomy. Primary outcome variables included mortality, recurrence, and survival. Recurrence-free and cancer-specific survivals were estimated using the Kaplan–Meier method.ResultsPatients undergoing segmentectomy were older than patients undergoing lobectomy (mean age 69.2 vs 66.8 years, P < .006). The mean preoperative forced expiratory volume in 1 second was significantly lower in the segmentectomy group than in the lobectomy group (71.8% vs 81.1%, P = .02). Mortality was similar after segmentectomy (1.1%) and lobectomy (1.2%). There was no difference in mortality, recurrence rates (14.0% vs 14.7%, P = 1.00), or 5-year cancer-specific survival (T1a: 90% vs 91%, P = .984; T1b: 82% vs 78%, P = .892) when comparing segmentectomy and lobectomy for pathologic stage 1A non–small cell lung cancer, when stratified by T stage.ConclusionsAnatomic segmentectomy may achieve equivalent recurrence and survival compared with lobectomy for patients with stage 1A non–small cell lung cancer. Prospective studies will be necessary to delineate the potential merits of anatomic segmentectomy in this setting

    Anatomic segmentectomy for stage I non–small-cell lung cancer: Comparison of video-assisted thoracic surgery versus open approach

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    ObjectivesAnatomic segmentectomy is increasingly being considered as a means of achieving an R0 resection for peripheral, small, stage I non–small-cell lung cancer. In the current study, we compare the results of video-assisted thoracic surgery (n = 104) versus open (n = 121) segmentectomy in the treatment of stage I non–small-cell lung cancer.MethodsA total of 225 consecutive anatomic segmentectomies were performed for stage IA (n = 138) or IB (n = 87) non–small-cell lung cancer from 2002 to 2007. Primary outcome variables included hospital course, complications, mortality, recurrence, and survival. Statistical comparisons were performed utilizing the t test and Fisher exact test. The probability of overall and recurrence-free survival was estimated with the Kaplan-Meier method, with significance being estimated by the log-rank test.ResultsMean age (69.9 years) and gender distribution were similar between the video-assisted thoracic surgery and open groups. Average tumor size was 2.3 cm (2.1 cm video-assisted thoracic surgery; 2.4 cm open). Mean follow-up was 16.2 (video-assisted thoracic surgery) and 28.2 (open) months. There were 2 perioperative deaths (2/225; 0.9%), both in the open group. Video-assisted thoracic surgery segmentectomy was associated with decreased length of stay (5 vs 7 days, P < .001) and pulmonary complications (15.4% vs 29.8%, P = .012) compared with open segmentectomy. Overall mortality, complications, local and systemic recurrence, and survival were similar between video-assisted thoracic surgery and open segmentectomy groups.ConclusionsVideo-assisted thoracic surgery segmentectomy can be performed with acceptable morbidity, mortality, recurrence, and survival. The video-assisted thoracic surgery approach affords a shorter length of stay and fewer postoperative pulmonary complications compared with open techniques. The potential benefits and limitations of segmentectomy will need to be further evaluated by prospective, randomized trials

    Defining sustainable and precautionary harvest rates for data-limited short-lived stocks: a case study of sprat (Sprattus sprattus) in the English Channel2023

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    Publication history: Accepted - 3 March 2023; Published - 17 April 2023.Empirical harvest control rules set catch advice based on observed indicators and are increasingly being used worldwide to manage fish stocks that lack formal assessments of stock and exploitation status. Within the International Council for the Exploration of the Sea, trend-based rules that adjust advice according to recent survey observations have been adopted; however, there is increasing evidence that such rules do not work well for short-lived pelagic species that can exhibit large inter-annual fluctuations in stock size. Constant harvest rates, removing a fixed proportion of observed biomass index, have been proposed as a suitable strategy for managing short-lived species. Unknown survey catchability has, however, remained a barrier to reliance on their application on these stocks in the past. We apply simulation testing to define a robust, sustainable constant harvest rate for a data-limited short-lived stock, using the English Channel sprat as a case study. By conditioning a management strategy evaluation framework based on existing and borrowed life-history parameters and precautionary considerations, we test and show that a constant harvest rate outperforms trend-based catch rules, maximizing yields while reducing risks of stock overexploitation, and conclude an 8.6% constant harvest rate provides sufficiently precautionary catch advice for this stock.Part of this work was funded by the UK Department of Environment, Food and Rural Affairs

    Effect of Crystallographic Texture on Magnetic Characteristics of Cobalt Nanowires

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    Cobalt nanowires with controlled diameters have been synthesized using electrochemical deposition in etched ion-track polycarbonate membranes. Structural characterization of these nanowires with diameter 70, 90, 120 nm and length 30 ÎĽm was performed by scanning electron microscopy, high-resolution transmission electron microscopy, and X-ray diffraction techniques. The as-prepared wires show uniform diameter along the whole length and X-ray diffraction analysis reveals that [002] texture of these wires become more pronounced as diameter is reduced. Magnetic characterization of the nanowires shows a clear difference of squareness and coercivity between parallel and perpendicular orientations of the wires with respect to the applied field direction. In case of parallel applied field, the coercivity has been found to be decreasing with increasing diameter of the wires while in perpendicular case; the coercivity observes lower values for larger diameter. The results are explained by taking into account the magnetocrystalline and shape anisotropies with respect to the applied field and domain transformation mechanism when single domain limit is surpassed

    Yolk sac macrophage progenitors traffic to the embryo during defined stages of development

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    Tissue macrophages in many adult organs originate from yolk sac (YS) progenitors, which invade the developing embryo and persist by means of local self-renewal. However, the route and characteristics of YS macrophage trafficking during embryogenesis are incompletely understood. Here we show the early migration dynamics of YS-derived macrophage progenitors in vivo using fate mapping and intravital microscopy. From embryonic day 8.5 (E8.5) CX(3)CR1+ pre-macrophages are present in the mouse YS where they rapidly proliferate and gain access to the bloodstream to migrate towards the embryo. Trafficking of pre-macrophages and their progenitors from the YS to tissues peaks around E10.5, dramatically decreases towards E12.5 and is no longer evident from E14.5 onwards. Thus, YS progenitors use the vascular system during a restricted time window of embryogenesis to invade the growing fetus. These findings close an important gap in our understanding of the development of the innate immune system

    Early carboniferous brachiopod faunas from the Baoshan block, west Yunnan, southwest China

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    38 brachiopod species in 27 genera and subgenera are described from the Yudong Formation in the Shidian-Baoshan area, west Yunnan, southwest China. New taxa include two new subgenera: Unispirifer (Septimispirifer) and Brachythyrina (Longathyrina), and seven new species: Eomarginifera yunnanensis, Marginatia cylindrica, Unispirifer (Unispirifer) xiangshanensis, Unispirifer (Septimispirifer) wafangjieensis, Brachythyrina (Brachythyrina) transversa, Brachythyrina (Longathyrina) baoshanensis, and Girtyella wafangjieensis. Based on the described material and constraints from associated coral and conodont faunas, the age of the brachiopod fauna from the Yudon Formation is considered late Tournaisian (Early Carboniferous), with a possibility extending into earlyViseacutean.<br /

    Meiotic Recombination Hotspots of Fission Yeast Are Directed to Loci that Express Non-Coding RNA

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    Polyadenylated, mRNA-like transcripts with no coding potential are abundant in eukaryotes, but the functions of these long non-coding RNAs (ncRNAs) are enigmatic. In meiosis, Rec12 (Spo11) catalyzes the formation of dsDNA breaks (DSBs) that initiate homologous recombination. Most meiotic recombination is positioned at hotspots, but knowledge of the mechanisms is nebulous. In the fission yeast genome DSBs are located within 194 prominent peaks separated on average by 65-kbp intervals of DNA that are largely free of DSBs.). Furthermore, we tested and rejected the hypothesis that the ncRNA loci and DSB peaks localize preferentially, but independently, to a third entity on the chromosomes.Meiotic DSB hotspots are directed to loci that express polyadenylated ncRNAs. This reveals an unexpected, possibly unitary mechanism for what directs meiotic recombination to hotspots. It also reveals a likely biological function for enigmatic ncRNAs. We propose specific mechanisms by which ncRNA molecules, or some aspect of RNA metabolism associated with ncRNA loci, help to position recombination protein complexes at DSB hotspots within chromosomes
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