Evaluation of the Grassi Test for the Completeness of Vagotomy

This article describes our experience with the Grassi test in the experimental laboratory, using dogs. We found the reliability of this test questionable for completeness of vagotomy

The Zollinger-Ellison Syndrome

Gastric acid hypersecretion and raised plasma gastrin levels were found in a young Black patient who presented with a perforated duodenal ulcer. The clinical and laboratory features are described and discussed. Although no tumour was found at laparotomy, the persistence of hypergastrinaemia after total gastrectomy confirmed the diagnosis of the Zollinger-Ellison syndrome

PRISMA/DB: a parallel, main memory relational DBMS

PRISMA/DB, a full-fledged parallel, main memory relational database management system (DBMS) is described. PRISMA/DB's high performance is obtained by the use of parallelism for query processing and main memory storage of the entire database. A flexible architecture for experimenting with functionality and performance is obtained using a modular implementation of the system in an object-oriented programming language. The design and implementation of PRISMA/DB are described in detail. A performance evaluation of the system shows that the system is comparable to other state-of-the-art database machines. The prototype implementation of the system runs on a 100-node parallel multiprocesso

Tumor-Infiltrating Lymphocyte Therapy or Ipilimumab in Advanced Melanoma.

Background Immune checkpoint inhibitors and targeted therapies have dramatically improved outcomes in patients with advanced melanoma, but approximately half these patients will not have a durable benefit. Phase 1-2 trials of adoptive cell therapy with tumor-infiltrating lymphocytes (TILs) have shown promising responses, but data from phase 3 trials are lacking to determine the role of TILs in treating advanced melanoma. Methods In this phase 3, multicenter, open-label trial, we randomly assigned patients with unresectable stage IIIC or IV melanoma in a 1:1 ratio to receive TIL or anti-cytotoxic T-lymphocyte antigen 4 therapy (ipilimumab at 3 mg per kilogram of body weight). Infusion of at least 5×109 TILs was preceded by nonmyeloablative, lymphodepleting chemotherapy (cyclophosphamide plus fludarabine) and followed by high-dose interleukin-2. The primary end point was progression-free survival. Results A total of 168 patients (86% with disease refractory to anti-programmed death 1 treatment) were assigned to receive TILs (84 patients) or ipilimumab (84 patients). In the intention-to-treat population, median progression-free survival was 7.2 months (95% confidence interval [CI], 4.2 to 13.1) in the TIL group and 3.1 months (95% CI, 3.0 to 4.3) in the ipilimumab group (hazard ratio for progression or death, 0.50; 95% CI, 0.35 to 0.72; P<0.001); 49% (95% CI, 38 to 60) and 21% (95% CI, 13 to 32) of the patients, respectively, had an objective response. Median overall survival was 25.8 months (95% CI, 18.2 to not reached) in the TIL group and 18.9 months (95% CI, 13.8 to 32.6) in the ipilimumab group. Treatment-related adverse events of grade 3 or higher occurred in all patients who received TILs and in 57% of those who received ipilimumab; in the TIL group, these events were mainly chemotherapy-related myelosuppression. Conclusions In patients with advanced melanoma, progression-free survival was significantly longer among those who received TIL therapy than among those who received ipilimumab