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

Metastasis to the gluteus maximus muscle from renal cell carcinoma with special emphasis on MRI features

<p>Abstract</p> <p>Background</p> <p>The skeletal muscle is an unusual site for metastasis from renal cell carcinoma (RCC). Metastatic RCC must be differentiated from benign primary soft-tissue tumors because aggressive surgical resection is necessary.</p> <p>Case presentation</p> <p>We present the case of a 65-year-old man with metastatic RCC in the gluteus maximus muscle (3.8 cm in diameter) found on enhanced computed tomography (CT) 6 years after nephrectomy. Retrospectively, the small mass (1 cm in diameter) was overlooked 5 years earlier on enhanced CT. Because the growth of the lesion was slow, benign tumor was a differential diagnosis. However, magnetic resonance imaging (MRI) showed that the mass had high-signal intensity on T1- and T2-weighted images (WIs) compared to that of skeletal muscle, with mild enhancement by Gadolinium. The MRI features were unusual for most soft-tissue tumors having low-signal intensity on T1-WI and high-signal intensity on T2-WI. Therefore, under a diagnosis of metastatic RCC, the lesion was resected together with the surrounding skeletal muscle. The histology was confirmed to be metastatic RCC.</p> <p>Conclusion</p> <p>MRI features of metastatic RCC may be beneficial in differentiating it from primary soft-tissue tumor.</p

Thermal Diffusivity of Sintered Steels with Flash Method at Ambient Temperature

Due to lack of reliable data of thermal diffusivity of sintered steels in literature, experimental investigations were conducted on samples made of different powder types (based on prealloyed, or diffusion-bonded, or admixed powders) and under different process conditions. So the influence of pressing pressure and sintering temperature on thermal diffusivity was established. Thermal diffusivity was measured using the "flash method", where a sample in the shape of a slab is irradiated with a light pulse on one of the two surfaces and temperature of the other surface is detected by an ambient temperature pyrometer. The value of the thermal diffusivity is obtained by least squares regression on the entire trend of the temperature vs. time using the analytical solution of the heat conduction as regression model. Results show the increase of the thermal diffusivity with increasing density. This outcome can be explained from the mutual effect of thermal conductivity and density on thermal diffusivity in porous media. The experimental results have also permitted to verify the influence of the composition of the sintered materials and carbon contents on thermal diffusivity

Experimental investigation on thermal diffusivity of PM steels

The scanty literature data on thermal diffusivity of P/M steels seems contradictory, if the cooling speed on quenching is the evaluation parameter. Due to the basic importance of diffusivity on the response of P/M steels to heat-treating, an experimental survey has been carried out, to collect data on various P/M steels, based on prealloyed, or diffusion-bonded, or admixed powders. The study has also covered the influence of processing parameters, such as compaction pressure and sintering temperature. The flash method has been used to measure the thermal diffusivity of P/M steels. This method directly measures the thermal diffusivity of a sample in slab shape. A plane-parallel sample is inserted in the test apparatus and then a short light pulse, produced by a laser or a flash lamp, heats the front surface of the sample. The heat diffuses through the sample, leading to a temperature rise on the sample rear surface. An infrared detector measures this temperature rise, versus time, and thermal diffusivity is derived from the least square regression on the whole temperature trend, using the analytical solution of heat conduction. The results show that thermal diffusivity increases as density increases. This achievement can be justified by a simple theoretical analysis of the thermal conductivity on thermal diffusivity. The collected data also enable us to ascertain the influence of sintered material composition and carbon content on thermal diffusivity. The results should contribute to clarify some uncertainties and perplexities on the behavior of properly elaborated P/M steels, to be hardened by heat treatment, conventional - such as oil quenching - or innovative, such as sinter hardening