Image-Guided Ablative Therapies for Lung Tumors

While the gold standard for early stage lung cancers is still surgical resection, many patients have comorbidities or suboptimal lung function making surgery unfavorable. At the same time, more and more small lung nodules are being incidentally discovered on computer tomography (CT), leading to the discovery of pre-malignant or very early stage lung cancers without regional spread, which could probably be eradicated without anatomical surgical resection. Various ablative energies and technologies are available on the market, including radiofrequency ablation, microwave ablation, cryoablation, and less commonly laser ablation and irreversible electroporation. For each technology, the mechanism of action, advantages, limitations, potential complications and evidence-based outcomes will be reviewed. Traditionally, these ablative therapies were done under CT guidance with percutaneous insertion of ablative probes. Recently, bronchoscopic ablation under ultrasound, CT, or electromagnetic navigation bronchoscopy guidance is gaining popularity due to improved navigation precision, reduced pleural-based complications, and providing a true “wound-less” option

The evolution of language: a comparative review

For many years the evolution of language has been seen as a disreputable topic, mired in fanciful "just so stories" about language origins. However, in the last decade a new synthesis of modern linguistics, cognitive neuroscience and neo-Darwinian evolutionary theory has begun to make important contributions to our understanding of the biology and evolution of language. I review some of this recent progress, focusing on the value of the comparative method, which uses data from animal species to draw inferences about language evolution. Discussing speech first, I show how data concerning a wide variety of species, from monkeys to birds, can increase our understanding of the anatomical and neural mechanisms underlying human spoken language, and how bird and whale song provide insights into the ultimate evolutionary function of language. I discuss the ‘‘descended larynx’ ’ of humans, a peculiar adaptation for speech that has received much attention in the past, which despite earlier claims is not uniquely human. Then I will turn to the neural mechanisms underlying spoken language, pointing out the difficulties animals apparently experience in perceiving hierarchical structure in sounds, and stressing the importance of vocal imitation in the evolution of a spoken language. Turning to ultimate function, I suggest that communication among kin (especially between parents and offspring) played a crucial but neglected role in driving language evolution. Finally, I briefly discuss phylogeny, discussing hypotheses that offer plausible routes to human language from a non-linguistic chimp-like ancestor. I conclude that comparative data from living animals will be key to developing a richer, more interdisciplinary understanding of our most distinctively human trait: language