To evaluate the imaging features of anorectal gastrointestinal stromal tumors (GISTs) with clinical and histopathologic correlation.
In this Institutional Review Board-approved, Health Insurance ...Portability and Accountability Act-compliant retrospective study, 16 patients (12 men; mean age 66 years (30-89 years)) with pathologically proven anorectal GISTs seen at our institution from January 2001 to July 2011 were identified. Electronic medical records were reviewed to obtain clinical data. Pretreatment imaging studies (computed tomography (CT) in 16 patients, magnetic resonance imaging (MRI) in 9 patients and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT in 8 patients) were evaluated by 2 radiologists until consensus. The location, size and imaging features of the primary tumor and metastases at presentation, if any, were recorded, and correlated with clinical data and pathologic features (histologic type, presence of necrosis, mitotic activity, risk category, immunohistochemical profile).
The mean tumor size was 6.9 × 6.0 cm. Of the 16 tumors, 11 (68.7%) were infralevator, 4 (25%) supra and infralevator and 1 (6.3%) supralevator; 9 (56.2%) were exophytic, 6 (37.5%) both exophytic and intraluminal, and 1 (6.3%) was intraluminal. The tumors were iso- to minimally hypoattenuating to muscle on CT, iso- to minimally hypointense on T1-weighted images, hyperintense on T2-weighted images and showed variable enhancement. Necrosis was seen in 4 (25%), and hemorrhage and calcification in 2 (12.5%) patients each. The tumors were FDG avid with a mean maximum standardized uptake value of 11 (8.4-16.8). All tumors were positive for KIT and CD34. Distant metastasis to liver was seen in 1 patient (6.3%) at presentation.
Anorectal GISTs are well-circumscribed, non-circumferential, predominantly infralevator, intramural or exophytic, FDG-avid, hypoattenuating masses, and present without lymphadenopathy or intestinal obstruction.
Air is an important medium for all living beings and is essential for the well-being of all. Monitoring of air is important to know the quality of air. The air quality monitoring was carried out in ...Kolhapur City under the National Air Monitoring Program. The present study involves the assessment of PM10 as described in the National Ambient Air Quality Standards (NAAQS). The source apportionment study related to particulate matter was carried out in Kolhapur City. The study also determined the average PM10 concentration in the city as it will be useful for preparing an action plan to reduce PM10 concentration. PM10 concentration was calculated as per the standard method adopted by CPCB. Sampling was carried out for 8 hours in three shifts twice a week at each sampling site for three consecutive years. Mahadwar Road (MR) and Dabholkar Corner (DC) were selected per the surrounding residential area, population density, and traffic conjunction. The third site Shivaji University (SUK), was selected as a control site. The results indicated that the PM10 level has risen above the prescribed standards of NAAQS. The reason for the rise in PM10 may be due to fossil fuel burning, construction activity, vehicles, and unpaved roads. The Analysis of Variance (ANOVA) technique is used to check the equality of the mean concentration of PM10 at these three locations and found a significant difference between mean concentrations of PM10, suggesting increased particulate matter.
Over the Mediterranean region, elevated tropospheric ozone (O3) values are recorded, especially in summer. We use the thermal Infrared Atmospheric Sounding Interferometer (IASI) and the Weather ...Research and Forecasting Model with Chemistry (WRF-Chem) to understand and interpret the factors and emission sources responsible for the high O3 concentrations observed in the Mediterranean troposphere. Six years (2008–2013) of IASI data have been analyzed and results show consistent maxima during summer, with an increase of up to 22% in the 0–8 km O3 column in the eastern part of the basin compared to the middle of the basin. We focus on summer 2010 to investigate the processes that contribute to these summer maxima. Using two modeled O3 tracers (inflow to the model domain and local anthropogenic emissions), we show that, between the surface and 2 km, O3 is mostly formed from anthropogenic emissions, while above 4 km it is mostly transported from outside the domain or from stratospheric origins. Evidence of stratosphere-to-troposphere exchange (STE) events in the eastern part of the basin is shown, and corresponds to a low water vapor mixing ratio and high potential vorticity.
Measurements carried out in Paris Magenta railway station in April–May 2006 underlined a repeatable diurnal cycle of aerosol concentrations and optical properties. The average daytime PM
10 and PM
...2.5 concentrations in such a confined space were approximately 5–30 times higher than those measured in Paris streets. Particles are mainly constituted of dust, with high concentrations of iron and other metals, but are also composed of black and organic carbon. Aerosol levels are linked to the rate at which rain and people pass through the station. Concentrations are also influenced by ambient air from the nearby streets through tunnel ventilation. During daytime approximately 70% of aerosol mass concentrations are governed by coarse absorbing particles with a low Angström exponent (∼0.8) and a low single-scattering albedo (∼0.7). The corresponding aerosol density is about 2 g cm
−3 and their complex refractive index at 355 nm is close to 1.56–0.035 i. The high absorption properties are linked to the significant proportion of iron oxides together with black carbon in braking systems. During the night, particles are mostly submicronic, thus presenting a greater Angström exponent (∼2). The aerosol density is lower (1.8 g cm
−3) and their complex refractive index presents a lower imaginary part (1.58–0.013 i), associated to a stronger single-scattering albedo (∼0.85–0.90), mostly influenced by the ambient air. For the first time we have assessed the emission (deposition) rates in an underground station for PM
10, PM
2.5 and black carbon concentrations to be 3314 ± 781(−1164 ± 160), 1186 ± 358(−401 ± 66) and 167 ± 46(−25 ± 9) μg m
−2 h
−1, respectively.
The radiative heating rate due to mineral dust over West Africa is investigated using the radiative code STREAMER, as well as remote sensing and in situ observations gathered during the African ...Monsoon Multidisciplinary Analysis Special Observing Period (AMMA SOP). We focus on two days (13 and 14 June 2006) of an intense and long lasting episode of dust being lifted in remote sources in Chad and Sudan and transported across West Africa in the African easterly jet region, during which airborne operations were conducted at the regional scale, from the southern fringes of the Sahara to the Gulf of Guinea. Profiles of heating rates are computed from airborne LEANDRE 2 (Lidar Embarqué pour l'étude de l'Atmosphère: Nuages Dynamique, Rayonnement et cycle de l'Eau) and space-borne CALIOP (Cloud Aerosol Lidar and Infrared Pathfinder Satellite Observations) lidar observations using two mineral dust model constrained by airborne in situ data and ground-based sunphotometer obtained during the campaign. Complementary spaceborne observations (from the Moderate-resolution Imaging Spectroradiometer-MODIS) and in-situ observations such as dropsondes are also used to take into account the infrared contribution of the water vapour. We investigate the variability of the heating rate on the vertical within a dust plume, as well as the contribution of both shortwave and longwave radiation to the heating rate and the radiative heating rate profiles of dust during daytime and nighttime. The sensitivity of the so-derived heating rate is also analyzed for some key variables for which the associated uncertainties may be large. During daytime, the warming associated with the presence of dust was found to be between 1.5 K day−1 and 4 K day−1, on average, depending on altitude and latitude. Strong warming (i.e. heating rates as high as 8 K day−1) was also observed locally in some limited part of the dust plumes. The uncertainty on the heating rate retrievals in the optically thickest part of the dust plume was estimated to be between 0.5 and 1.4 K day−1. During nighttime much smaller values of heating/cooling are retrieved (less than ±1 K day−1). Furthermore, cooling is observed as the result of the longwave forcing in the dust layer, while warming is observed below the dust layer, in the monsoon layer.
Background
Schwannomas are rare tumours that pose a significant management challenge in the abdomen, retroperitoneum and pelvis. No data are available to inform management strategy.
Methods
A ...collaborative international cohort study, across specialist sarcoma units, was conducted to include adults presenting between 2000 and 2017 with histopathologically confirmed schwannomas within the abdomen, retroperitoneum or pelvis.
Results
Of 485 patients across 12 centres, 38 (7·8 per cent) were discharged without follow‐up, 199 (41·0 per cent) underwent early resection and 248 (51·1 per cent) had radiological monitoring. Of these 248 patients, 96 (38·7 per cent) eventually had surgery, giving an overall resection rate of 60·8 per cent (295 of 485). At baseline, median tumour volume was 90·1 (i.q.r. 26·5–262·0) cm3. The estimated growth rate was 10·5 (95 per cent c.i. 9·4 to 11·6) per cent per year, and was consistent in the short term (within 2 years of diagnosis) and long term (beyond 2 years) (ρ = 0·405, P = 0·021). A decision to operate was more common in symptomatic patients (P < 0·001) and for rapidly growing tumours (growth rate more than 20 per cent per year) (P = 0·025). R0/R1 resection was achieved in 91·6 per cent of patients (263 of 287). Kaplan–Meier long‐term recurrence rates after R0/R1 resection were 2·3 and 6·7 per cent at 3 and 5 years respectively.
Conclusion
Specific recommendations include: indications for early surgery, prediction of growth from radiological monitoring, promotion of selective submacroscopic resection and cessation of postoperative imaging surveillance.
Antecedentes
Los schwannomas son tumores raros que plantean un importante desafío para su tratamiento en el abdomen, retroperitoneo y pelvis. No existen datos disponibles que informen de la estrategia de tratamiento.
Métodos
Se llevó a cabo un estudio de cohortes colaborativo internacional, entre unidades especializadas en sarcomas, que incluía a pacientes adultos con schwannomas de la cavidad abdominal, retroperitoneo o pelvis con confirmación histológica que se presentaron entre 2000 y 2017.
Resultados
De 485 pacientes de los 12 centros, 38 (7,8%) fueron dados de alta sin seguimiento, 199 (41,0%) fueron sometidos a resección precoz y 248 (51,1%) pacientes se incluyeron en seguimiento radiológico, de estos últimos 96 pacientes (38,7%) fueron sometidos finalmente a cirugía, con una tasa global de resección del 60,8% (295/485). Al inicio, la mediana del volumen tumoral fue 90,1 cm3 (rango intercuartílico: 26,5‐262,0). La tasa media de crecimiento fue 10,5% por año (i.c. del 95%: 9,4%‐11,6%), siendo uniforme en el seguimiento a corto (durante los 2 años del diagnóstico) y largo plazo (más allá de los 2 años, rho: 0,405, P = 0,021). La decisión de establecer la indicación quirúrgica fue más frecuente en pacientes sintomáticos (P < 0,001) y en tumores con crecimiento rápido (> 20% por año, P = 0,025). Se consiguió una resección R0/R1 en el 91,6%. Las tasas de recidiva a largo plazo de Kaplan‐Meier tras resección R0/R1 fueron 2% y 7% a 3 y 5 años, respectivamente.
Conclusión
Las recomendaciones específicas incluyen: indicaciones para la cirugía precoz, predicción del crecimiento en el seguimiento radiológico, fomentar la resección submacroscópica selectiva, y cese del seguimiento postoperatorio con pruebas de imagen.
Schwannomas present a significant management challenge, and surgery can result in morbidity. Individualized growth rates predicted after a period of radiological monitoring can help guide decision‐making. There is no role for surveillance after resection.
Practical guidelines
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•Effect of novel microbial consortium pretreatment on methane yield was evaluated.•Biological pretreatment showed increased digestibility of BSH co-substrate.•The pretreatment ...enhanced biogas production significantly by anaerobic digestion.•Biomethanation enhanced by 3300% over the control.
Microbial pretreatments have been identified as a compatible and sustainable process with anaerobic digestion compared to energy-intensive physicochemical pretreatments. In this study, barley straw and hay co-substrate was pretreated with a microaerobic barley straw-adapted microbial (BSAM) consortium prior to anaerobic digestion. The improved digestibility was investigated through 16S rRNA gene sequencing, microbial counts and C:N ratios. BSAM pretreatment resulted in 15.2 L kg−1 TS of methane yield after 35 days, almost 40 times more than the control. The methane content in total biogas produced were 58% (v/v) and 10% (v/v) in BSAM and control, respectively. This research demonstrated that BSAM-based pretreatment significantly increased the digestibility and surface area of the lignocellulosic material and considerably enhanced biomethanation. This study generates new potential bio-research opportunities in the emerging field of lignocellulosic anaerobic digestion-biorefineries.
Epigenetic aberrations are widespread in cancer, yet the underlying mechanisms and causality remain poorly understood
. A subset of gastrointestinal stromal tumours (GISTs) lack canonical kinase ...mutations but instead have succinate dehydrogenase (SDH) deficiency and global DNA hyper-methylation
. Here, we associate this hyper-methylation with changes in genome topology that activate oncogenic programs. To investigate epigenetic alterations systematically, we mapped DNA methylation, CTCF insulators, enhancers, and chromosome topology in KIT-mutant, PDGFRA-mutant and SDH-deficient GISTs. Although these respective subtypes shared similar enhancer landscapes, we identified hundreds of putative insulators where DNA methylation replaced CTCF binding in SDH-deficient GISTs. We focused on a disrupted insulator that normally partitions a core GIST super-enhancer from the FGF4 oncogene. Recurrent loss of this insulator alters locus topology in SDH-deficient GISTs, allowing aberrant physical interaction between enhancer and oncogene. CRISPR-mediated excision of the corresponding CTCF motifs in an SDH-intact GIST model disrupted the boundary between enhancer and oncogene, and strongly upregulated FGF4 expression. We also identified a second recurrent insulator loss event near the KIT oncogene, which is also highly expressed across SDH-deficient GISTs. Finally, we established a patient-derived xenograft (PDX) from an SDH-deficient GIST that faithfully maintains the epigenetics of the parental tumour, including hypermethylation and insulator defects. This PDX model is highly sensitive to FGF receptor (FGFR) inhibition, and more so to combined FGFR and KIT inhibition, validating the functional significance of the underlying epigenetic lesions. Our study reveals how epigenetic alterations can drive oncogenic programs in the absence of canonical kinase mutations, with implications for mechanistic targeting of aberrant pathways in cancers.
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