This multi-centre phase II clinical trial is the first prospective evaluation of radioembolisation of patients with colorectal liver metastases (mCRC) who failed previous oxaliplatin- and ...irinotecan-based systemic chemotherapy regimens.
Eligible patients had adequate hepatic, haemopoietic and renal function, and an absence of major hepatic vascular anomalies and hepato-pulmonary shunting. Gastroduodenal and right gastric arteries were embolised before hepatic arterial administration of yttrium-90 resin microspheres (median activity, 1.7 GBq; range, 0.9-2.2).
Of 50 eligible patients, 38 (76%) had received > or =4 lines of chemotherapy. Most presented with synchronous disease (72%), >4 hepatic metastases (58%), 25-50% replacement of total liver volume (60%) and bilateral spread (70%). Early and intermediate (>48 h) WHO G1-2 adverse events (mostly fever and pain) were observed in 16 and 22% of patients respectively. Two died due to renal failure at 40 days or liver failure at 60 days respectively. By intention-to-treat analysis using Response Evaluation Criteria in Solid Tumours, 1 patient (2%) had a complete response, 11 (22%) partial response, 12 (24%) stable disease, 22 (44%) progressive disease; 4 (8%) were non-evaluable. Median overall survival was 12.6 months (95% CI, 7.0-18.3); 2-year survival was 19.6%.
Radioembolisation produced meaningful response and disease stabilisation in patients with advanced, unresectable and chemorefractory mCRC.
We present an energy-balance model of the electronic intersubband relaxation in optically excited n-type Ge/SiGe quantum wells with absorption resonance in the THz range. To this aim, the energy ...relaxation rates of the electron system due to interactions with both nonpolar optical and acoustic phonons are calculated. The time dependence of the relative differential transmission is also evaluated and compared with experimental data from recent pump-probe measurements. The energy relaxation rates due to acoustic and optical phonon are investigated for different electron temperatures, set by the pump beam intensity. We find that the relaxation dynamics strongly depends on the intersubband energy spacing when this is close to the optical phonon energy. Finally, our results evidence that in this material system the time dependence of the depolarization shift may have a strong influence on the relative differential transmission signal.
Angiogenesis requires complex multistep signalling pathways and a high degree of spatial and temporal coordination among endothelial cells and pericytes. The two cell types exhibit numerous contacts ...in vivo and in vitro, including the occurrence of peg-socket junctions.
Ultrastructural findings in 9 cases of advanced gastric carcinomas were reviewed with special emphasis on endothelium/pericyte peg-socket junctions.
The incidence of peg-socket junctions was approximately 8% in 5 out of 9 cases. The remaining 4 cases showed a very low rate, including two cases in whom interactions were totally absent. Peg-socket junctions consisted of cytoplasmic projection from the pericyte protruding into the endothelial indentation. The endothelial cells interacting with pericytes showed ultrastructural signs of partial stabilization such as continuous endothelial lining, regularly constructed interendothelial junctions, more or less integrated pericytes, and multilayered basement membrane.
Our ultrastructural study confirms previous reports regarding pericyte/endothelial peg-socket interdigitations in murine and human granulation tissues and extends these findings to the microvasculature of human gastric carcinomas.
"Difficult vascular anatomy" is a challenge for Interventional Radiologists especially in liver directed therapies such as trans arterial radio embolization. Trans arterial radio embolization is a ...long and difficult procedure in which the basic knowledge of hepatic and gastro-enteric vascularization, with its high degree of variations, is very important in order to correctly administer the therapeutic drug selectively. In this report, we present a case of an atypical patient affected by an unresectable hepatocellular carcinoma, candidate for Radio-embolization treatment. His vascular anatomy was very difficult to manage, but the Interventional Radiologist was not only able to go over the "difficult anatomy," but also to take advantage of it.
This article discusses multimodal practices in the context of teaching and learning and how this idea might inform and facilitate mathematical learning, especially for Latinx students. We discuss ...qualitative data drawn from a study of an elementary bilingual classroom (age 10 and age 11) in a Midwestern city (USA) that is exceptional because the students successfully do high-level mathematics. We describe one class episode and one student’s use of multiple resources to create meaning. Through this we highlight the nature and relevance of multimodal practices for learning mathematics. This case highlights the necessity of creating environments, where students, especially those who have been historically excluded, use resources to make meaning and gain greater access to mathematics.
We calculate band-to-band radiative transition rate spectra in pure Ge as functions of applied tensile strain, heavy doping, charge injection density, and temperature. Direct and indirect ...phonon-assisted transitions are considered. Deformation potential theory is adopted to describe the conduction and valence near-gap edges. Biaxial strain has required appropriate treatment of system anisotropy through the evaluation of the mass tensor components for the different bands involved in the studied transitions. Population distribution in the Gamma and Lconduction valleys and in the valence states near Gamma have been evaluated accordingly considering the degeneracy condition of the sample, induced by high doping and high injection charge density. Also the effect of strain on the dipole matrix elements have been properly taken into account. The energy-resolved near-infrared spontaneous recombination spectra and the TE and TM polarized absorption/gain spectra have been obtained for a broad range of n-type doping, strain values, and excitation densities. We conclude that, despite the free carrier losses, net gain values as high as 6000 cm super(-4), are achievable for doping density and strain values reported in the literature.
Even though followed by a prolonged survival in highly selected patients, the promising results of Sugarbaker's trimodality treatment for malignant pleural mesothelioma (MPM) are debated and not yet ...uniformly replicated. The purpose of this study is to evaluate prospectively the reproducibility of the trimodality treatment results in a patient population with mesothelioma staged by the IMIG classification.
Fifty-four patients with MPM have been judged candidable to extended pleuropneumonectomy (EPP), to be followed by chemotherapy (paclitaxel+carboplatin) and radiotherapy (50 Gy).
At thoracotomy, 44 of the 54 surgical candidates (81%) underwent EPP; 73% of the operated patients completed the entire adjuvant chemo-radiotherapy with no major toxicity. The 30-day or in-hospital operative mortality rate was 4.5% (2 deaths), the major morbidity 36%, and the overall complication rate 50%. At 5 years the projected survival of the 42 surgical survivors submitted to EPP is 19%; median survival is 20 months. The restricted group of patients with epithelial, N0-1, completely resected MPM (microscopic negative margins) exhibits a projected 50% 5-year survival. Clinical understaging has shown up to be noticeable both at the thoracotomy exploration and pathology examination. Most of the disease recurrences are loco-regional and the current insufficiency of intraoperative or postsurgical radicality needs improvement, along with earlier diagnosis, more accurate staging, and preoperative induction for the multimodality treatment of pleural mesothelioma to become an established curative option.
This series confirms the reproducibility of the trimodality treatment for MPM,which is associated with prolonged survival for early-stage tumors at the cost of a not prohibitive treatment-related mortality rate.
Primary venous leiomyosarcoma is very rare and first description was made by Perl in 1871. Most cases are from venous system and half of them are reported to originate in inferior vena cava. We ...report the case of a 77-year-old Caucasian man with a leiomyosarcoma of the femoral vein. A leg preservation surgery was decided. Eight months later, the patient died of tumor progression. A PubMed search using the terms “leiomyosarcoma femoral vein” and “leiomyosarcoma vein” was performed. All cases of composite iliac-femoral leiomyosarcoma were excluded, and as far as possible, only well-documented cases were included. Median age was 55 years, seven men and six women, tumor resection was performed by six authors, six others performed a vascular resection, and one preferred for a thigh excision. Prognosis remains poor if metastasis is present, and in these cases, a conservative surgery is recommended to preserve patients’ quality of life.
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