Management of malignant insulinoma Ferrer-García, J. C.; Iranzo González-Cruz, V.; Navas-DeSolís, S. ...
Clinical & translational oncology,
09/2013, Letnik:
15, Številka:
9
Journal Article
Recenzirano
Aim
Malignant insulinoma is an infrequent functional endocrine tumor of the pancreas. Adequate therapy is a demanding challenge for oncologists and endocrinologists.
Objective
To evaluate the results ...of multidisciplinary management of malignant insulinoma.
Materials and methods
Retrospective review of patients with malignant insulinoma treated from 1995 to 2011.
Results
Seven patients with malignant insulinoma were included: four males and three females; median age was 61.8 years (range 37–78). Six tumors were sporadic and one was diagnosed in a patient with a type 1 multiple endocrine neoplasia (MEN-1). Surgery was performed in six cases and one patient was considered unresectable. Hypoglycemias persisted in all cases and somatostatin analogs, glucocorticoids and diazoxide were used. Two patients received everolimus. Other techniques were chemoembolization and internal radiation therapy with yttrium-90. Successful liver transplant was done in the patient with MEN-1.
Conclusion
Hypoglycemia management is complex and requires multiple therapies. Further evaluations will be necessary to determine the best treatment.
The aim of this study was to investigate the potential benefits of an extract obtained from seeds/fruits of an Oleaceae (Fraxinus excelsior L.) on glucose homeostasis and associated metabolic markers ...in non-diabetic overweight/obese subjects.
This study was performed in 22 participants (50–80 years-old; BMI 31.0kg/m2). The design was a longitudinal, randomized, crossover, double-blind, placebo-controlled 7-week nutritional intervention. The participants received daily 3 capsules each containing either 333mg of an extract from Fraxinus excelsior L. seeds (Glucevia®) or placebo capsules (control) in a random order for 3 weeks with 1 week of washout between treatments. Moreover, they followed a balanced covert energy-restricted diet (−15% energy). All variables were measured at the beginning and at the end of each period.
Compared to baseline, the administration of 1g of Glucevia® for 3 weeks resulted in significantly lower incremental glucose area under the curve (−28.2%; p<0.01), and significantly lower 2h blood glucose values (−14%; p<0.01) following an oral glucose tolerance test. No significant changes were found in the control group (−7.9% AUC, −1.6% 2h blood glucose). Furthermore, significant differences were found between responses in the control and Glucevia® groups with respect to serum fructosamine and plasma glucagon levels (p<0.01 and p<0.05, respectively). Interestingly, administration of Glucevia® significantly increased the adiponectin:leptin ratio (p<0.05) and decreased fat mass (p<0.01) compared to control (p<0.05).
The administration of an extract from Fraxinus excelsior L. seeds/fruits in combination with a moderate hypocaloric diet may be beneficial in metabolic disturbances linked to impaired glucose tolerance, obesity, insulin resistance and inflammatory status, specifically in older adults.
The next generation of water Cherenkov neutrino telescopes in the Mediterranean Sea are under construction offshore France (KM3NeT/ORCA) and Sicily (KM3NeT/ARCA). The KM3NeT/ORCA detector features an ...energy detection threshold which allows to collect atmospheric neutrinos to study flavour oscillation. This paper reports the KM3NeT/ORCA sensitivity to this phenomenon. The event reconstruction, selection and classification are described. The sensitivity to determine the neutrino mass ordering was evaluated and found to be 4.4
σ
if the true ordering is normal and 2.3
σ
if inverted, after 3 years of data taking. The precision to measure
Δ
m
32
2
and
θ
23
were also estimated and found to be
85
.
10
-
6
eV
2
and
(
-
3.1
+
1.9
)
∘
for normal neutrino mass ordering and,
75
.
10
-
6
eV
2
and
(
-
7.0
+
2.0
)
∘
for inverted ordering. Finally, a unitarity test of the leptonic mixing matrix by measuring the rate of tau neutrinos is described. Three years of data taking were found to be sufficient to exclude
event rate variations larger than 20% at
3
σ
level.
Ultrahigh energy cosmic ray air showers probe particle physics at energies beyond the reach of accelerators. Here we introduce a new method to test hadronic interaction models without relying on the ...absolute energy calibration, and apply it to events with primary energy 6-16 EeV (E_{CM}=110-170 TeV), whose longitudinal development and lateral distribution were simultaneously measured by the Pierre Auger Observatory. The average hadronic shower is 1.33±0.16 (1.61±0.21) times larger than predicted using the leading LHC-tuned models EPOS-LHC (QGSJetII-04), with a corresponding excess of muons.
Two consecutive cases are presented of vertical diplopia after blepharoplasty. They concern two women aged 41 and 63 years with vertical binocular diplopia after bilateral lower blepharoplasty using ...a trans-conjunctival approach. The diplopia was presented in both cases in the immediate postoperative period, being stable in one of the cases and progressive in the other. With the suspicion of restrictive strabismus, it was decided to explore the affected extra-ocular muscles, eliminate adhesions and coat the muscular bellies with amniotic membrane. Post-blepharoplasty diplopia is an uncommon, but very serious complication, given the expectations of these patients. The current literature reports unsatisfactory results in its management. In this study, it is considered that the muscular covering with amniotic membrane can provide better results in the surgical management of these patients, due to its anti-inflammatory and anti-adherence effect.
This letter presents a combined measurement of the energy spectra of atmospheric νe and νμ in the energy range between ∼100 GeV and ∼50 TeV with the ANTARES neutrino telescope. The analysis uses 3012 ...days of detector livetime in the period 2007–2017, and selects 1016 neutrinos interacting in (or close to) the instrumented volume of the detector, yielding shower-like events (mainly from νe+ν‾e charged current plus all neutrino neutral current interactions) and starting track events (mainly from νμ+ν‾μ charged current interactions). The contamination by atmospheric muons in the final sample is suppressed at the level of a few per mill by different steps in the selection analysis, including a Boosted Decision Tree classifier. The distribution of reconstructed events is unfolded in terms of electron and muon neutrino fluxes. The derived energy spectra are compared with previous measurements that, above 100 GeV, are limited to experiments in polar ice and, for νμ, to Super-Kamiokande.
We measure the energy emitted by extensive air showers in the form of radio emission in the frequency range from 30 to 80 MHz. Exploiting the accurate energy scale of the Pierre Auger Observatory, we ...obtain a radiation energy of 15.8±0.7(stat)±6.7(syst) MeV for cosmic rays with an energy of 1 EeV arriving perpendicularly to a geomagnetic field of 0.24 G, scaling quadratically with the cosmic-ray energy. A comparison with predictions from state-of-the-art first-principles calculations shows agreement with our measurement. The radiation energy provides direct access to the calorimetric energy in the electromagnetic cascade of extensive air showers. Comparison with our result thus allows the direct calibration of any cosmic-ray radio detector against the well-established energy scale of the Pierre Auger Observatory.
The Compact Muon Solenoid (CMS) experiment prepares its Phase-2 upgrade for the high-luminosity era of the LHC operation (HL-LHC). Due to the increase of occupancy, trigger latency and rates, the ...full electronics of the CMS Drift Tube (DT) chambers will need to be replaced. In the new design, the time bin for the digitization of the chamber signals will be of around 1 ns, and the totality of the signals will be forwarded asynchronously to the service cavern at full resolution. The new backend system will be in charge of building the trigger primitives of each chamber. These trigger primitives contain the information at chamber level about the muon candidates position, direction, and collision time, and are used as input in the L1 CMS trigger. The added functionalities will improve the robustness of the system against ageing. An algorithm based on analytical solutions for reconstructing the DT trigger primitives, called Analytical Method, has been implemented both as a software C++ emulator and in firmware. Its performance has been estimated using the software emulator with simulated and real data samples, and through hardware implementation tests. Measured efficiencies are 96 to 98% for all qualities and time and spatial resolutions are close to the ultimate performance of the DT chambers. A prototype chain of the HL-LHC electronics using the Analytical Method for trigger primitive generation has been installed during Long Shutdown 2 of the LHC and operated in CMS cosmic data taking campaigns in 2020 and 2021. Results from this validation step, the so-called Slice Test, are presented.
Neutrino detectors participate in the indirect search for the fundamental constituents of dark matter (DM) in form of weakly interacting massive particles (WIMPs). In WIMP scenarios, candidate DM ...particles can pair-annihilate into Standard Model products, yielding considerable fluxes of high-energy neutrinos. A detector like ANTARES, located in the Northern Hemisphere, is able to perform a complementary search looking towards the Galactic Centre, where a high density of dark matter is thought to accumulate. Both this directional information and the spectral features of annihilating DM pairs are entered into an unbinned likelihood method to scan the data set in search for DM-like signals in ANTARES data. Results obtained upon unblinding 3170 days of data reconstructed with updated methods are presented, which provides a larger, and more accurate, data set than a previously published result using 2101 days. A non-observation of dark matter is converted into limits on the velocity-averaged cross section for WIMP pair annihilation.
The KM3NeT research infrastructure is unconstruction in the Mediterranean Sea. KM3NeT will study atmospheric and astrophysical neutrinos with two multi-purpose neutrino detectors, ARCA and ORCA, ...primarily aimed at GeV–PeV neutrinos. Thanks to the multi-photomultiplier tube design of the digital optical modules, KM3NeT is capable of detecting the neutrino burst from a Galactic or near-Galactic core-collapse supernova. This potential is already exploitable with the first detection units deployed in the sea. This paper describes the real-time implementation of the supernova neutrino search, operating on the two KM3NeT detectors since the first months of 2019. A quasi-online astronomy analysis is introduced to study the time profile of the detected neutrinos for especially significant events. The mechanism of generation and distribution of alerts, as well as the integration into the SNEWS and SNEWS 2.0 global alert systems, are described. The approach for the follow-up of external alerts with a search for a neutrino excess in the archival data is defined. Finally, an overview of the current detector capabilities and a report after the first two years of operation are given.
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