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New therapeutic approaches to metastatic gastroenteropancreatic neuroendocrine tumors:A glimpse into the future

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World Journal of Gastrointestinal Oncology 2017年第1期9卷 4-20页

作者： esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouthDorset BH5 2AZUnited Kingdom

Neuroendocrine(NE) gastroenteropancreatic tumors are a heterogeneous group of neoplasias arising from neuroendocrine cells of the embryological gut. Their incidence have increased significantly over the past 3 decades probably due to the improvements in imaging and diagnosis. The recent advances in molecular biology have translated into an expansion of therapeutic approaches to these patients. Somatostatin analogs, which initially were approved for control of hormonal syndromes, have recently been proven to inhibit tumor growth. Several new drugs such as antiangiogenics and others targeting mammalian target of rapamycin pathways have been approved to treat progressive pancreatic neuroendocrine tumors(NETs) although their role in nonpancreatic is still controversial. The treatment of NETs requires a coordinated multidisciplinary approach. The management of localized NETs primarily involves surgical resection followed by surveillance. However, the treatment of unresectable and/or metastatic disease may involve a combination of surgical resection, systemic therapy, and liver-directed therapies with the goal of alleviating symptoms of peptide release and controlling tumor growth. This article will review the current therapeutic strategies for metastatic gastroenteropancreatic NETs and will take a glimpse into the future approaches.

关键词： Gastroenteropancreatic neuroendocrine tumors Peptide receptor radionuclide therapy Somatostatin analogs Octreotide Transarterial chemoembolization Carcinoid syndrome Setotonin Chromogranin

Vasoactive intestinal peptide secreting tumour:An overview

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World Journal of Gastrointestinal Oncology 2022年第4期14卷 808-819页

作者： esther Una Cidon Department of Medical Oncology University Hospitals DorsetBournemouth BH77DWDorsetUnited Kingdom

Vasoactive intestinal peptide(VIP)secreting tumour(VIPoma)is a rare functional neuroendocrine tumour that typically arises from pancreatic islet *** present as sporadic,solitary pancreatic neoplasias with an estimated incidence of one in ten million individuals per *** around 5%of VIPomas are associated with multiple endocrine neoplasia type I *** VIP secretion produces a clinical syndrome characterized by refractory watery diarrhoea,hypokalemia and metabolic *** coupled with elevated plasma levels of VIP are *** majority of VIPomas are malignant and have already metastasized at the time of diagnosis(60%).Metastases occur most frequently in the liver,or regional lymph nodes,lungs,kidneys and *** reports of skin metastases have been *** surgical resection continues to be the only potentially curative ***,when the neoplasia cannot be excised completely,surgical debulking may provide palliative *** palliative options have included recently the peptide receptor radionuclide therapy which has shown to be effective and *** article will review all aspects of pancreatic VIPomas highlighting aspects such as clinical presentation,diagnosis and management.

关键词： VIPoma Octreotide Secretory diarrhoea Multiple endocrine neoplasia Vasoactive intestinal peptide Vermer-Morrison syndrome

Apoptosis in skeletal muscle and its relevance to atrophy

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World Journal of Gastroenterology 2006年第46期12卷 7463-7466页

作者： esther E Dupont-Versteegden University of Arkansas for Medical Sciences Departments of Geriatrics and Physiology and Biophysics 4301 West Markham #807 Little Rock AR 72205 and University of Kentucky Department of Rehabilitation Sciences Division of Physical Therapy 900 S Limestone Lexington KY 40536-0200 United States

Apoptosis is necessary for maintaining the integrity of proliferative tissues, such as epithelial cells of the gastrointestinal system. The role of apoptosis in post mitotic tissues, such as skeletal muscle, is less well defined. Apoptosis during muscle atrophy occurs in both myonuclei and other muscle cell types. Apoptosis of myonuclei likely contributes to the loss of muscle mass, but the mechanisms underlying this process are largely unknown. Caspase-dependent as well as -independent pathways have been implicated and the mode by which atrophy is induced likely determines the apoptotic mechanisms that are utilized. It remains to be determined whether a decrease in apoptosis will alleviate atrophy and distinct research strategies may be required for different causes of skeletal muscle loss.

关键词： Skeletal muscle Apoptosis Disuse atrophy Aging

Small mammal diversity of Mt. Kenya based oncarnivore fecal and surface bone remains

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Zoological Research 2019年第1期40卷 61-69页

作者： Ogeto Mwebi esther Nguta Veronica Onduso Ben Nyakundi Xue-Long Jiang esther N.Kioko Osteology Section Department of Zoology National Museums of Kenya Kunming Institute of Zoology Chinese Academy of Sciences Sino-African Joint Research Center Chinese Academy of Sciences

Ecological dynamics and faunal diversity documentation is normally conducted by direct observation and trapping of live animals. However,surveys of carnivore scat prey and surface bone remains, which are relatively inexpensive, can provide complementary data that expand carnivore diet breadth and may improve accuracy regarding inferences of the ecological dynamics of a given ecosystem. We used this inexpensive method to document species diversity variation with elevation on the leeward(Sirimon) and windward(Chogoria)areas of Mt. Kenya. Bone and fecal specimens were opportunistically collected by walking 2 km in opposite directions from transect points selected at 200-m intervals along the elevational gradient of the study areas. We collected a total of 220 carnivore fecal and owl pellet specimens from both study sites, which were mainly deposited by the spotted hyena(Crocuta crocuta), leopard(Panthera pardus),serval(Leptailurus serval), genet(Genetta sp.), and Mackinder's Cape owl(Bubo capensis mackinderi).Serval scats were the most common, followed by those of the spotted hyena. Scats and bones were found at the lowest density at the lowest elevations,peaked at mid-higher elevations, and then declined at the highest elevations. Based on skeletal analysis only, there were more species in Sirimon(19) than in Chogoria(12). Small fauna(rodents to duiker size bovids) formed the bulk of the identified remains,representing 87.9% of the Sirimon fauna and 90.9% of the Chogoria fauna. The genus Otomys was the dominant prey of the owl and serval in both sites. Three giraffe teeth were found at 3 500 m a.s.l. in Chogoria on the edge of Lake El is, suggesting that it is an occasional visitor to such high elevations. This study underscores the value of fecal and bone surveys in understanding the diet and diversity of mammals in ecological ecosystems,but such surveys should be complemented with analysis of hairs found in scats to obtain a more complete list of carnivore prey at M

关键词： Ecological dynamics Faunal diversity Scats Pellets Mt.Kenya

New approaches in angiogenic targeting for colorectal cancer

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World Journal of Gastroenterology 2007年第44期13卷 5857-5866页

作者： Aleix Prat esther Casado Javier Cortés Department of Medical Oncology Vall d'Hebron University Hospital Barcelona Spain Department of Medical Oncology Vall d'Hebron University Hospital Barcelona Spain Department of Medical Oncology Hospital General de Manresa Barcelona Spain

Colorectal carcinoma （CRC） is one of the leading causes of cancer death worldwide. In the last decade, the addition of irinotecan and oxaliplatin to standard fluorouracil-based chemotherapy regimens have set the new benchmark of survival for patients with metastatic CRC at approximately 20 too. Despite these advances in the management of CRC, there is a strong medical need for more effective and well-tolerated therapies. The dependence of tumor growth and metastasis on blood vessels makes angiogenesis a rational target for therapy. One of the major pathways involved in this process is the vascular endothelial growth factor （VEGF） and its receptors （VEGFR）. In 2004, the first agent targeting angiogenesis, bevacizumab （BV）, was approved as an adjunct to first-line cytotoxic treatment of metastatic CRC. The role of BV as part of adjuvant treatment and in combination with other targeted therapies is the subject of ongoing trials. However, BV is associated with an increase in the risk of arterial thromboembolic events, hypertension and gastrointestinal perforations and its use must be cautious. Novel VEGFR TK inhibitors with different ranges of nanomolar potencies, selectivities, and pharmacokinetic properties are entering phase 111 trials for the treatment of cancer. Conversely, one of these novel agents, vatalanib, has been shown not to confer survival benefit in first and second-line treatment of advanced CRC. The basis of these findings is being extensively evaluated. Ongoing and new well-designed trials will define the optimal clinical application of the actual antiangiogenic agents, and, on the other hand, intensive efforts in basic research will identify new agents with different antiangiogenic approaches for the treatment of CRC. In this review we discuss and highlight current and future approaches in angiogenic targeting for CRC.

关键词： Angiogenesis inhibitors Vascular endothelial growth factor VEGF receptors Bevacizumab Vatalanib Colorectal carcinoma

Unexplained liver laceration after metastasis radiofrequency ablation

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World Journal of Gastroenterology 2009年第40期15卷 5103-5105页

作者： esther Ua Javier Trueba Jose Manuel Montes Medical Oncology Service Clinical University Hospital of Valladolid Radiology Service Clinical University Hospital of Valladolid

Many studies have established the role of radiofrequency (RF) ablation as a minimally invasive treatment for liver metastases. Although relatively safe, several complications have been reported with the increased use of RF ablation. We describe here a case of unexplained liver laceration after a RF procedure. A woman who presented a solitary metachronous liver metastasis underwent RF ablation treatment for this lesion. Six hours later the patient displayed fatigue and pallor. Emergency blood tests showed a haemoglobin level of < 7 g/dL and markedly elevated transaminase levels. A computed tomography examination revealed two areas of liver laceration with haematoma, one of them following the path of the needle and the other leading away from the f irst. Following a blood transfusion, the patient was haemodynamically stable and completely recovered 24 h later. The patient remained in bed for 1 wk. No surgical intervention was required, and she was discharged 1 wk later.

关键词： Colon cancer Liver haemorrhage Liver laceration Liver metastases Radiofrequency ablation

Systemic treatment of hepatocellular carcinoma:Past,present and future

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World Journal of Hepatology 2017年第18期9卷 797-807页

作者： esther Una Cidon Department of Medical Oncology Royal Bournemouth HospitalBournemouth BH7 7DWUnited Kingdom

Hepatocellular carcinoma(HCC) is a common neoplasia which represents the second leading cause of cancer related death. Most cases occur in developing countries, but its incidence is rising in Western countries due to hepatitis C. Although hepatitis therapies have evolved and the HCC screening has increased in several areas, 40% present with advanced disease which is only amenable for palliative systemic treatment. HCC continues posing a challenge, in part due to the inherent chemoresistance of this neoplasia, the pharmacologic challenges due to an ill liver, difficulty in assessing radiological responses accurately, etc. Traditional chemotherapy have shown some responses without clear survival benefit, however, sorafenib demonstrated advantages in survival in advanced HCC when liver function is kept and recently immunotherapy seems to be a promising approach for some patients. This article will briefly expose the most relevant systemic treatment modalities to offer a general view from the past to the future.

关键词： Hepatocellular carcinoma Alphafetoprotein Sorafenib Nivolumab MEK

Phase Transformation under Continuous Cooling Conditions in Medium Carbon Microalloyed Steels

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Journal of Materials Science & Technology 2014年第5期30卷 511-516页

作者： Manuel Gomez Lucia Rancel esther Escudero Sebastian F.Medina National Centre for Metallurgical Research CENIM-CSICAv.Gregorio del Amo 828040 MadridSpain

Several 35CrMo4 and 38MnV7 steels with different additions of Ti and V were manufactured by electroslag remelting. The influence of the alloying and microalloying elements on phase transformation at different cooling rates was studied and the continuous cooling transformation diagrams were plotted. In order to optimize the heat treatment and improve the mechanical properties, the range of cooling rates leading to a fully bainitic microstructure （without ferrite, pearlite and especially without martensite） was determined. Bainite and martensite transformation start temperatures （Bs, Ms） were also established and compared with the values predicted by empirical equations. The important role of precipitates （especially V carbonitride particles） on final microstructure and mechanical properties was assessed.

关键词： Microalloyed steel Phase transformation Precipitation Dilatometry Continuous cooling transformation diagram

Challenges and prospects in bridging precision medicine and artificial intelligence in genomic psychiatric treatment

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World Journal of Psychiatry 2024年第8期14卷 1148-1164页

作者： Uchenna esther Okpete Haewon Byeon Department of Digital Anti-aging Healthcare(BK21) Inje UniversityGimhae 50834South Korea

Precision medicine is transforming psychiatric treatment by tailoring personalized healthcare interventions based on clinical,genetic,environmental,and lifestyle factors to optimize medication *** study investigates how artificial intelligence(AI)and machine learning(ML)can address key challenges in integrating pharmacogenomics(PGx)into psychiatric *** this integration,AI analyzes vast genomic datasets to identify genetic markers linked to psychiatric ***-driven models integrating genomic,clinical,and demographic data demonstrated high accuracy in predicting treatment outcomes for major depressive disorder and bipolar *** study also examines the pressing challenges and provides strategic directions for integrating AI and ML in genomic psychiatry,highlighting the importance of ethical considerations and the need for personalized *** implementation of AI-driven clinical decision support systems within electronic health records is crucial for translating PGx into routine psychiatric *** research should focus on developing enhanced AI-driven predictive models,privacy-preserving data exchange,and robust informatics systems to optimize patient outcomes and advance precision medicine in psychiatry.

关键词： Precision medicine Psychiatric treatment Genomic data Machine learning Deep learning Clinical decision making Data privacy Review