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Surgical resection for esophageal carcinoma: Speaking the language

World journal of Gastroenterology 2005年第15期11卷 2211-2212页

作者： robert j. korst Division of Thoracic Surgery

The terminology used to describe esophagectomy for carcinoma can be confusing, even for specialists in gastrointestinal disease. As a result, specific terms are often used out of their intended context. To simplify the nomenclature, two points regarding procedures for surgical resection of the esophagus are critical: the extent of resection (radical vs standard) and the operative approach (choice of incisions). It is important to understand that the radicality of the resection may have little to do with the operative approach, with the exception of esophagectomy without thoracotomy (transhiatal esophagectomy), which mandates the performance of a standard or non-radical resection. Esophagectomy has emerged as the standard curative treatment option for patients with esophageal carcinoma; however, unlike the surgical resection of other types of solid tumors, many different surgical options and/or approaches exist for these patients. This heterogeneity of care may result from the fact that the esophagus is accessible through more than one body cavity (left hemithorax, right hemithorax, abdomen).In addition, and partially as a result of its accessibility,different types of surgical specialists harbor this operation in their armamentarium, including general surgeons,thoracic surgeons, and surgical oncologists. Despite this enthusiasm amongst surgeons, little consensus exists as to which option is most oncologically sound. Further, the details of the various surgical approaches and procedures for resection of the esophagus are often difficult to comprehend, even for specialists in gastrointestinal disease, with much of the relevant terminology used out of its intended context. To facilitate the understanding of the surgical options for esophageal carcinoma, it is useful to view the operation from two angles: the extent of resection (Aradical@ vs Astandard@) and the operative approach (choice of incisions).

关键词： Esophageal carcinoma Terminology

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Mechanisms underlying feed intolerance in the critically ill: Implications for treatment

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World journal of Gastroenterology 2007年第29期13卷 3909-3917页

作者： Adam Deane Marianne j Chapman robert j Fraser Laura k Bryant Carly Burgstad Nam Q Nguyen Intensive Care Unit Royal Adelaide Hospital Adelaide South Australia Discipline of Medicine University of Adelaide and Investigation and Procedures Unit Repatriation General Hospital Adelaide South Australia Investigation and Procedures Unit Repatriation General Hospital Adelaide South Australia Department of Gastroenterology and Hepatology Royal Adelaide Hospital Adelaide South Australia

Malnutrition is associated with poor outcomes in critically ill patients. Although nutritional support is yet to be proven to improve mortality in non-malnourished critically ill patients, early enteral feeding is considered best practice. However, enteral feeding is often limited by delayed gastric emptying. The best method to clinically identify delayed gastric emptying and feed intolerance is unclear. Gastric residual volume （GRV） measured at the bedside is widely used as a surrogate marker for gastric emptying, but the value of GRV measurement has recently been disputed. While the mechanisms underlying delayed gastric emptying require further investigation, recent research has given a better appreciation of the pathophysiology. A number of pharmacological strategies are available to improve the success of feeding. Recent data suggest a combination of intravenous metoclopramide and en/thromycin to be the most successful treatment, but novel drug therapies should be explored. Simpler methods to access the duodenum and more distal small bowel for feed delivery are also under investigation. This review summarises current understanding of the factors responsible for, and mechanisms underlying feed intolerance in critical illness, together with the evidence for current practices. Areas requiring further research are also highlighted.

关键词： Critical illness Enteral nutrition Gastric emptying Gastric motility Gastrointestinal hormones Metoclopramide Erythromycin Prokinetic therapy

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Depression, anxiety, and cardiac morbidity outcomes after coronary artery bypass surgery： a contemporary and practical review

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journal of Geriatric Cardiology 2012年第2期9卷 197-208页

作者： Phillip j Tully robert A Baker Department of Surgery Flinders Medical Centre and Flinders University of South Australia 3 Flinders Drive Bedford Park SA 5042 Australia School of Psychology University of Adelaide Hughes Building North Terrace Adelaide SA 5005 Australia Discipline of Psychiatry The University of Adelaide Eleanor Harold Building Frome Road Adelaide SA 5005 Australia Heart Failure Self Management Program Ambulatory and Primary Healthcare Directorate Hampstead Rehabilitation Centre 207 Hampstead Road Northfield SA 5085 Australia

Research to date indicates that the number of coronary artery bypass graft （CABG） surgery patients affected by depression （i.e., major, minor, dysthymia） approximates between 30% and 40% of all cases. A longstanding empirical interest on psychosocial factors in CABG surgery patients highlights an association with increased risk of morbidity in the short and longer term. Recent evidence suggests that both depression and anxiety increase the risk for mortality and morbidity after CABG surgery independent of medical factors, although the behavioral and biological mechanisms are poorly understood. Though neither depression nor anxiety seem to markedly affect neuropsy- chological dysfunction, depression confers a risk for incident delirium. Following a comprehensive overview of recent literature, practical advice is described for clinicians taking into consideration possible screening aids to improve recognition of anxiety and depression among CABG surgery patients. An overview of contemporary interventions and randomized, controlled trials are described, along with suggestions for future CABG surgery research.

关键词： Depression Depressive disorder Coronary artery bypass Coronary artery disease Antidepressive agents Anxiety

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Diffusion-weighted magnetic resonance imaging to predict response of hepatocellular carcinoma to chemoembolization

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World journal of Gastroenterology 2010年第25期16卷 3161-3167页

作者： johnathan C Chung Neel k Naik robert j Lewandowski Mary F Mulcahy Laura M kulik kent T Sato robert k Ryu Riad Salem Andrew C Larson Reed A Omary Department of Radiology North-western University Chicago IL 60611 United States Clinical Sciences Research Division Gastrointestinal Oncology Program Robert H. Lurie Comprehensive Cancer Center Chicago IL 60611 United StatesMary F Mulcahy Department of Medicine Division of Hema-tology and Oncology Northwestern Memorial Hospital Chi-cago IL 60611 United States Department of Hepatology Northwestern Uni-versity Chicago IL 60611 United States Reed A Omary Department of Biomedi-cal Engineering Northwestern University Chicago IL 60611 United States

AIM: To investigate whether intra-procedural diffusion- weighted magnetic resonance imaging can predict response of hepatocellular carcinoma (HCC) during trans- catheter arterial chemoembolization (TACE). METHODS: Sixteen patients (15 male), aged 59 ±11 years (range: 42-81 years) underwent a total of 21 separate treatments for unresectable HCC in a hybrid magnetic resonance/interventional radiology suite. Ana- tomical imaging and diffusion-weighted imaging (b = 0, 500 s/mm2) were performed on a 1.5-T unit. Tumor enhancement and apparent diffusion coefficient (ADC, mm2/s) values were assessed immediately before and at 1 and 3 mo after TACE. We calculated the percent change (PC) in ADC values at all time points. We compared follow-up ADC values to baseline values using a paired t test (α = 0.05). RESULTS: The intra-procedural sensitivity, specificity, and positive and negative predictive values (%) for detecting a complete or partial 1-mo tumor response using ADC PC thresholds of ±5%, ±10%, and ±15% were 77, 67, 91, and 40; 54, 67, 88, and 25; and 46, 100, 100, and 30, respectively. There was no clear predictive value for the 3-mo follow-up. Compared to baseline, the immediate post-procedure and 1-mo mean ADC values both increased; the latter obtaining statistical significance (1.48 ± 0.29 mm2/s vs 1.65 ± 0.35 × 10-3 mm2/s, P 15% predicted 1-mo anatomical HCC response with the greatest accuracy, and can provide valuable feedback at the time of TACE.

关键词： Hepatocellular carcinoma Transcatheter arterial chemoembolization Diffusion-weighted imaging Apparent diffusion coefficient Functional imaging biomarker

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Early Cretaceous subduction initiation beneath southern Tibet caused the northward flight of India

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Geoscience Frontiers 2020年第4期11卷 1123-1131页

作者： Haoyu Hu robert j.Stern Geosciences Department University of Texas at DallasRichardsonTX75083-0688USA

Collision between the Indian and Eurasian plates formed the ~2500 km long Yarlung Zangbo Suture Zone and produced the Himalaya mountains and Tibetan *** we offer a new explanation for tectonic events leading to this collision:that the northward flight of India was caused by an Early Cretaceous episode of subduction initiation on the southern margin of *** data for ophiolites along the Yarlung Zangbo Suture Zone show restricted ages between 120 Ma and 130 Ma,and their supra-subduction zone affinities are best explained by seafloor spreading in what became the forearc of a north-dipping subduction zone on the southern margin of *** subsequent evolution of this new subduction zone is revealed by integrating data for arcrelated igneous rocks of the Lhasa terrane and Xigaze forearc basin *** slab pull from this new subduction zone triggered the rifting of India from East Gondwana in Early Cretaceous time and pulled it northward to collide with Tibet in Early Paleogene time.

关键词： Cretaceous northward subduction

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Wild rice research: Advancing plant science and food security

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Molecular Plant 2022年第4期15卷 563-565页

作者： robert j.Henry Queensland Alliance for Agriculture and Food Innovation University of QueenslandBrisbaneQLD 4072Australia ARC Centre of Excellence for Plant Success in Nature and Agriculture University of QueenslandBrisbaneQLD 4072Australia

Rice was domesticated in Asia(Oryza sativa)and Africa(Oryza glaberrima)from Oryza rufipogon and Oryza bathii,*** Oryza genus has a pantropical *** genetic diversity in Oryza provides an extensive gene pool to adapt rice to climate change and address future food *** primary gene pool of domesticated rice includes species that are readily accessible for rice breeding due to ease of crossing,while more distant species are also sources of useful genes that can be recovered with greater difficulty(Figure 1).Advances in genomics and gene editing provide a path for use of this wider *** of Oryza species also offer potential insights into rice biology that may be critical for ongoing rice food security.

关键词： sativa Oryza breeding

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Hepatitis C risk assessment,testing and referral for treatment in urban primary care:Role of race and ethnicity

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World journal of Gastroenterology 2007年第7期13卷 1074-1078页

作者： Stacey B Trooskin Victor j Navarro robert j Winn David j Axelrod A Scott McNeal Maricruz Velez Steven k Herrine Simona Rossi Division of Gastroenterology and Hepatology Thomas Jefferson University Philadelphia PA 19107 United States Department of Family Medicine Thomas Jefferson University Philadelphia PA 19107 United States Division of Internal Medicine Thomas Jefferson University Philadelphia PA 19107 United States Delaware Valley Community Health Inc. Philadelphia PA 19107 United States

AIM: To determine rates of hepatitis C (HCV) risk factor ascertainment, testing, and referral in urban primary care practices, with particular attention to the effect of race and ethnicity. METHODS: Retrospective chart review from four primary care sites in Philadelphia; two academic primary care practices and two community clinics was performed. Demographics, HCV risk factors, and other risk exposure information were collected. RESULTS: Four thousand four hundred and seven charts were reviewed. Providers documented histories of injection drug use (IDU) and transfusion for less than 20% and 5% of patients, respectively. Only 55% of patients who admitted IDU were tested for HCV. Overall, minorities were more likely to have information regarding a risk factor documented than their white counterparts (79% vs 68%, P kely to have a risk factor history documented, compared to blacks and whites (P kely to be tested for HCV than whites in the presence of a known risk factor (23% vs 35%, P = 0.004). Among patients without documentation of risk factors, blacks and Hispanics were more likely to be tested than whites (20% and 24%, vs 13%, P k factor history in urban primary care is uncommon, (2)Racial differences exist with respect to HCV risk factor ascertainment and testing, (3) Minority patients, positive for HCV, are less likely to be referred for subspecialty care and treatment. Overall, minorities are less likely to be tested for HCV than whites in the presence of a known risk factor.

关键词： Hepatitis C Minority groups Urban health Primary health care Risk assessment

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Towards standardizing retinal optical coherence tomography angiography:a review

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Light(Science & Applications) 2022年第4期11卷 520-541页

作者： Danuta M.Sampson Adam M.Dubis Fred k.Chen robert j.Zawadzki David D.Sampson Surrey Biophotonics Centre for VisionSpeech and Signal Processing and School of Biosciences and MedicineThe University of SurreyGuildford GU27XHUK NIHR Biomedical Research Centre at Moorflelds Eye Hospital NHS Trust and UCL Institute of Ophthalmology London EC1V 2PDUK. Centre for Ophthalmology and Visual Science(incorporating Lions Eye Institute) The University of Western AustraliaNedlandsWestern Australia 6009Australia. Department of Ophthalmology Royal Perth HospitalPerthWestern Australia 6000Australia. Ophthalmology Department of SurgeryUniversity of MelbourneMelbourneVictoria 3002Australia. Department of Ophthalmology&Vision Science University of California DavisSacramentoCA 95817USA. Surrey Biophotonics Advanced Technology InstituteSchool of Physics and School of Biosciences and MedicineUniversity of SurreyGuildfordSurrey GU27XHUK

The visualization and assessment of retinal microvasculature are important in the study,diagnosis,monitoring,and guidance of treatment of ocular and systemic *** the introduction of optical coherence tomography angiography(OCTA),it has become possible to visualize the retinal microvasculature volumetrically and without a contrast *** lab-based and commercial clinical instruments,imaging protocols and data analysis methods and metrics,have been applied,often inconsistently,resulting in a confusing picture that represents a major barrier to progress in applying OCTA to reduce the burden of *** data and software sharing,and cross-comparison and pooling of data from different studies are *** inabilities have impeded building the large databases of annotated OCTA images of healthy and diseased retinas that are necessary to study and define characteristics of specific *** paper addresses the steps needed to standardize OCTA imaging of the human retina to address these *** review of the OCTA literature,we identify issues and inconsistencies and propose minimum standards for imaging protocols,data analysis methods,metrics,reporting of findings,and clinical practice and,where this is not possible,we identify areas that require further *** hope that this paper will encourage the unification of imaging protocols in OCTA,promote transparency in the process of data collection,analysis,and reporting,and facilitate increasing the impact of OCTA on retinal healthcare delivery and life science investigations.

关键词： transparency steps inconsistent

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Spatio-temporal variation in childhood growth in Nigeria:a comparison of aggregation and interpolation

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International journal of Digital Earth 2017年第11期10卷 1166-1176页

作者： Elise Hellwig robert j.Hijmans Environmental Science and Policy University of CaliforniaDavisDavisCAUSA

The mean height-for-age Z-score(HAZ)of children under five is an important indicator of the health status of a *** values are frequently aggregated and reported at the national level,potentially obscuring important within-country *** evaluated aggregation and interpolation methods to provide sub-national estimates over space and time,using survey data from Nigeria in 1990,2003,2008,and *** aggregated HAZ values by region and by state,and interpolated the values spatially and spatio-temporally using thin plate *** results were evaluated with cross-validation using the root mean squared error(RMSE)as a measure of goodness of *** HAZ values increased from 1990 to 2013,but values rose more sharply in southern Nigeria than in the *** methods performed better than assuming a constant national *** state-level aggregation,and the spatial and spatio-temporal interpolations had similar RMSE values,but the interpolation methods showed more detailed spatial ***-temporal interpolation produced good results in all conditions,including in years with sparse sampling and when extrapolating to years for which there were no observations.

关键词： Height-for-age health surveys DHS prediction stunting

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Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use

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Asian journal of Andrology 2016年第3期18卷 373-380,I0007页

作者： j Abram McBride robert M Coward Department of Urology University of North Carolina School of Medicine Chapel Hill NC 27599-7235 USA.

The use of testosterone replacement therapy （TRT） for hypogonadism continues to rise, particularly in younger men who may wish to remain fertile. Concurrently, awareness of a more pervasive use of anabolic-androgenic steroids （AAS） within the general population has been appreciated. Both TRT and AAS can suppress the hypothalamic-pituitary-gonadal （HPG） axis resulting in diminution of spermatogenesis. Therefore, it is important that clinicians recognize previous TRT or AAS use in patients presenting for infertility treatment. Cessation of TRT or AAS use may result in spontaneous recovery of normal spermatogenesis in a reasonable number of patients if allowed sufficient time for recovery. However, some patients may not recover normal spermatogenesis or tolerate waiting for spontaneous recovery. In such cases, clinicians must be aware of the pathophysiologic derangements of the HPG axis related to TRT or AAS use and the pharmacologic agents available to reverse them. The available agents include injectable gonadotropins, selective estrogen receptor modulators, and aromatase inhibitors, but their off-label use is poorly described in the literature, potentially creating a knowledge gap for the clinician. Reviewing their use clinically for the treatment of hypogonadotropic hypogonadism and other HPG axis abnormalities can familiarize the clinician with the manner in which they can be used to recover spermatogenesis after TRT or AAS use.

关键词： anabolic steroids hypogonadism infertility spermatogenesis testosterone testosterone replacement therapy vasectomy reversal

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