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Modern treatment of gastric gastrointestinal stromal tumors

World Journal of Gastroenterology 2012年第46期18卷 6720-6728页

作者： Kevin K Roggin mitchell c posner Department of Surgery Pritzker School of Medicine University of Chicago

Gastrointestinal stromal tumors (GIST) are rare mesenchymal smooth muscle sarcomas that can arise anywhere within the gastrointestinal tract. Sporadic mutations within the tyrosine kinase receptors of the interstitial cells of cajal have been identified as the key molecular step in GIST carcinogenesis. Although many patients are asymptomatic, the most common associated symptoms include: abdominal pain, dyspepsia, gastric outlet obstruction, and anorexia. Rarely, GIST can perforate causing life-threatening hemoperitoneum. Most are ultimately diagnosed on cross-sectional imaging studies (i.e., computed tomography and/or magnetic resonance imaging in combination with upper endoscopy. Endoscopic ultrasonographic localization of these tumors within the smooth muscle layer and acquisition of neoplastic spindle cells harboring mutations in the c-KIT gene is pathognomonic. curative treatment requires a complete gross resection of the tumor. Both open and minimally invasive operations have been shown to reduce recurrence rates and improve long-term survival. While there is considerable debate over whether GIST can be benign neoplasms, we believe that all GIST have malignant potential, but vary in their propensity to recur after resection and metastasize to distant organ sites. Prognostic factors include location, size (i.e., > 5 cm), grade (> 5-10 mitoses per 50 high power fields and specific mutational events that are still being defined. Adjuvant therapy with tyrosine kinase inhibitors, such as imatinib mesylate, has been shown to reduce the risk of recurrence after one year of therapy. Treatment of locally-advanced or borderline resectable gastric GIST with neoadjuvant imatinib has been shown to induce regression in a minority of patients and stabilization in the majority of cases. This treatment strategy potentially reduces the need for more extensive surgical resections and increases the number of patients eligible for curative therapy. The modern surgical treatment of

关键词： Gastrointestinal stromal tumors Laparoscopic resections of gastrointestinal stromal tumors Imatinib mesylate Gastrectomy

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Transhiatal versus transthoracic esophagectomy for esophageal cancer

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World Journal of Gastroenterology 2010年第30期16卷 3804-3810页

作者： J camilo Barreto mitchell c posner Section of General Surgery and Surgical Oncology Department of SurgeryUniversity of Chicago Pritzker School of Medicine5841 S. Maryland AveMC 5094ChicagoIL 60637United States

Esophageal cancer continues to represent a formidable challenge for both patients and clinicians. Relative 5-year survival rates for patients have improved over the past three decades, probably linked to a combination of improved surgical outcomes, progress in systemic chemotherapy and radiotherapy, and the increasing acceptance of multimodality treatment. Surgical treatment remains a fundamental component of the treatment of localized esophageal adenocarcinoma. Multiple approaches have been described for esophagectomy, which can be thematically grouped under two major categories: either transthoracic or transhiatal. The main controversy rests on whether a more extended resection through thoracotomy provides superior oncological outcomes as opposed to resection with relatively limited morbidity and mortality through a transhiatal approach. After numerous trials have addressed these issues, neither approach has consistently proven to be superior to the other one, and both can provide excellent short-term results in the hands of experienced surgeons. Moreover, the available literature suggests that experience of the surgeonand hospital in the surgical management of esophageal cancer is an important factor for operative morbidity and mortality rates, which could supersede the type of approach selected. Oncological outcomes appear to be similar after both procedures.

关键词： Esophageal cancer Transhiatal esophageal resection Transthoracic esophageal resection

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Landscape Genetics of Plants: challenges and Opportunities

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Plant communications 2020年第6期1卷 43-57页

作者： mitchell B.cruzan Elizabeth c.Hendrickson Department of Biology Portland State UniversityPO Box 751PortlandOR 97207USA

Dispersal is one of the most important but least understood processes in plant ecology and evolutionary *** of seeds maintains and establishes populations,and pollen and seed dispersal are responsible for gene flow within and among *** views of dispersal and gene flow assume models that are governed solely by geographic distance and do not account for variation in dispersal vector behavior in response to heterogenous *** genetics integrates population genetics with Geographic Information Systems(GIS)to evaluate the effects of landscape features on gene flow patterns(effective dispersal).Surprisingly,relatively few landscape genetic studies have been conducted on *** present advantages because their populations are stationary,allowing more reliable estimates of the effects of landscape features on effective dispersal *** the other hand,plant dispersal is intrinsically complex because it depends on the habitat preferences of the plant and its pollen and seed dispersal *** discuss strategies to assess the separate contributions of pollen and seed movement to effective dispersal and to delineate the effects of plant habitat quality from those of landscape features that affect vector *** analyses of seed dispersal for three species indicate that isolation by landscape resistance is a better predictor of the rates and patterns of dispersal than geographic *** of effective dispersal are lower in areas of high plant habitat quality,which may be due to the effects of the shape of the dispersal kernel or to movement behaviors of biotic *** genetic studies in plants have the potential to provide novel insights into the process of gene flow among populations and to improve our understanding of the behavior of biotic and abiotic dispersal vectors in response to heterogeneous landscapes.

关键词： effective dispersal cpDNA ResistanceGA circuitscape geographic information systems(GIS) ecological niche modeling(ENM)

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Herbal extracts as hepatoprotectants against acetaminophen hepatotoxicity

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World Journal of Gastroenterology 2010年第19期16卷 2448-2450页

作者： Hartmut Jaeschke c David Williams mitchell R McGill Anwar Farhood Department of Pharmacology Toxicology and Therapeutics University of Kansas Medical Center Kansas City KS 66160 United States Department of Pathology Brackenridge Hospital Austin TX 78701 United States

Many plant-derived natural products have the potential to be hepatoprotective and therefore can be used to treat acute and chronic liver diseases. The challenge is to identify the most promising compounds and evaluate their protective mechanism. In a recently published article, Wang et al evaluated extracts of the plant Gentiana manshurica Kitagawa (GM) in a model of acetaminophen hepatotoxicity. The authors concluded that GM is hepatoprotective against acetaminopheninduced liver injury due to its antioxidant properties and anti-apoptotic capacity. We would like to discuss the limitations of this experimental approach and question the conclusion based on the data presented in this manuscript and the published literature.

关键词： Acetaminophen Drug hepatotoxicity Herbal extracts N-acetylcysteine

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Survival outcomes in early-onset oesophageal adenocarcinoma patients:A systematic review and meta-analyses

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World Journal of Gastroenterology 2024年第38期30卷 4221-4231页

作者： Ashleigh Russell Shauna mitchell Richard c Turkington Helen G coleman centre for Public Health Queen's University BelfastBelfast BT126BAUnited Kingdom Patrick G Johnston centre for cancer Research Queen's University BelfastBelfast BT71NNUnited Kingdom

BAcKGROUND The incidence of oesophageal adenocarcinoma(OAc)has been reported to be increasing in many *** this trend,an increase in incidence of early-onset OAc,defined as OAc in adults aged under 50 years,has been *** is unclear whether survival outcomes for early-onset OAc patients differ from older age *** To investigate survival outcomes in early-onset OAc *** Ovid Medline and Embase were searched from inception to January 2022 for relevant studies relating to early-onset OAc and survival *** regarding the overall five-year survival and risk of death of younger and older patients with OAc were extracted and pooled using meta-analyses to produce pooled estimates and 95%cIs where *** Eleven studies which compared survival of early-onset OAc,defined as age at diagnosis ofcluded.A narrative review of median and mean survival demonstrated conflicting results,with studies showing early-onset OAc patients having both better and worse outcomes compared to older age groups.A meta-analysis of five-year survival demonstrated similar outcomes across age groups,with 22%-25%of patients in the young,middle and older age groups alive after five years.A meta-analysis of four studies demon-strated that early-onset OAc patients did not have a significantly increased risk of death compared to middle-aged patients(hazard ratio 1.12,95%cI:0.85-1.47).INTRODUcTION There is concern that the incidence of oesophageal adenocarcinoma(OAc)in patients under 50,described as early-onset OAc,is ***,data regarding survival of younger patients with OAc is ***,while increasing age remains a major non-modifiable risk factor for cancer,the incidence of early-onset cancers,largely accepted to be in adults aged under 50 years,is increasing[1].This includes an observed increase in the incidence of gastrointestinal malignancies such as colorectal,oesophageal,gastric and he

关键词： Early-onset cancer Early-onset oesophageal adenocarcinoma Survival cancer epidemiology Systematic review Meta-analysis

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The thermal and storage stability of bovine haemoglobin by ultraviolet-visible and circular dichroism spectroscopies

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Journal of Pharmaceutical Analysis 2016年第4期6卷 242-248页

作者： Ruchir Bhomia Vivek Trivedi Nichola J.coleman John c.mitchell School of Science University of GreenwichCentral Avenue

The effects of temperature,pH and long-term storage on the secondary structure and conformation changes of bovine haemoglobin（bHb） were studied using circular dichroism（cD） and ultraviolet-visible（UV-vis） *** network software was used to deconvolute the cD data to obtain the fractional content of the five secondary *** storage stability of bHb solutions in pH 6,7 and8 buffers was significantly higher at 4 ℃ than at 23 ℃ for the first 3 days.A complete denaturation of bHb was observed after 40 days irrespective of storage temperature or *** bHb solutions were also exposed to heating and cooling cycles between 25 and 65 ℃ and structural changes were followed by UVvis and cD *** experiments demonstrated that α-helix content of bHb decreased steadily with the increasing temperature above 35 ℃ at all pH *** loss in a-helicity and gain in random coil conformations was pH-dependent and the greatest under alkaline ***,there was minimal recovery of the secondary structure content upon cooling to 25 ℃.The use of bHb as a model drug is very common and this study elucidates the significance of storage and processing conditions on its stability.

关键词： Bovine haemoglobin circular dichroism Thermal stability Storage stability Ultraviolet-visible spectroscopy

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Selective androgen receptor modulators for the treatment of late onset male hypogonadism

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Asian Journal of Andrology 2014年第2期16卷 256-261,I0009页

作者： christopher c coss Amanda Jones Michael L Hancock mitchell S Steiner James T Dalton GTx Inc. Memphis Tennessee USA.

Several testosterone preparations are used in the treatment of hypogonadism in the ageing male. These therapies differ in their convenience, flexibility, regional availability and expense but share their pharmacokinetic basis of approval and dearth of long-term safety data. The brevity and relatively reduced cost of pharmacokinetic based registration trials provides little commercial incentive to develop improved novel therapies for the treatment of late onset male hypogonadism. Selective androgen receptor modulators （SARMs） have been shown to provide anabolic benefit in the absence of androgenic effects on prostate, hair and skin. current clinical development for SARMs is focused on acute muscle wasting conditions with defined clinical endpoints of physical function and lean body mass. Similar regulatory clarity concerning clinical deficits in men with hypogonadism is required before the beneficial pharmacology and desirable pharmacokinetics of SARMs can be employed in the treatment of late onset male hypogonadism.

关键词： hypogonadism late onset hypogonadism selective androgen receptor modulators testosterone

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A call for international research on cOVID-19-induced brain dysfunctions

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National Science Review 2021年第12期8卷 13-14页

作者： Pedro A.Valdes-Sosa Alan c.Evans mitchell J.Valdes-Sosa Mu-ming Poo Global Brain consortium University of Electronic Sciences and Technology of China (UESTC) cuban Neuroscience center (cNEURO) Cuban Academy of Sciences Global Brain consortium Royal Society of CanadaMc Gill Center for Integrative Neuroscience Mc Gill University center for Excellence in Brain Science and Intelligence Technology Institute of NeuroscienceChinese Academy of Sciences

The cOVID-19 pandemic, still raging worldwide, imposes staggering human and economic costs. These will only increase as many convalescent patients suffer consequences for many *** the virus can target multiple organ s...

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Total dysphagia after short course of systemic corticotherapy:Herpes simplex virus esophagitis

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World Journal of Gastroenterology 2013年第31期19卷 5178-5181页

作者： Isa Jetté-cté Denise Ouellette claire Béliveau Andrew mitchell Division of Thoracic Surgery Maisonneuve-Rosemont Hospital University of MontrealMontreal H3L 2H8 Canada Department of Infectious Diseases and Microbiology Maisonneuve-Rosemont Hospital University of MontrealMontreal H3L 2H8 Canada Department of Pathology Maisonneuve-Rosemont Hospital University of Montreal Montreal H3L 2H8 Canada

A 72 year-old female developed a herpetic esophagitis after 3 d of oral corticotherapy for an acute exacerbation of chronic obstructive pulmonary disease,presenting as odynophagia and total *** were taken during a first esophagogastroduodenoscopy(EGD) and the patient was referred to the thoracic surgery service with a presumptive diagnosis of esophageal cancer.A second EGD was planned for dilatation,but by that time the stenosis was completely *** biopsies taken during the first EGD revealed multiple herpetic viral inclusions and ulcerations without any dysplasia or *** front of a severe esophageal stenosis,one must still exclude the usual differential diagnosis peptic stenosis and *** of endoscopic lesions can suggest the diagnosis but must be promptly confirmed by biopsy,viral culture or polymerase chain *** immune systemic effects of corticotherapy are well known and herpetic esophagitis occurs most frequently in immunocompromised individuals,this case emphasizes the importance of clinical awareness concerning short courses of corticotherapy for immunocompetent *** article discusses the reactivation process of herpetic infection in this context and addresses its diagnostic and therapeutic issues.

关键词： Herpes simplex Esophagitis Dysphagia corticosteroids Immunocompetence

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The Impact of Sleep-Wake Behaviour on Tennis Match Performance in Junior State Grade Tennis Players

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Journal of Science in Sport and Exercise 2023年第2期5卷 156-166页

作者： mitchell Turner Philipp Beranek Ian c.Dunican Travis cruickshank School of Medical and Health Sciences Edith Cowan University270 Joondalup DrivePerthWA 6027Australia centre for Sleep Science School of Human SciencesThe University of Western AustraliaPerthWA 6009Australia centre for Precision Health School of Medical and Health SciencesEdith Cowan UniversityPerthAustralia Perron Institute for Neurological and Translational Sciences PerthAustralia

Purpose To date,no study has investigated the extent to which sleep-wake behaviour(SWB)influences match performance in junior tennis *** study aimed to assess the influence of SWB for the week and night before on match performance,particularly match analytics and *** This study recruited 10 junior state grade tennis players who wore an actigraphy device and completed a sleep diary for the week before their match on two separate occasions throughout their competition *** wore a global positioning system device to track their movement during matches,and an experienced tennis coach recorded players'match *** This study showed that the sleep fragmentation index was significantly lower the week before matches in females who had won than those who had ***,the sleep fragmentation index was significantly lower the night before a given match than the week *** sleep fragmentation index and sleep latency significantly influenced match performance in junior tennis *** percentage of second serves points won differed between match wins and losses for male players,while winners and forced errors differed for female *** These findings provide a detailed profile of tennis match play in junior state grade *** individual differences,reduced restlessness the night before a match coincides with increased match performance.

关键词： Sleep fragmentation Tennis analytics Global positioning system Sleep quality Sleep duration

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