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Management of distal cholangiocarcinoma with arterial involvement: Systematic review and case series on the role of neoadjuvant therapy

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2689-2701页

作者： lewis A Hall Duncan Loader Santiago Gouveia Marta Burak James Halle-Smith Peter Labib Moath Alarabiyat Ravi Marudanayagam Bobby V Dasari Keith J roberts Syed S Raza Michail Papamichail David C Bartlett robert P Sutcliffe Nikolaos A Chatzizacharias Department of Hepatopancreatobiliary Surgery and Liver Transplantation University Hospitals Birmingham NHS Foundation TrustBirmingham B152GWUnited Kingdom Institute of Immunology and Immunotherapy University of BirminghamBirmingham B152TTUnited Kingdom College of Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Clinical Sciences University of BirminghamBirmingham B152TTUnited Kingdom

BACKGROUND The use of neoadjuvant therapy(NAT)in distal cholangiocarcinoma(dCCA)with regional arterial or extensive venous involvement,is not widely accepted and evidence is *** To synthesise evidence on NAT for dCCA and present the experience of a highvolume tertiary-centre managing dCCA with arterial *** A systematic review was performed according to PRISMA guidance to identify all studies reporting outcomes of patients with dCCA who received *** patients from 2017 to 2022 who were referred for NAT for dCCA at our centre were retrospectively collected from a prospectively maintained *** characteristics,NAT type,progression to surgery and oncological outcomes were *** Twelve studies were *** definition of“unresectable”locally advanced dCCA was *** studies reported outcomes for 9 patients who received NAT for dCCA with extensive vascular involvement.R0 resection rate ranged between 0 and 100%but without survival benefit in most *** studies considered either NAT in resectable dCCA or inclusive with extrahepatic *** presented case series includes 9 patients(median age 67,IQR 56-74 years,male:female 5:4)referred for NAT for borderline resectable or locally advanced *** patients progressed to surgery and 2 were *** patient died at 14 months with evidence of recurrence at 6 months and the other died at 51 months following recurrence 6 months *** Evidence for benefit of NAT is *** on criteria for uniform definition of resectability for dCCA is *** propose using the established National-Comprehensive-Cancer-Network®criteria for pancreatic ductal adenocarcinoma.

关键词： Cholangiocarcinoma Neoadjuvant therapy Arterial involvement Locally advanced Systematic review

Different characteristics of chronic dibutyltin dichloride-induced pancreatitis and cholangitis in mouse and rat

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Hepatobiliary & Pancreatic Diseases International 2020年第2期19卷 169-174页

作者： Friederike Lütt Luise Ehlers Horst Nizze robert Jaster Department of Medicine II Division of GastroenterologyRostock University Medical CenterE.-Heydemann-Str.618057 RostockGermany Institute of Pathology Rostock University Medical CenterStrempelstraβ1418057 RostockGermany

Background:Current animal models of chronic pancreatitis(CP)often provide only limited pathophysio-logical insights since they incompletely reflect the human *** induced by injection of dibutyltin dichloride(DBTC-pancreatitis)shares with human CP the important feature of extended fibrosis and would be an even more attractive model if it could be transferred from rats to mice,as recently sug-gested in the context of combined ethanol and DBTC *** study aimed to evaluate the effects of DBTC in pancreas and liver of C57BL/6 mice,a strain commonly used to engineer genetic mouse ***:C57BL/6 mice and lewis rats were exposed to variable doses of *** an investigation period of up to 4 weeks,laboratory findings and histopathological changes of pancreas and liver were ***:Chronic DBTC-pancreatitis in rats was characterized by acinar cell damage,ductal changes,fi-brosis,and inflammatory cell *** treated with DBTC at 6–8 mg/kg body weight,the standard doses in rats,showed transient increases of lipase activities but no morphological signs of chronic DBTC-pancreatitis 4 weeks after injection of the *** doses of 10–12 mg/kg DBTC were intolerable due to their high *** contrast,mice and rats presented with a similar histopathology of the liver that can be characterized as a chronic-proliferative DBTC-cholangitis with predominating damage and proliferation of the small bile ducts as well as secondary portal inflammatory cell infiltrates and a begin-ning portal ***:The DBTC-model cannot be transferred from rats to C57BL/6 mice with respect to chronic DBTC-pancreatitis,but might be of interest to study DBTC-cholangitis in both species.

关键词： Animal models Cholangitis Pancreatitis

Racial Disparities in Survival Outcomes of Prostate Cancer Patients after Surgery for Bone Metastases

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Journal of Cancer Therapy 2013年第4期4卷 27-36页

作者： robert L. Satcher Oluwatosin Bamidele Patrick Lin Sue-Hwa Lin Bryan Moon Mike Hernandez Valerae lewis Janice Chilton Department of Health Disparities Research The University of Texas MD Anderson Cancer Center Houston USA Department of Orthopedic Oncology The University of Texas MD Anderson Cancer Center Houston USA Department of Translational Molecular Pathology The University of Texas MD Anderson Cancer Center Houston USA School of Public Health University of Texas Health Science Center Houston USA

Introduction: This study reviewed patients’ demographic, clinical and treatment characteristics to identify prognostic factors associated with survival of prostate cancer after developing bone metastases. We explored the racial disparities in these factors and how they relate with survival. Methods: We conducted a retrospective study on 79 men diagnosed with bone metastasis secondary to prostate cancer who underwent surgery at a single institution?from November 1977 to June 2011. Descriptive statistics were used to summarize patients’ characteristics. The Kaplan-Meier method was used to estimate characteristics of the survival distribution using two origination points—diagnosis and surgery. Cox hazard regression explored the relationship between prognostic factors and overall survival. Results: The majority of men were White (n = 63;80%) followed by Black (n = 7;9%), Hispanic (n = 7;9%), and Asian (n = 2;2%). Multivariate factors associated with poorer survival after bone metastasis surgery included race (Black), Gleason score > 8, and radiation treatment. Patients not receiving radiation had a longer survival experience relative to patients who received radiation before or after surgery (10.3 vs 6.5 months;P = 0.030). There was an association of PSA level at the time of bone metastasis diagnosis with survival following diagnosis but prior to surgery. The median time interval (Tm in months) between prostate cancer diagnosis and bone metastasis diagnosis was 39.1 (White), 31.2 (Hispanic), 15 (Blacks) and 43 (Asians). Patients with Tm m > 35 months (HR = 3.22;P Conclusion: The median survival and time interval from prostate cancer diagnosis to bone metastasis diagnosis was shorter in Blacks with respect to other races. The more aggressive nature of the disease in Blacks is likely due to the biology of the disease rather than access to treatment.

关键词： Metastasis Bone Prostate Cancer Racial Gleason Score

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冰晶核化动力学在地形云中的应用

气象科技 1990年第1期18卷 76-85页

作者： Rochelle.R.Blumenstein robert M.Rauber lewis O.Grant William G Finnen 张令钊科罗拉多州立大学大气科学系

1.引言控制对流云和地形云增雨的主要因子包括目标云和播撒(或催化)物质的特有性能.对于冷云播撤,成核剂的关键的可变因素包括核化机制、核化时间速率和产量(或成核率).在被催化的云中,有效的核化时间可能十分短促.

关键词：核化地形云气溶胶粒子特有性气溶胶颗粒可变因素上升气流云室上风方云中

High tolerance to mutations in a Chlamydia trachomatis peptide deformylase loop

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World Journal of Biological Chemistry 2011年第5期2卷 90-97页

作者： Christopher B Oey Christal lewis John E Kerrigan Department of Physiology and Biophysics Robert Wood Johnson Medical SchoolUniversity of Medicine and Dentistry of New JerseyPiscatawayNJ 08854United States Cancer Institute of New Jersey Robert Wood Johnson Medical SchoolUniversity of Medicine and Dentistry of New JerseyPiscatawayNew BrunswickNJ 08903 United States

AIM:To determine if and how a loop region in the peptide deformylase(PDF)of Chlamydia trachomatis regulates enzyme function. METHODS:Molecular dynamics simulation was used to study a structural model of the chlamydial PDF(cPDF) and predict the temperature factor per residue for the protein backbone ***-directed mutagenesis was performed to construct cPDF *** properties of the resulting variants were determined by an enzyme assay using formyl-Met-Ala-Ser as a substrate. RESULTS:In silico analysis predicted a significant increase in atomic motion in the DGELV sequence(residues 68-72)of a loop region in a cPDF mutant,which isresistant to PDF inhibitors due to two amino acid substitutions near the active site,as compared to wild-type *** D68R and D68R/E70R cPDF variants demonstrated significantly increased catalytic *** E70R mutant showed only slightly decreased efficiency. Although deletion of residues 68-72 resulted in a nearly threefold loss in substrate binding,this deficiency was compensated for by increased catalytic efficiency. CONCLUSION:Movement of the DGELV loop region is involved in a rate-limiting conformational change of the enzyme during ***,there is no stringent sequence requirement for this region for cPDF enzyme activity.

关键词： Antibacterial Chlamydia Peptide deformylase Sexually transmitted infection

Validation of a Novel Method for Cardiac Output Estimation by CT Coronary Angiography

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Advances in Computed Tomography 2012年第2期1卷 11-16页

作者： Hetal H. Mehta Brian G. Choi Reza Sanai Raman S. Dusaj Amr Mohsen Chunlei Liang Jannet F. lewis robert K. Zeman Department of Mechanical and Aerospace Engineering The George Washington University Washington DC USA Department of Medicine The George Washington University Washington DC USA Department of Radiology The George Washington University Washington DC USA

Background: Cardiac output can be estimated during retrospectively gated CT coronary angiography by anatomically determining left ventricular volumes;prospective triggering to minimize radiation precludes this methodology. We propose an alternative method for cardiac output estimation based on preclinical models suggesting that cardiac output may be inversely related to contrast washout from the aortic root during timing bolus scanning, as measured by peak aortic root contrast attenuation. Methods: 34 patients had CT coronary angiography timing bolus performed with 20 ml iodixanol at 5.5 ml/s followed by 20 ml normal saline at 5.5 ml/s through an 18-Ga antecubital catheter. Peak aortic root contrast attenuation was correlated to cardiac output calculated by echocardiography using heart rate stroke volume from biplane Simpson’s ***: Mean age was 58 ± 13 years;body surface area, 2.0 ± 0.5 m2. 53% were women. Stroke volume, cardiac output and cardiac index were 67 ± 19 ml, 4.5 ± 1.6 L/min, and 2.2 ± 0.7 L/min/m2, respectively. Peak aortic root contrast attenuation was 207 ± 46 HU and correlated to cardiac output and cardiac index with r = –0.64, p Conclusion: This novel method for cardiac output estimation by CTCA appears feasible. The CT physiologic parameters using the timing test-bolus data moderately correlated with echocardiographic assessment of cardiac output. The calculation of cardiac output adds important hemodynamic data to anatomic information provided by CTCA, and further development of this method may preserve assessment of left ventricular performance in prospective triggering.

关键词： Cardiac Output Coronary CT Angiography Hemodynamics Prospective Triggering Validation

Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon

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Open Journal of Obstetrics and Gynecology 2024年第6期14卷 967-978页

作者： Jeffrey-lewis Nzang Cliford Ebontane Ebong Simon Manga Florence Manjuh Félix Essiben Isidore Tompeen Judith Seungue Serge robert Nyada Jeanne Hortence Fouedjio Ymele Fouelifack Julius Sama Dohbit Kloukanmey Zonal Hospital Mdecins Sans Frontires Kloukanmey Benin Faculty of Medicine and Biomedical Sciences University of Yaound 1 Yaound Cameroon Gynecology and Obstetrics Unit Central Hospital of Yaound Yaound Cameroon Womens Health Program Cameroon Baptist Convention Health Services Yaound Cameroon Department of Obstetrics and Gynaecology Gyneco-Obstetric and Pediatric Hospital of Yaound Yaound Cameroon Expanded Program of Immunization Ministry of Health Yaound Cameroon Department of Obstetrics and Gynaecology Gynaecological Endoscopic Surgery and Human Reproductive Teaching Hospital Yaounde Cameroon Department of Obstetrics and Gynaecology University of Dschang Dschang Cameroon Higher Institute of Medical Technology Nkolondom Yaound Cameroon

Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a

关键词： High-Risk Human Papillomavirus Precancerous Digital Cervicography VIA/VILI Serotype

Incidence of anastomotic stricture after Ivor-lewis oesophagectomy using a circular stapling device

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World Journal of Gastrointestinal Surgery 2019年第11期11卷 407-413页

作者： robert Tyler Amit Nair Meagan Lau James Hodson Rizwan Mahmood Jan Dmitrewski Department of Upper Gastrointestinal Surgery University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUnited Kingdom Institute of Translational Medicine University Hospitals Birmingham NHS Foundation TrustBirmingham B152THUnited Kingdom Department of Gastroenterology Russells Hall HospitalDudley DY12HQUnited Kingdom

BACKGROUND Benign oesophageal strictures carry a significant level of morbidity,causing burdensome symptoms impacting on quality of ***-oesophagectomy anastomotic stricture rates as high as 41%have been reported in the *** can require endoscopic dilatation,often multiple times to relieve *** aim of the present study was to determine a single surgeons stricture rate in a series of 2-stage Ivor-lewis procedures,and to identify any independent risk factors in their *** To determine a single surgeons stricture rate in a series of 2-stage Ivor-lewis procedures,and to identify any independent risk factors in their *** We performed a retrospective analysis of a prospectively collected database of Ivor-lewis oesophagectomy performed from 2004-2018 to determine the stricture *** database comprised a single-surgeon series of open,two-stage oesophagectomies with a circular stapled intra-thoracic *** location,histology,neoadjuvant chemotherapy,stapler size,T-stage and R-status were analysed to see if they could predict stricture *** was defined as dysphagia requiring endoscopic *** with anastomotic leaks were excluded on the basis they would develop an anastomotic *** One hundred and seventy patients were collected in the *** were excluded on the basis of anastomotic leak,perioperative death and early *** hundred and fifty-four patients(119 males,35 females)with a mean age of 64±10 years were eligible for analysis.A total of 15 patients developed strictures a median of 99 d(interquartile range:84-133)after surgery,giving a Kaplan-Meier estimated stricture rate of 10%at one *** of the factors considered were found to be significantly associated with *** In this study the stricture rate was 10%,with the majority occurring in the first 100 d after *** significant independent factors were found in the deve

关键词： Oesophageal cancer Anastomosis Stricture Stapled Circular

Nuclear Odontogenic Ameloblast-Associated Protein (ODAM) Correlates with Melanoma Sentinel Lymph Node Metastasis

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Journal of Cancer Therapy 2013年第8期4卷 1283-1289页

作者： Sagar S. Gandhi Daniel P. Kestler Charles T. Bruker James M. McLaughlin robert E. Heidel Sabina Siddiqui James S. Foster Keith D. Gray John Bell Alan Solomon James lewis Department of Pathology Boca Raton Regional Hospital Boca Raton Department of Surgery University of Michigan School of Medicine Ann Arbor USA Department of Surgery University of Tennessee Medical Center-Knoxville Knoxville USA Graduate School of Medicine University of Tennessee Medical Center-Knoxville Knoxville USA

We have examined primary tumor sections from melanoma patients by immunohistochmistry (IHC) for the presence of the odontogenic ameloblast-associated protein (ODAM). Within these patient tissues we have observed a correlation of nuclear ODAM staining in the primary tumors with sentinel lymph node (SLN) metastasis. Surgically, SLN invasion in melanoma is considered an important indicator of more aggressive, invasive melanoma and to date there are limited biomarkers which strongly correlate with metastatic disease. The observation that ODAM staining in melanoma associates with SLN invasion may have important prognostic implications which could assist in the management of melanoma. Notably, ODAM expression may correlate with pathway-signaling we have previously reported to be affected by ectopic ODAM expression in cultured melanoma and breast cancer cell lines.

关键词： Melanoma Sentinel Lymph Node Metastases ODAM Immunohistochemistry