The effect of impurities on the structure and energy of a crystal surface: Mg impurities in calcite as a case study

A new calculation methodology to study doped surfaces.

Pedunculated liposarcoma of the esophagus

Polypoid tumours of the esophagus present diagnostic and therapeutic problems. Liposarcomas are infrequent among them. We report a recent case. A 73-year-old male patient was seen in May 1995 in the Ear, Nose and Throat (ENT) Department, Clinica Modelo de Morón, with intermittent dysphagia and dyspnoea due to recurrent vomiting. A laryngeal lineal tomography showed a subglottic obstruction due to extrinsic compression. The patient was referred to the Gastroenterology Department, where an upper gastrointestinal (upper GI) series demonstrated mega-esophagus with abundant retained food. Endoscopy showed a large intraluminal mass covered by normal mucosa which arose on the posterior wall. Videofluoroscopy and chest CT diagnosed a probable polypoid lipoma due to its densitometric characteristics. The tumour was resected by left cervicotomy and left esophagotomy. The patient's progress to date is favourable. Pathology studies showed a well-differentiated liposarcoma. According to the literature, the first case was reported in 1983, and ours is only the seventh case in the world to be documented.

A new computational approach to the study of epitaxy: the calcite/dolomite case

A new way to determine the adhesion and interfacial energies in epitaxial systems is presented.

Posterior capsule opacity in Retinitis Pigmentosa according to different biomaterials of intraocular lenses: Our clinical experience

BACKGROUND AND AIM

Complicated Cataract is frequently associated with Retinitis Pigmentosa (RP). This retinopathy is a great cause of visual impairment, and cataract surgery may resolve partially the situation and restore sight. Unfortunately, in this case there is a very high incidence of Posterior Capsule Opacity (PCO) ranging in several studies a percentage of 100% at six months. Our goal was to evaluate whether the high incidence of PCO is associated to specific type of Intraocular Lens (IOL) biomaterials.

MATERIALS AND METHODS

This observational retrospective study deals with 75 eyes of 43 patients affected with RP who underwent to cataract surgery with posterior chamber IOL implants (40% ECCE and 60% Phaco). Selected biomaterials were: 30 Poly (methyl methacrylate) (PMMA), 11 silicone, 34 acrylic. Observations were performed with retro-illumination camera and when recorded capsular fibrosis a PCO YAG laser capsulotomy was made. The patients were controlled at 3-6-12 months after the initial surgical treatment.

RESULTS

At three months of follow up, 80% of patients with PMMA, 81.8% silicone implants underwent to YAG capsulotomy while only 44% of acrylic type. At six months of follow-up 83.3% of patients with PMMA and 81.8% silicone implants underwent to YAG capsulotomy while only 49.88% of acrylic type. At 12 months of follow up 89.9% of patients with PMMA and 90.95 silicone implants underwent to YAG capsulotomy while only 52.82% of acrylic type.

CONCLUSIONS

We could not be able to differentiate incidence between different brand type of lens in PMMA. For Acrylic lens instead we noted an incidence of PCO of 41.38% with hydrophobic material and 60.0% of hydrophilic material. In conclusion to avoid massive PCO in RP, our experience is statistically significant, in fact the protective action of smooth material hydrophobic lens avoids the epithelial growth and fibrosis towards the center of visual axis.

Endoscopic ultrasound in the preoperative staging of gastric cancer: key messages for surgeons

Gastric cancer (GC) remains a frequent and important cause of cancer mortality worldwide. Many factors affect the prognosis of GC, but invasion and metastasis are the leading causes of death. Due to the various stage-oriented therapies available, after the diagnosis of GC it is important to determine the staging preoperatively in order to choose the appropriate management. GC staging is the workhorse of endoscopic ultrasound (EUS). EUS can distinguish the different wall layers of the gastrointestinal tract as well as assess regional lymph nodes. Furthermore, samples of suspicious lesions or lymph nodes can be obtained by means of EUS-guided fine-needle aspiration (EUS-FNA). In this narrative review, we highlight the current status of the usefulness of EUS for GC staging, with focus on early GC that still remains a diagnostic and therapeutic challenge. In particular, the possibility to ameliorate the accuracy of EUS, in this context, by using instruments with increased ultrasound frequency is emphasized.

The emerging role of endoscopic ultrasound-guided core biopsy for the evaluation of solid pancreatic masses

Pancreatic ductal adenocarcinoma is a lethal cancer with a 5-year survival rate of less than 5%. Surgical resection is the only curative treatment but only 20% are eligible for resection at the time of diagnosis. Early detection of cancer is of paramount importance in the management. Endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) is the preferred modality for obtaining tissue diagnosis of pancreatic masses. However, the diagnostic accuracy of EUS-FNA may be limited by several factors like availability of onsite cytopathology, adequacy of tissue core for histology, location of the mass, presence of underlying chronic pancreatitis, and experience of the endoscopist. Modern oncology is focusing on personalizing treatment based on tissue analysis of genetic aberrations and molecular biomarkers which are now available. Core tissue also aids in the diagnosis of disease entities like lymphoma, metastatic tumors, neuroendocrine tumors and autoimmune pancreatitis whose diagnosis rely on preserved tissue architecture and immunohistochemistry. Making accurate diagnosis of solid pancreatic masses is critical to avoid unnecessary resections in patients with benign lesions like focal lesions of chronic pancreatitis and autoimmune pancreatitis which mimic cancer. To overcome the limitations of FNA and to obtain adequate core tissue, a Tru-Cut biopsy needle was developed which met with variable success due to stiffness, cumbersome operation and technical failure using it in the duodenum/pancreatic head. More recently fine needle biopsy needles, with reverse bevel technology have become available in different sizes (19, 22, 25-gauge). The aim of this article was to review the emerging role of core biopsy needles in acquiring tissue in solid pancreatic masses and discuss its potential role in personalized medicine.

Hegemony and cost-effectiveness of endoscopic ultrasound (EUS) in the field of gastroenteropancreatic-neuroendocrine tumors (GEP-NETs)

Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a group of neoplasms arising from the diffuse neuroendocrine system of the gastrointestinal (GI) tract. They often represent a diagnostic challenge because of their little dimensions, the deep localization into the retroperitoneum or in extramucosal sites, the possibility to be multilocated and the heterogeneous patterns of presentation. Endoscopic ultrasound (EUS) is a cost-effective technique that enables to look very definitely at a suspicious mass and at the surrounding area both within the GI wall and in the pancreas, allowing to precisely assess T and N stage. Under EUS-guidance it is possible to obtain tissue samples in order to reach a definitive diagnosis and to establish the tumor grade. In the therapeutic field, EUS is crucial to assess the safety and the feasibility of resective endoscopic techniques for the GI-wall NETs and it can guide local ablative techniques for pancreatic NETs. After treatment, EUS can be successfully useful to assess complete endoscopic resection and to follow-up resected or ablated patients. It is so evident that EUS has a role in the whole route of NETs management, from diagnosis, evaluation, grading and staging assessment, to therapy and consequent follow-up.

Abstract P3-14-17: Results of a novel neoadjuvant chemotherapy (NAC) for breast cancer

Background: Achieving a pathologic complete response (pCR) after neoadjuvant chemotherapy (NAC) has been associated with improved disease free survival (DFS) and overall survival (OS). The Residual Cancer Burden Score (RCB) method is a useful tool that predicts DFS and OS after NAC. We present the results of pts with either triple negative or HER2 positive breast cancer treated with a novel NAC. Methods: 34 pts with localized breast cancer >1 cm with HER2+ (N = 19) or triple negative breast cancer (TNBC) (N = 15) were treated with this novel regimen consisting first of TEC (docetaxel 75 mg/m2, epirubicin 80 mg/m2, and cyclophosphamide 500 mg/m2) + PEG Filgrastim x 4 cycles. Following the 4th course, TNBC patients received 4 additional TEC cycles if they achieved CR by MRI, or were switched to a non cross-resistant regimen (vinorelbine, bevacizumab, capecitabine) if they had < CR. HER2+ pts received TEC x4 followed by docetaxel + trastuzumab x 4. RCB score was used to measure pathologic response. Pretreament PET scan was done and repeated after course 1 in order to correlate with RCB. Results: Median age was 56 (58 for Her2+ and 49 for TNBC). RCB = 0 (pCR) was achieved in 76%, while only 1 responded poorly (RCB = 3). There was no significant difference in the pCR rate between Her2+ and TNBC patients (74% vs 80% respectively), but there was a difference in the rate of pCR without DCIS and invasive cancer between these two (see table, p = 0.034). Pts with SUV drop > 5% after 1st TEC had 84% pCR while none with < 5% achieved pCR (p = 0.001). Comparison of our results with other NAC regimens reported in the literature is summarized in the table below:

ProtocolpCR (no invasive)pCR(no invasive and no DCIS)RCB 0-1Auxilio Cancer Center HER2+/TNBC74%/80%37%/73%79%/80%I-Spy trial 1 HER2+/TNBC45%/35%N/A61%/40%GeparQuinto HER2+/TNBCN/A45%/38.4%N/ANSABP B-40 TNBC51%N/AN/ANeoAltto HER2+47%N/AN/ANeoSphere HER2+39%N/AN/AMDACC FEC+trastuzumab HER2+60%N/AN/A

Conclusions: This novel chemotherapy approach results in a high pCR rate and RCB 0-1, which have been associated with improved clinical outcomes. Early PET can predict pCR. Although sample size is modest, results are encouraging and deserve further evaluation.

Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P3-14-17.