Leiomyosarcoma of the esophagus: results of surgical treatment

BACKGROUND: This study examined the results of surgical treatment of leiomyosarcoma of the esophagus. METHODS: Between January 1920 and December 1996, 17 patients (9 men and 8 women) with leiomyosarcoma of the esophagus were treated surgically at the Mayo Clinic. Median age was 58 years and ranged from 26 to 76 years. Symptoms included dysphagia in 11 patients (64.7%) and odynophagia in 6 (35.3%). The tumor was located in the middle third of the esophagus in 10 patients (58.8%) and in the cervical esophagus in 7 (41.2%). Procedures performed included esophagogastrectomy in 9 patients (Ivor Lewis in 5, left thoracoabdominal in 3, and transhiatal in 1), enucleation in 3, transgastric excision in 1, and exploration without resection in 4. RESULTS: The procedure was considered curative in 11 patients (64.7%). There was one operative death (mortality, 5.9%). Complications occurred in 3 patients (17.6%) and included anastomotic leak in 2 and bleeding requiring reoperation in 1. Growth pattern was infiltrating in 7, polypoid in 5, and intramural in 5. Histologically, the tumor was grade 1 in 6 patients, grade 2 in 2, grade 3 in 7, and grade 4 in 2. The tumor was postsurgically classified as stage I in 2 patients, stage IIA in 7, stage IIB in 1, stage IIIA in 5, stage IV in 1, and unknown in 1. Six patients (35.3%) received adjuvant treatment. Follow-up was complete in 16 patients (94.1%) and ranged from 1 to 182 months (median, 48 months). Five- and 10-year actuarial survivals were 47.0% and 31.0%, respectively. Seven patients (41.2%) are currently alive (median survival, 72 months); all underwent curative resection. Factors affecting survival included completeness of resection, growth pattern, postsurgical stage, tumor grade, and tumor location (p < 0.05). CONCLUSIONS: We conclude that leiomyosarcoma of the esophagus is rare. Complete resection provides long-term survival.     

Discontinuation of maintenance therapy in patients with quiescent cytomegalovirus retinitis and elevated CD4+ counts

OBJECTIVE: To determine whether maintenance therapy can be discontinued safety in patients with quiescent cytomegalovirus retinitis (CMVR) and increased CD4+ counts after treatment with highly active antiretroviral therapy (HAART). DESIGN: A prospective observational case series. PARTICIPANTS: Eight human immunodeficiency virus (HIV)-positive patients with quiescent CMVR who were taking HAART and had CD4+ counts above 100 cells/microliter elected to discontinue anti-CMV maintenance treatment. INTERVENTION: Biweekly-to-monthly indirect ophthalmoscopy and fundus photographs, monthly-to-quarterly CD4+ counts, and quarterly HIV viral loads were ordered. MAIN OUTCOME MEASURES: Twelve previously affected eyes were examined for evidence of recurrent retinitis, which was defined as any retinal whitening, border opacification, or expansion of areas of retinal pigment epithelial (RPE) atrophy greater than 750 microns. Four previously unaffected fellow eyes were observed for new CMVR. RESULTS: There was no reactivation or progression of retinitis in any patient during the mean follow-up interval of 11.4 months (range, 3-16 months). No previously unaffected eye developed CMVR. CD4+ remained elevated in all patients (range, 70-725; mean, 255). The HIV viral load ranged from undetectable to 139,000 copies. CONCLUSION: Discontinuation of maintenance therapy may be considered in patients with HAART-induced elevated CD4+ counts above 100 cells/microliter, prolonged relapse-free intervals during the reconstitution period before CD4+ counts rise above 100 cells/microliter, and completely quiescent retinitis characterized by RPE scarring only. Reduced risks of drug toxicity and drug-resistant organisms are potential benefits. Close observation for evidence of recurrent retinitis is indicated.     

Pre-Senescence Induction in Hepatoma Cells Favors Hepatitis C Virus Replication and Can Be Used in Exploring Antiviral Potential of Histone Deacetylase Inhibitors

Recent evidence suggests that fibrotic liver injury in patients with chronic hepatitis C correlates with cellular senescence in damaged liver tissue. However, it is still unclear how senescence can affect replication of the hepatitis C virus (HCV). In this work, we report that an inhibitor of cyclin-dependent kinases 4/6, palbociclib, not only induced in hepatoma cells a pre-senescent cellular phenotype, including G1 arrest in the cell cycle, but also accelerated viral replicon multiplication. Importantly, suppression of HCV replication by direct acting antivirals (DAAs) was barely affected by pre-senescence induction, and vice versa, the antiviral activities of host-targeting agents (HTAs), such as inhibitors of human histone deacetylases (HDACi), produced a wide range of reactions—from a dramatic reduction to a noticeable increase. It is very likely that under conditions of the G1 arrest in the cell cycle, HDACi exhibit their actual antiviral potency, since their inherent anticancer activity that complicates the interpretation of test results is minimized.     

Production of Steel 26KHMFBA Continuously-Cast Billets for Casing Pipes Using Barium-Containing Master Alloy

Metallurgist - Results are provided for a study showing the effect of Ca- and Ba-containing master alloys on composition and contamination with non-metallic inclusions during extra-furnace...     

Self-Propagating High-Temperature Synthesis of Cerium Chromite Substituted with Alkaline-Earth Metals

Cerium chromites, non-substituted and substituted with alkali-earth metals, are synthesized in the self-propagating high-temperature synthesis mode using solid interaction oxidizes. The characteristic temperatures and specifics of interaction between the components are determined for all systems considered. The structural and physicochemical parameters, including the spectroscopic characteristics of the synthesis products depending on the alkaline-earth metal substituent and the degree of substitution, are investigated.     

Toward a free-space parallel optoelectronic computer: a 300-MHz optoelectronic counter using holographic interconnects

We built and tested one of the key components of a free-space holographically interconnected stored-program optoelectronic computer: a counter. The counter is constructed with 1-ns-latency optoelectronic NOR gates and is interconnected with holographic optical elements. Two synchronization methods were also demonstrated: the gate-and-strobe method and the time-of-flight method. These counters represent prototypical optoelectronic finite-state controllers. They were developed to demonstrate the feasibility of providing optoelectronic controllers for optoelectronic processors.     

Terahertz radiation generation in multilayer quantum-cascade heterostructures

I–V and radiative characteristics of multilayer quantum-cascade GaAs/AlGaAs heterostructures with a double metal waveguide are investigated. The I–V characteristics typical of the quantum-cascade lasers are seen. The observed threshold-intensity growth and narrow radiation spectrum are characteristic of laser generation. The measured radiation frequency was found to be about 3 THz, which coincides with the calculated value. Thus, fully domestic terahertz quantum-cascade lasers are demonstrated for the first time.     

Graphene As a Sensitizing Additive to High-Energy Cobalt Salt for Enhanced Initiation by a High-Current Electron Beam

We have studied the influence of graphene additives on the initiation of high-energy cobalt salt by a high-current electron beam of nanosecond duration. The high-energy composite was prepared by ultrasonic mixing of 80 wt% cobalt amminate (NCP) and 20 wt % graphene. It is established that the use of graphene as a sensitizing additive in a high-energy composite decreases the necessary energy parameters of the initiating electron beam and increases the energy characteristics and combustion rate of high-energy materials.     

Fuzzy-trace theory and false memory: new frontiers

We describe the origins of fuzzy-trace theory, including Piagetian, interference, information-processing, and judgment and decision-making influences. The contrasting properties of gist and verbatim memory serve as its foundation and, in recent models of spontaneous and implanted false memories, explain seemingly contradictory developmental trends, such as reverse developmental findings, differential time courses for true and false memories, and conflicting effects of trace strength. However, approaches that integrate fuzzy-trace theory with neurological, social, emotional, and motivational perspectives are needed. A method for accomplishing this integration, using the recent models, is introduced and new research that spans these perspectives is discussed. Relations to other contemporary theories, especially source-monitoring and dual-process theories, are also explained. We conclude by rejecting the notion that spontaneous false memories are actually "true" and distinguish gist and verbatim senses of the term "true" that have different consequences in real life.