Synchronous Stage Research Articles

Water Wicking and Droplet Spreading on Randomly Structured Thin Nanoporous Layers.

Growing thin, nanostructured layers on metallic surfaces is an attractive, new approach to create superhydrophilic coatings on heat exchangers that enhance spray cooling heat transfer. This paper presents results of an experimental study of enhanced droplet spreading on zinc oxide, nanostructured surfaces of this type that were thermally grown on copper substrates. The spreading rate data obtained from experimental high speed videos was used to develop a model specifically for this type of ultrathin, nanoporous layer. This investigation differs from previous related studies of droplet spreading on porous surfaces, which have generally considered either ordered, thin, moderately permeable layers, or thicker, microporous layers. Our layers are both very thin and have nanoscale porosity, making them low-permeability layers that exhibit strong wicking. An added benefit is that the thermally grown, stochastic nature of our surfaces make manufacturing easily scalable and particularly attractive for spray-cooled heat exchanger applications. The model presented here can predict the spreading rate for the wetted footprint of a deposited water droplet over two spreading stages: an early synchronous spreading stage, followed by hemispreading. The comparison of experimental data and model predictions confirms the presence of these two specific spreading stages. The model defines the transition conditions between synchronous and hemispreading regimes based on the change in spreading mechanisms, and we demonstrate that the model predictions of spreading rate are in good agreement with the experimental determinations of droplet footprint variation with time. The results indicate that the early synchronous spreading regime is characterized by flow in the porous layer that is primarily localized near the upper droplet contact line. The potential use of these experimental findings and model for optimizing superhydrophilic, nanostructured surface coatings is also discussed, as it pertains to the surface's ability to enhance water vaporization processes.

Benefit of Surgical Resection of the Primary Tumor in Patients Undergoing Chemotherapy for Stage IV Colorectal Cancer with Unresected Metastasis

PurposeResection of the primary tumor in patients with unresected metastatic colorectal cancer is controversial, and often performed only for palliation of symptoms. Our goal was to determine if resection of the primary tumor in this patient population is associated with improved survival. MethodsThis is a retrospective cohort study of the National Cancer Data Base from 2004 to 2012. The study population included all patients with synchronous metastatic colorectal adenocarcinoma who were treated with systemic chemotherapy. The study groups were patients who underwent definitive surgery for the primary tumor and those who did not. Patients were excluded if they had surgical intervention on the sites of metastasis or pathology other than adenocarcinoma. Primary outcome was overall survival. ResultsOf the 65,543 patients with unresected stage IV colorectal adenocarcinoma undergoing chemotherapy, 55% underwent surgical resection of the primary site. Patients who underwent surgical resection of the primary tumor had improved median survival compared to patients treated with chemotherapy alone (22 vs 13 months, p < .0001). The surgical survival benefit was present for patients who were treated with either multi-agent or single-agent chemotherapy (23 vs 14 months, p < 0.001; 19 vs 9 months, p < 0.001). Surgical resection of the primary tumor was also associated with improved survival when using multivariate analysis with propensity score matching (OR = 0.863; 95% CI [0.805–.924]; HR = 0.914; 95% CI [0.888–0.942]). ConclusionsOur results show that in patients with synchronous unresected stage IV colorectal adenocarcinoma undergoing single- or multi-agent chemotherapy, after adjusting for confounding variables, definitive resection of the primary site was associated with improved overall survival. Large randomized controlled trials are needed to determine if there is a causal relationship between surgery and increased overall survival in this patient population.

Prognostic analysis for Chinese patients with stage I ovarian endometrioid carcinoma

BackgroundThis study aimed to identify the clinical and pathological characteristics and the possible prognostic factors for Chinese patients with early-stage ovarian endometrioid carcinoma.MethodsThe present study reviewed the medical records of patients who received initial treatment and a postoperative pathological diagnosis of ovarian endometrioid carcinoma at our center. In all, 78 patients had stage I ovarian endometrioid carcinoma.ResultsIn this series, the 5-year overall survival rate and 5-year disease-free survival (DFS) rates of patients with stage I ovarian endometrioid carcinoma was 98.7% and 87.2%, respectively. Univariate analysis showed the factors that influence the DFS rates include menopausal status, FIGO stage, histological grade, lymphadenectomy, cytology of ascites. Multivariate analysis showed that grade 3 and lymphadenectomy were the independent prognostic factors of DFS for Stage I ovarian endometrioid carcinoma (P = 0.0259, 0.0276 respectively). However, the coexisting endometriosis, concomitant endometrial disorders, dissection of para-aortic lymph node and more courses of thermotherapy had no influence on DFS. Besides, it was found that 19.3% of patients in this series had synchronous early stage and well-to-moderate differentiated endometrial carcinoma.ConclusionsGrade 3 and lymphadenectomy were indicated as the independent factors of DFS for stage I patients with ovarian endometrioid carcinoma. The endometrial changes should be considered seriously when fertility-sparing surgery was planned.

Evaluation of Partial Breast Reirradiation with Intraoperative Radiotherapy after Prior Thoracic Radiation: A Single-Institution Report of Outcomes and Toxicity.

Mastectomy is the current standard of care for ipsilateral breast tumor recurrences after prior whole breast irradiation (WBI). We report our single-institution experience with breast-conserving surgery (BCS) followed by intraoperative radiotherapy (IORT) as an alternative to salvage mastectomy for new or recurrent breast cancers that develop in the setting of prior thoracic radiation. We performed an IRB-approved retrospective review of patients treated with breast IORT between September 2013 and November 2016. We identified 12 patients who declined salvage mastectomy for their breast cancer after prior thoracic radiation. IORT was delivered using the Intrabeam™ device (Carl Zeiss, Germany). A dose of 20 Gy was prescribed to the lumpectomy cavity surface using 50 kV X-rays. We graded both acute and late treatment-related breast toxicities using the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.0. Local control, mastectomy-free survival, distant metastasis, and overall survival were determined. Our study included nine patients who developed a new or recurrent ipsilateral breast cancer after prior WBI for early-stage breast cancer, two patients with primary breast cancer after mantle-field radiation for Hodgkin's lymphoma, and one patient with a synchronous stage III non-small cell lung cancer treated with definitive radiation to the ipsilateral lung and mediastinum. The median time from prior radiation to presentation was 18 years (range: 2 months to 46 years). All patients successfully underwent partial breast reirradiation with IORT and were able to preserve their breast. At a median follow-up of 14 months (4-25 months), there were no local or distant recurrences. There was a single non-cancer-related death. In the acute setting, we observed grade 1 toxicity in 58% (n = 7), grade 2 toxicity in 17% (n = 2), and no grade 3 or higher toxicity. In the late setting, at least 3 months after IORT, we observed grade 1 hyperpigmentation and/or fibrosis in 50% (n = 6), symptomatic seroma requiring drainage in 33% (n = 4). A single patient developed an abscess requiring hospitalization and intravenous antibiotic therapy. BCS with IORT is a feasible salvage option for patients who present with localized breast cancer after prior thoracic radiation treatment. Continued follow-up of these patients is warranted given the incidence of delayed toxicity.

Adaptive synchronization in hidden broadband systems

Subject of Research. The paper deals with the method of adaptive synchronization in receiving devices of broadband communication systems of the hidden message exchange increasing the efficiency of computational capability usage of a receiving device. The research topicality is caused by the need in more effective usage of computing resources for accepting modules of broadband digital communication and radiolocation. Method. The proposed solution is an extension of sequential synchronization method being applied nowadays. The method consists of two synchronization stages: preliminary – hard, and subsequent – precise one. The entity of the proposed solution lies in computation of correlative function only in the area (window) near the expected central peak. The window movement along the accepted character sequence enables to find the actual peak position and to make synchronization. Decreasing of computing expenses is reached due to reduction of processed information volume. The method adaptivity is reached by exact retraining of synchronization during all communication session. The proposed solution is urgent for mobile systems of communication and radiolocation in condition of signal interference. Main Results. Simulation of synchronization system is carried out in the environment of Simulink (MATLAB). The signal created on the basis of a complex-valued matrix with the size equal to 3×4 with the special form of autocorrelation function is used as an example for synchronization. Model researches showed that the developed method enables to realize synchronization of transceiving system, without quitting the mode of the hidden (subnoise) message passing. It is shown that application of the developed method of the adaptive synchronization, gives the possibility to reduce significantly computational capability of a receiving device, necessary for synchronization. The number of operations in case of correlation function computation was decreased in 28 times as compared to a computation method in time over all range of counting and in 5 times concerning an algorithm of correlation function computation with the use of fast Fourier transform. Practical Relevance. Research results can find application in the design of receiving modules of broadband digital communication and radiolocation.

A practical and intelligent technique for coupling multiple neighboring microgrids at the synchronization stage

It is expected from a microgrid to supply its local demand independently; however, the load and generation intermittency may lead to overloading of a microgrid temporarily. It is suggested in the literature that this problem can be mitigated by importing the required power from one/more neighboring microgrid(s), after their temporary coupling. This paper focuses on the transition stage of forming a system of coupled microgrids. A suitable and practically applicable strategy is developed in this paper, which facilitates the appropriate connection of the microgrids. The performance of the developed strategy is evaluated by time-domain simulation studies in PSCAD/EMTDC.

Conditions and Linear Stability Analysis at the Transition to Synchronization of Three Coupled Phase Oscillators in a Ring

We consider a system of three nonidentical coupled phase oscillators in a ring topology. We explore the conditions that must be satisfied in order to obtain the phases at the transition to a synchrony state. These conditions lead to the correct mathematical expressions of phases that aid to find a simple analytic formula for critical coupling when the oscillators transit to a synchronization state having a common frequency value. The finding of a simple expression for the critical coupling allows us to perform a linear stability analysis at the transition to the synchronization stage. The obtained analytic forms of the eigenvalues show that the three coupled phase oscillators with periodic boundary conditions transit to a synchrony state when a saddle-node bifurcation occurs.

Management of patients with head and neck cancer (HNC) and synchronic stage I or II lung cancer. SYNCHRON GFPC 15-01 study.

e20048 Background: There is few published data’s of the management of patients with a HNC and a synchronic lung cancer. The aim of this observational study was to describe in a multicentric setting the management of these patients. Methods: The study included, consecutively all patients diagnosed between January 2011 and December 2015 in 19 French centers with a HNC and a synchronic lung cancer. Patients were described per the clinical characteristics, management and outcomes. Patient characteristics and treatment information was analyzed descriptively. Kaplan-Meier estimation was used to assess median overall survival. Results: The study included 62 patients: men : 84%; 62 ± 1.3 years old, current smokers: 68%, asbestos exposure: 11%; performans status: 0 and 1 for 22.5% and 66% of the patients respectively; hight rate of comorbidities, cardiovascular: 68%, COPD: 32%. Main histology for HNC was squamous: 98%, in oral cavity: 32%, oropharyngeal: 21%, hypo-pharyngeal: 22.5% and laryngeal: 24%. T classification was T1, T2, T3 and T4 in 18%, 29%, 29% and 16% of cases respectively, and N classification was N0, N1, N2, N3, for 40%, 24%, 21% and 6% of cases respectively. The main treatment was surgery, 47%, and chemo-radiotherapy, 52%. The diagnosis of lung cancer impacts the HNC management in 21% of the cases. Median delay between HNC and first day treatment was 54 ± 6 days. HNC progressive free survival rate was 68% at 2 years. Lung cancers were localized (stages I: 81%, stages II: 19%), squamous: 32%, adeno-carcinomas: 47%, larges cells or sarcomatosis: 7%. Main treatments were surgery: 56%, mainly lobectomy, radiotherapy: 15%, radio-chemotherapy: 10% and chemotherapy alone: 26%. Six patients didn’t receive active treatment. Median delay of treatment was 150 ± 16 days. Lung cancer progressive free survival rate was 28% at 2 years. OS was 55% at 2 years, better for stage I than stage II lung cancers. Conclusions: Synchronic lung cancer at HCN diagnosis impact management and outcomes of HNC with a delay in the management of lung cancer. Specific recommendations should be elaborate to improve the management of these patients.

Model experimental research on uplift single pile in calcareous sand of South China Sea

ABSTRACTVertical uplift static loading tests of single model pile were conducted in the in-lab calcareous sand and quartz sand by emulating practical condition of full-size piles in site. The settlement, lateral deflection, axial force, and friction distribution of the pile are analyzed for each physical test. The pile behaviors in calcareous sand and quartz sand are compared. From the test results, it can be found that the pile top displacement of uplift pile in calcareous sand can be divided into two stages: the pile–sand synchronous stage and pile–sand asynchronous (relative displacement) stage. Data from uplift tests show that the heave of calcareous sand around pile top is very small, which is resulted from the mutually restraint of surface particle. The mutual restriction of surface particle leads to “bottleneck effect” and strengthens ultimate side friction of upper pile segment. In addition, the shear dilatancy and particle breakage of calcareous sand lead to the upper harden and the lower soften of side friction, respectively. Cases of calcareous sand and quartz sand show different responses to pile forming methods, which due to the sands’ different characteristics of particle breakage when compressed as well as plastic deformation under loading–unloading conditions.

Prospective Analysis of Toxicity in Patients Treated with Strut Adjusted Volume Implant (SAVI) for Early Stage Breast Cancer

Prospective Analysis of Toxicity in Patients Treated with Strut Adjusted Volume Implant (SAVI) for Early Stage Breast Cancer

Large-scale production of Plasmodium falciparum gametocytes for malaria drug discovery

The tightly controlled induction of Plasmodium falciparum gametocytes in large-scale culture is a fundamental requirement for malaria drug discovery applications including, but not limited to, high-throughput screening. This protocol uses magnetic separation for isolation of hemozoin-containing parasites in order to (i) increase parasitemia, (ii) decrease hematocrit and (iii) introduce higher levels of young red blood cells in a culture simultaneously within 2-4 h. These parameters, along with red blood cell lysis products that are generated through schizont rupture, are highly relevant for enabling optimum induction of gametocytogenesis in vitro. No other previously published protocols have applied this particular approach for parasite isolation and maximization of fresh red blood cells before inducing gametocytogenesis, which is essential for obtaining highly synchronous gametocyte classical stages on a large scale. In summary, 500-1,000 million stage IV gametocytes can be obtained within 16 d from an initial 10 ml of asexual blood-stage culture.

Dataflow-Driven Crowdsourcing: Relational Models and Algorithms

Recently, microtask crowdsourcing has become a popular approach for addressing various data mining problems. Crowdsourcing workflows for approaching such problems are composed of several data processing stages which require consistent representation for making the work reproducible. This paper is devoted to the problem of reproducibility and formalization of the microtask crowdsourcing process. A computational model for microtask crowdsourcing based on an extended relational model and a dataflow computational model has been proposed. The proposed collaborative dataflow computational model is designed for processing the input data sources by executing annotation stages and automatic synchronization stages simultaneously. Data processing stages and connections between them are expressed by using collaborative computation workflows represented as loosely connected directed acyclic graphs. A synchronous algorithm for executing such workflows has been described. The computational model has been evaluated by applying it to two tasks from the computational linguistics field: concept lexicalization refining in electronic thesauri and establishing hierarchical relations between such concepts. The “Add–Remove–Confirm” procedure is designed for adding the missing lexemes to the concepts while removing the odd ones. The “Genus–Species–Match” procedure is designed for establishing “is-a” relations between the concepts provided with the corresponding word pairs. The experiments involving both volunteers from popular online social networks and paid workers from crowdsourcing marketplaces confirm applicability of these procedures for enhancing lexical resources.

Editing for Performance or Documenting Performance?: Exploring the Relationship Between Early Modern Text and Clowning

Editing for Performance or Documenting Performance?:Exploring the Relationship Between Early Modern Text and Clowning Stephen Purcell The complexity of the relationship between writing and performance on the early modern stage is particularly evident in its scenes of clowning. A performance tradition that relied upon a combination of scripted and unscripted speech, clowning resists documentation in printed form: indeed, printing turns it into something else entirely. As Richard Preiss has noted in his recent book on early modern clowning, [a] playbook is not a performance: it is the retrospective fantasy of one, abstracted from the play’s synchronic and diachronic stage lives, privileging certain voices over others, retroactively framing playgoing as a continuous, monological, readerly experience. (6) It might be helpful to think of the printed record of clowning scenes (and indeed of early modern drama more broadly) along the lines of the “geological metaphor” used by Michael Keefer in his 2007 edition of the play to describe the 1616 text of Doctor Faustus: as “the product of distinct phases of sedimentation and partial subduction” (20). Unlike those of a geological specimen, of course, the layers of sedimentation in a printed text are impossible to separate from one another. The metaphor is nonetheless useful to describe the multiple processes of scripting, performing, transcribing, copying, remembering, rescripting and reperforming that underlie the composition of an early modern playbook. In 2012, I undertook an exploration of the Doctor Faustus clown scenes in an open workshop with actors from The Pantaloons theater company. This was not an “excavation” of the text: there was no attempt to recover original practice. It was, rather, an attempt to gain an insight into the [End Page 5] structures underpinning such scenes, and to explore the ways in which layers of textual sedimentation might build up through a new process of scripting, improvisation, remembering, and rescripting. The workshop explored the differences between the clowning scenes of the two surviving texts of Doctor Faustus (1604 and 1616), and encouraged the actors to analyze the structure of one scene in particular before generating their own semi-improvised version of it. In order to approximate the process of memorial reconstruction and gain a practical sense of the differences between semi-improvised performance and textual accounts of it, I then asked the workshop audience to take notes and translate the resulting performance back into text. This article gives an overview of some of the ways in which the scene travelled through its various performative and textual forms, and speculates as to the relationship between clowning and text on the early modern stage and page. The texts of Doctor Faustus bear the traces of the play’s early performance history. The 1616 text, or B-text, is considerably longer than the earlier version, containing 676 additional lines. Recent scholarship has tended to conclude that the 1604 A-text is probably closest to the version of the play that was performed towards the end of Marlowe’s life (c. 1588), and that the B-text represents William Birde and Samuel Rowley’s revised version (for which Philip Henslowe recorded a payment in 1602). The B-text alone includes such episodes as Faustus’s rescue of Saxon Bruno from the Pope (3.1), and the three-scene sequence in which the knight humiliated by Faustus in 4.1, here named Benvolio, plots a revenge that subsequently backfires (4.1, 4.2, 4.3).1 The B-text also features two additional comic scenes, in which the clowns meet the horse-courser who was earlier cozened by Faustus (4.5), and then return in the subsequent scene to be humiliated at the court of the Duke of Vanholt (4.6). Curiously, though, despite the B-text’s greater overall length, the first clown scene, 1.4, is longer in the A-text. This first scene stages the meeting between the play’s primary clown, Robin, and Faustus’s servant Wagner. Wagner’s lines are substantially similar in both texts, but the A-text’s Clown is much more verbose than his equivalent in B. The second clown scene, 2.2, features a similar scenario in both texts—Robin has stolen one of Faustus’s books, and...

Thermochronology of Early Paleozoic collisional and subduction-collisional structures of Central Asia

The thermochronology of the Early Paleozoic collisional and subduction-collisional systems and blueschist complexes of the Central Asian Orogenic Belt has been reconstructed by the proposed method of “through” isotope dating. The evolution of these geologic structures is divided into short synchronous stages of active thermal events related to large-scale mantle-crustal magmatism, high-pressure/low-temperature and high-temperature/low-pressure metamorphism, and intense tectonic deformations. The plume activity of different intensities, both in intraoceanic and intracontinental environments, is presumed to be the deep mechanism of synchronization.

Time to first-line chemotherapy and travel distance to the cancer center and their relationship to subsequent-line therapies in stage IV CRC.

724 Background: Second and third line therapies in stage IV colorectal (CRC) have been associated with significant improvement in survival. However, not all patients receive all available therapies. Delay in starting treatment and travel burden can affect patient access and use of future therapy. Little is known about time to first line chemotherapy (TC) and travel distance to cancer center (TD) and their relationship to future therapies in stage IV CRC. The study aims to determine relationship between TC and TD with second and subsequent line of therapies. Methods: A patients cohort diagnosed with synchronous stage IV CRC during 2006-2010 in the province of Saskatchewan, Canada was studied. Patients with ECOG performance status of &gt; 1 or who did not receive chemotherapy were excluded. The logistic regression analyses were performed to assess relationship between TC and TD and subsequent line therapies. Results: 569 patients were diagnosed with synchronous stage IV CRC. 326 patients received first line chemotherapy (mostly FOLFIRI ± bevacizumab). Of 326 patients 62 with ECOG performance status (PS) &gt; 1 were excluded. The median age of 264 eligible patients was 62 yrs (IQR:53-72). 61% were male and 38% had ECOG PS of 0. Mean Charlson score was 9±1.3. 24% underwent metastasectomy. Median TC was 77 days (IQR: 53-107) and median TD was 64.4 km (IQR:4.8-166). 42.8% patients had to travel &gt; 100 km for their treatment. Of 326 patients 144 (55%) received future therapies. On multivariate analysis absence of comorbid illness (as per Charlson comorbid index), odd ratio (OR) 1.45 (95% CI: 1.19-1.77), no metastasectomy, OR 1.89 (1.03-3.46) and TD &lt; 100 km, OR 1.69 (1.003-2.84) were correlated with the utility of 2ndand subsequent line therapies. Conclusions: Our result revealed that although time to first line chemotherapy did not correlate with future systemic therapies, travel distance to Cancer Center &gt; 100 km was associated with low rate of second or subsequent line therapies in statge IV CRC patients with good performance status.

Frequency of unplanned surgical intervention in patients with stage IV colorectal cancer receiving palliative chemotherapy: An analysis of SEER-Medicare.

640 Background: Patients (pts) with synchronous stage IV colorectal cancer commonly begin palliative chemotherapy while the primary tumor remains. Single institution series report low rates of surgical intervention, but this has not been examined nationally. The present study utilizes a large national dataset to examine the natural history of unplanned surgical intervention in stage IV colorectal cancer pts on palliative chemotherapy. Methods: SEER-Medicare was queried for pts with metastatic colorectal cancer (1998-2009) who underwent resection or diversion (ICD9 procedure/CPT). The cohort was separated into 3 groups: elective (surgery on admission without urgent/emergent flag), urgent (surgery not on day of admission but within hospitalization or with urgent flag) and emergent (emergent flag). Pts who underwent any procedure for curative intent (elective colorectal surgery, liver directed therapy or surgery for pulmonary metastases) at any time were excluded. Demographics, tumor grade and comorbidities were analyzed for effect on intervention rate. Time to event for either urgent or emergent surgical intervention or censorship by death, were measured. Conditional analyses were performed to determine the risk of surgical intervention at 6 months, 1 and 2 years post diagnosis. Results: 3,992 pts met inclusion criteria. Median age=73; 53% male. White 79%, black 11% and other 10%. The overall intervention rate was 6%; 35% emergent, 65% urgent. At 42 months, 90% of the pts had died. The probability of requiring unplanned surgery between 6-12 months was 2.5%; 12-24 months=1.9%, and &gt;24 months=0.8%. Charlson comorbidity score of 1 was a significant predictor of surgical intervention (HR 1.64 [1.24, 2.19]). Sex, age and race had no influence on the likelihood of surgical intervention. Conclusions: This study represents a large series of stage IV colorectal cancer pts and the frequency of unplanned surgery in pts receiving palliative chemotherapy. Pts treated with palliative chemotherapy are unlikely to require urgent or emergent surgery, and therefore prophylactic surgery to reduce the risk of perforation or obstruction should not be routinely performed.

Efficient Production of Bovine Tetraploid Embryos by Electrofusion of In Vitro Produced Two-Cell Stage Embryos

Tetraploid complementation has been used to improve the production of cloned animals. The main objective of this study was to improve the efficiency of bovine tetraploid embryo production and the development potential of bovine tetraploid embryos into blastocysts. We assessed early embryonic cleavage timing and established the defined time quantum to collect synchronous 2-cell stage bovine embryos for electrofusion. Different electrofusion protocols were also tested. The second aim was to monitor ploidy transition by fluorescence visualization to shed lights on the nuclear fusion process of the cytoplasmic membrane-fused 2-cell stage bovine embryos. Karyotypes of day 8 blastocysts (day 0: day of electrofusion) were determined by karyotyping analysis. We found that electrofusion of in vitro produced bovine 2-cell stage embryos results in both tetraploid and diploid embryos and that blastocyst formation rates from fused 2-cell stage embryos are affected by the number of electrofusion pulses and the timing of how soon the 2-cell stage embryos are formed post insemination. We identified two distinct nuclear configurations after electrofusion of 2-cell stage embryos, each of which is uniquely related to the formation of tetraploid or diploid embryos. Based on the observation that tetraploid and diploid embryos derived from fused 2-cell stage embryos undergo different timings to become 2-cell stage embryos again, diploid and tetraploid 2-cell embryos can be readily separated after electrofusion. Finally, our study established an experimental protocol for the effective production of bovine tetraploid embryos by electrofusion of 2-cell embryos.

Cutaneous Metastases of the Synchronous Primary Endometrial and Bilateral Ovarian Cancer: An Infrequent Presentation and Literature Review.

There are limited data about the cutaneous metastases of gynecological malignancies in the literature. Based on this limited number of studies, cutaneous metastases from gynecological malignancies are uncommon occurrences. Cutaneous metastases from the synchronous endometrioid carcinoma of the uterine corpus and bilateral ovaries arising from endometriosis are extremely rare. Herein, we report a 51-year-old woman with FIGO Stage 1A Grade 1 endometrial endometrioid-type adenocarcinoma and synchronous bilateral Stage 1B ovarian endometrioid-type adenocarcinoma who presented 34 months following total abdominal hysterectomy and bilateral salpingo-oophorectomy with skin metastases. After the patient underwent an excisional biopsy, we applied a palliative radiotherapy. The patient received the combination therapy with cisplatin and doxorubicin after the completion of radiotherapy but the disease evolution was rapidly fatal and the patient died 4 months after her admission to our department due to widely disseminated disease.

Radical thoracic radiotherapy may provide favorable outcomes for stage IV non-small cell lung cancer.

This study investigates the outcome of synchronous stage IV non-small cell lung cancer (NSCLC) patients who received radical thoracic radiotherapy (TRT). We retrospectively reviewed the charts of stage IV NSCLC patients treated with TRT between January 2007 and December 2011. Radiotherapy was considered radical if it was the primary therapy with non-symptom driven intent, or consolidation therapy after initial chemotherapy and the biologically equivalent dose ≥53 Gy halted disease progression. The patients' demographics, disease characteristics, and treatment parameters were uniformly collected. Eighty-one patients were irradiated with radical intent, including 52% with more than five metastatic lesions. The minimum follow-up was 31.5 months for survivors. The median overall survival (OS) was 20.8 months, with three and four-year OS rates of 23% and 18%, respectively. The median progression-free survival (PFS) was 8.2 months, with one and two-year PFS rates of 23% and 9%, respectively. Partial response (PR) after TRT and administration of targeted therapy were predictive of longer OS. The factors associated with favorable PFS included earlier local tunor node stage, absence of concurrent chemotherapy, and post-TRT PR. No correlation was found between the number of metastatic lesions and survival outcome. Incidences of grade ≥2 toxicities in the lung and esophagus were 9% and 26%, respectively. Radical TRT may result in advantageous outcomes for selected stage IV NSCLC patients, regardless of the number of metastatic foci. Patients who achieved post-TRT PR attained the best outcomes.

Complications from the primary tumour are not related with survival in patients with synchronous stage IV colorectal cancer receiving chemotherapy without primary tumour resection

The aim of this study was to evaluate the rate of complications from the primary tumour (CPT) requiring surgical or endoscopic intervention during chemotherapy treatment in patients with incurable synchronous stage IV colorectal cancer, the possibility of predicting such complications and their influence on survival. One hundred and twenty-five patients were initially treated with chemotherapy. Patients were grouped on the basis of appearance or not of CPT. We assessed the relation between age, gender, carcinoembryonic antigen (CEA) level, primary tumour location, alkaline phosphatase level, unilobar or bilobar liver involvement, presence of peritoneal carcinomatosis, the number of sites of metastatic disease, the addition of target therapies to chemotherapy, the ability to traverse the tumour with an endoscope and the appearance of complications due to the primary tumour and overall survival. Mean age was 64.9 years, and 89 patients were men. Over a mean of 234 days, 25 patients (20 %) developed a CPT. Eighteen patients required surgery, and seven were treated exclusively by an endoscopic procedure. Mean survival was 15.8 months. We found a statistically relevant correlation between the inability to traverse the tumour with an endoscope and the occurrence of a CPT. There was no statistical differences in survival between both groups, but patients receiving target therapies had better survival. Twenty percent of patients will suffer a CPT during chemotherapy treatment. The inability to pass the tumour with an endoscope can predict the CPT. Survival was only related to the addition of target therapies to chemotherapy.