Experimental low-level direct current therapy in liver metastases: influence of polarity and current dose

Several authors recently reported on the successful local treatment of malignant disease with low-level direct current therapy. However, antitumoral effects in colorectal metastases has not been investigated experimentally. The aim of the present study was to assess the effectiveness of this therapy and the influence of polarity and current dose. Colorectal metastases were established in BD IX rats by the injection of colon cancer cells under the liver capsule. After three weeks, the liver tumor volumes were determined by magnetic resonance imaging of the liver. Low-level direct current therapy was applied via five platinum electrodes. Four different applications were used: 60 C/cm(3), anode at the center; 60 C/cm(3), cathode at the center; 80 C/cm(3), anode at the center; and 80 C/cm(3), cathode at the center. In the control group, five electrodes were placed without applying any direct current. All animals were sacrificed on postoperative day 7. Liver metastases were histologically examined for vital tumor cells. Statistical analysis was performed with chi(2)-test. The mean initial tumor diameter before treatment was 3.6 +/- 1.4 mm (volume: 25.2 +/- 9.7 mm(3)). Histological examination of the removed livers revealed significant destruction of the metastases with localized necroses in all treatment groups; 37% had a complete response rate and 63% a partial response rate. There were no significant necroses in the control group (P < 0.0001). The best treatment results were obtained in the group with an anode at the center and a current dose of 80 C/cm(3). Direct current therapy offers a new and safe method for the local treatment of liver metastases. We were able to observe that tumor damage is related to current dose but not to the polarity of the central electrode.     

Melanoma central nervous system metastases: current approaches,challenges, and opportunities

Melanoma central nervous system metastases are increasing, and the challenges presented by this patient population remain complex. In December 2015, the Melanoma Research Foundation and the Wistar Institute hosted the First Summit on Melanoma Central Nervous System (CNS) Metastases in Philadelphia, Pennsylvania. Here, we provide a review of the current status of the field of melanoma brain metastasis research; identify key challenges and opportunities for improving the outcomes in patients with melanoma brain metastases; and set a framework to optimize future research in this critical area.     

A current viewpoint on structure and evolution of collagens. I. Fibrillar collagens

This review summarizes current data of structure of the most representative group of superfamily of collagens—fibrillar collagens. The attention is focused on structural organization of individual domains and their functional role in the hierarchical stacking of collagen α-chains. There are presented characteristics of the main stages of biosynthesis and the supramolecular processing of fibrillar collagens. Also considered are some aspects of evolution of fibrillar collagens. The role of duplication of genome and genes, intergene combination, and translocation of exons in evolution of collagen genes is discussed.     

Limnological imbalances: an antipodean viewpoint

SUMMARY. 1. It is argued that modern limnology is excessively concerned with the study of fresh waters in the northern temperate region. Limnology has been and is unbalanced in its interests and emphases and, as a result, many widely held limnological concepts need revision. 2. The genesis of the argument is outlined. It involved the initial assumption that Australia was limnologically distinctive. Later, it was realized that since most of the world is arid, semi-arid, tropical or semi-tropical, Australia was much less distinctive than originally thought. 3. Other limnological assumptions considered in the paper concern saline lakes and salinization, the importance and nature of temporary bodies of standing fresh water, biological diversity in tropical fresh waters, the evolutionary importance of permanent freshwater lakes, and the global applicability of the River Continuum Concept. Consideration suggests that some widely-held views on these matters are erroneous. 4. Thus, saline lakes are more important (scientifically, commercially), widespread and numerous environments than is generally thought. Salinization is a significant environmental hazard for many rivers in semiarid regions. Temporary bodies of standing fresh water are geographically widespread and abundant aquatic environments with high species diversity, and in which many species have restricted distributions and low dispersal abilities. Biological diversity appears to be low in tropical fresh waters. Permanent freshwater lakes are perhaps less important loci for the evolution of the freshwater biota than generally thought, temporary fresh waters more so. Finally, the River Continuum does not seem to be applicable to many running waters outside the north temperate region. 5. A number of suggestions are made of how a better balance in limnology may be arrived at: how a more globally comprehensive intellectual framework may be built. Suggestions include: an increased awareness of the frequently different natures of waters within and beyond the northern temperate region; recognition of the potential benefits to be gained from the study of waters outside the northern temperate region;     

Model adequacy: A bayesian viewpoint

We present a BAYEsian theory for testing model adequacy which provides exact results whether the model is linear or nonlinear in the parameters. We consider two cases: (a) replicated data exists, and (b) no replicated data exists but an external estimate of the variance is available. Furthermore, we derive a useful approximation for testing model adequacy when the model is nonlinear in the parameters.     

Radiation therapy for bone-only metastases in breast cancer patients: A GOCO survey of current clinical practice

IntroductionThe role of radiation therapy (RT) for patients with bone-only metastatic (BOM) breast cancer has not been investigated sufficiently. The aim of this survey was to evaluate current clinical practice in treating breast cancer patients with BOM in Radiation Therapy Departments in Catalonia and Occitania within the scope of the GOCO group.Materials and methodsAn electronic questionnaire was completed by experienced radiation oncologists from fourteen RT centers. The items surveyed the professional experience, therapeutic approach, technique, dose stereotactic body RT (SBRT) availability.ResultsAll Radiation Oncology Departments (ROD) in Catalonia (12) and Occitania (2) responded to the survey. Eleven (78.5%) of the RODs advise RT for BOM as initial treatment in the oligometastatic setting. RT to asymptomatic bone oligometastases is more often restricted for “risky lesions”. The most inconsistent approaches were the treatment for asymptomatic lesions, when to treat bone metastases with respect to systemic treatment (ST) and the indication for RT after a complete response to ST.ConclusionWhile BOM breast cancer patients have a relatively good prognosis, there is a lack of consistency in their approach with RT. This can be explained by the absence of evidence-based guidelines and an incomplete availability of SBRT.     

Neonatal jaundice: the surgical viewpoint.

There is good evidence that neonatal hepatitis, biliary hypoplasia, biliary atresia and choledochal cyst are different stages of one disease process for which the term infantile obstructive cholangiopathy has been suggested. Thanks to the work of Kasai and the operation of hepatic portoenterostomy the surgical outlook has greatly improved, although in North America it still leaves much to be desired. One cannot procrastinate too long in the hope that the patient''s condition will improve spontaneously, because the surgical results are much better when the operation is performed before the patient is 10 weeks old. This article outlines the steps that should be followed in investigating neonatal jaundice, the nonsurgical measures that can be taken in an attempt to reverse or alleviate the underlying condition, and the specific role of the pediatric surgeon in the management of choledochal cyst and biliary atresia.