Predicting necrosis in residual mass analysis after retroperitoneal lymph node dissection: a retrospective study

Background: Recent studies have demonstrated that pathological analysis of retroperitoneal residual masses of patients with testicular germ cell tumors revealed findings of necrotic debris or fibrosis in up to 50% of patients. We aimed at pursuing a clinical and pathological review of patients undergoing post chemotherapy retroperitoneal lymph node dissection (PC-RPLND) in order to identify variables that may help predict necrosis in the retroperitoneum. Methods: We performed a retrospective analysis of all patients who underwent PC-RPLND at the University Hospital of the University of Sao Paulo and Cancer Institute of Sao Paulo between January 2005 and September 2011. Clinical and pathological data were obtained and consisted basically of: measures of retroperitoneal masses, histology of the orchiectomy specimen, serum tumor marker and retroperitoneal nodal size before and after chemotherapy. Results: We gathered a total of 32 patients with a mean age of 29.7; pathological analysis in our series demonstrated that 15 (47%) had necrosis in residual retroperitoneal masses, 15 had teratoma (47%) and 2 (6.4%) had viable germ cell tumors (GCT). The mean size of the retroperitoneal mass was 4.94 cm in our sample, without a difference between the groups (P = 0.176). From all studied variables, relative changes in retroperitoneal lymph node size (P = 0.04), the absence of teratoma in the orchiectomy specimen (P = 0.03) and the presence of choriocarcinoma in the testicular analysis after orchiectomy (P = 0.03) were statistically significant predictors of the presence of necrosis. A reduction level of 35% was therefore suggested to be the best cutoff for predicting the absence of tumor in the retroperitoneum with a sensitivity of 73.3% and specificity of 82.4%. Conclusions: Even though retroperitoneal lymph node dissection remains the gold standard for patients with residual masses, those without teratoma in the primary tumor and a shrinkage of 35% or more in retroperitoneal mass have a considerably smaller chance of having viable GCT or teratoma in the retroperitoneum and a surveillance program could be considered.

Optic Disc Margin Anatomy in Patients with Glaucoma and Normal Controls with Spectral Domain Optical Coherence Tomography

Objective: To characterize optic nerve head (ONH) anatomy related to the clinical optic disc margin with spectral domain-optical coherence tomography (SD-OCT). Design: Cross-sectional study. Participants: Patients with open-angle glaucoma with focal, diffuse, and sclerotic optic disc damage, and age-matched normal controls. Methods: High-resolution radial SD-OCT B-scans centered on the ONH were analyzed at each clock hour. For each scan, the border tissue of Elschnig was classified for obliqueness (internally oblique, externally oblique, or nonoblique) and the presence of Bruch's membrane overhanging the border tissue. Optic disc stereophotographs were co-localized to SD-OCT data with customized software. The frequency with which the disc margin identified in stereophotographs coincided with (1) Bruch's membrane opening (BMO), defined as the innermost edge of Bruch's membrane; (2) Bruch's membrane/border tissue, defined as any aspect of either outside BMO or border tissue; or (3) border tissue, defined as any aspect of border tissue alone, in the B-scans was computed at each clock hour. Main Outcome Measures: The SD-OCT structures coinciding with the disc margin in stereophotographs. Results: There were 30 patients (10 with each type of disc damage) and 10 controls, with a median (range) age of 68.1 (42-86) years and 63.5 (42-77) years, respectively. Although 28 patients (93%) had 2 or more border tissue configurations, the most predominant one was internally oblique, primarily superiorly and nasally, frequently with Bruch's membrane overhang. Externally oblique border tissue was less frequent, observed mostly inferiorly and temporally. In controls, there was predominantly internally oblique configuration around the disc. Although the configurations were not statistically different between patients and controls, they were among the 3 glaucoma groups. At most locations, the SD-OCT structure most frequently identified as the disc margin was some aspect of Bruch's membrane and border tissue external to BMO. Bruch's membrane overhang was regionally present in the majority of patients with glaucoma and controls; however, in most cases it was not visible as the disc margin. Conclusions: The clinically perceived disc margin is most likely not the innermost edge of Bruch's membrane detected by SD-OCT. These findings have important implications for the automated detection of the disc margin and estimates of the neuroretinal rim. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. Ophthalmology 2012;119:738-747 (C) 2012 by the American Academy of Ophthalmology.

Galaxy interactions I. Major and minor mergers

Aims. We study galaxy pair samples selected from the Sloan Digital Sky Survey (SDSS-DR7) and we perform an analysis of minor and major mergers with the aim of investigating the dependence of galaxy properties on interactions. Methods. We build a galaxy pair catalog requiring r(p) < 25 kpc h(-1) and Delta V < 350 km s(-1) within redshift z < 0.1. By visual inspection of SDSS images we remove false identifications and we classify the interactions into three categories: pairs undergoing merging, M; pairs with evident tidal features, T; and non disturbed, N. We also divide the pair sample into minor and major interactions according to the luminosity ratio of the galaxy members. We study star formation activity through colors, the 4000 angstrom break, and star formation rates. Results. We find that similar to 10% of the pairs are classified as M. These systems show an excess of young stellar populations as inferred from the D-n(4000) spectral index, colors, and star formation rates of the member galaxies, an effect which we argue is directly related to the ongoing merging process. We find similar to 30% of the pairs exhibiting tidal features (T pairs) with member galaxies showing evidence of old stellar populations. This can be associated either to the disruptive effect of some tidal interactions, or to the longer time-scale of morphological disturbance with respect to the bursts of the tidal induced star formation. Regardless of the color distribution, we find a prominent blue peak in the strongest mergers, while pairs with tidal signs under a minor merger show a strong red peak. Therefore, our results show that galaxy interactions are important in driving the evolution of galaxy bimodality. By adding stellar masses and star formation rates of the two members of the pairs, we explore the global efficiency of star formation of the pairs as a whole. We find that, at a given total stellar mass, major mergers are significantly more efficient (a factor approximate to 2) in forming new stars, with respect to both minor mergers or a control sample of non-interacting galaxies. We conclude that the characteristics of the interactions and the ratio of luminosity galaxy pair members involved in a merger are important parameters in setting galaxy properties.

Análisis geográfico de las actuales relaciones comerciales entre Canarias y Marruecos

[ES] En este trabajo formulamos como hipótesis de partida que Canarias, como frontera meridional de Europa, en un contexto de creciente internacionalización, tiene en los mercados africanos una gran baza histórica que desempeñar. Dado el interés general que este asunto suscita entre las ciencias sociales, se requiere abordarlo desde el análisis geográfico. Para cumplimentar este estudio se emplearon las estadísticas que ofrecen organismos oficiales como el Instituto Nacional de Estadística, Instituto Canario de Estadística, Agencia Estatal de la Administración Tributaria, Instituto de Comercio Exterior y entidades internacionales como la Conferencia de las Naciones Unidas para el Comercio y el Desarrollo (UNCTAD) y la Organización Mundial del Comercio (OCM).

Men at risk The Physical, Mental and Social Health of Men in Massachusetts

In 2009, Clark University was accepted as the university to represent Massachusetts in the National Policy Institute for Family Impact Seminars at the University of Wisconsin – Madison (http://familyimpactseminars.org). Family Impact Seminars are a series of annual seminars, briefing reports, and discussion sessions that provide up-to-date, solution-oriented research on current issues for state legislators, their aides, and legislative support bureau personnel. The seminars provide objective, nonpartisan research on current issues and do not lobby for particular policies. Seminar participants discuss policy options and identify common ground where it exists.

The Great Recession and its Impact on Families

In 2009, Clark University was accepted as the university to represent Massachusetts in the National Policy Institute for Family Impact Seminars at the University of Wisconsin – Madison (http://familyimpactseminars.org). Family Impact Seminars are a series of annual seminars, briefing reports, and discussion sessions that provide up-to-date, solution-oriented research on current issues for state legislators, legislative staff, and executive branch personnel. The seminars provide objective, nonpartisan research on current issues and do not lobby for particular policies. Seminar participants discuss policy options and identify common ground where it exists.

DEVELOPMENT OF CONFORMABLE CNG TANK FOR AUTOMOTIVE APPLICATION

The purpose of this study is to design, develop and integrate a Compressed Natural Gas (CNG) tank that will have a conformable shape for efficient storage in a light-duty pick-up truck. The CNG tank will be a simple rectangular box geometry to demonstrate capability of non-cylindrical shapes. Using CAD drawings of the truck, a conformable tank will be designed to fit under the pick-up bed. The intent of the non-cylindrical CNG tank is to demonstrate improvement in size over the current solution, which is a large cylinder in the box of a pick-up truck. The geometry of the tank’s features is critical to its size and strength. The optimized tank design will be simulated with Finite Element Analysis (FEA) to determine critical stress regions, and appropriate design changes will be made to reduce stress concentration. Following the American National Standard Institute (ANSI) guide, different aluminum alloys will be optimized to obtain the best possible result for the CNG tank.

Effectiveness of Colors used on Safety and Health Signs for Communicating Severity of Injury

Signs are used extensively in workplaces and on products to identify hazards and provide instructions for appropriate behavior. A fundamental element of these signs is the signal-word panel located at the top of the sign. The colors and words in this panel are intended to convey information about the hazard identified. One type of hazard information concerns the severity of injury/illness associated with the hazard. The standard of the American National Standards Institute (ANSI) for facility signs uses three severity categories: 1) death or serious injury, 2) minor or moderate injury, and 3) property damage. The standard specifies which signal-word panel format, including color, to use based in part on the severity category. The purpose of this study was to determine if college students associate color with severity. The sample population consisted of 59 students tested in nine small groups. Twelve signs were shown to them in random order. Five of the signs had a color for the background of the signal-word panel. The colors were red, orange, yellow, blue, and gray. The signal word was a nonsense word and the text panel contained repetitions of the letter x in sentence format. Subject rated their impressions of the colors using two ordered rating scales for severity. Results indicated that color had a highly significant effect on severity ratings. Median ratings were generally consistent with the ANSI standard, except for orange. Red rated highest on both scales. Blue and gray rated lowest. Yellow and orange were in between red and blue. According to the ANSI standard, orange should indicate the same severity as red. These results indicated that orange was associated with less severity than red. Apparently, the ANSI standard's use of orange to identify a hazard associated with death or a serious injury is questionable.

A urokinase receptor promoter element (-152/-135) bound with an AP-2-alpha-related protein and SP1 is required for the induction of gene expression by PMA and SRC

The urokinase-type plasminogen activator receptor (u-PAR) promotes extracellular matrix degradation, invasion and metastasis. A first objective of this dissertation was to identify cis-elements and trans-acting factors activating u-PAR gene expression through a previously footprinted (–148/–124) promoter region. Mobility shifting experiments on nuclear extracts of a high u-PAR-expressing colon cancer cell line (RKO) indicated Sp1, Sp3 and a factor similar to, but distinct from, AP-2α bound to an oligonucleotide spanning –152/–135. Mutations preventing the binding of the AP-2α-related factor reduced u-PAR promoter activity. In RKO, the expression of a dominant negative AP-2 (AP-2αB) diminished u-PAR promoter activity, protein and u-PAR mediated laminin degradation. Conversely, u-PAR promoter activity in low u-PAR-expressing GEO cells was increased by AP-2αA expression. PMA treatment, which induces u-PAR expression, caused an increased amount of the AP-2α-related factor-containing complex in GEO, and mutations preventing AP-2α-like and Sp1/Sp3 binding reduced the u-PAR promoter stimulation by PMA. In resected colon cancers, u-PAR protein amounts were related to the amount of the AP-2α-related factor-containing complex. In conclusion, constitutive and PMA- inducible u-PAR gene expression and -proteolysis are mediated partly through transactivation via a promoter sequence (–152/435) bound with an AP-2α-related factor and Sp1/Sp3. ^ A second interest of this dissertation was to determine if a constitutively active Src regulates the transcription of the u-PAR gene, since c-src expression increases invasion in colon cancer. Increased u-PAR protein and laminin degradation paralleling elevated Src activity was evident in SW480 colon cancer cells stably expressing a constitutively active Src (Y- c-src527F). Nuclear run-on experiments indicated that this was due largely to transcriptional activation. While transient transfection of SW480 cells with Y-c-src527F induced a u-PAR-CAT-reporter, mutations preventing Sp1-binding to promoter region –152/435 abolished this induction. Mobility shift assays revealed increased Sp1 binding to region –152/135 with nuclear extracts of Src-transfected SW480 cells. Finally, the amounts of endogenous u-PAR in resected colon cancers significantly correlated with Src-activity. These data suggest that u-PAR gene expression and proteolysis are regulated by Src, this requiring the promoter region (–152/–135) bound with Sp1, thus, demonstrating for the first time that transcription factor Sp1 is a downstream effector of Src. ^

C4I Roadmap March 2005

Patients expect to be safe from harm inside the walls of a hospital. Increasing reports of medical errors and adverse events have brought these concerns to public attention. Although we have celebrated many scientific advances over the past several decades, many patients do not benefit because the healthcare infrastructure is inadequate to deliver care to all. Studies confirm opportunities to improve in areas such as inpatient vaccination for flu and outpatient screening for breast, cervical or colon cancer. (Institute of Medicine, (IOM), 2000, 2001, 2004). This document outlines the steps needed to further increase our focus on patient safety in John Dempsey Hospital through the development of a multi-disciplinary Collaborative Center for Clinical Care Improvement (CCCCI). The dimensions of safety and outcomes are briefly discussed to provide some perspective on the scope of these challenges (Strongwater, 2003).

Construcción de normas locales para la técnica Rorschach : Sistema Comprehensivo

Se describe el camino recorrido por los temas de investigación abordados por el equipo desde 1995 hasta 2008, camino en el cual se sitúa el Proyecto de construcción de normas para la técnica Rorschach, Sistema Comprehensivo(1999-2004) El Objetivo se origina en la actual gran difusión internacional y en nuestro país, del Sistema Comprehensivo de Exner (1974) para la Técnica Rorschach, lo que planteó la necesidad de contar con normas de nuestro contexto cultural para analizar e interpretar los resultados. Luego de destinar un año completo a la capacitación del equipo en el Sistema Comprehensivo y de obtener mediante información del INDEC (Instituto Nacional de Estadísticas y Censos) la distribución de los rangos de género y edad demográficamente representativos de la población, se obtuvo la muestra de 506 casos, estratificados según rangos de edad de 18-25 años; 26-35 años; 36-45 años; 46 a 55 años y 56 a 65 años, En la muestra normativa se excluyeron todos los casos que estuvieran o hubieran estado en tratamiento psicoterapéutico o psiquiátrico. Se describe el proyecto y comentan resultados

Turismo y trabajo : Una aproximación desde el mercado hotelero

El presente trabajo tiene por objetivo profundizar en el comportamiento del mercado de trabajo en regiones donde la principal actividad económica es el turismo mediante el análisis de la información que desde el año 2004 se obtiene a través de la Encuesta de Ocupación Hotelera (EOH) que releva el INDEC. La posibilidad de contar con la EOH, especialmente en aquellas localidades que, por su dimensión no poseen información proveniente de las Encuestas Permanente de Hogares (EPH), abre la posibilidad de que, a través del comportamiento hotelero y para-hotelero, se acceda a una aproximación de la situación ocupacional en esas localidades, donde se presentan serias dificultades durante algunos períodos del año. Aunque la serie de que se dispone es aún breve 'en el mejor de los casos de hasta cinco años', se la analiza mediante técnicas estadísticas para determinación de estacionalidad, como punto de partida para un posterior seguimiento y puesta en discusión de otras alternativas de abordaje. Se trabaja con localidades de manera desagregada, pudiendo advertirse nítidamente las especificidades según la modalidad turística de cada una de ellas y concentrando el comportamiento de las mismas en dos grupos diferentes: a) Localidades con economías de perfiles más diversificadas; b) Localidades con base económica preponderantemente turística. Mediante este análisis se pretende alcanzar algunos resultados que, eventualmente complementados con información de carácter primaria tanto cuantitativa como de carácter más cualitativo, aporten al conocimiento de un mercado de trabajo cuyas especificidades lo tornan complejo y cuyas consecuencias preocupan tanto al sector público como al privado

Construcción de normas locales para la técnica Rorschach : Sistema Comprehensivo

Se describe el camino recorrido por los temas de investigación abordados por el equipo desde 1995 hasta 2008, camino en el cual se sitúa el Proyecto de construcción de normas para la técnica Rorschach, Sistema Comprehensivo(1999-2004) El Objetivo se origina en la actual gran difusión internacional y en nuestro país, del Sistema Comprehensivo de Exner (1974) para la Técnica Rorschach, lo que planteó la necesidad de contar con normas de nuestro contexto cultural para analizar e interpretar los resultados. Luego de destinar un año completo a la capacitación del equipo en el Sistema Comprehensivo y de obtener mediante información del INDEC (Instituto Nacional de Estadísticas y Censos) la distribución de los rangos de género y edad demográficamente representativos de la población, se obtuvo la muestra de 506 casos, estratificados según rangos de edad de 18-25 años; 26-35 años; 36-45 años; 46 a 55 años y 56 a 65 años, En la muestra normativa se excluyeron todos los casos que estuvieran o hubieran estado en tratamiento psicoterapéutico o psiquiátrico. Se describe el proyecto y comentan resultados

Turismo y trabajo : Una aproximación desde el mercado hotelero

El presente trabajo tiene por objetivo profundizar en el comportamiento del mercado de trabajo en regiones donde la principal actividad económica es el turismo mediante el análisis de la información que desde el año 2004 se obtiene a través de la Encuesta de Ocupación Hotelera (EOH) que releva el INDEC. La posibilidad de contar con la EOH, especialmente en aquellas localidades que, por su dimensión no poseen información proveniente de las Encuestas Permanente de Hogares (EPH), abre la posibilidad de que, a través del comportamiento hotelero y para-hotelero, se acceda a una aproximación de la situación ocupacional en esas localidades, donde se presentan serias dificultades durante algunos períodos del año. Aunque la serie de que se dispone es aún breve 'en el mejor de los casos de hasta cinco años', se la analiza mediante técnicas estadísticas para determinación de estacionalidad, como punto de partida para un posterior seguimiento y puesta en discusión de otras alternativas de abordaje. Se trabaja con localidades de manera desagregada, pudiendo advertirse nítidamente las especificidades según la modalidad turística de cada una de ellas y concentrando el comportamiento de las mismas en dos grupos diferentes: a) Localidades con economías de perfiles más diversificadas; b) Localidades con base económica preponderantemente turística. Mediante este análisis se pretende alcanzar algunos resultados que, eventualmente complementados con información de carácter primaria tanto cuantitativa como de carácter más cualitativo, aporten al conocimiento de un mercado de trabajo cuyas especificidades lo tornan complejo y cuyas consecuencias preocupan tanto al sector público como al privado