A biomechanical study on the effect of lengthening magnitude on spine off-loading in magnetically controlled growing rod surgery: Implications on lengthening frequency.

To assess whether the magnitude of lengthening in magnetically controlled growing rod (MCGR) surgeries has an immediate or delayed effect on spinal off-loading. 9 whole porcine spines were instrumented using two standard MCGRs from T9 to L5. Static compression testing using a mechanical testing system (MTS) was performed at three MCGR lengthening stages (0 mm, 2 mm, and 6 mm) in each spine.

Not All Gymnastic Exercises Are Suitable for Everyone: An Uncommon Cause of Thoracic Outlet Syndrome: A Case Report.

Case: A 34-year-old man spontaneously presented with bilateral thoracic outlet syndrome over 1 year. He was a gymnast active in rowing and weightlifting, with "slanted" shoulders, narrowed costoclavicular spaces, and well-developed scalene muscles. Imaging revealed fractures of multiple bilateral upper ribs in various degrees of nonunion.

Maintaining qualification for 340B.

After initial acceptance in the 340B Drug Pricing Program, hospitals and health systems should monitor and take steps to maintain their disproportionate share hospital status to continue to qualify for participation. Proactively managing the Supplemental Security Income (SSI) Ratio will ensure the organization avoids an unexpected decline in the Medicare portion of its 340B patient base. Even with the surge resulting from Medicaid expansion, tracking patient eligibility for Medicare/ SSI to ensure all patients who qualify are appropriately enrolled in the program is an important step in maintaining 340B program eligibility.

Long-term oncologic outcomes for simultaneous resection of synchronous metastatic liver and primary colorectal cancer.

Background: Twenty-five percent of patients with colorectal cancer present with simultaneous liver metastasis. Complete resection is the only potential curative treatment. Due to improvements in operative and perioperative management, simultaneous liver and colon resections are an accepted procedure at specialized centers for selected patients.

Fast track to 340B.

Hospitals that are newly qualified for the 340B Drug Pricing Program may have an opportunity for fast-track approval to participate in the program. Three steps are required to seize this opportunity: Use data analytics to assess current and future percentages of Medicaid utilization and eligibility for federal SSI cash benefits. Determine the feasibility of early cost report filing.

PET-based compartmental modeling of (124)I-A33 antibody: quantitative characterization of patient-specific tumor targeting in colorectal cancer.

Purpose: The molecular specificity of monoclonal antibodies (mAbs) directed against tumor antigens has proven effective for targeted therapy of human cancers, as shown by a growing list of successful antibody-based drug products. We describe a novel, nonlinear compartmental model using PET-derived data to determine the "best-fit" parameters and model-derived quantities for optimizing biodistribution of intravenously injected (124)I-labeled antitumor antibodies.

Methods: As an example of this paradigm, quantitative image and kinetic analyses of anti-A33 humanized mAb (also known as "A33") were performed in 11 colorectal cancer patients.

Mechanical temporal fluctuation induced distance and force systematic errors in Casimir force experiments.

The basic theory of temporal mechanical fluctuation induced systematic errors in Casimir force experiments is developed and applications of this theory to several experiments is reviewed. This class of systematic error enters in a manner similar to the usual surface roughness correction, but unlike the treatment of surface roughness for which an exact result requires an electromagnetic mode analysis, time dependent fluctuations can be treated exactly, assuming the fluctuation times are much longer than the zero point and thermal fluctuation correlation times of the electromagnetic field between the plates. An experimental method for measuring absolute distance with high bandwidth is also described and measurement data presented.

Simultaneous resection for rectal cancer with synchronous liver metastasis is a safe procedure.

Background: One quarter of colorectal cancer patients will present with liver metastasis at the time of diagnosis. Recent studies have shown that simultaneous resections are safe and feasible for stage IV colon cancer. Limited data are available for simultaneous surgery in stage IV rectal cancer patients.

Patient expectations of functional outcomes after rectal cancer surgery: a qualitative study.

Background: Rectal cancer patients' expectations of health and function may affect their disease- and treatment-related experience, but how patients form expectations of postsurgery function has received little study.

Objective: We used a qualitative approach to explore patient expectations of outcomes related to bowel function after sphincter-preserving surgery for rectal cancer.

Design: This was a cohort study of patients who were about to undergo sphincter-preserving surgery for rectal cancer.

Synergistic enhancement in the co-gelation of salt-soluble pea proteins and whey proteins.

This paper investigated the enhancement of thermal gelation properties when salt-soluble pea proteins were co-gelated with whey proteins in NaCl solutions, using different blend ratios, total protein concentrations, pH, and salt concentrations. Results showed that the thermal co-gelation of pea/whey proteins blended in ratio of 2:8 in NaCl solutions showed synergistic enhancement in storage modulus, gel hardness, paste viscosity and minimum gelation concentrations. The highest synergistic enhancement was observed at pH 6.

A phase II, randomized, controlled trial of acupuncture for reduction of Postcolectomy Ileus.

Purpose: Postoperative ileus (POI) prolongs hospital stay and increases risk of postoperative complications. We conducted a randomized, sham-controlled trial to evaluate whether acupuncture reduces POI more effectively than sham acupuncture.

Methods: Colon cancer patients undergoing elective colectomy were randomized to receive 30 min of true or sham acupuncture twice daily during their first 3 postoperative days.

Whole-mount pathologic analysis of rectal cancer following neoadjuvant therapy: implications of margin status on long-term oncologic outcome.

Objective: Extent of distal resection margins in rectal cancer surgery remains controversial. We set out to determine the long-term oncologic impact of resection margins in patients with locally advanced rectal cancer using a comprehensive pathologic whole-mount section analysis.

Background: It has been demonstrated that there is minimal disease beyond the gross tumor margin after neoadjuvant combined modality therapy (CMT) for rectal cancer.

Pulmonary recurrence predominates after combined modality therapy for rectal cancer: an original retrospective study.

Objective: To characterize patterns of recurrence in locally advanced rectal cancer treated with combined modality therapy (CMT): neoadjuvant chemoradiation + total mesorectal excision + adjuvant chemotherapy.

Methods: A total of 593 consecutive rectal cancer patients (1998 to 2007) with locally advanced (stage II/III) disease (noted on endorectal ultrasound or magnetic resonance imaging) who received CMT were analyzed for patterns of recurrence.

Results: After median 44-month follow-up (interquartile range, 25 to 64 months), 119 patients (20%) recurred: 105 distant, 7 local, 7 local and distant, and 112 distant-only recurrence.

Endoscopic management of complete colonic obstruction.

A patient with metastatic rectal cancer underwent a diverting transverse loop colostomy due to rectal obstruction. 16 months later, he underwent a low anterior resection to resect his rectal cancer along with reversal of his transverse colostomy, and creation of a temporary loop ileostomy. Six months later, he was brought to the operating room for closure of his ileostomy.

Hypofractionated stereotactic body radiotherapy in low-risk prostate adenocarcinoma: preliminary results of a multi-institutional phase 1 feasibility trial.

Background: Recent reports using extreme hypofractionated regimens in the treatment of low-risk prostate adenocarcinoma have been encouraging. Here, the authors report on their own multi-institutional experience with extreme hypofractionated stereotactic radiotherapy for early stage disease.

Methods: In total, at 4 centers, 45 patients with National Comprehensive Cancer Network-defined, low-risk prostate adenocarcinoma were enrolled in a phase 1, multi-institutional trial of hypofractionated radiosurgery with a proprietary radiosurgical device (CyberKnife).

Surgery and high-dose-rate intraoperative radiation therapy for recurrent squamous-cell carcinoma of the anal canal.

Background: Locoregionally recurrent squamous-cell carcinoma of the anal canal is managed with salvage surgery. High-dose-rate intraoperative radiation therapy has been used in selected patients with this disease to reduce the risk of local recurrence.

Objective: The aim of this article is to present our institutional experience with this technique.

(124)I-huA33 antibody PET of colorectal cancer.

Unlabelled: Humanized A33 (huA33) is a promising monoclonal antibody that recognizes A33 antigen, which is present in more than 95% of colorectal cancers and in normal bowel. In this study, we took advantage of quantitative PET to evaluate (124)I huA33 targeting, biodistribution, and safety in patients with colorectal cancer. We also determined the biodistribution of (124)I-huA33 when a large dose of human intravenous IgG (IVIG) was administered to manipulate the Fc receptor or when (124)I-huA33 was given via hepatic arterial infusion (HAI).

Management of patients with malignant bowel obstruction and stage IV colorectal cancer.

Background: Malignant bowel obstruction (MBO), a serious problem in stage IV colorectal cancer (CRC) patients, remains poorly understood. Optimal management requires realistic assessment of treatment goals. This study's purpose is to characterize outcomes following palliative intervention for MBO in the setting of metastatic CRC.

Recurrence rates and prognostic factors in ypN0 rectal cancer after neoadjuvant chemoradiation and total mesorectal excision.

Background: Neoadjuvant chemoradiation followed by surgery and adjuvant chemotherapy is typically recommended for patients with locally advanced rectal cancer. Patients with pathologically node-negative tumors have an improved prognosis, but recurrence patterns and independent prognostic factors in these patients have been incompletely characterized.

Methods: Using a retrospective cohort study design, we included all rectal cancer patients treated with neoadjuvant chemoradiation and curative surgery from 1993 through 2003, who had ypN0 tumors.

Evaluation of ¹⁸F-FDG-PET for early detection of suboptimal response of rectal cancer to preoperative chemoradiotherapy: a prospective analysis.

Background: Early identification of inadequate response to preoperative chemoradiotherapy (CRT) may spare rectal cancer patients the toxicity of ineffective treatment. We prospectively evaluated tumor response with (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) early in the course of preoperative CRT.

Methods: A total of 27 prospectively accrued patients with locally advanced rectal cancer (T(3-4)/N(1)) received preoperative CRT (5040 cGy + 5FU-based chemotherapy).

A predictive model for lymph node yield in colon cancer resection specimens.

Objective: To develop a predictive model of lymph node yield in a series of colon cancer resection specimens with detailed anatomic and surgical technique data.

Background: Lymph node yield in colon resection specimens has been associated with accuracy of staging and cancer outcomes. We hypothesized that lymph node yield is associated with multiple factors including patient, tumor,and surgical variables.

Significance of acellular mucin pools in rectal carcinoma after neoadjuvant chemoradiotherapy.

The presence of mucin pools lacking neoplastic epithelium ("acellular" mucin) in resection specimens of rectal carcinoma after neoadjuvant chemoradiotherapy (CRT) is a well-recognized phenomenon. The current recommendation by the College of American Pathologists is to regard acellular mucin as a type of treatment response and not as residual tumor. However, data-based evidence for or against such an approach is incomplete.

Impact of a temporary stoma on the quality of life of rectal cancer patients undergoing treatment.

Background: Data from randomized controlled trials support use of a diverting stoma in rectal cancer patients with low anastomoses, but there is little data on how this impacts patient quality of life (QOL). This study prospectively evaluates QOL in stage I-III rectal cancer patients undergoing sphincter-preserving surgery (SPS) with a temporary diverting stoma.

Materials And Methods: Patents were identified from a prospective single-institution study of stage I-III rectal cancer patients undergoing SPS.

Close distal margin and rectal cancer recurrence after sphincter-preserving rectal resection.

Purpose: Negative surgical margins are important for local control of rectal cancer treated with sphincter-preserving surgery. However, the association of rectal cancer recurrence with close distal margin is not well established.

Methods: Data were extracted from a prospective database of patients collected between 1991 and 2003.

Effects of obesity in rectal cancer surgery.

Background: Increased local recurrence after total mesorectal excision (TME) in obese rectal cancer patients has been attributed to technical difficulties associated with adiposity. In this study, we evaluate whether higher body mass index (BMI) compromises surgical resection in patients with locally advanced, mid-to-low rectal cancer after neoadjuvant therapy, adversely affecting long-term oncologic outcomes.

Study Design: Five-hundred and ninety-six patients with uT3/4 and/or uN1 rectal adenocarcinoma were treated from 1998 to 2007 with neoadjuvant therapy, followed by radical resection using TME.