Gastric Heterotopic Pancreas Presenting as Abdominal Pain with Acute and Chronic Pancreatitis in the Resected Specimen.

Heterotopic pancreas, also known as ectopic pancreas, is pancreatic tissue located outside the pancreatic parenchyma without vascular or ductal communication with the gland. Ectopic pancreas is rarely symptomatic, typically detected incidentally at surgery or autopsy. Eighty-five to 90% are in the upper GI tract, especially the gastric antrum.

Early complications of biologic extracellular matrix patch after use for femoral artery repair.

Background: The CorMatrix (CorMatrix Cardiovascular, Roswell, Ga) biologic extracellular patch derived from porcine small intestinal mucosa provides a biologic scaffold for cellular ingrowth and eventual tissue regeneration. It has been used in a variety of applications, including cardiac and vascular repair procedures.

Methods: CorMatrix was used as a patch arterioplasty for femoral artery repair in conjunction with endarterectomy for seven separate procedures in six patients (one patient underwent staged, bilateral femoral procedures).

Reversal of chemosensitivity and induction of cell malignancy of a non-malignant prostate cancer cell line upon extracellular vesicle exposure.

Background: Extracellular vesicle (EV) trafficking is a fundamental cellular process that occurs in cells and is required for different aspects of pathophysiology. EV trafficking leads to changes in cellular function including apoptosis, angiogenesis and proliferation required for increased tumor formation.

Results: We report several phenotypic changes mediated by EVs isolated from non-malignant and malignant prostate cells as well as patient biopsied prostate tumor samples.

The new wave of hospital consolidation.

Reimbursement challenges, spiraling healthcare costs, and a slow economic recovery are driving the latest wave of hospital consolidation. Health insurance companies and provider systems are forming partnerships in the consolidation field with the goal of reducing healthcare costs and improving quality. The "cost" of the acquisition may include debt and other obligations of the acquired hospital, such as pension liabilities, along with a multiyear capital commitment.

Value of cardiovascular magnetic resonance in suspected cardiac amyloidosis.

The diagnosis of cardiac amyloid can be challenging; requiring a high clinical index of suspicion and often many diagnostic tests to confirm. We describe a case demonstrating the characteristic pattern of amyloid by cardiovascular magnetic resonance and how this imaging modality can aid in the diagnosis.

Hospital revenues in critical condition.

As revenue growth declines among not-for-profit U.S. hospitals, Moody's anticipates challenges to revenue from the following: Medicare, Medicaid, commercial payers, patient volumes, uncompensated care, transition to ICD-10, fee-for-service and bundled payment.

Microvesicle induction of prostate specific gene expression in normal human bone marrow cells.

Purpose: Transfer of genetic material from cancer cells to normal cells occurs via microvesicles. Cell specific phenotypes can be induced in normal cells by the transfer of material in microvesicles, leading to genetic changes. We report the identification and expression of prostate specific genes in normal human marrow cells co-cultured with human prostate cancer cells.

Creation of a novel recuperative pain medicine service to optimize postoperative analgesia and enhance patient satisfaction.

Many patients have difficulty with pain control after transition from patient-controlled analgesia modalities to oral analgesics. The creation of a Recuperative Pain Medicine (RPM) service was intended to bridge this gap in pain management at the Hospital for Special Surgery. Specific goals were to improve patient and staff satisfaction with management of postoperative oral analgesics by improving clinical care, administrative policies, and patient and staff education.

Planning during turmoil: credit challenges and healthcare finance. Interview by Carole J. Bolster.

The crisis in the financial markets is having a major impact on hospitals' ability to access capital. Providers are seeking longer-term fixed-rate debt rather than shortterm debt. Hospital management teams and their boards need to understand the upside and downside of variable-rate debt and interest rate derivatives.

The failure of AHERF: 5 important lessons.

Important lessons from AHERF's downfall: Strong governance and oversight of management are needed to ensure accountability; Disciplined growth strategies need to be supported by rigorous financial planning and feasibility analysis; Physician integration is critical to grow market share, but needs to be methodical and measured; Robust information systems are necessary to manage costs, maximize revenue, and provide differentiation in quality and clinical outcomes; Disclosure of the financial performance of all of a health system's operations creates greater transparency and builds credibility.

Phase I/II study of trastuzumab, paclitaxel, cisplatin and radiation for locally advanced, HER2 overexpressing, esophageal adenocarcinoma.

Purpose: To determine the overall survival for patients with locally advanced, HER2 overexpressing, esophageal adenocarcinoma receiving trastuzumab, paclitaxel, cisplatin, and radiation on a Phase I-II study.

Methods And Materials: Patients with adenocarcinoma of the esophagus without distant organ metastases and 2+/3+ HER2 overexpression by immunohistochemistry (IHC) were eligible. All patients received cisplatin 25 mg/m2 and paclitaxel 50 mg/m2 weekly for 6 weeks with radiation therapy (RT) 50.

Herceptin and gemcitabine for metastatic pancreatic cancers that overexpress HER-2/neu.

Purpose: To determine the response rate and toxicities of Herceptin and gemcitabine for patients with metastatic pancreatic adenocarcinomas that overexpress HER-2/neu.

Methods And Materials: Patients with metastatic pancreatic cancer with 2+/3 + HER-2/neu expression by immunohistochemistry were eligible. Patients received gemcitabine, 1 g/m2/week, for 7 of 8 weeks followed by 3 of every 4 weeks, and Herceptin, 4 mg/kg loading dose, followed by 2 mg/kg/week.

Trastuzumab, paclitaxel, cisplatin, and radiation for adenocarcinoma of the esophagus: a phase I study.

Purpose: To conduct a phase I study incorporating trastuzumab with paclitaxel, cisplatin, and radiation for adenocarcinoma of the esophagus.

Methods And Materials: Patients with adenocarcinoma of the esophagus without distant organ metastases were eligible. All patients received cisplatin 25 mg/m2 and paclitaxel 50 mg/m2 weekly for 6 weeks with radiation 50.