text:
National Cancer Institute®
Last Modified: June 1, 2002
AU - Ibingira CB
Management of cancer of the stomach in Mulago Hospital Kampala, Uganda.
SO - East Afr Med J 2001 May;78(5):233-7
AD - Department of Anatomy, Makerere Medical School, Kampala, Uganda.
OBJECTIVE: To determine the clinical presentation, mode of investigation
and management of gastric cancer at New Mulago Hospital. DESIGN:
Prospective descriptive study. SETTINGS: Three general surgical wards,
Department of Surgery, New Mulago Hospital. SUBJECTS: Thirty five
patients were studied within 12 months. RESULTS: Gastric cancer was
found to be prevalent in tribes inhabiting volcanic areas of south
western Uganda especially the Banyankole (25%). The commonest mode of
clinical presentation was epigastric pain, weight loss, constipation,
epigastric tenderness, palpable epigastric mass and anaemia. The most
accurate mode of investigation was by endoscopy followed by barium meal.
The commonest locality was the pyloric atrium (40%) histologically
adenocarcinoma (95.5%) predominated. Gastric cancer was found to be more
common in patients with blood group O+ve. All patients had been
subjected to some kind of medical treatment especially with antiacids,
H2 receptor antagonists which contributed to the delay in presentation.
The majority of patients (94.5%) presented with advanced disease and no
curative surgery was possible. CONCLUSIONS: These results show that
early diagnosis of gastric cancer is still a dream at Mulago hospital
since most patients present with advanced disease. To address this
problem, all health workers should be sensitised on symptoms and signs
for early aggressive investigation or an early referral to enable early
diagnosis of gastric cancer. The investigatory capacity of rural
hospitals should be boosted to enable early detection of gastric cancer.
AU - Roukos DH
Adjuvant chemoradiotherapy in gastric cancer: wave goodbye to extensive
SO - Ann Surg Oncol 2002 Apr;9(3):220-1
AU - Hundahl SA; Macdonald JS; Benedetti J; Fitzsimmons T; Southwest Oncology
Group and the Gastric Intergroup
Surgical treatment variation in a prospective, randomized trial of
chemoradiotherapy in gastric cancer: the effect of undertreatment.
SO - Ann Surg Oncol 2002 Apr;9(3):278-86
AD - Queen's Cancer Institute, Honolulu, Hawaii 96813, USA.
BACKGROUND: Intergroup 0116 (Southwest Oncology Group 9008), a national,
multicenter, two-armed, prospective, randomized trial of adjuvant
postoperative chemoradiotherapy, has demonstrated significant benefit.
METHODS: We prospectively captured complete surgical information,
including the treatment of various lymph node stations, for 553 of the
556 eligible participants in this trial. Before any survival analysis,
we coded D level by using the Japanese general rules and used the
Maruyama program to estimate the likelihood of disease in undissected
regional node stations, defining the sum of these estimates as the
Maruyama Index of Unresected Disease (MI). We analyzed survival with Cox
multivariate regression. RESULTS: Fifty-four percent of participating
patients underwent D0 lymphadenectomy. The median MI was 70 (range,
0-429). In contrast to D level, MI proved to be an independent
prognostic factor, even with adjustment for the potentially linked
variables of T stage and number of positive nodes. We detected no
significant interaction between surgical or pathologic variables and the
favorable effect of adjuvant treatment, but the power to detect such
interaction was generally low. CONCLUSIONS: MI, a measure of unresected
regional nodal disease in gastric cancer, proved an independent
predictor of survival. Surgical undertreatment, as observed in this
trial, clearly undermined survival.
AU - Kasakura Y; Ajani JA; Fujii M; Mochizuki F; Takayama T
Management of perforated gastric carcinoma: a report of 16 cases and
review of world literature.
SO - Am Surg 2002 May;68(5):434-40
AD - Department of Gastrointestinal Oncology, The University of Texas M.D.
Anderson Cancer Center, Houston, USA.
Perforated gastric carcinoma is rare; however, it is a serious condition
associated with complications. To understand the proper management of
this disease and to characterize its clinical course we reviewed
available data on 16 patients with perforated gastric carcinoma. We
collected data on the age and sex of the patients as well as operative
findings and histological features of the primary tumor. The depth of
invasion and presence of lymph node metastasis were also recorded. The
Union Internationale Contre Cancer stage, extent of resection, and
surgical method used were reviewed. We also reviewed published
information on the management of perforated gastric carcinoma. The
carcinoma was stage I in three cases, stage II in one case, stage III in
three cases, and stage IV in nine cases. Many patients had distant
metastases. Fourteen patients underwent gastrectomy. Two patients whose
preoperative condition was poor died of surgery-related complications,
but patients with early-stage carcinoma underwent an R0 resection
(resection of the primary tumor with negative margins) and had minimal
complications. We conclude that the outcome of patients who were able to
undergo radical surgery was good and correlated with the stage of
cancer. It is important to perform gastrectomy rather than repair the
perforation first, and a proper lymphadenectomy should follow--thus a
two-step surgery when necessary.
AU - Martin RC 2nd; Jaques DP; Brennan MF; Karpeh M
Achieving RO resection for locally advanced gastric cancer: is it worth
the risk of multiorgan resection?
SO - J Am Coll Surg 2002 May;194(5):568-77
AD - Gastric and Mixed Tumor Service, Department of Surgery, Memorial
Sloan-Kettering Cancer Center, New York, NY 10021, USA.
BACKGROUND: In gastric adenocarcinoma, only complete resection (R0)
translates into survival benefit. Given the potential for increased
morbidity and mortality from multiple organ resection we asked the
question as to whether extended (multiple organ) resection was justified
1,283 patients underwent gastric resection for adenocarcinoma at
Memorial Sloan-Kettering Cancer Center, and were entered and followed in
a prospectively recorded database. Four hundred eighteen patients (33%)
underwent primary resection and had one or more organs resected in
addition to the stomach. Eight hundred twenty-six patients (64%)
underwent gastrectomy alone, with 39 patients (3%) not undergoing
gastrectomy. Clinicopathologic, operative, and morbidity data were
evaluated in this group. Complications were categorized by severity on a
scale from 0 to 5, 0 being no complication to 5 being death. Chi-square
analysis and the logistic regression method were used to compare and
estimate factors significantly associated with having a complication.
RESULTS: Three hundred thirty-seven patients had a single additional
organ resected, 63 had two organs, and 18 had three organs. Five hundred
eighty complications occurred in 33% of patients (404 of 1,283). The
perioperative mortality was 4% (48 patients). Logistic regression
identified the number of organs resected, two or greater, to be
predictive of complications (RR 2.0), as well as age greater than 70
years old (RR 1.57). When excluding minor complications (values 1 and
2), only the number of organs resected (RR 3.8) was a major factor for
severe complications (values 3, 4, and 5). CONCLUSIONS: Resection of two
or more adjacent organs in advanced gastric adenocarcinoma is associated
with a greater risk of developing a complication. The use of a graded
surgical complication scale is needed for better reporting and
comparison of complications. Achieving an R0 resection should still be
considered the goal, even in locally advanced gastric cancer, but
resection of additional organs should be performed judiciously.
AU - Klimenkov AA; Nered SN; Gubina GI
[Basic directions in studying cancer of the resected stomach]
SO - Vestn Ross Akad Med Nauk 2001;(9):71-4
The causes, incidence of, and the time of occurrence of cancer of the
stomach resected for benign diseases are analyzed. The outcomes of 384
operations for recurrent gastric cancer, including 174 radical ones, are
presented. The highest resectability was noted in late recurrence and
following Bilroth-II gastrectomy with long-loop forward colonic
anastomosis. The late outcomes depend on the time of recurrence, its
location in the remaining part of the stomach, and the presence of
lymphogenic metastases. Experience of 16 extirpations of esophagojejunal
anastomosis was used to show whether recurrent gastric cancer after
gastrectomy with satisfactory immediate and long-term outcomes can be
surgically treated. The fate of 292 patients with gastric cancer in whom
tumor cells were detected along the line of resection is traced.
Preventive resurgery in this group of patients is not unjustifiable as
in 80.8% of them recurrence fails to occur at all or is followed by late
AU - Lin YC; Chen JS; Wang CH; Wang HM; Chang HK; Liaul CT; Yang TS; Liaw CC;
Liu HE
Weekly high-dose 5-fluorouracil (5-FU), leucovorin (LV) and bimonthly
cisplatin in patients with advanced gastric cancer.
SO - Jpn J Clin Oncol 2001 Dec;31(12):605-9
AD - Department of Internal Medicine, Chang Gung Memorial Hospital, Taipei,
Taiwan. firstname.lastname@example.com
BACKGROUND: A phase II clinical trial was performed to evaluate the
activity and toxicity of bimonthly cisplatin and weekly 24-h infusion of
high-dose 5-fluorouracil and leucovorin in patients with advanced
23 chemo-naive patients of advanced gastric cancer were enrolled in this
study. The regimen consisted of weekly 24-h infusion of 5-FU (2,600
mg/m2) and LV 150 mg and bimonthly cisplatin (25-50 mg/m2) bolus for 12
weeks followed by a 2-week break. RESULTS: There were 10 male and 13
female patients with a median age of 52 years. A total of 428
chemotherapy treatments were given with a mean of 11. Seventeen patients
were evaluable for response. There were 41% (7/17) partial response, 18%
(3/17) stable disease and 41% (7/17) progressive disease. The grade III
or IV toxicity included anorexia 35% (8/23), fatigue 26% (6/23),
vomiting 17% (4/23) and mucositis 9% (2/23). One patient developed
perforated duodenal stump after chemotherapy. One patient died of
hyperammonemia-related coma. The median times to disease progression and
overall survival were 3.5 and 7 months, respectively. CONCLUSIONS: This
regimen showed modest activity against gastric cancer. However, there
was no survival advantage and there was greater toxicity than with
weekly high-dose 5-FU-LV alone.
AU - Leme PL; Rodrigues FC; Malheiros CA
[Duodenal-pyloric-antrum obstruction and metabolic disturbances: is
important an adequate preoperative care?]
SO - Rev Assoc Med Bras 2001 Jul-Sep;47(3):177-8
AU - Xu CT; Huang LT; Pan BR
Current gene therapy for stomach carcinoma.
SO - World J Gastroenterol 2001 Dec;7(6):752-9
AD - Editorial Department, the Journal of Fourth Military Medical University,
Xi'an, Shaanxi Province, China. firstname.lastname@example.com
AU - Pentheroudakis G; Lim KC; Dunlop DJ; Soukop M; Eatock MM
Non-infusional 5-fluorouracil, doxorubicin and cisplatin in the
treatment of locally advanced or metastatic gastro-oesophageal
SO - Acta Oncol 2001;40(7):855-61
AD - Department of Medical Oncology, St Mungo Institute, Glasgow Royal
Infirmary, Scotland. firstname.lastname@example.com
To reduce the Hickman line-associated morbidity of continuous infusion
5-fluorouracil combined with epirubicin and cisplatin (ECF) and to
investigate the need for infusional regimens, we conducted a
retrospective study in patients with advanced gastro-oesophageal
adenocarcinoma. Thirty-six patients, with histologically proven
irresectable gastro-oesophageal adenocarcinoma were given: 60 mg/m2
cisplatin on day 1, 35 mg/m2 doxorubicin on day 1 and 500 mg/m2
5-fluorouracil on days 1 and 8 (NIACF) every 3-weeks. A median of 3
cycles was administered. The principal toxicity was myelosuppression
with grade III/IV neutropenia in 47% of cycles. Neutropenic fever
occurred in 5% of the cycles: non-haematological toxicity was mild and
there were no treatment-related deaths. Administered dose intensity was
96.1% for doxorubicin, 93.6% for cisplatin and 90.5% for 5-fluorouracil.
There were 16 partial responses and 1 complete response (overall
response rate 47%, 95% confidence interval CI 31-63%); 8 patients had
stable disease. Median progression-free and overall survival rates were
5 months (95% CI 4-6) and 8 months (95% CI 6-10), respectively. NIACF is
a well-tolerated regimen in advanced gastro-oesophageal adenocarcinoma
that precludes the need for central venous access, with activity similar
to that observed with ECF.
AU - Maehara Y; Kakechi Y; Sumiyoshi Y; Kimura K; Takesue F; Oiwa H; Baba H;
Adachi Y; Tsujiya S; Haraguchi M; Korenaga T; Okamura T; Tamada R;
Ichikichi Y
[Departmental review of surgical cases in the last 17 years: Stomach
SO - Fukuoka Igaku Zasshi 2002 Mar;93(3 Suppl):9-11
AU - Gunderson LL
Gastric cancer--patterns of relapse after surgical resection.
SO - Semin Radiat Oncol 2002 Apr;12(2):150-61
AD - Department of Radiation Oncology, Mayo Medical School and Mayo
Foundation, Rochester, MN 55905, USA.
A knowledge of patterns of relapse after initial treatment with surgery
alone is essential to determining the relative importance of both local
(irradiation) and systemic adjuvants (chemotherapy, other) to surgery. A
presentation of anatomic factors and pathways of tumor spread provides a
basis for understanding the subsequent patterns of relapse data found in
clinical, autopsy, and reoperative series. Implications for adjuvant
therapy are summarized. Copyright 2002, Elsevier Science (USA). All
rights reserved.
AU - Kim HJ; Karpeh MS
Surgical approaches and outcomes in the treatment of gastric cancer.
SO - Semin Radiat Oncol 2002 Apr;12(2):162-9
AD - Department of Surgery, University of North Carolina, Chapel Hill, NC,
Resection with extended lymphadenectomy in obtaining local-regional
control with negative margins remains the only potentially curative
modality in the treatment of gastric cancer. Complete (R0) resections,
along with depth of invasion and adequate nodal staging, remain the most
important prognostic factors. Because current chemotherapy regimens have
limited benefit in advanced disease, the effectiveness of local-regional
modalities takes on greater significance. The extent of surgical
resection varies with the size, depth, location of the primary tumor,
and the stage of disease. Studying patterns of recurrent disease and
elucidating the impact of positive margins have led to insights into the
biology of the disease and the limitations of local-regional therapies.
Considerable controversy surrounds the notion of what defines an
adequate lymph node dissection (LND). The recommendation of routine
extended (D2) lymphadenectomy (ELND) is difficult to justify based on
available randomized studies, but ELND may benefit selected patients
when performed by surgeons who can accomplish the dissection with
acceptable morbidity/mortality rates. An extended LND results in
improved staging, allowing standardization of prognostic factors and
survival data worldwide. Patient selection remains critical, limiting
the role of surgery in advanced disease and reserving aggressive
surgical resection for patients with high curative potential. Copyright
2002, Elsevier Science (USA). All rights reserved.
AU - Willett CG
Results of radiation therapy in gastric cancer.
SO - Semin Radiat Oncol 2002 Apr;12(2):170-5
AD - Department of Radiation Oncology, Massachusetts General Hospital,
Boston, MA 02114, USA.
Radiation therapy has been used in the treatment of patients with
gastric cancer in two clinical settings: definitive therapy for locally
advanced, unresectable tumors and adjuvant therapy following surgery for
high-risk disease. For patients with locally advanced, unresectable or
subtotally resected gastric carcinoma, radiotherapeutic approaches with
and without chemotherapy have been employed, because these tumors appear
localized, without clinically detectable metastases. Combined treatment
with radiation therapy and chemotherapy appears to prolong survival but
rarely results in long-term cure. Although only a modest effect was seen
on survival, importantly, these studies established the foundation of
contemporary combined-modality therapy and have served to stimulate
further clinical investigation in gastric cancer as well as other
gastrointestinal disease sites. For patients undergoing resection and
lymphadenectomy with curative intent, the development of local or
regional failure is common, occurring in 40% to 65% of patients. Sites
of local and regional failure following resection include the
gastric/tumor bed in 20% to 55%, the anastomosis in 25% to 50%, and the
regional nodes in 40% to 50% of patients. Intergroup Trial 0116 (INT
0116), a phase III trial, has recently demonstrated that adjuvant
radiation therapy with concurrent and maintenance 5-fluorouracil (5-FU)
and leucovorin (LV) reduces local failure and improves survival.
Adjuvant therapy is now routinely administered to patients undergoing
resection of gastric cancer for high-risk disease. Ongoing trials are
now investigating new systemic agents with radiation therapy to
establish efficacy compared to 5-FU and LV, as well as evaluating
neoadjuvant approaches prior to resection. Copyright 2002, Elsevier
Science (USA). All rights reserved.
AU - Meyerhardt JA; Fuchs CS
Chemotherapy options for gastric cancer.
SO - Semin Radiat Oncol 2002 Apr;12(2):176-86
AD - Department of Adult Oncology, Dana Farber Cancer Institute, Boston, MA
Most patients diagnosed with gastric cancer in the United States and the
Western World will either present with advanced disease or have
recurrence after surgery, requiring discussions of chemotherapy. The
evolution of chemotherapy for gastric cancer has been mixed with
excitement and disappointment. Multiple single-agent chemotherapies have
been shown to be only modestly effective in advanced disease, and the
search for the best combination of therapy has been difficult.
Contemporary combination therapies for advanced gastric cancer, usually
containing 5-fluorouracil (5-FU) and/or cisplatin, demonstrate response
rates in the 20% to 40% range, with median survivals between 6 and 12
months. While newer, standard chemotherapeutics, including the taxanes
and irinotecan, may offer modest additional benefits, each requires
further examination in phase III trials. Among patients with curatively
resected disease, postoperative chemoradiotherapy appears to improve
overall survival significantly. As a greater understanding of the
molecular basis of gastric cancer is gained, the inclusion of
biologic-based therapies will hopefully advance our ability to treat
patients with gastric cancer more effectively. Copyright 2002, Elsevier
Science (USA). All rights reserved.
AU - Tepper JE; Gunderson LL
Radiation treatment parameters in the adjuvant postoperative therapy of
gastric cancer.
SO - Semin Radiat Oncol 2002 Apr;12(2):187-95
AD - Department of Radiation Oncology, University of North Carolina School of
Medicine, Chapel Hill, NC 27599, USA. firstname.lastname@example.com
Radiation therapy will be used much more commonly in the treatment of
adenocarcinoma of the stomach because of the results of the Intergroup
Trial demonstrating an advantage to adjuvant postoperative
chemoradiation therapy. Previous descriptions of radiation fields have
not emphasized the variation in local spread patterns between tumors
located in different portions of the stomach and the varying extent of
the primary tumor and lymph node spread. Based on data obtained from
surgical and pathologic series, we have recommended a variation in the
radiation fields from those routinely applied at the present time.
Tumors located primarily in the region of the gastric cardia have the
highest risk of nodal involvement in the pericardial region and along
the lesser and greater curvature, as well as risk of spread into the
periesophageal tissue. However, there is a lower risk of involvement in
the distally located nodes, especially in the gastric antrum,
periduodenal, and porta hepatis regions. For a patient who has been well
evaluated both surgically and pathologically, and found to be node
negative, it may not be necessary to treat the nodes in these lower risk
sites. Similarly, tumors that originate in the distal stomach, in the
region of the gastric antrum, have a high likelihood of spread to the
periduodenal, peripancreatic, and porta hepatis nodes, and a lower
likelihood of spread to the nodes near the cardia of the stomach, the
periesophageal and mediastinal nodes, or to the splenic hilar nodes. Any
tumor originating in the stomach has a high propensity of spread to
nodes along the greater and lesser curvature, although they are most
likely to spread to those sites in close anatomic proximity to the
primary tumor mass. Based on such information, we have described the
nodal and primary sites that should be treated for different T- and
N-stage tumors located in the cardia, body, or antrum of the stomach.
These should be used as guides for defining appropriate field
arrangements for the adjuvant postoperative therapy of gastric cancer.
Copyright 2002, Elsevier Science (USA). All rights reserved.
AU - Allum WH; Griffin SM; Watson A; Colin-Jones D; Association of Upper
Gastrointestinal Surgeons of Great Britain and Ireland; British Society
of Gastroenterology; British Association of Surgical Oncology
Guidelines for the management of oesophageal and gastric cancer.
SO - Gut 2002 Jun;50 Suppl 5():v1-23
AD - Department of Surgery, Epsom Hospital, Epsom, Surrey KT1 7EG, United
AU - Malatinec J; Bruncak P; Pelc J; Kovacs V; Cseri J
[Results of surgical treatment of gastric cancer]
SO - Rozhl Chir 2002 May;81(5):240-3
AD - Chirurgicke oddelenie, NsP Lucenec, Slovenska republika.
The authors retrospectively analyse a group (1991-2000) of 129 patients
with malignancies of the stomach operated at the Surgical Department of
The District Hospital in Lucenec. The operated patients were: males 83
(64%), females 46 (36%), mean age--63.4 years. Elective operations were
performed in 78.2% and acute operations in 21.8%. We were able to make
resections in 90 (69.8%) patients and palliative operations in 39
(30.2%) patients. On the basis of histologic
examinations-adenocarcinomas dominated (120 patients--93%). The
postoperative mortality was 4.65% and five-year survival 12%.
AU - Segol P
[Total esophagogastrectomy via left throacophrenic access for cancer of
the cardia]
SO - J Chir (Paris) 2001 Aug;138(4):217-21
AD - Service de Chirurgie Digestive, CHU Caen Cote de Nacre, Caen, France.
AU - Adani GL; Marcello D; Mazzetti J; Maestroni U; Anania G; Donini A
[Role of surgery in the treatment of primary gastric lymphoma and
assessment of new therapeutic approaches]
SO - G Chir 2001 Aug-Sep;22(8-9):273-6
AD - Dipartimento di Scienze Chirurgiche, Anestesiologiche e Radiologiche
Sezione di Clinica Chirurgica, Universita degli Studi di Ferrara.
Controversy remains regarding the best treatment for primary gastric
lymphoma (PGL). Recent developments in diagnosis and chemotherapy have
changed strategies for this disease. Fourteen patients with primary
gastric non-Hodgkin's lymphoma underwent surgery. Before surgery 9/14
patients underwent Helicobacter pylori eradication, and 4/14 were
treated with chemotherapy. In two patients chemotherapy was not possible
because of risk of perforation recurred. Total gastrectomy with N2
lymphadenectomy, splenectomy, biopsy of mesenteric lymph nodes, and
hepatic biopsy were done. Then patients underwent post-operative
chemotherapy. Involved-field radiation therapy was made in four
patients. The overall survival was 64.2 percent. Surgery was the
treatment of choice in cases of gastric lymphoma non-responsive to
medical therapy and to control complications or when gastroscopy did not
supply correct diagnosis.
AU - Newman E; Marcus SG; Potmesil M; Sewak S; Yee H; Sorich J; Hayek M;
Muggia F; Hochster H
Neoadjuvant chemotherapy with CPT-11 and cisplatin downstages locally
advanced gastric cancer.
SO - J Gastrointest Surg 2002 Mar-Apr;6(2):212-23; discussion 223
AD - Department of Surgery, New York University School of Medicine, New York,
New York 10016, USA. firstname.lastname@example.com
We examined the role of neoadjuvant therapy in downstaging locally
advanced gastric cancer. Preoperative staging was performed with a
combination of CT scans, endoscopic ultrasonography and/or laparoscopy,
and laparoscopic ultrasonography. Patients with T > or =3 tumors and/or
node-positive disease by preoperative clinical staging were eligible for
entry. Neoadjuvant therapy consisted of two cycles of CPT-11 (75
mg/m(2)) with cisplatin (25 mg/m(2)) weekly four times every 6 weeks.
This was followed by resection with D2 lymph node dissection and two
cycles of intraperitoneal chemotherapy with floxuridine and cisplatin.
Twenty-two patients were entered into the study (4 with T3N0 disease and
18 with T3N1 disease). Induction chemotherapy was well tolerated with
major toxicities being neutropenia and diarrhea. A median of 78%/75% of
the planned dosage of CPT-11/cisplatin was delivered. Two patients
withdrew consent during the first cycle and were lost to follow-up. One
patient progressed to stage IV disease during induction chemotherapy and
did not undergo surgery. Nineteen patients underwent surgery. One
patient had undetected stage IV disease (liver) and underwent a
palliative R2 resection. Of the 18 remaining patients, 17 had curative
R0 resections and one had a palliative R1 resection. A median of 21
lymph nodes (range 1 to 121) were examined histologically. There was one
postoperative death. Surgical morbidity did not appear to increase after
the neoadjuvant regimen. The median postoperative length of hospital
stay was 9 days (range 3 to 75 days). Postoperative pathologic staging
yielded 16% T3 lesions compared to 85% before treatment based on
clinical staging; postoperative American Joint Committee on Cancer
staging yielded 37% stage IIIA disease compared to 70% stage IIIA before
treatment. With a median follow-up of 15 months, median survival has not
yet been reached. We conclude that CPT-11-based neoadjuvant therapy
downstages locally advanced gastric cancer. Further follow-up is
necessary to determine the ultimate impact of this combination therapy
on recurrence and survival.
AU - Kim R; Yoshida K; Toge T
Current status and future perspectives of post-operative adjuvant
therapy for gastric carcinoma.
SO - Anticancer Res 2002 Jan-Feb;22(1A):283-9
AD - Department of Surgical Oncology, Research Institute for Radiation
Biology and Medicine, Hiroshima University, Japan.
The clinical benefit of post-operative adjuvant immunochemotherapy for
survival of patients with gastric carcinoma is unclear, although a
number of prospective randomized controlled studies have been conducted.
The current status and future perspectives of post-operative adjuvant
chemotherapy in gastric carcinoma have been evaluated in terms of
survival benefit. The results of randomized clinical studies vary in
accordance with the regimen and sample size. A meta-analysis, however,
indicated a survival benefit in patients treated with post-operative
adjuvant chemotherapy including mitomycin, anthracyclines,
cyclophosphamide, alkylating agents and 5-fluorouracil (odds ratio: 0.8
to approximately 0.82, 95% CI<1.0). The survival benefit was observed in
patients with stage II and stage III gastric carcinoma, but not those
with stage I. Further, the survival benefit in node-positive and high
histological grade subgroups was superior to that in node-negative and
low histological grade subgroups. Although combination therapy with
mitomycin, 5-fluorouracil and non-specific immunomodulators, such as PSK
and OK-432, appeared to improve overall survival without
immunomodulators, the survival effect of immunomodulators is still not
clear. There are several possible reasons why the survival benefit of
adjuvant chemotherapy or immunochemotherapy is small and marginal
compared to surgery alone: (i) low efficacy of the chemotherapy regimen;
(ii) small sample size; and (iii) differences in chemosensitivity of
treated patients based on genetic background. The determination of
subgroups responsive to chemotherapy and the development of a
rationale-based and molecular-targeted chemotherapy are required to
clearly demonstrate whether there is a survival benefit of
post-operative adjuvant chemotherapy in gastric carcinoma.
AU - Inada T; Ogata Y; Kubota T; Ishihara M; Tomikawa M; Ando J; Ozawa I;
Hishinuma S; Shimizu H; Kotake K
D2-lymphadenectomy improves the survival of patients with peritoneal
cytology-positive gastric cancer.
SO - Anticancer Res 2002 Jan-Feb;22(1A):291-4
AD - Department of Surgery, Tochigi Cancer Center, Utsunomiya, Japan.
BACKGROUND: According to the current Japanese Classification of Gastric
Cancer, patients with peritoneal cytology-positive (CY1) gastric cancer
are classified as stage IV and the curative potential of resection for
these patients is regarded as non-curative. MATERIALS AND METHODS: We
compared the clinical outcome of CY1 patients (n=55) with those of
patients with other non-curative factors (n=87), to clarify the optimal
surgical strategy for CY1 patients. RESULTS: The 5-year survival rate of
CY1 patients was 10.8%, which was significantly better than that
observed in the patients with the other non-curative factors. Among CY1
cases, survival outcome of the patients with lymph node metastasis
limited to within group 2 was significantly better than the patients
with group 3 lymph node metastasis. CONCLUSION: These results suggested
that gastrectomy combined with extended lymphadenectomy should be
recommended for patients with gastric cancer who have positive
peritoneal cytology as the only non-curative factor.
AU - Nakamura H; Yanai H; Nishikawa J; Okamoto T; Hirano A; Higaki M; Omori
K; Yoshida T; Okita K
Experience with photodynamic therapy (endoscopic laser therapy) for the
treatment of early gastric cancer.
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1599-603
AD - First Department of Internal Medicine, Yamaguchi University School of
Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi, 755-8505, Japan.
BACKGROUND/AIMS: Photodynamic therapy has been developed as an
endoscopic laser therapy for gastrointestinal malignant tumors. The
targets for curative upper gastrointestinal endoscopic therapy are
carcinomas that are considered statistically unlikely to be accompanied
with metastases to the lymph nodes. Endoscopic mucosal resection is the
therapy of first choice for such carcinomas. In the application of
photodynamic therapy, we narrow down its practical indications to
patients who are not indicated for curative endoscopic treatment by
preoperative examination or those with histologic findings of endoscopic
mucosal resection specimens who reject surgical treatment or are at high
risk in surgical treatment. METHODOLOGY: The effect of photodynamic
therapy using Porfimer sodium and an Excimer dye laser was evaluated
endoscopically in 8 lesions of 7 patients with early gastric cancer.
RESULTS: Complete responses were obtained in all patients. As side
effects, mild photosensitivity was seen in 6 patients and lasted for
several months. CONCLUSIONS: Photodynamic therapy was safety employed,
with success in 7 patients with early gastric cancer. We conclude that
photodynamic therapy can be a useful palliative method with high tumor
selectivity in the treatment of early gastric cancer.
AU - Ichikawa D; Ueshima Y; Shirono K; Kan K; Shioaki Y; Lee CJ; Hamashima T;
Deguchi E; Ikeda E; Mutoh F; Oka T; Kurioka H
Esophagogastrostomy reconstruction after limited proximal gastrectomy.
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1797-801
AD - Department of Surgery, Kyoto First Red Cross Hospital, 15-749 Honmachi,
Higashiyama-ku, Kyoto 605-0981, Japan. firstname.lastname@example.com
BACKGROUND/AIMS: Recent advances in diagnostic techniques have led to
the detection of an increasing number of early gastric cancers in the
upper third of the stomach. The objective of this study was to determine
the most appropriate surgical treatment for these cancers. METHODOLOGY:
The clinicopathologic characteristics of 35 patients with early gastric
cancer in the upper third of the stomach who underwent three different
types of gastrectomies were reviewed retrospectively from hospital
undergoing limited proximal gastrectomy with esophagogastrostomy
reconstruction had shorter operation times and less blood loss than
those for patients undergoing total gastrectomy or proximal gastrectomy
with jejunal interposition. No lymph node metastasis was identified in
any of these patients. Heartburn due to reflux esophagitis was seen in a
few patients of each group, but they were successfully treated by
antacids. The extreme reduction in food intake volume was more
frequently experienced in patients with total gastrectomy than those
with both proximal gastrectomies. When mortality due to other disease
was excluded, all patients survived without recurrence. CONCLUSIONS: A
limited proximal gastrectomy with esophagogastrostomy reconstruction
decreased surgical risk and realized preservation of maximal function.
AU - Lee JH; Noh SH; Lah KH; Choi SH; Min JS
The prognosis of stage IV gastric carcinoma patients after curative
SO - Hepatogastroenterology 2001 Nov-Dec;48(42):1802-5
AD - Department of Surgery, Yonsei University College of Medicine, C.P.O. Box
8044, 134 Shinchon-dong, Seadaemun-ku, 120-752, Seoul, Korea.
BACKGROUND/AIMS: In the UICC staging system, stage IV contains not only
those patients with distant metastasis but also patients with
far-advanced T and N status but without distant metastasis. We
investigated the prognostic factors of stage IV gastric carcinoma
patients, without distant metastasis after curative resection and the
role of surgery. METHODOLOGY: One hundred and ninety stage IV gastric
carcinoma patients, without distant metastasis were reviewed after
RESULTS: Male sex, distal third location, diffuse or infiltrative type
and histologically undifferentiated type were common. Of the 190
patients, 52 (27.4%) patients lived more than 3 years. The lymph node
ratio (positive lymph node/retrieved lymph node) and combined resection
independently affected survival (P = 0.0013, 0.0061, respectively). The
perigastric lymph node ratio was well correlated with overall lymph node
ratio (r = 0.794, P < 0.001). CONCLUSIONS: With the involvement of an
adjacent organ and knowing the perigastric lymph node ratio, the surgeon
can decide upon the extent of dissection and postoperative treatment.
However, a prospective study is warranted.
AU - Franciosi CM; Angelini C; Mussi C; Sartori P; Romano F; De Fina S;
Uggeri F
[Stomach lymphoma]
SO - Minerva Chir 2001 Aug;56(4):337-43
AD - Divisione di Clinica Chirurgica Generale I, Ospedale San Gerardo, II
Universita di Milano, Bicocca, Monza, Milan, Italy.
BACKGROUND: Primitive gastric lymphoma (PGL) is a rare tumour, and
although its incidence is rising it is difficult to state the role of
the various therapeutic methods in treating this disease. Aim of this
study is to point out what sequence of treatment is more effective
trying to find out some guidelines which can be useful in clinical
practice. METHODS: Retrospective analysis of clinical data of 54
patients with PGL admitted at a University surgical department during 10
years. All the patients underwent neoadjuvant or adjuvant chemotherapy
and D2 gastrectomy. Follow-up ranged from 6 to 120 months. Survival was
related to: Mushoff's stage of disease, the grade according to the
Working Formulation and the sequence of treatment. Statistical analysis
was performed by Kaplan-Maier method and the difference between survival
curves was compared by log-rank test. RESULTS: Mean postoperative
hospital stay was 12 days and morbidity was 18%. Five and 10 years
overall survival rates were 70 and 85%. There was a significant
difference in survival between patients with high grade PGL and those
with intermediate grade (p=0.0188) as well as in those with low grade
(p=0.0435). Patients in stages IE-II1E had a significantly longer
survival than those in stages IIIE-IVE (p=0.0123). Patients in stages
IE-II1E underwent neadjuvant chemotherapy and surgery and survived
longer than those in whom surgery preceded chemotherapy (p=0.0293)
instead for patients in stages IIIE-IVE neoadjuvant chemotherapy
shortened survival (p=0.0403). CONCLUSIONS: In personal opinion, in
patients in stages IE-II1E chemotherapy should be carried out before
surgery, while in those in stages IIIE-IVE the reverse scheme is more
effective in achieving longer survival rates.
AU - Melchart D; Clemm C; Weber B; Draczynski T; Worku F; Linde K;
Weidenhammer W; Wagner H; Saller R
Polysaccharides isolated from Echinacea purpurea herba cell cultures to
counteract undesired effects of chemotherapy--a pilot study.
SO - Phytother Res 2002 Mar;16(2):138-42
AD - Centre for Complementary Medicine Research, Department of Internal
Medicine II, Technische Universitat, Kaiserstrasse 9, 80801 Munich,
Germany. firstname.lastname@example.com
In an open prospective study with matched historical controls we aimed
to evaluate whether a polysaccharide fraction isolated from the herb
Echinacea purpurea could counteract the undesired effects of
chemotherapy. Fifteen patients with advanced gastric cancer undergoing
palliative chemotherapy with etoposide, leucovorin and 5-fluorouracil
(ELF) received for 10 days (beginning 3 days before chemotherapy) daily
i.v. injections of 2 mg of a polysaccharide fraction isolated from
Echinacea purpurea herb cell cultures (EPS-EPO VIIa). The median number
of leukocytes 14-16 days after chemotherapy was 3630/microL (range
1470-5770) in the patients receiving EPS-EPO VIIa compared with
2370/microL (870-3950) in the patients of the historical control group
(p = 0.015). EPS-EPO VIIa had no clinically relevant effects on
phagocytic activity of granulocytes or on lymphocyte subpopulations.
Sixty-eight adverse events including two deaths were observed, most
likely due to chemotherapy and the general condition of the patients.
However, an association with the test intervention cannot be ruled out
completely. The results of this pilot study suggest that EPS-EPO VIIa
might be effective in reducing chemotherapy-induced leukopenia. The
efficacy and safety should be investigated in further studies. Copyright
2002 John Wiley & Sons, Ltd.
AU - Liu JM; Chen LT; Chao Y; Li AF; Wu CW; Liu TS; Shiah HS; Chang JY; Chen
JD; Wu HW; Lin WC; Lan C; Whang-Peng J
Phase II and pharmacokinetic study of GL331 in previously treated
Chinese gastric cancer patients.
SO - Cancer Chemother Pharmacol 2002 May;49(5):425-8
AD - Division of Cancer Research, National Health Research Institutes,
Veterans General Hospital-Taipei, Shipai Road, Taipei, Taiwan.
PURPOSE: A phase II and pharmacokinetic study was designed to assess the
efficacy and toxicity profile of an epidophyllotoxin analogue, GL331, in
previously treated Chinese gastric cancer patients, with concurrent
pharmacokinetic evaluation of the drug's metabolism. MATERIAL AND
METHODS: GL331 was given at 200 mg/m(2) as a daily 3-h infusion for 5
days every 4 weeks. RESULTS: Enrolled in the study were 15 patients. One
patient died from neutropenic sepsis before evaluation, one patient did
not receive the full dose for reasons unrelated to GL331, nine patients
had progressive disease with a median survival of 80 days, and five had
stable disease with a median survival of 240 days. Grade 3 and 4
myelosuppression occurred in 10 of the 15 patients, with one death from
neutropenic sepsis. This patient's peak GL331 concentration was 16.8
microg/ml, which was high compared to the mean peak drug concentration
of 6+/-4.1 microg/ml. The mean systemic GL331 clearance was 12.1+/-7.2
l/h per m(2), much lower than 23.3+/-8.2 l/h per m(2) found in the phase
I trial. Topoisomerase IIalpha was determined by immunohistochemistry
and overexpression was detected in 3 of 11 specimens. CONCLUSIONS: GL331
was ineffective at this dose and schedule in this group of patients in
spite of adequate blood levels of the drug.
AU - Yokota T; Saito T; Teshima S; Yamada Y; Iwamoto K; Takahashi M; Kunii Y;
Murata K; Ishiyama S; Yamauchi H
Probability of lymph node metastasis in small gastric cancer tumor: is
it an indication for limited surgery?
SO - Int Surg 2001 Oct-Dec;86(4):206-9
AD - Department of Surgery, Sendai National Hospital, Japan.
The purpose of this study was to determine the factors that are
predictive of lymph node metastasis in a small gastric cancer tumor <2
cm in diameter. The clinicopathological features of 17 patients with
node-positive small gastric cancer were reviewed from the database of
gastric cancer at the Department of Surgery, Sendai National Hospital,
Sendai, Japan, and they were compared with those of 131 patients with
node-negative cancer. The independent risk factors influencing the lymph
node metastasis were determined by multiple logistic regression
analysis. Depth of invasion, macroscopic appearance, cancer-stromal
relationship, and lymphatic microinvasion were found to be associated
with lymph node metastasis. The variables found to be significant risk
factors for lymph node metastasis were depth of invasion (P = 0.0250)
and lymphatic microinvasion (P = 0.0028). It is possible for even a
small gastric cancer tumor to have lymph node metastasis. A surgeon
treating a small gastric cancer tumor must consider that although the
cure rate is high, >10% of these tumors have lymph node metastases.
Because of the possibility of lymph node metastasis, even with accurate
knowledge of the depth of cancer invasion, selective performance of
local resection or limited surgery with incomplete lymph node dissection
is not justified. Accurate preoperative diagnosis and the appropriate
decision for surgical indication are important. Large-scale randomized,
controlled trials should be performed to show the advantage of limited
surgery for gastric cancer.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.


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The NEW on-board weighing system for all agricultural loaders. See our latest video here!
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Category: Historical Fiction/Romance Description: Queen Guinevere is keeping a secret from her husband and now her life and the city of Camelot could be in danger unless King Arthur's love is strong enough to save them both. Lady Guinevere was betrothed to Prince Arthur as a young child and now that he has become the king, he is ready to make the young woman his wife. Knowing she will be the Queen of Camelot is exciting but what Guinevere wants more than anything, is to be one of Arthur's Knights of the Roundtable. With her raw beauty and his powerful nobility, the royal couple is a magnificent sight for all to see. Their attraction to one another is magnetic and Arthur vows to awaken Guinevere's hidden passion which sparks feelings between the two. Merlin is a wizard in secret and with his help, Guinevere will have the chance to compete in the Tournament of Knights. When Lancelot enters the knights competition, the man is seen sneaking in and out of Guinevere's chamber leaving everyone suspicious about the queen's actions. Arthur is quick to condemn his wife and this leads to the jeopardy of Guinevere's safety. Now, the king has to protect Camelot from those who have betrayed him. Arthur loves his Guinevere but is it enough to forgive the woman for the secrets she is keeping from the king? eBook Publisher: New Concepts Publishing, 2012 2012 eBookwise Release Date: July 2012
Available eBook Formats: OEBFF Format (IMP) [132 KB] Words: 31209Reading time: 89-124 min.
The next morning seemed to come and go quickly as Guinevere prepared for the wedding ceremony. After she had taken a long hot bath, Ava and five other servants came into the room to help Guinevere get ready. She sat in her silk chemise while the women brushed her dark brown hair into curls and pinned them on top of her head. Once the bride's hair was finished, Ava secured several small golden jewels into her hair, adding a touch of glimmer. The wedding dress was stunning and when the sunlight touched the fabric, the golden threads seem to sparkle. The ivory satin material was embroidered with gold strands in a beautiful fleur delis pattern and the edges of the dress were trimmed in golden crystals. Jeweled broaches pinned the sheer ivory train to her shoulders and the square neckline concealed much of her cleavage. Guinevere slipped on the ivory colored shoes and then smiled when she saw Ava tearing up.
"Ava, this is no time for tears," Guinevere whispered to her servant.
"You are so beautiful m'lady, I am truly happy for you," Ava replied.
"Thank you Ava, you are a true friend and I cherish that."
The king's steward escorted Lady Guinevere to a small private room next to the large chapel where he asked her to wait for the king. She nodded politely and then walked to the window where she could see the crowds of people that waited outside for the marriage of their king. The vast amount of people that lived in Camelot was surprising to Guinevere and everyone seemed to be anxiously waiting for the bells to ring, symbolizing the wedding had taken place. The waiting bride noticed that even those who only had meager funds looked healthy and clean. There was no poverty here. King Arthur was good to his people and Camelot truly was an ideal society.[End Excerpt] Knowing the man that Arthur was, made Guinevere feel reassured that she was doing the right thing, even if that meant giving up her life with a sword.


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Alleman blazes past Coal City
COAL CITY — Blazing a trail to four touchdowns, while blanking Coal City in the second half, Alleman Catholic's football team came up with a 28-13 Class 4A playoff victory over the Coalers on Saturday afternoon.
Alleman got a touchdown from Sean Wetherell in the first quarter and one by Adam Hoogerwerf in the second to take a 14-13 lead into the locker room. Coal City's scores came on a 14-yard TD pass from Brennan Shetina to Lane Cowherd in the first and a 4-yard TD pass from Shetina to Nick Peters in the second quarter. However, one of the PAT kicks blew wide for the locals.
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AP sources: Obama launching China trade case
Monday, September 17, 2012
WASHINGTON (AP) — President Barack Obama will launch a new trade enforcement case against China Monday, using the power of incumbency to counter Republican Mitt Romney's criticism that he is ceding American jobs to the Asian power. |


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By T.J. Pyette
A Havre dog groomer is working with the Toole County Sheriff's Office to launch a fund-raising effort on behalf of 170 dogs seized at the Port of Sweetgrass.
Shannon Lynnes, who owns Doggy Daycare Pet Resort, plans to initiate a fund-raising campaign on a national level, utilizing a circle of animal lovers and professionals she has become familiar with in her more than 20 years as a groomer.
"I'm planning to work the network and try to get a lot of coverage," Lynnes said Monday. "I'm going to be contacting television stations and media sources to begin with."
Toole County sheriff's deputy Kevin Gates said U.S. Customs confiscated the collies on Oct. 31 from a tractor-trailer owned by Johnathan Harman, 49, and Athena Lethcoe-Harman, 40.
The couple, en route from Alaska to Arizona, are accused of crowding more than 170 dogs and 11 cats in the trailer without food or water for a week. They are scheduled to appear in Justice Court in Shelby on Dec. 2 on 182 counts of misdemeanor cruelty to animals, according to court personnel. Their attorney said they will plead not guilty and will request a jury trial.
Gates said today that the collies are doing better, but volunteers to look after the dogs during the work week are scarce.
"We are a little short of help during the week," he said. "People are still coming on the weekends, but we have a need for volunteers in the middle of the week."
The Toole County Sheriff's Office also needs small bales of straw to use in building dog houses for the collies, Gates said.
"We are fortunate that the weather has been mild, but cold weather is coming and we need to prepare for the care of these dogs," Lynnes said.
Lynnes said she plans to approach the campaign on two levels, first soliciting money for a general donation fund, followed by some type of fund-raising event.
"I'm not sure what the event will be, but I'm going to be working with some of the 4-H groups in the state to coordinate that," Lynnes said, adding that a 4-H group from Kalispell has already expressed an interest in helping out with the effort.
Gates said the estimated cost of maintaining the dogs, $35,000 per month, is just too much for a relatively small county like Toole County to absorb. The animals are housed at the county fairgrounds.
The Harmans face fines of up to $500 on each charge, six months in jail or both. They might also be required for forfeit their animals to Toole County and pay all reasonable costs incurred in providing treatment for the animals.
Lynnes became involved with the project when she offered her services as a groomer to the Toole County Sheriff's Office.
Lynnes, director of the Montana School of Professional Dog Grooming, said she will be taking her students to Shelby to groom the dogs, and that she has already received more than $5,000 in equipment donations.
Spectrum Laboratories of Idaho is formulating a shampoo specifically for the rescued collies that Lynnes and her crew will use, she said.
The American Working Collie Association has also been involved in an effort to assist the rescued collies.
AWCA has coordinated the donation of stainless steel bowls and rubber gloves to Toole County, and will deploy a grooming team to Shelby soon, president Jean Levitt said in a statement at the group's Web site.
"AWCA has sought professional advice on collie stress management in order to support their emotional needs as well as physical needs during the grooming process. ... We have sought veterinary advice on the deployment of the grooming team. Our medical support team consisting of a veterinarian and a veterinary technician will precede the grooming team to (Montana)," Levitt said.
Gates said today that AWCA will be brought in to take care of the initial grooming needs of the collies and that Lynnes and her students will provide grooming upkeep and ongoing maintenance.
AWCA has established a fund to help defray the cost of its efforts c/o Bethany Burke, AWCA Treasurer, 2807 Lee Trevino Court, Shalimar, FL 32579. In the memo please designate: collie rescue-general, collie rescue-medical, collie rescue-stainless steel bowls.
Lynnes is asking that monetary donations be sent to the Toole County Community Collie Rescue Fund at First State Bank of Shelby, 260 Main St., Shelby, MT, 59474.


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New Zealand Fish. A Complete Guide. Paulin C, Stewart A, Robert C, McMillan P. 2001. Te Papa Press.
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If you find an unusual or rare fish, or simply one you would like to have identified, the fishes team is happy to do this for you. If the specimen is important, we will give you a copy of one of our books in exchange for it.
We prefer to receive frozen specimens so we can record important information on colours before the fish is preserved. Before sending anything, please contact us by:
The fish should be placed in a container that is large enough to allow the specimen to be laid flat, without bending the tail, to ensure that delicate fins do not get broken. The fish then needs to be carefully packed to prevent it being damaged in transit - filling the container with water and freezing it solid is a good way to do this.
For each specimen, please include information on where the fish was caught or found; the depth, date, method of capture; and the collector. Please write this in pencil on strong paper - don't use a ballpoint, as the ink dissolves in liquid. Notes on colour or a photograph are useful, but not essential. A label containing the information should be included with the specimen, ideally placed in the mouth or tied on! It's useful to keep a second record of this information, in case the label disintegrates. The fishes team can supply waterproof labels if required.
Once frozen, specimens can be sent via Halls Refrigerated Freight to our collection area in Tory Street, Wellington. Wrap the fish, first in wet newspaper or cloth, then in several layers of dry newspaper, and seal it inside two or three plastic bags. Place this parcel inside a cardboard box filled with crumpled newspaper. Label the box with the words 'Keep Frozen', and send it to:The Fishes TeamMuseum of New Zealand Te Papa Tongarewa169 Tory Street / PO Box 467Wellington 6140Very large specimens (longer than two metres) or bulk collections can also be sent frozen - but please contact us first so we can prepare for their arrival and storage. Please don't use couriers or standard mail.
Halls do not service all parts of New Zealand and use local compamies to get material to their depots. If you are unsure of how to contact the transport company, please get in touch with us and we can organise it from Wellington.
We have an account with Halls, so you will not have to pay transport costs.
Please include your name and address with specimens so that we can send you the identifications.
Andrew Stewart
Contact Andrew by email
Contact Andrew through our online enquiry form
© Copyright Museum of New Zealand Te Papa Tongarewa, Wellington, New Zealand.


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Take Action!
"Kill them all," is what Fox News commentator Erik Rush told his twitter followers. This hateful and violent attitude is unacceptable. Tell Fox News to drop Erik Rush for his hateful ideology.
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When there are international laws regulating the sales of ipods but not Ak-47s, there is a problem. Send an email to your Senators asking them to support a bulletproof Arms Trade Treaty!
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South Wales Argus - the first place to look for news in Newport and across Gwent
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Newport ex-soldier turns 100
12:40pm Tuesday 12th June 2012
A NEWPORT man who won honours for his service in the Second World War celebrated his 100th birthday.
'Thirty years on I remember my fallen comrades every day' - Gwent Falklands vet
10:30am Monday 2nd April 2012
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We are gearing up to host our first conference of 2013, and we thrilled who we have lined up to come speak. Speakers are Francis Chan, Jon Tyson & Rick Warren.
The goal of this conference is to encourage & enrich faith leaders to the idea of culture-shaping, culture creation, and embodying the gospel through their own lives and story.
We hope & pray that you can make what is surely to be a memorable day. This conference is designed for everyone a teaching pastor to your ushers.
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Thursday, January 17, 2013 from 9:00 AM to 3:00 PM (PST)
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The Master of Scholarly Resources Award (MSRA) is presented annually to an undergraduate student who has shown outstanding achievement in research methodology and writing. This competitive award is jointly sponsored by the Reinert-Alumni Library and the College of Arts and Sciences. MSRA Recipients are honored with a plaque and a cash prize of three hundred and fifty dollars ($350).
Any undergraduate student may submit a paper written for a course in the College of Arts and Sciences during the spring, summer, or fall semester of the calendar year. Papers must be at least seven pages long, use standard documentation style (APA, MLA, Chicago, or other style specified by the instructor), and include a complete bibliography or works cited list.
Due Date
This year the due date for submissions has been extended until Friday, May 17th, to include papers submitted for the 2012 calendar year plus papers written during the 2013 spring semester. This is a transitional year that will include allow us to bring the award in line with the traditional academic year instead of the calendar year. Submissions should be delivered to Mike Poma in the Reinert-Alumni Library. All applicants will be notified of the outcome by email when judging is complete, probably by the end of May.
Submission Requirements
There are three items of documentation required to complete your Master of Scholarly Resources Award submission, in addition to the research paper and bibliography itself:
- Application form (PDF)
- Cover essay
- Letter of support from your instructor
Cover essay - Your cover essay should describe your research process in approximately 700 words (1-1½ pages). Discuss any aspect of your research that you feel is relevant. For example, how did library resources help you focus your topic? What did you learn about the nature of the literature pertaining to your topic? If you used a research strategy, how did it evolve? What if anything surprised you? How much of your research was planned, and how much resulted from unexpected discoveries? How did you evaluate and choose the sources you used?
Letter of support - The letter from your instructor should address characteristics of your paper that distinguish it as an example of outstanding student scholarship and writing. You will need an original, signed copy of the letter to complete your submission package, together with the application form, cover essay, and a copy of the paper itself.
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The judges consider two broad questions in evaluating submissions. First, does the paper demonstrate excellent and innovative use of library research sources? Second, does it exhibit excellent writing style, with correct bibliographic documentation appropriate to the discipline? More specifically, the judges will look for evidence of:
- skill in selecting and evaluating the sources used;
- appropriate use of an array of primary and secondary sources, including hard copy and electronic formats;
- understanding of appropriate research methodologies;
- ability to synthesize sources used to create an original, well-focused, and coherent text;
- superior ability to articulate complex ideas clearly and effectively; and
- command of standard written English.
The Reinert-Alumni Library and the College of Arts and Sciences welcome all student submissions, and appreciate the faculty who support them with a letter of recommendation.


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Steamboat School Board to discuss city's interest in building fire station west of town
School district approached about potential to build fire station on land it owns near Silver Spur
Sunday, December 16, 2012
Past Event
Steamboat Springs School Board meeting
- Monday, December 17, 2012, 4 p.m.
- Steamboat Springs High School, 45 Maple St., Steamboat Springs
- All ages / Free
Steamboat Springs The Steamboat Springs School Board on Monday night will discuss whether a parcel of land it owns west of Steamboat could be a suitable location for a new fire station.
School Board president Brian Kelly said Friday that the district recently was approached by Steamboat Public Safety Director Joel Rae about the potential to build the station on part of the 35-acre parcel it owns near the Silver Spur neighborhood.
Kelly said the property, which is east of Steamboat II, was donated to the district by the Steamboat Education Fund Board in 1997 as a potential school site.
He added that the Fund Board purchased the land for about $360,000 at a time when the district's student population was growing.
"The idea back then was we could put a new middle school and elementary school out there," Kelly said.
He said city officials have not made any offer on the property, but they are inquiring about its potential for a fire station.
As part of its effort to relocate its emergency services out of downtown, the city of Steamboat is proposing to construct a new police station and two fire stations, one of which would be west of town.
Rae and other city officials, including Fire Chief Mel Stewart, have said a new station near Steamboat II and Heritage Park would improve response times in that part of town and also the overall efficiency of the city's emergency services.
The construction of the new station is dependent on successful negotiations with the Steamboat Springs Area Fire Protection District over sharing the cost of a new station.
City officials are proposing the rural fire district cover 73 percent of the operating costs of a new station west of town.
On Thursday, Rae said the school district property is one of multiple sites being considered to house such a station.
The Steamboat Springs City Council on Tuesday night will weigh the relocation proposals and also decide whether to sell its existing downtown emergency services building.
Kelly said no site planning has been done on school district's property, and he planned to superimpose the district's current elementary and middle school campus on the site to give the School Board an idea of what kind of campus it could support in the future.
He added that the board wouldn't want to "over encumber" the property and prevent a school from being built there in the future.
Also at Monday's meeting
• The School Board will get a glimpse at how technology is being used in classrooms at Steamboat Springs High School. The presentation is a continuation of a technology tour the board embarked on in early October to learn more about students were utilizing new tech tools.
• High school staff will present the board with their campus' Unified Improvement Plan. The plan will include a summary of students' performance on the Transitional Colorado Student Assessment Program, or TCAP, and will outline how school staff plans to help students meet certain curriculum guidelines.
To reach Scott Franz, call 970-871-4210 or email email@example.com
More like this story
- Steamboat School Board will wait to decide whether new fire station could be built on district land
- At open house, city of Steamboat unveils latest plans for relocation of downtown emergency services
- Steamboat City Council to weigh sale of emergency services building at Tuesday meeting
- Steamboat Springs City Council cancels proposed sale of downtown public safety building
- As city's plans for new police station progress, proposal for new fire station on pause
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Metformin use is associated with a decreased incidence of colorectal adenomas in diabetic patients with previous colorectal cancer
Digestive and Liver Diseases, 07/13/2012
Clinical Article
Lee JH et al. – The findings suggest that Metformin use in diabetic patients with previous colorectal cancer is associated with a lower risk of colorectal adenoma.
Methods- Among 488 consecutive diabetic patients who underwent colonoscopic surveillance after curative resection of colorectal cancer between 1998 and 2008, 240 patients were enrolled in this study and were compared in two groups: 114 patients taking metformin and 126 patients not taking metformin.
- Patient demographics, clinical characteristics, and colorectal adenoma incidence rate were analysed.
- After a median follow–up of 58 months, a total of 33 patients (28.9%) exhibited adenomatous colorectal polyps among the 114 patients who used metformin, compared with 58 (46.0%) patients with colorectal adenomas among the 126 patients who did not use metformin (odds ratio=0.48, 95% confidence interval=0.280–0.816, P=0.008).
- After adjustment for clinically relevant factors, metformin use was found to be associated with a decreased incidence of colorectal adenomas (odds ratio=0.27, 95% confidence interval=0.100–0.758, P=0.012) in diabetic patients with previous colorectal cancer.


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A-1 Plumbing Heating & Air Conditioning Coupons and Deals
Air conditioning comes in handy during those hot summer days when ice cream instantly melts into a soup and regular soup just vaporizes. Lower the mercury with this Groupon. $40 for an AC Tune-Up or Service Call for Repairs ($129 Value) The air-conditioning tune-up includes the following: Check of existing air temperature and return air temperature Filters check Thermostat check Check of the amp draw of the outdoor motor and the compressor Check of the outdoor fan blades and the fuses Inspection of compressor, control board, wiring, breakers, outdoor coil, blower wheel, evaporation coil, and condensation line Check of the ...
Every deal, one place.
Best deals from Groupon, LivingSocial and more.


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Checkout is for items in your cart, it's not for your Autoship order.
Everything you've purchased from our family of sites.
No gift wrap available
Paws Inc. Garfield Deluxe Rocker
Garfield Rocking Chair, your child's very own chair. Fun place to sit, visit with friends or watch your favorite show! The hard resin rockers are very strong to handle the rigors of today's kids. The construction is hard wood frame covered with poly urethane foam and upholstered in soft to the touch, yet durable polyester fabric that is easy to clean with mild soap and water. The seat bottom measures 13" by 13" and is 11" to the floor. There are coordinating furniture items such as a toy box, and bean bag available to match this cute rocker. You can create a whole room setting! Other items sold separately. This item is proudly made in the USA! 24"L 18.75" W 28"H
Product Notes
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+Another $7 million hidden from Manatee County school budget
Interim Manatee County Schools Superintendent David Gayler found another $7 million of unbudgeted items in the district's budget.
+County hires CSDC Systems, pays settlement for copyright infringement
Sarasota County commissioners approved a $200,000 legal settlement, and a $2.6 million contract with a tech firm for an IT upgrade.
+SCAT considers Siesta 'Trolleys'
Sarasota County commissioners will discuss spending $7.4 million for public transportation weeks after an audit exposed fiscal management issues in the department.
+Town issues Colony requirements
Town Manager Dave Bullock has put the Colony Beach & Tennis Resort Association on notice: The town expects further upgrades to the rundown property to make the outward appearance acceptable by Longboat Key standards.
+Teen entrepreneur draws national attention
Two years ago, 15-year-old Sam Vrinios started a custom game controller business in his garage. Now, he is on television.
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- Jun
1 Floridafitfest and 5K Treasure Run
9:00 am - 4:00 pm - Jun
8 World Oceans Day Family Festival
10:00 am - 1:00 pm
Hat's off to Dee Pelton, volunteers
Dee Pelton held a luncheon that will be tough to top. -
Youth sailors descend on City Island
Approximately 250 people hit the water Saturday, April 20 through Sunday, April 21, for Sailfest. The regatta, Sarasota Youth Sailing's biggest fundraiser of the year, included four classes of competition — Optimus, 420, Laser and Multi-hull — and a barbecue feast. -
Book club sunsets for the season
The Sunset Beach Book Club, in its 10th year, ended this season with a luncheon and discussion of the book "Gone Girl," by Gillian Flynn, April 18, at Lazy Lobster. Discussion moderator was Ricki Carroll. Together, the group read five books this season.


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If you registered for membership in the past 10 days, please reregister. I'm certain I accidentally deleted you when I was pruning the membership lists yesterday.
0 Members and 1 Guest are viewing this topic.
False. We were fortunate enough to visit back in the days when a small plane was allowed to fly into the inner canyon. Talk about awesome photographs! BTW, Orangina is a lightly carbonated Italian soft drink. It's very refreshing. If you ever see it, give it a go.I have NEVER had the urge to try SPANX.


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Anyone who knows me, knows that I love using old newspapers to discover the lives of my ancestors. I absolutely love finding the name of one of my family members in the pages of newspapers that were current to their lives. I have found blurbs that announce visits to a sister, aunt, or other relatives and friends. Other times, it's been a marriage announcement that pin-pointed an actual date for which I had only the month. And, of course, who doesn't like finding an obituary or birth announcement that contains a clue to a brick wall? I just love the unexpectedness and surprise element of using those old newspapers!
Now, there are subscription sites that you can join. I subscribe to GenealogyBank, Newspaper Archives, and Ancestry which all give access to old newspapers. There is a lot of overlap in what each site offers, and I will soon be needing to decide which ones to keep at the end of my subscriptions. But...if you are looking for free sites, I have one that I use all the time.
Chronicling America is sponsored by the National Endowment for Humanities and the Library of Congress as part of the National Digital Newspaper Program. At this time, the newspapers cover the years 1860 through 1922 and are only from the states of Arizona, California, District of Columbia, Florida, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Minnesota, Missouri, Montana, Nebraska, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Texas, Utah, Virginia, and Washington. The goal is to eventually have every state and US Territory represented.
Even if you are not one of the lucky ones who have ancestors in the currently represented states, you shouldn't ignore this site. You would be surprised at how many newspapers published news from states other than their own. I have found Ohio news regarding my ancestors in newspapers in West Virginia and beyond.
The same applies to hometown newspapers. Check for towns that are in close proximity to one another. A lot of my ancestors were from the small Ohio River town of Ripley. Unfortunately, the Ripley Bee and other local newspapers are not a part of Chronicling America. However, there are several newspapers from another small Ohio River town in Kentucky called Maysville. I have found numerous articles and blurbs with interesting news about those Ripley family members in the Maysville papers.
So, if you are like me and you like to use old newspapers to round out your family history, try Chronicling America. I think you will enjoy the experience!


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COLUMBUS (AP) -- Ohio gas prices are still creeping up.
The average price for a gallon of regular gas in Ohio was $3.29 in today's survey from auto club AAA.
, the Oil Price Information Service and Wright Express. That's 8 cents higher than a week ago.
Experts say prices are rising because of solid economic recovery in China and the U.S. and other factors.
Ohio's prices are slightly below the national average of $3.31, which is a penny higher than last week.
The lowest average price in Ohio Tuesday was $3.26 in the Akron area.
AAA Daily Fuel Gauge Report: http://fuelgaugereport.aaa.com


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Critical Reading for the Reflective Practitioner
By- Robert Clarke
- Peter Croft
The ability to arrive at an informed view on current literature findings on a particular topic is a skill that every practitioner needs to cultivate. 'Critical Reading for the Reflective Practitioner' encourages both GPs and other health care professionals to take a knowledgeable approach to published papers. It enables them to evaluate the findings, methods, results and statistics involved and to relate this to everyday practice.
Paperback, 352 Pages
Published: December 1998
Imprint: Butterworth Heinemann
- Introduction; PART I: ASSESSING AN INDIVIDUAL STUDY: CRITICAL APPRAISAL AND CRITICAL REFLECTION: What's the big idea?; Summarising a paper; Can I rely on the methods? - issues of measurement; Can I believe the results? - bias and confounding; Do I understand the results? - summary statistics; Reflecting on a study - implications for practice; Making sense of screening; Other types of evidence; Tackling the tabloids; PART II: CRITICAL READING AND REFLECTIVE PRACTICE: Paralysed by the literature?; Hot topic framework; Asthma in adults; Diabetes; Heartsink patients; Cervical screening; Referrals to outpatient clinics; Index.


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August 14, 2011 10:30 am
Nutritional Facts on BLK Water bottle…uh, there are none. Photo taken at 2 am, because Becky decided to take a detour.
Becky, the SH intern, was given the ultra-simple task of obtaining "BLK" water. Becky was given her very own Prius because she is apt to get lost and she can get lost longer in a hybrid. Well, it turns out that Becky did NOT get lost this time, but decided to stop and get a mani-pedi and do some shopping after she purchased the BLK water early in the day… Becky also stopped off at a hair-dresser friend and decided to let her friend change her hair color.
Becky at work. SH waited for hours and hours… 'cause of this mani-pedi.
All while I'm waitin' on gettin' the BLK water in ma hands!!! Becky also forgot to charge her cell phone, so when she was taking much longer to get the BLK stuff to me, being a caring "boss" and all that… there was an APB out on Becky and the local LEOs got involved. An errand that should have taken approximately two-three hours took Becky fourteen!
Actual Prius that Becky drove to get her hands on that BLK water…
Becky finally made it back, safe and sound… with BLK water in hand. (The following photos of Becky with the BLK water are re-creations as Becky actually rolled in after midnight and there was difficulty in taking photos at that time. The attempted photos were trashed as the blinding lights of the police escort that Becky received made the glare on Becky's car look like a disco ball.)
Well, here she is! The SH intern, Becky… all prouda herself, 'cause she got the BLK water.
OK, so let's get to it! Here's the rundown from our girl Becky…
Becky arrived at the supermarket which carries BLK water at approximately 1 pm yesterday. Becky reports that it was difficult once in the store to find the BLK water. Becky reports that she looked five times in the water section and could not locate the BLK water where she thought all water would be stocked. Becky gave up on searching the water section of the store and was on her way to ask one of the store employees for assistance when Becky spotted some eye shadow. Becky is easily distracted and spent over an hour at the makeup section of the grocery store, before remembering why she was in the store in the first place and after making her cosmetics selections, she continued the search for the BLK water.
BLK water/regular bottled water… which would you grab first?
Becky had to go to customer service, as the employees wandering around the store that she asked about the location of the BLK water had no idea what she was asking about… none of the employees ever heard of this mysterious BLK water. Customer service told Becky that, yes, the store does carry BLK water and she can find it in the "Organic Specialty Section." The very nice customer service person actually escorted Becky back to the "Organic Specialty Section" as that section is a sub-section of the "Organic Section" and is kind of hard to find.
While walking Becky back to where the BLK water is stocked, the customer service person asked Becky, "You do know that this is BLACK water?" Becky tells the very kind customer service person that, yes, she is aware that she will be buying BLACK water. Finally, they arrive at the "Organic Specialty Section" and Becky picks up the six bottles of BLK water as instructed and heads to the check out… cosmetics still in hand and no further distractions.
Becky… again, all prouda herself!
At the check out, the cashier looked at the BLK water and said, "What is this?" and then asked Becky, "You do realize that this is BLACK water?" Becky replied that she was aware of that fact and was sent to purchase it. The cashier went on to say that she heard that this product was in the store, but that no one had ever come through her line with it and was certain that Becky is the first customer to have purchased BLK water in the months that it has been in the store. The cashier held up a bottle and asked fellow cashiers that were within earshot if they had ever seen this come through their check out line and they all agreed that Becky's cashier is the first to have rung it up. Rung it up to the tune of $1.85 a bottle… that comes to a total of $11.10 for six bottles of BLK water.
Fast forward to today…
Got the BLK water and the glassware, etc. ready to go…
Preparing proper stemware to pour the BLK water into… hey, Becky does try! (You can't drink BLK water outta a wine glass!!!)
High-class plasticware ready for the BLK water… yep, BLK water was actually in these cups and consumed.
As Becky pissed me off so much yesterday… (I had to call in big-time favors from law enforcement friends because she was out shopping and trying to see how many miles the Prius could get on a full tank of gas)… she did not get today (Saturday) off. In preparing for the "tasting," Becky procured various stemware, glassware and plasticware in which to pour the BLK water. Hey, Becky may not be the brightest bulb, but she will do just about anything I ask of her and she's happy doin' it… kinda reminds me of KimZ and Sweetie, 'cept Becky don't live wit me!
Becky chuggin' down the BLK water… she loved the stuff!!!
Well, let's get to the reason for this entire post…
The first bottle of the chilled BLK water was unscrewed. There were three other people attending this "tasting," plus Becky and myself. So including the always distracted, but lovable Becky, five people were in attendance for the unscrewing and tasting of BLK water.
Here are the initial reactions/comments:
- "No flavor, but flat."
- "Stale swamp water."
- "Heavy tannins."
- "What did I just drink… Bane juice?" (This is some Batman reference…)
- "Left my mouth dry."
- "Metallic aftertaste."
- "There is a 'heaviness' to this."
- "They don't need to add anything to water."
- "It would be worth the trip to return this."
- "Oh, there's a saying on the bottle when it's empty!"
- "Tastes like water."
Becky's boyfriend came over to pick her up and take her home… and while here, he also tried out the BLK water. Interestingly, both Becky and her boyfriend had no problem drinking the stuff and actually LIKED the BLK water! It has to be an age thing as Becky just turned legal, same as her boyfriend. The others in the tasting party were over thirty… and all thought the BLK water was disgusting.
Enjoy the dark side??? Uh… no thanks!
Becky was lovin' the stuff, though. Her boyfriend, Carleton, refused to be photographed for this exclusive, very important review!
And what did SH think about BLK water??? Are you serious??? I ain't drinkin' that sh**!!!
Same bottle from last week's review of Skinnygirl margaritas. The remainder still sits… no one wants to drink it. Who can blame 'em? It's awful!!!
NOTE: The leftover Skinnygirl margarita bottle was also put out. No one wanted to drink it…
Also Note: There is still a RHONJ recap to come… got sidetracked by this BLK water crap!