A strictly anaerobic, moderately halophilic, gram-negative, rod-shaped bacterium was isolated from Great Salt Lake, Utah, sediments and designated GSLST (T = type strain). Strain GSLST grew optimally at pH 6.7 to 7.0 but had a very broad pH range for growth (pH 5.8 to 10.0). The optimum temperature for growth was 37"C, and no growth occurred at 15 or 55°C. The optimum salt concentration for growth was 10%. Strain GSLST required yeast extract and Trypticase peptone to ferment carbohydrates, pyruvate, and glycine betaine. Strain GSLST was resistant to penicillin, D-cycloserine, tetracycline, and streptomycin. The G+C content of this isolate was 31 mol%. The fermentation products from glucose utilization were acetate, butyrate, lactate, CO,, and H,, and in addition strain GSLST fermented glycine betaine to acetate and trimethylamine. All of these traits distinguish this organism from all previously described halophilic anaerobes. The 16s rRNA gene sequence of strain GSLST was found to be similar to, but also significantly different from, the 16s rRNA sequences of Haloanuerobium sahugo and Haloanaerobium praevalens. Therefore, strain GSLST ( = DSM 827ST) is described as a new species, Haloanaerobium alcaliphilum.
Background
The incidence of neuroendocrine tumors (NETs) has been increasing in recent decades and there has been a rising awareness by the physicians for the diagnosis of NETs. Several novel agents have been developed and demonstrated to improve the survival of NETs recently. Previously, we reported the incidence and survival of NETs in Taiwan by analyzing the 1996–2008 data from the Taiwan Cancer Registry (TCR). Here we performed an updated analysis on the incidence and survival of NETs in Taiwan from 1996 to 2015.
Methods
Data for the current analysis were obtained from the TCR and the Death Registry Database. The incidence was age-standardized to the WHO 2000 population and the overall survival was calculated by life-table method. The risk of NETs death was evaluated by performing Cox proportional hazards regression analysis.
Results
There were a total of 7,760 cases of NETs diagnosed during 1996–2015. The most common site of NETs was rectum (29.65%), followed by lung and bronchus (17.22%), and pancreas (10.71%). The incidence of NETs was 0.244 per 100,000 in 1996 and increased to 3.162 per 100,000 in 2015 with an annual percentage change (APC) of 15.44 (P < 0.0001). The site with the most rapid increase was pancreas with an APC of 28.04 (P < 0.0001). The 5- and 10-year survival rates of all NETs were 54.6% and 45.3%, respectively. Female and younger NETs patients had a better survival. The HR for survival of all NETs diagnosed between 2010 and 2015 was 0.91 (95%CI, 0.84–0.99) compared to those diagnosed between 2004 and 2009. Among the common sites of NETs, an improved survival of NETs diagnosed between 2010 and 2015 compared to those diagnosed between 2004 and 2009 was only observed in pancreatic NET (HR = 0.52, 95% CI, 0.41–0.66). This result was likely due to the early diagnosis and improvement in the treatment of pancreatic NET.
Conclusions
Overall, the incidence of NETs in Taiwan has continued to increase. The survival of pancreatic NET has shown recent improvement. The development of novel therapeutic agents has the potential to improve the prognosis of NETs of other primary sites in the near future.
Introduction: While the relevance of lymphadenectomy during pancreatic cancer resection is well-established, the importance of lymph node (LN) yield is ill-defined. We assessed the impact of LN yield on overall survival (OS) as a continuous measure using novel advanced statistical modeling methods. Methods: The population-based National Cancer Database from the USA was queried for patients with resected pancreatic adenocarcinoma (stage IA-IIB) from 2004-2014. LN yield was assessed as a continuous measure, and dichotomized to 1-14 LN and 15 LN yield. Survival was analyzed using multivariable-adjusted Cox regression, Joinpoint regression and covariance-balanced propensity score analyses, and nearfar-matching to account for unmeasured biases. Results: In 25,609 patients, mean age was 65.2 (SD: 10.7) years, 49.1% were female. Mean LN yield was 16.0 (SD: 9.3). Analyzing LN yield on a continuous scale, OS improved with increasing LN retrieval, even when stratified by tumor stage. Joinpoint regression revealed that LN positivity increased by 4.2% per collected LN up to 8 LNs, then 0.7% per LN >8. 5-year OS was 16.0% for 1-14 and 18.0% for 15 LNs (adjusted HR 0.92, CI: 0.89e0.94, p < 0.001) (Figure). Near-far-matching showed significant OS improvement (HR 0.91, CI 0.88e0.94, p < 0.001) and a trend towards improved relative survival (HR 0.97, CI: 0.93e1.00, P = 0.055) in 15 compared to 1-14 LNs. Conclusion: LN positivity increases with increasing LN yield, which when analyzed as a continuous measure translates into survival benefit across all tumor stages. Thus, adequate lymphadenectomy should be assessed by continuous parameters rather than definite LN cutoffs .
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