The unresolved case of sacral chordoma: from misdiagnosis to challenging surgery and medical therapy resistance.

PURPOSE: A sacral chordoma is a rare, slow-growing, primary bone tumor, arising from embryonic notochordal remnants. Radical surgery is the only hope for cure. The aim of our present study is to analyse our experience with the challenging treatment of this rare tumor, to review current treatment modalities and to assess the outcome based on R status. METHODS: Eight patients were treated in our institution between 2001 and 2011. All patients were discussed by a multidisciplinary tumor board, and an en bloc surgical resection by posterior perineal access only or by combined anterior/posterior accesses was planned based on tumor extension. RESULTS: Seven patients underwent radical surgery, and one was treated by using local cryotherapy alone due to low performance status. Three misdiagnosed patients had primary surgery at another hospital with R1 margins. Reresection margins in our institution were R1 in two and R0 in one, and all three recurred. Four patients were primarily operated on at our institution and had en bloc surgery with R0 resection margins. One had local recurrence after 18 months. The overall morbidity rate was 86% (6/7 patients) and was mostly related to the perineal wound. Overall, 3 out of 7 resected patients were disease-free at a median follow-up of 2.9 years (range, 1.6-8.0 years). CONCLUSION: Our experience confirms the importance of early correct diagnosis and of an R0 resection for a sacral chordoma invading pelvic structures. It is a rare disease that requires a challenging multidisciplinary treatment, which should ideally be performed in a tertiary referral center

Gamma-ray diagnostics of Type Ia supernovae: Predictions of observables from three-dimensional modeling

Besides the fact that the gamma-ray emission due to radioactive decays is responsible for powering the light curves of Type Ia supernovae (SNe Ia), gamma rays themselves are of particular interest as a diagnostic tool because they provide a direct way to obtain deeper insights into the nucleosynthesis and the kinematics of these explosion events. Focusing on two of the most broadly discussed SN Ia progenitor scenarios - a delayed detonation in a Chandrasekhar-mass white dwarf (WD) and a violent merger of two WDs - we use three-dimensional explosion models and perform radiative transfer simulations to obtain synthetic gamma-ray spectra. Both chosen models produce the same mass of 56Ni and have similar optical properties that are in reasonable agreement with the recently observed supernova SN 2011fe. In contrast to the optical regime, the gamma-ray emission of our two chosen models proves to be rather different. The almost direct connection of the emission of gamma rays to fundamental physical processes occuring in SNe Ia permits additional constraints concerning several explosion model properties that are not easily accessible within other wavelength ranges. Proposed future MeV missions such as GRIPS will resolve all spectral details only for nearby SNe Ia, but hardness ratio and light curve measurements still allow for a distinction of the two different models at 10 and 16 Mpc for an exposure time of 10^6 s, respectively. The possibility to detect the strongest line features up to the Virgo distance will offer the opportunity to build up a first sample of SN Ia detections in the gamma-ray energy range and underlines the importance of future space observatories for MeV gamma rays.Comment: 10 pages, 8 figures, accepted for publication by A&

Anxiety-like behavior of prenatally stressed rats is associated with a selective reduction of glutamate release in the ventral hippocampus

Abnormalities of synaptic transmission and plasticity in the hippocampus represent an integral part of the altered programming triggered by early life stress. Prenatally restraint stressed (PRS) rats develop long-lasting biochemical and behavioral changes, which are the expression of an anxious/depressive-like phenotype. We report here that PRS rats showed a selective impairment of depolarization- or kainate-stimulated glutamate and 3HD-aspartate release in the ventral hippo campus, a region encoding memories related to stress and emotions. GABA release was un affected in PRS rats. As a consequence of reduced glutamate release, PRS rats were also highly resistant to kainate-induced seizures. Abnormalities of glutamate release were associated with large reductions in the levels of synaptic vesicle-related proteins, such as VAMP (synaptobrevin), syntaxin-1, synaptophysin, synapsin Ia/b and IIa, munc-18, and Rab3A in the ventral hippocampus of PRS rats. Anxiety-like behavior in male PRS (and control) rats was inversely related to the extent of depolarization-evoked glutamate release in the ventral hippocampus. A causal relationship between anxiety-like behavior and reduction in glutamate release was demonstrated usingamixtureofthemGlu2/3 receptor antagonist, LY341495, and the GABAB receptor antagonist, CGP52432, which was shown to amplify depolarization-evoked 3HD-aspartate release in the ventral hippocampus. Bilateral micro infusion of CGP52432 plus LY341495 in the ventral hippocampus abolished anxiety-like behavior in PRS rats. These findings indicate that an impairment of glutamate release in the ventral hippocampus is a key component of the neuro plastic program induced by PRS, and that strategies aimed at enhancing glutamate release in the ventral hippocampus correct the "anxious phenotype" caused by early life stress

Crucial Physical Dependencies of the Core-Collapse Supernova Mechanism

We explore with self-consistent 2D F{\sc{ornax}} simulations the dependence of the outcome of collapse on many-body corrections to neutrino-nucleon cross sections, the nucleon-nucleon bremsstrahlung rate, electron capture on heavy nuclei, pre-collapse seed perturbations, and inelastic neutrino-electron and neutrino-nucleon scattering. Importantly, proximity to criticality amplifies the role of even small changes in the neutrino-matter couplings, and such changes can together add to produce outsized effects. When close to the critical condition the cumulative result of a few small effects (including seeds) that individually have only modest consequence can convert an anemic into a robust explosion, or even a dud into a blast. Such sensitivity is not seen in one dimension and may explain the apparent heterogeneity in the outcomes of detailed simulations performed internationally. A natural conclusion is that the different groups collectively are closer to a realistic understanding of the mechanism of core-collapse supernovae than might have seemed apparent.Comment: 25 pages; 10 figure

Beam Energy Dependence of the Third Harmonic of Azimuthal Correlations in Au+Au Collisions at RHIC

We present results from a harmonic decomposition of two-particle azimuthal correlations measured with the STAR detector in Au+Au collisions for energies ranging from $\sqrt{s_{NN}}=7.7$ GeV to 200 GeV. The third harmonic $v_3^2\{2\}=\langle \cos3(\phi_1-\phi_2)\rangle$, where $\phi_1-\phi_2$ is the angular difference in azimuth, is studied as a function of the pseudorapidity difference between particle pairs $\Delta\eta = \eta_1-\eta_2$. Non-zero {\vthree} is directly related to the previously observed large-$\Delta\eta$ narrow-$\Delta\phi$ ridge correlations and has been shown in models to be sensitive to the existence of a low viscosity Quark Gluon Plasma (QGP) phase. For sufficiently central collisions, $v_3^2\{2\}$ persist down to an energy of 7.7 GeV suggesting that QGP may be created even in these low energy collisions. In peripheral collisions at these low energies however, $v_3^2\{2\}$ is consistent with zero. When scaled by pseudorapidity density of charged particle multiplicity per participating nucleon pair, $v_3^2\{2\}$ for central collisions shows a minimum near {\snn}$=20$ GeV.Comment: 7 pages, 4 figures, for submission to Phys. Rev. Let

J/ψ\rm{J}/\psi production at low transverse momentum in p+p and d+Au collisions at sNN\sqrt{s_{NN}} = 200 GeV

We report on the measurement of $\rm{J}/\psi$ production in the dielectron channel at mid-rapidity (|y|<1) in p+p and d+Au collisions at $\sqrt{s_{NN}}$ = 200 GeV from the STAR experiment at the Relativistic Heavy Ion Collider. The transverse momentum $p_{T}$ spectra in p+p for $p_{T}$ < 4 GeV/c and d+Au collisions for $p_{T}$ < 3 GeV/c are presented. These measurements extend the STAR coverage for $\rm{J}/\psi$ production in p+p collisions to low $p_{T}$. The $$ from the measured $\rm{J}/\psi$ invariant cross section in p+p and d+Au collisions are evaluated and compared to similar measurements at other collision energies. The nuclear modification factor for $\rm{J}/\psi$ is extracted as a function of $p_{T}$ and collision centrality in d+Au and compared to model calculations using the modified nuclear Parton Distribution Function and a final-state $\rm{J}/\psi$ nuclear absorption cross section