Unresectable Pancreatic Adenocarcinoma: Eight Years Later.

Pancreatic cancer is the fourth leading cause of cancer deaths in the United States, and is considered uniformly fatal when patients present with unresectable, advanced-stage disease at the time of diagnosis. Long-term survival of patients with advanced-stage pancreatic adenocarcinoma remains rare, despite advances in adjuvant chemoradiation protocols. A 73-year-old male presented to our emergency department with abdominal pain and a history of biopsy-proven, stage III pancreatic adenocarcinoma. His initial staging CT scan and trans-duodenal ultrasound had demonstrated a stage IIa (T3, N0, Mx) lesion. On surgical exploration, he was up-staged to stage III (T4, N0, Mx), noting encasement of the superior mesenteric vessels and involvement of the portal vein. He underwent palliative choledochojejunostomy and was treated with 4 months of oxaliplatin and capecitabine, with concurrent radiation therapy (50.4 Gy), followed by 4 months of gemcitabine. After 7 months, the patient withdrew from therapy due to treatment intolerance. He then turned to self-medication with non-traditional herbal therapies. After 3 years of surveillance, he was lost to follow-up until presenting to our facility with abdominal pain 8 years after his initial diagnosis. On diagnostic CT scan during his current presentation for abdominal pain, he was found to have no evidence of pancreatic cancer. Based on our review of the literature, we present the longest known survival of a patient with surgically unresectable pancreatic adenocarcinoma. Further study of this patient's phenotypic or genotypic characteristics may provide insight into better therapeutic agents, or a predictive subset of patients who will benefit from specific chemotherapeutic options.

Comparative study between a single unit system and a two-unit cold standby system with varying demand.

The concerned paper illustrates the comparison of two stochastic models of a cable manufacturing plant with varying demand. Here, it shows the comparison between a single unit system (Model 1) and a two-unit cold standby system (Model 2). In Model 1, the system is either in working state on some demand or put to shut down mode on no demand. In Model 2, at initial stage, one of the units is operative while the other is kept as cold standby. At times when the operative unit stops working due to some breakdown/failure, the standby unit instantaneously becomes operative while the repairman repairs the failed unit. In this working model, only one unit remains operative at a time. However, there may be a state when both the units fail. The comparison of systems is done by means of MTSF (mean time to system failure), steady state availability and profit function using Laplace transforms and software package Code-Blocks 13.12. Different graphs have been plotted to discover which model is superior to the other model under the given conditions. The system is analysed by making use of semi-Markov processes and regenerative point technique.