BackgroundDespite much epidemiological research on brain cancer in the United States, the etiology for the various subtypes remains elusive. The black population in the United States currently experiences lower incidence but higher survival rates when compared to other races. Thus, the aim of this study is to analyze the trends in incidence and survival for the 6 most common primary brain tumors in the black population of the United States.Material/MethodsThe Surveillance, Epidemiology, and End Results (SEER) database was utilized in this study to analyze the incidence and survival rates for the 6 most common brain tumor subtypes. Joinpoint 3.5.2 software was used to analyze trends in the incidence of diagnosis from 1973 to 2008. A Kaplan-Meier curve was generated to analyze mean time to death and survival at 60 months.ResultsJoinpoint analysis revealed that per year the incidence of brain cancer in the U.S. black population increased by 0.11 between 1973 and 1989. After this period, a moderate decrease by 0.06 per annum was observed from 1989 to 2008. Lymphoma was the most common primary tumor subtype for black individuals ages 20–34, and glioblastoma was identified as the most common tumor subtype for black individuals in the age groups of 35–49, 50–64, 65–79, and 80+.ConclusionsThis population-based retrospective study of brain cancer in black adults in the United States revealed significant sex and age differences in the incidence of the 6 most common brain tumor subtypes from 1973 to 2008.

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Bouveret syndrome is defined as gastric outlet obstruction secondary to the impaction of a large gallstone in the proximal gastrointestinal tract. The obstruction occurs as result of a bilio-enteric or bilio-gastric fistula. This clinical entity is a rare variant of the more commonly recognized gallstone ileus, which tends to cause small bowel obstruction of the terminal ileum. The typical presentation of Bouveret syndrome consists of nausea, vomiting and abdominal pain secondary to obstruction. Diagnosis often requires radiographic imaging with computed tomography, which typically shows pneumobilia or a cholecystoduodenal fistula. Herein is a series consisting of three cases of Bouveret syndrome involving a bilioenteric, cholecystoduodenal, and choledochoduodenal fistula, respectfully, all of which required operative management. A discussion of the current literature regarding management of this rare syndrome follows.

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BackgroundSkeletal muscle damage due to frostbite represents a serious medical problem. Oxidative stress and inflammatory response cause muscle degeneration following skeletal muscle injury. Studies have shown that the heat shock proteins (hsp) are able to protect against oxidative stress and inflammation.ResultsIn the present study we used rat hindlimbs to examine the effects of several heat shock protein inducers, such as radicicol, 17‐AAG and 17‐DMAG following frostbite injury. Our results show that rat hindlimb muscles injected with these hsp inducers following frostbite injury exhibit less damage, less hypercontracted muscle fibers and less inflammatory cell infiltration as compared to control rat hindlimb muscles. We also find that these heat shock protein inducing compounds are able to conserve muscle function even when administered after frostbite injury has occurred. These results suggest that hsp inducing compounds are able to protect skeletal muscle if administered in the early stages following frostbite injury.ConclusionWe conclude that compounds that induce heat shock proteins are able to preserve skeletal muscle function and structure if injected shortly after frostbite injury. Our studies provide the basis for the development of therapeutic strategies to treat injury caused by frostbite involving severe muscle damage.This research was supported by an award from the USAMRMC.