The Inside Mystery of Jejunal Gastrointestinal Stromal Tumor: A Rare Case Report and Review of the Literature

Gastrointestinal stromal tumors (GISTs) are malignant and rare form of soft tissue sarcoma of the digestive tract. The incidence of gastrointestinal stromal tumors is very low Kramer et al. 2005 Jejunal GISTs are extremely rare. Here we present a rare case of jejunal GIST with unusually large size at presentation. The patient presented with severe abdomen pain, exophytic growth, and dimorphic anemia. Surgical resection of the tumor was carried out, and operative findings revealed a 15 × 10 cm growth, arising from serosal surface of jejunum, at the antimesenteric surface. Diagnosis in this case was made by subjecting the resected specimen to immunohistochemical analysis. In view of large size of the resected tumor, and high-risk histopathological features, imatinib mesylate 400 mg once daily was given as adjuvant chemotherapy. Patient is asymptomatic without any evidence of tumor recurrence after six months of postoperative followup. Imatinib as such is recommended in metastatic, residual or recurrent cases of GISTs or which are surgically not removable; however, recent recommendations suggests the use of imatinib mesylate after radical surgery in high-risk cases, because it has shown a significant decrease in the recurrence rate, and the Food and Drug Administration (FDA) has also approved the use of imatinib as adjuvant therapy after complete resection of localized, primary GIST

Soil Characteristics Affected by long term Application of Sewage Wastewater

ABSRACT: The long term effects of sewage water irrigation on soil properties and heavy metal concentrations at Rohtak city, Haryana (India) was investigated. At each location, soil samples were collected from the upper layer (0-10cm) for determination of various physico-chemical parameters. Heavy metals (Pb, Cu, Mn, Zn, Cd, Ni, and Fe) were also determined. The chemical analysis of sewage effluent showed that total salt concentration and heavy metal content was high compared to ground water but within the safe limits. Thus, sewage effluent remained within permissible limits for use as irrigation water. Soil analysis revealed that organic carbon, phosphorus, calcium and magnesium content were high in sewage irrigated soils compared to tube well irrigated soils. The soil pH decreased by 0.38 units as a result of sewage water irrigation. The continuous application of untreated sewage effluent for last 35 years resulted into significant accumulation of nutrients and heavy metals in soils. Organic carbon content showed positive correlation with all heavy metals except Zn while pH had negative correlation with all metals except Mn. Electrical conductivity had a positive correlation with all metals

Medical Malpractice : How Legal Liability Affects Medical Decisions

In health care, overuse and underuse of medical treatments represent equally dangerous deviations from an optimal use equilibrium and arouses concerns about possible implications for patients\u2019 health, and for the healthcare system in terms of both costs and access to medical care. Medical liability plays a dominant role among the elements that can affect these deviations. Therefore, a remarkable economic literature studies how medical decisions are influenced by different levels of liability. In particular, identifying the relation between liability and treatments selection, as well as disentangling the effect of liability from other incentives that might be in place, is a task for sound empirical research. Several studies have already tried to tackle this issue, but much more needs to be done. In the present chapter, we offer an overview of the state of the art in the study of the relation between liability and treatments selection. First, we reason on the theoretical mechanisms underpinning the relationship under investigation by presenting the main empirical predictions of the related literature. Second, we provide a comprehensive summary of the existing empirical evidence and its main weaknesses. Finally, we conclude by offering guidelines for further research

Removal of Zn+2 Ions from Aqueous Solution Using Anabaena variabilis : Equilibrium and Kinetic Studies

Zinc ions are present in different types of industrial effluents, being responsible for environmental pollution. Biosorption is a process in which solids of natural origin are employed for binding heavy metals. It is a promising alternative method to treat heavy metal wastes mainly because of high metal binding capacity. The effect of some important parameters on sorption capacity of cyanobacterial biosorbent for zinc uptake was studied. The optimum conditions pH, time, initial ion concentration, adsorbent dose; were found to be 8, 90 mins, 100 ppm and 1gm/100mL respectively. Immobilization of biomass was done in calcium alginate and agar matrices for reuse of biosorbent. Freundlich and Langmuir isotherms were applied to equilibrium data of zincions biosorption and Freundlich isotherm was found to fit the data. The maximum adsorption capacity was 71.42 mg/g for A. variabilis. The value of value of Kf and n were ranged from 0.4458 to 2.797 and 0.7726 to 2.797 for the cyanobacterial biosorbents. 0.1 M EDTA was used as an eluant and the biosorbent was reused up to five biosorption desorption cycles and percentage desorption of zinc ions was 93 to 84 from first to fifth cycle for the cyanobacterial biosorbents. Fourier transform infra-red analysis of algae with and without biosorption revealed the presence of carboxyl, hydroxyl, amino, amide and imine groups, which were responsible for biosorption of Zn+2 ions. The rate law for a pseudo-secondorder model fits the experimental data with a very high correlation coefficient and it was greater than 0.9771

Equilibrium Modelling and Spectroscopic Studies for the Biosorption of Zn+2 Ions from Aqueous Solution Using Immobilized Spirulinaplatensis

Biosorption equilibrium of zinc ions to Spirulinaplatensis   both in free and immobilized forms were studied in batch system with respect to pH, metal ion concentration, algal dosages and time. The maximum adsorption was observed at pH=8, optimum metal ion concentration and algal dose were 100 mg/L and 1g/100mL, respectively. Biosorption equilibrium was established in 90 minutes. The maximum attainable biosorption was found to be 97.1% for Spirulina platensis. The equilibrium adsorption capacities of adsorbents used for zinc ions were measured and extrapolated using Langmuir and Freundlich isotherms models. Langmuir model was found to be in better correlation with experimental data. The maximum Langmuir constants Q◦ (mg/g) and b were 92.93 and 0.0012, respectively for Spirulina platensis embedded in calcium alginate matrix. The immobilized Spirulina platensis in calcium of alginate matrix was the best biosorbent. 0.1 M EDTA was used as an eluant, which allowed the reuse of biomass in three biosorption-desorption cycles without considerable loss in biosorption capacity. 89-95 % zinc ions were desorbed with EDTA. The functional groups involved in zinc biosorption were identified by using Fourier Transform Infra Red spectroscopy. Spectroscopic analysis of algae revealed the presence of carboxyl, hydroxyl, amino, amide and imine groups, which were responsible for biosorption of zinc ions

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Not AvailableMain objective of this study was to optimize the analytical procedures, especially extraction and saponification method for the better analysis of β-carotene in milk fat. Saponification method with suitable potassium hydroxide (KOH) concentration, use of antioxidant, saponification time, and temperature was optimized to get best extraction procedure for β-carotene . Analysis of β-carotene was carried out by using reversed phase high performance liquid chromatography (RP-HPLC) using C18 column. Chromatographic conditions best tested for the study involves methanol: tetrahydrofuran: water (MeOH: THF: H2 O). The effect of time temperature combination at 45̊C/30 min with saturated ascorbic acid had a pronounced effect on the β-carotene extraction from milk fat. Study also reveals that a concentration level of 10M KOH was best suited for the extraction of unsaponifiable.Not Availabl

Revisit of (e,2e) and (e,3e) processes on atoms with twisted electron impact

International audienceWe compute Triple Differential Cross Section (TDCS) and Five-fold Differential Cross Section (FDCS) for (e,2e) and (e,3e) processes on atoms respectively to investigate the effects of non zero angular momentum and the apex angle of the twisted electron. We observed that the differential coincidence cross sections largely depend on these parameters