CMS physics technical design report : Addendum on high density QCD with heavy ions

Peer reviewe

Assessment of Metastatic Status of Axillary Lymph Nodes using Intravenous Fluorescein in Carcinoma Breast: A Novel Approach in Surgical Management

Background: Assessment of lymph node metastasis is of prime significance for staging and treatment planning for breast cancer. All enlarged lymph nodes do not contain metastasis. Sentinel lymph nodes biopsy is recommended for patients with clinically negative axilla. But there are no standard guidelines for managing patients with enlarge axillary lymph node. In the present paper we have evaluated the role of intravenous Fluorescein to identify the axillary nodal metastasis during axillary dissection. Aim: Identification of metastatic fluorescent node during axillary dissection. Methodology: The present cross-sectional study at All India Institute of medical sciences on 32 operable carcinoma breast cases were enrolled in the study. Fluorescent and non-fluorescent nodes were sent separately for histopathological evaluation. Result: Present study include a total of 32 cases. From these 32 cases a total of 267 lymph nodes were separated out in which 185 nodes were fluorescent and 82 nodes were non fluorescent. Out of 267 fluorescent node 103 were histologically positive and remaining nodes were free of tumor. In non-fluorescent nodes only 6 nodes show the presence of tumor. Conclusion: Intravenous 20% fluorescein sodium has a high sensitivity of 94.5% & specificity of 48% with positive predictive value of 55.7%, which is comparable to conventional sentinel lymph node procedure in detecting early metastasis. Besides time saving and non-toxic, this technique predicts the metastatic status of axillary lymph node during surgery, aiding appropriate surgical intervention

Pressure Sore at an Unusual Site- the Bilateral Popliteal Fossa: A Case report

Pressure sore is tissue ulceration due to unrelieved pressure, altered sensory perception, and exposure to moisture. Geriatric patients with organic problems and patients with spinal cord injuries are the high-risk groups. Soft tissues over bony prominences are the common sites for ulcer development. About 95% of pressure ulcers occur in the lower part of the body. Ischial tuberosity, greater trochanter, sacrum and heel are common sites. In addition to these, pressure sores at unusual sites like nasal alae, malar eminences, cervical region and medial side of knee have also been described. Only 1.6% of the patients present with sores in areas outside the pelvis and lower extremity. In a paraplegic patient, pressure sores are usually over extensor surface of knee and heel but pressure ulcer over popliteal fossa are extremely rare. We herein report a case of a 36-years-old diabetic and paraplegic male, who presented with multiple bed sores involving the sacral area, heels and bilateral popliteal fossa. Popliteal fossa is an unusual site for pressure sores. Only one similar case has been previously reported in the literature

An unusual clinical presentation of plasma cell gingivitis related to "Acacia" containing herbal toothpaste

A 17-year-old female patient presented with unusual enlargement of the gingiva with generalized alveolar bone loss. In spite of periodontal therapy, including plaque control, scaling, root planning and surgical treatment, recurrence with the same degree of the gingival enlargement and further loss of attachment level occurred. Biopsy revealed dense infiltration of normal plasma cells separated by collagenous stroma. Discontinuation of herbal toothpaste resulted in remarkable remission of the gingival enlargement within 2 weeks. Enzyme-linked immunosorbent assay of toothpaste components disclosed " Acacia" as an etiologic antigenic agent and confirmed the diagnosis of plasma cell gingivitis (PCG). Usually, PCG is not associated with the loss of attachment. This case report appears to be the first publication to document an atypical presentation of PCG with generalized aggressive periodontitis related to the use of herbal toothpaste containing " Acacia" extract from the tree "Acacia Arabica.

Comparison of Quality of Life in Patients Undergoing Transhiatal Esophagectomy with or without Chemotherapy

Background/Aim: To compare the quality of life (QOL) in patients undergoing transhiatal esophagectomy (THE) with or without chemotherapy, who were admitted to the Post Graduate Institute of Medical Education and Research, Chandigarh and enrolled in the study, from July 2004 to October 2005. Patients and Methods: Thirty patients of esophageal carcinoma by purposive sampling were randomized into two groups i.e., patients undergoing THE after chemotherapy and patients undergoing THE without chemotherapy. Two QOL questionnaires, one generic i.e., EORTC-QLQ C-30 (European Organization for Research and Treatment of Cancer) and other esophageal cancer-specific i.e., EORTC OES-18 were utilized to assess the QOL. Result: Physical functional scales were better in patients, who received neoadjuvant chemotherapy. The role and social aspects of functional scales deteriorated after completion of treatment in both groups. This was primarily due to the effect of surgery. However, they were better from an emotional and cognitive point of value after surgery and radiotherapy. Fourteen out of 30 patients experienced vomiting and diarrhea due to radiotherapy. Conclusion: THE in esophageal carcinoma improves global health scales and majority of symptom scales in all patients. QOL improvement in general was better in patients who were administered neoadjuvant chemotherapy along with surgery

Giant Myofibroblastoma of the Male Breast: A Case Report and Literature Review

Myofibroblastomas are soft-tissue neoplasms that are thought to arise from myofibroblasts. They are mostly observed in males 41–85 years of age; however, this lesion also occurs in women. The usual clinical presentation is a unilateral painless lump that is not adherent to overlying or underlying structures. Microscopically, myofibroblastomas can be divided into 5 subtypes: classical, epithelioid, collagenised, cellular, and infiltrative. Mammary ducts and lobules are absent in the typical histological subtypes and the adjacent breast parenchyma may form a pseudocapsule. The majority of myofibroblastomas are immunoreactive for CD34, desmin, smooth muscle actin, and vimentin and are negative for cytokeratin and S-100 protein. We present a case of a giant myofibroblastoma arising in the background of gynecomastia in an adult male

Physics for Surgeons - Part 4: Energy Devices in Surgery

Modern surgery has advanced astoundingly in the last century owing to the advent of number of energy devices in the operation room. Surgeon in the past were only using electric current –monopolar diathermy to burn and couterize the tissue, the present day surgeons are equiped with a number of more advanced energy devices e.g. LASER, ultrasonic vibrating shears, radiofrequency, shockwaves, argon beam coagulator and advanced bipolar electric energy with hybrid systems and light energy of different wavelengths. In the present paper, we have explained the physical principles involved in the commonly used energy devices in the operation theatre

Gas hold-up profiles in foaming liquids in bubble columns

Radial variation of gas hold-up was investigated in 0.385 m i.d. bubble column using gamma ray tomography. The gas phase was air and the liquid phase comprised of aqueous solutions of n-butanol at different concentrations (0-0.5% v/v). These solutions exhibit foaming behaviour at higher concentrations. Radial profiles were measured at three axial locations (HD/D=0.259, 3 and 5). The fractional gas hold-up was compared with the air-water system under otherwise identical conditions. Superficial gas velocity was varied from 0.06 to 0.3 m/s. Two perforated sparger plates were used having the same free area (F.A.=0.42%) and two hole diameters (1 mm (multipoint sparger), and 25 mm (single point sparger)). The hold-up profiles were found to depend strongly on the sparger design and the concentration of the alcohol. All the results have been correlated on the basis of drift flux model