Staging of lung cancer in a tertiary care setting in Sri Lanka, using TNM 7th edition. A comparison against TNM6

<p>Abstract</p> <p>Background</p> <p>Lung cancer is a leading cause of cancer-related mortality in Sri Lanka and throughout the world. The latest staging system for lung cancer is the tumor node metastasis (TNM) 7^thedition in which there are major changes to the previous version. The objective of our study was to find out the implications of TNM7^thedition on lung cancer staging in a resource limited setting, and to compare it with the previous TNM 6^thedition.</p> <p>Methods</p> <p>Patients with histologically proven lung cancer consecutively presented to respiratory unit of Teaching Hospital Kandy, Sri Lanka were recruited to the study over a period of one year from April 2010 to March 2011. They were staged using CT, ultrasound scan of abdomen, bronchoscopy and CT spine and brain when necessary. Staging was done using TNM 7 as well as TNM6. Surgical or non-surgical treatment arms were decided on staging and the number of patients in each treatment arm was compared between the two staging systems.</p> <p>Results</p> <p>Out of 62 patients, thirty four patients (54%) had metastatic disease and 19 (30%) of them had pleural effusions (M1a), while 15 (24%) had distant metastasis (M1b). When compared to TNM6 there was no difference in the number of patients in T1 category, but the number in T2 was higher in TNM7 (25 Vs 20). Similarly the number in T3 group was higher in TNM7 (11 Vs 5) and the number in M category was doubled (34 Vs 17 [Chi-6.46, <it>p </it>= 0.011]) compared to TNM 6. The number of patients suitable for surgery were 17(27.5%) in TNM 7 and 18(29%) [Chi-0.02, <it>p </it>= 0.88] in TNM6.</p> <p>Conclusions</p> <p>This study shows that a significant proportion of patients were having advanced disease with distant metastasis on presentation. The number of patients falling to stage IV is significantly higher when staged with TNM7 but there was no significant difference in the number of patients undergoing surgery when TNM 7 was used compared to TNM6.</p

Microstructural rearrangements of 4,4′- methelenebis(phenyl isocyanate) (MDI) based polyurethanes in the presence of UV radiation

MDI based polyurethanes have vast variety of applications. Its applications will be broaden with an understanding of the microstructural changes in the polymer matrix due to UV exposure. In this study the fluorescence analysis has been used to uncover the microstructural changes of polymer matrix in a UV environment. When this polymer is exposed to UV radiation hard segments crystallize and the process is assisted localized melting. When the UV exposure was ceased molecules re-arrange back to their initial structure due to the tensile forces originating from softsegment crystallization. However, tensile forces are not strong enough for a complete recovery of the micro structure. Residual solvent molecules can also disturb the recovery

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Oesophageal duplication cyst: a rare cause of aero-digestive tract obstructio

Temperature Modeling with the Group Method of Data Handling to Inform Projected Rainfall Depth Changes for Extreme Events in Central West, New South Wales, Australia

The focus of this research is to introduce the application of the polynomial neural network of the group method of data handling (GMDH) for the first time in the regional area of the New South Wales state of Australia. Within this regional context, temperature data are modeled to assess its projected variation impacts on rainfall depth due to climate change. The study area encompasses six local government areas within the state’s Central West region. Stochastic methods for monotonic trend identification were used to support the modeling. Four established homogeneity tests were also used for assessing data integrity by determining the frequency of breakpoints within the mean of the data. The results of the GMDH modeling returned a coefficient of determination exceeding 0.9 for all stations dominated by an overall upward trend with an average maximum temperature increase of 0.459 °C per decade across the study region. The homogeneity tests found all data categorized as useful within the context of applicability for further climate change studies. By combining the modeled upward temperature trend with the intensity frequency distribution (IFD) design rainfall modification factor, projected depth increases by 2070 are obtained, enabling improved designs for stormwater infrastructure based on classified temperature variation scenarios

National Hosptial of Sri Lanka,

Virchow’s node is an enlarged, hard, left supraclavicular lymph node, which contain metastasis of a range of thoracic or abdominal visceral malignancy. It was initially named after Rudol

Bioinspired bi-phasic 3D nanoflowers of MgO/Mg(OH)2 coated melamine sponge as a novel bactericidal agent

Abstract By roughly mimicking the surface architectural design of dragonfly wings, novel bi-phasic 3D nanoflowers of MgO/Mg(OH)2 were successfully synthesized via the electrospinning technique. The 3D nanoflowers were coated over a commercial melamine sponge and extensively characterized by SEM, XRD, FTIR, and EDS. The formation of distinct dense 3D nano petals was revealed by SEM images whereby the mean petal thickness and mean distance between the adjacent petals were found to be 36 nm and 121 nm, respectively. The bactericidal activities of synthesized 3D nano-flowers coated melamine sponges were assessed against five different bacteria (Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa). This study demonstrated significant bactericidal activity of MgO/Mg(OH)2 3D nanoflowers coated MS against Gram-positive and Gram-negative bacteria. Plausible bactericidal mechanisms include envelope deformation, penetration, and induction of oxidative stress. This study introduces novel bioinspired biomaterial with the capacity to reduce the risk associated with pathogenic bacterial infections, especially in medical devices