Management of non-visualization following dynamic sentinel lymph node biopsy for squamous cell carcinoma of the penis

Objectives: To review the management and clinical outcomes of uni- or bilateral non-visualization of inguinal lymph nodes during dynamic sentinel lymph node biopsy (DSNB) in patients diagnosed with penile cancer and clinically impalpable inguinal lymph nodes (cN0), and to develop an algorithm for the management of patients in which non-visualization occurs. Patients and Methods: This is a retrospective observational study over a period of 4 years, comprising 166 patients with penile squamous cell carcinoma undergoing DSNB and followed up for a minimum of 6 months. All cases diagnosed with uni- or bilateral non-visualization of sentinel nodes in this cohort were identified from a penile cancer database. The management of the inguinal lymph nodes after non-visualization and the oncological outcomes including local and regional recurrence rates were documented. Results: Out of 166 consecutive patients undergoing DSNB, 20 patients (12%) had unilateral non-visualization after injection of intradermal 99mTc. Of these 20 patients, seven underwent repeat DSNB at a later date, with six having successful visualization. One patient had persistent non-visualization and proceeded to a superficial modified inguinal lymphadenectomy (SML). None of these patients experienced recurrence at follow-up. A further seven patients underwent modified SML with on-table frozen-section analysis of the lymph node packet; none of these patients were found to have micrometastatic disease in the inguinal lymph nodes, although one patient developed metastatic inguinal node disease at a later date. Six patients elected to undergo clinical surveillance and have remained disease-free. Conclusion: Patients with impalpable inguinal lymph nodes undergoing DSNB with ≥G2 T1 disease should ideally have bilateral visualization of the sentinel lymph nodes, reflecting the drainage pattern from the primary tumour. In the present series, 12% of patients were found to have unilateral non-visualization after DSNB. Among patients offered a repeat DSNB at a later date, localizing the sentinel node was successful in 86% of cases. Patients with favourable histological characteristics can be placed on clinical surveillance. Those with high-risk disease can be offered a repeat DSNB procedure on the proviso that SML may be carried out if there is repeated non-visualization. Larger cohorts are required to validate this proposed algorithm

Indian herb 'Sanjeevani' (Selaginella bryopteris) can promote growth and protect against heat shock and apoptotic activities of ultra violet and oxidative stress

Selaginella bryopteris is a lithophyte with remarkable ressurection capabilities. It is full of medicinal properties, hence also known as 'Sanjeevani' (one that infuses life). For lack of credible scientific evidence the plant is not in active use as a medicinal herb. We provide scientific evidence for whyS. bryopteris is known as 'Sanjeevani'. The aqueous extract of S. bryopteris possesses growth-promoting activity as well as protective action against stress-induced cell death in a number of experimental cell systems including mammalian cells. Treatment of the cells in culture with 10% aqueous extract enhanced cell growth by about 41% in Sf9 cells and 78% in mammalian cells. Pre-treatment of cells with the Selaginella extract (SE) (1-2× 5%) protected against oxidative stress (H2O2)-induced cell death. The killing potential of ultra violet (UV) was also significantly reduced when the cells were pre-treated with SE for 1 h. Thermal radiation suppressed cell growth by about 50%. Pre-treatment of cells with SE for 1 h afforded complete protection against heat-induced growth suppression. SE may possess anti-stress and antioxidant activities that could be responsible for the observed effects. Chemical analysis shows that SE contains hexoses and proteins. Taken together, S. bryopteris extract may help in stress-induced complications including those due to heat shock

Dilaton Contributions to the Cosmic Gravitational Wave Background

We consider the cosmological amplification of a metric perturbation propagating in a higher-dimensional Brans-Dicke background, including a non trivial dilaton evolution. We discuss the properties of the spectral energy density of the produced gravitons (as well as of the associated squeezing parameter), and we show that the present observational bounds on the graviton spectrum provide significant information on the dynamical evolution of the early universe.Comment: 26 pages, plain tex (to appear in Phys.Rev.D, 1 fig available from the authors upon req.

Fast Algorithms For Josephson Junction Arrays : Bus--bars and Defects

We critically review the fast algorithms for the numerical study of two--dimensional Josephson junction arrays and develop the analogy of such systems with electrostatics. We extend these procedures to arrays with bus--bars and defects in the form of missing bonds. The role of boundaries and of the guage choice in determing the Green's function of the system is clarified. The extension of the Green's function approach to other situations is also discussed.Comment: Uuencoded 1 Revtex file (11 Pages), 3 Figures : Postscript Uuencode

Antibacterial, Remineralising and Matrix Metalloproteinase Inhibiting Scandium-doped Phosphate Glasses for Treatment of Dental Caries

Objectives: Antibiotic resistance is increasingly a growing global threat. This study aimed to investigate the potential use of newly developed scandium-doped phosphate-based glasses (Sc-PBGs) as an antibacterial and anticariogenic agent through controlled release of Sc3+ ions. Methods: Sc-PBGs with various calcium and sodium oxide contents were produced and characterised using thermal and spectroscopic analysis. Degradation behaviour, ion release, antibacterial action against Streptococcus mutans, anti-matrix metalloproteinase-2 (MMP-2) activity, remineralisation potential and in vivo biocompatibility were also investigated. Results: The developed glass system showed linear Sc3+ ions release over time. The released Sc3+ shows statistically significant inhibition of S. mutans biofilm (1.2 log10 CFU reduction at 6 h) and matrix metalloproteinase-2 (MMP-2) activity, compared with Sc-free glass and positive control. When Sc-PBGs were mounted alongside enamel sections, subjected to acidic challenges, alternating hyper- and hypomineralisation layers consistent with periods of re- and demineralisation were observed demonstrating their potential remineralising action. Furthermore, Sc-PBGs produced a non-toxic response when implanted subcutaneously for 2 weeks in Sprague Dawley rats. Significance: Since Sc3+ ions might act on various enzymes essential to the biological mechanisms underlying caries, Sc-PBGs could be a promising therapeutic agent against cariogenic bacteria

Dynamical Compactification, Standard Cosmology and the Accelerating Universe

A cosmological model based on Kaluza-Klein theory is studied. A metric, in which the scale factor of the compact space evolves as an inverse power of the radius of the observable universe, is constructed. The Freedmann-Robertson-Walker equations of standard four-dimensional cosmology are obtained precisely. The pressure in our universe is an effective pressure expressed in terms of the components of the higher dimensional energy-momentum tensor. In particular, this effective pressure could be negative and might therefore explain the acceleration of our present universe. A special feature of this model is that, for a suitable choice of the parameters of the metric, the higher dimensional gravitational coupling constant could be negative.Comment: 11 pages, uses revte

Integration of D-dimensional 2-factor spaces cosmological models by reducing to the generalized Emden-Fowler equation

The D-dimensional cosmological model on the manifold $M = R \times M_{1} \times M_{2}$ describing the evolution of 2 Einsteinian factor spaces, $M_1$ and $M_2$, in the presence of multicomponent perfect fluid source is considered. The barotropic equation of state for mass-energy densities and the pressures of the components is assumed in each space. When the number of the non Ricci-flat factor spaces and the number of the perfect fluid components are both equal to 2, the Einstein equations for the model are reduced to the generalized Emden-Fowler (second-order ordinary differential) equation, which has been recently investigated by Zaitsev and Polyanin within discrete-group analysis. Using the integrable classes of this equation one generates the integrable cosmological models. The corresponding metrics are presented. The method is demonstrated for the special model with Ricci-flat spaces $M_1,M_2$ and the 2-component perfect fluid source.Comment: LaTeX file, no figure

The trace left by signature-change-induced compactification

Recently, it has been shown that an infinite succession of classical signature changes (''signature oscillations'') can compactify and stabilize internal dimensions, and simultaneously leads, after a coarse graining type of average procedure, to an effective (''physical'') space-time geometry displaying the usual Lorentzian metric signature. Here, we consider a minimally coupled scalar field on such an oscillating background and study its effective dynamics. It turns out that the resulting field equation in four dimensions contains a coupling to some non-metric structure, the imprint of the ''microscopic'' signature oscillations on the effective properties of matter. In a multidimensional FRW model, this structure is identical to a massive scalar field evolving in its homogeneous mode.Comment: 15 pages, LaTeX, no figure

Toda chains with type A_m Lie algebra for multidimensional m-component perfect fluid cosmology

We consider a D-dimensional cosmological model describing an evolution of Ricci-flat factor spaces, M_1,...M_n (n > 2), in the presence of an m-component perfect fluid source (n > m > 1). We find characteristic vectors, related to the matter constants in the barotropic equations of state for fluid components of all factor spaces. We show that, in the case where we can interpret these vectors as the root vectors of a Lie algebra of Cartan type A_m=sl(m+1,C), the model reduces to the classical open m-body Toda chain. Using an elegant technique by Anderson (J. Math. Phys. 37 (1996) 1349) for solving this system, we integrate the Einstein equations for the model and present the metric in a Kasner-like form.Comment: LaTeX, 2 ps figure