Adenocarcinoma of Lung Presenting as Unilateral Blindness: A Case Report

Introduction: Lung cancer is the most common cause of death among cancers. Over 55% have distant metastasis at presentation. Intraocular metastasis is a rare site of spread. It is extremely unusual for lung cancer to present primarily with features of choroidal involvement before any respiratory symptoms are manifest.Case Report: A 53 year old lady presented with protrusion of the left eye followed by sudden unilateral painless loss of vision one month later. She was diagnosed to have a left retinal detachment due to a choroidal mass in the left eye. Enucleation was done and showed a metastatic carcinoma of unknown primary. Immunohistochemistry was suggestive of adenocarcinoma with primary in the lung. She had a right mid-lobe lesion for which biopsy was attempted but failed. She also had multiple skeletal metastases and small lesions in the liver. Mutation analysis on the enucleation specimen was positive for exon 19 mutation of EGFR gene and she was started on single agent oral gefitinib 250mg daily and bisphosphonates. Reassessment done 3 months showed reduction in the size of the primary lung lesion with resolution of the liver lesions. Skeletal lesions remained the same.Conclusion: This case of choroidal metastasis presenting with retinal detachment demonstrates a very rare initial presentation of adenocarcinoma of the lung and highlights the need to look for a primary in the lung in cases of choroidal metastasis

Amoebic forms of Blastocystis spp. -evidence for a pathogenic role

Background: Blastocystis spp. are one of the most prevalent parasites isolated from patients suffering from diarrhea, flatulence, constipation and vomiting. It�s pathogenicity and pathophysiology remains controversial to date. Protease activity and amoebic forms have been reported previously in symptomatic isolates but there has been no conclusive evidence provided to correlate the protease activity and any specific life cycle stage of the parasite thus far. Methods: Symptomatic isolates with amoebic form were tested for protease activity and compared with symptomatic and asymptomatic isolates without amoebic form for 10 days culture period. Results: The present study demonstrates an elevated protease activity in cultures having a higher percentage of amoebic forms seen in symptomatic isolates. The growth curve demonstrated a significantly (p < 0.05) higher average number of parasite counts in asymptomatic compared to symptomatic isolates. Symptomatic isolates showed amoebic forms with percentages ranging from 5 to 17. Elevated protease activity was demonstrated in isolates that had higher percentages of amoebic forms with intense bands at higher molecular weight proteases (60 � 100 kDa). As days of culture proceeded, the protease quantification also showed a steady increase. Conclusion: This study elucidates a correlation between protease activity and percentage of amoebic forms. The finding implies that these forms could play a role in exacerbation of intestinal symptoms during Blastocystis spp. infection

AN AUTOMATED SOLUTION FOR AVOIDING ENVIRONMENTAL POLLUTION ON ROADS

The primary reason for such systems would be to alleviate traffic jam that is available in each and every major city. We offer a complete-blown implementation on actual smartphones, with an extensive assessment of their precision and efficiency. Our results make sure smartphone-based TISs can provide accurate traffic condition estimation while being secure and privacy protecting. Nonetheless, to make use of smartphone-based TISs, we have to ensure their privacy and security as well as their effectiveness. Simultaneously, as TISs require fine-grained location information, the privacy from the adding participants should be protected. This requirement for privacy is intensified poor smartphone-based TISs. Growing smartphone transmission, combined with wide coverage of cellular infrastructures, renders wise phone based traffic human resources (TISs) a beautiful option. This is actually the motivation of the paper: We leverage condition-of-the-art cryptographic schemes and easily available telecommunication infrastructure. We present an extensive solution for smartphone-based traffic estimation that is known as secure and privacy protecting

Imatinib resistance mutation analysis: experience from a tertiary oncology center

Purpose: BCR-ABL kinase domain (KD) mutations account for 50-90% of the imatinib resistance observed in patients of CML-chronic phase. In CML-CP patients receiving imatinib first-line, mutation analysis is recommended in case of failure or suboptimal response using European LeukemiaNet (ELN) criteria. The present study was carried out at a tertiary oncology centre in south India to assess which mutations accounted for resistance to imatinib among patients of chronic phase CML being treated with imatinib.Methods: This was a retrospective observational study. We analyzed patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure. Direct sequencing of the BCR-ABL transcript by the Sanger method was used for IRMA testing.Results: Out of 120 tested for IRMA, 36 (30%) had detectable mutations. We observed a higher frequency of mutations at amino acids T315, F359 and M351T.Conclusions: Among the patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure, 30% had IRMA +ve mutations. The high incidence of imatinib resistance in present study may be attributed to the fact that our patients were given higher dose of imatinib (600 mg), if they failed to achieve CCyR at 12 months or CHR at 3 months as they could not afford second generation TKIs.</p

Imatinib resistance mutation analysis: experience from a tertiary oncology center

Purpose: BCR-ABL kinase domain (KD) mutations account for 50-90% of the imatinib resistance observed in patients of CML-chronic phase. In CML-CP patients receiving imatinib first-line, mutation analysis is recommended in case of failure or suboptimal response using European LeukemiaNet (ELN) criteria. The present study was carried out at a tertiary oncology centre in south India to assess which mutations accounted for resistance to imatinib among patients of chronic phase CML being treated with imatinib.Methods: This was a retrospective observational study. We analyzed patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure. Direct sequencing of the BCR-ABL transcript by the Sanger method was used for IRMA testing.Results: Out of 120 tested for IRMA, 36 (30%) had detectable mutations. We observed a higher frequency of mutations at amino acids T315, F359 and M351T.Conclusions: Among the patients who were tested for imatinib resistance mutation in view of suboptimal responses while on imatinib or imatinib failure, 30% had IRMA +ve mutations. The high incidence of imatinib resistance in present study may be attributed to the fact that our patients were given higher dose of imatinib (600 mg), if they failed to achieve CCyR at 12 months or CHR at 3 months as they could not afford second generation TKIs

Clinicopathological Profile of Pure Neuroendocrine Neoplasms of the Esophagus: A South Indian Center Experience

Purpose. Neuroendocrine neoplasms (NENs) of the esophagus are very uncommon with only a few studies published worldwide. Studies on clinical profile, management, and outcomes are very uncommon. Methods. We report the largest single institution retrospective review of 43 patients of pure esophageal NENs out of our registry of gastrointestinal neuroendocrine tumors treated between 2005 and 2014. Data on the incidence, tumor location, clinical symptoms, stage at presentation, grading, treatment protocol, and treatment outcomes was collected and analyzed. Results. Among 1293 cases of esophageal cancers, pure esophageal NENs were diagnosed in 43 cases. The mean patient age was 55.8 years. The male : female ratio was 1.5 : 1. 81.4% of the tumors were located in the lower third of the esophagus and gastroesophageal junction. Neuroendocrine carcinomas (NEC; G3) accounted for the vast majority of NENs (83.7%). 53.5% patients were Stage IV and 32.5% were Stage III at presentation. The combined median survival of stages II and III patients was 18.25 months, with treatment. The median survival of treated patients with metastatic disease was 6.5 months. Conclusion. Esophageal NENs most commonly were neuroendocrine carcinomas, presented in metastatic stage and were associated with poor prognosis. Grade 2 (G2) tumors had better outcomes than NEC (G3). In nonmetastatic disease, presence of lymph node metastasis and unresectable disease had poorer outcomes

Investigation of conventional and ultrasonic vibration-assisted turning of hardened steel using a coated carbide tool

This study compares conventional turning (CT) and ultrasonic vibration-assisted turning (UVAT) in machining hardened AISI 52100 steel (62 HRC) with a PVD-coated TiAlSiN carbide tool. UVAT experiments, utilizing an ultrasonic frequency of 20 kHz and vibration amplitude of 20 µm, varied the cutting speed, feed, and depth of cut. Remarkably, UVAT reduced tool wear, extending tool longevity. Surprisingly, power consumption showed no significant differences between CT and UVAT. Mathematical models based on experimental data highlight the substantial impact of the cutting speed on tool wear, followed closely by the depth of cut. For power consumption, the depth of cut took precedence, with the cutting speed and feed rate playing pronounced roles in UVAT. This emphasizes the potential for further research on machinability, particularly exploring different vibration directions on the tool in feed, tangential, and radial aspects