Cm In Size Research Articles

A phase l and randomized phase ll trial of radium-223 dichloride, peposertib, and avelumab in advanced metastatic castrate-resistant prostate cancer (mCRPC): Phase l results.

5069 Background: Ra-223 improves the overall survival in patients with mCRPC to the bone. We assessed the safety of standard-of-care Ra-223 in combination with peposertib, a DNA-dependent protein kinase inhibitor, with or without avelumab, an anti-PD-L1 antibody. Methods: Patients with mCRPC and two or more skeletal metastases identified by bone scintigraphy with or without lymph node metastases up to 3 cm in size, but no visceral metastases, were eligible. Progression after progression after at least one androgen receptor pathway inhibitor or taxane was required. Phase 1 consisted of a two-step sequential safety lead-in using a 3+3 design. Step 1 combined 6 standard cycles of Ra-223 (55 kBq/kg), with increasing doses of peposertib: 50, 100, and 200 mg PO bid on days 3-26 of each cycle. Step 2 combined Ra-223 with the maximum tolerated dose of peposertib and added standard avelumab 800 mg IV every 14 days, starting at cycle 2 of Ra-223. Results: A total of 9 patients participated in Step 1, where the maximum tolerated peposertib dose of 200 mg PO bid with Ra-223 was deemed tolerable. A total of 6 patients participated in Step 2 and the combination of Ra-223, peposertib at 200 mg PO bid, and standard avelumab was deemed tolerable. Of the 15 patients in Phase 1, none experienced grade 4 or higher treatment-related toxicities, while 7 experienced grade 3 toxicities, including neutropenia (1), anemia (1), cardiac chest pain (1), fall (1), maculopapular rash (2), and lymphopenia (2). The median (Q1, Q3) PSA velocity from the beginning to the end of treatment was lower for Step 2 versus Step 1: 2.1 (-0.1, 4.6) versus 23.5 (18.6, 77.1) ng/mL/month (p = 0.0067). OS and PFS were calculated with the limitation that the Phase 1 was non-randomized. Median OS was not reached for Step 2, as only 1 of 6 patients had died, versus 15.2 months for Step 1, where 8 out of 9 patients had died (p = 0.0537). The patient who died in Step 2 discontinued therapy prematurely after 3 cycles due to progression and survived 15.2 months (the 5 alive completed all 6 cycles). The median radiographic PFS was 7 months for Step 2 versus 12.7 months for Step 1 (p = 0.8910). Conclusions: The combination of Ra-223 and peposertib, with or without avelumab was well tolerated. The triplet combination showed the most promising results at this early evaluation. We continue to accrue in the randomized Phase II portion of the trial. Clinical trial information: NCT04071236 .

Pelvic ultrasound: A missed opportunity for earlier detection of cervical cancer?

e17538 Background: Pelvic ultrasound is an imaging modality commonly used to detect and monitor gynecologic malignancy and has broad potential for use in low-resource settings due to its low cost and portability. In cases of cervical cancer, pelvic ultrasound has been shown to reliably detect tumor size, parametrial involvement, and increased vascularity. 1 The aim of this study was to assess the use of ultrasound among a cohort of cervical cancer patients and compare the findings to other imaging modalities. Methods: A retrospective cohort study was performed using a dual-institution database of patients who received treatment for cervical cancer at four New York City hospitals (one public and three private) from 2010-2024. Demographics, timing of diagnostic imaging, and results of diagnostic imaging were extracted from charts. Diagnostic reports were analyzed qualitatively with thematic analysis. 2 Results: Of the 2,009 patients in the database, 115 had comprehensive data on treatment and imaging available and 26 patients were identified as having had pelvic ultrasounds. Ultrasounds were ordered for the indications of vaginal bleeding (n=19, 73%), prior diagnosis or concern for malignancy (n=6, 23%), pelvic or abdominal pain (n=5, 19%), and thickened endometrium incidentally noted on prior CT scan (n=1, 4%). Of the 26 ultrasounds, 8% described the cervix as normal (n=2), 50% described the cervix as abnormal (n=13), and 38% did not comment on the cervix at all (n=10). Abnormal findings included a cervical mass (n=8, 62%), increased vascularity (n=6, 46%), or hypoechoic areas (n=3, 23%). Ultrasounds obtained prior to a diagnosis of cervical cancer were obtained on average 16.1 days prior to diagnosis, 2.1 days prior to first CT scan, 32.1 days prior to first MRI, and 23.5 days prior to first PET CT. Overall, 11 patients had a pelvic ultrasound in which the cervix was noted to be normal or not commented on and later had a CT, MRI, or PET scan showing significant abnormality, including masses measuring 2.1 to 6.4 cm in size. Conclusions: This study demonstrates that patients with cervical cancer are often initially evaluated with ultrasound, but the cervix is often not evaluated and significant abnormalities are missed, potentially leading to delays in diagnosis and treatment. Further exploration of the role of ultrasound imaging in the early detection of cervical cancer, potentially through quality improvement initiatives in conjunction with radiology colleagues could offer benefit to patients, especially in low-resource settings. 1. Hsiao YH, Yang SF, Chen YH, Chen TH, Tsai HD, Chou MC, Chou PH. Updated applications of Ultrasound in Uterine Cervical Cancer. J Cancer. 2021 Feb 22;12(8):2181-2189. doi: 10.7150/jca.49479. PMID: 33758596; PMCID: PMC7974902. 2. Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology . 2006;3(2):77-101. doi:10.1191/1478088706qp063oa.

Incidence, factors enabling to predict and management of hypocalcemia following total thyroidectomy for thyroid cancer: A prospective observational study.

e18127 Background: Hypocalcemia (transient) is the most common complication following total thyroidectomy. It may or may not be accompanied by hypoparathyroidism. Various factors, such as preoperative Vitamin D, magnesium and phosphorus levels and the need to perform central compartment dissection may be associated with this complication. Methods: In this prospective observational study (CTRI/2020/12/030092) conducted between March 2022 to October 2024, all patients diagnosed with thyroid cancer who were to undergo total thyroidectomy with or without neck dissection as per the tumour board decision were included. Preoperative serum vitamin D, magnesium phosphorus and calcium measurements were done in all patients in addition to the routine investigations. Postoperatively, serum parathormone was measured on day 1 morning, and serum calcium and albumin were measured on Day 2 morning. Patients were managed for postoperative hypocalcemia as per standard practice. Results: A total of 338 patients were included in the final analysis. The median age of the patients was 40.5 years. One hundred and six patients (31.4%) presented with a palpable neck node in our cohort, and 113 (33.4%) patients had a thyroid nodule >4 cm in size. A large majority of our patients had subnormal levels of vitamin D levels (n=300,90.2%) with a median value of 16.2 ng/ml (1.31-85.10 ng/ml). All these patients received corrections as per the standard practice. The central compartment and lateral neck were addressed in 64% of the patients. The incidence of (transient) hypocalcemia was 31.4% (n=106), out of which 44 patients had only biochemical hypocalcemia and 62 patients had both clinical and biochemical hypocalcemia. Preoperative serum vitamin D, magnesium and phosphorus levels did not have any influence on the patients developing (transient) hypocalcemia. Patients with postoperative day 1 serum parathormone levels of < 15 pg/ml developed clinical & biochemical (transient) hypocalcemia.[p<0.001,OR 2.74(1.219-4.242)]. Patients having a calcium delta (Preoperative calcium-postoperative day 2 corrected serum calcium) of >1.36 mg/dl and day 2 PTH levels < 5 pg/ml often required parenteral corrections. The median duration of hospital stay of our patients was 5 days. There was an increase in the duration of hospital stay in patients with (transient) hypocalcemia (p=0.016) and more so who required parenteral correction (p=0.015). Overall calcium delta >1.09,[p<0.001,17.604(9.560-32.416)], postoperative day 1 serum parathormone <15pg/ml [p<0.001,2.281 (1.22-4.257)] and ≤2 parathyroid saved [p=0.49,2.55(1.004-6.474)] influenced the duration of hospital stay. Conclusions: The incidence of (transient) hypocalcemia in our cohort of patients was 31.4% and it does influence the duration of hospital stay of the patients. Preoperative vitamin D, magnesium and phosphorus levels did not have any influence on the incidence of postoperative (transient) hypocalcemia. Clinical trial information: CTRI/2020/12/030092 .

Correlation between serum vitamin D3 and prolactin levels in pre-menopausal women with uterine fibroids

Objectives: Uterine fibroids (UFs) (leiomyomas) are common benign tumors affecting approximately 70% of women of reproductive age. Low serum vitamin D3 levels may promote fibroid growth and disease progression. In addition, fibroids can secrete prolactin (PRL), leading to hyperprolactinemia, which is associated with reproductive disorders and infertility. This study investigates the correlation between serum vitamin D3 (1,25-hydroxyvitamin D3) and PRL levels with fibroid number and size in premenopausal women. Materials and Methods: A cross-sectional study was conducted at Indira in vitro fertilization (IVF) Hospital and Fertility Clinics in India from April 15 to November 30, 2022. It included 160 premenopausal women: 80 with fibroids and 80 healthy controls. Cases were women with UFs ≥2 cm in size, diagnosed through transvaginal ultrasonography, compared to healthy controls. Results: The mean serum vitamin D3 and PRL levels in the case and control groups were 10.85 ± 3.34 ng/mL versus 19.64 ± 5.50 ng/mL and 27.79 ± 8.19 ng/mL versus 13.96 ± 4.09 ng/mL, respectively. Serum vitamin D3 was significantly lower (P < 0.001), and serum PRL was significantly higher (P < 0.001) in the case group compared to the control group. A strong correlation was observed between serum vitamin D3, PRL, and the number of fibroids in the case group (P < 0.0001). Serum vitamin D3 showed a negative correlation with fibroid number (r = −0.513), while serum PRL showed a positive correlation (r = 0.453), indicating that lower vitamin D3 and higher PRL levels are associated with an increased number of fibroids. Conclusion: Our study concluded that women with UFs had significantly lower serum vitamin D3 and higher PRL levels compared to healthy controls. These findings suggest that low vitamin D3 and high PRL levels are associated with increased fibroid number, growth, and disease progression. Thus, serum vitamin D3 and PRL may serve as important biomarkers for the management of UFs.

Gallstone Ileus: a case report and literature review of surgical treatment

ABSTRACT Gallstone ileus (GI) is a rare condition characterized by nonspecific clinical symptoms and signs, often leading to delayed diagnosis and treatment. We describe the case of a 71-year-old female patient with a ten-year history of gallstones who was admitted to the hospital with symptoms of cholecystitis. The patient was scheduled to undergo laparoscopic cholecystectomy several days after initiating antibiotic therapy. On the fifth day of treatment, she suddenly experienced severe abdominal pain accompanied by vomiting. The patient exhibited stable vital signs and mild abdominal distension. Abdominal radiography revealed air-fluid levels and a radiopaque mass in the left abdomen. A CT scan indicated bowel obstruction due to an intraluminal mass approximately 3 cm in size, suspected to be a gallstone. The patient was successfully treated with enterolithotomy via laparotomy. Postoperative esophagogastroduodenoscopy revealed a fistula extending from the second to the third portion of the duodenum to the gallbladder. Medical literature emphasizes the importance of the history of gallstones and the role of computed tomography in diagnosing GI. Additionally, enterolithotomy alone is considered a safe and effective management strategy for GI.

UNCOMMON CARDIAC MASS COMPRESSING THE LEFT ANTERIOR DESCENDING ARTERY: DIAGNOSTIC CHALLENGES AND MULTIMODALITY IMAGING EVALUATION

UNCOMMON CARDIAC MASS COMPRESSING THE LEFT ANTERIOR DESCENDING ARTERY: DIAGNOSTIC CHALLENGES AND MULTIMODALITY IMAGING EVALUATION

The Landmark Series: Evaluation and Management of Adrenal Incidentalomas.

Adrenal incidentalomas are adrenal masses ≥ 1cm discovered on imaging studies for unrelated clinical conditions. The prevalence of adrenal incidentalomas has increased as a byproduct of the widespread use of cross-sectional imaging, particularly in older adults. The clinical significance of adrenal incidentalomas varies based on tumor size, hormonal activity, and imaging characteristics. While most adrenal incidentalomas are benign and asymptomatic, a significant minority are hormonally active or malignant, necessitating careful evaluation and management. Adrenal hormone secretion can have significant clinical implications. Biochemical testing is crucial to assess for hormone excess, including steroid hormones (mineralocorticoids, glucocorticoids, and androgens), which are made in the adrenal cortex, as well as catecholamines, which are made in the adrenal medulla. Non-contrast computed tomography (CT) is the preferred modality for evaluating adrenal nodules as it allows for assessment of tissue density in Hounsfield units (HU). Benign lesions typically have an homogeneous appearance with HU ≤ 10. Contrast-enhanced CT with delayed washout can help differentiate benign tumors from malignant tumors. Tumors ≥ 4cm, or those with indeterminate features may require further imaging, such as magnetic resonance imaging (MRI) or positron emission tomography (PET)/CT. The management of adrenal incidentalomas is determined by hormonal secretion and imaging characteristics. Surgical resection is recommended for functional tumors and those that are suspicious for malignancy, including tumors ≥ 4cm in size and those with rapid growth. Non-functional tumors < 4 cm may undergo imaging surveillance. The goal of this review is to summarize the contemporary literature and guidelines on adrenal incidentalomas, and to describe the key principles regarding evaluation and management.

Sustainable Aquaculture: The Role of Probiotic Fortification In Enhancing Catfish Growth In Biofloc Aquaponics Technology

Catfish (Pangasius sp.) is a freshwater fish commodity that is widely cultivated in the Indonesian fisheries sector. The aim of this research was to determine the effect of fortification of liquid probiotics bioprisma and biogan on the protein and fat of catfish meat in the biofloc aquaponics technology. The catfish used in this study was 7-8 cm in size. The research was carried out using a completely randomized design (CRD) method with 3 treatments and 3 replications, the treatments were as follows: P0 = without addition of probiotics, P1 = addition of bioprisma probiotics 0.15 mL/l,5 L of water, P2 = addition of biogan probiotics 0,15 mL/l,5 L of water. The data obtained were then processed and calculated using ANOVA at a 95% confidence interval if a significant effect was found, then continued with Duncan's further test. This study indicates that the addition of probiotic to catfish culture media can affect body protein, body fat, and water quality environmental condition (ammonia, nitrite, nitrate, DO) of catfish. The addition of probiotics in the P1 (addition of bioprisma probiotics 0,15 mL/l ,5 L of water) gave the best effect in increasing the growth of catfish, 18,70% body protein and 8,73% body fat. The integration of biofloc with aquaponics technologies can eliminate geographical limitations and accelerate the urbanization of aquaculture.

Microwave Ablation of Colorectal Pulmonary Metastases Offers Excellent Local Tumor Control and CanProlong Time Off Chemotherapy.

To evaluate oncologic outcomes after microwave ablation (MWA) of colorectal pulmonary metastases, with focus on disease control without chemotherapy. This institutional review board-approved retrospective study examined patients with oligometastatic or oligoprogressive colorectal pulmonary metastases undergoing MWA between January 2011 and December 2021. Imaging response was assessed with CT at 4-8weeks post-MWA, with subsequent cross-sectional follow-up imaging every 2-4months. Local tumor progression-free survival (LTPFS), chemotherapy-free survival (CFS) and overall survival (OS) were calculated using Kaplan-Meier methodology. Variables were evaluated for predictive significance using the log-rank test and Cox regression. Two hundred twenty-five patients (127 male, 98 female; median age: 55years) with 720 pulmonary metastases underwent 400 MWA sessions (mean number of treated metastases per session: 1.8; range 1-9). Mean treated tumor size was 0.9cm. LTPFS at 1, 2 and 3-years was 91.9%, 85.9% and 81.5%, respectively. Tumors ≥ 1cm in size, pleural-based tumors and pre-MWA carcinoembryonic antigen (CEA) levels ≥ 10ng/mL were associated with shorter LTPFS (all P < 0.001). 74.7% (168/225) of patients did not receive chemotherapy for at least two months after the initial MWA. Median CFS was 12months (95% CI 7.8-16.2) and was significantly prolonged in patients with lung-only disease compared to those with concurrent extrapulmonary disease (34.4 vs. 4.0months, P < 0.001). Median OS was 47months (95% CI 36.7-57.3). MWA of colorectal pulmonary metastases is associated with high local tumor control rates and can offer prolonged CFS, particularly for patients without concurrent extrapulmonary disease.

Abstract 4734: Alteration of tumor immune environment in metastatic and non-metastatic papillary thyroid microcarcinoma

Abstract Introduction: Papillary thyroid microcarcinomas (PTMC), defined as tumors ≤1 cm in size, are mostly indolent and warrant conservative management. However, up to 10% of PTMC present with clinically significant lymph node metastases or very rarely with distant metastases (M1). Deciphering molecular signatures of metastases-prone PTMCs may help strategize management options. Therefore, the goal of this study was to analyze the transcriptome profiles and tumor microenvironment in metastatic and non-metastatic PTMC. Methods: Patients diagnosed with indolent non-metastatic (N0/Nx) PTMCs and with tumors metastatic to the lateral neck lymph nodes or distant sites (N1b/M1) were selected by reviewing medical records and pathology slides. RNA sequencing was done on 85 tumor samples and adjacent normal tissues. An R package pathfinder was used to do pathway enrichment analysis utilizing active subnetworks. A subset of samples (n=9) was subjected to multiplex immunofluorescence (MxIF) staining using CD8a and CD20 antibodies. Image analysis of the whole tissue, tumor, and three 400 µm regions around the tumor to count cytotoxic T cells, B-cells, and macrophages was done in a single-blinded manner using HALO (Indica Labs). Differential spatial expression was tested using t-test for normally distributed data and Mann-Whitney test for skewed data, with two-sided p≤0.05 rendered statistically significant. Results: The study cohort consisted of 17 patients from N0/Nx group and 19 presenting with N1b/M1 disease. No difference in the clinical characteristics, viz. age (39y vs 46y, p=0.64), gender (female 82.4% vs. 94.7%, p=0.24), median tumor size (0.6cm vs 0.8cm, p=0.27) was found between the groups. There was a significant downregulation of pathways involved in the regulation of B cell activation (FDR-adjusted p-value&amp;lt;0.001), activation of immune response (p&amp;lt;0.001), antigen receptor-mediated signaling pathway (p&amp;lt;0.001), humoral immune response (p&amp;lt;0.001), B cell receptor signaling pathway (p&amp;lt;0.001), pathways activating and regulating cell surface receptor and signal transduction (p&amp;lt;0.001) in primary tumors derived from the N1b/M1 compared to N0/Nx group. However, MxIF revealed no difference in B cell (CD20+/CD8a) infiltration in the primary tumors (p=0.43) nor in the tumor rims (p=0.92) between the groups. In contrast, there was a significantly higher number of cytotoxic T cells (CD8a+/CD20-) in the rims of the primary tumors from N1b/M1 group compared to N0/Nx (p=0.007). Conclusion: Metastasis-prone PTMC is characterized by a different immune landscape as compared with the classic indolent variant, with increased cytotoxic T cell infiltration in tumor edges and decreased activation of infiltrating B-cells. GeoMx DSP experiments are undergoing to identify immune cells and their crosstalk with the cancer cells that might be involved in transducing metastatic potential for a subset of PTMCs. Citation Format: Rhitajit Sarkar, Shilpa Thakur, Gus Fridell, Noemi Kedei, Maria Hernandez, Sonam Kumari, Maria Merino, Joanna Klubo-Gwiezdzinska. Alteration of tumor immune environment in metastatic and non-metastatic papillary thyroid microcarcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4734.

Surgery or Percutaneous Ablation for Liver Tumors? The Key Points Are: When, Where, and How Large.

The most recent comparisons between liver resection (LR) and percutaneous thermal ablation (PTA) reported similar efficacy and survival outcomes for primary and secondary liver tumors ≤ 3 cm in size. Nevertheless, LR still remains the most popular treatment strategy worldwide, and percutaneous ablation is usually reserved to patients who are not surgical candidates. However, in our opinion, the debate should no longer be what is the most effective treatment for patients with resectable small liver cancer who are not candidates for liver transplantation, but rather when LR or PTA are best suited to the individual patient. Subcapsular tumors or tumors closely adjacent to critical structures or vulnerable organs should undergo LR because ablation can often not achieve an adequate safety margin. Conversely, PTA should be considered the first choice to treat central tumors because it has lower complication rates, lower costs, and shorter hospital stay. Furthermore, recent technical improvements in tumor targeting and accurate assessment of the extent of the safety margin, such as stereotactic navigation, fusion imaging and software powered by Artificial Intelligence enabling the immediate comparison between the pre-procedure planned margins and the ablation area, are also changing the approach to tumors larger than 3 cm. The next trials should be aimed at investigating up to what tumor size PTA supported by these advanced technologies can achieve outcomes comparable to LR.

Low-Malignant-Potential Adenocarcinoma: A Histological Category with a Significantly Better Prognosis than Other Solid Adenocarcinomas at IA Stage.

Low-malignant-potential adenocarcinoma has been defined as a type of non-mucinous tumor, which has a total tumor size measuring ≤ 3 cm, exhibits ≥ 15% lepidic growth, lacks non-predominant high-grade patterns (≥10% cribriform, ≥5% micropapillary, ≥5% solid), has an absence of angiolymphatic or visceral pleural invasion, spread through air spaces (STAS), necrosis and >1 mitosis per 2 mm2. The aim of this study is to validate, with regard to cancer-specific survival (CSS) and disease-free survival (DFS), the proposed definition of LMP adenocarcinoma in an independent external cohort of lung adenocarcinoma patients having undergone surgical resection, and having presented with a long follow-up period. Clinicopathological characteristics of patients who underwent lung resection for adenocarcinoma from 1 January 2005 to 31 December 2014 were retrospectively analyzed. Patients with ground-glass opacity (GGO) and part-solid tumors, minimally invasive adenocarcinoma (MIA), adenocarcinoma in situ (AIS), tumors ≥5 cm in size, nodal involvement and/or distant metastases, patients who underwent neoadjuvant treatment, and those who had an incomplete follow-up or a follow-up shorter than 60 months were excluded. The proposed criteria for low-malignant-potential adenocarcinoma (LMPA) were tumor size ≤ 3 cm, invasive size ≥ 0,5 cm, lepidic growth ≥ 15%, and absence of the following: mitosis (>1 per 2 mm2), mucinous subtype, angiolymphatic invasion, visceral pleural invasion, spread through air spaces (STAS) and tumor necrosis. End points were disease-free survival (DFS) and cancer-specific survival (CSS). The log-rank test was used to assess differences between subgroups. Out of 80 patients meeting the proposed criteria, 14 (17.5%) had the LMPA characteristics defined. The mean follow-up time was 67 ± 39 months. A total of 19 patients died, all in the non-LMPA category, and 33 patients experienced recurrence: 4 (28.5%) with LMPA and 29 (43.9%) with non-LMPA. Log-rank analysis showed 100% 10-year CSS for patients with LMPA and 77.4% for patients without LMPA, with this difference being statistically significant (p-value = 0.047). Univariate analysis showed a significant association with the cStage (AJCC eighth edition), both for CSS (p value = 0.005) and DFS (p-value = 0.003). LMPA classification did not show a statistically significant impact on CSS and DFS, likely due to the limited number of events (CSS p-value = 0.232 and DFS p-value = 0.213). No statistical association was found for CSS and DFS with pT, the number of resected nodes (< or >10) or the number of resected N2 stations (< or >2). Our study confirmed the prognostic role of LMPA features, with a low risk of recurrence and a good CSS and DFS. The criteria for diagnosis are replicable and feasible for application. The clinical implications of these findings, such as pre-operative prediction and surveillance scheduling, may be the topic of future prospective studies.

In situ observation of the subsolidus reactions between petalite and spodumene + quartz in a hydrothermal diamond-anvil cell

Abstract Spodumene and petalite are the primary minerals mined from pegmatites, the most important sources of hard-rock Li resources. In Li-mineralized pegmatites, the subsolidus reaction of petalite → spodumene + 2quartz (1) and its reverse reaction: spodumene + 2quartz → petalite (2) produce secondary spodumene, usually in the form of spodumene and quartz intergrowths (SQI), and secondary petalite, respectively. The pressure-temperature (P–T) conditions under which these reactions occur have been investigated using quenching-type equipment (e.g., cold-seal pressure vessels). However, the kinetic parameters of the reactions are difficult to measure in these experiments and are thus frequently overlooked even though they can significantly improve our understanding of the formation of spodumene and petalite in pegmatites. In this study, we employed a hydrothermal diamond-anvil cell to observe the reaction process and crystallization dynamics in situ. The reaction rates (Vr) of Reaction (1) in sample systems with 5–95 wt% H2O ranged from 10−6 to 10−11 cm3/day at 355-753 MPa and 500–600 °C. Vr is driven by the Gibbs free energy change (ΔGr) of the reaction, which is pressure- and temperature-dependent. As ΔGr (&amp;lt; 0) decrease, Vr rises. Vr also correlates positively with the growth rate (Vg) of secondary spodumene, though Vg is lower than that of primary spodumene formed in pegmatite-forming melts. Hence, by extrapolating experimental ΔGr–Vr data to pressure-temperature (P–T) conditions of pegmatite formation, we can estimate Vr and thus assess Vg for secondary spodumene in natural SQI. For example, the formation of secondary spodumene in the Highbury pegmatite (South Africa) is ributed to Reaction (1), which occurred at a Vr of 10−8–10−9 34 cm3/day under conditions of 370 MPa and 400–500 °C. This Vr could correspond to a high Vg, leading to secondary spodumene crystals reaching up to 0.5 cm in size. In contrast, the fine-grained secondary spodumene (e.g., &amp;lt; 0.2 mm) in the Tanco pegmatite (Canada) is possibly attributed to a lower Vg under P–T conditions of ∼290–260 MPa and below 400 °C. Reaction (2) at 244 MPa and 600 °C yielded Vr of ∼10−7 cm3/day, approaching the growth rate of petalite crystallized from pegmatite-forming melts. Thus, secondary petalite is easy to form via Reaction (2) during pressure drops in pegmatite formation.

Dermatofibrosarcoma Protuberans of Inguinal Region: A Case Report

Dermatofibrosarcoma is a rare tumour involving the skin. It is a low-grade soft-tissue sarcoma that is commonly seen in middle-aged individuals, usually in the third and fourth decades of life, with males showing a higher prevalence than females. The authors reported a case of a 48-year-old female patient who presented to the hospital with complaints of multiple right inguinal swellings for three months, along with a reported recent increase in size over the last month. On examination, multiple papulomatous lesions, approximately 5×3 cm in size, were observed in the right inguinal region. Ultrasonography (USG) revealed well-defined lesions with a relatively mixed pattern and a few cystic areas noted in the subcutaneous plane, measuring approximately 40×25 mm. These lesions exhibited raised vascularity on colour Doppler imaging. The histopathological examination revealed myxoid tissue showing spindle or satellite cells with oval elongated nuclei and indistinct cytoplasm, suggestive of dermatofibrosarcoma. Dermatofibrosarcoma protuberans is an unusual soft-tissue tumour of the skin, and ultrasonography can significantly help in its diagnosis and management.

Two modes of terrestrial phosphide formation

Abstract In anorthite-diopside-tridymite paralava of the Hatrurim Complex, Daba-Siwaqa, Jordan, phosphides from two facies environments were found. Large xenomorphic phosphide aggregates, presented by minerals of the barringerite-transjordanite series, murashkoite and zuktamrurite, were noted at the intimate contact of the paralava with the host rocks. Moreover, the contact facies of the paralava, composed of large diopside crystals up to 1 cm in size and cemented by hydrosilicates, zeolites, and calcite, are enriched in phosphides. In the contact facies, it was possible to observe pseudomorphs of barringerite and murashkoite after fish bones and inclusions of minute needle-like barringerite crystals in diopside with morphological manifestations of the simultaneous crystallization of these minerals. In the central part of the weakly altered paralava with abundant amygdules, two nodules containing ore minerals were detected. In the first nodule, barringerite and schreibersite were found; the second contained nickelphosphide. In this paper we discuss the hypothesis that phosphides at the contact facies of the paralava formed as a result of reducing carbothermal reactions with the participation of thermally altered and graphitized fish-bone remains as a source of carbon and phosphorus and oxidized pyrite framboids as an iron source: Fe2O3 + 3C = 2Fe(lq) + 3CO(g), 2Ca5(PO4)3F + 14C = 3P2(g) + 14CO(g) + 10Cao + F2(g) and nFe(lq) + ½P2(g) = FenP, where n = ½, 1, 2, 3. The process of phosphide formation during hot paralava injection, the temperature of which exceeded 1400 °C, into previously altered host rocks with contamination of material containing bone remains, took place in a small volume in a kinetic mode, which led to the preservation of the primary form of bone remains when they were replaced by phosphides. The formation of phosphides in the central part of the paralava occurred with the participation of gases that transported phosphorus reduced as a result of carbothermal reactions. The phosphorous was absorbed by drops of metal or sulfide melt, which led to the formation of phosphides.

Topical application of Gopyadi ghritha in diabetic ulcer-A case report

Diabetic ulcers represent a prevalent complication associated with diabetes, typically manifesting on the dorsal surfaces of the toes and the plantar regions of the metatarsal heads and heels. While these ulcers are frequently observed on the feet, they can develop in various locations throughout the body. The etiology of diabetic ulcers is linked to factors such as inadequate blood circulation, elevated blood glucose levels (hyperglycemia), nerve damage, and the presence of irritated or injured feet, which may ultimately necessitate lower limb amputation. Patients with diabetes often experience diminished microvascular circulation, hindering the ability of phagocytic cells to reach infected areas and facilitate healing. Consequently, infections in these individuals are notoriously difficult to treat. The occurrence of diabetic ulcers can be associated with pramehajanya dushtavrana. In the Susrutha Samhitha, Acharya Susrutha discusses Shashtirupakaramas for the management of vrana. Among these, Ghritha is utilized as a topical treatment to promote healing. Specifically, Gopyadi ghritha, referenced in Sahasrayogam within the ghrithaprakaranam, exhibits a ropana effect even in marmasthana prameha vrana and was employed in this case report. A 69-year-old female patient with a known diagnosis of type 2 diabetes mellitus presented to the outpatient department of GAVC Tripunithura, reporting a non-healing ulcer measuring 4x2.5 cm at the base of the second and third right toes, along with a 1.2x0.5 cm ulcer on the anterolateral aspect of the right ankle joint, persisting for six months. The management involved the application of Gopyadi ghritha topically for 42 days, alongside internal medications aimed at controlling diabetes and infections. Remarkably, the ulcer completely healed within this timeframe, with no complications or recurrence noted even after one year. This case underscores the potential for managing diabetic foot ulcers (up to 10x10 cm in size) without infections through the application of Gopyadi ghritha, resulting in expedited and effective healing with minimal scarring within 42 days.

Comparative oncological features of centrally and peripherally located small-sized radiologically solid-dominant non-small-cell lung cancer.

This study aimed to compare the oncological features of centrally and peripherally located small-sized (≤2 cm), radiologically solid-dominant, cN0 non-small-cell lung cancer (NSCLC). We retrospectively reviewed 1240 patients who underwent lobectomy or segmentectomy for radiologically solid-dominant cN0 NSCLC tumours ≤2 cm in size. Tumours were categorized as centrally (inner two-thirds of the pulmonary parenchyma) or peripherally (outer one-third) located. Clinicopathological characteristics and prognoses were compared between the 2 groups. Among the 1240 patients, 299 had centrally located and 941 had peripherally located tumours. Centrally located tumours showed a significantly higher proportion of pure solid tumours and pathological lymph node upstaging than peripherally located tumours (P = 0.018 and P = 0.038, respectively). Multivariable logistic regression analysis identified central location as an independent predictor for pN1 (odds ratio, 1.91; 95% confidence interval, 1.09-3.36; P = 0.024), but not for pN2, upstaging. The cumulative incidence of loco-regional and distant recurrences did not significantly differ between the 2 groups (P = 0.455 and P = 0.383, respectively). Overall survival and recurrence-free survival rates were also similar among patients with central and peripheral tumours (P = 0.267 and P = 0.269, respectively). Patient prognosis following complete anatomical resection was comparable between centrally and peripherally located radiologically solid-dominant cN0 NSCLC tumours ≤2 cm in size. However, centrally located tumours were associated with a higher risk of pN1 upstaging, highlighting the importance of thorough hilar lymph node dissection in these patients.

A rare case of giant epiphrenic diverticulum

Epiphrenic diverticulum is a type of pulsion diverticulum and are often asymptomatic and small in size. Symptomatic large epiphrenic dicverticulum has very low prevalence. We present a very rare case of giant oesophageal epiphrenic diverticulum of around 9 cm in size. Open thoracotomy or thorascopic procedure is generally require for the treatment. But with the help of robotic surgery, even very large epiphrenic can be excised transhiataly with good and early postoperative recovery. The robotic system has an advantage of better visualization and better degree of movement which help in the ease of dissection of the diverticulum. Large epiphrenic diverticulum in upper part of the lower oesophagus can be dissected and excised easily transhiatally avoiding thoracotomy-associated morbidity.

Growth and Maintenance of Abalone Seeds (Haliotis Squamata) with Seaweed Feed at Balai Perikanan Budidaya Laut Lombok

Abalone is a seafood commodity with high economic value, because it is a food that is rich in protein and has aesthetic value in its shell. Market demand continues to increase in several Asian countries. The majority of the abalone industry still relies on natural products, resulting in continued exploitation of abalone. Abalone cultivation is the right choice to prevent extinction due to exploitation. One of the cultivation activities is raising abalone seeds, so this activity aims to understand the management of raising abalone seeds (Haliotis squamata) so that they produce quality seeds. This activity was carried out from March 13th until May 6th 2024 at BPBL Lombok, Sekotong. Data collection techniques use secondary data and primary data. Abalone seed rearing management includes several stages, including preparation of rearing tanks, namely cleaning fiber tubs and sterilizing the tubs, spreading seeds 1-2 cm in size, 2 months old with a density of 500 fish/basket, management of feeding Gracilaria sp., Sargassum sp. and Ulva sp. given ad libitum, the results of measuring the growth of abalone seeds have increased with absolute weight growth of 2.87 gr, absolute length growth of 0.59 cm, and SGR growth of 1.04 % per day, as well as seed SR value of 95.7 %, water quality management and checking water quality parameters during maintenance and handling pests that can attack abalone seeds.

Localized soft tissue sarcomas

Soft tissue sarcomas are rare malignant tumors originating from mesenchymal tissue. They are mostly located in the extremities, followed by the trunk and retroperitoneal regions. The group of soft tissue sarcomas comprises over 80distinct histological subtypes, each with unique biological characteristics, with liposarcomas and leiomyosarcomas being the most frequent subtypes. In the clinical practice the algorithm from image, biopsy and (sarcoma) board has become established for the diagnostics of any soft tissue space-occupying lesion exceeding 3 cm in size. This enables the planning of awide R0 resection, which can be defined as the standard for sarcoma surgery. For locally advanced and/or frequently metastasizing tumors, (neo)adjuvant radiotherapy and/or chemotherapy are usually indicated. Patients benefit from asarcoma board to determine the treatment strategy. After treatment, clinical and radiological follow-ups should be conducted every 3-6months, depending on the grade of the primary tumor.