bluuebunny/crossref_metadata_2025 huggingface dataset:
Former les enseignants à l’analyse didactique. Un cas en histoire
Authors: Doussot Sylvain
Published: March 2024

L’article analyse le cas d’une étudiante en master de formation d’enseignant d’histoire, en France, dans un dispositif de formation par la recherche qui la conduit à l’apprentissage de concepts de didactique de l’histoire. Ce cas vaut par son exceptionnalité, qui permet de dessiner des conditions à cet apprentissage par une approche de « didactique de la formation » (à la didactique de l’histoire) qui met en relation problématique le système didactique du dispositif : le savoir visé (concepts didactiques), les connaissances mises en jeu par l’étudiante et les savoirs mis en jeu par le dispositif de formation. Le cheminement et les traces du cheminement de cette étudiante fournissent en effet des données rares d’une analyse qualitative d’une formation professionnelle et universitaire par la recherche. Sous l’angle théorique de l’apprentissage par construction de problème et travail des obstacles épistémologiques, nous confrontons les données (écrits successifs de l’étudiante, transcriptions des échanges en séminaire et en entretien, échanges par mails, au fil de l’année) et nos hypothèses didactiques (l’obstacle que constitue pour les étudiants l’appréhension des situations d’enseignement séparant le fonctionnement des savoirs disciplinaires et les relations pédagogiques). Il ressort de l’analyse que la principale condition à l’apprentissage constaté dans l’appropriation des concepts par cette étudiante consiste en un processus de comparaison continue, au sens de la Grounded Theory (Glaser et Strauss, 1967), cadré par l’action du formateur. Ce qui ouvre des perspectives concernant la formation par la recherche.
Perceptions d’enseignants du potentiel d’un MOOC pour soutenir leur développement professionnel continu
Authors: Duchaine Marie-Pier , Gaudreau Nancy , Frenette Éric
Published: March 2024

Le développement professionnel des enseignants revêt une importance cruciale pour assurer leur rétention et leur bien-être au sein de nos écoles. Il s’avère donc essentiel de proposer à ces derniers des activités de formation continue qui répondent à leurs besoins et qui s’alignent sur les conditions d’efficacité identifiées par la recherche dans le domaine. Cet article présente les résultats d’une recherche visant à documenter la satisfaction générale des enseignants et la contribution perçue des modalités de formation-accompagnement déployées dans le cadre d’un MOOC. À partir d’un devis de recherche mixte, les résultats mettent en lumière le niveau très élevé de satisfaction ainsi que le fort potentiel de ce dispositif pour soutenir le développement professionnel continu des enseignants. De nombreux leviers susceptibles de favoriser la satisfaction des enseignants participant à un MOOC ont aussi été identifiés.
Effect of Moringa oleifera on semen quality profiles in endangered Teressa goat under tropical humid island ecosystem
Authors: Perumal P. , Sunder Jai , De A. K. , Nahak A. K. , Chaurasia D. K. , Balamurugan T. C. , Bhattacharya D.
Published: March 2024

Objective:

To investigate the effect of Moringa oleifera leaf extract on semen quality parameters in Teressa goat buck.

Methods:

A total of 25 semen samples from six bucks were selected for the study. Spermatozoa of 150× 106 were incubated in 0, 300, 500 and 700 μg of leaf extract as group I, II, III and IV, respectively. Liquid stored semen samples were analysed for motility, viability, total sperm abnormalities, plasma membrane, acrosomal and nuclear integrities, seminal plasma intracellular enzymes [aspartate aminotransferase (AST), alanine aminotransferase (ALT) and lactate dehydrogenase (LDH)] and total antioxidant capacity (TAC) and spermatozoa malondialdehyde (MDA) and cholesterol efflux in comparison with the control group (group I) for up to 72 h.

Results:

Moringa oleifera leaf extract (500 μg/150× 106 spermatozoa)-treated semen had significantly higher motility, viability, plasma membrane, acrosomal and nuclear integrities, and TAC (P<0.05), and had significantly lower total sperm abnormalities, AST, ALT, LDH, MDA production and cholesterol efflux compared to those in other Moringa oleifera leaf extract treated (300 or 700 μg/150×106 spermatozoa) and control groups at different hours of liquid storage (P<0.05). Semen quality parameters and TAC showed an increasing trend and total sperm abnormalities, MDA production, leakage of intra-cellular enzymes and cholesterol efflux showed a decreasing trend from group I to group III and then an opposite trend from group II to group IV at different hours of liquid storage.

Conclusions:

Moringa oleifera leaf extract 500 μg/150×106 spermatozoa can be used for liquid semen preservation in Teressa goat at Andaman and Nicobar Islands.
Adiponectin orchestrates testosterone suppression in biological pathways
Authors: Ikekhuamen Ekhoye Ehitare , Kingsle Imonna
Published: March 2024

This current review highlights adiponectin engagement with AdipoRl and AdipoR2 which subsequently triggers pathways such as AMPK, PPARα, and MAPK, thereby modulating testicular steroidogenesis. Adiponectin's actions on Leydig and adrenal cells inhibit androgen secretion by suppressing the steroidogenic acute regulatory protein (StAR). Given that StAR facilitates cholesterol to testosterone conversion, AMPK inhibits this process by modulating cholesterol transport and suppressing StAR expression through multiple avenues. Furthermore, adiponectin-induced PPARα activation impedes mitochondrial cholesterol influx, further modulating androgen biosynthesis. The suppressive influence of PPARα on steroidogenic genes, notably StAR, is evident. Collectively, adiponectin signalling predominantly attenuates androgen production, ensuring metabolic and reproductive equilibrium. Imbalances, as seen in conditions like hypogonadism and obesity-related infertility, highlight their crucial roles and potential clinical interventions for reproductive disorders.
Protective effect of co-enzyme Q10 on testicular tissue and sperm parameters in adult male rats treated with Sunset Yellow FCF
Authors: Nazari Rohollah , Akbari Somayeh , Naseh Maryam , Yousufzai Shayan , Hosseini Seyede Fatemeh , Karimi Fatemeh
Published: March 2024

Objective:

To determine the protective effect of co-enzyme Q10 (CoQ10) on testicular tissue and sperm parameters in male rats treated with Sunset Yellow FCF.

Methods:

Sixty male Sprague-Dawley rats were randomly divided into 6 groups of the control, CoQ10 (10 mg/kg/day), low dose of Sunset Yellow (2.5 mg/kg), high dose of Sunset Yellow (70 mg/kg), low dose of Sunset Yellow (2.5 mg/kg) plus CoQ10, and high dose of Sunset Yellow (70 mg/kg) plus CoQ10. The drugs were administered via daily oral gavages for 6 weeks. At the end of the experiment, sperm analysis, stereological and histological assessments of the testis were carried out.

Results:

The normal morphology (by 41.1%) and progressive spermatozoa (by 74.8%), testicle volume (by 33.4%), lumen volume (by 38.3%), interstitial tissue volume (by 44.7%), seminiferous tubule volume (by 40.7%), and number of spermatogonia (by 53.9%) and Leydig cells (by 70.7%) reduced in the rats that received high doses of Sunset Yellow in comparison to the control group. Nonetheless, all these alterations were recovered by CoQ10 treatment in the CoQ10 plus high dose of Sunset Yellow group. Furthermore, low doses of Sunset Yellow did not affect different parameters of the testis and sperm.

Conclusions:

CoQ10 could, to some extent, prevent structural changes of the testis induced by the high dose of Sunset Yellow.
Clinico-microbiological profile on multidrug-resistant enterococci in urinary tract infection patients in a tertiary care hospital
Authors: Chatterjee Rupak , Chakraborty Aitihya , Biswas Malabika , Mukherjee Shatavisa , Chakraborty Banya , Chatterjee Nandini , Karmakar Partha Sarathi , Anuradha S. , Pramanik Netai
Published: March 2024

Background:

Considering enterococci as an emerging important cause of nosocomial infections, and antibiotic resistance by Enterococcus as a major obstacle for treatment, determination of the prevalence of various Enterococcus species and their antibiotic resistance pattern among urinary isolates is very crucial and need of the hour. The present study tried to identify the burden of urinary tract infections (UTIs) caused by Enterococcus species and analyze the current antibiotic susceptibility patterns of the uropathogenic isolates and evaluate the risk factors.

Methods:

A cross-sectional study included all clinico-microbiologically diagnosed cases of admitted UTI cases. Hospital records were analyzed for the clinical background of the UTI cases, and urine sample was collected and processed for antibiotic susceptibility testing. Data were statistically analyzed.

Results:

Out of the 372 urine samples, Enterococcus spp. was identified in 13.44% of isolates as the causal uropathogen. Enterococcus faecalis was the predominant species identified, followed by Enterococcus faecium. Cases were mostly observed in clinical settings of sepsis followed by pyelonephritis and cystitis. Antimicrobial susceptibility profile showed that resistance was most frequently observed with norfloxacin followed by levofloxacin, ciprofloxacin, ampicillin, and high-level gentamicin. Linezolid showed maximum sensitivity, followed by vancomycin, nitrofurantoin, and others.

Conclusion:

The rise of multidrug-resistant (MDR) Enterococcus species is of particular concern in terms of antibiotic therapy. Speciation along with routine culture and sensitivity is essential to gather knowledge about the available antibiotics in MDR uropathogenic Enterococcus species, particularly oral choices.
Wind turbines: Vacated/abandoned homes study – Exploring research participants’ descriptions of observed effects on their pets, animals, and well water
Authors: Krogh Carmen Marie , McMurtry Robert Y. , Johnson W. Ben , Punch Jerry L. , Dumbrille Anne , Alves-Pereira Mariana , Hughes Debra , Rogers Linda , Rand Robert W. , Gillis Lorrie
Published: March 2024

Background:

Neighbors living within 10 km of industrial wind turbines have reported occurrences of adverse health effects and contemplated vacating their homes. Some participants described concerns for wildlife and effects on their pets, animals, and well water. While sources such as the scientific literature, social media, and Internet websites have reported these effects, research is limited.

Methods:

This ethics-reviewed study used the qualitative grounded theory methodology and interviewed 67 consenting participants, 18 years or older who had previously lived, or were currently living within 10 km of wind turbines. Audio files were transcribed to text, and the data were coded and analyzed using NVivo Pro (version 12.6) software.

Objectives:

The objectives of this study were to explore participants’ descriptions of effects related to their pets, animals, and well water and to generate a theory.

Results:

Data analysis revealed primary themes of environmental interference and altered living conditions and associated sub-themes of effects on animals and well water.

Discussion:

Internationally and in Ontario neighbors have reported effects on their pets and domestic animals, concerns for wildlife, and a loss of potable well water. It is recommended that members of the public, government authorities, policy-makers, researchers, health practitioners and social scientists with an interest in health policy acknowledge the potential for these effects and seek resolution for those negatively affected.
Immunotherapy experience in sinonasal NUT midline carcinoma, case report
Authors: Caner Burcu , Orhan Sibel O. , Deligonul Adem , Evrensel Turkkan
Published: March 2024

NUT midline carcinoma (NMC) is an aggressive malignant neoplasm arising from midline structures. Although it is classified as a rare disease, the pathological nonspecific appearance as undifferentiated/poorly differentiated carcinoma and the difficulty in making the definitive diagnosis are probably the reasons for the underdiagnosis; the disease is thought to be more prevalent. There is no standard treatment for the disease. The disease shows a poor response to chemotherapy and radiotherapy, and patients’ survival is poor. We present a case of sinonasal NMC treated with chemotherapy and immunotherapy in first-line, which is the first in the literature. The patient presented with metastatic disease and received cisplatin-fluorouracil-docetaxel-pembrolizumab treatment. The tumor’s PD-L1 expression was 10%, evaluated by tumor proportion score. The response to the therapy was poor, and the patient died of disease progression 5.4 months after the diagnosis. The efficacy of immunotherapy in NMC is not known. More reports are needed to draw conclusions.
Comparative dosimetric, setup margin, and treatment time analysis between ring gantry and C-Arm linear accelerators for VMAT-based craniospinal irradiation plans
Authors: Biswal Subhra S. , Sarkar Biplab , Goyal Monika
Published: March 2024

Purpose:

The purpose of this study is to evaluate the dosimetric and treatment delivery characteristics of volumetric modulated arc therapy technique (VMAT)-based craniospinal axis irradiation (CSI) between ring gantry Halcyon (HAL) and C-arm based Novalis Tx (NTx) linear accelerator. Set-up margin and treatment delivery time for both machines were also taken into account.

Materials and Methods:

Fifteen patients, 4 females and 11 males treated between March 2019 and February 2022 within the age group 4–56 years simulated in the supine position and were planned for multiple isocentre VMAT technique in ring gantry Halcyon and C-Arm Novalis linear accelerator for 6FFF and 6 MV flatten beam energy. The number of isocenters was the same in both the machines, usually three for adult adolescent age group patients and two for pediatric patients. Total on-couch time and the patient positional shift were captured for each isocenter during each session of treatment. Margins were calculated using Herk’s formula of margin = 2.5Σ +0.7σ. Dosimetry, on-couch time, and set-up margin were compared between two competing arms.

Results:

Ninety-five percent of PTV coverage (P = 0.333), volume receiving 107% (P = 0.676), total MU (P = 0.818) in both the arms were comparable and statically insignificant. Low-dose spillage such as D20% (P = 0.212) and D50% (P = 0.008) was lesser in HAL comparable to NTx. CI and HI were statically insignificant. Out of 26 organs at risk (OAR), only 3 organs showed a statically significant dose difference. The mean and maximum setup margin in any linear direction was 0.45 and 0.53 cm for HAL and 0.37 and 0.56 cm for NTx and, variation was statistically insignificant (0.23 < P < 0.47). On-couch time was 4.0 ± 5.5 min lesser for HAL and the difference in on-couch time between the two arms was statistically different.

Conclusion:

Even though the majority of the delivery parameters such as gantry speed, dose rate, beam characteristic (flatten or unflatten), MLC width, and speed between the ring gantry HAL and C-arm NTx linear accelerators were distinctly different, they offered no or minimal difference in the dose distribution and in the setup margin. HAL gives a faster treatment time delivery, which could be crucial for some selective cases such as patients receiving treatment under general anesthesia.
Cytotoxic effect of Rotheca serrata on cancer cell lines MCF-7 and neuroblastoma SH-SY5Y
Authors: Gadade Jayashree P. , Patil Swaroopa A.
Published: March 2024

Introduction:

Rotheca serrata (Lamiaceae), a highly medicinal plant is used as an antidote for snakebite and the plant possesses medicinal properties like hepatoprotective, antitussive, antioxidant, anticancer, neuro-protective, used in rheumatoid arthritis and is also a α-glucoside inhibitor. AIM OF THE STUDY: This work aimed to study the anticancerous effect of Rotheca serrata (root and leaf) on cancer cell lines MCF-7 (breast cancer cell line) and Neuroblastoma SH-SY5Y.

Materials and Methods:

This investigation was a preliminary one which supported the retrospective and safe use of plants as described in Ayurveda. Dulbecco’s Modified Eagle Medium with High Glucose (DMEM-HG) for culturing MCF-7- Human Breast cancer cell line and Minimum essential Medium (MEM)+F12 medium for culturing SH-SY5Y- Homo sapiens bone marrow neuroblast were used. MTT assay measured the cell proliferation rate and conversely, when metabolic events lead to apoptosis or necrosis, the reduction in cell viability.

Results:

The results indicated that the Methanolic extract of Rotheca serrata (root and leaf) showed high anticancer activity. Different concentrations of plant extracts (25, 50, 100, 200, 400 µg/ml) were used to study the anticancerous activity, amongst which the significant results were obtained for 400 µg/ml concentration (both root & leaf). Effective anticancer activity against MCF – 7 breast cancer cells was shown in methanoilc extracts and were expressed as IC 50 values; in root (IC 50 value = 61.8259 ± 7.428 µg/ml) and in leaf (IC 50 value = 78.1497 ± 6.316 µg/ml). The MTT assay in case of neuroblastoma (SH-SY5Y) cell lines revealed that 400 µg/ml concentration of leaf methanolic extract showed effective inhibition of cancer cells with IC 50 value 37.8462 ± 2.957 µg/ml as compared to IC 50 value of root methanolic extract which was 57.0895 ± 2.351 µg/ml.

Conclusion:

R. serrata possess anticancer activity against breast cancer cell line (MCF-7) and neuroblastoma (SH-SY 5Y) cell lines. This study may to design plant-based drugs without side effects. Dosage compensation for specific type of cancer needs to be monitored in patients with 1st stage.
Immunosenescence and immunotherapy in older NSCLC patients
Authors: Zhang Jing , Zhao Linlin , Li Huzi , Jia Yingjie , Kong Fanming
Published: March 2024

Nonsmall cell lung cancer (NSCLC) predominantly affects the elderly since its incidence and mortality rates skyrocket beyond the age of 65. The landscape of NSCLC treatment has been revolutionized by immune checkpoint inhibitors (ICIs), which have emerged after a long and mostly inactive period of conventional treatment protocols. However, there is limited data on the exact effects of these chemicals on older patients, whose care can be complicated by a variety of conditions. This highlights the need to understand the efficacy of emerging cancer medicines in older patients. In this study, we will review the data of ICIs from clinical trials that were relevant to older people with NSCLC and poor performance status. We will also discuss the role of immunosenescence in immunotherapy and biomarkers in predicting the efficacy of ICIs in patients with advanced NSCLC.
Extranodal follicular dendritic cell sarcoma presenting as colonic mass: A diagnostic and therapeutic challenge
Authors: Pasricha Sunil , Durga Garima , Sharma Anila , Jajodia Ankush , Singh Shivendra , Gupta Gurudutt , Kamboj Meenakshi , Koyyala Venkata Pradeep Babu , Gupta Manoj , Mehta Anurag
Published: March 2024

Folliclular dendritic cell sarcoma (FDCS) is an extremely rare neoplasm originating from folliclular dendritic cells, both nodally and extranodally. Its primary presentation as a large colonic mass is rare and can be misdiagnosed as epithelial tumor/soft tissue tumor both clinically and through histomorphology. Due to its rarity and limited consensus guidelines about its management, it presents as a diagnostic and therapeutic challenge for pathologists and oncologists. However, accurate diagnosis is imperative due to its distinct prognostic and therapeutic implications. Herein we report, two cases of extranodal FDCS of colon with the aim of contributing to the management of this uncommon entity.
Clinicopathological outcomes of microsatellite instability in colorectal cancer
Authors: Gülşen Taygun , Ergenç Muhammer , Şenol Zafer , Emirzeoğlu Levent , Güleç Bülent
Published: March 2024

Aims:

This study aims to evaluate the histopathological features and prognostic parameters of tumors with microsatellite instability (MSI) compared with those without MSI in patients who underwent surgery for colorectal cancer (CRC).

Setting and Design:

Follow-up for CRC at Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital was retrospectively evaluated between March 2017 and March 2021.

Methods and Material:

The patients were divided into two groups: those with and without MSI. Groups were compared in survival parameters. As a secondary result, groups were compared in pathological parameters such as stage, tumor diameter, degree of differentiation, and lymphovascular, and perineural invasion.

Statistical Analysis Used:

Survival calculations were performed using the Kaplan–Meier analysis method. The effects of various prognostic factors related to tumor and patient characteristics on disease-free and overall survival (OS) were investigated by log-rank test.

Results:

Two hundred fourteen patients were analyzed. The median age of the patients was 66 (30–89), and 59.3% (n = 127) were male. There were 25 patients in the MSI group and 189 patients in the non-MSI group. We found that MSI tumors had a significantly higher differentiation degree than non-MSI tumors and larger tumor diameters. MSI tumors frequently settled in the proximal colon, and more lymph nodes were removed in the resection material. MSI tumors had longer disease-free survival, cancer-specific survival, and overall survival.

Conclusions:

By diagnosing microsatellite instability, CRCs can be divided into two groups. The histopathological features of the tumor and the prognosis of the disease differ between these groups. MSI can be a predictive marker in the patient’s follow-up and treatment.
Challenges in commissioning the “TSET” technique: A new approach towards monitor unit calculation and beam profile measurements
Authors: Trivedi Gaurav , Oinam Arun S. , Yadav Budhi Singh , Singh Pushpendra P. , Singh Ranjit , Robert Ngangom
Published: March 2024

Introduction:

Total skin electron beam therapy, commonly known as TSET, is a good choice of treatment for patients suffering from mycosis fungoides. The aim of this study was to introduce a new approach to the beam profile measurement using diodes and to calculate the monitor units required for the TSET treatment by the use of a simple setup of output measurement. Dosimetric measurements required for the treatment were taken to establish the Stanford technique in the department, and the measured data was compared with the published data.

Materials and Methods:

High-energy Linear Accelerator Clinac–DHX, Varian medical system, Palo Alto, CA, was commissioned for TSET. The output of the machine was measured by the use of a Parallel-Plate Chamber (PPC40) as per the TRS 398 recommendation. Diode dosimeters (EDD2 and EDD5) were used for beam profile measurements due to easy setup and to reduce the measurement time.

Results:

Homogeneous dose distribution within a field size of 80 cm x160 cm was observed with the variation of -5.0% on the horizontal axis and -5.4% on the vertical axis. The calculated monitor unit to deliver 200 cGy per fraction per field at the source to surface (SSD) of 416 cm was 489 MU.

Conclusion:

The technique described for the output measurements is simple and accurate. Results of the absorbed dose and MU measured were within good agreement compared to the published literature.
Wheat germ agglutinin conjugated chitosan nanoparticles for gemcitabine delivery in MCF-7 cells; synthesis, characterisation and in vitro cytotoxicity studies
Authors: Derakhshandeh Katayoun , Ghalaei Parviz Mohammadi , Aryaeinejad Shakiba , Hoseini Seyed Abolfazl
Published: March 2024

Objective and Aim:

Numerous clinical trials indicated combination regimens containing gemcitabine could extend progression-free survival of breast cancer patients without increasing the incidence of serious adverse effects. Orally administered gemcitabine is being metabolized by enzymes present in intestinal cells rapidly; thereupon, the current study was aimed to preparing, optimizing, and evaluating cytotoxicity of wheat germ agglutinin conjugated gemcitabine-chitosan nanoparticles (WGA-Gem-CNPs) in MCF-7 and HEK293 cells and to determining their cellular uptake by Caco-2 cells.

Methods:

Gem-CNPs were prepared by Ionic Gelation method and optimum formulation was implied for WGA conjugation optimisation. Nanoparticles formation was approved by FTIR and DSC analyses; then particles were characterized by DLS and release profile was prepared. MTT assay was performed in MCF-7 and HEK293.

Results:

Optimized Gem-CNPs and WGA-Gem-CNPs particle size were estimated as 126.6 ± 21.8 and 144.8 ± 36.1 nm, respectively. WGA conjugation efficacy was calculated as 50.98 ± 2.32 percent and encapsulation efficiency in WGA-Gem-CNPs was 69.44 ± 3.41 percent. Three-hour Caco-2 cellular uptake from Gem-CNPs and WGA-Gem-CNPs were estimated as averagely 3.5 and 4.5 folds higher than free drug, respectively. Gem-CNPs and WGA-Gem-CNPs reduced IC50 in MCF-7 cells by 2 and 2.5 folds, respectively; such decrease for HEK293 cells was as much as 2.4 and 6.3 folds, in same order.

Conclusion:

Demonstrated significant in vitro uptake of WGA-Gem-CNPs and cytotoxicity might be considered for more studies as a potential carrier for oral delivery of gemcitabine.
Initial presentation of hepatocellular carcinoma as pharyngeal mass mimicking advanced hypopharyngeal carcinoma
Authors: Sukumaran Renu , Kattoor Jayasree , Valsalamony Jiji , Varghese Bipin T.
Published: March 2024

Hepatocellular carcinoma (HCC) is a highly malignant tumor with frequent intrahepatic and extrahepatic metastases. Extrahepatic metastasis occurs in one-third of patients with HCC and indicates a dismal prognosis. The head and neck region is an extremely uncommon site of metastatic HCC. Extrahepatic metastasis at first presentation, although uncommon, indicates advanced disease with a poor prognosis. Herein, we present the case of a 68-year-old male patient with a neck mass. Clinical examination and initial radiology were suggestive of an advanced primary pharyngeal malignancy. Biopsy showed neoplasm with large polygonal cells with clear/granular cytoplasm. The neoplastic cells showed positivity for Hep Par1, CD10, and CEA. A diagnosis of metastatic HCC was given. Subsequently, serum alpha-fetoprotein level was found to be markedly elevated and further imaging showed multiple mass lesions in the liver. It is necessary to recognize that the pharyngeal region is a potential site of HCC metastasis. Accurate diagnosis and risk stratification can help in avoiding unnecessary costs and delay in treatment.
A comparative study of whole brain radiotherapy with concomitant thalidomide versus whole brain radiotherapy alone in brain metastases
Authors: Chyrmang Deiwakor , Devi Yumkhaibam S. , Baidya Kishalay , Singh Laishram J. , Nongrum Daffilyne L. , Devi Ningthoujam D.
Published: March 2024

Background:

Brain metastasis increases morbidity and mortality in cancer patients. This study was undertaken to compare tumor response and treatment-related toxicities in patients treated with orally administered thalidomide concomitantly with whole brain radiotherapy to whole brain radiotherapy alone in brain metastases.

Methods:

This randomized control trial was conducted in radiation oncology department, RIMS among 42 patients of brain metastases distributed in two study arms during the period August 2018 to July 2020. Twenty patients in Arm-A received whole brain radiotherapy to a dose of 3,750 cGy in 15 fractions with concomitant oral thalidomide 200 mg daily in first week and 400 mg/day from second week of radiation onward till the end of radiotherapy, whereas 20 patients of Arm-B received whole brain radiation of 3,750 cGy in 15 fractions alone.

Results:

Patient characteristics were comparable. Median central nervous system progression free survival was 2 months for Arm-A and 3 months for Arm-B, whereas median overall survival study was 4 months for Arm-A and 3 months for Arm-B. Overall response rate in Arm-A was 56% and in Arm-B was 44%. Treatment-related toxicities were more in arm-A but were manageable.

Conclusion:

Addition of thalidomide to whole brain radiotherapy makes no significant difference. Though not statistically significant, but still, Arm-A had shown some percentage benefits. Further studies with larger sample sizes should be done.
Outcomes of the patients with metastatic male breast cancer
Authors: Dogan Izzet , Khanmammadov Nijat , Ozkurt Selnur , Aydiner Adnan , Saip Pinar
Published: March 2024

Background:

The goal of this research is to investigate the clinical characteristics and prognosis of men with metastatic breast cancer (mMBC).

Methods:

A retrospective analysis of the data of 28 patients was conducted. Kaplan–Meier and Cox regression analyses were used to assess overall survival (OS) and prognostic variables.

Results:

At the time of diagnosis, the median age was 57 years (range 26–86). The most prevalent pathological subtype was invasive ductal carcinoma (92.6%). HER2 positivity was 21.6% in patients, with estrogen and progesterone receptor positivity at 96.4% and 71.4%, respectively. Bone-75%, lung-39.3%, brain-21.4%, and adrenal gland-10.7% were the most prevalent metastatic sites. Trastuzumab-based chemotherapy was given to six patients. During the study period, 14 patients (or half) died. All patients had a median OS of 42.6 months (range: 21.6–63.7). The OS rates after 1, 3, and 5 years were 95.7%, 54.2%, and 36.6%, respectively. The number of metastatic locations (P = 0.045), brain metastasis (P = 0.033), and a history of regular alcohol intake (P = 0.008) were all shown to be statistically significant factors affecting OS in univariate analysis. However, multivariate analysis did not support the findings. In addition, we discovered that trastuzumab-based therapy and de-novo metastatic disease had no effect on OS for mMBC.

Conclusions:

The data on mMBC is restricted because of its rarity. The prognosis of mMBC was shown to be poor in this investigation. Despite the small number of patients, we discovered that in univariate analysis, having brain metastases, the number of metastatic locations, and a history of alcohol intake may be prognostic factors.
Risk factors for local recurrence of keloids and hypertrophic scars after postoperative electron beam radiotherapy
Authors: Katano Atsuto , Minamitani Masanari , Yamashita Hideomi
Published: March 2024

Objective:

Keloids and hypertrophic scars are benign fibroproliferative lesions that occur as a result of skin injury. Postoperative radiation therapy is used to reduce the recurrence rate because of the high recurrence rate with surgical treatment alone. This study aimed to identify the risk factors for recurrence after postoperative electron beam radiotherapy.

Materials and Methods:

Patients with keloid or hypertrophic scars with at least one lesion and who underwent postoperative electron beam radiotherapy at our institution from June 2013 to March 2022 were included in the study, while patients with a follow-up period of fewer than three months were excluded.

Results:

A retrospective analysis was performed on 94 lesions in 81 patients. Exactly two years after the treatment, the actuarial local control rate was 86.4%. The chest wall, shoulder, and suprapubic area were identified as high-risk recurrence sites. Compared to other body sites, these sites had significantly lower local control rates (two-year local control rates: 75.5% vs. 95.2%, P = 0.005). After multivariate analysis, treatment site (P = 0.014), male gender (P = 0.019), and younger age (P = 0.029) were revealed to be statistically significant risk factors for local recurrence. Risk factors for keloid recurrence after postoperative electron beam radiotherapy were therefore identified.

Conclusion:

This result could be used for follow-up and as a determinant for the optimal dose/fractionation of postoperative radiotherapy.
Leiomyosarcoma of sphenoid sinus- A rare tumor at an unusual site
Authors: Rana Deepika , Gautam Rashmi , Mallya Varuna , Khurana Nita , Mehar Ravi , Singh Kishore
Published: March 2024

Leimyosarcoma (lms) is a malignant soft tissue tumor of smooth muscles. The tumor arises intramuscularly and in subcutaneous locations. It is unusual to encounter lms in head and neck region, even more infrequent to discover lms in nasal and paranasal sinuses. A case of 28 years old male with leiomyosarcoma originating from sphenoid sinus with intracranial extension is being presented with aim to highlight its rarity and to highlight the differential diagnosis and the need for prudent diagnosis in the work-up of the patient
Mucosa-associated lymphoid tissue lymphoma at the parotid gland
Authors: Lin Jiun-Sheng , Liu Chung-Ji
Published: March 2024

MALT (mucosa-associated lymphoid tissue) lymphomas are low-grade extra-nodal B-cell lymphomas that may involve various sites in the head and neck including the thyroid, salivary, and lacrimal glands. Development of MALT lymphoma in the head and neck is often associated with auto-immune diseases such as Sjögren syndrome or Hashimoto thyroiditis. Here, we report a case of a MALT lymphoma of the left buucal mucosa that likely arose in the parotid gland. The patient was successfully treated with surgical excision with chemotherapy and remained disease-free at the 10-year follow-up. Since it was rare in the head and neck region, we present this case.
Dosimetric comparison between carotid-sparing IMRT and 3DCRT in early glottic cancer patients treated with definitive radiation therapy
Authors: Kaur Harkirat , Thakur Niketa , Sharma Ramita , Sudan Meena , Jain Neeraj , Kaur Supreet , Lehal Priyanka
Published: March 2024

Background:

The purpose of this study was to evaluate the dosimetric benefits of carotid-sparing IMRT (intensity-modulated radiation therapy) over 3DCRT (three-dimensional conformal radiation therapy) in early glottic cancer patients.

Material and Methods:

Ten patients with histologically proven early-stage squamous cell cancer of glottis (T1N0), treated with definitive radiotherapy, were selected retrospectively for the dosimetric analysis. Patients were originally treated with 3DCRT technique. For comparison purpose, IMRT plans were generated for each patient. Dosimetric comparison was done between two techniques (IMRT and 3DCRT) in terms of PTV (planning target volume) coverage, HI (homogeneity index), CI (conformity index), and doses to right carotid artery, left carotid artery, and spinal cord.

Results:

V95% for the PTV was higher in IMRT plans (98.26%) as compared to 3DCRT plans (95.12%) (P-value <0.001), whereas V105% for PTV was significantly higher in 3DCRT plans (16.77%) as compared to IMRT plans (0.32%) (P-value 0.11). In terms of both HI and CI, IMRT plans showed better conformity as compared to 3DCRT plans, with statistically significant difference. Both right and left carotid arteries’ average mean and maximum doses were significantly lower in IMRT plans as compared to 3DCRT plans (P-value <0.001). IMRT plans resulted in significant carotid-sparing as compared to 3DCRT plans in terms of V35 and V50 (P-value <0.001).

Conclusion:

Carotid-sparing IMRT resulted in better PTV coverage and lower carotid artery dose as compared to 3DCRT in early glottic cancer patients.
Long-term treatment results of conventional and hypofractionation radiotherapy in postmastectomy cancer breast patients: A retrospective study from rural cancer center of Maharashtra, India
Authors: Jain Vandana S. , Bakshi Nanki , Jain Shailendra M. , Mandloi Varsha , Malik Yusuf , Kharde Anup
Published: March 2024

Aim:

This study aims to evaluate the long-term treatment outcome of conventional and hypofractionation radiotherapy in postmastectomy cancer breast patients.

Material and Methods:

A total of 140 postmastectomy breast cancer patients were included in this retrospective study, who were treated from 2012 to 2014 with chemotherapy and various fractionation radiotherapy schedules. Radiotherapy treatment records for study group-I received radiotherapy 4256 cGy in 16 fractions over 3½ weeks, group-II patients received 4005 cGy in 15 fractions over 3 weeks, and conventional radiotherapy group-III received 5000 cGy in 25 fractions over 5 weeks.

Results:

The median follow-up of patients from all groups was 60 months (range 9 to 111 months). There were 39 cases with disease failure, 13 (26%) in group I (42.56 Gy), 16 (40%) in group II (40.05 Gy), and 10 (20%) in group III (50 Gy). There were 4 locoregional recurrences (LRRs), two isolated, and 11 distant failures in group I, 3 LRRs (1 isolated LRR) and 15 distant failures in group II, and only one LRR and 9 distant failures in group III. The disease-free survival (DFS) were 74%, 60%, and 80%, respectively, in groups I, II, and III (P =0.044).

Conclusion:

The long-term results of this study show that hypofractionation radiotherapy in postmastectomy cases is well tolerated and acute and late side effects are also comparable to conventional fractionation. In our study, locoregional and distant failure seems slightly higher with hypofractionation schedules than in other studies, highlighting the need for more studies with long-term follow-up in postmastectomy patients.
Heterotopic bone formation in a case of clear cell renal cell carcinoma: A case report
Authors: Bavikar Rupali , Patel Payal , Verma Anubhaw , Ingale Yaminy , Randive Ruchi
Published: March 2024

Renal cell carcinoma (RCC) with heterotopic formation has been reported very rarely. We report this rare entity in a 33-year-old female patient who came to the out-patient department after complaining of pain in the lumbar region of the left side for 2 years. A computed tomography scan showed a heterogeneously enhancing lesion originating from the posterior cortex of the left kidney in the upper pole. It had many chunky calcification foci and was treated with left robotic partial nephrectomy. Histo-pathological examination revealed clear cell RCC with the heterotopic bone formation with a tumor size measuring 5 × 4 × 2.5 cm; the tumor was limited to the kidney, and the tumor resection margin were free of tumor, WHO/ISUP Grade 2. The pathological stage (AJCC 8th edition PTNM) was p T1b p NX p MX. The prognostic implications regarding calcification are poorly addressed in the literature. Patients suffering from osseous metaplasia are often in their early stages of the disease and have a favorable prognosis.
Primary and adjuvant intensity-modulated radiotherapy in oropharyngeal carcinoma patients from a single institution
Authors: Hauswald Henrik , Petrow Eugen , Roeder Falk , Debus Juergen , Zwicker Felix , Huber Peter E.
Published: March 2024

Background:

To retrospectively access outcome, adverse events and prognostic factors in oropharyngeal carcinoma (OPC) patients treated with intensity-modulated radiotherapy (IMRT).

Methods:

Ninety-eight OPC patients were treated between 2000 and 2015. Thirty-three patients received definitive and 65 adjuvant radiotherapy. Seventy-one percent had simultaneous chemotherapy. Patients were systematically followed up (mean 114 months, range 19–197 months). Statistical analysis used Kaplan–Meier method, Cox regression analysis, and log-rank test. Adverse events were classified according to common toxicity criteria version (CTCAE) 4.03.

Results:

The 1-, 5-, and 10-year overall survival rates in the adjuvant vs. definitive cohort were 90.8% vs. 66.7%, 67.4% vs. 33.1%, and 57.7% vs. 16.5%. Survival in the adjuvant cohort was significantly longer than in the definitive cohort (P < 0.00005). Patients <65 years had a significantly longer survival than older patients. Locoregional tumor control rates after 1-, 5-, and 10 years in the adjuvant vs. definitive cohort were 90.2% vs. 66.7%, 82.2% vs 45.4%, and 72.1% vs. 30.3%. Locoregional tumor control in the adjuvant cohort was significantly longer than in the definite cohort (P < 0.005). Distant metastases were diagnosed in 20.4% of all patients. Most patients had mild CTCAE grade 1 and 2 adverse events and mild late adverse events including xerostomia, dysphagia, and lymphedema.

Conclusion:

Intensity-modulated radiotherapy for OPC is an important part of the treatment algorithm alone and in particular after surgery while the additional benefits of chemotherapy might be age dependent. Despite advanced tumor stages, nearly half of our patients were alive in the long term. The majority of patients had relatively mild chronic adverse events.
Significance of platelet parameters in invasive squamous cell carcinoma of uterine cervix
Authors: Anand Ankit , Raju Kalyani
Published: March 2024

Background:

Cervical cancer is the second most common cancer among females worldwide. The role of platelets in cancer progression and metastasis have been evaluated in various cancers. This study is done to assess the association between platelet parameters and invasive squamous cell carcinoma of the cervix.

Materials and Methods:

Eighty cases of squamous cell carcinoma of the cervix were retrospectively collected from the medical record department. Values of platelet parameters such as platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), platelet-large cell ratio (P-LCR), platelet-lymphocyte ratio (PLR), platelet-neutrophil ratio (PNR), and platelet-monocyte ratio (PMR) are collected from automated hematology analyzer. These values were compared with 80 healthy controls which were randomly selected. Values of platelet parameters were also compared among Federation Internationale de Gynecolgie et d’Obstetrique (FIGO) stages in 80 cases.

Result:

Mean ± standard deviation (SD) for platelet count, MPV, PDW, PCT, P-LCR, PLR, PNR, and PMR among cases were 316 ± 100.37 × 109/L, 9.98 ± 0.96, 11.11 ± 2.27, 0.31 ± 0.092, 24.09 ± 7.62, 179.35 ± 85.53, 63.89 ± 42.10, and 492.29 ± 192.86, respectively, and in controls were 300.30 ± 79.40 × 109/L, 9.97 ± 0.83, 10.97 ± 1.80, 0.59 ± 2.65, 23.94 ± 6.81, 137.72 ± 50.52, 60.07 ± 26.68, and 563.65 ± 602.55, respectively. The PLR between cases and controls was statistically significant. The platelet count and PCT between stages was statistically significant wherein the values increased from stage II to stage IV.

Conclusion:

Platelet parameters are importance in cervical cancer. PLR, platelet count, and PCT are platelet parameters that can be used as predictors and prognostic parameters in cervical cancer. These parameters are cost-effective and can be considered in low resource settings. However, a multicentric study with a larger sample size should be done to extrapolate the findings for patient care.
Pituitary gland metastasis of breast cancer presenting as diabetes insipidus: A case report
Authors: Abdelkrim Asma Ben , Ammar Nouha , Saad Ghada , Zaghouani Houneida
Published: March 2024

Metastasis to pituitary gland is a rare condition, and patients are usually asymptomatic. Diabetes insipidus (DI) is the most common presenting symptom, and breast cancer is the most common source of pituitary metastasis (PM). We report a case of PM of breast cancer presenting as DI. A 45-year-old female patient presented to our department with complaints of polyuria and polydipsia. She had a medical history of metastatic breast adenocarcinoma. Laboratory data showed normal fasting plasma glucose level and hypotonic urine. Brain magnetic resonance imaging (MRI) showed infiltration of the pituitary stalk and the absence of the posterior pituitary bright spot consistent with metastasis to the pituitary gland. The water deprivation and vasopressin challenge tests confirmed central DI. Pituitary function tests revealed disconnection hyperprolactinemia with a menopausal profile. The patient was treated with vasopressin with great clinical results. Pituitary metastases are rare but should be suspected in patients with metastatic cancer who present with DI.
Modified FOLFIRINOX (mFOLFIRINOX) as neoadjuvant therapy and ‘salvage’ in patients with high risk locally advanced rectal cancers – tolerance and early outcomes
Authors: Prajapati Ramjas , Ostwal Vikas , Srinivas Sujay , Engineer Reena , Bhargava Prabhat , Saklani Avanish , D’Souza Ashwin , Kumar Suman , Peelay Zoya , Manali P. , Ramaswamy Anant
Published: March 2024

Background:

There is limited data with regard to the use of modified 5-fluoroural-leucovorin-irinotecan-oxaliplatin (mFOLFIRINOX) in terms of tolerance and enabling total mesorectal excision (TME) of locally advanced rectal adenocarcinomas (LARC) with high-risk characteristics (T4b status, signet ring histology etc) post standard neoadjuvant long course chemoradiation (NACTRT) or short course radiation (SCRT) and chemotherapy.

Materials and Methods:

Patients with LARC from January 2018 to December 2020 receiving mFOLFIRINOX post NACTRT/SCRT to facilitate TME were evaluated. The primary endpoint was assessment of grade 3 and grade 4 treatment related toxicity and TME rates. Event free survival (EFS), where event was defined as disease progression or recurrence post resection after mFOLFIRINOX, was calculated by Kaplan Meier method.

Results:

Forty-seven patients were evaluated with a median age of 33 years (Range:18-59), 45% T4b status, 96% radiological circumferential margin (CRM) involved (79% CRM positive post NACTRT/SCRT), 43% extramural venous invasion (n=33) and 36% signet ring histology. 62% had received prior NACTRT and 38% had received SCRT with chemotherapy before receiving mFOLFIRINOX. The most common grade 3 and grade 4 treatment related side effects included diarrhoea (7%), anaemia (4%) and infections (4%). Intended duration of mFOLFIRINOX or beyond was completed in 94% of patients. 60% of patients underwent curative local resection with R0 resection rates of 100% (n=28) and pathological complete response rates of 21%. The most common surgeries done were exenterations and abdominoperineal in 22% and 17% patients respectively. With a median follow up of 19 months, 24 patients had recurred or progressed for a median EFS of 20 months [95% confidence interval (CI): 15-24].

Conclusions:

Locally advanced rectal cancers with high-risk characteristics are a niche group of cancers with less-than-optimal outcomes post standard neoadjuvant strategies. mFOLFIRINOX appears to be well tolerated and enables TME in a significant proportion of these patients.
Radiotherapy result of a case of Kaposi’s sarcoma located on the vocal cord
Authors: Ozer Elif Eda , Soydemir Gulsen P. , Bolukbas Meltem Kirli , Kocbiyik Alper
Published: March 2024

Kaposi’s sarcoma (KS) is an angiogenic tumor. KS lesions frequently develop in the skin and oral cavity mucosa in the head and neck regions, and pure laryngeal localization is extremely rare. We reported a 64-year-old male patient without HIV, HBV, and HCV positivity presented with a hemangiomatous lesion detected incidentally in the right vocal cord. Biopsy was taken for histopathological and immunohistochemical evaluation. Examination revealed that spindle cells were of vascular origin and expressed HHV-8, a specific marker associated with Kaposi’s sarcoma-associated herpesvirus. Positron emission tomography-computed tomography (PET/CT) demonstrated an increased fluorodeoxyglucose (FDG) uptake in the vocal cord. The patient was treated with a 30 Gy volumetric arc plan. Disease-free follow-up continues in the first year after low-dose definitive RT. This is the first case report of KS in the vocal cord in which the most detailed data about RT were shared.