Search

Surgical resection is a generally accepted treatment for residual masses after chemotherapy for metastatic testicular germ cell tumour (GCT). About half the patients have necrosis in post-chemotherapy residual masses, whereas rest have viable tumour and teratoma. The likelihood of leaving behind teratoma with its subsequent complications such as growing teratoma syndrome necessitates resection outweighing its surgical complications. Ours is a retrospective observational study and aims at assessing post-chemotherapy residual masses in testicular GCTs and to predict importance of teratomatous and non-seminomatous components. A total of 62 cases of testicular GCTs resected after chemotherapy between January 2012 and June 2019 were included. Demographic, clinical, biochemical and imageological findings were noted and categorised according to WHO classification (2016). They were divided into two groups - those who underwent retroperitoneal lymph node dissection (RPLND) post-high inguinal orchidectomy (HIO) and chemotherapy (CT) as group 1 (

Introduction: Wrinkles or rhytids are a part of the natural ageing process of the human body. Long pulsed Nd: YAG laser (LPND) promotes dermal collagen remodelling without damaging the superficial layers and hence reduce periorbital wrinkles. Materials and Methods: Patients seeking treatment for periorbital wrinkles, and willing to participate in the study were included. Wrinkles were graded on the basis of wrinkle severity score (WSS) at baseline and one month after 4 monthly sessions of treatment. The 1064nm LPND was employed with settings of: spot size - 10mm, on time - 40 to 50 ms, fluence - 30 to 50 J/cm2 and frequency - 1 Hz. Three overlapping passes were done on both sides of the face. Outcome was measured by subjects, investigator and a blinded dermatologist. Appropriate statistical analysis was done. Results: Twenty eight sites were treated in 14 subjects. Male to female ratio was 3:4. Their mean age was 45.86 8.75. Mean WSS by investigator at baseline was 3.18 1.188 and at the end of treatment was 1.89 1.031 (p = 0.001). Mean WSS by the blinded dermatologist was 3.18 1.188 at baseline and 2.43 1.034 at end of the treatment (p =0.001). The subject’s degree of satisfaction was found to be 2.96 1.036. There were no significant adverse events. Conclusion: LPND for periorbital wrinkles is both patient and physician friendly, offering maximum results with minimal discomfort and downtime. This modality needs further exploration in the treatment of periorbital wrinkles in the Indian population. Keywords: Long pulsed Nd: YAG laser, Non ablative, Periorbital wrinkles, Skin resurfacing.

The study area belongs to the Singhbhum metamorphic belt of Jharkhand, situated in the eastern part of India. The spatial distribution of the index minerals in the pelitic schists of the area shows Barrovian type of metamorphism. Three isograds, viz. garnet, staurolite and sillimanite, have been delineated and the textural study of the schists has revealed a time relation between crystallization and deformation. Series of folds with shifting values of plunges in the supracrustal rocks having axial-planar schistosity to the folds have been widely cited. Development of these folds could be attributed to the second phase of deformation. In total, two phases of deformation, D1 and D2, in association with two phases of metamorphism, M1 and M2, have been lined up in the study area. Chemographic plots of reactant and product assemblages corresponding to various metamorphic reactions suggest that the pattern of metamorphic zones mapped in space is in coherence with the temporal-sequential change during prograde metamorphism. The prograde P–T evolution of the study area has been obtained using conventional geothermobarometry, internally consistent winTWQ program and Perple_X software in the MnNCKFMASHTO model system. Our observations suggest that the progressive metamorphism in the area is not related to granitic intrusion or migmatization but that it was possibly the ascending plume that resulted in the M1 phase of metamorphism followed by D1 deformation. The second and prime metamorphic phase, M2, with its possible heat source generated by crustal overloading, was preceded by D1 and it lasted until late- to post-D2 deformation.

We present results on growth of ReS2 thin film both on c plane sapphire substrate and MoS2 template by pulsed laser deposition (PLD). Films tend to grow with (0001)ReS2 ⊥ (0001)Al2O3 and (0001)ReS2 ⊥ (0001)MoS2 ∥ (0001)Al2O3 at deposition temperature below 300 °C. Films are polycrystalline grown at temperature above 300 °C. The smoothness and epitaxial quality of the films are significantly improved when grown on MoS2 template compared to sapphire substrate. The results show that PLD is suitable to grow ReS2 thin film over large area (10 × 10 mm2) for practical device application.

Introduction: Nail changes are present in 25-50% of patients with psoriasis with higher frequency in arthritis. Dermoscopy can be a useful tool for better visualization and quantifying the nail defects. Aim of the Study: To evaluate the dermoscopic findings in nail psoriasis. Settings and Design: Hospital based cross sectional descriptive study. Materials and Methods: 110 clinically diagnosed psoriatic fingernails were included in the study. The Nail Psoriasis Severity Index (NAPSI) scores were recorded. Dermoscopic evaluation was conducted and the features were recorded. Comparison of features was done with mild, moderate and high NAPSI groups and arthritic and non-arthritic patients. Statistical analysis included percentages, frequency, chi square test and Fischer’s exact test. Results: The most common dermoscopic findings included subungual hyperkeratosis (90.9%), onycholysis (64.5%) and pitting (62.7%). Pitting, nail plate thickening, transverse grooves, trachyonychia, and onycholysis were associated with higher NAPSI scores (p Conclusion: Dermoscopy coupled with NAPSI scoring in nail psoriasis can serve as a useful guide to assess the nail, cutaneous and arthritic psoriasis. Keywords: Dermoscopy, Nail psoriasis, NAPSI.

A new locality of sapphirine-spinel-bearing granulites from the Kaithapalli area which lies NW of Chilka Lake, Odisha is reported. The area tectonically forms a northern part of Eastern Ghats belt. It occurs as small enclaves within the khondalite and pelitic granulite. The mineral assemblage includes spinel-sapphirine-garnet-cordierite-orthopyroxene-sillimanite-biotite-k-feldspar-plagioclase-quartz. Development of reaction textures and symplectites are common in the sapphirine-spinel granulites which have been used to describe reaction history. The relative XMg values among various minerals are as follows: cordierite > biotite > sapphirine > orthopyroxene > garnet > spinel. The P-T evolution of these sapphirine-spinel granulites constrained through the pseudosection modelling in the NCKFMASH model system using Perple_X software indicate conditions of ultra-high temperature (UHT) metamorphism. The P-T estimates computed by isopleths define a retrograde trajectory with decompression of c.2.5 kbar from P-Tmax of c.10.5 kbar at c.950 $$^{\underset{\raise0.3em\hbox{$\smash{\scriptscriptstyle-}$}}{o} }C$$ . The sequence of reactions as deduced from the symplectite assemblages, together with pseudosection modelling, from the Kaithapalli area, offer greater opportunities for providing a better picture of petrological evolution of northern part of the Eastern Ghats Belt (EGB).

We have grown ultrathin crystalline epitaxial thin films of MoS2 on c-sapphire by employing atomic layer deposition, without the need for post-annealing. The films have been characterized by using various microscopic and spectroscopic techniques. The crystallographic epitaxial relationships between the films and the substrate are 〈01−10〉 Al2O3∥〈11−20〉 MoS2 and 〈0001〉Al2O3∥〈0001〉 MoS2. Interestingly, the films show a high density of nanowalls and exhibit a high surface to volume ratio. The high surface area of the nanowall network results in excellent electrochemical characteristics as demonstrated by the performance of the Na-ion battery with MoS2 as the active electrode. The battery exhibits high capacity, remarkable stability, cyclability and high rate capability over a wide range of operating currents, even in the absence of conducting and binder additives. The MoS2 Li-ion battery also exhibits similar features.

Large area MoS2 and WS2 van der Waals epitaxial thin films with control over number of layers including monolayer is grown by pulsed laser deposition utilizing slower growth kinetics. The films grown on c-plane sapphire show stiffening of A(1g) and E-2g(1) phonon modes with decreasing number of layers for both MoS2 and WS2. The observed stiffening translate into the compressive strain of 0.52% & 0.53% with accompanying increase in fundamental direct band gap to 1.74 and 1.68 eV for monolayer MoS2 and WS2, respectively. The strain decays with the number of layers. HRTEM imaging directly reveals the nature of atomic registry of van der Waals layers with the substrate and the associated compressive strain. The results demonstrate a practical route to stabilize and engineer strain for this class of material over large area device fabrication. (C) 2017 Elsevier B.V. All rights reserved.

Primary hepatic leiomyosarcoma is an extremely rare tumor with a dismal prognosis and difficulty in diagnosis. We present a 36-year-old female who presented with complaints of pain in right hypochondrium and epigastric region. Real-time ultrasonography revealed an enlarged liver with multiple hypoechoic lesions of varying sizes in both the lobes of the liver. USG guided core biopsy from the lesion showed an infiltrating malignant spindle cell neoplasm positive for smooth muscle actin and caldesmon-H confirming the diagnosis of leiomyosarcoma. It is vital to diagnose these lesions even on limited biopsies as early diagnosis can reduce hospital and operative morbidity and mortality rates in the patients. Keywords: Primary hepatic Leiomyosarcoma, small biopsy, immunohistochemistry.

Aims: To apply reticulin algorithm (RA) to the diagnosis of adrenocortical tumors on adrenalectomy specimens and compare its efficacy to the modified Weiss criteria or Lin–Weiss–Bisceglia (LWB) criteria for oncocytic variant. Materials and Methods: Adrenocortical tumors (ACTs) diagnosed on resected specimens including the variants during January 2010–June 2016 were retrieved from the pathology records. The demographic and clinical data were obtained from medical records. The functional status of the tumor was noted based on clinical and biochemical evaluation. The location, size, and gross appearance of the tumor were noted. The corresponding hematoxylin and eosin-stained slides were independently assessed by two pathologists applying modified Weiss criteria and LWB criteria for the oncocytic variant as applicable. Reticulin stain was performed on representative sections in all cases. All the tumors were classified according to RA, and the diagnoses made by each system were correlated. Results: There were 15 ACTs in the study period. There were two adenomas including one oncocytoma which showed Weiss score (WS) of 2 and intact reticulin framework. There were 13 adrenal cortical carcinomas including two oncocytic variants with WS ranging from 4 to 7. There was disruption of reticulin and thick, irregular reticulin fibers in all tumors, irrespective of the histology. It correlated with modified Weiss and LWB criteria. Conclusions: The RA was simple, easy to apply, and correlated well with modified Weiss criteria in the diagnosis of ACTs including the oncocytic variant.

Urothelial carcinoma has a varied and wide histological spectrum posing a diagnostic challenge in H&E examination alone. Immunohistochemical markers like GATA-3 along with other appropriate panel of IHC can be used. However, the percentage positivity and its intensity may vary in different variants and grades of primary and metastatic urothelial carcinoma. To observe the GATA-3 expression patterns in all the grades and different variants of primary and metastatic urothelial carcinomas. It is a prospective and retrospective observational study. All the clinically suspected urothelial carcinoma (UC) during January 2016 to December 2017 were included in the study. Depending on the differential diagnosis considered, immunohistochemistry (IHC) markers including CK7, CK20, p63, AMACR, CDX2, and p16 were done to differentiate UC from other primary carcinomas. The tumors confirmed as UC were analyzed further for GATA-3 expression by Chi-square test. The number of UC in the present study was 126 including 122 (bladder in 107, ureter in 7, renal pelvis in 5, and urethra in 3) primary and 4 metastatic UC (3 in lung and 1 in liver). Age of the patients ranged from 29 to 80 (mean 61.28) years with male/female ratio 4:1. GATA-3 showed positivity in 97 (79.5%) primary UC. GATA-3 was positive in all normal urothelium and non-invasive UC (100%), while it was positive in 69/94 (73.4%) invasive UC including variants. GATA-3 was positive in 35/39 LP invasive (89.74%) and 34/55 (61.81%) MP invasive UC. GATA-3 was positive in 39/40 papillary cases (97.5%) and 45/59 (76.27%) cases of non-papillary UC. GATA-3 showed strong expression in all metastatic UC (100%). GATA-3 expression was seen in 101/126 (80.15%) of UC including primary and metastatic carcinomas and hence was a useful marker in diagnosing UC. The GATA-3 positivity decreased from normal urothelium to UC; low-grade UC to high-grade UC; non-invasive to invasive UC; lamina propria invasive to muscle invasive UC; papillary to non-papillary UC.

Background: Immunohistochemistry (IHC) is a cost-effective and routinely available ancillary technique for the diagnosis of Ewing sarcoma family of tumors (ESFT). However, molecular confirmation is needed for precise diagnosis. Aim: This study aimed to determine the sensitivity and specificity of the commonly used IHC markers cluster differentiation (CD99) and friend leukemia integration1 (FLI1) in a series of molecularly confirmed ESFT. Materials and Methods: Retrospective review of the ESFT confirmed by either fluorescence in situ hybridization (FISH) or reverse transcriptase polymerase chain reaction (RT-PCR) during a period of 10 years was done. The demographic, clinical, and radiologic data were noted from medical records. The histology was reviewed with CD99, FLI1, and additional markers, wherever performed. The sensitivity and specificity of CD99 and FLI1 for the diagnosis of ESFT were calculated. Results: There were 72 ESFT patients in the study period, confirmed by FISH (EWSR1 rearrangement) in 53 and RT-PCR (EWS-FLI1) in 19. The female-to-male ratio was 1.06. The median age at diagnosis was 21 years. The cases included 22 skeletal and 50 extraskeletal sites. The positivity of CD99 and FLI1 was 98.46% and 94.83%, respectively, and both were positive in 55/72 (76.39%) cases. The sensitivity and specificity of CD99 were 98.46% and 20%, and those of FLI1 were 94.83% and 28.57%, respectively. Conclusion: Although the sensitivity for CD99 and FLI1 was high, the specificity was low toward the diagnosis of ESFT. The combined use of CD99 and FLI1 could confirm only 76.39% of molecularly confirmed ESFT, emphasizing the need for a precise diagnosis by molecular technique.

Inorganic solids with low thermal conductivity are of great interest for thermoelectric applications. The formation of synthetic nanostructures by matrix encapsulation is one of the important strategies for thermal conductivity reduction through phonon scattering. Here, we report the reduction of lattice thermal conductivity near the theoretical minimum limit, κmin, in SnTe via spontaneous formation of nanodomains of the Sb-rich layered intergrowth SnmSb2nTe3n+m compounds, which are natural heterostructures. High-resolution transmission electron microscopy of Sn1−xSbxTe samples reveals the formation of endotaxial Sb rich nanoprecipitates (2–10 nm) along with super-structured intergrowth nanodomains (10–30 nm), which are the key features responsible for the significant reduction of lattice thermal conductivity in SnTe. This mechanism suggests a new avenue for the nanoscale engineering in SnTe to achieve low lattice thermal conductivities. Moreover, the presence of Sb improves the electronic transport properties by aliovalent cation doping which optimizes the hole concentration in SnTe. As a result, an enhanced thermoelectric figure of merit, zT, of ∼1 has been achieved for the composition of Sn0.85Sb0.15Te at 800 K. The high zT sample exhibits the Vickers microhardness value of ∼136 HV which is double that of pristine SnTe and is significantly higher than those of the present state-of-the-art thermoelectric materials.

Ni50Mn37Sn13 and Ni50Mn35Sn15 epitaxial alloy thin films with two different compositions are grown on c plane sapphire substrate by pulsed laser deposition. The epitaxial relationship between untransformed L 2 1 and sapphire is α-Al2O3 [ 0 1 1 ¯ 0 ] ‖ L 2 1 [ 0 1 1 ]. The Curie temperatures of the films are 316 and 334 K, respectively. The microstructure of the films consists of untransformed austenite ( L 2 1 ) and three different martensite with L 1 0 , 4 O and 5 M structures. The relative volume fractions of four predominant phases are ∼50, 40, 5 and 5%, respectively at room temperature for both the films. The epitaxial L 2 1 phase grows under tensile strain on sapphire (0 0 0 1) substrate and favours the formation of predominantly L 1 0 over other martensite phases below the transition temperature. The interface between various untransformed and transformed phases are found to be coherent. The overall experimental magnetization of the thin films is slightly less than the theoretical values. Local HREELS spectra of Mn and Ni L 3 , 2 absorption edges confirm the presence of some non-magnetic phases in the structure particularly in 4 O and 5 M form of martensite might account for the observed differences with the theoretical value.

Context: The diagnosis of prostatic adenocarcinoma on histopathology depends on architectural and cytomorphological features supported by immunohistochemistry (IHC). Though all the prostate markers show excellent specificity, the sensitivity and percentage positivity vary. Aims: In this study, we aim to study the expression of prostein in normal, benign, and malignant (primary and metastatic) lesions with particular emphasis on its utility in the differential diagnosis of poorly differentiated and metastatic prostatic adenocarcinoma along with a standard panel of IHC markers. Settings and Design: This was both a prospective and retrospective as well as descriptive and observational study. Subjects and Methods: All samples from patients with clinically suspected carcinoma prostate from both primary and metastatic sites from June 2015 to May 2016 were included in the study. Samples with difficulty in diagnosis on hematoxylin and eosin staining were subjected to a panel of IHC markers along with prostein. Statistical Analysis Used: Receiver operating curve analysis and Chi-square test. Results: Prostein showed a 100% sensitivity and specificity to identify normal prostatic epithelium, benign and premalignant lesions, and prostatic adenocarcinoma. Prostein showed a specificity of 100% in differentiating prostatic carcinoma from poorly differentiated urothelial carcinoma and in differentiating metastatic prostatic carcinoma from adenocarcinoma of nonprostatic origin. Conclusions: Prostein is a new and promising prostate-specific marker that showed slightly more sensitivity and specificity than prostate-specific antigen. Thus, adding prostein to the IHC panel will greatly improve the detection of poorly differentiated primary and metastatic lesions of the prostate.

Context: There is an alarming rise in the incidence of chronic and recurrent dermatophytosis (CRD) in India. Many factors including tinea unguium may be responsible for it. Aims: To evaluate various epidemiological and clinical factors including the presence of tinea unguium as a risk factor for CRD. Settings and Design: This was a case-control study in which patients attending the dermatology outpatient department of a tertiary care hospital in February–March 2019 were recruited. A total of 80 consecutive clinically diagnosed patients with CRD as per the case definition (cases) were selected. Another 80 consecutive patients with dermatophytosis other than CRD (controls) were also selected. Patients were clinically evaluated with special attention for the presence of tinea unguium. Results: Among the total of 80 cases, 44 (55%) and 36 (45%) were diagnosed to have chronic dermatophytosis and recurrent dermatophytosis respectively. CRD was relatively uncommon in patients younger than 20 years. Sharing of linen, family history, and topical corticosteroid abuse were also frequent among patients with CRD. Tinea unguium was present in six cases (7.5%) and two controls (2.5%) which was not statistically significant (P = 0.27). Conclusions: The current epidemic of CRD may be primarily due to a pathogen with certain specific epidemiological and clinical determinants. It may be primarily a skin pathogen with less or no affinity toward the hair and nail.

Context: Morphological cocktails in renal cell carcinoma (RCC). Aims: Minimal immunohistochemistry (IHC) panel to resolve the diagnosis of renal cell cacinoma (RCC) with morphological overlaps. Settings and Design: RCC is the most common malignancy in kidney accounting for 90% of all kidney cancers. Clear cell RCC is the most common histological type followed by papillary RCC. However, many of the RCCs show morphological cocktails which may pose diagnostic difficulties in small biopsies and even in the resection specimens. Accurate diagnosis has both prognostic and therapeutic implications; hence, correct differentiation is necessary. Subjects and Methods: This retrospective study includes all renal cell tumors diagnosed on core biopsies, radical and partial nephrectomies between January 2015 and September 2017 were studied. The demographic, clinical, and gross findings were noted. The cases that had morphological overlap among the subtypes were subjected to a panel of IHC markers, including CD10, CK7, alpha-methyl acyl-coenzymeA racemase (AMACR), and CD117. Results: There were 128 RCC in the study period, and morphological overlap was seen in 36 (27.9%) specimens including 13 core biopsies, 16 radical, and 7 partial nephrectomies. IHC resolved 35/36 (97.2%) cases rendering a diagnosis of clear cell (11), papillary (15), chromophobe (4), and oncocytoma (5). However, in one case where the provisional diagnosis was oncocytic tumor, all IHC markers were negative rendering IHC noncontributory. Conclusions: Difficulty in diagnosis was encountered in many core biopsies, resection specimens which when subjected to IHC panel of CD10, CK7, AMACR, and CD117 helped in resolving the diagnosis of subtypes of RCC.