#cemri

[109100]

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[wing-news]

CEMRI মাঝারি, ক্ষুদ্র এবং মাইক্রো উদ্যোগের জন্য ভার্চুয়াল প্রোগ্রামের আয়োজন করে

CEMRI মাঝারি, ক্ষুদ্র এবং মাইক্রো উদ্যোগের জন্য ভার্চুয়াল প্রোগ্রামের আয়োজন করে

দুর্গাপুর-ভিত্তিক সেন্ট্রাল মেকানিক্যাল ইঞ্জিনিয়ারিং রিসার্চ ইনস্টিটিউট (সিইএমআরআই) মঙ্গলবার মাঝারি, ক্ষুদ্র ও ক্ষুদ্র উদ্যোক্তাদের জন্য একটি ভার্চুয়াল প্রোগ্রামের আয়োজন করেছে যাতে তাদের উচ্চ-মানের যন্ত্রপাতি এবং ইনস্টিটিউটের সুবিধা প্রদান করা যায়। একটি বিবৃতি অনুসারে, ওয়েবিনারে সেন্ট্রাল টুল রুম অ্যান্ড ট্রেনিং সেন্টার, কলকাতা, ভুবনেশ্বর, পাটনা এবং গুয়াহাটি এবং নাগাল্যান্ডের 65 জন…

[marathinewslive]

CEMRI मध्यम, लघु आणि सूक्ष्म उद्योगांसाठी आभासी कार्यक्रम आयोजित करते

CEMRI मध्यम, लघु आणि सूक्ष्म उद्योगांसाठी आभासी कार्यक्रम आयोजित करते

नवी दिल्ली, 24 ऑगस्ट: दुर्गापूरस्थित सेंट्रल मेकॅनिकल इंजिनीअरिंग रिसर्च इन्स्टिट्यूट (सीईएमआरआय) ने मंगळवारी मध्यम, लघु आणि सूक्ष्म उद्योगांसाठी संस्थेचे उच्चस्तरीय उपकरणे आणि सुविधा उपलब्ध करून देण्यासाठी आभासी कार्यक्रमाचे आयोजन केले. वेबिनारमध्ये सेंट्रल टूल रूम आणि ट्रेनिंग सेंटर, कोलकाता, भुवनेश्वर, पाटणा आणि गुवाहाटी आणि नागालँडमधील 65 हून अधिक अधिकारी आणि उद्योजक उपस्थित होते.…

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[lupine-publishers-sjfn]

Lupine Publishers | Central Nervous System Manifestation of Multiple Myeloma: A Case Report

Lupine Publishers | Open Access Journal of Oncology and Medicine

Abstract

Multiple myeloma accounts for <1% of all malignancies and Central nervous system (CNS) manifestation of multiple myeloma (MM) is rare. Multiple myelomais characterized by malignant transformation of plasma cells that produces immunoglobulin chains. The accumulation of plasma cells in bone marrow results in clinical features like anaemia, osteolytic lesions, hypocalcaemia, renal failure and immunodeficiency [1,2]. The involvement of central nervous system is very uncommon in multiple myeloma and it may present early or late during the course of disease. The neurological symptoms can be diffuse headache, persistent vomiting, vertigo, weakness in limbs, urinary incontinence etc. Symptoms can be attributed to spinal cord or nerve root compression, peripheral neuropathies, and uremia [3,4]. Likely risk factors of CNS manifestation are unfavourable cytogenetics, high tumour load, low marrow involvement. In this report we describe a patient with CNS involvement after receiving systemic chemotherapy and symptomatic treatment.

Keywords: Central nervous system, Multiple myeloma

Case Report

A 52 years pleasant lady presented with complaint of pain in left leg with lower backache and tingling sensations for 10 days. Subsequently she developed pain in right leg followed by urine incontinence. MRI Lumbosacral Spine was done which reported ill defined lesions at L3-L4 vertebra (with associated periosseous fluid collections) and multiple focal lesions in the L4 vertebra, bilateral sacral ala and both iliac bones along with indentations upon the thecal sac by spondyliticridges, secondary spinal canal stenosis and neural foraminal narrowing at multiple levels and left exiting nerve root compression at L3-L4, L5-S1 levels (Table 1). She underwent L1-L5 stabilization, L3 decompression with laminectomy, biopsy, posterolateral fusion with local autograft. Histopathology reported plasma cell dyscrasia at L3-L4 level. Immunohistochemistry reported tumor cells are focally positive for CD-138 and kappa light chain and negative for lambda light chain. On further evaluation bone marrow biopsy reported plasma cells approximately 50% of total nucleated cells suggestive of plasma cell myeloma. Bone marrow aspiration shows plasmacytosis approximately 24% of total nucleated cells which confirmed the diagnosis. She received 15 cycles of Bortezomib and Thalidomide.

In view of persistent pain in legs MRI dorsal spine was done which reported well defined altered intensity expansile lesion in L3 vertebra extending into epidural space. She received palliative external beam radiotherapy to L3 vertebra 30Gy/10 fractions. She remained asymptomatic for a month. Then she presented with complaint of lower limbs weakness and nausea, loss of appetite, constipation, weight loss (Table 2). USG whole abdomen was done which reported multiple hypoechoic masses in epigastric region. Whole body PET CT reported metabolically active soft mass lesion in gastro hepatic region measuring 9.7x5.5 cm SUV max 20.3, recto uterine pouch measuring 9.2 x 7.8cm SUV 20.9, left iliac fossa measuring 7.2x4.0cm- ?mitotic, metabolically active mesenteric nodes measuring upto 2.2cm-? mitotic and metabolically active lytic lesion involving L3 vertebra with paravertebral soft tissue component infiltrating left psoas muscles.

To confirm the diagnosis CT guided core needle biopsy from supraumbilical mass was done which was compatible with multiple myeloma. She then received 1st cycle of Bortezomib, cyclophosphamide and dexamethasone. After few days, she developed headache, giddiness and syncopal attacks. On evaluation CEMRI brain reported diffuse leptomeningeal enhancement involving both cerebral as well as cerebellar hemispheres. Mild enhancement of basal cistern with associated marginal dilation of ventricular system (Figure 1). In view of above mentioned complaints, cerebrospinal fluid study was done (Table 3) (Figure 2). CEMRI spine was done which reported no abnormal enhancement in vertebra, cord or thecal sac (Figures 3 & 4). She received 7 fractions (14 Gy) out of 12 planned fractions (24Gy) of whole brain radiotherapy and two intra thecal injection of methotrexate. MRI upper abdomen with MRCP reported large mass replacing entire head and body region of pancreas. Mass encases and compresses CBD with mild bilobar intra hepatic biliary radical dilation. There is also encasement of second part of duodenum with possible infiltrartion of adjacent hepatic parenchyma as well. Features are suggestive of aggressive pancreatic malignanacy, possibility of pancreatic lymphoma. Thickening and edema of gall bladder wall was seen which was suggestive of concomitant cholecystitis. She was advised for ERCP with SEMS placement which was refused by attendants (Figure 5). In view of her deranged liver function test, both radiotherapy and methotrexate were discontinued and she was maintained on supportive care (Table 4).

Discussion

Central nervous system is a rare location of involvement in MM, however it should be considered if a patient with MM presents with neurologic symptoms. Patients with MM often have neurological complications, either due to metabolic disorders such as hypocalcaemia, uraemia and hyper viscosity or due to peripheral neuropathy, spinal cord compression and cranial nerve infiltration [1,2]. The most common cause is spinal cord compression and cranial nerve infiltration [3,4]. The patient may present as a known case of MM with CNS features or as a new case with CNS symptoms. The clinical presentation depends on degree and site of infiltration. The symptoms and signs are headache, memory loss, behavioural changes, convulsions, nausea, vomiting, vertigo, urinary incontinence, backache, and limb weakness [3,4]. These symptoms can be attributed to spinal cord or nerve root compression, raised intracranial tension, meningeal inflammation [5]. In our case she presented with the complaint of headache, giddiness and syncopal attacks. This can be explained by CEMRI brain imaging which reported diffuse leptomeningeal enhancement involving both cerebral as well as cerebellar hemispheres. CSF study was done to reported to be negative. She received 7 fractions out of 12 fractions planned for whole brain radiotherapy and two injections of intrathecal Methotrexate injections [6]. In view of deranged LFT, radiotherapy and IT chemotherapy was stopped and was managed conservatively. She passed away after 2 weeks due to sepsis with LRTI with MM as underlying cause.

Conclusion

In conclusion this patient had an aggressive disease in view of abdominal deposits and unresponsiveness to multiple lines of systemic disease. CNS involvement in cases of MM portends extremely poor prognosis and median overall survival of <6 months. While in this case there was CSF infiltration which would portend even poorer prognosis but she succumbed to sepsis due to Lower respiratory tract infection. CNS disease in MM can be effectively palliated especially because of relative radio sensitivity of MM due to which early responses are seen at lesser doses and an early diagnosis can improve quality of life effectively.

[cancersfakianakis1]

C11 Methionine PET (MET-PET) Imaging of Glioblastoma for Detecting Post-operative Residual Disease and Response to Chemoradiation Therapy

Publication date: Available online 18 June 2018 Source:International Journal of Radiation Oncology*Biology*Physics Author(s): Yingbing Wang, Otto Rapalino, Pedram Heidari, Jay Loeffler, Helen A. Shih, Kevin Oh, Umar Mahmood Purpose/ObjectivesResponse criteria of glioblastoma after chemoradiation do not account for metabolic changes that occur after treatment. The purpose of this study is to evaluate the utility of positron emission tomography imaging with C11 Methionine (MET-PET) for detecting changes that occur after chemoradiation therapy and the value of molecular biomarkers for predicting magnitude of metabolic response.Materials and MethodsNewly diagnosed glioblastoma patients undergoing standard chemoradiation treatment were enrolled in this prospective imaging study with MET-PET scan performed within 3 days following surgical resection and again at 4 weeks after completion of chemoradiation. Near contemporaneous contrast enhanced MRI (ceMRI) was performed within 2 weeks of each MET-PET. MET-PET imaging was analyzed for SUVmax, SUVmean, and SUVvolume on a multimodality workstation (Syngovia 24B, Siemens).ResultsA total of 18 subjects underwent baseline post-operative MET-PET imaging, of which 14 subjects underwent post-chemoradiation MET-PET imaging. Among subjects who showed residual MET-avid disease on immediate post-operative MET-PET scans and also underwent post-chemo radiation MET-PET imaging (n=10), mean ΔSUVmax was -40% (range -100%-0%), mean ΔSUVmean was -35% (range -100%-0%), and mean ΔSUV volume was -64% (range -100%-0%). Δtumor/brain reference was -40% (range -100%-0%) using SUVmax and -35% (range -100%-0%) using SUVmean. In contrast, none of the T2 weighted images on ceMRI showed reduction in abnormal T2/FLAIR signal by greater than 25% by visual assessment. ΔSUVmax, ΔSUVmean, and ΔSUVvolume correlated with MGMT methylation status (p=0.01), but not with EGFR, or c-MET amplification status. All patients were IDH-1 wildtype.ConclusionsMET-PET scanning shows significant decrease in metabolic signal at 1 month post-chemoradiation compared to the immediate post-operative period, even when T2/FLAIR changed little. MGMT promoter methylation status further predicts differential metabolic responses. MET-PET may be a useful tool for delineation of radiation targets and assessment of response.

Teaser

C11 Methionine PET may be a useful tool for delineation of radiation targets and assessment of response in glioblastoma. C11 Methionine PET scanning can show a significant decrease in extent of MET-avid glioblastoma at 1 month after completion of chemoradiation compared to the immediate post-operative period, even when T2/FLAIR changes little. MGMT promoter methylation status further predicts differential metabolic responses. https://ift.tt/2t7ghbO

[kitapindiroku]

Yeni Deniz Mecmuası Dergisi Sayı:3 Kitabı pdf indir pdf indir

Yeni Deniz Mecmuası Dergisi Sayı:3 Yeni Deniz Mecmuası’nın 216 sayfa hacmindeki 3. sayısı Orhan Veli’nin “Gemliğe Doğru” adlı şiiriyle açılıyor. Kapak konusu ise Cevat Ülkekul, Gülşah Çeliker ve Bedia Ceylan Güzelce’nin kaleme aldığı “Denizlerde İzi Silinmeyen Kaptan Piri Reis”.   Derginin dosya konusunda Turgut Yüksel’in imzası var. Yüksel, Sait Faik hikâyelerindeki balık avlarını inceliyor. Selim İleri, Oktay Rifat’ın ve bir ihtiyar yalının peşinden gidiyor. Emin Nedret İşli’nin arşivinden hazırlanan “Albüm” sayfalarında ise deniz banyoları, deniz hamamları ve yüzmek hakkında kitaplar var.  A. Ömer Türkeş, edebiyatımızdaki vapurları “Romanlardan Duyulan Vapur Düdükleri” yazısıyla anlatıyor. Ömer Durmaz okuru Denizyolları’nın ilk kadrolu grafik tasarımcısı Gülümser Aral Üretmen ile tanıştırıyor. Delal Arya ise bir konteyner gemisiyle Afrika denizlerinde yaptığı yolculuğu yazdı. Nejat Tarakçı inzivaya çekilmiş insanlara benzettiği deniz fenerlerinin hikâyelerini ve Türkiye’nin ilk deniz feneri müteahhidi Orhan Kızıldemir’i anlatıyor.   Dergide yer alan diğer konu başlıkları ve yazarlar şöyle: -Karadeniz’de Sürekli Barışın Anahtarı: Montreux (Cem Gürdeniz), Hipokrates’ten Bugüne Soğuk Suyun Cazibesi (Sargun A. Tont), Denizcilik ve Tematik Filateli Koleksiyonu (Ali Can Ertuğrul), 16. Yüzyılda Kostantiniye’den İskenderiye’ye Ticaret Gemisiyle Yolculuk (Ömer Bozkurt), Deniz Bilimlerinde Neredeyiz? Nereye Gitmeliyiz? (Emin Özsoy), Amerika ve Osmanlı’nın Akdeniz’de Başlayan Seyir Defteri (Burcu Bostanoğlu), Nerede Benim Eski Vapurlarım? (Artun Ünsal), 18. Yüzyıl Osmanlı İmparatorluğu’nda İç ve Dış Deniz Ticareti  (Daniel Panzac), Caligula’nın Saray Gemileri (Nalan Fırat) , Kazazede Gulli’nin Hayatta Kalma Sırrı (Tunca Arslan),  Atatürk’ün Yatı Diye Bilinen Rüya’nın Hazin Öyküsü (Sait Keresteci), İki Deprem Bir Amiral (Deniz Mehmet Irak), Cemil Kavukçu’nun Maviye Boyanmış Sular’ı (Cemre Cemri)

Yeni Deniz Mecmuası Dergisi Sayı:3 Kitabı pdf indir pdf indir oku

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