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Graphical abstract Highlights • The synthesis of a series of new condensed pyranotriazolopyrimidines. • All compounds were tested for their anticoagulant and for anti-tyrosinase effects. • The SAR was discussed with the help of the molecular docking analyses. Abstract Pyrimidine-fused compounds are of great interest for the discovery of potent bioactive agents. This study describes the synthesis of novel pyranopyrimidines 3a-f and pyranotriazolopyrimidines 4a-d derivatives via the cyclocondensation reaction of α-functionalized iminoether 2 , which was obtained from 2-amino-3-cyanopyrane 1 , with a series of primary aromatic amines and hydrazides, respectively. Structures of all synthesized compounds were established on the basis of spectroscopic methods including 1H NMR, 13C NMR and ES-HRMS. They were finally tested for their anticoagulant and anti-tyrosinase activities. Significant results have been obtained and the structure-activity relationship (SAR) was discussed with the help of molecular docking analysis. [ABSTRACT FROM AUTHOR]

The structural integrity of the chest and abdominal walls and perineum is frequently altered by cancer extirpation. Advances in reconstructive surgery and the availability of innovative techniques have helped the cancer surgeon to proceed with radical excisions with minimum morbidity. The ability to harvest flaps from distant sites and the availability of good prosthetic materials have now become part of the routine armamentarium of the plastic surgeon engaged in reconstructive surgery of these areas. Newer technologies incorporating tissue engineering may allow the reconstructive surgeon to achieve better functional and aesthetic rehabilitation of these patients. [ABSTRACT FROM AUTHOR]

The author discusses the increase in the geriatric population in India and the problems facing the health-care sector. He informs that the likeliness of developing cancer has been found to be more in older people than the young people. The need of proper management of the patients, understanding physiology of aging and the impacts of body fat is also discussed.

• Extracts and phytochemicals of Citharexylum spinosum L. were biologically screened, • The anti-tyrosinase, anti-cholinesterase and cytotoxic activities were evaluated, • The structure-activity relationship analysis was sufficiently and widely discussed, • The natural compounds that exhibited the significant bioactivities were docked. Previously phytochemical investigations carried out on the flowers and trunk bark extracts of Citharexylum spinosum L. tree, allowed the isolation of twenty molecules belonging to several families of natural substances [triterpene acids, iridoid glycosides, phenylethanoid glycosides, 8,3′-neolignan glycosides, together with other phenolic compounds]. In the present work, a biological evaluation (anti-tyrosinase, anticholinesterase and cytotoxic activities) was performed on the prepared extracts and the isolated secondary metabolites. The results showed that the EtOAc extract of the trunk bark displayed the highest anti-tyrosinase effect with a percent inhibition of 55.0 ± 1.8% at a concentration of 100 µg/mL. The highest anticholinesterase activity was presented by the same extract with an IC 50 value of 99.97 ± 3.01 µg/mL. The EtOAc extract of flowers and that of the trunk bark displayed the best cytotoxic property with IC 50 values of 96.00 ± 2.85 and 88.75 ± 2.00 µg/mL, respectively, against the human cervical cancer cell line (HeLa), and IC 50 values of 188.23 ± 3.88 and 197.00 ± 4.25 µg/mL, respectively, against the human lung cancer (A549) cell lines. Biological investigation of the pure compounds showed that the two 8,3′-neolignan glycosides, plucheosides D 1 -D 2 , generate the highest anti-tyrosinase potency with a percent inhibition of 61.4 ± 2.0 and 79.5 ± 2.3%, respectively, at a concentration of 100 µM. The iridoid glycosides exhibited a significant anticholinesterase activity with IC 50 values ranging from 17.19 ± 1.02 to 52.24 ± 2.50 µM. Triterpene pentacyclic acids and iridoid glycosides exerted encouraging cytotoxic effects against HeLa with IC 50 values ranging from 9.00 ± 1.10 to 25.00 ± 1.00 µM. The study of the structure–activity relationship (SAR) has been sufficiently and widely discussed. The natural compounds that exhibited the significant bioactivities were docked. [ABSTRACT FROM AUTHOR]

• A series of new benzopyrimidinones derivatives was designed and synthesized. • All compounds were evaluated for their in vitro anti-tyrosinase activity. • The fused benzopyrimidinone-pyrazole 5a displayed a high anti-tyrosinase potential. • Molecular docking and in-silico SAR evaluation explained the noted activity. 2-substitued-benzopyrimidinones 2 were synthesized in high to excellent yields in a single step via condensation of 2-aminobenzamide 1 with some aryl-aldehydes in the presence of iodine. Cyclocondensation reaction of hydrazides 3 which were obtained in two steps from benzopyrimidinones 2 , with some electrophilic species such as 2,4-pentandione, 2,5-hexandione, 1-phenylbutan-1,3-dione and cyclic anyhdrides provided the new compounds 4a–c , 5a–c , 6a–c , 7a–c , 8a–c and 9a–c. The synthesized compounds were characterized by spectroscopic means. They were also evaluated for their anti-tyrosinase potential. The structure-activity relationship (SAR) was discussed on the basis of the molecular docking analysis. [ABSTRACT FROM AUTHOR]

Introduction and Aim Borderline ovarian comprises 10-15% of ovarian neoplasms, present at an early stage, have low recurrence rate and excellent long term survival. But little is known about the role of fertility sparing surgeries and the need of complete staging. Our aim is to evaluate the clinicopathological features, factors affecting recurrences and reproductive outcomes in patients with borderline ovarian tumors. Methods Single institution retrospective study conduced at Amrita Institute of Medical Sciences from January 2010 till July 2015. All patients with borderline ovarian tumors treated at Amrita Institute were included. Out come was correlated with stage, type of surgery, type of peritoneal implants and with histological type. Results Total 651 patients with epithelial ovarian malignancies were treated during this period out of which 64 were borderline (10.5%). 27 (42%)patients underwent fertility preserving surgery. 55 patients (86%) were stage I, 2 patients (3%) belonged to stage II and 5 patients (8%) belonged to stage III. 37 (57.8%) were serous, 26(41%) were mucinous and 1 patient (1.6%) had endometrioid histology. Micro invasion was seen in 9, invasive implants in 3 and micro papillary pattern in 3 patients. After a median follow up of 21(9-69) months, 6 patients (9.4%) had recurrence of which 2 were serous, 4 mucinous and 5 in patients who underwent fertility preserving surgery. All patients with invasive implants received adjuvant chemotherapy and none of them had recurrence. Conclusion Fertility sparing surgeries are associated with a higher rate of recurrence. Women with invasive implants treated with chemotherapy does not have an increased recurrence rate. [ABSTRACT FROM AUTHOR]

Aims and Objectives: Currently the triple technique (including preoperative SLN imaging using SPECT CT after radioactive colloid injection; intraoperative injection of blue dye; and intraoperative usage of hand held gamma probe) has been demonstrated to be most accurate for the identification of Sentinel lymph node (SLN). However the availability of nuclear medicine department for SLN imaging is one of the major barriers in the diffusion of SLNB technology. The purpose of this study was to investigate whether the SLN detection rate using the intraoperative dual mapping (radioactive colloid + methylene blue dye) technique is comparable to the triple technique in a prospective trial. Methods: This prospective trial was started in the department of breast and gynecology oncology in collaboration with department of nuclear medicine at Amrita Institute of Medical Sciences, Kochi, Kerala in May 2017. Intraoperative dual SLN mapping technique consisted of subareolar injection of technetium 99m- labelled filtered sulphur colloid (15-37 MBq) and 3ml of 1% isosulphan blue dye just after anaesthetic induction followed by locating and dissecting the SLN using hand held gamma probe and blue dye. Triple technique consisted of subareolar injection of radioactive colloid followed by SPECT CT preoperatively; subareolar injection of blue dye intraoperatively; locating and dissection of SLN using gamma probe and blue dye. SLN biopsies (SLNBs) or complete axillary dissections were carried out, and SLNs identified during these procedures were classified as containing both blue dye and radioactivity ("blue-hot" nodes), radioactivity alone ("hot-only" nodes), or blue dye alone ("blue-only" nodes). Cases were categorized and tabulated based on the presence or absence of these three types of SLNs. Endpoint measured was the overall SLN detection rates and were compared between the two techniques. Results: Out of total 375 SLNBs done, 203 were done using triple technique and 41 using dual technique. SLN detection rates with intraoperative dual mapping technique was 100%, while that of triple technique of SLN identification was 97.6% (p = 0.216). We looked into the SLN detection rate of the individual procedures of the two techniques (triple versus dual technique): SLN detection rate of preoperative imaging using SPECT CT after radioactive dye injection was 100% in triple technique (procedure not performed in dual technique); SLN detection rate of intraoperative injection of blue dye ("blue" node) was 76% in both the techniques; SLN detection rate of "hot" nodes with the gamma probe was 94.5% in triple and 99% in dual technique; and the SLN detection rate of "hot and blue" nodes was 96.7% in triple and 100% in dual technique. Using either technique the SLN location was in axilla in 100% of cases. In 100% cases the surgical approach for SLN biopsy remained same. Conclusion: SLN detection rate of intraoperative dual technique was equivalent to the SLN detection rate of triple technique. Thereby in low resource settings where SPECT CT imaging is not possible in vicinity, the sentinel lymph node biopsy can still be performed by procuring the radioactive colloid (from outside centre) and blue dye and the hand held gamma probe. [ABSTRACT FROM AUTHOR]

Objective: To investigate the outcome of LABC patients at our institution with non pathological complete response (non pCR) after NAC (Neo-adjuvant chemotherapy). To identify the factors for the risk stratification of patients with non pCR after NAC. Methods: This was a single institution retrospective analysis done at Amrita Institute of Medical Sciences. Records of locally advanced breast cancer patients, who underwent definitive surgery following neoadjuvant chemotherapy from 2004 to 2014, were analysed and 224 eligible patients were identified. 34 patients with pCR were excluded from analysis. Patient, tumor and treatment specific data of 190 patients with non pCR were collected. Univariate and Multivariate analysis was used for the association of various factors with survival. According to change in clinical to pathological T&N stage, patients were categorized into Upstage, downstage and stage remaining same. Downstaging was defined as any decrease in T and/or N stage after NAC. Patients with a decrease in N stage but with an increase in T stage (and vice versa) were classified as upstage. Result: Median age of diagnosis was 48.5 years (range, 25- 81 years). Median follow up period was 48.5 months (Range, 3- 151 months). The overall survival of pCR patients was significantly higher than the non pCR patients (82.5% versus 56.4%; p=0.022).The 5 and 10-year DFS of non pCR cohort was 57% and 46.1% respectively and 5 and 10-year OS was 70.3 and 65.9% respectively. On univariate analysis patient, tumor and treatment specific factors found to be associated with survival were: ypN(p). [ABSTRACT FROM AUTHOR]

New 1,3-bis- N-acyliminium species generated easily with nontoxic Bi(OTf)3 catalyst at very low loadings (2 mol-%) were trapped inter- and intramolecularly with various poly-nucleophiles. This mild, efficient, practical and general tandem approach provides an array of substituted isoindolinones and cyclic N,O-acetals. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the treatment and survival pattern of patients with advanced epithelial ovarian cancer. Methods and results: Retrospective study of all advanced epithelial ovarian cancer patients treated in the department of gynaecologic oncology from an academic centre, in a four year period from 1 January 2008-31 December 2011. Selection criteria: All patients with advanced epithelial ovarian cancer (stage III and IV) who underwent surgery from 2008-2011and had a follow-up of at least three months after completion of treatment were included. The decision on whether primary surgery or neoadjuvant chemotherapy (NACT) in advanced ovarian cancer was based on age, performance status, clinical and imaging findings. Results: A total of 178 cases of epithelial ovarian cancer were operated on during this four year period. Among them 28 patients were recurrent cases, 22 had early stages of ovarian cancer, and the rest 128 had stage III and IV ovarian cancer. In these 128 patients, 50(39.1%) underwent primary surgery and 78(60.9%) had NACT followed by surgery. In the primary surgery group 36(72.0%) patients had optimal debulking while in the NACT group 59(75.6%) patient had optimal debulking. With a median follow-up of 34 months, the median overall survival (OS) and progression free survival (PFS) was 53 and 49 months respectively. Patients who underwent primary surgery had better median PFS than patients who had NACT (56 months versus 39 months, p = 0.002). In stage III C the difference median PFS was significant for those treated with primary surgery when compared with NACT (55 months versus 39 months, p = 0.012). In patients who had optimal debulking to no residual disease (n = 90), primary surgery gave a significant improved PFS (59 months versus 38 months, p = 0.001) when compared with NACT. In univariate analysis, NACT was associated with increased risk of death (HR: 0.350; CI: 0.177-0.693). Conclusion: In advanced epithelial ovarian cancer, primary surgery seems to have a definite survival advantage over NACT in patients who can be optimally debulked to no residual disease. [ABSTRACT FROM AUTHOR]

This paper explores the potential of the negatively charged SiN x using plasma charge injection technology to passivate the front textured boron-diffused emitter of n-type Si solar cells. The high- x value single SiN x layer with x ≥ 1.30 (x = N/Si) previously developed for the planarized rear-side passivation of p-type silicon solar cells, with an excellent passivation and charge stability, was found to be unacceptable for the passivation on the front textured boron emitter of n-type cells due to a severe bulk lifetime degradation issue. Therefore, in this study, we investigated a new concept of depositing a dual- x SiN x with a low- x SiN x layer (x ∼1.01) on top of a high- x SiN x layer (x ∼1.30) for passivation of the front textured rough surface of boron diffused emitter in n-type cells. The optimized dual- x SiN x stack reveals the promise of charge retention for more than 25 years in field operation as well as excellent passivation of boron-doped emitter without bulk lifetime degradation. N-type cells with the optimized dual- x SiN x after charge injection show comparable cell performance to Al 2 O 3 passivated reference cells. The results of cell-level light stability tests using one-cell minimodules exhibit cell performance decay characteristics similar to the traditional Al 2 O 3 /SiN x passivated reference module. • The charge retention ability of plasma-induced negatively charged single- x SiN x , as well as dual- x SiN x films was investigated for the passivation of boron emitters in an attempt to replace the Al 2 O 3 passivation. • Significant improvement in the passivation quality of the dual-x SiN x passivated p+ emitter without bulk lifetime degradation after negative charge injection, which makes it comparable to the cell performance of a traditional Al 2 O 3 passivated boron emitter. • Mini-modules fabricated using n-type cells with B emitter passivated with negatively charged SiN x stack showed excellent charge retention ability under simulated sunlight, resulting in passivation quality and reliability comparable to Al 2 O 3 passivated boron emitter reference cells. [ABSTRACT FROM AUTHOR]

Primary peritoneal carcinomas are rare, highly aggressive malignant neoplasms containing both sarcomatous and carcinomatous elements. Surgical debulking is the mainstay of treatment for primary peritoneal carcinomas. Systemic chemotherapy is advised in all cases because of the early spreading of these tumours. We report on a case of primary peritoneal carcinosarcoma occurring in a 22-year-old woman. [ABSTRACT FROM AUTHOR]

CONTEXT: Hysterectomy is an integral part of ovarian cancer surgery. The authors have evaluated the uterine involvement in ovarian cancer in this study. AIMS: Conventionally, removal of the uterus is considered an essential part of ovarian cancer surgery, but rationale for same in absence of its gross involvement is questionable. Aim of this study was to evaluate the microscopic involvement of uterus in ovarian cancer and whether there are any predictors of uterine involvement. SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: The authors analyzed 128 patients of epithelial ovarian cancer (EOC) operated from 2004 January to 2008 June, who had not undergone hysterectomy previously. Data regarding their demographic, clinical, and pathological findings was collected and analyzed. Statistical analysis used: Chi-square test. RESULTS: Most of our patients (n=111) presented with stage III or above. Serous carcinoma was the most common histology encountered (86.7%). Uterus was grossly involved in only 19 patients and microscopic involvement was noted in 20 patients. Only one patient with absence of gross involvement had microscopic disease in the uterus. Involvement of the uterus was found to be independent of stage, type of tumor, laterality, and preoperative chemotherapy. The grade of tumor and gross uterine involvement were only factors that showed statistically significant correlation with microscopic uterine involvement. Only one patient had synchronous endometrial cancer. CONCLUSIONS: Uterine involvement in EOC is not common. Absence of gross uterine involvement reliably predicts absence of microscopic disease. [ABSTRACT FROM AUTHOR]

Hemostasis is a fundamental principle of surgery for which electrocoagulation is universally used. Bipolar electrocautery has an advantage over monopolar electrocautery in terms of the precision of the extent of tissue coagulation and the lateral extent of thermal tissue injury. However, secondary to the thermal changes induced in the tissue due to electric current passage, there is charring of tissue, which adheres to the cautery tip. This, not only decreases its effectiveness, but also, by getting avulsed while removing the cautery tip from the surgical field, causes rebleeding and more trauma to the tissue. Irrigation of the surgical field during application of cautery reduces the charring effect, thereby improving the efficiency and efficacy. Irrigation-coupled electrocautery devices are available but are costly to acquire and maintain. We describe a simple and reliable version of an irrigation-coupled cautery device, which is of immense functional utility in our experience. It decreases the amount of charring of the tissue and its adherence to the bipolar forceps tips, thereby decreasing the frustrating loss of effectiveness and also increases the life of the bipolar forceps as cleaning needs to be less frequent. By virtue of its simplicity and cost-effectiveness, it can be used in almost all hospitals and situations. [ABSTRACT FROM AUTHOR]

Background: A number of patients with advanced-stage epithelial ovarian cancer do survive beyond 5 years. The long-term follow-up data are limited, especially for the Indian setting. We evaluated the 10-year survival outcome and influencing clinicopathological factors.Methods: A retrospective analysis of advanced-stage epithelial ovarian cancer patients who underwent primary cytoreductive surgery (PCS) or interval cytoreductive surgery (ICS) from 2005 to 2008 was conducted. Survival analysis was performed with the Kaplan-Meier method, and the Cox proportional hazards model was used for prognostic clinicopathological factors analysis.Results: Ninety-four patients with a median age of 54.5 (18-79) years were evaluated. The median follow-up period was 11.2 years. The overall survival (OS) rates at 5, 7, and 10 years were 37%, 23%, and 18%, respectively. The median OS (MOS) was 46 (95% confidence interval [CI], 36-55.8) months and progression-free survival (PFS) was 19.5 (15.3-23.6) months. Long-term survival was significantly predicted by R0 resection (complete cytoreduction with no macroscopic residual disease) and PFS >20 months while prolonged PFS was influenced by age ≤55 years and R0 resection. For the R0 resection group, patients who underwent PCS had better overall survival in comparison with ICS [72.1(25.2-119) months vs 47.4 (34.9-59.9)months] on 10 years follow-up but was not significant statistically.Conclusion: Patients with age ≤55 years, R0 resection, PFS >20 months have a better 10-year survival outcome. Among R0 resection, patients undergoing PCS have clinically a better outcome on 10-year follow-up. [ABSTRACT FROM AUTHOR]

Background: Breast cancer is a heterogeneous group of disease, and recently, intrinsic sub-typing on the basis of gene expression profiling is found to be a predictor of breast cancer clinical course. The St. Gallen has released surrogate classification for breast cancer sub-types depending on immunohistochemistry (IHC) markers.Aim: The aim of our study was to analyze the distribution of sub-types using IHC surrogate markers in our patient population and to assess the clinico-pathological factors in different sub-types.Materials and Methods: A total of 635 non-metastatic patients who underwent radical intend treatment from January 2011 to December 2013 were included for this retrospective analysis. A statistical analysis was done by Windows SPSS version 20. The Chi-square test was used to examine the correlations of these sub-types with clinico-pathological parameters. The Kaplan-Meier method estimates were used for survival analysis.Results: The median follow-up was 42.77 months (5 months to 112 months). Luminal B was the predominant group. Disease free survival (DFS) at 5 years was 95% in luminal A, 78% in luminal B HER-2 negative, 80% in luminal B HER-2 positive, 72% in triple negative, and 79% in HER-2/neu non-luminal. Tumor size, Ki67, T stage, N stage, and grade were significantly associated with DFS in all biological type with a P value of less than 0.05.Conclusion: Surrogate classification was successfully applied in our patient cohort. Luminal B and triple negative sub-groups were more prevalent in our patients, and this finding is at variance with published international data. Biological sub-type also emerged as an important predictor of survival. [ABSTRACT FROM AUTHOR]

Objective: To investigate the prognostic value of lymph node ratio (LNR) after neoadjuvant chemotherapy (NAC) according to breast cancer molecular subtypes.Methods: From 2004 to 2014, patients with definitive surgery after NAC were identified. LNR was calculated for node positive patients who underwent axillary dissection and at least 10 nodes (LNT) were removed. Disease free and overall survivals were analysed using Kaplan-Meier test and compared using log rank test for ypN0-3, LNR categories (LNRC) ≤0.2 (low), 0.21-0.65 (intermediate), >0.65 (high), and single LNR cut-off value.Results: Of 224 analysed patients: ypN0 72 (32.1%), ypN+ 152 (67.9%). Of 118 LNT ≥10 ypN+ patients LNRC: Low risk 48 (40.7%), intermediate risk 36 (30.5%), high risk 34 (28.8%). Factors significantly different in LNR categories were ypN (P < 0.001); extranodal extension (P < 0.001); present status of patients (P < 0.001); and disease status (P = 0.029). LNRC was inversely associated with 5-year DFS: Low 52.3%, intermediate 40%, and high 12.2% (log rank P < 0.001); and OS: Low 64.4%, intermediate 58.3%, and high 13.6% (log rank P < 0.001). Significant association of LNRC and DFS and OS were demonstrated in TNBC (P < 0.001) and HER2 subtypes (P = 0.045 and 0.005 respectively). A single value of LNR = 0.25 in node positive was found significant for DFS and OS in TNBC (P < 0.001) and Her2+ (P = 0.013 and P = 0.001 respectively) but not for HR+ (DFS: P = 0.132; OS: P = 0.144).Conclusion: Residual nodal disease after NAC analysed by LNRC or LNR = 0.25 cut-off value, is prognostic and can discriminate between favourable and unfavourable outcomes for TNBC and Her2+ breast cancers. [ABSTRACT FROM AUTHOR]

Introduction Triple negative breast cancer is a distinct biological entity and recent data shows it as a heterogeneous group with at least 6 subtypes with difference in clinical outcome. TNBC is found in approximately 15 % of newly diagnosed breast cancer patients and is more prevalent in younger patients (. [ABSTRACT FROM AUTHOR]

A series of imidazo[2,1- b ][1,3,4]thiadiazole linked indolinone conjugates were synthesized and investigated for antiproliferative activity in different human cancer cell lines by changing various substitutions at indolinone and phenyl ring systems. Among them conjugates 7 , 14 and 15 were exhibited potent antiproliferative activity with GI 50 values from 0.13 to 3.8 μΜ and evaluated for cell cycle analysis, tubulin polymerization assay and apoptosis. Treatment with 7 , 14 and 15 were resulted in accumulation of cells in G2/M phase, inhibition of tubulin assembly, disruption of microtubule network. Inhibition of tubulin polymerization was further supported by Western blot analysis. In addition, the conjugates ( 7 , 14 and 15) also showed apoptosis in HeLa cell line, detailed biological studies such as Hoechst 33,258 staining, DNA fragmentation and caspase-3 assays suggested that these compounds induce cell death by apoptosis. Docking studies revealed that these compounds ( 7 , 14 and 15) bind with αAsn101, αThr179, αSer178, βCys241, βLys254 and βLys352 in the colchicine-binding site of the tubulin. [ABSTRACT FROM AUTHOR]

Chemical equations for the article "Bi(OTf)3-Catalyzed Access to 2,3-Substituted Isoindolinones and Tricyclic N,O-Acetals by Trapping of Bis-N-acyliminium Species in a Tandem Process" by A. Aliyenne, appeared in the periodical "European Journal of Organic Chemistry" is presented.

Objective: The purpose of this study was to evaluate microvessel density (MVD) as assessed by C-type lectin 14A (CLEC14A), which is a new marker for endothelial cells, and compare its expression to CD31 and CD105 in epithelial ovarian cancer (EOC). Methods: MVD was evaluated in tumors ( n = 50) from patients with EOC who underwent primary surgery and in patients with EOC who received preoperative chemotherapy ( n = 49) using immunohistochemistry with antibodies to CLEC14A, CD31 and CD105. The median duration of follow-up was 24.5 months (range 1−101 months). The effect of prognostic factors on event-free survival (EFS) and overall survival (OS) was assessed using the Cox regression model. Results: The amount of residual disease was found to be an independent prognostic factor in multivariate analysis with respect to EFS ( P = 0.009) and OS ( P < 0.001). The mean MVD of CLEC14A (MVD = 6), in tumors from patients who underwent primary surgery, was significantly lower than that of CD31 (MVD = 25, P < 0.0001) and CD105 (MVD = 11, P = 0.018). However, there was no significant correlation between MVD as detected by these markers and clinical outcome. There was no expression of CLEC14A in tumors from patients who received preoperative chemotherapy and the MVD of CD31 and CD105 was significantly reduced ( P = 0.001 and 0.006, respectively) in this set of patients. Conclusion: This study demonstrates MVD as detected by CLEC14A in EOC. Treatment with chemotherapy reduces tumor blood vessels significantly. We suggest that CLEC14A may be a more specific endothelial marker to assess tumor angiogenesis. [ABSTRACT FROM AUTHOR]

Neuroendocrine tumor (Merkel cell carcinoma-MCC) of the vulva is a very rare entity with less than 15 cases reported in the English literature. It is known for its aggressive behaviour and propensity for early dissemination. The actual cell of origin and etiology of this disease is controversial. In absence of any definite guidelines for management (due to its rarity), extrapolation of data from extra-vulvar MCC seems logical. We present a case of vulvar neuroendocrine tumor who presented at a locally advanced stage. [ABSTRACT FROM AUTHOR]

Objective: In the surgery of breast cancer, axillary reverse mapping (ARM) is the identification and preservation of arm draining lymph node (ARM node) during an axillary dissection. The assumption is that the ARM node is different from node draining breast and is unlikely to be involved even in the patients with axillary nodal metastases. If we can identify and preserve ARM node using lymphoscintigraphy; morbidity of lymphedema, as seen with axillary dissection, may be avoided. Materials and Methods: Pathologically proven 50 breast cancer patients undergoing initial surgery (cTx-4, cN0-2, and Mx-0) were included in this study. Less than 37 MBq, 0.5 ml in equally divided doses of filtered 99mTc sulfur colloid was injected intradermally into the second and third web spaces. ARM nodes in the axilla were identified with the help of Gamma Probe intraoperatively; however, their location was noted with the reference to specific anatomical landmarks and sent for histopathological examination after excision. Results: The ARM node was successfully identified in 47/50 cases (sensitivity - 94%). In 40 out of 47 cases (85%), the location of the ARM node was found to lateral to the subscapular pedicle, above the second intercostobrachial nerve and just below the axillary vein. Of the 47 patients in whom ARM node/s were identified, metastasis was noted in 5 of them (10%). Four out of these 5 patients had the pN3 disease. Conclusion: ARM node exists, and it is feasible to identify ARM node using radio isotope technique with an excellent sensitivity. ARM node seems to have a fairly constant location in more than 80% cases. It is involved with metastasis (10% cases) only when there are multiple lymph nodal metastases in the axilla. [ABSTRACT FROM AUTHOR]

A short and effective approach to the synthesis of the topoisomerase I inhibitor isoindolo[2,1-b]isoquinolin-7(5H)-one and the alkaloid rosettacin belonging to the aromathecin family is presented. The key step of this sequence, which resulted in the formation of a fivemembered ring, was the aryl radical cyclization of enamides generated using N-acyliminium chemistry. [ABSTRACT FROM AUTHOR]

A new series of 2-aryl 1,2,4-oxadiazolo-benzimidazole conjugates have been synthesized and evaluated for their antiproliferative activity in the sixty cancer cell line panel of the National Cancer Institute (NCI). Compounds 5l ( NSC : 761109/1) and 5x ( NSC : 761814/1) exhibited remarkable cytotoxic activity against most of the cancer cell lines in the one dose assay and were further screened at five dose concentrations (0.01, 0.1, 1, 10 and 100 μM) which showed GI 50 values in the range of 0.79–28.2 μM. Flow cytometric data of these compounds showed increased cells in G2/M phase, which is suggestive of G2/M cell cycle arrest. Further, compounds 5l and 5x showed inhibition of tubulin polymerization and disruption of the formation of microtubules. These compounds induce apoptosis by DNA fragmentation and chromatin condensation as well as by mitochondrial membrane depolarization. In addition, structure activity relationship studies within the series are also discussed. Molecular docking studies of compounds 5l and 5x into the colchicine-binding site of the tubulin, revealed the possible mode of interaction by these compounds. [ABSTRACT FROM AUTHOR]

Aims: 1. To audit our performance as a dedicated gynaecologic oncology unit and to analyse how it has evolved over the years. 2. To retrospectively evaluate the outcome of advanced ovarian cancer treated with neoadjuvant chemotherapy (NACT) followed by interval surgery versus upfront surgery. Methods and results: One hundred and ninety-eight patients with advanced epithelial ovarian cancer (EOC) who were treated from 2004 to 2010 were analysed. Eighty-two patients (41.4%) underwent primary surgery and 116 (58.6%) received NACT. Overall, an optimal debulking rate of 81% was achieved with 70% for primary surgery and 88% following NACT. The optimal cytoreduction rate has improved from 55% in 2004 to 97% in 2010. In primary surgery, the optimal debulking rate increased from 42.8% in 2004 to 93% in 2010, whereas in NACT group the optimal cytoreduction rate increased from 60% to 100% by 2010. On the basis of the surgical complexity scoring system it was found that surgeries with intermediate complexity score had progressively increased over the years. There was a mean follow-up of 21 months ranging from 6 to 70 months. The progression-free survival and overall survival (OS) in patients undergoing primary surgery were 23 and 40 months, respectively, while it was 22 and 40 months in patients who received NACT. However, patients who had suboptimal debulking, irrespective of primary treatment, had significantly worse OS (26 versus 47 months) compared with those who had optimal debulking. Conclusions: As a dedicated gynaecologic oncology unit there has been an increase in the optimal cytoreduction rates. The number of complex surgeries, as denoted by the category of intermediate complexity score, has increased. Patients with advanced EOC treated with NACT followed by interval debulking have comparable survival to the patients undergoing primary surgery. Optimal cytoreduction irrespective of primary modality of treatment gives better survival. [ABSTRACT FROM AUTHOR]

CONTEXT: As of today, there is no validated standard method to assess clinical response of breast cancer to neo- adjuvant chemotherapy (NACT). Some centers use clinical dimensions while others use radiological measurements to evaluate response according to RECIST criteria. AIMS: The aim was to correlate and compare the clinical, radiological, and pathological parameters for assessing the tumor response in patients of breast cancer receiving NACT. SETTINGS AND DESIGN: Single institution, prospective nonrandomized study conducted over a 2-year period. MATERIALS AND METHODS: Patients with diagnosed breast cancer were assessed for response to NACT prior to surgery using clinical and radiological techniques. This was correlated with pathological reponse which was assessed by measuring gross dimensions and Miller-Payne grading of response to chemotherapy. STATISTICAL ANALYSIS USED: Spearman's rho nonparametric. RESULTS: Fifty two patients completed the evaluation (out of 313 cases of ca breast treated during the same period) with a median age of 52.5 years. We noted a 26.9% clinical complete response (CR) and 19.2% had pathological CR. Clinical evaluation had a sensitivity and specificity of 73.5% and 88.5% respectively compared to 14.2% and 100% respectively for radiological assessment. CONCLUSIONS: Clinical assessment of response to NACT shows a higher sensitivity compared to radiological assessment. However the overall low sensitivity and specificity rates of clinical assessment mandate a search for a better method of evaluation. [ABSTRACT FROM AUTHOR]

Background: Interest in translational studies aimed at investigating biologic markers in predicting response to primary chemotherapy (PCT) in breast cancer has progressively increased. We conducted a pilot study to evaluate feasibility of evaluating biomarkers of response to PCT at one & 21 days after first cycle. Methods: Adult, non-pregnant, non-lactating women with histologically confirmed infiltrating duct carcinoma underwent serial core biopsies after first cycle of PCT and these were scored for Ki-67, Bcl-2 and Caspase-3 using immunohistochemistry. Results: We recruited 30 patients with a mean age of 51 years. We were successful 95.6% times in performing a core biopsy and of these 84.6% had adequate tissue in the cores harvested. After a mean of 4 cycles of PCT, 26 patients underwent surgery and good response was noted in 9 patients (30%) using Miller-Payne criteria. There was a trend noted in all markers, which appeared different in those with good response and poor response. Good responders had significantly higher Ki-67 and significantly lower Bcl-2 at baseline and a significant decrease in Ki-67 and Caspase-3 at 21 days after the first chemotherapy. Conclusion: We report a detectable change in biomarkers as early as 24-48 hours after the first chemotherapy along with a definite trend in change that can possibly be used to predict response to chemotherapy in an individual patient. The statistical significance and clinical utility of such changes needs to be evaluated and confirmed in larger trials. [ABSTRACT FROM AUTHOR]

The article offers the author's insights on the peer review initiative of the National Cancer Grid (NCG) of India which aims to reduce the disparities on cancer care. Topics discussed include the peer review at the Cachar Cancer Centre (CCC) in Silchar, the evaluation of healthcare providers and services, and several measures of reducing cancer care disparities such as data sharing, continuing medical education, and adoption of evidence-based guidelines for common cancer management.

We report on the fabrication of fully screen-printed bifacial large area (239 cm2) high-efficiency n-type Si solar cells with ion-implanted homogeneous boron emitter on the front side and carrier-selective tunnel oxide passivated contact (TOPCon) on the rear. Our phosphorus-doped poly-Si/SiO x passivated contact with SiN x capping layer gave excellent surface passivation with a very low recombination current density (J 0_TOPCon) of ~1 fA/cm2 after a simulated firing treatment at ~770 °C without metallization. After screen-printed and fire-through metallization on n-TOPCon with ~13% metal coverage, metallized J 0_TOPCon value increased to only ~5 fA/cm2. In addition, homogenous boron implanted emitter (~180 Ω/) passivated with ALD Al 2 O 3 layer capped with PECVD SiN x /SiO x double-layer antireflection (DLAR) coating gave excellent passivation with emitter recombination current density of ~12 fA/cm2 prior to metallization. The industrial screen-printed, fire-through contacts with floating busbars on this boron emitter gave metallized emitter recombination current density of ~31 fA/cm2. This resulted in a low-cost industrial screen-printed n-type bifacial Si solar cell with 22.6% efficiency and 702 mV open-circuit voltage (V oc). • Fabrication of a low-cost industrial screen-printed n-type bifacial Si solar cell with 22.6% efficiency and 702 mV open-circuit voltage (Voc). • Excellent recombination current density of ~1 fA/cm2 on n-TOPCon capped with SiN x layer without metallization and ~5 fA/cm2 with ~13% coverage of screen-printed fire-through metallization. • Low recombination current density of ~12 fA/cm2 on unmetallized lightly doped B emitter. • ~14 mV increase in Voc with ~0.5% efficiency enhancement with floating busbars on the front emitter due to reduced front metal/Si contact area on the lightly doped B emitter. [ABSTRACT FROM AUTHOR]

Summary: The delivery of affordable and equitable cancer care is one of India's greatest public health challenges. Public expenditure on cancer in India remains below US$10 per person (compared with more than US$100 per person in high-income countries), and overall public expenditure on health care is still only slightly above 1% of gross domestic product. Out-of-pocket payments, which account for more than three-quarters of cancer expenditures in India, are one of the greatest threats to patients and families, and a cancer diagnosis is increasingly responsible for catastrophic expenditures that negatively affect not only the patient but also the welfare and education of several generations of their family. We explore the complex nature of cancer care systems across India, from state to government levels, and address the crucial issues of infrastructure, manpower shortages, and the pressing need to develop cross-state solutions to prevention and early detection of cancer, in addition to governance of the largely unregulated private sector and the cost of new technologies and drugs. We discuss the role of public insurance schemes, the need to develop new political mandates and authority to set priorities, the necessity to greatly improve the quality of care, and the drive to understand and deliver cost-effective cancer care programmes. [ABSTRACT FROM AUTHOR]