Search results for: transperineal template biopsies of prostate
390 Identification of Genomic Mutations in Prostate Cancer and Cancer Stem Cells By Single Cell RNAseq Analysis
Authors: Wen-Yang Hu, Ranli Lu, Mark Maienschein-Cline, Danping Hu, Larisa Nonn, Toshi Shioda, Gail S. Prins
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Background: Genetic mutations are highly associated with increased prostate cancer risk. In addition to whole genome sequencing, somatic mutations can be identified by aligning transcriptome sequences to the human genome. Here we analyzed bulk RNAseq and single cell RNAseq data of human prostate cancer cells and their matched non-cancer cells in benign regions from 4 individual patients. Methods: Sequencing raw reads were aligned to the reference genome hg38 using STAR. Variants were annotated using Annovar with respect to overlap gene annotation information, effect on gene and protein sequence, and SIFT annotation of nonsynonymous variant effect. We determined cancer-specific novel alleles by comparing variant calls in cancer cells to matched benign cells from the same individual by selecting unique alleles that were only detected in the cancer samples. Results: In bulk RNAseq data from 3 patients, the most common variants were the noncoding mutations at UTR3/UTR5, and the major variant types were single-nucleotide polymorphisms (SNP) including frameshift mutations. C>T transversion is the most frequently presented substitution of SNP. A total of 222 genes carrying unique exonic or UTR variants were revealed in cancer cells across 3 patients but not in benign cells. Among them, transcriptome levels of 7 genes (CITED2, YOD1, MCM4, HNRNPA2B1, KIF20B, DPYSL2, NR4A1) were significantly up or down regulated in cancer stem cells. Out of the 222 commonly mutated genes in cancer, 19 have nonsynonymous variants and 11 are damaged genes with variants including SIFT, frameshifts, stop gain/loss, and insertions/deletions (indels). Two damaged genes, activating transcription factor 6 (ATF6) and histone demethylase KDM3A are of particular interest; the former is a survival factor for certain cancer cells while the later positively activates androgen receptor target genes in prostate cancer. Further, single cell RNAseq data of cancer cells and their matched non-cancer benign cells from both primary 2D and 3D tumoroid cultures were analyzed. Similar to the bulk RNAseq data, single cell RNAseq in cancer demonstrated that the exonic mutations are less common than noncoding variants, with SNPs including frameshift mutations the most frequently presented types in cancer. Compared to cancer stem cell enriched-3D tumoroids, 2D cancer cells carried 3-times higher variants, 8-times more coding mutations and 10-times more nonsynonymous SNP. Finally, in both 2D primary and 3D tumoroid cultures, cancer stem cells exhibited fewer coding mutations and noncoding SNP or insertions/deletions than non-stem cancer cells. Summary: Our study demonstrates the usefulness of bulk and single cell RNAseaq data in identifying somatic mutations in prostate cancer, providing an alternative method in screening candidate genes for prostate cancer diagnosis and potential therapeutic targets. Cancer stem cells carry fewer somatic mutations than non-stem cancer cells due to their inherited immortal stand DNA from parental stem cells that explains their long-lived characteristics.Keywords: prostate cancer, stem cell, genomic mutation, RNAseq
Procedia PDF Downloads 16389 Single Cell Analysis of Circulating Monocytes in Prostate Cancer Patients
Authors: Leander Van Neste, Kirk Wojno
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The innate immune system reacts to foreign insult in several unique ways, one of which is phagocytosis of perceived threats such as cancer, bacteria, and viruses. The goal of this study was to look for evidence of phagocytosed RNA from tumor cells in circulating monocytes. While all monocytes possess phagocytic capabilities, the non-classical CD14+/FCGR3A+ monocytes and the intermediate CD14++/FCGR3A+ monocytes most actively remove threatening ‘external’ cellular materials. Purified CD14-positive monocyte samples from fourteen patients recently diagnosed with clinically localized prostate cancer (PCa) were investigated by single-cell RNA sequencing using the 10X Genomics protocol followed by paired-end sequencing on Illumina’s NovaSeq. Similarly, samples were processed and used as controls, i.e., one patient underwent biopsy but was found not to harbor prostate cancer (benign), three young, healthy men, and three men previously diagnosed with prostate cancer that recently underwent (curative) radical prostatectomy (post-RP). Sequencing data were mapped using 10X Genomics’ CellRanger software and viable cells were subsequently identified using CellBender, removing technical artifacts such as doublets and non-cellular RNA. Next, data analysis was performed in R, using the Seurat package. Because the main goal was to identify differences between PCa patients and ‘control’ patients, rather than exploring differences between individual subjects, the individual Seurat objects of all 21 patients were merged into one Seurat object per Seurat’s recommendation. Finally, the single-cell dataset was normalized as a whole prior to further analysis. Cell identity was assessed using the SingleR and cell dex packages. The Monaco Immune Data was selected as the reference dataset, consisting of bulk RNA-seq data of sorted human immune cells. The Monaco classification was supplemented with normalized PCa data obtained from The Cancer Genome Atlas (TCGA), which consists of bulk RNA sequencing data from 499 prostate tumor tissues (including 1 metastatic) and 52 (adjacent) normal prostate tissues. SingleR was subsequently run on the combined immune cell and PCa datasets. As expected, the vast majority of cells were labeled as having a monocytic origin (~90%), with the most noticeable difference being the larger number of intermediate monocytes in the PCa patients (13.6% versus 7.1%; p<.001). In men harboring PCa, 0.60% of all purified monocytes were classified as harboring PCa signals when the TCGA data were included. This was 3-fold, 7.5-fold, and 4-fold higher compared to post-RP, benign, and young men, respectively (all p<.001). In addition, with 7.91%, the number of unclassified cells, i.e., cells with pruned labels due to high uncertainty of the assigned label, was also highest in men with PCa, compared to 3.51%, 2.67%, and 5.51% of cells in post-RP, benign, and young men, respectively (all p<.001). It can be postulated that actively phagocytosing cells are hardest to classify due to their dual immune cell and foreign cell nature. Hence, the higher number of unclassified cells and intermediate monocytes in PCa patients might reflect higher phagocytic activity due to tumor burden. This also illustrates that small numbers (~1%) of circulating peripheral blood monocytes that have interacted with tumor cells might still possess detectable phagocytosed tumor RNA.Keywords: circulating monocytes, phagocytic cells, prostate cancer, tumor immune response
Procedia PDF Downloads 161388 Identifying Common Behavioural Traits of Lone-Wolves in Recent Terrorist Attacks in Europe
Authors: Khaled M. Khan, Armstrong Nhlabatsi
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This article attempts to analyse behavioural traits of lone-wolves who struck and killed innocents in six different attacks in Europe in last nine months. The main objective of this study is to develop a profiling template in order to capture commonality of characteristics of these attackers. This study tries to understand the homogeneity of lone-wolves in terms of their social background and state of mind. The commonality among them can possibly be used to build a profiling template that could help detecting vulnerable persons who are prone to be self-radicalised or radicalised by someone else. The result of this study provides us an understanding of their commonality in terms of their state of mind and social characteristics.Keywords: behavioral pattern, terrorism, profiling, commonality
Procedia PDF Downloads 400387 Synthesis and Characterization of Molecularly Imprinted Polymer as a New Adsorbent for the Removal of Pyridine from Organic Medium
Authors: Opeyemi Elujulo, Aderonke Okoya, Kehinde Awokoya
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Molecularly imprinted polymers (MIP) for the adsorption of pyridine (PYD) was obtained from PYD (the template), styrene (the functional monomer), divinyl benzene (the crosslinker), benzoyl peroxide (the initiator), and water (the porogen). When the template was removed by solvent extraction, imprinted binding sites were left in the polymer material that are capable of selectively rebinding the target molecule. The material was characterized by Fourier transform infrared spectroscopy and differential scanning calorimetry. Batch adsorption experiments were performed to study the adsorption of the material in terms of adsorption kinetics, isotherms, and thermodynamic parameters. The results showed that the imprinted polymer exhibited higher affinity for PYD compared to non-imprinted polymer (NIP).Keywords: molecularly imprinted polymer, bulk polymerization, environmental pollutant, adsorption
Procedia PDF Downloads 140386 Using Multiomic Plasma Profiling From Liquid Biopsies to Identify Potential Signatures for Disease Diagnostics in Late-Stage Non-small Cell Lung Cancer (NSCLC) in Trinidad and Tobago
Authors: Nicole Ramlachan, Samuel Mark West
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Lung cancer is the leading cause of cancer-associated deaths in North America, with the vast majority being non-small cell lung cancer (NSCLC), with a five-year survival rate of only 24%. Non-invasive discovery of biomarkers associated with early-diagnosis of NSCLC can enable precision oncology efforts using liquid biopsy-based multiomics profiling of plasma. Although tissue biopsies are currently the gold standard for tumor profiling, this method presents many limitations since these are invasive, risky, and sometimes hard to obtain as well as only giving a limited tumor profile. Blood-based tests provides a less-invasive, more robust approach to interrogate both tumor- and non-tumor-derived signals. We intend to examine 30 stage III-IV NSCLC patients pre-surgery and collect plasma samples.Cell-free DNA (cfDNA) will be extracted from plasma, and next-generation sequencing (NGS) performed. Through the analysis of tumor-specific alterations, including single nucleotide variants (SNVs), insertions, deletions, copy number variations (CNVs), and methylation alterations, we intend to identify tumor-derived DNA—ctDNA among the total pool of cfDNA. This would generate data to be used as an accurate form of cancer genotyping for diagnostic purposes. Using liquid biopsies offer opportunities to improve the surveillance of cancer patients during treatment and would supplement current diagnosis and tumor profiling strategies previously not readily available in Trinidad and Tobago. It would be useful and advantageous to use this in diagnosis and tumour profiling as well as to monitor cancer patients, providing early information regarding disease evolution and treatment efficacy, and reorient treatment strategies in, timethereby improving clinical oncology outcomes.Keywords: genomics, multiomics, clinical genetics, genotyping, oncology, diagnostics
Procedia PDF Downloads 159385 Molecularly Imprinted Polymer and Computational Study of (E)-2-Cyano-3-(Dimethylamino)-N-(2,4-Dioxo-1,2,3,4-Tetrahydropyrimidin-5-Yl)Acrylam-Ide and Its Applications in Industrial Applications
Authors: Asmaa M. Fahim
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In this investigation, the (E)-2-cyano-3-(dimethylamino)-N-(2,4-dioxo-1,2,3,4-tetrahydropyrimidin-5-yl)acrylam-ide (4) which used TAM as a template which interacts with Methacrylic Acid (MAA) monomer, in the presence of CH₃CN as progen. The TAM-MMA complex interactions are dependent on stable hydrogen bonding interaction between the carboxylic acid group of TAM(Template) and the hydroxyl group of MMA(methyl methacrylate) with minimal interference of porogen CH₃CN. The physical computational studies were used to optimize their structures and frequency calculations. The binding energies between TAM with different monomers showed the most stable molar ratio of 1:4, which was confirmed through experimental analysis. The optimized polymers were investigated in industrial applications.Keywords: molecular imprinted polymer, computational studies, SEM, spectral analysis, industrial applications
Procedia PDF Downloads 156384 Chromatographic Preparation and Performance on Zinc Ion Imprinted Monolithic Column and Its Adsorption Property
Authors: X. Han, S. Duan, C. Liu, C. Zhou, W. Zhu, L. Kong
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The ionic imprinting technique refers to the three-dimensional rigid structure with the fixed pore sizes, which was formed by the binding interactions of ions and functional monomers and used ions as the template, it has a high level of recognition to the ionic template. The preparation of monolithic column by the in-situ polymerization need to put the compound of template, functional monomers, cross-linking agent and initiating agent into the solution, dissolve it and inject to the column tube, and then the compound will have a polymerization reaction at a certain temperature, after the synthetic reaction, we washed out the unread template and solution. The monolithic columns are easy to prepare, low consumption and cost-effective with fast mass transfer, besides, they have many chemical functions. But the monolithic columns have some problems in the practical application, such as low-efficiency, quantitative analysis cannot be performed accurately because of the peak shape is wide and has tailing phenomena; the choice of polymerization systems is limited and the lack of theoretical foundations. Thus the optimization of components and preparation methods is an important research direction. During the preparation of ionic imprinted monolithic columns, pore-forming agent can make the polymer generate the porous structure, which can influence the physical properties of polymer, what’ s more, it can directly decide the stability and selectivity of polymerization reaction. The compounds generated in the pre-polymerization reaction could directly decide the identification and screening capabilities of imprinted polymer; thus the choice of pore-forming agent is quite critical in the preparation of imprinted monolithic columns. This article mainly focuses on the research that when using different pore-forming agents, the impact of zinc ion imprinted monolithic column on the enrichment performance of zinc ion.Keywords: high performance liquid chromatography (HPLC), ionic imprinting, monolithic column, pore-forming agent
Procedia PDF Downloads 212383 Electrical Properties of Polarization-Induced Aluminum Nitride/Gallium Nitride Heterostructures Homoepitaxially Grown on Aluminum Nitride Sapphire Template by Molecular Beam Epitaxy
Authors: Guanlin Wu, Jiajia Yao, Fang Liu, Junshuai Xue, Jincheng Zhang, Yue Hao
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Owing to the excellent thermal conductivity and ultra-wide bandgap, Aluminum nitride (AlN)/Gallium nitride (GaN) is a highly promising material to achieve high breakdown voltage and output power devices among III-nitrides. In this study, we explore the growth and characterization of polarization-induced AlN/GaN heterostructures using plasma-assisted molecular beam epitaxy (PA-MBE) on AlN-on-sapphire templates. To improve the crystal quality and demonstrate the effectiveness of the PA-MBE approach, a thick AlN buffer of 180 nm was first grown on the AlN-on sapphire template. This buffer acts as a back-barrier to enhance the breakdown characteristic and isolate leakage paths that exist in the interface between the AlN epilayer and the AlN template. A root-mean-square roughness of 0.2 nm over a scanned area of 2×2 µm2 was measured by atomic force microscopy (AFM), and the full-width at half-maximum of (002) and (102) planes on the X-ray rocking curve was 101 and 206 arcsec, respectively, using by high-resolution X-ray diffraction (HR-XRD). The electron mobility of 443 cm2/Vs with a carrier concentration of 2.50×1013 cm-2 at room temperature was achieved in the AlN/GaN heterostructures by using a polarization-induced GaN channel. The low depletion capacitance of 15 pF is resolved by the capacitance-voltage. These results indicate that the polarization-induced AlN/GaN heterostructures have great potential for next-generation high-temperature, high-frequency, and high-power electronics.Keywords: AlN, GaN, MBE, heterostructures
Procedia PDF Downloads 83382 Decisional Regret in Men with Localized Prostate Cancer among Various Treatment Options and the Association with Erectile Functioning and Depressive Symptoms: A Moderation Analysis
Authors: Caren Hilger, Silke Burkert, Friederike Kendel
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Men with localized prostate cancer (PCa) have to choose among different treatment options, such as active surveillance (AS) and radical prostatectomy (RP). All available treatment options may be accompanied by specific psychological or physiological side effects. Depending on the nature and extent of these side effects, patients are more or less likely to be satisfied or to struggle with their treatment decision in the long term. Therefore, the aim of this study was to assess and explain decisional regret in men with localized PCa. The role of erectile functioning as one of the main physiological side effects of invasive PCa treatment, depressive symptoms as a common psychological side effect, and the association of erectile functioning and depressive symptoms with decisional regret were investigated. Men with localized PCa initially managed with AS or RP (N=292) were matched according to length of therapy (mean 47.9±15.4 months). Subjects completed mailed questionnaires assessing decisional regret, changes in erectile functioning, depressive symptoms, and sociodemographic variables. Clinical data were obtained from case report forms. Differences among the two treatment groups (AS and RP) were calculated using t-tests and χ²-tests, relationships of decisional regret with erectile functioning and depressive symptoms were computed using multiple regression. Men were on average 70±7.2 years old. The two treatment groups differed markedly regarding decisional regret (p<.001, d=.50), changes in erectile functioning (p<.001, d=1.2), and depressive symptoms (p=.01, d=.30), with men after RP reporting higher values, respectively. Regression analyses showed that after adjustment for age, tumor risk category, and changes in erectile functioning, depressive symptoms were still significantly associated with decisional regret (B=0.52, p<.001). Additionally, when predicting decisional regret, the interaction of changes in erectile functioning and depressive symptoms reached significance for men after RP (B=0.52, p<.001), but not for men under AS (B=-0.16, p=.14). With increased changes in erectile functioning, the association of depressive symptoms with decisional regret became stronger in men after RP. Decisional regret is a phenomenon more prominent in men after RP than in men under AS. Erectile functioning and depressive symptoms interact in their prediction of decisional regret. Screening and treating depressive symptoms might constitute a starting point for interventions aiming to reduce decisional regret in this target group.Keywords: active surveillance, decisional regret, depressive symptoms, erectile functioning, prostate cancer, radical prostatectomy
Procedia PDF Downloads 217381 Assessment of the Radiation Absorbed Dose Produced by Lu-177, Ra-223, AC-225 for Metastatic Prostate Cancer in a Bone Model
Authors: Maryam Tajadod
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The treatment of cancer is one of the main challenges of nuclear medicine; while cancer begins in an organ, such as the breast or prostate, it spreads to the bone, resulting in metastatic bone. In the treatment of cancer with radiotherapy, the determination of the involved tissues’ dose is one of the important steps in the treatment protocol. Comparing absorbed doses for Lu-177 and Ra-223 and Ac-225 in the bone marrow and soft tissue of bone phantom with evaluating energetic emitted particles of these radionuclides is the important aim of this research. By the use of MCNPX computer code, a model for bone phantom was designed and the values of absorbed dose for Ra-223 and Ac-225, which are Alpha emitters & Lu-177, which is a beta emitter, were calculated. As a result of research, in comparing gamma radiation for three radionuclides, Lu-177 released the highest dose in the bone marrow and Ra-223 achieved the lowest level. On the other hand, the result showed that although the figures of absorbed dose for Ra and Ac in the bone marrow are near to each other, Ra spread more energy in cortical bone. Moreover, The alpha component of the Ra-223 and Ac-225 have very little effect on bone marrow and soft tissue than a beta component of the lu-177 and it leaves the highest absorbed dose in the bone where the source is located.Keywords: bone metastases, lutetium-177, radium-223, actinium-225, absorbed dose
Procedia PDF Downloads 111380 Identification of Novel Differentially Expressed and Co-Expressed Genes between Tumor and Adjacent Tissue in Prostate Cancer
Authors: Luis Enrique Bautista-Hinojosa, Luis A. Herrera, Cristian Arriaga-Canon
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Text should be written in the third person. Please avoid using "I" “my” or the pronoun "one". It is best to say "It is believed..." rather than "I believe..." or "One believes...".Keywords: transcriptomics, co-expression, cancer, biomarkers
Procedia PDF Downloads 71379 Exploiting the Tumour Microenvironment in Order to Optimise Sonodynamic Therapy for Cancer
Authors: Maryam Mohammad Hadi, Heather Nesbitt, Hamzah Masood, Hashim Ahmed, Mark Emberton, John Callan, Alexander MacRobert, Anthony McHale, Nikolitsa Nomikou
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Sonodynamic therapy (SDT) utilises ultrasound in combination with sensitizers, such as porphyrins, for the production of cytotoxic reactive oxygen species (ROS) and the confined ablation of tumours. Ultrasound can be applied locally, and the acoustic waves, at frequencies between 0.5-2 MHz, are transmitted efficiently through tissue. SDT does not require highly toxic agents, and the cytotoxic effect only occurs upon ultrasound exposure at the site of the lesion. Therefore, this approach is not associated with adverse side effects. Further highlighting the benefits of SDT, no cancer cell population has shown resistance to therapy-triggered ROS production or their cytotoxic effects. This is particularly important, given the as yet unresolved issues of radiation and chemo-resistance, to the authors’ best knowledge. Another potential future benefit of this approach – considering its non-thermal mechanism of action – is its possible role as an adjuvant to immunotherapy. Substantial pre-clinical studies have demonstrated the efficacy and targeting capability of this therapeutic approach. However, SDT has yet to be fully characterised and appropriately exploited for the treatment of cancer. In this study, a formulation based on multistimulus-responsive sensitizer-containing nanoparticles that can accumulate in advanced prostate tumours and increase the therapeutic efficacy of SDT has been developed. The formulation is based on a polyglutamate-tyrosine (PGATyr) co-polymer carrying hematoporphyrin. The efficacy of SDT in this study was demonstrated using prostate cancer as the translational exemplar. The formulation was designed to respond to the microenvironment of advanced prostate tumours, such as the overexpression of the proteolytic enzymes, cathepsin-B and prostate-specific membrane antigen (PSMA), that can degrade the nanoparticles, reduce their size, improving both diffusions throughout the tumour mass and cellular uptake. The therapeutic modality was initially tested in vitro using LNCaP and PC3 cells as target cell lines. The SDT efficacy was also examined in vivo, using male SCID mice bearing LNCaP subcutaneous tumours. We have demonstrated that the PGATyr co-polymer is digested by cathepsin B and that digestion of the formulation by cathepsin-B, at tumour-mimicking conditions (acidic pH), leads to decreased nanoparticle size and subsequent increased cellular uptake. Sonodynamic treatment, at both normoxic and hypoxic conditions, demonstrated ultrasound-induced cytotoxic effects only for the nanoparticle-treated prostate cancer cells, while the toxicity of the formulation in the absence of ultrasound was minimal. Our in vivo studies in immunodeficient mice, using the hematoporphyrin-containing PGATyr nanoparticles for SDT, showed a 50% decrease in LNCaP tumour volumes within 24h, following IV administration of a single dose. No adverse effects were recorded, and body weight was stable. The results described in this study clearly demonstrate the promise of SDT to revolutionize cancer treatment. It emphasizes the potential of this therapeutic modality as a fist line treatment or in combination treatment for the elimination or downstaging of difficult to treat cancers, such as prostate, pancreatic, and advanced colorectal cancer.Keywords: sonodynamic therapy, nanoparticles, tumour ablation, ultrasound
Procedia PDF Downloads 137378 Prevalence of High Risk Human Papillomavirus in Cervical Dysplasia and Cancer Samples from Twin Cities in Pakistan
Authors: Sana Gul, Sheeba Murad, Aneela Javed
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Introduction: Human Papilloma Virus (HPV) is small DNA virus mostly infecting mucosa and cutaneous keratinocytes. So far, more than 200 Human papillomaviruses are known. HPV have been divided into high- and low-risk on the basis of their oncogenic potential. High risk HPV is considered to be the main etiological cause for cervical cancer. Objective: Current study was designed to screen the local cervical cancer patients from the twin cities of Pakistan for the occurance of high risk HPV. Methodology: A total of 67 formalin fixed paraffin-embedded samples of cervical cancer biopsies were obtained from the government hospitals in Islamabad and Rawalpindi. Cervical cancer biopsies were examined for the presence of HPV DNA. Polymerase chain reaction (PCR) was used for the amplification of a region in the HPV-L1 gene for the general detection of the Papilloma virus and for the genotype specific detection of high risk HPV 16 and 18 using the GP5/GP6 primers and genotype specific primers respectively. Results: HPV DNA was detected in 59 out of 67 samples analyzed. 30 samples showed the presence of HPV16 while 22 samples were positive for HPV 18 . HPV subtype could not be determined in 7 samples. Conclusion: Our results show a strong association between HPV infection and cervical cancer among women in twin cities of Pakistan. One way to minimize the disease burden in relation to HPV infection in Pakistani population is the use of prophylactic vaccines and routine screening. An early diagnosis of HPV infection will allow better health management to reduce the risk of developing cervical cancer.Keywords: cervical cancer, Pakistan, human papillomavirus, HPV 16
Procedia PDF Downloads 338377 Switching to the Latin Alphabet in Kazakhstan: A Brief Overview of Character Recognition Methods
Authors: Ainagul Yermekova, Liudmila Goncharenko, Ali Baghirzade, Sergey Sybachin
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In this article, we address the problem of Kazakhstan's transition to the Latin alphabet. The transition process started in 2017 and is scheduled to be completed in 2025. In connection with these events, the problem of recognizing the characters of the new alphabet is raised. Well-known character recognition programs such as ABBYY FineReader, FormReader, MyScript Stylus did not recognize specific Kazakh letters that were used in Cyrillic. The author tries to give an assessment of the well-known method of character recognition that could be in demand as part of the country's transition to the Latin alphabet. Three methods of character recognition: template, structured, and feature-based, are considered through the algorithms of operation. At the end of the article, a general conclusion is made about the possibility of applying a certain method to a particular recognition process: for example, in the process of population census, recognition of typographic text in Latin, or recognition of photos of car numbers, store signs, etc.Keywords: text detection, template method, recognition algorithm, structured method, feature method
Procedia PDF Downloads 184376 Diagnostic Accuracy Of Core Biopsy In Patients Presenting With Axillary Lymphadenopathy And Suspected Non-Breast Malignancy
Authors: Monisha Edirisooriya, Wilma Jack, Dominique Twelves, Jennifer Royds, Fiona Scott, Nicola Mason, Arran Turnbull, J. Michael Dixon
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Introduction: Excision biopsy has been the investigation of choice for patients presenting with pathological axillary lymphadenopathy without a breast abnormality. Core biopsy of nodes can provide sufficient tissue for diagnosis and has advantages in terms of morbidity and speed of diagnosis. This study evaluates the diagnostic accuracy of core biopsy in patients presenting with axillary lymphadenopathy. Methods: Between 2009 and 2019, 165 patients referred to the Edinburgh Breast Unit had a total of 179 axillary lymph node core biopsies. Results: 152 (92%) of the 165 initial core biopsies were deemed to contain adequate nodal tissue. Core biopsy correctly established malignancy in 75 of the 78 patients with haematological malignancy (96%) and in all 28 patients with metastatic carcinoma (100%) and correctly diagnosed benign changes in 49 of 57 (86%) patients with benign conditions. There were no false positives and no false negatives. In 67 (85.9%) of the 78 patients with hematological malignancy, there was sufficient material in the first core biopsy to allow the pathologist to make an actionable diagnosis and not ask for more tissue sampling prior to treatment. There were no complications of core biopsy. On follow up, none of the patients with benign cores has been shown to have malignancy in the axilla and none with lymphoma had their initial disease incorrectly classified. Conclusions: This study shows that core biopsy is now the investigation of choice for patients presenting with axillary lymphadenopathy even in those suspected as having lymphoma.Keywords: core biopsy, excision biopsy, axillary lymphadenopathy, non-breast malignancy
Procedia PDF Downloads 238375 Current Status of Ir-192 Brachytherapy in Bangladesh
Authors: M. Safiqul Islam, Md Arafat Hossain Sarkar
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Brachytherapy is one of the most important cancer treatment management systems in radiotherapy department. Brachytherapy treatment is moved into High Dose Rate (HDR) after loader from Low Dose Rate (LDR) after loader due to radiation protection advantage. HDR Brachytherapy is a highly multipurpose system for enhancing cure and achieving palliation in many common cancers disease of developing countries. High-dose rate (HDR) Brachytherapy is a type of internal radiation therapy that delivers radiation from implants placed close to or inside, the tumor(s) in the body. This procedure is very effective at providing localized radiation to the tumor site while minimizing the patient’s whole body dose. Brachytherapy has proven to be a highly successful treatment for cancers of the prostate, cervix, endometrium, breast, skin, bronchus, esophagus, and head and neck, as well as soft tissue sarcomas and several other types of cancer. For the time being in our country we have 10 new HDR Remote after loading Brachytherapy. Right now 4 HDR Brachytherapy is already installed and running for patient’s treatment out of 10 HDR Brachytherapy. Ir-192 source is more comfortable than Co-60. In that case people or expert personnel prefer Ir-192 source for different kind of cancer patients. Ir-192 are economically, more flexible and familiar in our country.Keywords: Ir-192, brachytherapy, cancer treatment, prostate, cervix, endometrium, breast, skin, bronchus, esophagus, soft tissue sarcomas
Procedia PDF Downloads 431374 Submicron Size of Alumina/Titania Tubes for CO2-CH4 Conversion
Authors: Chien-Wan Hun, Shao-Fu Chang, Jheng-En Yang, Chien-Chon Chen, Wern-Dare Jheng
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This research provides a systematic way to study and better understand double nano-tubular structure of alunina (Al2O3) and titania (TiO2). The TiO2 NT was prepared by immersing Al2O3 template in 0.02 M titanium fluoride (TiF4) solution (pH=3) at 25 °C for 120 min, followed by annealing at 450 °C for 1 h to obtain anatase TiO2 NT in the Al2O3 template. Large-scale development of film for nanotube-based CO2 capture and conversion can potentially result in more efficient energy harvesting. In addition, the production process will be relatively environmentally friendly. The knowledge generated by this research will significantly advance research in the area of Al2O3, TiO2, CaO, and Ca2O3 nano-structure film fabrication and applications for CO2 capture and conversion. This green energy source will potentially reduce reliance on carbon-based energy resources and increase interest in science and engineering careers.Keywords: alumina, titania, nano-tubular, film, CO2
Procedia PDF Downloads 393373 Synthesis and Characterization of Nano-Alumina Using Neem Oil as the Template for Efficient Hydrogen Generation via Photo-Hydrolysis of Sodium Borohydride
Authors: Dina M. Abd El-Aty, D. Aman, E. G. Zaki, Heba M. Salem
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A friendly environmental source of energy as hydrogen was produced by photo-hydrolysis of hydrogen storage material as sodium borohydride (NaBH4), which is non-toxic and stores a high percentage of hydrogen. The photoreaction was produced under visible light and nano-alumina as a catalyst. In this study, we use more economical and friendly environmental oil as a template to produce a nano-catalyst. The prepared catalyst was characterized by X-Ray diffraction, N2-adsorption-desorption, Fourier Transforms Infrared, Scanning Electron microscope and X-Ray Photoelectron Spectroscopy. Different parameters such as catalyst weight, NaBH4 weight and time of irradiation were studied to obtain a highly efficient photo-hydrolysis reaction. The reaction is pseudo-first order and the hydrogen production rate was determined as 1500 ml min-1 g-1 at the optimum conditions.Keywords: photo-reaction, nano-alumina, hydrogen production, sodium borohydride, visible light
Procedia PDF Downloads 81372 A Multi-Templated Fe-Ni-Cu Ion Imprinted Polymer for the Selective and Simultaneous Removal of Toxic Metallic Ions from Wastewater
Authors: Morlu Stevens, Bareki Batlokwa
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The use of treated wastewater is widely employed to compensate for the scarcity of safe and uncontaminated freshwater. However, the existence of toxic heavy metal ions in the wastewater pose a health hazard to animals and the environment, hence, the importance for an effective technique to tackle the challenge. A multi-templated ion imprinted sorbent (Fe,Ni,Cu-IIP) for the simultaneous removal of heavy metal ions from waste water was synthesised employing molecular imprinting technology (MIT) via thermal free radical bulk polymerization technique. Methacrylic acid (MAA) was employed as the functional monomer, and ethylene glycol dimethylacrylate (EGDMA) as cross-linking agent, azobisisobutyronitrile (AIBN) as the initiator, Fe, Ni, Cu ions as template ions, and 1,10-phenanthroline as the complexing agent. The template ions were exhaustively washed off the synthesized polymer by solvent extraction in several washing steps, while periodically increasing solvent (HCl) concentration from 1.0 M to 10.0 M. The physical and chemical properties of the sorbents were investigated using Fourier Transform Infrared Spectroscopy (FT-IR), X-ray Diffraction (XRD) and Atomic Force Microscopy (AFM) were employed. Optimization of operational parameters such as time, pH and sorbent dosage to evaluate the effectiveness of sorbents were investigated and found to be 15 min, 7.5 and 666.7 mg/L respectively. Selectivity of ion-imprinted polymers and competitive sorption studies between the template and similar ions were carried out and showed good selectivity towards the targeted metal ion by removing 90% - 98% of the templated ions as compared to 58% - 62% of similar ions. The sorbents were further applied for the selective removal of Fe, Ni and Cu from real wastewater samples and recoveries of 92.14 ± 0.16% - 106.09 ± 0.17% and linearities of R2 = 0.9993 - R2 = 0.9997 were achieved.Keywords: ion imprinting, ion imprinted polymers, heavy metals, wastewater
Procedia PDF Downloads 312371 Strained Channel Aluminum Nitride/Gallium Nitride Heterostructures Homoepitaxially Grown on Aluminum Nitride-On-Sapphire Template by Plasma-Assisted Molecular Beam Epitaxy
Authors: Jiajia Yao, GuanLin Wu, Fang liu, JunShuai Xue, JinCheng Zhang, Yue Hao
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Due to its outstanding material properties like high thermal conductivity and ultra-wide bandgap, Aluminum nitride (AlN) has the promising potential to provide high breakdown voltage and high output power among III-nitrides for various applications in electronics and optoelectronics. This work presents material growth and characterization of strained channel Aluminum nitride/Gallium nitride (AlN/GaN) heterostructures grown by plasma-assisted molecular beam epitaxy (PA-MBE) on AlN-on-sapphire templates. To improve the crystal quality and manifest the ability of the PA-MBE approach, a thick AlN buffer with a thickness of 180 nm is first grown on AlN template, which acts as a back-barrier to enhance the breakdown characteristic and isolates the leakage path existing in the interface between AlN epilayer and AlN template, as well as improve the heat dissipation. The grown AlN buffer features a root-mean-square roughness of 0.2 nm over a scanned area of 2×2 µm2 measured by atomic force microscopy (AFM), and exhibits full-width at half-maximum of 95 and 407 arcsec for the (002) and (102) plane the X-ray rocking curve, respectively, tested by high resolution x-ray diffraction (HR-XRD). With a thin and strained GaN channel, the electron mobility of 294 cm2 /Vs. with a carrier concentration of 2.82×1013 cm-2 at room temperature is achieved in AlN/GaN double-channel heterostructures, and the depletion capacitance is as low as 14 pF resolved by the capacitance-voltage, which indicates the promising opportunities for future applications in next-generation high temperature, high-frequency and high-power electronics with a further increased electron mobility by optimization of heterointerface quality.Keywords: AlN/GaN, HEMT, MBE, homoepitaxy
Procedia PDF Downloads 94370 Microstructure Characterization on Silicon Carbide Formation from Natural Wood
Authors: Noor Leha Abdul Rahman, Koay Mei Hyie, Anizah Kalam, Husna Elias, Teng Wang Dung
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Dark Red Meranti and Kapur, kinds of important type of wood in Malaysia were used as a precursor to fabricate porous silicon carbide. A carbon template is produced by pyrolysis at 850°C in an oxygen free atmosphere. The carbon template then further subjected to infiltration with silicon by silicon melt infiltration method. The infiltration process was carried out in tube furnace in argon flow at 1500°C, at two different holding time; 2 hours and 3 hours. Thermo gravimetric analysis was done to investigate the decomposition behavior of two species of plants. The resulting silicon carbide was characterized by XRD which was found the formation of silicon carbide and also excess silicon. The microstructure was characterized by scanning electron microscope (SEM) and the density was determined by the Archimedes method. An increase in holding time during infiltration will increased the density as well as formation of silicon carbide. Dark Red Meranti precursor is likely suitable for production of silicon carbide compared to Kapur.Keywords: density, SEM, silicon carbide, XRD
Procedia PDF Downloads 421369 FDX1, a Cuproptosis-Related Gene, Identified as a Potential Target for Human Ovarian Aging
Authors: Li-Te Lin, Chia-Jung Li, Kuan-Hao Tsui
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Cuproptosis, a newly identified cell death mechanism, has attracted attention for its association with various diseases. However, the genetic interplay between cuproptosis and ovarian aging remains largely unexplored. This study aims to address this gap by analyzing datasets related to ovarian aging and cuproptosis. Spatial transcriptome analyses were conducted in the ovaries of both young and aged female mice to elucidate the role of FDX1. Comprehensive bioinformatics analyses, facilitated by R software, identified FDX1 as a potential cuproptosis-related gene with implications for ovarian aging. Clinical infertility biopsies were examined to validate these findings, showing consistent results in elderly infertile patients. Furthermore, pharmacogenomic analyses of ovarian cell lines explored the intricate association between FDX1 expression levels and sensitivity to specific small molecule drugs. Spatial transcriptome analyses revealed a significant reduction in FDX1 expression in aging ovaries, supported by consistent findings in biopsies from elderly infertile patients. Pharmacogenomic investigations indicated that modulating FDX1 could influence drug responses in ovarian-related therapies. This study pioneers the identification of FDX1 as a cuproptosis-related gene linked to ovarian aging. These findings not only contribute to understanding the mechanisms of ovarian aging but also position FDX1 as a potential diagnostic biomarker and therapeutic target. Further research may establish FDX1's pivotal role in advancing precision medicine and therapies for ovarian-related conditions.Keywords: cuproptosis, FDX1, ovarian aging, biomarker
Procedia PDF Downloads 39368 The Fabrication of Scintillator Column by Hydraulic Pressure Injection Method
Authors: Chien Chon Chen, Chun Mei Chu, Chuan Ju Wang, Chih Yuan Chen, Ker Jer Huang
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Cesiumiodide with Na doping (CsI(Na)) solution or melt is easily forming three- dimension dendrites on the free surface. The defects or bobbles form inside the CsI(Na) during the solution or melt solidification. The defects or bobbles can further effect the x-ray path in the CsI(Na) crystal and decrease the scintillation characteristics of CsI(Na). In order to enhance the CsI(Na) scintillated property we made single crystal of CsI(Na) column in the anodic aluminum oxide (AAO) template by hydraulic pressure injection method. It is interesting that when CsI(Na) melt is confined in the small AAO channels, the column grow as stable single column without any dendrites. The high aspect ratio (100~10000) of AAO and nano to sub-micron channel structure which is a suitable template for single of crystal CsI(Na) formation. In this work, a new low-cost approach to fabricate scintillator crystals using anodic aluminum oxide (AAO) rather than Si is reported, which can produce scintillator crystals with a wide range of controllable size to optimize their performance in X-ray detection.Keywords: cesiumiodide, AAO, scintillator, crystal, X-ray
Procedia PDF Downloads 461367 Removal of Pb²⁺ from Waste Water Using Nano Silica Spheres Synthesized on CaCO₃ as a Template: Equilibrium and Thermodynamic Studies
Authors: Milton Manyangadze, Joseph Govha, T. Bala Narsaiah, Ch. Shilpa Chakra
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The availability and access to fresh water is today a serious global challenge. This has been a direct result of factors such as the current rapid industrialization and industrial growth, persistent droughts in some parts of the world, especially in the sub-Saharan Africa as well as population growth. Growth of the chemical processing industry has also seen an increase in the levels of pollutants in our water bodies which include heavy metals among others. Heavy metals are known to be dangerous to both human and aquatic life. As such, they have been linked to several diseases. This is mainly because they are highly toxic. They are also known to be bio accumulative and non-biodegradable. Lead for example, has been linked to a number of health problems which include damage of vital internal body systems like the nervous and reproductive system as well as the kidneys. From this background therefore, the removal of the toxic heavy metal, Pb2+ from waste water was investigated using nano silica hollow spheres (NSHS) as the adsorbent. Synthesis of NSHS was done using a three-stage process in which CaCO3 nanoparticles were initially prepared as a template. This was followed by treatment of the formed oxide particles with NaSiO3 to give a nanocomposite. Finally, the template was destroyed using 2.0M HCl to give NSHS. Characterization of the nanoparticles was done using analytical techniques like XRD, SEM, and TGA. For the adsorption process, both thermodynamic and equilibrium studies were carried out. Thermodynamic studies were carried out and the Gibbs free energy, Enthalpy and Entropy of the adsorption process were determined. The results revealed that the adsorption process was both endothermic and spontaneous. Equilibrium studies were also carried out in which the Langmuir and Freundlich isotherms were tested. The results showed that the Langmuir model best described the adsorption equilibrium.Keywords: characterization, endothermic, equilibrium studies, Freundlich, Langmuir, nanoparticles, thermodynamic studies
Procedia PDF Downloads 214366 The TiO2 Refraction Film for CsI Scintillator
Authors: C. C. Chen, C. W. Hun, C. J. Wang, C. Y. Chen, J. S. Lin, K. J. Huang
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Cesium iodide (CsI) melt was injected into anodic aluminum oxide (AAO) template and was solidified to CsI column. The controllable AAO channel size (10~500 nm) can makes CsI column size from 10 to500 nm in diameter. In order to have a shorter light irradiate from each singe CsI column top to bottom the AAO template was coated a TiO2 nano-film. The TiO2 film acts a refraction film and makes X-ray has a shorter irradiation path in the CsI crystal making a stronger the photo-electron signal. When the incidence light irradiate from air (R=1.0) to CsI’s first surface (R=1.84) the first refraction happen, the first refraction continue into TiO2 film (R=2.88) and produces the low angle of the second refraction. Then the second refraction continue into AAO wall (R=1.78) and produces the third refraction after refractions between CsI and AAO wall (R=1.78) produce the fourth refraction. The incidence light after through CsI and TiO2 film refractions arrive to the CsI second surface. Therefore, the TiO2 film can has shorter refraction path of incidence light and increase the photo-electron conversion efficiency.Keywords: cesium iodide, anodic aluminum oxide (AAO), TiO2, refraction, X-ray
Procedia PDF Downloads 424365 Optimizing Machine Learning Through Python Based Image Processing Techniques
Authors: Srinidhi. A, Naveed Ahmed, Twinkle Hareendran, Vriksha Prakash
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This work reviews some of the advanced image processing techniques for deep learning applications. Object detection by template matching, image denoising, edge detection, and super-resolution modelling are but a few of the tasks. The paper looks in into great detail, given that such tasks are crucial preprocessing steps that increase the quality and usability of image datasets in subsequent deep learning tasks. We review some of the methods for the assessment of image quality, more specifically sharpness, which is crucial to ensure a robust performance of models. Further, we will discuss the development of deep learning models specific to facial emotion detection, age classification, and gender classification, which essentially includes the preprocessing techniques interrelated with model performance. Conclusions from this study pinpoint the best practices in the preparation of image datasets, targeting the best trade-off between computational efficiency and retaining important image features critical for effective training of deep learning models.Keywords: image processing, machine learning applications, template matching, emotion detection
Procedia PDF Downloads 12364 Prostheticly Oriented Approach for Determination of Fixture Position for Facial Prostheses Retention in Cases with Atypical and Combined Facial Defects
Authors: K. A.Veselova, N. V.Gromova, I. N.Antonova, I. N. Kalakutskii
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There are many diseases and incidents that may result facial defects and deformities: cancer, trauma, burns, congenital anomalies, and autoimmune diseases. In some cases, patient may acquire atypically extensive facial defect, including more than one anatomical region or, by contrast, atypically small defect (e.g. partial auricular defect). The anaplastology gives us opportunity to help patient with facial disfigurement in cases when plastic surgery is contraindicated. Using of implant retention for facial prosthesis is strongly recommended because improves both aesthetic and functional results and makes using of the prosthesis more comfortable. Prostheticly oriented fixture position is extremely important for aesthetic and functional long-term result; however, the optimal site for fixture placement is not clear in cases with atypical configuration of facial defect. The objective of this report is to demonstrate challenges in fixture position determination we have faced with and offer the solution. In this report, four cases of implant-supported facial prosthesis are described. Extra-oral implants with four millimeter length were used in all cases. The decision regarding the quantity of surgical stages was based on anamnesis of disease. Facial prostheses were manufactured according to conventional technique. Clinical and technological difficulties and mistakes are described, and prostheticly oriented approach for determination of fixture position is demonstrated. The case with atypically large combined orbital and nasal defect resulting after arteriovenous malformation is described: the correct positioning of artificial eye was impossible due to wrong position of the fixture (with suprastructure) located in medial aspect of supraorbital rim. The suprastructure was unfixed and this fixture wasn`t used for retention in order to achieve appropriate artificial eye placement and better aesthetic result. In other case with small partial auricular defect (only helix and antihelix were absent) caused by squamoized cell carcinoma T1N0M0 surgical template was used to avoid the difficulties. To achieve the prostheticly oriented fixture position in case of extremely small defect the template was made on preliminary cast using vacuum thermoforming method. Two radiopaque markers were incorporated into template in preferable for fixture placement positions taking into account future prosthesis configuration. The template was put on remaining ear and cone-beam CT was performed to insure, that the amount of bone is enough for implant insertion in preferable position. Before the surgery radiopaque markers were extracted and template was holed for guide drill. Fabrication of implant-retained facial prostheses gives us opportunity to improve aesthetics, retention and patients’ quality of life. But every inaccuracy in planning leads to challenges on surgery and prosthetic stages. Moreover, in cases with atypically small or extended facial defects prostheticly oriented approach for determination of fixture position is strongly required. The approach including surgical template fabrication is effective, easy and cheap way to avoid mistakes and unpredictable result.Keywords: anaplastology, facial prosthesis, implant-retained facial prosthesis., maxillofacil prosthese
Procedia PDF Downloads 112363 Fast and Scale-Adaptive Target Tracking via PCA-SIFT
Authors: Yawen Wang, Hongchang Chen, Shaomei Li, Chao Gao, Jiangpeng Zhang
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As the main challenge for target tracking is accounting for target scale change and real-time, we combine Mean-Shift and PCA-SIFT algorithm together to solve the problem. We introduce similarity comparison method to determine how the target scale changes, and taking different strategies according to different situation. For target scale getting larger will cause location error, we employ backward tracking to reduce the error. Mean-Shift algorithm has poor performance when tracking scale-changing target due to the fixed bandwidth of its kernel function. In order to overcome this problem, we introduce PCA-SIFT matching. Through key point matching between target and template, that adjusting the scale of tracking window adaptively can be achieved. Because this algorithm is sensitive to wrong match, we introduce RANSAC to reduce mismatch as far as possible. Furthermore target relocating will trigger when number of match is too small. In addition we take comprehensive consideration about target deformation and error accumulation to put forward a new template update method. Experiments on five image sequences and comparison with 6 kinds of other algorithm demonstrate favorable performance of the proposed tracking algorithm.Keywords: target tracking, PCA-SIFT, mean-shift, scale-adaptive
Procedia PDF Downloads 431362 Image Segmentation with Deep Learning of Prostate Cancer Bone Metastases on Computed Tomography
Authors: Joseph M. Rich, Vinay A. Duddalwar, Assad A. Oberai
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Prostate adenocarcinoma is the most common cancer in males, with osseous metastases as the commonest site of metastatic prostate carcinoma (mPC). Treatment monitoring is based on the evaluation and characterization of lesions on multiple imaging studies, including Computed Tomography (CT). Monitoring of the osseous disease burden, including follow-up of lesions and identification and characterization of new lesions, is a laborious task for radiologists. Deep learning algorithms are increasingly used to perform tasks such as identification and segmentation for osseous metastatic disease and provide accurate information regarding metastatic burden. Here, nnUNet was used to produce a model which can segment CT scan images of prostate adenocarcinoma vertebral bone metastatic lesions. nnUNet is an open-source Python package that adds optimizations to deep learning-based UNet architecture but has not been extensively combined with transfer learning techniques due to the absence of a readily available functionality of this method. The IRB-approved study data set includes imaging studies from patients with mPC who were enrolled in clinical trials at the University of Southern California (USC) Health Science Campus and Los Angeles County (LAC)/USC medical center. Manual segmentation of metastatic lesions was completed by an expert radiologist Dr. Vinay Duddalwar (20+ years in radiology and oncologic imaging), to serve as ground truths for the automated segmentation. Despite nnUNet’s success on some medical segmentation tasks, it only produced an average Dice Similarity Coefficient (DSC) of 0.31 on the USC dataset. DSC results fell in a bimodal distribution, with most scores falling either over 0.66 (reasonably accurate) or at 0 (no lesion detected). Applying more aggressive data augmentation techniques dropped the DSC to 0.15, and reducing the number of epochs reduced the DSC to below 0.1. Datasets have been identified for transfer learning, which involve balancing between size and similarity of the dataset. Identified datasets include the Pancreas data from the Medical Segmentation Decathlon, Pelvic Reference Data, and CT volumes with multiple organ segmentations (CT-ORG). Some of the challenges of producing an accurate model from the USC dataset include small dataset size (115 images), 2D data (as nnUNet generally performs better on 3D data), and the limited amount of public data capturing annotated CT images of bone lesions. Optimizations and improvements will be made by applying transfer learning and generative methods, including incorporating generative adversarial networks and diffusion models in order to augment the dataset. Performance with different libraries, including MONAI and custom architectures with Pytorch, will be compared. In the future, molecular correlations will be tracked with radiologic features for the purpose of multimodal composite biomarker identification. Once validated, these models will be incorporated into evaluation workflows to optimize radiologist evaluation. Our work demonstrates the challenges of applying automated image segmentation to small medical datasets and lays a foundation for techniques to improve performance. As machine learning models become increasingly incorporated into the workflow of radiologists, these findings will help improve the speed and accuracy of vertebral metastatic lesions detection.Keywords: deep learning, image segmentation, medicine, nnUNet, prostate carcinoma, radiomics
Procedia PDF Downloads 95361 A Case of Mantle Cell Lymphoma Presenting With GI Symptoms and Noted to Have Extranodal Involvement of the Stomach and Colon on Presentation
Authors: Saba Amreen Syeda, Summaiah Asim, Syeda, Hafsa, Essam Quraishi
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Mantle Cell Lymphoma (MCL) is a relatively uncommon type of lymphoma that comprises approximately 7 percent of non hodgkin's lymphomas (NHL), Classic MCL presents mostly in lymph nodes and occasionally in extranodal sites. About 26 % of MCL is present primarily in the Gastrointestinal tract. While both the upper GI tract and the lower GI tract could be involved, it is rare to present with concurrent upper and lower GI involvement with MCL. We present the case of a 51-year-old Asian Indian male that presented to our clinic with complaints of chronic diarrhea for the last one year, progressively worsening over the past three months. The Patient also reported black stool as well as bright red blood per rectum. Patient reported severe fatigue on minimal exertion. On a physical exam, the patient was noted to have matted lymphadenopathy in the neck. Patient was noted to be anemic with a hemoglobin to be 8 g/dl. Esophagogastroduodenoscopy and colonoscopy was performed. EGD showed a large 4 cm ulcer in the gastric antrum with thick heaped up edges. There was bleeding on contact. Colonoscopy showed a large 35 mm multilobulated polyp in the ascending colon, which was biopsied. The patient was also noted to have nodular proctitis in the mid rectum. This was localized and extended to about 5 cm. This area was biopsied as well. Biopsies from the stomach, colon, as well as the rectum, returned with findings of mantle cell lymphoma on pathology. Lymphoid cells in the biopsy were stained strongly positive for CD 20, cyclin D1, and CD 5. There was the absence of stain for CD 3 and CD 10. The IHC stain for CD 23 was negative. Biopsies from neck LAD were obtained and were also positive for MCL. The patient was referred to oncology for staging and treatment.Keywords: mantle cell lymphoma, GI bleed, diarrhea, gastric ulcer, colon polyp
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