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In this paper, the axial behaviour of boundary elements of rectangular ductile reinforced concrete (RC) walls is investigated. For this purpose, axial tests on rectangular RC prisms representing the boundary zones of ductile RC walls are carried out. Critical design parameters influencing the local compression response of ductile wall boundaries are identified and the effect of these parameters on the axial response of RC prisms is experimentally investigated. Key parameters investigated in this study include loading history, transverse reinforcement detailing (arrangement, spacing and diameter), longitudinal reinforcement detailing (yield strength and area) and cover concrete. The influence of these parameters on the performance of RC wall boundary zones is discussed in light of the experimental observations of the prisms tested in this study. The experimental test results reaffirm the susceptibility of isolated wall boundary elements to the progression of large out-of-plane deformations and subsequent instability. The experiment test results show that loading history and transverse reinforcement detailing are the critical parameters that influence the failure modes of boundary zone prisms.

Pancreatoduodenectomy is a complex surgical procedure involving three anastomoses. Anastomosis of the pancreatic stump with the gastrointestinal tract is associated with most complications described in the postoperative period. So, there have been multiple attempts to discover safe and sound steps for this particular anastomosis. Pancreaticogastrostomy involves anastomosis between the remaining pancreas and stomach. Since it was first performed, its surgical steps have been modified multiple times, but there is no gold standard method to perform it. In this paper, we describe the surgical steps of pancreaticogastrostomy in difficult pancreatic stumps in eight patients using two transpancreatic sutures, one purse string suture, and the incorporation of transpancreatic sutures in the third layer of the gastrojejunostomy anastomosis. Postoperative outcomes of this series have provided encouraging short-term results.

HER2-positive metastatic breast cancer (MBC) represents a challenging subtype of breast cancer, characterized by aggressive disease and poor clinical outcomes. Trastuzumab emtansine (TDM1), an antibody–drug conjugate combining trastuzumab and emtansine, has demonstrated efficacy in clinical trials as a second-line treatment for patients progressing after prior therapies. This study aims to provide real-world evidence on the efficacy and safety of TDM1 in HER2-positive MBC patients. A retrospective analysis was conducted on 70 HER2-positive MBC patients treated with TDM1 at our centre between January 2020 and December 2022. Clinical characteristics, progression-free survival (PFS), overall survival (OS), response rates, and toxicity were evaluated using hospital records. PFS and OS were calculated using Kaplan–Meier methods, and survival curves were compared with log-rank tests. The median age of patients was 47 years, with a majority presenting with advanced disease and prior treatment lines. The median PFS was 6.1 months (95% CI, 4.5–7.6), and the median OS was 14.4 months (95% CI, 10.2–18.0). The objective response rate was 75.7%, with 12.8% achieving a complete response and 62.8% a partial response. PFS was significantly longer in hormone receptor-positive patients compared to hormone receptor-negative patients (8.1 vs. 4.1 months, p = 0.035). Toxicity was manageable, with grade 3–4 adverse events including elevated transaminases (8.5%), thrombocytopenia (5.7%), and anemia (4.2%). The efficacy of TDM1 in this real-world cohort aligns with clinical trial data, though PFS and OS were somewhat lower compared to trials, likely due to the inclusion of patients with more extensive disease and prior treatments. Notably, TDM1 demonstrated activity against CNS metastases and a manageable safety profile, with higher incidence of hepatic and hematologic toxicities. Our study supports the use of TDM1 as a viable option for treating HER2-positive MBC in routine clinical practice, confirming its effectiveness and safety profile observed in clinical trials.

Background Solitary fibrous tumor (SFT) is a distinct fibroblastic tumor that can occur at any anatomical site and can manifest a variety of histopathological features. NAB2-STAT6 gene fusion has recently emerged as a sensitive and specific molecular marker and its surrogate on immunohistochemistry, STAT6 has also displayed considerable efficacy. Nevertheless, its histologic diversity can result in diagnostic challenges, especially when classic features are not apparent. Methods A retrospective study was conducted at a tertiary cancer centre in North India over 3 years to document the clinicopathologic and immunomorphologic profile of SFTs. Immunohistochemical analysis of BCOR and p53 were gauged additionally and patients were stratified according to Modified Demicco and Salas criteria for risk of metastasis. Results Sixteen patients of SFT were identified, affecting middle-aged men and women equally. Though lung/pleura are known to be involved commonly, SFT affects other sites such as the kidney, brain, buccal mucosa, liver, and penis as well. The majority endured localized disease while a lesser number suffered locoregional/distant spread. Two patients revealed features of a malignant profile. Risk stratification according to the Modified Demicco and Salas criteria evinced comparable results. No discernible relationship however was highlighted between the immunohistochemical expression of BCOR, p53, and any significant SFT parameter. Conclusion Although SFTs are very rare substantially benign mesenchymal neoplasms, pathologists must be conversant with their histological diversity and be vigilant of their malignant attributes. The worth of STAT6 immunohistochemistry for precise diagnosis and long-term studies for delineating clinical behavior cannot be overemphasized.

Background Metaplastic breast cancer with heterologous mesenchymal differentiation, known earlier as carcinosarcoma, consists of both infiltrating ductal carcinoma cells and mesenchymal cells, and is associated with an aggressive course. The mesenchymal component is rarely endothelial, with only two previously reported cases. The present case is the third among those. Moreover, the disease outcome was good, unlike the usual course of carcinosarcoma. Case presentation A 59-year-old multiparous woman of Indo-aryan ethnicity developed a lump in her left breast and was diagnosed with breast carcinosarcoma having an endothelial component, with the help of histopathological examination and immunohistochemistry. The tumor was surgically removed; then the patient received adjuvant chemotherapy, epirubicin, and cyclophosphamide, followed by adjuvant radiotherapy to the whole breast, followed by tumor bed boost. The patient was clinic-radiologically disease-free even at 26 months post-treatment. Conclusion Surgery followed by adjuvant chemotherapy and radiotherapy gives better outcomes compared with surgery alone, with a doubtful role of neoadjuvant chemotherapy. Targeted therapies can be considered in patients not responding to conventional treatment.

Tissue loss in the forearm is a common entity. There are various etiologies to tissue loss like trauma, burn, post-surgery, etc. Coverage of defect or tissue loss of the forearm is a surgical challenge and options available for forearm coverage are limited. To bypass this difficulty, McGregor pedicled groin flap is used by us to cover large forearm defects with successful outcomes in this case series.

IntroductionMetaplastic breast cancer (MBC) is a rare malignancy that accounts for < 1% of all breast cancers. The aim of this study is to evaluate the clinicopathologic characteristics of MBC patients treated at a tertiary cancer center.Materials and methodsIn this study, the authors retrospectively analyzed the prospectively maintained data of MBC patients treated at a tertiary cancer care center in North India between January 2019 and July 2022.ResultsA total of 28 MBCs were identified. The median age of presentation was 47 years (range 27-81 years). Seventeen patients (60.7%) presented with clinical T3/T4 disease, and axillary nodal involvement was detected in 11 patients (39.3%) at presentation. Two patients had metastatic disease at presentation. A preoperative diagnosis of MBC on core biopsy was attained in five patients (17.9%), and the most common histologic subtype was sarcomatoid carcinoma. Triple-negative receptor status was observed in 15 patients (53.6%). Six patients (21.4%) underwent upfront breast conservation surgery and another six (21.4%) upfront mastectomy. Thirteen patients (46.4%) underwent mastectomy following neoadjuvant therapy. Definitive axillary nodal metastasis was found in eight patients (32%). Following neoadjuvant chemotherapy, five patients (35.7%) had stable disease, disease progression was evident in five patients (35.7%), partial response in four patients (28.6%), and no patient evinced complete response. Adjuvant postoperative radiation therapy was administered in 16 patients (57.1%). At a median follow-up of 13.2 months (range 4-26 months), 16 patients (57.1%) were alive with no evidence of disease, one patient (3.6%) was alive with disease, nine patients (32.1%) died of disease, and two patients (7.2%) died of other causes. One patient suffered from locoregional recurrence and nine patients developed distant metastasis.ConclusionMBC is an infrequent entity among breast carcinomas in India, which is similar to the reports of MBC worldwide. The diagnosis of MBC is difficult and requires the use of immunohistochemistry. Most of the cases in our study presented with a larger tumor size; however, they displayed a relatively lower incidence of nodal involvement as well as hormone receptor negativity. Being a rare and heterogeneous disease, large-scale studies are essential for better understanding and management of these tumors.

Metastatic breast cancer (MBC) patients have numerous options for treatment. However, it is essential to consider treatments with favorable toxicity profiles and convenient modes of administration. Eribulin has shown effectiveness in aggressive MBC, but there is a lack of sufficient real-world data specific to Indian patients. We conducted a retrospective audit of patients with MBC who received intravenous Eribulin between 2019 and 2023 at a dosage of 1.4 mg/m on days 1 and 8 every 3 weeks. The median Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. During the specified time, 107 consecutive patients with MBC received Eribulin treatment. The median age was 52 years (range, 28-75 years) with 3 patients with male breast cancer. The median number of prior chemotherapy lines and involved sites were 3 (range, 2-5) and 3 (range, 1-6), respectively. Visceral involvement was present in 84 (78.5%) patients. A median of 3 cycles of Eribulin (range, 1-11) was administered. Eribulin resulted in partial responses in 49 (45.8%) patients, stable disease in 11 (10.3%) patients and progressive disease in 47 (43.9%) patients. The median PFS was 4.0 months (95% CI: 3.4-4.6), and the median OS was 10.0 months (95% CI: 8.3-11.7). For patients with triple-negative breast cancer (TNBC), the median OS was 8 months (95% CI: 5.6-10.4), whereas non-TNBC patients had a median OS of 11 months (95% CI: 9.1-12.8) (hazard ratio, 1.9, 95% CI: 1.2-3.1, = 0.002). Eribulin was well-tolerated, with dose reduction was needed in 9 (8.4%) of the patients in the overall cohort. Eribulin is a viable and safe option for treating heavily pre-treated MBC in real-world settings. The study found comparable efficacy in both TNBC and non-TNBC patients.

A three-parametric Gompertz function was applied to modelbiomass partitioning data in Arabidopsis thaliana L.Fitting and evaluation statistics of the model suggested that cumulative data of root biomass growth performed better than that of shoot growth while relative growth rate data demonstrated reverse trend. Both AGR and CGR peak was higher for shoot growth than root growth. Upper asymptotic values for both shoot and root growth came out to be 1.541 and 0.313 respectively at the end of growth cycle. Time- dependent analysis suggested that RGR declined exponentially over time and RGR-shoots (RGRs) was higher than that of RGR-roots (RGRr). Size-dependent RGR demonstrated that due to low rate of decline, RGRs was higher than that of RGRr.