Biopsy proven cancer of the neck, which even after a complete clinical & radiological workup (that includes physical examination, CT scan, esophgeoscopy, laryngoscopy, bronchoscopy & multiple survillence biopsies) reveals or yields no primary demonstrable lesion.
Biopsy proven cancer of the neck, which even after a complete clinical & radiological workup (that includes physical examination, CT scan, esophgeoscopy, laryngoscopy, bronchoscopy & multiple survillence biopsies) reveals or yields no primary demonstrable lesion.
Liver Anatomy (basics), types of liver injuries, ingury scoring scale for liver, CT pictures of different grades, non-operative and operative managment of liver trauma.
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Made by Surgical Club Armata Manus (armata-manus.com)
Surgical Anatomy of the Liver : Ηepatectomies - Dimitris P. KorkolisDimitris P. Korkolis
- The liver is the largest gland in the body and has a wide variety of functions
- Weight: 1/50 of body weight in adult & 1/20 of body weight in infant
- It is exocrine(bile) & endocrine organ(Albumin , prothrombin & fibrinogen)
Function of the liver :
- Secretion of bile & bile salt
- Metabolism of carbohydrate, fat and protein
- Formation of heparin & anticoagulant substances
- Detoxication
- Storage of glycogen and vitamins
- Activation of vita .D
This is a Central presentation, presented at National Institute of Cancer Research & Hospital(NICRH), Mohakhali, Dhaka, Bangladesh on Metastatic neck node of unknown primary.
Metastasis of Neck Node with Unknown Primary Himanshu Soni
carcinoma of unknown Primary accounts for 5%-10% of all tumours. 3–5% of head and neck cancers presented as cervical squamous cell carcinomas of unknown primary
HEAD AND NECK OCCULT PRIMARY CANCERS. SAM & RICH.pptxRitchieShija
Carcinoma of unknown primary is a diagnosis given when doctors aren't able to locate where a cancer began.
Most often, cancer is diagnosed when doctors discover the spot where the cancer began (primary tumor). If the cancer has spread (metastasized), those sites might be discovered, too.
In carcinoma of unknown primary, also known as occult primary cancer, doctors find the cancer cells that spread in the body, but they can't find the primary tumor.
In carcinoma of unknown primary, also known as occult primary cancer, doctors find the cancer cells that spread in the body, but they can't find the primary tumor. Doctors consider the location of the primary tumor when choosing the most appropriate treatments.So if carcinoma of unknown primary is found, doctors work to try to identify the primary tumor site. Your doctor might consider your risk factors, symptoms, and results from exams, imaging tests and pathology tests when trying to determine where your cancer began.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Acetabularia Information For Class 9 .docxvaibhavrinwa19
Acetabularia acetabulum is a single-celled green alga that in its vegetative state is morphologically differentiated into a basal rhizoid and an axially elongated stalk, which bears whorls of branching hairs. The single diploid nucleus resides in the rhizoid.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
for beginners, providing thorough training in areas such as SEO, digital communication marketing, and PPC training in Noida. After finishing the program, students receive the certifications recognised by top different universitie, setting a strong foundation for a successful career in digital marketing.
Exploiting Artificial Intelligence for Empowering Researchers and Faculty, In...Dr. Vinod Kumar Kanvaria
Exploiting Artificial Intelligence for Empowering Researchers and Faculty,
International FDP on Fundamentals of Research in Social Sciences
at Integral University, Lucknow, 06.06.2024
By Dr. Vinod Kumar Kanvaria
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Executive Directors Chat Leveraging AI for Diversity, Equity, and InclusionTechSoup
Let’s explore the intersection of technology and equity in the final session of our DEI series. Discover how AI tools, like ChatGPT, can be used to support and enhance your nonprofit's DEI initiatives. Participants will gain insights into practical AI applications and get tips for leveraging technology to advance their DEI goals.
Natural birth techniques - Mrs.Akanksha Trivedi Rama University
Lymph node metastasis in neck (secondaries in cervical lymph nodes diagnosis and lab investigations
1. Lymph node metastasis in neck
(secondaries in cervical lymph nodes)
DIAGNOSIS AND INVESTIGATIONS
By Somu Venkatesh
Roll Number 118
Final year part 2
3. Secondaries in the Neck lymph nodes
They are divided into 3 types
1.Secondaries in the Neck with Known Primary
2.Secondaries in the Neck with Clinically Unidentified Primary
3.Secondaries in the Neck with an Occult Primary
4. 1.SecondariesintheNeckwithKnownPrimary
• Here secondaries are present and primary has been
identified clinically in the oral cavity, pharynx, larynx,
thyroid or other areas.
• Investigations: Biopsy from the primary and
FNAC from the secondaries
• Treatment:
• Primary is treated by -Curative Radiotherapy or
Surgery(wide excision).
• Secondaries, when mobile are treated by radical lymph
node block dissection in the neck
5. 2.Secondariesin the Neckwith Clinically
UnidentifiedPrimary
• Hard neck lymph nodes are secondaries, but primary
has not been identified clinically.
• Investigations: FNAC from the secondaries
Then search for the primary is done by various
investigations. They are
a) Panendoscopy
b) Surveillance biopsy
c) FNAC of thyroid and suspected areas
d) CT scan.
6. a. Panendoscopy
- Nasopharyngoscopy
- Laryngoscopy
- Oesophagoscopy
- Bronchoscopy.
b. Surveillance biopsy : Blind biopsies are taken from
Fossa of Rosenmuller
Lateral wall of pharynx
Pyriform fossa
Tonsillar bed
Base of tongue
Subglottic region (larynx)
7. c. FNAC of thyroid and suspected areas
d. CT scan
(Note: Surveillance biopsy is done to reveal unknown primary in
15% of cases of secondaries in neck. If this surveillance biopsy is
negative, then ipsilateral tonsillectomy may be needed.)
Treatment
Primary is treated by Curative radiotherapy.
Secondaries in the neck is treated by Radical Neck Dissection.
8. 3.Secondaries in the Neck with an
Occult Primary
• Occult = hidding from view
• Secondaries in the neck lymph nodes are confirmed by
FNAC, but primary has not been revealed clinically and
by any available investigations.
• Occult primary : When all the investigations do not show any
evidence of primary.
• Reasons for primary lesion being occult
Too small a primary to detect;
Possibility of immunological spontaneous regression of primary and
Inability of the present diagnostic tools to detect the primary.
9. • Histologically secondaries in neck with occult primary may be
of squamous cell carcinoma or of nonsquamous cell
carcinoma, i.e., adenocarcinoma/poorly differentiated
tumours (lymphoma/sarcoma/melanoma).
• In upper and midcervical region 80% are due to squamous cell
carcinoma.
• In lower cervical and supraclavicular region 40% can be
adenocarcinomas.
• Common sites of primary here (for adenocarcinoma) are
thyroid, breast, gastrointestinal tract, salivary glands, lungs,
prostate and kidney.
10. • 70% of occult nodes occur in jugulodigastric group.
• Differential diagnosis for secondary with occult primary is
lymphoma and primary branchogenic carcinoma.
11. Investigations for seconday tumour
FNAC is the tool to confirm the occult secondary.
Open biopsy (if FNAC is inconclusive)-incision/excision
Open biopsy helps in high suspects of lymphomas or poorly
differentiated carcinomas .
It facilitates tissue study, immunohistochemistry, and special
stains.
Many studies prove that risk of seedling, survival and
prognosis will not alter by open biopsy.
But at present it is proposed only when FNAC fails or special
methods are mandatory to type the disease.
After open biopsy, frozen section confirmation and immediate
neck dissection has to be done.
12. Immunoperoxidase staining is the most commonly
used on FNAC specimen or formalin fixed paraffin tissue using
monoclonal or polyclonal antibodies.
Immunoperoxidase mainly used in
lymphomas/neuroendocrine tumours
Electron microscopy is superior to
immunohistochemistry as ultrastructure details can be
assessed. But it is costly.
Chromosomal analysis for tumour specific genes is
used in B, T and germ cell lymphomas.
13. Investigation for occult primary
• CECT is the investigation of choice to look for primary
• FNAC of node/open biopsy to confirm
• Other methods are – MRI , triple endoscopy, surveillance
biopsy, FNAC of thyroid, ipsilateral tonsillectomy if surveillance
biopsy and other methods are negaive
14. Treatment
Initially the SECONDARIES in the neck are treated by Radical
Neck Dissection, then regular follow-up is done (at 3 monthly
intervals) until the primary reveals.
Once PRIMARY is revealed it is confirmed by biopsy and
treated accordingly, either by Curative Radiotherapy or by
Wide Excision depending on location of revealed primary.
Prognosis
This type is usually less aggressive and has got better
prognosis.
15. Nodal staging in secondaries
• Nx – nodes cannot be assessed
• No – no nodal metastasis
• N1 – single node same side <3 cm
• N2a – single node same side 3-6cm
• N2b – multiple nodes same side <6cm
• N2c – bilateral /contralateral nodes < 6cm
• N3 – node > 6 cm
17. Investigations for secondaries in neck
FNAC of secondary:
open incision biopsy is not advised here. It destroys the fascial
barriers and causes the spread of tumours faster and earlier
into next level nodes or other soft tissues. Eventual neck
dissection technically becomes difficult. Recurrence rate in
neck will be higher after open biopsy.
If FNAC of node and all investigations for primary become
negative, then open biopsy of node following confirmation
with frozen section and immediate neck dissection is
undertaken. In such situation if neck dissection is delayed
after open biopsy confirmation, chances of cure will be
reduced.
19. Biopsy from primary : Incision biopsy is the choice here.
Blind biopsies from suspected areas.
Panendoscopy with examination under anaesthesia.
CT scan is to see the base of skull, paranasal sinuses,
nasopharynx, extension of primary tumour/secondary
deposites; CT scan of chest and abdomen.
Chest X-ray to visualise primary or secondaries in case
melanomas or mediastinal nodes.
MRI scan or PET scan in conjunction with CT scan or MRI. MRI
identifies soft tissue extension/changes; guided primary
biopsy is possible; extension into bone is identified.
CT chest and abdomen in case of infraclavicular primaries or
to assess nodes.