Prognostic significance of pre- and post-operative serum carcinoembryonic antigen levels in patients presented with rectal carcinoma; an experience from Shaukat Khanum Memorial Cancer Hospital and Research Center Lahore.

OBJECTIVE: To explore the importance of serum carcinoembryonic antigen level as a tumour marker in rectal carcinoma. METHODS: The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, and comprised data of patients with rectal carcinoma from January 1996 to December 2015. Serum carcinoembryonic antigen levels were analysed using immulite@2000 system analyser. On the basis of serum carcinoembryonic antigen levels, data of patients was divided into four groups. Group A had normal serum levels both before and after surgical resection; Group B had normal levels pre-surgery but post-surgery levels were raised; Group C had raised levels pre-surgery that went down to normal post-surgery; and Group D had raised levels both before and after surgery. SPSS 23 was used for data analysis. RESULTS: Of the 401 patients, 267(66.6%) were males, and 204(50.9%) were aged <50 years. Group A had 267(66.6%) patients, Group B 26(6.5%), Group C 79(`9.7) and Group D had 29(7.2%) patients. Stage III disease was the most common 343(85.5%) and it was true across the groups. Overall recurrence was in 141(35.2%) patients. Group D had the highest recurrence rate 26(89.7%), while Group C had the lowest 18(22.8%). CONCLUSIONS: Fluctuating levels of carcinoembryonic antigen affected post-operative outcome.

A clinical study and treatment results of adrenocortical carcinoma patients presented in Shaukat Khanum Memorial Cancer Hospital and Research Center, Lahore.

Adrenocortical carcinoma is a rare and aggressive malignancy with an incidence of 0.5-2 per million per year and its overall prognosis is very poor. This study was aimed to point out the factors associated with tumour recurrence and patient's survival after complete surgical resection of this aggressive malignancy. Patients admitted from January 2011 till December 2015 were retrospectively reviewed using case notes. In these five years 29 patients were admitted with adrenal tumour out of which 13 had adrenocortical carcinoma. On five year follow up, six (46.2%) patients developed recurrence. MEAN disease free survival was 31.0 ± 23.92 (2-63) months 53.8% while MEAN overall survival was 46.69 ± 22.81 (14-80) months 92.3%. Results concluded that hormonally active tumour on clinical presentation, positive surgical resection margins, positive nodal status and poorly differentiated tumour on histopathology are the factors associated with tumour recurrence and patient's survival.

Risk factors effecting development of metachronous liver metastasis in rectal cancer patients after curative surgical resection. Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore experience.

OBJECTIVE: To determine risk factors affecting development of metachronous liver metastasis in rectal cancer patients after curative surgical resection. METHODS: The retrospective cohort study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised data of patients with histologically proven rectal carcinoma admitted to the department of surgical oncology from January 2005 to December 2015. Clinical data of all patients, including age, gender, clinical presentation, clinical and pathological tumour-nodes-metastasis classification, neoadjuvant chemo-radiotherapy, surgery, adjuvant chemotherapy, pre- and postoperative carcinoembryonic antigen levels, histopathological findings and tumour recurrence were analysed. SPSS 23 was used for data analysis.. RESULTS: Of the 434 patients, 26(6%) developed liver metastasis. Of them, 18(69%) were male and 16(61.5%) were aged below 50 years. On clinical staging, 2(7.7%) patients had stage II disease, 22(84.6%) had stage III, and 2(7.7%) patients had stage IV disease. At last follow-up, 2(7.7%) patients were alive without disease, 7(27%) had expired, while 17(65.4%) were alive with disease.. CONCLUSIONS: Tumour depth, lymph node metastasis, postoperative carcinoembryonic antigen levels, complete tumour response on histopathology were found to beresponsible for metachronous liver metastases in rectal cancer patients following curative resection.

The MARS2013 Mars analog mission.

We report on the MARS2013 mission, a 4-week Mars analog field test in the northern Sahara. Nineteen experiments were conducted by a field crew in Morocco under simulated martian surface exploration conditions, supervised by a Mission Support Center in Innsbruck, Austria. A Remote Science Support team analyzed field data in near real time, providing planning input for the management of a complex system of field assets; two advanced space suit simulators, four robotic vehicles, an emergency shelter, and a stationary sensor platform in a realistic work flow were coordinated by a Flight Control Team. A dedicated flight planning group, external control centers for rover tele-operations, and a biomedical monitoring team supported the field operations. A 10 min satellite communication delay and other limitations pertinent to human planetary surface activities were introduced. The fields of research for the experiments were geology, human factors, astrobiology, robotics, tele-science, exploration, and operations research. This paper provides an overview of the geological context and environmental conditions of the test site and the mission architecture, in particular the communication infrastructure emulating the signal travel time between Earth and Mars. We report on the operational work flows and the experiments conducted, including a deployable shelter prototype for multiple-day extravehicular activities and contingency situations.

Field trial of a dual-wavelength fluorescent emission (L.I.F.E.) instrument and the Magma White rover during the MARS2013 Mars analog mission.

Abstract We have developed a portable dual-wavelength laser fluorescence spectrometer as part of a multi-instrument optical probe to characterize mineral, organic, and microbial species in extreme environments. Operating at 405 and 532 nm, the instrument was originally designed for use by human explorers to produce a laser-induced fluorescence emission (L.I.F.E.) spectral database of the mineral and organic molecules found in the microbial communities of Earth's cryosphere. Recently, our team had the opportunity to explore the strengths and limitations of the instrument when it was deployed on a remote-controlled Mars analog rover. In February 2013, the instrument was deployed on board the Magma White rover platform during the MARS2013 Mars analog field mission in the Kess Kess formation near Erfoud, Morocco. During these tests, we followed tele-science work flows pertinent to Mars surface missions in a simulated spaceflight environment. We report on the L.I.F.E. instrument setup, data processing, and performance during field trials. A pilot postmission laboratory analysis determined that rock samples acquired during the field mission exhibited a fluorescence signal from the Sun-exposed side characteristic of chlorophyll a following excitation at 405 nm. A weak fluorescence response to excitation at 532 nm may have originated from another microbial photosynthetic pigment, phycoerythrin, but final assignment awaits development of a comprehensive database of mineral and organic fluorescence spectra. No chlorophyll fluorescence signal was detected from the shaded underside of the samples.

A case for using ground-based thermal inertia measurements to detect Martian caves.

Martian caves are regarded as one of the most interesting locations in which to search for life on the planet. Data obtained during the MARS2013 expedition at Hamar Laghdad Ridge in the Tafilalt region of Morocco indicate that even small cavities can display thermal behavior that is characteristic for caves. For example, temperature in a cavity equaled 14°C±0.1°C before sunrise, which was higher than the temperature of the ambient air (10°C±0.1°C) and proximate rocks (9°C±0.1°C) at the same time. Within 30 min after sunrise, when the temperature of surrounding rocks corresponded to 15°C, this thermal relationship reversed. Measurements were conducted under simulated spaceflight conditions, including near-real-time interpretation of data that were acquired in a complex flight planning environment. We conclude that using ground-based thermal contrast measurements, in 7-14 µm band before and after sunset, is an effective method for Mars astronauts to identify caves, possibly superior to usage of space-based or ground-penetrating data.