Coherent interaction-free detection of microwave pulses with a superconducting circuit.

The interaction-free measurement is a fundamental quantum effect whereby the presence of a photosensitive object is determined without irreversible photon absorption. Here we propose the concept of coherent interaction-free detection and demonstrate it experimentally using a three-level superconducting transmon circuit. In contrast to standard interaction-free measurement setups, where the dynamics involves a series of projection operations, our protocol employs a fully coherent evolution that results, surprisingly, in a higher probability of success. We show that it is possible to ascertain the presence of a microwave pulse resonant with the second transition of the transmon, while at the same time avoid exciting the device onto the third level. Experimentally, this is done by using a series of Ramsey microwave pulses coupled into the first transition and monitoring the ground-state population.

Experimental demonstration of robustness under scaling errors for superadiabatic population transfer in a superconducting circuit.

We study experimentally and theoretically the transfer of population between the ground state and the second excited state in a transmon circuit by the use of superadiabatic stimulated Raman adiabatic passage (saSTIRAP). We show that the transfer is remarkably resilient against variations in the amplitudes of the pulses (scaling errors), thus demostrating that the superadiabatic process inherits certain robustness features from the adiabatic one. In particular, we provide new evidence of a plateau that appears at high values of the counterdiabatic pulse strength, which goes beyond the usual framework of saSTIRAP. This article is part of the theme issue 'Shortcuts to adiabaticity: theoretical, experimental and interdisciplinary perspectives'.

Giant virilising adrenal cortical carcinoma.

Androgen secreting adrenocortical carcinoma (ACC) is a very rare disease with a poor prognosis. Approximately 80% of tumors are functional, most commonly secreting glucocorticoids. We herewith report a case of a huge functional ACC of the right adrenal gland in a 33-year-old female who presented with complaints of hirsutism, amenorrhea and an abdominal lump. On abdominal examination a large lump was palpable in the right hypochondrium reaching up to the umbilicus. Contrast-enhance computed tomography (CECT) revealed a mass in the right suprarenal region. The tumor measured 29 cm × 20 cm × 12 cm and weighed 7.8 kg, the largest reported case of ACC in the world to the best of our knowledge.

Giant virilising adrenal cortical carcinoma

Androgen secreting adrenocortical carcinoma (ACC) is a very rare disease with a poor prognosis. Approximately 80% of tumors are functional, most commonly secreting glucocorticoids. We herewith report a case of a huge functional ACC of the right adrenal gland in a 33-year-old female who presented with complaints of hirsutism, amenorrhea and an abdominal lump. On abdominal examination a large lump was palpable in the right hypochondrium reaching up to the umbilicus. Contrast-enhance computed tomography (CECT) revealed a mass in the right suprarenal region. The tumor measured 29 cm × 20 cm × 12 cm and weighed 7.8 kg, the largest reported case of ACC in the world to the best of our knowledge.

Papillary tumor in pineal region: Immunohistochemistry meeting the diagnostic challenge.

Papillary tumor of pineal region (PTPR) is extremely rare and poses diagnostic challenge with other central nervous system tumors having papillary architecture. Immunohistochemistry is crucial for a definitive diagnosis of PTPR.

Quantum signatures of chaos, thermalization, and tunneling in the exactly solvable few-body kicked top.

Exactly solvable models that exhibit quantum signatures of classical chaos are both rare as well as important-more so in view of the fact that the mechanisms for ergodic behavior and thermalization in isolated quantum systems and its connections to nonintegrability are under active investigation. In this work, we study quantum systems of few qubits collectively modeled as a kicked top, a textbook example of quantum chaos. In particular, we show that the three- and four-qubit cases are exactly solvable and yet, interestingly, can display signatures of ergodicity and thermalization. Deriving analytical expressions for entanglement entropy and concurrence, we see agreement in certain parameter regimes between long-time average values and ensemble averages of random states with permutation symmetry. Comparing with results using the data of a recent transmons-based experiment realizing the three-qubit case, we find agreement for short times, including a peculiar steplike behavior in correlations of some states. In the case of four qubits we point to a precursor of dynamical tunneling between what in the classical limit would be two stable islands. Numerical results for larger number of qubits show the emergence of the classical limit including signatures of a bifurcation.

18F-Fluorocholine-Positron Emission Tomography/Computerised Tomography is Useful in Localising 99mTc-Sesta-methoxyisobutylisonitrile-Negative Parathyroid Cyst Causing Normocalcemic Primary Hyperparathyroidism.

Parathyroid cysts are extremely rare and are rarely associated with primary hyperparathyroidism (PHPT), which are difficult to localise, as they are 99mTc-sesta-methoxyisobutylisonitrile (sestaMIBI) negative. We report for the first time the utility of 18F-fluorocholinepositron emission tomography/computerised tomography (PC-PET/CT) in localising parathyroid cyst causing normocalcemic PHPT. A 76-year-old lady with progressively worsening osteoporosis from 2014-2017 (in spite of annual zolendronic acid infusions, daily calcium and vitamin-D supplementation) with persistently normal serum calcium and vitamin D, but elevated parathyroid hormone, had normal sestaMIBI scans of the neck on multiple occasions. FC-PET/CT finally revealed soft tissue uptake, suggestive of right superior parathyroid adenoma/ hyperplasia. Surgical removal of the culprit lesion resulted in resolution of hyperparathyroidism, histopathologic evaluation of which revealed a cystic lesion lined by chief cell variant parathyroid cells without any nuclear atypia, capsular or vascular invasion. FC-PET/CT is useful in localising culprit parathyroid lesions, especially when they are sestaMIBI negative. PC-PET/CT is useful in localising parathyroid hyperplasia and ectopic parathyroids, which are frequently missed by sestaMIBI. There is an urgent need for comparative studies between sestaMIBI and FC-PET/CT in PHPT. We report for the first time the usefulness of FC-PET/CT in localising sestaMIBI-negative functional parathyroid cyst causing normocalcemic PHPT.

Unusual presentation of renal cell carcinoma: A rare case report.

Cutaneous and intraoral metastasis from any malignancy is not common. Cutaneous spread is usually noted in 5%-10% of high-grade malignancies, as in carcinoma breast, lung, colon, ovary, and malignant melanoma. Only 4.6% cases of cutaneous spread are from renal cell carcinoma (RCC). Intraoral spread from RCC is much rarer with an incidence of approximately 1% of all malignant oral tumors, noted sometimes in tongue, palate, buccal mucosa, gingiva, and lips. RCC is a highly aggressive tumor which requires early diagnosis for increasing the chance of cure. In our case, a 54-year-old male presented with swelling over upper lip, scalp, and retromolar area, which on histopathology and immunohistochemistry revealed clear cell carcinoma compatible with metastatic RCC.

Occult phosphaturic mesenchymal tumour of femur cortex causing oncogenic osteomalacia - diagnostic challenges and clinical outcomes.

BACKGROUND: Tumor induced osteomalacia (TIO) are extremely rare paraneoplastic syndrome with less than 300 reported cases. This report highlights the pitfalls and challenges in diagnosing and localizing TIO in patients with refractory and resistant osteomalacia. PATIENT AND METHODS: 41- year gentleman with 4-year history of musculoskeletal weakness and pathologic fractures presented in wheelchair bound incapacitated state of 1-year duration. Investigations were significant for severe hypophosphatemia, severe phosphaturia, normal serum calcium, reduced 1,25-dihydroxy vitamin-D, elevated ALP, elevated intact parathyroid hormone (iPTH), and pseudo-fractures involving pelvis and bilateral femur. Whole body MRI and 99mTc methylene diphosphonate bone-scan were also normal. Whole body FDG-PET scan involving all 4 limbs revealed a small FDG avid lesion at lateral border of lower end of left femur (SUV max 3.9), which was well characterized on 3-dimensional CT reconstruction. Plasma C-terminal fibroblast growth factor (FGF)-23 was 698 RU/ mL (normal < 150 RU/ml). Wide surgical excision of the tumor was done. Histopathology confirmed mesenchymal tumor of mixed connective tissue variant. Serum phosphorous normalized post-surgery day-1. High dose oral calcium and vitamin-D was continued. FGF-23 normalized post surgery (73RU/ml). Physical strength improved significantly and now he is able to walk independently. CONCLUSION: TIO is frequently confused with normocalcemic hyperparathyroidism and vitamin-D resistant rickets/osteomalacia, which increases patient morbidity. Imaging for tumor localization should involve whole body from head to tip of digits, cause these tumors are notoriously small and frequently involve digits of hands and legs. Complete surgical removal of the localized tumor is key to good clinical outcomes.

Cylindroma of the breast: a rare case report.

Cylindroma is a benign adnexal tumor, which occurs as solitary dermal nodules on the scalp and forehead. Cylindroma of the breast is a rare lesion. Fine-needle aspiration is often the first line of investigation. In this communication, we illustrate the cytomorphological feature of cylindroma in a 61-year-old female patient who presented with a breast lump. Fine-needle aspiration cytology in this case reveals the islands of tumor cells formed a "jig-saw" pattern, along with the bland, basaloid cells associated with globular, extracellular material. These features are typical of cylindroma, but differential diagnosis of adenoidcystic carcinoma should always be kept in mind as the management of both tumors are different.

Rapunzel Syndrome Causing Appendicitis in an 8-year-old Girl.

Rapunzel syndrome is a rare type of presentation of trichobezoar, an extension of hair fibers into the small bowel and rarely beyond the ileocecal valve. Its clinical presentation is deceptive ranging from abdominal mass to symptoms of obstruction. We report a 8-year-old girl admitted with a history of abdominal pain and vomiting off and on for a period of 1 year. Ultrasound findings were suggestive of subacute intestinal obstruction. On laparotomy, trichobezoar was found in the stomach extending into small bowel and was removed. Appendix was inflammed hence it was also resected. Microscopic evidence of a hair shaft was seen in the appendix indicating appendicitis was due to luminal obstruction by hair concretions.