Association of the prognostic role of FGFR4 Gly388Arg polymorphism with treatment outcomes after chemoradiotherapy in esophageal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 60-60
Author(s):  
Sanghee Cho ◽  
Min-Ho Shin ◽  
Jun-Eul Hwang ◽  
Hyung-jung Shim ◽  
Min-Jee Kim ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Early Stage ◽  
Stage Iv ◽  
Stage Ii ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Prognostic Role ◽  
Overall Response ◽  
Genotypic Analysis

60 Background: Fibroblast growth factor receptor 4 (FGFR4) has been associated with increased risk, staging, and metastasis in several type of cancer. The purpose of this study was to evaluate the prognostic role of FGFR4 Gly388Arg polymorphism in esophageal cancer after chemoradiotherapy. Methods: Peripheral blood samples from 250 patients who were treated with chemoradiotherapy were used for this study. Patients were diagnosed as a stage of I in 12 (5%), II in 54 (21%), III in 115 (46%) and IV in 69 (28) patients. All of the patients were received chemotherapy using cisplatin and fluorouracil or docetaxel. Results: The overall response was 85%, with 21% complete response and 64% partial response. The overall survival (stage II, 34months; stage III, 23.3 months; stage IV, 19.3 months, p=0.005) and progression survival (stage II, 23.8 months; stage III, 12.8 months; stage IV, 9 months, p=0.001) was significantly improved according to stage. In FGFR4 genotypic analysis, 96 patients (38.6%) were homozygous for Gly388 allele, with 113 heterozygous (45.4%) and 40 (16.0) homozygous for Arg388 allele. There was no significant association between FGFR4 genotype and stage. However, Gly388 allele patients show better overall response rate (90.6%) than Arg388 carriers (82.4%, p=0.050). In early stage (I, II, n=66), Gly388 allele patients tendted to have a better OS (p=0.898) or PFS (p=0.597) than Arg388 carriers. However, in advanced stage (III, IV), the survival outcomes was similar between genotypes. Conclusions: Present study shows that FGFR4 Gly388 allele has a prognostic role in response after chemoradiotherapy in esophageal cancer. Especially in early stage of esophageal cancer, FGFR4 might have an important role in disease progression and survival outcomes. It suggests that the possibility of new therapeutic target for esophageal cancer treatment.

Stage and histology influence the relationship between MDM2 promoter polymorphism and esophageal cancer and overall survival (OS)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 21047-21047
Author(s):  
H. J. Mackay ◽  
P. Bradbury ◽  
K. Asomaning ◽  
W. Zhou ◽  
M. Kulke ◽  
...  
Keyword(s):  
Overall Survival ◽  
Esophageal Cancer ◽  
Early Stage ◽  
Disease Stage ◽  
Advanced Stage ◽  
Mdm2 Snp309 ◽  
Prognostic Role ◽  
Histologic Subtype ◽  
The Relationship

21047 Background: A single nucleotide polymorphism in the MDM2 promoter (SNP309) has been found to affect OS of advanced stage gastric adenocarcinoma (AD) and early stage squamous (SQ) cell carcinoma of the lung. The aim of this study was to evaluate the role of this polymorphism in the prognosis of esophageal cancer, another aerodigestive cancer. Methods: 150 early stage (E) and 118 locally advanced stage (LA) esophageal cancers were genotyped for MDM2 SNP309 using Taqman. The primary endpoint was overall survival (OS). Results: E disease: n=23 stage I; n=127 stage II. LA disease: n=93, Stage III; n=25, Stage IVA. AD comprised 215 (81%), while SQ comprised 45 (17%) of cases; 8 (3%) had poorly differentiated tumors. Median follow-up = 32 months. Median OS were 36 and 21 months for E and LA disease, respectively. Both histology and disease stage affected the relationship between SNP309 and esophageal cancer OS (see Table ). The wildtype T/T genotype conferred a worse OS in E patients (log-rank, p=0.03), especially those with AD (log-rank, p=0.003). In Cox proportional hazards interaction analyses, after adjusting for age, gender, stage and PS, there were statistically significant interactions between MDM2 SNP309 and disease stage (interaction p=0.004) and between MDM2 SNP309 and histologic subtype (AD vs. SQ)(interaction p=0.02). Thus, the direction of SNP309 association from our AD and E esophageal cancer patients are opposite to those of our SQ and LA esophageal cancer patients. However, our SQ and LA results are similar to the SQ lung cancer and advanced stage gastric cancers previously reported. This suggests that biologic mechanisms underpinning the prognostic role of SNP309 are dependent on extent of disease and histologic subtype. Conclusion: Histology and disease stage interact with the prognostic role of MDM2 SNP309 polymorphism in esophageal cancer OS. [Table: see text] No significant financial relationships to disclose.

Microsatellite instability as a prognostic factor in stadium II colon cancer patients. A meta-analysis of published literature.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15075-e15075
Author(s):  
Jan Novotny ◽  
Ioannis Gkekas ◽  
Ladislav Pecen ◽  
Karin Strigard ◽  
Richard Palmquist ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Microsatellite Instability ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Stage Ii ◽  
Survival Outcomes ◽  
Prognostic Role ◽  
Hazard Ratios ◽  
Stage Ii Colon Cancer

e15075 Background: The prognostic role of microsatellite instability (MSI) in stage II colon cancer patients remains controversial despite it has been investigated in a number of studies. Hazard ratios differ considerably among these studies. We performed a meta-analysis to define the significance of MSI in this group of patients. Methods: Studies indexed in PubMed presenting separate data on MSI status and survival outcomes for stage II colon cancer patients have been analyzed using fixed-effect meta-analysis of hazard ratio according to the method of Peto. Results: Analysis was performed on 19 studies including 5998 patients. 47.2% patients received postoperative chemotherapy, 52.8% were males and 47.2% females. Eight studies included also rectal cancer patients. MSI was detected in 20.8 % of the patients. Hazard ration (HR) for overall survival (OS): MSI vs MSS for the entire population: 0.73 (95% confidence interval (CI): 0.33-1.65); HR for disease free survival (DFS): 0.60 (95% CI: 0.27-1.32). No statistical significant difference was found when comparing studies analyzing MSI with genotyping (MG) and immunohistochemistry (IHC) (MG vs IHC: HR OS 0.45, 95% CI 0.10-2.05 vs. 0.95, 95% CI 0.57–1.58; HR DFS 0.51, 95% CI: 0.14-1.85 vs. 0.67, 95% CI 0.26-1.70). However, numerically MSI determination with genotyping shows remarkably lower hazard ratios (further from HR equal to one) for both OS and DFS. Separate analysis of studies investigating colon cancer patients only showed HR OS 0.72 (95% CI: 0.31-1.71); HR DFS 0.60 (95% CI: 0.27-1.31). Conclusions: This is the first meta-analysis that evaluates the prognostic role of MSI in the well defined population of colon cancer patients with stage II disease. No significant relation was found between MSI status and various survival outcomes. Routine determination of MSI status to guide postoperative management of stage II colon cancer patients cannot be recommended based on the presently included studies. This study was supported from the unrestricted grant of Cancerforskningsfonden i Norrland/Lions Cancerforskningsfond LP 14-2065 and Akademisk Miljö NLL-576531.

The prognostic role of PD-L1 expression according to MSI status in stage III colon cancer after curative resection.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 555-555 ◽  
Author(s):  
Sang-Hee Cho ◽  
Jun Eul Hwang ◽  
Woo Kyun Bae ◽  
Ik-Joo Chung
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Curative Resection ◽  
Stage Iii ◽  
Survival Outcomes ◽  
Prognostic Role ◽  
Stage Iii Colon Cancer ◽  
Significant Difference ◽  
Resected Stage

555 Background: Tumors expressing PD-L1 can render immune inactivated via triggering of PD-1 receptor on T cells with various pathways. Based on these mechanism, the blockade PD-1/PD-L1 pathway based been used as a therapeutic target for metastatic CRC. In the present study, we evaluated the prognostic role of PD-L1 expression associated with microsatellite status in surgically resected stage III colon cancer patients. Methods: PD-L1 expression was performed by immunohistochemistry from 182 stage III colon cancer patients after curative resection. Using the immunohistochemical stain, percentages of PD-L1 positive tumor cells and staining intensity were evaluated and categorized as ‘strong’ and ‘weak’ positive group. Clinical and histopathologic parameters including of MSI status and survival outcomes were analyzed with IDO expression which stands for the suppressive immune environment. Results: Strong PD-L1 expression was observed in 29% of all patients. PNI and lymphocyte response response were more frequently shown in strong PD-L1 patients. Among these patients, MSI was shown in 23 patients (12%). Although there was no significant difference between MSI and PD-L1 status, strong PD-L1 tended to better OS in MSS colon cancer (P = 0.056). In contrast, strong PD-L1 expression significantly correlated with significantly worse prognosis in disease free survival (P = 0.001) and overall survival (P < 0.001) than weak PD-L1 expression inMSI patients regardless of adjuvant chemotherapy. In MSI patients, the strong IDO expression was tended to be more frequently shown in strong PD-L1 expression patients (36.4%) than weak PD-L1 expression patients (14.3%). Conclusions: The expression of PD-L1 is differently affected on the survival according to the status of microsatellite. There is no significant relationship between the expression of PD-L1 and prognosis in MSS stage III colon cancer patients. However, in MSI colon cancer which has been well known as a highly immunogenic property, strong PD-L1 expression is significantly associated with poor prognosis on survival outcomes reflecting of immunosuppressive microenvironment in curative resected stage III colon cancer patient.

scholarly journals Geochemical Characteristics of Mineral Assemblages from the Yamansu Iron Deposit, NW China, and Their Metallogenic Implications

Minerals ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 39 ◽  
Author(s):  
Zhiyuan Sun ◽  
Jingbin Wang ◽  
Yuwang Wang ◽  
Lingli Long
Keyword(s):  
Early Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Oscillatory Zoning ◽  
Stage Iii ◽  
Iron Deposit ◽  
Nw China ◽  
Mineral Assemblages ◽  
Geochemical Analyses

The Yamansu deposit, which is hosted in the volcanic-sedimentary sequence of the Carboniferous Yamansu Formation in Eastern Tianshan, NW China, contains many skarns, and the orebodies occur in the ore district in stratoidal, banded or lenticular forms. Four alteration stages, namely, albite–tourmaline–apatite–Grt1 (Stage I), K-feldspar–Grt2 (Stage II), magnetite–chlorite–epidote (Stage III), and quartz–calcite–axinite–Grt3 (Stage IV), are distinguished in the Yamansu deposit. The mineral geochemistry associated with each different stage is presented to provide a better understanding of the corresponding metallogenic processes. The ore-forming fluid in Stage I was derived from a magmatic–hydrothermal source and formed at high temperatures with many volatiles. This ore-forming fluid, which contained considerable metallogenic materials during the early stage, likely experienced diffusive metasomatism in a closed system with low water/rock (W/R) ratios. Mineral geochemical analyses show that the Fe content gradually increases from Stage I to Stage II, indicating that accumulated ore-forming materials were available during changes in the physicochemical conditions from a reducing environment with neutral pH to oxidizing conditions with mildly acidic pH. During the main metallogenic stage (Stage III), mineral assemblages reflect moderate- to high-temperature conditions, and the ore-forming fluid was created and destroyed periodically; the magnetite ores were deposited in a fluctuating fluid system. The multilayered orebodies, multigenerational garnets, and minerals with oscillatory zoning indicate that the ore-forming fluid may have developed periodic fluctuations, and this special multistage fluctuation of the hydrothermal fluid in the Yamansu deposit was the key factor controlling the multiple extraction, enrichment and precipitation of metallogenic materials.

Which side is better? The impact of primary tumor side in early stage colorectal cancer (CRC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15106-e15106
Author(s):  
Margaret Lee ◽  
Andrew Mackinlay ◽  
Christine Semira ◽  
Antonio Jose Jimeno ◽  
Belinda Lee ◽  
...  
Keyword(s):  
Adjuvant Therapy ◽  
Primary Tumor ◽  
Early Stage ◽  
Stage Iv ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Early Stage Disease ◽  
Stage Iv Disease ◽  
The Impact

e15106 Background: Multiple studies have indicated the prognostic and potential predictive significance of primary tumor side in metastatic CRC. To date, the few studies examining its impact in early stage disease have either combined data across multiple stages or restricted analysis to overall survival (OS) data. A by stage analysis of the impact of tumor side on recurrence risk is critical if it is to impact adjuvant therapy decisions. Methods: We examined data from a multi-site Australian registry of consecutive patients diagnosed from 2003-2016. Tumors at and distal to the splenic flexure, including the rectum, were considered a left primary (LP). Rectal patients treated with initial chemoradiation were excluded. Clinico-pathologic and outcome data were examined. Data analysis was provided by the healthcare group at IBM Research Australia. Results: A total of 6123 patients were identified, of which 1046 (17.1%) had initial stage I, 1892 (30.9%) had stage II, 1708 (27.9%) had stage III, and 1477 (24.1%) had stage IV disease. Most patients were male (55.2%), and had a LP (n = 3818, 62.4%). Median age at diagnosis was 68.8 years, was higher in patients with a right primary (RP) (71.6 versus 67.0 years for LP, p < 0.001), with more females in the RP group (51.1% vs 41.0% for LP, p < 0.001). The proportion of RP varied by stage, highest in stage II (44.9%), lowest in stage IV (31.5%). For all stage IV disease, including metachronous cases, OS was worse with a RP (HR 1.32, 95% CI 1.14-1.53). For early stage cases, distant recurrence free survival (DRFS) was similar for RP vs LP for stage I (HR 0.63, 95% CI 0.32-1.23), better for stage II RP (HR 0.72, 95% CI 0.55-0.95) and worse for stage III RP disease (HR 1.22, 1.01-1.48). OS did not differ for RP vs LP for stage I or II disease, but was worse for stage III disease with a RP (HR 1.39, 95% CI 1.13-1.70). Furthermore, post recurrence survival was poorer in stage III RP disease (HR 1.61, 95% CI 1.33-1.96). Conclusions: Primary tumor side has potential as an important prognostic marker in early stage CRC. Our novel finding of a variable impact by stage indicate that an assessment of cohorts where recurrence data is available is critical to fully understanding the implications of tumor side for adjuvant therapy decision making.

Evaluation of the Safety of Ovarian Preservation at Early Stage of Endometrial Cancer in Premenopausal Women

2021 ◽  
Author(s):  
Elham Shirali ◽  
Mitra Modarres Gilani ◽  
Fariba Yarandi ◽  
Omid Hemmatian ◽  
Azar Ahmadzadeh ◽  
...  
Keyword(s):  
Endometrial Cancer ◽  
Early Stage ◽  
Stage Iv ◽  
Premenopausal Women ◽  
Stage Ii ◽  
Stage Iii ◽  
Cross Sectional ◽  
Ovarian Preservation ◽  
Stage Ib ◽  
Stage Ia

Background: Endometrial cancer usually occurs at postmenopause stage of life but its incidence in younger patients is increasing in the last decades. The objective of the study was to evaluate the ovarian preservation in the early stage of endometrial cancer. Methods: In this cross-sectional study, 174 patients with endometrial cancer who underwent Total Abdominal Hysterectomy (TAH) and Bilateral Salpingo-oophorectomy in 5 years were included. Results: The results showed that 51.1% of the patients were at stage IA, 28.7% at stage IB, 6.9% at stage II, 11.5% at stage III and 1.7% at stage IV of endometrial cancer when they underwent surgery. One patient (1.12%) at stage IA of endometrial cancer, one patient (2%) at stage IB and one patient (8.3%) at stage II had micrometastasis in ovaries, and 8 patients (40%) at stage III and 2 patients (66.6%) at stage IV had micrometastasis and co-existing tumor. Conclusion: In conclusion, findings revealed the high safety of ovarian preservation in endometrial cancer at earlier stages of the endometrial cancer with low risk of ovarian involvement.

scholarly journals SAT-169 Adrenocortical Cancer Is Diagnosed at Large Size and Advanced Stage in a Canadian Referral Center; Focus on Modes of Presentation Depending on Stages

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jonathan Poirier ◽  
Catherine Alguire ◽  
Nadia Gagnon ◽  
Mathieu Latour ◽  
André Lacroix ◽  
...  
Keyword(s):  
Tumor Size ◽  
Early Stage ◽  
Stage Iv ◽  
Initial Diagnosis ◽  
Stage Ii ◽  
Stage Iii ◽  
Disease Stage ◽  
Referral Center ◽  
Modes Of Presentation ◽  
Mode Of Presentation

Abstract Context: Adrenocortical carcinoma (ACC) is a rare tumor with an incidence of 0.7-2 per million. Based on the ENSAT staging classification, tumor stage is the most important prognostic factor; the presence of lymph nodes involvement and metastases is an indicator of poor prognosis. Absence of any local or distant tumor invasion represents an early stage disease and is classified based on tumor size of &lt;5 cm (stage I) or &gt;5 cm (stage II). Advanced disease is confirmed if there is tumoral invasion, either locally in the surrounding tissues/nodes (stage III) or in other organs/vascular structures (stage IV). Objective: To describe patient characteristics, staging and modes of presentation at initial diagnosis in our cohort of ACC patients. Methods: We retrospectively reviewed paper and electronic charts of patients with pathology-confirmed ACCs who were treated at our referral center from 1995 to May 2019. Results: One hundred four patients were diagnosed with ACC: 28 were men (26.9%) and 76 (73.1%) were women and median age was 51 years. The overall modes of presentation were hormonal hypersecretion (40.4%), mass-related symptoms (36.5%), incidentalomas (17.3%) and unknown (1.9%). Hormonal profile was available for 71 tumors: 67,6 % were secreting [androgen and cortisol co-secretion (39.4%), cortisol only (28.2%)] and 18,3% were non-secreting. At initial diagnosis, sixty-four patients (61.5%) had tumors &gt;10 cm including 32.7% between 10-14.9 cm (n:34), 19.2% were 15-20 cm (n:20) and 9.6% were &gt;20cm (n:10). Initial ENSAT stages were I (6.7%), II (17.3%), III (28.8%) and IV (44.2%) and unknown (2,9%). The age repartition was similar for most patients (median ~50 yo) regardless of disease stage or tumor size except in the subgroup of very large tumors (&gt;20 cm) for which the median age was 40 yo. The mode of presentation at initial diagnosis varied at various stages. Incidentaloma was a frequent mode of presentation of earlier ACC stages; Stage 1: 3/7 (42,9%), stage II: 7/18 (38,9%), stage III: 4/30 (13,3%) and stage IV: 4/46 (8,7%). Hormonal excess symptoms led to ACC diagnosis less frequently in early stages (stages I and II) (24%) than in later stages (stage III and IV) (47,3%), while the hormonal work up showed high prevalence of secreting tumors in both groups (58,8% and 88,7%). Mass-related initial symptoms were similar in both groups 36% vs 39%. Conclusions: In our cohort, 61.5% of ACC tumors were larger than 10 cm at initial diagnosis. Seventy-three percent of ACC patients had an advanced ENSAT stage III or IV disease which is associated with a 5 years survival of less than 50%. Incidentalomas is a frequent mode of presentation in stages I and II, while clinical hormonal excess symptoms were more frequent in later stages III and IV. Early stage diagnosis presents a difficult challenge in ACC and new biomarkers are needed to improve the odds against this deadly cancer.

Carboplatin and chlorambucil combination chemotherapy as treatment for patients with ovarian cancer

1994 ◽  
Vol 4 (1) ◽  
pp. 66-71
Author(s):  
B. D. Evans ◽  
P. Chapman ◽  
P. Dady ◽  
G. Forgeson ◽  
D. Perez ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Small Volume ◽  
Residual Disease ◽  
Stage Iv ◽  
Complete Response ◽  
Stage Ii ◽  
Stage Iii ◽  
Actuarial Survival ◽  
Moderate Volume ◽  
Grade Iii

Fifty-six patients with ovarian cancer (three stage IC, nine stage II, 33 stage III and II stage IV) were treated with carboplatin 350 mg m−2 i.v. day 1 and chlorambucil orally 0.15 mg kgm−1 days 1–7 inclusive, repeated every 28 days for eight courses. The regimen was well tolerated and was virtually free of nephro- and neurotoxicity. Grade III or IV hematology toxicity occurred in 18 patients but only 31 or 330 courses administered were delayed. Of 40 assessable patients eight achieved a clinical/radiologic complete response and 17 a clinical/radiologic partial response. Actuarial survival at 50 months was 65% for stage II patients, 27% for stage III patients and no stage IV patients survived beyond 20 months. Forty-two per cent of patients with residual disease less 2 cm survived 50 months, compared with 44% of patients with moderate volume (2–5 cm) residual disease and 6% of patients with bulk residual disease. This is an active, well tolerated regimen. However, only patients with small volume residual disease have a significant chance of prolonged survival.

scholarly journals The gravireceptor of Phycomyces. Its development following gravity exposure.

1984 ◽  
Vol 84 (6) ◽  
pp. 845-859 ◽  
Author(s):  
D S Dennison ◽  
W Shropshire
Keyword(s):  
Spatial Relationship ◽  
Stage Iv ◽  
Development Stage ◽  
Stage Ii ◽  
Stage Iii ◽  
Mature Stage ◽  
Early Exposure ◽  
Altered Gravity

The gravitropism of a mature stage IV Phycomyces sporangiophore has a shorter and more uniform latency if the sporangiophore is exposed horizontally to gravity during its earlier development (stage II and stage III). This early exposure to an altered gravitational orientation causes the sporangiophore to develop a gravireceptor as it matures to stage IV and resumes elongation. A technique has been developed to observe the spatial relationship between the vacuole and the protoplasm of a living sporangiophore and to show the reorganization caused by this exposure to altered gravity. Possible gravireceptor mechanisms are discussed.

scholarly journals Clinicopathological Profile of Wilms’ Tumour in Children

2014 ◽  
Vol 32 (1) ◽  
pp. 5-8
Author(s):  
M Mazumder ◽  
A Islam ◽  
N Farooq ◽  
M Zaman
Keyword(s):  
Wilms Tumor ◽  
Stage Iv ◽  
Abdominal Distension ◽  
Stage Ii ◽  
Stage Iii ◽  
Wilms Tumour ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Clinicopathological Profile ◽  
Treatment Objective

Introduction: Wilms’ tumor is the most common primary malignant renal tumor of childhood. It is important to pick up the children with wilms’ tumor earlier as early stages has excellent outcomes after treatment. Objective : To find out the common clinical presentations and pathological profile of Wilms’ tumor in children. Methods and Materials : A hospital based prospective study done with twenty diagnosed patients of Wilms tumour enrolled from department of Pediatric haemato-oncology, BSMMU, Dhaka in the period between January to December 2008. Results- The peak incidence of Wilms’ tumor was in 1 to 5 years age group (80%,n=16). Median age at presentation was 49 months with male: female ratio 1.8:1.The most common presentation was abdominal swelling (80%,n=16),followed by flank mass (75%,n=15), abdominal pain (55%,n=11), haematuria (15%,n=3), hypertension (10%,n=2). Thirteen raised from right kidney, ratio of right to left involvement 1.8:1. Histologically 13(65%) patients had triphasic histology having blastemal, stromal and epithelial elements, 7(35%) was biphasic having blastema and epithelia. All had favourable histological pattern. Most patients presented in stage III (55%,n=11) followed by stage II (25%,n=5), Stage IV(10%,n=2), Stage I(10%,n=2). No bilateral presentation. Conclusions : Most of the patients of Wilms’ tumor presented within 1 to 5 years of age(80%) with abdominal distension(80%) and flank mass(75%), few associated with haematuria(15%) and hypertension(10%). Histologically all were favourable and maximum presented in stage III (55%) followed by stage II(25%). DOI: http://dx.doi.org/10.3329/jbcps.v32i1.21015 J Bangladesh Coll Phys Surg 2014; 32: 5-8

Sign in / Sign up

Export Citation Format

Share Document