Effective optical identification of type "0-IIb" early gastric cancer with narrow band imaging magnification endoscopy, successfully treated by endoscopic submucosal dissection

Background Endoscopic submucosal dissection (ESD) is currently considered the minimal invasive endoscopic treatment for early gastric cancer. Most superficial gastric neoplastic lesions are depressed type ”0-IIc” (70-80%), while totally flat, classified as type ”0-IIb” early gastric cancer, is rarely reported (0.4%). The aim of the present study was to assess the efficacy of narrow band imaging (NBI) magnification endoscopy in identifying type “0-IIb” early gastric cancer and ESD treatment with curative intention.Methods Twelve of 615 (2%) patients (10 males, median 72 years), treated by ESD at our center, were diagnosed as type “0-IIb” gastric cancer. Ten had exclusively type “0-IIb”, while two had combined types “0-IIb+IIc” and “0-IIa+IIb” gastric cancer. Initial diagnosis was made during screening gastroscopy, while NBI magnification endoscopy combined with indigo-carmine chromoendoscopy were also used.Results White light endoscopy showed only superficial redness. One patient with signet-ring carcinoma showed whitish appearance. Indigo-carmine chromoendoscopy showed better visualization, while NBI magnification endoscopy revealed abnormal mucosal microsurface and microvascular findings which enabled border marking. ESD with curative intention was completed without complications. Histological examination showed complete (R0) resection, in 10 patients (83%). One patient with positive margins received additional surgery (8%). Mean procedure time was 149 (range 60-190) min. One to six years post-ESD all patients remain alive.Conclusions ESD is considered a safe and effective curative treatment for type “0-IIb” gastric cancer, resulting in long-term disease-free survival. NBI magnification endoscopy is effective for accurate optical identification and border marking of type “0-IIb” early gastric cancer

A new method to retrieve the real part of the equivalent refractive index of atmospheric aerosols

This document is the Accepted Manuscript version of the following article: S. Vratolis, et al, ‘A new method to retrieve the real part of the equivalent refractive index of atmospheric aerosols’, Journal of Aerosol Science, Vol. 117: 54-62, March 2018. Under embargo until 29 December 2019. The final, published version is available online at DOI: https://doi.org/10.1016/j.jaerosci.2017.12.013.In the context of the international experimental campaign Hygroscopic Aerosols to Cloud Droplets (HygrA-CD, 15 May to 22 June 2014), dry aerosol size distributions were measured at Demokritos station (DEM) using a Scanning Mobility Particle Sizer (SMPS) in the size range from 10 to 550 nm (electrical mobility diameter), and an Optical Particle Counter (OPC model Grimm 107 operating at the laser wavelength of 660 nm) to acquire the particle size distribution in the size range of 250 nm to 2.5 μm optical diameter. This work describes a method that was developed to align size distributions in the overlapping range of the SMPS and the OPC, thus allowing us to retrieve the real part of the aerosol equivalent refractive index (ERI). The objective is to show that size distribution data acquired at in situ measurement stations can provide an insight to the physical and chemical properties of aerosol particles, leading to better understanding of aerosol impact on human health and earth radiative balance. The resulting ERI could be used in radiative transfer models to assess aerosol forcing direct effect, as well as an index of aerosol chemical composition. To validate the method, a series of calibration experiments were performed using compounds with known refractive index (RI). This led to a corrected version of the ERI values, (ERICOR). The ERICOR values were subsequently compared to model estimates of RI values, based on measured PM2.5 chemical composition, and to aerosol RI retrieved values by inverted lidar measurements on selected days.Peer reviewe

Distribution of surficial sediments in the Southern Evoikos and Petalioi Gulfs, Greece

A series of 123 surficial sediment samples from the Southern Evoikos and Petalioi Gulfs was studied for grain-size properties, carbonate content and mineralogical composition. Distribution of the sediments revealed two sedimentary provinces. The first concerns the Southern Evoikos Gulf, characterised by silty sediments with relatively low carbonate content. Quartz, feldspars, micas, clay and carbonate minerals are the major mineralogical components of the sediments. These sediments are the result of the Asopos River supply during Holocene and they contribute to the formation of smooth bottom morphology. The second province concerns the Petalioi Gulf (Northern and Southern), where the surficial sediments are mainly sandy and characterised by very high carbonate content. Their mineralogical composition reflects the lithology of the drainage basin. Since the modern terrigenous solid supply is limited, these sediments are not considered as products of recent sedimentation, but older deposits (relict sands). Their presence at such depths is justified by sea-level fluctuations and their preservation is due to the low sedimentation rate in the Petalioi Gulf, in combination with the strong hydrodynamic status of the area

Mesoscale modeling of combined aerosol and photo-oxidant processes in the Eastern Mediterranean

International audienceParticulate matter and photo-oxidant processes in the Eastern Mediterranean have been studied using the UAM-AERO mesoscale air quality model in conjunction with the NILU-CTM regional model. Meteorological data were obtained from the RAMS prognostic meteorological model. The modeling domain includes the eastern Mediterranean area between the Greek mainland and the island of Crete. The modeling system is applied to study the atmospheric processes in three periods, i.e. 13?16 July 2000, 26?30 July 2000 and 7?14 January 2001. The spatial and temporal distributions of both gaseous and particulate matter pollutants have been extensively studied together with the identification of major emission sources in the area. The modeling results were compared with field data obtained in the same period. The objective of the current modeling work was mainly to apply the UAM-AERO mesoscale model in the eastern Mediterranean in order to assess the performed field campaigns and determine that the applied mesoscale model is fit for this purpose. Comparison of the modeling results with measured data was performed for a number of gaseous and aerosol species. The UAM-AERO model underestimates the PM10 measured concentrations during summer and winter campaigns. Discrepancies between modeled and measured data are attributed to unresolved particulate matter emissions. Particulate matter in the area is mainly composed by sulphate, sea salt and crustal materials, and with significant amounts of nitrate, ammonium and organics. During winter the particulate matter and oxidant concentrations were lower than the summer values

BIM enabled optimisation framework for environmentally responsible and structurally efficient design systems

The present research investigates the potential for reducing the environmental impacts of structural systems through a more efficient use of materials. The main objective of this research is to explore and to develop a holistic and integrated methodology that utilises Building Information Modelling's (BIM) capabilities combined with structural analysis and Life Cycle Assessment (LCA) as well as a two-staged structural optimisation solver that achieves efficient and environmentally responsible steel design solutions. The implemented workflow utilises Autodesk Revit-BIM, Tally-LCA and Autodesk Robot-Structural Analysis. RobOpt is the plug-in that has been established using the Application Programming Interface (API) of Robot and the .NET framework of C?, and it inherits several structural functionalities based on Robot Finite Element Method (FEM) engine. The proposed RobOpt application can be accessed via a graphic user interface (GUI) within the Robot software. The developed BIM-enabled optimisation methodology could be utilised as a design tool to inform early stage structural design solutions. A prototypical steel framed structural system under certain loads has been explored. The resulting bespoke I-beam sections from the custom genetic algorithm (GA) optimisation demonstrate that significant savings-up to 21%-can be achieved in all tested environmental indicators when compared to the standard UK catalogue of steel sections. Considering all, the proposed framework constitutes a useful and an intuitive workflow, which aims to quantify the environmental savings of structural systems by utilising, advanced computational analysis and common construction techniques

Characterisation of Airborne Particulate Matter in Different European Subway Systems

Air quality sampling campaigns in three European subway systems (Barcelona, Athens and Oporto) were conducted in order to characterise particulate matter (PM) to better understand the main factors controlling it. PM mass concentrations varied among the European subway platforms, and also within the same underground system, this being mainly associated to differences in the design of the stations and tunnels, system age, train frequency, ventilation and air‐conditioning systems, commuter\u27s density, rails geometry and outdoor air quality. PM concentrations displayed clear diurnal patterns, depending largely on the operation and frequency of the trains and the ventilation system. Chemically, subway PM2.5 on the platforms consisted of iron, carbonaceous material, crustal matter, secondary inorganic compounds, insoluble sulphate, halite and trace elements. Fe was the most abundant element, accounting for 19–46% of the bulk PM2.5, which is generated mainly from mechanical wear at rail‐wheel‐brake interfaces. A source apportionment analysis allowed the identification of outdoor (sea salt, fuel‐oil combustion and secondary aerosol) and subway sources on platforms. The use of air‐conditioning inside the trains was an effective approach to reduce exposure concentrations, being more efficient removing coarser particles. PM concentrations inside the trains were greatly affected by the surrounding (i.e. platforms and tunnels) air quality conditions

The safety and efficacy of intravenous ferric carboxymaltose in anaemic patients undergoing haemodialysis: a multi-centre, open-label, clinical study

Background. Patients with chronic kidney disease (CKD) often present with iron depletion and iron deficiency anaemia (IDA) because of frequent blood (and iron) loss. Therapy consists of repletion of iron stores and intravenous (i.v.) iron has become the standard care in this setting. However, older i.v. iron preparations have their limitations. This study primarily investigated the safety, and also the efficacy, of ferric carboxymaltose (FCM), a next-generation i.v. iron formulation, given as a bolus–push injection in patients with CKD undergoing maintenance haemodialysis (HD)

Percutaneous endoscopic gastrojejunostomy for a patient with an intractable small bowel injury after repeat surgeries: a case report

<p>Abstract</p> <p>Introduction</p> <p>The management of intestinal injury can be challenging, because of the intractable nature of the condition. Surgical treatment for patients with severe adhesions sometimes results in further intestinal injury. We report a conservative management strategy using percutaneous endoscopic gastrojejunostomy for an intractable small bowel surgical injury after repeated surgeries.</p> <p>Case presentation</p> <p>A 78-year-old Japanese woman had undergone several abdominal surgeries including urinary cystectomy for bladder cancer. After this operation, she developed peritonitis as a result of a small bowel perforation thought to be due to an injury sustained during the operation, with signs consistent with systemic inflammatory response syndrome: body temperature 38.5°C, heart rate 92 beats/minute, respiratory rate 23 breaths/minute, white blood cell count 11.7 × 10⁹/L (normal range 4-11 × 10⁹/μL). Two further surgical interventions failed to control the leak, and our patient's clinical condition and nutritional status continued to deteriorate. We then performed percutaneous endoscopic gastrojejunostomy, and continuous suction was applied as an alternative to a third surgical intervention. With this endoscopic intervention, the intestinal leak gradually closed and oral feeding became possible.</p> <p>Conclusion</p> <p>We suggest that the technique of percutaneous endoscopic gastrojejunostomy combined with a somatostatin analog is a feasible alternative to surgical treatment for small bowel leakage, and is less invasive than a nasojejunal tube.</p