Role of staging laparoscopy in upstaging CT findings and influencing treatment decisions in gastric cancers

Background: It is estimated that 990000 new gastric cancer (GC) cases occur in the world annually. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination and to determine the influence of staging laparoscopy on treatment decisions in gastric cancers.Methods: This was a prospective study conducted in a tertiary care hospital between August 2014 and February 2016. Thirty patients out of a series of 60 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted.Results: The strengths of agreement between the CT stage and the final histopathological stage were Kw- 0.314 (95% confidence interval [CI]; 0.03-0.66; P≥0.0001) for T stage and 0.00 (95% CI; 0.0-0.00) for M stage, compared with 0.668 (95% CI; 0.39-0.98; P≥0.0001) and 1.00 (95% CI; 1.0-1.0; P≥0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 12 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT.Conclusions: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT and influences treatment decision making apart from preventing unnecessary laparotomies

'Template-free' hierarchical MoS<inf>2</inf>foam as a sustainable 'green' scavenger of heavy metals and bacteria in point of use water purification

Molybdenum disulfide (MoS2), with its unique optical and electrical properties, has been explored for a variety of applications in the recent past. Still, its capabilities in point-of-use heavy metal ion removal remain to be explored. Herein, for the first time using a facile approach, we fabricated three-dimensional (3D) MoS2 foam from exfoliated single to few-layered MoS2 sheets for the selective exclusion of heavy metals and stringent bactericidal response. This foam was able to exclude 99.9% of Pb(ii) and 98.7% of As(iii) instantaneously and reduced more than 98% of bacteria E. coli. Moreover, the foam exhibits selective toxicity towards bacterial cells while showing no observable toxicity towards mammalian cells. The foam can be recycled and reused for at least five cycles under accelerated conditions and thus can be used for a promising non-cytotoxic, facile, and environmentally benign process for inline water remediation to remove heavy metal ions from the feed and as a potential antibacterial agent

Towards a constraint-based multi-agent approach to complex applications

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN040840 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Analysis and evaluation of Sri Lanka's Ceiling on Housing Property Law

ThesisThesis, 1977Thesis (M.Eng.), Asian Institute of Technology, 1977PhotocopyThesis on housing and land reform in the urban areas of Sri Lanka. Discusses the effects of the restriction of private land ownership on land tenure particularly in the low income groups and on slum landlordism; violations by landowners, administrative aspects, legal aspects, social implications. Includes text of the legislation

RUNGE-KUTTA METHOD FOR FUZZY VOLTERRA INTEGRO-DIFFERENTIAL EQUATIONS

In this work, we use Runge-Kutta method of order four for solving of fuzzy Volterra integro-differential equations (FVIDE). We give some numerical examples to illustrate the theor

Role of staging laparoscopy in upstaging CT findings and influencing treatment decisions in gastric cancers

Background: It is estimated that 990000 new gastric cancer (GC) cases occur in the world annually. The aim of this study was to examine the accuracy of laparoscopy in staging patients with gastric cancer in comparison with preoperative computed tomography (CT) examination and to determine the influence of staging laparoscopy on treatment decisions in gastric cancers.Methods: This was a prospective study conducted in a tertiary care hospital between August 2014 and February 2016. Thirty patients out of a series of 60 patients with gastric adenocarcinoma underwent a preoperative staging CT followed by a staging laparoscopy. The strengths of the agreement between the CT stage, the laparoscopic stage, and the final histopathological stage were determined by the weighted Kappa statistic (Kw). The number of patients with treatment decision-changes was counted.Results: The strengths of agreement between the CT stage and the final histopathological stage were Kw- 0.314 (95% confidence interval [CI]; 0.03-0.66; P≥0.0001) for T stage and 0.00 (95% CI; 0.0-0.00) for M stage, compared with 0.668 (95% CI; 0.39-0.98; P≥0.0001) and 1.00 (95% CI; 1.0-1.0; P≥0.0001) for the laparoscopic T and M stages, respectively. Unsuspected metastases that were not detected by CT, were found in 12 patients at laparoscopy, all of whom had T3 or T4 locally advanced tumors evident on CT.Conclusions: Preoperative laparoscopic staging of gastric cancer is indicated for potential surgical candidates with locally advanced disease in the absence of metastases on CT and influences treatment decision making apart from preventing unnecessary laparotomies

Uncommon presentation of hypereosinophilic syndrome

The hypereosinophilic syndrome is a group of diseases characterised by persistent blood eosinophilia, defined as more than 1500 cells per micro liter [1], with end-organ involvement and no recognised secondar