Early esophagical squamous cancer, endoscopic and histological aspects: clinical case

Introducere. Cancerul esofagian precoce este definit ca neoplazia limitată la mucoasă sau submucoasă și fără răspândire limfatică sau metastază la distanță. La 31% dintre pacienți cancerul esofagian, conform studiilor publicate, poate fi depistat precoce, inclusiv in situ. Caz clinic. Pacient bărbat, vârsta 65 ani, acuză discomfort la deglutiție, episoade de pirozis, eructații. Raport endoscopic descriptiv: La distanta de 32-36 cm de la incisivi, în segmentul toracic distal al esofagului, se determină o arie bine delimitată, formă neregulată, diferență clară de culoare (roșie-maro neuniformă după intensitate), conturată de mucoasă esofagiană tipică roz-pală. În regim de endoscopie 125x magnificație optică și NBI (GIF XZ1200 Evis X1 Olympus, Japan) – leziune de 35 x 20 mm, plană (0-IIb, Paris 2002), demarcatie de culoare, bine delineată vascular: vascular pattern - multiple anse capilare intrepiteliale (IPCL) deformate (dilatare neuniformă, șerpuire, calibru neregulat și variația figurii), Inoue model IPCL-V2, delineație foveolară nesemnificativă în regimurile endoscopice folosite. Concluzie endoscopică: Leziune neoplazica intraepitelială plană (0-IIb, Paris 2002), suspiciu pentru cancer precoce, scuamos, esofagian. Forceps biopsie optic ghidată, 3 fragmente din ariile cu schimbări majore. Raport patologic descriptiv: macroscopic - fragmente bioptice dimensiuni 0,2-0,3 cm, culoare roz-pală; microscopic - fragmente din mucoasa esofagiană, acoperită cu epiteliu stratificat scuamos nekeratinizat hiperplaziat, zonal cu modificări citonucleare în toata grosimea epiteliului, caracterizate de hipercromazia nuceelor, pierderea polarității lor, polimorfizm moderat și figuri mitotice tipice. Concluzie histologică: Neoplazie scuamoasă intraepitelială grad înalt (Cod ICD-O/WHO 8077/2). Concluzii. Tehnologia endoscopică contemporană oferă capacități avansate de diagnosticare sigură pentru cancerul esofagian precoce facilitând indicații pentru terapie endoscopică endoluminală radicală minim-invazivă organomenajantă.Introduction. Early esophageal cancer is defined as neoplasia confined to the mucosa or submucosa and without lymphatic spread or distant metastasis. In 31% of patients, esophageal cancer, according to published studies, can be detected early, including in situ. Clinical case. Male patient, 65 years old, complains of discomfort when swallowing, episodes of heartburn, belching. Descriptive endoscopic report: At a distance of 32-36 cm from the incisors, in the distal thoracic segment of the esophagus, a well-defined area is determined, irregular in shape, clear difference in color (uneven red-brown depending on the intensity), outlined by typical esophageal mucosa pale pink In endoscopy mode 125x optical magnification and NBI (GIF XZ1200 Evis X1 Olympus, Japan) – 35 x 20 mm lesion, flat (0-IIb, Paris 2002), color demarcation, well delineated vascular: vascular pattern - multiple capillary loops interepithelial cells (IPCL) deformed (uneven dilatation, tortuosity, irregular caliber and figure variation), Inoue model IPCL-V2, insignificant foveolar delineation in the endoscopic regimes used. Endoscopic conclusion: Flat intraepithelial neoplastic lesion (0-IIb, Paris 2002), suspicious for early, squamous, esophageal cancer. Optically guided biopsy forceps, 3 fragments from areas with major changes. Descriptive pathological report: macroscopic - biopsy fragments size 0.2-0.3 cm, pale pink color; microscopically - fragments of the esophageal mucosa, covered with hyperplastic non-keratinized stratified squamous epithelium, zonally with cytonuclear changes throughout the thickness of the epithelium, characterized by hyperchromasia of nuclei, loss of their polarity, moderate polymorphism and typical mitotic figures. Histological conclusion: High-grade squamous intraepithelial neoplasia (ICD-O/WHO code 8077/2). Conclusions. Contemporary endoscopic technology offers advanced capabilities for safe diagnosis of early esophageal cancer facilitating indications for minimally invasive radical endoluminal organ-sparing endoscopic therapy

Riemannian submersions from almost contact metric manifolds

In this paper we obtain the structure equation of a contact-complex Riemannian submersion and give some applications of this equation in the study of almost cosymplectic manifolds with Kaehler fibres.Comment: Abh. Math. Semin. Univ. Hamb., to appea

A Measurement of the Cosmic Microwave Background Gravitational Lensing Potential from 100 Square Degrees of SPTpol Data

We present a measurement of the cosmic microwave background (CMB) gravitational lensing potential using data from the first two seasons of observations with SPTpol, the polarization-sensitive receiver currently installed on the South Pole Telescope (SPT). The observations used in this work cover 100 deg$^2$ of sky with arcminute resolution at 150 GHz. Using a quadratic estimator, we make maps of the CMB lensing potential from combinations of CMB temperature and polarization maps. We combine these lensing potential maps to form a minimum-variance (MV) map. The lensing potential is measured with a signal-to-noise ratio of greater than one for angular multipoles between $100< L <250$. This is the highest signal-to-noise mass map made from the CMB to date and will be powerful in cross-correlation with other tracers of large-scale structure. We calculate the power spectrum of the lensing potential for each estimator, and we report the value of the MV power spectrum between $100< L <2000$ as our primary result. We constrain the ratio of the spectrum to a fiducial $\Lambda$CDM model to be $A_{\rm MV}=0.92 \pm 0.14 {\rm\, (Stat.)} \pm 0.08 {\rm\, (Sys.)}$. Restricting ourselves to polarized data only, we find $A_{\rm POL}=0.92 \pm 0.24 {\rm\, (Stat.)} \pm 0.11 {\rm\, (Sys.)}$. This measurement rejects the hypothesis of no lensing at $5.9 \sigma$ using polarization data alone, and at $14 \sigma$ using both temperature and polarization data.Comment: 16 pages, 8 figure

Detection of B-mode Polarization in the Cosmic Microwave Background with Data from the South Pole Telescope

Gravitational lensing of the cosmic microwave background generates a curl pattern in the observed polarization. This "B-mode" signal provides a measure of the projected mass distribution over the entire observable Universe and also acts as a contaminant for the measurement of primordial gravity-wave signals. In this Letter we present the first detection of gravitational lensing B modes, using first-season data from the polarization-sensitive receiver on the South Pole Telescope (SPTpol). We construct a template for the lensing B-mode signal by combining E-mode polarization measured by SPTpol with estimates of the lensing potential from a Herschel-SPIRE map of the cosmic infrared background. We compare this template to the B modes measured directly by SPTpol, finding a non-zero correlation at 7.7 sigma significance. The correlation has an amplitude and scale-dependence consistent with theoretical expectations, is robust with respect to analysis choices, and constitutes the first measurement of a powerful cosmological observable.Comment: Two additional null tests, matches version published in PR

CMB Polarization B-mode Delensing with SPTpol and Herschel

We present a demonstration of delensing the observed cosmic microwave background (CMB) B-mode polarization anisotropy. This process of reducing the gravitational-lensing generated B-mode component will become increasingly important for improving searches for the B modes produced by primordial gravitational waves. In this work, we delens B-mode maps constructed from multi-frequency SPTpol observations of a 90 deg$^2$ patch of sky by subtracting a B-mode template constructed from two inputs: SPTpol E-mode maps and a lensing potential map estimated from the $\textit{Herschel}$ $500\,\mu m$ map of the CIB. We find that our delensing procedure reduces the measured B-mode power spectrum by 28% in the multipole range $300 < \ell < 2300$; this is shown to be consistent with expectations from theory and simulations and to be robust against systematics. The null hypothesis of no delensing is rejected at $6.9 \sigma$. Furthermore, we build and use a suite of realistic simulations to study the general properties of the delensing process and find that the delensing efficiency achieved in this work is limited primarily by the noise in the lensing potential map. We demonstrate the importance of including realistic experimental non-idealities in the delensing forecasts used to inform instrument and survey-strategy planning of upcoming lower-noise experiments, such as CMB-S4.Comment: 17 pages, 10 figures. Comments are welcome

Measurements of Sub-degree B-mode Polarization in the Cosmic Microwave Background from 100 Square Degrees of SPTpol Data

We present a measurement of the $B$-mode polarization power spectrum (the $BB$ spectrum) from 100 $\mathrm{deg}^2$ of sky observed with SPTpol, a polarization-sensitive receiver currently installed on the South Pole Telescope. The observations used in this work were taken during 2012 and early 2013 and include data in spectral bands centered at 95 and 150 GHz. We report the $BB$ spectrum in five bins in multipole space, spanning the range $300 \le \ell \le 2300$, and for three spectral combinations: 95 GHz $\times$ 95 GHz, 95 GHz $\times$ 150 GHz, and 150 GHz $\times$ 150 GHz. We subtract small ($< 0.5 \sigma$ in units of statistical uncertainty) biases from these spectra and account for the uncertainty in those biases. The resulting power spectra are inconsistent with zero power but consistent with predictions for the $BB$ spectrum arising from the gravitational lensing of $E$-mode polarization. If we assume no other source of $BB$ power besides lensed $B$ modes, we determine a preference for lensed $B$ modes of $4.9 \sigma$. After marginalizing over tensor power and foregrounds, namely polarized emission from galactic dust and extragalactic sources, this significance is $4.3 \sigma$. Fitting for a single parameter, $A_\mathrm{lens}$, that multiplies the predicted lensed $B$-mode spectrum, and marginalizing over tensor power and foregrounds, we find $A_\mathrm{lens} = 1.08 \pm 0.26$, indicating that our measured spectra are consistent with the signal expected from gravitational lensing. The data presented here provide the best measurement to date of the $B$-mode power spectrum on these angular scales.Comment: 21 pages, 4 figure

Measurements of the Temperature and E-Mode Polarization of the CMB from 500 Square Degrees of SPTpol Data

We present measurements of the $E$-mode polarization angular auto-power spectrum ($EE$) and temperature-$E$-mode cross-power spectrum ($TE$) of the cosmic microwave background (CMB) using 150 GHz data from three seasons of SPTpol observations. We report the power spectra over the spherical harmonic multipole range $50 < \ell \leq 8000$, and detect nine acoustic peaks in the $EE$ spectrum with high signal-to-noise ratio. These measurements are the most sensitive to date of the $EE$ and $TE$ power spectra at $\ell > 1050$ and $\ell > 1475$, respectively. The observations cover 500 deg$^2$, a fivefold increase in area compared to previous SPTpol analyses, which increases our sensitivity to the photon diffusion damping tail of the CMB power spectra enabling tighter constraints on \LCDM model extensions. After masking all sources with unpolarized flux $>50$ mJy we place a 95% confidence upper limit on residual polarized point-source power of $D_\ell = \ell(\ell+1)C_\ell/2\pi <0.107\,\mu{\rm K}^2$ at $\ell=3000$, suggesting that the $EE$ damping tail dominates foregrounds to at least $\ell = 4050$ with modest source masking. We find that the SPTpol dataset is in mild tension with the $\Lambda CDM$ model ($2.1\,\sigma$), and different data splits prefer parameter values that differ at the $\sim 1\,\sigma$ level. When fitting SPTpol data at $\ell < 1000$ we find cosmological parameter constraints consistent with those for $Planck$ temperature. Including SPTpol data at $\ell > 1000$ results in a preference for a higher value of the expansion rate (H_0 = 71.3 \pm 2.1\,\mbox{km}\,s^{-1}\mbox{Mpc}^{-1} ) and a lower value for present-day density fluctuations ($\sigma_8 = 0.77 \pm 0.02$).Comment: Updated to match version accepted to ApJ. 34 pages, 17 figures, 6 table