Endoscopy : an evolving speciality

The practice of endoscopy has been rapidly changing due to new emerging technologies and novel techniques. There has been more focus on colonoscopy training with the development of structured programmes including simulators. Chromoendoscopy and magnification endoscopy have enabled improved diagnosis of small neoplastic lesions and will be important for the success of colorectal cancer screening programmes. The small bowel is now accessible to diagnostic modalities like capsule endoscopy and to therapeutic tools through the double balloon enteroscope. Endoscopic therapy has also become more sophisticated with endoscopic therapy of reflux disease now possible. Excision of large colorectal adenomatous polyps by endoscopic mucosal resection and dissection of submucosal tumours may reduce the need for surgical intervention. The practice of endoscopy has rapidly changed over the past few years. What was once a simple diagnostic procedure made possible by the development of fibre optics has become a speciality in its own right. This article will highlight some aspects of endoscopic practice that have undergone major changes over the past few years and that will shape endoscopy practice in the future.peer-reviewe

Generative Adversarial Networks (GANs) for Simulating Human Behaviors during Bone Registration to Improve Registration Algorithms

Computer-assisted orthopedic surgical procedures routinely require the registration of a bone to preoperative surgical planning data. The registration procedure requires the collection of points on the bone that are then matched to points or surfaces on a 3-D bone model. To improve the registration algorithms, simulations of the real-world registration processer are performed to test the changes to the algorithms. The present publication proposes the use of generative adversarial networks (GANs) to generate registration simulation data that closely matches that of real-world experimental/actual data

Pre-operative Visualization of Remaining Bone after Robotic Cutting

A method to pre-operatively display bone that may remain after robotic cutting in total joint arthroplasty. The method includes the use of a 3-D bone model, a 3-D implant model, and a cut volume. A user plans a position of the 3-D implant model relative to the 3-D bone model to designated the best fit, fill, or alignment for a final implant on a bone. The 3-D bone model is then split at the ideal plane definitions where the implant planar surfaces intersect with the bone model. Next, the cut volume is subtracted from the planar removal elements to create a set of volumes that define the bone that will remain after robotic cutting. The 3-D bone model with the simulated cut and remaining bone is displayed to the user, which may assist with planning for the procedure

Determining the Reliability of a Robotic Surgical System for Producing Good Clinical Outcomes

A method to determine the reliability of a robotic surgical system for producing good clinical outcomes is described herein. The method utilizes machine learning (ML) or artificial intelligence (AI) to classify, analyze, or rank how reliable a robotic system is at producing good clinical outcomes as a function of patient specific factors, medical staff factors, robotic system factors, and/or intraoperative factors. A plurality of potential inputs for the ML or AI algorithms is provided as well as the possible outputs for a given robotic system. The method may be particularly useful for surgical robot manufacturers, surgeons, and health care facilities

European Society of Surgical Oncology's strategy for clinical research : Paving the way for a culture of research in cancer surgery

As part of its mission to promote the best surgical care for cancer patients, the European Society of Surgical Oncology (ESSO) has been developing multiple programmes for clinical research along with its educational portfolio. This position paper describes the different research activities of the Society over the past decade and an action plan for the upcoming five years to lead innovative and high quality surgical oncology research. ESSO proposes to consider pragmatic research methodologies as a complement to randomised clinical trials (RCT), advocates for increased funding and operational support in conducting research and aims to enable young surgeons to be active in research and establish partnerships for translational research activities. (C) 2019 Published by Elsevier Ltd.Peer reviewe

Immunohistochemical Localization of REG Ia Protein in Salivary Gland Tumors

The regenerating gene( Reg) Ia protein has a trophic effect on gastric epithelial cells, and its overexpressionis reported in gastrointestinal cancers. The salivary gland is a component of the digestive system, andtherefore, REG Ia protein may play some role in the pathophysiology of salivary gland tumors. In the presentstudy, we determined the immunohistochemical localization of REG Ia protein in salivary gland tumorsand moreover investigated its relationship to clinicopathological features. Twenty-eight patients with salivarygland tumor were enrolled. The specimens resected by surgery from those patients were examinedusing immunohistochemistry for REG Ia protein and Ki67. Five of the 16 pleomorphic adenomas (31.3%)were positive for REG Ia protein. Regarding salivary gland carcinomas, four of five mucoepidermoid carcinomas(80%), three of five adenoid cystic carcinomas (60%), one of two polymorphous low-grade adenocarcinomas(50%) were also positive for REG Ia protein. However, no relationships were found betweenREG Ia protein expression and clinicopathological features. Regarding the Ki67 expression, strong signalwas observed in the tumor cells of patients with salivary gland adenoma as well as carcinoma. REG Ia proteinis expressed not only in adenocarcinoma but also precancerous adenoma cells proliferating actively,suggesting that REG Ia protein may play a role at least in part in the development of salivary gland tumors

Prognosis Following Surgery for Recurrent Ovarian Cancer and Diagnostic Criteria Predictive of Cytoreduction Success : A Systematic Review and Meta-Analysis

Acknowledgments GO SOAR Collaborators: Karen Ash, Paul Kamfwa. Funding This research received no external funding.Peer reviewedPublisher PD

Pathological Approach for Surveillance of Ulcerative Colitis-associated cancer:Usefulness of Immunohistochemistry for p53

The patients with long-standing ulcerative colitis( UC) have a high-risk of neoplastic lesions in the colonicmucosa. The UC-associated neoplastic lesion is difficult to detect by endoscopic examination or diagnosehistologically. In the present study, we aimed to clarify whether immunohistochemistry for p53 is useful todiscriminate the UC-associated neoplasia from inflammed regenerating epithelium. Tissue samples were obtainedfrom colorectomy specimens from 20 patients with long-standing UC (range 6-29 years). The surfaceof microstructure of the tissues was observed by stereomicroscopy, and the sections were examined usingimmunohistochemistry for p53. All of T2-4 carcinomas were detectable by endoscopic examination beforesurgery, whereas considerable number of dysplasias (52.5%), Tis carcinomas (33.3%), and T1 carcinomas(60.0%) were undetectable. Fifty-three of 67 UC-associated neoplastic lesions (79.1%) were of flat-typemacroscopically. The detection rate of flat-type neoplasias( 45.3%) was significantly lower than that of protrudingones (100%). The positivity of p53 overexpression was 0 % in UC-II, 52.5 % in UC-III, and 70.4 %in UC-IV, respectively. UC-II lesions had lower positivity of p53 overexpression than UC-III( P=0.027) or-IV lesions( P=0.003). Immunohistochemical analysis of p53 protein is useful to discriminate the UC-associatedneoplasia from inflammed regenerating epithelium

Localization of Stem Cells in Small Intestinal Epithelium:Strategies for Identifying Small Intestinal Stem Cells

In the small intestine, stem cells are considered to exist at the bottom of the crypt. Actively proliferatingtransitional cells supplied from stem cells are differentiated into two directions upward and downward. Upwardcells are differentiated into absorbing epithelial cells, goblet cells, and endocrine cells, and downwardcells differentiated into Paneth cells. However there are some difficulties to identify the stem cells becauseof their unique characteristics. At first, stem cells occur as actual stem cells and potential stem cells, andsecond, there is diversity in stem cells. Therefore, molecules suitable for a marker of small intestinal stemcells are necessary to distinguish "true" stem cells from others. Energetically searched for in recent years,Musashi-1, type 1A bone morphogenetic protein receptor (BMPR-1A), phospho-phosphatase and tensinhomolog deleted on chromosome ten( phospho-PTEN), doublecortin and calmodulin kinase-like-1( DCAMKL1),ephrin receptors( Eph receptors), integrins, and leucine-rich repeat-containing G protein-coupled receptor5 (Lgr5) are proposed. Among them, Musashi-1 draws attention as one of a candidate marker forsmall intestinal stem cells. We here introduce our reviews about expression of Musashi-1 and Hes1 proteinsin the small intestine, and would like to overview the way to identify the small intestinal stem cells