Endoscopic treatment of patients with early forms of gastric cancer

Leningrad regional oncological dispensary, Russia, Al XIII-lea Congres al Asociației Chirurgilor „Nicolae Anestiadi” și al III-lea Congres al Societății de Endoscopie, Chirurgie miniminvazivă și Ultrasonografie ”V.M.Guțu” din Republica MoldovaBackground: Currently, most patients with gastric tumors are detected in late stages. Early diagnosis is a major factor in improving treatment outcomes. On the other hand, patients who are diagnosed on early stages often receive aggressive treatment and are not subjects to less invasive interventions. Material and Methods: In our clinic we have been using endoscopic surgery for early gastric cancer since 2009. Japanese colleagues are the most experienced in this kind of treatment that is why we follow the recommendations of Japanese Gastric Cancer Association (JGCA). The main criterion provided that endoscopic removal is possible is the depth of tumor invasion. We evaluate the depth of invasion primarily by endoscopic ultrasonography. According to our data the accuracy of this method is 94%. The main operation used for the treatment of early gastric cancer is endoscopic submucosal dissection (ESD). Its main advantages are single block resection within healthy tissues and adequate morphological assessment of the removed tumor. In the last ten years we have performed 148 ESD (145 patients) for early forms of gastric cancer. Surgeries were radical in 95% of cases. Results:There were no cases of postoperative mortality. Progression of the disease was noted only in one patient. These endoscopic surgeries have proved to be effective, safe and reasonable in treating early gastric cancer. Conclusions: Thus, endoscopic surgery significantly reduces the cost of treatment and hospital stay (average - 3.7 days), facilitates rehabilitation and improves the quality of patients’ life

Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis

Supported by F. Hoffmann–La Roche

Family case of multiple sclerosis in Perm Region

The etiology of multiple sclerosis (MS) is not known still. Family cases of MS could prove the genetic predisposition for this disease. We describe here rare for Perm Region family history with three cases of MS in one generation which are characterized by significant clinical polymorphism

New Cr-Ni-Base Alloy for High-Temperature Applications Designed on the Basis of First Principles Calculations

We use ab initio calculations to analyze the influence of 4d and 5d transition metal alloying elements on cohesive properties of the bulk and a representative grain boundary in Cr within the framework of the Rice–Thomson–Wang approach. The results obtained for Cr are combined with the analogous results for Ni to select Ta and Nb as promising alloying additions to dual-phase (α/γ) Cr-Ni-base high-temperature alloys. Ta and Nb are added to the alloying system of an existing alloy I (Cr-Ni-W-V-Ti) in an attempt to design a chemical composition of a new alloy II (Cr-Ni-W-V-Ti) + (Ta-Nb). Investigation of the microstructure of the Ta-bearing Cr-Ni-alloy reveals a Ta enrichment of large γ-areas near GBs in α-matrix that we consider as potency to increase the cohesive strength of GBs and the cohesive energy of the bulk in γ-phase. Mechanical testing of alloys I and II demonstrates that the alloy II has improved tensile strength and creep resistance at high temperatures

Crohn’s disease with isolated gastric involvement as an example of a rare disease phenotype: a clinical case

Crohn's disease (CD), along with ulcerative colitis, is one of the predominant nosological forms of inflammatory bowel diseases. In CD, any part of the gastrointestinal tract can be affected; however, the process is commonly associated with terminal ileum or colon involvement. CD cases with isolated or mixed involvement of upper gastrointestinal tract (esophagus, stomach, and duodenum) are rare and least studied types of the disease. In isolated stomach involvement, the complaints are non-specific and include epigastric pain, gastric dyspepsia, early satiety, decreased appetite, and nausea. Isolated CD of upper gastrointestinal tract can be diagnosed after comprehensive work-up and always requires a high diagnostic level, including clinical, endoscopic and morphological one. We present a clinical case of CD with isolated stomach involvement in a 62-year-old woman. The diagnosis was confirmed by the histopathological findings of an epithelioid cell granuloma in the gastric antrum. Treatment with systemic corticosteroids reduced the disease clinical activity and improved the histological characteristics of the gastric biopsy sampled obtained by endoscopy. In this clinical case, there were specific macroscopic gastric lesions found at endoscopy in CD patients with upper gastrointestinal tract involvement, which is characterized by thickened longitudinal folding and linear grooves. This type of lesion has been described in the literature as “bamboo joint-like appearance”.Conclusion: Comprehensive assessment of clinical manifestations, endoscopic and histopathological specific features is crucial for the timely diagnosis and treatment of inflammatory bowel diseases