The role of optical and virt ual colonoscopy in colorectal neoplasms

Purpose: High prevalence of colon carcinoma explains the continued high mortality rate of this disease.Utilizing a strategy of virtual colonoscopy (VC) in patients aged over 50 years with optical colonoscopy (OC) following-up for removal of detected adenomatous polyps may result in lowering the colon cancer death rate. However, VC diagnostic potential has not been widely recognized yet.Material and methods: This article reviews the currently available in diagnostic options in colorectal neoplasms and discusses their advantages and drawbacks.Results: VC has many advantages over the existing options and its several drawbacks can be mitigated so that it would become a valuable diagnostic modality. A strategy that utilizes VC for screening of patients over the age of 50 years and OC for screening high-risk individuals and those with positive VC findings would result in a significantly reduced colon cancer mortality rate.Conclusion: Both OC and VC (i.e., CTC and MRC) progress toward the clinical needs as new technologies are developed and applied to overcome the drawbacks of these diagnostic methods. Each of them plays a unique role for colon cancer prevention

Our experience in laparoscopic adrenalectomy

Purpose: Laparoscopic adrenalectomy (LA) has become the procedure of choice to treat functioning and non-functioning adrenal tumours. With improving experience, large adrenal tumours (> 5 cm) are being successfully tackled by laparoscopy.Material and methods: Thirty-five laparoscopic adrenalectomies performed in 32 patients for adrenal lesions during the period from 2006 to 2012 were analyzed.Results: Mean tumour size was 5,03 cm (range, 2-11 cm). Tumour size was larger than 8 cm in four patients. The lesions were localized on the right side in 17 patients and on the left one in 15 patients while bilateral tumours were established in three patients. Functioning tumours were present in 22 out of 32 patients. Average blood loss was 112 mL (range, 20-400 mL) with the mean operating time being 144 min (range, 45-270 min). Three patients underwent conversion to open procedure. Final histology revealed malignant tumours in three of 32 patients (9,52%).Conclusion: LA is safe and feasible for large adrenal lesions. Mere size should not be considered as a contraindication to laparoscopic approach in large adrenal masses. Graded approach, perfect preoperative assessment and planning, team work and adherence to anatomical and surgical principles are the key to success

Diagnostic and treatment strategy in complicated colon diverticulitis

Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage I a) to localized abscesses (stages I b and II), to free perforation with purulent (stage III) or feculent (stage IV) peritonitis. The planned therapy of colonic diverticulitis is very difficult because preoperative diagnosis is uncommon and the method of treatment is usually decided at the time of laparotomy. While there is a little debate about the best treatment for mild episodes, uncertainty persists about the optimal management for severe episodes and complicated diverticulitis

Billiary drainage in obstructive jaundice

In patients with obstructive jaundice, when the endoscopic approach fails to achieve biliary drainage, percutaneous cannulation and combined endoscopic/percutaneous endoprosthesis insertion can simultaneously or subsequently be performed. The present study compares these two approaches. Endoscopic retrograde biliary drainage (ER BD) and percutaneous transhepatic biliary drainage (PTBD) are the two main non-surgical treatment options for obstructive jaundice in patients with hepatocellular carcinoma (HCC). ER BD is usually the first-line treatment because of its low hemorrhage risk. Some authors have reported that the successful drainage rate ranges from 72 to 100%. Mean stent patency time and mean survival range from 1,0 to 15,9 and from 2,8 to 12,3 months, respectively. PTBD is often an important second-line treatment when ER BD is impossible. With regard to materials, metallic stents offer the benefit of longer patency than plastic stents. The dominant effect of biliary drainage suggests that successful jaundice therapy could enhance anticancer treatment by increasing the life expectancy, decreasing the mortality, or both. We present an overview of the efficacy of ER BD and PTBD for obstructive jaundice in HCC patients who are not candidates for surgical resection and summarize the current indications and outcomes of reported clinical use. Traditionally, surgical techniques have been used, however, in the last 20 years the availability of both endoscopic and interventional radiological procedures has increased. Тhe technical success of the procedure depends on the experience of the interventional radiologist performing the drainage. It can be as high as nearly 100%. Clinical efficacy is usually lower but still over 90%. When endoscopic drainage alone fails, a combined percutaneous/ endoscopic procedure should only be performed if it can be carried out simultaneously

Endoscopic radical treatment in early rectal cancer

Purpose: Standard radical treatment for early rectal cancer includes a removal of the tumour with total mesorectal excision. There are numerous new techniques for endoscopic treatment which could shift the strategy for obtaining the postoperative results.Material and methods: We report our radical endoscopic treatment of early rectal carcinoma by endoscopic submucosal dissection (ESD ). Forty-five patients with early-stage rectal cancer (carcinoma in situ, T1sm1 and T1sm2) were enrolled. All of them were staged by 3-D endorectal ultrasound. In 43 cases, the tumours were endoscopically removed. The postoperative results were analyzed and presented only. No oncological results were reported.Results: The mean lesion size was 31,0 mm (range, 19-82 mm), and the mean operating time was 86 min. (range, 48-131 min.). Forty-two lesions were resected en bloc with tumour-free margins with a successful rate of 97,33% (42/43). Three lesions were understaged or their localization in the rectum was not suitable for endoscopic treatment. The following complications were observed: perforation of the rectum in one patient (4%) treated conservatively, and major bleeding in four patients (10%) stopped by endoscopic hemostasis. Neither systematic complications, nor mortality were observed.Conclusion: ESD procedure for early-stage rectal cancers is safe and effective. It has the advantage of a shorter hospital recovery. The postoperative results are significantly better in comparison of radical surgical treatment such as transanal excision. The perioperative morbidity is of different kind and the postoperative period is shorter

Are the natural sciences ready for truth, healing, and reconciliation with Indigenous peoples in Canada? Exploring ‘settler readiness’ at a world-class freshwater research station

This is the final version. Available on open access from Springer via the DOI in this recordThe Experimental Lakes Area in Northwestern Ontario, Canada, is a globally prominent freshwater research facility, conducting impactful whole-of-lake experiments on so-called ‘pristine’ lakes and watersheds. These lakes are located in traditional Anishinaabe (Indigenous) territory and the home of 28 Treaty #3 Nations, something rarely acknowledged until now. Indeed, Indigenous peoples in the area have historically been excluded from the research facility’s governance and research. Shortly after it changed hands in 2014—from the federal government to the not-for-profit International Institute of Sustainable Development (IISD)—the Truth and Reconciliation Commission (TRC) of Canada released its Calls to Action to all Canadians. The newly named International Institute of Sustainable Development-Experimental Lakes Area (IISD-ELA) began to respond with a number of initiatives aimed to develop relationships with local Indigenous peoples and communities. In this paper, from the perspectives of IISD-ELA staff members, we share findings from an exploratory study into the relationships beginning to develop between IISD-ELA and Treaty #3 Nations. We used semi-structured interviews (n = 10) to identify how staff perceived their initial efforts and contextualize those with the current literature on meaningfully engagement in reconciliation. Our analysis highlights perceived barriers, including time, resources, and funding constraints, as well as an acknowledged lack of cultural awareness and sensitivity training. Participants also recognized the need to engage Indigenous knowledge holders and embrace their ways of knowing at the research station. While the study is small in scale, as an international leader in freshwater science, transparency in the IISD-ELA’s journey in reconciliation has the potential to inform, influence, and ‘unsettle’ settler-colonial scientists, field stations, and institutions across the country and beyond.Canada Research Chairs Progra

Conservation laws for self-adjoint first order evolution equations

In this work we consider the problem on group classification and conservation laws of the general first order evolution equations. We obtain the subclasses of these general equations which are quasi-self-adjoint and self-adjoint. By using the recent Ibragimov's Theorem on conservation laws, we establish the conservation laws of the equations admiting self-adjoint equations. We illustrate our results applying them to the inviscid Burgers' equation. In particular an infinite number of new symmetries of these equations are found and their corresponding conservation laws are established.Comment: This manuscript has been accepted for publication in Journal of Nonlinear Mathematical Physic

EXTRA SPINDLE POLES (Separase) controls anisotropic cell expansion in Norway spruce (Picea abies) embryos independently of its role in anaphase progression

The caspase-related protease separase (EXTRA SPINDLE POLES, ESP) plays a major role in chromatid disjunction and cell expansion in Arabidopsis thaliana. Whether the expansion phenotypes are linked to defects in cell division in Arabidopsis ESP mutants remains elusive. Here we present the identification, cloning and characterization of the gymnosperm Norway spruce (Picea abies, Pa) ESP. We used the P. abies somatic embryo system and a combination of reverse genetics and microscopy to explore the roles of Pa ESP during embryogenesis. Pa ESP was expressed in the proliferating embryonal mass, while it was absent in the suspensor cells. Pa ESP associated with kinetochore microtubules in metaphase and then with anaphase spindle midzone. During cytokinesis, it localized on the phragmoplast microtubules and on the cell plate. Pa ESP deficiency perturbed anisotropic expansion and reduced mitotic divisions in cotyledonary embryos. Furthermore, whilst Pa ESP can rescue the chromatid nondisjunction phenotype of Arabidopsis ESP mutants, it cannot rescue anisotropic cell expansion. Our data demonstrate that the roles of ESP in daughter chromatid separation and cell expansion are conserved between gymnosperms and angiosperms. However, the mechanisms of ESP-mediated regulation of cell expansion seem to be lineage-specific

Tudor staphylococcal nuclease is a docking platform for stress granule components and is essential for SnRK1 activation in Arabidopsis

Tudor staphylococcal nuclease (TSN; also known as Tudor-SN, p100, or SND1) is a multifunctional, evolutionarily conserved regulator of gene expression, exhibiting cytoprotective activity in animals and plants and oncogenic activity in mammals. During stress, TSN stably associates with stress granules (SGs), in a poorly understood process. Here, we show that in the model plant Arabidopsis thaliana, TSN is an intrinsically disordered protein (IDP) acting as a scaffold for a large pool of other IDPs, enriched for conserved stress granule components as well as novel or plant-specific SG-localized proteins. While approximately 30% of TSN interactors are recruited to stress granules de novo upon stress perception, 70% form a protein-protein interaction network present before the onset of stress. Finally, we demonstrate that TSN and stress granule formation promote heat-induced activation of the evolutionarily conserved energy-sensing SNF1-related protein kinase 1 (SnRK1), the plant orthologue of mammalian AMP-activated protein kinase (AMPK). Our results establish TSN as a docking platform for stress granule proteins, with an important role in stress signalling