A Comparison of the Endoscopic and Histopathological Findings of Upper Gastrointestinal Mucosa with Helicobacter Pylori Infection

Helicobacter pylori infects the gastric mucosa or the duodenal wall undergoing gastric meteplasia, and is found in nearly 100% of chronic gastritis and duodenal ulcers. Helicobacter pylori produces urease that converts urea into ammonia, which will protect the organism from the acidic environment and will cause further damage to the gastrointestinal mucosa. Helicobacter pylori can be detected through histopathological evaluation, macroscopic endoscopy, serologic test, urea breath test, biopsy urease test, culture and stool analysis. Histiopathologically, Helicobacter pylori infection demonstrates neutrophil infiltration into the gastric mucosa, classified as focal infiltration. We conducted a prospective study of 50 chronic dyspeptic patients. We took their history, performed physical examinations, gastroscopy with judgement for macroscopic endoscopic appearance, histopathology from biopsy specimens, and the CLO test. There were 50 chronic dyspeptic patients in the study, with an age ranging from 23-81 years, and a mean age 49±12 year. Most of them were male (33 cases). There were 17 female cases. From the CLO test, there were 30 cases with CLO (+) and 20 cases CLO (-). From the 30 cases with CLO (+), 22 were male and 8 female. Gastroscopy revealed 25 cases of gastric ulcer, 7 duodenal ulcer, 2 gastric cancer, 15 gastritis, and 30 gastropathy. A gastroscopic appearance of chronic dyspepsia with positive Helicobacter pylori were found mostly in gastric ulcer (18 cases), followed by duodenal ulcer (6 cases), gastritis (5 cases) and one case of gastric cancer. A gastroscopic appearance of chronic dyspepsia with negative Helicobacter pylori were found mostly in gastritis 10 cases, while the remaining in gastric ulcer (7 cases), gastric cancer (2 cases), and a case of duodenal ulcer. Gastroscopy revealed 15 cases of gastritis. From the 5 gastritis cases with CLO (+), 3 cases had lesions located at the antrum and 2 cases at the corpus, while from the remaining 10 cases of gastritis with CLO (-), 8 cases had lesions located at the antrum, and 2 at the corpus. The time to colonization was shortest in duodenal ulcer (grade IV), followed by gastric ulcer (grade II) and gastritis (grade I) in CLO (-) examination. From cases of gastritis with CLO (+), 4 were moderate cases and one case severe, while from cases of gastritis with CLO (-) there were 7 mild cases, and 3 moderate cases with no severe case found

Dyspepsia and Depression, Anxiety, Stress Scales (DASS) Score

Background: Dyspepsia is a constellation of symptoms referable to the gastroduodenal region of the upper gastrointestinal tract. Emotional disturbances are often associated with dyspepsia and have been proposed as one of the possible causes of dyspepsia. This study was aimed to evaluate the difference between the severity of dyspepsia using porto alegre dyspeptic symptoms questionnaire (PADYQ) and emotional disturbances using depression, anxiety, stress scales (DASS).Method: This study was a cross-sectional analytical study. All the subjects were evaluated using PADYQ and DASS. PADYQ is classified into four categories (no, mild, moderate and severe dyspepsia symptoms). Data was analyzed using Independent t-test and Mann-Whitney test. A p < 0.05 was considered as statistically significant.Results: There were 90 subjects that enrolled in this study, consisted of 47 (52.2%) males and 43 (47.8%) females. Thirty three (36.7%) subjects had PADYQ score was < 6, while it was ≥ 6 in the other 57 (63.3%) subjects. DASS scores were significantly different in subjects without dyspepsia symptoms compared to subjects with dyspepsia symptoms. There is a difference in DASS scores between subjects with different categories of dyspepsia symptoms (p < 0.05). Conclusion: There was a difference in the severity of emotional disturbances among subjects with dyspepsia symptoms and without dyspepsia symptoms. The severity of emotional disturbances parallel with the severity of dyspepsia. Evaluation of emotional disturbances in case of dyspepsia will be helpful in the management of dyspepsia

Transboundary clusters in the coastal zones of the European part of Russia: inventory, typology, factors, and prospects

This article presents an inventory and a typology of the existing and emerging economic clusters in the coastal zone of the European part of Russia. The authors hold that transboundary clustering takes priority in the Baltic coastal region - nine of the 56 clusters identified are located in the Kaliningrad region and another eight in Saint Petersburg and the Leningrad region. The authors describe major catalysts and immanent inhibitors in coastal zones. The former include a high density of coastal economies, proximity to international markets, and better logistics and communications. The inhibitors comprise geopolitical risks and institutional barriers. It is shown that the potential and prospects of transboundary clustering are affected by both global integration and disintegration patterns, coastal infrastructure, geopolitical and geoeconomic "neighbourhood", cultural excellence, and business and investment environment

Diagnostic Findings and ERCP Treatment in Patients with Obstructive Jaundice During Two Years at H. Adam Malik Hospital, Medan

Background: The methods of ERCP have been used for diagnostic and therapeutic purposes to pass bile fluid and extract stones from the bile duct in patients with obstructive extrahepatic jaundice. Method: A retrospective study was performed on patients with obstructive extrahepatic jaundice patients who underwent ERCP during a two-years time period from January 1999 to December 2000. ERCP was performed with a premedication of 10 mg midazolam, followed by a chollangiography contrast containing 1 mg/dl of Garamicin and 25 mg of Pethidine if sphincterotomy was performed. Results: From 126 patients with obstructive extrahepatic jaundice treated with ERCP, the male to female ratio was 1.86:1. The majority of the (group) of patients were between 51-60 years of age (33.3 % ). The youngest patient (group) was 24 years and the oldest 97 years. The diagnostic study found the following cases: normal 3 cases (2.8%), bile duct stone 46 cases (43.4%), carcinoma of ampula vater 20 cases (18.9%), CBD tumor 7 cases (6.6%), carcinoma of head of pancreas 2 cases (1.9%), diverticle 4 cases (3.8%), duodenal tumor 1 case (0.9%), carcinoma of ampula vater and bile duct stone 1 case (0.9%), SOD 5 cases (4.7%), CBD stricture 1 case (0.9%) and failure 16 cases (15.1%). The patients receivied the following treatment: sphyncterotomy 36 cases (51.4%), stent application 11 cases ( 15.7%), sphincterotomy with stent 18 cases (25.7%) and basket method 5 cases (7.1%)

Fuel elements of thermionic converters

Work on thermionic nuclear power systems has been performed in Russia within the framework of the TOPAZ reactor program since the early 1960s. In the TOPAZ in-core thermionic convertor reactor design, the fuel element`s cladding is also the thermionic convertor`s emitter. Deformation of the emitter can lead to short-circuiting and is the primary cause of premature TRC failure. Such deformation can be the result of fuel swelling, thermocycling, or increased unilateral pressure on the emitter due to the release of gaseous fission products. Much of the work on TRCs has concentrated on preventing or mitigating emitter deformation by improving the following materials and structures: nuclear fuel; emitter materials; electrical insulators; moderator and reflector materials; and gas-exhaust device. In addition, considerable effort has been directed toward the development of experimental techniques that accurately mimic operational conditions and toward the creation of analytical and numerical models that allow operational conditions and behavior to be predicted without the expense and time demands of in-pile tests. New and modified materials and structures for the cores of thermionic NPSs and new fabrication processes for the materials have ensured the possibility of creating thermionic NPSs for a wide range of powers, from tens to several hundreds of kilowatts, with life spans of 5 to 10 years

Profile of Colorectal Cancer Patients in Endoscopic Unit at Dr. Pirngadi Hospital - Medan

Background: Colorectal cancer is the third most prevalent cancer and the second leading cause of cancer death worldwide every year. Rates of this Malignancy vary by country. In Indonesia, the prevalence is estimated to have an increased tendency. The objectives of this sudy was to examine the prevalence and profile of colorectal cancer, which are diagnosed by endoscopic examination. Method: The study was conducted retrospectively, by examining the Result of endoscopic findings of patients with rectal bleeding, altered bowel habit, chronic diarrhea, unexplain abdominal pain, and other signs and symptoms at The Endoscopic Unit Department of Internal Medicine, Dr. Pirngadi hospital from January 2004 to June 2008. Results: We found 197 patients with colorectal cancer (CRC) from 760 patients examined by colonoscopy (25.9%). One hundred and one patients (51.3%) out of 197 CRC patients were female. Most were in the group of age 51-60 years (28.9%). The most frequent ethnic of the patients were Bataknese (46.2%). The most common symptom was rectal bleeding (70.6%). The most common location of CRC was in the rectum (74.6%). Histopathologic Result was adenocarcinoma. Conclusion: The prevalence of colorectal cancer in this study were twenty six percents. Rectal bleeding appeared to be the most common sign in this study. Rectum was the most common site of the cancer. Most of patients were Bataknese. Patients were at advanced stage and most of them were having well-differentiated adenocarcinoma

Reinforcement learning or active inference?

This paper questions the need for reinforcement learning or control theory when optimising behaviour. We show that it is fairly simple to teach an agent complicated and adaptive behaviours using a free-energy formulation of perception. In this formulation, agents adjust their internal states and sampling of the environment to minimize their free-energy. Such agents learn causal structure in the environment and sample it in an adaptive and self-supervised fashion. This results in behavioural policies that reproduce those optimised by reinforcement learning and dynamic programming. Critically, we do not need to invoke the notion of reward, value or utility. We illustrate these points by solving a benchmark problem in dynamic programming; namely the mountain-car problem, using active perception or inference under the free-energy principle. The ensuing proof-of-concept may be important because the free-energy formulation furnishes a unified account of both action and perception and may speak to a reappraisal of the role of dopamine in the brain

Diversity of hard-bottom fauna relative to environmental gradients in Kongsfjorden, Svalbard

A baseline study of hard-bottom zoobenthos in relation to environmental gradients in Kongsfjorden, a glacial fjord in Svalbard, is presented, based on collections from 1996 to 1998. The total species richness in 62 samples from 0 to 30 m depth along five transects was 403 species. Because 32 taxa could not be identified to species level and because 11 species are probably new to science, the total number of identified species was 360. Of these, 47 species are new for Svalbard waters. Bryozoa was the most diverse group. Biogeographic composition revealed features of both Arctic and sub-Arctic properties of the fauna. Species richness, frequency of species occurrence, mean abundance and biomass generally decreased towards the tidal glaciers in inner Kongsfjorden. Among eight environmental factors, depth was most important for explaining variance in the composition of the zoobenthos. The diversity was consistently low at shallow depths, whereas the non-linear patterns of species composition of deeper samples indicated a transitional zone between surface and deeper water masses at 15&#x2013;20 m depth. Groups of &#x201C;colonial&#x201D; and &#x201C;non-colonial&#x201D; species differed in diversity, biogeographic composition and distribution by location and depth as well as in relation to other environmental factors. &#x201C;Non-colonial&#x201D; species made a greater contribution than &#x201C;colonial&#x201D; species to total species richness, total occurrence and biomass in samples, and were more influenced by the depth gradient. Biogeographic composition was sensitive to variation of zoobenthic characteristics over the studied depth range. A list of recorded species and a description of sampling sites are presented