Improvement on the Magnetic Shielding for the XRISM/Resolve Adiabatic Demagnetization Refrigerator

We report modeling, fabrication, cryogenic tensile testing, and magnetic field measurements of a shield around an adiabatic demagnetization stage (ADR) built for the XRISM/Resolve instrument. During testing of a near-identical stage built for Astro-H, a previous spaceflight mission, it was determined that the magnet at full current generated a field external to the shield that violated the maximum dipole-moment requirement of the spacecraft. In addition, there was an interference with the detector assembly nearby when the magnet was greater than 85% of it's typical maximum current. Starting with the Astro-H shield design, we performed a parametric study that increased the thickness of the shield in critical regions. This calculation proceeded until the magnetic field satisfied the estimated maximum field allowed at the detector array based upon the Astro-H measurements. We also performed a detailed measurement of the field generated by the ADR stage at full current as a function of relative angle between the magnet axis and a series of flux-gate magnetometers. Details and results from the calculation and subsequent measurement will be presented

Character and environmental lability of cyanobacteria-derived dissolved organic matter

Autotrophic dissolved organic matter (DOM) is central to the carbon biogeochemistry of aquatic systems, and the full complexity of autotrophic DOM has not been extensively studied, particularly by high-resolution mass spectrometry (HRMS). Terrestrial DOM tends to dominate HRMS studies in freshwaters due to the propensity of such compounds to ionize by negative mode electrospray, and possibly also because ionizable DOM produced by autotrophy is decreased to low steady-state concentrations by heterotrophic bacteria. In this study, we investigated the character of DOM produced by the widespread cyanobacteriaMicrocystis aeruginosausing high-pressure liquid chromatography-electrospray ionization-high-resolution mass spectrometry.M. aeruginosaproduced thousands of detectable compounds in axenic culture. These compounds were chromatographically resolved and the majority were assigned to aliphatic formulas with a broad polarity range. We found that the DOM produced byM. aeruginosawas highly susceptible to removal by heterotrophic freshwater bacteria, supporting the hypothesis that this autotroph-derived organic material is highly labile and accordingly only seen at low concentrations in natural settings

Follow-up of patients with curatively resected colorectal cancer: a practice guideline

BACKGROUND: A systematic review was conducted to evaluate the literature regarding the impact of follow-up on colorectal cancer patient survival and, in a second phase, recommendations were developed. METHODS: The MEDLINE, CANCERLIT, and Cochrane Library databases, and abstracts published in the 1997 to 2002 proceedings of the annual meeting of the American Society of Clinical Oncology were systematically searched for evidence. Study selection was limited to randomized trials and meta-analyses that examined different programs of follow-up after curative resection of colorectal cancer where five-year overall survival was reported. External review by Ontario practitioners was obtained through a mailed survey. Final approval of the practice guideline report was obtained from the Practice Guidelines Coordinating Committee. RESULTS: Six randomized trials and two published meta-analyses of follow-up were obtained. Of six randomized trials comparing one follow-up program to a more intense program, only two individual trials detected a statistically significant survival benefit favouring the more intense follow-up program. Pooling of all six randomized trials demonstrated a significant improvement in survival favouring more intense follow-up (Relative Risk Ratio 0.80 (95%CI, 0.70 to 0.91; p = 0.0008). Although the rate of recurrence was similar in both of the follow-up groups compared, asymptomatic recurrences and re-operations for cure of recurrences were more common in patients with more intensive follow-up. Trials including CEA monitoring and liver imaging also had significant results, whereas trials not including these tests did not. CONCLUSION: Follow-up programs for patients with curatively resected colorectal cancer do improve survival. These follow-up programs include frequent visits and performance of blood CEA, chest x-rays, liver imaging and colonoscopy, however, it is not clear which tests or frequency of visits is optimal. There is a suggestion that improved survival is due to diagnosis of recurrence at an earlier, asymptomatic stage which allows for more curative resection of recurrence. Based on this evidence and consideration of the biology of colorectal cancer and present practices, a guideline was developed. Patients should be made aware of the risk of disease recurrence or second bowel cancer, the potential benefits of follow-up and the uncertainties requiring further clinical trials. For patients at high-risk of recurrence (stages IIb and III) clinical assessment is recommended when symptoms occur or at least every 6 months the first 3 years and yearly for at least 5 years. At the time of those visits, patients may have blood CEA, chest x-ray and liver imaging. For patients at lower risk of recurrence (stages I and Ia) or those with co-morbidities impairing future surgery, only visits yearly or when symptoms occur. All patients should have a colonoscopy before or within 6 months of initial surgery, and repeated yearly if villous or tubular adenomas >1 cm are found; otherwise repeat every 3 to 5 years. All patients having recurrences should be assessed by a multidisciplinary team in a cancer centre

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

Background: Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR) is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM). If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma 3 cm, located between 115 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane i

Weiterentwicklung der Endoskopischen Mikrochirurgie Schlussbericht

Since 1980 we worked on the development of Minimal Invasive Surgery. After the introduction of Transanal Endoscopic Microsurgery (TEM) into clinical practise in 1984, as the first endoscopic surgical method, the emphasis of our investigation was put on clinical studies to evaluate those new endoscopic treatments. Besides that the aim in 1989 was to establish methods of Minimal Invasive Surgery for the treatment of diseases of the esophagus (EMDE), the gall bladder and inguineal hernia. Because of the then booming introduction of Mininmal Invasive Surgery into clinical practise all over the world we extended our investigations into the development of complex operation systems and technological innovations. Following main programs have been performed: clinical trial TEM, 373 patients from 1989 till 1993; clinical evaluation of Transanal Endoscopic Rectopexy; clinical trial on Endoscopic Microsurgical Dissection of the Esophagus, 37 patients from 1989 till 1993; development and experimental evaluation of Cholecystotomy; experimental development and clinical evaluation of Laparoscopic Colorectal procedures; evaluation of advanced techniques in Video-Documentation (3-Chip, Betacam-System) (orig.)Available from TIB Hannover: DtF QN1(28,22) / FIZ - Fachinformationszzentrum Karlsruhe / TIB - Technische InformationsbibliothekSIGLEBundesministerium fuer Forschung und Technologie (BMFT), Bonn (Germany)DEGerman