Endoscopic treatment of pancreatic fluid collection in gastric heterotopic pancreas. A case report.

BACKGROUND: Heterotopic pancreas is defined as pancreatic tissue located outside the pancreatic parenchyma that lacks an anatomic or vascular connection to the normal pancreas. Symptomatic gastric heterotopic pancreas is a rare condition that can manifest as acute or chronic pancreatitis. Asymptomatic heterotopic pancreas does not require treatment, while symptomatic lesions should be resected. The modality of final resection of heterotopic pancreas depends on its size and the depth of gastric wall involvement. METHODS AND RESULTS: A 36-year-old woman was admitted for recurrent epigastralgia. Abdominal computed tomography (CT) scan revealed that an abscess had formed in the gastric antrum. After multidisciplinary discussion we decided for conservative treatment with intravenous antibiotics and further detailed endoscopic diagnostic. Esophagogastroduodenoscopy revealed a submucosal mass with a central fistula and intermittent pus secretion in the prepyloric region of the gastric antrum, which was subsequently drained with a double pigtail stent under endoscopic ultrasound (EUS) and fluoroscopy. The possibility of pancreatic fluid collection in the case of heterotopic pancreas was suggested during the EUS examination, and histology subsequently confirmed heterotopic pancreatic tissue. The patient was in good condition and without any abdominal pain. According to a control CT scan after 10 weeks, the fluid collection was completely resolved. Due to the possible recurrence of pancreatitis, resection of heterotopic pancreas was proposed to the patient. Since the lesion involved the muscularis propria of the gastric wall, surgical resection of the mass was indicated. CONCLUSION: Fluid collections after acute pancreatitis in heterotopic pancreas in the gastric antrum can be successfully managed by endoscopy.

[Religiosity and spirituality as ressources for head neck cancer patients]. / Religiosität und Spiritualität als Ressourcen in der Betreuung von Patienten mit Kopf-Hals-Tumoren.

OBJECTIVE: Spiritual Care is a well established part of palliative medicine. Are religiosity / spirituality also ressources of patients during the early phases of a head neck cancer (HNC) disease? MATERIAL AND METHODS: We included 113 HNC patients (27 women, 84 men, 2 divers) to a prospective study using questionnaires focused on actual burden (NRS), spirituality as ressource (SpREUK-15, spiritual needs (SpNQ-20), interpretation of illness (IIQ), and life satisfaction of patients (BMLSS-10, BMLSS-Support, WHO-5). 39 patients were still under therapy, 74 participants were cancer-survivors. RESULTS: Only 31/111 (28 %) patients feel themselve as spiritual and/or religious. 72 % are neither spiritual nor religious. 51/111 see reflexion about their cancer disease as a specific ressource to overcome their actual cancer situation. Spiritual needs are religious in 35/112, existential in 67/112, inner peace in 90/112, and generativity in 84/112 patients. The accepted own religiosity and the actual stadium of disease are highly relevant impact factors on spiritual needs and ressources. HNC patients show a high part of depressive moods (WHO-5) and are (in trend) un-satisfied with their life and support situation. CONCLUSION: Up to 90 % of HNC patients have specific spiritual needs which are often hidden. Modern concepts of integrative oncology discover them, and enourage via these ressources the quality of life and the coping of cancer patients.

Correlation between ADR of screening and all colonoscopies.

BACKGROUND AND AIMS: Colonoscopy with polypectomy are associated with a reduction in the incidence of colorectal cancer (CRC), as well as mortality, secondary to CRC. Because of the variation in physicians' performance and the risk of interval CRC after a colonoscopy, several quality indicators have been established. ADR (adenoma detection rate) is a generally accepted quality indicator. But it is also a target of possible gaming and achieving an adequate number of colonoscopies only from screening may be a problem for some practices. The aim of this study was to compare ADR for colonoscopies done for various indications and to look for correlations between the ADR of screening and all examinations. METHODS: We retrospectively assessed the quality indicators of all colonoscopies performed in a nonuniversity hospital, Frydek-Mistek, from January 2013 to December 2017. We calculated the ADR for all colonoscopies in patients over 50 years of age (subdivided into screening, surveillance, diagnostic) and separately only for screening colonoscopies. Correlations were made using the Pearson's correlation coeficient. RESULTS: The sample was composed of 6925 patients over 50 years of age (3620 men, 3305 women, mean age 66.2 years). The ADRs for screening and surveillance were higher than for diagnostic colonoscopies for all of the endoscopists, and the ADRs for all colonoscopies were lower than for screening, but sufficiently over 25%. There was a positive correlation between the ADR of screening and all colonoscopies (r=0.906, P<0.005). CONCLUSIONS: The calculation of ADR for all colonoscopies was possible in our endoscopic department, and there was a positive correlation with ADR for screening colonoscopies. ADR for all colonoscopies is a good tool for calculating real ADR from large sample sizes without gaming. TRIAL REGISTRATION: ClinicalTrials.gov (NCT03730441).

[Oncology Services for Patients with Head Neck Cancer during Corona-Times - Patients' Perspective]. / Auswirkungen der COVID-19-Pandemie auf die Versorgung von HNO-Tumoren ­ die Patientenperspektive.

OBJECTIVE: COVID-19 pandemic has impact on the oncology service system for tumor patients. What is the view of head and neck cancer patients (HNC) on this situation and which coping strategies were developed? MATERIAL & METHODS: In study 1 PRIO asked 433 tumor patients regarding their impressions/fears during the lockdown between April 15 and May 15, 2020 (online, standardized questionnaire). In 2nd study 292 tumor patients reported their pandemic-induced perceived changes and coping strategies by established questionnaires (WHO-5, MLQ, GrAw-7). An analysis of the HNC-data obtained by standardized questionnaires was performed. RESULTS: Study 1 had 91 HNC, study 2-84 HNC. Study 1 shows high stress levels for the majority of HNC (53,8 %). Personal fears regarding the own disease and therapies (39.6 %) are a central problem. The participants await physical (24.7 %) as well as psychological (21.3 %) consequences due to the pandemic and its current management. During the lockdown the isolation (banned visitors at any hospital) was discussed as critical main point by 58.5 % of HNC patients. Study 2 (after lockdown) underlined the mental stress caused by pandemic. Intensified relations within the families (58/100 points) as well as more intensive experience of nature and silence (58/60 points) are the most perceived changes in corona-times. HNC showed increased own inactivity (MLQ) and depressed well-being (WHO-5) and attention to the moment (GrAw-7). CONCLUSIONS: HNC patients have had high burden and fears due to the COVID-19 pandemic in spring 2020. Their views are important for further strategies to organize and stabilize the oncology service system during further pandemic periods.

Nanoscale Zero-Valent Iron Has Minimum Toxicological Risk on the Germination and Early Growth of Two Grass Species with Potential for Phytostabilization.

Two Poaceae species, Agrostis capillaris and Festuca rubra, were selected for their potential as phytostabilizing plants in multicontaminated soils. These species are resistant to contamination and maintain high concentrations of contaminants at the root level. Nanoscale zero-valent iron (nZVI) is an engineered nanomaterial with the ability to stabilize metal(loid)s in soils; its potential toxicological effects in the selected species were studied in a germination test using: (i) control variant without soil; (ii) soil contaminated with Pb and Zn; and (iii) contaminated soil amended with 1% nZVI, as well as in an hydroponic experiment with the addition of nZVI 0, 25, 50 and 100 mg L-1. nZVI had no negative effects on seed germination or seedling growth, but was associated with an increase in shoot growth and reduction of the elongation inhibition rate (root-dependent) of F. rubra seedlings. However, applications of nZVI in the hydroponic solution had no effects on F. rubra but A. capillaris developed longer roots and more biomass. Increasing nZVI concentrations in the growing solution increased Mg and Fe uptake and reduced the Fe translocation factor. Our results indicate that nZVI has few toxic effects on the studied species.

Norepinephrine transporter-derived homing peptides enable rapid endocytosis of drug delivery nanovehicles into neuroblastoma cells.

BACKGROUND: Currently, the diagnosis and treatment of neuroblastomas-the most frequent solid tumors in children-exploit the norepinephrine transporter (hNET) via radiolabeled norepinephrine analogs. We aim to develop a nanomedicine-based strategy towards precision therapy by targeting hNET cell-surface protein with hNET-derived homing peptides. RESULTS: The peptides (seq. GASNGINAYL and SLWERLAYGI) were shown to bind high-resolution homology models of hNET in silico. In particular, one unique binding site has marked the sequence and structural similarities of both peptides, while most of the contribution to the interaction was attributed to the electrostatic energy of Asn and Arg (< - 228 kJ/mol). The peptides were comprehensively characterized by computational and spectroscopic methods showing ~ 21% ß-sheets/aggregation for GASNGINAYL and ~ 27% α-helix for SLWERLAYGI. After decorating 12-nm ferritin-based nanovehicles with cysteinated peptides, both peptides exhibited high potential for use in actively targeted neuroblastoma nanotherapy with exceptional in vitro biocompatibility and stability, showing minor yet distinct influences of the peptides on the global expression profiles. Upon binding to hNET with fast binding kinetics, GASNGINAYLC peptides enabled rapid endocytosis of ferritins into neuroblastoma cells, leading to apoptosis due to increased selective cytotoxicity of transported payload ellipticine. Peptide-coated nanovehicles significantly showed higher levels of early apoptosis after 6 h than non-coated nanovehicles (11% and 7.3%, respectively). Furthermore, targeting with the GASNGINAYLC peptide led to significantly higher degree of late apoptosis compared to the SLWERLAYGIC peptide (9.3% and 4.4%, respectively). These findings were supported by increased formation of reactive oxygen species, down-regulation of survivin and Bcl-2 and up-regulated p53. CONCLUSION: This novel homing nanovehicle employing GASNGINAYLC peptide was shown to induce rapid endocytosis of ellipticine-loaded ferritins into neuroblastoma cells in selective fashion and with successful payload. Future homing peptide development via lead optimization and functional analysis can pave the way towards efficient peptide-based active delivery of nanomedicines to neuroblastoma cells.

Chlorophyll a fluorescence and Raman spectroscopy can monitor activation/deactivation of photosynthesis and carotenoids in Antarctic lichens.

Lichens survive harsh weather of Antarctica as well as of other hostile environments worldwide. Therefore, this investigation is important to understand the evolution of life on Earth in relation to their stress tolerance strategy. We have used chlorophyll a fluorescence (ChlF) and Raman spectroscopy, respectively, to monitor the activation/deactivation of photosynthesis and carotenoids in three diverse Antarctic lichens, Dermatocarpon polyphyllizum (DP), Umbilicaria antarctica (UA), and Leptogium puberulum (LP). These lichens, post 4 h or 24 h of hydration, showed differences in their ChlF transients and values of major ChlF parameters, e.g., in the maximum quantum efficiency of PSII photochemistry (Fv/Fm), and yields of fluorescence and heat dissipation (Φf,d), of effective quantum efficiency of PSII photochemistry (ΦPSII) and of non-photochemical quenching (Φnpq), which may be due to quantitative and/or qualitative differences in the composition of their photobionts. For understanding the kinetics of hydration-induced activation of photosynthesis, we screened ΦPSII of these lichens and reported its non-linear stimulation on a minute time scale; half of the activation time (t1/2) was fastest ~4.05 ± 0.29 min for DP, which was followed by 5.46 ± 0.18 min for UA, and 13.95 ± 1.24 min for LP. Upon drying of fully activated lichen thallus, there was a slow decay, in hours, of relative water content (RWC) as well as of Fv/Fm. Raman spectral signatures were different for lichens having algal (in DP and UA) and cyanobacteria (in LP) photobionts, and there was a significant shift in ν1(C=C) Raman band of carotenoids post 24 h hydration as compared to their value at a dry state or post 4 h of hydration; this shift was decreased, when drying, in DP and LP but not in UA. We conclude that hydration nonlinearly activated photosynthetic apparatus/reactions of these lichens in minute time range but there was a de-novo synthesis of chlorophylls as well as of carotenoids post 24 h. Their dehydration-induced deactivation, however, was comparatively slow, in hours range, and there seemed a degradation of synthesized chlorophylls and carotenoids post dryness. We conclude that in extremophilic lichens, their photosynthetic partners, in particular, possess a complex survival and photoprotective strategy to be successful in the extreme terrestrial environments in Antarctica.

A correlative approach, combining chlorophyll a fluorescence, reflectance, and Raman spectroscopy, for monitoring hydration induced changes in Antarctic lichen Dermatocarpon polyphyllizum.

Lichens are successful colonizers in extreme environments worldwide, and they are considered to have played an important role during the evolution of life. Here, we have used a correlative approach, combining three optical signals (chlorophyll a fluorescence (ChlF), reflectance, and Raman spectra), to monitor hydration induced changes in photosynthetic properties of an Antarctic chlorolichen Dermatocarpon polyphyllizum. We measured these three signals from this lichen at different stages (after 4 h, 24 h, and 48 h) of hydration, and compared the data obtained from this lichen in "dry state" as well as in different "hydrated state". We found that dry state of this lichen has: (1) no variable ChlF, (2) high reflectance, with no red-edge and almost zero photochemical reflectance index (PRI), and (3) low-intensity Raman bands of their carotenoids. Furthermore, 4 h of hydration, increased its relative water content (RWC) by 93%, showed red-edge in reflectance spectra, and changed the maximum quantum yield of PSII photochemistry (Fv/Fm) from 0 to 0.57 ±â€¯0.01. We found that reflectance indices, normalized difference index (NDVI) and PRI, significantly differed between brown and black/green surface areas, at all hydration stages; whereas, a shift in the Raman ν1(CC) band, between brown and black/green surface areas, occurred in 24 h or 48 h hydrated samples. These data indicate that hydration shortly (within 4 h) activated functions of photosynthetic apparatus, and the de novo synthesis of carotenoids occured in 24 h or 48 h. Furthermore, exposure to high irradiance (2000 µmol photons m-2 s-1), in 48 h hydrated lichen, significantly reduced Fv/Fm (signifies photoinhibition) and increased PRI (represents changes in xanthophyll pigments). We conclude that the implication of such a correlative approach is highly useful for understanding survival and protective mechanisms on extremophile photosynthetic organisms.

Efficacy and safety of etanercept in psoriasis and psoriatic arthritis in the PRESTA study: analysis in patients from Central and Eastern Europe.

BACKGROUND: Data are limited on the effectiveness of anti-TNF and other biologics on psoriatric arthritis (PsA) in Central and Eastern Europe (CEE). The objective of this analysis was to evaluate the efficacy of etanercept (ETN) in PsA patients from CEE. METHODS: In PRESTA, patients were randomized to receive ETN 50 mg BIW or 50 mg QW for 12 weeks (double-blind phase) and ETN 50 mg QW for 12 additional weeks (open label). In this analysis, only patients from Czech Republic, Hungary, Poland and Serbia were included. The primary efficacy variable was the proportion of subjects achieving a physician global assessment (PGA) of psoriasis status: "clear" or "almost clear" at week 12. RESULTS: In the 307 patients, 54% BIW/QW compared with 40% (QW/QW) (p = .02), achieved "clear"/"almost clear" for PGA of psoriasis at week 12 increasing, to 68% and 60%, respectively (p = .134) by week 24. Mean improvement from baseline in PASI were 59% versus 49% (p = .005) at week 6 and 87% versus 81% (p < .05) at week 24, for the BIW/QW and QW/QW groups, respectively. ETN was well tolerated in both groups over 24 weeks. CONCLUSIONS: Both dose regimens of ETN provided significant improvements in efficacy in PsA treatment and were well tolerated.

Comparative study on toxicity of extracellularly biosynthesized and laboratory synthesized CdTe quantum dots.

Nanobiosynthesis belongs to the most recent methods for synthesis of nanoparticles. This type of synthesis provides many advantages including the uniformity in particle shape and size. The biosynthesis has also a significant advantage regarding chemical properties of the obtained particles. In this study, we characterized the basic properties and composition of quantum dots (QDs), obtained by the extracellular biosynthesis by Escherichia coli. Furthermore, the toxicity of the biosynthesized QDs was compared to QDs prepared by microwave synthesis. The obtained results revealed the presence of cyan CdTe QDs after removal of substantial amounts of organic compounds, which stabilized the nanoparticle surface. QDs toxicity was evaluated using three cell lines Human Foreskin Fibroblast (HFF), Human Prostate Cancer cells (PC-3) and Breast Cancer cells (MCF-7) and the MTT assay. The test revealed differences in the toxicity between variants of QDs, varying about 10% in the HFF and 30% in the MCF-7 cell lines. The toxicity of the biosynthesized QDs to the PC-3 cell lines was about 35% lower in comparison with the QDs prepared by microwave synthesis.

[Overview of current modalities of colorectal cancer screening]. / Prehled soucasných metod screeningu kolorektálního karcinomu.

There are one-step and two-steps programs for colorectal cancer screening. The aim of all screening examinations is to detect early stage of the disease in asymptomatic patient. The aim of this article is actual review of current screening modalities such as fecal occult blood test, flexible sigmoideoscopy, colonoscopy, CT colonography, capsule endoscopy, blood-based tests and stool DNA tests. Colonoscopy still remains the gold standard for detection of colorectal neoplasias. In majority of countries worldwide programs for colorectal cancer screening are based on immunochemical fecal occult blood test followed by colonoscopy when positive.

The efficacy of treatment of local residual neoplasia under standardized conditions.

OBJECTIVES: Piecemeal endoscopic mucosal resection (EMR) is frequently used for the treatment of non-poly-poid colorectal lesions larger than 20 mm. Nevertheless, local residual neoplasia occurs (LRN) in as much as 15 % of cases. The aim of our prospective interventional study was to evaluate the efficacy of treatment of LRN under standardized conditions. METHODS: In two high volume non-university endoscopy centers, LRN has been treated according to the newly proposed classification based on endoscopic appearance by argon plasma coagulation (APC), endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD). Primary outcome, efficacy of LRN treatment, was defined as both endoscopic and histological absence of neoplastic tissue in the post-EMR site 6 months after LRN treatment session. RESULTS: Twenty-five patients with 25 LRN lesions were enrolled. Among them, 12 (48 %), 8 (32 %) and 5 (20 %) were treated by APC, EMR and ESD, respectively, with efficacy in 10 (90.9 %), 7 (87.5 %) and 4 (100 %), respectively. CONCLUSIONS: Using standardized approach based on therapy directed by LRN morphology, LRN may be eradicated in 91.3 % during one session. KEY WORDS: colonoscopy - endoscopic mucosal resection - local residual neoplasia.

Adaptation strategies of endolithic chlorophototrophs to survive the hyperarid and extreme solar radiation environment of the Atacama Desert.

The Atacama Desert, northern Chile, is one of the driest deserts on Earth and, as such, a natural laboratory to explore the limits of life and the strategies evolved by microorganisms to adapt to extreme environments. Here we report the exceptional adaptation strategies of chlorophototrophic and eukaryotic algae, and chlorophototrophic and prokaryotic cyanobacteria to the hyperarid and extremely high solar radiation conditions occurring in this desert. Our approach combined several microscopy techniques, spectroscopic analytical methods, and molecular analyses. We found that the major adaptation strategy was to avoid the extreme environmental conditions by colonizing cryptoendolithic, as well as, hypoendolithic habitats within gypsum deposits. The cryptoendolithic colonization occurred a few millimeters beneath the gypsum surface and showed a succession of organized horizons of algae and cyanobacteria, which has never been reported for endolithic microbial communities. The presence of cyanobacteria beneath the algal layer, in close contact with sepiolite inclusions, and their hypoendolithic colonization suggest that occasional liquid water might persist within these sub-microhabitats. We also identified the presence of abundant carotenoids in the upper cryptoendolithic algal habitat and scytonemin in the cyanobacteria hypoendolithic habitat. This study illustrates that successful lithobiontic microbial colonization at the limit for microbial life is the result of a combination of adaptive strategies to avoid excess solar irradiance and extreme evapotranspiration rates, taking advantage of the complex structural and mineralogical characteristics of gypsum deposits-conceptually called "rock's habitable architecture." Additionally, self-protection by synthesis and accumulation of secondary metabolites likely produces a shielding effect that prevents photoinhibition and lethal photooxidative damage to the chlorophototrophs, representing another level of adaptation.

Dietary habits of colorectal neoplasia patients in comparison to their first-degree relatives.

AIM: To compare the dietary habits between colorectal neoplasia patients, their first-degree relatives, and unrelated controls. METHODS: From July 2008 to April 2011, we collected epidemiological data relevant to colorectal cancer from patients with colorectal neoplasias, their first-degree relatives, and also from a control group consisting of people referred for colonoscopy with a negative family history of colorectal cancer and without evidence of neoplasia after colonoscopic examination. The first-degree relatives were divided into two groups following the colonoscopic examination: (1) patients with neoplasia or (2) patients without neoplasia. Dietary habits of all groups were compared. A χ (2) test was used to assess the association between two dichotomous categorical variables. RESULTS: The study groups consisted of 242 patients with colorectal neoplasias (143 men, 99 women; mean age: 64 ± 12 years) and 160 first-degree relatives (66 men, 94 women; mean age: 48 ± 11 years). Fifty-five of the first-degree relatives were found to have a neoplastic lesion upon colonoscopy, while the remaining 105 were without neoplasia. The control group contained 123 individuals with a negative family history for neoplastic lesions (66 men, 57 women; mean age: 54 ± 12 years). Two hypotheses were tested. In the first, the dietary habits of first-degree relatives with neoplasia were more similar to those of patients with neoplasia, while the dietary habits of first-degree relatives without neoplasia were similar to those of the control group. In the second, no sex-related differences in dietary habits were expected between the particular groups. Indeed, no significant differences were observed in the dietary habits between the groups of patients, controls and first-degree relatives with/without neoplastic lesions. Nevertheless, statistically significant sex-related differences were observed in all groups, wherein women had healthier dietary habits than men. CONCLUSION: In all groups examined, women had healthier dietary habits than men. Modification of screening guidelines according to sex may improve the efficiency of screening programs.

Chromoendoscopy to detect early synchronous second primary esophageal carcinoma in patients with squamous cell carcinomas of the head and neck?

Objective. To evaluate the use of flexible esophagoscopy and chromoendoscopy with Lugol's solution in the detection of early esophageal carcinomas (second primary carcinomas) in patients with squamous cell carcinoma of the head and neck (HNSCC). Methods. All patients with newly diagnosed HNSCC underwent office-based Lugol's chromoendoscopy. After flexible esophagoscopy with white light, 3.0% Lugol's iodine solution was sprayed over the entire esophageal mucosa. Areas with less-intense staining (LVLs) were evaluated and biopsies taken. Results. 132 patients with HNSCC were enrolled in this study. The most frequent primary tumors were oropharyngeal (49/132), tumors of the oral cavity (36/132), and larynx (35/132). The majority of subjects (107/132 patients, 81.1%) had advanced HNSCC carcinomas (stages III and IV). Multiple LVLs were discovered in 24 subjects (18.2%) and no LVLs in 108 (81.8%) subjects. Fifty-five LVL biopsy specimens were obtained and assessed. Squamous cell carcinomas were detected in two patients, peptic esophagitis in 11 patients, gastric heterotopic mucosa in two patients, hyperplasia in two patients, and low- and high-grade dysplasia in three patients. Conclusion. Although only two patients with synchronous primary carcinomas were found among the patients, esophagoscopy should be recommended after detection of HNSCC to exclude secondary esophageal carcinoma or dysplasia.

Local residual neoplasia after endoscopic treatment of laterally spreading tumors during 15 months of follow-up.

BACKGROUND: Among superficial neoplastic lesions of the colon and rectum, a laterally spreading tumor (LST) is a flat elevated type at least 10 mm in size. It can be treated by conventional endoscopic resection (CER). Nevertheless, local residual neoplasia (LRN) may occur during follow-up. The aim of this prospective study was to evaluate the occurrence of LRN and the risk factors for its presence. METHODS: Consecutive patients referred for CER of an LST were included. Follow-up colonoscopies were performed after 3 and 15 months. LRN was defined histologically as the presence of neoplastic tissue in the post-CER site. RESULTS: Of a total of 127 patients with 127 lesions, follow-up could not be completed in 48 (37.8%). Of the remaining 79 (62.2%) patients (64.6% men, mean age 66.1±9.7 years), 63 (79.7%) were negative and 16 (20.3%) were positive for the presence of LRN after 15 months. Of 62 (78.5%) patients without LRN after 3 months, 55 (88.7%) remained negative after 15 months. Of 17 (21.5%) patients with LRN after 3 months, eight (47.1%) were negative after 15 months. In a multivariate analysis, LST size of at least 20 mm was found to be a significant risk factor after 3 months (odds ratio, 5.837; 95% confidence interval 1.199-28.425; P=0.029). After 15 months, the only significant risk factor was the presence of LRN observed after 3 months (odds ratio, 6.0; 95% confidence interval, 1.793-20.073; P=0.004). CONCLUSION: This prospective study shows that the occurrence of LRN is frequent and its treatment is less effective than reported previously. These are important limitations of CER and should be taken into consideration for the management of patients with LSTs.

Use of Raman spectroscopy for identification of compatible solutes in halophilic bacteria.

We explored the use of Raman spectroscopy to detect organic osmotic solutes as biomarkers in the moderately halophilic heterotrophic bacterium Halomonas elongata grown in complex medium (accumulation of glycine betaine) and in defined medium with glucose as carbon source (biosynthesis of ectoine), and in the anoxygenic phototrophic Ectothiorhodospira marismortui known to synthesize glycine betaine in combination with minor amounts of trehalose and N-α-carbamoyl glutamineamide. We tested different methods of preparation of the material: lyophilization, two-phase extraction of water-soluble molecules, and perchlorate extraction. Raman signals of glycine betaine and ectoine were detected; perchlorate extraction followed by desalting the extract on an ion retardation column gave the best results. Lyophilized cells of E. marismortui showed strong signals of carotenoid pigments, and glycine betaine could be detected only after perchlorate extraction and desalting. The data presented show that Raman spectroscopy is a suitable tool to assess the mode of osmotic adaptation used by halophilic microorganisms.

High-frequency ultrasound probe sonography staging for colorectal neoplasia with superficial morphology: its utility and impact on patient management.

BACKGROUND: This prospective study aimed to evaluate the impact of high-frequency ultrasound probe sonography (HFUPS) staging on the management of patients with superficial colorectal neoplasia (SCN) as determined by the endoscopic characteristics of lesions. METHODS: Consecutive patients referred for endoscopic treatment of nonpedunculated SCN were enrolled in this study. A lesion was considered high risk if a depressed area or invasive pit pattern was present. The gold standard for final staging included histology from endoscopic or surgical resection. The impact on treatment was defined as any modification of the therapeutic algorithm based on the result of the HFUPS examination compared with that based on endoscopy alone. RESULTS: In this study, 48 lesions in 48 patients were evaluated. Of these, 28 (58%) were considered high risk, and the remaining 20 (42%) were regarded as low risk. A total of seven lesions (15%) that could not be examined with HFUPS and another non-neoplastic lesion were excluded from final analysis. For the remaining 40 lesions, the overall accuracy of the HFUPS examination to predict the correct T-stage was 90% (95% confidence interval [CI], 77-96%). The HFUPS examination had a positive impact on the treatment of 0 low-risk and 11 high-risk (42%) lesions. CONCLUSION: The impact of HFUPS on the treatment of SCN depends on their endoscopic characteristics. It is negligible for low-risk SCNs, and these lesions can be treated on the basis of their endoscopic appearance alone. Nevertheless, compared with endoscopy alone, HFUPS changed the subsequent therapeutic approach in a positive way for up to 42% of high-risk lesions, including those with a depressed component and an invasive pit pattern. These endoscopic features can therefore be recommended as the entry criteria for an HFUPS examination.

Recurrent oesophageal intramucosal squamous carcinoma treated by endoscopic mucosal resection and subsequent radiofrequency ablation using HALO system.

The method of radiofrequency ablation (RFA) is currently used for the treatment of high-grade dysplasia in Barrett's oesophagus. It has theoretical potential also for the use in squamous epithelial neoplasias. The authors present a case report of an early diagnosis of squamous cancer in a high-risk patient, its endoscopic treatment and follow-up, and successful RFA of recurrent neoplasia. RFA can expand our therapeutic possibilities for the management of recurrent neoplastic lesions after endoscopic treatment of squamous oesophageal cancer.