No Interval Cancers in Endoscopic Practice.

Colonoscopy is long time the most preferred method for CRC screening along with diagnosis and treatment for a range of colon diseases. Based on its difficulty in visualizing precursor CRC lesions, mostly those located on the right colon, this method can be subject of improvement. The colonoscopy quality can be influenced by many factors such as colon preparation, retraction time, the colonoscopists medical training and knowledges as well as the performance of endoscopy equipment. The bad quality of colonoscopy will result in the emergence of interval cancers defined, based on the author, as cancers that appear at 3-5 years up to 10 years from the colonoscopy procedure. Interval cancers have predominantly incriminated both the colonoscopy quality and the clinician competences and less the tumor biology. Subsequently there were set quality indicators of colonoscopy in order to raise the quality of the exploration. Among the important indicators, proving their utility in studies, the ADR (adenoma detection rate) is most commonly used along with PDR (polyp detection rate) and APC (adenoma per colonoscopy). Following the purpose of obtaining a higher colonoscopy quality the medical units should keep in check all indicators. Furthermore, there should be an active involvement in an additional training of non-conforming medical personnel or even restrain of practice, given the medical legal actions that have interval cancers as a main cause.

Tuning the electrical properties of the p-type transparent conducting oxide Cu1-xCr1+xO2 by controlled annealing.

Off-stoichiometric copper chromium oxide delafossite received lately a great interest due to its high p-type electrical conductivity and adequate optical transmittance in the visible range. However, for a suitable integration in active devices such as p-n junctions, transistors or optoelectronic devices, the electronic properties must be efficiently tailored. Here, post-deposition thermal treatment is proven as an adequate approach for finely controlling the electrical properties of this former degenerate semiconducting material. The energetics of the annealing process are investigated using two different approaches, as a function of the annealing temperature and as a function of the annealing time, allowing the accurate determination of the activation energy of the annealing of defects. By using this method, the electrical carrier concentration was varied in the 1021 - 1017 cm-3 range while the recorded changes in the drift mobility covered three orders of magnitude. Moreover, we demonstrate the ability to accurately manipulate the Fermi level of such materials, which is of great importance in controlling the carrier injection and extraction in optoelectronic active layers.

Noninvasive Fibrosis Assessment in Chronic Viral Hepatitis C associated with End Stage Renal Disease.

INTRODUCTION: HCV is considered the most encountered viral infection that affect patients after hemodialysis sessions. Even though liver biopsy is considered the golden standard for hepatic diagnosis, additional methods have been used for assessing liver fibrosis. Transient elastography (TE) has evolved as a reference method in some European countries and allows the physician to carry out a fibrosis evaluation in a noninvasive, low-cost and rapid method. Our objective was to assess the efficacy of TE in staging patients with HCV liver disease associated with ESRD, thus choosing the correct moment to perform the procedure. MATERIALS AND METHODS: We included 34 patients known with ESRD within the regional Nephrology Clinic of Olt County Hospital and also having positive hepatitis C viral liver marker. TE was performed before and hemodialysis and data was analyzed. RESULTS: The patients where we have encountered significant changes were especially within the F0 and F1 stage with a decrease of fibrosis after hemodialysis. Thus, 7 patients which had no fibrosis (F0) went from 4,14±0,98kPa to 3,54±0,84 (p<0,05) and 12 patients from the F1 stage went from 6,22±0,39kPa to 5,47±0,58kPa. The other stages had no significant changes with F2 changing after hemodialysis from 8.03±0,62kPa to 7, 76±0,6kPa. CONCLUSIONS: TE represents a valuable tool for stiffness assessment and should be taken into considerations as a major option for ESRD patients with liver disease. However, more patients should be enrolled to strengthen this theory and thus providing more reliable results.

Transient quantum trapping of fast atoms at surfaces.

We report on the experimental observation and theoretical study of the bound state resonances in fast atom diffraction at surfaces. In our studies, the 4He atom beam has been scattered from a high-quality LiF(001) surface at very small grazing incidence angles. In this regime, the reciprocal lattice vector exchange with the surface allows transient trapping of the 0.3-0.5 keV projectiles into the quasistationary states bound by the attractive atom-surface potential well which is only 10 meV deep. Analysis of the linewidths of the calculated and measured resonances reveals that prior to their release, the trapped projectiles preserve their coherence over travel distances along the surface as large as 0.2 µm, while being in average only at some angstroms in front of the last atomic plane.

Heteronanojunctions with atomic size control using a lab-on-chip electrochemical approach with integrated microfluidics.

A versatile tool for electrochemical fabrication of heteronanojunctions with nanocontacts made of a few atoms and nanogaps of molecular spacing is presented. By integrating microfluidic circuitry in a lab-on-chip approach, we keep control of the electrochemical environment in the vicinity of the nanojunction and add new versatility for exchanging and controlling the junction's medium. Nanocontacts made of various materials by successive local controlled depositions are demonstrated, with electrical properties revealing sizes reaching a few atoms only. Investigations on benchmark molecular electronics material, trapped between electrodes, reveal the possibility to create nanogaps of size matching those of molecules. We illustrate the interest of a microfluidic approach by showing that exposure of a fabricated molecular junction to controlled high solvent flows can be used as a reliability criterion for the presence of molecular entities in a gap.

[Heterotopic accessory pancreas in surgical pathology: review of 23 years experience]. / Pancreasul accesor heterotopic in patologia chirurgicala: experienta a 23 de ani.

BACKGROUND: The abnormal presence of the pancreatic tissue in other digestive organs is rare but sometimes is the cause of some surgical diseases. MATERIAL AND METHOD: This retrospective study is focussed on heterotopic pancreas cases diagnosed in 2nd Surgical Clinic of "Sf. Spiridon" Emergency Hospital from Iasi between Jan. 1986 and Dec. 2008. RESULTS: 22 patients (15 males/68.2% and 7 females/31.8%) aged between 23 and 76 years were grouped in A group--clinical symptomatic cases (3 patients/13.6%), group B--coincidental cases (17 patients/77.3%) and group C--incidental cases (2 patients/9%). Group A patients presented with obstructing prepyloric polypoid tumors and recquired antrectomy and gastroduodenal anastomosis. 13 patients of group B (76.4%) recquired surgery for pyloroduodenal stenosis and in 4 cases of this group with severe upper-GI bleeding, a subtotal gastric resection (3 patients) or antrectomy (1 case) was performed. In group C patients jejunal HP was histopathologically diagnosed during extensive intestinal resection for colonic malignancies (ascendant colonic and transverse colonic cancers) with jejunal invasion. HP cases were categorized as type I in 40.9% cases (ducts, acini and pancreatic islets), type II in 45.4% cases (ducts and acini) and type III (exclusively with ducts) in 13.6% cases. In 76% patients HP was localized in mucosal and submucosal layers, in 16% intramucosal and in 8% in subserous layer. CONCLUSION: HP is most often an unexpected symptomless coincidental diagnosis during gastrointestinal surgical diseases.

[The absence of haptic perception in laparoscopic cholecystectomy--risk factor for biliary lesions]. / Absenta perceptiei haptice în colecistectomia laparoscopica--factor de risc pentru leziuni biliare.

BACKGROUND: Bile duct injuries are the main serious technical complication of laparoscopic cholecystectomy (LC). Each lesion is peculiar in its features as well as the surgeon's reaction when face it. AIM: To reveal the place of the human error according to accepted principles of cognitive psychology, beside other risk-factors involved in biliary accidents during LC. METHOD: Retrospective study on 18 patients treated for severe biliary lesions during LC in 1st Surgical Clinic of "Sf. Spiridon" Hospital, Iasi, Romania, between March 1993 and March 2008. According to Strasberg's classification the lesions were: type C (n=1; 3%), type D (n=13; 39.4%), type E1-2 (n=2; 6.1%) and type E5 (n=2; 6.1%). In the medical records we followed up the technical aspects of the procedure (section, dissection, clips) and the lesional and anatomic factors attended at the moment of LC. We also assessed the concerned surgeons experience based on the number of the LC at time of the biliary accident. RESULTS: In our experience (10046 LC) the incidence of the biliary injuries was 0.1% only. We met four lesional and/or anatomic factors (mean) on each case with biliary lesion. Only five cases (27.7%) were detected intraoperatively, but Spearman's correlation between time of detection and surgeons experience is insignificant. CONCLUSION: Our results, rounded with cognitive psychology data from literature, suggest the role of the absence of haptic perception during laparoscopic procedures, in the occurrence of some errors, even in circumstances with "perfect visibility".

The histopathologic type of the periampullary tumors. Is it important for survival?

BACKGROUND: The ampulla of Vater is a junction with four histologic epithelial types: ampullary, duodenal, pancreatic and biliary. The tumors of this region are named periampullary adenocarcinomas, but the histologic type of these malignancies seems to have an important significance for survival. AIM: Our purpose is to determine whether the histologic type of the resectable vaterian adenocarcinomas is a prognostic factor. METHODS: We reviewed the medical records of 38 patients who underwent RO-R1 pancreatoduodenectomy for periampullary adenocarcinomas between 1998 and 2007 in one single surgical center. The histopathologic reports and the microscopic samples were reevaluated independently by two senior pathologists. Using our database we assessed the overall survival based on histologic type, tumor stage, lymph nodes involvement, tumor size and the level of differentiation. RESULTS: The histologic type of the adenocarcinomas was intestinal in 23 cases (60.5%) and pancreatobiliary in 15 cases (39.5%). The median overall survival was significantly higher in patients with well differentiate intestinal-type in T1-T2 stage without nodes involvement. In a multivariable Cox regression analysis the regional lymph nodes involvement and the differentiation degree remained significant prognostic factors. CONCLUSION: The intestinal type of periampullary adenocarcinomas has a long survival, but the lymph nodes involvement and the lower degree of differentiation are associated with a high risk of death in these malignancies.

[Preclinical assay on a magnetic carrier type ferrofluid]. / Studiu preclinic asupra unui purtator magnetic tip ferofluid.

UNLABELLED: The aim of the study was to determine the acute toxicity and the antimicrobial actions of an original magnetic carrier, type ferrofluid. The hydrophilic ferrofluid was prepared by covering the Fe3O4 nannoparticles with ammoniumoleate. The absolute amount of iron was of 40 mg/ml ferrofluid. METHODS: Acute toxicity was evaluated on five groups of Swiss male mice, after a single intraperitoneal administration of 1, 0.75, 0.5, 0.25 and 0.125 ml dose of pure ferrofluid/100 g body weight (b.w.), using step-level toxicity method. The study groups of mice were follow-up for 10 days. We did not use the same volume of solution for all the study groups because we were concerned about not to modify the behavior of the ferrofluid (but for each group we used the same volume of solution). The tasks of this part of the study were: 1) the record of the mice death in the first 10 days after intraperitoneal administration of ferrofluid; 2) the behavior of the animal subjects; 3) the morphopathologic examination of kidney, lung, heart, liver and peritoneum samples from the death mice and from the after ten days survivors which were sacrificed. We also investigated the possible antibacterial actions of the ferrofluid on E. coli spp., Klebsiella spp., Staphylococcus aureus Streptococcus group D., in the second part of the study, using standard lab kit. The validation of the results was performed using controls for E. colli and Staphylococcus aureus. RESULTS: The death of the mice was registered between 24 and finished after 96 hours. The maximum tolerated dose (MTD), was of 0.25 ml (10 mg iron/100 g b.w.) and the lethal dose hundred percent (LD100) was of 0.75 ml/(30 mg iron/100 b.w.). In our study we did not determined any kind of antibacterial action of the ferrofluid. CONCLUSIONS: 1) LD100, in our study, was of 30 mg iron/100 g b.w., and DMT of 10 mg iron/100 g b.w. 2) The death of the mice may be due to toxic aggression of ammonium ions released, in vivo, from the ammoniumoleate coverage of magnetite nannoparticles. 3) There were no in vitro antibacterial actions for this ferrofluid.

Associated respiratory and herpes virus infections in patients with acute keratitis.

Viral antigens were detected by immunofluorescence in exfoliated conjunctival cells from 100 out of 110 keratitis patients investigated. The overall prevalence of respiratory virus antigens (parainfluenza, influenza, adenovirus) was twice as high as that of herpes antigens. The ratio between respiratory and herpes virus antigens was of 4:1 in the patients with acute respiratory syndromes in the past history, as against 2:1 in those who had had no respiratory illness.

Contribution of the rapid viral diagnosis by immunofluorescence to the choice of therapy in uveitis cases.

Viral and inframicrobial antigens were detected by immunofluorescence (IF) in exfoliated conjunctival and corneal cells from 22 patients with uveitis, 2-9 different antigens being simultaneously visualized in 17 of the cases. The treatment applied on the ground of the etiological diagnosis specified by IF reactions consisted in the administration of tetracycline, Flumidin (Virustat), standard gamma-globulin or specific antiherpes immunoglobulin, the NIVGRIP inactivated influenza vaccine. This therapy led to persistent recovery (coincident with the disappearance of the antigens from conjunctival cells) in 15 cases and to clinical improvement in 7 cases. The importance of the rapid viral diagnosis by IF for the choice of an adequate therapy of uveitis is discussed.