Dimensional changes in the Kolahoi glacier from 1857 to 2014.

This study assimilates data from historical records (1857-1961/84), survey of India topographic maps, and a series of multispectral satellite data (1962-2014) for analyzing the shrinkage and dimensional changes of the Kolahoi glacier, Jammu and Kashmir, between 1857 and 2014. The composite results show that the glacier has receded by ∼3423 m (21.8 m/year) in the past 157 years. The historical records reveal that the glacier retreated by >1609 m from 1857 to 1909, 800 m from 1912 to 1961, and 210 m from 1961 to 1984. From 1962 to 2014 (52 years), we observed a retreat of 1014 ± 64 m (19.5 ± 1.1 m/year). We noted a marked disparity in the retreat rates of primary snout (PS) and secondary snout (SS) which was found to be 19.5 ± 1.1 m/year for PS and 11.34 ± 1.1 m/year for SS. Further, our investigations reveal that the changes in the length are accompanied by considerable changes in the area. The area of the glacier reduced from 14.46 ± 0.34 km2 (1962) to 11.28 ± 0.21 km2 (2014) amounting an overall deglaciation of 3.18 ± 0.34 km2 or 22.99 ± 2.3% in the past 52 years. Besides, the glacier has started degenerating at a much accelerated pace showing a deglaciation of 11.1 ± 1.9% and a recession rate of ~27.8 ± 3.2 m/year in just 14 years (2000-2014). These results warrant the detailed studies regarding various controlling factors, besides the climate change.

A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model.

BACKGROUND: Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures. OBJECTIVE: To compare the diagnostic yield of balloon-assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model. DESIGN: Prospective, cohort study. SETTING: International gastroenterology meeting. SUBJECT: A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps"). INTERVENTIONS: Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-assisted colonoscopy. MAIN OUTCOME MEASUREMENTS: Detection of simulated polyps. RESULTS: The median polyp detection rate for all simulated polyps was significantly higher with balloon-assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P < .0001). The significantly higher simulated polyp detection rate with balloon-assisted versus standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P < .0001) and obscured polyps (88.0% vs 25.0%; P < .0001). LIMITATIONS: Non-randomized design, use of a colon model, and simulated colon polyps. CONCLUSION: As compared with standard colonoscopy, balloon-assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology.

Coexistence of ANCA-associated glomerulonephritis and anti-phospholipase A(2) receptor antibody-positive membranous nephropathy.

Antibodies to myeloperoxidase (MPO) and proteinase 3 (PR3) have been demonstrated to mediate anti-neutrophil cytoplasmic antibody (ANCA)-associated disease. For membranous nephropathy, antibodies to the podocyte-expressed phospholipase A(2) receptor (anti-PLA(2)R) are highly associated with disease activity and have been reported in at least 70% of patients with idiopathic membranous nephropathy (IMN). We present a case of a 56-year-old male with a 1 year history of hypertension, leg edema, and proteinuria, who presented with advanced renal failure and was found to have both ANCA-associated glomerulonephritis (GN) and IMN on kidney biopsy. Consistent with the idea that this is due to the chance occurrence of two independent diseases, we found both anti-MPO and anti-PLA(2)R antibodies in the patient's sera. Treatment with methylprednisolone, plasmapheresis, and cyclophosphamide resulted in improvement in kidney function and proteinuria, together with the simultaneous decrease in both autoantibodies. This is the first demonstration of two pathogenic antibodies giving rise to ANCA-associated GN and IMN in the same patient. It confirms the importance of classifying disease based upon the underlying mechanism, in addition to renal histopathology, to both optimize therapy and predict prognosis.

Infectious causes of colorectal cancer.

Colorectal cancer is a major cause of cancer-related morbidity and mortality in the United States and many other regions of the world. Our understanding of the pathogenesis of colorectal cancer, from the precursor adenomatous polyp to adenocarcinoma, has evolved rapidly. Colorectal carcinogenesis is a sequential process characterized by the accumulation of multiple genetic and molecular alterations in colonic epithelial cells. However, the development of colorectal cancer involves more then just a genetic predisposition. External or environmental factors presumably play a significant role, and inflammatory bowel diseases, obesity, alcohol consumption, and a diet high in fat and low in fiber have all been implicated as risk factors for the development of either colonic adenomas or carcinomas. We are becoming increasingly aware of microbes as causes of malignancies. This article reviews the various microbes that have been associated with the development of colorectal carcinomas.