Artificial intelligence for the real-time classification of intrapapillary capillary loop patterns in the endoscopic diagnosis of early oesophageal squamous cell carcinoma: A proof-of-concept study.

Background: Intrapapillary capillary loops (IPCLs) represent an endoscopically visible feature of early squamous cell neoplasia (ESCN) which correlate with invasion depth - an important factor in the success of curative endoscopic therapy. IPCLs visualised on magnification endoscopy with Narrow Band Imaging (ME-NBI) can be used to train convolutional neural networks (CNNs) to detect the presence and classify staging of ESCN lesions. Methods: A total of 7046 sequential high-definition ME-NBI images from 17 patients (10 ESCN, 7 normal) were used to train a CNN. IPCL patterns were classified by three expert endoscopists according to the Japanese Endoscopic Society classification. Normal IPCLs were defined as type A, abnormal as B1-3. Matched histology was obtained for all imaged areas. Results: This CNN differentiates abnormal from normal IPCL patterns with 93.7% accuracy (86.2% to 98.3%) and sensitivity and specificity for classifying abnormal IPCL patterns of 89.3% (78.1% to 100%) and 98% (92% to 99.7%), respectively. Our CNN operates in real time with diagnostic prediction times between 26.17 ms and 37.48 ms. Conclusion: Our novel and proof-of-concept application of computer-aided endoscopic diagnosis shows that a CNN can accurately classify IPCL patterns as normal or abnormal. This system could be used as an in vivo, real-time clinical decision support tool for endoscopists assessing and directing local therapy of ESCN.

[Modern approaches to the diagnosis of precancerous pathology and early lung cancer]. / Sovremennye podkhody k diagnostike predopukholevoi patologii i rannego raka legkogo.

AIM: To assess the possibilities of modern diagnostic techniques to diagnose precancerous pathology and early central lung cancer. MATERIAL AND METHODS: Analysis of Russian and foreign publications for precancerous pathology and early lung cancer, results and comparison of various diagnostic techniques. RESULTS: Central lung cancer has a stepwise development with transformation of normal bronchial epithelium to hyperplastic followed by focal metaplasia, dysplasia, cancer in situ (CIS) and microinvasive cancer. Fluorography, chest X-ray, computed tomography, magnetic resonance imaging and sputum cytology examination are used to diagnose lung cancer. However, endoscopy plays a leading role in diagnosis of early central lung cancer which rapidly and effectively detects changes of tracheobronchial tree mucosa at the initial stages of carcinogenesis thanks to the use of modern techniques (spectral, autofluorescent and ZOOM - endoscopy).

Endoscopic submucosal dissection: European Society of Gastrointestinal Endoscopy (ESGE) Guideline

This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system 1 2 was adopted to define the strength of recommendations and the quality of evidence. Main Recommendations: 1 ESGE recommends endoscopic en bloc resection for superficial esophageal squamous cell cancers (SCCs), excluding those with obvious submucosal involvement (strong recommendation, moderate quality evidence). Endoscopic mucosal resection (EMR) may be considered in such lesions when they are smaller than 10 mm if en bloc resection can be assured. However, ESGE recommends endoscopic submucosal dissection (ESD) as the first option, mainly to provide an en bloc resection with accurate pathology staging and to avoid missing important histological features (strong recommendation, moderate quality evidence). 2 ESGE recommends endoscopic resection with a curative intent for visible lesions in Barrett's esophagus (strong recommendation, moderate quality evidence). ESD has not been shown to be superior to EMR for excision of mucosal cancer, and for that reason EMR should be preferred. ESD may be considered in selected cases, such as lesions larger than 15 mm, poorly lifting tumors, and lesions at risk for submucosal invasion (strong recommendation, moderate quality evidence). 3 ESGE recommends endoscopic resection for the treatment of gastric superficial neoplastic lesions that possess a very low risk of lymph node metastasis (strong recommendation, high quality evidence). EMR is an acceptable option for lesions smaller than 10 - 15 mm with a very low probability of advanced histology (Paris 0-IIa). However, ESGE recommends ESD as treatment of choice for most gastric superficial neoplastic lesions (strong recommendation, moderate quality evidence). 4 ESGE states that the majority of colonic and rectal superficial lesions can be effectively removed in a curative way by standard polypectomy and/or by EMR (strong recommendation, moderate quality evidence). ESD can be considered for removal of colonic and rectal lesions with high suspicion of limited submucosal invasion that is based on two main criteria of depressed morphology and irregular or nongranular surface pattern, particularly if the lesions are larger than 20 mm; or ESD can be considered for colorectal lesions that otherwise cannot be optimally and radically removed by snare-based techniques (strong recommendation, moderate quality evidence).(AU)

[Barrett esophagus: modern diagnosis, drug therapy and reduce risk of cancer].

This article describes ways of risk reducing of esophageal adenocarcinoma with the use of modern screening treatment methods of GERD and Barrett esophagus.

[Serologic screening for preneoplastic pathology and early stomach cancer].

Cancer of stomach is currently regarded as the final result of a staged multifactor process during which the microenvironment affects cells and causes their changes. One of the main triggering factors is Hp infection. Adenocarcinoma of stomach develops via stages of gastritis, precancerous changes, and cancer. The possibility to prevent cancer ensues from the potential irreversibility of premalignant processes in gastric mucosa, in the first place its atrophy; hence, the importance of its early diagnosis. The state of the endoscopic service in this country is inadequate for mass screening of patients with symptoms of dyspepsia. "GastroPanel", a new serological test for the diagnosis of gastric pathology provides information about histological and functional characteristics of gastric mucosa in the antral and fundal regions of the stomach. The method determines serum gastrin-17, pepsinogen-1, and IgG expressed in response to Hp infection. Our results demonstrate high diagnostic efficiency of "GastroPanel" as a screening technique for atrophic gastritis and assessment of stomach cancer risk.

Short communication. Sarcomere length changes during fish swimming.

NASA: The interaction between actin and myosin represents the fundamental force-producing mechanism in all skeletal muscles. Interaction between analogous proteins also occurs within cells, resulting in movement of subcellular organelles. Although considerable detail is known about the muscle sarcomere length-tension relationship and how isometric force potential is a function of myofilament overlap (Gordon et al. 1966), there are no direct measurements of myofilament movement during locomotion. We have taken advantage of the transparent morphology of the glass catfish (Kryptopterus bicirri) to investigate noninvasively sarcomere length changes which occur during free swimming.^ieng

The neuromuscular basis of swimming movements in embryos of the amphibian Xenopus laevis.

When removed from their egg membranes, Xenopus embryos can swim. High-speed cinematography shows that, in swimming, lateral undulations pass rostro-caudally down the body. The swimming rhythm period is 40-100 ms. In swimming, electrical activity in myotomal muscles alternates on opposite sides of a segment and sweeps rostro-caudally in ipsilateral myotomes. Myotome muscle physiology was examined. Muscle fibres are electrically coupled to each other, and the fibres are able to spike. The possible role of a myotomal conduction pathway in swimming is discussed.

[Locomotion of Barents Sea ophiuroids]. / Lokomotsii ofiur Barentsova moria.

Locomotion of 5 species of Ophiuroids from the Barents Sea has been described--Ophiura albida, O. robusta, O. sarsi, Ophiacantha bidentata, Ophiopholis aculeata. Representatives from the genus Ophiura move by means of one or two symmertic pairs of arms which perform rhythmic rowing beats. The feet tube do not participate in their locomotion. Locomotion pattern in O. bidentata and especially O. aculeata, which have long flexible arms, is more complex. However, the analysis indicates that they replace themselves by a comparatiely limited set of standard "programmed" movements which may be used in various combinations. In locomotion of these species, the tube feet are involved which provide for the reliable contact of distal ends of the active rays with the supporting surface; due to this contact the animals can move in a straightforward direction.

[Turning over in the ophiuroid Amphipholis kochii]. / Pereverachivanie ofiury Amphipholis kochii

The reaction of turning over in the ophiuroid A. kochii Lütken begins when the ambulacral legs are detached from the substrate. At the bottom, when aboral side of the animal touches the substrate, turning over begins with oral flexion of three arms. In water, turning over begins with aboral flexion of all the arms. The organism takes the shape of a ball, its center of gravity being shifted to the side of a disc which outer surface is formed by the oral part. As a result, when dropped into the water with its oral side upwards, the ophiuroid passively turns over due to the gravity force. Single arm isolated together with the adjacent part of the nervous ring is capable of turning over. After sectioning the nervous ring, coordinated activity of the arms during turning over is disturbed.

[Coordination of the movement of the tube feet and arms of ophiurae during locomotion]. / Koordinatsiia dvizhenii ambulakral'nykh nozhek i luchei pri lokomotsii ofiury

A role of the tube feet is considered for locomotion of ophiura Amphipholis kochii. During stepping, a tube foot sticks to the ground at its front position, and comes unstuck at the end of the step when reaching a certain hind position (relatively the direction of locomotion). Such an organization of the tubefoot mechanisms of stepping simplifies considerably the cooridination of tube feet and arms movements. The tube feet stick to the ground automatically when the arm on which they are located performs motor functions and push or pull the ophiura forwards; on the contrary, the tube feet come unstuck automatically when their arm moves forwards. Thus, the central nervous system is likely not to participate in the coordination of the tube feet and arms movements. It only determines the common direction of stepping for all tube feet, whereas the coordination between the tube feet and arms is achieved because of special properties of the tube feet stepping mechanisms.

[Types of locomotion in Ophiuroidea]. / Vidy lokomotsii u ofiur

Locomotor movements of two species of ophiura from the Sea of Japan: Ophiura sarsi vadicola Djakonov and Amphipholis kochii Lütken, were filmed. Ophiura sarsi moves by means of two symmetric pairs of arms which perform rhythmical rowing movements, the fifth arm is passive and directed backwards. Animals of this species do not use tube feet in locomotion. In Amphipholis kochii, three main modes of locomotor movements were found. (1) "Breast stroke" in which two symmetric side arms periodically move forwards, and then push forwards the body and three other arms. In this mode, one arm (leading) is directed forwards, while two others backwards. When the side arms move-forwards or backwards, a wave of successive flexions and extensions propagates along the arm segments. (2) "Pushing" by means of the hind arm and "pulling" with the help of the leading arm. (3) Locomotion by means of the tube feet which perform stepping movements. These three modes of locomotion are observed either separately or in various combinations with each other. In (1) and (2) modes of locomotion the tube feet perform also the coupling of the active arms with the ground which is necessary for the animal movement.

[Coordination of arm movement during locomotion in Ophiuroidea]. / Koordinatsiia dvizhenii luchei pri lokomotsii ofiury

Ophiura Amphipholis kochii Lütken can move with any one of five arms directed forwards; therefore, each arm performs various functions during locomotion. The arm amputated together with the adjoining part of the central nervous ring is capable of complicated behaviour, particularly, of locomotion. Transection of the central nervous ring results in disturbances of the arms coordination. Experiments with amputation of a part of the arms showed that afferent signals from arms are important for determination of the leading arm and mode of locomotion. The experimental data suggest that each arm has an autonomous nervous centre, and coordinated activity of all arms is acheaved by an interaction of the nervous centres. The interaction results in function distribution among the arms and in synchronization of arm movements. The leading arm prevails, since the influences exerting by its centre determine activity of adjacent centres.