Normal Pit Research Articles

Gastric Epithelial Neoplasm of Fundic-Gland Mucosa Lineage: Showed the Same Genetic Lineage and Ki67 May Help in Their Identification

Abstract Introduction/Objective Gastric epithelial neoplasm of the fundic-gland mucosa lineages (GEN-FGMLs) are rare form of gastric tumors that encompasses oxyntic gland adenoma (OGA), gastric adenocarcinoma of the fundic-gland type (GA-FG), and gastric adenocarcinoma of the fundic-gland mucosa type (GA-FGM). There is no consensus on the clinicopathologica and molecular characteristics of GEN-FGMLs, and misdiagnosis is common because of similarities in symptoms. Methods/Case Report The NGS and immunohistochemical staining were performed on 37 cases diagnosed with GEN-FGMLs with a thorough histological evaluation. Gene alternations were analysed and compared across histological subtypes. we used an artificial intelligence approach for the recognition of the Ki67 immunohistochemistry stained. Results (if a Case Study enter NA) The patient’s ages ranged from 42 to 79 years, with a median age of 60. 17 were male and 20 were female. Morphologically, 19 OGAs, 16 GA-FGs, and two GA-FGMs were identified. Histopathological similarities exist between GEN-FGMLs. The tumors demonstrated well-formed glands, expanding with dense growth patterns comprising pale, blue-grey columnar cells with mild nuclear atypia. The normal gastric pit epithelium covered the entire surface of the OGA and GA-FG, but the dysplasia pit epithelium covered the GA-FGM. Compared with OGA, GA-FG and GA-FGM were more prominent in the macroscopic view (p<0.05) and had larger sizes (p<0.0001). Additionally, GA-FG and GA-FGM exhibited higher Ki67 indices than OGA (p<0.0001). The heterogeneity of mutational signatures, somatic mutations, and copy number variations was revealed across histological subtypes. The top five mutational signatures in OGA were ROS1, CTNNA1, GNAS, BRCA2, and ZFHX3. The top five mutational signatures in GA-FG and GA-FGM were GNAS, MLL3, BRAF, MSH3, and EGFR. GNAS were both found in OGA, GA-FG and GA-FGM. Compared with well-differencent gastric adenocarcinoma, The top five mutational signatures in GEN-FGMLs were GNAS, BRAF, ROS1, MLL3, and MSH3. Recurrently mutated key signaling pathways across tumor types in GEN-FGML were Wnt signaling pathways. Conclusion GEN-FGMLs are a group of well-differentiated gastric tumors with favourable biological behaviours. Compared with OGA, GA-FG and GA-FGM have larger sizes and higher Ki67 proliferation indices, indicating that they play a critical role in the identification of GEN-FGML. GEN-FGMLs showed the same genetic lineage, the Wnt signalling pathway plays a role in the development and progression of GEN-FGMLs.

Analysis of differences in microorganisms and aroma profiles between normal and off-flavor pit mud in Chinese strong-flavor Baijiu

The unique cellar fermentation process of CFSB is the reason for its characteristic “cellar aroma” flavor. The types, abundance, community structure and metabolic activity of microorganisms in the pit mud directly affect the microbial balance in the white spirit production environment, promoting the formation of typical aromas and influencing the quality of CFSB. During the production process, the production of off-flavor in the cellar may occur. The aim of this study is to elucidate the differences in microbiota and flavor between normal pit mud and abnormal pit mud (pit mud with off-flavor). A total of 46 major volatile compounds were identified, and 24 bacterial genera and 21 fungal genera were screened. The esters, acids, and alcohols in the abnormal pit mud were lower than those in the normal pit mud, while the aldehydes were higher. Indole, 3-methyl-, which have been proven to be responsible for the muddy and musty flavors, were detected in both types of pit mud, and for the first time, high levels of 4-Methylanisole were detected in the pit mud. The microbial composition of the two types of pit mud showed significant differences in the bacterial genera of Sporosarcina, Lactobacillus, Garciella, Anaerosalibacter, Lentimicrobium, HN-HF0106, Petrimonas, Clostridium_sensu_stricto_12 and Bacillus, and the fungal genera of Millerozyma, Penicillium, Mortierella, Monascus, Saccharomyces, Issatchenkia, Pithoascus, Pseudallescheria, and Wickerhamomyces. While we speculate that Sporosarcina is the predominant bacterial genus responsible for the imbalance of microbiota in pit mud.

Gastric epithelial neoplasm of fundic-gland mucosa lineage: representative of the low atypia differentiated gastric tumor and Ki67 may help in their identification.

Gastric epithelial neoplasm of the fundic-gland mucosa lineages (GEN-FGMLs) are rare forms of gastric tumors that encompass oxyntic gland adenoma (OGA), gastric adenocarcinoma of the fundic-gland type (GA-FG), and gastric adenocarcinoma of the fundic-gland mucosa type (GA-FGM). There is no consensus on the cause, classification, and clinicopathological features of GEN-FGMLs, and misdiagnosis is common because of similarities in symptoms. 37 cases diagnosed with GEN-FGMLs were included in this study. H&E-stained slides were reviewed and clinicopathological parameters were recorded. Immunohistochemical staining was conducted for MUC2, MUC5AC, MUC6, CD10, CD56, synaptophysin, chromograninA, p53, Ki67, pepsinogen-I, H+/K+-ATPase and Desmin. The patients' ages ranged from 42 to 79years, with a median age of 60. 17 were male and 20 were female. Morphologically, 19 OGAs, 16 GA-FGs, and two GA-FGMs were identified. Histopathological similarities exist between OGA, GA-FG, and GA-FGM. The tumors demonstrated well-formed glands, expanding with dense growth patterns comprising pale, blue-grey columnar cells with mild nuclear atypia. These cells resembled fundic gland cells. None of the OGA invaded the submucosal layer. The normal gastric pit epithelium covered the entire surface of the OGA and GA-FG, but the dysplasia pit epithelium covered the GA-FGM. Non-atrophic gastritis was observed in more than half of the background mucosa. All cases were diffusely positive for MUC6 and pepsinogen-I on immunohistochemistry. H+/K+-ATPase staining was negative or showed a scattered pattern in most cases. MUC5AC was expressed on the surface of GA-FGMs. p53 was focally expressed and the Ki67 index was low (1%-20%). Compared with OGA, GA-FG and GA-FGM were more prominent in the macroscopic view (p < 0.05) and had larger sizes (p < 0.0001). Additionally, GA-FG and GA-FGM exhibited higher Ki67 indices than OGA (p < 0.0001). Specimens with Ki-67 proliferation indices >2.5% and size >4.5mm are more likely to be diagnosed with GA-FG and GA-FGM than OGA. GEN-FGMLs are group of well-differentiated gastric tumors with favourable biological behaviours, low cellular atypia, and low proliferation. Immunohistochemistry is critical for confirming diagnosis. Compared with OGA, GA-FG and GA-FGM have larger sizes and higher Ki67 proliferation indices, indicating that they play a critical role in the identification of GEN-FGML. Pathologists and endoscopists should be cautious to prevent misdiagnosis and overtreatment, especially in biopsy specimens.

Incidental Colonic Ganglioneuroma on Surveillance Colonoscopy.

CASE REPORT A 73-year-old man with a history of diverticulitis after left hemicolectomy and an end-to-end colo-colonic anastomosis underwent a screening colonoscopy with resection of 4, 2-10-mm tubular adenomas. A 10-mm semipedunculated polyp with a normal mucosal pit pattern under narrow-band imaging was found in the splenic flexure (Figure 1). The polyp was resected using a hot snare and submitted for histopathological diagnosis, which demonstrated colonic mucosa with distorted crypt architecture. The lamina propria was expanded by collection of spindle cells within fibrillary matrix, and irregular nests and groups of ganglion cells indicated a ganglioneuroma (GN) (Figure 2). No clinical symptoms were associated with this finding, and a prior colonoscopy revealed no evidence of GN. Surveillance colonoscopy was recommended in 3 years, given the presence of an adenoma of ≥10 mm in size.Figure 1.: (A) A semipedunculated polyp under white-light imaging in the splenic flexure. (B) A semipedunculated polyp with a normal mucosal pit pattern under narrow-band imaging in the splenic flexure.Figure 2.: (A) An (H&E original magnification 20×) image of the colonic polyp consisting of abnormal appearing ganglion cells (single arrow) and spindled Schwann cells (double arrows). (B) An (H&E original magnification 10×) image of the colonic polyp consisting of abnormal appearing ganglion cells and spindled Schwann cells. H&E, hematoxylin & eosin.Ganglioneuromas of the gastrointestinal tract are rare tumors composed of ganglion cells, nerve fibers, and supporting cells. Gastrointestinal GNs are usually confined to the large intestine and are morphologically classified into 3 categories, namely, polypoid GNs, ganglioneuromatous polyposis, and diffuse ganglioneuromatosis.1 Polypoid GNs are mostly solitary and small (measuring <20 mm), with a sessile or pedunculated appearance. Colonic GNs are characterized by a normal colonic pit pattern under narrow-band imaging. These lesions produce no characteristic symptoms and are usually found incidentally during endoscopy. Rarely, they present with abdominal pain, obstruction, ileus, appendicitis, or weight loss depending on their size and anatomical location.2 Ganglioneuromatous polyposis and diffuse ganglioneuromatosis are associated with genetic syndromes, such as neurofibromatosis 1, multiple endocrine neoplasia 2B syndrome, and juvenile polyposis. Solitary GNs are generally not associated with familial syndromes, although they have been reported in cases of Cowden disease, tuberous sclerosis, polyposis coli, and juvenile polyposis.1 Gastrointestinal GNs are usually treated with endoscopic resection. Currently, no guidelines exist on the management of solitary GNs or recommendations for interval surveillance colonoscopy. Repeat colonoscopy is not necessary because of the benign nature of these lesions, which tend not to recur.3 DISCLOSURES Author contributions: S. Agarwal and Y. Wang designed and drafted the article and acquired data. PG Iyer drafted and revised the article for intellectual content. CL Leggett designed and drafted the article , acquired data, revised the article for important intellectual content, and is the article guarantor. Financial disclosure: None to report. Informed patient consent was obtained for this case report.

English

Land degradation affecting the livelihoods of people living in dryland areas, particularly the Sub-Saharan Africa countries like Ethiopia. Degraded land rehabilitation in dryland is a challenging task due to moisture limitation. This study was conducted to evaluate the effects of soil and water conservation structures on growth of planted tree and rehabilitation of indigenous plant species in West Guji Zone, Dugda Dawa District. Four multipurpose tree species (MPTs) namely Faidherbia albida, Melia azedarach, Moringa stenopetala, and Sesbania sesban were planted in four soil and moisture conservation structures (soil level bund, half-moon, trench and normal pit). Data of survival rate, height and diameter growth of planted tree species and, diversity and species richness of indigenous plant species were collected. The survival rate of all planted MPTs species were declining along the study years; however, the survival rate was better under soil level bund and half-moon. Under control treatments, all planted MPTs died at the end of the study period. The height and stem diameter of F. albida, M. azedarach and M. stenopetala were best in soil level bund and half-moon and followed by the trench. Whereas, the growth performance of Sesbania sesban was not significantly different among the three moisture conservation structures. Furthermore, soil moisture conservation structures significantly increased the indigenous plant species regeneration after the intervention. The mean indigenous plant species diversity and richness were significantly highest in half-moon and soil level bund followed by trench and, lowest in Control (normal pit). Thus, the results a potential for alternative forest and soil restoration in arid areas. Key words: Rehabilitation, Land degradation, survival rate,Trees growth, Indigenous plant species diversity, Moisture conservation structures.&nbsp;

Volume Rendering of Angiographic Optical Coherence Tomography Angiography in Fovea Plana and Normal Foveal Pit.

This paper aims to study adaptative vascular arrangements in idiopathic fovea plana with volume-rendered optical coherence tomography angiography (OCTA). A retrospective review of two cases of idiopathic fovea plana (mean age: 26.5 years) and two age-matched controls imaged with OCTA was conducted using spectral-domain OCTA (RTVue XR Avanti, Optovue, Inc., Fremont, CA) equipped with the AngioVue software. Both en face OCTA slabs and OCTA b scans were processed through Fiji software (http://fiji.sc; software version 2.0.0-rc-68/1.52e), and then extracted as image sequences for volume rendering reconstructions using the ImageVis3D volume rendering system (3.1.0 release). Eyes with idiopathic fovea plana demonstrated a regular superficial vascular plexus connecting to a single vascular monolayer representing the deeper vascular plexuses. At this location, several vertical short path connections were demonstrated, in contraposition with normal eyes where short path connections were infrequently observed. Advances in three-dimensional OCTA reconstruction increase the understanding of vascular connections and arrangement in retinal plexuses and possible anatomical variations that cannot be detected with conventional two-dimensional b scans.

Performance Evaluation of Multipurpose Tree Species Integrated with Moisture Conservation Structures on Degraded Area Closure at Babille District, Ethiopia

Tree planting on degraded lands plays a key role in forest rehabilitation processes through afforestation and/or reforestation. Moisture conservation structures have significant impact on seedling survivals at degraded lands. The objectives of this study were to evaluate the effect of moisture conservation structures on seedling survival and growth performance of selected tree species. Field experiment was conducted for four (2016-2020) in degraded area closure at Babile District East Hararghe Zone, Ethiopia. The experimental design followed was the split plot design. The moisture conservation structures as main plot used were Soil level bund, Trench and normal pit (used as control). The tree species grown as subplots were Moringa oleifera, Melia azedarach, Grevillea robusta, Leuceana leucocephala and Sesbanea sesban. The five tree species were planted by using seedlings. The tree survival rate, plant height, diameter at breast height and root collar diameter of the five tree species were measured every three months in year after transplanting. The result shows that moisture conservation structures were significant in tree survival rate, plant height, and root collar diameter but not in tree diameter at breast height. Tree seedling height and root collar diameter grown in the Soil level bund were significantly higher than those grown in moisture conservation structures, trench and normal pit (P≤0.05). Survival rate and diameter at breast height grown in the Trench were significantly higher than those grown in moisture conservation structures, soil level bund and normal pit (P≤0.05). The survival rate of tree seedling was higher when grown in Trench than normal pit (control) (P≤0.05). The interaction of tree species seedlings and moisture conservation structures shows that those seedlings grown on moisture conservation structures were significantly thicker, taller and more survived than those grown on the normal pit (control) (P≤0.05). Based on the experiments, it is concluded that moisture conservation structures particularly the Trenches was considered as the most appropriate planting pit. Therefore, further demonstration of Trenches tree planting should be carried out.

Effects of a Trench as a Moisture Harvesting Structure on the Biomass Production and Growth of Trees Planted to Restore Degraded Land, Southern Ethiopia

Knowledge about the biomass productivity of trees planted in a rainwater harvesting structure, i.e., a trench (T), relative to a normal pit (P) on degraded land is scarce. The objective of this research paper is to compare the effect of T with P on the growth and biomass production of the Acacia saligna and Casuarina equisetifolia which were planted on degraded land. All the individual stems of both species in the T and P, their diameters at breast height (DBH) and heights in 2016 and 2020 were measured. Species-specific allometric equations were used to quantify the biomass production of the studied species. The t-tests were used for data analysis; both A. saligna and C. equisetifolia individuals planted in the T had higher DBH and height increment as compared with A. saligna and C. equisetifolia that were planted and grown in a P. The results also revealed significant differences on the mean DBH and height of A. saligna and C. equisetifolia planted in a T and P (p &lt; 0.05). Between 2016 and 2020, the total biomass (TB) of A. saligna planted in a T and in a P increased significantly (p &lt; 0.05) on average by 25.5 kg/tree and 7.7 kg/tree, respectively (p &lt; 0.05). Similarly, the mean TB values of the C. equisetifolia planted in a T and a P between 2016 and 2020 increased significantly (p &lt; 0.05) by 28.9 kg/tree and 13.1 kg/tree, respectively. Finally, establishing trenches to restore degraded lands was shown to facilitate growth and biomass production of planted species on degraded land.

Seismic reflection data reveal the 3D structure of the newly discovered Exmouth Dyke Swarm, offshore NW Australia

Abstract. Dyke swarms are common on Earth and other planetary bodies, comprising arrays of dykes that can extend laterally for tens to thousands of kilometres. The vast extent of such dyke swarms, and their presumed rapid emplacement, means they can significantly influence a variety of planetary processes, including continental break-up, crustal extension, resource accumulation, and volcanism. Determining the mechanisms driving dyke swarm emplacement is thus critical to a range of Earth Science disciplines. However, unravelling dyke swarm emplacement mechanics relies on constraining their 3D structure, which is difficult given we typically cannot access their subsurface geometry at a sufficiently high enough resolution. Here we use high-quality seismic reflection data to identify and examine the 3D geometry of the newly discovered Exmouth Dyke Swarm, and associated structures (i.e. dyke-induced normal faults and pit craters). Dykes are expressed in our seismic reflection data as ∼335–68 m wide, vertical zones of disruption (VZD), in which stratal reflections are dimmed and/or deflected from sub-horizontal. Borehole data reveal one ∼130 m wide VZD corresponds to an ∼18 m thick, mafic dyke, highlighting that the true geometry of the inferred dykes may not be fully captured by their seismic expression. The Late Jurassic dyke swarm is located on the Gascoyne Margin, offshore NW Australia, and contains numerous dykes that extend laterally for &gt; 170 km, potentially up to &gt; 500 km, with spacings typically &lt; 10 km. Although limitations in data quality and resolution restrict mapping of the dykes at depth, our data show that they likely have heights of at least 3.5 km. The mapped dykes are distributed radially across a ∼39∘ wide arc centred on the Cuvier Margin; we infer that this focal area marks the source of the dyke swarm. We demonstrate that seismic reflection data provide unique opportunities to map and quantify dyke swarms in 3D. Because of this, we can now (i) recognise dyke swarms across continental margins worldwide and incorporate them into models of basin evolution and fluid flow, (ii) test previous models and hypotheses concerning the 3D structure of dyke swarms, (iii) reveal how dyke-induced normal faults and pit craters relate to dyking, and (iv) unravel how dyking translates into surface deformation.

Endocytoscopy for the differential diagnosis of colorectal low-grade adenoma: a novel possibility for the “resect and discard” strategy

Endocytoscopy, a next-generation endoscopic system, facilitates observation at a maximum magnification of×520. To our knowledge, no study has reported high-precision diagnosis of colorectal low-grade adenoma, endoscopically. We aimed to reveal which endocytoscopic findings may be used as indicators of low-grade adenoma and to assess whether a "resect and discard" strategy using endocytoscopy is feasible. Lesions diagnosable with endocytoscopy were examined retrospectively between May 2005 and July 2017. A normal pit-like structure in endocytoscopic images was considered a normal pit (NP) sign and used as an indicator of low-grade adenoma. The primary outcome was the diagnostic accuracy of the NP sign for low-grade adenoma. We evaluated agreement rates between endocytoscopic and pathologic diagnosis for surveillance colonoscopy interval recommendation (SCIR) and performed a validation study to verify the agreement rates. For 748 lesions in 573 cases diagnosed as colorectal adenoma using endocytoscopy, the results were as follows: sensitivity of the NP sign for low-grade adenoma, 85.0%; specificity, 90.7%; positive predictive value, 96.6%; negative predictive value, 66.1%; accuracy, 86.4%; and positive likelihood ratio, 9.2 (P< .001). The agreement rate between endocytoscopic and pathologic diagnosis for SCIR was 94.4% (95% confidence interval [CI], 92.2%-96.1%; P< .001) under United States guidelines and 96.3% (95% CI, 94.5%-97.7%; P< .001) under European Union guidelines. All inter- and intraobserver agreement rates for expert and nonexpert endoscopists had κ values≥0.8 except one nonexpert pair. Endocytoscopy is an effective modality in determining the differential diagnosis of colorectal low-grade adenoma. (University Hospital Medical Information Network Clinical Trials database registration number: UMIN000018623.).

Underwater Colonoscopic Diagnosis of an Unusual Colonic Lesion

A 66-year-old man was referred for screening colonoscopy because of a positive fecal occult blood test. His medical history includes hypertension. He underwent a colonoscopy and multiple polypoid lesions were found in the transverse colon (Figure A). These polypoid lesions are soft with normal pit patterns on close view with chromoendoscopy (Figure B, Video 1). There was no fluid drainage out of these polypoid lesions after the biopsy. Instead, these lesions became deflated after biopsy (Video 1) and we performed an underwater colonoscopy.

Nystagmus associated with macular dysplasia

ABSTRACT Purpose To describe Optical Coherence Tomography (OCT) findings of the macula in patients with nystagmus, mainly the relationship between spectral-domain OCT (SD-OCT) images and nystagmus in macular dysplasia. Methods In this study, 17 cases (29 eyes) with congenital macular abnormalities in patients with albinism, macular heterotopias, congenital aniridia, foveal hypoplasia, congenital macular coloboma, and congenital retinoschisis were retrospectively analyzed. Patients underwent multimodal retinal imaging examinations including ultra-widefield fundus imaging, SD-OCT, autofluorescence, and visual field. When the pit was not clearly presented, SD-OCT imaging was centered at the expected foveal center. Results In cases of oculocutaneous albinism SD-OCT showed the absence of the foveal pit and increased foveal thickness, with nystagmus. Their fundus revealed a lack of pigment in retinal pigment epithelium with visible large choroidal vessels. SD-OCT in congenital aniridia showed a planar fovea in the macula with the lack of a foveal pit and nystagmus. SD-OCT showed the absence of a foveal pit in foveal hypoplasia with nystagmus. In cases of monocular macular heterotopia, no nystagmus was found; the fellow eye had good vision and the macular morphology was usually normal. Nystagmus was not found in patients with congenital macular coloboma and congenital retinoschisis in this study. Conclusion SD-OCT plays an important role in the diagnosis and prognosis of macular dysplasia in patients with nystagmus. Absence of a normal foveal pit is an OCT-imaging characteristic of macular dysplasia associated with nystagmus.

Effect of Different Moisture Harvesting Techniques on Seedling Survivals and Growth of Trees in Degraded Lands of Southern Tigray

Tree planting on degraded lands play a key role in forest rehabilitation processes through afforestation and/or reforestation. Moisture harvesting structures (MHSs) has significant impact on seedling survivals at degraded lands. The objectives of this study were to investigate the impact of water harvesting techniques on seedling survival and growth performance of trees. Field experiments were conducted for two rainy seasons in southern Tigray, Atsela watershed. The experimental design followed was the split plot design. The MHSs as main plot used were eye-brow basins (EBs), micro trench (MTs), improved pit (IPs) and as control normal pit (NPs). The tree species grown as subplots were Eucalyptus camaldulensis, Grevillea robusta, Olea europaea and Cupressus lusitanica. The four tree species were planted by using seedlings. The tree survival rate, height, crown width (CW) and root collar diameter (RCD) of the four tree species were measured every six months after transplanting. The result shows that MHSs were significant in tree seedling height, CW and RCD but not in tree survival rate. Tree seedling height and CW grown in EBs were significantly higher than those grown in MTs, IPs and NP (P≤0.05). RCD of tree seedling was higher when grown in EBs than NP (control) (P≤0.05). The interaction of tree species seedlings and MHSs shows that those seedlings grown on MHSs were significantly thicker, taller and more survived than those grown on the NPs (control) (P≤0.05). So based on the experiments, it is concluded that MHSs particularly the eyebrow basin was considered as the most appropriate planting pit. Therefore, further demonstration of eyebrow basin tree planting should be carried out.

Wall Deflection and Ground Surface Settlement due to Excavation Width and Foundation Pit Classification

Foundation pits have obvious spatial effect, and the lateral wall deflection, ground movement and basal heave stability are closely related with the excavation width. A database of 92 case histories with extensive excavation widths in soft soil in China are collected and analyzed. The maximum lateral wall deflections and maximum ground surface settlements measured are smaller than the case histories there before. With the increase of excavation width, the maximum lateral wall deflections and the maximum ground surface settlements increase firstly and then tend to stable. The database indicates that the type of retaining structure has little relevance to the excavation width of the foundation pit. There are two types of basal heave according to the excavation width, single-peak and double-peak. Three types of foundation pit considering excavation width, named wide foundation pit, normal foundation pit and narrow foundation pit, are proposed based on the slip circle basal heave analysis approach. The classification method is consistent with the measured data and the simulated results.

Sa1909 GRADING OF DYSPLASIA FOR DIAGNOSING COLORECTAL ADENOMAS USING ENDOCYTOSCOPY

Recent opinions have expressed that if an endoscopic diagnosis of adenomas can be made with high accuracy, then, the omission of a pathological diagnosis following endoscopic resection is acceptable. Currently, there is no clear consensus regarding whether endoscopic treatment is required for all adenomas. Colonoscopy-based grading of dysplasia can be clinically effective for diagnosing adenomas, if such a diagnosis of adenomas, particularly of low-grade adenomas, can be made with high accuracy. In this study, we focused on the existence of mixed-pit pattern type I lesions in slit-like lumens, which is an endocytoscopy (EC) finding characteristic of adenomas, and investigated pathological findings that were correlated with this observation. We retrospectively examined 724 lesions among the neoplastic lesions that could be observed by EC between May 2005 and May 2017 and that were classified as EC2 according to the EC classification system and could be pathologically examined via endoscopic resection. Lesions characterized by mixed-pit pattern type I in slit-like lumens were classified as EC2 normal pit (NP) sign (+), while those characterized by slit-like lumens only were classified as EC2 NP sign (−). We investigated the final pathological diagnosis results, and also examined the location, diameter, and morphological type of NP (+) lesions to elucidate their clinical traits. A total of 466 lesions were classified as EC2 NP sign (+). Of these, low-grade adenomas accounted for 450 lesions and advanced lesions (high-grade dysplasia, tubulovillous adenoma, invasive cancer) accounted for 16. NP sign (+) as an indicator of low-grade adenomas had a sensitivity of 85.4%, specificity of 90.8%, positive predictive value of 96.6%, negative predictive value of 67.1%, accuracy of 86.7%, and positive likelihood ratio of 9.23. Furthermore, an examination of the EC2 NP (+) rate by location, diameter, and morphological type of the lesions revealed that 56.6% of the lesions were located in the distal colon and 75.7% were located in the proximal colon; 81.4% of the lesions were ≤10 mm in diameter and 10.9% were ≥10 mm. Further, 53.9% of the lesions were of the protruding morphological type and 79.8% were of the flat/depressed type. Taken together, this indicated that the EC2 NP sign (+) rate was significantly higher in lesions located in the proximal colon (p < 0.001), that were ≤10 mm in diameter (p < 0.001), and that were of the flat/depressed type (p < 0.001). These results suggest that when using EC for diagnosing colorectal neoplastic lesions, NP sign is a good indicator of low-grade adenomas with the EC2 classification. Furthermore, the NP (+) rate tended to be high in lesions located in the proximal colon, that were ≤10 mm in diameter, and that were of the flat/depressed type.

Early Survival Evaluation of Trees and Shrubs for Their Adaptability Planted Under Moisture Conservation Structures at Hawi Gudina District, West Hararghe Zone, Ethiopia

The ever-increasing demand for biomass energy in developing countries like Ethiopia seeks urgent attention. Tree growth depends on genetic potential of the species and environmental conditions. A study was conducted at Hawi Gudina district during 2010-2013 to evaluate early survival of different agroforestry trees/shrubs (Meliaazedarach, Moringaoleifera, Leucaena leucocephala, Grevilia robusta and Sesbania sesban) for their adaptability planted under three different moisture conservation structures. These different trees and shrubs species were planted in randomized complete block design with unequal replications. Unbalanced analysis of variance revealed that the interaction of tree/shrubs survival with planting methods was found insignificant (P>0.05) at 1, 2 and 3 years of age after transplanting. The main effect of moisture conservation structures is also not significant. But highly significant variations among species in survival rate (P<0.01) was recorded at all three years of ages. Among the species tested, Moringaoliefera and Melia azedarach showed superior performance with survival rate of 100% followed by Sesbania sesban with survival rate of 88.9%. Though there was no significant difference in survival rate of trees/shrubs with respect to different planting methods. The mean survival of seedlings planted in half-moon (80%) is higher than in normal pit (73.33%) and trench (60%) three years after establishment. Similarly, species planted in half-moon recorded relatively higher in diameter and height size followed by trench micro catchment. Moringa oliefera, Melia azedarach and Sesbania sesban with half-moon planting method, offers much promise for future use in agroforestry practices in the area and similar agro ecologies.

English

The study was conducted for three consecutive years (2011/2012 to 2013/2014) to evaluate the growth and production of banana (Robusta variety) with different water harvesting structure in Daro Labu districts of Oda Leku peasant association. The water harvesting structures used as treatments were semi-circular bund with and without mulch, negarim micro catchment with and without mulch and normal pit with and without mulch (control). The treatments were laid out in randomized complete block design on three farms as a replication. The data on yield, number of fingers, survival rate/6 month, number of sucker/2 years, plant height, and area coverage/1 year and 9 months were collected. The statistical analysis revealed that there was no significant difference (p>0.05) among treatments on survival rate, number of sucker, plant height, and area coverage but there was a highly significant variation (p<0.01) among treatments on yield and number of fingers. The means of plant height, area coverage and number of sucker on semicircular bund with mulch and negarim micro catchment with mulch were better than the structures without mulch and control. Both structures are therefore recommended with mulch for banana production in moisture stress areas and similar agro-ecologies. Key words: Negarim, semi-circle, survival rate, area coverage, number of sucker, banana, mulch.

The influence of clips on scars after EMR: clip artifact

Laterally spreading lesions ≥20 mm are conventionally removed by EMR. Endoscopic clips are increasingly used to mitigate the risk of delayed bleeding. Clips may alter the endoscopic appearance of the scar after EMR, interfering with the assessment of adenoma recurrence. We aimed to evaluate this. Prospective, single-center data from the Australian Colonic Endoscopic resection study (January 2011-May 2015) were analyzed. Patients undergoing EMR of laterally spreading lesions with endoscopic clips used at the EMR defect were eligible. Data included patient and lesion characteristics and procedural, clinical, and histologic outcomes. Clips were used in 111 of 885 lesions (12.5%). A total of 62 of 111 clipped lesions had standardized, high-definition, white light, and narrow-band images of the scars after EMR at first surveillance colonoscopy, and the patients were enrolled. Analysis of the images showed 4 situations: a bland scar (N = 27), residual adenoma (N = 6), mucosal elevation with normal pit pattern (N = 14), or granulation tissue related to the presence of residual clips (N = 15). The latter 2 entities were termed post-EMR scar clip artifact (ESCA). Overall, 29 of 62 previously clipped EMR sites (46.8%) had ESCA at a median follow-up of 5.2 months. Twenty scars had residual clips, and 15 of 20 (75.0%) showed ESCA (P = .002). Lesions clipped for prophylaxis of bleeding were more likely to show ESCA than those clipped for deep mural injury or intraprocedural bleeding (65.5% vs 41.7%; P = .006). ESCA was associated with female sex (P = .010) and greater age (P = .011). ESCA is characterized by a nodular elevation of the mucosa with a normal pit pattern and can occur with or without residual clips. Prophylactic clip closure and the presence of residual clips are associated with ESCA. ( NCT01368289.).

A Symptomatic Anorectal Polyp

A Symptomatic Anorectal Polyp

Improved Splenic Function after Stem Cell Transplant for Sickle Cell Disease

Introduction: Splenic dysfunction is a critical complication of SCD that begins in early childhood and can cause fatal sepsis. Hematopoietic stem cell transplant (HSCT) is a proven cure for SCD, however, its long-term effect on the spleen in patients who had SCD is not well characterized. This information could be helpful to further inform medical professionals and families considering HSCT for SCD. Better understanding of the splenic function of patients after transplant for SCD could also provide important information regarding these patients’ future risk of infection and other possible problems related to asplenia.Methods: We conducted a retrospective cohort study of pediatric patients who had HSCT for SCD at two transplant centers. Patients were excluded for analysis if they had pre-HSCT splenectomy, died less than one year post-transplant, failed to engraft, or had no post-HSCT spleen function testing. Tc99m liver-spleen (LS) scans and red blood cell (RBC) pit counts, validated tests to evaluate the spleen in SCD, were used to assess splenic function. Splenic uptake on scans was classified as either present or absent. RBC pit count was classified as either normal or abnormal. If a patient had multiple LS scans or RBC pit counts post-HSCT, then the most recent test was used for this analysis.Results: Fifty-five evaluable patients were identified (53 patients with a post-HSCT LS scan, 29 patients with a post-HSCT RBC pit count, and 27 patients with both tests). Almost all (52/55, 95%) patients had hemoglobin SS or Sβ0 disease. Median age at transplant was 8.8 years (range 1.8-22.0 years). Conditioning regimen and stem cell source varied, however, 48/55 (87%) received myeloablative conditioning and an HLA-identical sibling donor HSCT. At a median 2.0 years post-HSCT (range 0.9-8.9 years), 48/53 (91%) had spleen uptake present on LS scan. At a median 3.2 years post-HSCT (range 1.0-11.4 years), 24/29 (83%) had a normal RBC pit count. Analysis of patients who had both pre- and post-HSCT tests showed that patients had significantly improved outcomes post-HSCT:TablePre-HSCTPost-HSCTp-valueSpleen Uptake Present on LS scan17/36 (47%)32/36 (89%)0.0002Normal RBC pit count6/20 (30%)17/20 (85%)0.0004All patients (17/17, 100%) with LS scan spleen uptake pre-HSCT had uptake present post-HSCT compared to 15/19 (79%) patients with absent spleen uptake pre-HSCT had uptake present post-HSCT (p=0.11). Four patients had absent spleen uptake at 1 year post-HSCT but had uptake present at 2 years post-HSCT.Conclusion: Our study represents the largest comprehensive evaluation of long-term splenic function in patients after HSCT for SCD. Our results suggest that successful HSCT mitigates damage to the spleen induced by SCD. In patients with splenic function pre-transplant, HSCT appears to preserve this function. In patients lacking splenic function, HSCT appears to engender the return of function in most, but not all patients. DisclosuresNo relevant conflicts of interest to declare.