AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training ...AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.展开更多
Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy.Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify pat...Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy.Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify patients for endoscopy to detect early gastric cancer.These non-invasive biomarkers have been endorsed and recommended by many international consensus guidelines.In this letter,we reviewed the literature and evidence supporting the use of serum biomarkers as a dynamic test to monitor the status of atrophic gastritis.展开更多
The Dongsithouane National Production Forest (DNPF) is one of the largest natural forest areas in Savannakhet, Lao PDR, which has been a vital support for the local community’s livelihood, Recently, significant chang...The Dongsithouane National Production Forest (DNPF) is one of the largest natural forest areas in Savannakhet, Lao PDR, which has been a vital support for the local community’s livelihood, Recently, significant changes in land use and land cover (LULC) have been observed in this area, leading to a reduction of natural forests. There were two separate methods of this study: firstly, to identify LULC changes across three different periods, spectral imagery from the Landsat 5 Thematic Mapper (TM) for the years 2001 and 2011, and the Landsat 8 Operational Land Imager (OLI) for 2021 were used as the primary data sources. The satellite images were preprocessed for various forest classes, including pretreatment of the top of atmosphere reflectance by using QGIS software’s semi-automatic classification plug-in (SCP), and ArcGIS was used for post-classification. A supervised classification approach was applied to the satellite images from 2001, 2011, and 2021 to generate diverse maps of LULC. Secondly, a household survey dataset was used to investigate influential factors. Approximately 220 households were interviewed in order to collect socio-economic information (including data on population growth, increased business activities, location of the area, agriculture land expansion, and need for settlement land). Household survey data was analyzed by using SPSS. Descriptive statistics, including frequency distributions and percentages, were applied to observe characteristics. Additionally, a binary logistic regression model was used to analyze the socioeconomic factors related to LULC change in DNPF. Key findings indicated a decline in natural forest areas within the study site. Specifically, both dry dipterocarp forest (−11.35%) and mixed deciduous forest (−0.18%) decreased from 2001 to 2021. The overall accuracy of the LULC maps was 94%, 86%, and 89% for the years 2001, 2011, and 2021 respectively. In contrast, agricultural land increased significantly by 155.70%, while built-up land, and water bodies increased by 65.54% and 35.33%, respectively. The results also highlighted a significant increase in construction land, up to 65.54%. Furthermore, the study found a correlation between agricultural expansion and a reduction of forest areas, along with an increase in built-up land along the forest areas’ boundaries. Timber exploitation and charcoal production also contributed to the decline in forest cover. The logistic regression model identified significant determinants of LULC change, including the area’s location, agricultural land expansion, increased business activity, and the need for settlement land. These factors have influenced the management of DNPF. Urgent sustainable management practices and actions, including forest ecosystem protection, village agricultural zoning, water source and watershed protection and public awareness, are required to preserve the forest areas of DNPF.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP) is a procedure that can result in serious complications, and thus should be handled by a skilled endoscopist to minimize the risk of complications and to enhance th...Endoscopic retrograde cholangiopancreatography(ERCP) is a procedure that can result in serious complications, and thus should be handled by a skilled endoscopist to minimize the risk of complications and to enhance the success rate. The incidence of ERCP-related complications is 5%-10%, most commonly involving post-ERCP pancreatitis and clinically significant post-endoscopic sphincterotomy bleeding. Although ERCP-related perforation has a relatively lower incidence of 0.14%-1.6%, this complication is associated with a high mortality rate of 4.2%-29.6%. A classification of perforation type based on the instrument that caused the perforation was recently described that we postulated could affect the implementation of perforation management. In the present article, an algorithm for management and prevention of ERCP-related perforations is proposed that is based on the perforation type and delay of diagnosis. Available evidence demonstrates that a delayed diagnosis and/or treatment of perforation re-sults in a poorer prognosis, and thus should be at the forefront of procedural consideration. Furthermore, this review provides steps and recommendations from the pre-procedural stage through the post-procedural evaluation with consideration of contributing factors in order to minimize ERCP-related complication risk and improve patient outcome. To avoid perforation, endoscopists must evaluate the risks related to the individual patient and the procedure and perform the procedure gently. Once a perforation occurs, immediate diagnosis and early management are key factors to minimize mortality.展开更多
The amount of volunteered geographic information(VGI)has increased over the past decade,and several studies have been conducted to evaluate the quality of VGI data.In this study,we evaluate the completeness of the roa...The amount of volunteered geographic information(VGI)has increased over the past decade,and several studies have been conducted to evaluate the quality of VGI data.In this study,we evaluate the completeness of the road network in the VGI data set OpenStreetMap(OSM).The evaluation is based on an accurate and efficient network-matching algorithm.The study begins with a comparison of the two main strategies for network matching:segment-based and nodebased matching.The comparison shows that the result quality is comparable for the two strategies,but the node-based result is considerably more computationally efficient.Therefore,we improve the accuracy of node-based algorithm by handling topological relationships and detecting patterns of complicated network components.Finally,we conduct a case study on the extended node-based algorithm in which we match OSM to the Swedish National Road Database(NVDB)in Scania,Sweden.The case study reveals that OSM has a completeness of 87%in the urban areas and 69%in the rural areas of Scania.The accuracy of the matching process is approximately 95%.The conclusion is that the extended node-based algorithm is sufficiently accurate and efficient for conducting surveys of the quality of OSM and other VGI road data sets in large geographic regions.展开更多
BACKGROUND:In general,the dose requirement and complications of propofol are lower when used in the diluted form than in the undiluted form.The aim of this study was to determine the dose requirement and complications...BACKGROUND:In general,the dose requirement and complications of propofol are lower when used in the diluted form than in the undiluted form.The aim of this study was to determine the dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography.METHODS:Eighty-six patients were randomly assigned to either group D (diluted propofol) or U (undiluted propofol).All patients were sedated with 0.02-0.03 mg/kg midazolam (total dose ≤2 mg for age <70 years and 1 mg for age ≥70) and 0.5-1 μg/kg fentanyl (total dose ≤75 μg for age <70 and ≤50 μg for age ≥70).Patients in group U (42) were sedated with standard undiluted propofol (10 mg/mL).Patients in group D (44) were sedated with diluted propofol (5 mg/mL).All patients in both groups were monitored for the depth of sedation using the Narcotrend system.The primary outcome variable was the total dose of propofol used during the procedure.The secondary outcome variables were complications during and immediately after the procedure,and recovery time.RESULTS:All endoscopies were completed successfully.Mean propofol doses per body weight and per body weight per hour in groups D and U were 3.0 mg/kg,6.2 mg/kg per hour and 4.7 mg/kg,8.0 mg/kg per hour,respectively.The mean dose of propofol,expressed as total dose,dose/kg or dose/kg per hour and the recovery time were not significantly different between the two groups.Sedation-related adverse events during and immediately after the procedure were higher in group U (42.9%) than in group D (18.2%) (P=0.013).CONCLUSIONS:Propofol requirement and recovery time in the diluted and undiluted propofol groups were comparable.However,the sedation-related hypotension was significantly lower in the diluted group than the undiluted group.展开更多
Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2%-4%of alimentary tract duplications.Most cases are diagnosed within the first year of life,following presentation of abdo...Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2%-4%of alimentary tract duplications.Most cases are diagnosed within the first year of life,following presentation of abdominal pain,vomiting,and weight loss and clinical discovery of an abdominal palpable mass.This case report describes a very uncommon symptomatic gastric duplication cyst diagnosed for the first time in adulthood.Only a few other case reports of similar condition exist,and all were identified by endosonography.The current case involves a 52-year-old male who presented with a onemonth history of progressive iron deficiency anemia without overt gastrointestinal bleeding.The patient underwent esophagogastroduodenoscopy,which revealed a 2.0 cm pinkish subepithelial lesion,suspected to be a gastrointestinal stromal tumor(GIST)and source of gastrointestinal bleeding.The endosonography showed inhomogeneous hypoechoic lesions with focal anechoic areas arising from a second and third layer of the gastric wall.Differential diagnoses of GIST,neuroendocrine tumor,or pancreatic heterotopia were made.The lesion was removed using an endoscopic submucosal resection technique.Histopathology revealed an erosive gastric mass composed of a complex structure of dilated gastric glands surrounded by fibro-muscular tissue,fibroblasts,and smooth muscle bundles,which led to the diagnosis of gastric duplication.展开更多
AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were ...AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist （T.A.）. Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures （70.4%） were done with standard technique （group A） and 223 procedures （29.6%） with early pre-cutting technique in case of difficult cannulation （group B）. The results and complications of ERCP were compared. RESULTS： Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group 13. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred. CONCLUSION： For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.展开更多
Endoscopic ultrasound(EUS)-guided biliary drainage is accepted as a less invasive,alternative treatment for patients in whom endoscopic retrograde cholangiopancreatography has failed. Most patients with malignant hila...Endoscopic ultrasound(EUS)-guided biliary drainage is accepted as a less invasive,alternative treatment for patients in whom endoscopic retrograde cholangiopancreatography has failed. Most patients with malignant hilar obstruction undergo EUSguided hepaticogastrostomy. The authors present the case of a 77-year-old man with advanced hilar cholangiocarcinoma who had undergone a rouxen-Y hepaticojejunostomy several months prior. He developed progressive jaundice and a low-grade fever that persisted for one week. The enteroscopic-assisted endoscopic retrograde cholangiopancreatography failed,thus the patient was scheduled for EUS-guided biliary drainage. In order to obtain adequate drainage,both intrahepatic systems were drained. This report describes the technique used for bilateral drainage via a transgastric approach. Currently,only a few different techniques for EUS-guided right system drainage have been reported in the literature. This case demonstrates that bilateral EUS-guided biliary drainage is feasible and effective in patients with hilar cholangiocarcinoma,and thus can be used as an alternative to percutaneous biliary drainage.展开更多
Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low...Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies(pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography(ERCP) fails. Up to this point, the only alternative interventions for these conditions were percutaneous transhepatic biliary drainage or surgery. Endoscopic ultrasound guided interventions was introduced for a couple decades with the better visualization and achievement of the pancreatobiliary tract. And it's still in the process of ongoing development. The inventions of new techniques and accessories lead to more feasibility of high-ended procedures. Endoscopic ultrasound guided biliary drainage was a novel treatment modality for the patient who failed ERCP with the less invasive technique comparing to surgical bypass. The technical and clinical success was high with acceptable complications. Regarded the ability to drain the biliary tract internally without an exploratory laparotomy, this treatment modality became a very interesting procedures for many endosonographers, worldwide, in a short period. We have reviewed the literature and suggest that endoscopic ultrasoundguided biliary drainage is also an option, and one with a high probability of success, for biliary drainage in the patients who failed conventional endoscopic drainage.展开更多
Marine information has been increasing quickly. The traditional database technologies have disadvantages in manipulating large amounts of marine information which relates to the position in 3-D with the time. Recently...Marine information has been increasing quickly. The traditional database technologies have disadvantages in manipulating large amounts of marine information which relates to the position in 3-D with the time. Recently, greater emphasis has been placed on GIS （geographical information system）to deal with the marine information. The GIS has shown great success for terrestrial applications in the last decades, but its use in marine fields has been far more restricted. One of the main reasons is that most of the GIS systems or their data models are designed for land applications. They cannot do well with the nature of the marine environment and for the marine information. And this becomes a fundamental challenge to the traditional GIS and its data structure. This work designed a data model, the raster-based spatio-temporal hierarchical data model （RSHDM）, for the marine information system, or for the knowledge discovery fi＇om spatio-temporal data, which bases itself on the nature of the marine data and overcomes the shortages of the current spatio-temporal models when they are used in the field. As an experiment, the marine fishery data warehouse （FDW） for marine fishery management was set up, which was based on the RSHDM. The experiment proved that the RSHDM can do well with the data and can extract easily the aggregations that the management needs at different levels.展开更多
Common bile duct(CBD)stone is a common biliary problem,which often requires endoscopic approach as the initial treatment option.Roughly,7%-12%of the subjects who experience cholecystectomy were subsequently referred t...Common bile duct(CBD)stone is a common biliary problem,which often requires endoscopic approach as the initial treatment option.Roughly,7%-12%of the subjects who experience cholecystectomy were subsequently referred to biliary endoscopist for further management.In general,there are three classifications of difficult CBD stone,which are based on the characteristics of the stone(larger than 15 mm,barrel or square-shaped stones,and hard consistency),accessibility to papilla related to anatomical variations,and other clinical conditions or comorbidities of the patients.Currently,endoscopic papillary large balloon dilation(EPLBD)of a previous sphincterotomy and EPLBD combined with limited sphincterotomy performed on the same session is still recommended by the European Society of Gastrointestinal Endoscopy as the main approach in difficult CBD stones with history of failed sphincterotomy and balloon and/or basket attempts.If failed extraction is still encountered,mechanical lithotripsy or cholangioscopy-assisted lithotripsy or extracorporeal shockwave lithotripsy can be considered.Surgical approach can be considered when stone extraction is still failed or the facilities to perform lithotripsy are not available.To our knowledge,conflicting evidence are still found from previous studies related to the comparison between endoscopic and surgical approaches.The availability of experienced operator and resources needs to be considered in creating individualized treatment strategies for managing difficult biliary stones.展开更多
Gastric antral vascular ectasia(GAVE) accounted for 4% of non-variceal gastrointestinal hemorrhage.Even though unclear pathogenesis,GAVE often associated with chronic renal failure,autoimmune diseases and cirrhosis.As...Gastric antral vascular ectasia(GAVE) accounted for 4% of non-variceal gastrointestinal hemorrhage.Even though unclear pathogenesis,GAVE often associated with chronic renal failure,autoimmune diseases and cirrhosis.Asymptomatic lesions were reasonably not to treated.The treatment options for GAVE are nonendoscopic and endoscopic treatments.For the pharmacological treatment,some success were reported for the use of octreotide,thalidomide and tranexamic acid.While the endoscopic treatment is the mainstay for treatment of symptomatic lesions.The endoscopic ablative therapies such as argon plasma coagulation was reported with good clinical outcomes.However,these treatment options had some limitation due to the need of special equipment and multiple sessions needed to control the bleeding.We reported another treatment option using the routine-achievable instrument such as endoscopic band ligation as an initial treatment which also provided a good treatment outcome and less sessions.展开更多
AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general ...AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population.METHODSBetween January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.RESULTSWe enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.CONCLUSIONIBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.展开更多
Urban buildings and urban traffic network are considered as the vital arteries of cities which have particular effects especially after the crisis in the search and rescue operations. The aim of this study is to deter...Urban buildings and urban traffic network are considered as the vital arteries of cities which have particular effects especially after the crisis in the search and rescue operations. The aim of this study is to determine the vulnerability of urban areas especially, buildings and traffic networks using multicriteria geographic information systems and decisionmaking methods. As there are many effective criteria on the seismic vulnerability that they have uncertain and vague properties, the method of this paper is applying fuzzy ordered weighted average(OWA) to model the seismic vulnerability of urban buildings and traffic networks in the most optimistic and pessimistic states. The study area is district 6 of Tehran that is affected by the four major faults, and thus will be threatened by the earthquakes. The achieved results illustrated the vulnerability with different degrees of risk levels including very high, high, medium, low and very low. The results show that in the most optimistic case 14% and in the pessimistic case 1% of buildings tolerate in very low vulnerability. The vulnerability of urban street network also indicates that in the optimistic case 12% and in the pessimistic case at most 9% of the area are in appropriate condition and the North and NorthEast of the study area are more vulnerable than South of it.展开更多
AIM:To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.METHODS:The medical records and endoscopic report...AIM:To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.METHODS:The medical records and endoscopic reports of the patients who underwent endoscopic ultrasound-guided biliary drainage(EUS-BD) owing to failed endoscopic retrograde cholangiopancreatography in our institute between June 2011 and January 2014 were collected and reviewed.All the procedures were performed in the endoscopic suite under intravenous sedation with propofol and full anaesthetic monitoring.Then we used the Soehendra stent retriever as new equipment for neo-tract creation and dilation when performing EUS-BD procedures.The patients were observed in the recovery room for 1-2 h and transferred to the regular ward,patients' clinical data were reviewed and analysed,clinical outcomes were defined by using several different criteria.Data were analysed by using SPSS 13 and presented as percentages,means,and medians.RESULTS:A total of 12 patients were enrolled.The most common indications for EUS-BD in this series were failed common bile duct cannulation,duodenal obstruction,failed selective intrahepatic duct cannulation,and surgical altered anatomy for 50%,25%,16.7%,and 8.3%,respectively.Seven patients underwent EUS-guided hepaticogastrostomy(58.3%),and 5 underwent EUS-guided choledochoduodenostomy(41.7%).The technical success rate was 100%,while the clinical success rate was 91.7%.Major and minor complications occurred in 16.6% and 33.3% of patients,respectively,but there were no procedurerelated death.CONCLUSION:Soehendra stent retriever could be used as an alternative instrument for biliary access in endoscopic ultrasound guided biliary drainage.展开更多
There is an increasing role for endoscopic ultrasound(EUS)-guided interventions in the treatment of many conditions. Although it has been shown that these types of interventions are effective and safe, they continue t...There is an increasing role for endoscopic ultrasound(EUS)-guided interventions in the treatment of many conditions. Although it has been shown that these types of interventions are effective and safe, they continue to be considered only as alternative treatments in some situations. This is in part due to the occurrence of complications with these techniques, which can occur even when performed by experienced endosonographers. Although common complications have been described for many procedures, it is also crucial to be aware of uncommon complications. This review describes rare complications that have been reported with several EUS-guided interventions. EUS-guided biliary drainage is accepted as an alternative treatment for malignant biliary obstruction. Most of the uncommon complications related to this procedure involve stent malfunction, such as the migration or malposition of stents. Rare complications of EUS-guided pancreatic pseudocyst drainage can result from air embolism and infection. Finally, a range of uncommon complications has been reported for EUS-guided celiac plexus neurolysis, involving neural and vascular injuries that can be fatal. The goal of this review is to identify possible complications and promote an understanding of how they occur in order to increase general awareness of these adverse events with the hope that they can be avoided in the future.展开更多
With the development of location technologies, advanced LBS-based ITS increasingly requires the capability of database technologies to manage the continuously arrived vehicles’ location, traffic jam and other interre...With the development of location technologies, advanced LBS-based ITS increasingly requires the capability of database technologies to manage the continuously arrived vehicles’ location, traffic jam and other interrelated information of large amounts of traffic in the following years. And some burst arrival stream data will challenge the real-time performance and the allocation of limited resource. However, choosing a desirable database operator scheduling strategy can significantly improve the performance of the system. The path capability strategy was chosen and improved as ITS’ operator scheduling strategy to meet the real-time response and the minimal memory requirement of the system.展开更多
Primary mediastinal neuroendocrine tumors are a rare malignancy that accounts for < 10% of all mediastinal tumors. The case presented here involves a 52-yearold man who had been suffering for 3 mo from chronic coug...Primary mediastinal neuroendocrine tumors are a rare malignancy that accounts for < 10% of all mediastinal tumors. The case presented here involves a 52-yearold man who had been suffering for 3 mo from chronic cough, anorexia and substantial weight loss, as well as 2 wk of jaundice prior to his admission. A computed tomography scan showed a 4.3 cm × 6.6 cm mediastinal mass with multiple liver nodules scattered along both hepatic lobes. Endoscopic ultrasound showed a large heterogeneous hypoechoic mass at the mediastinum with multiple target-like nodules in the liver. Fine-needle aspiration specimens revealed numerous, small, round cells with hyperchromatic nuclei, scarce cytoplasm, and frequent mitotic features. Immunohistochemical study revealed positive results for AE1/AE3, CD56 and chromogranin A, with negative findings for synaptophysin, CK20, vimentin, CK8/18 and CD45. The patient was subsequently diagnosed with a poorly differentiated neuroendocrine carcinoma, small cell type. A bone marrow biopsy also revealed extensive involvement by the carcinoma.展开更多
UAV remote sensing as a digital aerial photography, not only has some basic photogrammetry features, but also has some other features. In this paper, aim at the characteristics of UAV remote sensing, begin with image ...UAV remote sensing as a digital aerial photography, not only has some basic photogrammetry features, but also has some other features. In this paper, aim at the characteristics of UAV remote sensing, begin with image data acquisition, the various parameter setting in the route planning were introduced, some of the principle was analyzed, the design of control points was described, and some of the considerations when laid control points were summarized.展开更多
文摘AIM： To determine the incidence of colonoscopic perforation （CP）, and evaluate clinical findings, management and outcomes of patients with CP from the World Gastroenterology Organization （WGO） Endoscopy Training Center in Thailand. METHODS： All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok were reviewed. Incidence of CP, patients＇ characteristics, endoscopic information, intraoperative findings, management and outcomes were analyzed. RESULTS： A total of 17357 endoscopic procedures of the colon （13 699 colonoscopies and 3658 flexible sigmoidoscopies） were performed in Siriraj hospital over a 9-year period. Fifteen patients （0.09%） had CP： 14 from colonoscopy and 1 from sigmoidoscopy. The most common site of perforation was in the sigmoid colon （80%）, followed by the transverse colon （13%）. Perforations were caused by direct trauma from either the shaft or the tip of the endoscope （n = 12,80%） and endoscopic polypectomy （n = 3, 20%）. All patients with CP underwent surgical management： primary repair （27%） and bowel resection （73%）. The mortality rate was 13% and postoperative complication rate was 53%. CONCLUSION： CP is a rare but serious complication following colonoscopy and sigmoidoscopy, with high rates of morbidity and mortality. Incidence of CP was 0.09%. Surgery is still the mainstay of CP management.
文摘Atrophic gastritis and intestinal metaplasia may progress to gastric malignancy.Non-invasive serum biomarkers have been extensively studied and proven to be useful as a screening tool to stratify risk and identify patients for endoscopy to detect early gastric cancer.These non-invasive biomarkers have been endorsed and recommended by many international consensus guidelines.In this letter,we reviewed the literature and evidence supporting the use of serum biomarkers as a dynamic test to monitor the status of atrophic gastritis.
文摘The Dongsithouane National Production Forest (DNPF) is one of the largest natural forest areas in Savannakhet, Lao PDR, which has been a vital support for the local community’s livelihood, Recently, significant changes in land use and land cover (LULC) have been observed in this area, leading to a reduction of natural forests. There were two separate methods of this study: firstly, to identify LULC changes across three different periods, spectral imagery from the Landsat 5 Thematic Mapper (TM) for the years 2001 and 2011, and the Landsat 8 Operational Land Imager (OLI) for 2021 were used as the primary data sources. The satellite images were preprocessed for various forest classes, including pretreatment of the top of atmosphere reflectance by using QGIS software’s semi-automatic classification plug-in (SCP), and ArcGIS was used for post-classification. A supervised classification approach was applied to the satellite images from 2001, 2011, and 2021 to generate diverse maps of LULC. Secondly, a household survey dataset was used to investigate influential factors. Approximately 220 households were interviewed in order to collect socio-economic information (including data on population growth, increased business activities, location of the area, agriculture land expansion, and need for settlement land). Household survey data was analyzed by using SPSS. Descriptive statistics, including frequency distributions and percentages, were applied to observe characteristics. Additionally, a binary logistic regression model was used to analyze the socioeconomic factors related to LULC change in DNPF. Key findings indicated a decline in natural forest areas within the study site. Specifically, both dry dipterocarp forest (−11.35%) and mixed deciduous forest (−0.18%) decreased from 2001 to 2021. The overall accuracy of the LULC maps was 94%, 86%, and 89% for the years 2001, 2011, and 2021 respectively. In contrast, agricultural land increased significantly by 155.70%, while built-up land, and water bodies increased by 65.54% and 35.33%, respectively. The results also highlighted a significant increase in construction land, up to 65.54%. Furthermore, the study found a correlation between agricultural expansion and a reduction of forest areas, along with an increase in built-up land along the forest areas’ boundaries. Timber exploitation and charcoal production also contributed to the decline in forest cover. The logistic regression model identified significant determinants of LULC change, including the area’s location, agricultural land expansion, increased business activity, and the need for settlement land. These factors have influenced the management of DNPF. Urgent sustainable management practices and actions, including forest ecosystem protection, village agricultural zoning, water source and watershed protection and public awareness, are required to preserve the forest areas of DNPF.
文摘Endoscopic retrograde cholangiopancreatography(ERCP) is a procedure that can result in serious complications, and thus should be handled by a skilled endoscopist to minimize the risk of complications and to enhance the success rate. The incidence of ERCP-related complications is 5%-10%, most commonly involving post-ERCP pancreatitis and clinically significant post-endoscopic sphincterotomy bleeding. Although ERCP-related perforation has a relatively lower incidence of 0.14%-1.6%, this complication is associated with a high mortality rate of 4.2%-29.6%. A classification of perforation type based on the instrument that caused the perforation was recently described that we postulated could affect the implementation of perforation management. In the present article, an algorithm for management and prevention of ERCP-related perforations is proposed that is based on the perforation type and delay of diagnosis. Available evidence demonstrates that a delayed diagnosis and/or treatment of perforation re-sults in a poorer prognosis, and thus should be at the forefront of procedural consideration. Furthermore, this review provides steps and recommendations from the pre-procedural stage through the post-procedural evaluation with consideration of contributing factors in order to minimize ERCP-related complication risk and improve patient outcome. To avoid perforation, endoscopists must evaluate the risks related to the individual patient and the procedure and perform the procedure gently. Once a perforation occurs, immediate diagnosis and early management are key factors to minimize mortality.
文摘The amount of volunteered geographic information(VGI)has increased over the past decade,and several studies have been conducted to evaluate the quality of VGI data.In this study,we evaluate the completeness of the road network in the VGI data set OpenStreetMap(OSM).The evaluation is based on an accurate and efficient network-matching algorithm.The study begins with a comparison of the two main strategies for network matching:segment-based and nodebased matching.The comparison shows that the result quality is comparable for the two strategies,but the node-based result is considerably more computationally efficient.Therefore,we improve the accuracy of node-based algorithm by handling topological relationships and detecting patterns of complicated network components.Finally,we conduct a case study on the extended node-based algorithm in which we match OSM to the Swedish National Road Database(NVDB)in Scania,Sweden.The case study reveals that OSM has a completeness of 87%in the urban areas and 69%in the rural areas of Scania.The accuracy of the matching process is approximately 95%.The conclusion is that the extended node-based algorithm is sufficiently accurate and efficient for conducting surveys of the quality of OSM and other VGI road data sets in large geographic regions.
文摘BACKGROUND:In general,the dose requirement and complications of propofol are lower when used in the diluted form than in the undiluted form.The aim of this study was to determine the dose requirement and complications of diluted and undiluted propofol for deep sedation in endoscopic retrograde cholangiopancreatography.METHODS:Eighty-six patients were randomly assigned to either group D (diluted propofol) or U (undiluted propofol).All patients were sedated with 0.02-0.03 mg/kg midazolam (total dose ≤2 mg for age <70 years and 1 mg for age ≥70) and 0.5-1 μg/kg fentanyl (total dose ≤75 μg for age <70 and ≤50 μg for age ≥70).Patients in group U (42) were sedated with standard undiluted propofol (10 mg/mL).Patients in group D (44) were sedated with diluted propofol (5 mg/mL).All patients in both groups were monitored for the depth of sedation using the Narcotrend system.The primary outcome variable was the total dose of propofol used during the procedure.The secondary outcome variables were complications during and immediately after the procedure,and recovery time.RESULTS:All endoscopies were completed successfully.Mean propofol doses per body weight and per body weight per hour in groups D and U were 3.0 mg/kg,6.2 mg/kg per hour and 4.7 mg/kg,8.0 mg/kg per hour,respectively.The mean dose of propofol,expressed as total dose,dose/kg or dose/kg per hour and the recovery time were not significantly different between the two groups.Sedation-related adverse events during and immediately after the procedure were higher in group U (42.9%) than in group D (18.2%) (P=0.013).CONCLUSIONS:Propofol requirement and recovery time in the diluted and undiluted propofol groups were comparable.However,the sedation-related hypotension was significantly lower in the diluted group than the undiluted group.
文摘Gastric duplication cyst is a very rare gastrointestinal tract malformation that accounts for 2%-4%of alimentary tract duplications.Most cases are diagnosed within the first year of life,following presentation of abdominal pain,vomiting,and weight loss and clinical discovery of an abdominal palpable mass.This case report describes a very uncommon symptomatic gastric duplication cyst diagnosed for the first time in adulthood.Only a few other case reports of similar condition exist,and all were identified by endosonography.The current case involves a 52-year-old male who presented with a onemonth history of progressive iron deficiency anemia without overt gastrointestinal bleeding.The patient underwent esophagogastroduodenoscopy,which revealed a 2.0 cm pinkish subepithelial lesion,suspected to be a gastrointestinal stromal tumor(GIST)and source of gastrointestinal bleeding.The endosonography showed inhomogeneous hypoechoic lesions with focal anechoic areas arising from a second and third layer of the gastric wall.Differential diagnoses of GIST,neuroendocrine tumor,or pancreatic heterotopia were made.The lesion was removed using an endoscopic submucosal resection technique.Histopathology revealed an erosive gastric mass composed of a complex structure of dilated gastric glands surrounded by fibro-muscular tissue,fibroblasts,and smooth muscle bundles,which led to the diagnosis of gastric duplication.
文摘AIM： To compare the results and complications of early pre-cutting technique with standard technique. METHODS： From January 2003 to December 2004, a total of 426 consecutive therapeutic biliary ERCP procedures were performed by one endoscopist （T.A.）. Data were retrospectively collected according to procedure indication and results. Of these, 293 procedures （70.4%） were done with standard technique （group A） and 223 procedures （29.6%） with early pre-cutting technique in case of difficult cannulation （group B）. The results and complications of ERCP were compared. RESULTS： Success rate of first attempt cannulation was 98.0% in group A and 87.8% in group 13. The overall incidence of post-ERCP pancreatitis, hemorrhage, perforation and cholangitis was 0%, 0.2%, 0.5% and 0.5%, respectively. Morbidity rate was not significantly different. No procedure-related mortality was occurred. CONCLUSION： For an experienced hand, the early pre-cutting technique for biliary cannulation is safe and effective as standard technique.
文摘Endoscopic ultrasound(EUS)-guided biliary drainage is accepted as a less invasive,alternative treatment for patients in whom endoscopic retrograde cholangiopancreatography has failed. Most patients with malignant hilar obstruction undergo EUSguided hepaticogastrostomy. The authors present the case of a 77-year-old man with advanced hilar cholangiocarcinoma who had undergone a rouxen-Y hepaticojejunostomy several months prior. He developed progressive jaundice and a low-grade fever that persisted for one week. The enteroscopic-assisted endoscopic retrograde cholangiopancreatography failed,thus the patient was scheduled for EUS-guided biliary drainage. In order to obtain adequate drainage,both intrahepatic systems were drained. This report describes the technique used for bilateral drainage via a transgastric approach. Currently,only a few different techniques for EUS-guided right system drainage have been reported in the literature. This case demonstrates that bilateral EUS-guided biliary drainage is feasible and effective in patients with hilar cholangiocarcinoma,and thus can be used as an alternative to percutaneous biliary drainage.
文摘Endoscopic retrograde cholangiopancreatography had been a treatment modality of choice for both benign and malignant biliary tract obstruction for more than half century, with a very high clinical success rate and low complications. But in certain circumstances, such as advanced and locally advanced pancreatobiliary malignancies(pancreatic cancer, cholangiocarcinoma, ampullary tumor) and tight benign strictures, endoscopic retrograde cholangiopancreatography(ERCP) fails. Up to this point, the only alternative interventions for these conditions were percutaneous transhepatic biliary drainage or surgery. Endoscopic ultrasound guided interventions was introduced for a couple decades with the better visualization and achievement of the pancreatobiliary tract. And it's still in the process of ongoing development. The inventions of new techniques and accessories lead to more feasibility of high-ended procedures. Endoscopic ultrasound guided biliary drainage was a novel treatment modality for the patient who failed ERCP with the less invasive technique comparing to surgical bypass. The technical and clinical success was high with acceptable complications. Regarded the ability to drain the biliary tract internally without an exploratory laparotomy, this treatment modality became a very interesting procedures for many endosonographers, worldwide, in a short period. We have reviewed the literature and suggest that endoscopic ultrasoundguided biliary drainage is also an option, and one with a high probability of success, for biliary drainage in the patients who failed conventional endoscopic drainage.
基金supported by the National Key Basic Research and Development Program of China under contract No.2006CB701305the National Natural Science Foundation of China under coutract No.40571129the National High-Technology Program of China under contract Nos 2002AA639400,2003AA604040 and 2003AA637030.
文摘Marine information has been increasing quickly. The traditional database technologies have disadvantages in manipulating large amounts of marine information which relates to the position in 3-D with the time. Recently, greater emphasis has been placed on GIS （geographical information system）to deal with the marine information. The GIS has shown great success for terrestrial applications in the last decades, but its use in marine fields has been far more restricted. One of the main reasons is that most of the GIS systems or their data models are designed for land applications. They cannot do well with the nature of the marine environment and for the marine information. And this becomes a fundamental challenge to the traditional GIS and its data structure. This work designed a data model, the raster-based spatio-temporal hierarchical data model （RSHDM）, for the marine information system, or for the knowledge discovery fi＇om spatio-temporal data, which bases itself on the nature of the marine data and overcomes the shortages of the current spatio-temporal models when they are used in the field. As an experiment, the marine fishery data warehouse （FDW） for marine fishery management was set up, which was based on the RSHDM. The experiment proved that the RSHDM can do well with the data and can extract easily the aggregations that the management needs at different levels.
文摘Common bile duct(CBD)stone is a common biliary problem,which often requires endoscopic approach as the initial treatment option.Roughly,7%-12%of the subjects who experience cholecystectomy were subsequently referred to biliary endoscopist for further management.In general,there are three classifications of difficult CBD stone,which are based on the characteristics of the stone(larger than 15 mm,barrel or square-shaped stones,and hard consistency),accessibility to papilla related to anatomical variations,and other clinical conditions or comorbidities of the patients.Currently,endoscopic papillary large balloon dilation(EPLBD)of a previous sphincterotomy and EPLBD combined with limited sphincterotomy performed on the same session is still recommended by the European Society of Gastrointestinal Endoscopy as the main approach in difficult CBD stones with history of failed sphincterotomy and balloon and/or basket attempts.If failed extraction is still encountered,mechanical lithotripsy or cholangioscopy-assisted lithotripsy or extracorporeal shockwave lithotripsy can be considered.Surgical approach can be considered when stone extraction is still failed or the facilities to perform lithotripsy are not available.To our knowledge,conflicting evidence are still found from previous studies related to the comparison between endoscopic and surgical approaches.The availability of experienced operator and resources needs to be considered in creating individualized treatment strategies for managing difficult biliary stones.
文摘Gastric antral vascular ectasia(GAVE) accounted for 4% of non-variceal gastrointestinal hemorrhage.Even though unclear pathogenesis,GAVE often associated with chronic renal failure,autoimmune diseases and cirrhosis.Asymptomatic lesions were reasonably not to treated.The treatment options for GAVE are nonendoscopic and endoscopic treatments.For the pharmacological treatment,some success were reported for the use of octreotide,thalidomide and tranexamic acid.While the endoscopic treatment is the mainstay for treatment of symptomatic lesions.The endoscopic ablative therapies such as argon plasma coagulation was reported with good clinical outcomes.However,these treatment options had some limitation due to the need of special equipment and multiple sessions needed to control the bleeding.We reported another treatment option using the routine-achievable instrument such as endoscopic band ligation as an initial treatment which also provided a good treatment outcome and less sessions.
文摘AIMTo investigate the prevalence and the risk of temporomandibular disorders (TMDs) in patients with irritable bowel syndrome (IBS) (including each subtype: constipation, diarrhoea, and mixed) compared to the general population.METHODSBetween January 2014 and December 2015 we enrolled consecutively adult patients diagnosed with IBS at the outpatient clinic of the University of Salerno and healthy controls (HC) without IBS. At enrollment, we analyzed all patients for the presence of TMDs according to the Research Diagnostic Criteria for TMD.RESULTSWe enrolled 91 IBS patients (23 IBS-D, 30 IBS-C and 38 IBS-M) and 57 HC in the study. We found a higher risk of having TMD (OR = 3.41, 95%CI: 1.66-7.01) compared to the HC. The risk of having TMD was independent of IBS-subtype. Multiple regression analysis showed that facial pain was positively related to abdominal pain and higher level of depression.CONCLUSIONIBS patients had a more than three times greater risk of TMD compared to HC. The risk of having TMD was similar in different IBS subtypes. IBS patients that also fulfilled criteria for TMD seem to share along with chronic facial and abdominal pain a significant co-occurrence with psychiatric disorders and female preponderance.
文摘Urban buildings and urban traffic network are considered as the vital arteries of cities which have particular effects especially after the crisis in the search and rescue operations. The aim of this study is to determine the vulnerability of urban areas especially, buildings and traffic networks using multicriteria geographic information systems and decisionmaking methods. As there are many effective criteria on the seismic vulnerability that they have uncertain and vague properties, the method of this paper is applying fuzzy ordered weighted average(OWA) to model the seismic vulnerability of urban buildings and traffic networks in the most optimistic and pessimistic states. The study area is district 6 of Tehran that is affected by the four major faults, and thus will be threatened by the earthquakes. The achieved results illustrated the vulnerability with different degrees of risk levels including very high, high, medium, low and very low. The results show that in the most optimistic case 14% and in the pessimistic case 1% of buildings tolerate in very low vulnerability. The vulnerability of urban street network also indicates that in the optimistic case 12% and in the pessimistic case at most 9% of the area are in appropriate condition and the North and NorthEast of the study area are more vulnerable than South of it.
文摘AIM:To assess the feasibility and safety of the use of soehendra stent retriever as a new technique for biliary access in endoscopic ultrasound-guided biliary drainage.METHODS:The medical records and endoscopic reports of the patients who underwent endoscopic ultrasound-guided biliary drainage(EUS-BD) owing to failed endoscopic retrograde cholangiopancreatography in our institute between June 2011 and January 2014 were collected and reviewed.All the procedures were performed in the endoscopic suite under intravenous sedation with propofol and full anaesthetic monitoring.Then we used the Soehendra stent retriever as new equipment for neo-tract creation and dilation when performing EUS-BD procedures.The patients were observed in the recovery room for 1-2 h and transferred to the regular ward,patients' clinical data were reviewed and analysed,clinical outcomes were defined by using several different criteria.Data were analysed by using SPSS 13 and presented as percentages,means,and medians.RESULTS:A total of 12 patients were enrolled.The most common indications for EUS-BD in this series were failed common bile duct cannulation,duodenal obstruction,failed selective intrahepatic duct cannulation,and surgical altered anatomy for 50%,25%,16.7%,and 8.3%,respectively.Seven patients underwent EUS-guided hepaticogastrostomy(58.3%),and 5 underwent EUS-guided choledochoduodenostomy(41.7%).The technical success rate was 100%,while the clinical success rate was 91.7%.Major and minor complications occurred in 16.6% and 33.3% of patients,respectively,but there were no procedurerelated death.CONCLUSION:Soehendra stent retriever could be used as an alternative instrument for biliary access in endoscopic ultrasound guided biliary drainage.
文摘There is an increasing role for endoscopic ultrasound(EUS)-guided interventions in the treatment of many conditions. Although it has been shown that these types of interventions are effective and safe, they continue to be considered only as alternative treatments in some situations. This is in part due to the occurrence of complications with these techniques, which can occur even when performed by experienced endosonographers. Although common complications have been described for many procedures, it is also crucial to be aware of uncommon complications. This review describes rare complications that have been reported with several EUS-guided interventions. EUS-guided biliary drainage is accepted as an alternative treatment for malignant biliary obstruction. Most of the uncommon complications related to this procedure involve stent malfunction, such as the migration or malposition of stents. Rare complications of EUS-guided pancreatic pseudocyst drainage can result from air embolism and infection. Finally, a range of uncommon complications has been reported for EUS-guided celiac plexus neurolysis, involving neural and vascular injuries that can be fatal. The goal of this review is to identify possible complications and promote an understanding of how they occur in order to increase general awareness of these adverse events with the hope that they can be avoided in the future.
基金This work is supported by the MIC ( Ministry of Information and Communication) , Korea ,under the ITRC(Information Technology Research Center) support program supervised by the IITA (Institute of Information Technology Assess-ment) .
文摘With the development of location technologies, advanced LBS-based ITS increasingly requires the capability of database technologies to manage the continuously arrived vehicles’ location, traffic jam and other interrelated information of large amounts of traffic in the following years. And some burst arrival stream data will challenge the real-time performance and the allocation of limited resource. However, choosing a desirable database operator scheduling strategy can significantly improve the performance of the system. The path capability strategy was chosen and improved as ITS’ operator scheduling strategy to meet the real-time response and the minimal memory requirement of the system.
文摘Primary mediastinal neuroendocrine tumors are a rare malignancy that accounts for < 10% of all mediastinal tumors. The case presented here involves a 52-yearold man who had been suffering for 3 mo from chronic cough, anorexia and substantial weight loss, as well as 2 wk of jaundice prior to his admission. A computed tomography scan showed a 4.3 cm × 6.6 cm mediastinal mass with multiple liver nodules scattered along both hepatic lobes. Endoscopic ultrasound showed a large heterogeneous hypoechoic mass at the mediastinum with multiple target-like nodules in the liver. Fine-needle aspiration specimens revealed numerous, small, round cells with hyperchromatic nuclei, scarce cytoplasm, and frequent mitotic features. Immunohistochemical study revealed positive results for AE1/AE3, CD56 and chromogranin A, with negative findings for synaptophysin, CK20, vimentin, CK8/18 and CD45. The patient was subsequently diagnosed with a poorly differentiated neuroendocrine carcinoma, small cell type. A bone marrow biopsy also revealed extensive involvement by the carcinoma.
文摘UAV remote sensing as a digital aerial photography, not only has some basic photogrammetry features, but also has some other features. In this paper, aim at the characteristics of UAV remote sensing, begin with image data acquisition, the various parameter setting in the route planning were introduced, some of the principle was analyzed, the design of control points was described, and some of the considerations when laid control points were summarized.
