Gastric adenocarcinoma carries a poor prognosis, in part due to the late stage of diagnosis. Risk factors include Helicobacter pylori infection, family history of gastric cancer—in particular, hereditary diffuse gastric cancer and pernicious anaemia. The stages in the progression to cancer include chronic gastritis, gastric atrophy (GA), gastric intestinal metaplasia (GIM) and dysplasia. The key to early detection of cancer and improved survival is to non-invasively identify those at risk before endoscopy. However, although biomarkers may help in the detection of patients with chronic atrophic gastritis, there is insufficient evidence to support their use for population screening. High-quality endoscopy with full mucosal visualisation is an important part of improving early detection. Image-enhanced endoscopy combined with biopsy sampling for histopathology is the best approach to detect and accurately risk-stratify GA and GIM. Biopsies following the Sydney protocol from the antrum, incisura, lesser and greater curvature allow both diagnostic confirmation and risk stratification for progression to cancer. Ideally biopsies should be directed to areas of GA or GIM visualised by high-quality endoscopy. There is insufficient evidence to support screening in a low-risk population (undergoing routine diagnostic oesophagogastroduodenoscopy) such as the UK, but endoscopic surveillance every 3 years should be offered to patients with extensive GA or GIM. Endoscopic mucosal resection or endoscopic submucosal dissection of visible gastric dysplasia and early cancer has been shown to be efficacious with a high success rate and low rate of recurrence, providing that specific quality criteria are met.

/pdf/british-society-of-gastroenterology-guidelines-on-the-438o7abnac.pdf

British Society of Gastroenterology guidelines on the diagnosis and management of patients at risk of gastric adenocarcinoma

Gastric dysplasia is a neoplastic lesion and a precursor of gastric cancer. The Padova, Vienna, and World Health Organization classifications were developed to overcome the discrepancies between Western and Japanese pathologic diagnoses and to provide a universally accepted classification of gastric epithelial neoplasia. At present, the natural history of gastric dysplasia is unclear. Much evidence suggests that patients with high-grade dysplasia are at high risk of progression to carcinoma or synchronous carcinoma. Therefore, endoscopic resection is required. Although patients with low-grade dysplasia have been reported to be at low risk of progression to carcinoma, due to the marked histologic discrepancies between forceps biopsy and endoscopic specimens, endoscopic resection for this lesion is recommended, particularly in the presence of other risk factors (large size; depressed gross type; surface erythema, unevenness, ulcer, or erosion; and tubulovillous or villous histology). Helicobacter pylori eradication in patients with dysplasia after endoscopic resection appear to reduce the incidence of metachronous lesions.

/pdf/diagnosis-and-management-of-gastric-dysplasia-34akund2vp.pdf

Diagnosis and management of gastric dysplasia.

Mechanical properties and microstructural investigations of TIG welded 40 mm and 60 mm thick SS 316L samples for fusion reactor vacuum vessel applications

Emissivity of silver and stainless steel from 80 K to 300 K: Application to ITER thermal shields

https://tsapps.nist.gov/publication/get_pdf.cfm?pub_id=914418

Emissivity of Silver and Stainless Steel From 80 K to 300 K: Application to ITER Thermal Shields Temperatures | NIST

Final design of ITER vacuum vessel thermal shield

Thermal analysis on detailed 3D models of ITER thermal shield

AIM: To investigate how many discrepancies occur in patients before and after endoscopic treatment of referred adenoma and the reason for these results.

Kwanwoo Nam

Papers

Final design of ITER vacuum vessel thermal shield

Thermal analysis on detailed 3D models of ITER thermal shield

Spectrum of final pathological diagnosis of gastric adenoma after endoscopic resection.

Manufacture and test of mock-up for ITER thermal shield

Progress of detailed design and supporting analysis of ITER thermal shield