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Sample records for capsule endoscopy findings

  1. Finding the solution for incomplete small bowel capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    José; Cotter; Francisca; Dias; de; Castro; Joana; Magalhes; Maria; Joo; Moreira; Bruno; Rosa

    2013-01-01

    AIM:To evaluate whether the use of real time viewer(RTV)and administration of domperidone to patients with delayed gastric passage of the capsule could reduce the rate of incomplete examinations(IE)and improve the diagnostic yield of small bowel capsule endoscopy(SBCE).METHODS:Prospective single center interventional study,from June 2012 to February 2013.Capsule location was systematically checked one hour after ingestion using RTV.If it remained in the stomach,the patient received 10 mg domperidone per os and the location of the capsule was rechecked after 30 min.If the capsule remained in the stomach a second dose of10 mg of domperidone was administered orally.After another 30 min the position was rechecked and if the capsule remained in the stomach,it was passed into the duodenum by upper gastrointestinal(GI)endoscopy.The rate of IE and diagnostic yield of SBCE were compared with those of examinations performed before the use of RTV or domperidone in our Department(control group,January 2009-May 2012).RESULTS:Both groups were similar regarding age,sex,indication,inpatient status and surgical history.The control group included 307 patients,with 48(15.6%)IE.The RTV group included 82 patients,with3(3.7%)IE,P=0.003.In the control group,average gastric time was significantly longer in patients with IE than in patients with complete examination of the small bowel(77 min vs 26 min,P=0.003).In the RTV group,the capsule remained in the stomach one hour after ingestion in 14/82 patients(17.0%)vs 48/307(15.6%)in the control group,P=0.736.Domperidone did not significantly affect small bowel transit time(260min vs 297 min,P=0.229).The capsule detected positive findings in 39%of patients in the control group and 49%in the RTV group(P=0.081).CONCLUSION:The use of RTV and selective administration of domperidone to patients with delayed gastric passage of the capsule significantly reduces incomplete examinations,with no effect on small bowel transit time or diagnostic yield.

  2. Capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Miguel Mu(n)oz-Navas

    2009-01-01

    Capsule endoscopy (CE) is a simple, safe, non-invasive, reliable technique, well accepted and tolerated by the patients, which allows complete exploration of the small intestine. The advent of CE in 2000 has dramatically changed the diagnosis and management of many diseases of the small intestine, such as obscure gastrointestinal bleeding, Crohn's disease, small bowel tumors, polyposis syndromes, etc. CE has become the gold standard for the diagnosis of most diseases of the small bowel. Lately this technique has also been used for esophageal and colonic diseases.

  3. Esophageal capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Ignacio Fernandez-Urien; Cristina Carretero; Raul Armendariz; Miguel Mu(n)oz-Navas

    2008-01-01

    Capsule endoscopy is now considered as the first imaging tool for small bowel examination.Recently,new capsule endoscopy applications have been developed,such as esophageal capsule endoscopy and colon capsule endoscopy.Esophageal capsule endoscopy in patients with suspected esophageal disorders is feasible and safe,and could be also an alternative procedure in those patients refusing upper endoscopy.Although large-scale studies are needed to confirm its utility in GERD and cirrhotic patients,current results are encouraging and open a new era in esophageal examination.

  4. Obscure gastrointestinal bleeding: which factors are associated with positive capsule endoscopy findings?

    Directory of Open Access Journals (Sweden)

    Iolanda Ribeiro

    Full Text Available Background: Capsule endoscopy is a first line examination to evaluate obscure gastrointestinal bleeding. The identification of factors associated with the detection of lesions by capsule endoscopy could improve resource utilization and patient selection. Objectives: To identify factors associated with positive capsule endoscopy findings in patients with obscure gastrointestinal bleeding. Methods: Retrospective, single-center study, including 203 patients (214 capsule endoscopy procedures submitted to capsule endoscopy in the setting of obscure gastrointestinal bleeding. Type of obscure gastrointestinal bleeding, number of units of packed red blood cells transfused, type of positive finding, number of endoscopy studies performed prior to capsule endoscopy, comorbidities, medication and Charlson index were evaluated. Overt bleeding was subdivided into ongoing and previous gastrointestinal bleeding. Only lesions with high hemorrhagic potential (P2 were classified as positive findings. Results: The mean age was 62.2 years and 59.7% of patients were female. Most patients were referred for occult gastrointestinal bleeding (64.5%, while 35.5% were referred for overt gastrointestinal bleeding (63.2% previous-overt gastrointestinal bleeding. The most frequent positive findings included ulcers/erosions (34% and angioectasias (32%. In univariate analysis, the identification of positive findings was significantly higher in those with ongoing-overt bleeding (p < 0.001, advanced age (p = 0.003, increasing number of pre-capsule endoscopies (p < 0.001, increasing transfusion requirements (p < 0.001, moderate/severe renal disease (p = 0.009 and antiplatelet drugs (p = 0.021 and NSAID intake (p = 0.005. In multivariate analysis, positive findings were significantly higher only in those with ongoing-overt bleeding (odds ratio [OR] 18.68, 95% confidence interval [CI] 3.98-85.6, p < 0.001, higher transfusion requirements (OR 1.23, 95% CI 1.1-1.4, p < 0.001 and NSAID

  5. Capsule endoscopy

    Science.gov (United States)

    ... It is about the size of a large vitamin pill. The person swallows the capsule, and it takes pictures all the way through ... can be started in the doctor's office. The capsule is the size of a large vitamin pill, about an inch (2.5 centimeters) long ...

  6. Colon capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Ignacio Fernandez-Urien; Cristina Carretero; Ana Borda; Miguel Mu(n)oz-Navas

    2008-01-01

    Wireless capsule endoscopy has become the first imaging tool for small bowel examination.Recently,new capsule endoscopy applications have been developed,such as esophageal capsule endoscopy and colon capsule endoscopy.Clinical trials results have shown that colon capsule endoscopy is feasible,accurate and safe in patients suffering from colonic diseases.It could be a good alternative in patients refusing conventional colonoscopy or when it is contraindicated.Upcoming studies are needed to demonstrate its utilty for colon cancer screening and other indications such us ulcerative colitis.Comparative studies including both conventional and virtual colonoscopy are also required.

  7. Wireless capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    A Mata; J Llach; JM Bordas

    2008-01-01

    Wireless capsule endoscopy is a new technique that allows complete exploration of the small bowel without external wires. Its role has been analyzed in many small bowel diseases such as obscure gastrointestinal bleeding, Crohn's disease and gastrointestinal polyposis syndromes with promising results. Studies on other pathologies (I.e. Small bowel tumour, celiac disease) are under evaluation to define the role of this technique.

  8. Capsule endoscopy in celiac disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Video capsule endoscopy is an attractive and patient- friendly tool that provides high quality images of the small bowel. Obscure gastrointestinal bleeding is the primary and most evaluated indication to capsule endoscopy; however, indications are expanding and a small number of preliminary reports have been presented concerning the role of video capsule endoscopy in the diagnosis of celiac disease. The purpose of this review is to update the current knowledge and to hypothesize on future perspectives of the use of video capsule endoscopy in patients with celiac disease.

  9. Colon capsule endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

    Science.gov (United States)

    Spada, C; Hassan, C; Galmiche, J P; Neuhaus, H; Dumonceau, J M; Adler, S; Epstein, O; Gay, G; Pennazio, M; Rex, D K; Benamouzig, R; de Franchis, R; Delvaux, M; Devière, J; Eliakim, R; Fraser, C; Hagenmuller, F; Herrerias, J M; Keuchel, M; Macrae, F; Munoz-Navas, M; Ponchon, T; Quintero, E; Riccioni, M E; Rondonotti, E; Marmo, R; Sung, J J; Tajiri, H; Toth, E; Triantafyllou, K; Van Gossum, A; Costamagna, G

    2012-05-01

    PillCam colon capsule endoscopy (CCE) is an innovative noninvasive, and painless ingestible capsule technique that allows exploration of the colon without the need for sedation and gas insufflation. Although it is already available in European and other countries, the clinical indications for CCE as well as the reporting and work-up of detected findings have not yet been standardized. The aim of this evidence-based and consensus-based guideline, commissioned by the European Society of Gastrointestinal Endoscopy (ESGE) is to furnish healthcare providers with a comprehensive framework for potential implementation of this technique in a clinical setting.

  10. Capsule endoscopy of the esophagus.

    Science.gov (United States)

    Waterman, Matti; Gralnek, Ian M

    2009-08-01

    Video capsule endoscopy has acquired wide clinical acceptance since its the US Food and Drug Administration approval in 2001. Recently, the technology of video capsule endoscopy has been adapted to other organs in the gastrointestinal tract, including the esophagus and colon. In this review, we discuss esophageal capsule endoscopy (ECE)-the procedure, its indications, contraindications, safety, and future applications. ECE is a minimally invasive procedure that uses special video capsules with ability to acquire images from 2 cameras with high image storing speed of 14 to 18 frames per second. A special ingestion procedure allows for prolonged esophageal transit time and an optimized view of the gastroesophageal junction. ECE has been shown to have moderately high sensitivity and accuracy in the diagnosis and surveillance of Barrett esophagus in patients with gastroesophageal reflux disease but has not demonstrated superiority to esogastroduodenoscopy in cost-effectiveness models. In patients with portal hypertension, ECE has a sensitivity of 63% to 100% for screening of esophageal varices, but does not seem to be superior to esogastroduodenoscopy in its cost-effectiveness. No serious complications have been reported after ECE although a low rate of esophageal capsule retention (0.7% to 2.2%) has been reported, usually because of unsuspected esophageal strictures. Contraindications to capsule endoscopy include known or suspected gastrointestinal and esophageal obstruction, strictures, or fistulas, intestinal pseudoobstruction, and children under 10 years of age. It is expected that improvements in imaging technology will improve the accuracy of ECE with the development of immunological-based and chemical-based diagnostic capabilities.

  11. Understanding Capsule Endoscopy

    Science.gov (United States)

    ... Testimonials For Patients Conditions Find A Doctor Procedures Purchase Educational Materials Questions to Ask Your MD Screen4coloncancer. ... 963-8332 Email: info@asge.org ASGE on Facebook ASGE on Youtube ASGE on Twitter Privacy | Terms ...

  12. How helpful is capsule endoscopy to surgeons?

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Bulent Sivri; Yusuf Bayraktar

    2007-01-01

    Capsule endoscopy is a new technology that, for the first time, allows complete, non-invasive endoscopic imaging of the small bowel. The efficacy of capsule endoscopy in the diagnosis of suspected small bowel diseases has been established. Important applications for surgeons include observations of obscure gastrointestinal bleeding and small bowel neoplasms.

  13. Colon Capsule Endoscopy: Review and Perspectives

    Directory of Open Access Journals (Sweden)

    David Friedel

    2016-01-01

    Full Text Available Colon capsule endoscopy utilizing PillCam COLON 2 capsule allows for visualization potentially of the entire colon and is currently approved for patients who cannot withstand the rigors of traditional optical colonoscopy (OC and associated sedation as well as those that had an OC that was incomplete for technical reasons other than a poor preparation. We will then describe the prior experience and current status of colon capsule endoscopy.

  14. Therapeutic Capsule Endoscopy: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Mahdi Rasouli

    2011-01-01

    Full Text Available The increasing demand for non-invasive (or less-invasive monitoring and treatment of medical conditions has attracted both physicians and engineers to work together and investigate new methodologies. Wireless capsule endoscopy is a successful example of such techniques which has become an accepted routine for diagnostic inspection of the gastrointestinal tract. This method offers a non-invasive alternative to traditional endoscopy and provides the opportunity for exploring distal areas of the small intestine which are otherwise not accessible. Despite these advantages, wireless capsule endoscopy is still limited in functionality compared to traditional endoscopy. Wireless capsule endoscopes with advanced functionalities, such as biopsy or drug delivery, are highly desirable. In this article, the current status of wireless capsule endoscopy is reviewed together with some of its possible therapeutic applications as well as the existing challenges.

  15. The future of wireless capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    We outline probable and possible developments with wireless capsule endoscopy. It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. This will be attractive to patients especially for cancer or varices detection because capsule endoscopy is painless and is likely to have a higher take up rate compared to conventional colonoscopy and gastroscopy. Double imager capsules with increased frame rates have been used to image the esophagus for Barrett's and esophageal varices. The image quality is not bad but needs to be improved if it is to become a realistic substitute for flexible upper and lower gastrointestinal endoscopy. An increase in the frame rate, angle of view, depth of field, image numbers, duration of the procedure and improvements in illumination seem likely. Colonic, esophageal and gastric capsules will improve in quality, eroding the supremacy of flexible endoscopy, and become embedded into screening programs. Therapeutic capsules will emerge with brushing, cytology, fluid aspiration, biopsy and drug delivery capabilities. Electrocautery may also become possible. Diagnostic capsules will integrate physiological measurements with imaging and optical biopsy, and immunologic cancer recognition. Remote control movement will improve with the use of magnets and/or electrostimulation and perhaps electromechanical methods. External wireless commands will influence capsule diagnosis and therapy and will increasingly entail the use of real-time imaging. However, it should be noted that speculations about the future of technology in any detail are almost always wrong.

  16. Capsule endoscopy in neoplastic diseases

    Institute of Scientific and Technical Information of China (English)

    Marco Pennazio; Emanuele Rondonotti; Roberto de Franchis

    2008-01-01

    Until recently,diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques.An array of new methods has recently been developed,increasing the possibility of detecting these tumors at an earlier stage.Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ,since it is non-invasive and enables the entire small bowel to be visualized.Highquality images of the small-bowel mucosa may be captured and small and fiat lesions recognized,without exposure to radiation.Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range,1.6%-2.4%)and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding.The majority of tumors identified by CE are malignant;many were unsuspected and not found by other methods.However,it remains difficult to identify pathology and tumor type based on the lesion's endoscopic appearance.Despite its limitations,CE provides crucial information leading in most cases to changes in subsequent patient management.Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms,ultimately resulting in a survival advantage and in cost savings,remains to be determined through carefully-designed studies.

  17. Intestinal preparation prior to capsule endoscopy administration

    Institute of Scientific and Technical Information of China (English)

    Vicente Pons Beltrán; Cristina Carretero; Bego(n)a Gonzalez-Suárez; I(n)aqui Fernández-Urien; Miguel Mu(n)oz Navas

    2008-01-01

    In order to have an adequate view of the whole small intestine during capsule endoscopy,the preparation recommended consists of a clear liquid diet and an overnight fast.However,visualization of the small bowel during video capsule endoscopy can be impaired by intestinal contents.To improve mucosal visualization,some authors have evaluated different regimens of preparation.There is no consensus about the necessity of intestinal preparation for capsule endoscopy and it should be interesting to develop adequate guidelines to improve its efficacy and tolerability.Moreover,the effect of preparation type (purgative) on intestinal transit time is not clear.Since a bowel preparation cannot definitively improve its visibility (and theoretically the yield of the test),it is not routinely recommended.

  18. Capsule endoscopy: Current status in obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    R Gupta; Nageshwar Duvvuru Reddy

    2007-01-01

    Capsule endoscopy (CE) is a safe, non invasive diagnostic modality for the evaluation of small bowel lesions. Obscure gastrointestinal bleeding (OGIB) is one of the most important indications of capsule endoscopy.Capsule endoscopy has a very high diagnostic yield especially if the bleeding is ongoing. This technique appears to be superior to other techniques for the detection of suspected lesions and the source of bleeding. Capsule endoscopy has been shown to change the outcome in patients with obscure gastrointestinal (GI)bleed.

  19. Capsule endoscopy in pediatric patients

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Wireless capsule endoscope (WCE) for the investigation of the small bowel is an approved technique both in adults and children (more than 10 years old). The present review provides data on the indications, diagnostic yield, adverse events and limitations of the WCE technique in children and tries to predict the future of WCE usage in this population of patients.

  20. Capsule Endoscopy for Portal Hypertensive Enteropathy

    Directory of Open Access Journals (Sweden)

    Seong Ran Jeon

    2016-01-01

    Full Text Available Portal hypertensive enteropathy (PHE is a mucosal abnormality of the small bowel that is observed in patients with portal hypertension (PH and can lead to gastrointestinal bleeding and anemia. The pathogenesis is still not completely understood. The introduction of new endoscopic methods, including capsule endoscopy (CE or balloon-assisted enteroscopy, has increased the detection of these abnormalities. CE can also serve as a road map for deciding subsequent interventions and evaluating the treatment effect. The prevalence of PHE is reportedly 40–70% in patients with PH. Endoscopic findings can be roughly divided into vascular and nonvascular lesions such as inflammatory-like lesions. Traditionally, PHE-associated factors include large esophageal varices, portal hypertensive gastropathy or colopathy, Child-Turcotte-Pugh class B or C, a history of variceal treatment, and acute gastrointestinal bleeding. More recently, on using scoring systems, a high computed tomography or transient elastography score was reportedly PHE-related factors. However, the prevalence of PHE and its related associated factors remain controversial. The management of PHE has not yet been standardized. It should be individualized according to each patient’s situation, the availability of therapy, and each institutional expertise.

  1. Video capsule endoscopy in inflammatory bowel disease

    Science.gov (United States)

    Collins, Paul D

    2016-01-01

    Video capsule endoscopy (VCE) has evolved to become an important tool for the non-invasive examination of the small bowel, which hitherto had been relatively inaccessible to direct visualisation. VCE has been shown to play a role in monitoring the activity of small bowel Crohn’s disease and can be used to assess the response to anti-inflammatory treatment in Crohn’s disease. For those patients with Crohn’s disease who have undergone an intestinal resection, VCE has been assessed as a tool to detect post-operative recurrence. VCE may also aid in the reclassification of patients with a diagnosis of Inflammatory Bowel Disease Unclassified to Crohn’s disease. The evolution of colon capsule endoscopy (CCE) has expanded the application of this technology further. The use of CCE to assess the activity of ulcerative colitis has been described. This advance in capsule technology has also fuelled interest in its potential role as a minimally invasive tool to assess the whole of GI tract opening the possibility of its use for the panenteric assessment of Crohn’s disease. VCE is a safe procedure. However, the risk of a retained capsule is higher in patients with suspected or confirmed Crohn’s disease compared with patients having VCE examination for other indications. A retained video capsule is rare after successful passage of a patency capsule which may be utilised to pre-screen patients undergoing VCE. This paper describes the use of VCE in the assessment of inflammatory bowel disease. PMID:27499830

  2. Reproducibility of Wireless Capsule Endoscopy in the Investigation of Chronic Obscure Gastrointestinal Bleeding

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    Dimitrios Christodoulou

    2007-01-01

    Full Text Available BACKGROUND: Capsule endoscopy (CE is a valuable tool in the diagnostic evaluation of obscure gastrointestinal bleeding, but limited information is available on the reproducibility of CE findings.

  3. Optimal Bowel Preparation for Video Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Hyun Joo Song

    2016-01-01

    Full Text Available During video capsule endoscopy (VCE, several factors, such as air bubbles, food material in the small bowel, and delayed gastric and small bowel transit time, influence diagnostic yield, small bowel visualization quality, and cecal completion rate. Therefore, bowel preparation before VCE is as essential as bowel preparation before colonoscopy. To date, there have been many comparative studies, consensus, and guidelines regarding different kinds of bowel cleansing agents in bowel preparation for small bowel VCE. Presently, polyethylene glycol- (PEG- based regimens are given primary recommendation. Sodium picosulphate-based regimens are secondarily recommended, as their cleansing efficacy is less than that of PEG-based regimens. Sodium phosphate as well as complementary simethicone and prokinetics use are considered. In this paper, we reviewed previous studies regarding bowel preparation for small bowel VCE and suggested optimal bowel preparation of VCE.

  4. Expanding role of capsule endoscopy in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Capsule endoscopy has been shown to detect small bowel inflammatory changes better than any other imaging modality. Selection criteria have been optimized to increase the yield of capsule endoscopy in patients suspected to have Crohn's disease. Capsule endoscopy allows for earlier diagnosis of Crohn's disease of the small bowel and improved diagnosis of colitis in patients where it is unclear if they suffer from Crohn's or ulcerative colitis. A test capsule is available to assess for small bowel strictures and thus avoid capsule retention. A common language has been developed and a new scoring index will be added to capsule software. It is envisioned that the manner in which we treat Crohn's disease in the future will change, based on earlier diagnosis and treatment aimed at mucosal healing rather than symptom improvement.

  5. Blood detection in wireless capsule endoscopy using expectation maximization clustering

    Science.gov (United States)

    Hwang, Sae; Oh, JungHwan; Cox, Jay; Tang, Shou Jiang; Tibbals, Harry F.

    2006-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. Other endoscopies such as colonoscopy, upper gastrointestinal endoscopy, push enteroscopy, and intraoperative enteroscopy could be used to visualize up to the stomach, duodenum, colon, and terminal ileum, but there existed no method to view most of the small intestine without surgery. With the miniaturization of wireless and camera technologies came the ability to view the entire gestational track with little effort. A tiny disposable video capsule is swallowed, transmitting two images per second to a small data receiver worn by the patient on a belt. During an approximately 8-hour course, over 55,000 images are recorded to a worn device and then downloaded to a computer for later examination. Typically, a medical clinician spends more than two hours to analyze a WCE video. Research has been attempted to automatically find abnormal regions (especially bleeding) to reduce the time needed to analyze the videos. The manufacturers also provide the software tool to detect the bleeding called Suspected Blood Indicator (SBI), but its accuracy is not high enough to replace human examination. It was reported that the sensitivity and the specificity of SBI were about 72% and 85%, respectively. To address this problem, we propose a technique to detect the bleeding regions automatically utilizing the Expectation Maximization (EM) clustering algorithm. Our experimental results indicate that the proposed bleeding detection method achieves 92% and 98% of sensitivity and specificity, respectively.

  6. Capsule endoscopy and push enteroscopy in the diagnosis of obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    戈之铮; 胡运彪; 萧树东

    2004-01-01

    Background In obscure gastrointestinal (GI) bleeding, it is often difficult to detect the bleeding sites located in the small bowel with conventional radiological, scintigraphic or angiographic techniques. Push enteroscopy and capsule endoscopy are currently considered to be the most effective diagnostic procedures. The aim of this study was to compare the detection rates between capsule endoscopy and push enteroscopy. Methods From May 2002 through January 2003, we prospectively examined by capsule endoscopy 39 patients with suspected small bowel diseases, in particular GI bleeding of unknown origin in Renji Hospital. Among them, 32 complained of obscure recurrent GI bleeding. Between January 1993 and October 1996, we used push enteroscopy on 36 patients who suffered from unexplained GI bleeding. All patients had prior normal results on gastroscopy, colonoscopy, small bowel barium radiography, scintigraphy and/or angiography. Results M2A capsule endoscopy disclosed abnormal small bowel findings in 26 (82%) out of 32 patients. Twenty-one of them had significant pathological findings explaining their clinical disorders. Diagnostic yield was therefore 66% (21 of 32 patients). Definite bleeding sites diagnosed by capsule endoscopy in 21 patients included angiodysplasia (8), inflammatory small-bowel (5), small-bowel polyps (4), gastrointestinal stromal tumour (2), carcinoid tumour and lipoma (1), and hemorrhagic gastritis (1). Push enteroscopy detected the definite sources of bleeding in 9 (25%) of the 36 patients. Patients with definite bleeding sources included angiodysplasias (2), leiomyosarcoma (2), leiomyoma (1), lymphoma (1), Crohn's disease (1), small-bowel polyps (1) and adenocarcinoma of ampulla (1). Suspected bleeding sources were shown by push enteroscopy in two additional patients (6%), and in other five patients (16%) by capsule endoscopy.Conclusions The present study of patients with obscure GI bleeding showed that capsule endoscopy significantly superior

  7. Wireless capsule video endoscopy:Three years of experience

    Institute of Scientific and Technical Information of China (English)

    Rami Eliakim

    2004-01-01

    AIM: To review and summerize the current literatue regarding M2A wireless capsule endoscopy.METHODS: Peer reviewed publications regarding the use of capsule endoscopy as well as our personal experience were reviewed.RESULTS: Review of the literature dearly showed that capsule endoscopy was superior to enteroscopy, small bowel follow through and computerized tomography in patients with obscure gastrointestinal bleeding, iron deficiency anemia,or suspected Crohn′s disease. It was very sensitive for the diagnosis of small bowel tumors and for survailance of small bowel pathology in patients with Gardner syndrome or familial adenomatous polyposis syndrome. Its role in celiac disease and in patients with known Crohn′s disease was currently being investigated.CONCLUSION: Capsule video endoscopy is a superior and more sensitive diagnostic tool than barium follow through,enteroscopy and entero- CT in establishing the diagnosis of many small bowel pathologies.

  8. Risk factors for incomplete small-bowel capsule endoscopy

    NARCIS (Netherlands)

    Westerhof, Jessie; Weersma, Rinse K.; Koornstra, Jan J.

    2009-01-01

    Background: In 20% to 30% of capsule endoscopy (CE) procedures, the capsule does not reach the cecum within recording time, with incomplete imaging of the small bowel, which limits the value of CE. Objective: To identify possible risk factors for incomplete small-bowel CE examinations. Design: Data

  9. Pentagonal shaped microstrip patch antenna in wireless capsule endoscopy system

    Directory of Open Access Journals (Sweden)

    Bondili Kohitha Bai

    2012-01-01

    Full Text Available Wireless capsule endoscopy is a best option for exploring inaccessible areas of small intestine for inspection of gastrointestinal tract. This technique brings less pain compare to conventional endoscopy technique. The wireless endoscopy system comprises of three main modules: an ingestible capsule that is swallowed by the patient, an external control unit and display device for image display. In this paper we proposed pentagonal shape microstrip patch antenna for wireless capsule endoscopy system. Inhibiting characteristics of a single microstrip patch like low gain, light weight, thin thickness and smaller bandwidth, make it more popular. This kind of antenna is aggressive miniaturized to meet the requirements of the wireless capsule endoscope. The simulation results show that the designed Circular Polarization (CP pentagonal shaped microstrip patch antenna gives axial ratio of 0.6023 at 2.38 GHz and CP axial ratio bandwidth of 36MHz with 1.5%. The antenna designed for wireless capsule endoscopy is a proposed one, which may work effectively when compared to other antennas in the capsule.

  10. Clinical utility, safety and tolerability of capsule endoscopy in urban Southeast Asian population

    Institute of Scientific and Technical Information of China (English)

    Tiing-Leong Ang; Kwong-Ming Fock; Tay-Meng Ng; Eng-Kiong Teo; Yi-Lyn Tan

    2003-01-01

    AIM:Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies. In this prospective study, we aimed to determine the clinical utility, safety and tolerability of capsule endoscopy in the evaluation of suspected small bowel disease in an urban Southeast Asian population.METHODS: We used the given (M2A) capsule endoscopy system in 16 consecutive patients with suspected small bowel pathology. In 9 patients the indication was obscure gastrointestinal bleeding, while in 6 patients it was to determine the extent of small bowel involvement in Crohn's disease. One patient underwent capsule endoscopy for evaluation of chronic abdominal pain. Patient's tolerability to the procedure was evaluated by standardized questionnaires and all patients were reviewed at one week to ensure that the capsule had been excreted without any adverse events.RESULTS: Abnormal findings were present in 8 patients (50%). The cause of obscure gastrointestinal bleeding was determined in 5 out of 9 patients. Findings included 2 cases of angiodysplasia, 2 cases of jejunal ulcers and 1 case of both angiodysplasia and jejunal ulcer. One patient had small bowel erosions and foci of erythema of doubtful significance.Ileal lesions were diagnosed in 2 out of 6 patients with Crohn's disease. Capsule endoscopy was well tolerated by all patients. One patient with Crohn's disease had a complication of capsule retention due to terminal ileum stricture. The capsule eventually passed out spontaneously after 1 month.CONCLUSION: Our study, which represented the first Asian series, further confirms the diagnostic utility, safety and tolerability of wireless capsule endoscopy.

  11. Upper gastrointestinal findings detected by capsule endoscopy in obscure gastrointestinal bleeding Hallazgos digestivos altos de la cápsula endoscópica en la hemorragia digestiva de origen oscuro

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    B. Velayos

    2009-01-01

    Full Text Available Objective: we analyzed our experience with the use of capsule endoscopy in areas that can be explored with gastroscopy to justify obscure bleeding, as well as the outcome after a new recommended gastroscopy in order to determine if a second gastroscopy before the capsule study can provide any benefit in the management of this disease. Methods: we retrospectively studied 82 patients who were explored with capsule endoscopy for obscure gastrointestinal bleeding who had undergone previously only one gastroscopy. Findings in the zones which were accessible by gastroscopy were normal, mild/known and severe/unknown. In the latter cases we recommended a second gastroscopy, and their treatment and outcome were subjected to further study. Results: capsule endoscopy did not find any unknown esophageal findings. In 63% of cases, no gastric or duodenal lesions were shown; in 20%, lesions were mild or had been previously diagnosed, and in 17%, a new gastroscopy was recommended due to the discovery of an unknown condition which could be the cause of the obscure bleeding. This new information brought about a change in treatment for 78% of patients in this group, all of whom improved from their illness. Capsule endoscopy found significant intercurrent alterations in the small intestine in only 14% of cases. Conclusions: the performance of a second gastroscopy, previous to capsule endoscopy, in the study of obscure gastrointestinal bleeding can offer benefits in diagnostic terms and may introduce therapeutic changes. A detailed analysis of the upper tract frames in intestinal capsule endoscopy studies is mandatory since it may provide relevant information with clinical impact on the management of these patients.Objetivo: hemos analizado los hallazgos que la cápsula endoscópica aportó de las zonas accesibles a una gastroscopia que podrían justificar un sangrado digestivo oscuro, así como la evolución de estos enfermos tras la nueva gastroscopia recomendada

  12. Indications of capsule endoscopy in Crohn´s disease.

    Science.gov (United States)

    Luján-Sanchis, Marisol; Sanchis-Artero, Laura; Suárez-Callol, Patricia; Medina-Chuliá, Enrique

    2014-01-01

    Capsule endoscopy currently plays a relevant role for Crohn´s disease. This manuscript will discuss the current indications and practical uses of capsule endoscopy in this disease. It is a non-invasive technique that represents a significant advance in the endoscopic diagnosis of small bowel conditions. These circumstances, together with its diagnostic yield and excellent tolerability, make it considerably acceptable by both patients and physicians. This paper discusses the current evidence on the specific circumstances where capsule endoscopy may be indicated for three specific scenarios: Suspected Crohn´s disease, indeterminate colitis, and established Crohn´s disease, where it plays an extensive role. Furthermore, the impact and implications of capsule endoscopy results for follow-up are reviewed. These recommendations must be interpreted and applied in the setting of the integral, individual management of these patients. Understanding its appropriate use in daily clinical practice and an analysis of results may define endoscopic scoring systems to assess activity and mucosal healing in this condition. The present role of capsule endoscopy for Crohn´s disease is subject to ongoing review, and appropriate usage uncovers novel applications likely to result in relevant changes for the future management of these patients.

  13. Capsule endoscopy in the diagnosis of Crohn’s disease

    Directory of Open Access Journals (Sweden)

    Niv Y

    2013-05-01

    Full Text Available Yaron NivDepartment of Gastroenterology, Rabin Medical Center, Tel Aviv University, Petah Tikva, IsraelAbstract: Crohn’s disease is a chronic inflammatory disorder affecting any part of the gastrointestinal tract, but frequently involves the small and large bowel. Typical presenting symptoms include abdominal pain and diarrhea. Patients with this disorder may also have extraintestinal manifestations, including arthritis, uveitis, and skin lesions. The PillCam™SB capsule is an ingestible disposable video camera that transmits high quality images of the small intestinal mucosa. This enables the small intestine to be readily accessible to physicians investigating for the presence of small bowel disorders, such as Crohn’s disease. Four meta-analyses have demonstrated that capsule endoscopy identifies Crohn’s disease when other methods are not helpful. It should be noted that it is the best noninvasive procedure for assessing mucosal status, but is not superior to ileocolonoscopy, which remains the gold standard for assessment of ileocolonic disease. Mucosal healing along the small bowel can only be demonstrated by an endoscopic procedure such as capsule endoscopy. Achievement of long-term mucosal healing has been associated with a trend towards a decreased need for hospitalization and a decreased requirement for corticosteroid treatment in patients with Crohn’s disease. Recently, we have developed and validated the Capsule Endoscopy Crohn’s Disease Activity Index (also known as the Niv score for Crohn’s disease of the small bowel. The next step is to expand our score to the colon, and to determine the role and benefit of a capsule endoscopy activity score in patients suffering from Crohn’s ileocolitis and/or colitis. This scoring system will also serve to improve our understanding of the impact of capsule endoscopy, and therefore treatment, on the immediate outcome of this disorder. As the best procedure available for assessing

  14. Capsule endoscopy in diagnosis of small bowel Crohn′s disease

    Institute of Scientific and Technical Information of China (English)

    Zhi-Zheng Ge; Yun-Biao Hu; Shu-Dong Xiao

    2004-01-01

    AIM: To evaluate the effectiveness of wireless capsule endoscopy in patients with suspected Crohn′s disease (CD)of the small bowel undetected by conventional modalities,and to determine the diagnostic yield of M2A Given Capsule.METHODS: From lay 2002 to April 2003, we prospectively examined 20 patients with suspected CD by capsule endoscopy. The patients had the following features:abdominal pain, weight loss, positive fecal occult blood test, iron deficiency anaemia, diarrhoea and fever. All the patients had normal results in small bowel series (SBS)and in upper and lower gastrointestinal endoscopy before they were examined. Mean duration of symptoms before diagnosis was 6.5 years.RESULTS: Of the 20 patients, 13 (65%) were diagnosed as CD of the small bowel according to the findings of M2A Given Capsule. The findings detected by the capsule were mucosal erosions (2 patients), aphthas (5 patients),nodularity (1 patient), large ulcers (2 patients), and ulcerated stenosis (3 patients). The distribution of the lesions was mainly in the distal part of the small bowel,and the mild degree of lesions was 54%.CONCLUSION: Wireless capsule endoscopy is effective in diagnosing patients with suspected CD undetected by conventional diagnostic methods. It can be used to detect early lesions in the small bowel of patients with CD.

  15. Effect of small bowel preparation with simethicone on capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    You-hong FANG; Chun-xiao CHEN; Bing-ling ZHANG

    2009-01-01

    Background: Capsule endoscopy is a novel non-invasive method for visualization of the entire small bowel. The diagnostic yield of capsule endoscopy depends on the quality of visualization of the small bowel mucosa and its complete passage through the small bowel. To date, there is no standardized protocol for bowel preparation before capsule endoscopy. The addition ofsimethicone in the bowel preparation for the purpose of reducing air bubbles in the intestinal lumen had only been studied by a few investigators. Methods: Sixty-four participants were randomly divided into two groups to receive a bowel preparation of polyethylene glycol (PEG) solution (Group 1) and both PEG solution and simethicone (Group 2). The PEG solution and sime-thicone were taken the night before and 20 min prior to capsule endoscopy, respectively. Frames taken in the small intestine were examined and scored for luminal bubbles by two professional capsule endoscopists. Gastric emptying time and small bowel transit time were also recorded. Results: Simethicone significantly reduced luminal bubbles both in the proximal and distal small intes-tines. The mean time proportions with slight bubbles in the proximal and distal intestines in Group 2 were 97.1% and 99.0%, respectively, compared with 67.2% (P<0.001) and 68.8% (P<0.001) in Group 1. Simethicone had no effect on mean gastric emptying time, 32.08 min in Group 2 compared with 30.88 min in Group 1 (P=0.868), but it did increase mean small intestinal transit time from 227.28 to 281.84 min (P=0.003). Conclusion: Bowel preparation with both PEG and simethicone significantly reduced bubbles in the intestinal lumen and improved the visualization of the small bowel by capsule endoscopy without any side effects observed.

  16. Investigating obscure gastrointestinal bleeding : capsule endoscopy or double balloon enteroscopy?

    NARCIS (Netherlands)

    Westerhof, J.; Weersma, R. K.; Koornstra, J. J.

    2009-01-01

    The possibility to visualise the small bowel has dramatically improved with the introduction of capsule endoscopy (CE) and double balloon enteroscopy (DBE). CE and DBE have become standard practice in investigating suspected diseases of the small bowel. An important reason to perform small bowel inv

  17. Initial Experience of Video Capsule Endoscopy After Intestinal Transplantation

    Science.gov (United States)

    Varkey, Jonas; Oltean, Mihai; Pischel, Andreas Bernd; Simrén, Magnus; Herlenius, Gustaf

    2016-01-01

    Background Intestinal transplantation is a procedure which inflicts immunological and infectious complications that affect the transplanted graft, posing both diagnostic and therapeutic challenges. Video capsule endoscopy (VCE) offers easy access to the entire small intestine and presents itself as an interesting option. However, at present, no studies evaluating the usefulness of video capsule endoscopies in this setting have been published. Our aim was to evaluate the usefulness of VCE in detecting complications that arise after intestinal transplantation. Methods We included 7 adult patients with either isolated intestine (n = 1) or multivisceral grafts (n = 6). These patients underwent 12 VCE between 2004 and 2015 at the Sahlgrenska University Hospital. The median age was 42 (21-67) years (4 women/3 men). VCE was used in clinical situations where the conventional diagnostic methods failed to provide answers to the clinical question. Results Indications for the procedure were: suspicion of rejection (n = 4 examinations), gastrointestinal dysmotility (n = 4 examinations), high stomal output (n = 2 examinations), suspicion of lymphoproliferative disease in the transplanted graft (n = 1 examination), and clinical surveillance (n = 1 examination). The median time after transplantation for performing an examination was 740 (26-3059) days. VCE was useful in 83% of the examinations and the results influenced the planned management. The overall agreement between VCE findings and biopsies was moderate (κ = 0.54, P = 0.05) but increased when comparing the presence of inflammation/rejection (κ = 0.79, P < 0.001). Conclusions VCE is a promising diagnostic method after intestinal transplantation. However, larger studies are needed to evaluate its potential risks and gains. PMID:27990484

  18. Polyp Detection and Segmentation from Video Capsule Endoscopy: A Review

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

    Full Text Available Video capsule endoscopy (VCE is used widely nowadays for visualizing the gastrointestinal (GI tract. Capsule endoscopy exams are prescribed usually as an additional monitoring mechanism and can help in identifying polyps, bleeding, etc. To analyze the large scale video data produced by VCE exams, automatic image processing, computer vision, and learning algorithms are required. Recently, automatic polyp detection algorithms have been proposed with various degrees of success. Though polyp detection in colonoscopy and other traditional endoscopy procedure based images is becoming a mature field, due to its unique imaging characteristics, detecting polyps automatically in VCE is a hard problem. We review different polyp detection approaches for VCE imagery and provide systematic analysis with challenges faced by standard image processing and computer vision methods.

  19. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    Directory of Open Access Journals (Sweden)

    Guobing Pan

    2012-01-01

    Full Text Available Wireless capsule endoscopy (WCE offers a feasible noninvasive way to detect the whole gastrointestinal (GI tract and revolutionizes the diagnosis technology. However, compared with wired endoscopies, the limited working time, the low frame rate, and the low image resolution limit the wider application. The progress of this new technology is reviewed in this paper, and the evolution tendencies are analyzed to be high image resolution, high frame rate, and long working time. Unfortunately, the power supply of capsule endoscope (CE is the bottleneck. Wireless power transmission (WPT is the promising solution to this problem, but is also the technical challenge. Active CE is another tendency and will be the next geneion of the WCE. Nevertheless, it will not come true shortly, unless the practical locomotion mechanism of the active CE in GI tract is achieved. The locomotion mechanism is the other technical challenge, besides the challenge of WPT. The progress about the WPT and the active capsule technology is reviewed.

  20. OMOM capsule endoscopy in diagnosis of small bowel disease

    Institute of Scientific and Technical Information of China (English)

    Chen-yi LI; Bing-ling ZHANG; Chun-xiao CHEN; You-ming LI

    2008-01-01

    Objective: To assess the diagnostic efficiency of OMOM capsule endoscopy (CE) in a group of patients with different indications. Methods: Data from 89 consecutive patients (49 males, 40 females) with suspected small bowel disease who under-went OMOM CE (Jinshan Science and Technology Company, Chongqing, China) examination were obtained by retrospective review. The patients' indications of the disease consisted of the following: obscure gastrointestinal bleeding (OGIB), abdominal pain or diarrhea, partial intestinal obstruction, suspected inflammatory bowel disease, tumor of unknown origin, hypoproteinemia, constipation, weight loss, and elevated tumor markers. Results: CE failed in one patient. Visualization of the entire small bowel was achieved in 75.0%. Capsules were naturally excreted by all patients. The detection rate of abnormalities was 70.5% for pa-tients with suspected small bowel disease, and the diagnostic yield for patients with OGIB was higher than that for patients with abdominal pain or diarrhea (85.7% vs 53.3%, P<0.005). Angiodysplasia was the most common small bowel finding. Active bleeding sites were noted in the small intestine in 11 cases. Conclusion: OMOM CE is a useful diagnostic tool for the diagnosis of variably suspected small bowel disease, whose diagnostic efficiency is similar to that of the Pillcam SB (small bowel) CE (Given Imaging, Yoqneam, Israel).

  1. Small intestinal model for electrically propelled capsule endoscopy

    Directory of Open Access Journals (Sweden)

    Woo Sang Hyo

    2011-12-01

    Full Text Available Abstract The aim of this research is to propose a small intestine model for electrically propelled capsule endoscopy. The electrical stimulus can cause contraction of the small intestine and propel the capsule along the lumen. The proposed model considered the drag and friction from the small intestine using a thin walled model and Stokes' drag equation. Further, contraction force from the small intestine was modeled by using regression analysis. From the proposed model, the acceleration and velocity of various exterior shapes of capsule were calculated, and two exterior shapes of capsules were proposed based on the internal volume of the capsules. The proposed capsules were fabricated and animal experiments were conducted. One of the proposed capsules showed an average (SD velocity in forward direction of 2.91 ± 0.99 mm/s and 2.23 ± 0.78 mm/s in the backward direction, which was 5.2 times faster than that obtained in previous research. The proposed model can predict locomotion of the capsule based on various exterior shapes of the capsule.

  2. Electromagnetic wave propagation of wireless capsule endoscopy in human body

    Institute of Scientific and Technical Information of China (English)

    LIM; Eng-Gee; 王炤; 陈瑾慧; TILLO; Tammam; MAN; Ka-lok

    2013-01-01

    Wireless capsule endoscopy(WCE) is a promising technique which has overcome some limitations of traditional diagnosing tools, such as the comfortlessness of the cables and the inability of examining small intestine section. However, this technique is still far from mature and asks for the feasible improvements. For example, the relatively low transmission data rate and the absence of the real-time localization information of the capsule are all important issues. The studies of them rely on the understanding of the electromagnetic wave propagation in human body. Investigation of performance of WCE communication system was carried out by studying electromagnetic(EM) wave propagation of the wireless capsule endoscopy transmission channel. Starting with a pair of antennas working in a human body mimic environment, the signal transmissions and attenuations were examined. The relationship between the signal attenuation and the capsule(transmitter) position, and direction was also evaluated. These results provide important information for real-time localization of the capsule. Moreover, the pair of antennas and the human body were treated as a transmission channel, on which the binary amplitude shift keying(BASK) modulation scheme was used. The relationship between the modulation scheme, data rate and bit error rate was also determined in the case of BASK. With the obtained studies, it make possible to provide valuable information for further studies on the selection of the modulation scheme and the real-time localization of the capsules.

  3. Small bowel capsule endoscopy in 2007: Indications, risks and limitations

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Capsule endoscopy has revoluzionized the study of the small bowel by providing a reliable method to evaluate,endoscopically, the entire small bowel. In the last six years several papers have been published exploring the possible role of this examination in different clinical conditions. At the present time capsule endoscopy is generally recommended as a third examination, after negative bidirectional endoscopy, in patients with obscure gastrointestinal bleeding. A growing body of evidence suggests also an important role for this examination in other clinical conditions such as Crohn's disease, celiac disease, small bowel polyposis syndromes or small bowel tumors. The main complication of this examination is the retention of the device at the site of a previously unknown small bowel stricture. However there are also some other open issues mainly due to technical limitations of this tool (which is not driven from remote control, is unable to take biopsies, to insufflate air, to suck fluids or debris and sometimes to correctly size and locate lesions).The recently developed double balloon enteroscope, owing to its capability to explore a large part of the small bowel and to take targeted biopsies, although being invasive and time consuming,can overcome some limitations of capsule endoscopy.At the present time, in the majority of clinical conditions (i.e. obscure GI bleeding), the winning strategy seems to be to couple these two techniques to explore the small bowel in a painless, safe and complete way (with capsule endoscopy) and to define and treat the lesions identified (with double balloon enteroscopy).

  4. Capsule endoscopy of the future: What's on the horizon?

    Science.gov (United States)

    Slawinski, Piotr R; Obstein, Keith L; Valdastri, Pietro

    2015-10-01

    Capsule endoscopes have evolved from passively moving diagnostic devices to actively moving systems with potential therapeutic capability. In this review, we will discuss the state of the art, define the current shortcomings of capsule endoscopy, and address research areas that aim to overcome said shortcomings. Developments in capsule mobility schemes are emphasized in this text, with magnetic actuation being the most promising endeavor. Research groups are working to integrate sensor data and fuse it with robotic control to outperform today's standard invasive procedures, but in a less intrusive manner. With recent advances in areas such as mobility, drug delivery, and therapeutics, we foresee a translation of interventional capsule technology from the bench-top to the clinical setting within the next 10 years.

  5. New reduced volume preparation regimen in colon capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Yasuo Kakugawa; Kazuhide Higuchi; Shinji Tanaka; Hideki Ishikawa; Hisao Tajiri; Yutaka Saito; Shoichi Saito; Kenji Watanabe; Naoki Ohmiya; Mitsuyuki Murano; Shiro Oka; Tetsuo Arakawa; Hidemi Goto

    2012-01-01

    AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method" (group A) with the "conventional volume method" (group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution (PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule (PillCam COLON(R) capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level.RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine (94%) subjects in group A and 25 (86%) subjects in group B had adequate bowel preparation (ns).Twenty-two (71%) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55%) of the 29 subjects in group B (ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.

  6. Evaluation of Fujinon intelligent chromo endoscopy-assisted capsule endoscopy in patients with obscure gastroenterology bleeding

    Institute of Scientific and Technical Information of China (English)

    Tarun Gupta; Mostafa Ibrahim; Jacques Deviere; André Van Gossum

    2011-01-01

    AIM: To investigate the potential benefit of Fujinon intelligent chromo endoscopy (FICE)-assisted small bowel capsule endoscopy (SBCE) for detection and characterization of small bowel lesions in patients with obscure gastroenterology bleeding (OGIB).METHODS: The SBCE examinations (Pillcam SB2, Given Imaging Ltd) were retrospectively analyzed by two GI fellows (observers) with and without FICE enhancement. Randomization was such that a fellow did not assess the same examination with and without FICE enhancement. The senior consultant described findings as PO, PI and P2 lesions (non-pathological, intermediate bleed potential, high bleed potential), which were considered as reference findings. Main outcome measurements: Inter-observer correlation was calculated using kappa statistics. Sensitivity and specificity for P2 lesions was calculated for FICE and white light SBCE.RESULTS: In 60 patients, the intra-class kappa correlations between the observers and reference findings were 0.88 and 0.92 (P2), 0.61 and 0.79 (PI), for SBCE using FICE and white light, respectively. Overall 157 lesions were diagnosed using FICE as compared to 114 with white light SBCE (P = 0.15). For P2 lesions, the sensitivity was 94% vs 97% and specificity was 95% vs 96% for FICE and white light, respectively. Five (P2 lesions) out of 55 arterio-venous malformations could be better characterized by FICE as compared to white light SBCE. Significantly more P0 lesions were diagnosed when FICE was used as compared to white light (39 vs 8, P < 0.001).CONCLUSION: FICE was not better than white light for diagnosing and characterizing significant lesions on SBCE for OGIB. FICE detected significantly more non-pathological lesions. Nevertheless, some vascular lesions could be more accurately characterized with FICE as compared to white light SBCE.

  7. Comparison of esophageal capsule endoscopy and esophagogastroduodenoscopy for diagnosis of esophageal varices

    Institute of Scientific and Technical Information of China (English)

    Catherine T Frenette; John G Kuldau; Donald J Hillebrand; Jill Lane; Paul J Pockros

    2008-01-01

    AIM: To investigate the utility of esophageal capsule endoscopy in the diagnosis and grading of esophageal varices.METHODS: Cirrhotic patients who were undergo-ing esophagogastroduodenoscopy (EGD) for variceal screening or surveillance underwent capsule endos-copy. Two separate blinded investigators read each capsule endoscopy for the following results: variceal grade, need for treatment with variceal banding or prophylaxis with beta-blocker therapy, degree of portal hypertensive gastropathy, and gastric varices.RESULTS: Fifty patients underwent both capsule and EGD. Forty-eight patients had both procedures on the same day, and 2 patients had capsule endoscopy within 72 h of EGD. The accuracy of capsule endos-copy to decide on the need for prophylaxis was 74%,with sensitivity of 63% and specificity of 82%. Inter-rater agreement was moderate (kappa = 0.56). Agree-ment between EGD and capsule endoscopy on grade of varices was 0.53 (moderate). Inter-rater reliability was good (kappa = 0.77). In diagnosis of portal hyper.tensive gastropathy, accuracy was 57%, with sensitiv-ity of 96% and specificity of 17%. Two patients had gastric varices seen on EGD, one of which was seen on capsule endoscopy. There were no complications from capsule endoscopy.CONCLUSION: We conclude that capsule endoscopy has a limited role in deciding which patients would benefit from EGD with banding or beta-blocker thera-py. More data is needed to assess accuracy for staging esophageal varices, PHG, and the detection of gastric varices.

  8. At a watershed? Technical developments in wireless capsule endoscopy.

    Science.gov (United States)

    Swain, Paul

    2010-10-01

    This article reviews some of the technical developments that allowed the introduction of the wireless capsule 10 years ago into human usage. Technical advances and commercial competition have substantially improved the performance of clinical capsule endoscopy, especially in optical quality. Optical issues including the airless environment, depth of focus, dome reflection, the development of white light light-emitting diodes, exposure length and the advent of adaptive illumination are discussed. The competition between charge coupled devices and complementary metal oxide silicone technologies for imaging, lens improvements and the requirements for different frame rates and their associated power management strategies and battery type choices and the introduction of field enhancement methods into commercial capsule technology are considered. Capsule technology stands at a watershed. It is mainly confined to diagnostic small intestinal imaging. It might overtake other forms of conventional diagnostic endoscopy, especially colonoscopy but also gastroscopy and esophagoscopy but has to improve both technically and compete in price. It might break out of its optical diagnostic confinement and become a therapeutic modality. To make this leap there have to be several technical advances especially in biopsy, command, micromechanical internal movements, remote controlled manipulation and changes in power management, which may include external power transmission.

  9. Diagnostic yield and safety of capsule endoscopy Rendimiento diagnóstico y seguridad de la cápsula endoscópica

    OpenAIRE

    2006-01-01

    Introduction: the capsule endoscopy (CE), from his approval, has become a first line diagnostic procedure for the study of the small bowel disease. The aim of this study is to report our experience since the implantation of this technique in our hospital. Material and methods: retrospective review of the CE undertaken in Department of Endoscopy. There was gathered in every case the age, sex, motive of consultation, previous diagnostic procedures, capsule endoscopy findings and complication of...

  10. A study comparing tolerability, satisfaction and acceptance of three different techniques for esophageal endoscopy: sedated conventional, unsedated peroral ultra thin, and esophageal capsule.

    Science.gov (United States)

    Nakos, G; Karagiannis, S; Ballas, S; Galanis, P; Alevizopoulos, G; Nakos, A; Mavrogiannis, C

    2009-01-01

    Three methods of esophagoscopy are available until now: sedated conventional endoscopy, unsedated ultrathin endoscopy, and esophageal capsule endoscopy. The three methods carry comparable diagnostic accuracy and different complication rates. Although all of them have been found well accepted from patients, no comparative study comprising the three techniques has been published. The aim of this study was to compare the three methods of esophagoscopy regarding tolerability, satisfaction, and acceptance. Twenty patients with large esophageal varices and 10 with gastroesophageal reflux disease were prospectively included. All patients underwent consecutively sedated conventional endoscopy, unsedated ultrathin endoscopy, and esophageal capsule endoscopy. After each procedure, patients completed a seven-item questionnaire. The total positive attitude of patients toward all methods was high. However, statistical analysis revealed the following differences in favor of esophageal capsule endoscopy: (i) total positive attitude has been found higher (chi(2)= 18.2, df = 2, P= 0.00), (ii) less patients felt pain (chi(2)= 6.9, df = 2, P= 0.03) and discomfort (chi(2)= 22.1, df = 2, P= 0.00), (iii) less patients experienced difficulty (chi(2)= 13.7, df = 2, P= 0.01), and (iv) more patients were willing to undergo esophageal capsule endoscopy in the future (chi(2)= 12.1, df = 2, P= 0.002). Esophageal capsule endoscopy was characterized by a more positive general attitude and caused less pain and discomfort. Sedated conventional endoscopy has been found more difficult. More patients would repeat esophageal capsule endoscopy in the future. Patients' total position for all three available techniques for esophageal endoscopy was excellent and renders the observed advantage of esophageal capsule endoscopy over both sedated conventional and unsedated ultrathin endoscopy a statistical finding without a real clinical benefit.

  11. Video capsule endoscopy and the hidden gastrointestinal diseases

    Directory of Open Access Journals (Sweden)

    Helmy Ahmed

    2006-01-01

    Full Text Available Video capsule endoscopy (VCE has recently been introduced to fill the gap between examinations of the upper and lower gastrointestinal tract, mainly to examine the small bowel (SB for sources of obscure bleeding in addition to many other indications. VCE represents a minute endoscope, embedded in a swallowable capsule that is propelled by peristalsis and achieves the journey to the right colon in 5-8 hours. Images captured by the capsule are recorded on a hard drive attached to the patient′s belt. Many studies have recently shown that the diagnostic yield of VCE is superior to that of push enteroscopy. This mini-review contains information on the technical aspects, indications, safety and tolerance of VCE. It is well known that radiological investigations of the small bowel (SB have a limited diagnostic yield, are relatively invasive, and often lead to late discovery of diseases, especially malignancy and profuse bleeding, at a worse stage. Also, push enteroscopy is limited by the depth of the insertion of the instrument to the proximal jejunum and, in the retrograde, to the last 50-80 cm of the terminal ileum, with an ability to visualize the entire SB only in 10-70% of cases. Introduction of video capsule endoscopy (VCE is therefore regarded a significant advance in investigating intestinal diseases, and closes the gap in evaluating the SB, "the black box" of endoscopy(1. This mini-review describes the current indications of VCE and the prerequisites for accurate examination, and briefly discusses its tolerance and safety.

  12. The development and application of wireless capsule endoscopy.

    Science.gov (United States)

    Glukhovsky, A; Jacob, H

    2004-06-01

    The introduction of the Video Capsule Endoscope (VCE) by Given Imaging Ltd. (Yoqneam, Israel) in 2001, and its subsequent approval by the FDA as a first line tool in the detection of abnormalities of the small bowel, is indicative of the rapid acceptance of capsule endoscopy by the practicing gastroenterological community. An extensive clinical trials program consistently revealed a high diagnostic yield of the VCE when compared to other diagnostic modalities of the small intestine. The capsule endoscope contains a miniature color video camera, illumination sources, lens, transmitter/controller, antenna, and a power source. It is small enough to easily swallow (11 x 26 mm), and it is propelled through the gastrointestinal (GI) tract by peristalsis. Its development was enabled by a series of technological breakthroughs that occurred at the close of the 20th century. The VCE is one of the most exciting examples of the recent trend for minimally invasive autonomous medical tools in diagnostic, monitoring, and therapeutic applications. Expanding applications of the VCE to additional parts of the GI tract, adding physiological sensors, and--in the more remote future--addition of therapeutic capabilities will likely occur as this new branch of endoscopy develops.

  13. Wireless capsule endoscopy and proximal small bowel lesions in Crohn’s disease

    Institute of Scientific and Technical Information of China (English)

    Carmelina; Petruzziello; Sara; Onali; Emma; Calabrese; Francesca; Zorzi; Marta; Ascolani; Giovanna; Condino; Elisabetta; Lolli; Paola; Naccarato; Francesco; Pallone; Livia; Biancone

    2010-01-01

    AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detec...

  14. Factors associated with incomplete small bowel capsule endoscopy studies

    Institute of Scientific and Technical Information of China (English)

    Mitchell; M; Lee; Andrew; Jacques; Eric; Lam; Ricky; Kwok; Pardis; Lakzadeh; Ajit; Sandhar; Brandon; Segal; Sigrid; Svarta; Joanna; Law; Robert; Enns

    2010-01-01

    AIM:To identify patient risk factors associated with incomplete small bowel capsule endoscopy(CE) studies.METHODS:Data from all CE procedures performed at St.Paul's Hospital in Vancouver,British Columbia,Canada,between December 2001 and June 2008 were collected and analyzed on a retrospective basis.Data collection for complete and incomplete CE study groups included patient demographics as well as a number of potential risk factors for incomplete CE including indication for the procedure,hospitalization,dia...

  15. Obscure gastrointestinal bleeding: difficulties in comparing CT enterography and video capsule endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, Philippe [Hopital Lariboisiere-APHP 2, Department of Imaging and Nuclear Medicine, Paris (France); UMR INSERM 965-Paris 7 ' ' Angiogenese et recherche translationnelle' ' , Paris (France); Universite Diderot-Paris 7, Paris (France)

    2012-06-15

    A paper reports the results of a retrospective study that was designed to evaluate the potential role of video capsule endoscopy (VCE) in elucidating the cause of bleeding in patients with obscure gastrointestinal bleeding (OGIB) for whom CT enterography was negative. The authors highlight the limitations of dual-phase CT enterography for the detection of flat lesions of the small bowel such as ulcers, angiodysplasias or arteriovenous malformations, and confirm the superiority of VCE for the detection of this category of lesions. This commentary discusses some of the issues raised. Key Points circle Video capsule endoscopy surpasses CT enterography in detecting flat small bowel lesions. circle Retrospective VCE and CT enterography findings in obscure bleeding need further evaluation. circle A fair and unbiased comparison of the two investigations is still needed. (orig.)

  16. Diagnosis of Ascaris lumbricoides infection using capsule endoscopy.

    Science.gov (United States)

    Yamashita, Eduardo Tomohissa; Takahashi, Wagner; Kuwashima, Daniel Yuiti; Langoni, Tiago Ribeiro; Costa-Genzini, Adriana

    2013-04-16

    Ascaris lumbricoides (A. lumbricoides) is the most common intestinal roundworm parasite, infecting approximately one quarter of the world's population. Infection can lead to various complications because it can spread along the gastrointestinal tract. Although A. lumbricoides infection is a serious healthcare issue in developing countries, it now also has a worldwide distribution as a result of increased immigration and travel. Intestinal obstruction is the most common complication of A. lumbricoides infection, potentially leading to even more serious consequences such as small bowel perforation and peritonitis. Diagnosis is based primarily on stool samples and the patient's history. Early diagnosis, aided in part by knowledge of the local prevalence, can result in early treatment, thereby preventing surgical complications associated with intestinal obstruction. Further, delay in diagnosis may have fatal consequences. Capsule endoscopy can serve as a crucial, non-invasive diagnostic tool for A. lumbricoides infection, especially when other diagnostic methods have failed to detect the parasite. We report a case of A. lumbricoides infection that resulted in intestinal obstruction at the level of the ileum. Both stool sample examination and open surgery failed to indicate the presence of A. lumbricoides, and the cause of the obstruction was only revealed by capsule endoscopy. The patient was treated with anthelmintics.

  17. Five years' experience with capsule endoscopy in a single Center

    Institute of Scientific and Technical Information of China (English)

    Taylan Kav; Yusuf Bayraktar

    2009-01-01

    Capsule endoscopy (CE) is a novel technology that facilitates highly effective and noninvasive imaging of the small bowel. Although its efficacy in the evaluation of obscure gastrointestinal bleeding (OGIB) has been proven in several trials, data on uses of CE in different small bowel diseases are rapidly accumulating in the literature, and it has been found to be superior to alternative diagnostic tools in a range of such diseases.Based on literature evidence, CE is recommended as a first-line investigation for OGIB after negative bidirectional endoscopy. CE has gained an important role in the diagnosis and follow-up of Crohn's disease and celiac disease and in the surveillance of small bowel tumors and polyps in selected patients. Capsule retention is the major complication, with a frequency of 1%-2%. The purpose of this review was to discuss the procedure, indications, contraindications and adverse effects associated with CE. We also review and share our five-year experience with CE in various small bowel diseases. The recently developed balloon-assisted enteroscopies have both diagnostic and therapeutic capability. At the present time, CE and balloon-assisted enteroscopies are complementary techniques in the diagnosis and management of small bowel diseases.

  18. Wireless Capsule Endoscopy Detects Meckel’s Diverticulum in a Child with Unexplained Intestinal Blood Loss

    Directory of Open Access Journals (Sweden)

    I. Xinias

    2012-10-01

    Full Text Available Meckel’s diverticulum (MD is the most common congenital anomaly of the gastrointestinal (GI tract, affecting about 2% of the population. Most cases of Meckel’s diverticula are asymptomatic. The diagnosis of symptomatic MD is often difficult to make. We report the case of an 8-year-old boy who presented with GI bleeding due to MD. The diagnostic difficulties after an initial negative endoscopic evaluation and the diagnostic value of the various endoscopic procedures are discussed. The patient had suffered from bright red stools for 20 h before hospital admission. GI scintigraphy with 99mTc-Na-pertechnetate was negative for heterotopic gastric tissue in the small bowel area. Colonoscopy performed in order to exclude Crohn’s disease was also negative. He was placed on ranitidine at a dose of 6 mg/kg body weight twice daily. The patient remained asymptomatic over a period of 6 months before he was readmitted due to macroscopic rectal bleeding. Upper endoscopy and colonoscopy used to investigate the source of bleeding showed normal macroscopic findings. Radiolabeling of blood constituents with 99mTc on delayed imaging showed radionucleotide concentration in the ascending and transverse colon suggestive of a lesion in the ileocecal area. Further investigation with the use of wireless capsule endoscopy revealed a MD. Wireless capsule endoscopy may thus be indicated for patients with GI blood loss when other diagnostic methods, such as upper and lower endoscopy and colonoscopy, have failed to identify the source of bleeding.

  19. Application of Wireless Power Transmission Systems in Wireless Capsule Endoscopy: An Overview

    OpenAIRE

    2014-01-01

    Wireless capsule endoscopy (WCE) is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB). To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE) units may utilize advanced features such as active system control over capsule motion...

  20. Portable wireless power transmission system for video capsule endoscopy.

    Science.gov (United States)

    Zhiwei, Jia; Guozheng, Yan; Bingquan, Zhu

    2014-10-01

    Wireless power transmission is considered a practical way of overcoming the power shortage of wireless capsule endoscopy (VCE). However, most patients cannot tolerate the long hours of lying in a fixed transmitting coil during diagnosis. To develop a portable wireless power transmission system for VCE, a compact transmitting coil and a portable inverter circuit driven by rechargeable batteries are proposed. The couple coils, optimized considering the stability and safety conditions, are 28 turns of transmitting coil and six strands of receiving coil. The driven circuit is designed according to the portable principle. Experiments show that the integrated system could continuously supply power to a dual-head VCE for more than 8 h at a frame rate of 30 frames per second with resolution of 320 × 240. The portable VCE exhibits potential for clinical applications, but requires further improvement and tests.

  1. Analysis of Wireless Capsule Endoscopy Images using Local Binary Patterns

    Directory of Open Access Journals (Sweden)

    Adriana Florentina CONSTANTINESCU

    2015-06-01

    Full Text Available Wireless capsule endoscopy, the gold standard in the screening and diagnosis of small bowel diseases, is one of the most recent investigations for gastrointestinal pathology. This examination has the advantages of being non-invasive, painless, with a large clinical yield, especially for small bowel diseases, but also some disadvantages. The long time necessary for reading and interpreting all frames acquired is one of these disadvantages. This inconvenient could be improved through different methods by using software applications. In this study we have used a software application for texture analysis based on local binary pattern (LBP operator. This operator detects and removes non-informative frames in a first step, then identifies potential lesions. Our study group consisted of 33 patients from the Gastroenterology and Hepatology Centre Craiova and from the 1st Internal Medicine and Gastroenterology Clinic from the Emergency County Hospital of Craiova. The patients included in the study have corresponded to our inclusion criteria established. The exclusion criteria were represented by the contraindications of the capsule endoscopy. In the first phase of the study, we have removed the non-informative frames from the original videos obtained, and we have acquired an average reduction of 6.96% from the total number of images. In the second phase, using the same LBP operator, we have correctly identified 93.16% of telangiectasia lesions. Our study demonstrated that software applications based on LBP operator can lead to a shorter analysis time, by reducing the overall frames number, and can also provide support in diagnosis.

  2. Capsule endoscopy in patients with cardiac pacemakers, implantable cardioverter defibrillators and left heart assist devices.

    Science.gov (United States)

    Bandorski, Dirk; Höltgen, Reinhard; Stunder, Dominik; Keuchel, Martin

    2014-01-01

    According to the recommendations of the US Food and Drug Administration and manufacturers, capsule endoscopy should not be used in patients carrying implanted cardiac devices. For this review we considered studies indexed (until 30.06.2013) in Medline [keywords: capsule endoscopy, small bowel endoscopy, cardiac pacemaker, implantable cardioverter defibrillator, interference, left heart assist device], technical information from Given Imaging and one own publication (not listed in Medline). Several in vitro and in vivo studies included patients with implanted cardiac devices who underwent capsule endoscopy. No clinically relevant interference was noticed. Initial reports on interference with a simulating device were not reproduced. Furthermore technical data of PillCam (Given Imaging) demonstrate that the maximum transmission power is below the permitted limits for cardiac devices. Hence, impairment of cardiac pacemaker, defibrillator or left ventricular heart assist device function by capsule endoscopy is not expected. However, wireless telemetry can cause dysfunction of capsule endoscopy recording. Application of capsule endoscopy is feasible and safe in patients with implanted cardiac devices such as pacemakers, cardioverter defibrillators, and left heart assist devices. Development of new technologies warrants future re-evaluation.

  3. Is there a role for colon capsule endoscopy beyond colorectal cancer screening? A literature review.

    Science.gov (United States)

    Triantafyllou, Konstantinos; Beintaris, Iosif; Dimitriadis, George D

    2014-09-28

    Colon capsule endoscopy is recommended in Europe alternatively to colonoscopy for colorectal cancer screening in average risk individuals. The procedure has also been proposed to complete colon examination in cases of incomplete colonoscopy or when colonoscopy is contraindicated or refused by the patient. As tissue samples cannot be obtained with the current capsule device, colon capsule endoscopy has no place in diagnosing ulcerative colitis or in dysplasia surveillance. Nevertheless, data are accumulating regarding its feasibility to examine ulcerative colitis disease extent and to monitor disease activity and mucosal healing, even though reported results on the capsule's performance in this field vary greatly. In this review we present the currently available evidence for the use of colon capsule endoscopy to complement colonoscopy failure to reach the cecum and its use to evaluate ulcerative colitis disease activity and extent. Moreover, we provide an outlook on issues requiring further investigation before the capsule becomes a mainstream alternative to colonoscopy in such cases.

  4. Capsule endoscopy and enteroscopy: modern modalities to investigate the small bowel in paediatrics.

    Science.gov (United States)

    Sidhu, R; Sanders, D S; McAlindon, M E; Thomson, M

    2008-02-01

    Historically the small bowel has been considered a technically difficult area to examine because of its length (3-5 metres), location and tortuosity. Capsule endoscopy and enteroscopy have revolutionised the investigation pathway of the small bowel in adults. They are now developing increasingly important roles as modalities of investigation in paediatrics. This review appraises the current literature to define the clinical indications and practical aspects of capsule endoscopy and enteroscopy that are of interest to the clinician.

  5. The role of capsule endoscopy after negative CT enterography in patients with obscure gastrointestinal bleeding

    Energy Technology Data Exchange (ETDEWEB)

    Heo, Hyun Mi; Park, Chan Hyuk; Lee, Jin Ha; Kim, Bo Kyung; Cheon, Jae Hee; Kim, Tae Il; Kim, Won Ho; Hong, Sung Pil [Yonsei University College of Medicine, Department of Internal Medicine and Institute of Gastroenterology, Seoul (Korea, Republic of); Lim, Joon Seok [Yonsei University College of Medicine, Department of Diagnostic Radiology, Seoul (Korea, Republic of)

    2012-06-15

    The aim of the present study was to evaluate the role of capsule endoscopy in patients with obscure gastrointestinal bleeding (OGIB) after negative computed tomographic (CT) enterography. We retrospectively included 30 patients with OGIB who received capsule endoscopy after negative CT enterography. The median age of the patients was 60 years, and 60% of patients were male. The median follow-up duration was 8 months. Overt bleeding was 60%, and occult bleeding was 40%. Based on capsule endoscopy results, a definitive diagnosis was made for 17 patients (57%): ulcer in nine patients (30%), active bleeding with no identifiable cause in five (17%), angiodysplasia in two (7%) and Dieulafoy's lesion in one (3%). Two patients with jejunal ulcers were diagnosed with Crohn's disease. Seven patients (41%) with positive capsule endoscopy received double balloon enteroscopy and two patients (12%) received steroid treatment for Crohn's disease. Patients with overt bleeding, a previous history of bleeding, or who received large amounts of blood transfusions were more likely to show positive capsule endoscopy. Capsule endoscopy showed high diagnostic yields in patients with OGIB after negative CT enterography and may help to provide further therapeutic plans for patients with OGIB and negative CT enterography. circle CT enterography has been widely used in evaluating obscure gastrointestinal bleeding (OGIB). circle Capsule endoscopy showed high diagnostic yield for OGIB after negative CT enterography. circle Negative CT enterography does not exclude important causes of small bowel bleeding. circle Most lesions missed at CT-enterography are flat and can be detected by capsule endoscopy. (orig.)

  6. Wireless Capsule Endoscopy for Obscure Gastrointestinal Bleeding: Single Center, One Year Experience

    Directory of Open Access Journals (Sweden)

    Shou-jiang Tang

    2004-01-01

    Full Text Available BACKGROUND: Wireless capsule endoscopy (CE is increasingly being used in the investigation of obscure gastrointestinal (GI bleeding, but some studies have found that many of the bleeding lesions recognized by this technique are within the reach of conventional endoscopy.

  7. Capsule endoscopy: Improving transit time and image view

    Institute of Scientific and Technical Information of China (English)

    Zvi Fireman; D Paz; Y Kopelman

    2005-01-01

    AIM: To evaluate the effect of various methods of small bowel preparation on the transit time and the quality of visualization of the entire small bowel mucosa.METHODS: Ninety-five patients underwent capsule endoscopy (CE) by easily swallowing the capsule. They were divided into three study groups according to the preparation used: group A (n = 26) by polyethylene glycol (PEG) liter or with sodium phosphate (SP) 12 h prior to the CE study; group B (n = 29) by erythromycin 1 h prior to the CE study; and group C (n = 40) without any preparation. Visualization ranged from good to satisfactory to poor.RESULTS: The gastric emptying time in the group prepared with erythromycin was shorter but without statistical significance and the small bowel transit time was unaffected. In elderly subjects prepared by PEG or SP, the gastric emptying time was significantly longer (163.7 min, P = 0.05). The transit times of the three sub-groups were not affected by gender or pathology.The grade of cleaning of the entire study group was 3.27±1.1. The erythromycin group presented significantly the worst quality of images (P = 0.05) compared to the other sub-groups. Age, gender, and pathology had no effect on the quality of the cleaning of the small bowel in the sub-groups. One (1.05%) case had no natural excretion.CONCLUSION: Erythromycin markedly reduces gastric emptying time, but has a negative effect on the quality of the image in the small bowel. The preparation of elderly subjects with PEG or SP has a negative effect on the small bowel transit time.

  8. The Importance of Alternative Diagnostic Modalities in the Diagnosis of Small Bowel Tumors After a Negative Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Iolanda Ribeiro

    2015-05-01

    We report the case of a patient with overt obscure gastrointestinal bleeding due to a gastrointestinal stromal tumor diagnosed by CT enterography after two negatives capsule endoscopies. This case shows that capsule endoscopy may overlook significant life threatening lesions and highlights the importance of using other diagnostic modalities after a negative capsule endoscopy, especially in patients with a high index of suspicion for small bowel tumoral pathology or persistent/recurrent bleeding.

  9. Hemosuccus Pancreaticus in the Era of Capsule Endoscopy and Double Balloon Enteroscopy Complicated by Multifocal Mycobacterium chelonae/abscessus Infection

    Directory of Open Access Journals (Sweden)

    Shabana F. Pasha

    2007-08-01

    Full Text Available Hemosuccus pancreaticus is a rare etiology of obscure gastrointestinal bleeding characterized by bleeding into the pancreatic duct. The diagnosis may be delayed for months to years, due to the episodic nature of bleeding and failure to consider the diagnosis. Patients often undergo multiple endoscopies and radiologic evaluations prior to diagnosis. Incidental gastrointestinal findings may lead to unnecessary endoscopic and surgical interventions. This report describes a patient with hemosuccus pancreaticus diagnosed in the era of video capsule endoscopy and double balloon enteroscopy, whose management was complicated by multifocal Mycobacteria chelonae/abscessus infection.

  10. Sensitivity and inter-observer variability for capsule endoscopy image analysis in a cohort of novice readers

    Institute of Scientific and Technical Information of China (English)

    Gary C Chen; Pedram Enayati; Tam Tran; Mary Lee-Henderson; Clifford Quan; Gareth Dulai; Ian Arnott; James Sul; Rome Jutabha

    2006-01-01

    AIM: To determine the performance of novice readers (4th year medical students) for detecting capsule endoscopy findings.METHODS: Ten capsule endoscopy cases of small bowel lesions were administered to the readers. Gold standard findings were pre-defined by gastroenterologists. Ten gold standard "targets" were identified among the 10cases. Readers were given a 30-min overview of Rapid Reader software and instructed to mark any potential areas of abnormalities. A software program was developed using SAS to analyze the thumbnailed findings.RESULTS: The overall sensitivity for detecting the gold standard findings was 80%. As a group, at least 5 out of 10 readers detected each gold standard finding per recording. All the gold standard targets were identified when the readers' results were combined. Incidental finding/false positive rate ranged between 8.2-59.8 per reader.CONCLUSION: A panel of medical students with minimal endoscopic experience can achieve high sensitivity in detecting lesions on capsule endoscopy.A group of novice readers can pre-screen recordings to thumbnail potential areas of small bowel lesions for further review. These thumbnails must be reviewed to determine the clinical relevance. Further studies are ongoing to assess other cohorts.

  11. Acute extensive ischemic enteritis in a young man diagnosed with wireless capsule endoscopy: a case report.

    Science.gov (United States)

    Jeong, Woo Seong; Song, Hyun Joo; Na, Soo Young; Boo, Sun Jin; Kim, Heung Up; Kim, Jinseok; Choi, Guk Myung

    2013-03-25

    Ischemic enteritis is caused by either the interruption or significant reduction of arterial inflow to the small intestine. Risk factors are old age, diabetes mellitus and cardiovascular disease. It is very rare in young patients. We experienced a 21-year-old man with recurrent acute ischemic enteritis who was diagnosed with capsule endoscopy. He had previously taken medications for pulmonary hypertension and obstruction of both carotid arteries, and about 20 months earlier, he had been admitted due to hematochezia. Two sessions of angiography did not reveal the cause of hematochezia. At that time, capsule endoscopy showed mucosal edema and erythema in the terminal ileum, suggesting healed ischemic enteritis. The patient was admitted again due to hematochezia. Abdominal computed tomography showed focal celiac trunk stenosis and diffuse wall thickening of the small intestine, suggesting ischemic enteritis. Capsule endoscopy showed multiple active ulcers and severe hemorrhage with exudate, extending from the proximal jejunum to the terminal ileum. Using capsule endoscopy, the patient was diagnosed with acute extensive ischemic enteritis. Because endoscopic images of ischemic enteritis have rarely been reported, we report a case of a 21-year-old man who was diagnosed acute extensive ischemic enteritis with capsule endoscopy.

  12. Capsule Endoscopy for Ileitis with Potential Involvement of Other Sections of the Small Bowel

    Directory of Open Access Journals (Sweden)

    Hyun Seok Lee

    2016-01-01

    Full Text Available Ileitis is defined as inflammation of the ileum. This condition includes ulcers, aphthous ulcers, erosions, and nodular or erythematous mucosa. Various etiologies are associated with ileitis. Crohn’s disease, ulcerative colitis, medications such as nonsteroidal anti-inflammatory drugs, infectious conditions, neoplasms, infiltrative disorders, vasculitides, spondyloarthritis, endometriosis, and radiation therapy-related conditions involve the ileum. However, the differential diagnosis of terminal ileitis can be difficult in many cases. Video capsule endoscopy (VCE has become a useful tool for the diagnosis of a variety of small bowel lesions. This review describes each of the various conditions associated with ileitis and the diagnostic value of VCE for ileitis, which may help identify and evaluate these conditions in clinical practice. Based on the information provided by VCE, a definitive diagnosis could be made using the patients’ medical history, clinical course, laboratory and ileocolonoscopic findings, radiologic imaging findings, and histologic findings.

  13. Obscure gastrointestinal bleeding: preliminary comparison of 64-section CT enteroclysis with video capsule endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Khalife, Samer; Vahedi, Kouroche; Dray, Xavier; Marteau, Philippe [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Digestive Diseases, Paris Cedex 10 (France); Soyer, Philippe; Hamzi, Lounis; Place, Vinciane; Boudiaf, Mourad [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Abdominal Imaging, Paris Cedex 10 (France); Alatawi, Abdullah [Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Digestive Diseases, Paris Cedex 10 (France); Hopital Lariboisiere-AP-HP, Universite Diderot-Paris 7, Department of Abdominal Imaging, Paris Cedex 10 (France)

    2011-01-15

    To retrospectively compare the diagnostic capabilities of 64-section CT enteroclysis with those of video capsule endoscopy (VCE) to elucidate the cause of obscure gastrointestinal bleeding. Thirty-two patients who had 64-section CT enteroclysis and VCE because of obscure gastrointestinal bleeding were included. Imaging findings were compared with those obtained at double balloon endoscopy, surgery and histopathological analysis, which were used as a standard of reference. Concordant findings were found in 22 patients (22/32; 69%), including normal findings (n = 13), tumours (n = 7), lymphangiectasia (n = 1) and inflammation (n = 1), and discrepancies in 10 patients (10/32; 31%), including ulcers (n = 3), angioectasias (n = 2), tumours (n = 2) and normal findings (n = 3). No statistical difference in the proportions of abnormal findings between 64-section CT enteroclysis (11/32; 34%) and VCE (17/32, 53%) (P = 0.207) was found. However, 64-section CT enteroclysis helped identify tumours not detected at VCE (n = 2) and definitely excluded suspected tumours (n = 3) because of bulges at VCE. Conversely, VCE showed ulcers (n = 3) and angioectasias (n = 2) which were not visible at 64-section CT enteroclysis. Our results suggest that 64-section CT enteroclysis and VCE have similar overall diagnostic yields in patients with obscure gastrointestinal bleeding. However, the two techniques are complementary in this specific population. (orig.)

  14. Surveillance of FAP: a prospective blinded comparison of capsule endoscopy and other GI imaging to detect small bowel polyps

    Directory of Open Access Journals (Sweden)

    Tescher Paul

    2010-04-01

    Full Text Available Abstract Background Familial adenomatous polyposis (FAP is a hereditary disorder characterized by polyposis along the gastrointestinal tract. Information on adenoma status below the duodenum has previously been restricted due to its inaccessibility in vivo. Capsule Endoscopy (CE may provide a useful adjunct in screening for polyposis in the small bowel in FAP patients. This study aims to evaluate the effectiveness of CE in the assessment of patients with FAP, compared to other imaging modalities for the detection of small bowel polyps. Method 20 consecutive patients with previously diagnosed FAP and duodenal polyps, presenting for routine surveillance of polyps at The Royal Melbourne Hospital were recruited. Each fasted patient initially underwent a magnetic resonance image (MRI of the abdomen, and a barium small bowel follow-through study. Capsule Endoscopy was performed four weeks later on the fasted patient. An upper gastrointestinal side-viewing endoscopy was done one (1 to two (2 weeks after this. Endoscopists and investigators were blinded to results of other investigations and patient history. Results Within the stomach, upper gastrointestinal endoscopy found more polyps than other forms of imaging. SBFT and MRI generally performed poorly, identifying fewer polyps than both upper gastrointestinal and capsule endoscopy. CE was the only form of imaging that identified polyps in all segments of the small bowel as well as the only form of imaging able to provide multiple findings outside the stomach/duodenum. Conclusion CE provides important information on possible polyp development distal to the duodenum, which may lead to surgical intervention. The place of CE as an adjunct in surveillance of FAP for a specific subset needs consideration and confirmation in replication studies. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12608000616370

  15. Current Clinical Indications for Small Bowel Capsule Endoscopy.

    Science.gov (United States)

    Rosa, Bruno; Cotter, José

    2015-01-01

    Introdução: A enteroscopia por cápsula é o exame de primeira linha no diagnóstico de diversas patologias do intestino delgado. Este artigo tem por objectivo rever e analisar criticamente as indicações actuais para enteroscopia por cápsula na prática clínica. Material e Métodos: Revisão bibliográfica suportada em artigos indexados na PubMed. Resultados e Discussão: A enteroscopia por cápsula permite a avaliação não invasiva da mucosa do intestino delgado, com elevado rendimento diagnóstico. Em doentes com hemorragia digestiva de causa obscura, o rendimento da enteroscopia por cápsula aumenta quando realizada precocemente após o evento hemorrágico. O tratamento das angiectasias com enteroscopia assistida por balão permite diminuir a recidiva hemorrágica, enquanto o risco de recidiva em doentes com enteroscopia por cápsula 'negativa' é controverso. A entero-TC/entero-RM podem superiorizar-se à enteroscopia por cápsula no diagnóstico de alguns tumores. O 'Smooth Protruding Index on Capsule Endoscopy' (score SPICE) auxilia na diferenciação entre verdadeiros tumores submucosos e abaulamentos não patológicos. A enteroscopia por cápsula é valiosa em doentes com suspeita de doença de Crohn quando a ileocolonoscopia não é diagnóstica, permitindo também estadiar a extensão e actividade das lesões em doentes com diagnóstico prévio de doença de Crohn, com potenciais implicações prognósticas e terapêuticas. A enteroscopia por cápsula permite ainda o diagnóstico de complicações em doentes com doença celíaca refractária. Conclusões: Actualmente, a importãncia da enteroscopia por cápsula é reconhecida no contexto da hemorragia digestiva de causa obscura e/ou suspeita de tumores do intestino delgado, bem como na suspeita de doença de Crohn ou em doentes com doença de Crohn conhecida para determinar a localização, extensão e actividade da doença, e ainda para a investigação de doentes com doença celíaca refractária.

  16. An improved YEF-DCT based compression algorithm for video capsule endoscopy.

    Science.gov (United States)

    Mostafa, Atahar; Khan, Tareq; Wahid, Khan

    2014-01-01

    Video capsule endoscopy is a non-invasive technique to receive images of intestine for medical diagnostics. The main design challenges of endoscopy capsule are accruing and transmitting acceptable quality images by utilizing as less hardware and battery power as possible. In order to save wireless transmission power and bandwidth, an efficient image compression algorithm needs to be implemented inside the endoscopy electronic capsule. In this paper, an integer discrete-cosine-transform (DCT) based algorithm is presented that works on a low-complexity color-space specially designed for wireless capsule endoscopy application. First of all, thousands of human endoscopic images and video frames have been analyzed to identify special intestinal features present in those frames. Then a color space, referred as YEF, is used. The YEF converter is lossless and takes only a few adders and shift operation to implement. A low-cost quantization scheme with variable chroma sub-sampling options is also implemented to achieve higher compression. Comparing with the existing works, the proposed transform coding based compressor performs strongly with an average compression ratio of 85% and a high image quality index, peak-signal-to-noise ratio (PSNR) of 52 dB.

  17. Colon Capsule Endoscopy: Detection of Colonic Polyps Compared with Conventional Colonoscopy and Visualization of Extracolonic Pathologies

    Directory of Open Access Journals (Sweden)

    Alexander F Hagel

    2014-01-01

    Full Text Available BACKGROUND: Conventional colonoscopy (CC is the gold standard for diagnostic examination of the colon. However, the overall acceptance of this procedure is low due to patient fears of complications or embarrassment. Colon capsule endoscopy (CCE represents a minimally invasive, patient-friendly procedure that offers complete visualization of the entire intestine.

  18. Inter-observer agreement for detection of small bowel Crohn's disease with capsule endoscopy

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Kjeldsen, Jens

    2010-01-01

    OBJECTIVE: Compared to other modalities, capsule endoscopy (CE) has a high diagnostic yield for diagnosing small bowel Crohn's disease (CD). The aim of this study was to determine the inter-observer agreement for detection of small bowel CD with predefined diagnostic criteria. MATERIAL AND METHODS...

  19. Unawareness of a Prolonged Retained Capsule Endoscopy: The Importance of Careful Follow-Up and Cooperation between Medical Institutions

    Directory of Open Access Journals (Sweden)

    Susumu Saigusa

    2014-01-01

    Full Text Available A 50-year-old man with anemia was referred to our hospital to undergo capsule endoscopy (CE, which revealed small intestinal ulcers. After 5 months of CE, he returned because of recurrent anemia without abdominal symptoms. Abdominal X-ray and computed tomography showed capsule retention in the small intestine at the pelvic cavity. The capsule remained at the same place for 7 days. We performed capsule retrieval by laparoscopy-assisted surgery with resection of the involved small intestine, including an ileal stricture. Resected specimen showed double ulcers with different morphologies, an ulcer scar with stricture, and a wide ulcer at the proximal side of the others. Each ulcer had different histopathological findings such as the degree of fibrosis and monocyte infiltration. These differences led us to consider that the proximal ulcer may have been secondarily induced by capsule retention. Our experience indicated that careful follow-up and the cooperation between medical institutions after CE examination should be undertaken for patients with incomplete examination, unknown excretion of the capsule, and/or ulcerative lesions despite the lack of abdominal symptoms. Additionally, a retained CE remaining over long periods and at the same place in the small intestine may lead to secondary ulceration.

  20. What is the impact of capsule endoscopy in the long term period?

    Institute of Scientific and Technical Information of China (English)

    Asli Ormeci; Filiz Akyuz; Bulent Baran; Suut Gokturk; Tugrul Ormeci; Binnur Pinarbasi; Ozlem Mutluay Soyer; Sami Evirgen; Umit Akyuz; Cetin Karaca; Kadir Demir; Sabahattin Kaymakoglu; Fatih Besisik

    2016-01-01

    AIM: To assess the clinical impact of capsule endoscopy(CE) in the long-term follow-up period in patients with obscure gastrointestinal bleeding(OGIB). METHODS: One hundred and forty-one patients who applied CE for OGIB between 2009 and 2012 were retrospectively analyzed, and this cohort was then questioned prospectively. Demographic data of the patients were determined via the presence of comorbid diseases, use of non-steroidal anti-inflammatory drugs anticoagulant-antiaggregant agents, previous diagnostic tests for bleeding episodes, CE findings, laboratory tests and outcomes.RESULTS: CE was performed on 141 patients becauseof OGIB. The capsule was retained in the upper gastrointestinal(GI) system in two of the patients, thus video monitoring was not achieved. There were 139 patients [62% male, median age: 72 years(range: 13-93 years) and a median follow-up duration: 32 mo(range: 6-82 mo)]. The overall diagnostic yield of CE was 84.9%. Rebleeding was determined in 40.3%(56/139) of the patients. The rebleeding rates of patients with positive and negative capsule results at the end of the follow-up were 46.6%(55/118) and 4.8%(1/21), respectively. In the multivariate analysis, usage of NSAIDs, anticoagulant-antiaggregant therapies(OR = 5.8; 95%CI: 1.86-18.27) and vascular ectasia(OR = 6.02; 95%CI: 2.568-14.146) in CE were detected as independent predictors of rebleeding. In the univariate analysis, advanced age, comorbidity, and overt bleeding were detected as predictors of rebleeding.CONCLUSION: CE is a reliable method in the diagnosis of obscure GI bleeding. Negative CE correlated with a significantly lower rebleeding risk in the long-term follow-up period.

  1. Capsule endoscopy retention as a helpful tool in the management of a young patient with suspected small-bowel disease

    Institute of Scientific and Technical Information of China (English)

    Chryssostomos Kalantzis; Periklis Apostolopoulos; Panagiota Mavrogiannis; Dimitrios Theodorou; Xenofon Papacharalampous; Ioannis Bramis; Nikolaos Kalantzis

    2007-01-01

    Capsule endoscopy is an easy and painless procedure permitting visualization of the entire small-bowel during its normal peristalsis. However, important problems exist concerning capsule retention in patients at risk of small bowel obstruction. The present report describes a young patient who had recurrent episodes of overt gastrointestinal bleeding of obscure origin, 18 years after small bowel resection in infancy for ileal atresia.Capsule endoscopy was performed, resulting in capsule retention in the distal small bowel. However, this event contributed to patient management by clearly identifying the site of obstruction and can be used to guide surgical intervention, where an anastomotic ulcer is identified.

  2. Prospective small bowel mucosal assessment immediately after chemoradiotherapy of unresectable locally advanced pancreatic cancer using capsule endoscopy: a case series.

    Science.gov (United States)

    Yamashina, Takeshi; Takada, Ryoji; Uedo, Noriya; Akasaka, Tomofumi; Hanaoka, Noboru; Takeuchi, Yoji; Higashino, Koji; Ioka, Tatsuya; Ishihara, Ryu; Teshima, Teruki; Nishiyama, Kinji; Iishi, Hiroyasu

    2016-01-01

    In this case series, three consecutive patients with unresectable locally advanced pancreatic cancer (ULAPC) underwent capsule endoscopy (CE) before and after chemoradiotherapy (CRT) to evaluate duodenal and jejunal mucosa, and to examine the relationship between CE findings and dose distribution. CE after CRT showed duodenitis and proximal jejunitis in all three patients. The most inflamed region was the third part of the duodenum, and in dose distribution, this was the closest region to the center of irradiation. This case series shows that CE can safely diagnose acute duodenitis and proximal jejunitis caused by CRT for ULAPC, and that dose distribution is possible to predict the degree of duodenal and jejunal mucosal injuries.

  3. [Report on 16 cases of small intestine ascariasis diagnosed by capsule endoscopy].

    Science.gov (United States)

    Wang, Pu; Li, Rong-Zhi; Huang, Zhi-Yin; Tang, Cheng-Wei

    2013-06-01

    The clinical data and capsule endoscopy image of 16 adult patients with small intestine ascariasis were reviewed and analyzed retrospectively from June 2006 to June 2012 in West China Hospital. Among the 16 patients, 15 cases manifested as gastrointestinal bleeding, 15 cases showed anemia (3 severe, 10 moderate, and 2 mild), 2 had hypoalbuminemia, 1 had peripheral blood eosinophilia. All the cases were found to be fecal occult blood positive, but no Ascaris eggs found in the feces. Capsule endoscopy showed they were infected with Ascaris worms. The worms were found in the proximal small intestine in 14 patients and 2 in the distal intestine. Mucosal erythema and erosions around the worm were observed in 3 cases, and 7 cases were found with active bleeding or old haemorrhage in small intestine.

  4. High sensitivity of quick view capsule endoscopy for detection of small bowel Crohn's disease

    DEFF Research Database (Denmark)

    Halling, Morten Lee; Nathan, Torben; Kjeldsen, Jens;

    2014-01-01

    Capsule endoscopy (CE) has a high sensitivity for diagnosing small bowel Crohn's disease, but video analysis is time consuming. The quick view (qv) function is an effective tool to reduce time consumption. The aim of this study was to determine the rate of missed small bowel ulcerations with qv......-CE compared to standard view and the diagnostic accuracy of qv-CE in suspected Crohn's disease....

  5. Small bowel involvement documented by capsule endoscopy in Churg-Strauss syndrome

    Science.gov (United States)

    Beye, Birane; Lesur, Gilles; Claude, Pierre; Martzolf, Lionel; Kieffer, Pierre; Sondag, Daniel

    2015-01-01

    Churg-Strauss syndrome is a small and medium vessel vasculitis and is also known as allergic granulomatous angiitis. Gastrointestinal involvement is common in patients with Churg-Strauss syndrome (20-50%). The most common symptoms are abdominal pain, diarrhoea and occasionally gastrointestinal bleeding and perforation. We present a case of Churg-Strauss syndrome with small bowel lesions documented by video capsule endoscopy. PMID:26664542

  6. Efficiency of bowel preparation for capsule endoscopy examination:A meta-analysis

    Institute of Scientific and Technical Information of China (English)

    Yaron Niv

    2008-01-01

    Good preparation before endoscopic procedures is essential for successful visualization.The small bowel is difficult to evaluate because of its length and complex configuration.A meta-analysis was conducted of studies comparing small bowel visualization by capsule endoscopy with and without preparation.Medical data bases were searched for all studies investigating the preparation for capsule endoscopy of the small bowel up to July 31,2007.Studies that scored bowel cleanness and measured gastric and small bowel transit time and rate of cecum visualization were included.The primary endpoint was the quality of bowel visualization.The secondary endpoints were transit times and proportion of examinations that demonstrated the cecum,with and without preparation.Meta-analysis was performed with StatDirect Statistical software,version 2.6.1 (http://statsdirect.com).Eight studies met the inclusion criteria.Bowel visualization was scored as "good" in 78% of the examinations performed with preparation and 49% performed without (P<0.0001).There were no significant differences in transit times or in the proportion of examinations that demonstrated the cecum with and without preparation.Capsule endoscopy preparation improves the quality of small bowel visualization,but has no effect on transit times,or demonstration of the cecum.

  7. GISentinel: a software platform for automatic ulcer detection on capsule endoscopy videos

    Science.gov (United States)

    Yi, Steven; Jiao, Heng; Meng, Fan; Leighton, Jonathon A.; Shabana, Pasha; Rentz, Lauri

    2014-03-01

    In this paper, we present a novel and clinically valuable software platform for automatic ulcer detection on gastrointestinal (GI) tract from Capsule Endoscopy (CE) videos. Typical CE videos take about 8 hours. They have to be reviewed manually by physicians to detect and locate diseases such as ulcers and bleedings. The process is time consuming. Moreover, because of the long-time manual review, it is easy to lead to miss-finding. Working with our collaborators, we were focusing on developing a software platform called GISentinel, which can fully automated GI tract ulcer detection and classification. This software includes 3 parts: the frequency based Log-Gabor filter regions of interest (ROI) extraction, the unique feature selection and validation method (e.g. illumination invariant feature, color independent features, and symmetrical texture features), and the cascade SVM classification for handling "ulcer vs. non-ulcer" cases. After the experiments, this SW gave descent results. In frame-wise, the ulcer detection rate is 69.65% (319/458). In instance-wise, the ulcer detection rate is 82.35%(28/34).The false alarm rate is 16.43% (34/207). This work is a part of our innovative 2D/3D based GI tract disease detection software platform. The final goal of this SW is to find and classification of major GI tract diseases intelligently, such as bleeding, ulcer, and polyp from the CE videos. This paper will mainly describe the automatic ulcer detection functional module.

  8. MR enterography versus capsule endoscopy in paediatric patients with suspected Crohn's disease

    Energy Technology Data Exchange (ETDEWEB)

    Casciani, Emanuele; Masselli, Gabriele; Polettini, Elisabetta; Bertini, Luca; Gualdi, Gianfranco [University, Radiology DEA, Azienda Policlinico Umberto I, Rome (Italy); Di Nardo, Giovanni; Oliva, Salvatore; Cucchiara, Salvatore [University, Pediatric Gastroenterology, Rome (Italy); Floriani, Irene [Istituto di Ricerche Farmacologiche ' ' Mario Negri' ' , Milan (Italy)

    2011-04-15

    The aim of this prospective study was to compare the diagnostic yield of MR enterography (MRE) with small-bowel capsule endoscopy (SBCE) in paediatric patients with suspected Crohn's disease (CD). Paediatric patients with suspected CD were considered eligible to be enrolled in the study. All patients underwent diagnostic work-up including 1.5-T MRE, ileo-colonoscopy and oesophagogastroduodenoscopy. SBCE was not performed if MRE showed SB stricture or extra-intestinal findings consistent with symptoms. Sixty consecutive paediatric patients (36 male; average age 14) were enrolled into the study. A positive diagnosis for CD was made in 19 patients, 29 had a negative result and 12 were affected by other gastro-intestinal conditions. SBCE was performed in 37 patients (61.7%); 23 patients were excluded (strictures in five, extra-intestinal findings in 11 and parents' refusal in seven cases). The accuracy, sensitivity, and specificity of MRE and SBCE were 98.3%, 100%, 97.6%, and 91.9%, 90.9%, 92.3%, respectively. Both MRE and SBCE are accurate methods for patients with suspected CD. MRE can be used as a primary imaging technique in suspected CD, in that it allows access to the ileal stricture, which forms a contra-indication for SBCE and provides extra-intestinal information. (orig.)

  9. Feasibility of capsule endoscopy in elderly patients with obscure gastrointestinal bleeding. An up-to-date report

    Directory of Open Access Journals (Sweden)

    Orlando G

    2012-11-01

    Full Text Available Abstract Background Anemia is the most common hematologic abnormality in older populations. Furthermore, iron deficiency anemia is common and merits investigation and treatment, as it usually results from chronic occult bleeding from the gastrointestinal tract. In view of a wide use of capsule endoscopy as a diagnostic procedure for occult gastrointestinal bleeding and of the growth of aging population, we performed a literature review about the feasibility of capsule endoscopy in the elderly. Methods We conducted a literature search in the PubMed database in July 2012, and all English-language publications on capsule endoscopy in elderly patients since 2005 were retrieved. The potential original articles mainly focused on obscure gastrointestinal bleeding were all identified and full texts were obtained and reviewed for further hand data retrieving. Results We retrieved only six papers based on different primary end-points. Four were retrospective non randomized studies and two were prospective non randomized studies. In the end 65, 70, 80 and 85 years were used as an age cut-off. All studies evaluate the diagnostic yield of capsule endoscopy in iron deficiency anemia. Only three studies assess the feasibility of capsule examination of the elderly. Conclusions Iron deficiency anemia in the elderly with or without obscure gastrointestinal bleeding is the major indication for capsule endoscopy after a negative esophago-gastro-duodenoscopy and colonoscopy. It is safe and effective to identify a small bowel pathology without a great discomfort for the elderly. Inability to swallow the capsule, battery failure before capsule reaches the cecum, and capsule retention are some of the important problems associated with capsule endoscopy in elderly as well as in younger patients.

  10. Achieving real-time capsule endoscopy (CE) video visualization through panoramic imaging

    Science.gov (United States)

    Yi, Steven; Xie, Jean; Mui, Peter; Leighton, Jonathan A.

    2013-02-01

    In this paper, we mainly present a novel and real-time capsule endoscopy (CE) video visualization concept based on panoramic imaging. Typical CE videos run about 8 hours and are manually reviewed by physicians to locate diseases such as bleedings and polyps. To date, there is no commercially available tool capable of providing stabilized and processed CE video that is easy to analyze in real time. The burden on physicians' disease finding efforts is thus big. In fact, since the CE camera sensor has a limited forward looking view and low image frame rate (typical 2 frames per second), and captures very close range imaging on the GI tract surface, it is no surprise that traditional visualization method based on tracking and registration often fails to work. This paper presents a novel concept for real-time CE video stabilization and display. Instead of directly working on traditional forward looking FOV (field of view) images, we work on panoramic images to bypass many problems facing traditional imaging modalities. Methods on panoramic image generation based on optical lens principle leading to real-time data visualization will be presented. In addition, non-rigid panoramic image registration methods will be discussed.

  11. Detection of Bleeding in Wireless Capsule Endoscopy Images Using Range Ratio Color

    CERN Document Server

    Al-Rahayfeh, Amer A; 10.5121/ijma.2010.2201

    2010-01-01

    Wireless Capsule Endoscopy (WCE) is device to detect abnormalities in colon,esophagus,small intestinal and stomach, to distinguish bleeding in WCE images from non bleeding is a hard job by human reviewing and very time consuming. Consequently, automation for classifying bleeding frames not only will expedite the process but will reduce the burden on the doctors. Using the purity of the red color we can detect the Bleeding areas in WCE images. But, we could find various intensity of red color values in different parts of the small intestinal,so it is not enough to depend on the red color feature alone. We select RGB(Red,Green,Blue) because it takes raw level values and it is easy to use. In this paper we will put range ratio color for each of R,G,and B. Therefore, we divide each image into multiple pixels and apply the range ratio color condition for each pixel. Then we count the number of the pixels that achieved our condition. If the number of pixels grater than zero, then the frame is classified as a bleedi...

  12. A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Masanao Nakamura

    2016-01-01

    Full Text Available Background. Although the usefulness of capsule endoscopy (CE and double-balloon endoscopy (DBE for the evaluation of Crohn’s disease (CD is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit. Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications. Results. CE results were assessed as useful indications in 28 (45% of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77% of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis. Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis.

  13. Capsule endoscopy in clinical practice: concise up-to-date overview

    Directory of Open Access Journals (Sweden)

    Anastasios Koulaouzidis

    2009-11-01

    Full Text Available Anastasios Koulaouzidis, Sarah DouglasCentre for Liver and Digestive Disorders, Royal Infirmary of Edinburgh, Edinburgh, UKAbstract: Until recently, the small bowel was considered a ‘no man’s land’ as the imaging modalities available for its investigation were laborious, invasive, costly, or involve significant radiation exposure. Wireless capsule endoscopy (WCE has changed the field dramatically, over the last eight years. The established indications for small bowel WCE are obscure gastrointestinal bleed/anemia, Crohn’s disease, hereditary polyposis syndromes, and to a lesser extent, evaluation of side effects of nonsteroidal anti-inflammatory medications and coeliac disease. We herein present an overview of the capsule examination, which seems to be a quickly improving area.Keywords: capsule, imaging, small bowel, Crohn’s, celiac, GI bleed

  14. On-the-fly detection of images with gastritis aspects in magnetically guided capsule endoscopy

    Science.gov (United States)

    Mewes, P. W.; Neumann, D.; Juloski, A. L.; Angelopoulou, E.; Hornegger, J.

    2011-03-01

    Capsule Endoscopy (CE) was introduced in 2000 and has since become an established diagnostic procedure for the small bowel, colon and esophagus. For the CE examination the patient swallows the capsule, which then travels through the gastrointestinal tract under the influence of the peristaltic movements. CE is not indicated for stomach examination, as the capsule movements can not be controlled from the outside and the entire surface of the stomach can not be reliably covered. Magnetically-guided capsule endoscopy (MGCE) was introduced in 2010. For the MGCE procedure the stomach is filled with water and the capsule is navigated from the outside using an external magnetic field. During the examination the operator can control the motion of the capsule in order to obtain a sufficient number of stomach-surface images with diagnostic value. The quality of the examination depends on the skill of the operator and his ability to detect aspects of interest in real time. We present a novel computer-assisted diagnostic-procedure (CADP) algorithm for indicating gastritis pathologies in the stomach during the examination. Our algorithm is based on pre-processing methods and feature vectors that are suitably chosen for the challenges of the MGCE imaging (suspended particles, bubbles, lighting). An image is classified using an ada-boost trained classifier. For the classifier training, a number of possible features were investigated. Statistical evaluation was conducted to identify relevant features with discriminative potential. The proposed algorithm was tested on 12 video sequences stemming from 6 volunteers. A mean detection rate of 91.17% was achieved during leave-one out cross-validation.

  15. Re-bleeding events in patients with obscure gastrointestinalbleeding after negative capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Pedro Magalh?es-Costa; Miguel Bispo; Sofia Santos; Gilberto Couto; Leopoldo Matos; Cristina Chagas

    2015-01-01

    a negative capsule endoscopy in patients with obscuregastrointestinal bleeding (OGIB) and the risk factorsassociated with the procedure.METHODS: Patients referred to Hospital Egas Moniz(Lisboa, Portugal) between January 2006 and October2012 with OGIB and a negative capsule endoscopy wereretrospectively analyzed. The following study variableswere included: demographic data, comorbidities,bleeding-related drug use, hemoglobin level, indicationfor capsule endoscopy, post procedure details, work-upand follow-up. Re-bleeding rates and associated factorswere assessed using a Cox proportional hazard analysis.The Kaplan-Meier method was used to estimate thecumulative incidence of re-bleeding at 1, 3 and 5 years,and the differences between factors were evaluated.RESULTS: The study population consisted of 640patients referred for OGIB investigation. Wirelesscapsule endoscopy was deemed negative in 113patients (17.7%). A total of 64.6% of the populationwas female, and the median age was 69 years. Themedian follow-up was forty-eight months (interquartilerange 24-60). Re-bleeding occurred in 27.4% of thecases. The median time to re-bleeding was fifteenmonths (interquartile range 2-33). In 22.6% (n = 7)of the population, small-bowel angiodysplasia wasidentified as the culprit lesion. A univariate analysisshowed that age 〉 65 years old, chronic kidney disease,aortic stenosis, anticoagulant use and overt OGIB wererisk factors for re-bleeding; however, on a multivariateanalysis, there were no risk factors for re-bleeding. Thecumulative risk of re-bleeding at 1, 3 and 5 years offollow-up was 12.9%, 25.6% and 31.5%, respectively. Magalh‘s-Costa P et al . A long-term follow-up study for re-bleeding events Patients who presented with overt OGIB tended to rebleed sooner (median time for re-bleeding: 8.5 mo vs 22 mo). CONCLUSION: Patients with OGIB despite a negative capsule endoscopy have a significant re-bleeding risk; therefore, these patients

  16. Capsule Endoscopy for Crohn’s Disease: Current Status of Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Dong-Hoon Yang

    2016-01-01

    Full Text Available Crohn’s disease (CD is an idiopathic inflammatory bowel disease involving the small and/or large intestine. More than 50% of Western CD patients and up to 88% of Asian CD patients may have small intestinal involvement. Video capsule endoscopy (VCE has a higher diagnostic yield than small bowel barium radiography and computed tomography enterography for the detection of small intestinal involvement of CD. VCE also provides diagnostic yields comparable to magnetic resonance- (MR- based enterography or enteroclysis and may have several advantages over MR-based tests for the detection of early small intestinal lesions. Several studies have suggested the use of VCE-based disease activity scoring systems to evaluate small intestinal mucosal disease activity, although their clinical relevance needs to be further studied. A possible indication for VCE is recurrence monitoring after complete surgical excision of CD-involved segments but its usefulness and efficacy compared with conventional endoscopy should be evaluated. The capsule retention rate ranges from 0 to 5.4% in suspected CD patients and from 0 to 13.2% in established CD patients. If VCE is necessary, significant small bowel stricture should be ruled out before VCE by performing a patency capsule study and/or small bowel radiological study in suspected or established CD patients.

  17. Application of Wireless Power Transmission Systems in Wireless Capsule Endoscopy: An Overview

    Directory of Open Access Journals (Sweden)

    Md Rubel Basar

    2014-06-01

    Full Text Available Wireless capsule endoscopy (WCE is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB. To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE units may utilize advanced features such as active system control over capsule motion, drug delivery systems, semi-surgical tools and biopsy. However, the inclusion of the above advanced features demands additional power that make conventional power source methods impractical. In this regards, wireless power transmission (WPT system has received attention among researchers to overcome this problem. Systematic reviews on techniques of using WPT for WCE are limited, especially when involving the recent technological advancements. This paper aims to fill that gap by providing a systematic review with emphasis on the aspects related to the amount of transmitted power, the power transmission efficiency, the system stability and patient safety. It is noted that, thus far the development of WPT system for this WCE application is still in initial stage and there is room for improvements, especially involving system efficiency, stability, and the patient safety aspects.

  18. Application of wireless power transmission systems in wireless capsule endoscopy: an overview.

    Science.gov (United States)

    Basar, Md Rubel; Ahmad, Mohd Yazed; Cho, Jongman; Ibrahim, Fatimah

    2014-06-19

    Wireless capsule endoscopy (WCE) is a promising technology for direct diagnosis of the entire small bowel to detect lethal diseases, including cancer and obscure gastrointestinal bleeding (OGIB). To improve the quality of diagnosis, some vital specifications of WCE such as image resolution, frame rate and working time need to be improved. Additionally, future multi-functioning robotic capsule endoscopy (RCE) units may utilize advanced features such as active system control over capsule motion, drug delivery systems, semi-surgical tools and biopsy. However, the inclusion of the above advanced features demands additional power that make conventional power source methods impractical. In this regards, wireless power transmission (WPT) system has received attention among researchers to overcome this problem. Systematic reviews on techniques of using WPT for WCE are limited, especially when involving the recent technological advancements. This paper aims to fill that gap by providing a systematic review with emphasis on the aspects related to the amount of transmitted power, the power transmission efficiency, the system stability and patient safety. It is noted that, thus far the development of WPT system for this WCE application is still in initial stage and there is room for improvements, especially involving system efficiency, stability, and the patient safety aspects.

  19. Design of a video capsule endoscopy system with low-power ASIC for monitoring gastrointestinal tract.

    Science.gov (United States)

    Liu, Gang; Yan, Guozheng; Zhu, Bingquan; Lu, Li

    2016-11-01

    In recent years, wireless capsule endoscopy (WCE) has been a state-of-the-art tool to examine disorders of the human gastrointestinal tract painlessly. However, system miniaturization, enhancement of the image-data transfer rate and power consumption reduction for the capsule are still key challenges. In this paper, a video capsule endoscopy system with a low-power controlling and processing application-specific integrated circuit (ASIC) is designed and fabricated. In the design, these challenges are resolved by employing a microimage sensor, a novel radio frequency transmitter with an on-off keying modulation rate of 20 Mbps, and an ASIC structure that includes a clock management module, a power-efficient image compression module and a power management unit. An ASIC-based prototype capsule, which measures Φ11 mm × 25 mm, has been developed here. Test results show that the designed ASIC consumes much less power than most of the other WCE systems and that its total power consumption per frame is the least. The image compression module can realize high near-lossless compression rate (3.69) and high image quality (46.2 dB). The proposed system supports multi-spectral imaging, including white light imaging and autofluorescence imaging, at a maximum frame rate of 24 fps and with a resolution of 400 × 400. Tests and in vivo trials in pigs have proved the feasibility of the entire system, but further improvements in capsule control and compression performance inside the ASIC are needed in the future.

  20. Possible Radio Interference Between Video Capsule Endoscopy and Second-Generation OmniPod Patch Pump.

    Science.gov (United States)

    Pitocco, Dario; Rizzi, Alessandro; Tortora, Annalisa; Manto, Andrea; Zaccardi, Francesco; Ghirlanda, Giovanni; Costamagna, Guido; Riccioni, Maria Elena

    2016-07-01

    Video capsule endoscopy (VCE) is a noninvasive diagnostic tool used to observe the small intestinal mucosa. We report a case of a 57-year-old woman with T2DM, treated with continuous subcutaneous insulin infusion using second-generation OmniPod patch pump, undergoing VCE (Given M2A; VCE Ltd, Yoqneam, Israel) for melena and anemia. During VCE, an abnormal interruption of communication between video capsule and its receiver occurred. Two hours after capsule ingestion, the patient activated the insulin pump infusion through the Personal Diabetes Manager (PDM) because she drank a sugary beverage for the first time after ingestion. Due to this, we decided to repeat VCE after the removal of the insulin pump and PDM: at this time, the capsule recorded for more than 10 h without any interruption. The video capsule and second-generation OmniPod patch pump use the same radio frequency and this may cause interference between these two devices. In patients using second-generation OmniPod patch pump undergoing VCE, we suggest to switch to intravenous insulin infusion or multiple daily injection or to use a different model of VCE, as MiRoCam (Intromedic, Seoul, Korea).

  1. Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

    Institute of Scientific and Technical Information of China (English)

    Daniel; Ahn; Praveen; Guturu

    2010-01-01

    The PillCam ESO(Given Imaging,Israel) or esophageal capsule endoscopy(ECE) is a novel technique used in the diagnostic evaluation of esophagus.Many studies have been performed to compare the accuracy of ECE against the current gold standard esophagogastro-duodenoscopy and a meta-analysis recently published by Lu et al suggests that ECE may have an acceptable sensitivity and specificity in detecting esophageal varices.We would like to discuss the importance and implication of publication bias in this meta-an...

  2. clinical Applications of capsule Endoscopy%胶囊内镜的临床应用

    Institute of Scientific and Technical Information of China (English)

    言红健; 鲁素彩; 田自力; 王阳阳

    2012-01-01

      Objective To assess the value and summarize the expierence of clinical applications of capsule endoscopy. Methods From June 2008 to June 2011, 67 male and 52 female patients aged 21-83 years old were examined with capsule endoscopy in our hospital. The examinations were generally conducted from 8:00 to 11:00 AM and polyethylene glycol elect rolyte powder was used for bowel preparation. Results Less than 60 min were taken to pass throgh the pylorus in 104 cases, and more than 120 min in 14 cases. Intramuscular injection of metoclopramide was applied to facilitate movement of the capsule endoscopies in 12 cases, and flexible endoscope in 2 cases. After 1-3 days, the capsule endoscopies were usually excreted from the bowels. Small intestine examination was completed in 103 case (88.65%), while total colon examination in 3 cases (2.52%). The detection of jejun-ilealintestinal, gastroduodenal and colonic lesion were 33.05%, 33.61% and 2.54%respectively. There occurred a few complications, including a case of incarcerated pyriform sinus and a case of capsule retention. conclusion With its security, convenience, good-compliance and less complications, capsule endoscopy is highly significant for diagnosis of small intesinal lesions.%  目的总结和探讨胶囊内镜应用价值和体会.方法2008年6月至2011年6月河北大学附属医院胶囊内镜检查119例,男性67例,女性52例,年龄21~83岁,检查前服用聚乙二醇电解质散清洁肠道,吞服胶囊时间为8:00-11:00.结果胶囊通过幽门时间:120 min 14例,其中12例应用胃复安10 mg,肌肉注射,通过幽门,2例内镜协助胶囊通过幽门.胶囊排出时间:多为1~3 d.小肠检查完成103例(86.55%),全结肠检查完成3例(2.52%).小肠病变检出率为33.05%,胃十二指肠病变检出率为33.61%,结肠病变检出率为2.54%,总阳性率为69.49%.并发症:梨状窝胶囊嵌顿1例;胶囊滞留1例.结论胶囊内镜检查安全、方便、依从性好、并

  3. Colon capsule endoscopy: What we know and what we would like to know.

    Science.gov (United States)

    Spada, Cristiano; Barbaro, Federico; Andrisani, Gianluca; Minelli Grazioli, Leonardo; Hassan, Cesare; Costamagna, Isabella; Campanale, Mariachiara; Costamagna, Guido

    2014-12-01

    Colonoscopy is usually perceived as an invasive and potentially painful procedure, being also affected by a small, but definite, risk of major complications (cardiopulmonary complications, perforation, hemorrhage) and even mortality. To improve both acceptability and safety, PillCam Colon Capsule Endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) has been developed. CCE represents a non-invasive technique that is able to explore the colon without sedation and air insufflation. The Second Generation of Colon Capsule Endoscopy (PillCam Colon 2) (CCE-2) was proven to be an accurate tool to detect colonic neoplastic lesions when used in average risk individuals. To date, the evidence supports the use of CCE-2 in case of colonoscopy failure, in patients unwilling to perform colonoscopy and when colonoscopy is contraindicated. Other potential applications, such as colorectal cancer screening or diagnostic surveillance of inflammatory bowel disease need to be clarified. In this paper, the current "state of the art", potential application of CCE and future needs are evaluated.

  4. Capsule endoscopy assisted by traditional upper endoscopy Cápsula endoscópica asistida por una endoscopia alta tradicional

    Directory of Open Access Journals (Sweden)

    N. Almeida

    2008-12-01

    Full Text Available Background and aims: capsule endoscopy (CE can be prevented by difficulties in swallowing the device and/or its gastric retention. In such cases, endoscopic delivery of the capsule to duodenum is very useful. We describe the indications and outcomes of cases in which traditional endoscopic techniques allowed placement of the capsule in duodenum. Patients and methods: this is a retrospective, descriptive case series. All patients in the above conditions were identified and indications for CE, endoscopic-placement technique, complications and completeness of small bowel imaging were registered. Results: endoscopic-assisted delivery of the capsule was necessary in 13 patients (2.1% of all CE; 7 males; mean age - 47.9 ± 24.9 years, range 13 to 79 years. Indications for endoscopic delivery included: inability to swallow the capsule (7, gastric retention in previous exams (3, abnormal upper gastrointestinal anatomy (3. In eight patients, the capsule was introduced in GI tract with: foreign body retrieval net alone (3, retrieval net and a translucent cap (2, prototype delivery device (2 or a polypectomy snare (1. Five patients ingested the capsule that was then placed in duodenum with a polypectomy snare (3 or a retrieval net (2. No major complications occurred. Complete small bowel examination was possible in 10 patients (77%. Conclusions: endoscopic placement of capsule endoscope in the duodenum is rarely needed. However it may be safely performed by different techniques avoiding some limitations of CE. The best methods for endoscopic delivery of the capsule in the duodenum seem to be a retrieval net with a translucent cap when the patient is unable to swallow the device or a retrieval net only to capture the capsule in the stomach when the patient swallows it easily.Antecedentes y objetivos: la cápsula endoscópica puede resultar inútil en caso de dificultad para tragar el dispositivo y/o de retención gástrica del mismo. En tales casos, llevar

  5. Diagnostic accuracy of capsule endoscopy for small bowel Crohn's disease is superior to that of MR enterography or CT enterography

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Nathan, Torben; Rafaelsen, Søren Rafael;

    2011-01-01

    Capsule endoscopy (CE) detects small bowel Crohn's disease with greater diagnostic yield than radiologic procedures, although there are concerns that CE has low specificity. We compared the sensitivity and specificity of CE, magnetic resonance imaging enterography (MRE) and computed tomography...... enterography (CTE) in patients with suspected or newly diagnosed Crohn's disease....

  6. Double-Balloon Enteroscopy following Capsule Endoscopy in the Management of Obscure Gastrointestinal Bleeding: Outcome of a Combined Approach

    Directory of Open Access Journals (Sweden)

    Patarapong Kamalaporn

    2008-01-01

    Full Text Available BACKGROUND: There is no consensus on the relative accuracy of capsule endoscopy (CE versus double-balloon enteroscopy (DBE to investigate obscure gastrointestinal bleeding (GIB. CE is less invasive, but DBE more directly examines the small bowel, and allows tissue sampling plus therapeutic intervention.

  7. Capsule endoscopy in suspected small bowel Crohn's disease: Economic impact of disease diagnosis and treatment

    Institute of Scientific and Technical Information of China (English)

    Jonathan A Leighton; Ian M Gralnek; Randel E Richner; Michael J Lacey; Frank J Papatheofanis

    2009-01-01

    AIM: To model clinical and economic benefits of capsule endoscopy (CE) compared to ileo-colonoscopy and small bowel follow-through (SBFT) for evaluation of suspected Crohn's disease (CD).METHODS: Using decision analytic modeling, total and yearly costs of diagnostic work-up for suspected CD were calculated, including procedure-related adverse events,hospitalizations, office visits, and medications. The model compared CE to SBFT following ileo-colonoscopy and secondarily compared CE to SBFT for initial evaluation.RESULTS: Aggregate charges for newly diagnosed,medically managed patients are approximately $8295.Patients requiring aggressive medical management costs are $29 508; requiring hospitalization, $49 074.At sensitivity > 98.7% and specificity of > 86.4%, CE is less costly than SBFT.CONCLUSION: Costs of CE for diagnostic evaluation of suspected CD is comparable to SBFT and may be used immediately following ileo-colonoscopy.

  8. Virtual chromoendoscopy in small bowel capsule endoscopy: New light or a cast of shadow?

    Institute of Scientific and Technical Information of China (English)

    José; Cotter; Joana; Magalh?es; Francisca; Dias; de; Castro; Mara; Barbosa; Pedro; Boal; Carvalho; Sílvia; Leite; Maria; Jo?o; Moreira; Bruno; Rosa

    2014-01-01

    AIM: To evaluate whether virtual chromoendoscopy can improve the delineation of small bowel lesions previously detected by conventional white light small bowel capsule endoscopy(SBCE). METHODS: Retrospective single center study. One hundred lesions selected from forty-nine consecutive conventional white light SBCE(SBCE-WL) examinations were included. Lesions were reviewed at three Flexible Spectral Imaging Color Enhancement(FICE) settings and Blue Filter(BF) by two gastroenterologists with ex-perience in SBCE, blinded to each other’s findings, whoranked the quality of delineation as better, equivalent or worse than conventional SBCE-WL. Inter-observer percentage of agreement was determined and analyzed with Fleiss Kappa(k) coefficient. Lesions selected for the study included angioectasias(n = 39), ulcers/ero-sions(n = 49) and villous edema/atrophy(n = 12). RESULTS: Overall, the delineation of lesions was im-proved in 77% of cases with FICE 1, 74% with FICE 2, 41% with FICE 3 and 39% with the BF, with a percent-age of agreement between investigators of 89%(k = 0.833), 85%(k = 0.764), 66%(k = 0.486) and 79%(k = 0.593), respectively. FICE 1 improved the delineation of 97.4% of angioectasias, 63.3% of ulcers/erosions and 66.7% of villous edema/atrophy with a percentage of agreement of 97.4%(k = 0.910), 81.6%(k = 0.714) and 91.7%(k = 0.815), respectively. FICE 2 improved the delineation of 97.4% of angioectasias, 57.1% of ulcers/erosions and 66.7% of villous edema/atrophy, with a percentage of agreement of 89.7%(k = 0.802), 79,6%(k = 0.703) and 91.7%(k = 0.815), respectively. FICE 3 improved the delineation of 46.2% of angioecta-sias, 24.5% of ulcers/erosions and none of the cases of villous edema/atrophy, with a percentage of agreement of 53.8% [k = not available(NA)], 75.5%(k = NA) and 66.7%(k = 0.304), respectively. The BF improved the delineation of 15.4% of angioectasias, 61.2% of ulcers/erosions and 25% of villous edema/atrophy, with a per-centage of agreement

  9. In-to-out body path loss for wireless radio frequency capsule endoscopy in a human body.

    Science.gov (United States)

    Vermeeren, G; Tanghe, E; Thielens, A; Martens, L; Joseph, W; Vermeeren, G; Tanghe, E; Thielens, A; Martens, L; Joseph, W; Tanghe, E; Thielens, A; Martens, L; Vermeeren, G; Joseph, W

    2016-08-01

    Physical-layer characterization is important for design of in-to-out body communication for wireless body area networks (WBANs). This paper numerically investigates the path loss of an in-to-out body radio frequency (RF) wireless link between an endoscopy capsule and a receiver outside the body using a 3D electromagnetic solver. A spiral antenna in the endoscopy capsule is tuned to operate in the Medical Implant Communication Service (MICS) band at 402 MHz, accounting for the properties of the human body. The influence of misalignment, rotation of the capsule, and human body model are investigated. Semi-empirical path loss models for various homogeneous tissues and 3D realistic human body models are provided for manufacturers to evaluate the performance of in-to-out-body WBAN systems.

  10. A Review of Machine-Vision-Based Analysis of Wireless Capsule Endoscopy Video

    Directory of Open Access Journals (Sweden)

    Yingju Chen

    2012-01-01

    Full Text Available Wireless capsule endoscopy (WCE enables a physician to diagnose a patient's digestive system without surgical procedures. However, it takes 1-2 hours for a gastroenterologist to examine the video. To speed up the review process, a number of analysis techniques based on machine vision have been proposed by computer science researchers. In order to train a machine to understand the semantics of an image, the image contents need to be translated into numerical form first. The numerical form of the image is known as image abstraction. The process of selecting relevant image features is often determined by the modality of medical images and the nature of the diagnoses. For example, there are radiographic projection-based images (e.g., X-rays and PET scans, tomography-based images (e.g., MRT and CT scans, and photography-based images (e.g., endoscopy, dermatology, and microscopic histology. Each modality imposes unique image-dependent restrictions for automatic and medically meaningful image abstraction processes. In this paper, we review the current development of machine-vision-based analysis of WCE video, focusing on the research that identifies specific gastrointestinal (GI pathology and methods of shot boundary detection.

  11. Thermo-mechanical actuator-based miniature tagging module for localization in capsule endoscopy

    Science.gov (United States)

    Chandrappan, Jayakrishnan; Ruiqi, Lim; Su, Nandar; Yen Yi, Germaine Hoe; Vaidyanathan, Kripesh

    2011-04-01

    Capsule endoscopy is a frontline medical diagnostic tool for the gastro intestinal tract disorders. During diagnosis, efficient localization techniques are essential to specify a pathological area that may require further diagnosis or treatment. This paper presents the development of a miniature tagging module that relies on a novel concept to label the region of interest and has the potential to integrate with a capsule endoscope. The tagging module is a compact thermo-mechanical actuator loaded with a biocompatible micro tag. A low power microheater attached to the module serves as the thermal igniter for the mechanical actuator. At optimum temperature, the actuator releases the micro tag instantly and penetrates the mucosa layer of a GI tract, region of interest. Ex vivo animal trials are conducted to verify the feasibility of the tagging module concept. X-ray imaging is used to detect the location of the micro tag embedded in the GI tract wall. The method is successful, and radiopaque micro tags can provide valuable pre-operative position information on the infected area to facilitate further clinical procedures.

  12. How much helpful is the capsule endoscopy for the diagnosis of small bowel lesions?

    Institute of Scientific and Technical Information of China (English)

    Osman Ersoy; Bulent Sivri; Serap Arslan; Figen Batman; Yusuf Bayraktar

    2006-01-01

    AIM: To assess the practically usefulness and diagnostic yield of this new method in a group of patients with suspected small bowel lesions.METHODS: Capsule endoscopic (CE) examination by using M2A capsule endoscope TM (Given Imaging,Yoqneam, Israel) was performed in thirty nine patients (26 males, 13 females) with suspected small intestinal lesions. The composing of the patients was as follows:obscure gastrointestinal bleeding in twenty three patients, known Crohn's disease in 6 patients, in whom CE was used to evaluate the severity and extension of the diseases, chronic diarrhea in 8 patients, abdominal pain in one patient and malignancy in one patient with unknown origin.RESULTS: In two patients CE failed. Different abnormalities were revealed in 26 patients overall.Detection rate of abnormalities was highest among patients with obscure gastrointestinal bleeding and the source of bleeding was demonstrated in 17 of 23 patients with obscure bleeding (73.9%). Entero-Behcet was diagnosed in two patients by CE as a source of obscure gastrointestinal bleeding. In 6 patients with known Crohn's disease, CE revealed better evaluation of the disease extension. In 3 of 8 (37.5%) patients with chronic diarrhea; CE revealed some mucosal abnormalities as the cause of chronic diarrhea. In a patient with unexplained abdominal pain and in a cancer patient with unknown origin, CE examination was normal.CONCLUSION: In our relatively small series, we found that capsule endoscopy is a useful diagnostic tool particularly in diagnosis of obscure gastrointestinal bleeding, chronic diarrhea and in estimating the extension of Crohn's disease.

  13. Clinical Application of Colon Capsule Endoscopy%胶囊结肠镜的临床应用

    Institute of Scientific and Technical Information of China (English)

    孟欣颖; 周长宏

    2013-01-01

    Colon capsule endoscopy (CCE) is a newly developed capsule endoscopy to detect colonic mucosal lesion. Initially, CCE was applied for screening of colon cancer, but now it is also used to diagnose and evaluate inflammatory bowel disease ( IBD) , especially ulcerative colitis ( UC ). CCE has advantages and disadvantages in compared with conventional colonoscope. This article reviewed the clinical application of CCE.%胶囊结肠镜(CCE)是一种检查结肠黏膜病变的新型胶囊内镜.最初用于结肠癌的筛查,目前逐渐用于炎症性肠病,尤其是溃疡性结肠炎的诊断和病情评估.CCE在临床应用方面与传统结肠镜相比各有优劣.本文就CCE的临床应用现状作一综述.

  14. Obscure gastrointestinal bleeding and small bowel pathology: comparison between wireless capsule endoscopy and multidetector-row CT enteroclysis.

    Science.gov (United States)

    Filippone, Antonella; Cianci, Roberta; Milano, Angelo; Valeriano, Sergio; Di Mizio, Veronica; Storto, Maria Luigia

    2008-01-01

    Obscure gastrointestinal bleeding is defined as bleeding of unknown origin, that persists or recurs after negative conventional barium contrast studies and upper and lower tract endoscopy. The causes of such a bleeding frequently arise in the small bowel, and they are represented by mucosal vascular abnormalities, neoplasms and other conditions such as Crohn's disease, Meckel's diverticulum, and vasculitis. Conventional barium contrast studies and push enteroscopy allow only a limited small bowel examination; moreover, intraoperative endoscopy may be inconclusive, since the small bowel is difficult to evaluate given its length and tortuous course. In the same way, angiographic diagnosis is stricktly related to the activity rate of hemorrhage. Wireless capsule endoscopy and multidetector-row CT enteroclysis are two recently developed minimally invasive techniques that may provide a complete small bowel examination, the first offering a direct visualization of the mucosal aspect, the second allowing evaluation of mural and extramural pathologies. This review is an update of the technique and clinical application of capsule endoscopy and multidetector-row CT enteroclysis in patients suffering from obscure small bowel bleeding.

  15. Cross-sectional small intestinal surveillance of maintenance hemodialysis patients using video capsule endoscopy: SCHEMA study

    Science.gov (United States)

    Hosoe, Naoki; Matsukawa, Shigeaki; Kanno, Yoshihiko; Naganuma, Makoto; Imaeda, Hiroyuki; Ida, Yosuke; Tsuchiya, Yoshitsugu; Hibi, Toshifumi; Ogata, Haruhiko; Kanai, Takanori

    2016-01-01

    Background and study aims: Small intestinal pathology in hemodialysis (HD) patients has been studied in only a small number of retrospective case series. One method for noninvasively surveying small intestinal disorders is video capsule endoscopy (VCE). The primary aim of this study was to investigate the prevalence of small intestinal abnormalities among asymptomatic maintenance HD outpatients using VCE. The secondary aim was to assess the clinical impact of these abnormalities. Patients and methods: This study consisted of two phases. In phase I, a cross-sectional study, a cohort of patients who received maintenance HD three times weekly at an outpatient hemodialysis clinic were studied using VCE. Phase II was a prospective cohort study with follow up for 1 year after VCE. Results: Fifty-six patients were enrolled in this study, and two were excluded from analysis due to capsule retention in the stomach. The prevalence of small bowel abnormalities in HD patients was 64.8 % (35/54) (95 % confidential interval 52.1 % – 77.6 %). Of 54 patients, 21 (38.9 %) had mucosal lesions, 10 (18.5 %) had vascular lesions, and 4 (7.4 %) had both lesion types. During the 1-year follow-up period, events occurred in four patients. A small bowel-associated event was observed in one patient, who underwent laparoscopy-assisted small intestinal partial resection 3 months after diagnosis by VCE. All patients in whom events were seen had small bowel abnormalities; no events were observed in the VCE-negative group. Conclusions: Although asymptomatic maintenance HD patients had a high prevalence of small bowel abnormalities (64.8 %), they did not have a high incidence of small bowel-associated events during the 1-year follow-up. PMID:27227120

  16. Clinical Efficacy of Various Diagnostic Tests for Small Bowel Tumors and Clinical Features of Tumors Missed by Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jung Wan Han

    2015-01-01

    Full Text Available Background. We aimed to evaluate the efficacy of various diagnostic tools such as computerized tomography (CT, small bowel follow-through (SBFT, and capsule endoscopy (CE in diagnosing small bowel tumors (SBTs. Additionally, we aimed to evaluate the clinical features of SBTs missed by CE. Methods. We retrospectively studied 79 patients with histologically proven SBT. Clinical data were analyzed with particular attention to the efficacy of CT, SBFT, and CE in detecting SBT preoperatively. We also analyzed the clinical features of SBTs missed by CE. Results. The most common symptoms of SBT were bleeding (43% and abdominal pain (13.9%. Diagnostic yields were as follows: CT detected 55.8% of proven SBTs; SBFT, 46.1%; and CE, 83.3%. The sensitivity for detecting SBTs was 40.4% for CT, 43.9% for SBFT, and 79.6% for CE. Two patients with nondiagnostic but suspicious findings on CE and seven patients with negative findings on CE were eventually found to have SBT. These nine patients were eventually diagnosed with gastrointestinal stromal tumor (4, small polyps (3, inflammatory fibroid polyp (1, and adenocarcinoma (1. These tumors were located in the proximal jejunum (5, middle jejunum (1, distal jejunum (1, and proximal ileum (1. Conclusion. CE is more efficacious than CT or SBFT for detecting SBTs. However, significant tumors may go undetected with CE, particularly when located in the proximal jejunum.

  17. Complimentary Imaging Modalities for Investigating Obscure Gastrointestinal Bleeding: Capsule Endoscopy, Double-Balloon Enteroscopy, and Computed Tomographic Enterography

    Directory of Open Access Journals (Sweden)

    Ye Chu

    2016-01-01

    Full Text Available Objectives. The complimentary value of computed tomographic enterography (CTE and double-balloon enteroscopy (DBE combined with capsule endoscopy (CE was evaluated in the diagnosis of obscure gastrointestinal bleeding (OGIB. Methods. Patients who received CE examinations at Ruijin Hospital between July 2007 and July 2014 with the indication of OGIB were identified, and those who also underwent DBE and/or CTE were included. Their clinical information was retrieved, and results from each test were compared with findings from the other two examinations. Results. The overall diagnostic yield of CE was comparable with DBE (73.9% versus 60.9% but was significantly higher than the yield of CTE (87% versus 25%, p<0.001. The diagnostic yield of angiodysplasia at CE was significantly higher than CTE (73% versus 8%, p<0.001 and DBE (39.1% versus 17.4%, p=0.013, while no significant difference was found between the three approaches for small bowel tumors. DBE and CTE identified small bowel diseases undetected or undetermined by CE. Conversely, CE improved diagnosis in the cases with negative CTE and DBE, and findings at initial CE directed further diagnosis made by DBE. Conclusions. Combination of the three diagnostic platforms provides complementary value in the diagnosis of OGIB.

  18. Wireless capsule endoscopy in the investigation of patients with chronic renal failure and obscure gastrointestinal bleeding (preliminary data)

    Institute of Scientific and Technical Information of China (English)

    Stephanos Karagiannis; Spyros Goulas; Georgios Kosmadakis; Petros Galanis; Dimitrios Arvanitis; John Boletis; Evangelos Georgiou; Christos Mavrogiannis

    2006-01-01

    AIM: To investigate the role of wireless capsule endoscopy (WCE) in detection of small bowel (SB) pathology in patients with chronic renal failure (CRF) and obscure bleeding.METHODS: Consecutive CRF patients with obscure bleeding were prospectively studied. Patients with normal renal function and obscure bleeding, investigated during the same period with WCE, were used for the interpretation of results.RESULTS: Seventeen CRF patients (11 overt, 6 occult bleeding) and 51 patients (33 overt, 18 occult bleeding) with normal renal function were enrolled in this study.Positive SB findings were detected in 70.6% of CRF patients and in 41.2% of non-CRF patients (P < 0.05). SB angiodysplasia was identified in 47% of CRF patients and in 17.6% of non-CRF patients. Univariate logistic regression revealed CRF as a significant predictive factor for angiodysplasia (P < 0.05). Therapeutic measures were undertaken in 66% of the patients with the positive findings.CONCLUSION: According to our preliminary results, SB angiodysplasia was found in an increased prevalence among CRF patients with obscure bleeding. WCE is useful in diagnosis of gastrointestinal pathologies and in planning appropriate therapeutic intervention and, therefore, should be included in the work-up of this group of patients.

  19. Coffee enema for preparation for small bowel video capsule endoscopy: a pilot study.

    Science.gov (United States)

    Kim, Eun Sun; Chun, Hoon Jai; Keum, Bora; Seo, Yeon Seok; Jeen, Yoon Tae; Lee, Hong Sik; Um, Soon Ho; Kim, Chang Duck; Ryu, Ho Sang

    2014-07-01

    Coffee enemas are believed to cause dilatation of bile ducts and excretion of bile through the colon wall. Proponents of coffee enemas claim that the cafestol palmitate in coffee enhances the activity of glutathione S-transferase, an enzyme that stimulates bile excretion. During video capsule endoscopy (VCE), excreted bile is one of the causes of poor preparation of the small bowel. This study aimed to evaluate the feasibility and effect of coffee enema for preparation of the small bowel during VCE. In this pilot study, 17 of 34 patients were assigned to the coffee enema plus polyethylene glycol (PEG) 2 L ingestion group, whereas the 17 remaining control patients received 2 L of PEG only. The quality of bowel preparation was evaluated in the two patient groups. Bowel preparations in the proximal segments of small bowel were not differ between two groups. In the mid and distal segments of the small intestine, bowel preparations tend to be better in patients who received coffee enemas plus PEG than in patients who received PEG only. The coffee enema group did not experience any complications or side effects. Coffee enemas may be a feasible option, and there were no clinically significant adverse events related to coffee enemas. More prospective randomized studies are warranted to improve small bowel preparation for VCE.

  20. Prospective evaluation of small bowel preparation with bisacodyl and sodium phosphate for capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Andreas Franke; Frank Hummel; Phillip Knebel; Christoph Antoni; Ulrich Bocker; Manfred V Singer; Matthias Lohr

    2008-01-01

    AIM: To determine the effect of Prepacol?, a combination of sodium phosphate and bisacodyl, on transit and quality of capsule endoscopy (CE).METHODS: Fivety two consecutive patients were included in this prospective study. CE was performed following a 12 h fasting period. Twenty six patients were randomized for additional preparation with Prepacor. The quality of CE was assessed separately for the proximal and the distal small bowel by 3 experienced endoscopists on the basis of a graduation which was initially developed with 20 previous CE.RESULTS: Preparation with Prepacol? accelerated small bowel transit time (262 ± 55 min vs 287 ± 97 min), but had no effect on the quality of CE. Visibility was significantly reduced in the distal compared to the proximal small bowel.CONCLUSION: The significantly reduced visibility of CE in the distal small bowel allocates the need for a good preparation. Since Prepacol? has no beneficial effect on CE the modality of preparation and the ideal time of application remains unclear. Further standardized examinations are necessary to identify sufficient preparation procedures and to determine the impact of the volume of the preparation solution.

  1. Meta-analysis of capsule endoscopy in patients diagnosed or suspected with esophageal varices

    Institute of Scientific and Technical Information of China (English)

    Yi Lu; Rui Gao; Zhuan Liao; Liang-Hao Hu; Zhao-Shen Li

    2009-01-01

    AIM: To review the literature on capsule endoscopy (CE) for detecting esophageal varices using conventional esophagogastroduodenoscopy (EGD) as the standard.METHODS: A strict literature search of studies comparing the yield of CE and EGD in patients diagnosed or suspected as having esophageal varices was conducted by both computer search and manual search. Data were extracted to estimate the pooled diagnostic sensitivity and specificity.RESULTS: There were seven studies appropriate for meta-analysis in our study, involving 446 patients.The pooled sensitivity and specificity of CE for detecting esophageal varices were 85.8% and 80.5%,respectively. In subgroup analysis, the pooled sensitivity and specificity were 82.7% and 54.8% in screened patients, and 87.3% and 84.7% in the screened/patients under surveillance, respectively.CONCLUSION: CE appears to have acceptable sensitivity and specificity in detecting esophageal varices. However, data are insufficient to determine the accurate diagnostic value of CE in the screen/surveillance of patients alone.

  2. A VECTOR QUANTIZATION BASED APPROACH FOR CFA DATA COMPRESSION IN WIRELESS ENDOSCOPY CAPSULE

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    A novel approach for near-lossless compression of Color Filtering Array(CFA)data in wireless endoscopy capsule is proposed in this paper.The compression method is based on pre-processing and vector quantization.First,the CFA raw data are low pass filtered and rearranged during pre-processing.Then,pairs of pixels are vector quantized into macros of 9 bits by applying block par-tition and index mapping in succession.These macros are entropy compressed by Joint Photographic Experts Group-Lossless Standard(JPEG-LS)finally.The complex step of codeword searching in Vector Quantization(VQ)is avoided by a predefined partition rule,which is suitable for hardware imple- mentation.By control of the pre-processor and VQ scheme,either high quality compression under an- filtered case or high ratio compression under filtered case can be realized,with the average Peak Sig- nal-to-Noise Ratio(PSNR)more than 43dB and 37dB respectively.Compared with the state-of-the-art method and the previously proposed method,our compression approach outperforms in compression performance as well as in flexibility.

  3. Beneficial Effects of Combining Computed Tomography Enteroclysis/Enterography with Capsule Endoscopy for Screening Tumor Lesions in the Small Intestine

    Directory of Open Access Journals (Sweden)

    Hiroaki Shibata

    2015-01-01

    Full Text Available Aim. To compare the efficacy of using computed tomography enteroclysis/enterography (CTE, capsule endoscopy (CE, and CTE with CE for diagnosing tumor lesions in the small intestine. Materials and Methods. We included 98 patients who underwent CE during the observation period and were subjected to CTE at our hospital from April 2008 to May 2014. Results. CTE had a significantly higher sensitivity than CE (84.6% versus 46.2%, P=0.039, but there were no significant differences in specificity, positive or negative predictive values, or diagnostic accuracy rates. The sensitivity of CTE/CE was 100%, again significantly higher than that of CE P=0.002. The difference in specificity between CTE/CE and CE was not significant, but there were significant differences in positive predictive values (100% for CTE/CE versus 66.7% for CE, P=0.012, negative predictive values (100% versus 92.1%, P=0.008, and diagnostic accuracy rate (100% versus 89.8%, P=0.001. The diagnostic accuracy rate was also significantly higher in CTE/CE versus CTE (100% versus 95.9%, P=0.043. Conclusion. Our findings suggested that a combination of CTE and CE was useful for screening tumor lesions in the small intestine. This trial is registered with number UMIN000016154.

  4. Portal hypertensive enteropathy diagnosed by capsule endoscopy and demonstration of the ileal changes after transjugular intrahepatic portosystemic shunt placement: a case report

    Directory of Open Access Journals (Sweden)

    Carella Alessandra

    2011-03-01

    Full Text Available Abstract Introduction Recent data suggest that mucosal abnormalities can occur even in the duodenum, jejunum, and distal ileum of cirrhosis patients. We present a case of portal hypertensive enteropathy in a cirrhosis patient shown by capsule endoscopy and the effect of transjugular intrahepatic portosystemic shunt on the ileal pictures. Case presentation An 83-year-old Caucasian woman was admitted to our hospital for anemia and a positive fecal occult blood test. An upper gastrointestinal endoscopy revealed small varices without bleeding signs and hypertensive gastropathy. Colonoscopy was negative. To rule out any other cause of bleeding, capsule endoscopy was performed; capsule endoscopy revealed severe hyperemia of the jejunum-ileal mucosa with active bleeding. Because of the persistence of anemia and the frequent blood transfusions, not responding to β-blocker drugs or octreotide infusion, a transjugular intrahepatic portosystemic shunt was performed. Anemia improved quickly after the transjugular intrahepatic portosystemic shunt, and no further blood transfusion was necessary in the follow-up. The patient developed portal encephalopathy two months later and was readmitted to our department. We repeated the capsule endoscopy that showed a significant improvement of the gastric and ileal mucosa without any signs of bleeding. Conclusion Hypertensive enteropathy is a rare condition, but it seems more common with the introduction of capsule endoscopy in clinical practice. This case shows that the jejunum can be a source of bleeding in cirrhosis patients, and this is the first demonstration of its resolution after transjugular intrahepatic portosystemic shunt placement.

  5. Efficacy of pediatric colonoscopy used as push enteroscopy in the management of capsule endoscopy findings Eficacia del colonoscopio pediátrico como enteroscopio de pulsión en el manejo de los hallazgos de la cápsula endoscópica

    Directory of Open Access Journals (Sweden)

    F. Pérez Roldán

    2009-07-01

    Full Text Available Background: recent advances in endoscopy have enabled us to explore the small intestine more efficiently, both with capsule endoscopy and double-balloon enteroscopy. However, these methods are not available in all hospitals. Therefore, when capsule endoscopy reveals proximal jejunal lesions, a possible alternative for treatment could involve push enteroscopy combined with colonoscopy. Lesions can thus be marked for subsequent monitoring. Objectives: to describe the efficacy of pediatric colonoscopy for diagnosis, the marking of the area explored, and therapeutic options. Material and methods: between October 2007 and September 2008 a total of 21 enteroscopies were performed using a pediatric colonoscope. Nine of these were used to take jejunal biopsy samples due to suspected disease of the mucosa. In 10 of the remaining 12, capsule endoscopy revealed lesions (vascular malformations or jejunal bleeding, and in 2 intestinal transit time was analyzed due to suspected jejunal stenosis. We used a PENTAX EC-3470-LK pediatric colonoscope, whose 11.6-mm sectional diameter and 3.8-mm working channel make it possible to administer all the usual endoscopic treatments. Results: therapeutic endoscopy was performed on 7 men and 5 women (mean age 63.3 years. Jejunal lesions were observed in 10 cases (5 cases of angiodysplasia, 2 cases of jejunal stenosis, 1 case of nonmalignant thickened jejunal folds, 1 eroded submucosal tumor, and 1 case of duodenal and jejunal varices. The most distal area was marked with India ink (2, hemoclips (4, or both to help locate the lesions using simple abdominal radiography or capsule endoscopy. Conclusions: jejunal enteroscopy enabled a firm diagnosis to be made in most of the patients studied. We were able to treat 58% of patients and mark the areas explored for subsequent follow-up. With hemoclips we were able to locate the most distal point explored using simple abdominal radiography.Introducción: los recientes avances en

  6. Diagnosis agreement between capsule endoscopy and double-balloon enteroscopy in obscure gastrointestinal bleeding at a referral center

    Directory of Open Access Journals (Sweden)

    Enrique Pérez-Cuadrado-Robles

    2015-08-01

    Full Text Available Background and aim: Capsule endoscopy and double-balloon enteroscopy are well-recognized procedures in obscure gastrointestinal bleeding, with many factors that may influence their diagnosis yield. The aim of the present study was to characterize the degree of agreement between both techniques with focus on the type of lesion in a large cohort of patients at a referral center. Material and method: One thousand two hundred and nine capsules were administered in 1,078 patients and 381 enteroscopies were performed in 361 patients with obscure-gastrointestinal bleeding from 2004 to 2014. Results: Both procedures were carried out in 332 patients (mean age: 65.22 ± 15.41, 183 men and they have a similar diagnosis yield (70.5% vs. 69.6%, p = 0.9. Overall enteroscopy diagnosis yield was higher within patients with a previous positive capsule endoscopy (79.3% vs. 27.9%, p < 0.001. The degree of agreement was very good for polyps (0.89 [95% CI: 0.78-0.99], good for vascular lesions (0.66 [95% CI: 0.55-0.77] and tumors (0.66 [95% CI: 0.55-0.76] and moderate for ulcers (0.56 [95% CI: 0.46-0.67]. Diverticula (0.39 [95% CI: 0.29-0.5] achieved a fair agreement. The results of CE and DBE differed in 73 patients (22%. Conclusions: The present study confirms that although overall diagnostic yield by capsule endoscopy and double-balloon enteroscopy is similar, there are many factors which can modify these values, mainly the type of lesion.

  7. VIDEO CAPSULE ENDOSCOPY: A TOOL FOR THE ASSESSMENT OF SMALL BOWEL TRANSIT TIME

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    Reza A Hejazi

    2016-02-01

    Full Text Available Purpose: Video capsule endoscopy (VCE is a procedure that uses a wireless camera to take pictures of the gastrointestinal tract. A wireless motility capsule (WMC of a similar size has been developed, which measures pH, pressure, and temperature, and can be used to assess regional and total gastrointestinal transit times. VCE could also potentially be used as a tool for measuring small bowel transit time (SBTT.Methods: This study was designed to obtain SBTT from VCE and compare it with historical data generated by WMC. Gastric transit time (GTT was also measured. Patients were included if the indication for VCE was either iron deficiency anemia (IDA or overt obscure GI bleed (OOGIB and they did not have any known motility disorder. Results from VCE were also compared in diabetic versus non-diabetic patients. Results: There were a total of 147 VCE studies performed, including 42 for OOGIB and 105 for IDA. Median GTT and SBTT were 0.3 and 3.6 hours, respectively. The overall median GTT and SBTT were 0.3 and 3.6 hours, respectively, in the IDA group compared with 0.3 and 3.4 hours in the OOGIB group. When compared with WMC, the GTT and SBTT were significantly faster in both groups (GTT: 3.6 hours and SBTT: 4.6 hours. The median GTT and SBTT were not significantly different in diabetics versus non-diabetics: (GTT: 17.5 vs. 18.0 minutes (P=0.86 and SBTT: 3.9 hours (237 minutes vs. 3.8 hours (230 minutes, respectively (P=0.90.Conclusion: SBTT as measured using VCE is not significantly different in OOGIB compared with IDA. Both GTT and SBTT are significantly faster as assessed by VCE, which is initiated in the fasting state, compared with WMC measurement, which is initiated after a standard meal. In summary, VCE could potentially be used for measuring SBTT in the fasting state.

  8. Magnetic resonance enterography or video capsule endoscopy – what do Crohn’s disease patients prefer?

    Directory of Open Access Journals (Sweden)

    Lahat A

    2016-06-01

    Full Text Available Adi Lahat,1,2 Uri Kopylov,1,2 Marianne M Amitai,3 Sandra Neuman,1,2 Nina Levhar,1,2 Doron Yablecovitch,1,2 Benjamin Avidan,1,2 Henit Yanai,2,4 Iris Dotan,2,4 Yehuda Chowers,5,6 Batya Weiss,7 Shomron Ben-Horin,1,2,* Rami Eliakim1,2,* On behalf of the Israeli IBD Research Network (IIRN 1Department of Gastroenterology, Chaim Sheba Medical Center, Tel Hashomer, Israel; 2Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; 3Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Israel; 4IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Medical Center, Tel Aviv, Isarel; 5Rambam Health Care Campus, Haifa, Israel; 6Bruce Rappaport School of Medicine, Technion Israel Institute of Technology, Haifa, Israel; 7Edmond and Lily Safra Children’s Hospital, Tel Hashomer, Israel *These authors contributed equally to this work Background: Despite differences in the information obtained by capsule endoscopy (CE and magnetic resonance enterography (MRE, one of these modalities is usually needed when evaluating disease activity. There are no data on patients’ preference that would help guide the choice between these two modalities in these instances.Aim: To compare patients’ tolerance and preference to MRE versus CE.Patients and methods: Patients with known small bowel Crohn’s disease (CD in clinical remission (Crohn’s disease activity index  [CDAI] <150 or with mild symptoms (CDAI <220 were prospectively recruited. All patients underwent MRE followed by CE. Patients were asked to fill out a questionnaire addressing specific points regarding inconvenience during the preparation for the procedures, the procedures, and postprocedures. Side effects and procedure preference were addressed. Questionnaires were included for analysis only when more than 95% of the items were addressed.Results: Fifty-six patients fulfilled inclusion criteria. Pre-exam discomfort, during-exam discomfort, nausea, vomiting

  9. 临床应用111例分析%Clinical application of OMOM capsule endoscopy in 111 cases

    Institute of Scientific and Technical Information of China (English)

    梅玫; 罗雁; 刘会领; 陆伟

    2016-01-01

    96.4%(56/111). The capsule endoscopy remained in the stomach for an average of (41±18) min. The mean transit time in the small bowel was (292 ±88) min. The detection rate and diagnostic rate of all patients were 82.9%(92/111), and 50.5%(56/111), the OGIB group 95.5%(42/44) and 68.2%(30/44), the Chronic abdominal pain group 78.3%(36/46) and 39.1%(18/46), the abdominal distention group 81.8%(9/11) and 27.3%(3/11), the chronic diarrhea group 50%(5/10) and 20%(2/10). The detection rate and diagnostic yield of the OGIB group were significantly higher than the three groups in also (P<0.05). Conclusion OMOM capsule endoscopy has high diagnostic rate in small-bowel disease because it is safe and atraumatic. It can be used in finding small intestinal disease, especially in patients with obscure gastrointestinal bleeding.

  10. Magnetic resonance enterography or video capsule endoscopy – what do Crohn’s disease patients prefer?

    Science.gov (United States)

    Lahat, Adi; Kopylov, Uri; Amitai, Marianne M; Neuman, Sandra; Levhar, Nina; Yablecovitch, Doron; Avidan, Benjamin; Yanai, Henit; Dotan, Iris; Chowers, Yehuda; Weiss, Batya; Ben-Horin, Shomron; Eliakim, Rami

    2016-01-01

    Background Despite differences in the information obtained by capsule endoscopy (CE) and magnetic resonance enterography (MRE), one of these modalities is usually needed when evaluating disease activity. There are no data on patients’ preference that would help guide the choice between these two modalities in these instances. Aim To compare patients’ tolerance and preference to MRE versus CE. Patients and methods Patients with known small bowel Crohn’s disease (CD) in clinical remission (Crohn’s disease activity index [CDAI] <150) or with mild symptoms (CDAI <220) were prospectively recruited. All patients underwent MRE followed by CE. Patients were asked to fill out a questionnaire addressing specific points regarding inconvenience during the preparation for the procedures, the procedures, and postprocedures. Side effects and procedure preference were addressed. Questionnaires were included for analysis only when more than 95% of the items were addressed. Results Fifty-six patients fulfilled inclusion criteria. Pre-exam discomfort, during-exam discomfort, nausea, vomiting, bloating, and abdominal pain were all significantly more prominent in MRE as compared to CE (P<0.0001, P<0.0001, P<0.0001, P=0.009, P=0.0002, P<0.0001, respectively). MRE was perceived as a more difficult procedure (P<0.0001). Furthermore, MRE was associated with a specific adverse event – claustrophobia. Seventy-eight percent of patients (44 patients) preferred to repeat CE as compared to 22% (P<0.0001) who preferred MRE. Conclusion CE was better tolerated by CD patients compared to MRE and was preferred by 78% of patients. The superior tolerability of CE should be considered along with the diagnostic features, and more data sought when choosing between these two modalities for CD patients for long-term follow-up. PMID:27354774

  11. Randomized controlled trial of cholestyramine and hydrotalcite to eliminate bile for capsule endoscopy

    Directory of Open Access Journals (Sweden)

    Chen Hong-Bin

    2016-01-01

    Full Text Available Background/Aims: Bile is the main cause of poor bowel preparation for capsule endoscopy (CE. We aimed to determine whether cholestyramine and hydrotalcite can eliminate bile in the bowel. Patients and Methods: Patients undergoing CE were randomized into two groups. Group A patients (n = 75 recieved 250 mL 20% mannitol and 1 L 0.9% saline orally at 20:00 hours on the day before and at 05:00 hours on the day of CE and 20 mL simethicone 30 min before CE. Group B patients (n = 73 were treated identically, except for taking oral cholestyramine and hydrotalcite, starting 3 days before CE. Greenish luminal contents were assessed by four tissue color bar segments using Color Area Statistics software. Bowel cleanliness was evaluated by visualized area percentage assessment of cleansing (AAC score. Result: Bowel cleanliness (82.7% [62/75] vs 46.6% [34/73]; χ2 = 14.596, P = 0.000. and detected greenish luminal contents (20.0% [15/75] vs 8.2% [6/73]; χ2 = 4.217, P = 0.040 were significantly greater in Group A than in Group B. Greenish luminal contents in the two groups differed significantly in the captured small-bowel (t = −13.74, P = 0.000 segments and proximal small-bowel (t = −0.7365, P = 0.000 segments, but not for the distal small-bowel (t = −0.552, P = 0.581 segments. Conclusions: Cholestyramine and hydrotalcite were ineffective in eliminating bile and improving small-bowel preparation.

  12. Microultrasound characterisation of ex vivo porcine tissue for ultrasound capsule endoscopy

    Science.gov (United States)

    Lay, H. S.; Cox, B. F.; Sunoqrot, M.; Démoré, C. E. M.; Näthke, I.; Gomez, T.; Cochran, S.

    2017-01-01

    Gastrointestinal (GI) disease development and progression is often characterised by cellular and tissue architectural changes within the mucosa and sub-mucosa layers. Current clinical capsule endoscopy and other approaches are heavily reliant on optical techniques which cannot detect disease progression below the surface layer of the tissue. To enhance the ability of clinicians to detect cellular changes earlier and more confidently, both quantitative and qualitative microultrasound (μUS) techniques are investigated in healthy ex vivo porcine GI tissue. This work is based on the use of single-element, focussed μUS transducers made with micromoulded piezocomposite operating at around 48 MHz. To explore the possibility that μUS can detect Crohn’s disease and other inflammatory bowel diseases, ex vivo porcine small bowel tissue samples were cannulised and perfused with phosphate-buffered saline followed by various dilutions of polystyrene microspheres. Comparison with fluorescent imaging showed that the microspheres had infiltrated the microvasculature of the samples and that μUS was able to successfully detect this as a mimic of inflammation. Samples without microspheres were analysed using quantitative ultrasound to assess mechanical properties. Attenuation coefficients of 1.78 ± 0.66 dB/mm and 1.92 ± 0.77 dB/mm were obtained from reference samples which were surgically separated from the muscle layer. Six intact samples were segmented using a software algorithm and the acoustic impedance, Z, for varying tissue thicknesses, and backscattering coefficient, BSC, were calculated using the reference attenuation values and tabulated.

  13. Role of capsule endoscopy in suspected celiac disease: A European multi-centre study

    Science.gov (United States)

    Luján-Sanchis, Marisol; Pérez-Cuadrado-Robles, Enrique; García-Lledó, Javier; Juanmartiñena Fernández, José-Francisco; Elli, Luca; Jiménez-García, Victoria-Alejandra; Egea-Valenzuela, Juan; Valle-Muñoz, Julio; Carretero-Ribón, Cristina; Fernández-Urién-Sainz, Ignacio; López-Higueras, Antonio; Alonso-Lázaro, Noelia; Sanjuan-Acosta, Mileidis; Sánchez-Ceballos, Francisco; Rosa, Bruno; González-Vázquez, Santiago; Branchi, Federica; Ruano-Díaz, Lucía; Prieto-de-Frías, César; Pons-Beltrán, Vicente; Borque-Barrera, Pilar; González-Suárez, Begoña; Xavier, Sofía; Argüelles-Arias, Federico; Herrerías-Gutiérrez, Juan-Manuel; Pérez-Cuadrado-Martínez, Enrique; Sempere-García-Argüelles, Javier

    2017-01-01

    AIM To analyze the diagnostic yield (DY), therapeutic impact (TI) and safety of capsule endoscopy (CE). METHODS This is a multi-centre, observational, analytical, retrospective study. A total of 163 patients with suspicion of celiac disease (CD) (mean age = 46.4 ± 17.3 years, 68.1% women) who underwent CE from 2003 to 2015 were included. Patients were divided into four groups: seronegative CD with atrophy (Group-I, n = 19), seropositive CD without atrophy (Group-II, n = 39), contraindication to gastroscopy (Group-III, n = 6), seronegative CD without atrophy, but with a compatible context (Group-IV, n = 99). DY, TI and the safety of CE were analysed. RESULTS The overall DY was 54% and the final diagnosis was villous atrophy (n = 65, 39.9%), complicated CD (n = 12, 7.4%) and other enteropathies (n = 11, 6.8%; 8 Crohn’s). DY for groups I to IV was 73.7%, 69.2%, 50% and 44.4%, respectively. Atrophy was located in duodenum in 24 cases (36.9%), diffuse in 19 (29.2%), jejunal in 11 (16.9%), and patchy in 10 cases (15.4%). Factors associated with a greater DY were positive serology (68.3% vs 49.2%, P = 0.034) and older age (P = 0.008). On the other hand, neither sex nor clinical presentation, family background, positive histology or HLA status were associated with DY. CE results changed the therapeutic approach in 71.8% of the cases. Atrophy was associated with a greater TI (92.3% vs 45.3%, P disease. CE is safe procedure with a high degree of concordance with histology and it helps in the differential diagnosis of CD. PMID:28216978

  14. Enhanced Diagnostic Yield with Prolonged Small Bowel Transit Time during Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Jonathan M. Buscaglia, Sumit Kapoor, John O. Clarke, Juan Carlos Bucobo, Samuel A. Giday, Priscilla Magno, Elaine Yong, Gerard E. Mullin

    2008-01-01

    Full Text Available Background: The effect of small bowel transit time (SBTT on diagnostic yield during capsule endoscopy (CE has not been previously evaluated. Our study aim was to assess the effect of SBTT on the likelihood of detecting intestinal pathology during CE. Methods: We reviewed collected data on CE studies performed at Johns Hopkins Hospital from January 2006 to June 2007. In patients investigated for anemia or obscure bleeding, the following lesions were considered relevant: ulcers, erosions, AVMs, red spots, varices, vascular ectasias, and presence of blood. In patients with diarrhea or abdominal pain, ulcers, erosions, and blood were considered relevant. Age, gender, study indication, hospital status, and quality of bowel preparation were identified as candidate risk factors affecting SBTT. Univariate logistic and linear regression analyses were performed to study the effect of SBTT on diagnostic yield. Results: Total of 212 CE studies were analyzed; most were in outpatients (n=175, 82.9% and with excellent bowel preparation (n=177, 83.5%. Mean SBTT was 237.0min (3.9hrs. Age, gender, bowel prep, hospital status, and study indication did not significantly affect SBTT. However, increased SBTT was independently associated with increased diagnostic yield; OR=1.7 in SBTT=2-4hr (p=0.41, OR=1.8 in SBTT=4-6hrs (p=0.30, OR=9.6 in SBTT=6-8hrs (p=0.05. Conclusion: Prolonged SBTT during CE (>6 hr is associated with an increased diagnostic yield. This may be due to a positive effect on image quality during a “slower” study. The use of promotility agents may adversely affect the ability of CE to detect significant intestinal pathology.

  15. Risk factors for re-bleeding events in obscure gastrointestinal bleeding patients with negative findings in capsule endoscopy%胶囊内镜阴性结果的不明原因消化道出血患者再出血因素分析

    Institute of Scientific and Technical Information of China (English)

    孙清华; 张金平; 李东颖; 李建生

    2016-01-01

    目的 分析研究胶囊内镜(CE)阴性结果的不明原因消化道出血(OGIB)患者再出血率与相关危险因素.方法 选取郑州大学第一附属医院2011年1月至2012年12月间行CE检查的OGIB患者,通过查阅病历、电话和门诊随访等方式,观察CE检查阴性患者的再出血率,分析再出血相关危险因素.结果 共纳入198例患者,196例完成随访,平均随访时间(16.1±5.3)个月,其中94例CE阴性并未接受特异性治疗的患者作为主要研究对象,再出血率为34.0% (32/94),累积再出血率在随访第6、12、18、24个月,分别为3.2%、6.4%、20.2%、34.0%.CE检查后未接受特异性治疗的患者再出血率比较,CE检查阳性患者(23.7%)与CE检查阴性患者(34.0%)间差异无统计学意义(P =0.246).糖尿病病史(HR=3.250,95% CI:1.296 ~8.154,P=0.012)、CE前最低血红蛋白量≤80 g/L(HR=0.397,95% CI:0.172 ~0.917,P=0.031)、CE检查后继续服用阿司匹林(HR=4.915,95% CI:1.887 ~ 12.800,P=0.001)为CE检查阴性的OGIB患者再出血的独立危险因素.结论 CE检查结果阴性的患者再出血风险仍较大,也应在CE检查后密切随访,对于具有危险因素的CE阴性患者,建议CE检查后的12 ~ 24个月内复查胶囊内镜或其他小肠检查(电子小肠镜、CT小肠成像等).%Objective To investigate the frequency of and risk factors for re-bleeding in obscure gastrointestinal bleeding (OGIB) patients who had negative findings in capsule endoscopy (CE).Methods Patients with OGIB referred for CE to the First Affiliated Hospital of Zhengzhou University between January 2011 and December 2012 were identified.Follow-up data were obtained via medical records review,telephone interviews or follow-up clinic visits in order to establish therate of re-bleeding and identify the risk factors associated with re-bleeding among patients with negative CE findings.Results A total of 198 patients were included in this study,of whom 196 patients

  16. A feasibility trial of computer-aided diagnosis for enteric lesions in capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Tao Gan; Jun-Chao Wu; Ni-Ni Rao; Tao Chen; Bing Liu

    2008-01-01

    AIM: To investigate and evaluate the feasibility of the computer-aided screening diagnosis for enteric lesions in the capsule endoscopy (CE).METHODS: After developing a series of algorithms for the screening diagnosis of the enteric lesions in CE based on their characteristic colors and contours,the normal and abnormal images obtained from 289 patients were respectively scanned and diagnosed by the CE readers and by the computer-aided screening for the enteric lesions with the image-processed software (IPS). The enteric lesions shown by the images included esoenteritis, mucosal ulcer and erosion, bleeding, spaceoccupying lesions, angioectasia, diverticula, parasites,etc. The images for the lesions or the suspected lesions confirmed by the CE readers and the computers were collected, and the effectiveness rate of the screening and the number of the scanned images were evaluated,respectively.RESULTS: Compared with the diagnostic results obtained by the CE readers, the total effectiveness rate (sensitivity) in the screening of the commonlyencountered enteric lesions by IPS varied from 42.9%to 91.2%, with a median of 74.2%, though the specificity and the accuracy rates were still low, and the images for the rarely-encountered lesions were difficult to differentiate from the normal images. However, the number of the images screened by IPS was 5000 on average, and only 10%-15% of the original images were left behind. As a result, a large number of normal images were excluded, and the reading time decreased from 5 h to 1 h on average.CONCLUSION: Though the total accuracy and specificity rates by the computer-aided screening for the enteric lesions with IPS are much lower than those by the CE readers, the computer-aided screening diagnosis can exclude a large number of the normal images and confine the enteric lesions to 5000 images on average,which can reduce the workload of the readers in the scanning of the images. This computer-aided screening technique can make a

  17. 胶囊内镜在儿科应用的护理%Capsule Endoscopy in Pediatric Care Applications

    Institute of Scientific and Technical Information of China (English)

    潘玉凤

    2015-01-01

    Objective To study the endoscopy and influence of pediatric nursing capsule. Methods Choose 72 cases of children who accept capsule endoscopy in the hospital, as research subjects, which were randomly divided into two groups, each of 36 cas-es. Control group: usual care. Observer Group: row before capsule endoscopy for patients with psychological care items ready and bowel preparation, good food and activities inspection mission to observe the inspection carried out, the capsule was observed after checking discharge cases, bowel preparation before cleaning degree and examination results, while comparing patient satisfaction with quality of care. Results The observer group of patients with intestinal cleanliness is better than patients in the control group, the difference was statistically significant (P<0.05). Markedly observation group underwent capsule examination was 72.2%, effec-tive rate is 47.2%of patients in the control group capsule examination, the difference was statistically significant (P<0.05). Obser-vation of patients' satisfaction quality of care was 97.2% in the control group, the quality of care and patient satisfaction was 77.8% in the control group, the difference was statistically significant (P<0.05). Conclusion Strengthen nursing intervention can provide good bowel preparation for capsule endoscopy environment, improving lesion detection rate and the quality of care and pa-tient satisfaction.%目的:探讨儿科胶囊内镜检查的护理措施及影响。方法整群选择该院接受胶囊内镜检查的患儿72例作为研究对象,随机分成两组,各36例。对照组院接受常规护理。观察组院在行胶囊内镜检查前为患者进行心理护理、物品准备及肠道准备,检查中做好饮食与活动的宣教,观察检查进行情况,检查后观察胶囊排出情况、前肠道准备清洁度及检查效果,同时比较患者对护理质量的满意度。结果观察组患者的肠道清洁度优于对照

  18. Morpho-functional evaluation of small bowel using wireless motility capsule and video capsule endoscopy in patients with known or suspected Crohn’s disease: pilot study

    Science.gov (United States)

    Yung, Diana; Douglas, Sarah; Hobson, Anthony R.; Giannakou, Andry; Plevris, John N.; Koulaouzidis, Anastasios

    2016-01-01

    Background and study aims: SmartPill® (Given Imaging Corp.,Yoqneam,Israel) is an ingestible, non-imaging capsule that records physiological data including contractions and pH throughout the gastrointestinal tract. There are scarce data looking at SmartPill® assessment of patients with known/suspected small-bowel Crohn’s Disease (CD). This pilot study aims to investigate feasibility and safety of SmartPill® to assess gut motility in this group.  Patients and methods: Over 1 year, patients with known/suspected CD, referred for small-bowel capsule endoscopy (SBCE), were invited to participate and 12 were recruited (7 female, 5 male, mean age 44.2 ± 16.6 years). They underwent hydrogen breath test to exclude small-bowel bacterial overgrowth, patency capsule (Agile®), and provided stool samples for fecal calprotectin (FC). Patients ingested PillCam®SB2 and SmartPill® 4 hours apart. Using unpublished data, 33 healthy controls also were identified for the study. P < 0.05 was considered statistically significant. Results: Of the 12 patients enrolled, 10 underwent complete Smartpill® examination (1 stomach retention, 1 dropout). Pillcam® was complete in 10 (1 dropout, 1 stomach retention). Mean fecal calprotectin was 340 ± 307.71 mcg/g. The study group had longer transit times and lower gut motility index than did the controls. The difference in motility appears to be statistically significant (P < 0.05). Longer transit times for SmartPill® (not statistically significant) may have been due to different specifications between the capsules. Limitations included transient Smartpill® signal loss (5/10 studies). Conclusions: This is the first pilot to attempt combining SBCE and SmartPill® to assess small-bowel CD. Data on motility in CD are scarce. Multimodal information can provide a clearer clinical picture. Despite concerns about capsule retention in CD patients, SmartPill® seems safe for use if a patency capsule is employed beforehand. PMID

  19. Prevalence of upper digestive endoscopy and gastric histopathology findings in morbidly obese patients

    Directory of Open Access Journals (Sweden)

    Judite Dietz

    2012-03-01

    Full Text Available CONTEXT: The prevalence of obesity has been increasing in modern society. Roux-en-y gastric bypass is a bariatric surgery that involves the exclusion of significant part of the stomach. Atrophy, intestinal metaplasia and gastric cancer have been associated with infection by Helicobacter pylori. OBJECTIVES: To evaluate the presence of endoscopy findings and histological changes in morbid obese patients for the presence of inflammatory cells, inflammatory activity, lymphoid hyperplasia, H. pylori infection, atrophy and intestinal metaplasia in the gastric mucosa. METHODS: Upper digestive endoscopy and gastric histopathological were studied in 126 obese patients in the preoperative evaluation for bariatric surgery. RESULTS: Upper digestive endoscopy abnormalities were diagnosed in 73/126 (57.9% patients. In three patients (2.4% the upper gastrointestinal endoscopy diagnosed gastric ulcer and one patient (0.8% had duodenal ulcer. The histopathological from gastric biopsies of these obese patients showed 65.1% of mucosa inflammation, inflammatory activity in 50.0%, infection by H. pylori in 53.2%, lymphoid hyperplasia in 50.0% and atrophy and/or intestinal metaplasia in 16.7%. CONCLUSIONS: In present study, with routine preoperative upper gastrointestinal endoscopy and histopathological examination, were detected 57.9% patients with endoscopy abnormalities, high prevalence of infection by H. pylori (53% and 16.7% of gastric atrophy and/or intestinal metaplasia.

  20. Capsule endoscopy in non-steroidal anti-inflammatory drugs-enteropathy and miscellaneous, rare intestinal diseases

    Institute of Scientific and Technical Information of China (English)

    Gerard Gay; Michel Delvaux; Muriel Frederic

    2008-01-01

    Despite significant advances over the last decade,mucosal lesions of the small bowel are poorly detected by imaging studies such as CT scan,MRI-enteroclysis and contrast-enhanced abdominal ultrasound.Capsule endoscopy (CE) has dramatically changed the diagnostic approach to intestinal diseases.Moreover,the use of CE can be extended to include other conditions.However,it is difficult to assess the positive influence of CE on patient outcomes in conditions involving a small number of patients,or in critically ill and difficult to examine patients.CE has the advantage of diagnosing intestinal lesions and of directing the use of double balloon enteroscopy (DBE) in order to obtain biopsy specimens.Moreover,CE allows repeated assessment in chronic conditions,especially to detect relapse of an infectious disease.

  1. Gastric digestion of α-lactalbumin in adult human subjects using capsule endoscopy and nasogastric tube sampling.

    Science.gov (United States)

    Sullivan, Louise M; Kehoe, Joseph J; Barry, Lillian; Buckley, Martin J M; Shanahan, Fergus; Mok, K H; Brodkorb, André

    2014-08-28

    In the present study, structural changes in the milk protein α-lactalbumin (α-LA) and its proteolysis were investigated for the potential formation of protein-fatty acid complexes during in vivo gastric digestion. Capsule endoscopy allowed visualisation of the digestion of the test drinks, with nasogastric tubes allowing sampling of the gastric contents. A total of ten healthy volunteers had nasogastric tubes inserted into the stomach and ingested test drinks containing 50 g/l of sucrose and 25 g/l of α-LA with and without 4 g/l of oleic acid (OA). The samples of gastric contents were collected for analysis at 3 min intervals. The results revealed a rapid decrease in the pH of the stomach of the subjects. The fasting pH of 2·31 (SD 1·19) increased to a pH maxima of pH 6·54 (SD 0·29) after ingestion, with a subsequent decrease to pH 2·22 (SD 1·91) after 21 min (n 8). Fluorescence spectroscopy and Fourier transform IR spectroscopy revealed partial protein unfolding, coinciding with the decrease in pH below the isoelectric point of α-LA. The activity of pepsin in the fasting state was found to be 39 (SD 12) units/ml of gastric juice. Rapid digestion of the protein occurred: after 15 min, no native protein was detected using SDS-PAGE; HPLC revealed the presence of small amounts of native protein after 24 min of gastric digestion. Mirocam® capsule endoscopy imaging and video clips (see the online supplementary material) revealed that gastric peristalsis resulted in a heterogeneous mixture during gastric digestion. Unfolding of α-LA was observed during gastric transit; however, there was no evidence of a cytotoxic complex being formed between α-LA and OA.

  2. Comparison between capsule endoscopy and balloon enteroscopy in diagnosing small bowel diseases%胶囊内镜和小肠镜对小肠疾病诊断价值比较

    Institute of Scientific and Technical Information of China (English)

    蔡顺天; 彭丽华; 杨云生; 李中原; 王淑芳; 李闻; 孙刚; 窦艳; 王巍峰; 黄启阳

    2015-01-01

    Objective To compare capsule endoscopy (CE) with balloon enteroscopy in diagnosing small bowel diseases and describe the disease constitution of small bowel.Methods Clinical data about patients who underwent capsule endoscopy and balloon enteroscopy from August 2003 to December 2013 in ourdigestive endoscopy center, including gender, age, indication, examination finding, complication and so on, were retrospectively analyzed. The overall detection rate of small bowel diseases between capsule endoscopy and balloon enteroscopy was compared and the spectrum of small bowel diseases was described.Results One hundred and sixty-five capsule endoscopy procedures were carried out in 163 patients,obscure gastrointestinal bleeding was the most common indication (OGIB, 57.58%). Overall detection rate of abnormalfindings in the small bowel was 72.12% by capsule endoscopy, and the detection rate of capsule endoscopy for OGIB patients was 80.00%. Five hundred and sixty-one balloon enteroscopy procedures were performed in 442 patients and OGIB was the most common indication (55.43%). Overall detection rate of abnormalfindings was 64.25% by balloon enteroscopy and it was 64.90% in OGIB patients. Diagnostic yield of capsule endoscopy for small bowel diseases was similar to that of balloon enteroscopy (72.12%vs 64.25%,P=0.068). Subgroup analysis in OGIB showed that the detection rate of capsule endoscopy was higher than that of balloon enteroscopy (80.00%vs 64.90%,P=0.007). Small boweldiseases found in patients underwent balloon enteroscopy were as follows: inflammatory diseases (39.79%), neoplasm (34.15%), vascular diseases (13.73%), diverticula (8.10%) and other gastrointestinal diseases such as lymphangiectasia and atrophy of villus (4.23%). As for capsule endoscopy, inflammatory diseases was the most commonfindings (42.86%), followed by vascular diseases (25.21%), neoplasm (including tumors and polyps, 21.85%), other gastrointestinal diseases (8.40%) and diverticula (1

  3. The role of capsule endoscopy combined with double-balloon enteroscopy in diagnosis of small bowel diseases

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-bo; GE Zhi-zheng; DAI Jun; GAO Yun-jie; LIU Wen-zhong; HU Yun-biao; XIAO Shu-dong

    2007-01-01

    Background The diagnosis of small bowel diseases remains relatively inefficient using traditional imaging techniques.Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) are two novel methods of enteroscopy for examining the entire small bowel. The aim of this study was to evaluate the detection rate and diagnostic accuracy of CE and DBE in patients with suspected small bowel diseases and to investigate the clinical significance of combined use of these two novel modalities.Methods Two hundred and eighteen patients were evaluated for suspected small bowel disease, including 116 with obscure gastrointestinal bleeding and 102 with obscure abdominal pain or chronic diarrhea. One hundred and sixty-five out of these patients underwent CE first and 53 patients underwent DBE (under anesthesia with propofol) first. DBE was recommended after negative or equivocal evaluation on CE and vise versa. Introduction of the endoscope during DBE was either orally or anally and the patients were referred for a second procedure using the opposite route several days later when no abnormalities were found on the first procedure. The detection rates, diagnostic accuracy, tolerance and frequency of adverse events of these two modalities were then analyzed.Results Failure of the procedure was seen in one patient with CE and in two patients with DBE. Sixty-four DBE procedures were carried out in 51 patients; by the oral route in 34 cases, the anal route in 4 and both routes in 13 cases.The overall detection rate of small bowel diseases using CE (72.0%, 118/164) was superior to that with DBE (41.2%,21/51); χ2=16.1218, P<0.0001. The diagnostic rate (51.8%, 85/164) was also higher than that with the latter procedure (39.2%, 20/51), but was not significantly different (χ2=2.4771, P>0.05). Furthermore, the detection rate of small bowel diseases in patients with obscure gastrointestinal bleeding using CE (88.0%, 88/100) was superior to that of DBE (60.0%,9/15); χ2=7.7457, P=0

  4. Fecal occult blood testing for the prediction of small-bowel pathology detected by capsule endoscopy: a systematic review and meta-analysis

    Science.gov (United States)

    Yung, Diana E.; Vijayan, Sanju; Avni, Tomer; Douglas, Sarah; Kopylov, Uri; Koulaouzidis, Anastasios

    2017-01-01

    Background Fecal occult blood testing (FOBT) has been suggested as a potential screening tool for small-bowel capsule endoscopy (CE). We conducted a meta-analysis of studies correlating FOBT and CE findings to examine the predictive value of positive FOBT for CE findings. Methods PubMed and Embase search. Sensitivity, specificity and diagnostic odds ratios (DORs) were calculated. Results Six studies were identified. Four used fecal immunochemical testing (FIT), one used FIT and guaiac FOBT, one used hemoglobin/haptoglobin complex testing (Hb/Hpt). Five of the 6 studies were suitable for statistical analysis. For all positive FOBT, sensitivity for small-bowel findings was 0.60 (95%CI 0.50-0.69), specificity was 0.72 (95%CI 0.52-0.86), and DOR was 3.96 (95%CI 1.50-10.4). For the 4 studies using only FIT, sensitivity was 0.48 (95%CI 0.36-0.61), specificity was 0.60 (95%CI 0.42-0.76), and DOR was 1.41 (95%CI 0.72-2.75). Conclusions Although a number of modalities have been suggested for screening small-bowel CE referrals, none of them, including FOBT, offer a comprehensive solution. Further work is required to refine screening methods for small-bowel CE referrals.

  5. Sedation With Propofol Has No Effect on Capsule Endoscopy Completion Rates: A Prospective Single-Center Study.

    Science.gov (United States)

    Gan, Huo-Ye; Weng, Yi-Jie; Qiao, Wei-Guang; Chen, Zhen-Yu; Xu, Zhi-Min; Bai, Yang; Gong, Wei; Wan, Tian-Mo; Pan, De-Shou; Shi, Yong-Sheng; Qiu, Ai-Jun; Zhi, Fa-Chao

    2015-07-01

    Patients who need both capsule endoscopy (CE) and colonoscopy often undergo both examinations on the same day to avoid repeated bowel preparation and fasting. Sedation can relieve pain and is commonly used for colonoscopies but may influence the CE completion rate.To determine whether sedation with propofol influences the completion rate and small-bowel transit time (SBTT) of CE.From July 2014 to December 2014, patients (18-65 years old) who needed both CE and colonoscopy were assessed consecutively for enrollment in our study. Colonoscopies were performed with or without sedation based on patient preferences on the day of capsule ingestion. The completion rate, SBTT, and diagnostic yield of CEs were recorded. Patients' satisfaction and pain scores were also recorded.Sedation with propofol had no significant effect on CE completion rates (83.3% sedation group vs 81.8% nonsedation group, P = 0.86) but was associated with increased SBTT (403.6 ± 160.3 sedation group vs 334.5 ± 134.4 nonsedation group, P = 0.006). The diagnostic yields in the sedation and nonsedation groups were 69.4% and 65.9%, respectively (P = 0.74). The median satisfaction scores were 8.6 in the sedation group and 3.5 in the nonsedation group (P sedation group and 6.7 in the nonsedation group (P Sedation with propofol increased SBTT but had no effect on CE completion rates, suggesting that CE and colonoscopy with propofol can be performed on the same day (clinical trial registration number: ChiCTR-ONRC-14004866).

  6. 胶囊内镜在儿童小肠疾病诊治中的应用价值%Clinical value of wireless capsule endoscopy in diagnosis of small bowel disease in children

    Institute of Scientific and Technical Information of China (English)

    马鸣; 张冰凌; 陈春晓; 李甫棒; 黄晓磊; 王培鑫; 陈洁

    2009-01-01

    Objective The pathological change of small bowel is difficult to examine because it is anatomically unique. The development of wireless capsule endoscopy provides an unique opportunity to visualize the entire small bowel in a minimally invasive manner. The aim of this study was to assess the safety and clinical value of wireless capsule endoscopy in children. Methods During the last 4 years (June, 2004-June, 2008), 46 times of wireless capsule endoscopy were performed in 43 patients with suspected small bowel disease, including obscure gastrointestinal bleeding (n=11), recurrent abdominal pain (n=20), chronic diarrhea (n=9), protein losing enteropathy (n=2), recurrent vomiting (n=1). Of the 43 cases, 28 were male and 15 were female, the age ranged from 6 to 18 years, 8 of these cases were <10 years old. The weight of the patients ranged between 15 kg and 60 kg. The average time of capsule passing through the stomach and the small intestine, the tolerance to and complication of wireless capsule endoscopy in patients, the image quality of capsule endoscopy, and the cleanliness of small intestine after fasting for 8 hours were observed and recorded. Result All the patients could easily swallow the capsule and had good tolerance. The overall success rate was 94% (43/46). The median time of capsule passing through the stomach and small intestine was 73 min (range, 3-600 min) and 246 min (range, 73-413 min), respectively. The diagnostic yield of pathological change in small intestine was 90% (37/41), and the diagnostic accordance rate was 84% (31/37). Based on the wireless capsule endoscopy, diagnostic findings included Crohn's diseases (15), lymph follicular hyperplasia (4), nonspecific enteritis (4), vascular malformations (3), small bowel tumour (2), primary intestinal lymphangiectasia (2), gastrointestinal motility disorders (2), Meckel's diverticulum (1), angioma (1), small intestinal worm disease (1), duodenal ulcer (1), and polyposis syndromes (1). The capsule of

  7. 胶囊内镜联合仿真内窥镜在不明原因消化道出血中的应用%Capsule endoscopy combined with CT virtual endoscopy in obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    牛思; 李修岭; 葛英辉; 梁宝松; 李晓芳

    2013-01-01

    Objective To explore the value of application capsule endoscopy(capsule endoscopy,CE)combined with CT virtual endoscopy(CT virtual endoscopy,CTVE.) in the obscure gastrointestinal bleeding(OGIB).Methods Totally 21 patients with OGIB had been examinationed with CE and CTVE,to analyze the value of the two methods in OGIB.Results The lession has been found in 19 cases,including seven cases of small intestinal stromal tumors,three cases of inflammation,one case of granuloma,one case of small intestine,one case of vascular malformations,one case of metastases,two cases of small bowel diverticula,one case of bowel malformation,one case of Dieulafoy ulcer,one case of colon,one case of hookworm.The matching rate of the two methods is 81.0%.Conclusion CE combined with CTVE have high value of application in the diagnosis of the obscure gastrointestinal bleeding.%目的 探讨胶囊内镜(capsule endoscopy,CE)联合仿真内窥镜(CT virtual endoscopy,CTVE)在不明原因消化道出血(obscure gastrointestinal bleeding OGIB)中的应用价值.方法 对21例因不明原因消化道出血的患者同时行CE及CTVE检查分析两者联合在不明原因消化道出血的应用价值.结果 共有19例患者发现了病变,其中小肠间质瘤7例,炎症3例,肉芽肿1例,小肠血管畸形1例,转移瘤1例,小肠憩室2例,肠管畸形1例,Dieulafoy溃疡1例,结肠癌1例,钩虫病1例;两者吻合率81.0%.结论 CE联合CTVE在不明原因消化道出血中有较高的应用价值.

  8. Hardware-efficient low-power image processing system for wireless capsule endoscopy.

    Science.gov (United States)

    Turcza, Pawel; Duplaga, Mariusz

    2013-11-01

    This paper presents the design of a hardware-efficient, low-power image processing system for next-generation wireless endoscopy. The presented system is composed of a custom CMOS image sensor, a dedicated image compressor, a forward error correction (FEC) encoder protecting radio transmitted data against random and burst errors, a radio data transmitter, and a controller supervising all operations of the system. The most significant part of the system is the image compressor. It is based on an integer version of a discrete cosine transform and a novel, low complexity yet efficient, entropy encoder making use of an adaptive Golomb-Rice algorithm instead of Huffman tables. The novel hardware-efficient architecture designed for the presented system enables on-the-fly compression of the acquired image. Instant compression, together with elimination of the necessity of retransmitting erroneously received data by their prior FEC encoding, significantly reduces the size of the required memory in comparison to previous systems. The presented system was prototyped in a single, low-power, 65-nm field programmable gate arrays (FPGA) chip. Its power consumption is low and comparable to other application-specific-integrated-circuits-based systems, despite FPGA-based implementation.

  9. Small bowel capsule endoscopy, a modern tool for celiac disease diagnosis - case presentation

    Directory of Open Access Journals (Sweden)

    Suceveanu Andra Iulia

    2014-05-01

    Full Text Available Celiac disease is a clinically heterogeneous disease characterized by an inadequate immunological response when patients with specific genetic phenotypes are exposed to gluten. This article presents a case of a young woman diagnosed in Gastroenterology Department of “ St. Andrew Apostle” Emergency Hospital of Constanta with celiac disease after multiple admissions into the hospital for unspecific symptoms such as pallor, fatigue, pirosis, weight loss and 1-2 soft stools/day. The history with period irregularities and infertility without a known cause, a recent unexplained bone fracture, the muscle weakness, neuropsychiatric symptoms characterized by sleep disturbances and irritability correlated with the biological features characterized by moderate feriprive anemia, Ca and Mg decreased level, thyroid autoimmune impairment and gastrointestinal symptoms raised the suspicion of an autoimmune disorder with multiple targets. The videcapsule endoscopy (VCE revealed the specific pattern of the celiac disease: villous atrophy of jejunum, scalloping, absent folds and cobblestone mucosal pattern. Results were correlated with immunology tests results. The patient was transferred on a gluten free diet and the clinical and VCE controlsrevealed the healing of the jejunum mucosa. The VCE can be the tool for positive diagnosis of an unusual and heterogeneous celiac disease in patients with various symptoms without an apparent cause.

  10. Lubiprostone decreases the small bowel transit time by capsule endoscopy: an exploratory, randomised, double-blind, placebo-controlled 3-way crossover study.

    Science.gov (United States)

    Matsuura, Mizue; Inamori, Masahiko; Endo, Hiroki; Matsuura, Tetsuya; Kanoshima, Kenji; Inoh, Yumi; Fujita, Yuji; Umezawa, Shotaro; Fuyuki, Akiko; Uchiyama, Shiori; Higurashi, Takuma; Ohkubo, Hidenori; Sakai, Eiji; Iida, Hiroshi; Nonaka, Takashi; Futagami, Seiji; Kusakabe, Akihiko; Maeda, Shin; Nakajima, Atsushi

    2014-01-01

    The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE) and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen), a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen), or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen). The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117-407) minutes in the P-P regimen, 122.5 (27-282) minutes in the L-P regimen, and 110.5 (11-331) minutes in the P-L regimen (P = 0.042). This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE.

  11. Lubiprostone Decreases the Small Bowel Transit Time by Capsule Endoscopy: An Exploratory, Randomised, Double-Blind, Placebo-Controlled 3-Way Crossover Study

    Directory of Open Access Journals (Sweden)

    Mizue Matsuura

    2014-01-01

    Full Text Available The aim of this study was to investigate the usefulness of lubiprostone for bowel preparation and as a propulsive agent in small bowel endoscopy. Six healthy male volunteers participated in this randomized, 3-way crossover study. The subjects received a 24 μg tablet of lubiprostone 60 minutes prior to the capsule ingestion for capsule endoscopy (CE and a placebo tablet 30 minutes before the capsule ingestion (L-P regimen, a placebo tablet 60 minutes prior to CE and a 24 μg tablet of lubiprostone 30 minutes prior to CE (P-L regimen, or a placebo tablet 60 minutes prior to r CE and a placebo tablet again 30 minutes prior to CE (P-P regimen. The quality of the capsule endoscopic images and the amount of water in the small bowel were assessed on 5-point scale. The median SBTT was 178.5 (117–407 minutes in the P-P regimen, 122.5 (27–282 minutes in the L-P regimen, and 110.5 (11–331 minutes in the P-L regimen (P=0.042. This study showed that the use of lubiprostone significantly decreased the SBTT. We also confirmed that lubiprostone was effective for inducing water secretion into the small bowel during CE.

  12. Comparison between Capsule Endoscopy and Magnetic Resonance Enterography for the Detection of Polyps of the Small Intestine in Patients with Familial Adenomatous Polyposis

    Directory of Open Access Journals (Sweden)

    E. Akin

    2012-01-01

    Full Text Available Objective. The objective of this study was to assess the utility of magnetic resonance enterography (MRE compared with capsule endoscopy (CE for the detection of small-bowel polyps in patients with familial adenomatous polyposis (FAP. Methods. Patients underwent MRE and CE. The polyps were classified according to size of polyp: 10 mm (large size. The location (jejunum or ileum and the number of polyps (1–5, 6–20, >20 detected by CE were also assessed. MRE findings were compared with the results of CE. Results. Small-bowel polyps, were detected by CE in 4 of the 6 (66% patients. Three patients had small-sized polyps and one patient had medium-sized polyps. CE detected polyps in four patients that, were not shown on MRE. Desmoid tumors were detected on anterior abdominal wall by MRE. Conclusion. In patients with FAP, CE can detect small-sized polyps in the small intestine not seen with MRE whereas MRE yields additional extraintestinal information.

  13. Effectiveness of Capsule Endoscopy Compared with Other Diagnostic Modalities in Patients with Small Bowel Crohn’s Disease: A Meta-Analysis

    Science.gov (United States)

    Choi, Miyoung; Lim, Sungwon; Choi, Myung-Gyu; Shim, Ki-Nam; Lee, Seon Heui

    2017-01-01

    Background/Aims As a result of the rapid development of medical diagnostic tools, physicians require concrete evidence to evaluate the effectiveness of the tools. We aimed to investigate the effectiveness and additional diagnostic benefits of capsule endoscopy (CE) in patients with small bowel Crohn’s disease (CD). Methods We performed a systematic search of databases, including MEDLINE, EMBASE, and the Cochrane Library, as well as eight domestic databases. Two reviewers independently screened all references. Diagnostic data from the studies were collected, and a meta-analysis was performed. Results Twenty-four studies were included. In cases of suspected CD, CE demonstrated a superior diagnostic yield compared with small bowel follow-through (SBFT) and enteroclysis (EC); however, there was no difference compared with computed tomography enterography or magnetic resonance enterography. In cases with established CD, CE demonstrated a higher diagnostic yield only compared with EC. In the detection of terminal ileum lesions, CE exhibited a significantly increased detection rate compared with ileoscopy. Conclusions The findings of our meta-analysis indicate that CE is superior to SBFT and EC in the evaluation of suspected CD cases. CE is also a more effective diagnostic modality in patients with established CD compared with EC. PMID:27728963

  14. 胶囊内镜在消化道疾病的临床应用%Clinical Application of Capsule Endoscopy in Gastrointestinal Diseases

    Institute of Scientific and Technical Information of China (English)

    李萍; 郑苏云; 杨敏

    2011-01-01

    目的 探讨国产OMOM胶囊内镜在消化道疾病的诊断价值.方法 总结分析曲靖市第一人民医院消化内科108例行胶囊内镜检查的临床资料.结果 108例均完成检查,发现病灶82例(75.9%),食道病变7例,胃病变39例,十二指肠球部病变24例,小肠病变64例,结肠病变12例.胶囊平均工作时间7.8 h,在食道内平均上作时间为34 s;胃内平均工作时54 min 42 s,小肠平均工作时间为3 h 53 min;结肠平均工作时间2 h48min,胶囊排出体外平均时间为35 h.结论 OMOM胶囊是一种无创、无交叉感染的新型的消化道检查方法,对消化道疾病特别是小肠疾病有较高的诊断价值.%Objective To investigate the diagnostic value of domestic OMOM capsule endoscopy in gastrointestinal diseases. Mothod We summarized and analysed the clinical data of 108 patients who received capsule endoscopy in our hospital. Results All the 108 patients completed capsule endoscopy inspection,pathological changes (75.9%) were found in 82 patients, including 7 patients with esophagus disease, 39 patients with gastric disease, 24 patients with duodenal disease, 64 patients with small intestine disease and 12 patients with colon disease. The average working time of capsule was 7.8 h, including 34 s in esophagus, 54 min 42s in stomach, 3 h 53min in small intestine, 2 h 4groin in clone. The average time of the capsule excreted from the body was 35 h. Conclusion OMOM capsule endoscopy is a new noninvasive inspection method for digestive tract without cross-infection, and has high value in diagnosis of digestive diseases, especially for small intestine disease.

  15. Diagnostic yield and safety of capsule endoscopy Rendimiento diagnóstico y seguridad de la cápsula endoscópica

    Directory of Open Access Journals (Sweden)

    J. L. Matas

    2006-09-01

    Full Text Available Introduction: the capsule endoscopy (CE, from his approval, has become a first line diagnostic procedure for the study of the small bowel disease. The aim of this study is to report our experience since the implantation of this technique in our hospital. Material and methods: retrospective review of the CE undertaken in Department of Endoscopy. There was gathered in every case the age, sex, motive of consultation, previous diagnostic procedures, capsule endoscopy findings and complication of the technique. One took to end a descriptive and analytical analysis. Results: there was achieved a total of 416 explorations in 388 patients. The obscure gastrointestinal bleeding was the most frequent indication (83.30% followed by suspected Crohn's disease (7.5%. Angiodisplasia was the endoscopic lesion more frequently detected (42.2%, especially, in patients with digestive bleeding of obscure origin (OR 3.13 p Introducción: la cápsula endoscópica desde su aprobación se ha convertido en un procedimiento diagnóstico de primera línea para el estudio del intestino delgado. El objetivo del estudio es exponer la experiencia desde la implantación de esta técnica en nuestro hospital. Material y métodos: se hizo una revisión retrospectiva de los estudios realizados en el Servicio de Endoscopia. Se recogió en cada caso la edad, sexo, motivo de consulta, procedimientos diagnósticos previos, diagnósticos endoscópicos e incidencias inherentes a la técnica y se llevó a cabo un análisis descriptivo y analítico. Resultados: se realizaron un total de 416 exploraciones en 388 pacientes. La hemorragia digestiva de origen oscuro fue la indicación más frecuente (83,30% seguida de la sospecha de enfermedad de Crohn (7,5%. La angiodisplasia fue la lesión endoscópica más detectada (42,2% cuando se analizó la hemorragia digestiva oscura (OR 3.13 p < 0,001 seguida de la flebectasia (10,6% y las úlceras sugerentes de enfermedad de Crohn (9,9%. La

  16. Magnetic resonance enterography versus capsule endoscopy activity indices for quantification of small bowel inflammation in Crohn’s disease

    Science.gov (United States)

    Kopylov, Uri; Klang, Eyal; Yablecovitch, Doron; Lahat, Adi; Avidan, Benjamin; Neuman, Sandra; Levhar, Nina; Greener, Tomer; Rozendorn, Noa; Beytelman, Arkadi; Yanai, Henit; Dotan, Iris; Chowers, Yehuda; Weiss, Batya; Ben-Horin, Shomron; Amitai, Marianne M.; Eliakim, Rami

    2016-01-01

    Background: Video capsule endoscopy (VCE) and magnetic resonance enterography (MRE) are the prime modalities for the evaluation of small bowel (SB) Crohn’s disease (CD). Mucosal inflammation on VCE is quantified using the Lewis score (LS). Diffusion-weighted (DW) magnetic resonance imaging (MRI) allows for accurate assessment of SB inflammation without administration of intravenous contrast material. The Magnetic Resonance Index of Activity (MaRiA) and the Clermont index are quantitative activity indices validated for contrast-enhanced MRE and DW-MRE, respectively. The aim of this study was to compare the quantification of distal SB inflammation by VCE and MR-related activity indices. Methods: Patients with known quiescent SB CD were prospectively recruited and underwent MRE and VCE. LS, MaRIA and Clermont scores were calculated for the distal SB. Results: Both MRI-based indices significantly correlated with the LS and the Clermont index (r = 0.50, p = 0.001 and r = 0.53, p = 0.001, respectively). Both MaRIA and Clermont scores were significantly lower in patients with mucosal healing (LS < 135). The area under the curve (AUC) with both MR scores was moderate for prediction of any mucosal inflammation (LS ⩾ 135) and excellent for prediction of moderate-to-severe inflammation (LS ⩾ 790) (0.71 and 0.74 versus 0.93 and 0.91 for MaRIA and Clermont score, respectively). Conclusions: Modest correlation between VCE- and MRE-based quantitative indices of inflammation in patients with quiescent SB CD was observed. Between-modality correlation was higher in patients with endoscopically severe disease. DW-MRE gauged by Clermont score was at least as accurate as contrast-enhanced MRE for quantification of SB inflammation. PMID:27582877

  17. Evaluation of visualized area percentage assessment of cleansing score and computed assessment of cleansing score for capsule endoscopy

    Directory of Open Access Journals (Sweden)

    Chen Hong-Bin

    2013-01-01

    Full Text Available Background/Aim: The purpose of this study was to evaluate the clinical significance of visualized area percentage assessment of cleansing score (AAC and computed assessment of cleansing score (CAC of these two small bowel cleanliness scores systems for capsule endoscopy (CE. Materials and Methods: The reliability and consistency of the AAC and CAC scores were evaluated by comparing the scores by two examiners (one expert, one without any training in CE. Reliability was determined using the intraclass correlation coefficient (ICC and consistency was determined using the kappa statistic. Results: The inter-observer agreement was excellent for both the AAC and CAC scores. For AAC, the ICC was 0.791 (95% confidence interval: 0.677-0.868, and for CAC the ICC was 1.000. Using 1.5 as the cutoff, there was no significant difference between AAC and CAC results by the expert examiner (kappa = 0.756, P = 0.000 or the non-expert examiner (kappa = 0.831, P = 0.000. Evaluation of small bowel cleanliness using AAC took 15-30 min, and evaluation using CAC took about 2-3 min. The overall adequacy assessment (OAA using the AAC was not significantly different between the two examiners (χ2 = 0.586, P = 0.444. There were also no significant differences between the OAA using the AAC and the OAA using the CAC by the expert examiner (χ2 = 1.730, P = 0.188 or the non-expert examiner (χ2 = 1.124, P = 0.289. Conclusion: Both of these scores for assessment of small bowel cleanliness can be useful in clinical practice, but the CAC is simpler to use.

  18. Endoscopic findings in patients with upper gastrointestinal bleeding clinically classified into three risk groups prior to endoscopy

    Institute of Scientific and Technical Information of China (English)

    Leonardo Tammaro; Maria Carla Di Paolo; Angelo Zullo; Cesare Hassan; Sergio Morini; Sebastiano Caliendo; Lorella Pallotta

    2008-01-01

    AIM: To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy.METHODS: All consecutive UGIB patients referred to a single endoscopic center during a 16 mo period were enrolled. Before endoscopy patients were stratified according to a simple clinical score (T-score),including T1 (high-risk), T2 (intermediate-risk) and T3 (low-risk). Endoscopy was performed in all cases within 2 h, and high-risk stigmata were considered for further analysis.RESULTS: Out of the 436 patients included into the study, 126 (29%) resulted to be T1, 135 (31%) T2,and 175 (40%) T3. Overall, stigmata of recent haernorrhage (SRH) were detected in 118 cases (27%). SRH occurred more frequently in Tt patients than in T2/T3 cases (85% vs 3.2%; x2 = 304.5309, P < 0.001). Older age (t = 3.311; P <0.01) and presence of comorbidities (x2 = 14.7458; P < 0.01) were more frequently detected in T1 than in T2/T3 patients.CONCLUSION: Our simplified clinical score appeared to be associated with the detection of endoscopic findings which may deserve urgent endoscopy. A further,randomised study is needed to assess its accuracy in safely scheduling endoscopy in UGIB patients.

  19. A two-hop wireless power transfer system with an efficiency-enhanced power receiver for motion-free capsule endoscopy inspection.

    Science.gov (United States)

    Sun, Tianjia; Xie, Xiang; Li, Guolin; Gu, Yingke; Deng, Yangdong; Wang, Zhihua

    2012-11-01

    This paper presents a wireless power transfer system for a motion-free capsule endoscopy inspection. Conventionally, a wireless power transmitter in a specifically designed jacket has to be connected to a strong power source with a long cable. To avoid the power cable and allow patients to walk freely in a room, this paper proposes a two-hop wireless power transfer system. First, power is transferred from a floor to a power relay in the patient's jacket via strong coupling. Next, power is delivered from the power relay to the capsule via loose coupling. Besides making patients much more conformable, the proposed techniques eliminate the sources of reliability issues arisen from the moving cable and connectors. In the capsule, it is critical to enhance the power conversion efficiency. This paper develops a switch-mode rectifier (rectifying efficiency of 93.6%) and a power combination circuit (enhances combining efficiency by 18%). Thanks to the two-hop transfer mechanism and the novel circuit techniques, this system is able to transfer an average power of 24 mW and a peak power of 90 mW from the floor to a 13 mm × 27 mm capsule over a distance of 1 m with the maximum dc-to-dc power efficiency of 3.04%.

  20. 胶囊内镜检查后上消化道大出血临床研究%The clinical research of upper gastrointestinal hemorrhage by Capsule endoscopy examination

    Institute of Scientific and Technical Information of China (English)

    温瑞芳

    2013-01-01

    Compared with conventional endoscopy,capsule endoscopy is painless,non-invasive,non-wire et al, and can objectively reflect the specific circumstances capsule endoscopy of the upper gastrointestinal diseases lesions occur what provide a certainclinical reference value for the diagnosis of gastrointestinal diseases. The patients with Capsule endoscopy applications had upper gastrointestinal bleeding occurs in the text. I study capsule endoscopy after gastrointestinal bleeding patients,so as to provide some guidance.%与传统胃镜检查相比,胶囊内镜具有无痛、无创、无导线等很多优点,且胶囊内镜能够对上消化道疾病发生病变的具体情况予以客观反映,为诊断上消化道疾病提供具一定价值的临床参考资料。但我院在胶囊内镜的应用中,出现了检查后患者发生上消化道大出血的现象,本文对其进行探讨,希望对临床上有所帮助。

  1. Feasibility of capsule endoscopy for direct imaging of drug delivery systems in the fasted upper-gastrointestinal tract

    DEFF Research Database (Denmark)

    Pedersen, Pernille Barbre; Bar-Shalom, Daniel; Baldursdottir, Stefania;

    2014-01-01

    PURPOSE: To develop a minimally-invasive method for direct visualization of drug delivery systems in the human stomach and to compare the obtained results with an established in vitro model. The method should provide the capsule rupture, dispersion characteristics, and knowledge regarding...... the surrounding physiological environment in the stomach. METHODS: A capsule endoscopic method was developed. The disintegration time, dispersion characteristics and the impact of the physiological environment on different lipid based delivery systems in different gelatin capsules in the fasted stomach of nine......-invasive capsule endoscopic method was developed for direct visualizing of drug delivery systems in the human stomach and maybe later, in the duodenum....

  2. Usefulness of capsule endoscopy in patients with suspected small bowel disease Utilidad de la cápsula endoscópica en pacientes con sospecha de patología de intestino delgado

    Directory of Open Access Journals (Sweden)

    A. Caunedo

    2004-01-01

    Full Text Available Aim: to study the usefulness and safety of capsule endoscopy as a diagnostic tool in various small bowel disorders. Design: a retrospective analysis of a series of cases. Material and methods: between August 2001 and August 2002, 92 capsule endoscopy procedures were performed in 88 patients (53M/39F, age: 43.87 ± 16.78. Indications included: chronic diarrhea (n = 33; unknown abdominal pain (n = 29; occult gastrointestinal bleeding or iron-deficiency anemia (n = 13; abdominal discomfort in NSAID takers (n = 7; staging of gastrointestinal tumors (n = 4, and asymptomatic controls (n = 2. Previously performed gastroscopy, colonoscopy, and small-bowel follow-through were not conclusive in all patients. Results: most frequently relevant findings included: jejuno-ileal apthas and ulcerations (29 patients, vascular malformations (13 patients, and intestinal neoplasm (6 patients. The groups with a higher rate of findings related to this indication were occult gastrointestinal bleeding (76.92% and chronic diarrhea (67.85%, with the lowest rate in the abdominal pain group (34.48%. Therapeutic strategy was directly changed in 36 of 88 patients (40.90% because of capsule-endoscopic findings. The only observed complication was the failed excretion of one of the capsules because of an unknown ulcerated intestinal stricture. Conclusions: capsule endoscopy is a safe procedure which can study the entire small bowel, meaning a valuable tool for the management of patients with suggestive signs and symptoms of intestinal disorders.Objetivo: estudiar la utilidad y seguridad de la cápsula endoscópica como prueba diagnóstica en distintas patologías de intestino delgado. Diseño: análisis retrospectivo de una serie de casos. Material y métodos: entre agosto de 2001 y agosto de 2002 se realizaron 92 cápsulo-endoscopias a 88 pacientes (53H/39M, edad: 43,87± 16,78. Las indicaciones fueron: diarrea crónica (n = 33; dolor abdominal no filiado (n = 29; hemorragia

  3. 胶囊内镜检查对小肠疾病的诊断价值%Value of Capsule Endoscopy in the Diagnosis of Intestinal Diseases

    Institute of Scientific and Technical Information of China (English)

    曹海滨; 黄继英; 高虹; 时宝忆

    2012-01-01

    目的:分析胶囊内镜在消化道疾病中的应用,探讨可能影响其检查结果的因素.方法:疑有消化道疾病但经胃镜、肠镜和腹部超声后均不能明确诊断的患者37例,按年龄分为2组,其中≥70岁为高龄组(20例).对37例患者进行胶囊内镜检查,并对可能影响胶囊内镜检查的因素如年龄、性别、腹部手术史、糖尿病史、是否服用非甾体类消炎药等做多因素回归分析.结果:37例患者经胶囊内镜检查后,明确诊断16例(43.2%);可疑诊断13例(35.1%);阴性病例8例(21.6%).总检出率为78.4%.胶囊内镜检出小肠克隆氏病1例,小肠腺癌1例,出血性空肠炎1例,升结肠癌1例,血管显露、血管发育不良26例,小肠炎症10例,小肠息肉11例.本研究中,高龄患者的食管内时间、胃内时间和小肠内时间较长,但2组差异无统计学意义;37例均无胶囊滞留体内,但有1例食管滞留和1例胃内滞留,且均发生在高龄组; 1例褐色肠液多影响观察,1例图像存在干扰影响观察.本研究有5例胶囊未进入结肠,视为未完成小肠检查,均发生在高龄患者中,2组差异具有统计学意义(t=-2.315,P=0.027),说明年龄对于小肠的检查有影响.多因素回归分析显示,腹部手术史、糖尿病史、服用非甾体类消炎药药物史等2组差异均无统计学意义.结论:对于怀疑小肠疾患而无检查禁忌的高龄患者,胶囊内镜可作为首选检查,因其具有安全、无痛苦、顺应性好等优点而易于被患者接受.但高龄患者的胃肠道活动减弱,食管和胃内滞留率增高,小肠通过时间延长,所以在胶囊内镜的检查过程中应加强监测,可予增加胃肠蠕动的药物.%Objective:To investigate the value of capsule endoscopy in intestinal diseases. Methods:A total of 37 patients suspected of digestive diseases, without clear diagnosis by gastroscopy, colonoscopy and abdominal ultrasound, were inspected by capsule endoscopy. Among the

  4. Virtual endoscopy in odontogenic sinus disease. Study technique and main pathological findings.

    Science.gov (United States)

    Fanucci, Ezio; Leporace, Mario; Di Costanzo, Giuseppe; Mannino, Michela; Simonetti, Giovanni

    2004-09-01

    The use of CT scans in dental pathology is an established technique. The potential applications of Dentascan are further enhanced by the use of virtual navigation software, resulting in endoscopy-like imaging of the maxillary sinus, thus optimising both the diagnostic and therapeutic approach to sinus pathology of dental origin. The aim of this paper is to illustrate the technical-methodological aspects of maxillary sinus virtual endoscopy with Dentascan software and to document the most important and frequent diseases.

  5. Capsule endoscopy in elderly patients with obscure small intestine bleeding%胶囊内镜在老年患者疑诊小肠出血性疾病的应用探讨(附18例分析)

    Institute of Scientific and Technical Information of China (English)

    李舒丹; 张啸; 张筱凤

    2011-01-01

    目的 评估胶囊内镜对老年患者疑诊小肠出血性疾病的诊断价值,并探讨老年患者行胶囊内镜检查相应注意事项.方法 对18例行胶囊内镜检查的疑诊小肠出血性疾病的老年患者的资料进行回顾性分析.结果 共纳入老年患者18例,成功17例,14例见小肠病变.其中,血管病变10例,小肠钩虫病1例,小肠淋巴管扩张症1例,小肠疑似占位2例.其中,3位患者胶囊内镜滞留于食管下段,1例失败,另2例用胃镜将其推入胃内,检查成功.所有患者胶囊均在检查后3d内自行排出体外.结论 胶囊内镜检查方法安全,对老年患者消化道出血的诊断,特别是考虑小肠出血性疾病的患者有很好的诊断价值,但由于老年患者自身的特殊性,易发生胶囊滞留于食管或胃腔等情况.%[Objective]To evaluate the diagnostic value of capsule endoscopy(CE)in elderly patients with obscure small intestine bleeding, and analyze the special announcements of capsule endoscopy in elderly patient population.[Methods]Included in the present study were 18 elderly patients with obscure small intestine bleeding referred to our hospital for CE.[Results]18 cases were referred to this study.Examinations were completed in 17 cases, 14 of which with various intestinal disorders.The most common findings were vascular lesions(10 cases), 1 case was found with ancylostomiasis of small intestine.1 case was found with intestinal lymphangiectasia.2 cases were found with small intestine neoformation.Among these cases, capsule retentions in inferior segment esophagus were happened in 3 cases.1 case failed.In other two cases, capsules were pushed to stomach with gastroscope.All capsules were excreted in 3 days.[Conclusion]CE is a safe and effective procedure for elderly patients with small intestine bleeding.But capsule retentions in esophagus and stomach are possibly easily happened in elderly patients.

  6. Virtual chromoendoscopy can be a useful software tool in capsule endoscopy La Cromoendoscopia virtual puede ser una herramienta de software útil en la cápsula endoscópica

    Directory of Open Access Journals (Sweden)

    Gabriela Duque

    2012-05-01

    Full Text Available Background: capsule endoscopy (CE has revolutionized the study of small bowel. One major drawback of this technique is that we cannot interfere with image acquisition process. Therefore, the development of new software tools that could modify the images and increase both detection and diagnosis of small-bowel lesions would be very useful. The Flexible Spectral Imaging Color Enhancement (FICE that allows for virtual chromoendoscopy is one of these software tools. Aims: to evaluate the reproducibility and diagnostic accuracy of the FICE system in CE. Methods: this prospective study involved 20 patients. First, four physicians interpreted 150 static FICE images and the overall agree-ment between them was determined using the Fleiss Kappa Test. Second, two experienced gastroenterologists, blinded to each other results, analyzed the complete 20 video streams. One interpreted conventional capsule videos and the other, the CE-FICE videos at setting 2. All findings were reported, regardless of their clinical value. Non-concordant findings between both interpretations were analyzed by a consensus panel of four gastroenterologists who reached a final result (positive or negative finding. Results: in the first arm of the study the overall concordance between the four gastroenterologists was substantial (0.650. In the second arm, the conventional mode identified 75 findings and the CE-FICE mode 95. The CE-FICE mode did not miss any lesions identified by the conventional mode and allowed the identification of a higher number of angiodysplasias (35 vs 32, and erosions (41 vs. 24. Conclusions: there is reproducibility for the interpretation of CE-FICE images between different observers experienced in conventional CE. The use of virtual chromoendoscopy in CE seems to increase its diagnostic accuracy by highlighting small bowel erosions and angiodysplasias that weren't identified by the conventional mode.

  7. Guideline for wireless capsule endoscopy in children and adolescents: a consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition) and the SEPD (Spanish Society for Digestive Diseases)

    OpenAIRE

    Federico Argüelles-Arias; Ester Donat; Ignacio Fernández-Urien; Fernando Alberca; Federico Argüelles-Martín; María José Martínez; Manuel Molina; Vicente Varea; Juan Manuel Herrerías-Gutiérrez; Carmen Ribes-Koninckx

    2015-01-01

    Introduction: Capsule endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. Material and methods: Some experts from the Spanish Society of Gastroenterology (SEPD) and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP) were invited to answer different issues about CE in children. These sections were: a) Indications, contraindications and limitations; b) efficacy of CE in different c...

  8. Guideline for wireless capsule endoscopy in children and adolescents: a consensus document by the SEGHNP (Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the SEPD (Spanish Society for Digestive Diseases

    Directory of Open Access Journals (Sweden)

    Federico Argüelles-Arias

    2015-12-01

    Full Text Available Introduction: Capsule endoscopy (CE in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. Material and methods: Some experts from the Spanish Society of Gastroenterology (SEPD and Spanish Society for Pediatric Gastroenterology, Hepatology, and Nutrition (SEGHNP were invited to answer different issues about CE in children. These sections were: a Indications, contraindications and limitations; b efficacy of CE in different clinical scenarios; c CE performance; d CE-related complications; e Patency capsule; and f colon capsule endoscopy. They reviewed relevant questions on each topic. Results: The main indication is Crohn's disease (CD. There is no contraindication for the age and in the event that the patient not to swallow it, it should be administered under deep sedation with endoscopy and specific device. The CE is useful in CD, for the management of OGIB in children and in Peutz-Jeghers syndrome (in this indication has the most effectiveness. The main complication is retention, which should be specially taken into account in cases of CD already diagnosed with malnutrition. A preparation regimen based on a low volume of polyethylene glycol (PEG the day before plus simethicone on the same day is the best one in terms of cleanliness although does not improve the results of the CE procedure. Conclusions: CE is safe and useful in children. Indications are similar to those of adults, the main one is CD to establish both a diagnosis and disease extension. Moreover, only few limitations are detected in children.

  9. 胶囊内镜在小肠疾病中的应用进展%Progress of Application of Capsule Endoscopy in Small Bowel Diseases

    Institute of Scientific and Technical Information of China (English)

    刘昆

    2011-01-01

    胶囊内镜(CE)技术发展迅速,已成为一线小肠无创检查技术之一,目前已广泛用于不明原因消化道出血(0GIB)、炎症性肠病、小肠肿瘤、乳糜泻和腹痛等的诊断,其与双气囊小肠镜(DBE)联合应用可提高小肠疾病的诊疗水平.本文就CE在小肠疾病中的应用进展作一综述.%Capsule endoscopy (CE) has evolved in recent years to be a first-line, noninvasive diagnostic technique for small bowel diseases, and has now been widely used in the diagnosis of obscure gastrointestinal bleeding (OGIB),inflammatory bowel disease, small bowel tumor, celiac disease and abdominal pain, etc. The combination of CE and double-balloon enteroscopy (DBE) could further enhance the diagnostic and therapeutic yield in small bowel diseases. This article reviewed the progress of application of CE in small bowel diseases.

  10. Dual-Level Security based Cyclic18 Steganographic Method and its Application for Secure Transmission of Keyframes during Wireless Capsule Endoscopy.

    Science.gov (United States)

    Muhammad, Khan; Sajjad, Muhammad; Baik, Sung Wook

    2016-05-01

    In this paper, the problem of secure transmission of sensitive contents over the public network Internet is addressed by proposing a novel data hiding method in encrypted images with dual-level security. The secret information is divided into three blocks using a specific pattern, followed by an encryption mechanism based on the three-level encryption algorithm (TLEA). The input image is scrambled using a secret key, and the encrypted sub-message blocks are then embedded in the scrambled image by cyclic18 least significant bit (LSB) substitution method, utilizing LSBs and intermediate LSB planes. Furthermore, the cover image and its planes are rotated at different angles using a secret key prior to embedding, deceiving the attacker during data extraction. The usage of message blocks division, TLEA, image scrambling, and the cyclic18 LSB method results in an advanced security system, maintaining the visual transparency of resultant images and increasing the security of embedded data. In addition, employing various secret keys for image scrambling, data encryption, and data hiding using the cyclic18 LSB method makes the data recovery comparatively more challenging for attackers. Experimental results not only validate the effectiveness of the proposed framework in terms of visual quality and security compared to other state-of-the-art methods, but also suggest its feasibility for secure transmission of diagnostically important keyframes to healthcare centers and gastroenterologists during wireless capsule endoscopy.

  11. New Evidence on the Impact of Antithrombotics in Patients Submitted to Small Bowel Capsule Endoscopy for the Evaluation of Obscure Gastrointestinal Bleeding

    Directory of Open Access Journals (Sweden)

    Pedro Boal Carvalho

    2014-01-01

    Full Text Available Objectives. Small bowel capsule endoscopy (SBCE plays a decisive role in the obscure gastrointestinal bleeding (OGIB diagnosis. Antithrombotics may increase bleeding risk in patients with preexistent lesions or through direct mucosal aggression. We aimed to correlate antithrombotics usage with lesions with bleeding potential found in SBCE. Methods. Retrospective single-center study including 274 consecutive SBCE performed over 7 years for OGIB. The lesions were classified as P0 (no bleeding potential, P1 (uncertain bleeding potential: erosions, and P2 (high bleeding potential: angioectasias, ulcers, and tumors. We assessed antiplatelet and anticoagulant drug use during the 60 days preceding SBCE. Results. One-third of the patients were under antithrombotic therapy. The diagnostic yield of SBCE for P2 lesions was 30.0%. Angioectasias (20.4% were the most frequently observed lesions. There was a significant correlation between anticoagulant drug use and a higher incidence of P2 lesions in the small bowel (43.2% versus 26.5%; OR = 2.11, P=0.026. We found no significant correlation between antiplatelets and lesions with bleeding potential in SBCE. Conclusions. Small bowel lesions with high bleeding potential were more frequently detected when the patient was on anticoagulant drugs, resulting in a twofold risk. Antiplatelet drugs were not associated with small bowel lesions.

  12. The role of small bowel endoscopy in small bowel Crohn's disease: when and how?

    Science.gov (United States)

    Kim, Mikang

    2016-01-01

    Endoscopy has a crucial role in the diagnosis, management, and surveillance of inflammatory bowel disease (IBD). It contributes in supporting the diagnosis of IBD with the clinical history, physical examination, laboratory findings, and targeted biopsies. Furthermore, endoscopy has a significant role in assessing disease activity and distribution in treatment efficacy evaluation, post-surgical recurrence risk, and cancer surveillance in patients with long-lasting illness. Endoscopy also provides therapeutic potential for the treatment of IBD, especially with stricture dilatation and treatment of bleeding. Small bowel (SB) endoscopy (capsule endoscopy and device-assisted enteroscopy) and cross-sectional radiologic imaging (computed tomography enterography and magnetic resonance enterography) have become important diagnostic options to diagnose and treat patients with SB Crohn's disease. We reviewed the present role of SB endoscopy in patients with SB Crohn's disease. PMID:27433142

  13. A meta-analysis of the yield of capsule endoscopy compared to double-balloon enteroscopy in patients with small bowel diseases

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To compare the diagnostic yield of capsule endoscopy(CE) with that of double-balloon enteroscopy (DBE).METHODS: Pubmed, Embase, Elsevier ScienceDirect,the China Academic Journals Full-text Database, and Cochrane Controlled Trials Register were searched for the trials comparing the yield of CE with that of DBE.Outcome measure was odds ratio (OR) of the yield. Fixed or random model method was used for data analysis.RESULTS: Eight studies (n = 277) which prospectively compared the yield of CE and DBE were collected. The results of meta-analysis indicated that there was no difference between the yield of CE and DBE [170/277 vs 156/277, OR 1.21 (95% CI: 0.64-2.29)]. Based on sub analysis, the yield of CE was significantly higher than that of double-balloon enteroscopy without combination of oral and anal insertion approaches [137/219 vs 110/219, OR 1.67 (95% CI: 1.14-2.44), P < 0.01), but not superior to the yield of DBE with combination of the two insertion approaches [26/48 vs 37/48, OR 0.33 (95% CI: 0.05-2.21), P > 0.05)]. A focused meta-analysis of the fully published articles concerning obscure GI bleeding was also performed and showed similar results wherein the yield of CE was significantly higher than that of DBE without combination of oral and anal insertion approaches [118/191 vs 96/191, fixed model: OR 1.61(95% CI: 1.07-2.43), P <0.05)] and the yield of CE was significantly lower than that of DBE by oral and anal combinatory approaches [11/24 vs 21/24, fixed model:OR 0.12 (95% CI: 0.03-0.52), P < 0.01)].CONCLUSION: With combination of oral and anal approaches, the yield of DBE might be at least as high as that of CE. Decisions made regarding the initial approach should depend on patient's physical status, technology availability, patient's preferences, and potential for therapeutic endoscopy.

  14. Low volume polyethylene glycol with ascorbic acid,sodium picosulfate-magnesium citrate,and clear liquid diet alone prior to small bowel capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Erin Rayner-Hartley; Majid Alsahafi; Paula Cramer; Nazira Chatur; Fergal Donnellan

    2016-01-01

    AIM:To compare low volume polyethylene glycol with ascorbic acid,sodium picosulfate-magnesium citrate and clear liquid diet alone as bowel preparation prior to small bowel capsule endoscopy(CE).METHODS:We retrospectively collected all CE studies done from December 2011 to July 2013 at a single institution.CE studies were reviewed only if low volume polyethylene glycol with ascorbic acid,sodium picosulfatemagnesium citrate or clear liquid diet alone used as the bowel preparation.The studies were then reviewed by the CE readers who were blinded to the preparation type.Cleanliness and bubble burden were graded independently within the proximal,middle and distal small bowel using a four-point scale according to the percentage of small bowel mucosa free of debris/bubbles:grade 1 = over 90%,grade 2 = between 90%-75%,grade 3 = between 50%-75%,grade 4 = less than 50%.Data are expressed as mean ± SEM.ANOVA and Fishers exact test were used where appropriate.P values < 0.05 were considered statistically significant.RESULTS:A of total of 123 CE studies were reviewed.Twenty-six studies were excluded from analysis because of incomplete small bowel examination.In the remainingstudies,48 patients took low volume polyethylene glycol with ascorbic acid,31 took sodium picosulfate-magnesium citrate and 27 took a clear liquid diet alone after lunch on the day before CE,followed by overnight fasting in all groups.There was no significant difference in small bowel cleanliness(1.98 ± 0.09 vs 1.84 ± 0.08 vs 1.76 ± 0.08) or small bowel transit time(213 ± 13 vs 248 ± 14 ± 225 ± 19 min) for clear liquid diet alone,Movi Prep and PicoSalax respectively.The bubble burden in the mid small bowel was significantly higher in the Movi Prep group(1.6 ± 0.1 vs 1.9 ± 0.1 vs 1.6 ± 0.1,P < 0.05).However this did not result in a significant difference in diagnosis of pathology.CONCLUSION:There was no significant difference in small bowel cleanliness or diagnostic yield of small bowel CE between

  15. 胶囊内镜检查失败原因分析和安全性评估%An analysis of failure and safety profiles of capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    卫炜; 戈之铮; 高云杰; 胡运彪; 萧树东

    2008-01-01

    目的 分析胶囊内镜(capsule endoscopy,CE)因技术和临床因素导致检查失败的原因及其对诊断的影响,评估其在特殊人群中使用的安全性.方法 回顾性分析2002年5月至2006年5月4年间在上海仁济医院因可疑小肠疾病接受CE检查的300例患者.技术问题为与仪器设备相关的问题,临床问题为与患者相关的问题.分析上述两类问题发生情况及对诊断的影响并评估CE检查在儿童组、高龄组、安置起搏器者、胃毕-Ⅱ式术后者、肠道憩室者、小肠克罗恩病者及小肠息肉病者中使用的安全性.结果 共出现4次技术问题(1.3%)(胶囊未被激活1例,胶囊内部电池电量<6 h2例,图像下载失败1例),其中2次影响到CE的诊断;临床问题共出现99次(33.0%)(正常电池电量维持时间内CE未达回盲部95次,吞咽胶囊失败4次),35次(35.4%)影响诊断结果.儿童组6例中胶囊吞咽不能发生3例,外套管下胃镜辅助送入法可成功解决此问题;高龄组13例中CE滞留于食管内3例(23.0%);2例安置心脏起搏器患者CE检查中未发现仪器间互相干扰;2例胃毕-Ⅱ式术后者未发生CE滞留;16例肠道憩室者中1例发生滞留;42例克罗恩病者5例发生CE滞留,但无一发生急性肠梗阻;5例息肉病者中无一例发生CE滞留及肠梗阻.结论 因CE自身技术因素导致检查失败者在临床应用中极少出现,所遇常见临床问题为正常电池电量维持时间内CE未达回盲部.CE对于小肠疾病而言是一项安全有效的检查方法.%objective To analyse the incidence of technical breakdown and clinical problem leading to the failure of capsule endoscopy examination and their influence on the diagnosis and to evaluate its feasibility and safety in special patient population.Methods A retrospective study of 300 consecutive patients referred to Renji Hospital for evaluation of suspected small bowel diseases between May 2002 and May 2006 was done.This included

  16. Double-balloon endoscopy and capsule endoscopy for small intestinal bleeding%双气囊内镜和胶囊内镜诊断小肠出血的临床评价

    Institute of Scientific and Technical Information of China (English)

    张以洋; 韩树堂; 周晓白; 肖君; 史伟

    2010-01-01

    目的 评价双气囊内镜和胶囊内镜对小肠出血的临床诊断价值.方法 比较双气囊内镜、胶囊内镜及全消化道造影对小肠出血病灶的总体检出率;通过自身对照,比较双气囊内镜和胶囊内镜对小肠出血诊断率;分析胶囊内镜对1次双气囊内镜检查明确诊断率的影响.结果 105例小肠出血患者中,双气囊内镜检出克罗恩病24例,腺癌15例,慢性非特异性炎症12例,不明原因小肠溃疡10例,小肠间质肿瘤8例,小肠息肉8例,小肠血管畸形出血6例,钩虫病5例,麦克尔憩室及多发憩室5例,小肠淋巴瘤3例,无明显异常9例,阳性率91.4%(96/105).其中40例进行胶囊内镜检查,病变检出率75.0%(30/40);75例患者全消化道造影检查,病变检出率33.3%(25/75).根据胶囊内镜结果1次双气囊内镜检查明确诊断率90.0%(36/40),而根据临床特征及消化道造影结果1次双气囊内镜检查明确诊断率69.2%(45/65).结论 小肠疾病的主要病因是小肠良性溃疡(包括克罗恩病)、肿瘤、慢性炎症,其次是息肉、血管畸形、寄生虫感染、麦克尔憩室及淋巴瘤等.双气囊内镜对小肠出血诊断率高于胶囊内镜,胶囊内镜能提高1次双气囊内镜明确诊断率.%Objective To study the diagnostic value of double-balloon endoscopy (DBE) and capsule endoscopy (CE) for small intestinal bleeding. Methods Overall detection rates of small intestinal bleeding with DBE, CE and the whole alimentary tract barium meal were compared. Positive rates of bleeding detection with DBE and CE were compared within the same patients. Influence of CE on one-procedure rate of DBE was analyzed. Results In 105 cases of small intestine bleeding, DBE detected 24 cases of Crohn's disease, 15 adenocarcinoma, 12 chronic nonspecific inflammation, 10 small intestinal ulcer of unknown reason, 8 entero-mesenchymoma, 8 polypus, 6 vascular deformation hemorrhage, 5 ancylostomiasis, 5 Mechel's diverticula ( including

  17. The Function of Capsule Endoscopy Combined with Colonoscopy in the Diagnosis of Irritable Bowel Syndrome%胶囊内镜联合结肠镜在诊断肠易激综合征的作用

    Institute of Scientific and Technical Information of China (English)

    包福元; 叶伟智; 周小戈; 卓宇宏

    2016-01-01

    目的::探讨胶囊内镜联合结肠镜检查在诊断肠易激综合征中的作用及意义。方法:回顾分析2013年2月~2014年2月在某院就诊的64例疑诊为肠易激综合征患者(且后续均进行胶囊内镜及结肠镜检查)。在临床基本资料提示基础上,对64例患者的胶囊内镜联合结肠镜的检查结果进行分析,评价其联合检查在诊断肠易激综合征中的意义。结果:64例疑诊为肠易激综合征患者经临床常规检查(腹部B超、胃镜、结肠镜),18.7%的患者存在结肠器质性病变,检出率为18.7%。64例疑诊为肠易激综合征患者联合二者检查结果,7例检查正常,1例结肠憩塞,2例结肠息肉,54例患者小肠异常合并溃疡性结肠炎5例,寄生虫2例,血管畸形2例,检出率89.1%。两种检查方法检出率比较,差异具有统计学意义(P<0.05)。结论:胶囊内镜联合结肠镜检查作为临床诊断 IBS排他性检查,可提高肠易激综合征临床确诊率。%Objective:To discuss the function and significance of capsule endoscopy combined with colonoscopy in the diagnosis of irritable bowel syndrome.Methods:Retrospective analyze 64 cases of patients suspected diagnosed with irritable bowel syndrome in a hospital from February 2013 to February 2014 (and followed with capsule endoscopy and colonoscopy).Based on the clinical basic information,the results of cap-sule endoscopy combined with colonoscopy examination were analyzed,and its significance in the diagnosis of irritable bowel syndrome was evaluated.Results:After clinical routine examination (abdominal type-B ultra-sonic,gastroscopy,colonoscopy),18.7% of patients had organic colon lesions,detection rate was 18.7%. After capsule endoscopy combined with colonoscopy examination,7 cases were normal,1 case was colon re-lease plug,2 cases were colon polyps,54 cases were small intestinal abnormalities,5 cases were combined with ulcerative colitis merger,2 cases had parasites ,2 cases had

  18. Oestrogen receptor-alpha and -beta expression in breast implant capsules: experimental findings and clinical correlates.

    Science.gov (United States)

    Persichetti, Paolo; Segreto, Francesco; Carotti, Simone; Marangi, Giovanni Francesco; Tosi, Daniele; Morini, Sergio

    2014-03-01

    Myofibroblasts provide a force to decrease the surface area of breast implant capsules as the collagen matrix matures. 17-β-Oestradiol promotes myofibroblast differentiation and contraction. The aim of the study was to investigate the expression of oestrogen receptors α and β in capsular tissue. The study enrolled 70 women (80 capsules) who underwent expander or implant removal, following breast reconstruction. Specimens were stained with haematoxylin/eosin, Masson trichrome and immunohistochemistry and immunofluorescence stainings for alpha-smooth muscle actin (α-SMA), oestrogen receptor-alpha (ER-α) and oestrogen receptor-beta (ER-β). The relationship between anti-oestrogenic therapy and capsular severity was evaluated. A retrospective analysis of 233 cases of breast reconstruction was conducted. Myofibroblasts expressed ER-α, ER-β or both. In the whole sample, α-SMA score positively correlated with ER-α (p = 0.022) and ER-β expression (p < 0.004). ER-β expression negatively correlated with capsular thickness (p < 0.019). In capsules surrounding expanders α-SMA and ER-α, expressions negatively correlated with time from implantation (p = 0.002 and p = 0.016, respectively). The incidence of grade III-IV contracture was higher in patients who did not have anti-oestrogenic therapy (p < 0.036); retrospective analysis of 233 cases confirmed this finding (p < 0.0001). This study demonstrates the expression of oestrogen receptors in myofibroblasts of capsular tissue. A lower contracture severity was found in patients who underwent anti-oestrogenic therapy.

  19. Report on 17 Cases of Small Intestine Heavy ancylostomiasis Diagnosed by Capsule Endoscopy%胶囊内镜诊断小肠重度钩虫感染的临床价值

    Institute of Scientific and Technical Information of China (English)

    甘涛; 朱林林; 杨丽

    2015-01-01

    目的:探讨胶囊内镜对小肠重度钩虫病的检查指征及诊断价值。方法回顾分析四川大学华西医院2006年6月-2013年10月通过胶囊内镜诊断的17例小肠钩虫重度感染患者,进行统计学分析。结果17例患者都有反复消化道出血和中重度贫血,粪检3例虫卵阳性,3例嗜酸粒细胞百分比增高。所有患者均经胶囊内镜明确诊断为重度钩虫感染,镜下可见多条白色透明或暗红色线状寄生虫广泛分布于小肠肠腔内,以空肠段为主,部分钩虫聚集成团,多条虫体头端钩附与小肠粘膜,造成黏膜广泛损伤、糜烂和出血。结论尽管胶囊内镜是诊断小肠钩虫病的的最佳检查手段,但因检查费用高昂,应严格掌握检查指征。%Objective To appraise the diagnostic value and examination indication of capsule endoscopy for small in-testine heavy ancylostomiasis.Methods A retrospective study was carried out to analyze the clinical data and image from capsule endoscope in 17 patients with small intestine heavy ancylostomiasis in the hospital from June 2006 to Oc-tober 2013.Results All patients were diagnosed by capsule endoscopy.Of these patients,all manifested as recurrent gastrointestinal bleeding,had heavy iron deficiency anemia.Hookworm eggs were found in stool specimens of 3 cases, only 3 cases showed peripheral eosinophilia.The hookworms were hoar or kermesinus,and about 5-10 mm in length, mainly located in jejunum.Some gathered into a mass and hooked the intestinal wall,caused erosion and injury of intes-tinal mucosa.Conclusion Though capsule endoscopy is the best diagnostic technique for intestinal ancylostomiasis,the indication should be strictly controlled due to the expensive fees.

  20. 胶囊内镜在不明原因消化道出血疾病诊断中的应用%Application of capsule endoscopy to diagnosis of unclear alimentary tract hemorrhage diseases

    Institute of Scientific and Technical Information of China (English)

    胡莉琼; 徐辉

    2012-01-01

    目的 探讨胶囊内镜在不明原因消化道出血中的诊断价值.方法 对2008年8月~2011年2月64例不明原因消化道出血患者行胶囊内镜检查结果回顾性分析,评价其疾病诊断率和安全性、全小肠检查完成率及图像质量.结果 64例受检查患者中,成功完成胶囊内镜检查63例,1例因幽门溃疡、梗阻,内镜下送胶囊入十二指肠失败.胶囊在1~4 d内自然排出,胃内通过时间2~349 min,平均56 min;小肠内检查时间35~497 min,平均295 min.患者全小肠检查完成率为74.6%(47/63).63例患者中,有52例检出病变,阳性率达82.5%(52/63).所得图像较清晰.结论 胶囊内镜安全性好,患者痛苦少,在不明原因消化道出血疾病诊断中有较好的诊断价值.%Objective To discuss the value of capsule endoscopy in the diagnosis of unclear gastrointestinal bleeding. Methods A retrospective analysis of examination results was made among 64 case of unclear gastrointestinal bleeding who underwent capsule endoscopy from August 2008 to February 2011. The diagnosis rate of disease, safety,the completion rate of whole small intestine examination and image quality were evaluated. Results Among the 64 patients,63 ones successfully completed the examination by capsule endoscopy. The capsule was failed to be sent to duodenum in 1 case because of pylonc ulcer and obstruction. The capsule was naturally excreted within 1 - 4 d. The transit time within the stomach was 2 - 349 min, and the average time was 56 min. The examination time within the small intestine was 35 - 497 min with the average time of 295 min. The completion rate of whole small intestine examination was 74. 6%( 47/63 ). Among the 63 cases,pathological changes were detected in 52 ones with the positive rate of 82. 5%( 52/63 ),and the obtained images were quite clear. Conclusion Capsule endoscopy has a great value in the diagnosis of unclear gastrointestinal bleeding with good safety and less pain for patients.

  1. Upper Endoscopy

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  2. Present status of endoscopy, therapeutic endoscopy and the endoscopy training system in Indonesia.

    Science.gov (United States)

    Makmun, Dadang

    2014-04-01

    Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85000 general practitioners and 25000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health-care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3-6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures.

  3. 国产OMOM胶囊内镜对不同小肠疾病应用评价%Evaluation of capsule endoscopy for different diagnosis of small bowel disease

    Institute of Scientific and Technical Information of China (English)

    张文兴; 黄湘俊

    2013-01-01

    [Objective] To explore the diagnostic value and the safety of capsule endoscopy different diagnosis of small bowel disease.[Methods] 115 cases accepted capsule endoscopy examination.There were 65 cases of obscure gastrointestinal bleeding (OGIB),30 cases of chronic abdominal pain,25 cases of chronic diarrhea,35cases chronic abdominal pain associated with diarrhea,gastric and small bowel transit time,complication,detection rate and diagnostic yield were valuated.[Results] 155 patients had no discomfortable feeling and complication during the examination,achievement ratio was 96.77%.The capsule endoscopy remained in the stomach for an average of (55.6±44.2) min.The mean transit time in the small bowel was (261.5±91.3) min.The mean time to reach the cecum was (384±24.2) min,the detection rate and diagnostic yield of the OGIB group were (86.15% and 63.07%),the Chronic abdominal pain group (60% and 43.3%),the chronic diarrhea group (52% and 40%),chronic abdominal pain was associated with diarrhea group (65.7% and 51.4%).The detection rate and diagnostic yield of the OGIB group were significantly higher than the first three (P <0.05).[Conclusions] The of OMOM capsule endoscopy is safe and convenient,with high detection rate and diagnostic yield,especially OGIB.%目的 探讨OMOM胶囊内镜对不同小肠疾病诊断的诊断价值及安全性.方法 155例患者进行胶囊内镜检查,其中不明原因消化道出血(OGIB)65例,慢性腹痛30例,慢性腹泻25例,慢性腹痛伴腹泻35例,观察运行时间、并发症、病变检出率及病变诊断率.结果 155例患者检查中无不适及明显并发症,检查成功率96.77%,胶囊内镜在胃内运行时间平均为(55.6±44.2)min,在小肠内运行时间平均为(261.5±91.3)min,到达盲肠时间平均为(384±24.2)min.OGIB组病变检出率86.15%,病变诊断率为63.07%.慢性腹痛组病变检出率为60%,病变诊断率为43.3%.慢性腹泻病组变检出率为52

  4. Value of Capsule Endoscopy in Diagnosing Obscure Gastrointestinal Bleeding%国产胶囊内镜对不明原因消化道出血的诊断价值

    Institute of Scientific and Technical Information of China (English)

    王云; 易小敏; 王毅; 莫乐君

    2011-01-01

    目的 分析评价国产胶囊内镜对不明原因消化道出血的诊断价值.方法 对13例曾进行胃镜及结肠镜检查未能明确诊断的不明原因消化道出血患者的胶囊内镜检查结果进行统计分析.结果 13例患者进行了14次胶囊内镜检查,除1例患者外,其他12例患者成功检查13次,成功率为92.86%(13/14),无穿孔、过敏等不良反应发生.11例检出病变,检出率为91.67%(11/l2),其中小肠多发性溃疡4例,小肠多发性糜烂伴蛔虫及钩虫感染1例,小肠紫癜1例,小肠多发性憩室伴蛔虫感染1例,小肠糜烂2例,小肠黏膜呈节段性炎症性、增生性改变2例;1例未发现异常.结论 胶囊内镜检查因其安全、患者无痛苦、检查阳性率高,可作为不明原因消化道出血的首选检查手段.%Objective To assess the value of capsule endoscope (made in china) in the diagnosis of obscure gastrointestinal bleeding.Methods The capsule endoscopy was performed in 13 patients with obscure gastrointestinal bleeding that the pathogeny was not found by gastroscopy and intestinal endoscopy.Results In all 14 times of capsule endoscopy, 13 times of examinations in 12 patients were successful(92.86% ) and no complications such as perforation and allergy occurred.The total detection rate of pathological changes was 91.67% (11/12 ).There were 4 cases with small intestinal multiple ulcers; 1 case with small intestinal multiple erosion,ancylostomiasis and ascariasis; 1 case with small intestinal purpura;l case with small intestinal multiple diverticulums and ascariasis ;2 cases with small intestinal erosion ,2 cases with small intestinal segmental inflammation and hyperplasia.One case was normal.Conclusion Capsule endoscopy has the advantage of higher safety,freedom of injury and higher diagnosis rate, and can be recommended as the primary diagnosis method for the obscure gastrointestinal bleeding.

  5. Obscure gastrointestinal bleeding: a complication of radiation enteritis diagnosed by wireless capsule endoscopy Hemorragia digestiva de origen oscuro secundaria a enteritis actínica: diagnóstico por cápsula endoscópica

    Directory of Open Access Journals (Sweden)

    D. Martínez Ares

    2004-02-01

    Full Text Available Obscure gastrointestinal bleeding is a common disorder and may account for as many as 5% of all gastrointestinal hemorrhages. It is often caused by lesions in the small intestine, which were very complicated to examine prior to the advent of wireless capsule endoscopy. Here we present the case of a 31-year-old woman with obscure gastrointestinal bleeding as a complication of radiation enteritis, which was diagnosed only after she underwent an examination with wireless capsule endoscopy. This technique has proven to be far superior to other radiographic and endoscopic methods in diagnosing obscure gastrointestinal bleeding and pathologies of the small intestine in general.La hemorragia digestiva de origen oscuro es una entidad frecuente pudiendo representar hasta un 5% del total de las hemorragias digestivas. Su origen se encuentra en muchas ocasiones en lesiones en el intestino delgado, cuya exploración era muy complicada antes de la aparición de la cápsula endoscópica. Presentamos el caso de una mujer de 31 años con una hemorragia digestiva de origen oscuro secundaria a una enteritis actínica que sólo pudo ser diagnosticada tras ser sometida a la exploración con cápsula endoscópica. Esta técnica se ha mostrado claramente superior a las otras técnicas radiológicas y endoscópicas en el diagnóstico de las hemorragias digestivas de origen oscuro y la patología del intestino delgado en general.

  6. The diagnotic significance of the capsule endoscopy for intractable gastrointestinal hemorrhage in the elderly%胶囊内镜对老年人不明原因消化道出血的诊断价值

    Institute of Scientific and Technical Information of China (English)

    言红健; 鲁素彩; 田自力; 王阳阳

    2013-01-01

      目的总结和探讨胶囊内镜对老年人不明原因消化道出血的应用价值和体会。方法2008年6月至2012年10月对不明原因消化道出血老年患者胶囊内镜检查32例,男性26例,女性6例,年龄60~83岁,平均65.2岁。表现为反复血便、黑便、粪便反复潜血试验阳性和程度不等的贫血,均经胃镜、结肠镜检查无阳性发现。所有患者都在出血停止1~2周之间进行胶囊内镜检查。检查前服用聚乙二醇电解质散清洁肠道,吞服胶囊时间为8:00-11:00。结果除1例未完成胶囊内镜吞服外,胶囊通过幽门时间120 min 6例,其中5例应用胃复安10 mg,肌肉注射,通过幽门,1例内镜协助胶囊通过幽门。胶囊排出时间多为1~4 d。小肠检查完成29例(90.62%)。阳性发现26例,其中小肠糜烂、溃疡性病变13例(50.00%),小肠息肉样病变6例(23.07%),小肠血管发育不良(血管显露,血管畸形)5例(19.23%),小肠肿瘤2例(7.69%)。小肠病变检出总阳性率81.25%,阴性5例。并发症只有梨状窝胶囊嵌顿1例。结论胶囊内镜检查对老年人不明原因消化道出血安全、方便、依从性好、并发症发生率低,对小肠病变诊断率高,只要掌握好适应症,选择好检查时机,是非常有意义的。%  Objective To assess the value and summarize the expierence and the diagnotic significance of the capsule endoscopy for intractable gastrointestinal hemorrhage in the elderly. Methods From June 2008 to October 2012, 26 male and 6 female patients aged 60-83 years old were examined with capsule endoscopy in our hospital. Among these patients with an average of 65.2 years, 17 persons were in age from 60 to 70 years, 10 persons from 70 to 80 years, and the age of 5 persons beyonds 80 years. All of them were found to have bloody stool, melena or positive occult blood test and anemia in varying degrees. However, we obtained

  7. Report on 55 Cases of Small Intestine Hookworm Disease Diagnosed by Capsule Endoscopy%胶囊内镜诊断小肠钩虫感染55例报告

    Institute of Scientific and Technical Information of China (English)

    王璞; 李荣智; 黄志寅; 唐承薇

    2013-01-01

    Objective To demonstrate the diagnostic value of capsule endoscopy for small intestine hookworm disease. Methods A retrospective study was carried out to analyze the clinical data and capsule endoscope image of 55 patients with small intestine hookworm disease in the hospital from June 2006 to June 2012. Results Among these patients, 40 cases manifested as gastrointestinal bleeding, 7 had iron deficiency anemia, 6 had chronic abdominal pain, and 2 showed abdominal distension or discomfort. Hookworm eggs were found in stool specimens of 2 cases, 6 cases showed peripheral eosinophilia, 46 cases were found to be fecal occult blood positive. Out of the 55 cases investigated, 44 showed anemia (11 severe, 26 moderate, and 7 mild). All patients were definitely diagnosed by capsule endoscopy. The hookworms were translucent and about 5-10 mm in length. Hookworms in most cases were diffusely distributed, but 12 patients suffered massive and severe hookworm infection. In most cases, hookworms were found in the proximal small intestine, and 6 in the distal intestine. Erosion and injury in intestinal mucosa around the hookworm were observed in several cases. Conclusion Capsule endoscopy is an effective and safe diagnostic technique for hookworm disease in small intestine.%目的 探讨胶囊内镜对小肠钩虫病的诊断价值.方法 回顾性分析四川大学华西医院2006年6月-2012年6月收治的55例经胶囊内镜确诊的小肠钩虫病患者的临床资料和胶囊内镜图像,进行统计学分析.结果 55例患者中消化道出血者40例,不明原因缺铁性贫血者7例,慢性腹痛者6例,腹胀不适等症状者2例;2例粪便虫卵阳性,6例嗜酸粒细胞百分比增高;46例大便隐血阳性;44例贫血,其中重度贫血11例,中度贫血26例,轻度贫血7例.所有患者均经胶囊内镜明确诊断为钩虫感染,镜下可见虫体半透明,吸血后充血呈红色线状,长度约5~10 mm.多数为散发寄生,12例钩虫聚集成团.

  8. 胶囊内镜在小肠疾病诊断中的临床应用体会%The Experience of Using Capsule Endoscopy in Diagnosis of Small Bowel Diseases

    Institute of Scientific and Technical Information of China (English)

    江凤翔; 杨蒲芳; 陈范嵘; 朱春燕; 朱健焕

    2014-01-01

    Objective:To evaluate the diagnostic value,security and patients’ tolerance of capsule endoscopy in the diagnosis of small bowel disease process.Method:From may 2010 to now,gastroendoscopy and colonoscopy examination negative patients who were suspected with small bowel diseases accept capsule endoscopy examination,in them 16 patients with obscure gastrointestinal bleeding.Result:20 patients were positive with lesions,including 11 with intestinal vascular malformation,1 with Peutz-Jeghers syndrome,3 with Crohn’s disease,1 with NASID related ulcers,2 with intestinal local uplift lesions, 2 with small intestinal villus atrophy.7 patients were negative.2 patients were not successful to complete examination.The average time of capsule kept staying in stomach was 65 min(11 s-420 min).The average time capsule went through the small intestine was 312 min(171-453 min),the average time capsule reached the cecum was 371 min(210-476 min),the average whole time was 446 min(390-620 min),the average time doctor reading medical image was 96 min(60-120 min), the mean photos number was 58 193,the average time capsule excreted out was 46 h(24-120 h).The good image quality was obtained.In the whole process,the tolerance of patients was good,no pain,swallowing capsules without any difficulty,no serious complication occurred during examination.Conclusion:Authough capsule endoscopy has some shortcomings such as pathological tissues can not be got,because of its high safety,no pain,it still has its unique advantages in diagnosis of small intestinal diseases,especially in obscure gastrointestinal bleeding.%目的:评价胶囊内镜在小肠疾病诊断过程中的诊断价值、安全性、耐受性。方法:自2011年5月至今,笔者所在科应用OMOM胶囊内镜对胃镜肠镜检查阴性的疑似小肠病变患者进行胶囊内镜检查,其中包括不明原因的消化道出血16例。结果:发现病灶者20例,所见病变其中包括小肠血管畸形11例,

  9. Temporal evolution of multidetector CT findings after endoscopic submucosal dissection in patients with early gastric cancer: Correlation with endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Yeo, Dong Myung, E-mail: duehdaud@gmail.com [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Chung, Dong Jin, E-mail: bookdoo7@catholic.ac.kr [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Cheung, Dae Young, E-mail: adagio@catholic.ac.kr [Department of Internal Medicine, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of); Lee, Jae Mun, E-mail: jaemun@catholic.ac.kr [Department of Radiology, Yeouido St. Mary' s Hospital, The Catholic University of Korea (Korea, Republic of)

    2014-06-15

    by 2D CT images (223 days versus 99 days). Three-dimensional imaging features revealed ulcer, ulcer mound, and fold convergence. Ulcer mounds disappeared first (median, 12.5 days; range, 2–14 days after ESD), ulcers appeared up to 4 months after ESD (median, 14 days; range, 2–174 days after ESD) and fold convergence continued to the end of the study (median, 74 days; range, 2–223 days after ESD). We found that sensitivity, specificity, and overall accuracy of 3D CTG were 70.0%, 92.9%, 83.3% for ulcer, 28.6%, 100%, 71.4% for ulcer mound, and 71.4%, 100%, 75% for fold convergence regarding endoscopy, respectively. Conclusion: On follow-up 2D or 3D CT images after ESD, early findings were of perigastric fat infiltration, ulcer, and surrounding oedema. Focal wall thickening and fold convergence continued to be observed late in the study. The overlying enhancing layer did not show temporal evolution.

  10. Upper Endoscopy

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  11. Upper Endoscopy

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  12. Upper Endoscopy

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  14. Upper Endoscopy

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  15. Report on 16 Cases of Small Intestine Ascariasis Diagnosed by Capsule Endoscopy%胶囊内镜诊断小肠蛔虫感染16例报告

    Institute of Scientific and Technical Information of China (English)

    王璞; 李荣智; 黄志寅; 唐承薇

    2013-01-01

    The clinical data and capsule endoscopy image of 16 adult patients with small intestine ascariasis were reviewed and analyzed retrospectively from June 2006 to June 2012 in West China Hospital.Among the 16 patients,15 cases manifested as gastrointestinal bleeding,15 cases showed anemia (3 severe,10 moderate,and 2 mild),2 had hypoalbuminemia,1 had peripheral blood eosinophilia.All the cases were found to be fecal occult blood positive,but no Ascaris eggs found in the feces.Capsule endoscopy showed they were infected with Ascaris worms.The worms were found in the proximal small intestine in 14 patients and 2 in the distal intestine.Mucosal erythema and erosions around the worm were observed in 3 cases,and 7 cases were found with active bleeding or old haemorrhage in small intestine.%回顾性分析四川大学华西医院2006年6月至2012年6月共16例经胶囊内镜确诊的成人小肠蛔虫病患者的临床资料和胶囊内镜图像.16例粪检均未查见虫卵,其中消化道出血15例,贫血15例(重度3例、中度10例和轻度2例),低白蛋白血症2例,外周血嗜酸粒细胞增高1例,粪隐血阳性16例.经胶囊内镜检查均为蛔虫感染,其中14例虫体位于上段小肠,2例位于下段小肠.3例观察到虫体周围小肠黏膜充血红斑和糜烂灶,7例观察到小肠腔内有活动性渗血或陈旧性出血.

  16. 多层螺旋 CT 口服小肠造影与胶囊内镜对不明原因腹痛患者诊断价值的对比研究%Comparison of diagnostic value of multi-slice computer tomography enterography versus capsule endoscopy for unexplained abdominal pain

    Institute of Scientific and Technical Information of China (English)

    梁晓燕; 伦伟健; 黄鹤; 贾柳萍

    2016-01-01

    Objective To compare and evaluate the diagnositic value of multi-slice computer tomography enterography (MSCTE)versus capsule endoscopy for patients with unexplained abdominal pain.Methods twenty-nine cases of unknown abdominal pain were collected.8 cases of 29 cases received MSCTE examination,24 cases received the capsule endoscopy and 3 cases received both of the examinations.Results The detection rate for lesions was 62.5% by MSCTE and 75.0% by capsule endoscopy.There was no statistical difference between the two methods(P >0.05).The detection rate in cases undergoing both examinations was 1 00%. Conclusions MSCTE and capsule endoscopy have high diagnostic value in patients with unexplained abdominal pain.The detection rate can be increased if the two methods are combined to conduct examination.%目的:对比多层螺旋 CT 口服小肠造影(MSCTE)与胶囊内镜对不明原因腹痛患者的诊断价值。方法收集29例不明原因腹痛患者,其中 MSCTE 检查8例,胶囊内镜检查24例,同时接受两种方法检查3例。结果 MSCTE 病变检出率为62.5%,胶囊内镜为75.0%,两者差别无统计学意义(P >0.05),联合两者病变检出率为100%。结论 MSCTE 与胶囊内镜检查对不明原因腹痛患者具有较高的诊断价值,二者联合诊断意义更高。

  17. Magnifying endoscopy with narrow-band imaging findings in the diagnosis of Barrett's esophageal adenocarcinoma spreading below squamous epithelium.

    Science.gov (United States)

    Omae, Masami; Fujisaki, Junko; Shimizu, Tomoki; Igarashi, Masahiro; Yamamoto, Noriko

    2013-05-01

    It has been described that most cases of Barrett's esophageal adenocarcinoma in Japan are cases of Barrett's esophageal adenocarcinoma on a background of short-segment Barrett's esophagus, frequently occurring rostrad to Barrett's epithelium, adjacent to the squamous epithelium of the right wall of the esophagogastric junction. Barrett's esophageal adenocarcinoma may spread below the squamous epithelium when the tumor is situated adjacent to the squamocolumnar junction, so that it is usually difficult to diagnose its presence and extent by conventional endoscopy alone. We have noted that the spread of Barrett's esophageal adenocarcinoma below the squamous epithelium is recognizable as annular vascular formations (AVF) by magnifying endoscopy with narrow-band imaging (ME-NBI), and have verified it by 3-D stereo-reconstruction using serial sections from a specimen of the same lesion. When horizontal cross-sections of the tissue were viewed from the surface, AVF emerged at a depth of approximately 100 μm from the surface and disappeared at a depth of approximately 300 μm. Therefore, it would be presumed to be difficult to visualize the characteristic structural features by ME-NBI if the carcinomatous glandular ducts were situated deeper than approximately 300 μm underneath a thick layer of squamous epithelium. Thickness of the overlying squamous epithelium may be a limiting factor for whether or not the characteristic structural features can be detected.

  18. Upper Endoscopy

    Medline Plus

    Full Text Available ... Document Link: The role of endoscopy in dyspepsia http://dx.doi.org/10.1016/j.gie.2015.04.003 Document Link: Quality indicators for EGD http://dx.doi.org/10.1016/j.gie.2014. ...

  19. A Magnetic Sensing and Inclination Sensing System for Wirelessly Tracking Capsule Endoscopy%胶囊内窥镜倾角传感式磁跟踪系统的设计

    Institute of Scientific and Technical Information of China (English)

    郭旭东; 翟刚; 葛斌; 严荣国

    2014-01-01

    In order to further improve the tracking precision and real time performance, a novel tracking method using inclination sensing and magnetic sensing was investigated to non-invasively track a capsule endoscopy in the gastrointestinal tract. First,the principle of angle measurement employing an inclination sensor was analyzed and a rotation angle for tracking is deduced. The prototype of the tracking system was developed based on the tracking principle. The tracking experiment shows that the mean errors of the two rotation angles are 4. 2° and 4. 5°, respectively. The standard deviations of the two rotation angles are 2. 2° and 2. 4°,respectively. The mean errors of x,y and z components are 0. 011 3 m,0. 012 1 m,0. 010 4 m,respectively. The standard deviations of x,y and z components are 0. 008 2 m,0. 007 5 m,0. 006 8 m,respectively. Since the angle was acquired by the inclination sensor,the number of the excitation coils can be reduced. For each position and orientation of the capsule endoscopy,the amount of data and the sampling time decreases. As the unknowns decreases in the tracking nonlinear equations,the tracking precision is improved.%为了提高胶囊内窥镜的跟踪精度,增强实时性,提出了倾角传感与磁场传感相结合的无线跟踪方法。推导了倾角传感模块在跟踪系统中的角度测量原理,基于坐标旋转和空间磁场理论,建立了倾角传感式磁跟踪数学模型,获得了胶囊方位与磁场信号的数学关系式。根据倾角传感的磁跟踪方案,设计开发了系统样机,包括:磁场发生装置、倾角式无线磁传感模块、无线数据接收装置、数据处理平台。跟踪实验表明,角度跟踪平均误差为4.2°、4.5°,标准偏差为2.2°、2.4°;x分量、y分量、z分量的平均位置误差为0.0113 m、0.0121 m、0.0104 m,标准偏差为0.0082 m、0.0075 m、0.0068 m。倾角传感器的引入减少了励磁源的个数,减小了每轮跟踪的采样数据量和采

  20. Fecal calprotectin as a biomarker of inflammatory lesions of the small bowel seen by videocapsule endoscopy

    Directory of Open Access Journals (Sweden)

    Juan Egea-Valenzuela

    2015-04-01

    Full Text Available Introduction: The levels of calprotectin in the stools are proportional to neutrophil activity in the enteric lumen, so fecal calprotectin is a useful intestinal inflammatory biomarker. It is an extended tool as predictor of colonic pathology but there is scare evidence about its utility in the small bowel. Objective: To test the yield of fecal calprotectin to detect lesions in the small bowel. Material and methods: We have retrospectively included 71 patients sent for small bowel capsule endoscopy in study for suspected inflammatory bowel disease. All of them had a determination of fecal calprotectin and had been sent to colonoscopy with no findings. Patients have been divided in groups: A, fecal calprotectin 100 µg/g, and we have analyzed which of them presented inflammatory lesions in capsule endoscopy studies. Results: The rate of patients with signi ficative lesions was 1 out of 10 (10% in group A, 6 out of 24 (25% in group B, and 21 out of 34 (62% in group C. If we consider levels over 50 µg/g pathologic, fecal calprotectin presents sensitivity: 96%, specificity: 23%, NPV: 90% and PPV: 56%. If we consider levels over 100 µg/g pathologic these values are sensitivity: 75%, specificity: 67%, NPV: 79% and PPV: 62%. Conclusions: Fecal calprotectin has high sensitivity but not so good specificity for predicting small bowel lesions after a normal colonoscopy. In daily practice it will be more useful to establish in 100 µg/g the limit to indicate capsule endoscopy studies.

  1. Diagnostic value of capsule endoscopy combined with computed tomography enterography for small intestinal diseases%胶囊内镜联合小肠CT造影在小肠疾病中的诊断价值

    Institute of Scientific and Technical Information of China (English)

    刘雁冰; 孙燕; 蔡玲燕; 袁琼英; 刘菲

    2016-01-01

    目的:评估胶囊内镜(capsule endoscopy,CE)联合小肠CT造影(computed tomography enterography,CTE)对小肠疾病的诊断价值.方法:回顾分析114例疑似小肠疾病的患者,在间隔2-7 d内先后行CE及小肠CTE检查,参照最终诊断结果(病理诊断或后续随访结果),比较这两种检查方法发现小肠疾病的阳性率,以及二者联合对小肠疾病诊断准确性的影响.结果:114例患者中,不明原因消化道出血35例,不明原因腹痛(伴或不伴大便习惯改变)32例,疑诊克罗恩病29例,不明原因消瘦18例.CE和CTE对不明原因消化道出血的诊断阳性率分别为51.4%和40.0%,二者相比有统计学意义(P<0.05),二者联合诊断阳性率为57.1%.CE和CTE对不明原因腹痛患者的病变检出率差异不大(46.9% vs 40.6%,P>0.05),二者联合诊断的阳性率为59.3%,较单独CE和CTE诊断率更高(P<0.05).对疑诊克罗恩病患者,CE能更多地发现小肠病变,诊断阳性率高于CTE(86.2% vs 65.5%,P<0.05),联合二者检查,诊断阳性率提高到93.1%,与CTE相较有显著差异.结论:CE和CTE对疑似小肠疾病患者都有较好的诊断价值,但CE对不明原因消化道出血、疑似克罗恩病的诊断价值高于CTE,二者联合意义更大.

  2. Wireless capsule endoscopy video classification using an unsupervised learning approach%无监督学习的无线胶囊内诊镜视频分类方法

    Institute of Scientific and Technical Information of China (English)

    冯文刚; 高隽; Bill P.Buckles; 吴克伟

    2011-01-01

    Since Wireless Capsule Endoscopy ( WCE) is a novel technology for recording the videos of the digestive tract of a patient,the problem of segmenting the WCE videos of the digestive tract into sub-images corresponding to the mouth,stomach, small intestine and large intestine regions is not well addressed in the literature. A few papers addressing this problem use a supervised learning approach that presumes availability of a large database of correctly labeled training samples. Considering the difficulties in procuring sizable WCE training data sets needed for achieving high classification accuracy,we introduce an unsupervised learning approach that employs Scale invariant feature transform (SIFT) with color information for extraction of local features and uses probabilistic latent semantic analysis (pLSA) model for data semantic analysis. Our results indicate that this method compares well in classification accuracy with the state-of-the-art supervised classification approach to WCE image classification.%近年来在对病人的消化道系统检查中,无线胶囊内诊镜(WCE)是一种最新技术,可以让医生直接观察到病人的病灶所在,但是对于消化道系统中的口腔、胃、小肠和大肠的WCE视频分类却是难点所在.相关研究中均采用通过人工标记的训练库的有监督学习方法.为了在WCE训练数据中获得高识别率,提出一种无监督学习方法,它利用融合颜色信息的尺度不变特征转换( SIFT)获取局部特征,再利用概率隐语义分析模型(pLSA)数据训练中进行语义内容分析.实验结果表明,在WCE图像分类中本方法与当前最新的监督分类方法一样可以获得高准确率.

  3. 胶囊内镜与CT小肠造影在不明原因消化道出血中的诊断价值%Diagnostic value of capsule endoscopy and CT enteroclysis in obscure gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    王培学; 张怡; 马晶晶; 张红杰

    2016-01-01

    目的 探讨胶囊内镜(capsule endoscopy,CE)及CT小肠造影(computed tomography enteroclysis,CTE)在不明原因消化道出血(obscure gastrointestinal bleeding,OGIB)中的诊断价值.方法 回顾性分析2011-01/2016-06在南京医科大学第一附属医院诊断为OGIB且先后接受CE和CTE两项检查的70例患者,比较CE和CTE在OGIB患者病变检出率、病因诊断率及两者诊断符合率,结果 (1)CE病变检出率、病因诊断率显著高于CTE(90.00% vs 22.86%,P=0.000;61.43%vs 10.00%,P=0.000),两者病变检出符合率仅为27.14%;(2)CE联合CTE病变检出率及病因诊断率均略高于CE,但无显著差异(P>0.05);(3)在显性出血中CE病变检出率高于隐性出血(94.83% vs 66.67%,P=0.015);(4)CE对血管性病变、糜烂/溃疡、憩室的诊断高于CTE(P<0.05),然而,CTE对肠道肿瘤的检出高于CE(4例CTE提示肿瘤后经手术证实者,通过CE仅发现其中2例).结论 CE和CTE均是安全、有效的用于OGIB检查方法,CE在OGIB中的诊断率明显优于CTE,两者联合应用价值并不明显优于CE,但对于OGIB患者CE检查无阳性发现者,行CTE检查可成为有益补充,尤其对于小肠肿瘤的发现.

  4. Clinical analysis of capsule endoscopy nine cases of unexplained gastrointestinal bleeding stranded stomach, small intestine%胶囊内镜检查不明原因消化道出血滞留胃、小肠的9例临床分析

    Institute of Scientific and Technical Information of China (English)

    罗山铖; 赵伟; 杜志强; 杨小东; 樊芳

    2014-01-01

    Objective to analyze retrospectively capsule endoscopy in our hospital stay in patients with stomach, small intestine, and analyze the reasons put forward corresponding countermeasures. Methods a retrospective analysis of the author's Hospital in december 2010 - december 2013 application capsule endoscopy does not name the reason 130 cases of gastrointestinal bleeding patients. the results of 130 patients in a total of nine patients had stomach, small intestine retention, retention rate was 6.9%, gastric retention seven cases, two cases removed by endoscopy, one case of combined surgical removal, four cases of the use of drugs, equipment, etc. into the small intestine, intestinal stranded two cases, one case removed through surgery, anal discharge after one case in february. Conclusion capsule endoscopy capsule endoscopy retention is the more serious complications, preoperative patient rigorous screening, routine gastroscopy, attention bowel preparation, real-time monitoring guidance. retention in the stomach more than one hour to take a drug or device into the small intestine, small intestine stranded in the absence of obstruction occurs feasible to observe, if the obstruction should prompt surgical treatment.%目的:回顾性分析我院行胶囊内镜检查滞留在胃、小肠的患者,分析原因,提出相应的对策。方法回顾性分析笔者医院2010年12月至2013年12月应用胶囊内镜检查130例不名原因消化道出血患者。结果130例患者中共有9例患者出现胃、小肠滞留,滞留率为6.9%,胃内滞留7例,2例通过胃镜取出,1例手术合并取出,4例使用药物、器械等送入小肠,小肠滞留 2例,1例通过手术取出,1例 2月后肛门排出。结论胶囊内镜滞留是胶囊内镜检查中比较严重的并发症,术前对患者进行严格筛查,常规胃镜检查,重视肠道准备,实时监测指导。滞留胃内超过1小时采取药物或器械送入小肠,滞留小肠若

  5. Achados das endoscopias digestivas altas em crianças e adolescentes de Sergipe Findings of gastroduodenal endoscopy in children and adolescents of Sergipe, Brazil

    Directory of Open Access Journals (Sweden)

    Danielle Santos Souza

    2008-12-01

    with children's parents or caregivers and research of medical records. The resultant variables from the endoscopy examination were the anatomical and histopatologic findings, and the urease test. RESULTS: 21 patients, with a mean age of 8.9±3.6 years, were studied; 52% of them were females and 57% came from rural areas of the state. Urease test was performed in 17 (81% patients and resulted positive in eight (47% of them. Out of the 21 patients, 14 (67% had some endoscopic abnormality. Among the 17 children that had biopsies performed, 15 (88% showed abnormal results. Histopathological search of Helicobacter pylori was performed in 15 patients and the results were positive in 60%. This agent was isolated in all five children with endoscopic diagnosis of nodular antral gastritis. No complications of the procedure were noted in the studied patients. CONCLUSIONS: In a series of pediatric cases clinically selected, anatomical and histopatologics findings and the urease test obtained by esophagogastroduodenoscopy identified alterations in most patients and it was carried out safely.

  6. Risk factors for false negative diagnosis of obscure gastrointestinal bleeding by capsule endoscopy%不明原因消化道出血胶囊内镜漏诊的原因分析

    Institute of Scientific and Technical Information of China (English)

    匡蕾; 陈烨; 智发朝; 姜泊; 张亚历; 刘思德; 李爱民; 叶山亮; 陈宇轩; 徐扬志; 肖坤; 陈振煜; 万田谟; 白杨

    2012-01-01

    具有较大影响,存在憩室病、末端回肠及回盲部病变、图像质量差的患者漏诊风险较大.%Objective To analyze the risk factors for false negative diagnosis of obscure gastrointestinal bleeding (OGIB) by capsule endoscopy.Methods A total of 133 OGIB inpatients,104 in true positive group and 29 in false negativc group,were reviewed.The features of demography,diseases and capsule endoscopy were collected and then analyzed,which included 10 variables like age,sex,time of bleeding,diseases accompanied,type and location of the disease,hemoglobin concentration,transit time of CE,quality of CE pictures and type of purgative agents.All data were analyzed with t test,and all the enumeration data were analyzed with chi square test.Logistic regression was used to analyze the correlation between the factors and results of diagnosis.Results Age ( t =2.095,P =0.038 ),concentration of hemoglobin ( t =2.143,P=0.034),type (X2 =20.222,P <0.001) and location (X2 =33.732,P <0.001) of the diseases,image quality of the CE (X2 =9.219,P =0.002 ) and the type of purgative agents (X2 =6.999,P =0.024) were found to have statistical differences between the two groups.Chi-square and partition Chi-square test revealed the occurrence of civerticulosis and lesion location,i.e.lower ileum and ileumcecum,were of statistical difference between the two groups (X2 =22.233,P < 0.001 and x2 =24.412,P < 0.001 ).Univariate logistic regression showed diverticulosis ( OR =0.102,P <0.001 ),lower bowel diseases ( OR =0.110,P <0.001 ),poor quality of CE pictures ( OR =0.258,P =0.004 ) and the use of sodium phosphate agent ( OR =0.367,P =0.027) were risk factors for false negative diagnosis,while older age facilitated diagnosis ( OR =1.024,P =0.041 ).However,multivariate logistic regression showed no statistic significance in type of purgative agent ( P =0.05 ) or the concentration of hemoglobin ( P =0.394).Furthermore,elder age facilitated positive diagnosis ( OR =1.031,P =0

  7. Endoscopy in The Philippines

    Institute of Scientific and Technical Information of China (English)

    Jonard T.Co

    2008-01-01

    @@ Endoscopy has gained fame and acceptance due to its proven value in its diagnostic and therapeutic aspects. Quality levels of endoscopy practice has been benchmarked as the the only way to maximize the benefits of this wonderful medical innovation.

  8. Capsule endoscopy—A mechatronics perspective

    Science.gov (United States)

    Lin, Lin; Rasouli, Mahdi; Kencana, Andy Prima; Tan, Su Lim; Wong, Kai Juan; Ho, Khek Yu; Phee, Soo Jay

    2011-03-01

    The recent advances in integrated circuit technology, wireless communication, and sensor technology have opened the door for development of miniature medical devices that can be used for enhanced monitoring and treatment of medical conditions. Wireless capsule endoscopy is one of such medical devices that has gained significant attention during the past few years. It is envisaged that future wireless capsule endoscopies replace traditional endoscopy procedures by providing advanced functionalities such as active locomotion, body fluid/tissue sampling, and drug delivery. Development of energy-efficient miniaturized actuation mechanisms is a key step toward achieving this goal. Here, we review some of the actuators that could be integrated into future wireless capsules and discuss the existing challenges.

  9. [Learning gastroenterologic endoscopy].

    Science.gov (United States)

    Koelsch, K A

    1976-11-01

    1. Knowledge of the gastroenterological endoscopy and biopsy is necessary at all levels of medical education. 2. Knowledge of students: possible methods, diagnostic effectiveness, stress of the patients. Knowledge of the candidates for specialisation: indications, contraindications, possibilities of the method also in reference to the individual case. Persons interested in the subspecialisation gastro-enterology: theory, possibilities and limits, technical performance. Experienced endoscopists: regular refreshment and supplementation of knowledge and skill in highly specialised endoscopic centres. 3. Tested teaching methods are lecture, report, study of atlants and text-books, demonstrations of diapositives in connection with schematic figures, seminars with diapositives, film demonstrations, work at the patient under supervision of the tutor and use of a demonstration device as well as endoscopic demonstration by means of colour television. The centre is, however, the individual examination of the patient. 4. Knowledge of the subspecialist: History of endoscopy, knowledge of instruments, optics and endoscopic perspective, physical fundaments about light and photography, human macro- and microscopic anatomy, care of instruments and desinfection. Indications, contraindications, possibilities and limits of the method, emergency and intensive medicine, writing of the findings.

  10. Upper Endoscopy

    Medline Plus

    Full Text Available ... Testimonials For Patients Conditions Find A Doctor Procedures Purchase Educational Materials Questions to Ask Your MD Screen4coloncancer. ... 963-8332 Email: info@asge.org ASGE on Facebook ASGE on Youtube ASGE on Twitter Privacy | Terms ...

  11. The effect of tongga and acupressure with Meridian tapping in patients who have acheck of capsule endoscopy%益气润肠汤结合穴位按摩及经络拍打对行胶囊内镜检查患者的影响

    Institute of Scientific and Technical Information of China (English)

    林瑞华; 潘慧人; 谢春生; 陈礼彬

    2013-01-01

    Objective To explore the effect of tongga and acupressure with Meridian tapping in patients who have acheck of capsule endoscopy. Methods A total of 160 inpatients divided into two groups (Experimental group and Control group). Experimental group used in tongga and acupressure with Meridian tapping. Control group has Polyethylene glycol electrolyte bulk. Result Experimental group has more cleaner of intestinal than control group (P<0.05), the image of capsule endoscopy more well and the capsule used less time in intestinal than control group (P<0.05). Conclunsion Tongga and acupressure with Meridian tapping in patients can have more well effect and less harmful.%目的:探讨益气润肠汤结合穴位按摩及经络拍打对行胶囊内镜检查患者的影响。方法将160例患者分为实验组和对照组,实验组口服益气润肠汤结合穴位按摩及经络拍打,对照组口服复方聚乙二醇电解质散,比较2组在肠道清洁程度、胶囊内镜检查效果及胶囊排出时间。结果实验组肠道清洁度明显优于对照组(P<0.05),且检查效果显示图象更清晰(P<0.05),胶囊在完成图象拍摄后较对照组更快排出(P<0.05)。结论服用中药益气润肠汤结合穴位按摩及经络拍打,在胶囊内镜检查中可提高检查的成功率和疾病的诊断率及减少并发症,具有重要作用。

  12. Breast ductal endoscopy: how many procedures qualify?

    Directory of Open Access Journals (Sweden)

    Papalabros Alexandros

    2009-06-01

    Full Text Available Abstract Background Breast ductal endoscopy is a relatively new diagnostic method with ever growing importance in the work-up of patients with bloody nipple discharge. The ability to perform ductal endoscopy is very important and useful for breast fellows. Learning curve in breast ductal endoscopy remains a terra incognita, since no systematic studies have addressed this topic. The purpose of this study is to determine the point (number of procedures during training beyond which ductal endoscopy is successfully performed. Findings Ten breast fellows received training in our Breast Unit. For the training process, an ex vivo model was adopted. Fellows were trained on 20 surgical specimens derived from modified radical mastectomy for breast cancer. The target of the education program was to acquire proficiency in performing ductoscopy. The achievement of four consecutively successful ductal endoscopies was determined as the point beyond which proficiency had been achieved. The number of procedures needed for the achievement of proficiency as defined above ranged between 9 and 17 procedures. The median value was 13 procedures; i.e. 50% of trainees had achieved proficiency at the 13th procedure or earlier. Conclusion These pilot findings point to approximately 13 procedures as a point beyond which ductal endoscopy is successfully performed; studies on a larger number of fellows are nevertheless needed. Further research, focusing on the learning curves of different training models of ductal endoscopy, seems desirable.

  13. Breast ductal endoscopy: how many procedures qualify?

    Science.gov (United States)

    Zagouri, Flora; Sergentanis, Theodoros N; Giannakopoulou, Georgia; Panopoulou, Effrosyni; Chrysikos, Dimosthenis; Bletsa, Garifallia; Flessas, John; Filippakis, George; Papalabros, Alexandros; Bramis, Kostas J; Zografos, George C

    2009-01-01

    Background Breast ductal endoscopy is a relatively new diagnostic method with ever growing importance in the work-up of patients with bloody nipple discharge. The ability to perform ductal endoscopy is very important and useful for breast fellows. Learning curve in breast ductal endoscopy remains a terra incognita, since no systematic studies have addressed this topic. The purpose of this study is to determine the point (number of procedures during training) beyond which ductal endoscopy is successfully performed. Findings Ten breast fellows received training in our Breast Unit. For the training process, an ex vivo model was adopted. Fellows were trained on 20 surgical specimens derived from modified radical mastectomy for breast cancer. The target of the education program was to acquire proficiency in performing ductoscopy. The achievement of four consecutively successful ductal endoscopies was determined as the point beyond which proficiency had been achieved. The number of procedures needed for the achievement of proficiency as defined above ranged between 9 and 17 procedures. The median value was 13 procedures; i.e. 50% of trainees had achieved proficiency at the 13th procedure or earlier. Conclusion These pilot findings point to approximately 13 procedures as a point beyond which ductal endoscopy is successfully performed; studies on a larger number of fellows are nevertheless needed. Further research, focusing on the learning curves of different training models of ductal endoscopy, seems desirable. PMID:19566939

  14. Drug-Induced Sleep Endoscopy.

    Science.gov (United States)

    Charakorn, Natamon; Kezirian, Eric J

    2016-12-01

    Drug-induced sleep endoscopy (DISE) is an upper airway evaluation technique in which fiberoptic examination is performed under conditions of unconscious sedation. Unique information obtained from this 3-dimensional examination of the airway potentially provides additive benefits to other evaluation methods to guide treatment selection. This article presents recommendations regarding DISE technique and the VOTE Classification system for reporting DISE findings and reviews the evidence concerning DISE test characteristics and the association between DISE findings and treatment outcomes.

  15. Endoscopy Reporting Standards

    OpenAIRE

    Daphnée Beaulieu; Alan N Barkun; Catherine Dubé; Jill Tinmouth; Pierre Hallé; Myriam Martel

    2013-01-01

    OBJECTIVES: The Canadian Association of Gastroenterology (CAG) recently published consensus recommendations for safety and quality indicators in digestive endoscopy. The present article focuses specifically on the identification of key elements that should be found in all electronic endoscopy reports detailing recommendations adopted by the CAG consensus group.METHODS: A committee of nine individuals steered the CAG Safety and Quality Indicators in Endoscopy Consensus Group, which had a total...

  16. Enteroclysis CT and PEG-CT in patients with previous small-bowel surgical resection for Crohn's disease: CT findings and correlation with endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Minordi, Laura Maria; Vecchioli, Amorino; Poloni, Giuliana; Bonomo, Lorenzo [Radiology Institute, UCSC, Department of Bio-Imaging and Radiological Sciences, Rome (Italy); Guidi, Luisa; De Vitis, Italo [Catholic University (UCSC), Gastrointestinal Department, Complesso Integrato Columbus, Rome (Italy)

    2009-10-15

    The aim of this study was to evaluate the accuracy of multidetector CT in patients with Crohn's disease (CD) relapse after ileocolic resection compared with endoscopy. Thirty-four patients were studied by endoscopy and multidetector CT, after oral administration of polyethylene glycol solution (n = 21) or after administration of methylcellulose via nasojejunal tube (n = 13). In CT examinations we evaluated the presence of mural thickening, target sign, perienteric stranding, comb sign, fibrofatty proliferation and complications. Endoscopic results were classified in accordance with Rutgeerts score (from 0 to 4). The statistical evaluations were carried out by using Fisher's exact text and {chi} {sup 2} testing (p < 0.05, statistically significant difference). Sensitivity, specificity and accuracy of the CT were 96.9%, 100% and 97%, respectively. We found a statistically significant correlation between an endoscopic score of 4 and the CT signs of target sign, perienteric stranding, comb sign and fibrofatty proliferation, and between scores 1 and 2 and mucosal hyperdensity without or with mural thickening, respectively (p < 0.05). Moreover, only CT identified the presence of jejunal and proximal ileum disease in two and three patients, respectively, and fistulas in three patients. CT is a reliable method in the diagnosis of CD relapse and shows agreement with the approved endoscopic Rutgeerts score. (orig.)

  17. Sedation for pediatric endoscopy.

    Science.gov (United States)

    Lee, Myung Chul

    2014-03-01

    It is more difficult to achieve cooperation when conducting endoscopy in pediatric patients than adults. As a result, the sedation for a comfortable procedure is more important in pediatric patients. The sedation, however, often involves risks and side effects, and their prediction and prevention should be sought in advance. Physicians should familiarize themselves to the relevant guidelines in order to make appropriate decisions and actions regarding the preparation of the sedation, patient monitoring during endoscopy, patient recovery, and hospital discharge. Furthermore, they have to understand the characteristics of the pediatric patients and different types of endoscopy. The purpose of this article is to discuss the details of sedation in pediatric endoscopy.

  18. Sedation for Esophagogastroduodenal Endoscopy

    Directory of Open Access Journals (Sweden)

    Tayfun Aydin

    2011-05-01

    Full Text Available Different anesthetic techniques and drugs can be used for esophagogastroduedonal endoscopy. However, the scientists are still searching for appropriate drugs and protocols for sedation during esophagogastroduedonal endoscopy. The aim of this review is to discuss the topics related with sedation and esophagogastroduedonal endoscopy in the light of literature. Today standard procedure for diagnostic esophagogastroduedonal endoscopy usually consists of topical pharyngeal anesthesia, minimal sedation or anxiolysis, which may be complemented with analgesia when needed. When a prolonged, complex, or particularly troublesome or painful examination is foreseen, deeper sedation with multiple drugs and in closed observation of a staff may be required.

  19. Usefulness of CT virtual endoscopy in imaging a large esophagorespiratory fistula

    Energy Technology Data Exchange (ETDEWEB)

    Sonomura, Tetsuo; Kishi, Kazushi; Ishii, Seigo; Kawai, Nobuyuki; Masuda, Mitsunori; Terada, Masaki; Nakamine, Hirokazu; Sato, Morio

    2000-04-01

    A 73-year-old woman with a large esophagorespiratory fistula underwent bronchoscopy and computed tomographic (CT) virtual endoscopy before stenting. Noninvasive CT virtual endoscopy showed the large fistula, and the CT findings agreed with the bronchoscopic findings.

  20. Endoscopy in Amphibians.

    Science.gov (United States)

    Chai, Norin

    2015-09-01

    Despite advances in exotic animal endoscopy, descriptions involving amphibians are scarce. Amphibian endoscopy shares some similarities with reptiles, especially in lizards. Selected procedures are discussed, including stomatoscopy, gastroscopy, coelioscopy, and biopsy of coelomic organs and lesions. This short overview provides the practitioner with pragmatic advice on how to conduct safe and effective endoscopic examinations in amphibians.

  1. Symptomatic Patency Capsule Retention in Suspected Crohn's Disease

    DEFF Research Database (Denmark)

    Rasmussen, Bjørn; Nathan, Torben; Jensen, Michael Dam

    2016-01-01

    The main limitation of capsule endoscopy is the risk of capsule retention. In patients with suspected Crohn's disease, however, this complication is rare, and if a small bowel stenosis is not reliably excluded, small bowel patency can be confirmed with the Pillcam patency capsule. We present two...... patients examined for suspected Crohn's disease who experienced significant symptoms from a retained patency capsule. Both patients had Crohn's disease located in the terminal ileum. In one patient, the patency capsule caused abdominal pain and vomiting and was visualized at magnetic resonance enterography...

  2. Endoscopy in pregnancy.

    LENUS (Irish Health Repository)

    O'mahony, Seamus

    2012-02-03

    Endoscopy is rarely required during pregnancy. The potential risks of endoscopy during pregnancy include foetal hypoxia due to sedative drugs and exposure to radiation. There is no evidence that endoscopy precipitates premature labour, and studies in this area have concluded that endoscopy during pregnancy is generally safe. There should be a strong indication for the procedure, which should be deferred whenever possible to the second trimester. Procedures should be performed without any sedation, or with the lowest dose of sedative medication. Radiation exposure should be kept to a minimum. Support should be obtained from specialists in obstetrics and anaesthesia. Indications for endoscopy during pregnancy are as follows: (1) gastroscopy: upper gastrointestinal bleeding, dysphagia, uncontrolled nausea\\/vomiting; (2) sigmoidoscopy\\/colonoscopy: rectal bleeding, diarrhoea; and (3) ERCP: choledocholithiasis, biliary pancreatitis. Sedative drugs, such as midazolam appear to be safe if used carefully. Radiation exposure during ERCP can be kept well below the danger level for teratogenicity.

  3. The race for mainstream gastrointestinal endoscopy: frontrunners.

    Science.gov (United States)

    Seltenreich, H; Van Den Bogaerde, J; Sorrentino, D

    2012-08-01

    In recent years, gastrointestinal endoscopy has evolved and branched out from a primary naked-eye diagnostic technique to a multitude of sophisticated investigative and therapeutic procedures. While many of the new endoscopic techniques are currently too complex or expensive to make it to mainstream clinical practice, others are already bringing major progress to the management of digestive diseases. In this review we will discuss a selected group of the emerging techniques and technologies used to increase the diagnostic yield in the colon and small intestine, including Third Eye® Retroscopes®, colon capsule endoscopy, spiral enteroscopy and confocal laser endomicroscopy. We will also discuss over-the-scope clip devices, a relatively simple and inexpensive tool potentially capable of noninvasive closing intestinal perforations and allowing the removal of infiltrating tumors.

  4. 胶囊内镜、CT小肠成像、小肠造影及回结肠镜对克罗恩病诊断价值的比较%The diagnosis of Crohn's disease of the small bowel: comparing CT enterography, capsule endoscopy, small-bowel follow through and ileocolonoscopy

    Institute of Scientific and Technical Information of China (English)

    陆星华; 秦明伟; 温小恒; 刘炜; 史济华; 钱家鸣; 李景南

    2010-01-01

    目的 比较4种影像技术方法在小肠克罗恩病(CD)诊断中的应用价值.方法 57例经临床病理诊断为小肠CD的患者伴有不同程度腹痛、消瘦、腹泻或发热、大便潜血阳性等症状体征,进行回结肠镜、CT小肠成像(CTE)、胶囊内镜(CE)、小肠造影(SBFT)检查,发现异常患者则具体记录病变部位、性质,并对单项检杳及两项检查联合的阳性检出率进行比较.结果 57例CD患者中50例完成了回结肠镜检查,33例发现回肠末端溃疡(66.00%),17例回肠末端正常;CTE 34例,发现小肠病变29例(85.29%);CE 27例,其中1例发生CE在胃内潴留未达小肠,发现小肠病变26例(96.30%);SBFT 39例,发现小肠病变26例(66.67%).CE诊断CD的阳性率最高(96.30%),而回结肠镜最低(66.0%),4种检查方法的阳性率差异有统计学意义(P=0.006).两种检查方法联合的诊断CD的阳性检出率:CE+CTE为92.86%(13/14),SBFT+CTE为90.91%(20/22),CE+回结肠镜为95.65%(22/23),CE+SBFT为100%(17/17),回结肠镜+CTE为89.66%(26/29),回结肠镜+SBFT为77.78%(28/36),两种检查联合的组间比较,差异无统计学意义(P=0.140).结论 CE、CTE诊断轻度、中度CD的阳性率比SBFT高,CE发现早期黏膜病变较好,CTE发现肠壁及肠外病变较好,最重要的是CE及CTE可应用于非梗阻性小肠CD患者,传统技术如SBFT或回结肠镜阴性或不能明确诊断时,CE还可用于解释临床症状、随访及指导治疗.%Objective To investigate the diagnostic value of capsule endoscopy (CE), CT enterography (CTE), ileocolonoscopy and small bowel follow through (SBFT) for small bowel Crohn's disease (CD). Methods Fifty-seven consecutive patients with CD underwent ileocolonoscopy, CTE, CE, and SBFT. It included the presence of the following symptoms and signs: abdominal pain, weight loss,diarrhea, fever and positive fecal occult blood test. The location and the characteristics of intestinal and extra-intestinal lesions detected by four techniquks

  5. Upper GI Endoscopy

    Science.gov (United States)

    ... to diagnose conditions such as cancer celiac disease gastritis Doctors also use upper GI endoscopy to treat ... Bhutani MS. Esophagogastroduodenoscopy. Medscape website. emedicine.medscape.com/article/1851864-overview#a17 . Updated June 3, 2013. Accessed ...

  6. Functional imaging and endoscopy

    Institute of Scientific and Technical Information of China (English)

    Jian-Guo Zhang; Hai-Feng Liu

    2011-01-01

    The emergence of endoscopy for the diagnosis of gastrointestinal diseases and the treatment of gastrointestinal diseases has brought great changes.The mere observation of anatomy with the imaging mode using modern endoscopy has played a significant role in this regard.However,increasing numbers of endoscopies have exposed additional deficiencies and defects such as anatomically similar diseases.Endoscopy can be used to examine lesions that are difficult to identify and diagnose.Early disease detection requires that substantive changes in biological function should be observed,but in the absence of marked morphological changes,endoscopic detection and diagnosis are difficult.Disease detection requires not only anatomic but also functional imaging to achieve a comprehensive interpretation and understanding.Therefore,we must ask if endoscopic examination can be integrated with both anatomic imaging and functional imaging.In recent years,as molecular biology and medical imaging technology have further developed,more functional imaging methods have emerged.This paper is a review of the literature related to endoscopic optical imaging methods in the hopes of initiating integration of functional imaging and anatomical imaging to yield a new and more effective type of endoscopy.

  7. [Mid-gastrointestinal bleeding - endoscopy sheds light in the darkness].

    Science.gov (United States)

    May, A

    2014-08-01

    Mid-gastrointestinal bleeding is defined as a bleeding of the small bowel and is the most common indication for small bowel endoscopy. Intraoperative enteroscopy has been regarded as gold standard for a long time. With the introduction of different endoscopy techniques, they play now the central role, whereas intraoperative enteroscopy has become a reserve method for selected patients. Actually, there are, beside capsule endoscopy, five non-surgical, flexible enteroscopy techniques available. In Germany and Europe balloon-assisted enteroscopy (double balloon and single balloon enteroscopy) is mainly used. Double balloon enteroscopy (DBE) is the "oldest" flexible enteroscopy technique and has become established throughout the world for diagnostic and therapeutic examinations of the small bowel. The majority of the studies have been performed with DBE and it provides the highest rate of complete enteroscopy. Nevertheless, technical improvements to make enteroscopy easier and faster are still required. In patients with chronic MGI or problematic situations capsule endoscopy is an ideal screening option. In case of acute MGI the flexible enteroscopy techniques should be preferred because of the high diagnostic yield combined with the possibility of endoscopic therapeutic interventions. In difficult cases with unsuccessful enteroscopy, CT angiography and conventional angiography with the option of embolisation had proved their value.

  8. Investigation on Rebleeding Risk Factors in Obscure Gastrointestinal Bleeding Patients after Capsule Endoscopy%不明原因消化道出血患者胶囊内镜检查后再出血的危险因素探讨

    Institute of Scientific and Technical Information of China (English)

    虞竹雯; 肖坤庭; 徐小明; 张陈霏; 陈卫昌

    2015-01-01

    Background:Because of its non-invasiveness,direct inspection,and high detection rate,capsule endoscopy(CE) has been accepted as the first-line examination for diagnosis of obscure gastrointestinal bleeding(OGIB). However,no matter the result of CE is positive or negative,it is unable to accurately predict the occurrence of rebleeding. Aims:To preliminarily investigate the related risk factors of rebleeding in OGIB patients with positive or negative CE for reducing the rebleeding rate. Methods:One hundred and sixteen OGIB patients undergone CE and with follow-up data from October 2009 to October 2013 at the First Affiliated Hospital of Soochow University were recruited,the rebleeding rate of patients with positive and negative CE,and the risk factors of rebleeding were analyzed. Results:CE diagnostic rate was 56. 9% , and the overall rebleeding rate was 37. 9% . The rebleeding rate in CE positive patients was significantly higher than that in CE negative patients(48. 5% vs. 24. 0% ,P < 0. 01). Male,age ≥50 years,hypertension,accumulated bleeding ≥500 mL within 3 months before CE were the independent risk factors of increase in rebleeding rate in CE positive patients. Age≥50 years,abnormal blood coagulation,without specific treatment were the independent risk factors of increase in rebleeding rate in CE negative patients. Conclusions:Followed-up should be performed in OGIB patients with risk factors of rebleeding for at least 24 months after CE. Repeated examination can be avoided in OGIB patients without risk factors.

  9. Clinical research about diagnostic value of capsule endoscopy combining with multi-slice spiral CT in obscure gastrointestinal bleeding%胶囊内镜联合多排螺旋CT诊断不明原因消化道出血的临床研究

    Institute of Scientific and Technical Information of China (English)

    丁元军

    2013-01-01

    目的 探讨胶囊内镜(capsule endoscopy CE)联合多排螺旋CT(MSCT)在不明原因消化道出血中的诊断作用和价值.方法 收集不明原因消化道出血患者80例,进行胶囊内镜及多排螺旋CT检查,统计两种检查手段病变的检出率及其部位并进行分析.结果 80例中CE诊断阳性46例,诊断阳性率为57.5%;MSCT诊断阳性33例,诊断阳性率为41.3%,P<0.05;CE和MSCT联合诊断的阳性率为63.8%,与CE相比P>0.05,与MSCT相比P<0.05;CE和MSCT的诊断一致率为71.3%;另有34例在检查后进行了外科手术,检出病变34种;CE和MSCT均有病变漏诊,但MSCT漏诊更多.结论 ①CE联合MSCT检查对不明原因消化道出血的诊断阳性率较CE有所提高,但无统计学意义.②CE联合MSCT检查在判断小肠肿瘤的病变性质及肠外情况的了解中具有优势,建议对不明原因消化道出血进行CE和MSCT的联合检查.

  10. Drug-induced sedation endoscopy in children <2 years with obstructive sleep apnea syndrome: upper airway findings and treatment outcomes.

    Science.gov (United States)

    Boudewyns, A; Van de Heyning, P; Verhulst, S

    2017-02-20

    Few data are available about the pattern of upper airway (UA) obstruction in children DISE) in young OSAS children to investigate the pattern of UA obstruction and the value of DISE in therapeutic decision making. Retrospective analysis of ≤2-year-old children undergoing DISE-directed UA surgery. OSAS severity and the treatment outcomes were documented by polysomnography. Data are available for 28 patients, age 1.5 years (1.3-1.8), BMI-z score 0.5 (-0.7 to 1.3) with severe OSAS, obstructive apnea/hypopnea index (oAHI) 13.8/hr (7.5-28.3). All but 3 had (>50%) obstruction at the level of the adenoids, and all but 5 had (>50%) tonsillar obstruction. DISE-directed treatment consisted of adenoidectomy (n = 4), tonsillectomy (n = 1), and AT (n = 23). There was a significant improvement in respiratory parameters. Twenty children (71.4%) had a postoperative oAHI DISE showed a collapse of the epiglottis in 6 and late-onset laryngomalacia in 4. These findings did not affect surgical outcome. Adenotonsillar hypertrophy is the major cause of UA obstruction, and DISE-directed UA surgery was curative in 71,4% of children ≤2 years. We suggest that DISE may be helpful in surgical decision making. Circumferential UA narrowing may result in less favorable surgical outcomes.

  11. Preliminary evaluation on the characteristics of the patients with clinical significant endoscopy findings%门诊胃镜检查患者临床特征的初探

    Institute of Scientific and Technical Information of China (English)

    陆京京; 周丽雅

    2013-01-01

    Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0%) patients with dyspepsia and reflux symptoms,300(31.8%)patients with dyspepsia and without reflux symptoms,and 86(9.1%)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5%) patients were diagnosed with CSEF,119(12.6%) with erosive esophagitis,28(3.0%) with Barrett esophagus,102 (10.8%)with peptic ulcers,66 (7.0%) with gastric dysplasia,and 13 (1.4%) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95%CI:1.148 to 2.451),older age (OR=1.032,95%CI:1.021 to 1.044),alcohol intake (OR=1.761,95%CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95% CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 %CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95%CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.%目的 研究门诊胃镜检查后诊断内镜下有临床意义的病变(CSEF)的相关因素,探索确定适宜

  12. Diagnosis of Ascaris lumbricoides infection using capsule endoscopy

    OpenAIRE

    Yamashita, Eduardo Tomohissa; Takahashi, Wagner; Kuwashima, Daniel Yuiti; Langoni, Tiago Ribeiro; Costa-Genzini, Adriana

    2013-01-01

    Ascaris lumbricoides (A. lumbricoides) is the most common intestinal roundworm parasite, infecting approximately one quarter of the world’s population. Infection can lead to various complications because it can spread along the gastrointestinal tract. Although A. lumbricoides infection is a serious healthcare issue in developing countries, it now also has a worldwide distribution as a result of increased immigration and travel. Intestinal obstruction is the most common complication of A. lumb...

  13. Wireless capsule endoscopy as a tool in diagnosing autoimmune enteropathy

    DEFF Research Database (Denmark)

    Gram-Kampmann, Eva-Marie; Lillevang, Søren T; Detlefsen, Sönke;

    2015-01-01

    Autoimmune enteropathy (AE) is an immune mediated illness of the intestinal mucosa. The cause is unknown, and the diagnosis is based on typical characteristics displayed. There is no gold standard for treatment. We present two adult cases of AE and demonstrate the challenges in establishing...

  14. Photometric stereo endoscopy

    Science.gov (United States)

    Parot, Vicente; Lim, Daryl; González, Germán; Traverso, Giovanni; Nishioka, Norman S.; Vakoc, Benjamin J.

    2013-01-01

    Abstract. While color video endoscopy has enabled wide-field examination of the gastrointestinal tract, it often misses or incorrectly classifies lesions. Many of these missed lesions exhibit characteristic three-dimensional surface topographies. An endoscopic system that adds topographical measurements to conventional color imagery could therefore increase lesion detection and improve classification accuracy. We introduce photometric stereo endoscopy (PSE), a technique which allows high spatial frequency components of surface topography to be acquired simultaneously with conventional two-dimensional color imagery. We implement this technique in an endoscopic form factor and demonstrate that it can acquire the topography of small features with complex geometries and heterogeneous optical properties. PSE imaging of ex vivo human gastrointestinal tissue shows that surface topography measurements enable differentiation of abnormal shapes from surrounding normal tissue. Together, these results confirm that the topographical measurements can be obtained with relatively simple hardware in an endoscopic form factor, and suggest the potential of PSE to improve lesion detection and classification in gastrointestinal imaging. PMID:23864015

  15. Findings of an experimental study in a rabbit model on posterior capsule opacification after implantation of hydrophobic acrylic and hydrophilic acrylic intraocular lenses

    Directory of Open Access Journals (Sweden)

    Nikolaos Trakos

    2009-01-01

    Full Text Available Nikolaos Trakos1, Elli Ioachim2, Elena Tsanou2, Miltiadis Aspiotis1, Konstantinos Psilas1, Chris Kalogeropoulos11University Eye Clinic of Ioannina, Ioannina, Greece; 2Pathology Department, University of Ioannina, Ioannina, GreecePurpose: Study on cell growth on the posterior capsule after implantation of hydrophobic acrylic (Acrysof SA 60 AT and hydrophilic acrylic (Akreos Disc intraocular lenses (IOL in a rabbit model and comparison of posterior capsule opacification (PCO.Methods: Phacoemulsification was performed in 22 rabbit eyes, and two different IOL types (Acrysof SA60 AT and Akreos Disc were implanted. These IOLs had the same optic geometry (square edged but different material and design. Central PCO (CPCO, peripheral PCO (PPCO, Sommering’s ring (SR formation, type of growth, extension of PCO, cell type, inhibition, and fibrosis were evaluated three weeks after surgery. Histological sections of each globe were prepared to document the evaluation of PCO.Results: No statistically significant difference was observed between a hydrophobic acrylic IOL and a hydrophilic acrylic IOL in relation to the CPCO, PPCO, type of growth, extension, cell type, inhibition, and fibrosis. Statistically significant difference was observed in relation to the formation of SR with Acrysof SA 60 AT group presenting more SR than Akreos Disc group.Conclusion: PCO was not influenced by the material of the IOL or the design of the haptics of the IOLs we studied.Keywords: posterior capsule opacification, intraocular lenses, rabbit model

  16. Evaluation of diagnosis value by capsule endoscopy and dual phase enhanced CT of small intestine and ;colon for obscure gastrointestinal bleeding%CE与小肠结肠双期增强CT对不明原因消化道出血诊断价值的评价

    Institute of Scientific and Technical Information of China (English)

    许菲; 刘曌宇; 廖光全; 胡继芬; 吴小力

    2015-01-01

    Objective To analyze pathogenesis of obscure gastrointestinal bleeding (OGIB), and to compare diagnosis value and advantages of capsule endoscopy (CE) and dual phase enhanced CT of small intestine and colon for OGIB. Methods A total of 101 clinically diagnosed OGIB patients received CE and dual phase enhanced CT of small intestine and colon respectively. Detection rates for different lesions by CE and dual phase enhanced CT of small intestine and colon were calculated for comparison. Results Among 101 patients receiving CE, there were 77 cases with lesions. There were 69 cases with small intestine lesion and 8 cases with lesion outside small intestine. Dual phase enhanced CT of small intestine and colon showed 25 lesion cases. There were 15 cases with small intestine lesion and 10 cases with lesion outside small intestine. The difference of detection rate of hemorrhage-related small intestine lesion between the two methods had statistical significance(P<0.05). Conclusion CE is an effective diagnosis method for OGIB, and it provides much higher detection rate than dual phase enhanced CT of small intestine and colon. Implement of CT combined with CE for OGIB patients can improve detection rate and provide guidance for surgical treatment.%目的:分析不明原因消化道出血(OGIB)的病因,比较CE(CE)与小肠结肠双期增强CT对OGIB的诊断价值及优势。方法临床诊断考虑为OGIB的患者101例,分别行CE及小肠结肠双期增强CT检查,计算CE及小肠结肠双期增强CT对不同病变的检出率,比较其差异。结果101例行CE检查患者共发现病变77例,其中小肠病变69例,小肠外病变8例。小肠结肠双期增强CT发现病变25例,其中小肠病变15例,小肠外病变10例。两种方法的出血相关小肠病变检出率比较,差异有统计学意义(P<0.05)。结论 CE是对OGIB的有效检查方法,其病变检出率明显高于小肠结肠双期增强CT,临床上对于OGIB患者采用CT联合CE的检查方法

  17. Dynamics of nonspherical compound capsules in simple shear flow

    Science.gov (United States)

    Luo, Zheng Yuan; Bai, Bo Feng

    2016-10-01

    The dynamics of an initially ellipsoidal compound capsule in a simple shear flow is investigated numerically using a three-dimensional front-tracking finite-difference model. Membrane bending resistance is included based on Helfrich's energy function besides the resistances against shear deformation and area dilatation governed by the constitutive law of Skalak et al. In this paper, we focus specifically on how the presence of a spherical inner capsule and its size affects the characteristics and transition of various dynamical states of nonspherical compound capsules (i.e., the outer capsule). Significant differences in the dynamical characteristics are observed between compound capsules and homogeneous capsules in both qualitative and quantitative terms. We find the transition from swinging to tumbling can occur at vanishing viscosity mismatch through increasing the inner capsule size alone to a critical value regardless of the initial shape of the nonspherical compound capsule (i.e., prolate or oblate). Besides, for compound capsules with viscosity mismatch, the critical viscosity ratio for the swinging-to-tumbling transition remarkably decreases by increasing the inner capsule size. It is thus concluded that the inner capsule size is a key governing parameter of compound capsule dynamics apart from the capillary number, aspect ratio, and viscosity ratio that have been long identified for homogeneous capsules. Further, we discuss the mechanisms underlying the effects of the inner capsule on the compound capsule dynamics from the viewpoint of the effective viscosity of internal fluid and find that the effects of the inner capsule on compound capsule dynamics are qualitatively similar to that of increasing the internal viscosity on homogeneous capsule dynamics. However, in quantitative terms, the compound capsule cannot be viewed as a homogeneous capsule with higher viscosity as obvious inhomogeneity in fluid stress distribution is induced by the inner membrane.

  18. Indications and Relative Utility of Lower Endoscopy in the Management of Clostridium difficile Infection

    Directory of Open Access Journals (Sweden)

    Nora E. Burkart

    2011-01-01

    Full Text Available Background. Diagnosis and management of Clostridium difficile infection (CDI rely upon clinical assessments and diagnostic studies. Among diagnostic tests, lower gastrointestinal (GI endoscopy in the setting of CDI remains controversial. Objective. To describe the role of lower endoscopy in CDI management. Methods. Retrospective study of lower endoscopies in CDI at four metropolitan hospitals, July 2005 through December 2007. Results. Of 1760 CDI inpatients, 45 lower endoscopies were performed on 43 patients. Most common indications were ruling out other etiologies (42%, inconclusive stool studies (36%, and worsening course (11%. Most endoscopies (73% had positive findings, including pseudomembranous colitis (49% and nonspecific colitis (24%. Biopsies were performed in 31 cases, more with nonspecific colitis (10/11, 92% compared to pseudomembranous colitis (14/22, 64%. Conclusion. While not recommended as a primary screening tool, lower GI endoscopy can add valuable information in CDI when other colonic pathologies may exist, studies are inconclusive, or clinical status worsens.

  19. The Role of Emergency Endoscopy in Small Bowel Bleeding: A Review

    Directory of Open Access Journals (Sweden)

    Enrique Pérez-Cuadrado-Robles

    2016-03-01

    Full Text Available There is no consensus on the timing and management of emergency overt obscure gastrointestinal bleeding. Emergency capsule endoscopy and balloon-assisted enteroscopy have a high diagnostic and therapeutic yield in these situations. Most lesions detected by small bowel endoscopy are amenable to endoscopic haemostasis, although some lesions still require surgery or interventional radiology. The management of these patients is varied, and doubt persists about which technique should be preferred as first-line treatment. This narrative review analyses the usefulness and impact of small bowel endoscopic techniques in the emergency setting for severe overt obscure gastrointestinal bleeding.

  20. Association between findings of drug-induced sleep endoscopy and hypoxemia%药物诱导睡眠内镜检查结果与低氧血症相关性研究

    Institute of Scientific and Technical Information of China (English)

    周鹏; 神平; 刘稳; 李培华; 李红权

    2016-01-01

    目的:通过回顾药物诱导睡眠内镜检查结果,寻找阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者上气道塌陷形态与多导睡眠监测结果的关联。方法经多导睡眠监测(PSG)诊断为 OSAHS 的患者51例,右美托咪定诱导睡眠后内镜观察仰卧位患者睡眠期腭咽、口咽侧壁、舌根、会厌和喉部5个部位的塌陷情况,并分析与多导睡眠监测仪(PSG)监测参数的相关性。结果腭咽部完全阻塞患者的呼吸暂停指数(AHI)、氧降指数(ODI)、血氧饱和度低于90%时间比(T <90%)明显高于不完全阻塞患者,最低血氧饱和度(LSaO2)明显低于不完全阻塞患者。口咽部塌陷方向均为 X 轴方向,即表现为侧壁塌陷,完全阻塞或不完全阻塞患者相较无阻塞患者,有着明显增高的 AHI、ODI 和 T <90%,明显降低的 LSaO2。结论口咽侧壁及腭咽部的阻塞表现出更明显的低氧血症,需要重视并予以积极治疗。%Objective To explore the correlation between patterns of upper airway collapse and results of polysomnog-raphy (PSG)in patients with obstructive sleep apnea-hypopnoea syndrome (OSAHS)by reviewing drug-induced sleep endoscopy (DISE)findings.Methods A total of 51 OSAHS cases confirmed by PSG underwent DISE after taking dexmedetomidine.The findings were observed using the VOTEL (velum,oropharynx,tongue base,epiglottis and lar-ynx)classification system.Associations between DISE and polysomnographic parameters were analyzed.Results Both velum collapse and complete lateral oropharyngeal collapse were significantly associated with increased severity of OSAHS,reflected by elevated apnea-hypopnea index (AHI),oxygen desaturation index (ODI),and T <90%,but decreased lowest oxygen saturation (LSaO2 ).If both collapses were on the X axis,the collapses were presented as lat-eral collapses.Conclusion There is strong association between complete lateral oropharyngeal wall

  1. Training the gastrointestinal endoscopy trainer.

    Science.gov (United States)

    Waschke, Kevin A; Anderson, John; Macintosh, Donald; Valori, Roland M

    2016-06-01

    Endoscopy training has traditionally been accomplished by an informal process in the endoscopy unit that parallels apprenticeship training seen in other areas of professional education. Subsequent to an audit, a series of interventions were implemented in the English National Health Service to support both service delivery and to improve endoscopy training. The resulting training centers deliver a variety of hands-on endoscopy courses, established in parallel with the roll out of a colon cancer screening program that monitors and documents quality outcomes among endoscopists. The program developed a 'training the trainer' module that subsequently became known as the Training the Colonoscopy Trainer course (TCT). Several years after its implementation, colonoscopy quality outcomes in the UK have improved substantially. The core TCT program has spread to other countries with demonstration of a marked impact on endoscopy training and performance. The aim of this chapter is to describe the principles that underlie effective endoscopy training in this program using the TCT as an example. While the review focuses on the specific example of colonoscopy training, the approach is generic to the teaching of any technical skill; it has been successfully transferred to the teaching of laparoscopic surgery as well as other endoscopic techniques.

  2. Design of Endoscopic Capsule With Multiple Cameras.

    Science.gov (United States)

    Gu, Yingke; Xie, Xiang; Li, Guolin; Sun, Tianjia; Wang, Dan; Yin, Zheng; Zhang, Pengfei; Wang, Zhihua

    2015-08-01

    In order to reduce the miss rate of the wireless capsule endoscopy, in this paper, we propose a new system of the endoscopic capsule with multiple cameras. A master-slave architecture, including an efficient bus architecture and a four level clock management architecture, is applied for the Multiple Cameras Endoscopic Capsule (MCEC). For covering more area of the gastrointestinal tract wall with low power, multiple cameras with a smart image capture strategy, including movement sensitive control and camera selection, are used in the MCEC. To reduce the data transfer bandwidth and power consumption to prolong the MCEC's working life, a low complexity image compressor with PSNR 40.7 dB and compression rate 86% is implemented. A chipset is designed and implemented for the MCEC and a six cameras endoscopic capsule prototype is implemented by using the chipset. With the smart image capture strategy, the coverage rate of the MCEC prototype can achieve 98% and its power consumption is only about 7.1 mW.

  3. A New Concept for Magnetic Capsule Colonoscopy based on an Electromagnetic System

    Directory of Open Access Journals (Sweden)

    Gioia Lucarini

    2015-03-01

    Full Text Available Traditional endoscopy based on flexible endoscopes is reliable and effective, but poorly tolerated by patients; it also requires extended training by physicians. In order to reduce the invasiveness of these procedures, wireless passive capsule endoscopy has been proposed and clinically used during the past decade. A capsule endoscope with an active locomotion mechanism is desirable for carrying out controllable interactive procedures that are normally not possible using passive devices. Due to many difficulties in embedding actuators in swallowable devices, many researchers and companies have adopted an external magnetic field actuation solution. Magnetic resonance modified systems or permanent magnets are used to manoeuvre capsules remotely; however, both these cases present some limitations: magnetic resonance systems are bulky and expensive and permanent magnets are intrinsically unstable to control, and it is impossible to switch them off. Within this framework, the authors present the design and assessment of a magnetic system for endoscopic capsules based on an electromagnetic approach. In particular, the use of a single electromagnet was proposed and investigated: magnetic attraction, locomotion forces and magnetic torques were modelled for guaranteeing the reliable navigation of the capsule and based on these specifications, an electromagnet was designed, developed and experimentally evaluated. The results demonstrated the feasibility of the proposed approach for active locomotion capsule endoscopy.

  4. Digestive Endoscopy in Morocco: What Future Perspectives?

    Directory of Open Access Journals (Sweden)

    Professor Adil Ibrahimi

    2016-12-01

    Full Text Available Interventional endoscopy has evolved in parallel with diagnostic endoscopy and throughout the years, the performance of interventional endoscopy has proved to be efficient in improving morbidity and mortality in many diseases: biliopancreatic catheterism, dilatations of most stenosis in different parts of the digestive tube, haemostatic treatment, prosthetic fitting and installation, as well as benign and malignant tumors removal (polypectomy, mucosectomy....

  5. Patency(C) and agile(C) capsules

    Institute of Scientific and Technical Information of China (English)

    àngel Caunedo-àlvarez; Javier Romero-Vazquez; Juan M Herrerias-Gutierrez

    2008-01-01

    Small bowel strictures can be missed by current diagnostic methods.The Patency capsule is a new non-endoscopic dissolvable capsule which has as an objective of checking the patency of digestive tract,in a non-invasive manner.The available clinical trials have demonstrated that the Patency(C) capsule is a good tool for assessment of the functional patency of the small bowel,and it allows identification of those patients who can safely undergo a capsule endoscopy,despite clinical and radiographic evidence of small-bowel obstruction.Some cases of intestinal occlusion have been reported with the Patency(C) capsule,four of them needed surgery.So,a new capsule with two timer plugs (Agile(C) capsule) has been recently developed in order to minimize the risk of occlusion.This new device stars its dissolution process earlier (30 h after ingestion) and its two timer plugs have been designed to begin the disintegration even when the device is blocked in a tight stricture.

  6. Autofluorescence imaging and magnification endoscopy

    Institute of Scientific and Technical Information of China (English)

    Monalisa Filip; Sevasti(t)a Iordache; Adrian S(a)ftoiu; Tudorel Ciurea

    2011-01-01

    It is well known that angiogenesis is critical in the transition from premalignant to malignant lesions.Consequently,early detection and diagnosis based on morphological changes to the microvessels are crucial.In the last few years,new imaging techniques which utilize the properties of light-tissue interaction have been developed to increase early diagnosis of gastrointestinal (GI)tract neoplasia.We analyzed several "red-flag" endoscopic techniques used to enhance visualization of the vascular pattern of preneoplastic and neoplastic lesions (e.g.trimodal imaging including autofluorescence imaging,magnifying endoscopy and narrow band imaging).These new endoscopic techniques provide better visualization of mucosal microsurface structure and microvascular architecture and may enhance the diagnosis and characterization of mucosal lesions in the GI tract.In the near future,it is expected that trimodal imaging endoscopy will be practiced as a standard endoscopy technique as it is quick,safe and accurate for making a precise diagnosis of gastrointestinal pathology,with an emphasis on the diagnosis of early GI tract cancers.Further large-scale randomized controlled trials comparing these modalities in different patient subpopulations are warranted before their endorsement in the routine practice of GI endoscopy.

  7. Relationship between timing of endoscopy and mortality in patients with peptic ulcer bleeding

    DEFF Research Database (Denmark)

    Laursen, Stig B; Leontiadis, Grigorios I; Stanley, Adrian J;

    2017-01-01

    BACKGROUND AND AIMS: The optimal timing of endoscopy in patients with peptic ulcer bleeding (PUB) remains unclear. The aim of this study was to examine the association between timing of endoscopy and mortality in PUB. METHODS: A nationwide cohort study based on a database of consecutive patients...... admitted to hospital with PUB in Denmark. Patients were stratified according to presence of hemodynamic instability at presentation and American Society of Anesthesiologists (ASA) score. Using descriptive statistics and logistic regression analyses, we identified optimal time frames for endoscopy...... and analyzed the association between timing of endoscopy and in-hospital mortality after adjusting for confounding factors. RESULTS: A total of 12,601 patients were included. We did not find any universal association between timing of endoscopy and mortality in hemodynamically stable patients with an ASA...

  8. Update of endoscopy in liver disease: More than just treating varices

    Institute of Scientific and Technical Information of China (English)

    Christoforos Krystallis; Gail S Masterton; Peter C Hayes; John N Plevris

    2012-01-01

    The management of complications in liver disease is often complex and challenging. Endoscopy has undergone a period of rapid expansion with numerous novel and specialized endoscopic modalities that are of increasing value in the investigation and management of the patient with liver disease. In this review, relevant literature search and expert opinions have been used to provide a brief overview and update of the current endoscopic management of patients with liver disease and portal hypertension. The main areas covered are safety of endoscopy in patients with liver disease, the use of standard endoscopy for the treatment of varices and the role of new endoscopic modalities such as endoscopic ultrasound, esophageal capsule, argon plasma coagulation, spyglass and endomicroscopy in the investigation and treatment of liver-related gastrointestinal and biliary pathology. It is clear that the role of the endoscopy in liver disease is well beyond that of just treating varices. As the technology in endoscopy expands, so does the role of the endoscopist in liver disease.

  9. Ultrahigh speed en face OCT capsule for endoscopic imaging.

    Science.gov (United States)

    Liang, Kaicheng; Traverso, Giovanni; Lee, Hsiang-Chieh; Ahsen, Osman Oguz; Wang, Zhao; Potsaid, Benjamin; Giacomelli, Michael; Jayaraman, Vijaysekhar; Barman, Ross; Cable, Alex; Mashimo, Hiroshi; Langer, Robert; Fujimoto, James G

    2015-04-01

    Depth resolved and en face OCT visualization in vivo may have important clinical applications in endoscopy. We demonstrate a high speed, two-dimensional (2D) distal scanning capsule with a micromotor for fast rotary scanning and a pneumatic actuator for precision longitudinal scanning. Longitudinal position measurement and image registration were performed by optical tracking of the pneumatic scanner. The 2D scanning device enables high resolution imaging over a small field of view and is suitable for OCT as well as other scanning microscopies. Large field of view imaging for screening or surveillance applications can also be achieved by proximally pulling back or advancing the capsule while scanning the distal high-speed micromotor. Circumferential en face OCT was demonstrated in living swine at 250 Hz frame rate and 1 MHz A-scan rate using a MEMS tunable VCSEL light source at 1300 nm. Cross-sectional and en face OCT views of the upper and lower gastrointestinal tract were generated with precision distal pneumatic longitudinal actuation as well as proximal manual longitudinal actuation. These devices could enable clinical studies either as an adjunct to endoscopy, attached to an endoscope, or as a swallowed tethered capsule for non-endoscopic imaging without sedation. The combination of ultrahigh speed imaging and distal scanning capsule technology could enable both screening and surveillance applications.

  10. The American Society for Gastrointestinal Endoscopy (ASGE) diagnostic algorithm for obscure gastrointestinal bleeding: eight burning questions from everyday clinical practice.

    Science.gov (United States)

    Rondonotti, Emanuele; Marmo, Riccardo; Petracchini, Massimo; de Franchis, Roberto; Pennazio, Marco

    2013-03-01

    The diagnosis and management of patients with obscure gastrointestinal bleeding are often long and challenging processes. Over the last 10 years the introduction in clinical practice of new diagnostic and therapeutic procedures (i.e. Capsule Endoscopy, Computed Tomographic Enterography, Magnetic Resonance Enterography, and Device Assisted Enteroscopy) has revolutionized the diagnostic/therapeutic work-up of these patients. Based on evidence published in the last 10 years, international scientific societies have proposed new practice guidelines for the management of obscure gastrointestinal bleeding, which include these techniques. However, although these algorithms (the most recent ones are endorsed by the American Society for Gastrointestinal Endoscopy - ASGE) allow the management of the large majority of patients, some issues still remain unsolved. The present paper reports the results of the discussion, based on the literature published up to September 2011, among a panel of experts and gastroenterologists, working with Capsule Endoscopy and with Device Assisted Enteroscopy, attending the 6th annual meeting of the Italian Club for Capsule Endoscopy and Enteroscopy. Eight unresolved issues were selected: each of them is presented as a "Burning question" and the "Answer" is the strategy proposed to manage it, according to both the available evidence and the discussion among participants.

  11. [Sedation in pediatric digestive endoscopy].

    Science.gov (United States)

    Montanari, F; Viola, L; Amarri, S

    2001-01-01

    Sedation for children doing diagnostic or operative pediatric gastrointestinal endoscopy (PE) procedures is performed differently over the world and no consensus is yet agreed on the best paediatric endoscopy sedation (PES). Some centres do not use any sedation, especially in infants, most centre use some form of sedation: conscious sedation, deep sedation and general anaesthesia. We review sedation drugs and describe our centre protocol on 188 consecutive PE: oral premedication with flunitrazepam (0.05 mg/kg/dose) at least 30 min before procedure, petidine (1 mg/kg) followed by increasing boluses of midazolam (0.05 mg/kg up to a maximal 0.2 mg/kg or 5 mg) were given i.v. to obtain a conscious sedation. All PE could be performed and ended safely, PES resulted satisfactory in approximately 65% of patient having conscious sedation. SaO2 Endoscopy and sedation was always performed by the PE team in the immediate vicinity of anaesthesiologists at work. PE can be safely performed with conscious sedation. Basic and advanced resuscitation skills are needed for the PE team who wish to perform both endoscopic and sedation procedures.

  12. An approach to the capsule endoscopic robot with active drive motion

    Institute of Scientific and Technical Information of China (English)

    Da-qiang GU; Yong ZHOU

    2011-01-01

    Commercialized capsule-type endoscopes move passively by peristaltic waves (and gravity), which makes it difficult for doctors to diagnose the areas of interest more thoroughly and actively. To resolve this problem of passivity, it is necessary to find a special locomotion principle, which fits the gastrointestinal (GI) tract. In this paper, a legged locomotive mechanism with shape memory alloy (SMA) actuation based on the peristaltic principle is proposed, and then the structure of the locomotion mechanism is introduced. Based on the preliminary results, the design, modeling, and fabrication of an SMA microactuation concept for application in an endoscopic capsule are given, as well as the SMA spring and legged component design, which is the core section of the system design. We used the pseudo-rigid-body model (PRBM) to analyze nonlinear and large deflections of the SMA legged component. Thus, a prototype endoscope with an SMA spring and six legged components was designed and fabricated. It is 15 mm in diameter and 33 mm in total length, with a hollow space to house other parts needed for endoscopy such as a camera, a radio frequency (RF) module, and sensors. During testing, the locomotive mechanism was effective in a plastic tube environment.

  13. Endoscopy: MedlinePlus Health Topic

    Science.gov (United States)

    ... Upper Endoscopy for Kids (North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition) - PDF Also in Spanish Women Hysteroscopy (American College of Obstetricians and Gynecologists) - ...

  14. European Society of Gastrointestinal Endoscopy - Establishing the key unanswered research questions within gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Rees, Colin J; Ngu, Wee Sing; Regula, Jaroslaw

    2016-01-01

    Background and study aim: Gastrointestinal endoscopy is a rapidly evolving research field. The European Society of Gastrointestinal Endoscopy (ESGE) plays a key role in shaping opinion and endoscopy activity throughout Europe and further afield. Establishing key unanswered questions within the fi...

  15. [Evaluation of nopal capsules in diabetes mellitus].

    Science.gov (United States)

    Frati Munari, A C; Vera Lastra, O; Ariza Andraca, C R

    1992-01-01

    To find out if commercial capsules with dried nopal (prickle-pear cactus, Opuntia ficus indica may have a role in the management of diabetes mellitus, three experiments were performed: 30 capsules where given in fasting condition to 10 diabetic subjects and serum glucose was measured through out 3 hours; a control test was performed with 30 placebo capsules. OGTT with previous intake of 30 nopal or placebo capsules was performed in ten healthy individuals. In a crossover and single blinded study 14 diabetic patients withdrew the oral hypoglycemic treatment and received 10 nopal or placebo capsules t.i.d. during one week; serum glucose, cholesterol and tryglycerides levels were measured before and after each one-week period. Five healthy subjects were also studied in the same fashion. Opuntia capsules did not show acute hypoglycemic effect and did not influence OGTT. In diabetic patients serum glucose, cholesterol and tryglycerides levels did not change with Opuntia, but they increased with placebo (P nopal, while cholesterol and triglycerides decreased (P < 0.01 vs. placebo). The intake of 30 Opuntia capsules daily in patients with diabetes mellitus had a discrete beneficial effect on glucose and cholesterol. However this dose is unpractical and at present it is not recommended in the management of diabetes mellitus.

  16. SWALLOWABLE WIRELESS CAPSULAR ENDOSCOPY: A NOVEL BREAKTHROUGH IN THE BIOMEDICAL INDUSTRY AND FUTURE PROGRESS

    Directory of Open Access Journals (Sweden)

    P.V. Waghmare*, C.V. Panchal and B.N. Poul

    2013-11-01

    Full Text Available Wireless capsule endoscopy (WCE is a medical procedure which has revolutionized for the first time a painless inspection of the small intestine. It is a simple, safe, non-invasive, reliable technique, well accepted and tolerated by the patients, which allows complete exploration of the small intestine. WCE has vitamin size pill which captures images of the digestive tract and entire small bowel, transported passively by peristalsis. WCE is a novel breakthrough in the biomedical industry and future progresses in key technologies, expected to drive the development of the next generation of such devices. WCE became an essential component in the management of several clinical conditions. WCE offers diagnostic tool for diseases like small bowel, gastrointestinal bleeding, Crohn's disease, localization of small bowel tumor, colon cancer screening, assessment of esophageal disorders and diagnosis of coeliac disease. However, compared with wired endoscopies, the limited working time, the low frame rate and the low image resolution limit the wider application. The progress of this new technology is reviewed in this paper and the evolution tendencies are analyzed to be high image resolution, high frame rate, long working time and also current indications of capsule endoscopy.

  17. Inductive-Based Wireless Power Recharging System for an Innovative Endoscopic Capsule

    Directory of Open Access Journals (Sweden)

    Giuseppe Tortora

    2015-09-01

    Full Text Available Wireless capsule endoscopic devices are adopted for painless diagnosis of cancer and other diseases affecting the gastrointestinal tract as an alternative to traditional endoscopy. Although much work has been done to improve capsule performance in terms of active navigation, a major drawback is the limited available energy on board the capsule, usually provided by a battery. Another key shortcoming of active capsules is their limitation in terms of active functionalities and related costs. An inductive-based wireless recharging system for the development of an innovative capsule for colonoscopy is proposed in this paper; the aim is to provide fast off-line battery recovery for improving capsule lifecycle and thus reducing the cost of a single endoscopic procedure. The wireless recharging system has been properly designed to fit the dimensions of a capsule for colonoscopy but it can be applied to any biomedical devices to increase the number of times it can be used after proper sterilization. The current system is able to provide about 1 W power and is able to recharge the battery capsule in 20 min which is a reasonable time considering capsule operation time (10–15 min.

  18. An ultra-low-power image compressor for capsule endoscope

    Directory of Open Access Journals (Sweden)

    Weng Ping-Kuo

    2006-02-01

    Full Text Available Abstract Background Gastrointestinal (GI endoscopy has been popularly applied for the diagnosis of diseases of the alimentary canal including Crohn's Disease, Celiac disease and other malabsorption disorders, benign and malignant tumors of the small intestine, vascular disorders and medication related small bowel injury. The wireless capsule endoscope has been successfully utilized to diagnose diseases of the small intestine and alleviate the discomfort and pain of patients. However, the resolution of demosaicked image is still low, and some interesting spots may be unintentionally omitted. Especially, the images will be severely distorted when physicians zoom images in for detailed diagnosis. Increasing resolution may cause significant power consumption in RF transmitter; hence, image compression is necessary for saving the power dissipation of RF transmitter. To overcome this drawback, we have been developing a new capsule endoscope, called GICam. Methods We developed an ultra-low-power image compression processor for capsule endoscope or swallowable imaging capsules. In applications of capsule endoscopy, it is imperative to consider battery life/performance trade-offs. Applying state-of-the-art video compression techniques may significantly reduce the image bit rate by their high compression ratio, but they all require intensive computation and consume much battery power. There are many fast compression algorithms for reducing computation load; however, they may result in distortion of the original image, which is not good for use in the medical care. Thus, this paper will first simplify traditional video compression algorithms and propose a scalable compression architecture. Conclusion As the result, the developed video compressor only costs 31 K gates at 2 frames per second, consumes 14.92 mW, and reduces the video size by 75% at least.

  19. Innovation and Best Practices in Endoscopy

    NARCIS (Netherlands)

    C.W. Teshima (Christopher)

    2013-01-01

    textabstractAdvances in gastrointestinal (GI) endoscopy have played an important role in improving the diagnostic and therapeutic options for physicians treating patients with GI diseases. Indeed, the advent of endoscopy transformed the field of Gastroenterology and contributed significantly to its

  20. Appropriate use of endoscopy in the diagnosis and treatment of gastrointestinal diseases: up-to-date indications for primary care providers

    Directory of Open Access Journals (Sweden)

    Vien X Nguyen

    2010-11-01

    Full Text Available Vien X Nguyen1, Vi Thuy Le Nguyen2, Cuong C Nguyen11Department of Gastroenterology, Mayo Clinic, Scottsdale, AZ, USA; 2Department of Pharmacy, Banner Baywood Medical Center, Mesa, AZ, USAAbstract: The field of endoscopy has revolutionized the diagnosis and treatment of ­gastrointestinal (GI diseases in recent years. Besides the ‘traditional’ endoscopic ­procedures (esophagogastroduodenoscopy, colonoscopy, flexible sigmoidoscopy, and endoscopic retrograde cholangiopancreatography, advances in imaging technology (endoscopic ultrasonography, ­wireless capsule endoscopy, and double balloon enteroscopy have allowed GI specialists to detect and manage disorders throughout the digestive system. This article reviews various ­endoscopic procedures and provides up-to-date endoscopic indications based on the ­recommendations of American Society for Gastrointestinal Endoscopy and American Cancer Society for primary care providers in order to achieve high-quality and cost-effective care.Keywords: endoscopy, endoscopic indications, endoscopic procedures, imaging, primary care, gastrointestinal disorders, appropriate use

  1. Fluorescence endoscopy and photodynamic therapy.

    Science.gov (United States)

    Messmann, H; Endlicher, E; Gelbmann, C M; Schölmerich, J

    2002-10-01

    Fluorescence endoscopy is a new technique which allows a better detection of non-visible malignant or premalignant lesions or, those which are difficult to detect. Exogenously applied sensitisers accumulate selectively in malignant lesions and induce fluorescence after illumination with light of adequate wavelength. However, also endogenous fluorophores, different located in malignant or benign lesions, induce a different autofluorescence in these lesions. Tissue fluorescence can be detected by optical sampling of the mucosa using fluorescence spectroscopy or by generating real time fluorescence images with specialised camera systems. Compared to point fluorescence spectroscopy the latter technique enables the screening of large surface areas of mucosa. Meanwhile, fluorescence endoscopy is a widely used technique in urology employing 5-aminolaevulinic acid sensitisation. In gastroenterology, this technique seems promising for the detection of early cancers or dysplasia in patients with Barrett's oesophagus or ulcerative colitis. Using different sensitisers, photodynamic therapy seems to be a promising option for patients with advanced oesophageal cancer and in the palliative treatment of non-resectable bile duct cancer, furthermore for patients with early gastric cancer and dysplasia in Barrett's oesophagus. Probably, by laser light fractionation or a combination of different sensitisers, an enhanced effect can be expected.

  2. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

    Full Text Available Introduction: Elective upper and lower GI endoscopy is usually performed in children on an outpatient basis with the child under sedation or general anesthesia (GA. The objective of this study was to describe Anesthesia related complications in   children undergoing elective GI endoscopy.   Materials and Methods: The study design was descriptive on 1388 patients undergoing elective GI endoscopy in Sheikh Hospital from 2009 to 2013. All patient received propofol or standard inhalational anesthesia. We examined patients’ demographic data  ,  location of GI endoscopy ,  perioperative vital singe ,  recovery time , respiratory and cardiac complications , post operative nausea and vomiting , agitation , diagnosis and outcome   Results: Pediatric patients aged 2 to 17 years. 29 % of elective GI endoscopy was upper GI endoscopy and 70.3 % was lower GI endoscopy and 0.7 was both of them. 47.7 % of Pediatric patients were female and 52.3 % was male. We haven’t significant or fatal anesthesia related respiratory and cardiac complications (no apnea, no cardiac arrest. 8 patients (0.5% have transient bradicardia in post operative care Unit. 83 patients (5.9% have post operative nausea and vomiting controlled by medication.  6 patients (0.4% have post operative agitation controlled by medication.   Conclusions: General anesthesia and deep sedation in children undergoing elective GI endoscopy haven’t significant or fatal anesthesia related complications. We suggest Anesthesia for infants, young children, children with neurologic impairment, and some anxious older children undergoing elective GI endoscopy. Keyword: Anesthesia, Complication, Endoscopy, Pediatric.

  3. Propeller-based wireless device for active capsular endoscopy in the gastric district.

    Science.gov (United States)

    Tortora, Giuseppe; Valdastri, Pietro; Susilo, Ekawahyu; Menciassi, Arianna; Dario, Paolo; Rieber, Fabian; Schurr, Marc Oliver

    2009-01-01

    An innovative approach to active locomotion for capsular endoscopy in the gastric district is reported in this paper. Taking advantage of the ingestion of 500 ml of transparent liquid by the patient, an effective distension of the stomach is safely achieved for a timeframe of approximately 30 minutes. Given such a scenario, an active swallowable capsule able to navigate inside the stomach thanks to a four propeller system has been developed. The capsule is 15 mm in diameter and 30 mm in length, and it is composed of a supporting shell containing a wireless microcontroller, a battery and four motors. The motors enable the rotation of propellers located in the rear side of the device, thus obtaining a reliable locomotion and steering of the capsule in all directions in a liquid. The power consumption has been properly optimized in order to achieve an operative lifetime consistent with the time of the diagnostic inspection of the gastric district, assumed to be no more than 30 minutes. The capsule can be easily remotely controlled by the endoscopist using a joystick together with a purposely developed graphical user interface. The capsule design, prototyping, in vitro, ex vivo and preliminary in vivo tests are described in this work.

  4. Outcome of endoscopy-negative iron deficiency anemia in patients above 65

    Science.gov (United States)

    Clere-Jehl, Raphaël; Sauleau, Erik; Ciuca, Stefan; Schaeffer, Mickael; Lopes, Amanda; Goichot, Bernard; Vogel, Thomas; Kaltenbach, Georges; Bouvard, Eric; Pasquali, Jean-Louis; Sereni, Daniel; Andres, Emmanuel; Bourgarit, Anne

    2016-01-01

    Abstract After the age of 65 years, iron deficiency anemia (IDA) requires the elimination of digestive neoplasia and is explored with upper and lower gastrointestinal (GI) endoscopy. However, such explorations are negative in 14% to 37% of patients. To further evaluate this issue, we evaluated the outcomes of patients aged over 65 years with endoscopy-negative IDA. We retrospectively analyzed the outcomes of in-patients over the age of 65 years with IDA (hemoglobin <12 g/dL and ferritin <70 μg/L) who had negative complete upper and lower GI endoscopies in 7 tertiary medical hospitals. Death, the persistence of anemia, further investigations, and the final diagnosis for IDA were analyzed after at least 12 months by calling the patients’ general practitioners and using hospital records. Between 2004 and 2011, 69 patients (74% women) with a median age of 78 (interquartile range (IQR) 75–82) years and hemoglobin and ferritin levels of 8.4 (IQR 6.8–9.9) g/dL and 14 (IQR 8–27) μg/L, respectively, had endoscopy-negative IDA, and 73% of these patients received daily antithrombotics. After a follow-up of 41 ± 22 months, 23 (33%) of the patients were dead; 5 deaths were linked with the IDA, and 45 (65%) patients had persistent anemia, which was significantly associated with death (P = 0.007). Further investigations were performed in 45 patients; 64% of the second-look GI endoscopies led to significant changes in treatment compared with 25% for the capsule endoscopies. Conventional diagnoses of IDA were ultimately established for 19 (27%) patients and included 3 cancer patients. Among the 50 other patients, 40 (58%) had antithrombotics. In endoscopy-negative IDA over the age of 65 years, further investigations should be reserved for patients with persistent anemia, and second-look GI endoscopy should be favored. If the results of these investigations are negative, the role of antithrombotics should be considered. PMID:27893668

  5. Leadership and team building in gastrointestinal endoscopy.

    Science.gov (United States)

    Valori, Roland M; Johnston, Deborah J

    2016-06-01

    A modern endoscopy service delivers high volume procedures that can be daunting, embarrassing and uncomfortable for patients [1]. Endoscopy is hugely beneficial to patients but only if it is performed to high standards [2]. Some consequences of poor quality endoscopy include worse outcomes for cancer and gastrointestinal bleeding, unnecessary repeat procedures, needless damage to patients and even avoidable death [3]. New endoscopy technology and more rigorous decontamination procedures have made endoscopy more effective and safer, but they have placed additional demands on the service. Ever-scarcer resources require more efficient, higher turnover of patients, which can be at odds with a good patient experience, and with quality and safety. It is clear from the demands put upon it, that to deliver a modern endoscopy service requires effective leadership and team working [4]. This chapter explores what constitutes effective leadership and what makes great clinical teams. It makes the point that endoscopy services are not usually isolated, independent units, and as such are dependent for success on the organisations they sit within. It will explain how endoscopy services are affected by the wider policy and governance context. Finally, within the context of the collection of papers in this edition of Best Practice & Research: Clinical Gastroenterology, it explores the potentially conflicting relationship between training of endoscopists and service delivery. The effectiveness of leadership and teams is rarely the subject of classic experimental designs such as randomized controlled trials. Nevertheless there is a substantial literature on this subject within and particularly outside healthcare [5]. The authors draw on this wider, more diffuse literature and on their experience of delivering a Team Leadership Programme (TLP) to the leaders of 70 endoscopy teams during the period 2008-2012. (Team Leadership Programme Link-http://www.qsfh.co.uk/Page.aspx?PageId=Public).

  6. Sedation regimens for gastrointestinal endoscopy.

    Science.gov (United States)

    Moon, Sung-Hoon

    2014-03-01

    Sedation allows patients to tolerate unpleasant endoscopic procedures by relieving anxiety, discomfort, or pain. It also reduces a patient's risk of physical injury during endoscopic procedures, while providing the endoscopist with an adequate setting for a detailed examination. Sedation is therefore considered by many endoscopists to be an essential component of gastrointestinal endoscopy. Endoscopic sedation by nonanesthesiologists is a worldwide practice and has been proven effective and safe. Moderate sedation/analgesia is generally accepted as an appropriate target for sedation by nonanesthesiologists. This focused review describes the general principles of endoscopic sedation, the detailed pharmacology of sedatives and analgesics (focused on midazolam, propofol, meperidine, and fentanyl), and the multiple regimens available for use in actual practice.

  7. Engineering Stable Hollow Capsules

    Institute of Scientific and Technical Information of China (English)

    2003-01-01

    @@ Scientists at the CAS Institute of Chemistry have been succeeded in fabricating stable hollow capsules by extending covalent layer-by-layer self-assembly(CSA)technique from 2-dimensional to 3-dimensional systems.

  8. Role of videocapsule endoscopy for gastrointestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    Cristina Carretero; Ignacio Fernandez-Urien; Maite Betes; Miguel Mu(n)oz-Navas

    2008-01-01

    Obscure gastrointestinal bleeding (OGIB) is defined as bleeding of an unknown origin that persists or recurs after negative initial upper and lower endoscopies.Several techniques,such as endoscopy,arteriography,scintigraphy and barium radiology are helpful for recognizing the bleeding source;nevertheless,in about 5%-10% of cases the bleeding lesion cannot be determined.The development of videocapsule endoscopy (VCE) has permitted a direct visualization of the small intestine mucosa.We will analyze those techniques in more detail.The diagnostic yield of CE for OGIB varies from 38% to 93%,being in the higher range in those cases with obscure-overt bleeding.

  9. Capsule enteroscopy and radiology of the small intestine

    Energy Technology Data Exchange (ETDEWEB)

    Fork, Frans-Thomas [Malmoe University Hospital, Department of Diagnostic Radiology, Malmoe (Sweden); Aabakken, Lars [Rikshospitalet University Hospital, Department of Gastroenterology, Oslo (Norway)

    2007-12-15

    In a very few years, the video capsule for small bowel enteroscopy has gained widespread clinical acceptance. It is readily ingested, disposable, and allows for a complete, low-invasive endoscopic examination of the entire mucosa of the small bowel. It is a patient-friendly method and a first-line procedure in the difficult evaluation of obscure gastrointestinal bleeding. It has the highest proven figure of diagnostic sensitivity for detecting lesions of the mucosa, irrespective of aetiology. The limitations of capsule endoscopy include difficulty in localising mucosal lesions anatomically and its restricted use in patients with dysphagia, strictures or motor dysfunction. Strictures, transmural and extra-mural lesions in patients with small bowel Crohn's disease are evaluated by MRI- enterography and CT-enterography. (orig.)

  10. Capsule contraction syndrome

    Directory of Open Access Journals (Sweden)

    Mesut COŞKUN

    2009-06-01

    Full Text Available Capsule contraction syndrome occurs after fibrous metaplasia of lens proteins that leads to capsular bag contraction. Excessive front capsular wrinkling is seen in capsule contraction syndrome and there is an imbalance between powers supplying capsular integrity. This situation leads to zonular weakness. Capsule contraction syndrome is associated with pseudoexfoliation, older age, uveitis, pars planitis and myotonic muscular dystrophy. In order to decrease the risk of capsule contraction syndrome, front capsulerhexis area should be open as 5.5-6 mm diameter and a curysoft intraocular lens should be used. In order to prevent lens epithelial proliferation and metaplasia, lens epithelial cells at inferior surface of front capsule should be aspirated carefully. If postoperative capsular contraction detected, front capsulotomy should be performed by Nd-YAG laser at postoperative 2 to 3 weeks. In patients that Nd-YAG laser is unsuccessful, capsular tension should be decreased by surgical microincisions. In present study, we evaluated etiology, prevention and management of capsule contraction syndrome in the light of actual literature knowledge.

  11. Contact Endoscopy of mucosal lesions of oral cavity – Preliminary experience

    Science.gov (United States)

    Mishra, Awadhesh Kumar; Nilakantan, Ajith; Sahai, Kavita; Datta, Rakesh; Malik, Ajay

    2014-01-01

    Background Contact Endoscopy is a non invasive tool to visualise alterations in cell architecture in vivo. In this study we investigated the diagnostic accuracy of Contact Endoscopy in detecting malignancy in oral mucosal lesions. Methods 76 patients with oral mucosal lesions requiring biopsy were included. Contact Endoscopy was performed by Otolaryngologist before biopsy and findings recorded. The lesion was then biopsied and sent for histopathological examination by Pathologist who was blinded to Contact Endoscopy findings. Findings of Contact Endoscopy were compared with histopathological findings taking the latter as the gold standard. Two biopsies were reported as ‘inconclusive’ on histopathological examination and hence excluded from the final analysis. Data of the remaining 74 patients is presented here. Results Clinically lesions were diagnosed as ulcero-proliferative lesions in 34 patients, Leukoplakia in 19, Erythroplakia in 9, Lichen planus in 5 and Submucous fibrosis in 7 patients. Histopathological examination revealed presence of malignancy in 97.06% of ulcero-proliferative mucosal lesions, 10.53% of leukoplakia and 33.33% of erythroplakia while corresponding figures on Contact Endoscopy were 94.12%, 5.26% and 11.11% respectively. No malignancy was detected in lichen planus and submucous fibrosis by either technique. When compared with histopathological examination, CE showed sensitivity of 84.21%, specificity of 94.44% and accuracy of 89.19%. No adverse effects on the patients were seen due to the procedure or stain. Conclusion Contact Endoscopy may be useful in determining cellular structure in vivo without biopsy to detect oral malignancy early. Further studies are suggested. PMID:25378780

  12. Ketamine Sedation in Gastrointestinal Endoscopy in Children

    Directory of Open Access Journals (Sweden)

    Ayman E. Eskander

    2016-07-01

    CONCLUSION: Ketamine sedation found to be safe for paediatric gastrointestinal endoscopy in Egyptian children without co-morbidities. Transient Hypoxia (13% may occur but easily reversed by nasal oxygen therapy.

  13. Indicators of Safety Compromise in Gastrointestinal Endoscopy

    OpenAIRE

    Borgaonkar, Mark R; Lawrence Hookey; Roger Hollingworth; Kuipers, Ernst J; Alan Forster; David Armstrong; Alan Barkun; Ronald Bridges; Rose Carter; Chris de Gara; Catherine Dube; Robert Enns; Donald MacIntosh; Sylviane Forget; Grigorios Leontiadis

    2012-01-01

    The growth in the use of endoscopy to diagnose and treat many gastointestinal disorders, and its central role in cancer screening programs, has led to a significant increase in the number of procedures performed. This growth, however, has also led to many variations in, among others, the provision of services, the choice of sedative medications and the training of providers. The recognition of the significance of quality in endoscopy has prompted several countries, including Canada, to initia...

  14. Lubricin in human breast tissue expander capsules.

    Science.gov (United States)

    Cheriyan, Thomas; Guo, Lifei; Orgill, Dennis P; Padera, Robert F; Schmid, Thomas M; Spector, Myron

    2012-10-01

    Capsular contraction is the most common complication of breast reconstruction surgery. While presence of the contractile protein alpha smooth muscle actin (α-SMA) is considered among the causes of capsular contraction, the exact etiology and pathophysiology is not fully understood. The objective of this study was to investigate the possible role of lubricin in capsular formation and contraction by determining the presence and distribution of the lubricating protein lubricin in human breast tissue expander capsules. Related aims were to evaluate select histopathologic features of the capsules, and the percentage of cells expressing α-SMA, which reflects the myofibroblast phenotype. Capsules from tissue expanders were obtained from eight patients. Lubricin, at the tissue-implant interface, in the extracellular matrix, and in cells, and α-SMA-containing cells were evaluated immunohistochemically. The notable finding was that lubricin was identified in all tissue expander capsules: as a discrete layer at the tissue-implant interface, extracellular, and intracellular. There was a greater amount of lubricin in the extracellular matrix in the intimal-subintimal zone when compared with the tissue away from the implant. Varying degrees of synovial metaplasia were seen at the tissue-implant interface. α-SMA-containing cells were also seen in all but one patient. The findings might help us better understand factors involved in capsule formation.

  15. Upper gastrointestinal endoscopy in children: The Lagos University Teaching Hospital experience

    Directory of Open Access Journals (Sweden)

    Oluwafunmilayo Funke Adeniyi

    2016-12-01

    Full Text Available Background. Paediatric endoscopy is now standard care in the developed world for the management of gastrointestinal (GI disorders. However, in developing countries endoscopy remains an underutilised tool. Objective. To determine the indications and the spectrum of endoscopic findings in children seen at the Lagos University Teaching Hospital, Nigeria. Methods. The indications for upper GI endoscopy and endoscopic findings in children ≤16 years old, referred for the procedure from June 2013 to June 2016, were documented. The endoscopic yield in these children was also determined. Results. In total 71 children were referred for upper GI endoscopy during the study period. There were 35 boys and 36 girls aged 3 months to 16 years. The indications for upper endoscopy were recurrent abdominal pain in 37 (52.1%, upper GI bleeding in 17 (23.9%, recurrent vomiting in 7 (9.9%, dyspepsia in 5 (7.0, heartburn in 2 (2.8%, dysphagia in 1 (1.4, portal hypertension in 1 (1.4 and ingestion of corrosives in 1 (1.4% of the subjects. Endoscopic findings were as follows: gastritis 19 (26.8%, hiatus hernia in 13 (18.3%, gastric erosions in 12 (16.9%, oesophageal varices 6 (8.4%, duodenitis in 4 (5.6%, gastric ulcer in 3 (4.2%, gastric polyp in 2 (2.8%. The overall endoscopic yield was 60.2%. Conclusion. There is a need to increase the awareness of the role of paediatric endoscopy in the diagnosis and treatment of GI disorders in developing countries. Recurrent abdominal pain still remains a relevant indication for the procedure. The need to develop training programmes for paediatric endoscopy and paediatric gastroenterology in general in developing countries cannot be overemphasised.

  16. Recent advances in photoacoustic endoscopy.

    Science.gov (United States)

    Yoon, Tae-Jong; Cho, Young-Seok

    2013-11-16

    Imaging based on photoacoustic effect relies on illuminating with short light pulses absorbed by tissue absorbers, resulting in thermoelastic expansion, giving rise to ultrasonic waves. The ultrasonic waves are then detected by detectors placed around the sample. Photoacoustic endoscopy (PAE) is one of four major implementations of photoacoustic tomography that have been developed recently. The prototype PAE was based on scanning mirror system that deflected both the light and the ultrasound. A recently developed mini-probe was further miniaturized, and enabled simultaneous photoacoustic and ultrasound imaging. This PAE-endoscopic ultrasound (EUS) system can offer high-resolution vasculature information in the gastrointestinal (GI) tract and display differences between optical and mechanical contrast compared with single-mode EUS. However, PAE for endoscopic GI imaging is still at the preclinical stage. In this commentary, we describe the technological improvements in PAE for possible clinical application in endoscopic GI imaging. In addition, we discuss the technical details of the ultrasonic transducer incorporated into the photoacoustic endoscopic probe.

  17. NIF capsule performance modeling

    Directory of Open Access Journals (Sweden)

    Weber S.

    2013-11-01

    Full Text Available Post-shot modeling of NIF capsule implosions was performed in order to validate our physical and numerical models. Cryogenic layered target implosions and experiments with surrogate targets produce an abundance of capsule performance data including implosion velocity, remaining ablator mass, times of peak x-ray and neutron emission, core image size, core symmetry, neutron yield, and x-ray spectra. We have attempted to match the integrated data set with capsule-only simulations by adjusting the drive and other physics parameters within expected uncertainties. The simulations include interface roughness, time-dependent symmetry, and a model of mix. We were able to match many of the measured performance parameters for a selection of shots.

  18. Diagnosis of Adult Chronic Rhinosinusitis: Can Nasal Endoscopy Predict Intrasinus Disease?

    Directory of Open Access Journals (Sweden)

    Arif Ali Kolethekkat

    2013-11-01

    Full Text Available Objectives: To define the role of endoscopic evaluation of middle meatus in adult patients clinically diagnosed to have chronic rhino-sinusitis and its ability to predict intra-sinus mucosal involvement as compared to CT scan.Methods: This prospective analytical study was conducted on consecutive patients with diagnosis of chronic rhino-sinusitis who were symptomatic and fulfilled the American Academy of Otolaryngology - Head and Neck Surgery Task Force criteria. The patients were enrolled prospectively and were subjected to rigid diagnostic nasal endoscopy and classified as defined by the revised Sinus Allergy Health Partnership Task Force criteria. The patients then underwent non contrast CT sinuses on the same day. Results were analyzed as a diagnostic test evaluation using CT as a gold standard.Results: Among the 75 study patients with symptom based chronic rhino-sinusitis, nasal endoscopy was abnormal in 65 patients (87%. Of these patients, 60/65 (92% showed positive findings on CT scan. Ten patients had normal endoscopy, of these 6/10 (60% had abnormal CT scan. Sensitivity and specificity of diagnostic nasal endoscopy against CT scan were 91% (95% CI: 81-97 and 44% (95% CI: 14-79, respectively. The likelihood ratio for positive nasal endoscopy to diagnose chronic rhino-sinusitis was 1.6 and the likelihood ratio to rule out chronic rhino-sinusitis when endoscopy was negative was 0.2.Conclusion: Nasal endoscopy is a valid and objective diagnostic tool in the work up of patients with symptomatic chronic rhino-sinusitis. When clinical suspicion is low (90% of patients when clinical suspicion is high (88% as defined in this study by AAO-HNS Task Force criteria. Negative endoscopy, however, does not totally exclude the sinus disease in patients fulfilling task force criteria. CT scan may be needed on follow-up if there is clinical suspicion in 10% of these patients who are negative on endoscopy if symptoms persists. It is thus possible to reduce

  19. Computer-aided decision support systems for endoscopy in the gastrointestinal tract: a review.

    Science.gov (United States)

    Liedlgruber, Michael; Uhl, Andreas

    2011-01-01

    Today, medical endoscopy is a widely used procedure to inspect the inner cavities of the human body. The advent of endoscopic imaging techniques-allowing the acquisition of images or videos-created the possibility for the development of the whole new branch of computer-aided decision support systems. Such systems aim at helping physicians to identify possibly malignant abnormalities more accurately. At the beginning of this paper, we give a brief introduction to the history of endoscopy, followed by introducing the main types of endoscopes which emerged so far (flexible endoscope, wireless capsule endoscope, and confocal laser endomicroscope). We then give a brief introduction to computer-aided decision support systems specifically targeted at endoscopy in the gastrointestinal tract. Then we present general facts and figures concerning computer-aided decision support systems and summarize work specifically targeted at computer-aided decision support in the gastrointestinal tract. This summary is followed by a discussion of some common issues concerning the approaches reviewed and suggestions of possible ways to resolve them.

  20. Guidelines for sedation in gastroenterological endoscopy.

    Science.gov (United States)

    Obara, Katsutoshi; Haruma, Ken; Irisawa, Atsushi; Kaise, Mitsuru; Gotoda, Takuji; Sugiyama, Masanori; Tanabe, Satoshi; Horiuchi, Akira; Fujita, Naotaka; Ozaki, Makoto; Yoshida, Masahiro; Matsui, Toshiyuki; Ichinose, Masao; Kaminishi, Michio

    2015-05-01

    Recently, the need for sedation in gastrointestinal endoscopy has been increasing. However, the National Health Insurance Drug Price list in Japan does not include any drug specifically used for the sedation. Although benzodiazepines are the main medication, their use in cases of gastrointestinal endoscopy has not been approved. This has led the Japan Gastrointestinal Endoscopy Society to develop the first set of guidelines for sedation in gastrointestinal endoscopy on the basis of evidence-based medicine in collaboration with the Japanese Society for Anesthesiologists. The present guidelines comprise 14 statements, five of which were judged to be valid on the highest evidence level and three on the second highest level. The guidelines are not intended to strongly recommend the use of sedation for gastrointestinal endoscopy, but rather to indicate the policy as to the choice of appropriate procedures when such sedation is deemed necessary. In clinical practice, the final decision as to the use of sedation should be made by physicians considering patient willingness and physical condition.

  1. System for clinical photometric stereo endoscopy

    Science.gov (United States)

    Durr, Nicholas J.; González, Germán.; Lim, Daryl; Traverso, Giovanni; Nishioka, Norman S.; Vakoc, Benjamin J.; Parot, Vicente

    2014-02-01

    Photometric stereo endoscopy is a technique that captures information about the high-spatial-frequency topography of the field of view simultaneously with a conventional color image. Here we describe a system that will enable photometric stereo endoscopy to be clinically evaluated in the large intestine of human patients. The clinical photometric stereo endoscopy system consists of a commercial gastroscope, a commercial video processor, an image capturing and processing unit, custom synchronization electronics, white light LEDs, a set of four fibers with diffusing tips, and an alignment cap. The custom pieces that come into contact with the patient are composed of biocompatible materials that can be sterilized before use. The components can then be assembled in the endoscopy suite before use. The resulting endoscope has the same outer diameter as a conventional colonoscope (14 mm), plugs into a commercial video processor, captures topography and color images at 15 Hz, and displays the conventional color image to the gastroenterologist in real-time. We show that this system can capture a color and topographical video in a tubular colon phantom, demonstrating robustness to complex geometries and motion. The reported system is suitable for in vivo evaluation of photometric stereo endoscopy in the human large intestine.

  2. Arteriovenous Malformation Detected by Small Bowel Endoscopy

    Directory of Open Access Journals (Sweden)

    Takaaki Fujii

    2014-10-01

    Full Text Available Gastrointestinal bleeding that originates in the small intestine is often difficult to diagnose. When successful diagnosis reveals a lesion that can be localized preoperatively, the laparoscopic approach is an appropriate and beneficial treatment modality for small bowel resection. A 69-year-old man presented with a 6-month history of gastrointestinal bleeding and symptomatic transfusion-dependent anemia. Upper and lower endoscopy were normal. Double-balloon endoscopy established the source of the bleeding as a 0.5-cm polypoid mass appearing as a submucosal tumor with redness and pulsation in the lower ileum, suggesting a vascular lesion. Laparoscopic small bowel resection was successful in removing the mass in the ileum. Histological evaluation of the mass revealed an arteriovenous malformation. Preoperative small bowel endoscopy can be useful for diagnosing the cause and localization of arteriovenous malformation in the small intestine.

  3. Requirements and standards facilitating quality improvement for reporting systems in gastrointestinal endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement.

    Science.gov (United States)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-03-01

    To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on the requirements for high-quality endoscopy reporting systems in GI endoscopy. Recommendations 1 Endoscopy reporting systems must be electronic. 2 Endoscopy reporting systems should be integrated into hospitals' patient record systems. 3 Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources. 4 Endoscopy reporting systems shall restrict the use of free-text entry to a minimum, and be based mainly on structured data entry. 5 Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated. 6 Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically. 7 Endoscopy reporting systems shall facilitate the inclusion of information on histopathology of detected lesions, patient satisfaction, adverse events, and surveillance recommendations. 8 Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format. 9 Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees. 10 Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  4. Ingestible Wireless Capsule Technology: A Review of Development and Future Indication

    Directory of Open Access Journals (Sweden)

    M. R. Basar

    2012-01-01

    Full Text Available Ingestible wireless capsule endoscopy (WCE is the one and only painless, effective, novel, diagnostic technology for inspecting the entire gastrointestinal (GI tract for various diseases, such as obscure gastrointestinal bleeding (OGIB, tumors, cancer, Crohn’s disease, and celiac disease. Since the development of this technology, several companies have made remarkable improvements in their clinical products, but there are still some limitations that relate to the use of conventional wired endoscopy. Some of the major limitations that currently impede its wider application include its inability to repeat the view of critical areas, working time constraints, and poor image resolution. Many research groups currently are working on ways to solve these limitations. Presently, developing the ability to control the movement of the capsule, increasing its image transmission speed, and obtaining high-quality images are the main issues in the research area. A complex capsule with some therapeutic tools for the treatment of diseases of the GI tract also is at the beginning of development for the next generation of an active medical robot. In this paper, we report the status of several activities related to WCE, including improvement of capsule technology, research progress, technical challenges, and key indicators concerning the next-generation, active, medical robot.

  5. New imaging techniques and opportunities in endoscopy.

    Science.gov (United States)

    Kiesslich, Ralf; Goetz, Martin; Hoffman, Arthur; Galle, Peter Robert

    2011-09-06

    Gastrointestinal endoscopy is undergoing major improvements, which are driven by new available technologies and substantial refinements of optical features. In this Review, we summarize available and evolving imaging technologies that could influence the clinical algorithm of endoscopic diagnosis. Detection, characterization and confirmation are essential steps required for proper endoscopic diagnosis. Optical and nonoptical methods can help to improve each step; these improvements are likely to increase the detection rate of neoplasias and reduce unnecessary endoscopic treatments. Furthermore, functional and molecular imaging are emerging as new diagnostic tools that could provide an opportunity for personalized medicine, in which endoscopy will define disease outcome or predict the response to targeted therapy.

  6. Peripheral facial nerve palsy after therapeutic endoscopy.

    Science.gov (United States)

    Kim, Eun Jeong; Lee, Jun; Lee, Ji Woon; Lee, Jun Hyung; Park, Chol Jin; Kim, Young Dae; Lee, Hyun Jin

    2015-03-01

    Peripheral facial nerve palsy (FNP) is a mononeuropathy that affects the peripheral part of the facial nerve. Primary causes of peripheral FNP remain largely unknown, but detectable causes include systemic infections (viral and others), trauma, ischemia, tumor, and extrinsic compression. Peripheral FNP in relation to extrinsic compression has rarely been described in case reports. Here, we report a case of a 71-year-old man who was diagnosed with peripheral FNP following endoscopic submucosal dissection. This case is the first report of the development of peripheral FNP in a patient undergoing therapeutic endoscopy. We emphasize the fact that physicians should be attentive to the development of peripheral FNP following therapeutic endoscopy.

  7. Preprocedural Assessment for Sedation in Gastrointestinal Endoscopy.

    Science.gov (United States)

    Tetzlaff, John E; Maurer, Walter G

    2016-07-01

    The role of the anesthesia service in sedation for gastrointestinal endoscopy (GIE) has been steadily increasing. The goals of preprocedural assessment are determined by the specific details of the procedure, the issues related to the illness that requires the endoscopy, comorbidities, the goals for sedation, and the risk of complications from the sedation and the endoscopic procedure. Rather than consider these issues as separate entities, they should be considered as part of a continuum of preparation for GIE. This is told from the perspective of an anesthesiologist who regularly participates in the full range of sedation for GIE.

  8. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

    Jensen, J T; Vilmann, P; Horsted, T

    2011-01-01

    of hypoxemia were documented in 1764 patients (4.4%), in 56/983 upper endoscopies (5.7%) and 22/754 lower endoscopies (2.9%) (P = 0.007). Assisted ventilation was necessary in 19 cases (1.1%) and anesthesiologic assistance was requested 10 times. Two patients required endotracheal intubation. A change in blood....... In the implementation phase, data from 1822 endoscopic procedures in 1764 patients were prospectively collected. All adverse events related to sedation were recorded (defined as oxygen saturation intubation, change in blood pressure > 20 mmHg). RESULTS: 78 cases...

  9. Potential impact of enhanced practice efficiency on endoscopy waiting times.

    LENUS (Irish Health Repository)

    Harewood, G C

    2009-06-01

    With the growing demand on endoscopy services, optimising practice efficiency has assumed increasing importance. Prior research has identified practice changes, which increase the efficiency in endoscopy. In this study, the potential impact of these practice changes on the current and projected future endoscopy waiting times at our institution was assessed.

  10. Organization and logistics of drug-induced sleep endoscopy in a training hospital.

    Science.gov (United States)

    Benoist, L B L; de Vries, N

    2015-09-01

    Drug-induced sleep endoscopy (DISE) is a rapidly growing method to evaluate airway collapse in patients receiving non-CPAP therapies for sleep-disordered breathing (SDB). The growing number of DISEs has consequences for the organization of clinical protocols. In this paper we present our recent experiences with DISE, performed by an ENT resident, with sedation given by a nurse anesthetist, in an outpatient endoscopy setting, while the staff member/sleep surgeon discusses the findings and the recommended treatment proposal on the same day.

  11. Endoluminal Diagnosis of Early Gastric Cancer and Its Precursors: Bridging the Gap Between Endoscopy and Pathology.

    Science.gov (United States)

    Uedo, Noriya; Yao, Kenshi

    Although dye-based and image-enhanced endoscopic techniques have revolutionized endoscopic diagnosis, conventional white light endoscopy still plays an important role in the diagnosis of early gastric cancer (EGC) during routine endoscopy. Chromoendoscopy reveals morphological characteristics of the mucosal lesions by enhancing mucosal contrast, while narrow-band imaging (NBI) facilitates detailed evaluation of the vascular architecture and surface features. Positive diagnostic findings of EGC on white light imaging and indigo carmine chromoendoscopy are a sharply demarcated lesion and irregularity in surface morphology or color. Magnifying NBI further improves diagnostic accuracy of white light imaging and chromoendoscopy. We review our approach to the endoscopic diagnosis of (pre-)malignant lesions in the stomach and discuss in detail novel endoscopic microvascular architectural patterns which further leverage diagnostic biopsy yield. We expect that further improvement of endoscopic techniques and correlative studies will close the gap between endoscopy and pathology.

  12. Management of adhesive capsulitis

    Directory of Open Access Journals (Sweden)

    Stupay KL

    2015-08-01

    Full Text Available Kristen L Stupay,1 Andrew S Neviaser2 1Tulane University School of Medicine, New Orleans, LA, USA; 2George Washington University Medical Faculty Associates, Washington, DC, USA Abstract: Adhesive capsulitis of the shoulder is a condition of capsular contracture that reduces both active and passive glenohumeral motion. The cause of adhesive capsulitis is not known but it is strongly associated with endocrine abnormalities such as diabetes. Diverse terminology and the absence of definitive criteria for diagnosis make evaluating treatment modalities difficult. Many treatment methods have been reported, most with some success, but few have been proved to alter the natural course of this disease. Most afflicted patients will achieve acceptable shoulder function without surgery. Those who remain debilitated after 8–12 months are reasonable candidates for invasive treatments. Here, the various treatment methods and the data to support their use are reviewed. Keywords: frozen shoulder, stiff shoulder, periarthritis, painful shoulder 

  13. Microscopic Colitis with Macroscopic Endoscopic Findings

    OpenAIRE

    Atif Saleem; Brahmbhatt, Parag A.; Sarah Khan; Mark Young; LeSage, Gene D.

    2013-01-01

    Microscopic Colitis (MC) is characterized by chronic watery diarrhea, grossly normal appearing colonic mucosa during conventional white light endoscopy, and biopsy showing microscopic inflammation. We report a case of collagenous colitis with gross endoscopic findings.

  14. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement.

    Science.gov (United States)

    Bretthauer, Michael; Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-04-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE's viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient's satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations.

  15. Capsule-train stability

    Science.gov (United States)

    Bryngelson, Spencer H.; Freund, Jonathan B.

    2016-07-01

    Elastic capsules flowing in small enough tubes, such as red blood cells in capillaries, are well known to line up into regular single-file trains. The stability of such trains in somewhat wider channels, where this organization is not observed, is studied in a two-dimensional model system that includes full coupling between the viscous flow and suspended capsules. A diverse set of linearly amplifying disturbances, both long-time asymptotic (modal) and transient (nonmodal) perturbations, is identified and analyzed. These have a range of amplification rates and their corresponding forms are wavelike, typically dominated by one of five principal perturbation classes: longitudinal and transverse translations, tilts, and symmetric and asymmetric shape distortions. Finite-amplitude transiently amplifying perturbations are shown to provide a mechanism that can bypass slower asymptotic modal linear growth and precipitate the onset of nonlinear effects. Direct numerical simulations are used to verify the linear analysis and track the subsequent transition of the regular capsule trains into an apparently chaotic flow.

  16. Highlights of pancreatobiliary endoscopy in international digestive endoscopy network 2012: how much has it advanced?

    Science.gov (United States)

    Dong, Seok Ho

    2012-09-01

    The pancreatobiliary organ is composed of one of the most complicated structures and complex physiological functions among other digestive organs in our body. This is why endoscopic procedure in pancreaticobiliary system requires rather complicated techniques. In International Digestive Endoscopy Network (IDEN) 2012, many interesting pancreatobiliay endoscopy related topics were presented. Basic procedures like endoscopic papillary balloon dilation (EPBD), advanced techniques like endoscopic necrosectomy, prevention and management of post-ERCP pancreatitis, and spyglass system are reviewed in this highlight summary.

  17. Standardization and Coding of Gastrointestinal Endoscopy Reports

    NARCIS (Netherlands)

    M.J.M. Groenen (Marcel)

    2011-01-01

    textabstractGastrointestinal endoscopy has developed rapidly in the last five decades. It started in the sixties, when the first commercial model of the then recently invented fully flexible fiberoptic gastroscope was developed. In the late sixties fiberoptic endoscopes changed to forward viewing, w

  18. Intraoperative endoscopy in obstructive hypopharyngeal carcinoma

    Institute of Scientific and Technical Information of China (English)

    Predrag Pesko; Djordjije Saranovic; Vera Todorovic; Milos Bjelovic; Predrag Sabljak; Dejan Stojakov; Ebrahimi Keramatollah; Dejan Velickovic; Bratislav Spica; Branka Nenadic; Aleksandra Djuric-Stefanovic

    2006-01-01

    AIM: To demonstrate the necessity of intraoperative endoscopy in the diagnosis of secondary primary tumors of the upper digestive tract in patients with obstructive hypopharyngeal carcinoma.METHODS: Thirty-one patients with hypopharyngeal squamous cell carcinoma had been operated, with radical intent, at our Institution in the period between 1978 and 2004. Due to obstructive tumor mass, in 7(22.6%) patients, preoperative endoscopic evaluation of the esophagus and stomach could not be performed. In those patients, intraoperative endoscopy, made through an incision in the cervical esophagus, was standard diagnostic method for examination of the esophagus and stomach.RESULTS: We found synchronous foregut carcinomas in 3 patients (9.7%). In two patients, synchronous carcinomas had been detected during preoperative endoscopic evaluation, and in one (with obstructive carcinoma) using intraoperative endoscopy. In this case, preoperative barium swallow and CT scan did not reveal the existence of second primary tumor within esophagus, despite the fact that small, but T2 carcinoma, was present.CONCLUSION: It is reasonable to use intraoperative endoscopy as a selective screening test in patients with obstructive hypopharyngeal carcinoma.

  19. Virtual endoscopy in neurosurgery: a review.

    Science.gov (United States)

    Neubauer, André; Wolfsberger, Stefan

    2013-01-01

    Virtual endoscopy is the computerized creation of images depicting the inside of patient anatomy reconstructed in a virtual reality environment. It permits interactive, noninvasive, 3-dimensional visual inspection of anatomical cavities or vessels. This can aid in diagnostics, potentially replacing an actual endoscopic procedure, and help in the preparation of a surgical intervention by bridging the gap between plain 2-dimensional radiologic images and the 3-dimensional depiction of anatomy during actual endoscopy. If not only the endoscopic vision but also endoscopic handling, including realistic haptic feedback, is simulated, virtual endoscopy can be an effective training tool for novice surgeons. In neurosurgery, the main fields of the application of virtual endoscopy are third ventriculostomy, endonasal surgery, and the evaluation of pathologies in cerebral blood vessels. Progress in this very active field of research is achieved through cooperation between the technical and the medical communities. While the technology advances and new methods for modeling, reconstruction, and simulation are being developed, clinicians evaluate existing simulators, steer the development of new ones, and explore new fields of application. This review introduces some of the most interesting virtual reality systems for endoscopic neurosurgery developed in recent years and presents clinical studies conducted either on areas of application or specific systems. In addition, benefits and limitations of single products and simulated neuroendoscopy in general are pointed out.

  20. Blood-based Biomarkers at Large Bowel Endoscopy and Prediction of Future Malignancies

    DEFF Research Database (Denmark)

    Kring, Thomas S; Piper, Thomas B; Jørgensen, Lars N;

    2015-01-01

    Soluble cancer-related protein biomarker levels may be increased in subjects without findings at large bowel endoscopy performed due to symptoms associated with colorectal cancer. The present study focused on a possible association between increased biomarker levels in such subjects and subsequen...

  1. Tethered capsule OCT endomicroscopy for upper gastrointestinal tract imaging by using ball lens probe (Conference Presentation)

    Science.gov (United States)

    Dong, Jing; Gora, Michalina J.; Reddy, Rohith; Trasischker, Wolfgang; Poupart, Oriane; Lu, Weina; Carruth, Robert W.; Grant, Catriona N.; Soomro, Amna R.; Tiernan, Aubrey R.; Rosenberg, Mireille; Nishioka, Norman S.; Tearney, Guillermo J.

    2016-03-01

    While endoscopy is the most commonly used modality for diagnosing upper GI tract disease, this procedure usually requires patient sedation that increases cost and mandates its operation in specialized settings. In addition, endoscopy only visualizes tissue superfically at the macroscopic scale, which is problematic for many diseases that manifest below the surface at a microscopic scale. Our lab has previously developed technology termed tethered capsule OCT endomicroscopy (TCE) to overcome these diagnostic limitations of endoscopy. The TCE device is a swallowable capsule that contains optomechanical components that circumferentially scan the OCT beam inside the body as the pill traverses the organ via peristalsis. While we have successfully imaged ~100 patients with the TCE device, the optics of our current device have many elements and are complex, comprising a glass ferrule, optical fiber, glass spacer, GRIN lens and prism. As we scale up manufacturing of this device for clinical translation, we must decrease the cost and improve the manufacturability of the capsule's optical configuration. In this abstract, we report on the design and development of simplificed TCE optics that replace the GRIN lens-based configuration with an angle-polished ball lens design. The new optics include a single mode optical fiber, a glass spacer and an angle polished ball lens, that are all fusion spliced together. The ball lens capsule has resolutions that are comparable with those of our previous GRIN lens configuration (30µm (lateral) × 7 µm (axial)). Results in human subjects show that OCT-based TCE using the ball lens not only provides rapid, high quality microstructural images of upper GI tract, but also makes it possible to implement this technology inexpensively and on a larger scale.

  2. Endoscopic Evaluation of Swallowing (Endoscopy)

    Science.gov (United States)

    ... More Than One Language Adult Speech and Language Child Speech and Language Swallowing and Feeding Self-Help Groups Find a Professional Advertising Disclaimer Advertise with us The ASHA Leader  Speech- ...

  3. Endoscopy in screening for digestive cancer.

    Science.gov (United States)

    Lambert, René

    2012-12-16

    The aim of this study is to describe the role of endoscopy in detection and treatment of neoplastic lesions of the digestive mucosa in asymptomatic persons. Esophageal squamous cell cancer occurs in relation to nutritional deficiency and alcohol or tobacco consumption. Esophageal adenocarcinoma develops in Barrett's esophagus, and stomach cancer in chronic gastric atrophy with Helicobacter pylori infection. Colorectal cancer is favoured by a high intake in calories, excess weight, low physical activity. In opportunistic or individual screening endoscopy is the primary detection procedure offered to an asymptomatic individual. In organized or mass screening proposed by National Health Authorities to a population, endoscopy is performed only in persons found positive to a filter selection test. The indications of primary upper gastrointestinal endoscopy and colonoscopy in opportunistic screening are increasingly developing over the world. Organized screening trials are proposed in some regions of China at high risk for esophageal cancer; the selection test is cytology of a balloon or sponge scrapping; they are proposed in Japan for stomach cancer with photofluorography as a selection test; and in Europe, America and Japan; for colorectal cancer with the fecal occult blood test as a selection test. Organized screening trials in a country require an evaluation: the benefit of the intervention assessed by its impact on incidence and on the 5 year survival for the concerned tumor site; in addition a number of bias interfering with the evaluation have to be controlled. Drawbacks of screening are in the morbidity of the diagnostic and treatment procedures and in overdetection of none clinically relevant lesions. The strategy of endoscopic screening applies to early cancer and to benign adenomatous precursors of adenocarcinoma. Diagnostic endoscopy is conducted in 2 steps: at first detection of an abnormal area through changes in relief, in color or in the course of

  4. Bowel magnetic resonance imaging of pediatric patients with oral mannitol. MRI compared to endoscopy and intestinal ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Borthne, Arne S.; Reiseter, Tor [Ullevaal University Hospital, Department of Pediatric Radiology, Oslo (Norway); Abdelnoor, Michael [Ullevaal University Hospital, Section of Epidemiology and Biostatistics, Centre of Clinical Research, Oslo (Norway); Rugtveit, Jarle [Ullevaal University Hospital, Department of Pediatric Gastroenterology, Oslo (Norway); Perminow, Goeri [Akershus County University Hospital, Department of Pediatrics, Nordbyhagen (Norway); Kloew, Nils-Einar [Ullevaal University Hospital, Department of Cardiovascular Radiology, Oslo (Norway)

    2006-01-01

    The purpose of this study was to assess the sensitivity, specificity, and diagnostic accuracy of magnetic resonance imaging (MRI) in pediatric patients with clinical suspicion of inflammatory bowel disease (IBD) by comparing MRI and ultrasound (US) to endoscopy, the gold standard. A median volume of 300 ml of mannitol in a 4.5% watery solution were ingested by 43 children prior to examination. The 53 MRI examinations were compared with 20 endoscopies and 41 US of the terminal ileum. The outcomes were MRI quality; pathologic findings; level of adverse events; and concordance between endoscopy, MRI, and US estimated by kappa statistics. The ileum and terminal ileum were very good or excellently imaged in approximately 80% of cases. Wall thickening and enhancement were most frequent in the terminal ileum. MRI compared with endoscopy had a sensitivity of 81.8% [95% confidence interval (CI)], specificity of 100%, diagnostic accuracy of 90%, and kappa value of 0.80 (95% CI), indicating a good degree of concordance. A similar degree of concordance was achieved between US and endoscopy. In spite of the frequent adverse reactions, such as diarrhea and nausea, half of the patients were prepared to repeat the examination. The results of MRI are concordant with endoscopy and US of the terminal ileum. (orig.)

  5. Optimal Design of Capsule Transporting Pipeline carrying Spherical Capsules

    Science.gov (United States)

    Asim, Taimoor; Mishra, Rakesh; Ubbi, Kuldip

    2012-05-01

    A capsule pipeline transports material or cargo in capsules propelled by fluid flowing through a pipeline. The cargo may either be contained in capsules (such as wheat enclosed inside sealed cylindrical containers), or may itself be the capsules (such as coal compressed into the shape of a cylinder or sphere). As the concept of capsule transportation is relatively new, the capsule pipelines need to be designed optimally for commercial viability. An optimal design of such a pipeline would have minimum pressure drop due to the presence of the solid medium in the pipeline, which corresponds to minimum head loss and hence minimum pumping power required to drive the capsules and the transporting fluid. The total cost for the manufacturing and maintenance of such pipelines is yet another important variable that needs to be considered for the widespread commercial acceptance of capsule transporting pipelines. To address this, the optimisation technique presented here is based on the least-cost principle. Pressure drop relationships have been incorporated to calculate the pumping requirements for the system. The maintenance and manufacturing costs have been computed separately to analyse their effects on the optimisation process. A design example has been included to show the usage of the model presented. The results indicate that for a specific throughput, there exists an optimum diameter of the pipeline for which the total cost for the piping system is at its minimum.

  6. Determining the Optimum Font Size for Braille on Capsule Paper

    OpenAIRE

    Watanabe, Tetsuya

    2014-01-01

    Braille fonts allow us to easily make braille labels on capsule paper. For legibility, fonts should be printed at optimum sizes. To find the optimum sizes for Japanese braille fonts, we conducted an experiment in which a Japanese braille font was printed at various sizes on capsule paper and read and rated by young braille users. The results show that braille printed at 17 and 18 point sizes were read faster and evaluated higher than those printed at smaller or bigger sizes.

  7. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Science.gov (United States)

    Batista, Jorge Pablo; del Vecchio, Jorge Javier; Golanó, Pau; Vega, Jordi

    2015-01-01

    Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL) travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL) described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion. PMID:26060592

  8. Flexor Digitorum Accessorius Longus: Importance of Posterior Ankle Endoscopy

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

    Full Text Available Endoscopy for the posterior region of the ankle through two portals is becoming more widespread for the treatment of a large number of conditions which used to be treated with open surgery years ago. The tendon of the flexor hallucis longus (FHL travels along an osteofibrous tunnel between the posterolateral and posteromedial tubercles of the talus. Chronic inflammation of this tendon may lead to painful stenosing tenosynovitis. The aim of this report is to describe two cases depicting an accessory tendon which is an anatomical variation of the flexor hallucis longus in patients with posterior friction syndrome due to posterior ankle impingement and associated with a posteromedial osteochondral lesion of the talus. The anatomical variation (FDAL described was a finding during an endoscopy of the posterior region of the ankle, and we have spared it by sectioning the superior flexor retinaculum only. The accessory flexor digitorum longus is an anatomical variation and should be taken into account when performing an arthroscopy of the posterior region of the ankle. We recommend this treatment on this type of injury although we admit this does not make a definite conclusion.

  9. Magnetism in metal-organic capsules

    Energy Technology Data Exchange (ETDEWEB)

    Atwood, Jerry L.; Brechin, Euan K; Dalgarno, Scott J.; Inglis, Ross; Jones, Leigh F.; Mossine, Andrew; Paterson, Martin J.; Power, Nicholas P.; Teat, Simon J.

    2010-01-07

    Nickel and cobalt seamed metal-organic capsules have been isolated and studied using structural, magnetic and computational approaches. Antiferromagnetic exchange in the Ni capsule results from coordination environments enforced by the capsule framework.

  10. Diagnostic utility of narrow-band imaging endoscopy for pharyngeal superficial carcinoma

    Institute of Scientific and Technical Information of China (English)

    Noboru Yoshimura; Kenichi Goda; Hisao Tajiri; Yukinaga Yoshida; Takakuni Kato; Yoichi Seino; Masahiro Ikegami; Mitsuyoshi Urashima

    2011-01-01

    AIM: To investigate the endoscopic features of pha-ryngeal superficial carcinoma and evaluate the utility of narrow-band imaging (NBI) for this disease.METHODS: In the present prospective study, 335 patients underwent conventional white light (CWL) en-doscopy and non-magnified/magnified NBI endoscopy, followed by an endoscopic biopsy, for 445 superficial lesions in the oropharynx and hypopharynx. The macroscopic appearance of superficial lesions was categorized as either elevated (< 5 mm in height), flat, or depressed (not ulcerous). Superficial carcinoma (SC) was defined as a superficial lesion showing high-grade dysplasia or squamous cell carcinoma on histology. The color, delineation, and macroscopic appearances of the lesions were evaluated by CWL endoscopy. The ratio of the brownish area/intervascular brownish epithelium (IBE), as well as microvascular proliferation, dilation, and irregularities, was determined by non-magnified/ magnified NBI endoscopy. An experienced pathologist who was unaware of the endoscopic findings made the histological diagnoses. By comparing endoscopic findings with histology, we determined the endoscopic features of SC and evaluated the diagnostic utility of NBI.RESULTS: The 445 lesions were divided histologically into two groups: a non-SC group, including non-neo-plasia and low-grade dysplasia cases, and an SC group. Of the 445 lesions examined, 333 were classified as non-SC and 112 were classified as SC. There were no significant differences in age, gender, or the location of the lesions between the patients in the two groups. The mean diameter of the SC lesions was significantly greater than that of non-SC lesions (11.0 7.6 mm vs 4.6 3.6 mm, respectively, P < 0.001). Comparisons of CWL endoscopy findings for SC and non-SC lesions by univariate analysis revealed that the incidence of redness (72% vs 41%, respectively, P< 0.001) and a flat or depressed type of lesion (58% vs 44%, respectively, P = 0.013) was significantly higher in

  11. An Innovative Wireless Endoscopic Capsule With Spherical Shape.

    Science.gov (United States)

    Fontana, Rossella; Mulana, Francesca; Cavallotti, Carmen; Tortora, Giuseppe; Vigliar, Mario; Vatteroni, Monica; Menciassi, Arianna

    2017-02-01

    This paper aims to contribute to the advancement of the Wireless Capsule Endoscopy (WCE) field for ColoRectal Cancer (CRC) screening, by developing all electronic circuits to build an innovative wireless endoscopic capsule with a spherical shape, conceived to reduce the friction during its locomotion and thus improving patient's acceptability. The proposed capsule embeds an image sensor with optics and Light Emitting Diodes (LEDs), a control unit with a telemetry module, an actuation system, a battery with a smart recharging circuit able to recharge in 20 minutes, a smart power-on circuit and a localization module. Everything is devised to fit in a small spherical shape with a diameter of 26 mm and a weight of 12.70 g. The authors present a description of the sub-modules involved in the capsule development, together with the firmware and hardware integration. In order to reduce the bandwidth for matching the specifications of the target commercial telemetry, the firmware interfacing of a custom encoder was performed, which is able to compress the incoming images with a negligible loss of information and occupying a number of Look Up-Tables (LUTs) less than 1780. As a preliminary work, a versatile Field Programmable Gate Arrays (FPGA) based demo-board system has been developed in order to test and optimize the functionalities and the performance of the single sub-modules and wireless vision chain system. This work allows to demonstrate the feasibility of a complex biomedical system, with severe constraints by highlighting the necessity to enhance the frame rate in the future.

  12. The colon. Clinical radiology and endoscopy. Kolon: Klinische Radiologie - Endoskopie

    Energy Technology Data Exchange (ETDEWEB)

    Rosenbusch, G.; Reeders, J.W.A.J.

    1993-01-01

    This comprehensive reference work presents in-depth information on the diagnostic radiology and endoscopy of the colon. After a brief review of the history of colon examinations, two chapters explain the anatomy, physiology and pharmacology of the large intestine as well as the methods and techniques applied for radiological examination of the colon. The pathology and characteristical findings and the diagnostic evaluation of the various types of disease are the main subject, with the chapters discussing inflammations and tumors consuming by far most of the space, but there is also valuable information on vascular lesions, traumata, latrogenous or post-surgery lesions, among others, and on the characteristical findings in children. Numerous tables, radiographs and endoscopic images together with drawings illustrate and accompany the textbook information. (orig.). 492 figs., 95 tabs.

  13. Role of endoscopy in early oesophageal cancer.

    Science.gov (United States)

    Mannath, Jayan; Ragunath, Krish

    2016-12-01

    Incidence of oesophageal adenocarcinoma has increased exponentially in the West over the past few decades. Following detection of advanced cancers, 5-year survival rates remain bleak, making identification of early neoplasia, which has a better outcome, important. Detection of subtle oesophageal lesions during endoscopy can be challenging, and advanced imaging techniques might improve their detection. High-definition endoscopy has become a standard in most endoscopy centres, and this technology probably provides better delineation of mucosal features than standard-definition endoscopy. Various image enhancement techniques are now available with the development of new electronics and software systems. Image enhancement with chromoendoscopy using dyes has been a cost-effective option for many years, yet these techniques have been replaced in some contexts by electronic chromoendoscopy, which can be used with the press of a button. However, Lugol's chromoendoscopy remains the gold standard to identify squamous dysplasia. Identification and characterization of subtle neoplastic lesions could help to target biopsies and perform endoscopic resection for better local staging and definitive therapy. In vivo histology with techniques such as confocal endomicroscopy could make endotherapy feasible within a shorter timescale than when relying on histology on tissue samples. Once early neoplasia is identified, treatments include endoscopic resection, endoscopic submucosal dissection or various ablative techniques. Endotherapy has the advantage of being a less invasive technique than oesophagectomy, and is associated with lower mortality and morbidity. Endoscopic ablation therapies have evolved over the past few years, with radiofrequency ablation showing the best results in terms of success rates and complications in Barrett dysplasia.

  14. Aspects of computer vision in surgical endoscopy

    Science.gov (United States)

    Rodin, Vincent; Ayache, Alain; Berreni, N.

    1993-09-01

    This work is related to a project of medical robotics applied to surgical endoscopy, led in collaboration with Doctor Berreni from the Saint Roch nursing-home in Perpignan, France). After taking what Doctor Berreni advises, two aspects of endoscopic color image processing have been brought out: (1) The help to the diagnosis by the automatic detection of the sick areas after a learning phase. (2) The 3D reconstruction of the analyzed cavity by using a zoom.

  15. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

    Full Text Available Background: Intracranial endoscopy is a minimum invasive procedure, which reduces trauma to the brain, is cost-effective, and carries a shortened hospital stay with an improved postoperative outcome. Objective: To monitor intracranial pressure changes during intracranial endoscopy among children and adults under general anesthesia/sedation, and to compare the intracranial pressure changes between children and adults receiving general anesthesia and among adults receiving general anesthesia and sedation. Methods: The present cross-sectional study was conducted in one of the tertiary care hospitals of Lucknow. This was carried out in the department of neurosurgery from January 2008 to December 2008. Patients who were not fit for general anesthesia received local anesthesia under sedation. Patients participating in the study were divided into three groups. Intracranial pressure was recorded at specific intervals. Parametric data were subjected to statistical analysis using a student\\s t test. Result: A total of 70 patients were undergoing intracranial endoscopy under general anesthesia during the study period. In both groups A and B, intracranial pressure increases the maximum during inflation of the balloon. In group C, all the variations in ICP were found to be statistically significant. In the comparison of intracranial pressure changes between groups A and B, no significant difference was found. All correlations in the comparison of groups B and C were found to be statistically significant (p< 0.001. Conclusion: There is a need for continuous intraoperative monitoring of ICP intracranial endoscopy, because ICP increases in various stages of the procedure, which can be detrimental to the perfusion of the brain. [Arch Clin Exp Surg 2013; 2(4.000: 240-245

  16. Characteristics of the Small Bowel Lesions Detected by Capsule Endoscopy in Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Harunobu Kawamura

    2013-01-01

    Full Text Available Obscure gastrointestinal bleeding (OGIB is one of the common complications in patients with chronic kidney disease (CKD, especially those who are on maintenance hemodialysis (HD. However, little is known about the characteristics of the small-bowel lesions in these patients, or of the factors that could predict the presence of such lesions. Therefore we enrolled a total of 42 CKD patients (including 19 HD patients and 23 non-HD patients, and compared the incidence of the small-bowel lesions among two groups. Furthermore, to identify predictive factors for the presence of small-bowel lesions, we performed multivariate logistic-regression-analyses. The incidence of small-bowel vascular lesions was significantly higher in CKD patients than in age-and-sex matched non-CKD patients (P<0.001. On the other hand, there was any significant difference of the incidence of small-bowel lesions between HD and non-HD patients. In CKD patients, past history of blood transfusion (OR 5.66; 95% CI 1.10–29.1, P=0.04 was identified as an independent predictor of the presence of vascular lesions, and history of low-dose aspirin use (OR 6.00; 95% CI 1.13–31.9, P=0.04 was identified as that of erosive/ulcerated lesions. This indicated that proactive CE examination would be clinically meaningful for these patients.

  17. Recommendations to quantify villous atrophy in video capsule endoscopy images of celiac disease patients

    Science.gov (United States)

    Ciaccio, Edward J; Bhagat, Govind; Lewis, Suzanne K; Green, Peter H

    2016-01-01

    AIM To quantify the presence of villous atrophy in endoscopic images for improved automation. METHODS There are two main categories of quantitative descriptors helpful to detect villous atrophy: (1) Statistical and (2) Syntactic. Statistical descriptors measure the small intestinal substrate in endoscope-acquired images based on mathematical methods. Texture is the most commonly used statistical descriptor to quantify villous atrophy. Syntactic descriptors comprise a syntax, or set of rules, for analyzing and parsing the substrate into a set of objects with boundaries. The syntax is designed to identify and distinguish three-dimensional structures based on their shape. RESULTS The variance texture statistical descriptor is useful to describe the average variability in image gray level representing villous atrophy, but does not determine the range in variability and the spatial relationships between regions. Improved textural descriptors will incorporate these factors, so that areas with variability gradients and regions that are orientation dependent can be distinguished. The protrusion syntactic descriptor is useful to detect three-dimensional architectural components, but is limited to identifying objects of a certain shape. Improvement in this descriptor will require incorporating flexibility to the prototypical template, so that protrusions of any shape can be detected, measured, and distinguished. CONCLUSION Improved quantitative descriptors of villous atrophy are being developed, which will be useful in detecting subtle, varying patterns of villous atrophy in the small intestinal mucosa of suspected and known celiac disease patients. PMID:27803772

  18. A Near-Lossless Image Compression Algorithm Suitable for Hardware Design in Wireless Endoscopy System

    Directory of Open Access Journals (Sweden)

    Xie Xiang

    2007-01-01

    Full Text Available In order to decrease the communication bandwidth and save the transmitting power in the wireless endoscopy capsule, this paper presents a new near-lossless image compression algorithm based on the Bayer format image suitable for hardware design. This algorithm can provide low average compression rate ( bits/pixel with high image quality (larger than dB for endoscopic images. Especially, it has low complexity hardware overhead (only two line buffers and supports real-time compressing. In addition, the algorithm can provide lossless compression for the region of interest (ROI and high-quality compression for other regions. The ROI can be selected arbitrarily by varying ROI parameters. In addition, the VLSI architecture of this compression algorithm is also given out. Its hardware design has been implemented in m CMOS process.

  19. A Near-Lossless Image Compression Algorithm Suitable for Hardware Design in Wireless Endoscopy System

    Directory of Open Access Journals (Sweden)

    ZhiHua Wang

    2007-01-01

    Full Text Available In order to decrease the communication bandwidth and save the transmitting power in the wireless endoscopy capsule, this paper presents a new near-lossless image compression algorithm based on the Bayer format image suitable for hardware design. This algorithm can provide low average compression rate (2.12 bits/pixel with high image quality (larger than 53.11 dB for endoscopic images. Especially, it has low complexity hardware overhead (only two line buffers and supports real-time compressing. In addition, the algorithm can provide lossless compression for the region of interest (ROI and high-quality compression for other regions. The ROI can be selected arbitrarily by varying ROI parameters. In addition, the VLSI architecture of this compression algorithm is also given out. Its hardware design has been implemented in 0.18μm CMOS process.

  20. Endoscopy in Canada: Proceedings of the National Roundtable

    Directory of Open Access Journals (Sweden)

    Noah Switzer

    2015-01-01

    Full Text Available This 2014 roundtable discussion, hosted by the Canadian Association of General Surgeons, brought together general surgeons and gastroenterologists with expertise in endoscopy from across Canada to discuss the state of endoscopy in Canada. The focus of the roundtable was the evaluation of the competence of general surgeons at endoscopy, reviewing quality assurance parameters for high-quality endoscopy, measuring and assessing surgical resident preparedness for endoscopy practice, evaluating credentialing programs for the endosuite and predicting the future of endoscopic services in Canada. The roundtable noted several important observations. There exist inadequacies in both resident training and the assessment of competency in endoscopy. From these observations, several collaborative recommendations were then stated. These included the need for a formal and standardized system of both accreditation and training endoscopists.

  1. Flexible Gastrointestinal Endoscopy in Ferrets (Mustela putorius furo).

    Science.gov (United States)

    Pignon, Charly; Huynh, Minh; Husnik, Roman; Jekl, Vladimir

    2015-09-01

    Gastrointestinal disease is a common complaint in ferrets (Mustela putorius furo). Their relatively simple and short gastrointestinal tract makes them good candidates for flexible endoscopy. However, apart from a few references in biomedical research articles, there is little information on the use of flexible endoscopy in ferrets. This review describes patient preparation, equipment, and select gastrointestinal endoscopy techniques in ferrets, including esophagoscopy, gastroscopy, duodenoscopy, percutaneous endoscopic gastrostomy, jejunoileoscopy, colonoscopy, and biopsy.

  2. Usefulness of Double-Balloon Endoscopy in the Postoperative Gastrointestinal Tract

    Directory of Open Access Journals (Sweden)

    Masaki Endo

    2011-01-01

    Full Text Available Background. The small intestine has been considered to be a highly difficult organ to visualize in imaging examinations due to its anatomical location compared with the stomach and the colon. In recent years, many imaging modalities have become available, such as CT enterography, MR enterography, capsule endoscopy (CE, and double-balloon endoscopy (DBE. Patients and Methods. DBE was performed in the postoperative intestines of 91 patients (128 DBE examinations at Iwate Medical University between 2004 and 2010. There were 61 male and 30 female patients, and their mean age was 69.7 years (range: 30–80 years. Results. A total of 124 DBE examinations were performed with endoscope insertion into the reconstructed intestines. The endoscope reached the blind end in 115 of 124 examinations, (92.7%. There were 17 patients with obscure gastrointestinal bleeding in whom 30 DBE examinations were performed. The bleeding site was identified in 12 patients (70.6%. Nine patients underwent endoscopic treatment. Hemostasis was achieved in all patients. Conclusion. DBE is very useful modality for the assessment and application of endotherapy to areas of the small bowel which have been altered by surgery.

  3. Flexible and transparent gastric battery: energy harvesting from gastric acid for endoscopy application.

    Science.gov (United States)

    Mostafalu, Pooria; Sonkusale, Sameer

    2014-04-15

    In this paper, we present the potential to harvest energy directly from the digestive system for powering a future wireless endoscopy capsule. A microfabricated electrochemical cell on flexible parylene film is proposed as a gastric battery. This electrochemical cell uses gastric juice as a source of unlimited electrolyte. Planar fabricated zinc [Zn] and palladium [Pd] electrodes serve as anode and cathode respectively. Due to planar geometry, no separator is needed. Moreover the annular structure of the electrodes provides lower distance between cathode and anode reducing the internal resistance. Both electrodes are biocompatible and parylene provides flexibility to the system. For a surface area of 15 mm(2), 1.25 mW is generated which is sufficient for most implantable endoscopy applications. Open circuit output voltage of this battery is 0.75 V. Since this gastric battery does not require any external electrolyte, it has low intrinsic weight, and since it is flexible and is made of biocompatible materials, it offers a promising solution for power in implantable applications.

  4. Reporting systems in gastrointestinal endoscopy: Requirements and standards facilitating quality improvement: European Society of Gastrointestinal Endoscopy position statement

    Science.gov (United States)

    Aabakken, Lars; Dekker, Evelien; Kaminski, Michal F; Rösch, Thomas; Hultcrantz, Rolf; Suchanek, Stepan; Jover, Rodrigo; Kuipers, Ernst J; Bisschops, Raf; Spada, Cristiano; Valori, Roland; Domagk, Dirk; Rees, Colin; Rutter, Matthew D

    2016-01-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is state-of-the-art integrated digital reporting systems for standardized documentation of the procedures. The current paper describes the ESGE’s viewpoints on requirements for high-quality endoscopy reporting systems. The following recommendations are issued: Endoscopy reporting systems must be electronic.Endoscopy reporting systems should be integrated into hospital patient record systems.Endoscopy reporting systems should include patient identifiers to facilitate data linkage to other data sources.Endoscopy reporting systems shall restrict the use of free text entry to a minimum, and be based mainly on structured data entry.Separate entry of data for quality or research purposes is discouraged. Automatic data transfer for quality and research purposes must be facilitated.Double entry of data by the endoscopist or associate personnel is discouraged. Available data from outside sources (administrative or medical) must be made available automatically.Endoscopy reporting systems shall enable the inclusion of information on histopathology of detected lesions; patient’s satisfaction; adverse events; surveillance recommendations.Endoscopy reporting systems must facilitate easy data retrieval at any time in a universally compatible format.Endoscopy reporting systems must include data fields for key performance indicators as defined by quality improvement committees.Endoscopy reporting systems must facilitate changes in indicators and data entry fields as required by professional organizations. PMID:27087943

  5. Sedation in gastrointestinal endoscopy: current issues.

    Science.gov (United States)

    Triantafillidis, John K; Merikas, Emmanuel; Nikolakis, Dimitrios; Papalois, Apostolos E

    2013-01-28

    Diagnostic and therapeutic endoscopy can successfully be performed by applying moderate (conscious) sedation. Moderate sedation, using midazolam and an opioid, is the standard method of sedation, although propofol is increasingly being used in many countries because the satisfaction of endoscopists with propofol sedation is greater compared with their satisfaction with conventional sedation. Moreover, the use of propofol is currently preferred for the endoscopic sedation of patients with advanced liver disease due to its short biologic half-life and, consequently, its low risk of inducing hepatic encephalopathy. In the future, propofol could become the preferred sedation agent, especially for routine colonoscopy. Midazolam is the benzodiazepine of choice because of its shorter duration of action and better pharmacokinetic profile compared with diazepam. Among opioids, pethidine and fentanyl are the most popular. A number of other substances have been tested in several clinical trials with promising results. Among them, newer opioids, such as remifentanil, enable a faster recovery. The controversy regarding the administration of sedation by an endoscopist or an experienced nurse, as well as the optimal staffing of endoscopy units, continues to be a matter of discussion. Safe sedation in special clinical circumstances, such as in the cases of obese, pregnant, and elderly individuals, as well as patients with chronic lung, renal or liver disease, requires modification of the dose of the drugs used for sedation. In the great majority of patients, sedation under the supervision of a properly trained endoscopist remains the standard practice worldwide. In this review, an overview of the current knowledge concerning sedation during digestive endoscopy will be provided based on the data in the current literature.

  6. Bushen Yisui Capsule ameliorates axonal injury in experimental autoimmune encephalomyelitis

    Institute of Scientific and Technical Information of China (English)

    Ling Fang; Lei Wang; Qi Zheng; Tao Yang; Hui Zhao; Qiuxia Zhang; Kangning Li; Li Zhou; Haiyang Gong; Yongping Fan

    2013-01-01

    A preliminary clinical study by our group demonstrated Bushen Yisui Capsule (formerly cal ed Er-huang Formula) in combination with conventional therapy is an effective prescription for the treat-ment of multiple sclerosis. However, its effect on axonal injury during early multiple sclerosis re-mains unclear. In this study, a MOG 35-55-immunized C57BL/6 mouse model of experimental au-toimmune encephalomyelitis was intragastrical y administered Bushen Yisui Capsule. The results showed that Bushen Yisui Capsule effectively improved clinical symptoms and neurological function of experimental autoimmune encephalomyelitis. In addition, amyloid precursor protein expression was down-regulated and microtubule-associated protein 2 was up-regulated. Experimental findings indicate that the disease-preventive mechanism of Bushen Yisui Capsule in experimental autoim-mune encephalomyelitis was mediated by amelioration of axonal damage and promotion of rege-neration. But the effects of the high-dose Bushen Yisui Capsule group was not better than that of the medium-dose and low-dose Bushen Yisui Capsule group in preventing neurological dysfunction.

  7. Double-balloon endoscopy: Who needs it?

    DEFF Research Database (Denmark)

    Hendel, J.W.; Vilmann, P.; Jensen, T.

    2008-01-01

    Objective. Double-balloon endoscopy (DBE) made the small bowel accessible to inspection and therapy in its entirety. However, DBE is a time-consuming procedure that requires a highly skilled endoscopist, several nurses and - more often than not - anesthesiological support. This makes the selectio...... within the next 12 months. Conclusions. CE can be applied as a screening procedure for DBE and allows for an approximately two-thirds reduction in the need for DBE as well as enabling a choice to be made between the oral and anal route Udgivelsesdato: 2008...

  8. Shared governance in the endoscopy department.

    Science.gov (United States)

    Metcalf, R; Tate, R

    1995-01-01

    Studies have indicated that active participation by employees improves job satisfaction and performance. There is a sense of pride and accountability that is demonstrated in the work environment when staff are involved in the decision-making process. Recent emergence of a relatively new philosophy for management that promotes employee ownership is shared governance. This type of leadership allows individuals who are at the center of the work place to participate in the decisions that actively reflect their needs. In this article, the authors describe the process of implementing shared governance in an Endoscopy Department. The effectiveness of shared governance is evidenced by the renewed enthusiasm and energy demonstrated by the staff.

  9. Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology.

    Science.gov (United States)

    Rahman, Imdadur; Patel, Praful; Boger, Philip; Rasheed, Shahnawaz; Thomson, Mike; Afzal, Nadeem Ahmad

    2015-03-16

    Since the first report of use of endoscopy in children in the 1970s, there has seen an exponential growth in published experience and innovation in the field. In this review article we focus on modern age therapeutic endoscopy practice, explaining use of traditional as well as new and innovative techniques, for diagnosis and treatment of diseases in the paediatric upper gastrointestinal tract.

  10. Cerebral gas embolism due to upper gastrointestinal endoscopy

    NARCIS (Netherlands)

    ter Laan, Mark; Totte, Erik; van Hulst, Rob A.; van der Linde, Klaas; van der Kamp, Wim; Pierie, Jean-Pierre E.

    2009-01-01

    Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of oe

  11. Hindfoot endoscopy for posterior ankle impingement. Surgical technique

    NARCIS (Netherlands)

    van Dijk, C.N.; de Leeuw, P.A.J.; Scholten, P.E.

    2009-01-01

    BACKGROUND: The surgical treatment of posterior ankle impingement is associated with a high rate of complications and a substantial time to recover. An endoscopic approach to the posterior ankle (hindfoot endoscopy) may lack these disadvantages. We hypothesized that hindfoot endoscopy causes less mo

  12. Diagnosis of autoimmune gastritis by high resolution magnification endoscopy

    Institute of Scientific and Technical Information of China (English)

    George K Anagnostopoulos; Krish Ragunath; Anthony Shonde; Christopher J Hawkey; Kenshi Yao

    2006-01-01

    Endoscopic visualisation of gastric atrophy is usually not feasible with conventional endoscopy. Magnifying endoscopy is helpful to analyze the subepithelial microvascular architecture as well as the mucosal surface microstructure without tissue biopsy. Using this technique we were able to describe the normal gastric microvasculature pattern and we also identified characteristic patterns in two cases of autoimmune atrophic gastritis.

  13. Panic Attack during Elective Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Charalampos Mitsonis

    2011-01-01

    Full Text Available Background. Esophagogastroduodenoscopy (EGD and colonoscopy (CS can evoke anxiety, embarrassment, and discomfort. These concerns can culminate in panic attacks, which may traumatize patients and significantly decrease their compliance to the procedure. The objective of this study was to evaluate the relationship between preendoscopic anxiety and the possibility of a panic attack during an elective gastrointestinal endoscopy (EGE. Methods. The study population comprised of 79 Greek outpatients. The examination was carried out without the use of conscious sedation. Patients' anxiety levels were assessed before the procedure using the Greek version of the Spielberger State-Trait Anxiety Inventory (STAI-Y. Results. Seventy-nine patients were enrolled: 45 EGD and 34 CS. Females had higher state and trait anxiety levels than males (48.14 ± 7.94 versus 44.17 ± 7.43, <0.05; and 43.68 ± 6.95 versus 39.86 ± 7.46, <0.05. Patients who experienced panic attack had significantly higher levels of both trait and state anxiety, compared to those who were panic-free. There was no significant relationship between panic attacks and sex or type of procedure. Conclusions. Patients who experience panic attacks during endoscopic procedures appear to have significantly higher anxiety levels before the procedure. Administering the STAI questionnaire prior to the endoscopy seems to be a useful screening method for vulnerable patients.

  14. Virtual endoscopy of the urinary tract

    Institute of Scientific and Technical Information of China (English)

    George C. Kagadis; Dimitrios Siablis; Evangelos N. Liatsikos; Theodore Petsas; George C. Nikiforidis

    2006-01-01

    Technological breakthroughs have advanced the temporal and spatial resolutions of diagnostic imaging, and 3 dimensional (3-D) reconstruction techniques have been introduced into everyday clinical practice. Virtual endoscopy (VE)is a non-invasive technique that amplifies the perception of cross-sectional images in the 3-D space, providing precise spatial relationships of pathological regions and their surrounding structures. A variety of computer algorithms can be used to generate 3-D images, taking advantage of the information inherent in either spiral computed tomography or magnetic resonance imaging (MRI). VE images enable endoluminal navigation through hollow organs, thus simulating conventional endoscopy. Several clinical studies have validated the diagnostic utility of virtual cystoscopy, which has high sensitivity and specificity rates in the detection of bladder tumor. Published experience in the virtual exploration of the renal pelvis, ureter and urethra is encouraging but still scarce. VE is a safe, non-invasive method that could be applied in the long-term follow-up of patients with ureteropelvic junction obstruction, urinary bladder tumors and ureteral and/or urethral strictures. Its principal limitations are the inability to provide biopsy tissue specimens for histopathologic examination and the associated ionizing radiation hazards (unless MRI is used). However, in the case of endoluminal stenosis or obstruction, VE permits virtual endoluminal navigation both cephalad and caudal to the stenotic segment. To conclude, VE provides a less invasive method of evaluating the urinary tract, especially for clinicians who are less familiar with cross-sectional imaging than radiologists.

  15. Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy

    OpenAIRE

    2011-01-01

    p.225-230 Context - Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. Objective - To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. Methods - Recorded biopsies archive at “Complexo Hospitalar Professor Edgar Santos”, a general...

  16. Increased serological cancer-associated biomarker levels at large bowel endoscopy and risk of subsequent primary cancer (†)

    DEFF Research Database (Denmark)

    Hvolris, Martin H; Piper, Thomas B; Hammer, Emilie;

    2016-01-01

    Background Frequently, subjects offered colonoscopy due to symptoms of colorectal neoplasia are diagnosed with diverticula. The symptoms may, however, also be related to extra-colonic neoplasia. The present retrospective study evaluated a possible association between increased levels of predefined...... CEA, TIMP-1, CA19-9 and YKL-40 and findings at endoscopy. Diverticula were diagnosed in 1021 subjects. By 31 December 2012, subjects who had developed primary malignancy were identified retrospectively and relation between biomarker levels at endoscopy and risk of developing primary malignancy...... and CA19-9 were significantly associated with development of primary malignancy. A multivariable analysis showed that increased levels were associated with development of malignancy (p 

  17. Mucosal patterns of Helicobacter pylori-related gastritis without atrophy in the gastric corpus using standard endoscopy

    Institute of Scientific and Technical Information of China (English)

    Shwu-Tzy; Wu; Chien-Hua; Chen; Yeh-Huang; Hung; Tsung-Hsun; Yang; Vun-Siew; Pang; Yung-Hsiang; Yeh

    2010-01-01

    AIM:To identify the mucosal patterns of Helicobacter pylori(H.pylori )-related gastritis in the gastric corpus using standard endoscopy and to evaluate their reproducibility.METHODS:A total of 112 consecutive patients underwent upper gastrointestinal endoscopy.The endoscopists classified the endoscopic findings into 4 patterns.In the second part of the study,90 images were shown to 3 endoscopists in order to evaluate the inter-observer and intra-observer variability in image assessment.RESULTS:The mucosal p...

  18. What the Research Tells Us: Class Size Reduction. Information Capsule. Volume 1001

    Science.gov (United States)

    Romanik, Dale

    2010-01-01

    This Information Capsule examines the background and history in addition to research findings pertaining to class size reduction (CSR). This Capsule concludes that although educational researchers have not definitively agreed upon the effectiveness of CSR, given its almost universal public appeal, there is little doubt it is here to stay in some…

  19. Summary Report for Capsule Dry Storage Project

    Energy Technology Data Exchange (ETDEWEB)

    JOSEPHSON, W S

    2003-09-04

    There are 1.936 cesium (Cs) and strontium (Sr) capsules stored in pools at the Waste Encapsulation and Storage Facility (WESF). These capsules will be moved to dry storage on the Hanford Site as an interim measure to reduce risk. The Cs/Sr Capsule Dry Storage Project (CDSP) is conducted under the assumption the capsules will eventually be moved to the repository at Yucca Mountain, and the design criteria include requirements that will facilitate acceptance at the repository. The storage system must also permit retrieval of capsules in the event vitrification of the capsule contents is pursued. A cut away drawing of a typical cesium chloride (CsCI) capsule and the capsule property and geometry information are provided in Figure 1.1. Strontium fluoride (SrF{sub 2}) capsules are similar in design to CsCl capsules. Further details of capsule design, current state, and reference information are given later in this report and its references. Capsule production and life history is covered in WMP-16938, Capsule Characterization Report for Capsule Dry Storage Project, and is briefly summarized in Section 5.2 of this report.

  20. Validation of the Global Rating Scale for endoscopy.

    Science.gov (United States)

    Williams, T; Ross, A; Stirling, C; Palmer, K; Phull, P S

    2013-02-01

    The Global Rating Scale for endoscopy is a web-based tool that can be used to assess and improve the quality of an endoscopy service. It was developed by asking endoscopy health professionals what they would want from the service for themselves or their relatives if they were undergoing an endoscopic procedure. To date, the Global Rating Scale has not been validated by patients themselves. We used focus groups in order to access the views and opinions of patients who had recently had experience of endoscopy services. Six focus groups were undertaken in five different Health Board areas across Scotland; in total 26 people participated. The results indicated that from the patients' perspective the 12 items of the GRS covered all areas of the endoscopy experience. There were no specific concerns identified that were not already covered within the Global Rating Scale. We conclude that the Global Rating Scale does address quality issues that matter to patients undergoing endoscopy, and validates the use of the GRS as a quality assessment tool for endoscopy services.

  1. Analytical Quality check of oil based blend in Flaxilip capsule

    Directory of Open Access Journals (Sweden)

    Rajashree Rane

    2014-12-01

    Full Text Available Analysis of capsules containing blend in the powder form is easy, but it is bit difficult to analyse the soft gelatin capsule containing oil based blend. The purpose of this study was to develop test parameters to determine and supervise the quality of such herbal capsule formulation. Five different lots of soft gelatin Flaxilip capsule containing Linseed oil, Guggulu processed with linseed oil, Garlic oil, Fenugreek oil along with Soyabean oil as an excipient , were selected for the study. All the five lots were subjected to general capsule tests such as determination of average weight and disintegration time. Results obtained were around 1.3500g and 10minutes respectively. Specific test parameters applicable for oils like specific gravity, refractive index, acid value, peroxide value, saponification value, iodine value were applied quantitatively for quality evaluation. Standardised suitable classical methods were applied. Results in all the five lots were found to be well within inhouse limit. All the samples were subjected to heavy metals and microbiological testing. Compliance of corresponding findings with the standard pharmacopoeial guidelines assure the safe intake of the drug. For getting the better effect, the Guggulu that is Commiphora mukul used in the formulation was processed with linseed oil. Its presence was confirmed by carrying out HPTLC for E and Z guggulu sterone. Resemblance of spots at Rf ranging from 0.36 to 0.38 and 0.43 to 0.45 in Toluene : Acetone (9:1 system showed the presence of gugulu in blends of all the lots. Hence by applying all these test parameters one can ensure the quality of the soft gelatin ayurvedic capsule formulation containing oily base like in Flaxilip capsule.

  2. Oral chlorhexidine and microbial contamination during endoscopy

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Holzknecht, Barbara Juliane; Arpi, Magnus

    2013-01-01

    BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial contamin......BACKGROUND: One of the biggest concerns associated with transgastric surgery is contamination and risk of intra-abdominal infection with microbes introduced from the access route. The purpose of this study was to evaluate the effect of oral decontamination with chlorhexidine on microbial...... contamination of the endoscope. METHODS: In a prospective, randomized, single-blinded, clinical trial the effect of chlorhexidine mouth rinse was evaluated. As a surrogate for the risk of intra-abdominal contamination during transgastric surgery, microbial contamination of the endoscope during upper endoscopy...... microbial contamination of the endoscope, but micro-organisms with abscess forming capabilities were still present. PPI treatment significantly increased CFU and should be discontinued before transgastric surgery....

  3. Propofol alternatives in gastrointestinal endoscopy anesthesia

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Although propofol has been the backbone for sedation in gastrointestinal endoscopy, both anesthesiologists and endoscopists are faced with situations where an alternative is needed. Recent national shortages forced many physicians to explore these options. A midazolam and fentanyl combination is the mainstay in this area. However, there are other options. The aim of this review is to explore these options. The future would be, invariably, to move away from propofol. The reason is not in any way related to the drawbacks of propofol as a sedative. The mandate that requires an anesthesia provider to administer propofol has been a setback in many countries. New sedative drugs like Remimazolam might fill this void in the future. In the meantime, it is important to keep an open eye to the existing alternatives.

  4. Upper oesophageal images and Z-line detection with 2 different small-bowel capsule systems

    Institute of Scientific and Technical Information of China (English)

    Anastasios Koulaouzidis

    2012-01-01

    Transmission of oesophageal images may vary between different small-bowel capsule endoscopy models.A retrospective review of 100 examinations performed with 2 different Small-bowel capsule endoscopy (SBCE) systems (PillCam(R) and MiroCam(R)) was performed.The oral cavity/aero-digestive tract (i.e.,tongue,uvula and/or epiglottis) was captured/identified in almost all (99%)of PillCam(R) videos but in none of MiroCam(R) cases,P <0.0001.Furthermore,oesophageal images (i.e.,from the upper oesophageal sphincter to the Z-line were captured in 99% of PillCam(R) videos (mean ± SD,60.5 ±334.1 frames,range:0-3329 frames) and in 66% of Mirocam(R) cases (mean ± SD,11.1 ± 46.5 frames,range:0-382 frames),P < 0.0001.The Z-line was identified in 42% of PillCam(R) videos and 17% of MiroCam(R),P =0.0002.This information might be useful when performing SBCE in patients with high risks for aspiration.

  5. A retrospective study of pediatric endoscopy as performed in an adult endoscopy unit Estudio retrospectivo sobre la endoscopia pediátrica desarrollada en un servicio de endoscopias de adultos

    Directory of Open Access Journals (Sweden)

    L. Julián-Gómez

    2010-02-01

    Full Text Available Gastrointestinal endoscopy is a safe, efficient technique with minimal complications, and a useful diagnostic tool for the pediatric population. Under ideal conditions endoscopies for children should be performed by experienced pediatric endoscopists. In this study we report our experience with pediatric endoscopy at the general adult endoscopy unit in our hospital. Our goal is to quantify the number of endoscopies performed in children, as well as their indications and findings, the type of sedation or anesthesia used, and the time waiting for the test to occur. Our experience demonstrates that endoscopists in a general adult gastroenterology department, working together with pediatricians, may perform a relevant number of endoscopies in children in a fast, safe, effective manner.La endoscopia gastrointestinal es una técnica segura y eficiente con mínimas complicaciones, así como una útil herramienta diagnóstica en la población pediátrica. En condiciones ideales, las endoscopias en niños deberían ser realizadas por endoscopistas pediátricos experimentados. En este estudio reportamos nuestra experiencia en la realización de endoscopias pediátricas en la Unidad de Endoscopias general de adultos de nuestro hospital. El objetivo es cuantificar la cantidad de endoscopias realizadas en niños, así como las indicaciones y hallazgos de las mismas, el tipo de sedación o anestesia empleado y el tiempo de espera para la realización de la prueba. Nuestra experiencia demuestra que los endoscopistas de un servicio de gastroenterología general de adultos, en colaboración con pediatras, pueden realizar un número importante de endoscopias a niños, de forma rápida, segura y eficaz.

  6. The Value of Endoscopy in a Wildlife Raptor Service.

    Science.gov (United States)

    Desmarchelier, Marion R; Ferrell, Shannon T

    2015-09-01

    Although endoscopy is part of the basic standard of care in most avian practices, many wildlife rehabilitation centers do not have access to the equipment or do not use it on a regular basis. Endoscopic equipment is easily available at a lower cost on the used market or can be acquired through donations from local human hospitals. Several medical conditions encountered in wild raptors have an improved prognosis if they are diagnosed or treated early with the aid of endoscopy. In many cases, endoscopy provides a noninvasive alternative to exploratory surgery, saving cost and time and decreasing postoperative pain.

  7. Sedation and Monitoring in the Pediatric Patient during Gastrointestinal Endoscopy.

    Science.gov (United States)

    Chung, Hyun Kee; Lightdale, Jenifer R

    2016-07-01

    Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed. Finally, potential future directions for sedation and monitoring that may change the practice of pediatric gastroenterology and ultimately patient outcomes are examined.

  8. Guidelines for endoscopy in pregnant and lactating women

    Science.gov (United States)

    GUIDELINE Guidelines for endoscopy in pregnant and lactating women This is one of a series of statements discussing the ... text. This guide- line updates a previously issued guideline on this topic. 1 In preparing this guideline, ...

  9. Transmission of Infection by Flexible Gastrointestinal Endoscopy and Bronchoscopy

    NARCIS (Netherlands)

    Kovaleva, Julia; Peters, Frans T. M.; van der Mei, Henny C.; Degener, John E.

    2013-01-01

    Flexible endoscopy is a widely used diagnostic and therapeutic procedure. Contaminated endoscopes are the medical devices frequently associated with outbreaks of health care-associated infections. Accurate reprocessing of flexible endoscopes involves cleaning and high-level disinfection followed by

  10. Photon Production Within Storage Capsules

    CERN Document Server

    Rittmann, P D

    2003-01-01

    This report provides tables and electronic worksheets that list the photon production rate within SrF2 and CsC1 storage capsules, particularly the continuous spectrum of bremsstrahlung photons from the slowing down of the emitted electrons (BREMCALC).

  11. Nonoperating room anesthesia for the gastrointestinal endoscopy suite.

    Science.gov (United States)

    Tetzlaff, John E; Vargo, John J; Maurer, Walter

    2014-06-01

    Anesthesia services are increasingly being requested for gastrointestinal (GI) endoscopy procedures. The preparation of the patients is different from the traditional operating room practice. The responsibility to optimize comorbid conditions is also unclear. The anesthetic techniques are unique to the procedures, as are the likely events that require intervention by the anesthesia team. The postprocedure care is also unique. The future needs for anesthesia services in GI endoscopy suite are likely to expand with further developments of the technology.

  12. Sedation and analgesia in gastrointestinal endoscopy: What’s new?

    Institute of Scientific and Technical Information of China (English)

    Lorella; Fanti; Pier; Alberto; Testoni

    2010-01-01

    Various types of sedation and analgesia technique have been used during gastrointestinal endoscopy procedures.The best methods for analgesia and sedation during gastrointestinal endoscopy are still debated.Providing an adequate regimen of sedation/analgesia might be considered an art,influencing several aspects of endoscopic procedures: the quality of the examination,the patient’s cooperation and the patient’s and physician’s satisfaction with the sedation.The properties of a model sedative agent for endosc...

  13. Sedation and analgesia in gastrointestinal endoscopy: What’s new?

    OpenAIRE

    Fanti, Lorella; Testoni, Pier Alberto

    2010-01-01

    Various types of sedation and analgesia technique have been used during gastrointestinal endoscopy procedures. The best methods for analgesia and sedation during gastrointestinal endoscopy are still debated. Providing an adequate regimen of sedation/analgesia might be considered an art, influencing several aspects of endoscopic procedures: the quality of the examination, the patient’s cooperation and the patient’s and physician’s satisfaction with the sedation. The properties of a model sedat...

  14. Virtual endoscopy of the nasopharynx in the evaluation of its normal anatomy and alterations due to lymphoid hyperplasia: preliminary report

    Energy Technology Data Exchange (ETDEWEB)

    Pandolfo, Ignazio; Mazziotti, Silvio; Ascenti, Giorgio; Vinci, Sergio; Salamone, Ignazio; Colletti, Giovanni; Blandino, Alfredo [University of Messina, Department of Radiological Sciences, Messina (Italy)

    2004-10-01

    The purpose of this study was to evaluate the diagnostic usefulness of virtual endoscopy in establishing the anatomic appearance of nasopharynx, both normal and affected by lymphoid hyperplasia. Thirty-seven patients affected by chronic rhinosinusal and otomastoid pathology, all studied by rhinoscopy, were examined with multislice computed tomography (CT) and virtual endoscopy of the nasopharynx. Rhinoscopy showed a completely normal nasopharynx in 15 cases and a variable grade of lymphoid hypertrophy in 22 patients. A general agreement was observed between traditional and virtual endoscopy findings in both subgroups. The tasca of Luschka was detected in 13/15 of normal subjects and only in 3/22 patients. The Rosenmuller fossae appeared deeper in normal subjects and their symmetry could be considered an important criterion of normality. In all cases, a good evaluation of the tubaric ostium was obtained. Differentiation between hyperplasic lymphoid tissue and neoplasms is possible only in lymphoid hyperplasia characterized by median crest-like swelling with a narrow base. In most cases, differential diagnosis cannot be based only on morphological criteria of virtual endoscopy, but it should be evaluated considering the overall CT findings and clinical presentation. (orig.)

  15. The role of capnography in endoscopy patients undergoing nurse-administered propofol sedation: a randomized study.

    Science.gov (United States)

    Slagelse, Charlotte; Vilmann, Peter; Hornslet, Pernille; Jørgensen, Henrik L; Horsted, Tina I

    2013-10-01

    OBJECTIVE. Standard benzodiazepine/opioid cocktail has proven inferior to propofol sedation during complicated endoscopic procedures and in low-tolerance patients. Propofol is a short-acting hypnotic with a potential risk of respiratory depression at levels of moderate to deep sedation. The existing literature on capnography for endoscopy patients sedated with nurse-administered propofol sedation (NAPS) is limited. Can the addition of capnography to standard monitoring during endoscopy with NAPS reduce the number, duration, and level of hypoxia. MATERIALS AND METHODS. This study was a randomized controlled trial with an intervention group (capnography) and a control group (without capnography). Eligible subjects were consecutive patients for endoscopy at Gentofte Hospital compliant with the criteria of NAPS. RESULTS. Five hundred and forty patients, 263 with capnography and 277 without capnography, were included in the analysis. The number and total duration of hypoxia was reduced by 39.3% and 21.1% in the intervention group compared to the control group (p > 0.05). No differences in actions taken against insufficient respiration were found. Changes in end-tidal carbon dioxide (R = 0.177, p-value 0.05). Capnography is able to detect insufficient respiration that may lead to hypoxia prior to changes in pulse oximetry. However, due to a limited clinical benefit and additional costs associated with capnography, we do not find capnography necessary during the use of NAPS.

  16. Contact endoscopy for identifying the parathyroid glands during thyroidectomy.

    Science.gov (United States)

    Guimarães, A V; Brandão, L G; Dedivitis, R A

    2010-02-01

    Aim of this study was to analyse contact endoscopy as an auxiliary method for identifying parathyroid glands during thyroid surgery and to identify other variables that may interfere with this correlation. Overall, 125 patients underwent thyroid surgery between January 2004 and February 2006. The variables analysed were: the total duration of surgery; time taken to locate and identify parathyroid glands; improvement in identifying these; numbers of parathyroid glands located by the surgeon and confirmed by contact endoscopy; histopathological diagnosis; presence of thyroiditis; thyroid weight; number of parathyroid glands left in thyroid specimens; and number of parathyroid gland autotransplantations. A total of 331 parathyroid glands were observed by the surgeon. However, 282 glands were identified by contact endoscopy. Nine parathyroid glands (7.2%) were observed together with thyroid specimens (Kappa = 0.534). The longer the total duration of surgery (p = 0.03) and time taken to locate and identify (p = 0.00) the parathyroid glands by contact endoscopy, the lower the observed agreement. The second year of performing contact endoscopy led to better agreement between the results (p = 0.02). In conclusion, contact endoscopy is an efficient auxiliary method for identifying parathyroid glands during thyroid surgery. During the period studied, association between total duration of surgery and time taken to locate and identify parathyroid glands was statistically significant.

  17. Analysis of lomustine drug content in FDA-approved and compounded lomustine capsules.

    Science.gov (United States)

    KuKanich, Butch; Warner, Matt; Hahn, Kevin

    2017-02-01

    OBJECTIVE To determine the lomustine content (potency) in compounded and FDA-approved lomustine capsules. DESIGN Evaluation study. SAMPLE 2 formulations of lomustine capsules (low dose [7 to 11 mg] and high dose [40 to 48 mg]; 5 capsules/dose/source) from 3 compounders and from 1 manufacturer of FDA-approved capsules. PROCEDURES Lomustine content was measured by use of a validated high-pressure liquid chromatography method. An a priori acceptable range of 90% to 110% of the stated lomustine content was selected on the basis of US Pharmacopeia guidelines. RESULTS The measured amount of lomustine in all compounded capsules was less than the stated content (range, 59% to 95%) and was frequently outside the acceptable range (failure rate, 2/5 to 5/5). Coefficients of variation for lomustine content ranged from 4.1% to 16.7% for compounded low-dose capsules and from 1.1% to 10.8% for compounded high-dose capsules. The measured amount of lomustine in all FDA-approved capsules was slightly above the stated content (range, 104% to 110%) and consistently within the acceptable range. Coefficients of variation for lomustine content were 0.5% for low-dose and 2.3% for high-dose FDA-approved capsules. CONCLUSIONS AND CLINICAL RELEVANCE Compounded lomustine frequently did not contain the stated content of active drug and had a wider range of lomustine content variability than did the FDA-approved product. The sample size was small, and larger studies are needed to confirm these findings; however, we recommend that compounded veterinary formulations of lomustine not be used when appropriate doses can be achieved with FDA-approved capsules or combinations of FDA-approved capsules.

  18. Swallowable capsule with air channel for improved image-guided cancer detection in the esophagus

    Science.gov (United States)

    Seibel, Eric J.; Melville, C. David; Lung, Jonathan K. C.; Babchanik, Alexander P.; Lee, Cameron M.; Johnston, Richard S.; Dominitz, Jason A.

    2009-02-01

    A new type of endoscope has been developed and tested in the human esophagus, a tethered-capsule endoscope (TCE) that requires no sedation for oral ingestion and esophageal inspection. The TCE uses scanned red, green, and blue laser light to image the upper digestive tract using a swallowable capsule of 6.4mm in diameter and 18mm in length on a 1.4mm diameter tether. The TCE has been modified for image-guided interventions in the lower esophagus, specifically for more effective detection and measurement of the extent of Barrett's esophagus, a precursor to esophageal cancer. Three modifications have been tested in vivo: (1) weighting the capsule so it is negatively buoyant in water, (2) increasing the frame rate of 500-line images to 30 Hz (video rate), and (3) adding a 1.0mm inner diameter working channel alongside the tether for distending the lower esophagus with air pressure during endoscopy. All three modifications proved effective for more clearly visualizing the lower esophagus in the first few human subjects. The air channel was especially useful because it did not change tolerability in the first subject for unsedated endoscopy and the air easily removed bubbles obscuring tissue from the field of view. The air provided a non-invasive intervention by stimulating the mechanosensor of the lower esophageal sphincter at the precise time that the TCE was positioned for most informative imaging. All three TCE modifications proved successful for improved visualization of esophageal pathology, such as suspected Barrett's esophagus, without the use of sedation.

  19. Eosinophilic esophagitis in Saudi children: Symptoms, histology and endoscopy results

    Directory of Open Access Journals (Sweden)

    Mohammed Y Hasosah

    2011-01-01

    Full Text Available Background/Aim: Eosinophilic esophagitis (EE is a clinicopathologic entity characterized by esophageal symptoms in association with a dense eosinophilic infiltrate currently defined as >15 eosinophils per high power field in the appropriate clinical context. This is the first pediatric study in Saudi Arabia to give the experience with EE and examine its symptom, histology and endoscopy results. Materials and Methods: Retrospective chart review of all patients diagnosed with EE at National Guard Hospital, Jeddah Between 2007 and 2009. The authors identified EE on histologic criteria (≥15 eosinophils per high-power field together with their clinical context. The authors reviewed medical records for details of clinical presentation, laboratory data, radiologic, endoscopic, and histologic findings, and the results of treatment. Results: We identified 15 patients in our database in the last three years. 100% of the patients were males. The median age at presentation was 10 years (range, 3-17 years. The commonly reported symptoms were failure to thrive (86%, epigastric abdominal pain (53%, poor eating (40%, dysphagia with solid food (26%, food impaction (13%, and vomiting (20%. Asthma was reported in 46% and allergic rhinitis in 40%. Peripheral eosinophilia (>0.7 Χ 10/l was found in 66%. High serum IgE Level (>60 IU/ml was found in 60%. Upper endoscopic analysis revealed esophageal trachealization in 46%, esophageal erythema in 46%, white specks on the esophageal mucosa in 33%, esophageal narrowing in 13%, and normal endoscopy in 13%. The mean eosinophils per high-power field was 30.4 (range, 20-71. Histologic characteristics included degranulated eosinophils (86%, basal cell hyperplasia (93% and eosinophils clusters (micro-abscess in 73%. The treatment of EE revealed that they used swallowed corticosteroid in 50%, proton pump inhibitors in 66%, elemental diet/ food elimination in 13% and systemic corticosteroid in 13%. Conclusions: Failure to

  20. Clinical experience using the tethered capsule-based spectrally encoded confocal microendoscopy for diagnosis of eosinophilic esophagitis (Conference Presentation)

    Science.gov (United States)

    Do, Dukho; Alali, Sanaz; Kang, DongKyun; Tabatabaie, Nima; Lu, Weina; Grant, Catriona N.; Soomro, Amna R.; Nishioka, Norman S.; Rosenberg, Mireille; Hesterberg, Paul E.; Yuan, Qian; Garber, John J.; Katz, Aubrey J.; Shreffler, Wayne G.; Tearney, Guillermo J.

    2016-03-01

    Eosinophilic Esophagitis (EoE) is caused by food allergies, and defined by histological presence of eosinophil cells in the esophagus. The current gold standard for EoE diagnosis is endoscopy with pinch biopsy to detect more than 15 eosinophils/ High power field (HPF). Biopsy examinations are expensive, time consuming and are difficult to tolerate for patients. Spectrally encoded confocal microscopy (SECM) is a high-speed reflectance confocal microscopy technology capable of imaging individual eosinophils as highly scattering cells (diameter between 8 µm to 15 µm) in the epithelium. Our lab has developed a tethered SECM capsule that can be swallowed by unsedated patients. The capsule acquires large area confocal images, equivalent to more than 30,000 HPFs, as it traverses through the esophagus. In this paper, we present the outcome of a clinical study using the tethered SECM capsule for diagnosing EoE. To date, 32 subjects have been enrolled in this study. 88% of the subjects swallowed the capsules without difficulty and of those who swallowed the capsule, 95% preferred the tethered capsule imaging procedure to sedated endoscopic biopsy. Each imaging session took about 12 ± 2.4 minutes during which 8 images each spanning of 24 ± 5 cm2 of the esophagus were acquired. SECM images acquired from EoE patients showed abundant eosinophils as highly scattering cells in squamous epithelium. Results from this study suggest that the SECM capsule has the potential to become a less-invasive, cost-effective tool for diagnosing EoE and monitoring the response of this disease to therapy.

  1. Sedation and monitoring for gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-02-16

    The safe sedation of patients for diagnostic or therapeutic procedures requires a combination of properly trained physicians and suitable facilities. Additionally, appropriate selection and preparation of patients, suitable sedative technique, application of drugs, adequate monitoring, and proper recovery of patients is essential. The goal of procedural sedation is the safe and effective control of pain and anxiety as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation practices for gastrointestinal endoscopy (GIE) vary widely. The majority of GIE patients are ambulatory cases. Most of this procedure requires a short time. So, short acting, rapid onset drugs with little adverse effects and improved safety profiles are commonly used. The present review focuses on commonly used regimens and monitoring practices in GIE sedation. This article is to discuss the decision making process used to determine appropriate pre-sedation assessment, monitoring, drug selection, dose of sedative agents, sedation endpoint and post-sedation care. It also reviews the current status of sedation and monitoring for GIE procedures in Thailand.

  2. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk factors of these complications include the type, dose and mode of administration of sedative agents, as well as the patient's age and underlying medical diseases. Complications attributed to moderate and deep sedation levels are more often associated with cardiovascular and respiratory systems. However, sedation-related complications during GIE procedures are commonly transient and of a mild degree. The risk for these complications while providing any level of sedation is greatest when caring for patients already medically compromised. Significant unwanted complications can generally be prevented by careful pre-procedure assessment and preparation, appropriate monitoring and support, as well as post-procedure management. Additionally, physicians must be prepared to manage these complications. This article will review sedation-related complications during moderate and deep sedation for GIE procedures and also address their appropriate management.

  3. Proposal of a formal gynecologic endoscopy curriculum.

    Science.gov (United States)

    Morozov, Vadim; Nezhat, Ceana

    2009-01-01

    As minimally invasive surgery becomes the standard of care in the United States and around the world, the formal training of endoscopic surgeons is an issue of growing concern. With the implementation of the American Association of Gynecologic Laparoscopists/Society of Reproductive Surgeons (AAGL/SRS)-sponsored fellowship training in gynecologic endoscopy and a growing number of hands-on courses, we have the challenge of credentialing and certifying future gynecologic endoscopists. The objective of this article is to propose and to illustrate a uniform standardized core curriculum for obstetrics and gynecology residents, fellows in AAGL/SRS-sponsored fellowship programs, and participants in postgraduate courses. Consisting of 3 discrete parts, this proposal addresses formal laparoscopic training for gynecologists, already implemented and available to general surgeons, and a novel proposition for core training in hysteroscopy. The curriculum is distributed in a quarterly system with specific educational objectives in each quarter. After quarters 1 and 2, an online examination is given; after quarter 3, participants are required to take and pass a hands-on examination at a specified testing facility; and at the end of quarter 4, participants must demonstrate leadership skills in the operating room and in a teaching capacity, and promote the principles of the AAGL.

  4. Chemical inhibition of bacterial protein tyrosine phosphatase suppresses capsule production.

    Science.gov (United States)

    Standish, Alistair J; Salim, Angela A; Zhang, Hua; Capon, Robert J; Morona, Renato

    2012-01-01

    Capsule polysaccharide is a major virulence factor for a wide range of bacterial pathogens, including Streptococcus pneumoniae. The biosynthesis of Wzy-dependent capsules in both gram-negative and -positive bacteria is regulated by a system involving a protein tyrosine phosphatase (PTP) and a protein tyrosine kinase. However, how the system functions is still controversial. In Streptococcus pneumoniae, a major human pathogen, the system is present in all but 2 of the 93 serotypes found to date. In order to study this regulation further, we performed a screen to find inhibitors of the phosphatase, CpsB. This led to the observation that a recently discovered marine sponge metabolite, fascioquinol E, inhibited CpsB phosphatase activity both in vitro and in vivo at concentrations that did not affect the growth of the bacteria. This inhibition resulted in decreased capsule synthesis in D39 and Type 1 S. pneumoniae. Furthermore, concentrations of Fascioquinol E that inhibited capsule also lead to increased attachment of pneumococci to a macrophage cell line, suggesting that this compound would inhibit the virulence of the pathogen. Interestingly, this compound also inhibited the phosphatase activity of the structurally unrelated gram-negative PTP, Wzb, which belongs to separate family of protein tyrosine phosphatases. Furthermore, incubation with Klebsiella pneumoniae, which contains a homologous phosphatase, resulted in decreased capsule synthesis. Taken together, these data provide evidence that PTPs are critical for Wzy-dependent capsule production across a spectrum of bacteria, and as such represents a valuable new molecular target for the development of anti-virulence antibacterials.

  5. Chemical inhibition of bacterial protein tyrosine phosphatase suppresses capsule production.

    Directory of Open Access Journals (Sweden)

    Alistair J Standish

    Full Text Available Capsule polysaccharide is a major virulence factor for a wide range of bacterial pathogens, including Streptococcus pneumoniae. The biosynthesis of Wzy-dependent capsules in both gram-negative and -positive bacteria is regulated by a system involving a protein tyrosine phosphatase (PTP and a protein tyrosine kinase. However, how the system functions is still controversial. In Streptococcus pneumoniae, a major human pathogen, the system is present in all but 2 of the 93 serotypes found to date. In order to study this regulation further, we performed a screen to find inhibitors of the phosphatase, CpsB. This led to the observation that a recently discovered marine sponge metabolite, fascioquinol E, inhibited CpsB phosphatase activity both in vitro and in vivo at concentrations that did not affect the growth of the bacteria. This inhibition resulted in decreased capsule synthesis in D39 and Type 1 S. pneumoniae. Furthermore, concentrations of Fascioquinol E that inhibited capsule also lead to increased attachment of pneumococci to a macrophage cell line, suggesting that this compound would inhibit the virulence of the pathogen. Interestingly, this compound also inhibited the phosphatase activity of the structurally unrelated gram-negative PTP, Wzb, which belongs to separate family of protein tyrosine phosphatases. Furthermore, incubation with Klebsiella pneumoniae, which contains a homologous phosphatase, resulted in decreased capsule synthesis. Taken together, these data provide evidence that PTPs are critical for Wzy-dependent capsule production across a spectrum of bacteria, and as such represents a valuable new molecular target for the development of anti-virulence antibacterials.

  6. The association of matrix Gla protein isomers with calcification in capsules surrounding silicone breast implants.

    Science.gov (United States)

    Hunter, Larry W; Lieske, John C; Tran, Nho V; Miller, Virginia M

    2011-11-01

    Implanted silicone medical prostheses induce a dynamic sequence of histologic events in adjacent tissue resulting in the formation of a fibrotic peri-prosthetic capsule. In some cases, capsular calcification occurs, requiring surgical intervention. In this study we investigated capsules from silicone gel-filled breast prostheses to test the hypothesis that this calcification might be regulated by the small vitamin K-dependent protein, matrix Gla protein (MGP), a potent inhibitor of arterial calcification, or by Fetuin-A, a hepatocyte-derived glycoprotein also implicated as a regulator of pathologic calcification. Immunolocalization studies of explanted capsular tissue, using conformation-specific antibodies, identified the mineralization-protective γ-carboxylated MGP isomer (cMGP) within cells of uncalcified capsules, whereas the non-functional undercarboxylated isomer (uMGP) was typically absent. Both were upregulated in calcific capsules and co-localized with mineral plaque and adjacent fibers. Synovial-like metaplasia was present in one uncalcified capsule in which MGP species were differentially localized within the pseudosynovium. Fetuin-A was localized to cells within uncalcified capsules and to mineral deposits within calcific capsules. The osteoinductive cytokine bone morphogenic protein-2 localized to collagen fibers in uncalcified capsules. These findings demonstrate that MGP, in its vitamin K-activated conformer, may represent a pharmacological target to sustain the health of the peri-prosthetic tissue which encapsulates silicone breast implants as well as other implanted silicone medical devices.

  7. Low-power transceiver analog front-end circuits for bidirectional high data rate wireless telemetry in medical endoscopy applications.

    Science.gov (United States)

    Chi, Baoyong; Yao, Jinke; Han, Shuguang; Xie, Xiang; Li, Guolin; Wang, Zhihua

    2007-07-01

    State-of-the-art endoscopy systems require electronics allowing for real-time, bidirectional data transfer. Proposed are 2.4-GHz low-power transceiver analog front-end circuits for bidirectional high data rate wireless telemetry in medical endoscopy applications. The prototype integrates a low-IF receiver analog front-end [low noise amplifier (LNA), double balanced down-converter, bandpass-filtered automatic gain controlled (AGC) loop and amplitude-shift keying (ASK) demodulator], and a direct up-conversion transmitter analog front-end [20-MHz IF phase-locked loop (PLL) with well-defined amplitude control circuit, ASK modulator, up-converter, and power amplifier] on a single chip together with an internal radio frequency oscillator and local oscillating (LO) buffers. Design tradeoffs have been made over the boundaries of the different building blocks to optimize the overall system performance. All building blocks feature circuit topologies that enable comfortable operation at low power consumption. The circuits have been implemented in a 0.25-microm CMOS process. The measured sensitivity of the receiver analog front-end is -70 dBm with a data rate of 256 kbps, and the measured output power of the transmitter analog front-end could achieve -23 dBm with a data rate of 1 Mbps. The integrated circuit consumes a current of 6 mA in receiver mode and 5.6 mA in transmitter mode with a power supply of 2.5 V. This paper shows the feasibility of achieving the analog performance required by the wireless endoscopy capsule system in 0.25 microm CMOS.

  8. Automatic Polyp Detection in Pillcam Colon 2 Capsule Images and Videos: Preliminary Feasibility Report

    Directory of Open Access Journals (Sweden)

    Pedro N. Figueiredo

    2011-01-01

    Full Text Available Background. The aim of this work is to present an automatic colorectal polyp detection scheme for capsule endoscopy. Methods. PillCam COLON2 capsule-based images and videos were used in our study. The database consists of full exam videos from five patients. The algorithm is based on the assumption that the polyps show up as a protrusion in the captured images and is expressed by means of a P-value, defined by geometrical features. Results. Seventeen PillCam COLON2 capsule videos are included, containing frames with polyps, flat lesions, diverticula, bubbles, and trash liquids. Polyps larger than 1 cm express a P-value higher than 2000, and 80% of the polyps show a P-value higher than 500. Diverticula, bubbles, trash liquids, and flat lesions were correctly interpreted by the algorithm as nonprotruding images. Conclusions. These preliminary results suggest that the proposed geometry-based polyp detection scheme works well, not only by allowing the detection of polyps but also by differentiating them from nonprotruding images found in the films.

  9. Wireless power and data transmission strategies for next-generation capsule endoscopes

    Science.gov (United States)

    Puers, R.; Carta, R.; Thoné, J.

    2011-05-01

    Capsular endoscopy is becoming increasingly popular as an alternative to traditional gastro-intestinal (GI) examination techniques. However, the breakthrough of these devices is hindered by the limited amount of power that can be stored in a tiny pill. Most commercial devices use two watch batteries that can only provide an average power of 25 mW for about 6 h, certainly not sufficient for advanced robotic features. A dedicated inductive powering system, operating at 1 MHz to limit the human body absorption, has been developed which was proven to support the transfer of over 300 mW. The system relies on a condensed set of orthogonal ferrite coils, embedded in the capsule, and an external unit based on a Helmholtz coil driven by a class E amplifier. Control data can be sent through the inductive link by modulating the power carrier, whereas a dedicated high data rate RF link is used to transfer the images from the capsule to the base station. Besides evaluating the compatibility with radio transmission, several demonstrators were assembled combining the wireless powering system with various locomotion strategies and LED illumination. This paper describes the design and implementation of the inductive powering system, its combination with data transmission techniques and the testing activity with other capsule-dedicated modules.

  10. 3-D Magnetic Sensor Module for Locating and Tracking MEMS Swallowable Capsule Based on Scalar Form of Magnetic Dipole Model

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    MEMS swallowable capsule is a novel technology in the non-invasive surgery. This technology provides a way to diagnose directly into the deep intestinal where the traditional invasive technology implemented, such as X-Ray, endoscopy. It is a key for us to locate and track the position of a MEMS capsule in clinical applications. To solve this problem, we implemented a magnetic sensor module based on the scalar form of the magnetic dipole model,which was designed with very small size (5.2 * 2.1 * 1.2 cm) and easy to assemble to satisfy the system requirement. Here we discuss in detail the principle of magnetic dipole model, rules of selecting sensor and functions of the module. Some trials are established to test the characteristic of the module. The results of the Cm experiment demonstrates that the module follows the rules of the new magnetic dipole model form.

  11. Informative-frame filtering in endoscopy videos

    Science.gov (United States)

    An, Yong Hwan; Hwang, Sae; Oh, JungHwan; Lee, JeongKyu; Tavanapong, Wallapak; de Groen, Piet C.; Wong, Johnny

    2005-04-01

    Advances in video technology are being incorporated into today"s healthcare practice. For example, colonoscopy is an important screening tool for colorectal cancer. Colonoscopy allows for the inspection of the entire colon and provides the ability to perform a number of therapeutic operations during a single procedure. During a colonoscopic procedure, a tiny video camera at the tip of the endoscope generates a video signal of the internal mucosa of the colon. The video data are displayed on a monitor for real-time analysis by the endoscopist. Other endoscopic procedures include upper gastrointestinal endoscopy, enteroscopy, bronchoscopy, cystoscopy, and laparoscopy. However, a significant number of out-of-focus frames are included in this type of videos since current endoscopes are equipped with a single, wide-angle lens that cannot be focused. The out-of-focus frames do not hold any useful information. To reduce the burdens of the further processes such as computer-aided image processing or human expert"s examinations, these frames need to be removed. We call an out-of-focus frame as non-informative frame and an in-focus frame as informative frame. We propose a new technique to classify the video frames into two classes, informative and non-informative frames using a combination of Discrete Fourier Transform (DFT), Texture Analysis, and K-Means Clustering. The proposed technique can evaluate the frames without any reference image, and does not need any predefined threshold value. Our experimental studies indicate that it achieves over 96% of four different performance metrics (i.e. precision, sensitivity, specificity, and accuracy).

  12. Breath and string test: A diagnostic package for the identification of treatment failure and antibiotic resistance of Helicobacter pylori without the necessity of upper gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    Andreas Leodolter; Kathlen Wolle; Ulrike von Arnim; Stefan Kahl; Gerhard Treiber; Matthias P. Ebert; Ulrich Peitz; Peter Malfertheiner

    2005-01-01

    AIM: Helicobacter pylori ( H pylofi) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13C-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of Hpylori.METHODS: The UBT was routinely performed 4 to 6 wk after H pylorieradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed.Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under microaerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture.RESULTS: H pyloriwas successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. Hpyloriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%).CONCLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of Hpyloriwith little inconvenience to the patient.Upper GI-endoscopy can be avoided in several cases by applying consequently this diagnostic package.

  13. Motion of an elastic capsule in a constricted microchannel

    CERN Document Server

    Touchard, Antoine; Zhu, Lailai; Brandt, Luca

    2014-01-01

    We study the motion of an elastic capsule through a microchannel characterized by a localized constriction. We consider a capsule with a stress-free spherical shape and impose its steady state configuration in an infinitely long straight channel as the initial condition for our calculations. We report how the capsule deformation, velocity, retention time, and maximum stress of the membrane are affected by the capillary number, Ca, and the constriction shape. We estimate the deformation by measuring the variation of the three-dimensional surface area and a series of alternative quantities easier to extract from experiments. These are the Taylor parameter, the perimeter and the area of the capsule in the spanwise plane. We find that the perimeter is the quantity that reproduces the behavior of the three-dimensional surface area the best. We observe that, in general, area-deformation correlated quantities grow linearly with Ca, while velocity-correlated quantities saturate for large Ca but display a steeper incr...

  14. Optimizing early upper gastrointestinal cancer detection at endoscopy.

    Science.gov (United States)

    Veitch, Andrew M; Uedo, Noriya; Yao, Kenshi; East, James E

    2015-11-01

    Survival rates for upper gastrointestinal cancers are poor and oesophageal cancer incidence is increasing. Upper gastrointestinal cancer is also often missed during examinations; a predicament that has not yet been sufficiently addressed. Improvements in the detection of premalignant lesions, early oesophageal and gastric cancers will enable organ-preserving endoscopic therapy, potentially reducing the number of advanced upper gastrointestinal cancers and resulting in improved prognosis. Japan is a world leader in high-quality diagnostic upper gastrointestinal endoscopy and the clinical routine in this country differs substantially from Western practice. In this Perspectives article, we review lessons learnt from Japanese gastroscopy technique, training and screening for risk stratification. We suggest a key performance indicator for upper gastrointestinal endoscopy with a minimum total procedure time of 8 min, and examine how quality assurance concepts in bowel cancer screening in the UK could be applied to upper gastrointestinal endoscopy and improve clinical practice.

  15. Guidelines for conscious sedation and monitoring during gastrointestinal endoscopy.

    Science.gov (United States)

    Waring, J Patrick; Baron, Todd H; Hirota, William K; Goldstein, Jay L; Jacobson, Brian C; Leighton, Jonathan A; Mallery, J Shawn; Faigel, Douglas O

    2003-09-01

    This is one of a series of statements discussing the utilization of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy prepared this text. In preparing this guideline, a MEDLINE literature search was performed, and additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When little or no data exist from well-designed prospective trials, emphasis is given to results from large series and reports from recognized experts. Guidelines for appropriate utilization of endoscopy are based on a critical review of the available data and expert consensus. Further controlled clinical studies are needed to clarify aspects of this statement, and revision may be necessary as new data appear. Clinical consideration may justify a course of action at variance to these recommendations.

  16. The Endoscopy Global Rating Scale – Canada: Development And Implementation of a Quality Improvement Tool

    Directory of Open Access Journals (Sweden)

    Donald MacIntosh

    2013-01-01

    Full Text Available BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.

  17. Unsedated Transnasal Endoscopy: A Canadian Experience in Daily Practice

    Directory of Open Access Journals (Sweden)

    Sarah Cho

    2008-01-01

    Full Text Available BACKGROUND: Esophagogastroduodenoscopy (EGD is the most frequently performed diagnostic procedure for upper gastrointestinal disorders. The procedure is routinely performed under conscious sedation in North America. A significant proportion of morbidity and mortality associated with EGD is related to hypoxia due to conscious sedation. The use of sedation is also associated with an increase in cost, loss of work on the day of endoscopy and the need for the patient to be accompanied home after the procedure. Transnasal endoscopy has advantages such as no sedation and less patient monitoring, nursing time and expenses than conventional per oral EGD.

  18. Preventing Ulcer Rebleeding: The Role of Second-Look Endoscopy

    Directory of Open Access Journals (Sweden)

    SC Sydney Chung

    1999-01-01

    Full Text Available Whether a second-look endoscopy after initial endoscopic hemostasis is of value is controversial. Routine surveillance endoscopy on the next day and treatment of any remaining stigmata may provide marginal benefit, but existing studies are not large enough to demonstrate significant differences. Endoscopic retreatment when patients develop rebleeding may allow emergency surgery to be avoided if successful but may endanger life if further bleeding occurs. Early data indicate that surgery can be avoided in about 75% of patients by retreatment without an increase in mortality.

  19. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis

    Directory of Open Access Journals (Sweden)

    Héctor Julian Canaval-Zuleta

    Full Text Available Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  20. Endoscopy as a diagnostic and therapeutic alternative technique of taeniasis.

    Science.gov (United States)

    Canaval Zuleta, Héctor Julián; Company Campins, María M; Dolz Abadía, Carlos

    2016-06-01

    Despite a low incidence in developed countries, gastrointestinal taeniasis should be suspected in patients with abdominal pain, diarrhea, anemia, and/or malabsorption of unknown origin, even more so if they come from endemic regions or areas with poor hygienic and alimentary habits. Diagnosis is traditionally reached by identifying the parasite in stools, but more recently both serological and immunological approaches are also available. Based on a patient diagnosed by gastroscopy, a literature review was undertaken of patients diagnosed by endoscopy. We discuss endoscopy as diagnostic modality, and the effectiveness and safety that endoscopic treatment may provide in view of the potential risk for neurocysticercosis.

  1. Prediction of esophageal and gastric histology by macroscopic diagnosis during upper endoscopy in pediatric celiac disease

    Science.gov (United States)

    Boschee, Erin D; Yap, Jason Y K; Turner, Justine M

    2017-01-01

    AIM To determine the sensitivity of macroscopic appearance for predicting histological diagnosis at sites other than duodenum in pediatric celiac disease (CD). METHODS Endoscopic and histologic findings in pediatric patients undergoing upper endoscopy for first-time diagnosis of CD at Stollery Children’s Hospital from 2010-2012 were retrospectively reviewed. RESULTS Clinical charts from 140 patients were reviewed. Esophageal and gastric biopsies were taken in 54.3% and 77.9% of patients, respectively. Endoscopic appearance was normal in the esophagus and stomach in 75% and 86.2%. Endoscopic esophageal diagnoses were eosinophilic esophagitis (EE) (11.8%), esophagitis (7.9%), glycogenic acanthosis (1.3%) and non-specific abnormalities (3.9%). Endoscopic gastric diagnoses were gastritis (8.3%), pancreatic rest (0.9%), and non-specific abnormalities (4.6%). Histology was normal in 76.3% of esophageal and 87.2% of gastric specimens. Abnormal esophageal histology was EE (10.5%), esophagitis (10.5%), glycogenic acanthosis (1.3%) and non-specific (1.3%). Gastritis was reported in 12.8% of specimens. Sensitivity and specificity of normal endoscopy for predicting normal esophageal histology was 86.2% and 61.1%, and for normal gastric histology was 87.4% and 21.4%. CONCLUSION In the absence of macroscopic abnormalities, routine esophageal and gastric biopsy during endoscopy for pediatric CD does not identify major pathologies. These findings have cost and time saving implications for clinical practice. PMID:28216971

  2. Facile and Scalable Synthesis of Monodispersed Spherical Capsules with a Mesoporous Shell

    KAUST Repository

    Qi, Genggeng

    2010-05-11

    Monodispersed HMSs with tunable particle size and shell thickness were successfully synthesized using relatively concentrated polystyrene latex templates and a silica precursor in a weakly basic ethanol/water mixture. The particle size of the capsules can vary from 100 nm to micrometers. These highly engineered monodispersed capsules synthesized by a facile and scalable process may find applications in drug delivery, catalysis, separationm or as biological and chemical microreactors. © 2010 American Chemical Society.

  3. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy.

    Science.gov (United States)

    Dumonceau, J M; Riphaus, A; Aparicio, J R; Beilenhoff, U; Knape, J T A; Ortmann, M; Paspatis, G; Ponsioen, C Y; Racz, I; Schreiber, F; Vilmann, P; Wehrmann, T; Wientjes, C; Walder, B

    2010-11-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.

  4. Acetylene bubble-powered autonomous capsules: towards in situ fuel.

    Science.gov (United States)

    Moo, James Guo Sheng; Wang, Hong; Pumera, Martin

    2014-12-28

    A fuel-free autonomous self-propelled motor is illustrated. The motor is powered by the chemistry of calcium carbide and utilising water as a co-reactant, through a polymer encapsulation strategy. Expulsion of acetylene bubbles powers the capsule motor. This is an important step, going beyond the toxic hydrogen peroxide fuel used normally, to find alternative propellants for self-propelled machines.

  5. Clinical application of magnification endoscopy and narrow-band imaging in the upper gastrointestinal tract: new imaging techniques for detecting and characterizing gastrointestinal neoplasia.

    Science.gov (United States)

    Yao, Kenshi; Takaki, Yasuhiro; Matsui, Toshiyuki; Iwashita, Akinori; Anagnostopoulos, George K; Kaye, Philip; Ragunath, Krish

    2008-07-01

    This article introduces one of the most advanced endoscopy imaging techniques, magnification endoscopy with narrow-band imaging. This technique can clearly visualize the microvascular (MV) architecture and microsurface (MS) structure. The application of this technique is quite useful for characterizing the mucosal neoplasia in the hypopharynx, oropharynx, esophagus, and stomach. The key characteristic findings for early carcinomatous lesions are an irregular MV pattern or irregular MS pattern as visualized by this technique. Such a diagnostic system could be applied to the early detection of mucosal neoplasia throughout the upper gastrointestinal tract.

  6. Tethered capsule endomicroscopy: from bench to bedside at a primary care practice

    Science.gov (United States)

    Gora, Michalina J.; Simmons, Leigh H.; Quénéhervé, Lucille; Grant, Catriona N.; Carruth, Robert W.; Lu, Weina; Tiernan, Aubrey; Dong, Jing; Walker-Corkery, Beth; Soomro, Amna; Rosenberg, Mireille; Metlay, Joshua P.; Tearney, Guillermo J.

    2016-10-01

    Due to the relatively high cost and inconvenience of upper endoscopic biopsy and the rising incidence of esophageal adenocarcinoma, there is currently a need for an improved method for screening for Barrett's esophagus. Ideally, such a test would be applied in the primary care setting and patients referred to endoscopy if the result is suspicious for Barrett's. Tethered capsule endomicroscopy (TCE) is a recently developed technology that rapidly acquires microscopic images of the entire esophagus in unsedated subjects. Here, we present our first experience with clinical translation and feasibility of TCE in a primary care practice. The acceptance of the TCE device by the primary care clinical staff and patients shows the potential of this device to be useful as a screening tool for a broader population.

  7. Intrauterine fertilization capsules--a clinical trial

    DEFF Research Database (Denmark)

    Lenz, S; Lindenberg, S; Sundberg, K

    1991-01-01

    chorionic gonadotropin. Oocytes were collected by ultrasonically guided transvaginal aspiration, and spermatozoa were prepared by swim-up technique. The gametes were placed in agar capsules 4 hr after oocyte collection, and the capsules were introduced to the uterine fundus using an insertion tube...

  8. Species in the Cryptococcus gattii Complex Differ in Capsule and Cell Size following Growth under Capsule-Inducing Conditions

    Science.gov (United States)

    Fernandes, Kenya E.; Dwyer, Christine; Campbell, Leona T.

    2016-01-01

    traits related to infection and disease is important for determining whether these different species have clinical relevance. This study examined variation in attributes that are important for infecting and surviving in the host, including tolerance to various stresses, yeast cell size, and the amount of polysaccharide capsule that covers the cell. The cell size and capsule size were significantly different and inversely correlated across the species. Thermotolerance was highest in C. deuterogattii (VGII), the only species known to cause outbreaks, while most strains of the species C. bacillisporus (VGIII) and C. tetragattii (VGIV) grew poorly at 37°C. These findings argue for increased acceptance of the new species and may be useful for informing diagnosis and prognosis in clinical infection. PMID:28066814

  9. The Type a and Type b Polysaccharide Capsules Predominate in an International Collection of Invasive Kingella kingae Isolates.

    Science.gov (United States)

    Porsch, Eric A; Starr, Kimberly F; Yagupsky, Pablo; St Geme, Joseph W

    2017-01-01

    Kingella kingae is an encapsulated Gram-negative bacterium and an important etiology of osteoarticular infections in young children. A recent study examining a diverse collection of carrier and invasive K. kingae isolates from Israel revealed four distinct polysaccharide capsule types. In this study, to obtain a global view of K. kingae capsule type diversity, we examined an international collection of isolates using a multiplex PCR approach. The collection contained all four previously identified capsule types and no new capsule types. Over 95% of invasive isolates in the collection were type a or type b, similar to the findings in Israel. These results suggest that the type a and type b polysaccharide capsules may have enhanced pathogenic properties or may mark clonal groups of strains with specific virulence genes. In addition, they raise the possibility that a vaccine containing the type a and type b capsules might be an effective approach to preventing K. kingae disease. IMPORTANCEKingella kingae has emerged as a significant cause of septic arthritis, osteomyelitis, and bacteremia in young children. A recent study examining a diverse collection of K. kingae isolates from Israel revealed four different polysaccharide capsule types in this species, designated types a to d. To determine the global distribution of K. kingae capsule types, we assembled and capsule typed an international collection of K. kingae isolates. The findings reported here show that the type a and type b capsules represent >95% of the invasive isolates, similar to the Israeli isolate collection, suggesting that a polysaccharide-based vaccine targeting these two capsules could be an attractive approach to prevent K. kingae disease.

  10. Role of endoscopy in the management of acute diverticular bleeding

    Institute of Scientific and Technical Information of China (English)

    Charalampos Pilichos; Emmanouil Bobotis

    2008-01-01

    Colonic diverticulosis is one of the most common causes of lower gastrointestinal bleeding. Endoscopy is not only a useful diagnostic tool for localizing the bleeding site, but also a therapeutic modality for its management. To date, haemostatic methods have included adrenaline injection, mechanical clipping, thermal and electrical coagulation or combinations of them. The results of all published data are herein reviewed.

  11. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    Energy Technology Data Exchange (ETDEWEB)

    Shigematsu, Y.; Korogi, Y.; Hirai, T. [Kumamoto Univ. (Japan). Dept. of Radiology; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-10-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.) With 6 figs., 16 refs.

  12. Endoscopy: consensus on approving propofol sedation by nonanesthesiologists.

    Science.gov (United States)

    Riphaus, Andrea

    2010-04-01

    Propofol sedation by nonanesthesiologists is still a highly controversial issue despite the fact that numerous studies have approved this sedation regimen for gastrointestinal endoscopy. A new position statement from a collaboration of four different American gastroenterology and hepatology societies outlines the latest recommendations for nonanesthesiologist administration of propofol.

  13. A Quantitative Analysis of Published Skull Base Endoscopy Literature.

    Science.gov (United States)

    Hardesty, Douglas A; Ponce, Francisco A; Little, Andrew S; Nakaji, Peter

    2016-02-01

    Objectives Skull base endoscopy allows for minimal access approaches to the sinonasal contents and cranial base. Advances in endoscopic technique and applications have been published rapidly in recent decades. Setting We utilized an Internet-based scholarly database (Web of Science, Thomson Reuters) to query broad-based phrases regarding skull base endoscopy literature. Participants All skull base endoscopy publications. Main Outcome Measures Standard bibliometrics outcomes. Results We identified 4,082 relevant skull base endoscopy English-language articles published between 1973 and 2014. The 50 top-cited publications (n = 51, due to articles with equal citation counts) ranged in citation count from 397 to 88. Most of the articles were clinical case series or technique descriptions. Most (96% [49/51])were published in journals specific to either neurosurgery or otolaryngology. Conclusions A relatively small number of institutions and individuals have published a large amount of the literature. Most of the publications consisted of case series and technical advances, with a lack of randomized trials.

  14. Role of sleep endoscopy in obstructive sleep apnea syndrome

    Directory of Open Access Journals (Sweden)

    Suzan Salama

    2013-07-01

    Conclusion: Sleep endoscopy is a useful tool for the assessment of level, degree and shape of the upper airway obstruction during sleep in OSAS and this could be helpful in preoperative evaluation. Presence of obstruction at hypopharyngeal level or tongue base obstruction is an indicator of OSAS severity.

  15. Therapeutic upper gastrointestinal tract endoscopy inPaediatric Gastroenterology

    Institute of Scientific and Technical Information of China (English)

    Imdadur Rahman; Praful Patel; Philip Boger; Shahnawaz Rasheed; Mike Thomson; Nadeem Ahmad Afzal

    2015-01-01

    Since the first report of use of endoscopy in childrenin the 1970s, there has seen an exponential growthin published experience and innovation in the field. Inthis review article we focus on modern age therapeuticendoscopy practice, explaining use of traditional aswell as new and innovative techniques, for diagnosisand treatment of diseases in the paediatric uppergastrointestinal tract.

  16. The Prevalence of Barrett Esophagus Diagnosed in the Second Endoscopy

    Science.gov (United States)

    Suna, Nuretdin; Parlak, Erkan; Kuzu, Ufuk Baris; Yildiz, Hakan; Koksal, Aydin Seref; Oztas, Erkin; Sirtas, Zeliha; Yuksel, Mahmut; Aydinli, Onur; Bilge, Zulfikar; Taskiran, Ismail; Sasmaz, Nurgul

    2016-01-01

    Abstract At present, we do not know the exact prevalence of Barrett esophagus (BE) developing later in patients without BE in their first endoscopic screening. The purpose of this study was to determine the prevalence of BE on the second endoscopic examination of patients who had no BE in their first endoscopic examination. The data of the patients older than 18 years who had undergone upper gastrointestinal system endoscopy more than once at the endoscopy unit of our clinic during the last 6 years were retrospectively analyzed. During the last 6 years, 44,936 patients had undergone at least one endoscopic examination. Among these patients, 2701 patients who had more than one endoscopic screening were included in the study. Of the patients, 1276 (47.3%) were females and 1425 (52.7%) were males, with an average age of 54.9 (18–94) years. BE was diagnosed in 18 (0.66%) of the patients who had no BE in the initial endoscopic examination. The patients with BE had reflux symptoms in their medical history and in both endoscopies, they revealed a higher prevalence of lower esophageal sphincter laxity, hiatal hernia, and reflux esophagitis when compared to patients without BE (P < 0.001). Our study showed that in patients receiving no diagnosis of BE on their first endoscopic examination performed for any reason, the prevalence of BE on their second endoscopy within 6 years was very low (0.66%). PMID:27057907

  17. [Structuralization of digestive endoscopy report based on NLP].

    Science.gov (United States)

    Kong, Xiao-feng; Li, Ying; Li, Hao-min; Lu, Xu-dong

    2008-09-01

    This paper presents a method based on NLP to realize structuralization of digestive endoscopy reports. The method is taking advantage of existing NLP's processing technologies and introducing minimal standard terminology (MST) to transform a narrative gastroscopy report into the structuralization report based on MST, whose accuracy rate is 92.3%.

  18. Usefulness of magnifying endoscopy in post-endoscopic resection scar for early gastric neoplasm: A prospective short-term follow-up endoscopy study

    Institute of Scientific and Technical Information of China (English)

    Tae Hoon Lee; Il-Kwun Chung; Ji-Young Park; Chang Kyun Lee; Suck-Ho Lee; Hong Soo Kim; Sang-Heum Park; Sun-Joo Kim; Hyun-Deuk Cho; Young Hwangbo

    2009-01-01

    AIM: To investigate the relationship between postendoscopic resection (ER) scars on magnifying endoscopy (ME) and the pathological diagnosis in order to validate the clinical significance of ME.METHODS: From January, 2007 to June, 2008, 124 patients with 129 post-ER scar lesions were enrolled. Mucosal pit patterns on ME were compared with conventional endoscopy (CE) findings and histological results obtained from targeted biopsies.RESULTS: CE findings showed nodular scars (53/129),erythematous scars (85/129), and ulcerative scars (4/129). The post-ER scars were classified into four pit patterns of sulci and ridges on ME: (Ⅰ) 47 round; (Ⅱ)54 short rod or tubular; (Ⅲ) 19 branched or gyrus-like;and (Ⅳ) 9 destroyed pits. Sensitivity and specificitywere 88.9% and 62.5%, respectively, by the presence of nodularity on CE. Erythematous lesions were high sensitivity (100%), but specificity was as low as 36.7%. The range of the positive predictive value (PPV) on CE was as low as 10.6%-25%. Nine type Ⅳpit patterns were diagnosed as tumor lesions, and 120cases of type Ⅰ-Ⅲ pit patterns revealed non-neoplastic lesions. Thus, the sensitivity, specificity, and the PPV of ME were 100%.CONCLUSION: ME findings can detect the presence of tumor in post-ER scar lesions, and make evident the biopsy target site in short-term follow-up. Further large-scale and long-term studies are needed to determine whether ME can replace endoscopic biopsy.

  19. Clinical, endoscopic and histopathological profiles of parasitic duodenitis cases diagnosed by upper digestive endoscopy

    Directory of Open Access Journals (Sweden)

    Reinaldo Benevides dos Santos

    2011-12-01

    Full Text Available CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%, abdominal pain (78%, diarrhea (78% and weight loss (78% were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

  20. Canadian Association of Gastroenterology Practice Guideline for Granting of Privileges to Perform Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    H Miller MacSween

    1997-01-01

    Full Text Available The purpose of this statement is to provide guidelines to assist hospital credentialling committees in their task of granting privileges to perform gastrointestinal endoscopy. Endoscopy of the gastrointestinal tract has evolved over the past 30 years as a potent tool to assist in the evaluation, diagnosis and therapy of patients with gastrointestinal tract disorders. Although gastrointestinal endoscopy was initially developed as a purely diagnostic tool, the development of therapeutic endoscopic techniques has dramatically expanded the role of gastrointestinal endoscopy, frequently to a therapeutic one. In setting guidelines for training and credentialling one must recognize that, excluding flexible sigmoidoscopy, endoscopists should be well trained in therapeutic endoscopy.

  1. Comparison of esomeprazole enteric-coated capsules vs esomeprazole magnesium in the treatment of active duodenal ulcer: A randomized, double-blind, controlled study

    Institute of Scientific and Technical Information of China (English)

    Xiao-Yan Liang; Qing Gao; Neng-Ping Gong; Li-Ping Tang; Pi-Long Wang; Xiao-Hong Tao

    2008-01-01

    AIM: To evaluate the efficacy and tolerability of two different preparations of esomeprazole in healing duodenal ulcers.METHODS: A total of 60 patients with active duodenal ulcers were enrolled and randomized to receive esomeprazole enteric-coated capsules (40 mg) or esomeprazole magnesium (40 mg), once daily, for 4 consecutive wk, with ulcer healing being monitored by endoscopy. Safety and tolerability were also assessed.RESULTS: Fifty seven patients completed the whole trial. The ulcer healing rates at the end of wk 2 were 86.7% and 85.2% in the esomeprazole enteric-coated capsules and esomeprazole magnesium groups, respectively (P = 0.8410), and reached 100% at the end of wk 4 in both groups. Symptom relief at the end of wk 2 was 90.8% in the esomeprazole enteric-coated capsules group and 86.7% in the esomeprazole magnesium group (P = 0.5406); at the end of wk 4 symptom relief was 95.2% and 93.2%, respectively (P = 0.5786). Adverse events occurred in 16.7% of the esomeprazole enteric-coated capsules group and 14.8% of the esomeprazole magnesium group (P = 1.0000).CONCLUSION: The efficacies of esomeprazole enteric-coated capsules and esomeprazole magnesium in healing duodenal ulcer lesions and relieving gastrointestinal symptoms are equivalent. The tolerability and safety of both drugs were comparable.

  2. The Preliminary Study of Interferon-γGene Transfection to Human Tenon's Capsule Fibroblasts in Vitro#

    Institute of Scientific and Technical Information of China (English)

    Yuqing Lan; Jian Ge; Mingkai Lin; Jianliang Zheng; Huiyi Chen; Haiquan Liu; Jing Wei; Yanyan Li

    2000-01-01

    Purpose: To investigate the results of the interferon-gamma(IFN-y) gene transfer and transient expression in human Tenon's capsule fibroblast in vitro in order to find a way to gene therapy in vivo. Method: Using LipofectAMINE, IFN-γ gene was transferred in human Tenon's capsule fibroblasts with plasmid pcDNA3 IFN-y. Its mRNA transcription and protein expression were determined by RT-PCR and flow cytometry assay respectively.Result: The human Tenon's capsule fibroblasts transferred the IFN-γgene can express the IFN-γin transcription and protein level transiently.Conclusion: IFN-γ gene can be transferred successfully and expressed efficiently in human tenon's capsule fibroblast in vitro.

  3. Adhesive capsulitis of the wrist. Diagnosis and treatment.

    Science.gov (United States)

    Hanson, E C; Wood, V E; Thiel, A E; Maloney, M D; Sauser, D D

    1988-09-01

    Adhesive capsulitis occurs as a pathologic entity in the shoulder, hip, and ankle joints. Thickening and contracture of the wrist joint capsule were demonstrated on arthrograms performed on ten patients ranging in age from 20 to 82 years. The patients had pain and limited range of motion in the wrist. The findings included: (1) resistance to the injection of smaller than normal volumes of contrast material, (2) obliteration of recesses, and (3) extravasation of the contrast agent along the needle tract. Closed manipulation under general anesthesia of the wrist on four patients resulted in some improvement in range of motion. A distal ulna fracture in one older patient occurred as a complication of manipulation. Careful technique and judicious patient selection are of paramount importance.

  4. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    ), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  5. Comparative Evaluation of Chronic Rhinosinusitis Patients by Conventional Radiography, Computed Tomography and Diagnostic Nasal Endoscopy (DNE).

    Science.gov (United States)

    Srivastava, Mohit; Tyagi, Sushant; Kumar, Lalit

    2016-06-01

    Chronic rhinosinusitis is a common condition in medical practice. It is defined as inflammation of the mucosa of nose and paranasal sinuses, the fluids within these cavities, and/or the underlying bone that has been present with or without treatment for at least 12 weeks duration. In 1997, a detailed definition of the syndrome was developed by the Rhinosinusitis Task Force of the American Academy of Otolaryngology-Head and Neck Surgery, consisting of the major and minor diagnostic criterias. To study the role of conventional radiography, nasal endoscopy and computed tomography in the early diagnosis of chronic rhinosinusitis. The study was carried out in the Department of Otorhinolaryngology, Saraswati Institute of Medical Sciences. A total of 100 patients with clinical evidence of sinonasal diseases were evaluated with conventional radiography, Nasal endoscopy and computed tomographic evaluation. Out of 100 patients; 58 were male and 42 were female. M:F ratio = 1.38:1. Majority of the patients were being in the age group of 21-30 years (30 %). The most common finding on conventional radiography was opacification of maxillary sinus (42 %) followed mucosal thickening (26 %), haziness of the maxillary sinus (19 %) followed by air-fluid level (13 %). Five basic radiological patterns of sinonasal inflammatory disease are identified among 100 patients. These were (1) Infundibular 16 %, (2) Ostiomeatal unit 32 %, (3) Sphenoethmoidal 8 %, (4) Sinonasal polyposis 28 %, (5) Unclassified 16 %. The sensitivity and specificity of plain film radiography for detecting sinus opacifications was unacceptably low for paranasal sinuses, hence conventional radiography should not be used as a single diagnostic tool in preoperative evaluation. Nasal endoscopy having sensitivity and specificity almost as good as CT scanning, and being an outpatient procedure may reduce unnecessary diagnostic CT scanning procedures. It allows an unparalleled vision with brilliant

  6. Endoscopic findings and clinicopathologic characteristics of colonic schistosomiasis:A report of 46 cases

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    AIM:To make a retrospective analysis of endoscopy findings and clinicopathologic characteristics of colonic schistosomiasis in order to further improve our understanding of the disease and decrease its misdiagnosis. METHODS:Endoscopy findings and clinicopathologic characteristics of 46 intestinal schistosomiasis patients were retrospectively analyzed.All the patients underwent colonoscopy and all biopsy specimens stained with hematoxylin and eosin were observed under a light microscope. RESULTS:Of the 46 co...

  7. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy.

    Science.gov (United States)

    Dumonceau, J M; Riphaus, A; Aparicio, J R; Beilenhoff, U; Knape, J T A; Ortmann, M; Paspatis, G; Ponsioen, C Y; Racz, I; Schreiber, F; Vilmann, P; Wehrmann, T; Wientjes, C; Walder, B

    2010-12-01

    Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology.

  8. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anaesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  9. [Karyosphere capsule in Tribolium castaneum oocytes].

    Science.gov (United States)

    Batalova, F M; Bogoliubov, D S

    2013-01-01

    Structure and composition of the karyosphere (karyosome) capsule were studied in the oocytes of a laboratory insect, Tribolium castaneum, with the use of electron microscopy and immunoelectron cytochemistry. Basing on the study of nuclear structure dynamics, we distinguished 8 stages that characterize the period of oocyte growth. At the diplotene stage, T. castaneum oocyte chromosomes conjoin early into a compact karyosphere, but a significant chromatin condensation does not occur. The process of karyosphere formation is accompanied by the development of an extensive extrachromosome capsule surrounding chromatin. The capsule consists of a material of different morphological types. Significant molecular components of the T. castaneum karyosphere capsule are represented by the proteins of nuclear matrix including F-actin and lamin B. Besides the structural proteins, the Sm proteins of small nuclear (sn) RNPs and mature 2,2,7-trimethyl guanosine (TMG) 5'-capped snRNAs are revealed immunocytochemically in the karyosphere capsule. The obtained data can form a basis for further expansion of ideas on the functions of the karyosphere capsule as a specialized extrachromosomal nuclear domain of the oocytes. We believe that the T. castaneum karyosphere capsule plays not only a structural role, but may be involved directly in the processes related to gene expression.

  10. Contrast-Enhanced Cross Sectional Imaging and Capsule Endoscopy: New Perspectives for a Whole Picture of the Small Bowel

    Directory of Open Access Journals (Sweden)

    Pedro Boal Carvalho

    2016-01-01

    These diagnostic modalities are often not competitive but synergistic techniques. Knowing their characteristics, strengths and limitations, indications, contraindications and potential complications, as well as the adaptation to local availability and expertise, is essential to better select which procedures to perform in each patient, both safely and effectively, in order to optimize management and improve patient outcomes.

  11. Accuracy of Colon Capsule Endoscopy in Detecting Colorectal Polyps in Individuals with Familial Colorectal Cancer: Could We Avoid Colonoscopies?

    Science.gov (United States)

    Alvarez-Urturi, Cristina; Fernández-Esparrach, Gloria; Ibáñez, Inés Ana; Rodríguez De Miguel, Cristina; Dedeu, Josep Maria; Bessa, Xavier; Córdova, Henry; Pellisé, Maria; Balaguer, Francesc; Ginés, Angels; Barranco, Luis; Araujo, Isis K.; Andreu, Montserrat; Llach, Josep

    2017-01-01

    Background. Individuals with a family history of colorectal cancer (CRC) have an increased risk of CRC. We evaluated the diagnostic yield of CCE in the detection of lesions and also two different colon preparations. Methods. A prospective multicenter study was designed to assess CCE diagnostic yield in a cohort of asymptomatic individuals with a family history of CRC. CCE and colonoscopy were performed on the same day by 2 endoscopists who were blinded to the results of the other procedure. Results. Fifty-three participants were enrolled. The sensitivity, specificity, PPV, and NPV of CCE for detecting advanced adenomas were 100%, 98%, 67%, and 100%. Sensitivity, specificity, PPV, and NPV of CCE for the diagnosis of individuals with polyps were 87%, 97%, 93%, and 88%, respectively. CCE identify 100% of individuals with significant or advanced lesions. Overall cleanliness was adequate by 60.7% of them. The PEG-ascorbic boost seems to improve colon cleanliness, with similar colonic transit time. Conclusion. CCE is a promising tool, but it has to be considered as an alternative technique in this population in order to reduce the number of colonoscopies performed. More studies are needed to understand appropriate screening follow-up intervals and optimize the bowel preparation regimen. PMID:28265285

  12. Tag gas capsule with magnetic piercing device

    Science.gov (United States)

    Nelson, Ira V.

    1976-06-22

    An apparatus for introducing a tag (i.e., identifying) gas into a tubular nuclear fuel element. A sealed capsule containing the tag gas is placed in the plenum in the fuel tube between the fuel and the end cap. A ferromagnetic punch having a penetrating point is slidably mounted in the plenum. By external electro-magnets, the punch may be caused to penetrate a thin rupturable end wall of the capsule and release the tag gas into the fuel element. Preferably the punch is slidably mounted within the capsule, which is in turn loaded as a sealed unit into the fuel element.

  13. Required Be Capsule Strength For Room Temperature Transport

    Energy Technology Data Exchange (ETDEWEB)

    Cook, B

    2005-03-21

    The purpose of this memo is to lay out the criteria for the Be capsule strength necessary for room temperature transport. Ultimately we will test full thickness capsules by sealing high pressures inside, but currently we are limited to both thinner capsules and alternative measures of capsule material strength.

  14. The effect of upper gastrointestinal system endoscopy process on serum oxidative stress levels.

    Science.gov (United States)

    Turan, Mehmet Nuri; Aslan, Mehmet; Bolukbas, Filiz Fusun; Bolukbas, Cengiz; Selek, Sahbettin; Sabuncu, Tevfik

    2016-12-01

    Some authors have investigated the effects of oxidative stress in some process such as undergoing laparoscopic. However, the effect of upper gastrointestinal system endoscopy process on oxidative stress is unclear. We evaluated the short-term effect of upper gastrointestinal system endoscopy process on oxidative stress. Thirty patients who underwent endoscopy process and 20 healthy controls were enrolled in the prospective study. Serum total antioxidant capacity and total oxidant status measurements were measured before and after endoscopy process. The ratio percentage of total oxidant status to total antioxidant capacity was regarded as oxidative stress index. Before endoscopy process, serum total antioxidant capacity levels were higher, while serum total oxidant status levels and oxidative stress index values were lower in patients than controls, but this difference was not statistically significant (all, p > 0.05). After endoscopy process, serum total antioxidant capacity and total oxidant status levels were significantly higher in patients than before endoscopy process (both, p oxidative stress index values were slight higher in patients but this difference was not statistically significant (p > 0.05). We observed that serum TAC and TOS levels were increased in patients who underwent endoscopy process after endoscopy process. However, short-time upper gastrointestinal system endoscopy process did not cause an important change in the oxidative stress index. Further studies enrolling a larger number of patients are required to clarify the results obtained here.

  15. The poly-γ-d-glutamic acid capsule surrogate of the Bacillus anthracis capsule induces nitric oxide production via the platelet activating factor receptor signaling pathway.

    Science.gov (United States)

    Lee, Hae-Ri; Jeon, Jun Ho; Park, Ok-Kyu; Chun, Jeong-Hoon; Park, Jungchan; Rhie, Gi-Eun

    2015-12-01

    The poly-γ-d-glutamic acid (PGA) capsule, a major virulence factor of Bacillus anthracis, confers protection of the bacillus from phagocytosis and allows its unimpeded growth in the host. PGA capsules released from B. anthracis are associated with lethal toxin in the blood of experimentally infected animals and enhance the cytotoxic effect of lethal toxin on macrophages. In addition, PGA capsule itself activates macrophages and dendritic cells to produce proinflammatory cytokine such as IL-1β, indicating multiple roles of PGA capsule in anthrax pathogenesis. Here we report that PGA capsule of Bacillus licheniformis, a surrogate of B. anthracis capsule, induces production of nitric oxide (NO) in RAW264.7 cells and bone marrow-derived macrophages. NO production was induced by PGA in a dose-dependent manner and was markedly reduced by inhibitors of inducible NO synthase (iNOS), suggesting iNOS-dependent production of NO. Induction of NO production by PGA was not observed in macrophages from TLR2-deficient mice and was also substantially inhibited in RAW264.7 cells by pretreatment of TLR2 blocking antibody. Subsequently, the downstream signaling events such as ERK, JNK and p38 of MAPK pathways as well as NF-κB activation were required for PGA-induced NO production. In addition, the induced NO production was significantly suppressed by treatment with antagonists of platelet activating factor receptor (PAFR) or PAFR siRNA, and mediated through PAFR/Jak2/STAT-1 signaling pathway. These findings suggest that PGA capsule induces NO production in macrophages by triggering both TLR2 and PAFR signaling pathways which lead to activation of NF-kB and STAT-1, respectively.

  16. Endoscopic ultrasound with double-balloon endoscopy for the diagnosis of inverted Meckel’s diverticulum: a case report

    Directory of Open Access Journals (Sweden)

    Araki Akihiro

    2012-09-01

    Full Text Available Abstract Introduction Inverted Meckel’s diverticulum has usually been misdiagnosed in the cases based on computed tomography images presented in the literature. The final diagnosis was made intra-operatively or by pathology reports after surgery. Despite this, preoperative diagnosis could be made successfully by using endoscopic ultrasound with double-balloon endoscopy prior to surgery. Case presentation A 60-year-old Japanese woman with severe anemia complained of several episodes of black stool over the preceding 2 years. Abdominal computed tomography showed a 3.0-cm low-density tumor in the ileum, suggesting a diagnosis of intestinal lipoma. Examination of the tumor by endoscopic ultrasound with double-balloon endoscopy revealed a hypo-echoic layer corresponding to the muscularis propria, and a hyper-echoic layer corresponding to the fat tissue. These findings, which suggested that the tumor included areas outside the intestinal serosa, are not typical for a lipoma, despite the existence of a hyper-echoic layer corresponding to fatty tissue. We then considered a diagnosis of inverted Meckel’s diverticulum. Conclusion Lipoma and inverted Meckel’s diverticulum are difficult to differentially diagnose by computed tomography. Polypectomy is the preferred therapeutic approach when a lipoma is present; however, polypectomy in a patient with Meckel’s diverticulum requires full-thickness resection. Situations where polypectomy is performed without preparing for full-thickness resection can be avoided by first making a precise diagnosis using double-balloon endoscopy and endoscopic ultrasound.

  17. Pantoprazole before Endoscopy in Patients with Gastroduodenal Ulcer Bleeding: Does the duration of Infusion and Ulcer Location Influence the Effects?

    Directory of Open Access Journals (Sweden)

    Istvan Rácz

    2012-01-01

    Full Text Available The aim of this study was to investigate the effect of preemptive pantoprazole infusion on early endoscopic findings in patients with acute ulcer bleeding. Records of 333 patients admitted with acute ulcer bleeding were analyzed. Ulcer bleeders were given either 80 mg bolus of pantoprazole followed by continuous infusion of 8 mg per hour or saline infusion until endoscopy. In 93 patients saline infusion whereas in 240 patients bolus plus infusion of pantoprazole was administrated with mean (±SD durations of 5.45±12.9 hours and 6.9±13.2 hours, respectively (P=0.29. Actively bleeding ulcers were detected in 46/240 (19.2% of cases in the pantoprazole group as compared with 23/93 (24.7% in the saline infusion group (P=0.26. Different durations of pantoprazole infusion (0–4 hours, >4 hours, and >6 hours had no significant effect on endoscopic and clinical outcome parameters in duodenal ulcer bleeders. Gastric ulcer bleeders on pantoprazole infusion longer than 4 and 6 hours before endoscopy had actively bleeding ulcers in 4.3% and 5% compared to the 19.5% active bleeding rate in the saline group (P=0.02 and P=0.04. Preemptive infusion of high-dose pantoprazole longer than 4 hours before endoscopy decreased the ratio of active bleeding only in gastric but not in duodenal ulcer patients.

  18. Semipermeable Capsules Wrapping a Multifunctional and Self-regulated Co-culture Microenvironment for Osteogenic Differentiation

    Science.gov (United States)

    Correia, Clara R.; Pirraco, Rogério P.; Cerqueira, Mariana T.; Marques, Alexandra P.; Reis, Rui L.; Mano, João F.

    2016-02-01

    A new concept of semipermeable reservoirs containing co-cultures of cells and supporting microparticles is presented, inspired by the multi-phenotypic cellular environment of bone. Based on the deconstruction of the “stem cell niche”, the developed capsules are designed to drive a self-regulated osteogenesis. PLLA microparticles functionalized with collagen I, and a co-culture of adipose stem (ASCs) and endothelial (ECs) cells are immobilized in spherical liquified capsules. The capsules are coated with multilayers of poly(L-lysine), alginate, and chitosan nano-assembled through layer-by-layer. Capsules encapsulating ASCs alone or in a co-culture with ECs are cultured in endothelial medium with or without osteogenic differentiation factors. Results show that osteogenesis is enhanced by the co-encapsulation, which occurs even in the absence of differentiation factors. These findings are supported by an increased ALP activity and matrix mineralization, osteopontin detection, and the up regulation of BMP-2, RUNX2 and BSP. The liquified co-capsules also act as a VEGF and BMP-2 cytokines release system. The proposed liquified capsules might be a valuable injectable self-regulated system for bone regeneration employing highly translational cell sources.

  19. Measurement of motion detection of wireless capsule endoscope inside large intestine.

    Science.gov (United States)

    Zhou, Mingda; Bao, Guanqun; Pahlavan, Kaveh

    2014-01-01

    Wireless Capsule Endoscope (WCE) provides a noninvasive way to inspect the entire Gastrointestinal (GI) tract, including large intestine, where intestinal diseases most likely occur. As a critical component of capsule endoscopic examination, physicians need to know the precise position of the endoscopic capsule in order to identify the position of detected intestinal diseases. Knowing how the capsule moves inside the large intestine would greatly complement the existing wireless localization systems by providing the motion information. Since the most recently released WCE can take up to 6 frames per second, it's possible to estimate the movement of the capsule by processing the successive image sequence. In this paper, a computer vision based approach without utilizing any external device is proposed to estimate the motion of WCE inside the large intestine. The proposed approach estimate the displacement and rotation of the capsule by calculating entropy and mutual information between frames using Fibonacci method. The obtained results of this approach show its stability and better performance over other existing approaches of motion measurements. Meanwhile, findings of this paper lay a foundation for motion pattern of WCEs inside the large intestine, which will benefit other medical applications.

  20. Modeling of NIF Wetted-Foam Capsule Experiments

    Science.gov (United States)

    Peterson, Robert; Olson, Richard; Kline, John

    2015-11-01

    Wetting of a foam with liquid DT or DD in an ICF capsule provides a mechanism of directly controlling the convergence ratio of the implosion. The density of the DD or DT vapor in the central void in the CH foam is set by the temperature of the liquid fuel, so the convergence ratio is easily adjustable. The capsule is driven by a two step laser pulse on NIF. The ablator is made of high density carbon in these experiments, but it could be beryllium. The experiments will test how well the modeling computer codes agree with experiment as the convergence ratio increases. It is possible that has the convergence ratio increases, a point will be reached were the modeling no longer agree with experiment. We wish to find this limit. In the presentation we will present computer model simulations in 1-D of the performance of NIF wetted-foam capsules, where the vapor density, the ablator type, and the choice of fuel (DD or DT) are varied.

  1. An Active Endoscopy Robotic System for Direct Tracheal Inspection

    Institute of Scientific and Technical Information of China (English)

    YU Lian-zhi; YAN Guo-zheng; MA Guan-ying; ZAN Peng

    2007-01-01

    The development of active endoscopy techniques is one important area of medical robot. This paper designed a new flexible and active endoscopy robotic system for direct tracheal inspection. The mobile mechanism of the robot is based on the inchworm movement actuated by pneumatic rubber actuator. There are five air chambers controlled independently, by adjusting pressures in air chambers, the robot can move in a straight mode or in a bending mode. The inspection sensors and some therapy surgery tools can be equipped in the front of the robot.The prototype was made and its mechanical characteristics were analyzed. The robot could move smoothly in a small plastic tube, and the robot is respectable to be used for inspection in human trachea directly.

  2. Application of robotics in gastrointestinal endoscopy: A review.

    Science.gov (United States)

    Yeung, Baldwin Po Man; Chiu, Philip Wai Yan

    2016-02-07

    Multiple robotic flexible endoscope platforms have been developed based on cross specialty collaboration between engineers and medical doctors. However, significant number of these platforms have been developed for the natural orifice transluminal endoscopic surgery paradigm. Increasing amount of evidence suggest the focus of development should be placed on advanced endolumenal procedures such as endoscopic submucosal dissection instead. A thorough literature analysis was performed to assess the current status of robotic flexible endoscopic platforms designed for advanced endolumenal procedures. Current efforts are mainly focused on robotic locomotion and robotic instrument control. In the future, advances in actuation and servoing technology, optical analysis, augmented reality and wireless power transmission technology will no doubt further advance the field of robotic endoscopy. Globally, health systems have become increasingly budget conscious; widespread acceptance of robotic endoscopy will depend on careful design to ensure its delivery of a cost effective service.

  3. Computer vision and augmented reality in gastrointestinal endoscopy

    Science.gov (United States)

    Mahmud, Nadim; Cohen, Jonah; Tsourides, Kleovoulos; Berzin, Tyler M.

    2015-01-01

    Augmented reality (AR) is an environment-enhancing technology, widely applied in the computer sciences, which has only recently begun to permeate the medical field. Gastrointestinal endoscopy—which relies on the integration of high-definition video data with pathologic correlates—requires endoscopists to assimilate and process a tremendous amount of data in real time. We believe that AR is well positioned to provide computer-guided assistance with a wide variety of endoscopic applications, beginning with polyp detection. In this article, we review the principles of AR, describe its potential integration into an endoscopy set-up, and envisage a series of novel uses. With close collaboration between physicians and computer scientists, AR promises to contribute significant improvements to the field of endoscopy. PMID:26133175

  4. Quality Assurance in the Endoscopy Suite: Sedation and Monitoring.

    Science.gov (United States)

    Harris, Zachary P; Liu, Julia; Saltzman, John R

    2016-07-01

    Recent development and expansion of endoscopy units has necessitated similar progress in the quality assurance of procedure sedation and monitoring. The large number of endoscopic procedures performed annually underlies the need for standardized quality initiatives focused on mitigating patient risk before, during, and immediately after endoscopic sedation, as well as improving procedure outcomes and patient satisfaction. Specific standards are needed for newer sedation modalities, including propofol administration. This article reviews the current guidelines and literature concerning quality assurance and endoscopic procedure sedation.

  5. EVALUATION OF UPPER GASTROINTESTINAL ENDOSCOPY IN PATIENTS UNDERGOING BARIATRIC SURGERY

    OpenAIRE

    2015-01-01

    Background: Obesity has become epidemic, and is associated with greater morbidity and mortality. Treatment is multidisciplinary. Surgical treatment is a consistent resource in severe obesity. The indication of preoperative upper gastrointestinal endoscopy in asymptomatic patients is controversial; however, most studies recommend its implementation in all patients. Aim: To analyze endoscopic performance in patients who were in preoperative for bariatric surgery and compare them with control gr...

  6. Diagnostic Accuracy of the Initial Endoscopy for Ampullary Tumors

    OpenAIRE

    Lee, Hee Seung; Jang, Jong Soon; Lee, Seungho; Yeon, Myeong Ho; Kim, Ki Bae; Park, Jae Geun; Lee, Joo Young; Kim, Mi Jin; HAN, JOUNG-HO; Sung, Rohyun; Park, Seon Mee

    2015-01-01

    Background/Aims Ampullary tumors come in a wide variety of malignant forms. We evaluated the diagnostic accuracy of endoscopy for ampullary tumors, and analyzed the causes of misdiagnosis. Methods We compared endoscopic imaging and biopsy results to final diagnoses. Types of endoscope, numbers of biopsy specimens taken, and final diagnoses were evaluated as possible factors influencing diagnostic accuracy. Results Final diagnoses were 19 adenocarcinomas, 18 normal or papillitis, 11 adenomas, ...

  7. Systematic Design of edical Capsule Robots

    OpenAIRE

    Beccani, M; Tunc, H; Taddese, AZ; Susilo, E; Volgiesi, P; Ledeczi, A; Valdastri, P

    2015-01-01

    Medical capsule robots that navigate inside the body as diagnostic and interventional tools are an emerging and challenging research area within medical CPSs. These robots must provide locomotion, sensing, actuation, and communication within severe size, power, and computational constraints. This paper presents the first effort for an open architecture, platform design, software infrastructure, and a supporting modular design environment for medical capsule robots to further this research area.

  8. Hyperspectral Imaging Using Flexible Endoscopy for Laryngeal Cancer Detection

    Science.gov (United States)

    Regeling, Bianca; Thies, Boris; Gerstner, Andreas O. H.; Westermann, Stephan; Müller, Nina A.; Bendix, Jörg; Laffers, Wiebke

    2016-01-01

    Hyperspectral imaging (HSI) is increasingly gaining acceptance in the medical field. Up until now, HSI has been used in conjunction with rigid endoscopy to detect cancer in vivo. The logical next step is to pair HSI with flexible endoscopy, since it improves access to hard-to-reach areas. While the flexible endoscope’s fiber optic cables provide the advantage of flexibility, they also introduce an interfering honeycomb-like pattern onto images. Due to the substantial impact this pattern has on locating cancerous tissue, it must be removed before the HS data can be further processed. Thereby, the loss of information is to minimize avoiding the suppression of small-area variations of pixel values. We have developed a system that uses flexible endoscopy to record HS cubes of the larynx and designed a special filtering technique to remove the honeycomb-like pattern with minimal loss of information. We have confirmed its feasibility by comparing it to conventional filtering techniques using an objective metric and by applying unsupervised and supervised classifications to raw and pre-processed HS cubes. Compared to conventional techniques, our method successfully removes the honeycomb-like pattern and considerably improves classification performance, while preserving image details. PMID:27529255

  9. Sedation in gastrointestinal endoscopy: Where are we at in 2014?

    Science.gov (United States)

    Ferreira, Alexandre Oliveira; Cravo, Marília

    2015-02-16

    Gastrointestinal endoscopies are invasive and unpleasant procedures that are increasingly being used worldwide. The importance of high quality procedures (especially in colorectal cancer screening), the increasing patient awareness and the expectation of painless examination, increase the need for procedural sedation. The best single sedation agent for endoscopy is propofol which, due to its' pharmacokinetic/dynamic profile allows for a higher patient satisfaction and procedural quality and lower induction and recovery times, while maintaining the safety of traditional sedation. Propofol is an anesthetic agent when used in higher doses than those needed for endoscopy. Because of this important feature it may lead to cardiovascular and respiratory depression and, ultimately, to cardiac arrest and death. Fueled by this argument, concern over the safety of its administration by personnel without general anesthesia training has arisen. Propofol usage seems to be increasing but it's still underused. It is a safe alternative for simple endoscopic procedures in low risk patients even if administered by non-anesthesiologists. Evidence on propofol safety in complex procedures and high risk patients is less robust and in these cases, the presence of an anesthetist should be considered. We review the existing evidence on the topic and evaluate the regional differences on sedation practices.

  10. The Results of Upper Gastrointestinal Endoscopy Performed in Bayburt Province

    Directory of Open Access Journals (Sweden)

    Yavuz Ayar

    2013-09-01

    Full Text Available Aim: We analyzed the results of upper gastrointestinal endoscopy performed between November 2011 and January 2013 in the endoscopy unit at Bayburt State Hospital. Methods: Endoscopic analyses were done with a PENTAX EPK 100P equipment. The results were assessed retrospectively. Results: A total of 1008 patients (664 women, 344 men aged between 17 and 88 (mean: 50±18 years have undergone upper gastrointestinal endoscopy. 186 (18.4% patients were diagnosed with pangastritis, 81 - with esophagitis (8%, 68 - with antral gastritis (6.7%, 67 - with duodenal ulcer (6.6%, 57 - with gastric ulcer (5.6%, 35 - with alkaline reflux gastritis (3.6%, 21 - with duodenitis (2.1%, 5 - with gastric cancer (0.5%, 4 - with esophagial cancer (0.4%, 4 - with gastric polyp (0.4% and 3 patients were diagnosed with esophagial ulcer (0.3%. Conclusion: Lesions were most commonly observed in the stomach. Gastritis, esophagitis, duodenal and gastric ulcer were frequently observed in our city. (The Medical Bulletin of Haseki 2013; 51: 116-9

  11. Endoscopy-assisted cerebral falx incision via unilateral

    Directory of Open Access Journals (Sweden)

    DONG Ji-rong

    2012-04-01

    Full Text Available 【Abstract】Objective: To investigate the clinical features and treatment strategy of dissymmetric bilateral frontal contusion, and to summarize our experience in treat-ing these patients by minimally invasive surgery. Methods: Over the past 3 years, we have treated a total of 31 patients with dissymmetric bilateral frontal contusion using endoscopy-assisted unilateral cerebral falx incision. Other 30 patients treated by routine bilateral approaches within the same period were taken as control. Results: Seventeen cases (54.8% in the unilateral operation group survived and were in good condition, 8 (25.8% had moderate disability, 4 (12.9% had severe disability, 1 (3.2% was in vegetative state, and 1 (3.2% died. Compared with the control group, the Glasgow Out-come Scale score was not significantly different in the uni-lateral operation group, but the operation time, blood trans-fusion volume, the length of hospital stay, the incidences of mental disorder and olfactory nerve injury were greatly reduced in the unilateral operation group. Conclusions: Endoscopy-assisted unilateral cerebral falx incision can shorten the operation time, reduce surgical trauma and complications in treatment of patients with dis-symmetric bilateral frontal contusion. It can obviously di-minish the chance of delayed intracerebral hematoma and subsequently minimize the incidences of subfalcial and centrencephalic herniation. Key words: Brain injuries; Intracranial hemorrage, traumatic; Endoscopy; Surgically procedures, minimally invasive

  12. The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy

    Directory of Open Access Journals (Sweden)

    Alexander F. Hagel

    2017-01-01

    Full Text Available Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE. Lately, several hemostatic powders have been released to facilitate EE. Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications. Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies. Hemospray was applied during 35 examinations in 27 patients (19 males, 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60% and in 14 (40% as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%, while long-term success occurred in 23 applications (65.7%. Similar long-term results were found after primary application (64,3% or salvage therapy (66,7%. Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8% occurred with gastric perforation after Hemospray application. Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions.

  13. The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy

    Science.gov (United States)

    Albrecht, Heinz; Nägel, Andreas; Vitali, Francesco; Vetter, Marcel; Dauth, Christine; Neurath, Markus F.; Raithel, Martin

    2017-01-01

    Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE). Lately, several hemostatic powders have been released to facilitate EE. Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications. Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies). Hemospray was applied during 35 examinations in 27 patients (19 males), 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60%) and in 14 (40%) as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%), while long-term success occurred in 23 applications (65.7%). Similar long-term results were found after primary application (64,3%) or salvage therapy (66,7%). Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8%) occurred with gastric perforation after Hemospray application. Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions. PMID:28232848

  14. Fibre-optic nonlinear optical microscopy and endoscopy.

    Science.gov (United States)

    Fu, L; Gu, M

    2007-06-01

    Nonlinear optical microscopy has been an indispensable laboratory tool of high-resolution imaging in thick tissue and live animals. Rapid developments of fibre-optic components in terms of growing functionality and decreasing size provide enormous opportunities for innovations in nonlinear optical microscopy. Fibre-based nonlinear optical endoscopy is the sole instrumentation to permit the cellular imaging within hollow tissue tracts or solid organs that are inaccessible to a conventional optical microscope. This article reviews the current development of fibre-optic nonlinear optical microscopy and endoscopy, which includes crucial technologies for miniaturized nonlinear optical microscopy and their embodiments of endoscopic systems. A particular attention is given to several classes of photonic crystal fibres that have been applied to nonlinear optical microscopy due to their unique properties for ultrashort pulse delivery and signal collection. Furthermore, fibre-optic nonlinear optical imaging systems can be classified into portable microscopes suitable for imaging behaving animals, rigid endoscopes that allow for deep tissue imaging with minimally invasive manners, and flexible endoscopes enabling imaging of internal organs. Fibre-optic nonlinear optical endoscopy is coming of age and a paradigm shift leading to optical microscope tools for early cancer detection and minimally invasive surgery.

  15. Hyperspectral Imaging Using Flexible Endoscopy for Laryngeal Cancer Detection

    Directory of Open Access Journals (Sweden)

    Bianca Regeling

    2016-08-01

    Full Text Available Hyperspectral imaging (HSI is increasingly gaining acceptance in the medical field. Up until now, HSI has been used in conjunction with rigid endoscopy to detect cancer in vivo. The logical next step is to pair HSI with flexible endoscopy, since it improves access to hard-to-reach areas. While the flexible endoscope’s fiber optic cables provide the advantage of flexibility, they also introduce an interfering honeycomb-like pattern onto images. Due to the substantial impact this pattern has on locating cancerous tissue, it must be removed before the HS data can be further processed. Thereby, the loss of information is to minimize avoiding the suppression of small-area variations of pixel values. We have developed a system that uses flexible endoscopy to record HS cubes of the larynx and designed a special filtering technique to remove the honeycomb-like pattern with minimal loss of information. We have confirmed its feasibility by comparing it to conventional filtering techniques using an objective metric and by applying unsupervised and supervised classifications to raw and pre-processed HS cubes. Compared to conventional techniques, our method successfully removes the honeycomb-like pattern and considerably improves classification performance, while preserving image details.

  16. Recurrent Lower Gastrointestinal Bleeding: Ileal GIST Diagnosed by Video Capsule Endoscopy—A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Jie Ling

    2013-01-01

    Full Text Available Introduction. Gastrointestinal stromal tumor (GIST in the ileum is an extremely rare cause of recurrent lower gastrointestinal bleeding (GIB. Case Report. An 89-year-old man was admitted with melana. He had extensive PMH of CAD post-CABG/AICD, AAA repair, chronic anemia, myelodysplastic syndrome, lung cancer after resection, and recurrent GIB. Prior EGDs, colonoscopies, and upper device-assisted enteroscopy showed duodenal ulcer, A-V malformation s/p cauterization, and angioectasia. On admission, Hb was 6.0 g/dL. An endoscopic capsule study showed an ulcerated tumor in the ileum. CT showed no distant metastasis. The lesion was resected successfully and confirmed as a high-grade GIST. The patient was discharged with no further bleeding. Discussion. Early diagnosis for patients with ileal GIST is often challenging. Video capsule endoscopy and double balloon enteroscopy could be useful diagnostic tools. Surgical removal is the first line for a resectable GIST. Imatinib has become the standard therapy. Conclusion. This is a unique case of an ileal GIST in a patient with recurrent GIB which was diagnosed by video capsule. Complicated medical comorbidities often lead to a significant delay in diagnosis. Therefore, we recommend that if GIB does not resolve after appropriate treatments for known causes, the alternative diagnosis for occult GIB must be considered, including malignancy such as GIST.

  17. Micro-system Design for Wireless Endoscopy System.

    Science.gov (United States)

    Xie, Xiang; Li, Guolin; Chi, Baoyong; Yu, Xueyi; Zhang, Chun; Wang, Zhihua

    2005-01-01

    This paper proposes a micro-system design for the wireless endoscopic capsule, which assures that the capsule has small size(less than 25mm*10mm), can implement the diagnoses of whole human digestive tract and provide real time endoscopic image monitoring. The designs of two core hardware parts inside the capsule, low power analog-digital mix-mode single-chip and micro-antenna are discussed in detail. A new automatic retransmission request (ARQ) communication scheme is proposed for the high quality image communication system. The micro-antenna design with less than 9 mm diameter is implemented. The digital circuits have been verified on FPGAs and analog circuits have been simulated. The analog-digital mix-mode single-chip has been implemented in 0.18μm CMOS process.

  18. Capsule of parotid gland tumor: evaluation by 3.0 T magnetic resonance imaging using surface coils

    Energy Technology Data Exchange (ETDEWEB)

    Ishibashi, Mana; Fujii, Shinya; Nishihara, Keisuke; Matsusue, Eiji; Kodani, Kazuhiko; Kaminou, Toshio; Ogawa, Toshihide (Div. of Radiology, Dept. of Pathophysiological and Therapeutic Science, Tottori Univ. Faculty of Medicine, Tottori (Japan)), e-mail: ishibashi-ttr@umin.ac.jp; Kawamoto, Katsuyuki (Div. of Otolaryngology, Head and Neck Surgery, Dept. of Medicine of Sensory and Motor Organs, Tottori Univ. Faculty of Medicine, Tottori (Japan))

    2010-12-15

    Background: Magnetic resonance (MR) imaging of parotid gland tumors has been widely reported, although few reports have evaluated the capsule of parotid gland tumors in detail. Purpose: To evaluate the diagnostic usefulness of 3.0 T MR imaging with surface coils for detection of the parotid gland tumor capsule, and to clarify the characteristics of the capsules. Material and Methods: Seventy-eight patients with parotid gland tumors (63 benign and 15 malignant) were evaluated. Axial and coronal T2-weighted and contrast-enhanced T1-weighted images were obtained using a 3.0 T MR scanner with 70 mm surface coils. It was retrospectively assessed whether each parotid gland tumor was completely surrounded by a capsule. The capsule was classified as regular or irregular in terms of capsular thickness, and as none, mildly, or strongly enhancing in terms of contrast enhancement. Visual interpretations were compared with histopathological findings to evaluate the diagnostic ability of MR imaging to detect parotid gland tumor capsules. Statistical evaluation was conducted concerning the presence of capsules, capsular irregularity, and the difference in contrast enhancement between benign and malignant tumors, and that between pleomorphic adenomas and Warthin's tumors. Results: Capsules completely surrounding the tumor on MR imaging yielded a sensitivity of 87.7% (50/57), specificity of 90.5% (19/21), and accuracy of 88.5% (69/78). Benign tumors had a capsule completely surrounding the tumor significantly more often than malignant tumors (P = 0.009). Concerning capsular irregularity, malignant tumors tended to have more irregular capsules than benign tumors, although there were no significant differences. The capsules of malignant tumors enhanced significantly more strongly than those of benign tumors (P = 0.018). Conclusion: 3.0 T MR imaging using surface coils could correctly depict parotid gland tumor capsules in most cases. Most benign and some malignant tumors had

  19. Capsule expression in Streptococcus mitis modulates interaction with oral keratinocytes and alters susceptibility to human antimicrobial peptides.

    Science.gov (United States)

    Rukke, H V; Engen, S A; Schenck, K; Petersen, F C

    2016-08-01

    Streptococcus mitis is a colonizer of the oral cavity and the nasopharynx, and is closely related to Streptococcus pneumoniae. Both species occur in encapsulated and unencapsulated forms, but in S. mitis the role of the capsule in host interactions is mostly unknown. Therefore, the aim of this study was to examine how capsule expression in S. mitis can modulate interactions with the host with relevance for colonization. The S. mitis type strain, as well as two mutants of the type strain, an isogenic capsule deletion mutant, and a capsule switch mutant expressing the serotype 4 capsule of S. pneumoniae TIGR4, were used. Wild-type and capsule deletion strains of S. pneumoniae TIGR4 were included for comparison. We found that capsule production in S. mitis reduced adhesion to oral and lung epithelial cells. Further, exposure of oral epithelial cells to encapsulated S. mitis resulted in higher interleukin-6 and CXCL-8 transcription levels relative to the unencapsulated mutant. Capsule expression in S. mitis increased the sensitivity to human neutrophil peptide 1-3 but reduced the sensitivity to human β-defensin-3 and cathelicidin. This was in contrast with S. pneumoniae in which capsule expression has been generally associated with increased sensitivity to human antimicrobial peptides (AMPs). Collectively, these findings indicate that capsule expression in S. mitis is important in modulating interactions with epithelial cells, and is associated with increased or reduced susceptibility to AMPs depending on the nature of the AMP.

  20. Prior esophagogastroduodenoscopy does not affect the cecal intubation time at bidirectional endoscopies

    OpenAIRE

    Öner, Osman Zekai; Demirci, Rojbin Karakoyun; Gündüz, Umut Rıza; Aslaner, Arif; KOÇ, Ümit; Bülbüller, Nurullah

    2013-01-01

    Bidirectional endoscopy (BE) is often used to assess patients for the reason of anemia or to screen asymptomatic population for malignancy. Limited clinical data favors to perform first the upper gastrointestinal system endoscopy, but its effect to the duration of colonoscopy is yet to be determined. The aim of this retrospective study is to evaluate the effect of upper gastrointestinal system endoscopy on the time to achieve cecal intubation during colonoscopy in patients undergoing BE. Pati...

  1. The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

    OpenAIRE

    Donald MacIntosh; Catherine Dubé; Roger Hollingworth; Sander Veldhuyzen van Zanten; Sandra Daniels; George Ghattas

    2013-01-01

    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer.OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided.METHODS: Based on feedback from 22 sites across Canada that completed the...

  2. MRI findings in the painful hemiplegic shoulder

    Energy Technology Data Exchange (ETDEWEB)

    Tavora, D.G.F., E-mail: danielgurgel@sarah.b [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Gama, R.L.; Bomfim, R.C. [Department of Radiology, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil); Nakayama, M. [Department of Radiology, Federal University of Grande Dourados, Dourados (Brazil); Silva, C.E.P. [Department of Statistics, Sarah Network of Hospitals for Rehabilitation, Fortaleza (Brazil)

    2010-10-15

    Aim: To evaluate the magnetic resonance imaging (MRI) findings in painful hemiplegic shoulder (PHS) in hemiplegic post-stroke patients. Materials and methods: Patients with hemiplegia following their first cerebrovascular accident who were admitted to the Sarah Network of Hospitals for Rehabilitation were studied. Forty-five patients with pain in the hemiplegic shoulder and 23 post-stroke patients without shoulder pain were investigated. MRI and radiographic findings of the hemiplegic and contralateral asymptomatic shoulders were evaluated. Results: Some MRI findings were more frequent in PHS group, including synovial capsule thickening, synovial capsule enhancement, and enhancement in the rotator cuff interval. Conclusions: Adhesive capsulitis was found to be a possible cause of PHS.

  3. Job Stress and Job Satisfaction among Health-Care Workers of Endoscopy Units in Korea

    OpenAIRE

    Nam, Seung-Joo; Chun, Hoon Jai; Moon, Jeong Seop; Park, Sung Chul; Hwang, Young-Jae; Yoo, In Kyung; Lee, Jae Min; Kim, Seung Han; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae; Lee, Hong Sik; Kim, Chang Duck

    2016-01-01

    Background/Aims: The management of job-related stress among health-care workers is critical for the improvement of healthcare services; however, there is no existing research on endoscopy unit workers as a team. Korea has a unique health-care system for endoscopy unit workers. In this study, we aimed to estimate job stress and job satisfaction among health-care providers in endoscopy units in Korea. Methods: We performed a cross-sectional survey of health-care providers in the endoscopy units...

  4. Gastrointestinal endoscopy in a low budget context: delegating EGD to non-physician clinicians in Malawi can be feasible and safe.

    Science.gov (United States)

    Wilhelm, T J; Mothes, H; Chiwewe, D; Mwatibu, B; Kähler, G

    2012-02-01

    Gastrointestinal endoscopy is rarely performed in low-income countries in sub-Saharan Africa. One reason is the lack of available medical doctors and specialists in these countries. At Zomba Central Hospital in Malawi, clinical officers (non-physician clinicians with 4 years of formal training) were trained in upper gastrointestinal endoscopy. Prospectively recorded details of 1732 consecutive esophagogastroduodenoscopies (EGDs) performed between September 2001 and August 2010 were analyzed to evaluate whether upper gastrointestinal endoscopy can be performed safely and accurately by clinical officers. A total of 1059 (61.1%) EGDs were performed by clinical officers alone and 673 (38.9%) were carried out with a medical doctor present who performed or assisted in the procedure. Failure and complication rates were similar in both groups (P=0.105). Endoscopic diagnoses for frequent indications were generally evenly distributed across the two groups. The main difference was a higher proportion of normal findings and a lower proportion of esophagitis in the group with a doctor present, although this was significant only in patients who had presented with epigastric/abdominal pain (P<0.001). In conclusion, delegating upper gastrointestinal endoscopy to clinical officers can be feasible and safe in a setting with a shortage of medical doctors when adequate training and supervision are provided.

  5. Marginal turbid band and light blue crest, signs observed in magnifying narrow-band imaging endoscopy, are indicative of gastric intestinal metaplasia

    Directory of Open Access Journals (Sweden)

    An Jin

    2012-11-01

    Full Text Available Abstract Background Gastric intestinal metaplasia (IM usually appears in flat mucosa and shows few morphologic changes, making diagnosis using conventional endoscopy unreliable. Magnifying narrow-band imaging (NBI endoscopy enables evaluation of detailed morphological features that correspond with the underlying histology. The aim of this study was to investigate and clarify the diagnostic efficacy of magnifying NBI endoscopic findings for the prediction and diagnosis of IM. Methods Forty-seven patients were prospectively enrolled, and magnifying NBI examinations were performed in the lesser curvature of the midbody and the greater curvature of the upper body. The marginal turbid band (MTB was defined as an enclosing white turbid band on the epithelial surface/gyri; light blue crest (LBC, as a fine, blue-white line on the crest of the epithelial surface/gyri. Immediately after observation under magnifying endoscopy, biopsy specimens were obtained from the evaluated areas. Results The degree of IM significantly increased with increasing MTB/LBC positivity (MTB-/LBC-, 0.00 ± 0.00; MTB+/LBC-, 0.44 ± 0.51; MTB+/LBC+, 0.94 ± 0.24; p +/LBC+ areas than in MTB+/LBC- areas (p  Conclusion MTB and LBC observed in the gastric mucosa with magnifying NBI endoscopy are highly accurate indicators of the presence of IM. MTB likely represents a sign of early gastric IM, while LBC appears with progression to severe IM.

  6. Evaluation of the margins of differentiated early gastriccancer by using conventional endoscopy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Progress in double-balloon endoscopy (DBE) hasallowed for the diagnosis and treatment of disease inthe postoperative bowel. For example, a short DBE,which has a 2.8 mm working channel and 152 cmworking length, is useful for endoscopic retrogradecholangiopancreatography in bowel disease patients.However, afferent loop and Roux-limb obstruction,though rare, is caused by postoperative recurrence ofbiliary tract cancer with intractable complications. Mostof the clinical findings involving these complicationsare relatively nonspecific and include abdominal pain,nausea, vomiting, fever, and obstructive jaundice.Treatments by surgery, percutaneous transhepaticbiliary drainage, percutaneous enteral stent insertion,and endoscopic therapy have been reported. Thegeneral conditions of patients with these complicationsare poor due to cancer progression; therefore, a lessinvasive treatment is better. We report on the usefulnessof metallic stent insertion using an overtube for afferentloop and Roux-limb obstruction caused by postoperativerecurrence of biliary tract cancer under short DBE in twopatients with complexly reconstructed intestines.

  7. Duplication cyst of the small intestine found by double-balloon endoscopy: A case report

    Institute of Scientific and Technical Information of China (English)

    Haruei Ogino; Kazuhiko Nakamura; Toshiaki Ochiai; Norimoto Nakamura; Daisuke Yoshimura; Teppei Kabemura; Tetsuya Kusumoto; Hiroshi Matsuura; Akihiko Nakashima; Kuniomi Honda

    2008-01-01

    A 35-year-old man was admitted due to bloody stool and anemia.The bleeding source could not be detected by esophagogastroduodenoscopy or colonoscopy.Double balloon endoscopy (DBE)revealed a diverticulum-like hole in which coagula stuck in the ileum at 1 meter on the oral side from the ileocecal valve.The adjacent mucosa just to the oral side of the hole was elevated like a submucosal tumor.The lesion was considered the source of bleeding and removed surgically.It was determined to be a cyst with an ileal structure on the mesenteric aspect accompanying gastric mucosa.The diagnosis was a duplication cyst of the ileum,which is a rare entity that can cause gastrointestinal bleeding.In the present case,DBE was used to find the hemorrhagic duplication cyst in the ileum.

  8. Drug induced sleep endoscopy in the decision-making process of children with obstructive sleep apnea.

    Science.gov (United States)

    Galluzzi, Francesca; Pignataro, Lorenzo; Gaini, Renato Maria; Garavello, Werner

    2015-03-01

    Tonsillectomy and adenoidectomy (T&A) is currently recommended in children with Obstructive Sleep Apnea (OSA). However, the condition persists after surgery in about one third of cases. It has been suggested that Drug Induced Sleep Endoscopy (DISE) may be of help for planning a more targeted and effective surgical treatment but evidence is yet weak. The aim of this review is to draw recommendation on the use of DISE in children with OSA. More specifically, we aimed at determine the proportion of cases whose treatment may be influenced by DISE findings. A comprehensive search of articles published from February 1983 to January 2014 listed in the PubMed/MEDLINE databases was performed. The search terms used were: "endoscopy" or "nasoendoscopy" or "DISE" and "obstructive sleep apnea" and "children" or "child" or "pediatric." The main outcome was the rate of naive children with hypertrophic tonsils and/or adenoids. The assumptions are that clinical diagnosis of hypertrophic tonsils and/or adenoids is reliable and does not require DISE, and that exclusive T&A may solve OSA in the vast majority of cases even in the presence of other concomitant sites of obstruction. Five studies were ultimately selected and all were case series. The median (range) number of studied children was 39 (15-82). Mean age varied from 3.2 to 7.8 years. The combined estimate rate of OSA consequent to hypertrophic tonsils and/or adenoids was 71% (95%CI: 64-77%). In children with Down Syndrome, the combined estimated rate of hypertrophic tonsils and/or adenoids was 62% (95%CI: 44-79%). Our findings show that DISE may be of benefit in a minority of children with OSA since up to two thirds of naive cases presents with hypertrophic tonsils and/or adenoids. Its use should be limited to those whose clinical evaluation is unremarkable or when OSA persists after T&A.

  9. Scaling effects in spiral capsule robots.

    Science.gov (United States)

    Liang, Liang; Hu, Rong; Chen, Bai; Tang, Yong; Xu, Yan

    2017-04-01

    Spiral capsule robots can be applied to human gastrointestinal tracts and blood vessels. Because of significant variations in the sizes of the inner diameters of the intestines as well as blood vessels, this research has been unable to meet the requirements for medical applications. By applying the fluid dynamic equations, using the computational fluid dynamics method, to a robot axial length ranging from 10(-5) to 10(-2) m, the operational performance indicators (axial driving force, load torque, and maximum fluid pressure on the pipe wall) of the spiral capsule robot and the fluid turbulent intensity around the robot spiral surfaces was numerically calculated in a straight rigid pipe filled with fluid. The reasonableness and validity of the calculation method adopted in this study were verified by the consistency of the calculated values by the computational fluid dynamics method and the experimental values from a relevant literature. The results show that the greater the fluid turbulent intensity, the greater the impact of the fluid turbulence on the driving performance of the spiral capsule robot and the higher the energy consumption of the robot. For the same level of size of the robot, the axial driving force, the load torque, and the maximum fluid pressure on the pipe wall of the outer spiral robot were larger than those of the inner spiral robot. For different requirements of the operating environment, we can choose a certain kind of spiral capsule robot. This study provides a theoretical foundation for spiral capsule robots.

  10. European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.;

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evi......), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline....

  11. Synchronous multicentric small hepatocellular carcinomas: Defining the capsule on high-frequency intraoperative ultrasonography with pathologic correction

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, Jae Hong; Eom, Dae Woon; Ryu, Dae Shick; Park, Man Soo; Jung, Seung Mun; Choi, Kun Moo; Cheon, Gab Jin; Choi, Soo Jung; Jang, Hyuk Jai [Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung (Korea, Republic of)

    2016-08-15

    The aim of this study was to define the capsules of synchronous multicentric small hepatocellular carcinomas (HCCs) with use of high-frequency intraoperative ultrasonography (IOUS). Among the 131 consecutive patients undergoing hepatic resection and high-frequency IOUS for HCC, 16 synchronous multicentric small HCCs in 13 patients were histologically diagnosed in the resected specimens. High-frequency IOUS and pathologic findings of these lesions were compared, with particular focus on the presence and appearance of the capsule in or around each lesion. Synchronous multicentric small HCCs were pathologically classified into distinctly nodular (n=12) or vaguely nodular (n=4) types. All 12 distinctly nodular HCCs including six subcentimeter lesions showed detectable capsules on high-frequency IOUS and pathology. The capsules appeared as a hypoechoic rim containing hyperechoic foci (n=6), hypoechoic rim (n=5), or hyperechoic rim (n=1) with varying degrees of coverage around each lesion. Histologically, the capsules were composed of a combination of one to four layers consisting of a fibrous capsule, peritumoral fibrosis, prominent small vessels, and entrapped hepatic parenchyma. Synchronous multicentric small HCCs with distinctly nodular type, even at subcentimeter size, can show capsules with varying coverage and diverse echogenicity on high-frequency IOUS.

  12. Portable disposable ultrathin endoscopy tested through percutaneous endoscopic gastrostomy

    Science.gov (United States)

    Baeg, Myong Ki; Lim, Chul-Hyun; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, Bo-In; Lee, In-Seok; Choi, Myung-Gyu

    2016-01-01

    Abstract Background: A portable disposable ultrathin endoscope (DUE) with high visual quality and maneuverability would reduce the need for expensive facilities and emergency endoscopy could be available anywhere. It would increase patient satisfaction, prevent unnecessary sedation, and reduce infection. Our aim was to evaluate the usefulness of portable DUE in performing percutaneous endoscopic gastrostomy (PEG). Methods: We prospectively enrolled patients who underwent PEG under DUE guidance and compared them with historical controls who underwent PEG under conventional ultrathin endoscopy (CUE) guidance. The primary outcomes were successful stomach visualization and PEG tube insertion. Results: Twenty-five patients (19 male) were enrolled and compared with 25 gender and indication-matched controls. The most common indications for PEG were aspiration due to stroke or brain injury, dementia, and head and neck cancer. Entrance into the stomach was achieved in 92.0% (23/25) and 96% (24/25) in the DUE and CUE groups, and PEG was performed in 91.3% (21/23) and 95.8% (23/24), respectively. The mean insertion time for the DUE and CUE groups were 22.7 ± 9.3 minutes and 17.1 ± 5.7 minutes (P = 0.044). The 3 cases of failure to reach the stomach in both groups were caused by esophageal blockage. The 3 cases of failed PEG tube insertion were caused by poor visualization of the insertion site. Bleeding and pneumoperitoneum occurred in 1 and 2 patients in the DUE group. One case of fever was noted in the CUE group. All adverse events were conservatively managed. Conclusions: Our study shows that portable DUE in facilities without endoscopy equipment may be clinically feasible. PMID:27902596

  13. Swallowing Tablets and Capsules Increases the Risk of Penetration and Aspiration in Patients with Stroke-Induced Dysphagia.

    Science.gov (United States)

    Schiele, Julia T; Penner, Heike; Schneider, Hendrik; Quinzler, Renate; Reich, Gabriele; Wezler, Nikolai; Micol, William; Oster, Peter; Haefeli, Walter E

    2015-10-01

    We evaluated the prevalence of difficulties swallowing solid dosage forms in patients with stroke-induced dysphagia and whether swallowing tablets/capsules increases their risk of penetration and aspiration. Concurrently, we explored whether routinely performed assessment tests help identify patients at risk. Using video endoscopy, we evaluated how 52 patients swallowed four different placebos (round, oval, and oblong tablets and a capsule) with texture-modified water (TMW, pudding consistency) and milk and rated their swallowing performance according to the Penetration Aspiration Scale (PAS). Additionally, Daniels Test, Bogenhausener Dysphagiescore, Scandinavian Stroke Scale, Barthel Index, and Tinetti's Mobility Test were conducted. A substantial proportion of the patients experienced severe difficulties swallowing solid oral dosage forms (TMW: 40.4 %, milk: 43.5 %). Compared to the administration of TMW/milk alone, the placebos increased the PAS values in the majority of the patients (TMW: median PAS from 1.5 to 2.0; milk: median PAS from 1.5 to 2.5, each p value <0.0001) and residue values were significantly higher (p < 0.05). Whereas video-endoscopic examination reliably identified patients with difficulties swallowing medication, neither patients' self-evaluation nor one of the routinely performed bedside tests did. Therefore, before video-endoscopic evaluation, many drugs were modified unnecessarily and 20.8 % of these were crushed inadequately, although switching to another dosage form or drug would have been possible. Hence, safety and effectiveness of swallowing tablets and capsules should be evaluated routinely in video-endoscopic examinations, tablets/capsules should rather be provided with TMW than with milk, and the appropriateness of "non per os except medication" orders for dysphagic stroke patients should be questioned.

  14. Adverse Event and Complication Management in Gastrointestinal Endoscopy.

    Science.gov (United States)

    Richter, James M; Kelsey, Peter B; Campbell, Emily J

    2016-03-01

    Gastrointestinal endoscopy is a remarkably safe set of diagnostic and therapeutic techniques, and yet a small number of significant complications and adverse events are expected. Serious complications may have a material effect on the patient's health and well-being. They need to be anticipated and prevented if possible and managed effectively when identified. When complications occur they need to be discussed frankly with patients and their families. Informed consent, prevention, early detection, reporting, and systems improvement are critical aspects of effective complication management. Optimal complication management may improve patient satisfaction and outcome, as well as preserving the reputation and confidence of the endoscopist, and may minimize litigation.

  15. What is the current role of endoscopy in primary sclerosingcholangitis?

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Endoscopy has important roles in the managementof primary sclerosing cholangitis (PSC), ranging fromnarrowing down the differential diagnoses, screeningfor complications, determining prognosis and therapy.While the need for a diagnostic endoscopic retrogradecholangiopancreatography (ERCP) may be obviated by apositive magnetic resonance cholangiopancreatography(MRCP), a negative MRCP does not exclude PSC andmay therefore necessitate an ERCP, which is traditionallyregarded as the gold standard. In this editorial we havenot covered the endoscopic management of inflammatorybowel disease in the context of PSC nor of endoscopicsurveillance and treatment of portal hypertension complicatingPSC.

  16. New techniques for evaluating the gastrointestinal tract: capsular endoscopy

    Directory of Open Access Journals (Sweden)

    A E Karateyev

    2009-01-01

    Full Text Available The paper describes a procedure for capsular endoscopy (CE, a new high-technology method of evaluating the small bowel, and reports on its use in rheumatological care. Small bowel involvement is noted to be frequently encountered in rheumatic diseases, such as Behcet's disease, diffuse scleroderma, and seronegative spondylitis. According to the data of clinical trials, CE is effective in timely detecting this visceral abnormality. At the same time, CE is actually the only accurate method of diagnosing drug-induced enteropathy, a potentially menacing disease that frequently occurs with the use of nonsteroidal anti-inflammatory drugs.

  17. Training the Endoscopy Trainer: From General Principles to Specific Concepts

    Directory of Open Access Journals (Sweden)

    Sylvain Coderre

    2010-01-01

    Full Text Available Endoscopy instruction has progressed a great deal in recent years, evolving from the age-old dictum of ‘see one, do one’ to the current skillful application of sound educational principles. Some of these educational principles are generic and applicable to the teaching of any content at all levels, while others are quite specific to technical skills training. The present review summarizes these important principles under the following headings: creating a learner-centred curriculum; delivering an achievable learning task; and moving from theory to practice. The present article challenges national gastroenterology organizations to embrace these concepts in structured, outcome-based educational programs.

  18. Documentation of competency on sedation for gastrointestinal endoscopy.

    Science.gov (United States)

    Bjorkman, David J

    2010-01-01

    There is general consensus in national and societal guidelines that training for sedation should be part of basic training for endoscopy. There is no clear consensus, however, on the structure of that training. More importantly, these same guidelines are often silent on the specific requirements to demonstrate competency for administration of sedation, ways to document that competency and measures to assure that competency is maintained. In the absence of data demonstrating improved outcomes with specific approaches, the process and principles in this paper are proposed as a starting point to be modified by future research and data.

  19. Role of endoscopy in management of gastrointestinalcomplications of portal hypertension

    Institute of Scientific and Technical Information of China (English)

    Carmelo Luigiano; Giuseppe Iabichino; Antonino Judica; Clara Virgilio; Valentina Peta; Ludovico Abenavoli

    2015-01-01

    The management of patients with gastrointestinalcomplications of portal hypertension is often complexand challenging. The endoscopy plays an importantrole in the management of these patients. The role ofendoscopy is both diagnostic and interventional andin the last years the techniques have undergone arapid expansion with the advent of different and novelendoscopic modalities, with consequent improvementof investigation and treatment of these patients. Thechoice of best therapeutic strategy depends on manyfactors baseline disease, patient's clinical performanceand the timing when it is done if in emergency or aprophylactic approaches. In this review we evaluatethe endoscopic management of patients with thegastrointestinal complications of portal hypertension.

  20. Sleep Endoscopy in the Evaluation of Pediatric Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Aaron C. Lin

    2012-01-01

    Full Text Available Pediatric obstructive sleep apnea (OSA is not always resolved or improved with adenotonsillectomy. Persistent or complex cases of pediatric OSA may be due to sites of obstruction in the airway other than the tonsils and adenoids. Identifying these areas in the past has been problematic, and therefore, therapy for OSA in children who have failed adenotonsillectomy has often been unsatisfactory. Sleep endoscopy is a technique that can enable the surgeon to determine the level of obstruction in a sleeping child with OSA. With this knowledge, site-specific surgical therapy for persistent and complex pediatric OSA may be possible.

  1. Unsteady Pressures on a Generic Capsule Shape

    Science.gov (United States)

    Burnside, Nathan; Ross, James C.

    2015-01-01

    While developing the aerodynamic database for the Orion spacecraft, the low-speed flight regime (transonic and below) proved to be the most difficult to predict and measure accurately. The flow over the capsule heat shield in descent flight was particularly troublesome for both computational and experimental efforts due to its unsteady nature and uncertainty about the boundary layer state. The data described here were acquired as part of a study to improve the understanding of the overall flow around a generic capsule. The unsteady pressure measurements acquired on a generic capsule shape are presented along with a discussion about the effects of various flight conditions and heat-shield surface roughness on the resulting pressure fluctuations.

  2. Spectral measurements of asymmetrically irradiated capsule backlighters

    Science.gov (United States)

    Keiter, P. A.; Drake, R. P.

    2016-11-01

    Capsule backlighters provide a quasi-continuum x-ray spectrum over a wide range of photon energies [J. F. Hansen et al., Rev. Sci. Instrum. 79, 013504 (2008)]. Ideally one irradiates the capsule backlighter symmetrically, however, in complex experimental geometries, this is not always possible. In recent experiments we irradiated capsule backlighters asymmetrically and measured the x-ray spectrum from multiple directions. We will present time-integrated spectra over the photon energy range of 2-13 keV and time-resolved spectra over the photon energy range of 2-3 keV. We will compare the spectra from different lines of sight to determine if the laser asymmetry results in an angular dependence in the x-ray emission.

  3. Tank-treading and tumbling frequencies of capsules and red blood cells.

    Science.gov (United States)

    Yazdani, Alireza Z K; Kalluri, R Murthy; Bagchi, Prosenjit

    2011-04-01

    This study is motivated in part by the discrepancy that exists in the literature with regard to the dependence of the tank-treading frequency of red blood cells on the shear rate and suspending medium viscosity. Here we consider three-dimensional numerical simulations of deformable capsules of initially spherical and oblate spheroidal shapes and biconcave discoid representing the red blood cell resting shape. By considering a much broader range of the viscosity ratio (ratio of capsule or cell interior to suspending fluid viscosity), shear rate, and aspect ratio (ratio of minor to major axes) than that considered in the previous experiments, we find several new characteristics of the tank-treading and tumbling frequencies that have not been reported earlier. These new characteristics are the result of the large shape deformation and the coupling between shape and angular oscillations of the capsules or cells. For the spherical and oblate spheroidal capsules, the tank-treading frequency shows a nonmonotonic trend that is characterized by an initial decrease leading to a minimum followed by an increase with increasing viscosity ratio. For red blood cells, we find two regimes of the viscosity dependence of the tank-treading frequency: an exponential regime in which the tank-treading frequency decreases at a slower rate with increasing viscosity ratio, and a logarithmic range in which it decreases at a much faster rate. While this trend agrees well with different theoretical models of shape-preserving capsules, it was not evident in previous experimental results. When the shear rate dependence is considered, the tank-treading frequency of red blood cells and capsules of highly elongated initial shapes exhibits a nonmonotonic trend that is characterized by an initial increase leading to a maximum followed by a sharp decrease with decreasing shear rate. This anomalous behavior of the tank-treading frequency is shown to be due to a breathing-like dynamics of the capsule or

  4. Capsules with external navigation and triggered release.

    Science.gov (United States)

    Shchukin, Dmitry G; Shchukina, Elena

    2014-10-01

    Encapsulation is an important technology for pharmaceutical industry, food production, et cetera. Its current level of development requires capsule functionalization. One of the interesting ideas to provide new functionality to the microcapsule and nanocapsule is layer-by-layer deposition of functional species. This technique provides step-by-step adsorption of various species (polyelectrolytes, nanoparticles, proteins) when the layer growth is controlled by electrostatic, hydrogen bonding, hydrophobic forces and forming multilayer shells with nanometer precision. This review article introduces recent achievements of layer-by-layer technique attaining external navigation ability and release properties the capsule shell.

  5. Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

    .   Setting: June 2000 to August 2002, 41 GPs, Aarhus County, Denmark   Methods: 368 people with dyspepsia (epigastric pain/discomfort, no alarm symptoms) were randomly assigned to treatment with omeprazol 40 mg/day for two weeks (PPI group, n:185) or endoscopy (endoscopy group, n:183). Due to migration...

  6. Early Period Results and Clinical Characteristics of Upper Gastrointestinal Endoscopy in Sivrihisar State Hospital

    Directory of Open Access Journals (Sweden)

    Ozgur Turk

    2014-12-01

    Full Text Available Aim: Our aim was to identify the characteristics of the patient that performed upper gastrointestinal endoscopy in a new established endoscopy unit of a state hospital. We want to present the spectrum of gastrointestinal diseases in our hospitals region. Material and Method: We analyzed patients upper endoscopy results according to age, sex, complaints, clinical characteristics, type of anesthesia, and the necessity of biopsy. We reviewed 256 patients data between 2013 December-2014 July. All endoscopies were performed by same surgeon. Results: The highest complaint was epigastric pain (n=112, 43, 8%. Other complaints were followed as dyspepsia (n=84, 32.8%, heartburn (n=42, 16.4%, nausea (n=4, 1.6%, vomiting (n=2, 0.8%, dysphagia (n=6, 2.3%. We determined 218 gastritis (85.2%, 64 hiatal hernia (25%, 120 esophagitis (46.9%, 76 duodenitis (29.7%, 4 gastric ulcer (1.6%, 18 duodenal ulcers (7%, 20 bile reflux (7.8%, 26 Gastro esophageal reflux disease (GERD in patients (10.2%. 10 patients reported as normal (3.9%. Biopsy was performed in 186 of the patients. Discussion: Endoscopy can become an early diagnostic examination by increasing the availability of endoscopy. Also alarm symptoms should not be ignored and endoscopy should perform immediately in symptomatic patients. As an early result of upper gastrointestinal endoscopies that performed in this study; gastritis, esophagitis, duodenitis and hiatal hernia are common gastrointestinal diseases in our region.

  7. Esophageal stenting for benign and malignant disease : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

    NARCIS (Netherlands)

    Spaander, Manon C W; Baron, Todd H; Siersema, Peter D; Fuccio, Lorenzo; Schumacher, Brigitte; Escorsell, Àngels; Garcia-Pagán, Juan-Carlos; Dumonceau, Jean-Marc; Conio, Massimo; de Ceglie, Antonella; Skowronek, Janusz; Nordsmark, Marianne; Seufferlein, Thomas; Van Gossum, André; Hassan, Cesare; Repici, Alessandro; Bruno, Marco J

    2016-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). Th

  8. Summary of Guidelines for Infection Prevention and Control for Flexible Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lawrence Hookey

    2013-01-01

    Full Text Available BACKGROUND: High-quality processes to ensure infection prevention and control in the delivery of safe endoscopy services are essential. In 2010, the Public Health Agency of Canada and the Canadian Association of Gastroenterology (CAG developed a Canadian guideline for the reprocessing of flexible gastrointestinal endoscopy equipment.

  9. The role of capnography in endoscopy patients undergoing nurse-administered propofol sedation

    DEFF Research Database (Denmark)

    Slagelse, Charlotte; Vilmann, Peter; Hornslet, Pernille;

    2013-01-01

    . The existing literature on capnography for endoscopy patients sedated with nurse-administered propofol sedation (NAPS) is limited. Can the addition of capnography to standard monitoring during endoscopy with NAPS reduce the number, duration, and level of hypoxia. Materials and methods. This study...

  10. Altered multiaxial mechanical properties of the porcine anterior lens capsule cultured in high glucose.

    Science.gov (United States)

    Pedrigi, R M; Staff, E; David, G; Glenn, S; Humphrey, J D

    2007-02-01

    Hyperglycemia can alter the mechanical properties of tissues through the formation of advanced glycation endproducts in matrix proteins that have long half-lives. We used a custom experimental system and subdomain finite element method to quantify alterations in the regional multiaxial mechanical properties of porcine lens capsules that were cultured for 8 or 14 weeks in high glucose versus control media. Findings revealed that high glucose significantly stiffened the capsules in both the circumferential and the meridional directions, but it did not affect the known regional variations in anisotropy. Such information could be important in the design of both improved clinical procedures and intraocular implants for diabetic patients.

  11. Adhesive capsulitis of the hip: a case report: an entity in question.

    Science.gov (United States)

    Lowe, Rebecca

    2013-12-01

    Very little has been discussed in the medical literature concerning adhesive capsulitis of the hip (ACH). There are no articles to date in the physical therapy literature regarding ACH and only a dozen or so in medical journals. Evidence suggests ACH may present in a similar progression through four stages as adhesive capsulitis of the shoulder (ACS) (from synovial inflammation to capsular fibrosis). Consensus does not exist for management of ACS or ACH. However, most clinicians agree that treatment should be guided by the stage of the disorder, whether medically, surgically, or through physical therapy. A large part of the confusion for management of adhesive capsulitis (ACS and ACH) is due to the many studies that have not reported their findings by stage. Arthroscopy and synovial/capsular biopsy can confirm the presence and stage of adhesive capsulitis. Primary (idiopathic) ACH is proposed to be caused by biomechanical dysfunction in the hip or other joints related to the mechanical function of the hip. The treatment for stages 1 and 2 consists of using techniques to reduce inflammation and correct biomechanical faults that affect the hip. In stages 3 and 4 treatment focuses on the biomechanical dysfunction of the spine, hip(s), pelvic ring, and lower limb, if needed. In this case, the 55-year-old female patient presenting with probable stage 3 adhesive capsulitis, responded well to manual therapy and has been able to return to functional activities and maintain them with a home program.

  12. Exocrine contamination impairs implantation of pancreatic islets transplanted beneath the kidney capsule.

    Science.gov (United States)

    Gray, D W; Sutton, R; McShane, P; Peters, M; Morris, P J

    1988-11-01

    The effect of exocrine contamination on islets implanted under the kidney capsule has been studied by histological examination of pure or exocrine-contamination human, monkey, or rat islets transplanted to the kidney capsule of the nude rat, monkey, or rat, respectively. Exocrine contamination resulted in an appearance suggestive of impaired islet implantation, due to tissue necrosis and subsequent fibrosis. The effect of exocrine contamination was examined quantitatively in a rat islet isograft model in which handpicked DA rat islets were transplanted under the kidney capsule of normal DA rats. The islets were either pure or deliberately recontaminated with exocrine tissue (50 or 90% contamination). Four hundred pure islets were placed under one kidney capsule and 400 islets (of similar size and from the same islet preparation) were contaminated and then placed under the contralateral kidney capsule. After 2 weeks the kidneys were removed and extracted for insulin content. The insulin content of kidneys bearing islets contaminated by either 50 or 90% exocrine tissue was significantly reduced when compared to the contralateral kidney bearing pure islets. These findings support the view that exocrine contamination of islets resulted in impaired islet implantation when transplanted to a confined site such as the kidney subcapsule.

  13. Propofol Use for Sedation during Endoscopy in Adults: A Canadian Association of Gastroenterology Position Statement

    Directory of Open Access Journals (Sweden)

    Michael F Byrne

    2008-01-01

    Full Text Available Over the past decade, multiple clinical reports have demonstrated that the use of propofol sedation for gastrointestinal endoscopy by gastroenterologists and trained endoscopy nurses is safe and effective in appropriately selected patients. Proposed benefits of propofol sedation include rapid onset of action, improved patient comfort and rapid clearance, as well as prompt recovery and discharge from the endoscopy unit. As a result of medical evidence, a number of international professional societies have endorsed the use of propofol in gastrointestinal endoscopy. In Canada, no formal guidelines currently exist. In the present article, the Clinical Affairs Committee of the Canadian Association of Gastroenterology presents a position statement, incorporating updated information on the use of propofol sedation for endoscopy in adult patients.

  14. Current status of advanced gastrointestinal endoscopy training fellowships in the United States

    Directory of Open Access Journals (Sweden)

    Stephen J Heller

    2011-01-01

    Full Text Available Stephen J Heller, Jeffrey L TokarDepartment of Medicine, Fox Chase Cancer Center, Philadelphia, PA, USAAbstract: Rapid growth in the field of advanced gastrointestinal endoscopy has led to an increase in specialized therapeutic endoscopy fellowships. The cornerstones of these programs are training in endoscopic retrograde cholangiopancreatography (ERCP and endoscopic ultrasound. These procedures are more complex and challenging to master than routine colonoscopy and upper endoscopy, and in the case of ERCP, higher risk. The concentration of the educational experience in the hands of relatively fewer trainees with specialized interest in advanced endoscopy has resulted in providing a focused cohort of graduating fellows with higher case volumes in training, which likely enhances diagnostic and therapeutic success and safer performance of these procedures. Endoscopic simulators, although not currently in widespread use, have the potential to improve advanced procedural training without jeopardizing patient safety.Keywords: gastrointestinal endoscopy, training, procedures, safety 

  15. Validation of a realistic simulator for veterinary gastrointestinal endoscopy training.

    Science.gov (United States)

    Usón-Gargallo, Jesús; Usón-Casaús, Jesús M; Pérez-Merino, Eva M; Soria-Gálvez, Federico; Morcillo, Esther; Enciso, Silvia; Sánchez-Margallo, Francisco M

    2014-01-01

    This article reports on the face, content, and construct validity of a new realistic composite simulator (Simuldog) used to provide training in canine gastrointestinal flexible endoscopy. The basic endoscopic procedures performed on the simulator were esophagogastroduodenoscopy (EGD), gastric biopsy (GB), and gastric foreign body removal (FBR). Construct validity was assessed by comparing the performance of novices (final-year veterinary students and recent graduates without endoscopic experience, n=30) versus experienced subjects (doctors in veterinary medicine who had performed more than 50 clinical upper gastrointestinal endoscopic procedures as a surgeon, n=15). Tasks were scored based on completion time, and specific rating scales were developed to assess performance. Internal consistency and inter-rater agreement were assessed. Face and content validity were determined using a 5-point Likert-type scale questionnaire. The novices needed considerably more time than the experts to perform EGD, GB, and FBR, and their performance scores were significantly lower (pendoscopy scenarios were very realistic. The experts highly valued the usefulness of Simuldog for veterinary training and as a tool for assessing endoscopic skills. Simuldog is the first validated model specifically developed to be used as a training tool for endoscopy techniques in small animals.

  16. Recent advancement of therapeutic endoscopy in theesophageal benign diseases

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Over the past 30 years, the field of endoscopy haswitnessed several advances. With the advent ofendoscopic mucosal resection, removal of large mucosallesions have become possible. Thereafter, endoscopicsubmucosal resection was refined, permitting en blocremoval of large superficial neoplasms. Such techniqueshave facilitated the development of antirefluxmucosectomy, a promising novel treatment for gastroesophagealreflux. The introduction and use of overthe scope clips has allowed for endoscopic closureof defects in the gastrointestinal tract, which weretraditionally treated with surgical intervention. With thedevelopment of per-oral endoscopic myotomy (POEM),the treatment of achalasia and spastic disorders ofthe esophagus have been revolutionized. From thesubmucosal tunnelling technique developed for POEM,Per oral endoscopic tumor resection of subepithelialtumors was made possible. Simultaneously, advancesin biotechnology have expanded esophageal stentingcapabilities with the introduction of fully covered metaland plastic stents, as well as biodegradable stents.Once deemed a primarily diagnostic tool, endoscopy hasquickly transcended to a minimally invasive interventionand therapeutic tool. These techniques are reviewedwith regards to their application to benign disease ofthe esophagus.

  17. Routine Second-Look Endoscopy: Ineffective, Costly, and Potentially Misleading

    Directory of Open Access Journals (Sweden)

    Joseph Romagnuolo

    2004-01-01

    Full Text Available Despite the best medical and endoscopic efforts, some patients with nonvariceal upper gastrointestinal bleeding suffer recurrences. Because high risk stigmata (visible vessels, active bleeders and adherent clots often persist despite apparently successful initial hemostasis and have a variable natural history, it would seem reasonable to at least consider a routine second look endoscopy. However, a review of the literature revealed six randomized trials that, in aggregate, do not support such a strategy. In fact, a second look does not appear to be effective and is associated with an increased number of procedures, treatment sessions and possibly retreatment-related complications. In addition, the cointerventions in these trials are already out of date and the potential absolute risk reductions are low when a second look is used with intravenous proton pump inhibitors and/or the application of endoscopic hemoclips or combination endoscopic therapy. Finally, the Forrest classification may provide dangerously misleading estimates of prognosis because it is being used out of context. This review critically analyzes routine second look endoscopy.

  18. Mobile-Cloud Assisted Video Summarization Framework for Efficient Management of Remote Sensing Data Generated by Wireless Capsule Sensors

    Directory of Open Access Journals (Sweden)

    Irfan Mehmood

    2014-09-01

    Full Text Available Wireless capsule endoscopy (WCE has great advantages over traditional endoscopy because it is portable and easy to use, especially in remote monitoring health-services. However, during the WCE process, the large amount of captured video data demands a significant deal of computation to analyze and retrieve informative video frames. In order to facilitate efficient WCE data collection and browsing task, we present a resource- and bandwidth-aware WCE video summarization framework that extracts the representative keyframes of the WCE video contents by removing redundant and non-informative frames. For redundancy elimination, we use Jeffrey-divergence between color histograms and inter-frame Boolean series-based correlation of color channels. To remove non-informative frames, multi-fractal texture features are extracted to assist the classification using an ensemble-based classifier. Owing to the limited WCE resources, it is impossible for the WCE system to perform computationally intensive video summarization tasks. To resolve computational challenges, mobile-cloud architecture is incorporated, which provides resizable computing capacities by adaptively offloading video summarization tasks between the client and the cloud server. The qualitative and quantitative results are encouraging and show that the proposed framework saves information transmission cost and bandwidth, as well as the valuable time of data analysts in browsing remote sensing data.

  19. 21 CFR 872.3110 - Dental amalgam capsule.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Dental amalgam capsule. 872.3110 Section 872.3110...) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3110 Dental amalgam capsule. (a) Identification. A dental amalgam capsule is a container device in which silver alloy is intended to be mixed with...

  20. Pair-collision between heterogeneous capsules in simple shear: Effect of membrane stiffness and membrane constitutive laws

    Science.gov (United States)

    Singh, Rajesh; Sarkar, Kausik

    2012-11-01

    Deformability of red blood cells affects hydrodynamic properties of blood and thereby physiological functions in many cardiovascular diseases, e.g. in sickle cell anemia and malaria, the cell membrane becomes stiff affecting their circulation through microvessels. Here, we numerically simulate the hydrodynamic interaction between a pair of cell-like capsules in a free shear flow, using a front-tracking method. The membrane is modeled using various constitutive equations. By varying the stiffness of one capsule (C2) and keeping all other parameters constant, we find a significant effect on the deformation and trajectory of the other (C1) . Increasing the stiffness of C2 surprisingly increases the peak deformation of C1 while decreasing the cross-stream shift in its trajectory However, the relative trajectory between capsules remains the same. Effects of constitutive laws and difference in behaviors between capsules and drops are investigated explaining underlying physics. partial support from NSF.

  1. Electrohydrodynamic deformation of capsules in electric field

    Science.gov (United States)

    Das, Sudip; Thaokar, Rochish

    2016-11-01

    Micron size capsules are abundant in natural, technological and biological processes but they still require extensive investigation for better understanding of their mechanical behavior. A spherical capusle containing a Newtonian fluid bounded by a viscoelastic membrane and immersed in another Newtonian fluid, and subject to electric field is considered. Discontinuity of electrical properties such as conductivity and permittivity leads to a net Maxwell stress at the capsule interface. In response the capsule undergoes elastic deformation, leading to strain fields and elastic stresses that can balance the applied forces. We investigate this problem with fully resolved hydrodynamics in the Stokes flow limit and electrostatics using the capacitance model. Effect of AC, DC and pulsed DC fields is investigated. Our results show that membrane electrical properties have a huge impact on the equilibrium deformation as well as on the break up of capsules. Our results match with the literature results in the limit of high conductance of the membrane. Analytical theory is employed using spherical harmonics and numerical investigations are conducted using the Boundary integral method.

  2. Student Mobility. Information Capsule. Volume 0608

    Science.gov (United States)

    Blazer, Christie

    2007-01-01

    Mobility, rather than stability, has become the norm for students in schools across the United States. The student mobility rate is now higher in the United States than in any other industrialized country. This Information Capsule discusses the reasons for student mobility and the characteristics of highly mobile students and families. Research…

  3. Relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions

    Institute of Scientific and Technical Information of China (English)

    LI Hongling; WANG Changcheng; LIU Shuqing; XU Dongsheng; ZHANG Ju; CHEN hongmei

    2014-01-01

    Background The causes and mechanisms of chronic diarrhea are complex.This study aimed to explore the relationship between chronic diarrhea with normal colonoscopy findings and terminal ileum lesions.Methods All cases were collected from January 2009 to June 2010.The 40 patients in the patient group had chronic diarrhea with normal colonoscopy findings.Those who had hyperthyroidism,diabetes,chronic pancreatitis,cirrhosis,atrophic gastritis,short bowel syndrome and connective tissue diseases had been excluded.The control group contained 40 healthy individuals without diarrhea.Endoscopy of the terminal ileum was applied in both groups,with the endoscope inserted into terminal ileum for more than 20 cm.The patients diagnosed of chronic diarrhea with terminal ileum lesions were treated with metronidazole and probiotics for 10-14 days.Results Before treatment there were significant differences in endoscopy findings of the terminal ileum between the two groups (P <0.05).In the patient group,endoscopy showed congestion,edema,erosion and ulcers in 29 cases,hyperplasia and enlargement of lymphoid follicles in 10 cases with a maximal diameter of 7-8 mm,and 1 case showed normal endoscopy results.After treatment,35 patients recovered from diarrhea,and terminal ileum lesions disappeared in 30 cases as determined by endoscopy.In the control group,endoscopy showed scattered hyperplasia of lymphoid follicles in 5 cases,and the follicles were small with the maximal diameter being 3 mm.There was no hyperemia,edema,erosion or ulcers.Conclusions Chronic diarrhea patients with normal colonoscopy findings may have lesions in the terminal ileum that can be detected by endoscopy; including hyperemia,erosion,ulcers and lymphoid follicle hyperplasia.Therapeutic effect is good with metronidazole and probiotics.

  4. Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea.

    Science.gov (United States)

    Traxdorf, Maximilian; Tschaikowsky, Klaus; Scherl, Claudia; Bauer, Judith; Iro, Heinrich; Angerer, Florian

    2016-12-06

    The aim of this study was to establish a standardized protocol for drug-induced sleep endoscopy (DISE) to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative propofol was combined with real-time monitoring of the depth of sedation using bispectral analysis. In an observational study 57 patients (mean age 44.8 years, ± SD 10.5; mean apnea hypopnea Index (AHI) 30.8/hr, ± SD 21.6, mean BMI 28.2 kg/m(2), ± SD 5.3) underwent cardiorespiratory polysomnography followed by DISE with TCI and bispectral analysis. Sleep was induced solely by the intravenous infusion of propofol with a TCI-pump, with an initial target plasma level of 2.0 µg/ml. Under continuous monitoring of the patient's respiration, state of consciousness and value of the bispectral analysis, the target plasma propofol level was raised in steps of 0.2 µg/ml/2 min until the desired depth of sedation was reached. The mean value of the bispectral analysis at the target depth of sedation was determined and the obstruction patterns during DISE-TCI-bispectral analysis then classified according to the VOTE-system. Subsequently the results were analyzed according to polysomnographic and anthropometric data. The occurrence of multilevel obstruction sites across all degrees of severity of OSA clarifies the need for sleep endoscopy prior to upper airway surgery. The advantage of this technique is the reproducibility of the protocol even for heterogeneous groups of patients. In addition, the gradual controlled and standardized increase of the plasma level of propofol with real-time control of the bispectral index leads to a precisely controllable depth of sedation. The DISE-TCI-bispectral analysis procedure is a step towards a required reproducible protocol of sleep endoscopy - capable of standardization. However it is not yet known whether these observed obstruction patterns also correspond to findings in natural sleep.

  5. A STUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND CT SCAN IN CASES OF CHRONIC RHINOSINUSITIS

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-07-01

    Full Text Available BACKGROUND: The accurate diagnosis of Chronic Rhinosinusitis (CRS is still a challenge therefore, the American Academy of Otorhinolaryngology - Head and Neck Surgery (AAO - HNS 1 has met in a multidisciplinary encounter and formulated a consensus based on only clinical symptoms. The computed tomography (CT scan and the nasal endoscopy (NE were introduced to make an accurate diagnosis of CRS and verify the disease severity. AIM: The aim of this study is to make a correlation between nasal endoscopy and CT scan in cases of clinically diagnosed Chronic Rhinosinusitis patients. METHOD: A study was carried out on 90 patients at Jhalawar Medical College, Jhalawar (Raj. during Sept. 20 12 to Dec. 2014. Diagnostic Nasal Endoscopy and CT Scan PNS done in patients, suffering from Chronic Rhinosinusitis. As a classification instruments, Metson / Gliklich's classification was used to evaluate the tomographic diagnosis and the Stankiewicz / Chow' s classification to evaluate the endoscopic diagnosis of Chronic Rhinosinusitis. RESULTS: Our study showed high specificity of endoscopy in comparison to CT scan though CT scan results are more sensitive. CONCLUSION: Endoscopy can confirm a Chronic Rhinosi nusitis diagnosis, but cannot rule it out, and that CT should be performed in cases of suspected CRS even if mucopurulence is not noted on endoscopy. The CT scan and the nasal endoscopy making easier the treatment planning and the disease resolution.

  6. Role of virtual reality simulation in endoscopy training

    Institute of Scientific and Technical Information of China (English)

    Louis; Harpham--Lockyer; Faidon--Marios; Laskaratos; Pasquale; Berlingieri; Owen; Epstein

    2015-01-01

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simula-tors and the long-term benefits of their use are also discussed.

  7. A wide-angle camera module for disposable endoscopy

    Science.gov (United States)

    Shim, Dongha; Yeon, Jesun; Yi, Jason; Park, Jongwon; Park, Soo Nam; Lee, Nanhee

    2016-08-01

    A wide-angle miniaturized camera module for disposable endoscope is demonstrated in this paper. A lens module with 150° angle of view (AOV) is designed and manufactured. All plastic injection-molded lenses and a commercial CMOS image sensor are employed to reduce the manufacturing cost. The image sensor and LED illumination unit are assembled with a lens module. The camera module does not include a camera processor to further reduce its size and cost. The size of the camera module is 5.5 × 5.5 × 22.3 mm3. The diagonal field of view (FOV) of the camera module is measured to be 110°. A prototype of a disposable endoscope is implemented to perform a pre-clinical animal testing. The esophagus of an adult beagle dog is observed. These results demonstrate the feasibility of a cost-effective and high-performance camera module for disposable endoscopy.

  8. Role of virtual reality simulation in endoscopy training.

    Science.gov (United States)

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-12-10

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed.

  9. About human taeniasis and Taenia saginata diagnosis by endoscopy.

    Science.gov (United States)

    Galán Puchades, María Teresa

    2016-10-01

    La carta al editor se refiere al artículo de Canaval-Zuleta et al. aceptado para publicación, titulado "Endoscopy as an alternative diagnostic and therapeutic technique for Taenia saginata". El trabajo presenta una serie de incorrecciones que deben ser aclaradas, o al menos parte de ellas en solo 300 palabras. La información sobre las vias de infeccion en taeniasis, así como la patogenia y técnicas de diagnóstico, no se ajustan a la realidad. Asimismo, ya está publicado que el diagnóstico por endoscopia es una técnica muy sensible pero nada específica, pues no permite distinguir entre las 3 especies humanas del género Taenia.

  10. Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2012-01-01

    Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

  11. Basic ammonothermal GaN growth in molybdenum capsules

    Science.gov (United States)

    Pimputkar, S.; Speck, J. S.; Nakamura, S.

    2016-12-01

    Single crystal, bulk gallium nitride (GaN) crystals were grown using the basic ammonothermal method in a high purity growth environment created using a non-hermetically sealed molybdenum (Mo) capsule and compared to growths performed in a similarly designed silver (Ag) capsule and capsule-free René 41 autoclave. Secondary ion mass spectrometry (SIMS) analysis revealed transition metal free (<1×1017 cm-3) GaN crystals. Anomalously low oxygen concentrations ((2-6)×1018 cm-3) were measured in a {0001} seeded crystal boule grown using a Mo capsule, despite higher source material oxygen concentrations ((1-5)×1019 cm-3) suggesting that molybdenum (or molybdenum nitrides) may act to getter oxygen under certain conditions. Total system pressure profiles from growth runs in a Mo capsule system were comparable to those without a capsule, with pressures peaking within 2 days and slowly decaying due to hydrogen diffusional losses. Measured Mo capsule GaN growth rates were comparable to un-optimized growth rates in capsule-free systems and appreciably slower than in Ag-capsule systems. Crystal quality replicated that of the GaN seed crystals for all capsule conditions, with high quality growth occurring on the (0001) Ga-face. Optical absorption and impurity concentration characterization suggests reduced concentrations of hydrogenated gallium vacancies (VGa-Hx).

  12. Disparities in endoscopy use for colorectal cancer screening in the United States.

    Science.gov (United States)

    Gawron, Andrew J; Yadlapati, Rena

    2014-03-01

    It is well established that disparities exist for colorectal cancer (CRC) incidence rates and death. With screening, death from CRC may be considered a preventable occurrence. Endoscopy (flexible sigmoidoscopy and colonoscopy) is the only modality with therapeutic benefit of removal of pre-cancerous polyps. The Patient Protection and Affordable Care Act mandated that preventive screening services be covered, which includes endoscopy for colon cancer screening. Recent federal rules have eliminated cost sharing for polyp removal during screening colonoscopy in privately insured patients; however, this has not been mandated for Medicare patients. Understanding the current state of disparities in endoscopy use is important, as these policy changes will affect millions of patients. The purpose of this literature review was to summarize the known research on disparities in endoscopy use for colon cancer screening in the United States and highlight areas for future research.

  13. Evidence based review of the impact of image enhanced endoscopy in the diagnosis of gastric disorders

    Science.gov (United States)

    Hussain, Ikram; Ang, Tiing Leong

    2016-01-01

    Gastric cancer is the third most common cause of cancer-related death. Advanced stages of gastric cancers generally have grim prognosis. But, good prognosis can be achieved if such cancers are detected, diagnosed and resected at early stages. However, early gastric cancers and its precursors often produce only subtle mucosal changes and therefore quite commonly remain elusive at the conventional examination with white light endoscopy. Image-enhanced endoscopy makes mucosal lesions more conspicuous and can therefore potentially yield earlier and more accurate diagnoses. Recent years have seen growing work of research in support of various types of image enhanced endoscopy (IEE) techniques (e.g., dye-chromoendoscopy; magnification endoscopy; narrow-band imaging; flexible spectral imaging color enhancement; and I-SCAN) for a variety of gastric pathologies. In this review, we will examine the evidence for the utilization of various IEE techniques in the diagnosis of gastric disorders. PMID:28042388

  14. Current issues in endoscope reprocessing and infection control during gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    Douglas B Nelson; Lawrence F Muscarella

    2006-01-01

    The purpose of this article is to review the evidence regarding transmission of infection during gastrointestinal endoscopy, factors important in endoscope reprocessing and infection control, areas to focus on to improve compliance, and recent developments and advances in the field.

  15. Motion of an elastic capsule in a square microfluidic channel.

    Science.gov (United States)

    Kuriakose, S; Dimitrakopoulos, P

    2011-07-01

    In the present study we investigate computationally the steady-state motion of an elastic capsule along the centerline of a square microfluidic channel and compare it with that in a cylindrical tube. In particular, we consider a slightly over-inflated elastic capsule made of a strain-hardening membrane with comparable shearing and area-dilatation resistance. Under the conditions studied in this paper (i.e., small, moderate, and large capsules at low and moderate flow rates), the capsule motion in a square channel is similar to and thus governed by the same scaling laws with the capsule motion in a cylindrical tube, even though in the channel the cross section in the upstream portion of large capsules is nonaxisymmetric (i.e., square-like with rounded corners). When the hydrodynamic forces on the membrane increase, the capsule develops a pointed downstream edge and a flattened rear (possibly with a negative curvature) so that the restoring tension forces are increased as also happens with droplets. Membrane tensions increase significantly with the capsule size while the area near the downstream tip is the most probable to rupture when a capsule flows in a microchannel. Because the membrane tensions increase with the interfacial deformation, a suitable Landau-Levich-Derjaguin-Bretherton analysis reveals that the lubrication film thickness h for large capsules depends on both the capillary number Ca and the capsule size a; our computations determine the latter dependence to be (in dimensionless form) h ~ a(-2) for the large capsules studied in this work. For small and moderate capsule sizes a, the capsule velocity Ux and additional pressure drop ΔP+ are governed by the same scaling laws as for high-viscosity droplets. The velocity and additional pressure drop of large thick capsules also follow the dynamics of high-viscosity droplets, and are affected by the lubrication film thickness. The motion of our large thick capsules is characterized by a Ux-U ~ h ~ a(-2

  16. Capsule formation and asymbiotic seed germination in some hybrids of Phalaenopsis, influenced by pollination season and capsule maturity.

    Science.gov (United States)

    Balilashaki, Khosro; Gantait, Saikat; Naderi, Roohangiz; Vahedi, Maryam

    2015-07-01

    We explored the influence of pollination season and maturity of capsule on post-pollination capsule formation and in vitro asymbiotic seed germination, respectively. Three Phalaenopsis orchid hybrids, namely, 'Athens', 'Moscow' and 'Lusaka' flowers were artificially self-pollinated during winter, spring, summer and fall seasons and the impact of the pollination seasons was evident during capsule formation. It was observed that winter was the most suitable season for pollination of all the three Phalanaeopsis hybrids resulting in 80-88 % capsule formation. During summer, the pollination success rate was 24-28 %, but resulted in successful capsule formation. Season of pollination further delimited the germination efficiency of seeds harvested from capsules of variable maturity levels. Invariably, seeds collected from winter-pollinated capsules performed best in germination compared to other seasons, for instance, 'Moscow' seeds took less than 14 days to germinate from capsules developed following winter-pollination. Regarding the influence of capsule maturity on seed germination, we observed that seeds derived from 5-month mature capsules, invariably took least time to germinate than that of the 3-month or 7-month in all three hybrids, e.g., for 'Moscow' it was 13.9 days with a maximum of 90.3 % germination.

  17. A Pilot Study of Ketamine versus Midazolam/Fentanyl Sedation in Children Undergoing GI Endoscopy

    OpenAIRE

    Lightdale, Jenifer R; Mitchell, Paul D; Fredette, Meghan E.; Mahoney, Lisa B.; Zgleszewski, Steven E.; Lisa Scharff; Fox, Victor L

    2011-01-01

    Background. Ketamine sedation has been found superior by physician report to traditional sedation regimens for pediatric endoscopy. Goal. To objectively compare sedation with ketamine versus midazolam/fentanyl for children undergoing gastrointestinal endoscopy. Study. Patients received one of two regimens and were independently monitored using a standardized rating scale. Results. There were 2 episodes of laryngospasm during ketamine sedation. Univariate analyses showed patients sedated with ...

  18. Response of patients to upper gastrointestinal endoscopy: effect of inherent personality traits and premedication with diazepam.

    OpenAIRE

    1982-01-01

    The influence of personality traits on the reaction of patients to upper gastrointestinal endoscopy was studied prospectively in 86 patients. High N (neuroticism) scores on the Eysenck personality inventory were associated with poor tolerance to and future compliance with the procedure. Although premedication with diazepam did not affect the degree of discomfort and distress during the procedure, it guaranteed acceptance of repeat endoscopy by virtue of its strong amnesic effect. By contrast,...

  19. Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

    Directory of Open Access Journals (Sweden)

    Kouroumalis Elias

    2011-02-01

    Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

  20. General Anesthetic Versus Light Sedation: Effect on Pediatric Endoscopy Wait Times

    Directory of Open Access Journals (Sweden)

    Christine Edwards

    2013-01-01

    Full Text Available BACKGROUND: Wait times are an important measure of health care system effectiveness. There are no studies describing wait times in pediatric gastroenterology for either outpatient visits or endoscopy. Pediatric endoscopy is performed under light sedation or general anesthesia. The latter is hypothesized to be associated with a longer wait time due to practical limits on access to anesthesia in the Canadian health care system.