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Sample records for capsule endoscopy findings

  1. Capsule endoscopy

    DEFF Research Database (Denmark)

    Skovsen, Anders Peter; Burcharth, Jakob; Burgdorf, Stefan Kobbelgaard

    2013-01-01

    of capsule retention, especially in patients with known or suspected Crohn's disease, due to the propensity of Crohn's disease to form stenosis of the bowel. In cases where a stenosis is suspected, it is warranted to perform a patency capsule swallow before subjecting the patient to a capsule endoscopy....

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Capsule endoscopy in patients refusing conventional endoscopy

    OpenAIRE

    Romero-Vázquez, Javier; Argüelles-Arias, Federico; García-Montes, Josefa Maria; Caunedo-Álvarez, Ángel; Pellicer-Bautista, Francisco Javier; Herrerías-Gutiérrez, Juan Manuel

    2014-01-01

    Capsule endoscopy is nowadays the diagnostic technique of choice in the study of small bowel pathologies, allowing the non-invasive study of the entire mucosa. This has led, together with new technical advances, to the creation of two new models (PillCam ESO and PillCam Colon) for the study of esophageal and colonic diseases. These two new capsules offer an interesting alternative to conventional endoscopy in the study of the upper and lower digestive tracts, because traditional endoscopy is ...

  8. Comparison of Capsule Endoscopy Findings to Subsequent Double Balloon Enteroscopy: A Dual Center Experience

    Directory of Open Access Journals (Sweden)

    Amandeep S. Kalra

    2015-01-01

    Full Text Available Background. There has been a growing use of both capsule endoscopy (CE and double balloon enteroscopy (DBE to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective study of patients who underwent sequential CE and DBE, at two separate tertiary care academic centers from May 2007 to December 2011, was performed. Results. 116 patients were included in the study. The mean age ± SD was 66.6 ± 13.2 years. There were 56% males and 43.9% females. Measure of agreement between prior capsule and DBE findings was performed using kappa statistics, which gave kappa value of 0.396 with P<0.001. Also contingency coefficient was calculated and was found to be 0.732 (P<0.001. Conclusions. Our study showed good overall agreement between DBE and CE. Findings of angioectasia had maximum agreement of 69%.

  9. 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.

  10. Understanding Capsule Endoscopy

    Science.gov (United States)

    ... Management Products Endoscopy Unit Recognition Program - EURP Partnership Discounts ASGE Endoscopy Marketplace Career Center Tools to Educate ... with most new diagnostic procedures, not all insurance companies are currently reimbursing for this procedure. You may ...

  11. 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.

  12. Quantitative measurements in capsule endoscopy.

    Science.gov (United States)

    Keuchel, M; Kurniawan, N; Baltes, P; Bandorski, D; Koulaouzidis, A

    2015-10-01

    This review summarizes several approaches for quantitative measurement in capsule endoscopy. Video capsule endoscopy (VCE) typically provides wireless imaging of small bowel. Currently, a variety of quantitative measurements are implemented in commercially available hardware/software. The majority is proprietary and hence undisclosed algorithms. Measurement of amount of luminal contamination allows calculating scores from whole VCE studies. Other scores express the severity of small bowel lesions in Crohn׳s disease or the degree of villous atrophy in celiac disease. Image processing with numerous algorithms of textural and color feature extraction is further in the research focuses for automated image analysis. These tools aim to select single images with relevant lesions as blood, ulcers, polyps and tumors or to omit images showing only luminal contamination. Analysis of motility pattern, size measurement and determination of capsule localization are additional topics. Non-visual wireless capsules transmitting data acquired with specific sensors from the gastrointestinal (GI) tract are available for clinical routine. This includes pH measurement in the esophagus for the diagnosis of acid gastro-esophageal reflux. A wireless motility capsule provides GI motility analysis on the basis of pH, pressure, and temperature measurement. Electromagnetically tracking of another motility capsule allows visualization of motility. However, measurement of substances by GI capsules is of great interest but still at an early stage of development. PMID:26299419

  13. 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.

  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 Retentions and Incomplete Capsule Endoscopy Examinations: An Analysis of 2300 Examinations

    OpenAIRE

    Charlotte M. Höög; Lars-Åke Bark; Juan Arkani; Jacob Gorsetman; Olle Broström; Urban Sjöqvist

    2011-01-01

    Aim. To evaluate capsule endoscopy in terms of incomplete examinations and capsule retentions and to find risk factors for these events. Material and Methods. This retrospective and consecutive study includes data from 2300 capsule enteroscopy examinations, performed at four different hospitals in Stockholm, Sweden from 2003 to 2009. Results. The frequency of incomplete examinations was 20%. Older age, male gender, suspected, and known Crohn's disease were risk factors for an incomplete exami...

  20. 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.

  1. Guideline for Capsule Endoscopy: Obscure Gastrointestinal Bleeding

    OpenAIRE

    Shim, Ki-Nam; Moon, Jeong Seop; Chang, Dong Kyung; Do, Jae Hyuk; Kim, Ji Hyun; Min, Byung Hoon; Jeon, Seong Ran; Kim, Jin-Oh; Choi, Myung-Gyu; ,

    2013-01-01

    Capsule endoscopy (CE) is considered as a noninvasive and reliable diagnostic tool of examining the entire small bowel. CE has been performed frequently at many medical centers in South Korea; however, there is no evidence-based CE guideline for adequate diagnostic approaches. To provide accurate information and suggest correct testing approaches for small bowel disease, the guideline on CE was developed by the Korean Gut Image Study Group, a part of the Korean Society of Gastrointestinal End...

  2. A Review of Locomotion Systems for Capsule Endoscopy.

    Science.gov (United States)

    Liu, Lejie; Towfighian, Shahrzad; Hila, Amine

    2015-01-01

    Wireless capsule endoscopy for gastrointestinal (GI) tract is a modern technology that has the potential to replace conventional endoscopy techniques. Capsule endoscopy is a pill-shaped device embedded with a camera, a coin battery, and a data transfer. Without a locomotion system, this capsule endoscopy can only passively travel inside the GI tract via natural peristalsis, thus causing several disadvantages such as inability to control and stop, and risk of capsule retention. Therefore, a locomotion system needs to be added to optimize the current capsule endoscopy. This review summarizes the state-of-the-art locomotion methods along with the desired locomotion features such as size, speed, power, and temperature and compares the properties of different methods. In addition, properties and motility mechanisms of the GI tract are described. The main purpose of this review is to understand the features of GI tract and diverse locomotion methods in order to create a future capsule endoscopy compatible with GI tract properties. PMID:26292162

  3. 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

  4. 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.

  5. 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.

  6. 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.

  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. 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

  9. [Clinical practice using colon capsule endoscopy].

    Science.gov (United States)

    Kakugawa, Yasuo; Matsumoto, Minori; Saito, Yutaka

    2014-01-01

    PillCam COLON capsule endoscopy(CCE) (Given Imaging Ltd., Yoqneam, Israel) is one of the most recent diagnostic technologies designed to explore the colorectum. The first generation of CCE was released onto the market in 2006, and the second generation (PillCam COLON 2 : CCE-2), with increased sensitivity, was released in 2009. The CCE-2 has 2 imagers with a much wider angle of view that has been increased to 172 degrees per imager, allowing nearly 360 degrees coverage of the colon by two. The most unique feature of the CCE-2 is its adaptive frame rate (AFR). This new technology allows the CCE-2 to capture 35 images per second when in motion and 4 images per second when virtually stationary. The per-patient CCE-2 sensitivity for detecting polyps > or = 6 mm has been reported as 84%-91%. These recent advancements in this modality might offer physicians the option to screen for colorectal lesions noninvasively. PMID:24597367

  10. 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

  11. 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.

  12. 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.

  13. 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

  14. Inpatient capsule endoscopy leads to frequent incomplete small bowel examinations

    Institute of Scientific and Technical Information of China (English)

    Cemal Yazici; John Losurdo; Michael D Brown; Scott Oosterveen; Robert Rahimi; Ali Keshavarzian; Leila Bozorgnia

    2012-01-01

    AIM:To examine the predictive factors of capsule endoscopy (CE) completion rate (CECR) including the effect of inpatient and outpatient status.METHODS:We identified 355 consecutive patients who completed CE at Rush University Medical Center between March 2003 and October 2005.Subjects for CE had either nothing by mouth or clear liquids for the afternoon and evening of the day before the procedure.CE exams were reviewed by two physicians who were unaware of the study hypotheses.After retrospective analysis,21 cases were excluded due to capsule malfunction,prior gastric surgery,endoscopic capsule placement or insufficient data.Of the remaining 334 exams [264 out-patient (OP),70 in-patient (IP)],CE indications,findings,location of the patients [IP vs OP and intensive care unit (ICU) vs general medical floor (GMF)] and gastrointestinal transit times were analyzed.Statistical analysis was completed using SPSS version 17 (Chicago,IL).Chi-square,t test or fisher exact-tests were used as appropriate.Multivariate logistic regression analysis was used to identify variables associated with incomplete CE exams.RESULTS:The mean age for the entire study population was 54.7 years.Sixty-one percent of the study population was female,and gender was not different between IPs vs OPs (P =0.07).The overall incomplete CECR was 14% in our study.Overt obscure gastrointestinal bleeding (OGB) was significantly more common for the IP CE (P =0.0001),while abdominal pain and assessment of IBD were more frequent indications for the OP CE exams (P =0.002 and P =0.01,respectively).Occult OGB was the most common indication and arteriovenous malformations were the most common finding both in the IPs and OPs.The capsule did not enter the small bowel (SB) in 6/70 IPs and 8/264OPs (P =0.04).The capsule never reached the cecum in 31.4% (22/70) of IP vs 9.5% (25/ 264) of OP examinations (P < 0.001).The mean gastric transit time (GTT) was delayed in IPs compared to OPs,98.5 ±139.5 min vs 60.4

  15. 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.

  16. 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).

  17. 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.

  18. 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).

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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.)

  4. 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.

  5. 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.

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

    OpenAIRE

    Almeida, N; Figueiredo, P; Lopes, S; Freire, P.; Lérias, C; Hermano Gouveia; M. Correia Leitão

    2008-01-01

    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,...

  7. Three-dimensional image reconstruction in capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Anastasios Koulaouzidis; Alexandros Karargyris

    2012-01-01

    To date,limited research has been carried out in developing methods and materials that offer three-dimensional (3-D) representation of the digestive tract.In the field of capsule endoscopy (CE),hardware approaches have been developed that provide real time both 3-D information and texture using an infrared projector and a complementary metal oxide semiconductor camera.The major drawbacks of this system are its size,power consumption and packaging issues.A software approach to approximate a 3-D representation of digestive tract surface utilising current CE technology has been proposed.The algorithm utilizes the Shape from Shading technique and seem to provide promising results for polypoid structures and angioectasias.Further clinical evaluation is currently under way.

  8. 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.

  9. 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.)

  10. 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.

  11. Wireless capsule endoscopy video reduction based on camera motion estimation.

    Science.gov (United States)

    Liu, Hong; Pan, Ning; Lu, Heng; Song, Enmin; Wang, Qian; Hung, Chih-Cheng

    2013-04-01

    Wireless capsule endoscopy (WCE) is a novel technology aiming for investigating the diseases and abnormalities in small intestine. The major drawback of WCE examination is that it takes a long time to examine the whole WCE video. In this paper, we present a new reduction scheme for WCE video to reduce the examination time. To achieve this task, a WCE video motion model is proposed. Under this motion model, the WCE imaging motion is estimated in two stages (the coarse level and the fine level). In the coarse level, the WCE camera motion is estimated with a combination of Bee Algorithm and Mutual Information. In the fine level, the local gastrointestinal tract motion is estimated with SIFT flow. Based on the result of WCE imaging motion estimation, the reduction scheme preserves key images in WCE video with scene changes. From experimental results, we notice that the proposed motion model is suitable for the motion estimation in successive WCE images. Through the comparison with APRS and FCM-NMF scheme, our scheme can produce an acceptable reduction sequence for browsing and examination. PMID:22868484

  12. Current Status and Research into Overcoming Limitations of Capsule Endoscopy.

    Science.gov (United States)

    Kwack, Won Gun; Lim, Yun Jeong

    2016-01-01

    Endoscopic investigation has a critical role in the diagnosis and treatment of gastrointestinal (GI) diseases. Since 2001, capsule endoscopy (CE) has been available for small-bowel exploration and is under continuous development. During the past decade, CE has achieved impressive improvements in areas such as miniaturization, resolution, and battery life. As a result, CE is currently a first-line tool for the investigation of the small bowel in obscure gastrointestinal bleeding and is a useful alternative to wired enteroscopy. Nevertheless, CE still has several limitations, such as incomplete examination and limited diagnostic and therapeutic capabilities. To resolve these problems, many groups have suggested several models (e.g., controlled CO2 insufflation system, magnetic navigation system, mobile robotic platform, tagging and biopsy equipment, and targeted drug-delivery system), which are in development. In the near future, new technological advances will improve the capabilities of CE and broaden its spectrum of applications not only for the small bowel but also for the colon, stomach, and esophagus. The purpose of this review is to introduce the current status of CE and to review the ongoing development of solutions to address its limitations. PMID:26855917

  13. Diagnostic yield of small bowel capsule endoscopy depends on the small bowel transit time

    Institute of Scientific and Technical Information of China (English)

    Jessie Westerhof; Jan J Koornstra; Reinier A Hoedemaker; Wim J Sluiter; Jan H Kleibeuker; Rinse K Weersma

    2012-01-01

    AIM:TO investigate whether the small bowel transit time (SBTT) influences the diagnostic yield of capsule endoscopy (CE).METHODS:Six hundred and ninety-one consecutive CE procedures collected in a database were analyzed.SBTT and CE findings were recorded.A running mean for the SBTT was calculated and correlated to the diagnostic yield with a Spearman's correlation test.Subgroup analyses were performed for the various indications for the procedure.RESULTS:There was a positive correlation between the diagnostic yield and SBTT (Spearman's rho 0.58,P < 0.01).Positive correlations between diagnostic yield and SBlT were found for the indication obscure gastrointestinal bleeding (r =0.54,P < 0.01),for polyposis and carcinoid combined (r =0.56,P < 0.01) and for the other indications (r =0.90,P <0.01),but not for suspected Crohn's disease (r =-0.40).CONCLUSION:The diagnostic yield in small bowel capsule endoscopy is positively correlated with the small bowel transit time.This is true for all indications except for suspected Crohn's disease.

  14. 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.

  15. Small bowel capsule endoscopy in patients with cardiac pacemakers and implantable cardioverter defibrillators: Outcome analysis using telemetry review

    OpenAIRE

    2012-01-01

    AIM: To determine if there were any interactions between cardiac devices and small bowel capsules secondary to electromagnetic interference (EMI) in patients who have undergone small bowel capsule endoscopy (SBCE).

  16. 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.

  17. 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.

  18. 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.)

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

    OpenAIRE

    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...

  20. Automatic detection of informative frames from wireless capsule endoscopy images.

    Science.gov (United States)

    Bashar, M K; Kitasaka, T; Suenaga, Y; Mekada, Y; Mori, K

    2010-06-01

    Wireless capsule endoscopy (WCE) is a new clinical technology permitting visualization of the small bowel, the most difficult segment of the digestive tract. The major drawback of this technology is the excessive amount of time required for video diagnosis. We therefore propose a method for generating smaller videos by detecting informative frames from original WCE videos. This method isolates useless frames that are highly contaminated by turbid fluids, faecal materials and/or residual foods. These materials and fluids are presented in a wide range of colors, from brown to yellow, and/or have bubble-like texture patterns. The detection scheme therefore consists of two steps: isolating (Step-1) highly contaminated non-bubbled (HCN) frames and (Step-2) significantly bubbled (SB) frames. Two color representations, viz., local color moments in Ohta space and the HSV color histogram, are attempted to characterize HCN frames, which are isolated by a support vector machine (SVM) classifier in Step-1. The rest of the frames go to Step-2, where a Gauss Laguerre transform (GLT) based multiresolution texture feature is used to characterize the bubble structures in WCE frames. GLT uses Laguerre Gauss circular harmonic functions (LG-CHFs) to decompose WCE images into multiresolution components. An automatic method of segmentation was designed to extract bubbled regions from grayscale versions of the color images based on the local absolute energies of their CHF responses. The final informative frames were detected by using a threshold on the segmented regions. An automatic procedure for selecting features based on analyzing the consistency of the energy-contrast map is also proposed. Three experiments, two of which use 14,841 and 37,100 frames from three videos and the rest uses 66,582 frames from six videos, were conducted for justifying the proposed method. The two combinations of the proposed color and texture features showed excellent average detection accuracies (86

  1. 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

  2. Automated Adaptive Brightness in Wireless Capsule Endoscopy Using Image Segmentation and Sigmoid Function.

    Science.gov (United States)

    Shrestha, Ravi; Mohammed, Shahed K; Hasan, Md Mehedi; Zhang, Xuechao; Wahid, Khan A

    2016-08-01

    Wireless capsule endoscopy (WCE) plays an important role in the diagnosis of gastrointestinal (GI) diseases by capturing images of human small intestine. Accurate diagnosis of endoscopic images depends heavily on the quality of captured images. Along with image and frame rate, brightness of the image is an important parameter that influences the image quality which leads to the design of an efficient illumination system. Such design involves the choice and placement of proper light source and its ability to illuminate GI surface with proper brightness. Light emitting diodes (LEDs) are normally used as sources where modulated pulses are used to control LED's brightness. In practice, instances like under- and over-illumination are very common in WCE, where the former provides dark images and the later provides bright images with high power consumption. In this paper, we propose a low-power and efficient illumination system that is based on an automated brightness algorithm. The scheme is adaptive in nature, i.e., the brightness level is controlled automatically in real-time while the images are being captured. The captured images are segmented into four equal regions and the brightness level of each region is calculated. Then an adaptive sigmoid function is used to find the optimized brightness level and accordingly a new value of duty cycle of the modulated pulse is generated to capture future images. The algorithm is fully implemented in a capsule prototype and tested with endoscopic images. Commercial capsules like Pillcam and Mirocam were also used in the experiment. The results show that the proposed algorithm works well in controlling the brightness level accordingly to the environmental condition, and as a result, good quality images are captured with an average of 40% brightness level that saves power consumption of the capsule. PMID:27333609

  3. Role of wireless capsule endoscopy in the follow-up ofinflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The introduction of wireless capsule endoscopy in2000 has revolutionized our ability to visualize partsof the small bowel mucosa classically unreached bythe conventional endoscope, and since the recentintroduction of colon capsule endoscopy, a promisingalternative method has been available for the evaluationof large bowel mucosa. The advantages of wirelesscapsule endoscopy include its non-invasive characterand its ability to visualize proximal and distal parts ofthe intestine, while important disadvantages include theprocedure's inability of tissue sampling and significantincompletion rate. Its greatest limitation is the prohibiteduse in cases of known or suspected stenosis of theintestinal lumen due to high risk of retention. Wirelesscapsule endoscopy plays an important role in theearly recognition of recurrence, on Crohn's diseasepatients who have undergone ileocolonic resection forthe treatment of Crohn's disease complications, andin patients' management and therapeutic strategyplanning, before obvious clinical and laboratory relapse.Although capsule endoscopy cannot replace traditionalendoscopy, it offers valuable information on theevaluation of intestinal disease and has a significantimpact on disease reclassification of patients with aprevious diagnosis of ulcerative colitis or inflammatorybowel disease unclassified/indeterminate colitis.Moreover, it may serve as an effective alternativewhere colonoscopy is contraindicated and in cases withincomplete colonoscopy studies. The use of patencycapsule maximizes safety and is advocated in cases ofsuspected small or large bowel stenosis.

  4. 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.

  5. 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...

  6. A discrete-time localization method for capsule endoscopy based on on-board magnetic sensing

    International Nuclear Information System (INIS)

    Recent achievements in active capsule endoscopy have allowed controlled inspection of the bowel by magnetic guidance. Capsule localization represents an important enabling technology for such kinds of platforms. In this paper, the authors present a localization method, applied as first step in time-discrete capsule position detection, that is useful for establishing a magnetic link at the beginning of an endoscopic procedure or for re-linking the capsule in the case of loss due to locomotion. The novelty of this approach consists in using magnetic sensors on board the capsule whose output is combined with pre-calculated magnetic field analytical model solutions. A magnetic field triangulation algorithm is used for obtaining the position of the capsule inside the gastrointestinal tract. Experimental validation has demonstrated that the proposed procedure is stable, accurate and has a wide localization range in a volume of about 18 × 103 cm3. Position errors of 14 mm along the X direction, 11 mm along the Y direction and 19 mm along the Z direction were obtained in less than 27 s of elaboration time. The proposed approach, being compatible with magnetic fields used for locomotion, can be easily extended to other platforms for active capsule endoscopy

  7. Wireless powered capsule endoscopy for colon diagnosis and treatment

    International Nuclear Information System (INIS)

    This paper presents a wireless power transfer system integrated with an active locomotion and biopsy module in an endoscopic capsule for colon inspection. The capsule, which can move automatically, is designed for non-invasive biopsy and visual inspection of the intestine. To supply enough power for multiple functions and ensure safety for the human body, the efficiency of the current power transmission system needs to be improved. To take full advantage of the volume in the capsule body, a novel structure of receiving coils wound on a multi-core of MnZn ferrite hollow cylinder was used; with this new core, the efficiency increased to more than 7.98%. Up to 1.4 W of dc power can be delivered to the capsule as it travels along the gastrointestinal tract. Three micro motors were integrated for pumping, anchoring, locomotion and biopsy. A user interface and RF communication enables the operator to drive the capsule in an intuitive manner. To gauge the efficacy of the wireless power supply in a simulated real-world application, the biopsy and locomotion capabilities of the device were successfully tested in a slippery, soft tube and gut environment in vitro. (paper)

  8. 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.

  9. Adenocarcinoma of the third and fourth portions of the duodenum: The capsule endoscopy value

    Science.gov (United States)

    Paquissi, Feliciano Chanana; Lima, Ana Henriqueta Filipe Bunga Pimentel; Lopes, Maria de Fátima do Nascimento Vieira; Diaz, Francisco Viamontes

    2015-01-01

    Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However, its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions, emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man, 40 years old, with no medical history, with abdominal discomfort and progressive fatigue, presented four months ago with one episode of moderate melena. The physical examination was normal, except for mucosal pallor. Blood tests were consistent with microcytic, hypochromic iron deficiency anemia with 7.8 g/dL hemoglobin. The upper and lower endoscopy were normal. Additional work-up with video capsule endoscopy showed a polypoid lesion involving the third and fourth portions of the duodenum. Biopsy showed a moderately differentiated adenocarcinoma. Abdominal computed tomography showed a wall thickening from the third duodenal portion to the proximal jejunum, without distant metastasis. The patient underwent segmental resection (distal duodenum and proximal jejunum) with duodenojejunostomy. The surgical specimen histology confirmed the biopsy diagnosis, with transmural infiltration, without nodal involvement. Conclusion: Adenocarcinoma of the third and fourth portions of the duodenum is difficult to diagnose and capsule endoscopy is of great value. PMID:26309371

  10. 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.

  11. Capsule endoscopy of the future: What’s on the horizon?

    Science.gov (United States)

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

    2015-01-01

    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. PMID:26457013

  12. Adenocarcinoma of the third and fourth portions of the duodenum: The capsule endoscopy value

    OpenAIRE

    Paquissi, Feliciano Chanana; Lima, Ana Henriqueta Filipe Bunga Pimentel; Lopes, Maria de Fátima do Nascimento Vieira; Diaz, Francisco Viamontes

    2015-01-01

    Primary adenocarcinoma of the small intestine occurs in over 50% of cases in the duodenum. However, its location in the third and fourth duodenal portions occurs rarely and is a diagnostic challenge. The aim of this work is to report an adenocarcinoma of the third and fourth duodenal portions, emphasizing its diagnostic difficulty and the value of video capsule endoscopy. A man, 40 years old, with no medical history, with abdominal discomfort and progressive fatigue, presented four months ago...

  13. 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....

  14. 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.

  15. 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.)

  16. 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...

  17. 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

  18. Comparative assessment of feature extraction methods for visual odometry in wireless capsule endoscopy.

    Science.gov (United States)

    Spyrou, Evaggelos; Iakovidis, Dimitris K; Niafas, Stavros; Koulaouzidis, Anastasios

    2015-10-01

    Wireless capsule endoscopy (WCE) enables the non-invasive examination of the gastrointestinal (GI) tract by a swallowable device equipped with a miniature camera. Accurate localization of the capsule in the GI tract enables accurate localization of abnormalities for medical interventions such as biopsy and polyp resection; therefore, the optimization of the localization outcome is important. Current approaches to endoscopic capsule localization are mainly based on external sensors and transit time estimations. Recently, we demonstrated the feasibility of capsule localization based-entirely-on visual features, without the use of external sensors. This technique relies on a motion estimation algorithm that enables measurements of the distance and the rotation of the capsule from the acquired video frames. Towards the determination of an optimal visual feature extraction technique for capsule motion estimation, an extensive comparative assessment of several state-of-the-art techniques, using a publicly available dataset, is presented. The results show that the minimization of the localization error is possible at the cost of computational efficiency. A localization error of approximately one order of magnitude higher than the minimal one can be considered as compromise for the use of current computationally efficient feature extraction techniques. PMID:26073184

  19. 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

  20. Three-dimensional reconstruction of the digestive wall in capsule endoscopy videos using elastic video interpolation.

    Science.gov (United States)

    Karargyris, Alexandros; Bourbakis, Nikolaos

    2011-04-01

    Wireless capsule endoscopy is a revolutionary technology that allows physicians to examine the digestive tract of a human body in the minimum invasive way. Physicians can detect diseases such as blood-based abnormalities, polyps, ulcers, and Crohn's disease. Although this technology is really a marvel of our modern times, currently it suffers from two serious drawbacks: 1) frame rate is low (3 frames/s) and 2) no 3-D representation of the objects is captured from the camera of the capsule. In this paper we offer solutions (methodologies) that deal with each of the above issues improving the current technology without forcing hardware upgrades. These methodologies work synergistically to create smooth and visually friendly interpolated images from consecutive frames, while preserving the structure of the observed objects. They also extract and represent the texture of the surface of the digestive tract in 3-D. Thus the purpose of our methodology is not to reduce the time that the gastroenterologists need to spend to examine the video. On the contrary, the purpose is to enhance the video and therefore improve the viewing of the digestive tract leading to a more qualitative and efficient examination. The proposed work introduces 3-D capsule endoscopy textured results that have been welcomed by Digestive Specialists, Inc., Dayton, OH. Finally, illustrative results are given at the end of the paper. PMID:21147593

  1. 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.

  2. 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).

  3. 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

  4. Prospective controlled study on the effects of polyethylene glycol in capsule endoscopy

    Institute of Scientific and Technical Information of China (English)

    Takafumi Ito; Ken Ohata; Akiko Ono; Hideyuki Chiba; Yosuke Tsuji; Hajime Sato; Nobuyuki Matsuhashi

    2012-01-01

    AIM:To prospectively confirm whether a small amount of polyethylene glycol (PEG) ingested after swallowing endoscopy capsule improves image quality and completion rate.METHODS:Forty-four consecutive patients referred to us for capsule endoscopy (CE) were randomized to two groups.All patients were restricted to clear fluids for 12 h before the examination.Patients in group A (22cases) received no additional preparation,while those in group B (20 cases) ingested 500 mL of PEG within a 2 h period starting 30 min after swallowing the capsule.Clear fluids and meals were allowed 2 h and 4 h after capsule ingestion,respectively.Image quality was assessed as the percentage of visualized bowel surface area as follows:1:< 25%; 2:25%-49%; 3:50%-74%;4:75%-89%; 5:> 90%.The small bowel record was divided into five segments by time,and the score for each segment was evaluated.All CE examinations were performed with the Pillcam SB capsule endoscopy system (Given Imaging Co.Ltd.,Yoqnem).RESULTS:This study ended in December 2009,because sample size was considered large enough.A total of 44 patients were enrolled.Two patients in group B were excluded from the analysis because small bowel images could not be obtained from these patients; one had a full stomach,while the other presented with a massive gastric bleed.Thus,22 patients from group A and 20 patients from group B completed the study.There was no significant difference in age (P =0.22),sex (P =0.31),and indication for CE.No significant adverse events occurred in any of the study patients.In group A,image quality deteriorated as the capsule progressed distally.However,in group B,image quality was maintained to the distal small bowel.In each of the five segments,the visibility score was significantly higher in group B than in group A (segment 1:4.3 ±0.7 vs 4.7 ± 0.5,P =0.03; segment 2:4.2 ± 0.9 vs 4.8± 0.4,P =0.01; segment 3:4.0 ± 1.0 vs 4.6 ± 0.7,P=0.04; segment 4:3.6 ± 1.1 vs 4.5 ± 0.6,P =0

  5. Singular Value Decomposition Based Features for Automatic Tumor Detection in Wireless Capsule Endoscopy Images.

    Science.gov (United States)

    Faghih Dinevari, Vahid; Karimian Khosroshahi, Ghader; Zolfy Lighvan, Mina

    2016-01-01

    Wireless capsule endoscopy (WCE) is a new noninvasive instrument which allows direct observation of the gastrointestinal tract to diagnose its relative diseases. Because of the large number of images obtained from the capsule endoscopy per patient, doctors need too much time to investigate all of them. So, it would be worthwhile to design a system for detecting diseases automatically. In this paper, a new method is presented for automatic detection of tumors in the WCE images. This method will utilize the advantages of the discrete wavelet transform (DWT) and singular value decomposition (SVD) algorithms to extract features from different color channels of the WCE images. Therefore, the extracted features are invariant to rotation and can describe multiresolution characteristics of the WCE images. In order to classify the WCE images, the support vector machine (SVM) method is applied to a data set which includes 400 normal and 400 tumor WCE images. The experimental results show proper performance of the proposed algorithm for detection and isolation of the tumor images which, in the best way, shows 94%, 93%, and 93.5% of sensitivity, specificity, and accuracy in the RGB color space, respectively. PMID:27478364

  6. 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.

  7. 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

  8. 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. PMID:27366048

  9. Evaluation of friction enhancement through soft polymer micro-patterns in active capsule endoscopy

    Science.gov (United States)

    Buselli, Elisa; Pensabene, Virginia; Castrataro, Piero; Valdastri, Pietro; Menciassi, Arianna; Dario, Paolo

    2010-10-01

    Capsule endoscopy is an emerging field in medical technology. Despite very promising innovations, some critical issues are yet to be addressed, such as the management and possible exploitation of the friction in the gastrointestinal environment in order to control capsule locomotion more actively. This paper presents the fabrication and testing of bio-inspired polymeric micro-patterns, which are arrays of cylindrical pillars fabricated via soft lithography. The aim of the work is to develop structures that enhance the grip between an artificial device and the intestinal tissue, without injuring the mucosa. In fact, the patterns are intended to be mounted on microfabricated legs of a capsule robot that is able to move actively in the gastrointestinal tract, thus improving the robot's traction ability. The effect of micro-patterned surfaces on the leg-slipping behaviour on colon walls was investigated by considering both different pillar dimensions and the influence of tissue morphology. Several in vitro tests on biological samples demonstrated that micro-patterns of pillars made from a soft polymer with an aspect ratio close to 1 enhanced friction by 41.7% with regard to flat surfaces. This work presents preliminary modelling of the friction and adhesion forces in the gastrointestinal environment and some design guidelines for endoscopic devices.

  10. Determination of anthelmintic efficacy against Toxocara canis in dogs by use of capsule endoscopy.

    Science.gov (United States)

    Lee, Alice C Y; Epe, Christian; Bowman, Dwight D

    2015-09-15

    Industry guidelines for anthelmintic testing call for postmortem inspection of animals to verify treatment efficacy. A previous study showed that capsule endoscopy (CE) can be performed on dogs in vivo to quantify hookworms in the small intestine. Adoption of a minimally invasive procedure such as this could reduce the need for necropsy in efficacy trials. The present study employed CE to enumerate Toxocara canis in dogs, with two main goals: to determine if multiple capsule examinations improves the accuracy of worm counts compared to a single examination, and to establish if the efficacy of an anthelmintic compound is the same whether calculated using CE or necropsy data. To avoid needless animal sacrifice, the study was carried out on beagle dogs already in a product development trial with a planned terminal endpoint. Dogs were infected by oral inoculation with T. canis eggs. Untreated control dogs (n=8) were evaluated by CE three times while dogs treated with test compounds (3 groups of 4) were examined only once. Utilizing either the average count or just the last complete capsule examination, a robust correlation was found between CE and postmortem numbers (r=0.94, pcanis parasiticide trials. PMID:26321133

  11. 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 en...

  12. 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.

  13. 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

  14. 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.

  15. 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.

  16. A video wireless capsule endoscopy system powered wirelessly: design, analysis and experiment

    International Nuclear Information System (INIS)

    Wireless capsule endoscopy (WCE), as a relatively new technology, has brought about a revolution in the diagnosis of gastrointestinal (GI) tract diseases. However, the existing WCE systems are not widely applied in clinic because of the low frame rate and low image resolution. A video WCE system based on a wireless power supply is developed in this paper. This WCE system consists of a video capsule endoscope (CE), a wireless power transmission device, a receiving box and an image processing station. Powered wirelessly, the video CE has the abilities of imaging the GI tract and transmitting the images wirelessly at a frame rate of 30 frames per second (f/s). A mathematical prototype was built to analyze the power transmission system, and some experiments were performed to test the capability of energy transferring. The results showed that the wireless electric power supply system had the ability to transfer more than 136 mW power, which was enough for the working of a video CE. In in vitro experiments, the video CE produced clear images of the small intestine of a pig with the resolution of 320 × 240, and transmitted NTSC format video outside the body. Because of the wireless power supply, the video WCE system with high frame rate and high resolution becomes feasible, and provides a novel solution for the diagnosis of the GI tract in clinic

  17. 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.

  18. The feasibility of wireless capsule endoscopy in detecting small intestinal pathology in children under the age of 8 years: a multicentre European study

    NARCIS (Netherlands)

    A. Fritscher-Ravens; P. Scherbakov; P. Bufler; F. Torroni; T. Ruuska; H. Nuutinen; M. Thomson; M. Tabbers; P. Milla

    2009-01-01

    Objective: To systematically evaluate the feasibility and methodology to carry out wireless capsule endoscopy (WCE) in children,8 years to define small intestinal pathology. Design: Prospective European multicentre study with negative prior investigation. Patients and interventions: 83 children aged

  19. 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

  20. Design of a lossless image compression system for video capsule endoscopy and its performance in in-vivo trials.

    Science.gov (United States)

    Khan, Tareq H; Wahid, Khan A

    2014-01-01

    In this paper, a new low complexity and lossless image compression system for capsule endoscopy (CE) is presented. The compressor consists of a low-cost YEF color space converter and variable-length predictive with a combination of Golomb-Rice and unary encoding. All these components have been heavily optimized for low-power and low-cost and lossless in nature. As a result, the entire compression system does not incur any loss of image information. Unlike transform based algorithms, the compressor can be interfaced with commercial image sensors which send pixel data in raster-scan fashion that eliminates the need of having large buffer memory. The compression algorithm is capable to work with white light imaging (WLI) and narrow band imaging (NBI) with average compression ratio of 78% and 84% respectively. Finally, a complete capsule endoscopy system is developed on a single, low-power, 65-nm field programmable gate arrays (FPGA) chip. The prototype is developed using circular PCBs having a diameter of 16 mm. Several in-vivo and ex-vivo trials using pig's intestine have been conducted using the prototype to validate the performance of the proposed lossless compression algorithm. The results show that, compared with all other existing works, the proposed algorithm offers a solution to wireless capsule endoscopy with lossless and yet acceptable level of compression. PMID:25375753

  1. Design of a Lossless Image Compression System for Video Capsule Endoscopy and Its Performance in In-Vivo Trials

    Directory of Open Access Journals (Sweden)

    Tareq H. Khan

    2014-11-01

    Full Text Available In this paper, a new low complexity and lossless image compression system for capsule endoscopy (CE is presented. The compressor consists of a low-cost YEF color space converter and variable-length predictive with a combination of Golomb-Rice and unary encoding. All these components have been heavily optimized for low-power and low-cost and lossless in nature. As a result, the entire compression system does not incur any loss of image information. Unlike transform based algorithms, the compressor can be interfaced with commercial image sensors which send pixel data in raster-scan fashion that eliminates the need of having large buffer memory. The compression algorithm is capable to work with white light imaging (WLI and narrow band imaging (NBI with average compression ratio of 78% and 84% respectively. Finally, a complete capsule endoscopy system is developed on a single, low-power, 65-nm field programmable gate arrays (FPGA chip. The prototype is developed using circular PCBs having a diameter of 16 mm. Several in-vivo and ex-vivo trials using pig's intestine have been conducted using the prototype to validate the performance of the proposed lossless compression algorithm. The results show that, compared with all other existing works, the proposed algorithm offers a solution to wireless capsule endoscopy with lossless and yet acceptable level of compression.

  2. 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.

  3. 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.

  4. 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.

  5. Opioid Use Is Not Associated with Incomplete Wireless Capsule Endoscopy for Inpatient or Outpatient Procedures

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    Bryan Kleinman

    2014-01-01

    Full Text Available Objective. Wireless capsule endoscopy (WCE is commonly used to directly visualize the small bowel. Opioids have variably been linked with incomplete studies and prolonged transit times in heterogeneous cohorts. We aimed to investigate the effect of opioid use on WCE for inpatient and outpatient cohorts. Methods. We performed a retrospective review of patients receiving WCE at our institution from April 2010 to March 2013. Demographic data, medical history, and WCE details were collected. Transit times were compared by log-rank analysis. Multivariable logistic regression and Cox proportional hazard models were utilized. Results. We performed 314 outpatient and 280 inpatient WCE that met study criteria. In the outpatient cohort, gastric transit time (GTT was not significantly different between opioid and nonopioid users. Completion rates were similar as well (88% and 87%, P=0.91. In the inpatient cohort, GTT was significantly longer in patients receiving opioids than in patients not receiving opioids (44 versus 23 min, P=0.04, but completion rates were similar (71% versus 75%, P=0.31. Conclusion. Opioid use within 24 hours of WCE did not significantly affect completion rates for inpatients or outpatients. GTT was prolonged in inpatients receiving opioids but not in outpatients.

  6. Single center experience of capsule endoscopy in patients with obscure gastrointestinal bleeding

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    Mahesh Kumar Goenka; Shounak Majumder; Sanjeev Kumar; Pradeepta Kumar Sethy; Usha Goenka

    2011-01-01

    AIM: To identify optimum timing to maximize diagnostic yield by capsule endoscopy (CE) in patients with obscure gastrointestinal bleeding (OGIB).METHODS: We identified patients who underwent CE at our institution from August 2003 to December 2009.Patient medical records were reviewed to determine type of OGIB (occult, overt), CE results and complications,and timing of CE with respect to onset of bleeding.RESULTS: Out of 385 patients investigated for OGIB,284 (74%) had some lesion detected by CE. In 222 patients (58%), definite lesions were detected that could unequivocally explain OGIB. Small bowel ulcer/erosions secondary to Crohn's disease, tuberculosis or non-steroidal anti-inflammatory agent use were the commonest lesions detected. Patients with overt GI bleeding for <48 h before CE had the highest diagnostic yield (87%).This was significantly greater (P < 0.05) compared to that in patients with overt bleeding prior to 48 h (68%),as well as those with occult OGIB (59%).CONCLUSION: We established the importance of early CE in management of OGIB. CE within 48 h of overt bleeding has the greatest potential for lesion detection.

  7. 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.

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

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    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.

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

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    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.

  10. 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.

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

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    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.

  12. 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.

  13. 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

  14. Analysis of a grading system to assess the quality of small-bowel preparation for capsule endoscopy: in search of the Holy Grail

    Science.gov (United States)

    Goyal, Jatinder; Goel, Anshum; McGwin, Gerald; Weber, Frederick

    2014-01-01

    Background: The diagnostic yield of capsule endoscopy is vulnerable to inadequate visualization related to residual bile or chyme remaining in the lumen despite intestinal lavage. It has been challenging to determine the optimal lavage preparation of the bowel and patient diet before capsule endoscopy, as well as the timing of the procedure, because no well-accepted, validated grading system for assessing the quality of intestinal lavage before capsule endoscopy is available. There remains no consensus on the reliability of qualitative, quantitative, or computer-derived assessments of the quality of preparation for capsule endoscopy. This study evaluates intra-observer and interobserver agreement for a previously validated scale. Materials and methods: The digital images of 34 patients who underwent capsule endoscopy were independently reviewed by two blinded physicians according to a previously validated grading scale. One of the physicians reviewed and graded the patients a second time. The quality of the bowel luminal preparation was assessed with a qualitative parameter (fluid transparency) and a more quantitative parameter (mucosal invisibility) for each of three small-intestinal segments, and an overall small-bowel score for each parameter was assigned as well. A weighted kappa coefficient was used to calculate intra-observer (observer 1A and 1B) and interobserver (observer 1A and observer 2) agreement. A kappa value of 0.60 or more suggests strong agreement, 0.40 to 0.60 moderate agreement, and less than 0.40 poor agreement. Results: The intra-observer weighted kappa index for both fluid transparency and mucosal visibility was 0.52, which is consistent with moderate agreement. The interobserver weighted kappa indices for fluid transparency and mucosal invisibility were 0.29 and 0.42, respectively, demonstrating suboptimal interobserver agreement. The individual segment interobserver kappa indices were better for mucosal visibility (0.52, 0.39, and 0.47 for

  15. 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

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    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

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

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    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.

  17. 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.

  18. 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.

  19. Effect of erythromycin on image quality and transit time of capsule endoscopy: A two-center study

    Institute of Scientific and Technical Information of China (English)

    Eva Niv; Ido Bogner; Olga Barkay; Zamir Halpern; Elisabeth Mahajna; Roman Depsames; Yael Kopelman; Zvi Fireman

    2008-01-01

    AIM: To compare the effect of oral erythromycin vs no preparation with prokinetics on the transit time and the image quality of capsule endoscopy (CE) in evaluating small bowel (SB) pathology.METHODS: We conducted a retrospective, blinded (to the type of preparation) review of 100 CE studies,50 with no preparation with prokinetics from one medical center (Group A) and 50 from another center with administration of a single dose of 200 mg oral erythromycin 1 h prior to CE (Group B).Gastric, SB and total transit times were calculated, the presence of bile in the duodenum was scored, as was cleanliness within the proximal, middle and distal intestine.RESULTS: The erythromycin group had a slightly shorter gastric transit time (21 rain vs 28 min, with no statistical significance).SB transit time was similar for both groups (all P > 0.05).Total transit time was almost identical in both groups.The rate of incomplete examination was 16% for Group A and 10% for Group B (P = 0.37).Bile and cleanliness scores in different parts of the intestine were similar for the two groups (P > 0.05).CONCLUSION: Preparation for capsule endoscopy with erythromycin does not affect SB or total transit time.It tends to reduce gastric transit time, but it does not increase the cecum-reaching rate.Erythromycin does not adversely affect image quality.We consider the routine use of oral erythromycin preparation as being unjustified,although it might be considered in patients with known prolonged gastric emptying time.

  20. 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

  1. Wireless fluorescence capsule for endoscopy using single photon-based detection

    Science.gov (United States)

    Al-Rawhani, Mohammed A.; Beeley, James; Cumming, David R. S.

    2015-12-01

    Fluorescence Imaging (FI) is a powerful technique in biological science and clinical medicine. Current FI devices that are used either for in-vivo or in-vitro studies are expensive, bulky and consume substantial power, confining the technique to laboratories and hospital examination rooms. Here we present a miniaturised wireless fluorescence endoscope capsule with low power consumption that will pave the way for future FI systems and applications. With enhanced sensitivity compared to existing technology we have demonstrated that the capsule can be successfully used to image tissue autofluorescence and targeted fluorescence via fluorophore labelling of tissues. The capsule incorporates a state-of-the-art complementary metal oxide semiconductor single photon avalanche detector imaging array, miniaturised optical isolation, wireless technology and low power design. When in use the capsule consumes only 30.9 mW, and deploys very low-level 468 nm illumination. The device has the potential to replace highly power-hungry intrusive optical fibre based endoscopes and to extend the range of clinical examination below the duodenum. To demonstrate the performance of our capsule, we imaged fluorescence phantoms incorporating principal tissue fluorophores (flavins) and absorbers (haemoglobin). We also demonstrated the utility of marker identification by imaging a 20 μM fluorescein isothiocyanate (FITC) labelling solution on mammalian tissue.

  2. Time Series Analysis of the Effectiveness and Safety of Capsule Endoscopy between the Premarketing and Postmarketing Settings: A Meta-Analysis.

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    Kazuo Iijima

    Full Text Available Clinical studies for assessing the effectiveness and safety in a premarketing setting are conducted under time and cost constraints. In recent years, postmarketing data analysis has been given more attention. However, to our knowledge, no studies have compared the effectiveness and the safety between the pre- and postmarketing settings. In this study, we aimed to investigate the importance of the postmarketing data analysis using clinical data.Studies on capsule endoscopy with rich clinical data in both pre- and postmarketing settings were selected for the analysis. For effectiveness, clinical studies published before October 10, 2015 comparing capsule endoscopy and conventional flexible endoscopy measuring the detection ratio of obscure gastrointestinal bleeding were selected (premarketing: 4 studies and postmarketing: 8 studies from PubMed (MEDLINE, Cochrane Library, EMBASE and Web of Science. Among the 12 studies, 5 were blinded and 7 were non-blinded. A time series meta-analysis was conducted. Effectiveness (odds ratio decreased in the postmarketing setting (premarketing: 5.19 [95% confidence interval: 3.07-8.76] vs. postmarketing: 1.48 [0.81-2.69]. The change in odds ratio was caused by the increase in the detection ratio with flexible endoscopy as the control group. The efficacy of capsule endoscopy did not change between pre- and postmarketing settings. Heterogeneity (I2 increased in the postmarketing setting because of one study. For safety, in terms of endoscope retention in the body, data from the approval summary and adverse event reports were analyzed. The incidence of retention decreased in the postmarketing setting (premarketing: 0.75% vs postmarketing: 0.095%. The introduction of the new patency capsule for checking the patency of the digestive tract might contribute to the decrease.Effectiveness and safety could change in the postmarketing setting. Therefore, time series meta-analyses could be useful to continuously monitor the

  3. Upper gastrointestinal endoscopy: expected post-procedural findings and adverse events.

    Science.gov (United States)

    Hanna, Tarek N; Rohatgi, Saurabh; Shekhani, Haris N; Shahid, Fatima; Ojili, Vijayanadh; Khosa, Faisal

    2016-10-01

    Complications related to endoscopy are commonly encountered in the emergency department (ED) due to an increased use of outpatient diagnostic and therapeutic upper gastrointestinal endoscopic procedures. A majority of these procedures are performed on an outpatient basis, and patients with post-procedural symptoms may return to the ED. Since these patients often undergo computed tomography (CT) for diagnosis of post-procedure complications, the emergency radiologist should be familiar with the spectrum of expected post-procedural findings, as well as common and rare complications. We present a pictorial review of post-endoscopy complications and review imaging protocols in different clinical scenarios. PMID:27461259

  4. 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

    OpenAIRE

    A. Caunedo; M. Rodríguez-Téllez; J. M. García-Montes; B. J. Gómez-Rodríguez; Guerrero, J.; J. M. Herrerías Jr.; Pellicer, F.; J. M. Herrerías

    2004-01-01

    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...

  5. Dissecting Lewis score under the light of fecal calprotectin; an analysis of correlation of score components with calprotectin levels in capsule endoscopy

    OpenAIRE

    Koulaouzidis, Anastasios; Nemeth, Artur; Johansson, Gabriele Wurm; Toth, Ervin

    2015-01-01

    Background Lewis Score (LS) is an inflammatory score in small-bowel capsule endoscopy (SBCE). Fecal calprotectin (FC) is considered the non-invasive, ‘gold standard’ marker of gastrointestinal (GI) inflammation. Recently, we reported that LS shows only a moderate correlation with FC. In this study, we aim to evaluate which LS parameters have greater correlation with FC. Methods A retrospective, two-center study; 74 patients who underwent SBCE within 7 (median 1.5) days from a FC measurement. ...

  6. Is Occult Obscure Gastrointestinal Bleeding a Definite Indication for Capsule Endoscopy? A Retrospective Analysis of Diagnostic Yield in Patients with Occult versus Overt Bleeding

    OpenAIRE

    Ikue Watari; Shiro Oka; Shinji Tanaka; Makoto Nakano; Taiki Aoyama; Shigeto Yoshida; Kazuaki Chayama

    2013-01-01

    Background/Aim. Usefulness of capsule endoscopy (CE) for diagnosing small-bowel lesions in patients with obscure gastrointestinal bleeding (OGIB) has been reported. Most reports have addressed the clinical features of overt OGIB, with few addressing occult OGIB. We aimed to clarify whether occult OGIB is a definite indication for CE. Methods. We retrospectively compared the cases of 102 patients with occult OGIB and 325 patients with overt OGIB, all having undergone CE. The diagnostic yield o...

  7. Effectiveness of polaprezinc for low-dose aspirin-induced small-bowel mucosal injuries as evaluated by capsule endoscopy: a pilot randomized controlled study

    OpenAIRE

    Watari, Ikue; Oka, Shiro; Tanaka, Shinji; Aoyama, Taiki; Imagawa, Hiroki; Shishido, Takayoshi; Yoshida, Shigeto; Chayama, Kazuaki

    2013-01-01

    Background Treatment of low-dose aspirin (LDA)-induced small-bowel injury has not been established. Polaprezinc, a chelate of zinc and L-carnosine, may be efficacious for such injury. We conducted a pilot randomized controlled study to investigate whether polaprezinc is effective against LDA-induced small-bowel injuries. Methods Consecutive patients under long-term (>3 months) LDA treatment and who agreed to participate in our study underwent initial capsule endoscopy (CE). Patients with LDA-...

  8. Small bowel cleansing does not improve quality of wireless capsule endoscopy

    DEFF Research Database (Denmark)

    Wilkens, Rune; Langholz, Ebbe; Glerup, Henning

    increasing demand of early diagnosis, WCE becomes more important. However, a drawback is the limited visualization of the mucosa in patients with poor cleansing quality. The aim of our study was to determine the benefit of preparation with Picoprep prior to examination with WCE and evaluate two different...... by Park et al. 2010 [2] with a 3 grade subjective assessment every 5 minutes and Weyenberg et al. 2011 [3] with a computer assessment of cleansing using the colour bar in the capsule reading software. Mean overall score between groups were compared using students ttest. Results We enrolled 135...

  9. Development of a predictive model of Crohn’s disease proximal small bowel involvement in capsule endoscopy evaluation

    Science.gov (United States)

    Rodrigues-Pinto, Eduardo; Cardoso, Helder; Rosa, Bruno; Santos-Antunes, João; Rodrigues, Susana; Marques, Margarida; Lopes, Susana; Albuquerque, Andreia; Carvalho, Pedro; Moreira, Maria; Cotter, José; Macedo, Guilherme

    2016-01-01

    Background and study aims: One of the indications for capsule endoscopy (CE) is the detection of proximal small bowel (SB) involvement in Crohn's disease (CD) patients. Our aim was to assess clinical, laboratory and endoscopic predictors associated with proximal SB involvement in CD patients submitted to CE. Patients and methods: Retrospective multicenter study in which Lewis score (LS) was systematically determined in 190 CE of patients diagnosed with CD between 2003 and 2014. Results: Significant inflammatory activity (LS > 135) was present in 23 % of the patients in the first tertile and in 31 % of the patients in the second tertile. Albumin, haemoglobin, and total proteins were significantly lower in patients with a LS > 790 compared to patients with a LS  0.249 predicts proximal SB involvement with 90 % sensitivity and 40 % specificity (AUROC 0.732). Conclusions: One-third of patients had proximal SB involvement. Predictive factors were significant weight loss, stricturing behaviour, and ileal involvement at ileocolonoscopy. These data help to select CD patients that benefit the most from performing a CE. PMID:27556069

  10. Detection of small bowel tumor based on multi-scale curvelet analysis and fractal technology in capsule endoscopy.

    Science.gov (United States)

    Liu, Gang; Yan, Guozheng; Kuang, Shuai; Wang, Yongbing

    2016-03-01

    Wireless capsule endoscopy (WCE) has been a revolutionary technique to noninvasively inspect gastrointestinal (GI) tract diseases, especially small bowel tumor. However, it is a tedious task for physicians to examine captured images. To develop a computer-aid diagnosis tool for relieving the huge burden of physicians, the intestinal video data from 89 clinical patients with the indications of potential tumors was analyzed. Out of the 89 patients, 15(16.8%) were diagnosed with small bowel tumor. A novel set of textural features that integrate multi-scale curvelet and fractal technology were proposed to distinguish normal images from tumor images. The second order textural descriptors as well as higher order moments between different color channels were computed from images synthesized by the inverse curvelet transform of the selected scales. Then, a classification approach based on support vector machine (SVM) and genetic algorithm (GA) was further employed to select the optimal feature set and classify the real small bowel images. Extensive comparison experiments validate that the proposed automatic diagnosis scheme achieves a promising tumor classification performance of 97.8% sensitivity and 96.7% specificity in the selected images from our clinical data. PMID:26829705

  11. 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.

  12. 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.

  13. 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.

  14. 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

  15. 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.

  16. 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

  17. 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

  18. 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

    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 ...

  19. 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.

  20. 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.

  1. 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.

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

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    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.

  3. 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.

  4. Is Occult Obscure Gastrointestinal Bleeding a Definite Indication for Capsule Endoscopy? A Retrospective Analysis of Diagnostic Yield in Patients with Occult versus Overt Bleeding

    Directory of Open Access Journals (Sweden)

    Ikue Watari

    2013-01-01

    Full Text Available Background/Aim. Usefulness of capsule endoscopy (CE for diagnosing small-bowel lesions in patients with obscure gastrointestinal bleeding (OGIB has been reported. Most reports have addressed the clinical features of overt OGIB, with few addressing occult OGIB. We aimed to clarify whether occult OGIB is a definite indication for CE. Methods. We retrospectively compared the cases of 102 patients with occult OGIB and 325 patients with overt OGIB, all having undergone CE. The diagnostic yield of CE and identification of various lesion types were determined in cases of occult OGIB versus overt OGIB. Results. There was no significant difference in diagnostic yield between occult and overt OGIB. The small-bowel lesions in cases of occult OGIB were diagnosed as ulcer/erosive lesions (n=18, 18%, vascular lesions (n=11, 11%, and tumors (n=4, 3%, and those in cases of overt OGIB were diagnosed as ulcer/erosive lesions (n=51, 16%, vascular lesions (n=31, 10%, and tumors (n=20, 6%. Conclusion. CE detection rates and CE identification of various small-bowel diseases do not differ between patients with occult versus overt OGIB. CE should be actively performed for patients with either occult or overt OGIB.

  5. 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. PMID:26995355

  6. 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.

  7. Circuit Design and Operation of Wireless Capsule Endoscopy Driven by External Magnetic-field%外磁场驱动无线胶囊式内窥镜的电路设计与操作

    Institute of Scientific and Technical Information of China (English)

    叶福丽; 史贵连

    2011-01-01

    目的:利用外磁场驱动无线胶囊式内窥镜,可以使患者吞服的无线肠胃内窥镜在医生的控制下做多自由度的移动,使内窥镜的摄像头直接在可疑区域做有针对性的检查,大大增加了检查的成功率.方法:依靠3组线圈产生的磁场可以对处在任意位置、任意方向的附带有磁性材料的无线胶囊式内窥镜产生作用力.通过改变线圈内电流的大小和方向,操控胶囊内窥镜在人体内的位置以及指向.结果:设计出简单的操作装置,实现线圈的操作,进而实现对无线胶囊式内窥镜的控制.结论:外磁场驱动的无线胶囊式内窥镜减小了内窥镜的整体体积和质量,减轻了肠胃检查时的痛苦,缩短了医生的检查时间,使医生控制其移动更为容易和灵活.%Objective To drive the wireless capsule endoscopy that could be swallowed by the patients by extemal magnetic field so that it could move freely under the control of doctors, which made the vidicon of endoscopy work purposefully in the duhitahle area, and improved the efficiency of check greatly. Methods The magnetic field from three sets of coils could create effect to wireless capsule endoscopy with magnetic material. By controlling coil's circuit and its direction. the wireless endoscopy in body could move to any places and point to any direction. Results The design of operating device controlling coils was given in this paper, and came to realize the aim controlling the moving of wireless endoscopy.Conclusion The wireless capsule endoscopy driven by external magnetic field makes the size and weight of endoscopy less,which alleviates pain in gastroscopy and improves the working efficiency of doctors. [Chinese Medical Equipment Joumal,2011 ,32(4) :28-30

  8. 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.

  9. 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

  10. 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

  11. 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

  12. 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.

  13. 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.

  14. Public opinion survey after capsule endoscopy: patient's point of view on its utility Encuesta de opinión tras estudio con cápsula endoscópica: percepción de su utilidad por el enfermo

    Directory of Open Access Journals (Sweden)

    B. Velayos

    2006-06-01

    Full Text Available Aim: when programming a medical test such as capsule endoscopy (CE, finding the closest point between the patient's experience and his/her expectation is essential to improve any further explorations. For this purpose we designed a form which tries to collect the information required. Material and methods: from December 2003 to January 2005 we examined the small intestine of 98 patients with the help of CE. Later they were sent an anonymous questionnaire in July 2005, which included 10 questions upon the origin and previous knowledge of the patient about this technique, their tolerance to it, and the value they attached to it with regard to finding a new diagnosis and assigning different treatments, and also the incidence in the positive or negative evolution of their disease in particular and of medicine in general. Results: answer rate reached 58% and was slightly higher among women and people over 70 years; 80% of repliers had been informed about CE by a physician, while nearly all the rest had received previous information from the media; 37% had had symptoms for more than 12 months, while only 17% had suffered them for one month before the exploration. A bit over 30% did not know what the specific diagnostic field of the test was (most of them women and young people, although most of them were not surprised by the procedure. Over 75% showed "acceptable" or "excellent" tolerance, while 5.5% (most of them young people found it hard to bear. The opinion about its utility in the diagnosis was 37%, and although 70% thought that CE had revealed nothing new about their pathology, over 60% declared feeling better after the test; 84% pointed out that it had achieved a breakthrough for their quality of life (most of them men and very old people, and only 13% thought it was worthless. However, nearly all the answers agreed in that CE was an "important" or "very important" diagnostic device. Conclusions: after the test using CE, the diagnostic benefit

  15. The Effects Observed of Small Doses of Senna Immersion in the Capsule Endoscopy Bowel Preparation%小剂量番泻叶浸液在胶囊内镜肠道准备中的效果观察

    Institute of Scientific and Technical Information of China (English)

    杨院平; 黄若

    2013-01-01

      Objective To observe the different methods of cleaning effect of bowel preparation before capsule endoscopy. Methods Divided into 40 patients with bowel cleansing method random level magnesium sulfate group (at 4 p.m. of the day before capsule endoscopy drinking 50% magnesium sulfate 25g soluble in water a little firstly, then drinking 500 mL of water within half an hour later, the next day at 5 a.m drinking 50% magnesium sulfate 50g soluble in water a little firstly, then drinking more than 1000 mL of water within half an hour later) and senna-magnesium sulfate group (eating less residue diet two days ago before capsule endoscopy, senna daily 2-3g soaked with water 300 mL after 15 minutes, then drinking the senna immersion replace tea until 12h before check, then like the former group taking the magnesium sulfate). Results Magnesium sulfate group and senna-magnesium group patients all could tolerate the bowel preparation, bowel cleansing excellent rate the magnesium sulfate group of patients was 70%, senna-magnesiu sulfate group was 90%. Conclusion The small dose of senna immersion plus magnesium sulfate oral as bowel preparation method in capsule endoscopy can effectively improve the images clarity and lesion detection rate, worth in clinical popularize.%  目的观察不同方法对胶囊内镜检查前肠道准备的清洁效果。方法将40例患者按肠道清洁方法随机平分为硫酸镁组(检查前1d 下午4点将50%硫酸镁25g 溶于清水少许中饮完,其后半小时内饮水500mL,当日早晨5点50%硫酸镁50g 溶于清水少许中饮完,其后半小时内饮水1000mL 以上)及番泻叶-硫酸镁组(检查前2d 进食少渣饮食,每日番泻叶2~3g 用开水300mL 浸泡15min 后当茶饮用,检查前12h 停服番泻叶,按照前组办法服用硫酸镁)。结果硫酸镁组及番泻叶-硫酸镁组患者均能耐受肠道准备。肠道清洁评分显示硫酸镁组患者优良率为65%,番泻

  16. 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

  17. 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

  18. 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.

  19. 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,

  20. 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.

  1. 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.

  2. Effects of κ-carrageenan on rheological properties of dually modified sago starch: Towards finding gelatin alternative for hard capsules.

    Science.gov (United States)

    Fakharian, Mohammad-Hassan; Tamimi, Nasser; Abbaspour, Hossein; Mohammadi Nafchi, Abdorreza; Karim, A A

    2015-11-01

    Composite sago starch-based system was developed and characterized with the aim to find an alternative to gelatin in the processing of pharmaceutical capsules. Dually modified (Hydrolyzed-Hydroxypropylated) sago starches were combined with κ-carrageenan (0.25, 0.5, 0.75, and 1%). The rheological properties of the proposed composite system were measured and compared with gelatin as reference material. Results show that combination of HHSS12 (Hydrolysed-hydroxypropylated sago starch at 12h) with 0.5% κ-carrageenan was comparable to gelatin rheological behavior in pharmaceutical capsule processing. The solution viscosity at 50 °C and sol-gel transition of the proposed composite system were comparable to those of gelatin. The viscoelastic moduli (G' and G") for the proposed system were lower than those of gelatin. These results illustrate that by manipulation of the constituents of sago starch-based composite system, a suitable alternative to gelatin can be produced with comparable properties and this could find potential application in pharmaceutical capsule industry.

  3. Technical Evolution of Medical Endoscopy

    Directory of Open Access Journals (Sweden)

    S. Gross

    2009-01-01

    Full Text Available This paper gives a summary of the technical evolution of medical endoscopy. The first documented redirection of sunlight into the human body dates back to the 16th century. Rigid tubes with candle light were given a trial later on. Low light intensity forced the development of alternative light sources. Some of these experiments included burning chemical components. Electric lighting finally solved the problems of heat production and smoke. Flexible endoscopy increased the range of medical examinations as it allowed access to tight and angular body cavities. The first cameras for endoscopic applications made taking photos from inside the human body possible. Later on, digital video endoscopy made endoscopes easier to use and allowed multiple spectators to observe the endoscopic intervention. Swallowable capsules called pill-cams made endoscopic examinations of the small intestine possible. Modern technologies like narrow band imaging and fluorescence endoscopy increased the diagnostic significance of endoscopic images. Today, image processing is applied to decrease noise and enhance image quality. These enhancements have made medical endoscopy an invaluable tool in many diagnostic processes. In closing, an example is given of an interdisciplinary examination, which is taken from the archaeological field. 

  4. 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.

  5. 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 selection...... of patients for DBE a pivotal point. The mainstay of this screening examination of the small bowel is capsule endoscopy (CE). The aim of this study was to describe the results of this screening procedure and the subsequent DBE in patients with suspected mid-gastrointestinal bleeding (MGIB). Material...

  6. 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

  7. 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.

  8. 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.

  9. 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.

  10. [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.

  11. 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.

  12. New aspects of modern endoscopy

    Institute of Scientific and Technical Information of China (English)

    Johannes; Wilhelm; Rey; Ralf; Kiesslich; Arthur; Hoffman

    2014-01-01

    The prognosis for patients with malignancies of the ga-strointestinal-tract is strictly dependent on early detec-tion of premalignant and malignant lesions. However, small, flat or depressed neoplastic lesions remain dif-ficult to detect with these technologies thereby limiting their value for polyp and cancer screening. At the same time computer and chip technologies have undergone major technological changes which have greatly im-proved endoscopic diagnostic investigation. New imag-ing modalities and techniques are very notable aspects of modern endoscopy. Chromoendoscopy or filter-aided colonoscopy(virtual chromoendoscopy) with high defi-nition endoscopes is able to enhance the detection and characterization of lesions. Finally, confocal laser en-domicroscopy provides histological confirmation of the presence of neoplastic changes. The developing tech-niques around colonoscopy such as the retro-viewing colonoscope, the balloon-colonoscope or the 330-de-grees-viewing colonoscope try to enhance the efficacy by reducing the adenoma miss rate in right-sided, non-polypoid lesions. Colon capsule endoscopy is limited to identifying cancer and not necessarily small adenomas. Preliminary attempts have been made to introduce this technique in clinical routine.

  13. 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.)

  14. 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.

  15. 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.

  16. 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.

  17. Wireless capsule endo bronchoscopy

    Directory of Open Access Journals (Sweden)

    Baratz DM

    2014-03-01

    Full Text Available No abstract available. Article truncated at 150 words. Case Presentation History of Present Illness A 67 year-old man presents 10 days after swallowing a capsule endoscopy camera that was never retrieved. The wireless capsule was swallowed asymptomatically for evaluation of heme positive stools after negative upper and lower endoscopies. Patient noted that the evening after swallowing the camera he developed mild shortness of breath and cough. The cough and shortness of breath were persistent and worsened while lying down and when moving positions. He denied prior issues with swallowing or aspiration. Review of Systems Negative other than what is noted above. PMH, SH, and FH Past medical history: coronary artery disease, peripheral vascular disease, hyperlipidemia Surgical history: femoral-popliteal bypass, previous shoulder and back surgery Social history: 1 pack/day of cigarettes for 50 years, prior alcohol usage but not current, no illicit drugs Family history: no pulmonary diseases Physical Exam Vital signs: temperature 36.7º C, heart rate 86 beats per minute ...

  18. 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.

  19. Video-based measurements for wireless capsule endoscope tracking

    International Nuclear Information System (INIS)

    The wireless capsule endoscope is a swallowable medical device equipped with a miniature camera enabling the visual examination of the gastrointestinal (GI) tract. It wirelessly transmits thousands of images to an external video recording system, while its location and orientation are being tracked approximately by external sensor arrays. In this paper we investigate a video-based approach to tracking the capsule endoscope without requiring any external equipment. The proposed method involves extraction of speeded up robust features from video frames, registration of consecutive frames based on the random sample consensus algorithm, and estimation of the displacement and rotation of interest points within these frames. The results obtained by the application of this method on wireless capsule endoscopy videos indicate its effectiveness and improved performance over the state of the art. The findings of this research pave the way for a cost-effective localization and travel distance measurement of capsule endoscopes in the GI tract, which could contribute in the planning of more accurate surgical interventions. (paper)

  20. 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...

  1. Neuroendocrine liver metastases: Contributions of endoscopy and surgery to primary tumor search

    Institute of Scientific and Technical Information of China (English)

    Herwig Cerwenka

    2012-01-01

    Neuroendocrine tumors (NETs) are diagnosed with increasing frequency and patients often present with liver metastases at the time of diagnosis.Apart from treatment of the metastases,resection of the primary tumor at an early phase is recommended to prevent complications,although it may be difficult to locate,especially in patients with functionally inactive NETs.Small and multifocal tumors in the jejunum and ileum represent a particular challenge.Primary hepatic neuroendocrine carcinoma is extremely rare and is diagnosed only after exclusion of other primary tumors.Therefore,some uncertainty may remain,as small non-hepatic primary tumors may escape detection.Diagnostic work-up in these patients includes biochemical assays and imaging modalities (also comprising specific techniques of scintigraphy and positron emission tomography).This editorial highlights the contributions of endoscopy and operative exploration to the search for the primary tumor.Besides esophagogastro-duodenoscopy,endoscopic ultrasonography,colonoscopy and bronchoscopy,special endoscopic techniques such as balloon enteroscopy or capsule endoscopy are used with growing experience.Compared with balloon enteroscopy,capsule endoscopy is noninvasive and better tolerated,but it cannot localize a lesion precisely and does not allow biopsy or removal of lesions.Before proceeding to surgery,a discussion of the findings by a tumor board should be a standard procedure.Improvements in diagnostic tools have created new perspectives for the detection of obscure primary tumors in patients with neuroendocrine liver metastases,and these searches are best coordinated by a multidisciplinary team.

  2. 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

    OpenAIRE

    L. Julián-Gómez; Barrio, J.; Izquierdo, R.; P. Gil-Simón; S. Gómez de la Cuesta; Atienza, R.; C. de la Serna; M. Pérez-Miranda; P. Fernández-Orcajo; C. Alcalde; A. Caro-Patón

    2010-01-01

    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 ...

  3. [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.

  4. Quality assurance of endoscopy units.

    Science.gov (United States)

    Stebbing, John F

    2011-06-01

    This chapter reflects on how England has led the world in service development and quality assurance of endoscopy. It draws out themes of leadership, strategic vision and organisational culture. It emphasises the pivotal importance of focussing service improvement on enhancing the quality of a patient's experience of endoscopy. It describes the processes used here for quality assurance of endoscopy units and how these have dovetailed with other strands of work in transforming the English endoscopy service. The chapter presents discussion of the responses to accreditation processes and how the design of the JAG Accreditation process maximises its effectiveness. PMID:21764004

  5. On the Feasibility of Steering Swallowable Microsystem Capsules Using Computer-Aided Magnetic Levitation

    OpenAIRE

    Wu, Billy; Mintchev, Martin

    2008-01-01

    Swallowable capsule endoscopy is used for non-invasive diagnosis of some gastrointestinal (GI) organs. However, control over the position of the capsule is a major unresolved issue. This study presents a design for steering the capsule based on magnetic levitation. The levitation is stabilized with the aid of a computer-aided feedback control system and diamagnetism. Peristaltic and gravitational forces to be overcome were calculated. A levitation setup was built to analyze the fe...

  6. Double-balloon endoscopy and Peutz-Jeghers syndrome: a new look at an old disease.

    Science.gov (United States)

    Terauchi, Stephanie; Snowberger, Noel; Demarco, Daniel

    2006-10-01

    Peutz-Jeghers syndrome is a rare disease characterized by mucocutaneous hyperpigmentation and intestinal hamartomatous polyposis. Life-threatening complications include intestinal obstruction and increased risk of gastrointestinal malignancies. While colonoscopy continues to serve as the gold standard for examination of the colon, newer techniques such as capsule endoscopy and double-balloon endoscopy (DBE) are now being applied to both treatment and surveillance of this disease. Capsule endoscopy serves as a minimally invasive means of locating and characterizing polyps in symptomatic patients but is limited to detection only. DBE allows physicians to visit areas of the small bowel that were previously unreachable by older techniques and to treat lesions that are found. By using DBE to treat polyposis, hemorrhagic ulcers, angiodysplasia, strictures, and cancers, the number of small bowel resections can be decreased in these patients. PMID:17106494

  7. 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

  8. Small-bowel neoplasms in patients undergoing video capsule endoscopy

    DEFF Research Database (Denmark)

    Rondonotti, E; Pennazio, M; Toth, E;

    2008-01-01

    (6), diarrhea with malabsorption (1). The main primary small-bowel tumor type was gastrointestinal stromal tumor (GIST) (32%) followed by adenocarcinoma (20%) and carcinoid (15%); 66% of secondary small-bowel tumors were melanomas. Of the tumors, 80.6% were identified solely on the basis of VCE...

  9. 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...

  10. 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

  11. Endoscopic Evaluation of Swallowing (Endoscopy)

    Science.gov (United States)

    ... the Public / Speech, Language and Swallowing / Swallowing Endoscopic Evaluation of Swallowing (Endoscopy) Do you have problems swallowing? ... air into your throat. This part is called sensory testing. What happens after the test? The SLP ...

  12. 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. PMID:27345649

  13. Lower gastrointestinal endoscopies results

    Directory of Open Access Journals (Sweden)

    Ahmet Bozdağ

    2014-12-01

    Full Text Available Objectives: Endoscopic examinations have great potential in early diagnosis of colorectal adenomas and carcinomas with reducing to colorectal cancer incidence and mortality. We aimed to evaluate for diagnostic purposeful lower gastrointestinal endoscopic procedures in the second step state hospital retrospectively Methods: Between June 2010 and June 2013, we evaluated 278 patients with rectal bleeding, constipation and abdominal pain detected by lower gastrointestinal endoscopic procedures retrospectively. Results: The mean age of the patients was 54.8 ± 16.8 (15-90 year, respectively. 172 (61.9% of the patients were male and 106 (38.1% of the patients were female. 116 (41.7% of the patients was performed rectosigmoidoscopy and 162 (58.3% of the patients was performed colonoscopy. 51(18.3% of our patients were normal. 10 (3.6% of patients had colorectal cancer, 11(3.9% of patients had inflammatory bowel disease, 8 (2.9% of patients had parasitosis, 31(11.1% of patients had colorectal polyps, 12 (4.3% , in patients had diverticular disease, 2 (0.7% patients had rectal ulcer, 25 (9% patients had anal fissure and 159 (57.2% of the patients had hemorrhoidal disease. Conclusion: Lower gastrointestinal endoscopy is a method been the gold standard with a low complication rate and that can be easily applied in the evaluation to pathology of colorectal and anal canal. J Clin Exp Invest 2014; 5 (4: 580-582

  14. 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.

  15. Herniation of the anterior lens capsule

    Directory of Open Access Journals (Sweden)

    Pereira Nolette

    2007-01-01

    Full Text Available Herniation of the anterior lens capsule is a rare abnormality in which the capsule bulges forward in the pupillary area. This herniation can be mistaken for an anterior lenticonus where both the capsule and the cortex bulge forward. The exact pathology behind this finding is still unclear. We report the clinical, ultrasound biomicroscopy (UBM and histopathological findings of a case of herniation of the anterior lens capsule. UBM helped to differentiate this entity from anterior lenticonus. Light microscopy revealed capsular splitting suggestive of capsular delamination and collection of fluid (aqueous in the area of herniation giving it a characteristic appearance.

  16. Diamagnetically stabilized levitation control of an intraluminal magnetic capsule.

    Science.gov (United States)

    Lam, Michael; Mintchev, Martin

    2009-08-01

    Controlled navigation promotes full utilization of capsule endoscopy for reliable real-time diagnosis in the gastrointestinal (GI) tract, but intermittent natural peristalsis can disturb the navigational control, destabilize the capsule and take it out of levitation. The focus of the present work was to develop an economical and effective real-time magnetic capsule-guiding system that can operate in the presence of naturally existing peristalsis while retaining navigational control. A real-size magnetic navigation system that can handle peristaltic forces of up to 1.5 N was designed utilizing the computer-aided design (CAD) system Maxwell 3D (Ansoft, Pittsburg, PA) and was verified using a small-size physical experimental setup. The proposed system contains a pair of 50 cm diameter, 10,000-turn copper electromagnets with a 10 cm x 10 cm ferrous core driven by currents of up to 300 A and can successfully maintain position control over the levitating capsule during peristalsis. The addition of bismuth diamagnetic casing for stabilizing the levitating capsule was also studied. A modeled magnetic field around the diamagnetically cased permanent magnet was shown to be redistributed aligning its interaction with the external electromagnets, thus stabilizing the levitating capsule. In summary, a custom-designed diamagnetically facilitated capsule navigation system can successfully steer an intraluminal magnet-carrying capsule. PMID:19550023

  17. Diamagnetically-stabilized levitation control of an intraluminal magnetic capsule.

    Science.gov (United States)

    Lam, Michael; Mintchev, Martin P

    2008-01-01

    Controlled navigation promotes full utilization of capsule endoscopy for reliable real-time diagnosis in the gastrointestinal (GI) tract, but intermittent natural peristalsis can disturb the navigational control, destabilize the capsule and take it out of levitation. A real-size magnetic navigation system that can handle peristaltic forces of up to 1.5 N was designed utilizing the computer-aided design (CAD) system Maxwell 3D (Ansoft, Pittsburg, PA), and was verified using a small-size physical experimental setup. The proposed system contains a pair of 50-cm in diameter, 10,000-turns copper electromagnets with a 10-cm by 10-cm ferrous core driven by currents of up to 300 Amperes and can successfully maintain position control over the levitating capsule during peristalsis. The addition of Bismuth diamagnetic casing for stabilizing the levitating capsule was also studied. PMID:19163990

  18. SMAC — A Modular Open Source Architecture for Medical Capsule Robots

    OpenAIRE

    Marco Beccani; Ekawahyu Susilo; Christian Di Natali; Pietro Valdastri

    2014-01-01

    The field of Medical Capsule Robots (MCRs) is gaining momentum in the robotics community, with applications spanning from abdominal surgery to gastrointestinal (GI) endoscopy. MCRs are miniature multifunctional devices usually constrained in both size and on-board power supply. The design process for MCRs is time consuming and resource intensive, as it involves the development of custom hardware and software components. In this work, we present the STORM Lab Modular Architecture for Capsules ...

  19. 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. PMID:25376042

  20. IR light source based on LED for endoscopy applications

    OpenAIRE

    Ruiz López, Mabel

    2009-01-01

    Tesina final de master feta en col.laboració amb Transmural Biotech S.L A specific endoscopy technology uses an InfraRed (IR) light to achieve specific imaging of the vascular system. This IR light is obtained by an IR laser source. The aim of this study is to find a new IR illumination built with LEDs to substitute the existing IR source. LEDs may contribute in the endoscopy application with their advantage: LEDs cost is lower than lasers, LEDs have a longer lifetime, LEDs are...

  1. 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.

  2. Findings

    Science.gov (United States)

    ... Brain George Hightower searches for genetic mutations that affect HIV's ability to infect the brain. Read Issue All Issues Explore Findings by Topic Cell Biology Cellular Structures, Functions, Processes, Imaging, Stress Response Chemistry and Biochemistry Enzymes, Molecular Probes, Metabolic ...

  3. 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.

  4. Pneumatic Capsule Pipeline

    OpenAIRE

    ECT Team, Purdue

    2007-01-01

    Pneumatic capsule pipeline (PCP) uses wheeled capsules (vehicles) to carry cargoes through a pipeline filled with air. Modern large diameter PCP systems utilize through flow booster pumps, also known as jet pump injectors. These create the pressure differentials required to propel multiple capsules through a pipeline, while allowing both terminals at atmospheric pressure. This is done by placing a booster pump midway along the pipeline, and designing it in such a way that capsules can bypass ...

  5. 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.

  6. 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.

  7. Adhesive capsulitis of the shoulder: MR arthrography

    International Nuclear Information System (INIS)

    Adhesive capsulitis is a clinical syndrome involving pain and decreased joint motion caused by thickening and contraction of the joint capsule. The purpose of this study is to describe the MR arthrographic findings of this syndrome. Twenty-nine sets of MR arthrographic images were included in the study. Fourteen patients had adhesive capsulitis diagnosed by physical examination and arthrography, and their MR arthrographic findings were compared with those of 15 subjects in the control group. The images were retrospectively reviewed with specific attention to the thickness of the joint capsule, volume of the axillary pouch (length, width, height(depth)), thinkness of the coracohumeral ligament, presence of extra-articular contrast extravasation, and contrst filling of the subcoracoid bursa. Mean capsular thickness measured at the inferior portion of the axillary pouch was 4.1 mm in patients with adhesive capsulitis and 1.5 mm in the control group. The mean width of the axillary pouch was 2.5 mm in patients and 9.5 mm in controls. In patients, the capsule was significantly thicker and the axillary pouch significantly narrower than in controls (p<0.05). Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch (sensitivity 93%, specificity 80%) and a pouch narrower than 3.5 mm (sensitivity 93%, specificity 100%) were useful criteria for the diagnosis of adhesive capsulitis. In patients with this condition, extra-articular contrast extravasation was noted in six patients (43%) and contrast filling of the subcoracoid bursa in three (21%). The MR arthrographic findings of adhesive capsulitis are capsular thickening, a low-volume axillary pouch, extra-articular contrast extravasation, and contrast filling of the subcoracoid bursa. Capsule thickness greater than 2.5 mm at the inferior portion of the axillary pouch and a pouch width of less than 3.5 mm are useful diagnostic imaging characteristics

  8. 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.

  9. Diagnostic Endoscopy in Children of Two Months to 15 Years of Age

    Directory of Open Access Journals (Sweden)

    Seddiqe Amini-Ranjbar

    2009-01-01

    Full Text Available Problem statement: Considering high prevalence of gastrointestinal complaints in children and the important role of endoscopy in the diagnosis of such complaints, this study was designed to characterize the clinical, endoscopic and pathologic features of Iranian children undergoing upper Gastrointestinal (GI endoscopy. Approach: This prospective study was performed in an office-based setting in a private medical centre in Kerman, Iran, between December 2004 to January 2008. Three hundred forty pediatric patients who underwent upper endoscopy for dyspeptic symptoms or other reasons were enrolled into this study and data were gathered concerning age, sex, reason of endoscopy, endoscopy report and pathologic report. Upper GI endoscopy was performed using Pentax video endoscope. Results: The most prevalent reason of performing endoscopy (43.1% was abdominal pain. More than half of the cases with abdominal pain (54% were in the age range of 5-10 year old of whom 80% had an abnormal pathologic finding such as esophgitis and active chronic gastritis associated with helicobacter pylori. The most common endoscopic finding (31.2% and pathologic finding (40.3% was esophagitis. More than half of the children with esophagitis (56.6% had some degrees of hiatal hernia. In 35.5% of children with nodular gastritis, simultaneous esophagitis was observed. The rate of normal endoscopies and pathologies were respectively 10.8 and 19.4%. Conclusion: Considering low rate of normal endoscopic and pathologic reports in the studied subjects and also the variety of gastrointestinal complaints in them, it seems that proper selection of patients for undergoing upper GI endoscopy can have a significant directive role in the diagnosis of pediatric problems.

  10. 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.

  11. Developing the Pediatric Gastrointestinal Endoscopy Unit: A Clinical Report by the Endoscopy and Procedures Committee.

    Science.gov (United States)

    Pall, Harpreet; Lerner, Diana; Khlevner, Julie; Reynolds, Carrie; Kurowski, Jacob; Troendle, David; Utterson, Elizabeth; Evans, Pamela M; Brill, Herbert; Wilsey, Michael; Fishman, Douglas S

    2016-08-01

    There is significant variability in the design and management of pediatric endoscopy units. Although there is information on adult endoscopy units, little guidance is available to the pediatric endoscopy practitioner. The purpose of this clinical report, prepared by the NASPGHAN Endoscopy and Procedures Committee, is to review the important considerations for setting up an endoscopy unit for children. A systematic review of the literature was undertaken in the preparation of this report regarding the design, management, needed equipment, motility setup, billing and coding, and pediatric specific topics. PMID:26974415

  12. 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

  13. [Upper and lower gastrointestinal endoscopy].

    Science.gov (United States)

    Di Giulio, Emilio; Angeletti, Stefano; Desideri, Federico

    2016-06-01

    Recent-years technological innovation has achieved two important objectives: 1) to develop advanced diagnostic tools able to determine with a fair degree of accuracy the nature of a lesion by means of the simple endoscopic observation; 2) to improve the therapeutic approach to lesions, by extending the least-invasive endoscopic treatment also to lesions that in the past were referred to surgery. Advanced diagnostic methodologies have been achieved thanks to the introduction of high definition endoscopes and virtual chromo-endoscopy. Therapeutic innovation is represented by endoscopic sub-mucosal dissection (ESD) that enables the "en bloc" resection of the lesions, thus ensuring a more accurate histological evaluation of their level of infiltration and of the radicality of the resection. These diagnostic and therapeutic methodologies have been applied intensively in Barrett's esophagus, in the early gastric cancer and in the neoplastic lesions of colon-rectum. Concerning the screening of colon-rectum cancer, recent-years literature concentrated on defining the minimal necessary requirements to perform an effective and safe colonoscopy, the so-called "quality endoscopy", for which reference indicators and standards have been set.

  14. [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. PMID:1307994

  15. 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.

  16. 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

  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. 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.

  20. 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

  1. 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).

  2. 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.

  3. Setting up the Pediatric Endoscopy Unit.

    Science.gov (United States)

    Lerner, Diana G; Pall, Harpreet

    2016-01-01

    As pediatric gastrointestinal endoscopy continues to develop and evolve, pediatric gastroenterologists are more frequently called on to develop and direct a pediatric endoscopy unit. Lack of published literature and focused training in fellowship can render decision making about design, capacity, operation, equipment purchasing, and staffing challenging. To help guide management decisions, we distributed a short survey to 18 pediatric gastroenterology centers throughout the United States and Canada. This article provides practical guidance by summarizing available expert opinions on the topic of setting up a pediatric endoscopy unit. PMID:26616893

  4. 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.

  5. Management of adhesive capsulitis

    OpenAIRE

    Neviaser, Andrew

    2015-01-01

    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 cri...

  6. 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.

  7. A Prototype Design of a Wireless Capsule Endoscope

    Directory of Open Access Journals (Sweden)

    Y. Chan

    2006-01-01

    Full Text Available Diseases of the gastrointestinal tract, such as intestinal bleeding and ulceration, are very common. To determine the location of the disease, as well as to diagnose the problem, endoscopy is performed. A wireless capsule endoscope is a pill-sized device that is easily swallowed by the patient. It is equipped with a camera and a wireless transmitter so that as it travels through the patient's gastrointestinal tract, it takes pictures or video images of the tract and transmits the information out of the patient's body. This article discusses the possible solutions and challenges of a wireless capsule endoscope in terms of the choice of wireless frequency and circuit components. A prototype is built with commercially available components to demonstrate the concept of the device.

  8. [3D virtual endoscopy of heart].

    Science.gov (United States)

    Du, Aan; Yang, Xin; Xue, Haihong; Yao, Liping; Sun, Kun

    2012-10-01

    In this paper, we present a virtual endoscopy (VE) for diagnosis of heart diseases, which is proved efficient and affordable, easy to popularize for viewing the interior of the heart. The dual source CT (DSCT) data were used as primary data in our system. The 3D structure of virtual heart was reconstructed with 3D texture mapping technology based on graphics processing unit (GPU), and could be displayed dynamically in real time. When we displayed it in real time, we could not only observe the inside of the chambers of heart but also examine from the new angle of view by the 3D data which were already clipped according to doctor's desire. In the pattern of observation, we used both mutual interactive mode and auto mode. In the auto mode, we used Dijkstra Algorithm which treated the 3D Euler distance as weighting factor to find out the view path quickly, and, used view path to calculate the four chamber plane. PMID:23198444

  9. Guidelines for designing a digestive disease endoscopy unit: report of the World Endoscopy Organization.

    Science.gov (United States)

    Mulder, Chris J J; Jacobs, Maarten A J M; Leicester, Roger J; Nageshwar Reddy, D; Shepherd, Libby E A; Axon, Anthony T; Waye, Jerome D

    2013-07-01

    A dedicated digestive disease endoscopy unit is structurally and functionally differentiating rapidly as a result of increasing diagnostic and therapeutic possibilities in the last 10-20 years. Publications with practical details are scarce, imposing a challenge in the construction of such a unit. The lack of authoritative information about endoscopy unit design means that architects produce their own design with or without consulting endoscopists working in such a unit. A working group of the World Endoscopy Organization discussed and outlined a practical approach fordesign and construction of a modern endoscopy unit. Designing the layout is extremely important, necessitating thoughtful planning to provide comfort to the endoscopy staff and patients, and efficient data archiving and transmission during endoscopic services. PMID:23701732

  10. 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.

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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.

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

    Science.gov (United States)

    Uedo, Noriya; Yao, Kenshi

    2016-01-01

    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. PMID:27573777

  1. 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

  2. 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.

  3. Zoonotic Ancylostoma ceylanicum Infection Detected by Endoscopy

    OpenAIRE

    Ngui, Romano; Lim, Yvonne A. L.; Ismail, Wan Hafiz Wan; Lim, Kie Nyok; Mahmud, Rohela

    2014-01-01

    We report a case of Ancylostoma ceylanicum infection detected by endoscopy. It was diagnosed and confirmed using polymerase chain reaction (PCR) and DNA sequencing. The patient is a 58-year-old Malaysian woman who lives in a rural area, where uncontrolled populations of stray and semidomesticated dogs live in close proximity with humans.

  4. 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.

  5. 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.

  6. 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 

  7. 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.

  8. 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.

  9. 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.

  10. 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

  11. Transnasal endoscopy-assisted skull base surgery.

    Science.gov (United States)

    Stamm, Aldo M

    2006-09-01

    Skull base surgery (SBS), which originated in the 19th century, became refined in the 20th century in parallel with technological advancements and is now in the midst of further refinements largely driven by advances in endoscopic sinus surgery. With the development of modern SBS, lesions that were once inoperable and potentially fatal can now be eradicated successfully by means of endoscopy-assisted procedures that reduce or completely eliminate intracranial trauma, minimize postsurgical morbidity, and make full recovery possible. It is absolutely mandatory to have the appropriate instrumentation for endoscopy-assisted SBS. Among the new technologies available are advanced endoscopes, high-speed suction irrigation drills, digital video cameras, computed tomography and magnetic resonance imaging, and systems for 3-dimensional computer-assisted image-guided surgical navigation. An experienced endoscopic surgeon working with multidisciplinary teams, and using new instrumentation and techniques, can bring SBS to new levels of success in the 21st century. PMID:17040018

  12. Biopsies in Gastrointestinal Endoscopy: When and How

    Directory of Open Access Journals (Sweden)

    Armando Peixoto

    2016-01-01

    Full Text Available Gastrointestinal endoscopy and the acquisition of tissue samples are essential for the diagnosis and treatment of various diseases of the digestive system. However, given the differences between the recommendations and the clinical practice, the inexorable increase of requests for endoscopic examinations and the financial burden associated with it, it is crucial that we concentrate on the challenge that endoscopic biopsies represent. In this review we describe the available evidence in the literature, including the more recent published guidelines, on when or not to perform endoscopic biopsies in upper and lower endoscopy, focusing on the precise diagnosis of the most common gastrointestinal diseases that motivate endoscopic examinations and on the rational use of available resources without compromising proper management of patients.

  13. 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.

  14. How to Improve the Quality of Screening Endoscopy in Korea: National Endoscopy Quality Improvement Program.

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

    In Korea, gastric cancer screening, either esophagogastroduodenoscopy or upper gastrointestinal series (UGIS), is performed biennially for adults aged 40 years or older. Screening endoscopy has been shown to be associated with localized cancer detection and better than UGIS. However, the diagnostic sensitivity of detecting cancer is not satisfactory. The National Endoscopy Quality Improvement (QI) program was initiated in 2009 to enhance the quality of medical institutions and improve the effectiveness of the National Cancer Screening Program (NCSP). The Korean Society of Gastrointestinal Endoscopy developed quality standards through a broad systematic review of other endoscopic quality guidelines and discussions with experts. The standards comprise five domains: qualifications of endoscopists, endoscopic unit facilities and equipment, endoscopic procedure, endoscopy outcomes, and endoscopic reprocessing. After 5 years of the QI program, feedback surveys showed that the perception of QI and endoscopic practice improved substantially in all domains of quality, but the quality standards need to be revised. How to avoid missing cancer in endoscopic procedures in daily practice was reviewed, which can be applied to the mass screening endoscopy. To improve the quality and effectiveness of NCSP, key performance indicators, acceptable quality standards, regular audit, and appropriate reimbursement are necessary. PMID:27484810

  15. 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

  16. Nurse endoscopy in a district general hospital.

    OpenAIRE

    Goodfellow, P B; Fretwell, I. A.; Simms, J M

    2003-01-01

    INTRODUCTION: This study describes the first full year of independent practice by a newly appointed nurse endoscopist in a district general hospital. PATIENTS AND METHODS: Patients underwent either 'one stop' flexible sigmoidoscopy and barium enema or flexible sigmoidoscopy alone. Barium enema results, video photography, clinical follow-up, and histology were used to validate the results of the flexible sigmoidoscopy. One stop clinic: 161 endoscopies were performed, with 104 female patients (...

  17. Panic Attack during Elective Gastrointestinal Endoscopy

    OpenAIRE

    Charalampos Mitsonis; Nikolaos Dimopoulos; Marianna Zavrou; Vassiliki Psarra; Christos Giofkos; Christos Fiorakis; Athanasios Dimitriadis; Dimitrios Valavanis; Eleni Vousoura; Iannis Zervas; Efstathios Papavassiliou

    2011-01-01

    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 outpatie...

  18. Biopsies in Gastrointestinal Endoscopy: When and How

    OpenAIRE

    Armando Peixoto; Marco Silva; Pedro Pereira; Guilherme Macedo

    2016-01-01

    Gastrointestinal endoscopy and the acquisition of tissue samples are essential for the diagnosis and treatment of various diseases of the digestive system. However, given the differences between the recommendations and the clinical practice, the inexorable increase of requests for endoscopic examinations and the financial burden associated with it, it is crucial that we concentrate on the challenge that endoscopic biopsies represent. In this review we describe the available evidence in the li...

  19. 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

  20. Acquiring and maintaining competency in gastrointestinal endoscopy.

    Science.gov (United States)

    Dubé, Catherine; Rostom, Alaa

    2016-06-01

    In recent years, an important transformation has taken place in the field of gastrointestinal endoscopy training. Two important movements have helped initiate this transformation: patient centered quality and competency based training. Patient centered quality in endoscopy became an important focus for colorectal cancer screening programs, as it was acknowledged that colonoscopy services played a central role in the outcomes of screening. This prompted the need to close the quality loop through the development of innovative endoscopist training and upskilling programs. As well, the importance of leadership skills and leadership training was highlighted as a key factor in effective quality improvement. Competency-based training depends on well-defined goals of training and on the regular documentation and review of the learner's progress. This is facilitated by objective assessment and performance enhancing feedback, enabled by measurement tools that can provide a quantitative or qualitative assessment and identify areas in need of further development. Simulators and scope imagers can aid the acquisition of technical skills, particularly in the novice phase. These important advances in our evolving concepts around endoscopy training have also raised many questions, highlighting important knowledge gaps which, we hope, will be addressed in coming years. PMID:27345643

  1. Correlation of narrow band imaging endoscopy and histopathology in the diagnosis of nonerosive reflux disease

    Directory of Open Access Journals (Sweden)

    P Arul

    2015-01-01

    Full Text Available Background /Aim: Narrow band imaging (NBI is a novel, innovative high-resolution endoscopic technique, which utilizes spectral narrow band filter for the visualization of mucosal patterns and microvasculature. Nonerosive reflux disease (NERD is a type of gastroesophageal reflux disease (GERD and it is characterized by reflux symptoms without mucosal breaks on white light endoscopy (WLE. Biopsies from distal esophagus of GERD patients show group of histologic features such as basal cell hyperplasia, elongation of lamina propria papillae, and inflammatory cells. The present study was undertaken to evaluate diagnostic utility of NBI endoscopy and biopsy study in NERD patients and also to correlate NBI endoscopy findings with histologic features of GERD. Patients and Methods: A total of 71 cases of NERD having symptom score more than 10 and those not having erosion on WLE were recruited prospectively and underwent NBI endoscopic examination. Two mucosal biopsies were taken at 3 cm above the squamocolumnar junction. Results: Histologic features of GERD were seen in 50 (70.4% out of 71 cases. No significant correlation between NBI endoscopic findings with histologic features of GERD was found. Conclusion: The present study showed that histopathologic evaluation of distal esophageal mucosa has promising diagnostic value over NBI endoscopy in NERD patients. Use of newly introduced NBI technique requires tremendous familiarity for the detection of the cases of NERD, which show histologic features of GERD.

  2. 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.

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

    OpenAIRE

    Suceveanu Andra Iulia; Mazilu Laura; Suceveanu A.; Paris S.; Voinea F.; Parepa Irinel; Catrinoiu Doina

    2014-01-01

    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 ...

  4. 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

  5. Lossless and Low-Power Image Compressor for Wireless Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Tareq Hasan Khan

    2011-01-01

    Full Text Available We present a lossless and low-complexity image compression algorithm for endoscopic images. The algorithm consists of a static prediction scheme and a combination of golomb-rice and unary encoding. It does not require any buffer memory and is suitable to work with any commercial low-power image sensors that output image pixels in raster-scan fashion. The proposed lossless algorithm has compression ratio of approximately 73% for endoscopic images. Compared to the existing lossless compression standard such as JPEG-LS, the proposed scheme has better compression ratio, lower computational complexity, and lesser memory requirement. The algorithm is implemented in a 0.18 μm CMOS technology and consumes 0.16 mm × 0.16 mm silicon area and 18 μW of power when working at 2 frames per second.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. Upper gastrointestinal endoscopy — a view from general practice

    OpenAIRE

    Jones, Roger

    1986-01-01

    An open-access upper gastrointestinal endoscopy service for general practitioners is described. Between July 1981 and May 1985, 391 endoscopies were performed on 354 patients. In contrast to the results of other studies, demand for endoscopy and the pick-up rate for major lesions has remained steady, and the number of requests for barium meals has fallen by almost a quarter. Major lesions — cancer, gastric and duodenal ulcers and severe oesophagitis — were found in 33% of patients. Oesophagit...

  11. 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.

  12. 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

  13. Gastrothorax following upper gastrointestinal tract endoscopy

    OpenAIRE

    Ahmed, AlaEldin Hassan; Elsayed, Muaz Abdellatif

    2009-01-01

    A 27-year-old man presented with vomiting and breathlessness for 1 day, 5 days after upper gastrointestinal tract endoscopy. On admission, the patient was breathless but not cyanosed; he had sinus tachycardia (heart rate 110 beats/min) and was normotensive (blood pressure 120/75 mm Hg). There were signs of mediastinal shift to the right. There were no breath sounds over the left side of the chest but normal breath sounds were heard to the right of the sternum. His chest x ray, CT scan of the ...

  14. Optoacoustic endoscopy in curved scanning mode

    Science.gov (United States)

    He, Hailong; Buehler, Andreas; Ntziachristos, Vasilis

    2016-03-01

    Optoacoustic technique has been shown to resolve anatomical, functional and molecular features at depths that go beyond the reach of epi-illumination optical microscopy offering new opportunities for endoscopic imaging. Herein, we interrogate the merits of optoacoustic endoscopy implemented by translating a sound detector in linear or curved geometries. The linear and curved detection geometries are achieved by employing an intravascular ultrasound transducer (IVUS) within a plastic guide shaped to a line or a curve. This concept could be used together with optical endoscopes to yield hybrid optical and optoacoustic imaging.

  15. 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.

  16. Evolution of gastrointestinal endoscopy in the mainland of China

    Institute of Scientific and Technical Information of China (English)

    BAI Yu; LI Zhao-shen

    2009-01-01

    @@ INVENTION OF GASTROINTESTINAL ENDOSCOPY Gastrointestinal endoscopy is an important diagnostic and therapeutic tool in our daily medical practice. The evolution of endoscopic technologies from simple tubes to the flexible scopes of today was achieved by cooperation between physicians, surgeons, technicians, and manufactures.

  17. 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

  18. 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.

  19. Panic Attack during Elective Gastrointestinal Endoscopy.

    Science.gov (United States)

    Mitsonis, Charalampos; Dimopoulos, Nikolaos; Zavrou, Marianna; Psarra, Vassiliki; Giofkos, Christos; Fiorakis, Christos; Dimitriadis, Athanasios; Valavanis, Dimitrios; Vousoura, Eleni; Zervas, Iannis; Papavassiliou, Efstathios

    2011-01-01

    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, P < 0.05; and 43.68 ± 6.95 versus 39.86 ± 7.46, P < 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. PMID:22007196

  20. 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.

  1. 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.

  2. Simulating Space Capsule Water Landing with Explicit Finite Element Method

    Science.gov (United States)

    Wang, John T.; Lyle, Karen H.

    2007-01-01

    A study of using an explicit nonlinear dynamic finite element code for simulating the water landing of a space capsule was performed. The finite element model contains Lagrangian shell elements for the space capsule and Eulerian solid elements for the water and air. An Arbitrary Lagrangian Eulerian (ALE) solver and a penalty coupling method were used for predicting the fluid and structure interaction forces. The space capsule was first assumed to be rigid, so the numerical results could be correlated with closed form solutions. The water and air meshes were continuously refined until the solution was converged. The converged maximum deceleration predicted is bounded by the classical von Karman and Wagner solutions and is considered to be an adequate solution. The refined water and air meshes were then used in the models for simulating the water landing of a capsule model that has a flexible bottom. For small pitch angle cases, the maximum deceleration from the flexible capsule model was found to be significantly greater than the maximum deceleration obtained from the corresponding rigid model. For large pitch angle cases, the difference between the maximum deceleration of the flexible model and that of its corresponding rigid model is smaller. Test data of Apollo space capsules with a flexible heat shield qualitatively support the findings presented in this paper.

  3. Metallic stent insertion with double-balloon endoscopy for malignant afferent loop obstruction

    OpenAIRE

    Fujii, Masakuni; Ishiyama, Shuhei; Saito, Hiroaki; Ito, Mamoru; Fujiwara, Akiko; Niguma, Takefumi; Yoshioka, Masao; Shiode, Junji

    2015-01-01

    Progress in double-balloon endoscopy (DBE) has allowed for the diagnosis and treatment of disease in the postoperative bowel. For example, a short DBE, which has a 2.8 mm working channel and 152 cm working length, is useful for endoscopic retrograde cholangiopancreatography in bowel disease patients. However, afferent loop and Roux-limb obstruction, though rare, is caused by postoperative recurrence of biliary tract cancer with intractable complications. Most of the clinical findings involvin...

  4. Adhesive capsulitis: a case report

    OpenAIRE

    Kazemi, Mohsen

    2000-01-01

    Adhesive capsulitis or frozen shoulder is an uncommon entity in athletes. However, it is a common cause of shoulder pain and disability in the general population. Although it is a self limiting ailment, its rather long, restrictive and painful course forces the affected person to seek treatment. Conservative management remains the mainstay treatment of adhesive capsulitis. This includes chiropractic manipulation of the shoulder, therapeutic modalities, mobilization, exercise, soft tissue ther...

  5. Deformability-based capsule sorting

    Science.gov (United States)

    Le Goff, Anne; Munier, Nadege; Maire, Pauline; Edwards-Levy, Florence; Salsac, Anne-Virginie

    2015-11-01

    Many microfluidic devices have been developed for cancer diagnosis applications, most of which relying on costly antibodies. Since some cancer cells display abnormal mechanical properties, new sorting tools based on mechanical sensing are of particular interest. We present a simple, passive pinched flow microfluidic system for capsule sorting. The device consists of a straight microchannel containing a cylindrical obstacle. Thanks to a flow-focusing module placed at the channel entrance, capsules arrive well-centered in the vicinity of the obstacle. Pure size-sorting can be achieved at low shear rate. When increasing the shear rate, capsules are deformed in the narrow space between the pillar and the wall. The softer the capsule, the more tightly it wraps around the obstacle. After the obstacle, streamlines diverge, allowing for the separation between soft capsules, that follow central streamlines, and stiff capsules, that drift away from the obstacle with a wider angle. This proves that we have developed a flexible multipurpose sorting microsystem based on a simple design.

  6. Pneumatic capsule pipeline system

    Energy Technology Data Exchange (ETDEWEB)

    Murphy, J.; Partyka, J.; Rudd, L. [Laurentian Univ., School of Engineering, Sudbury, ON (Canada)

    2001-03-01

    With the rising cost of transporting ores and concentrates, alternatives to the traditional means of transportation by rail, trucks and hoists are being actively sought, as a means of reducing operating costs. Pneumatic encapsulated pipeline (PCP) transportation of raw, processed, or waste materials is being looked upon as a potentially viable alternative for material handling in the mining industry. There are several operating PCP systems in Europe and in Japan, although there are as yet no similar applications in North America. To evaluate the viability of pneumatic capsule pipeline systems, a 600 mm diameter, 70 m long pilot PCP plant, made of rigid fibreglass, was constructed at Laurentian University and several tests have already been conducted. It was found that any bulk material can be transported by PCP safely, with relatively small amounts of power, over long distances, and at a significantly reduced cost, while maintaining complete control. Both underground as well as surface applications appear to be viable. This paper concentrates on the results of experiments designed to test the energy requirements of a PCP system. Future studies should focus on exploring and improving the ability of PCP systems to transport vertically which would be a great advantage to hauling ore from underground mines to the surface. 3 refs., 2 tabs., 14 figs.

  7. Small bowel capsule endoscopy: Where are we after almost15 years of use?

    Institute of Scientific and Technical Information of China (English)

    Cedric Van de Bruaene; Danny De Looze; Pieter Hindryckx

    2015-01-01

    The development of capsule endoscopy (CE) in 2001has given gastroenterologists the opportunity toinvestigate the small bowel in a non-invasive way. CE ismost commonly performed for obscure gastrointestinalbleeding, but other indications include diagnosis orfollow-up of Crohn's disease, suspicion of a smallbowel tumor, diagnosis and surveillance of hereditarypolyposis syndromes, Nonsteroidal anti-inflammatorydrug-induced small bowel lesions and celiac disease.Almost fifteen years have passed since the release ofthe small bowel capsule. The purpose of this reviewis to offer the reader a brief but complete overviewon small bowel CE anno 2014, including the technicaland procedural aspects, the possible complications andthe most important indications. We will end with somefuture perspectives of CE.

  8. A case of acquired laryngomalacia in an infant, with endoscopy before and after establishing the diagnosis for the first time.

    Science.gov (United States)

    Gazzaz, Malak Jamal; El-Hakim, Hamdy

    2015-01-01

    A 12-week-old infant girl born at 27 weeks gestation, with multiple comorbidities, was referred to the paediatric otolaryngology team due to stridor and feeding difficulties. Initial airway endoscopy was performed, showing no abnormal findings. The infant underwent frequent hospitalisations for recurrent cyanotic spells. Despite initial laryngoscopy and bronchoscopy not showing abnormalities, a repeat endoscopy demonstrated laryngomalacia, significant enough to require a supraglottoplasty. This is the first report to confirm, with video evidence, that some cases of laryngomalacia are acquired rather than congenital, even in infancy. PMID:26628452

  9. 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...

  10. Computed tomography virtual endoscopy with angiographic imaging for the treatment of type Ⅳ-A choledochal cyst

    Institute of Scientific and Technical Information of China (English)

    Akihiko Tsuchida; Yuichi Nagakawa; Kazuhiko Kasuya; Bunso Kyo; Takahisa Ikeda; Yoshiaki Suzuki; Tatsuya Aoki

    2012-01-01

    Type Ⅳ-A choledochal cysts (CCs) are a congenital biliary anomaly which involve dilatation of the extrahepatic and intrahepatic bile ducts.We present the case of a 30-year-old woman with type Ⅳ-A CC,on whom threedimensional computed tomography (3D CT) and virtual endoscopy were performed.3D CT revealed partial dilatation in the posterior branch of the intrahepatic bile duct and a relative stricture between it and the extrahepatic bile duct.Virtual endoscopy showed that this stricture was membrane-like and separated from the surrounding blood vessels.Based on these image findings,complete cyst resection,bile duct plasty for the stricture,and hepaticojejunostomy were safely performed.To the best of our knowledge,there are no reports of imaging by virtual endoscopy of the biliarytract which show the surrounding blood vessels running along the bile duct.

  11. Gastrothorax following upper gastrointestinal tract endoscopy.

    Science.gov (United States)

    Ahmed, Alaeldin Hassan; Elsayed, Muaz Abdellatif

    2009-01-01

    A 27-year-old man presented with vomiting and breathlessness for 1 day, 5 days after upper gastrointestinal tract endoscopy. On admission, the patient was breathless but not cyanosed; he had sinus tachycardia (heart rate 110 beats/min) and was normotensive (blood pressure 120/75 mm Hg). There were signs of mediastinal shift to the right. There were no breath sounds over the left side of the chest but normal breath sounds were heard to the right of the sternum. His chest x ray, CT scan of the chest and a barium meal study revealed gastrothorax. He was operated on and at surgery the stomach and ascending colon were found herniating into the chest through a posterolateral defect of the left hemidiaphragm. These were moved back to the abdomen and the diaphragmatic defect was closed. The patient made an uneventful recovery and remained well when seen in the clinic 2 months following surgery. PMID:22140411

  12. Optimisation of a Horizontal Capsule Transporting Pipeline carrying Cylindrical Capsules

    Science.gov (United States)

    Asim, Taimoor; Mishra, Rakesh; Kollar, Laszlo; Ubbi, Kuldip

    2012-05-01

    Pipelines carrying fluids and slurries are quite common. The third-generation pipelines carrying spherical or cylindrical capsules (hollow containers) filled with minerals or other materials including hazardous liquids are rather a new concept. These pipelines need to be designed optimally for commercial viability. An optimal design of such a pipeline results in minimum pressure drop in the pipeline. This corresponds to minimum head loss and hence minimum pumping power required to drive the capsules and the transporting fluid. This study uses a rigorous approach to predict pumping cost based on Computational Fluid Dynamics (CFD) and hence optimize the design of the capsule transporting pipelines. Pressure drop relationship developed has been incorporated to calculate the pumping requirements for the system. Based on the least-cost principle, a methodology has been developed for the determination of the optimal diameter of cylindrical capsule carrying hydraulic pipeline. This procedure can be applied to obtain the optimal size of the capsule pipeline for minimum pumping and capital costs.

  13. 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.

  14. 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…

  15. Automated segmentation and characterization of esophageal wall in vivo by tethered capsule optical coherence tomography endomicroscopy.

    Science.gov (United States)

    Ughi, Giovanni J; Gora, Michalina J; Swager, Anne-Fré; Soomro, Amna; Grant, Catriona; Tiernan, Aubrey; Rosenberg, Mireille; Sauk, Jenny S; Nishioka, Norman S; Tearney, Guillermo J

    2016-02-01

    Optical coherence tomography (OCT) is an optical diagnostic modality that can acquire cross-sectional images of the microscopic structure of the esophagus, including Barrett's esophagus (BE) and associated dysplasia. We developed a swallowable tethered capsule OCT endomicroscopy (TCE) device that acquires high-resolution images of entire gastrointestinal (GI) tract luminal organs. This device has a potential to become a screening method that identifies patients with an abnormal esophagus that should be further referred for upper endoscopy. Currently, the characterization of the OCT-TCE esophageal wall data set is performed manually, which is time-consuming and inefficient. Additionally, since the capsule optics optimally focus light approximately 500 µm outside the capsule wall and the best quality images are obtained when the tissue is in full contact with the capsule, it is crucial to provide feedback for the operator about tissue contact during the imaging procedure. In this study, we developed a fully automated algorithm for the segmentation of in vivo OCT-TCE data sets and characterization of the esophageal wall. The algorithm provides a two-dimensional representation of both the contact map from the data collected in human clinical studies as well as a tissue map depicting areas of BE with or without dysplasia. Results suggest that these techniques can potentially improve the current TCE data acquisition procedure and provide an efficient characterization of the diseased esophageal wall. PMID:26977350

  16. 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.

  17. Virtual endoscopy using spiral CT in patients with carcinomas of the hypopharynx and larynx

    Energy Technology Data Exchange (ETDEWEB)

    Song, Sang Gook; Seo, Jeong Jin; Chung, Tae Woong; Kim, Hyeong Kil; Jeong, Gwang Woo; Jeong, Yong Yeon; Kang, Heoung Keun; Cho, Jae Sik [Medical School, Chonnam University, Kwangju (Korea, Republic of)

    2000-05-01

    To compare the usefulness of virtual endoscopy using spiral CT with that of laryngoscopy in the detection and evaluation of laryngeal and pharyngeal carcinomas. Twenty-four patients with pathologically proven laryngeal and pharyngeal carcinomas underwent laryngoscopy and virtual endoscopy using spiral CT. Eleven of the carcinomas were supraglottic, five were glottic, and eight were hypopharyngeal. Source images obtained by spiral CT were transmitted to an independent workstation and virtual endoscopic images were obtained using Navigator software. These were graded according to their quality (good, fair, bad), and were interpreted by two radiologists who were blinded to the conventional endoscopic findings. These latter were subsequently compared with the virtual endoscopic findings in terms of similarity to laryngoscopic examination and detectability of lesions. The overall image quality of virtual endoscopy was good in 16 cases (67%), fair in eight (33%), and bad in no case. Among the 11 supraglottic carcinomas, image quality was good in seven cases (64%), and fair in four (36%). In four of the five glottic carcinomas (80%) quality was good, and in one case (20%) it was fair, while among the eight hypopharyngeal carcinomas, quality was good in five cases (63%), and fair in three (37%). Overall, detection of the lesion was possible in 23 cases (96%). Due to the small size of the lesion, the one case of glottic carcinoma was not detected. Virtual endoscopy using spiral CT is a safe and noninvasive method, and also successfully detects laryngeal and pharyngeal lesions, with good image quality. For the evaluation of laryngeal and hypopharyngeal carcinoma, its use ma complement that of axial CT. (author)

  18. Computerisation of endoscopy reports using standard reports and text blocks

    NARCIS (Netherlands)

    M.J.M. Groenen (Marcel); E.J. Kuipers (Ernst); G.P. van Berge Henegouwen (Gerard); P. Fockens (Paul); R.J.T. Ouwendijk (Rob)

    2006-01-01

    textabstractBACKGROUND: The widespread use of gastrointestinal endoscopy for diagnosis and treatment requires effective, standardised report systems. This need is further increased by the limited storage of images, and by the need for structured databases for surveillance and epide

  19. 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

  20. 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.

  1. 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...

  2. 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.

  3. Triggered Release from Polymer Capsules

    Energy Technology Data Exchange (ETDEWEB)

    Esser-Kahn, Aaron P. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry; Odom, Susan A. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry; Sottos, Nancy R. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Materials Science and Engineering; White, Scott R. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Aerospace Engineering; Moore, Jeffrey S. [Univ. of Illinois, Urbana, IL (United States). Beckman Inst. for Advanced Science and Technology and Dept. of Chemistry

    2011-07-06

    Stimuli-responsive capsules are of interest in drug delivery, fragrance release, food preservation, and self-healing materials. Many methods are used to trigger the release of encapsulated contents. Here we highlight mechanisms for the controlled release of encapsulated cargo that utilize chemical reactions occurring in solid polymeric shell walls. Triggering mechanisms responsible for covalent bond cleavage that result in the release of capsule contents include chemical, biological, light, thermal, magnetic, and electrical stimuli. We present methods for encapsulation and release, triggering methods, and mechanisms and conclude with our opinions on interesting obstacles for chemically induced activation with relevance for controlled release.

  4. Cardiorespiratory compromise under conscious sedation during upper gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    To compare the cardiorespiratory effects of benzodiazepine and midazolam used for sedation in patients undergoing upper gastrointestinal endoscopy with cardiorespiratory changes in the non-sedated patients. A total of 252 adult patients without previous cardiorespiratory co-morbidity, undergoing upper gastrointestinal endoscopy were recruited. They were randomly allocated in to group I (placebo with saline administration), group II (diazepam administered) and group III (midazolam administered). The pulse rate, blood pressure, ECG and peripheral oxygen saturation (SpO/sub 2/ ) was noted at baseline, after pre-medication, during endoscopy and post endoscopy. Statistical analysis was done by paired t-test, Chi-square test and ANOVA as applicable. There was no difference in baseline record of the three groups. Significant fall in SpO/sub 2/ was noted in all the groups, more marked in the sedated one during endoscopy. Tachycardia developed in all the three groups and settled within 5 minutes of endoscopy. Blood pressure remained more stable in the sedated group. ECG changes included atrial and ventricular premature contraction in all the three groups. (author)

  5. The double capsules in macro-textured breast implants.

    Science.gov (United States)

    Giot, Jean-Philippe; Paek, Laurence S; Nizard, Nathanael; El-Diwany, Mostafa; Gaboury, Louis A; Nelea, Monica; Bou-Merhi, Joseph S; Harris, Patrick G; Danino, Michel A

    2015-10-01

    Breast implants are amongst the most widely used types of permanent implants in modern medicine and have both aesthetic and reconstructive applications with excellent biocompatibility. The double capsule is a complication associated with textured prostheses that leads to implant displacement; however, its etiology has yet to be elucidated. In this study, 10 double capsules were sampled from breast expander implants for in-depth analysis; histologically, the inner capsular layer demonstrated highly organized collagen in sheets with delamination of fibers. At the prosthesis interface (PI) where the implant shell contacts the inner capsular layer, scanning electron microscopy (SEM) revealed a thin layer which mirrored the three-dimensional characteristics of the implant texture; the external surface of the inner capsular layer facing the intercapsular space (ICS) was flat. SEM examination of the inner capsule layer revealed both a large bacterial presence as well as biofilm deposition at the PI; a significantly lower quantity of bacteria and biofilm were found at the ICS interface. These findings suggest that the double capsule phenomenon's etiopathogenesis is of mechanical origin. Delamination of the periprosthetic capsule leads to the creation of the ICS; the maintained separation of the 2 layers subsequently alters the biostability of the macro-textured breast implant.

  6. 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

  7. 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.

  8. Central Endoscopy Reading in Inflammatory Bowel Diseases.

    Science.gov (United States)

    Panés, Julián; Feagan, Brian G; Hussain, Fez; Levesque, Barrett G; Travis, Simon P

    2016-09-01

    Endoscopic assessment of the presence and severity of endoscopic lesions has become an essential part of clinical trials in ulcerative colitis and Crohn's disease, for both patient eligibility and outcome measures. Variability in lesion interpretation between and within observers and the potential bias of local investigators in patient assessment have long been recognized. This variability can be reduced, although not completely removed, by independent evaluation of the examinations by experienced off-site (central) readers, properly trained in regard to lesion definition and identification, that should be removed from direct patient contact and blinded to any other clinical or study data. Adding endoscopic demonstration of active disease to eligibility criteria has the potential to reduce placebo response rates, whereas in outcome assessment it has the potential to provide a more precise estimation of the treatment effect, increasing the efficiency of the study. Central endoscopy reading is still at the beginning of its development, and the paradigms of central reading need refinement in terms of the number of readers, the process by which a final score is assigned, the selection and sequence of central readers, and the endoscopic indices of choice. PMID:27604978

  9. Photodynamic laser therapy in tracheo bronchial endoscopy

    International Nuclear Information System (INIS)

    Hp and HpD have been found to be accumulated and retained by tumor tissues; intravenous Hp or HpD disseminates throughout the entire body, but it rapidly clears out of the normal cells, while remaining longer in tumor tissue, where it is 5-6 times more concentrated after 48-72 hours. Photo-Dynamic Therapy is based upon specific photosensitization of malignant tissue containing Hp after exposure to a visible activating light in the red region of the spectrum (630 nm). Absorption in the red allows deep penetration into tissue, biological effects of using this wavelength are in the order of 5-15 mm of tumor tissue thickness. Photosensitization produces a photochemical reaction releasing singlet Oxygen, that causes tissue death. The singlet Oxygen damages some biological processes such as replay and repair of nucleic acids, cell respiration, protein synthesis and cell membrane function. How-ever, the tissue damage is caused by involvement of the tumor microvascular system too. Many authors report that effects of PDT are secondary to the destruction of tumor microvasculature and the first observable signs occur in the subendothelial zone of the tumor capillary wall. PDT is effective in tracheobronchial endoscopy in treatment of precancerous lesions and early stage lung cancer. PDT has been employed in treatment of advanced carcinoma associated with YAG-Laser and Radiotherapy. (author). 29 refs., 1 tab

  10. [The future of gastrointestinal therapeutic endoscopy: NOTES].

    Science.gov (United States)

    Dray, X; Marteau, P

    2009-01-01

    Natural orifice translumenal endoscopic surgery (NOTES) allows access into the peritoneal cavity with a flexible endoscope, through the wall of the digestive or urogenital tracts. NOTES can be combined to laparoscopic surgery in so-called techniques. In the absence of any incision of the abdominal wall, NOTES procedures provide perfect cosmetic results, with virtually no risk of parietal complications, and with decreased postoperative pain. NOTES could particularly benefit to overweight patients and to patients receiving intensive or palliative care. Most NOTES studies have been performed on animal models, with great interest for both transgastric and transpelvic approaches. Successful NOTES peritoneoscopy, hysterectomy, oophorectomy, tubal ligation, gastrojejunal anastomosis, cholecystectomy, splenectomy, nephrectomy, and abdominal-wall hernia repair have been described. In human studies, the transvaginal route is preferred. NOTES clinical research focuses on low-morbidity procedures, such as cholecystectomy, appendectomy, and peritoneoscopy. Indirect benefits are expected from this research, with possible technological innovations in the field of endoscopic instrumentation (including sutures, anastomosis, traction and triangulation). Overall, NOTES is believed to make evolve both interventional endoscopy and minimally invasive surgery. PMID:19683406

  11. 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).

  12. 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).

  13. Seismic Endoscopy: Design of New Instruments

    Science.gov (United States)

    Conil, F.; Nicollin, F.; Gibert, D.

    2003-04-01

    In order to perform 3D images around shallow-depth boreholes, in conditions in the field and within reasonable times of data acquisitions, several instrumental developments have been performed. The first development concerns the design of a directional probe working in the 20-100 kHz frequency range; the idea is to create a tool composed of multiple elementary piezoelectric entities able to cover the whole space to explore; made of special polyurethane rigid foam with excellent attenuation performances, the prototypes are covered by flexible polyurethane electric resin. By multiplying the number of elementary receptors around the vertical axes and piling up each elementary sensor, a complete design of multi-azimuth and multi-offset has been concepted. In addition to this, a test site has been built in order to obtain a controlled medium at typical scales of interest for seismic endoscopy and dedicated to experiment near the conditions in the field. Various reflectors are placed in well known positions and filled in an homogeneous cement medium; the whole edifice (2.2 m in diameter and 8 metres in depth) also contains 4 PVC tubes to simulate boreholes. The second part of this instrumental developments concern the synthesis of input signals; indeed, many modern devices used in ultrasonic experiment have non linear output response outside their nominal range: this is especially true in geophysical acoustical experiments when high acoustical power is necessary to insonify deep geological targets. Thanks to the high speed electronic and computerised devices now available, it is possible to plug in experimental set-ups into non linear inversions algorithms like simulated annealing. First experiments showed the robustness of the method in case of non linear analogic architecture. Large wavelet families have or example been constructed thanks to the method and multiscale Non Destructive Testing Method have been performed as an efficient method to detect and characterise

  14. 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.

  15. 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.

  16. 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.

  17. Family love time capsule preview

    CERN Document Server

    Musgrave, Jim

    2015-01-01

    Create your own family time capsule online using EMRE Publishing's ePub3 Creator Studio. With our storage plans, your family videos, music playlists and mysteries can be preserved for coming generations to add to, embellish, and communicate using our Family Forum inside the Embellisher eReader for multimedia ""enhanced"" eBooks. Just like the ""American Sniper"" enhanced eBook, you can pay tribute to your fallen heroes and other family members who have distinguished themselves in life.

  18. 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.

  19. 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.

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

    International Nuclear Information System (INIS)

    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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

  5. [Training in digestive endoscopy. Considerations, experiences and methodological contributions].

    Science.gov (United States)

    Santos Lucero, R; Espiniella, F; Zárate, J O; Tomás, J; Grosso, M

    1986-01-01

    The bibliographical contributions on education in digestive endoscopy and the need of establishing in Argentina a curricular programming for its teaching-learning are considered. The experience of the authors acquired during the giving of eight Basic or initiation Courses and eight Advanced or Improvement Courses is presented. They used in them six didactic simulators and endoscopic cinematography that completed the written simulations. Conceptual and methodological aspects are exposed to perform the curricular programming of training comprising the student from the student of Medicine to the gastroenterologist or surgeon more devoted or specialist in digestive endoscopy. PMID:3661076

  6. 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...... 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....

  7. Asymmetric Membrane Osmotic Capsules for Terbutaline Sulphate

    OpenAIRE

    Gobade, N. G.; Marina Koland; K H Harish

    2012-01-01

    The aim of the present study was to design an asymmetric membrane capsule, an osmotic pump-based drug delivery system of ethyl cellulose for controlled release of terbutaline sulphate. asymmetric membrane capsules contains pore-forming water soluble additive, sorbitol in different concentrations in the capsule shell membrane, which after coming in contact with water, dissolves, resulting in an in situ formation of a microporous structure. The terbutaline sulphate is a β-adrenoreceptor agonist...

  8. Regulation of capsule in Neisseria meningitidis.

    Science.gov (United States)

    Tzeng, Yih-Ling; Thomas, Jennifer; Stephens, David S

    2016-09-01

    Neisseria meningitidis, a devastating pathogen exclusive to humans, expresses capsular polysaccharides that are the major meningococcal virulence determinants and the basis for successful meningococcal vaccines. With rare exceptions, the expression of capsule (serogroups A, B, C, W, X, Y) is required for systemic invasive meningococcal disease. Changes in capsule expression or structure (e.g. hypo- or hyper-encapsulation, capsule "switching", acetylation) can influence immunologic diagnostic assays or lead to immune escape. The loss or down-regulation of capsule is also critical in meningococcal biology facilitating meningococcal attachment, microcolony formation and the carriage state at human mucosal surfaces. Encapsulated meningococci contain a cps locus with promoters located in an intergenic region between the biosynthesis and the conserved capsule transport operons. The cps intergenic region is transcriptionally regulated (and thus the amount of capsule expressed) by IS element insertion, by a two-component system, MisR/MisS and through sequence changes that result in post-transcriptional RNA thermoregulation. Reversible on-off phase variation of capsule expression is controlled by slipped strand mispairing of homo-polymeric tracts and by precise insertion and excision of IS elements (e.g. IS1301) in the biosynthesis operon. Capsule structure can be altered by phase-variable expression of capsular polymer modification enzymes or "switched" through transformation and homologous recombination of different polymerases. Understanding the complex regulation of meningococcal capsule has important implications for meningococcal biology, pathogenesis, diagnostics, current and future vaccine development and vaccine strategies. PMID:26089023

  9. 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.

  10. Results of a survey in Andalusian Endoscopy Units Resultados de una encuesta realizada a unidades de endoscopia en los hospitales andaluces

    OpenAIRE

    J. M. Herrerías Gutiérrez; F. Argüelles Arias

    2006-01-01

    Introduction: in Spain, there is no indication of the resources that an endoscopy unit should have. As a consequence only the experience of professionals who have been working for years in this field can be used as a guide. However, there are some recent surveys on sedation in Spain that indicate how sedation is use in other units. Objectives: the objectives of the present study were: a) to find out the human and material resources available in endoscopy units in Andalusia; b) to analyze the ...

  11. 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.

  12. 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.

  13. Central Reading of Endoscopy Endpoints in Inflammatory Bowel Disease Trials.

    OpenAIRE

    Gottlieb, K; TRAVIS, S; Feagan, B; Hussain, F; Sandborn, WJ; Rutgeerts, P

    2015-01-01

    Central reading of endoscopy (CROE) is crucial in determining who qualifies for a trial but also has a role, independent of the selected scoring system, in decreasing measurement noise that can obscure separation between placebo and active drug. Benefits of CROE may not be independent of the method chosen, and controversy exists about the ideal approach.

  14. Computerisation of endoscopy reports using standard reports and text blocks

    NARCIS (Netherlands)

    M.J.M. Groenen; E.J Kuipers; G.P.V. Henegouwen; P. Fockens; R.J.T. Ouwendijk

    2006-01-01

    Background: The widespread use of gastrointestinal endoscopy for diagnosis and treatment requires effective, standardised report systems. This need is further increased by the limited storage of images, and by the need for structured databases for surveillance and epidemiology. We therefore aimed fo

  15. 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.

  16. 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. PMID:26949585

  17. 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.

  18. Diagnosis of Peptic Esophagitis in Children; Ultrasound versus Endoscopy

    Directory of Open Access Journals (Sweden)

    Mehdizadeh Mehrzad

    2003-05-01

    Full Text Available Background/Objectives: To investigate the value of transabdominal sonography for evaluation of esophagitis in children. Materials and Methods: A total of 74 children with the clinical suspicion of esophagitis underwent transabdominal sonography of the gastroesophageal junction. Thicknesses of the anterior and posterior walls of the gastroesophageal junction were measured, as well as the thickness of the mucosa. This was followed by endoscopy and biopsy. Results: In histopathologic examination 44 cases were diagnosed as having esophagitis (diseased group and 30 were reported normal (normal group. The mean wall thickness was significantly higher in the diseased group. Sonography based on wall thickness using cut-off point of 6.9 mm had a sensitivity of 96%. Negative predictive value of 91% and accuracy of 84%. Sonography based on mucosal thickness using cut-off point of 1.8 mm had a sensitivity of 96%, negative predictive value of 81% and accuracy of 69%. Endoscopy had a sensitivity of 82%, negative predictive value 65% and accuracy of 69%. Despite the high accuracy of sonography, endoscopy due to its ability to perform biopsy cannot be superseded by sonography in evaluation of reflux esophagitis, but owing to high sensitivity and negative predictive value of sonography, it has the potential to be used as a screening test. Conclusion: In the clinical setting of reflux esophagitis in children, if TAS of the GEJ showed a GEJ wall thickness of 6.9 mm or less and the mucosal thickness of 1.8 mm or less, and if there is no gastroesophageal reflux noted on sonography, the patient should be considered as normal and no endoscopy is required. On the other hand, if the patient showed a thickness of the wall of the GEJ 7 mm or more, or a thickness of the mucosa of GEJ 2 mm or more on TAS, an endoscopy should be performed and a biopsy should be obtained.

  19. Air enema used in the evaluation of acute colitis. A comparison between instant radiography and endoscopy

    International Nuclear Information System (INIS)

    Purpose: The purpose of this study was to evaluate air enema as a method of assessing acute colitis. Material and Methods: Twenty-seven patients with symptoms of acute colitis underwent plain abdominal radiography, air enema, and colonoscopy within 48 h. The films were evaluated by 3 observers with different levels of experience, both independently and together, and the results were then compared to the findings at endoscopy. Results: Air enema visualized a greater part of the colon than plain abdominal radiography. When air enema was compared to endoscopy as the reference, it showed good correlation, with a positive predictive value of 92% (sensitivity 62%, specificity 85%). Evaluation of the rectum was less accurate, a finding that emphasized the importance of rigid sigmoidoscopy. Conclusion: Air enema is a useful diagnostic method in acute colitis, it is easily performed and tolerated well with no observed complications. It is also easy to interpret, as shown by a high level of agreement (κ=0.67) among the 3 independent observers with very different levels of experience. (orig.)

  20. 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.

  1. 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.

  2. 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.

  3. Helicobacter pylori infection in patients with dyspeptic symptoms having normal endoscopy

    International Nuclear Information System (INIS)

    To find out the frequency of Helicobacter pylori infection in the local population presenting with dyspeptic symptoms but having normal upper gastrointestinal endoscopic findings. Hundred cases of dyspepsia having normal upper gastrointestinal endoscopy were taken as study population. Although the gold standard for presence or absence of Helicobacter pylori infection is culture but in this study the diagnostic method used was histopathology of gastric antrum. The male and female ratio was 2:1. Majority of the patients were either 40 years of age or less, mean age being 40.52 (sd+-13.22). The chief symptoms were pain epigastrium (46%) and upper abdominal discomfort (27%). Helicobacter pylori gastritis was found in 51% of cases. We conclude that Helicobacter pylori infection is quite common in dyspeptic patients apparently having normal endoscopic gastric mucosal findings. Eradication therapy should be instituted in positive cases to avoid its long-term complications. (author)

  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. 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

    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....

  6. 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.

  7. 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.

  8. 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.

  9. Hydrodynamick instabilities on ICF capsules

    International Nuclear Information System (INIS)

    This article summarizes our current understanding of hydrodynamic instabilities as relevant to ICF. First we discuss classical, single mode Rayleigh-Taylor instability, and nonlinear effects in the evolution of a single mode. Then we discuss multimode systems, considering: (1) the onset of nonlinearity; (2) a second order mode coupling theory for weakly nonlinear effects, and (3) the fully nonlinear regime. Two stabilization mechanisms relevant to ICF are described next: gradient scale length and convective stabilization. Then we describe a model which is meant to estimate the weakly nonlinear evolution of multi-mode systems as relevant to ICF, given the short-wavelength stabilization. Finally, we discuss the relevant code simulation capability, and experiments. At this time we are quite optimistic about our ability to estimate instability growth on ICF capsules, but further experiments and simulations are needed to verify the modeling. 52 refs

  10. 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.

  11. 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.

  12. Assessment of nasal obstruction with flexible nasal endoscopy

    International Nuclear Information System (INIS)

    Objective was to report the value of nasal endoscopy as an outpatient procedure in the diagnosis of posterior nasal obstruction. Over one year period, from March 2002 to March 2003, we evaluated 130 adult patients that attended the Ear, Nose and Throat Department of Sohag University Hospital in Egypt with persistent nasal obstruction via anterior rhinoscopy and flexible nasopharyngoscopy. We reported the cause and site of obstruction in relation to the choanae. We confirmed the diagnosis by CT scanning, rigid endoscopic examination under general anesthesia, and histopathological analysis of biopsies taken. Forty-six percent of our cases had posterior nasal obstruction, 43.5% due to post-choanal lesions (mainly adenoid), 33% due to pre-choanal lesions (mainly choanal polyps), and 23.5% due to choanal lesions (mainly choanal adenoid). We conclude that flexible nasal endoscopy is superior to visual examination in the evaluation of nasal obstruction; hence, we recommend its routine use. (author)

  13. Advances in material capsule technology in HANARO

    International Nuclear Information System (INIS)

    A material capsule system has been developed for irradiation tests of non-fissile materials in HANARO. This capsule system has been actively utilized for various material irradiation tests requested by users from research institutes, universities, and the industries. Based on the accumulated experience and the user's sophisticated requirements, several advances in material capsule technologies were obtained recently for a more precise control and analysis of the neutron irradiation effect in HANARO. New instrumented capsule technologies for a more precise control of the irradiation temperature and fluence of a specimen, irrespective of the reactor operation, have been developed and out-pile tested. The OR/IP capsule technologies for an irradiation test in the HANARO OR and IP test holes with a relatively lower neutron flux than the CT and IR test holes have also been developed and in-pile tested, successfully. A high temperature irradiation technology up to 1000degC is under development. An evaluation of the DPA (Displacement Per Atom) and activation of irradiated specimens was attempted by using the SPECTOR and ORIGEN2 codes, respectively. A new fluence monitor with a decreased activity was designed to measure the thermal and fast neutron fluences of the irradiated specimens. A friction welded tube using STS304 and Al1050 alloys was introduced to prevent a coolant leakage into a capsule during a capsule cutting process after an irradiation. (author)

  14. [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.

  15. Use of water jet instruments in gastrointestinal endoscopy

    OpenAIRE

    Nakano, Toru; Sato, Chiaki; Sakurai, Tadashi; Kamei, Takashi; NAKAGAWA, Atsuhiro; Ohuchi, Noriaki

    2016-01-01

    In recent years, water jet instruments have been used in the field of gastrointestinal endoscopy, mainly in two clinical situations: Investigation and treatment under endoscopic view. Injecting water jet into the gastrointestinal lumen is helpful for maintaining a clear endoscopic view, washing away blood or mucous in the lumen or on the surface of the tip of the endoscope. This contributes to reducing time and discomfort of examination. Water jet technology is an alternative method for disse...

  16. Giardiasis in Endoscopy Patients: A Comparison of Diagnostic Techniques

    OpenAIRE

    1990-01-01

    The results of a study comparing techniques for diagnosis of giardiasis during endoscopy are presented. Methods of diagnosis included examination of duodenal biopsy impression smears, culture of both biopsies and aspirates, and examination of preserved aspirate. Giardiasis was diagnosed in three of 80 patients; in each case the impression smear was positive. Cultures of duodenal biopsies were positive in two patients; in the third patient a biopsy was not available. The preserved aspirate was...

  17. Airway observations during upper endoscopy predicting obstructive sleep apnea

    Science.gov (United States)

    Harvin, Glenn; Ali, Eslam; Raina, Amit; Leland, William; Abid, Sabeen; Vahora, Zahid; Movahed, Hossein; Kachru, Sumyra; Tee, Rick

    2016-01-01

    Background This pilot study examined airway characteristics during upper endoscopy to determine who is at high risk for obstructive sleep apnea. Methods Patients undergoing routine upper endoscopy were divided into 2 groups according to the Berlin Questionnaire (high and low risk for sleep disordered breathing). Patients underwent routine upper endoscopy using propofol sedation. The airway was then evaluated for no, partial, or complete collapse at the levels of the palate/uvula/tonsils, the tongue base, the hypopharynx, and the larynx. They were given a score of 0 for no collapse, 1 for partial collapse, and 2 for complete collapse. The score for each of these levels was added to give a total score or severity index. The larynx was also evaluated for lateral pharyngeal collapse (minimal, up to 50%, >50%, or 100%). Results We found that patients with a partial obstruction at the level of the palate/uvula/tonsils, tongue base, hypopharynx, or larynx, or complete obstruction at any level more often had a positive Berlin questionnaire. Patients with a positive Berlin questionnaire were more often of increased weight (mean 197 vs 175 lbs, P=0.19), increased body mass index (31.2 vs 27.42 kg/m2, P=0.11), increased neck circumference (36.7 vs 34.7 cm, P=0.23), and had a higher total airway score (2.61 vs 1.67, P=0.09). Conclusions The results of our pilot study represent preliminary data regarding the use of upper endoscopy as a potential tool to evaluate patients for obstructive sleep apnea.

  18. Diagnosis of Peptic Esophagitis in Children; Ultrasound versus Endoscopy

    OpenAIRE

    Mehdizadeh Mehrzad; Farahmand Fatemeh; Jannati Javaad; Mahjoob Fatemeh; Almaasi Alireza

    2003-01-01

    Background/Objectives: To investigate the value of transabdominal sonography for evaluation of esophagitis in children. Materials and Methods: A total of 74 children with the clinical suspicion of esophagitis underwent transabdominal sonography of the gastroesophageal junction. Thicknesses of the anterior and posterior walls of the gastroesophageal junction were measured, as well as the thickness of the mucosa. This was followed by endoscopy and biopsy. Results: In histopathologic examination...

  19. Asymmetric membrane osmotic capsules for terbutaline sulphate

    Directory of Open Access Journals (Sweden)

    N G Gobade

    2012-01-01

    Full Text Available The aim of the present study was to design an asymmetric membrane capsule, an osmotic pump-based drug delivery system of ethyl cellulose for controlled release of terbutaline sulphate. asymmetric membrane capsules contains pore-forming water soluble additive, sorbitol in different concentrations in the capsule shell membrane, which after coming in contact with water, dissolves, resulting in an in situ formation of a microporous structure. The terbutaline sulphate is a β-adrenoreceptor agonist widely used in the treatment of asthma. The oral dosage regimen of terbutaline sulphate is 5 mg twice or thrice daily, the plasma half-life is approximate 3-4 h and it produces GI irritation with extensive first pass metabolism. Hence, terbutaline sulphate was chosen as a model drug with an aim to develop controlled release system. Different formulations of ethyl cellulose were prepared by phase inversion technique using different concentrations of sorbitol as pore forming agent. It was found that the thickness of the prepared asymmetric membrane capsules was increased with increase in concentration of ethyl cellulose and pore forming agent, i.e. sorbitol. The dye release study in water and 10% sodium chloride solution indicates that, the asymmetric membrane capsules follow osmotic principle to release content. The pores formed due to sorbitol were confirmed by microscopic observation of transverse section of capsule membrane. Data of in vitro release study of terbutaline sulphate from asymmetric membrane capsules indicated that, the capsules prepared with 10% and 12.5% of ethyl cellulose and 25% of sorbitol released as much as 97.44% and 76.27% in 12 h, respectively with zero order release rate. Hence asymmetric membrane capsule of 10% ethyl cellulose and 25% of sorbitol is considered as optimum for controlled oral delivery of terbutaline sulphate.

  20. Asymmetric membrane osmotic capsules for terbutaline sulphate.

    Science.gov (United States)

    Gobade, N G; Koland, Marina; Harish, K H

    2012-01-01

    The aim of the present study was to design an asymmetric membrane capsule, an osmotic pump-based drug delivery system of ethyl cellulose for controlled release of terbutaline sulphate. asymmetric membrane capsules contains pore-forming water soluble additive, sorbitol in different concentrations in the capsule shell membrane, which after coming in contact with water, dissolves, resulting in an in situ formation of a microporous structure. The terbutaline sulphate is a β-adrenoreceptor agonist widely used in the treatment of asthma. The oral dosage regimen of terbutaline sulphate is 5 mg twice or thrice daily, the plasma half-life is approximate 3-4 h and it produces GI irritation with extensive first pass metabolism. Hence, terbutaline sulphate was chosen as a model drug with an aim to develop controlled release system. Different formulations of ethyl cellulose were prepared by phase inversion technique using different concentrations of sorbitol as pore forming agent. It was found that the thickness of the prepared asymmetric membrane capsules was increased with increase in concentration of ethyl cellulose and pore forming agent, i.e. sorbitol. The dye release study in water and 10% sodium chloride solution indicates that, the asymmetric membrane capsules follow osmotic principle to release content. The pores formed due to sorbitol were confirmed by microscopic observation of transverse section of capsule membrane. Data of in vitro release study of terbutaline sulphate from asymmetric membrane capsules indicated that, the capsules prepared with 10% and 12.5% of ethyl cellulose and 25% of sorbitol released as much as 97.44% and 76.27% in 12 h, respectively with zero order release rate. Hence asymmetric membrane capsule of 10% ethyl cellulose and 25% of sorbitol is considered as optimum for controlled oral delivery of terbutaline sulphate. PMID:23204625

  1. 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.

  2. Percutaneous lithotripsy for removing difficult bile duct stones using endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, See Hyung; Sohn, Chul Ho; Kim, Young Hwan [Dongsan Medical Center, Keimyung University College of Medicine, Daegu (Korea, Republic of)

    2008-03-15

    To describe efficacy of percutaneous lithotripsy for removing difficult bile duct stones using endoscopy. A total of 88 patients with difficulties for the removal of bile duct stones using endoscopy (an impacted stone, stone size > 15 mm, intrahepatic duct (IHD) stone, stone size to bile duct diameter ratio > 1.0), were enrolled in this study. A 12 Fr sheath was inserted through the percutaneous transhepatic biliary drainage (PTBD) tract, and then nitrol stone baskets and a 0.035' snare wire were used to capture, fragment and remove the stones. The technical and clinical success rates were analyzed, together with an analysis of any complications. The overall technical success rate of stone removal was achieved in 79 of 88 patients (89.8%). In five of nine patients with failed stone removal, small residual IHD stones were noted on a cholangiogram. Even if stone removal failed in these cases, cholangitic symptoms were improved and the drainage catheter was successfully removed. Therefore, clinical success was achieved in 84 of 88 patients (95.5%). There were no significant procedure-related complications, except for sepsis in one case. Billiary stone removal using the stone basket and guide-wire snare technique through the PTBD tract is a safe and effective procedure that can be used as a primary method in patients with difficulties for the removal of bile duct stones using endoscopy.

  3. 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

  4. 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.

  5. 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

  6. Factors associated with patient absenteeism for scheduled endoscopy

    Institute of Scientific and Technical Information of China (English)

    Victor K Wong; Hong-Bin Zhang; Robert Enns

    2009-01-01

    AIM: To identify risk factors to help predict which patients are likely to fail to appear for an endoscopic procedure. METHODS: This was a retrospective, chart review, cohort study in a Canadian, tertiary care, academic, hospital-based endoscopy clinic. Patients included were: those undergoing esophagogastroduodenoscopy, colonoscopy or flexible sigmoidoscopy and patients who failed to appear were compared to a control group. The main outcome measure was a multivariate analysis of factors associated with truancy from scheduled endoscopic procedures. Factors analyzed included gender, age, waiting time, type of procedure, referring physician, distance to hospital, first or subsequent endoscopic procedure or encounter with gastroenterologist, and urgency of the procedure. RESULTS: Two hundred and thirty-four patients did not show up for their scheduled appointment. Compared to a control group, factors statistically significantly associated with truancy in the multivariate analysis were: non-urgent vs urgent procedure (OR 1.62, 95% CI 1.06, 2.450), referred by a specialist vs a family doctor (OR 2.76, 95% CI 1.31, 5.52) and office-based consult prior to endoscopy vs consult and endoscopic procedure during the same appointment (OR 2.24, 95% CI 1.33, 3.78). CONCLUSION: Identifying patients who are not scheduled for same-day consult and endoscopy, those referred by a specialist, and those with non-urgent referrals may help reduce patient truancy.

  7. 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

  8. 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...

  9. Informative frame detection from wireless capsule video endoscopic images

    Science.gov (United States)

    Bashar, Md. Khayrul; Mori, Kensaku; Suenaga, Yasuhito; Kitasaka, Takayuki; Mekada, Yoshito

    2008-03-01

    Wireless capsule endoscopy (WCE) is a new clinical technology permitting the visualization of the small bowel, the most difficult segment of the digestive tract. The major drawback of this technology is the high amount of time for video diagnosis. In this study, we propose a method for informative frame detection by isolating useless frames that are substantially covered by turbid fluids or their contamination with other materials, e.g., faecal, semi-processed or unabsorbed foods etc. Such materials and fluids present a wide range of colors, from brown to yellow, and/or bubble-like texture patterns. The detection scheme, therefore, consists of two stages: highly contaminated non-bubbled (HCN) frame detection and significantly bubbled (SB) frame detection. Local color moments in the Ohta color space are used to characterize HCN frames, which are isolated by the Support Vector Machine (SVM) classifier in Stage-1. The rest of the frames go to the Stage-2, where Laguerre gauss Circular Harmonic Functions (LG-CHFs) extract the characteristics of the bubble-structures in a multi-resolution framework. An automatic segmentation method is designed to extract the bubbled regions based on local absolute energies of the CHF responses, derived from the grayscale version of the original color image. Final detection of the informative frames is obtained by using threshold operation on the extracted regions. An experiment with 20,558 frames from the three videos shows the excellent average detection accuracy (96.75%) by the proposed method, when compared with the Gabor based- (74.29%) and discrete wavelet based features (62.21%).

  10. 21 CFR 520.1660b - Oxytetracycline hydrochloride capsules.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Oxytetracycline hydrochloride capsules. 520.1660b... Oxytetracycline hydrochloride capsules. (a) Specifications. The drug is in capsule form with each capsule containing 125 or 250 milligrams of oxytetracycline hydrochloride. Oxytetracycline is the...

  11. In-training gastrointestinal endoscopy competency assessment tools: Types of tools, validation and impact.

    Science.gov (United States)

    Walsh, Catharine M

    2016-06-01

    The ability to perform endoscopy procedures safely, effectively and efficiently is a core element of gastroenterology practice. Training programs strive to ensure learners demonstrate sufficient competence to deliver high quality endoscopic care independently at completion of training. In-training assessments are an essential component of gastrointestinal endoscopy education, required to support training and optimize learner's capabilities. There are several approaches to in-training endoscopy assessment from direct observation of procedural skills to monitoring of surrogate measures of endoscopy skills such as procedural volume and quality metrics. This review outlines the current state of evidence as it pertains to in-training assessment of competency in performing gastrointestinal endoscopy as part of an overall endoscopy quality and skills training program. PMID:27345645

  12. 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. PMID:26350415

  13. 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.

  14. Benefit of preoperative flexible endoscopy for patients undergoing weight-reduction surgery in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Al Akwaa Ahmad

    2008-01-01

    Full Text Available Background: Little information is available to demonstrate the importance of flexible endoscopic examination of the upper gastrointestinal tract in obese patients prior to the weight-reduction surgery. In spite of the controversies, there are more evidences to support the value of preoperative endoscopy. In this study, we aimed to evaluate the benefit of preoperative endoscopy in morbidly obese patients who have planned to undergo bariatric surgery. Materials and Methods: The medical records of morbidly obese patients who were admitted to our hospital from November 2004 to January 2007 and underwent flexible esophagogastroduodenoscopy (EGD prior to the weight-reduction surgery were reviewed. The endoscopic findings and demographic data were recorded and analyzed. Results: Sixty-five patients underwent EGD preoperatively. The mean age was 34.6 years (range: 18-52 years, their mean BMI was 57 (range: 35-92 with a maximum weight of 280 kg. Majority were females (64%. Endoscopic findings included gastritis in 44 patients (67.7%, hiatus hernia in 8 (12%, gastric erosions in 7 (10.7%, reflux esophagitis in 4 (6% and normal EGD findings in 15 patients (23%. There was no significant increase in reflux esophagitis in this group of patients. Sixty percent of the patients had comorbid medical conditions with diabetes mellitus being the most common. Conclusion: These data suggest that it might be necessary to perform preoperative EGD in patients undergoing bariatric surgery, although it possibly will not alter the surgical intervention. Prospectively conducted studies with larger number of patients are required to further explore the need of EGD in this subset of patients.

  15. Past, Present, and Future of the Korea-Japan Joint Symposium on Gastrointestinal Endoscopy

    OpenAIRE

    Kaminishi, Michio; Niwa, Hirohumi

    2011-01-01

    We herein discuss the history, the present situation, and the future prospects of Korean Society of Gastrointestinal Endoscopy (KSGE) and Japan Gastroenterological Endoscopy Society (JGES). Through the symposiums, endoscopy medicine in both countries has developed and matured remarkably, and Korea and Japan have taken a leadership position in this field. In the future, we continuously challenge to advance the symposium further, to hold international sessions, to develop the new KSGE journal C...

  16. Early Period Results and Clinical Characteristics of Upper Gastrointestinal Endoscopy in Sivrihisar State Hospital

    OpenAIRE

    Ozgur Turk

    2014-01-01

    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...

  17. 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...

  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. Interventional microadhesiolysis: A new nonsurgical release technique for adhesive capsulitis of the shoulder

    Directory of Open Access Journals (Sweden)

    Lim Tae-Kyun

    2008-01-01

    Full Text Available Abstract Background A nonsurgical intervention, interventional microadhesiolysis, was developed to release adhesions in joints and soft tissues. This paper introduces the procedure and evaluates the efficacy of the intervention for adhesive capsulitis of the shoulder. Methods Ten patients (five men and five women with primary adhesive capsulitis of the shoulder were treated at a chronic pain management center in Korea. Three specially made needles are used in interventional microadhesiolysis: the Round, Flexed Round, and Ahn's needles. A Round Needle is inserted on the skin over middle of supraspinatus and advanced under the acromion and acromioclavicular joint (subacromial release. A Flexed Round Needle is inserted two-fingers caudal to the inferior border of the scapular spine and advanced over the capsule sliding on the surface of infraspinatus muscle-tendon fascia. The capsule is released while an assistant simultaneously passively abducts the shoulder to full abduction (posteroinferior capsule release. An Ahn's Needle is inserted on the skin over the lesser tubercle and advanced under the coracoid process sliding on the surface of the subscapularis muscle (subcoracoid release. Results After the patients underwent interventional microadhesiolysis, the self-rated pain score or severity declined significantly (p p Conclusion Our findings suggest that interventional microadhesiolysis is effective for managing adhesive capsulitis of the shoulder.

  20. Towards Polymer-Based Capsules with Drastically Reduced Controlled Permeability

    Science.gov (United States)

    Andreeva, Daria V.; Sukhorukov, Gleb B.

    Small molecules (dyes, therapeutics, etc.) could be easily handled, stored, delivered, and released by polyelectrolyte capsules. To make the polyelectrolyte capsule more efficient for small molecule encapsulation, capsule permeability should be significantly decreased. Here, we demonstrate the possibility to entrap water-soluble molecular species into polyelectrolyte capsules modified by a low permeable dense polymer (polypyrrole). Possible future areas in PE capsule application as carriers for gases and volatiles in the pharmaceutical, food, and gases industry, agriculture and cosmetology are discussed.

  1. 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.

  2. 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.

  3. [Analysis of mediastinal lymphadenopathy in sarcoidosis with transesophageal ultrasonic endoscopy; influences on cardiovascular system].

    Science.gov (United States)

    Dambara, T; Ueki, J; Aiba, M; Tamaki, S; Saito, H; Matsuda, K; Nukiwa, T; Kira, S

    1989-01-01

    We studied influences of mediastinal lymphadenopathy on cardiovascular system in nine cases of sarcoidosis with transesophageal ultrasonic endoscopy. Chest x-ray films revealed bilateral hilar lymphadenopathy in all cases, whose diagnoses were made histologically with biopsies of peripheral lung through flexible fiber optic bronchoscope and/or of lymph nodes. These findings were typical in this disease. Many compartments of cardiovascular system in mediastinal and hilar regions were visible with this technique in all subjects. And enlarged lymph nodes changed dimensions in these compartments, especially in main pulmonary arteries, left atria, pulmonary veins and aorta. Furthermore, these phenomena were seen in azygos vein and superior caval vein in some cases. It is suggested that these lymph nodes may influence hemodynamics in above-mentioned compartments of cardiovascular system, if this phenomenon deteriorates more progressively. PMID:2657139

  4. 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.

  5. 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...... 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....

  6. 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.

  7. 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

  8. 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.

  9. Hemostatic effect of topical hemocoagulase spray in digestive endoscopy

    Science.gov (United States)

    Wang, Tao; Wang, Dan-Na; Liu, Wen-Tian; Zheng, Zhong-Qing; Chen, Xin; Fang, Wei-Li; Li, Shu; Liang, Li; Wang, Bang-Mao

    2016-01-01

    AIM: To evaluate the hemostatic effect of topical hemocoagulase spray in digestive endoscopy. METHODS: Eighty-nine patients who developed oozing bleeding during endoscopic treatment from September 2014 to October 2014 at Center for Digestive Endoscopy, Tianjin Medical University General Hospital were randomly divided into either a study group (n = 39) or a control group (n = 50). The study group was given topical hemocoagulase spray intraoperatively, while the control group was given traditional 8% norepinephrine spray. Hemostatic efficacy was compared between the two groups. Bleeding site, wound cleanliness and perforation were recorded, and the rates of perforation and late bleeding were compared. RESULTS: Successful hemostasis was achieved in 39 (100%) patients of the study group and in 47 (94.0%) patients of the control group, and there was no significant difference in the rate of successful hemostasis between the two groups. Compared with the control group, after topical hemocoagulase spray in the study group, the surgical field was clearer, the bleeding site was more easily identified, and the wound was cleaner. There was no significant difference in the rate of perforation between the study and control groups (16.7% vs 35.0%, P = 0.477), but the rates of late bleeding (0% vs 15.8%, P = 0.048) and overall complications (P = 0.032) were significantly lower in the study group. CONCLUSION: Topical hemocoagulase spray has a definite hemostatic effect for oozing bleeding in digestive endoscopy, and this method is convenient, safe, and reliable. It is expected to become a new method for endoscopic hemostasis. PMID:27433096

  10. 3D Printed Programmable Release Capsules.

    Science.gov (United States)

    Gupta, Maneesh K; Meng, Fanben; Johnson, Blake N; Kong, Yong Lin; Tian, Limei; Yeh, Yao-Wen; Masters, Nina; Singamaneni, Srikanth; McAlpine, Michael C

    2015-08-12

    The development of methods for achieving precise spatiotemporal control over chemical and biomolecular gradients could enable significant advances in areas such as synthetic tissue engineering, biotic-abiotic interfaces, and bionanotechnology. Living organisms guide tissue development through highly orchestrated gradients of biomolecules that direct cell growth, migration, and differentiation. While numerous methods have been developed to manipulate and implement biomolecular gradients, integrating gradients into multiplexed, three-dimensional (3D) matrices remains a critical challenge. Here we present a method to 3D print stimuli-responsive core/shell capsules for programmable release of multiplexed gradients within hydrogel matrices. These capsules are composed of an aqueous core, which can be formulated to maintain the activity of payload biomolecules, and a poly(lactic-co-glycolic) acid (PLGA, an FDA approved polymer) shell. Importantly, the shell can be loaded with plasmonic gold nanorods (AuNRs), which permits selective rupturing of the capsule when irradiated with a laser wavelength specifically determined by the lengths of the nanorods. This precise control over space, time, and selectivity allows for the ability to pattern 2D and 3D multiplexed arrays of enzyme-loaded capsules along with tunable laser-triggered rupture and release of active enzymes into a hydrogel ambient. The advantages of this 3D printing-based method include (1) highly monodisperse capsules, (2) efficient encapsulation of biomolecular payloads, (3) precise spatial patterning of capsule arrays, (4) "on the fly" programmable reconfiguration of gradients, and (5) versatility for incorporation in hierarchical architectures. Indeed, 3D printing of programmable release capsules may represent a powerful new tool to enable spatiotemporal control over biomolecular gradients. PMID:26042472

  11. 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.

  12. Simulation-based patient flow analysis in an endoscopy unit

    DEFF Research Database (Denmark)

    Koo, Pyung-Hoi; Nielsen, Karl Brian; Jang, Jaejin;

    2010-01-01

    One of the major elements in improving efficiency of healthcare services is patient flow. Patients require a variety of healthcare resources as they receive healthcare services. Poor management of patient flow results in long waiting time of patients, under/over utilization of medical resources......, low quality of care and high healthcare cost. This article addresses patient flow problems at a Gastrointestinal endoscopy unit. We attempt to analyze the main factors that contribute to the inefficient patient flow and process bottlenecks and to propose efficient patient scheduling and staff...

  13. 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.

  14. 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.

  15. 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.

  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. 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. PMID:27372777

  18. 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.

  19. Management of iatrogenic colorectal perforation: Fromsurgery to endoscopy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    Iatrogenic colon perforation is one the most perniciouscomplications for patients undergoing endoscopicscreening or therapy. It is a serious but rare complicationof colonoscopy. However, with the expansion of theindications for endoscopic therapies for gastrointestinaldiseases, the frequency of colorectal perforation hasincreased. The management of iatrogenic colorectalperforation is still a challenge for many endoscopists.The methods for treating this complication vary,including conservative treatment, surgical treatment,laparoscopy and endoscopy. In this review, we highlightthe etiology, recognition and treatment of colorectaliatrogenic perforation. Specifically, we shed light on theendoscopic management of this rare complication.

  20. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit

    Directory of Open Access Journals (Sweden)

    Rowena Almeida

    2016-01-01

    Full Text Available Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives.

  1. A Patient Flow Analysis: Identification of Process Inefficiencies and Workflow Metrics at an Ambulatory Endoscopy Unit.

    Science.gov (United States)

    Almeida, Rowena; Paterson, William G; Craig, Nancy; Hookey, Lawrence

    2016-01-01

    Background. The increasing demand for endoscopic procedures coincides with the paradigm shift in health care delivery that emphasizes efficient use of existing resources. However, there is limited literature on the range of endoscopy unit efficiencies. Methods. A time and motion analysis of patient flow through the Hotel-Dieu Hospital (Kingston, Ontario) endoscopy unit was followed by qualitative interviews. Procedures were directly observed in three segments: individual endoscopy room use, preprocedure/recovery room, and overall endoscopy unit utilization. Results. Data were collected for 137 procedures in the endoscopy room, 139 procedures in the preprocedure room, and 143 procedures for overall room utilization. The mean duration spent in the endoscopy room was 31.47 min for an esophagogastroduodenoscopy, 52.93 min for a colonoscopy, 30.47 min for a flexible sigmoidoscopy, and 66.88 min for a double procedure. The procedure itself accounted for 8.11 min, 34.24 min, 9.02 min, and 39.13 min for the above procedures, respectively. The focused interviews identified the scheduling template as a major area of operational inefficiency. Conclusions. Despite reasonable procedure times for all except colonoscopies, the endoscopy room durations exceed the allocated times, reflecting the impact of non-procedure-related factors and the need for a revised scheduling template. Endoscopy units have unique operational characteristics and identification of process inefficiencies can lead to targeted quality improvement initiatives. PMID:27446830

  2. 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.

  3. CAPSULE REMOVING WITH MAMMARY IMPLANT TO TREAT CAPSULE CONTRACTURE AFTER AUGMENTATION MAMMOPLASTY%带假体包膜剥离法治疗隆乳后包膜挛缩

    Institute of Scientific and Technical Information of China (English)

    蒙喜永; 王晋煌; 侯文明

    2001-01-01

    目的:探索去除挛缩包膜的最佳手术方法。方法:对11例隆乳后包膜挛缩的患者采用带假体包膜剥离法进行治疗。结果:该方法具有安全、易操作、痛苦小、出血少、不损坏假体和不易复发等优点。结论:带假体包膜剥离法是治疗假体隆乳后包膜挛缩的最佳手术方法之一%Objective: In order to find the best way to remove capsule contracture after silicone breast implants. Method:11 women with capsule contracture after silicone breast implants, we adopt the way to remove capsule with mammary implant. Results: This method is safe, painless, and easy to do, we can remove the capsule easy and the capsule can't contract again. Conclusion: The way to remove contractive capsule with mammary implant is one of the best way to treat capsule contracture after silicone breast implants.

  4. Use of water jet instruments in gastrointestinal endoscopy.

    Science.gov (United States)

    Nakano, Toru; Sato, Chiaki; Sakurai, Tadashi; Kamei, Takashi; Nakagawa, Atsuhiro; Ohuchi, Noriaki

    2016-02-10

    In recent years, water jet instruments have been used in the field of gastrointestinal endoscopy, mainly in two clinical situations: Investigation and treatment under endoscopic view. Injecting water jet into the gastrointestinal lumen is helpful for maintaining a clear endoscopic view, washing away blood or mucous in the lumen or on the surface of the tip of the endoscope. This contributes to reducing time and discomfort of examination. Water jet technology is an alternative method for dissecting soft tissue; this method does not harm the small vessels or cause mechanical or thermal damage. However, its use in clinical settings has been limited to the transmucosal injection of water into the submucosal layer that elevates the mucosa to prepare for endoscopic mucosal resection or endoscopic submucosal dissection, instead of tissue dissection, which may occur because of the continuous water jet. A preclinical study has been conducted using a pulsed water jet system as an alternative method for submucosal dissection by reducing intraoperative water consumption and maintenance of dissection capability. This review introduces recent studies pertaining to using a water jet in gastrointestinal endoscopy and discusses future prospects. PMID:26862362

  5. 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.

  6. 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.

  7. Use of water jet instruments in gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    In recent years, water jet instruments have been usedin the field of gastrointestinal endoscopy, mainly intwo clinical situations Investigation and treatmentunder endoscopic view. Injecting water jet into thegastrointestinal lumen is helpful for maintaining a clearendoscopic view, washing away blood or mucous in thelumen or on the surface of the tip of the endoscope.This contributes to reducing time and discomfort ofexamination. Water jet technology is an alternativemethod for dissecting soft tissue; this method doesnot harm the small vessels or cause mechanical orthermal damage. However, its use in clinical settingshas been limited to the transmucosal injection of waterinto the submucosal layer that elevates the mucosa toprepare for endoscopic mucosal resection or endoscopicsubmucosal dissection, instead of tissue dissection,which may occur because of the continuous waterjet. A preclinical study has been conducted using apulsed water jet system as an alternative method forsubmucosal dissection by reducing intraoperative waterconsumption and maintenance of dissection capability.This review introduces recent studies pertaining to usinga water jet in gastrointestinal endoscopy and discussesfuture prospects.

  8. Changing Practice in Gastrointestinal Endoscopy: Reducing Distractions for Patient Safety.

    Science.gov (United States)

    Hay, James M; Barnette, William; Shaw, Sandra Egeto

    2016-01-01

    Failure in communication during the process of delivering healthcare can have dangerous repercussions. Specifically, failure in interdisciplinary team communication contributes to lapses in patient care. Distractions in procedural areas disrupt team communication. Application of a structured communication algorithm creates agreed-upon cues that promote team communication and facilitate clinical decision making. Frequent disruptions before, during, and after gastro-intestinal endoscopy procedures place veterans at risk for an error. A hierarchical culture promotes intimidation and reduces the likelihood that staff will speak up for patient safety. An endoscopy procedure area implemented a "sterile cockpit" methodology to reduce the number of distractions during procedures. Data collected from a self-reported safety awareness were measured by two different questionnaires and collected through observation of actual practice. Improved awareness of distraction and the impact on patient safety was reported, with a reduction from 24 observed interruptions to zero in 9 months. After reducing distractions in the procedural area, there is a perception of improved nursing quality of care. Additional support is required to consistently remove electronic distractions during a procedure. PMID:27258458

  9. 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.

  10. MRI findings in the painful hemiplegic shoulder

    International Nuclear Information System (INIS)

    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.

  11. Upper gastrointestinal endoscopy in patients with liver cirrhosis: Spectrum and prevalence of lesions

    Directory of Open Access Journals (Sweden)

    Adegboyega Akere

    2016-01-01

    Full Text Available Aim: This was to describe the different types of lesions that can be found in patients with liver cirrhosis during upper gastrointestinal endoscopy. Patients and Methods: Consecutive patients with liver cirrhosis who gave their consent to participate in the study were recruited. The diagnosis of liver cirrhosis was made by clinical and radiological features and a total of 56 patients were recruited. After taking informed consent, upper gastrointestinal endoscopy was performed on all the patients. Results: The patients consisted of 43 (76.8% males and 13 (23.2% females. Mean age was 45.5 ΁ 13.8 years (range: 20-77 years. Analysis showed that 21 (37.5% patients were less than 40 years of age, 16 (28.6% were between 40 years and 49 years, and 19 (33.9% were 50 years and above. Esophageal varices was diagnosed in 54 (96.4% patients. The esophageal mucosal findings observed were erosions (7.1%, ulcer (1.8%, candidiasis (8.9% while one (1.8% patient had both esophageal erosions and candidiasis. Gastric varices were observed in 11 (19.6% patients and the analysis showed that the most frequent form was isolated gastric varices type 1 (IGV1 was recorded in six (10.7% patients. Portal hypertensive gastropathy (PHG was seen in 45 (80.4% patients. Other gastric mucosal lesions were erosions (12.5% and ulcers (10.7%. Duodenal varices were not seen in any of the patients. Other lesions seen were duodenitis, duodenal erosions, and duodenal ulcers in one (1.8% patient, one (1.8% patient, and four (7.1% patients, respectively. Conclusion: This study has revealed different pattern of lesions that can be seen in patients with liver cirrhosis apart from varices.

  12. 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 

  13. CT findings of ganglioneuroma

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Tae Joo; Yoon, Choon Sik; Kim, Myung Jun; Kim, Sang Jin; Oh, Ki Keun [Yonsei Univ., College of Medicine, Seoul (Korea, Republic of)

    1998-09-01

    Ganglioneuroma is a relatively uncommon benign tumor and has no pathognomonic radiological findings;diagnosis is therefore difficult. In order to better diagnose this tumor we analysed its CT findings and pathologic correlation. Seventeen tumors in 16 patients(M:F=3D9:7) diagnosed as ganglioneuroma between 1992 and 1996 were retrospectively analysed with regard to location, size, contour, long axis of the mass, enhancement pattern, calcification, necrosis and capsulation, all as seen on CT, and compared with histo-pathologic findings. Tumors were 1.5 to 10(mean, 5.6) cm in size, and their location was mediastinal(n=3D12), cervical(n=3D2), retroperitoneal (n=3D2) or adrenal(n=3D1). Fifteen had an oval or round contour and two were dumb-bell-shaped. The long axis of the lesion was craniocaudal in 14 cases and non-specific in three. Thirteen lesions showed heterogeneous enhancement, and four homogeneous. Capsule-like enhancement was noted on CT scans in eight cases;there was no definite correlation between enhancement pattern and pathologic findings. Calcification was seen in six cases and an inner low-density lesion in two. Ganglioneuroma is a benign neurogenic tumor, occurring most frequently at the posterior mediastinum. General CT findings of this tumor are a well-defined oval shape with a variable enhancement pattern, but several cases showed focal calcification or inner low density. For accurate diagnosis of ganglioneuroma both common and uncommon findings must therefore be considered.=20.

  14. 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.

  15. 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.

  16. 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.

  17. ADHESIVE CAPSULITIS: USE THE EVIDENCE TO INTEGRATE YOUR INTERVENTIONS

    OpenAIRE

    Page, Phil; Labbe, Andre

    2010-01-01

    Frozen shoulder syndrome, clinically known as adhesive capsulitis, is a painful and debilitating condition affecting up to 5% of the population. Adhesive capsulitis is considered fibrosis of the glenohumeral joint capsule with a chronic inflammatory response. Patients experience pain, limited range of motion, and disability generally lasting anywhere from 1 to 24 months. The purpose of this clinical suggestion is to review the pathophysiolgy of adhesive capsulitis and discuss physical therapy...

  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 520.2345a - Tetracycline hydrochloride capsules.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Tetracycline hydrochloride capsules. 520.2345a... Tetracycline hydrochloride capsules. (a) Specifications. Each capsule contains 50, 100, 125, 250, or 500 milligrams (mg) tetracycline hydrochloride. (b) Sponsor. See sponsors in § 510.600(c) of this chapter for...

  20. 21 CFR 520.608 - Dicloxacillin sodium monohydrate capsules.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Dicloxacillin sodium monohydrate capsules. 520.608... Dicloxacillin sodium monohydrate capsules. (a) Specifications. Each capsule contains dicloxacillin sodium monohydrate equivalent to 50, 100, 200, or 500 milligrams of dicloxacillin. (b) Sponsor. See No. 000856...

  1. 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...

  2. The diagnostic value of endoscopy and Helicobacter pylori tests for peptic ulcer patients in late post-treatment setting

    Directory of Open Access Journals (Sweden)

    Kull Ingrid

    2004-10-01

    Full Text Available Abstract Background Guidelines for management of peptic ulcer patients after the treatment are largely directed to detection of H. pylori infection using only non-invasive tests. We compared the diagnostic value of non-invasive and endoscopy based H. pylori tests in a late post-treatment setting. Methods Altogether 34 patients with dyspeptic complaints were referred for gastroscopy 5 years after the treatment of peptic ulcer using a one-week triple therapy scheme. The endoscopic and histologic findings were evaluated according to the Sydney classification. Bacteriological, PCR and cytological investigations and 13C-UBT tests were performed. Results Seventeen patients were defined H. pylori positive by 13C-UBT test, PCR and histological examination. On endoscopy, peptic ulcer persisted in 4 H. pylori positive cases. Among the 6 cases with erosions of the gastric mucosa, only two patients were H. pylori positive. Mucosal atrophy and intestinal metaplasia were revealed both in the H. pylori positive and H. pylori negative cases. Bacteriological examination revealed three clarithromycin resistant H. pylori strains. Cytology failed to prove validity for diagnosing H. pylori in a post-treatment setting. Conclusions In a late post-treatment setting, patients with dyspepsia should not be monitored only by non-invasive investigation methods; it is also justified to use the classical histological evaluation of H. pylori colonisation, PCR and bacteriology as they have shown good concordance with 13C-UBT. Moreover, endoscopy and histological investigation of a gastric biopsy have proved to be the methods with an additional diagnostic value, providing the physician with information about inflammatory, atrophic and metaplastic lesions of the stomach in dyspeptic H. pylori positive and negative patients. Bacteriological methods are suggested for detecting the putative antimicrobial resistance of H. pylori, aimed at successful eradication of infection in

  3. 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…

  4. Intrauterine fertilization capsules--a clinical trial

    DEFF Research Database (Denmark)

    Lenz, S; Lindenberg, S; Sundberg, K;

    1991-01-01

    Treatment of 26 women with tubal infertility was attempted using intrauterine capsules loaded with oocytes and spermatozoa. The stimulation protocol was as used for in vitro fertilization and embryo transfer and consisted of short-term use of Buserelin, human menopausal gonadotropin, and human ch...

  5. 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.

  6. Development of a multimedial filing system for an endoscopy unit.

    Science.gov (United States)

    Grassi, A; Casale, V; Ferro, S

    1994-01-01

    The rapid technological development of biomedical instruments, and of hardware and software systems is giving new opportunities in the management of medical activities. We have developed a multimedial filing system for an Endoscopy Unit which, thanks to its versatility, is also suitable for other medical branches. The system is built on a database, and includes clinical records of patients together with endoscopic pictures and vocal comments for each case. It was developed by using "Microsoft Windows 3.1" programming and is directly connected to the videoendoscopes. The system operates in a "Novell Netware" network. Future fields of interests are reported with regard to: a) image processing procedures that can be applied; b) other types of images that can be stored such as radiological, echographic images, etc.; c) transmission of information and a global multimedial filing system serving the entire hospital; and d) a written report, including the endoscopic images of the disease. PMID:8025303

  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

    2016-06-01

    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. 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.

  9. 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.

  10. Intravital microscopy of subpleural alveoli via transthoracic endoscopy

    Science.gov (United States)

    Schwenninger, David; Runck, Hanna; Schumann, Stefan; Haberstroh, Jörg; Meissner, Sven; Koch, Edmund; Guttmann, Josef

    2011-04-01

    Transfer of too high mechanical energy from the ventilator to the lung's alveolar tissue is the main cause for ventilator-induced lung injury (VILI). To investigate the effects of cyclic energy transfer to the alveoli, we introduce a new method of transthoracic endoscopy that provides morphological as well as functional information about alveolar geometry and mechanics. We evaluate the new endoscopic method to continuously record images of focused subpleural alveoli. The method is evaluated by using finite element modeling techniques and by direct observation of subpleural alveoli both in isolated rat lungs as well as in intact animals (rats). The results confirm the overall low invasiveness of the endoscopic method insofar as the mechanical influences on the recorded alveoli are only marginal. It is, hence, a suited method for intravital microscopy in the rat model as well as in larger animals.

  11. Unmeasured improvement work: the lack of routinely collected, service-related data in NHS endoscopy units in England involved in "modernisation".

    NARCIS (Netherlands)

    Thorne, K.; Hutchings, H.A.; Elwyn, G.

    2008-01-01

    BACKGROUND: The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. METHODS: This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely col

  12. Colonoscopic perforation: A report from World Gastroenterology Organization endoscopy training center in Thailand

    Institute of Scientific and Technical Information of China (English)

    Varut Lohsiriwat; Sasithorn Sujarittanakarn; Thawatchai Akaraviputh; Narong Lertakyamanee; Darin Lohsiriwat; Udom Kachinthorn

    2008-01-01

    AIM:To determine the incidence of colonoscopic perforation (CP),and evaluate clinical findings,management and outcomes of patients with CP from the World Gastroenterology Organization (WGO)Endoscopy Training Center in Thailand.METHODS:All colonoscopies and sigmoidoscopies performed between 1999 and 2007 in the Endoscopic unit,Faculty of Medicine Siriraj Hospital,Mahidol University,Bangkok were reviewed.Incidence of CP,patients' characteristics,endoscopic information,intra-operative findings,management and outcomes were analyzed.RESULTS:A total of 17357 endoscopic procedures of the colon (13 699 colonoscopies and 3658 flexible sigmoidoscopies) were performed in Siriraj hospital over a 9-year period.Fifteen patients (0.09%) had CP:14 from colonoscopy and 1 from sigmoidoscopy.The most common site of perforation was in the sigmoid colon (80%),followed by the transverse colon (13%).Perforations were caused by direct trauma from either the shaft or the tip of the endoscope (n=12,80%) and endoscopic polypectomy (n=3,20%).All patients with CP underwent surgical management:primary repair (27%) and bowel resection (73%),The mortality rate was 13% and postoperative complication rate was 53%.CONCLUSION:CP is a rare but serious complication following colonoscopy and sigmoidoscopy,with high rates of morbidity and mortality.Incidence of CP was 0.09%.Surgery is still the mainstay of CP management.

  13. 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.

  14. 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

      Title:   Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia: A Randomized Clinical Trial in General Practice.     Purpose: To compare the clinical efficacy of two strategies for management of dyspepsia in general practice in a RCT design.......   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......, dyspeptic contacts to GP or patients' satisfaction. Conclusions: Prompt endoscopy was superior to proton pump inhibitor concerning symptom improvement in management of dyspepsia in general practice when pain/discomfort was the primary symptom. There were no differences between the two strategies in respect...

  15. Analysis of the doses used in procedures performed in an endoscopy unit

    International Nuclear Information System (INIS)

    There have been recording and analysis of the doses received by patients undergoing radiologic studies in an endoscopy unit and compared with data published by the National Radiological Protection Board (NRPB).

  16. Capsule- and disk-filter procedure

    Science.gov (United States)

    Skrobialowski, Stanley C.

    2016-01-01

    Capsule and disk filters are disposable, self-contained units composed of a pleated or woven filter medium encased in a polypropylene or other plastic housing that can be connected inline to a sample-delivery system (such as a submersible or peristaltic pump) that generates sufficient pressure (positive or negative) to force water through the filter. Filter media are available in several pore sizes, but 0.45 µm is the pore size used routinely for most studies at this time. Capsule or disk filters (table 5.2.1.A.1) are required routinely for most studies when filtering samples for trace-element analyses and are recommended when filtering samples for major-ion or other inorganic-constituent analyses.

  17. Role of endoscopy in predicting the disease course in inflammatory bowel disease

    OpenAIRE

    Allez, Matthieu; Lémann, Marc

    2010-01-01

    Endoscopy provides a direct evaluation of mucosal lesions in inflammatory bowel disease (IBD), permitting the description of elementary lesions, their surface extent and severity. The severity of mucosal lesions directly reflects disease activity and may help to identify an aggressive behavior of the disease. Several studies have recently pointed out the potential role of endoscopy in the prediction of IBD outcome. Indeed, severe endoscopic lesions in Crohn’s disease (CD) patients, defined by...

  18. Developing a clinical research network : the Northern Region Endoscopy Group experience.

    OpenAIRE

    Rajasekhar, P.; Rees, C. van; Rutter, M; Hungin, P

    2014-01-01

    Research is central to the National Health Service. Clinical trial recruitment has been aided by the National Institute for Health Research's Comprehensive Research Network but these networks do not support development of research. The Northern Region Endoscopy Group (NREG) was founded in 2007, encompasses 17 endoscopy units and has become a highly successful collaborative research network. The network is now a major contributor to UK trials, has published over 20 papers (>60 abstracts) and h...

  19. Role of endoscopy in predicting the disease course in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    Matthieu; Allez; Marc; Lémann

    2010-01-01

    Endoscopy provides a direct evaluation of mucosal lesions in inflammatory bowel disease(IBD),permitting the description of elementary lesions,their surface extent and severity.The severity of mucosal lesions directly reflects disease activity and may help to identify an aggressive behavior of the disease.Several studies have recently pointed out the potential role of endoscopy in the prediction of IBD outcome.Indeed,severe endoscopic lesions in Crohn's disease(CD) patients,defined by deep and extensive ulce...

  20. Evaluation of interventional endoscopy unit efficiency metrics at a tertiary academic medical center

    OpenAIRE

    Yang, Dennis; Summerlee, Robert; Suarez, Alejandro L.; Perbtani, Yaseen; Williamson, J. Blair; Shrode, Charles W.; Gupte, Anand R.; Shailendra S. Chauhan; Draganov, Peter V; Forsmark, Chris E.; Wagh, Mihir S.

    2015-01-01

    Background and study aims: There is an increasing demand for interventional endoscopic services and the need to develop efficient endoscopic units. The aim of this study was to analyze performance data and define metrics to improve efficiency in a single academic interventional endoscopy center. ]Patients and methods: The prospective operations performance data (6-month period) of our interventional endoscopy unit (EU) was analyzed. First-case start time (FIRST) delay was defined as any time ...

  1. Resorcinarenes are hexameric capsules in solution

    OpenAIRE

    Evan-Salem, Tamar; Baruch, Inbal; Avram, Liat; Cohen, Yoram; Palmer, Liam C.; Rebek, Julius

    2006-01-01

    The host–guest complexes of resorcin[4]arenes with small molecules in organic solutions are examined using modern NMR spectroscopic methods. The complexation of glutaric acid and β-methyl d-glucopyranoside in chloroform were investigated through 2D COSY, 2D NOESY, 1D NOE, and diffusion-ordered NMR spectroscopy (DOSY) techniques. These methods indicate that the complex is a self-assembled capsule composed of six resorcinarenes that surround six guest molecules of glutaric acid or three molecul...

  2. Narrow-band imaging endoscopy with and without magnification in diagnosis of colorectal neoplasia

    Institute of Scientific and Technical Information of China (English)

    Qing-Jie Zhou; Jian-Min Yang; Bao-Ying Fei; Qi-Shun Xu; Wei-Quan Wu; Hong-Jun Ruan

    2011-01-01

    AIM: To evaluate the diagnostic efficacies of narrowband imaging (NBI) endoscopy with and without high magnification in distinguishing neoplasia from nonneoplasia colorectal lesions.METHODS: A total of 118 patients with 123 colorectal lesions examined by NBI endoscopy in the Zhejiang Provincial People's Hospital from September 2008 to April 2010 were enrolled in this study. These lesions were classified by pit pattern and capillary pattern, and then assessed by histopathology.RESULTS: Ten lesions not meeting the diagnostic criteria were excuded, the overall diagnostic accuracy of NBI endoscopy in distinguishing neoplasia from non-neoplasia colorectal lesions was 91.2% (103/113), and that of NBI endoscopy with and without high magnification was 93.0% (40/43) and 90.0% (63/70), respectively. Both were significantly higher than that of conventional colonoscopy reported in the literature (P 0.05).CONCLUSION: Besides NBI magnifying endoscopy,NBI endoscopy without magnification may also be used to distinguish neoplasia from non-neoplasia colorectal lesions.

  3. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures.

    Science.gov (United States)

    Rutter, Matthew D; Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2016-02-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. PMID:26966520

  4. The European Society of Gastrointestinal Endoscopy Quality Improvement Initiative: developing performance measures

    Science.gov (United States)

    Senore, Carlo; Bisschops, Raf; Domagk, Dirk; Valori, Roland; Kaminski, Michal F.; Spada, Cristiano; Bretthauer, Michael; Bennett, Cathy; Bellisario, Cristina; Minozzi, Silvia; Hassan, Cesare; Rees, Colin; Dinis-Ribeiro, Mário; Hucl, Tomas; Ponchon, Thierry; Aabakken, Lars; Fockens, Paul

    2015-01-01

    The European Society of Gastrointestinal Endoscopy (ESGE) and United European Gastroenterology (UEG) have a vision to create a thriving community of endoscopy services across Europe, collaborating with each other to provide high quality, safe, accurate, patient-centered and accessible endoscopic care. Whilst the boundaries of what can be achieved by advanced endoscopy are continually expanding, we believe that one of the most fundamental steps to achieving our goal is to raise the quality of everyday endoscopy. The development of robust, consensus- and evidence-based key performance measures is the first step in this vision. ESGE and UEG have identified quality of endoscopy as a major priority. This paper explains the rationale behind the ESGE Quality Improvement Initiative and describes the processes that were followed. We recommend that all units develop mechanisms for audit and feedback of endoscopist and service performance using the ESGE performance measures that will be published in future issues of this journal over the next year. We urge all endoscopists and endoscopy services to prioritize quality and to ensure that these performance measures are implemented and monitored at a local level, so that we can provide the highest possible care for our patients. PMID:26966520

  5. Collapse of experimental capsules under external pressure

    Energy Technology Data Exchange (ETDEWEB)

    Simonen, F.A.; Shippell, R.J. Jr.

    1980-01-01

    Stress analyses and developmental tests of capsules fabricated from thick-walled tubing were performed for an external pressure design condition. In the design procedure no credit was taken for the expected margin in pressure between yielding of the capsule wall and catastrophic collapse or flattening. In tests of AISI-1018 low carbon steel capsules, a significant margin was seen between yield and collapse pressure. However, the experimental yield pressures were significantly below predictions, essentially eliminating the safety margin present in the conservative design approach. The differences between predictions and test results are attributed to deficiencies in the plasticity theories commonly in use for engineering stress analyses. The results of this study show that the von Mises yield condition does not accurately describe the yield behavior of the AISI-1018 steel tubing material for the triaxial stress conditions of interest. Finite element stress analyses successfully predicted the transition between uniform inward plastic deformation and ovalization that leads to catastrophic collapse. After adjustments to correct for the unexpected yield behavior of the tube material, the predicted pressure-deflection trends were found to follow the experimental data.

  6. Collapse of experimental capsules under external pressure

    International Nuclear Information System (INIS)

    Stress analyses and developmental tests of capsules fabricated from thick-walled tubing were performed for an external pressure design condition. In the design procedure no credit was taken for the expected margin in pressure between yielding of the capsule wall and catastrophic collapse or flattening. In tests of AISI-1018 low carbon steel capsules, a significant margin was seen between yield and collapse pressure. However, the experimental yield pressures were significantly below predictions, essentially eliminating the safety margin present in the conservative design approach. The differences between predictions and test results are attributed to deficiencies in the plasticity theories commonly in use for engineering stress analyses. The results of this study show that the von Mises yield condition does not accurately describe the yield behavior of the AISI-1018 steel tubing material for the triaxial stress conditions of interest. Finite element stress analyses successfully predicted the transition between uniform inward plastic deformation and ovalization that leads to catastrophic collapse. After adjustments to correct for the unexpected yield behavior of the tube material, the predicted pressure-deflection trends were found to follow the experimental data

  7. Clinicoepidemiologic characterization and endoscopy in patients with colorectal cancer

    International Nuclear Information System (INIS)

    Colorectal carcinoma is recognized as the second death cause from cancer in most of developed countries; the increasing exposure to risk factor such as smoking, changes in diet, in lifestyles, as well as environmental and infectious factors is conductive to its morbidity and mortality increase. A prospective and descriptive study was conducted in 65 patients older than 18 years seen from April, 2007 to April, 2008 in the Endoscopy Service of the National Institute of Gastroenterology, diagnosed with colorectal carcinoma by colonoscopy and histology. In collection form were registered: sex, age, personal backgrounds of colon cancer, polyps, intestinal inflammatory disease and cholecystectomy; family backgrounds of colon cancer or another location; toxic habits: smoking and alcoholism; diet as regards: vegetal fiber ingestion and animal fat; anatomic location of cancer and histology. We conclude that there was predominance of female sex, the more frequent diagnosis age was between 60 and 70 years. The personal background of colon polyp and the family background of colon cancer were the more frequent. There was also predominance of smokers and heavy drinkers with or without effect. There was a great ingestion of animal fat and few ingestion of vegetal fiber. The more frequent anatomical location was the rectosygmoid, where the histological colon adenocarcinoma had the greater frequency

  8. Facial purpura in an elderly patient after upper gastrointestinal endoscopy

    Institute of Scientific and Technical Information of China (English)

    Ilhami Yüksel; (O)zlem Ekiz; Fuat Ekiz; (O)mer Basar; Oeman Yüksel

    2012-01-01

    To the editor:Upper gastrointestinal endoscopy (UGE) is a safe procedure and it is widely used without any complication in general.Complications are due to endoscopic procedure,invasive applications,local anesthetic medication or the sedative drugs like midazolam.Complications of the procedure are hemorrhage,peroration of the stomach or gut,respiratory arrest,reaction to the sedative drugs used like midazolam or pethidine,aspiration pneumonia,damaging of crowned teeth or dental bridgework,infection, cardiac arrest and finally under very unusual circmstances death.Mild complications are sore throat,numb throat,bloated feeling and feeling sleepy.1,2 Oral rash was reported to be a very rare complication (0.3%) of UGE in pediatric population.2 Some scholars reported a facial purpura after endoscopic procedure,previously3-5 Cutaneous complications after UGE may occur,however this condition is usually ignored by physicians.Herein,we present a case of facial purpura in an elderly patient as a mild complication of UGE.

  9. Single Nanowire Probe for Single Cell Endoscopy and Sensing

    Science.gov (United States)

    Yan, Ruoxue

    The ability to manipulate light in subwavelength photonic and plasmonic structures has shown great potentials in revolutionizing how information is generated, transformed and processed. Chemically synthesized nanowires, in particular, offers a unique toolbox not only for highly compact and integrated photonic modules and devices, including coherent and incoherent light sources, waveguides, photodetectors and photovoltaics, but also for new types of nanoscopic bio-probes for spot cargo delivery and in-situ single cell endoscopy and sensing. Such nanowire probes would enable us to carry out intracellular imaging and probing with high spatial resolution, monitor in-vivo biological processes within single living cells and greatly improve our fundamental understanding of cell functions, intracellular physiological processes, and cellular signal pathways. My work is aimed at developing a material and instrumental platform for such single nanowire probe. Successful optical integration of Ag nanowire plasmonic waveguides, which offers deep subwavelength mode confinement, and conventional photonic waveguides was demonstrated on a single nanowire level. The highest plasmonic-photonic coupling efficiency coupling was found at small coupling angles and low input frequencies. The frequency dependent propagation loss was observed in Ag nanowire and was confirmed by quantitative measurement and in agreement with theoretical expectations. Rational integration of dielectric and Ag nanowire waveguide components into hybrid optical-plasmonic routing devices has been demonstrated. This capability is essential for incorporating sub-100nm Ag nanowire waveguides into optical fiber based nanoprobes for single cell endoscopy. The nanoprobe system based on single nanowire waveguides was demonstrated by optically coupling semiconductor or metal nanowire with an optical fiber with tapered tip. This nanoprobe design requires minimal instrumentation which makes it cost efficient and readily

  10. RULE OF CARCINOGENETIC DEVELOPMENT OF GASTRIC CARDIA OBSERVED BY ENDOSCOPY

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective: To study the rule of development of early cancer of gastric cardiac in vivo. Methods: A prospective cohort was held in the high incidence area of cancer of esophagus and stomach in china. One hundred and six persons were examined regularly by endoscopy to observe the change of pro-cancer lesions of gastric cardiac by taking biopsy specimen. All specimens were diagnosed through normal pathological process. Results: The 106 subjects were examined twice in 1998 and 2002. Of 8 normal persons, 3 stayed normal, 4 turned to chronic gastritis, 1 developed early gastric cardiac cancer. Of 61 persons with chronic gastritis, 11 were observed to have gland atrophy, 4 with mild atypical hyperplasia, and 2 with highly atypical hyperplasia. Of 9 subjects showing atrophic chronic gastritis, 5 revealed no change, and 4 became chronic gastritis. Of 22 subjects who revealed mild atypical hyperplasia, 17 resolved, 4 showed no change, and 1 advanced to highly atypical hyperplasia. One person with highly atypical hyperplasia reverted to mild atypical hyperplasia. Of 5 subjects with early gastric cardiac cancer without any treatment, 1 became advanced cancer, 1 still stayed in early cancer stage, 3 turned to atypical hyperplasia. Conclusion: 1. The development of early cancer of gastric cardia would proceed through the stages of chronic gastritis, gland atrophy, and atypical hyperplasia. 2. The early cancer and pre-cancer lesions of gastric cardia is reversible, though possessing malignant possibility.

  11. 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

  12. 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.

  13. Evaluation of the margins of differentiated early gastriccancer by using conventional endoscopy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    AIM To evaluate the determination of the marginof differentiated-type early gastric cancers by usingconventional endoscopy.METHODS: We retrospectively evaluated 364 differentiatedearly gastric cancers that were endoscopicallyresected as en-bloc specimens and diagnosed pathologicallyin detail between November 2007 and October2008. All procedures were done with conventionalendoscopes and all endoscopic samples, before and afterindigo carmine dye, were re-evaluated using a digital filingsystem by one endoscopist. We analyzed the incidence oflesions with unclear margins and the relationship betweenunclear margins and relevant clinicopathological findings.RESULTS: The rate of lesions with unclear marginswas 20.6% (75/364). Multivariate regression analysissuggested that the factors that make the determinationof the margin difficult were normal color, presence ofcomponents of flat area (0-IIb), a diameter ≥ 21 mm,ulceration, and components of poorly differentiatedadenocarcinoma in the mucosal surface.CONCLUSION: As many as 20% of differentiated earlygastric cancers show unclear margins. Consideration ofthe factors associated with unclear margins may helpendoscopists to accurately determine the margins of thelesion.

  14. Endoscopy-verified occult subependymal dissemination of glioblastoma and brain metastasis undetected by MRI: prognostic significance

    Directory of Open Access Journals (Sweden)

    Iacoangeli M

    2012-12-01

    Full Text Available Maurizio Iacoangeli,1 Alessandro Di Rienzo,1 Roberto Colasanti,1 Antonio Zizzi,2 Maurizio Gladi,1 Lorenzo Alvaro,1 Niccolò Nocchi,1 Lucia Giovanna Maria Di Somma,1 Marina Scarpelli,2 Massimo Scerrati11Department of Neurosurgery, 2Department of Pathology, Università Politecnica delle Marche, Umberto I General Hospital, Ancona, ItalyAbstract: Although various prognostic indices exist for patients with malignant brain tumors, the prognostic significance of the subependymal spread of intracranial tumors is still a matter of debate. In this paper, we report the cases of two intraventricular lesions, a recurrent glioblastoma multiforme (GBM and a brain metastasis, each successfully treated with a neuroendoscopic approach. Thanks to this minimally invasive approach, we achieved good therapeutic results: we obtained a histological diagnosis; we controlled intracranial hypertension by treating the associated hydrocephalus and, above all, compared with a microsurgical approach, we reduced the risks related to dissection and brain retraction. Moreover, in both cases, neuroendoscopy enabled us to identify an initial, precocious subependymal tumor spreading below the threshold of magnetic resonance imaging (MRI detection. This finding, undetected in pre-operative MRI scans, was then evident during follow-up neuroimaging studies. In light of these data, a neuroendoscopic approach might play a leading role in better defining the prognosis and optimally tailored management protocols for GBM and brain metastasis.Keywords: subependymal spreading, glioblastoma, brain metastasis, endoscopy, minimally invasive surgery, prognosis

  15. Role of shocks and mix caused by capsule defects

    Science.gov (United States)

    Bradley, P. A.; Cobble, J. A.; Tregillis, I. L.; Schmitt, M. J.; Obrey, K. D.; Glebov, V.; Batha, S. H.; Magelssen, G. R.; Fincke, J. R.; Hsu, S. C.; Krasheninnikova, N. S.; Murphy, T. J.; Wysocki, F. J.

    2012-09-01

    An Eulerian code with a turbulent mix model is used to model a set of plastic (CH) ablator capsules with and without equatorial grooves. The "perfect" capsule results were used to calibrate simulations of capsules with equatorial grooves of different depths that provided information on increasingly perturbed implosions. Simulations with a turbulence model were able to calculate the same yield over mix (YOM) ratio (experiment/mix simulation) of 0.2 to 0.3 for thin (8-μm thick) and thick shell (15-μm thick) capsules with no grooves and thin capsules with shallow grooves. When the capsules have deep grooves, the YOM ratio increases to greater than unity, probably because the deformed shocks focus too strongly on the symmetry axis in our two-dimensional simulations. This is supported by a comparison of simulated and experimental x-ray images.

  16. The motion of a deforming capsule through a corner

    CERN Document Server

    Zhu, Lailai

    2014-01-01

    A three-dimensional deformable capsule convected through a channel/duct with a corner is studied via numerical simulations using an accelerated boundary integral method adapted to general geometries. A global spectral method is adopted to resolve the dynamics of the capsule's membrane developing elastic tensions according to the Neo-Hookean constitutive law and bending moments in an inertialess flow. The simulations show that the trajectory of the capsule closely follows the underlying streamlines and the deformation of the capsule induces an anti-clockwise rotation of its material points with respect to the travelling direction. The surface area, principle tension and elastic energy of the capsule increase around the corner. Their temporal evolutions are characterised by a clear phase delay and the loss of time-reversal symmetry of Stokes flow due to the elasticity of membrane. The capsule centroid velocity decreases approaching the corner as the mean flow does while a velocity overshoot is observed past the...

  17. Role of shocks and mix caused by capsule defects

    International Nuclear Information System (INIS)

    An Eulerian code with a turbulent mix model is used to model a set of plastic (CH) ablator capsules with and without equatorial grooves. The “perfect” capsule results were used to calibrate simulations of capsules with equatorial grooves of different depths that provided information on increasingly perturbed implosions. Simulations with a turbulence model were able to calculate the same yield over mix (YOM) ratio (experiment/mix simulation) of 0.2 to 0.3 for thin (8-μm thick) and thick shell (15-μm thick) capsules with no grooves and thin capsules with shallow grooves. When the capsules have deep grooves, the YOM ratio increases to greater than unity, probably because the deformed shocks focus too strongly on the symmetry axis in our two-dimensional simulations. This is supported by a comparison of simulated and experimental x-ray images.

  18. Capsule development and utilization for material irradiation tests

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Young Hwan; Kim, B. G.; Joo, K. N. [and others

    2000-05-01

    The development program of advanced nuclear structural and fuel materials includes the in-pile tests using the instrumented capsule at HANARO. The tests were performed in the in-core test holes of CT, IR 1 and 2 and OR 4 and 5 of HANARO. Extensive efforts have also been made to establish design and manufacturing technology for the instrumented capsule and its related system, which should be compatible with the HANARO's characteristics. Since the first instrumented capsule(97M-01K) had been designed and successfully fabricated, five tests were done to support the users and provided the economic benefits to user by generating the essential in-pile information on the performance and structural integrity of materials. This paper describes the present status and future plans of these R and D activities for the development of the instrumented capsule including in-situ material property measurement capsules and nuclear fuel test capsules.

  19. Pharmacokinetic Study on Lovastatin Sustained-release Tablet and Sustained-release Capsule in Begal Dogs

    Institute of Scientific and Technical Information of China (English)

    付琳; 代宗顺; 侯淑贤; 万元胜

    2004-01-01

    This study pharmacokinetically examined the lovastatin sustained-release tablet and sustained release capsule in Beagle dogs. An reversed-phase HPLC method was established for the determination of lovastatin in Beagle dog plasma. Pharmacokinetic findings were compared among three preparation(lovastatin sustained-release tablet, TP; sustained-release capsule, TJ and conventional capsule). Our results showed that the pharmacokinetic parameters in 6 dogs after single-dose oral administration of three perparations were calculated. Tmax , Cmax and MRT revealed significant difference (P<0.05). Relative bioavailability was 111. 5 ± 16. 9 % (TP) and 110.4% ± 9.6%(TJ). The pharmacokinetic parameters in the 6 dogs after multiple-dose oral administration of three perparations, Tmax Cmax MRT and DF had significant difference (P<0. 05); Cav, Cmin and AUC0-24 h displayed no significant difference (P>0.05). It is concluded that the lovastatin sustained-release tablet and sustained-release capsule are able to maintain a sustained-release for 24 h.

  20. Anterior capsule tear after laser iridotomy complicating phacoemulsification

    OpenAIRE

    Vivien Cherng Hui, Yip; Sanjay, Srinivasan; Benjamin Chong-Ming, Chang

    2011-01-01

    A 70-year-old Indian lady had a history of bilateral laser peripheral iridotomy (LPI) for primary angle closure. Subsequently she developed cataract in both the eyes. Right eye cataract surgery was complicated by an anterior capsule rupture, which was discovered intra-operatively at the site of the LPI. Trypan blue was used to stain the anterior capsule to delineate the anterior capsule defect. An attempt at continuous curvilinear capsulorhexis was unsuccessful, and the anterior capsulotomy w...

  1. Fibrous Calcareous Concretions in the Capsules of Human Pineal Glands

    OpenAIRE

    Kodaka Tetsuo; Mori Ryoichi; Ezure Hiromitsu; Ito Junji; Otsuka Naruhito

    2013-01-01

    We examined calcareous concretions in the capsule of 15 human pineal glands containing a large amount of the concretions in the matrix. The capsule concretions, brown to blackish-brown in color and/or translucent, were smaller than the matrix concretions, which were yellowish-white. The matrix concretions showed the typical mulberry-shaped overall appearance with scallop-shaped concentric laminations of non-fibrous structures, but the capsule concretions, which also contained Ca and P, showed...

  2. Effects of sedation during upper gastrointestinal endoscopy on endocrine response and cardiorespiratory function

    Directory of Open Access Journals (Sweden)

    G. Yetkin

    2007-12-01

    Full Text Available Upper gastrointestinal endoscopy is often accompanied by tachycardia which is known to be an important pathogenic factor in the development of myocardial ischemia. The pathogenesis of tachycardia is unknown but the condition is thought to be due to the endocrine response to endoscopy. The purpose of the present study was to investigate the effects of sedation on the endocrine response and cardiorespiratory function. Forty patients scheduled for diagnostic upper gastrointestinal endoscopy were randomized into 2 groups. While the patients in the first group did not receive sedation during upper gastrointestinal endoscopy, the patients in the second group were sedated with intravenous midazolam at the dose of 5 mg for those under 65 years or 2.5 mg for those aged 65 years or more. Midazolam was administered by slow infusion. In both groups, blood pressure, ECG tracing, heart rate, and peripheral oxygen saturation (SpO2 were monitored during endoscopy. In addition, blood samples for the determination of cortisol, glucose and C-reactive protein levels were obtained from patients in both groups prior to and following endoscopy. Heart rate and systolic arterial pressure changes were within normal limits in both groups. Comparison of the two groups regarding the values of these two parameters did not reveal a significant difference, while a statistically significant reduction in SpO2 was found in the sedation group. No significant differences in serum cortisol, glucose or C-reactive protein levels were observed between the sedated and non-sedated group. Sedation with midazolam did not reduce the endocrine response and the tachycardia developing during upper gastrointestinal endoscopy, but increased the reduction in SpO2.

  3. Increasing Z-pinch vacuum hohlraum capsule coupling efficiency.

    Energy Technology Data Exchange (ETDEWEB)

    Callahan, Debbie (LLNL); Vesey, Roger Alan; Cochrane, Kyle Robert (KTech); Nikroo, A. (General Atomics); Bennett, Guy R.; Schroen, Diana Grace (Schafer); Ruggles, Laurence E.; Porter, John L.; Streit, Jon (Schafer); Mehlhorn, Thomas Alan; Cuneo, Michael Edward

    2004-11-01

    Symmetric capsule implosions in the double-ended vacuum hohlraum (DEH) on Z have demonstrated convergence ratios of 14-21 for 2.15-mm plastic ablator capsules absorbing 5-7 kJ of x-rays, based on backlit images of the compressed ablator remaining at peak convergence [1]. Experiments with DD-filled 3.3-mm diameter capsules designed to absorb 14 kJ of x-rays have begun as an integrated test of drive temperature and symmetry, complementary to thin-shell symmetry diagnostic capsules. These capsule implosions are characterized by excellent control of symmetry (< 3% time-integrated), but low hohlraum efficiency (< 2%). Possible methods to increase the capsule absorbed energy in the DEH include mixed-component hohlraums, large diameter foam ablator capsules, transmissive shine shields between the z-pinch and capsule, higher spoke electrode x-ray transmission, a double-sided power feed, and smaller initial radius z-pinch wire arrays. Simulations will explore the potential for each of these modifications to increase the capsule coupling efficiency for near-term experiments on Z and ZR.

  4. Preparation of alginate-gelatin capsules and its properties

    Institute of Scientific and Technical Information of China (English)

    Xiao-yan LI; Xi-guang CHEN; Cheng-sheng LIU; Chen-guang LIU; Yu-ping XUE

    2008-01-01

    Capsules based on alginate and gelatin prepared by extrusion method could increase the cell numbers of Lactobacillus casei ATCC 393 to be 108 CFU·9-1 in the wet state of the capsules. The capsules were spherical, smooth-surfaced and non-aggregated with a diameter of (4.0±0.3) mm. The behavior of the samples were quite similar at low relative humidity (33%, 52%) and the ratio of weight change reached 93%. Four kinds of capsules in simulated gastric fluid (SGF) exhibited shrinkage while the beads eroded accompanied with slight swelling in simulated intestinal fluid (SIF). The pH values affected the stability of the capsules and with the increase in pH, the capsules chan-ged from shrank then swelled and finally, broke into pieces. The capsules behaved differently under different ion intens-ities and the introduction of gelatin weakened the stability of capsules compared with the alginate ones. Cells of L. casei ATCC 393 could be continuously released from the capsules in the simulated gastrointestinal tract (GIT) and the release amounts and speeds in SIF were much higher and faster than those in SGF.

  5. Increasing Z-pinch vacuum hohlraum capsule coupling efficiency

    International Nuclear Information System (INIS)

    Symmetric capsule implosions in the double-ended vacuum hohlraum (DEH) on Z have demonstrated convergence ratios of 14-21 for 2.15-mm plastic ablator capsules absorbing 5-7 kJ of x-rays, based on backlit images of the compressed ablator remaining at peak convergence (1). Experiments with DD-filled 3.3-mm diameter capsules designed to absorb 14 kJ of x-rays have begun as an integrated test of drive temperature and symmetry, complementary to thin-shell symmetry diagnostic capsules. These capsule implosions are characterized by excellent control of symmetry (< 3% time-integrated), but low hohlraum efficiency (< 2%). Possible methods to increase the capsule absorbed energy in the DEH include mixed-component hohlraums, large diameter foam ablator capsules, transmissive shine shields between the z-pinch and capsule, higher spoke electrode x-ray transmission, a double-sided power feed, and smaller initial radius z-pinch wire arrays. Simulations will explore the potential for each of these modifications to increase the capsule coupling efficiency for near-term experiments on Z and ZR

  6. Design procedure of capsule with multistage heater control (named MUSTAC)

    International Nuclear Information System (INIS)

    A capsule with electric heaters at multistage (named MUSTAC) is a type of capsule used in JMTR. The heaters are assembled in the capsule. Supply electric current to the heaters can be independently adjusted with a control systems that keeps irradiation specimens to constant temperature. The capsule being used, the irradiation specimen are inserted into specimen holders. Gas-gap size, between outer surface of specimen holders and inner surface of capsule casing, is calculated and determined to be flatten temperature of loaded specimens over the region. The rise or drop of specimen temperature in accordance with reactor power fluctuations is corrected within the target temperature of specimen by using the heaters filled into groove at specimen holder surface. The present report attempts to propose a reasonable design procedure of the capsules by means of compiling experience for designs, works and irradiation data of the capsules and to prepare for useful informations against onward capsule design. The key point of the capsule lies on thermal design. Now design thermal calculations are complicated in case of specimen holder with multihole. Resolving these issues, it is considered from new on that an emphasis have to placed on settling a thermal calculation device, for an example, a computer program on calculation specimen temperature. (author)

  7. The role of endoscopy in pediatric gastrointestinal bleeding

    Science.gov (United States)

    Franke, Markus; Geiß, Andrea; Greiner, Peter; Wellner, Ulrich; Richter-Schrag, Hans-Jürgen; Bausch, Dirk; Fischer, Andreas

    2016-01-01

    Background and study aims: Gastrointestinal bleeding in children and adolescents accounts for up to 20 % of referrals to gastroenterologists. Detailed management guidelines exist for gastrointestinal bleeding in adults, but they do not encompass children and adolescents. The aim of this study was to assess gastrointestinal bleeding in pediatric patients and to determine an investigative management algorithm accounting for the specifics of children and adolescents. Patients and methods: Pediatric patients with gastrointestinal bleeding admitted to our endoscopy unit from 2001 to 2009 (n = 154) were identified. Retrospective statistical and neural network analysis was used to assess outcome and to determine an investigative management algorithm. Results: The source of bleeding could be identified in 81 % (n = 124/154). Gastrointestinal bleeding was predominantly lower gastrointestinal bleeding (66 %, n = 101); upper gastrointestinal bleeding was much less common (14 %, n = 21). Hematochezia was observed in 94 % of the patients with lower gastrointestinal bleeding (n = 95 of 101). Hematemesis (67 %, n = 14 of 21) and melena (48 %, n = 10 of 21) were associated with upper gastrointestinal bleeding. The sensitivity and specificity of a neural network to predict lower gastrointestinal bleeding were 98 % and 63.6 %, respectively and to predict upper gastrointestinal bleeding were 75 % and 96 % respectively. The sensitivity and specifity of hematochezia alone to predict lower gastrointestinal bleeding were 94.2 % and 85.7 %, respectively. The sensitivity and specificity for hematemesis and melena to predict upper gastrointestinal bleeding were 82.6 % and 94 %, respectively. We then developed an investigative management algorithm based on the presence of hematochezia and hematemesis or melena. Conclusions: Hematochezia should prompt colonoscopy and hematemesis or melena should prompt esophagogastroduodenoscopy. If no

  8. Postirradiation examination of capsule GF-4

    International Nuclear Information System (INIS)

    The GF-4 capsule test was irradiated in the SILOE reactor at Grenoble, France between April 8, 1975 and July 26, 1976. High-enriched uranium (HEU) UC2 and weak acid resin (WAR) UC/sub x/O/sub y/ fissile and ThO2 fertile particles were tested. Postirradiation examination of cured-in-place fuel rods showed no fuel rod/graphite element interaction. In addition, all rods exhibited adequate structural integrity. Irradiation-induced dimensional changes for rods containing all TRISO-coated fuel were consistent with model predictions; however, rods containing BISO-coated fuel exhibited greater volumetric contractions than predicted

  9. Review on sedation for gastrointestinal tract endoscopy in children by non-anesthesiologists

    Science.gov (United States)

    Orel, Rok; Brecelj, Jernej; Dias, Jorge Amil; Romano, Claudio; Barros, Fernanda; Thomson, Mike; Vandenplas, Yvan

    2015-01-01

    AIM: To present evidence and formulate recommendations for sedation in pediatric gastrointestinal (GI) endoscopy by non-anesthesiologists. METHODS: The databases MEDLINE, Cochrane and EMBASE were searched for the following keywords “endoscopy, GI”, “endoscopy, digestive system” AND “sedation”, “conscious sedation”, “moderate sedation”, “deep sedation” and “hypnotics and sedatives” for publications in English restricted to the pediatric age. We searched additional information published between January 2011 and January 2014. Searches for (upper) GI endoscopy sedation in pediatrics and sedation guidelines by non-anesthesiologists for the adult population were performed. RESULTS: From the available studies three sedation protocols are highlighted. Propofol, which seems to offer the best balance between efficacy and safety is rarely used by non-anesthesiologists mainly because of legal restrictions. Ketamine and a combination of a benzodiazepine and an opioid are more frequently used. Data regarding other sedatives, anesthetics and adjuvant medications used for pediatric GI endoscopy are also presented. CONCLUSION: General anesthesia by a multidisciplinary team led by an anesthesiologist is preferred. The creation of sedation teams led by non-anesthesiologists and a careful selection of anesthetic drugs may offer an alternative, but should be in line with national legislation and institutional regulations. PMID:26240691

  10. Evaluation of CT virtual intravascular endoscopy in fenestrated stent grafts: a preliminary study

    Energy Technology Data Exchange (ETDEWEB)

    Sun, Z. [Dept. of Imaging and Applied Physics, Curtin Univ. of Tech., Perth, WA (Australia); Allen, Y.; Fitzsimmons, B.; Hartely, D. [Cook R and D, WA (Australia); Lawrence-Brown, M. [Dept. of Public Health, Curtin Univ. of Tech., Perth, WA (Australia)

    2007-06-15

    We aim in this study to investigate the potential value of CT virtual intravascular endoscopy in patients diagnosed with abdominal aortic aneurysms undergoing fenestrated stent grafts. Both pre-and post-fenestration (within 3 months of implantation) multislice CT data were collected in eight patients and used for generation of virtual endoscopy images in our preliminary study. Variable fenestrations were deployed in 25 aortic branches with scallop fenestration implanted in six aortic ostia, large fenestration in four aortic ostia and small fenestration in 15 renal ostia, respectively. Measurements of the aortic ostia diameters both pre- and post-fenestration were successfully performed with virtual intravascular endoscopy visualization, and endovascular stents as well as their relationship to the aortic ostia were clearly demonstrated. Our results showed that there was no significant change of diameter of the aortic ostia following fenestrated stem grafts. Endovascular stents were clearly visualized on virtual endoscopy images, and no apparent deformity or malrotation was observed in this small group. Our preliminary study provides new insights into anatomic configuration/dimension of aortic ostia and endovascular stents, and virtual intravascular endoscopy could be a valuable technique to follow-up patients treated with fenestrated stent grafts. (orig.)

  11. Multislice spiral CT virtual endoscopy: the clinical application in the diagnosis of vascular diseases

    International Nuclear Information System (INIS)

    Objective: To evaluate the display ability and the clinical application of multislice spiral CT virtual endoscopy (CTVE) in the diagnosis of vascular diseases. Methods: Fifty-six patients were examined by CT virtual endoscopy. 32 patients also had DSA for comparison. 18 patients were confirmed by operation (3 patients also had DSA). 9 patients with pulmonary embolism were confirmed by other examinations and treatments. Results: 56 patients showed successful CT virtual endoscopy images. CT virtual endoscopy images could clearly show the inner wall and inner structures of the vessels, mural thrombus, calcification form, stenosis of the vessels, the true and false lumina of aortic dissections, the lesion of false aneurysm, and the anatomic relationship between the lesion and surrounding structures of the normal vessels. Out of the 32 patients with vessel abnormalities on DSA, 24 patients (75%) showed the lesions on CTVE. 17 out of 18 patients with operation showed the lesions on CTVE. All 9 patients with pulmonary embolism showed the abnormalities on CTVE. Chi-square test: χ2=5.2809, P=0.071 patients showed the vascular diseases on CTVE in 56 patients (84%). Conclusion: MSCT virtual endoscopy could provide more information of the vessel by displaying the inner wall and allowing users to map the vessels in a display. It is helpful in correct diagnosis and guiding surgery

  12. Intraductal biliary and pancreatic endoscopy:An expanding scope of possibility

    Institute of Scientific and Technical Information of China (English)

    Joel R Judah; Peter V Draganov

    2008-01-01

    Intraductal endoscopy describes the use of an endoscope to directly visualize the biliary and pancreatic ducts.For many years,technological challenges have made performing these procedures difficult.The "mother-baby" system and other various miniscopes have been developed,but routine use has been hampered due to complex setup,scope fragility and the time consuming,technically demanding nature of the procedure.Recently,the SpyGlass peroral cholangiopancreatoscopy system has shown early success at providing diagnostic information and therapeutic options.The clinical utility of intraductal endoscopy is broad.It allows better differentiation between benign and malignant processes by allowing direct visualization and targeted sampling of tissue.Therapeutic interventions,such as electrohydraulic lithotripsy (EHL),laser lithotripsy,photodynamic therapy,and argon plasma coagulation (APC),may also be performed as part of intraductal endoscopy.Intraductal endoscopy significantly increases the diagnostic and therapeutic yield of standard endoscopic retrograde cholangiography (ERCP),and as technology progresses,it is likely that its utilization will only increase.In this review of intraductal endoscopy,we describe in detail the various endoscopic platforms and their diagnostic and clinical applications.

  13. Assessment of participant satisfaction with upper gastrointestinal endoscopy in South Korea

    Institute of Scientific and Technical Information of China (English)

    Hoo-Yeon Lee; Sun Mi Lim; Mi Ah Han; Jae Kwan Jun; Kui Son Choi; Myung-Il Hahm; Eun-Cheol Park

    2011-01-01

    AIM: To measure the perceived satisfaction with gastric cancer screening as part of the National Cancer Screening Program (NCSP) in South Korea. METHODS: Data were derived from the participants in a satisfaction survey of the Quality Evaluation of National Cancer Screening in 2009. This is a populationbased nationwide telephone survey of participants who were screened by the NCSP between May and October 2009. This study included 4412 participants who provided full sets of data and who had upper endoscopies for the purpose of gastric cancer screening. RESULTS: The negative appraisal percentages for each of the seven questions were as follows: explanation in preparation for the upper endoscopy, 12.3%; explanation about the process and procedure of the upper endoscopy, 13.8%; explanation about any pain or discomfort related to the upper endoscopy, 27.5%; level of pain during the procedure, 30.3%; physical environment, 16.2%; manner of the staff, 11.2%, and privacy protection, 8.8%. CONCLUSION: The critical issues identified by the Pareto analysis include the adequacy of the explanation about any pain or discomfort associated with the upper endoscopy and the level of pain experienced during the procedure.

  14. Cholangiocarcinoma and malignant bile duct obstruction: Areview of last decades advances in therapeutic endoscopy

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    In the last decades many advances have been achievedin endoscopy, in the diagnosis and therapy ofcholangiocarcinoma,however blood test, magneticresonance imaging, computed tomography scan mayfail to detect neoplastic disease at early stage, thus thediagnosis of cholangiocarcinoma is achieved usuallyat unresectable stage. In the last decades the roleof endoscopy has moved from a diagnostic role toan invaluable therapeutic tool for patients affectedby malignant bile duct obstruction. One of the majorissues for cholangiocarcinoma is bile ducts occlusion,leading to jaundice, cholangitis and hepatic failure.Currently, endoscopy has a key role in the work upof cholangiocarcinoma, both in patients amenable tosurgical intervention as well as in those unfit for surgeryor not amenable to immediate surgical curative resectionowing to locally advanced or advanced disease, withpalliative intention. Endoscopy allows successful biliarydrainage and stenting in more than 90% of patientswith malignant bile duct obstruction, and allows rapidreduction of jaundice decreasing the risk of biliary sepsis.When biliary drainage and stenting cannot be achievedwith endoscopy alone, endoscopic ultrasound-guidedbiliary drainage represents an effective alternativemethod affording successful biliary drainage in morethan 80% of cases. The purpose of this review is tofocus on the currently available endoscopic managementoptions in patients with cholangiocarcinoma.

  15. Preoperative Planning Using 3D Reconstructions and Virtual Endoscopy for Location of the Frontal Sinus

    Directory of Open Access Journals (Sweden)

    Abreu, João Paulo Saraiva

    2011-01-01

    Full Text Available Introduction: Computed tomography (TC generated tridimensional (3D reconstructions allow the observation of cavities and anatomic structures of our body with detail. In our specialty there have been attempts to carry out virtual endoscopies and laryngoscopies. However, such application has been practically abandoned due to its complexity and need for computers with high power of graphic processing. Objective: To demonstrate the production of 3D reconstructions from CTs of patients in personal computers, with a free specific program and compare them to the surgery actual endoscopic images. Method: Prospective study in which the CTs proper files of 10 patients were reconstructed with the program Intage Realia, version 2009, 0, 0, 702 (KGT Inc., Japan. The reconstructions were carried out before the surgeries and a virtual endoscopy was made to assess the recess and frontal sinus region. After this study, the surgery was digitally performed and stored. The actual endoscopic images of the recess and frontal sinus region were compared to the virtual images. Results: The 3D reconstruction and virtual endoscopy were made in 10 patients submitted to the surgery. The virtual images had a large resemblance with the actual surgical images. Conclusion: With relatively simple tools and personal computer, we demonstrated the possibility to generate 3D reconstructions and virtual endoscopies. The preoperative knowledge of the frontal sinus natural draining path location may generate benefits during the performance of surgeries. However, more studies must be developed for the evaluation of the real roles of such 3D reconstructions and virtual endoscopies.

  16. The comparison of upper endoscopy and scintigraphy results in the diagnostics of duodenogastric reflux

    International Nuclear Information System (INIS)

    The results of upper endoscopy in respect to the symptoms potentially indicative for duodenogastric reflux (DGR) have been compared to the results obtained by a scintigraphic method, elaborated by the group of the authors. Altogether 89 patients (48 women, 41 men) have been studied. For the analysis of signs indicative for functional disturbances of the upper digestive symptoms (status of the lower esophageal sphincter, gastric tone, presence of bile in the gastric content, status of the pyloric sphincter, influx of the duodenal content observed during the upper endoscopy, presence of the bile in the duodenum) the maximum accepted interval between the two investigations was 24 hours, while 1 month interval was accepted for the evaluations of structural changes (esophagitis, presence of hiatal hernis, gastritis and duodenitis, deformation of the pyloric sphincter and duodenal bulb. No statistically significant correlations has been found between any of the above mentioned parameters at upper endoscopy and the presence or absence of DGR as determined by the scintigraphic method. If a influx of the duodenal content into the stomach during the upper endoscopy, this could be considered as a specific indicator (specificity - 91,3%0, while the sensitivity (16,7%) is very low. There has been a trend to decreased DGR in patients with an atrophic gastritis, still this correlation was not statistically significant. The conclusion is made that the intubation of the stomach during the upper endoscopy could be causative for artificial DGR therefore leading to incorrect data interpretation and hyper diagnostics. (authors)

  17. Physalis angulata L. antineoplasic activity, in vitro, evaluation fromit's stems and fruit capsules

    OpenAIRE

    I.M. Ribeiro; M.T.G. Silva; R.D.A. Soares; C.M. Stutz; M. Bozza; T.C.B. Tomassini

    2002-01-01

    Physalis angulata L. (genus Physalis; family Solanaceae) is an herbaceous specimen that grows plentifully at North, Northeast and Middleast Brazilian's regions1. Its fruits are edible, roots and epigeal parts are taken as tea or infusion, all through the world as traditional medicine. Despite of this usefulness not much scientific work has been done on it. This research carried out with plant material (stems and fruit capsules) has the main aim to find out anti-neoplasic activity. The obtaine...

  18. Tethered capsule OCT endomicroscopy: from bench to bedside at the primary care office (Conference Presentation)

    Science.gov (United States)

    Gora, Michalina J.; Simmons, Leigh H.; Tiernan, Aubrey R.; Grant, Catriona N.; Soomro, Amna R.; Walker Corkery, Elizabeth S.; Rosenberg, Mireille; Metlay, Joshua P.; Tearney, Guillermo J.

    2016-03-01

    We have developed a swallowable tethered capsule OCT endomicroscopy (TCE) device that acquires microscopic images of the entire esophagus in unsedated subjects in a quick and comfortable procedure. To test its capabilities of TCE to become a population-based screening device, we conducted a clinical feasibility study in the primary care office. The swept-source OCT imaging system (1310nm central wavelength, 40kHz A-line rate, 10um axial resolution) together with the tethered capsule catheter (11x25mm capsule attached to a flexible tether) were transferred to the PCP office where unsedated patients scheduled for non-urgent PCP visits swallowed the capsule and microscopic OCT images of the entire esophagus were collected. After the whole length of the esophagus was imaged, the catheter was disinfected for reuse. Twenty subjects were enrolled in the study, including nine female and eleven male. All TCE procedures were performed by a nurse and lasted in average 5:42 ± 1:54 min. High-resolution images of the esophagus were obtained in all seventeen subjects that swallowed the capsule. Our clinical experience in this cohort, subject feedback, image quality, and technological adaptations for efficient utilization in this setting will be presented. The ease and simplicity of the procedure combined with high quality of the images demonstrate the potential for this technology to become a population-based screening device. Technology limitations and future development guided by findings from this initial experience will be discussed with the goal of effectively translating TCE to the outpatient primary care setting.

  19. The Implications of Endoscopic Ulcer in Early Gastric Cancer: Can We Predict Clinical Behaviors from Endoscopy?

    Science.gov (United States)

    Lee, Yoo Jin; Kim, Jie-Hyun; Park, Jae Jun; Youn, Young Hoon; Park, Hyojin; Kim, Jong Won; Choi, Seung Ho; Noh, Sung Hoon

    2016-01-01

    Background The presence of ulcer in early gastric cancer (EGC) is important for the feasibility of endoscopic resection, only a few studies have examined the clinicopathological implications of endoscopic ulcer in EGC. Objectives To determine the role of endoscopic ulcer as a predictor of clinical behaviors in EGC. Methods Data of 3,270 patients with EGC who underwent surgery between January 2005 and December 2012 were reviewed. Clinicopathological characteristics were analyzed in relation to the presence and stage of ulcer in EGC. Based on endoscopic findings, the stage of ulcer was categorized as active, healing, or scar. Logistic regression analysis was performed to analyze factors associated with lymph node metastasis (LNM). Results 2,343 (71.7%) patients had endoscopic findings of ulceration in EGC. Submucosal (SM) invasion, LNM, lymphovascular invasion (LVI), perineural invasion, and undifferentiated-type histology were significantly higher in ulcerative than non-ulcerative EGC. Comparison across different stages of ulcer revealed that SM invasion, LNM, and LVI were significantly associated with the active stage, and that these features exhibited significant stage-based differences, being most common at the active stage, and least common at the scar stage. The presence of endoscopic ulcer and active status of the ulcer were identified as independent risk factors for LNM. Conclusions Ulcerative EGC detected by endoscopy exhibited more aggressive behaviors than non-ulcerative EGC. Additionally, the endoscopic stage of ulcer may predict the clinicopathological behaviors of EGC. Therefore, the appearance of ulcers should be carefully evaluated to determine an adequate treatment strategy for EGC. PMID:27741275

  20. Usefulness of magnifying endoscopy with narrow-band imaging for diagnosis of depressed gastric lesions.

    Science.gov (United States)

    Sumie, Hiroaki; Sumie, Shuji; Nakahara, Keita; Watanabe, Yasutomo; Matsuo, Ken; Mukasa, Michita; Sakai, Takeshi; Yoshida, Hikaru; Tsuruta, Osamu; Sata, Michio

    2014-01-01

    The usefulness of magnifying endoscopy with narrow-band imaging (ME-NBI) for the diagnosis of early gastric cancer is well known, however, there are no evaluation criteria. The aim of this study was to devise and evaluate a novel diagnostic algorithm for ME-NBI in depressed early gastric cancer. Between August, 2007 and May, 2011, 90 patients with a total of 110 depressed gastric lesions were enrolled in the study. A diagnostic algorithm was devised based on ME-NBI microvascular findings: microvascular irregularity and abnormal microvascular patterns (fine network, corkscrew and unclassified patterns). The diagnostic efficiency of the algorithm for gastric cancer and histological grade was assessed by measuring its mean sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy. Furthermore, inter- and intra-observer variation were measured. In the differential diagnosis of gastric cancer from non-cancerous lesions, the mean sensitivity, specificity, PPV, NPV, and accuracy of the diagnostic algorithm were 86.7, 48.0, 94.4, 26.7, and 83.2%, respectively. Furthermore, in the differential diagnosis of undifferentiated adenocarcinoma from differentiated adenocarcinoma, the mean sensitivity, specificity, PPV, NPV, and accuracy of the diagnostic algorithm were 61.6, 86.3, 69.0, 84.8, and 79.1%, respectively. For the ME-NBI final diagnosis using this algorithm, the mean κ values for inter- and intra-observer agreement were 0.50 and 0.77, respectively. In conclusion, the diagnostic algorithm based on ME-NBI microvascular findings was convenient and had high diagnostic accuracy, reliability and reproducibility in the differential diagnosis of depressed gastric lesions. PMID:24649321

  1. Computer-aided detection of early cancer in the esophagus using HD endoscopy images

    Science.gov (United States)

    van der Sommen, Fons; Zinger, Svitlana; Schoon, Erik J.; de With, Peter H. N.

    2013-02-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The recent development of High-Definition (HD) endoscopy has enabled the specialist physician to identify cancer at an early stage. Nevertheless, it still requires considerable effort and training to be able to recognize these irregularities associated with early cancer. As a first step towards a Computer-Aided Detection (CAD) system that supports the physician in finding these early stages of cancer, we propose an algorithm that is able to identify irregularities in the esophagus automatically, based on HD endoscopic images. The concept employs tile-based processing, so our system is not only able to identify that an endoscopic image contains early cancer, but it can also locate it. The identification is based on the following steps: (1) preprocessing, (2) feature extraction with dimensionality reduction, (3) classification. We evaluate the detection performance in RGB, HSI and YCbCr color space using the Color Histogram (CH) and Gabor features and we compare with other well-known features to describe texture. For classification, we employ a Support Vector Machine (SVM) and evaluate its performance using different parameters and kernel functions. In experiments, our system achieves a classification accuracy of 95.9% on 50×50 pixel tiles of tumorous and normal tissue and reaches an Area Under the Curve (AUC) of 0.990. In 22 clinical examples our algorithm was able to identify all (pre-)cancerous regions and annotate those regions reasonably well. The experimental and clinical validation are considered promising for a CAD system that supports the physician in finding early stage cancer.

  2. Potential value of Cs-137 capsules

    Energy Technology Data Exchange (ETDEWEB)

    Bloomster, C.H.; Brown, D.R.; Bruno, G.A.; Hazelton, R.F.; Hendrickson, P.L.; Lezberg, A.J.; Tingey, G.L.; Wilfert, G.L.

    1985-04-01

    We determined the value of Cs-137 compared to Co-60 as a source for the irradiation of fruit (apples and cherries), pork and medical supplies. Cs-137, in the WESF capsule form, had a value of approximately $0.40/Ci as a substitute for Co-60 priced at approximately $1.00/Ci. The comparison was based on the available curies emitted from the surface of each capsule. We developed preliminary designs for fourteen irradiation facilities; seven were based on Co-60 and seven were based on Cs-137. These designs provided the basis for estimating capital and operating costs which, in turn, provided the basis for determining the value of Cs-137 relative to Co-60 in these applications. We evaluated the effect of the size of the irradiation facility on the value of Cs-137. The cost of irradiation is low compared to the value of the product. Irradiation of apples for disinfestation costs $.01 to .02 per pound. Irradiation for trichina-safe pork costs $.02 per pound. Irradiation of medical supplies for sterilization costs $.07 to .12 per pound. The cost of the irradiation source, either Co-60 or Cs-137, contributed only a minor amount to the total cost of irradiation, about 5% for the fruit and hog cases and about 20% for the medical supply cases. We analyzed the sensitivity of the irradiation costs and Cs-137 value to several key assumptions.

  3. Scheimpflug imaging of pediatric posterior capsule rupture

    Directory of Open Access Journals (Sweden)

    Grewal Dilraj

    2009-01-01

    Full Text Available We report a case of an 11-year-old boy who presented two days after blunt trauma to the left eye with a slingshot. On examination his best corrected visual acuity (BCVA was 20/20 in the right eye and 20/400 in the left eye. Slit-lamp examination of the left eye revealed a Vossius ring, traumatic cataract, traumatic posterior capsule tear (PCT. The contour of the posterior capsule bulge corresponded to the edges of the PCT. Rotating Scheimpflug imaging (Pentacam 70700:Oculus, Wetzlar Germany confirmed the traumatic cataract in the region of the PCT visualized as increased lens density at the cortex-vitreous interface. The extent of the PCT in the greatest and least dimensions was documented before and after intraocular lens (IOL implantation. Intra-operatively, the PCT was evident and phaco-emulsification with an IOL implant was performed. Postoperatively, his BCVA improved to 20/20 in the left eye with a well-centered in-the-bag IOL as found on slit-lamp and Scheimpflug images.

  4. Quality evaluation of simvastatin compounded capsules

    Directory of Open Access Journals (Sweden)

    Flávia Dias Marques-Marinho

    2011-09-01

    Full Text Available Simvastatin is commercially available as tablets and compounded capsules in Brazil. Very few reports regarding these capsules' quality, and consequently their efficacy, are available. The pharmaceutical quality of 30 batches of 20 mg simvastatin capsules from the market was evaluated by weight determination, content uniformity, disintegration (Brazilian Pharmacopeia, assay and dissolution test (USP32 tablet monograph. A HPLC method was developed for assay, content uniformity and dissolution test, and specifications were also established. Out of the 30 batches evaluated, 29 showed capsule disintegration within 45 min and individual weight variation was within ±10% or ±7.5% relative to average weight, for 300 mg, respectively. Only 27 batches met dissolution test criteria with values >80% of the labeled amount in 45 min; 21 batches showed simvastatin content between 90.0-110.0% of the labeled amount and 19 batches had at least 9 out of 10 capsules with content uniformity values between 85.0-115.0% of the labeled amount with RSDNo Brasil, a sinvastatina está comercialmente disponível na forma de comprimidos e cápsulas manipuladas. Poucos relatos estão disponíveis sobre a qualidade e, consequentemente, a eficácia dessas cápsulas. A qualidade de 30 lotes de sinvastatina 20 mg cápsulas do mercado foi avaliada através da determinação de peso, uniformidade de conteúdo, desintegração (Farmacopéia Brasileira, doseamento e teste de dissolução (monografia comprimidos USP32. Método por CLAE foi desenvolvido para o doseamento, uniformidade de conteúdo e teste de dissolução; além disso, especificações foram estabelecidas. Dos 30 lotes avaliados, 29 apresentaram desintegração da cápsula até 45 min e a variação do peso individual foi ± 10% ou ± 7,5% em relação ao peso médio, se 300 mg, respectivamente. Apenas 27 lotes preencheram os critérios do teste de dissolução com valores > 80% da quantidade rotulada, em 45 min, 21

  5. Protective Role of the Capsule and Impact of Serotype 4 Switching on Streptococcus mitis

    OpenAIRE

    Rukke, Håkon V.; Kalluru, Raja Sab; Repnik, Urska; Gerlini, Alice; José, Ricardo J.; Periselneris, Jimstan; Marshall, Helina; Griffiths, Gareth; Oggioni, Marco Rinaldo; Brown, Jeremy S.; Petersen, Fernanda C

    2014-01-01

    The polysaccharide capsule surrounding Streptococcus pneumoniae is essential for virulence. Recently, Streptococcus mitis, a human commensal and a close relative of S. pneumoniae, was also shown to have a capsule. In this study, the S. mitis type strain switched capsule by acquisition of the serotype 4 capsule locus of S. pneumoniae TIGR4, following induction of competence for natural transformation. Comparison of the wild type with the capsule-switching mutant and with a capsule deletion mut...

  6. Capsule shields the function of short bacterial adhesins

    DEFF Research Database (Denmark)

    Schembri, Mark; Dalsgaard, D.; Klemm, Per

    2004-01-01

    Bacterial surface structures such as capsules and adhesins are generally regarded as important virulence factors. Here we demonstrate that capsules block the function of the self-recognizing protein antigen 43 through physical shielding. The phenomenon is not restricted to Escherichia coli but can...

  7. Highly active antibody-modified magnetic polyelectrolyte capsules.

    Science.gov (United States)

    Valdepérez, Daniel; Del Pino, Pablo; Sánchez, Lourdes; Parak, Wolfgang J; Pelaz, Beatriz

    2016-07-15

    Polyelectrolyte hollow capsules are versatile platforms typically used for encapsulation of a wide variety of macromolecules in their cavity. The polymer shell of these capsules as composed by alternating layers of oppositely charged polyelectrolytes also allows for adding additional functionalities. The properties of the shell can be for example engineered by trapping different nanoparticles in-between the shell layers and/or by attaching bioactive molecules such as antibodies to the outermost layer. Herein, iron oxide NPs were inmobilized into the shell of polyelectrolyte capsules and the outermost layer of the shell was covalently modified with anti peroxidase antibodies. These capsules act as prototype model system, aiming to obtain a microstructure with the potential capability to specifically recognize and separate macromolecules. Due to the magnetic nanoparticles in the capsule shell, the capsules together with the attached target might be extracted by magnetic field gradients. Here we verified this approach by extracting horseradish peroxidase from a solution through magnetic separation with capsules bearing antibodies against horseradish peroxidase. The bioactivity of the capsules and the high degree of specific antibody functionalization were confirmed and quantified through an enzymatic reaction mediated by the extracted horseradish peroxidase. PMID:27089014

  8. 1964 computer run on a laser-imploded capsule

    International Nuclear Information System (INIS)

    WAZER Alchemy 7b (WA-7b) is a WAZER calculation of a laser-driven micro-implosion of a spherical capsule consisting of a thin gold pusher surrounded by a thick (frozen) deuterium ablator. The properties of the target capsule and the shape of the laser pulse used to irradiate it are described

  9. Experimental modulation of capsule size in Cryptococcus neoformans

    Directory of Open Access Journals (Sweden)

    Zaragoza Oscar

    2004-01-01

    Full Text Available Experimental modulation of capsule size is an important technique for the study of the virulence of the encapsulated pathogen Cryptococcus neoformans. In this paper, we summarize the techniques available for experimental modulation of capsule size in this yeast and describe improved methods to induce capsule size changes. The response of the yeast to the various stimuli is highly dependent on the cryptococcal strain. A high CO2 atmosphere and a low iron concentration have been used classically to increase capsule size. Unfortunately, these stimuli are not reliable for inducing capsular enlargement in all strains. Recently we have identified new and simpler conditions for inducing capsule enlargement that consistently elicited this effect. Specifically, we noted that mammalian serum or diluted Sabouraud broth in MOPS buffer pH 7.3 efficiently induced capsule growth. Media that slowed the growth rate of the yeast correlated with an increase in capsule size. Finally, we summarize the most commonly used media that induce capsule growth in C. neoformans.

  10. Design of capsules capable of argon-filling

    International Nuclear Information System (INIS)

    The possibility of the use of polycarbosilane capsules as fuel container in inertial confinement fusion experiments was analyzed in the paper. Primary study indicates that the polycarbosilane capsules can be filled with argon by means of diffusion and possess reasonable retention time for deuterium. (author)

  11. Comparative evaluation of scintigraphy and upper gastrointestinal tract endoscopy for detection of duodenogastric reflux

    Energy Technology Data Exchange (ETDEWEB)

    Mittal, B.R.; Ibrarullah, Mohammad; Agarwal, D.K.; Maini, Atul; Ali, Wasif; Sikora, S.S.; Das, B.K. (Sanjay Gandhi Postgraduate Inst. of Medical Sciences (India))

    1994-08-01

    Duodenogastric reflux, the reflux of duodenal bile into stomach, when suspected clinically requires an objective evaluation for proper management. In this study hepatobiliary scintigraphy in 91 patients of different clinical conditions was evaluated for presence of duodenogastric reflux. Upper gastrointestinal endoscopy was also performed in 44 of these patients. On scintigraphy duodenogastric reflux was present in 26 (29%) of 91 patients. Upper gastrointestinal endoscopy revealed presence of refluxed bile in the stomach in 12 (27%) of 44 patients. In the same groups of patients scintigraphy detected reflux in 18 (41%) of 44 patients. This shows that hepatobiliary scintigraphy is superior to upper gastrointestinal endoscopy in detection of duodenogastric reflux and also has the advantage of being non-invasive and physiological. (author).

  12. Ethnic issues in endoscopy%内镜术的伦理问题

    Institute of Scientific and Technical Information of China (English)

    美国消化内镜学会

    2010-01-01

    @@ This is one of a series of statements discussing the use of GI endoscopy in common clinical situations. The Standards of Practice Committee of the American Society for Gastrointestinal Endoscopy (ASGE) prepared this text. In preparing this guideline, a search of the medical literature was performed by using PubMed. Additional references were obtained from the bibliographies of the identified articles and from recommendations of expert consultants. When few or no data exist from well-designed prospective trials, emphasis is placed on results from large series and reports from recognized experts. Guidelines for appropriate use of endoscopy are based on a critical review of the available data and expert consensus at the time the guidelines are drafted. Further controlled clinical studies may be needed to clarify aspects of this guideline.

  13. Analysis of Fission Products on the AGR-1 Capsule Components

    Energy Technology Data Exchange (ETDEWEB)

    Paul A. Demkowicz; Jason M. Harp; Philip L. Winston; Scott A. Ploger

    2013-03-01

    The components of the AGR-1 irradiation capsules were analyzed to determine the retained inventory of fission products in order to determine the extent of in-pile fission product release from the fuel compacts. This includes analysis of (i) the metal capsule components, (ii) the graphite fuel holders, (iii) the graphite spacers, and (iv) the gas exit lines. The fission products most prevalent in the components were Ag-110m, Cs 134, Cs 137, Eu-154, and Sr 90, and the most common location was the metal capsule components and the graphite fuel holders. Gamma scanning of the graphite fuel holders was also performed to determine spatial distribution of Ag-110m and radiocesium. Silver was released from the fuel components in significant fractions. The total Ag-110m inventory found in the capsules ranged from 1.2×10 2 (Capsule 3) to 3.8×10 1 (Capsule 6). Ag-110m was not distributed evenly in the graphite fuel holders, but tended to concentrate at the axial ends of the graphite holders in Capsules 1 and 6 (located at the top and bottom of the test train) and near the axial center in Capsules 2, 3, and 5 (in the center of the test train). The Ag-110m further tended to be concentrated around fuel stacks 1 and 3, the two stacks facing the ATR reactor core and location of higher burnup, neutron fluence, and temperatures compared with Stack 2. Detailed correlation of silver release with fuel type and irradiation temperatures is problematic at the capsule level due to the large range of temperatures experienced by individual fuel compacts in each capsule. A comprehensive Ag 110m mass balance for the capsules was performed using measured inventories of individual compacts and the inventory on the capsule components. For most capsules, the mass balance was within 11% of the predicted inventory. The Ag-110m release from individual compacts often exhibited a very large range within a particular capsule.

  14. Analysing intracellular deformation of polymer capsules using structured illumination microscopy

    Science.gov (United States)

    Chen, Xi; Cui, Jiwei; Sun, Huanli; Müllner, Markus; Yan, Yan; Noi, Ka Fung; Ping, Yuan; Caruso, Frank

    2016-06-01

    Understanding the behaviour of therapeutic carriers is important in elucidating their mechanism of action and how they are processed inside cells. Herein we examine the intracellular deformation of layer-by-layer assembled polymer capsules using super-resolution structured illumination microscopy (SIM). Spherical- and cylindrical-shaped capsules were studied in three different cell lines, namely HeLa (human epithelial cell line), RAW264.7 (mouse macrophage cell line) and differentiated THP-1 (human monocyte-derived macrophage cell line). We observed that the deformation of capsules was dependent on cell line, but independent of capsule shape. This suggests that the mechanical forces, which induce capsule deformation during cell uptake, vary between cell lines, indicating that the capsules are exposed to higher mechanical forces in HeLa cells, followed by RAW264.7 and then differentiated THP-1 cells. Our study demonstrates the use of super-resolution SIM in analysing intracellular capsule deformation, offering important insights into the cellular processing of drug carriers in cells and providing fundamental knowledge of intracellular mechanobiology. Furthermore, this study may aid in the design of novel drug carriers that are sensitive to deformation for enhanced drug release properties.Understanding the behaviour of therapeutic carriers is important in elucidating their mechanism of action and how they are processed inside cells. Herein we examine the intracellular deformation of layer-by-layer assembled polymer capsules using super-resolution structured illumination microscopy (SIM). Spherical- and cylindrical-shaped capsules were studied in three different cell lines, namely HeLa (human epithelial cell line), RAW264.7 (mouse macrophage cell line) and differentiated THP-1 (human monocyte-derived macrophage cell line). We observed that the deformation of capsules was dependent on cell line, but independent of capsule shape. This suggests that the mechanical forces

  15. Endoprobe: a system for radionuclide-guided endoscopy.

    Science.gov (United States)

    Raylman, Raymond R; Srinivasan, Amarnath

    2004-12-01

    Methods to guide the surgical treatment of cancer utilizing handheld beta-sensitive probes in conjunction with tumor-avid radiopharmaceuticals [such as 18F-fluorodeoxyglucose (FDG)] have previously been developed. These technologies could also potentially be used to assist in minimally invasive techniques for the diagnosis of cancer. The goal of this project is to develop and test a system for performing radionuclide-guided endoscopies. This system (called Endoprobe) has four major subsystems: beta detector, position tracker, endoscope, and user interface. The beta detection unit utilizes two miniaturized solid state detectors to preferentially detect beta particles. The position tracking system allows real-time monitoring of the unit's location. The beta detector and position tracking system's receiver are mounted on the tip of an endoscope. Information from the beta detector and tracking system, in addition to the video signal from the endoscope, are combined and presented to the user via a computer interface. The system was tested in a simulated search for radiotracer-avid areas of esophageal cancer. The search for esophageal cancer was chosen because this type of cancer is often diagnosed with endoscopic procedures and has been reported to have good affinity for FDG. Accumulations of FDG in the normal organs of the abdomen were simulated by an anthropomorphic torso phantom filled with the appropriate amounts of radioactivity. A 1.5- mm-thick gelatin film containing FDG was used to simulate radiotracer uptake in the lining of normal esophagus. Esophageal lesions (both benign and malignant) were simulated by thin disks of gelatin (diameters=3.5-12 mm) containing appropriate concentrations of FDG embedded in the gelatin film simulating normal esophagus. Endoprobe facilitated visual identification and examination of the simulated lesions. The position tracking system permitted the location of the Endoprobe tip to be monitored and plotted in real time on a

  16. Balancing soft elasticity and low surface polarity in films of charged BSA capsules at air/fluid interface.

    Science.gov (United States)

    D, Madhumitha; Jaganathan, Maheshkumar; Dhathathreyan, Aruna; Miller, Reinhard

    2016-10-01

    Interaction between charged BSA colloids and the buffer at air/fluid interface has been studied using spread films of the capsules of the protein prepared at pH 4.5 and 7.5 (below and above the pI of BSA). Surface pressure-surface concentration plots, interfacial dilational rheology and Quartz crystal microbalance with dissipation have been used to characterize the films. The study shows that below the pI of the protein, the positively charged colloids entrain more water on the surface which leads to partial neutralization of the charges. Results suggest that the charged capsules are elastic due to the strongly adsorbed protein layers that restrict deformation and any small shape fluctuations is likely due to the distortion of the viscoelastic surface layer at pH=4.5. Capsules of BSA behave as 'soft elastic membrane' with interfacial properties lying between that of an elastic membrane and a slightly soluble diffuse capsule with low interfacial tension. Such elastic capsules would find applications in drug delivery and food colloids.

  17. Balancing soft elasticity and low surface polarity in films of charged BSA capsules at air/fluid interface.

    Science.gov (United States)

    D, Madhumitha; Jaganathan, Maheshkumar; Dhathathreyan, Aruna; Miller, Reinhard

    2016-10-01

    Interaction between charged BSA colloids and the buffer at air/fluid interface has been studied using spread films of the capsules of the protein prepared at pH 4.5 and 7.5 (below and above the pI of BSA). Surface pressure-surface concentration plots, interfacial dilational rheology and Quartz crystal microbalance with dissipation have been used to characterize the films. The study shows that below the pI of the protein, the positively charged colloids entrain more water on the surface which leads to partial neutralization of the charges. Results suggest that the charged capsules are elastic due to the strongly adsorbed protein layers that restrict deformation and any small shape fluctuations is likely due to the distortion of the viscoelastic surface layer at pH=4.5. Capsules of BSA behave as 'soft elastic membrane' with interfacial properties lying between that of an elastic membrane and a slightly soluble diffuse capsule with low interfacial tension. Such elastic capsules would find applications in drug delivery and food colloids. PMID:27318961

  18. Clinical Characteristics and Mortality of Life-Threatening Events Requiring Cardiopulmonary Resuscitation in Gastrointestinal Endoscopy Units.

    Science.gov (United States)

    Park, Hye Min; Kim, Eun Soo; Lee, Sang Min; Lee, Yoo Jin; Park, Kyung Sik; Cho, Kwang Bum; Kim, Eun Young; Jung, Jin Tae; Kim, Kyeong Ok; Jang, Byung Ik; Jung, Yun Jin; Yang, Chang Hun; Lee, Hyun Seok; Jeon, Seong Woo

    2015-10-01

    Little is known about life-threatening events during gastrointestinal endoscopy (GIE). This study aimed to evaluate the clinical characteristics of emergency conditions requiring cardiopulmonary resuscitation (CPR) in GIE units and to assess the risk factors for mortality in these cases.We retrospectively collected life-threatening cases that occurred in the GIE units of 6 tertiary hospitals from January 2012 to June 2014. Cases were defined as alert calls for resuscitation teams in emergency situations of respiratory failure or cardiac arrest. Demographic data, clinical features, and probable causes were assessed. Factors associated with mortality were elucidated using logistic regression analysis.Among 263,426 endoscopies, 40 cases of CPR (0.015%) occurred during the period (male 67.5%, median age 62 yr). Gastrointestinal bleeding (GIB), such as hematemesis or melena, was the most common indication for endoscopy (55%). The types of clinical situations encountered were as follows: respiratory insufficiency (47.5%), decreased blood pressure (25%), and cardiac arrhythmia (25%). Although most of these conditions were detected during endoscopy (67.5%), one-third of cases (32.5%) were found before or after procedures. The most frequent probable cause of cases was aggravation of underlying diseases (57.5%), such as uncontrolled bleeding or exacerbation of lung disease. Despite efforts to resuscitate, 18 patients (45%) died. GIB was the single independent risk factor for mortality (odds ratio 28.45, 95% confidence interval 1.55-523.33, P = 0.024).Life-threatening situations requiring CPR can occur during endoscopy, even before or after the procedure. Greater attention should be paid while endoscopy is performed for GIB. PMID:26512621

  19. High-speed precision weighing of pharmaceutical capsules

    International Nuclear Information System (INIS)

    In this paper, we present a cost-effective method for fast and accurate in-line weighing of hard gelatin capsules based on the optimized capacitance sensor and real-time processing of the capsule capacitance profile resulting from 5000 capacitance measurements per second. First, the effect of the shape and size of the capacitive sensor on the sensitivity and stability of the measurements was investigated in order to optimize the performance of the system. The method was tested on two types of hard gelatin capsules weighing from 50 mg to 650 mg. The results showed that the capacitance profile was exceptionally well correlated with the capsule weight with the correlation coefficient exceeding 0.999. The mean precision of the measurements was in the range from 1 mg to 3 mg, depending on the size of the capsule and was significantly lower than the 5% weight tolerances usually used by the pharmaceutical industry. Therefore, the method was found feasible for weighing pharmaceutical hard gelatin capsules as long as certain conditions are met regarding the capsule fill properties and environment stability. The proposed measurement system can be calibrated by using only two or three sets of capsules with known weight. However, for most applications it is sufficient to use only empty and nominally filled capsules for calibration. Finally, a practical application of the proposed method showed that a single system is capable of weighing around 75 000 capsules per hour, while using multiple systems could easily increase the inspection rate to meet almost any requirements

  20. Impact of endoscopy-based research on quality of life in healthy volunteers

    Institute of Scientific and Technical Information of China (English)

    Alexander; Link; Gerhard; Treiber; Brigitte; Peters; Thomas; Wex; Peter; Malfertheiner

    2010-01-01

    AIM:To study the impact of an endoscopy-based long-term study on the quality of life in healthy volunteers(HV).METHODS:Ten HV were included into a long-term prospective endoscopy-based placebo-controlled trial with 15 endoscopic examinations per person in 5 different drug phases.Participants completed short form-36(SF-36) and visual analog scale-based questionnaires(VAS) for different abdominal symptoms at days 0,7 and 14 of each drug phase.Analyses wereperformed according to short-and long-term changes and...