WorldWideScience

Sample records for colon capsule endoscopy

  1. Colon capsule endoscopy: toward the future.

    Science.gov (United States)

    Muguruma, Naoki; Tanaka, Kumiko; Teramae, Satoshi; Takayama, Tetsuji

    2017-02-01

    Colon capsule endoscopy is a wireless and minimally invasive technique for visualization of the whole colon. With recent improvements of technical features in second-generation systems, a more important role for colon capsule endoscopy is rapidly emerging. Although several limitations and drawbacks are yet to be resolved, its usefulness as a tool for colorectal cancer screening and monitoring disease activity in inflammatory bowel diseases has become more apparent with increased use. Further investigations, including multicenter trials, are required to evaluate the substantial role of the colon capsule in managing colorectal diseases.

  2. Colon capsule endoscopy: Advantages, limitations and expectations. Which novelties?

    Science.gov (United States)

    Riccioni, Maria Elena; Urgesi, Riccardo; Cianci, Rossella; Bizzotto, Alessandra; Spada, Cristiano; Costamagna, Guido

    2012-01-01

    Since the first reports almost ten years ago, wireless capsule endoscopy has gained new fields of application. Colon capsule endoscopy represents a new diagnostic technology for colonic exploration. Clinical trials have shown that colon capsule endoscopy is feasible, accurate and safe in patients suffering from colonic diseases and might be a valid alternative to conventional colonoscopy in selected cases such as patients refusing conventional colonoscopy or with contraindications to colonoscopy or when colonoscopy is incomplete. Despite the enthusiasm surrounding this new technique, few clinical and randomized controlled trials are to be found in the current literature, leading to heterogeneous or controversial results. Upcoming studies are needed to prove the substantial utility of colon capsule endoscopy for colon cancer screening, especially in a low prevalence of disease population, and for other indications such as inflammatory bowel disease. Possible perspectives are critically analysed and reported in this paper. PMID:22523610

  3. Colon capsule endoscopy: Current status and future directions

    Science.gov (United States)

    Tal, Andrea O; Vermehren, Johannes; Albert, Jörg G

    2014-01-01

    Colon capsule endoscopy (CCE; PillCam Colon; Given Imaging; Yoqneam, Israel) is a minimally invasive wireless technique for the visualization of the colon. With the recent introduction of the second generation colon capsule the diagnostic accuracy of CCE for polyp detection has significantly improved and preliminary data suggest it may be useful to monitor mucosal inflammation in patients with inflammatory bowel disease. Limitations include the inability to take biopsies and the procedural costs. However, given the potentially higher acceptance within an average risk colorectal cancer (CRC) screening population, its usefulness as a screening tool with regard to CRC prevention should be further evaluated. PMID:25469027

  4. Back-to-back colon capsule endoscopy and optical colonoscopy in colorectal cancer screening individuals

    DEFF Research Database (Denmark)

    Kobaek-Larsen, Morten; Kroijer, Rasmus; Dyrvig, Anne-Kirstine

    2018-01-01

    mm polyps in colon capsule endoscopy (97%; 95% CI: 94-100) was superior to colonoscopy (89%; 95% CI: 84-94). A complete capsule endoscopy examination (N=134) could detect patients with intermediate or greater risk (according to the European guidelines) with an accuracy, sensitivity, specificity......AIM: To determine the polyp detection rate and per-patient sensitivity for polyps >9 mm of colon capsule endoscopy (CCE) compared with colonoscopy as well as the diagnostic accuracy of CCE. METHOD: Individuals who had positive immunochemical faecal occult blood test during screening had...... investigator blinded colon capsule endoscopy and colonoscopy. Participants underwent repeat endoscopy if significant lesions detected by colon capsule endoscopy were considered to have been missed by colonoscopy. RESULTS: There were 253 participants. The polyp detection rate was significantly higher in colon...

  5. Detection of small colon bleeding in wireless capsule endoscopy videos.

    Science.gov (United States)

    Usman, Muhammad Arslan; Satrya, G B; Usman, Muhammad Rehan; Shin, Soo Young

    2016-12-01

    In the recent years, wireless capsule endoscopy (WCE) technology has played a very important role in diagnosing diseases within the gastro intestinal (GI) tract of human beings. The WCE device captures images of the GI tract of patient with a certain frame rate. Physicians examine these images in order to find abnormalities in the GI tract. This examination process is very time consuming and hectic for the physician as a WCE device captures around 60,000 images on the average. At present, there are no standards defined for the WCE image classification. Computer aided methods help reducing the burden on the physicians by automatically detecting the abnormalities in the GI tract such as small colon bleeding. In this paper, a pixel based approach to detect bleeding regions in the WCE videos by using a support vector classifier is proposed. Threshold analysis in HSV color space is performed to compute the features for training an optimal support vector machine. The HSV features of the WCE images are fed to the trained support vector classifier for classification. Also, our method includes image enhancement and edge removal in WCE images, which is done prior to classification, for robust results. The method offers high sensitivity, specificity and accuracy in terms of correctly classifying images that contain bleeding regions as compared to another contemporary method. A detailed experimental analysis is also provided for the purpose of method evaluation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Capsule endoscopy

    DEFF Research Database (Denmark)

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

    2013-01-01

    with ultrasound, MRI, and subsequently a capsule endoscopy. Six months later, the patient presented, and an abdominal CT-scan showed mechanical small bowel obstruction with suspicion of metallic foreign body and perforation. Laparotomy showed perforation, stenosis, and foreign body, approximately 5 cm from...

  7. Wireless powered capsule endoscopy for colon diagnosis and treatment.

    Science.gov (United States)

    Chen, Wenwen; Yan, Guozheng; He, Shu; Ke, Quan; Wang, Zhiwu; Liu, Hua; Jiang, Pingping

    2013-11-01

    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.

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

    OpenAIRE

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

    2014-01-01

    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 Ge...

  9. Colon Capsule Endoscopy: Where Are We and Where Are We Going

    Directory of Open Access Journals (Sweden)

    Yoo Min Han

    2016-09-01

    Full Text Available Colon capsule endoscopy (CCE is a noninvasive technique for diagnostic imaging of the colon. It does not require air inflation or sedation and allows minimally invasive and painless colonic evaluation. The role of CCE is rapidly evolving; for example, for colorectal screening (colorectal cancer [CRC] in average-risk patients, in patients with an incomplete colonoscopy, in patients refusing a conventional colonoscopy, and in patients with contraindications for conventional colonoscopy. In this paper, we comprehensively review the technical characteristics and procedure of CCE and compare CCE with conventional methods such as conventional colonoscopy or computed tomographic colonography. Future expansion of CCE in the area of CRC screening for the surveillance of polyps and adenomatous lesions and for assessment of inflammatory bowel disease is also discussed.

  10. Stomach, intestine, and colon tissue discriminators for wireless capsule endoscopy images

    Science.gov (United States)

    Berens, Jeff; Mackiewicz, Michal; Bell, Duncan

    2005-04-01

    Wireless Capsule Endoscopy (WCE) is a new colour imaging technology that enables close examination of the interior of the entire small intestine. Typically, the WCE operates for ~8 hours and captures ~40,000 useful images. The images are viewed as a video sequence, which generally takes a doctor over an hour to analyse. In order to activate certain key features of the software provided with the capsule, it is necessary to locate and annotate the boundaries between certain gastrointestinal (GI) tract regions (stomach, intestine and colon) in the footage. In this paper we propose a method of automatically discriminating stomach, intestine and colon tissue in order to significantly reduce the video assessment time. We use hue saturation chromaticity histograms which are compressed using a hybrid transform, incorporating the Discrete Cosine Transform (DCT) and Principal Component Analysis (PCA). The performance of two classifiers is compared: k-nearest neighbour (kNN) and Support Vector Classifier (SVC). After training the classifier, we applied a narrowing step algorithm to converge to the points in the video where the capsule firstly passes through the pylorus (the valve between the stomach and the intestine) and later the ileocaecal valve (IV, the valve between the intestine and colon). We present experimental results that demonstrate the effectiveness of this method.

  11. Wireless capsule endoscopy

    Science.gov (United States)

    Iddan, Gavriel; Meron, Gavriel; Glukhovsky, Arkady; Swain, Paul

    2000-05-01

    We have developed a new type of endoscopy, which for the first time allows painless endoscopic imaging of the whole of the small bowel. This procedure involves a wireless capsule endoscope and we describe here its successful testing in humans.

  12. Challenges and Future of Wireless Capsule Endoscopy.

    Science.gov (United States)

    Saurin, Jean-Christophe; Beneche, Nicolas; Chambon, Christine; Pioche, Mathieu

    2016-01-01

    In 2015, capsule endoscopy was introduced as the main investigation method for small bowel mucosal diseases, and its role in colonic diseases has been gradually revealed. Future challenges for capsule endoscopy, besides improvements of image quality and visualization of each part of the small bowel and colonic mucosa, include the development of gastric capsules, the capacity to perform histological examination of the mucosa, and maybe in the future, some capsule endoscopy-driven therapeutics. The aim of this review was to evaluate the clinical demands and feasibility of achieving the aforementioned objectives.

  13. Therapeutic impact of colon capsule endoscopy with PillCam™ COLON 2 after incomplete standard colonoscopy: a Spanish multicenter study.

    Science.gov (United States)

    Nogales, Óscar; García-Lledó, Javier; Luján, Marisol; Nicolás, David; Juanmartiñena, José Francisco; González-Suárez, Begoña; Sánchez Ceballos, Francisco; Couto, Ignacio; Olmedo, José; Garfia, Cristina; Carretero, Cristina; Fernández Urién, Ignacio; Rodríguez, Sarbelio; Asteinza, Matilde; Olivencia, Pilar; Masedo, Ángeles; Muñoz-Navas, Miguel; Merino, Beatriz; González Asanza, Cecilia

    2017-05-01

    Colon capsule endoscopy (CCE) is an alternative approach for the examination of the colon in patients who refuse colonoscopy or after incomplete colonoscopy (IC). We conducted a study to determine the frequency of complete colonoscopy after IC, the diagnostic yield of CCE, the therapeutic impact of lesions found in CCE, the level of colon cleanliness and the safety of the procedure. We performed a prospective, multicenter study involving ten Spanish hospitals. Consecutive outpatients aged ≥ 18 years with previous IC were invited to participate. The latest version of the CCE device, PillCam™ COLON 2 (CCE-2), was administered to all patients according to the protocol. The study population comprised 96 patients. The most frequent cause of IC was the inability to move past a loop using standard maneuvers (75/96 patients, 78%). Complete visualization of the colon was obtained with CCE-2 in 69 patients (71.9%). Of the 27 patients in whom the CCE-2 did not reach the hemorrhoidal plexus, it passed the colonic segment explored with the previous colonoscopy in 20 cases; therefore, it could be inferred that a combined approach (CCE-2 plus colonoscopy) enabled complete visualization of the colonic mucosa in 92.7% of patients. CCE-2 revealed new lesions in 58 patients (60.4%). Polyps were the most frequent finding (41 patients; 42.7% of the total number of patients). In 43 of the 58 patients (44.8% of the total number of patients), the new lesions observed led to modification of therapy, which included a new colonoscopy for polyp resection or surgery in patients with colonic neoplasm. CCE-2 is a suitable diagnostic procedure that can lead to more frequent diagnosis of significant colonic lesions after IC.

  14. Advances in Capsule Endoscopy

    Science.gov (United States)

    Scott, Ryan

    2015-01-01

    Wireless video capsule endoscopy (VCE) is a minimally invasive technology that has revolutionized the approach to small intestinal disease investigation and management. Designed primarily to provide diagnostic imaging of the small intestine, VCE is used predominantly for obscure gastrointestinal bleeding and suspected Crohn’s disease; however, numerous other indications have been established, including the assessment of celiac disease, investigation of small bowel tumors, and surveillance of hereditary polyposis syndromes. Since the introduction of small bowel VCE in 2000, more than 1600 articles have been published describing the evolution of this technology. The main adverse outcome is capsule retention, which can potentially be avoided by careful patient selection or by using a patency capsule. Despite the numerous advances in the past 15 years, limitations such as incomplete VCE studies, missed lesions, and time-consuming reporting remain. The inability to control capsule movement for the application of targeted therapy or the acquisition of tissue for histologic analysis remains among the greatest challenges in the further development of capsule technology. This article outlines the recent technological and clinical advances in VCE and the future directions of research in this field. PMID:27482183

  15. The future of wireless capsule endoscopy.

    Science.gov (United States)

    Swain, Paul

    2008-07-14

    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. [Future prospects in digestive endoscopy: wireless capsule endoscopy].

    Science.gov (United States)

    Sacher-Huvelin, S; Bourreille, A; Le Rhun, M; Galmiche, J-P

    2009-01-01

    Since the beginning of the millennium, the development of wireless capsule endoscopy has represented a major technological advance. The capsule is ingested by the patient and images are transmitted via several sensors positioned on the skin of the patient and downloaded in a computer system. The first applications were focused on the exploration of the small bowel which was previously considered as an obscure area for conventional endoscopy. Wireless capsule endoscopy of the small bowel is now an established technique with many acknowledged indications for the diagnosis of obscure bleeding, anemia of presumed digestive origin, Crohn's disease and small bowel tumors. Recently, thanks to technological progresses, novel capsules have been developed for specific segments of the gut namely the oesophagus and the colon. Recent data suggest that these new capsules could have potential applications for the diagnosis of oesophageal varices, Barrett's oesophagus and for the screening and/or surveillance of polyps of the colon. However, further studies are required before such strategies could be approved for clinical use or even replace conventional endoscopic modalities. In the long-term, progresses in signal processing as well as in the miniaturisation of sensors or markers may lead to a new generation of endoscopic robots. This technological breakthrough may ultimately result in new concepts and change current practice of digestive endoscopy.

  17. 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. Copyright © 2015 Elsevier Ltd. All rights reserved.

  18. Contraindications for video capsule endoscopy

    OpenAIRE

    Bandorski, Dirk; Kurniawan, Niehls; Baltes, Peter; Hoeltgen, Reinhard; Hecker, Matthias; Stunder, Dominik; Keuchel, Martin

    2016-01-01

    Video capsule endoscopy (VCE) has been applied in the last 15 years in an increasing field of applications. Although many contraindications have been put into perspective, some precautions still have to be considered. Known stenosis of the gastrointestinal tract is a clear contraindication for VCE unless surgery is already scheduled or at least has been considered as an optional treatment modality. In patients with a higher incidence of stenosis, as in an established diagnosis of Crohn?s dise...

  19. 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.

  20. Wireless capsule endoscopy: perspectives beyond gastrointestinal bleeding.

    Science.gov (United States)

    Redondo-Cerezo, Eduardo; Sánchez-Capilla, Antonio Damián; De La Torre-Rubio, Paloma; De Teresa, Javier

    2014-11-14

    Wireless capsule endoscopy (CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal (GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.

  1. Application of colon capsule endoscopy (CCE to evaluate the whole gastrointestinal tract: a comparative study of single-camera and dual-camera analysis

    Directory of Open Access Journals (Sweden)

    Remes-Troche JM

    2013-09-01

    Full Text Available José María Remes-Troche,1 Victoria Alejandra Jiménez-García,2 Josefa María García-Montes,2 Pedro Hergueta-Delgado,2 Federico Roesch-Dietlen,1 Juan Manuel Herrerías-Gutiérrez2 1Digestive Physiology and Motility Lab, Medical Biological Research Institute, Universidad Veracruzana, Veracruz, México; 2Gastroenterology Service, Virgen Macarena University Hospital, Seville, Spain Background and study aims: Colon capsule endoscopy (CCE was developed for the evaluation of colorectal pathology. In this study, our aim was to assess if a dual-camera analysis using CCE allows better evaluation of the whole gastrointestinal (GI tract compared to a single-camera analysis. Patients and methods: We included 21 patients (12 males, mean age 56.20 years submitted for a CCE examination. After standard colon preparation, the colon capsule endoscope (PillCam Colon™ was swallowed after reinitiation from its “sleep” mode. Four physicians performed the analysis: two reviewed both video streams at the same time (dual-camera analysis; one analyzed images from one side of the device (“camera 1”; and the other reviewed the opposite side (“camera 2”. We compared numbers of findings from different parts of the entire GI tract and level of agreement among reviewers. Results: A complete evaluation of the GI tract was possible in all patients. Dual-camera analysis provided 16% and 5% more findings compared to camera 1 and camera 2 analysis, respectively. Overall agreement was 62.7% (kappa = 0.44, 95% CI: 0.373–0.510. Esophageal (kappa = 0.611 and colorectal (kappa = 0.595 findings had a good level of agreement, while small bowel (kappa = 0.405 showed moderate agreement. Conclusion: The use of dual-camera analysis with CCE for the evaluation of the GI tract is feasible and detects more abnormalities when compared with single-camera analysis. Keywords: capsule endoscopy, colon, gastrointestinal tract, small bowel

  2. The history of time for capsule endoscopy.

    Science.gov (United States)

    Adler, Samuel N

    2017-05-01

    Capsule endoscopy was conceived by inventive minds of good people. In the beginning there was a will to do something for medicine. The idea fomented after a discourse between the talented engineer with his physician friend. It took years to develop the concept. Then excellent engineers created de novo the necessary components to turn the capsule into a viable reality. The story is a tribute to human ingenuity.

  3. Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children

    OpenAIRE

    Jodie Ouahed; Mohammad Shagrani; Ana Sant’Anna

    2013-01-01

    Objective: To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD) type unclassified (IBDU), and to assess whether capsule endoscopy findings result in altered patient management. Methods: Ten pediatric patients recently diagnosed with IBDU through standard investigations were recruited from the pediatric gastroenterology clinic at McMaster Children's Hospital to undergo capsul...

  4. Capsule Endoscopy: New Technology, Old Complication ...

    African Journals Online (AJOL)

    Wireless capsule endoscopy is a new tool in the armamentarium of the gastroenterologist to evaluate the small bowel non-invasively. It allows improved diagnostic yield with low complication rates relative to traditional modalities. But this new technology has its own set of complications, some which can lead to significant ...

  5. Hardware image assessment for wireless endoscopy capsules.

    Science.gov (United States)

    Khorsandi, M A; Karimi, N; Samavi, S; Hajabdollahi, M; Soroushmehr, S M R; Ward, K; Najarian, K

    2016-08-01

    Wireless capsule endoscopy is a new technology in the realm of telemedicine that has many advantages over the traditional endoscopy systems. Transmitted images should help diagnosis of diseases of the gastrointestinal tract. Two important technical challenges for the manufacturers of these capsules are power consumption and size of the circuitry. Also, the system must be fast enough for real-time processing of image or video data. To solve this problem, many hardware designs have been proposed for implementation of the image processing unit. In this paper we propose an architecture that could be used for the assessment of endoscopy images. The assessment allows avoidance of transmission of medically useless images. Hence, volume of data is reduced for more efficient transmission of images by the endoscopy capsule. This is done by color space conversion and moment calculation of images captured by the capsule. The inputs of the proposed architecture are RGB image frames and the outputs are images with converted colors and calculated image moments. Experimental results indicate that the proposed architecture has low complexity and is appropriate for a real-time application.

  6. Can we reduce capsule endoscopy reading times?

    NARCIS (Netherlands)

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

    Background: Analyzing small-bowel capsule endoscopy (CE) images is time Consuming. Objective: To determine the effect of reducing the number Of images on reacting time and interpretation of CE procedures. Design: Two techniques aimed at reducing the number of images to he viewed were Studied. The

  7. Wireless capsule endoscopy of the large intestine: a review with future projections.

    Science.gov (United States)

    Van Gossum, Andre

    2014-09-01

    Video capsule endoscopy, which was initially developed for exploring the small bowel, has been adapted for investigating the colon. This review summarizes recent developments in colon capsule technology as well as indications for its use. Second-generation PillCam colon capsule endoscopy (CCE-2) has been recently developed and has significantly improved the sensitivity and specificity of colon capsules for detecting polyps and/or tumors in patients with suspected or known colonic lesions. The use of CCE-2 has been shown to be of value in patients with incomplete standard colonoscopy. The use of CCE-2 has also been investigated in patients with ulcerative colitis and in outpatient settings. Several trials have tried to simplify the colon preparation regimen. Colon capsule endoscopy is a novel technique for exploring the colon. CCE-2 has improved the diagnostic capability of this noninvasive method. There is still room for improvement and simplification of colon preparation regimens. Apart from detection of polyps or neoplasms, colon capsule endoscopy has also been assessed in patients with inflammatory bowel disease.

  8. Ultrasound capsule endoscopy: sounding out the future.

    Science.gov (United States)

    Cox, Benjamin F; Stewart, Fraser; Lay, Holly; Cummins, Gerard; Newton, Ian P; Desmulliez, Marc P Y; Steele, Robert J C; Näthke, Inke; Cochran, Sandy

    2017-05-01

    Video capsule endoscopy (VCE) has been of immense benefit in the diagnosis and management of gastrointestinal (GI) disorders since its introduction in 2001. However, it suffers from a number of well recognized deficiencies. Amongst these is the limited capability of white light imaging, which is restricted to analysis of the mucosal surface. Current capsule endoscopes are dependent on visual manifestation of disease and limited in regards to transmural imaging and detection of deeper pathology. Ultrasound capsule endoscopy (USCE) has the potential to overcome surface only imaging and provide transmural scans of the GI tract. The integration of high frequency microultrasound (µUS) into capsule endoscopy would allow high resolution transmural images and provide a means of both qualitative and quantitative assessment of the bowel wall. Quantitative ultrasound (QUS) can provide data in an objective and measurable manner, potentially reducing lengthy interpretation times by incorporation into an automated diagnostic process. The research described here is focused on the development of USCE and other complementary diagnostic and therapeutic modalities. Presently investigations have entered a preclinical phase with laboratory investigations running concurrently.

  9. Wireless capsule endoscopy in adolescents with familial adenomatous polyposis.

    Science.gov (United States)

    Cavallo, Debora; Ballardini, Giovanni; Ferrari, Andrea; Delconte, Gabriele; Signoroni, Stefano; Sala, Paola; Chiaravalli, Stefano; Massimino, Maura; Bertario, Lucio; Vitellaro, Marco

    2016-01-01

    Guidelines for surveillance in patients with familial adenomatous polyposis (FAP) recommend mutation carriers to undergo periodic colorectal examination starting in the early teens. Performing colonoscopy in children may lead to complications. Wireless capsule endoscopy (WCE) has been introduced recently to evaluate both the upper and lower gastrointestinal tract, and seems suitable as a first screening examination for adolescents. The aim of this study was to evaluate the pros and cons of WCE. This was a retrospective review of a single institution database of adolescent patients with FAP identified through the Hereditary Colorectal Tumor Registry between 2007 and 2013. The main outcomes were identification of upper and lower gastrointestinal tract polyps, tolerance of the examination, and number and size of polyps. Of 46 adolescent patients with FAP, 14 (30.4%) patients carrying adenomatous polyposis coli gene (APC) mutation, 6 male and 8 female, age (median, range) 12 (10-17) years, body mass index 19 (13-24), underwent WCE as first screening examination. The examination was completed in 13 patients (93.3%). Wireless capsule endoscopy identified the duodenal papilla in 4 patients and colonic and rectal polyps in all 13 patients. In 7 patients, fewer than 25 polyps were identified. No complications were recorded related to the use of the video capsule. Wireless capsule endoscopy is feasible and well-tolerated as a first screening examination in adolescent patients. It cannot be used as alternative to the colonoscopy, but could improve compliance with colonoscopy, and increase early adherence to a surveillance program.

  10. What we have learned and what to expect from capsule endoscopy.

    Science.gov (United States)

    Adler, Samuel N; Bjarnason, Ingvar

    2012-10-16

    Capsule endoscopy was conceived by Gabriel Iddan and Paul Swain independently two decades ago. These applications include but are not limited to Crohn's disease of the small bowel, occult gastrointestinal bleeding, non steroidal anti inflammatory drug induced small bowel disease, carcinoid tumors of the small bowel, gastro intestinal stromal tumors of the small bowel and other disease affecting the small bowel. Capsule endoscopy has been compared to traditional small bowel series, computerized tomography studies and push enteroscopy. The diagnostic yield of capsule endoscopy has consistently been superior in the diagnosis of small bowel disease compared to the competing methods (small bowel series, computerized tomography, push enteroscopy) of diagnosis. For this reason capsule endoscopy has enjoyed a meteoric success. Image quality has been improved with increased number of pixels, automatic light exposure adaptation and wider angle of view. Further applications of capsule endoscopy of other areas of the digestive tract are being explored. The increased transmission rate of images per second has made capsule endoscopy of the esophagus a realistic possibility. Technological advances that include a double imager capsule with a nearly panoramic view of the colon and a variable frame rate adjusted to the movement of the capsule in the colon have made capsule endoscopy of the colon feasible. The diagnostic rate for the identification of patients with polyps equal to or larger than 6 mm is high. Future advances in technology and biotechnology will lead to further progress. Capsule endoscopy is following the successful modern trend in medicine that replaces invasive tests with less invasive methodology.

  11. Automatic blood detection in capsule endoscopy video

    Czech Academy of Sciences Publication Activity Database

    Novozámský, Adam; Flusser, Jan; Tachecí, I.; Sulík, L.; Bureš, J.; Krejcar, O.

    2016-01-01

    Roč. 21, č. 12 (2016), s. 1-8, č. článku 126007. ISSN 1083-3668 R&D Projects: GA ČR GA15-16928S Institutional support: RVO:67985556 Keywords : Automatic blood detection * capsule endoscopy video Subject RIV: JD - Computer Applications, Robotics Impact factor: 2.530, year: 2016 http://library.utia.cas.cz/separaty/2016/ZOI/flusser-0466936.pdf

  12. Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children.

    Science.gov (United States)

    Ouahed, Jodie; Shagrani, Mohammad; Sant'Anna, Ana

    2013-01-01

    To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD) type unclassified (IBDU), and to assess whether capsule endoscopy findings result in altered patient management. Ten pediatric patients recently diagnosed with IBDU through standard investigations were recruited from the pediatric gastroenterology clinic at McMaster Children's Hospital to undergo capsule endoscopy using the Pillcam SB(TM) (Given Imaging) capsule. Findings consistent with a diagnosis of Crohn's disease required the identification of at least three ulcerations. Three out of ten patients had newly identified findings on capsule endoscopy that met criteria for Crohn's disease. Three more patients had findings suspicious for Crohn's disease, but failed to meet the diagnostic criteria. Three additional patients had findings most consistent with ulcerative colitis, and one had possible gastritis with a normal intestine. Findings from capsule endoscopy allowed for changes in the medical management of three patients. In all ten cases, capsule endoscopy allowed for a better characterization of the type and extent of disease. No adverse outcomes occurred in the present cohort. This prospective study reveals that wireless capsule endoscopy is feasible, valuable, and non-invasive, offering the ability to potentially better characterize newly diagnosed pediatric IBDU cases by identifying lesions in the small bowel and reclassifying these as Crohn's disease. Copyright © 2013 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  13. Chromoendoscopy in magnetically guided capsule endoscopy

    Science.gov (United States)

    2013-01-01

    Background Diagnosis of intestinal metaplasia and dysplasia via conventional endoscopy is characterized by low interobserver agreement and poor correlation with histopathologic findings. Chromoendoscopy significantly enhances the visibility of mucosa irregularities, like metaplasia and dysplasia mucosa. Magnetically guided capsule endoscopy (MGCE) offers an alternative technology for upper GI examination. We expect the difficulties of diagnosis of neoplasm in conventional endoscopy to transfer to MGCE. Thus, we aim to chart a path for the application of chromoendoscopy on MGCE via an ex-vivo animal study. Methods We propose a modified preparation protocol which adds a staining step to the existing MGCE preparation protocol. An optimal staining concentration is quantitatively determined for different stain types and pathologies. To that end 190 pig stomach tissue samples with and without lesion imitations were stained with different dye concentrations. Quantitative visual criteria are introduced to measure the quality of the staining with respect to mucosa and lesion visibility. Thusly determined optimal concentrations are tested in an ex-vivo pig stomach experiment under magnetic guidance of an endoscopic capsule with the modified protocol. Results We found that the proposed protocol modification does not impact the visibility in the stomach or steerability of the endoscopy capsule. An average optimal staining concentration for the proposed protocol was found at 0.4% for Methylene blue and Indigo carmine. The lesion visibility is improved using the previously obtained optimal dye concentration. Conclusions We conclude that chromoendoscopy may be applied in MGCE and improves mucosa and lesion visibility. Systematic evaluation provides important information on appropriate staining concentration. However, further animal and human in-vivo studies are necessary. PMID:23758801

  14. Video capsule endoscopy of the small bowel.

    Science.gov (United States)

    Eliakim, Rami

    2013-03-01

    Small bowel capsule endoscopy (SBCE) was introduced 13 years ago by Given Imaging (Yokneam, Israel). It has become one of the most important investigational tools of the small bowel. The capsule is swallowed with water after a 12 h fast, propelled via peristalsis through the gastrointestinal tract and excreted naturally. A nonvideo patency capsule was developed to confirm functional patency of the gastrointestinal tract. Four additional companies have introduced competitive small bowel video capsules, some of which are Food and Drug Admistration (FDA) approved. Due to the easiness of the procedure, SBCE has become a first-line tool to detect small bowel abnormalities. The main indications for SBCE include obscure gastrointestinal bleeding, suspected Crohn's disease, small bowel tumors and practically any abnormal small bowel imaging. New indications are emerging like small bowel motility and monitoring of drug therapy and mucosal healing. The present review will describe the available capsules in the market, the procedure itself, present indications and future expectations. It will focus on the PillCam SB of Given Imaging as it is the one on which most of the literature is written. Over the past 10 years, SBCE has become a routine, first-line investigational tool of many small bowel pathologies.

  15. Automatic blood detection in capsule endoscopy video

    Science.gov (United States)

    Novozámský, Adam; Flusser, Jan; Tachecí, Ilja; Sulík, Lukáš; Bureš, Jan; Krejcar, Ondřej

    2016-12-01

    We propose two automatic methods for detecting bleeding in wireless capsule endoscopy videos of the small intestine. The first one uses solely the color information, whereas the second one incorporates the assumptions about the blood spot shape and size. The original idea is namely the definition of a new color space that provides good separability of blood pixels and intestinal wall. Both methods can be applied either individually or their results can be fused together for the final decision. We evaluate their individual performance and various fusion rules on real data, manually annotated by an endoscopist.

  16. Reducing redundancy in wireless capsule endoscopy videos.

    Science.gov (United States)

    Lee, Hyun-Gyu; Choi, Min-Kook; Shin, Byeong-Seok; Lee, Sang-Chul

    2013-07-01

    We eliminate similar frames from a wireless capsule endoscopy video of the human intestines to maximize spatial coverage and minimize the redundancy in images. We combine an intensity correction method with a method based an optical flow and features to detect and reduce near-duplicate images acquired during the repetitive backward and forward egomotions due to peristalsis. In experiments, this technique reduced duplicate image of 52.3% from images of the small intestine. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

  17. 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.

  18. Watermelon stomach seen by wireless‐capsule endoscopy

    OpenAIRE

    MASCARENHAS‐SARAIVA, M.; LOPES, L.; MASCARENHAS‐SARAIVA, A.

    2003-01-01

    Endoscopy. 2003 Jan;35(1):100. Watermelon stomach seen by wireless-capsule endoscopy. Mascarenhas-Saraiva M, Lopes L, Mascarenhas-Saraiva A. SourceDigestive Endoscopy and Motility Unit, Trindade Hospital, Rua Trinidade 115, 4000-541 Porto, Portugal. PMID:12510242[PubMed - indexed for MEDLINE

  19. Role of wireless capsule endoscopy in the follow-up of inflammatory bowel disease.

    Science.gov (United States)

    Mitselos, Ioannis V; Christodoulou, Dimitrios K; Katsanos, Konstantinos H; Tsianos, Epameinondas V

    2015-06-10

    The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure's inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn's disease patients who have undergone ileocolonic resection for the treatment of Crohn's disease complications, and in patients' management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis.

  20. Multilevel wireless capsule endoscopy video segmentation

    Science.gov (United States)

    Hwang, Sae; Celebi, M. Emre

    2010-03-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology (FDA approved in 2002) allowing doctors to view most of the small intestine. WCE transmits more than 50,000 video frames per examination and the visual inspection of the resulting video is a highly time-consuming task even for the experienced gastroenterologist. Typically, a medical clinician spends one or two hours to analyze a WCE video. To reduce the assessment time, it is critical to develop a technique to automatically discriminate digestive organs and shots each of which consists of the same or similar shots. In this paper a multi-level WCE video segmentation methodology is presented to reduce the examination time.

  1. Wireless capsule endoscopy years after Michelassi stricturoplasty for Crohn's disease.

    Science.gov (United States)

    Sciaudone, G; Pellino, G; Guadagni, I; Pezzullo, A; Selvaggi, F

    2010-01-01

    The use of wireless capsule endoscopy in Crohn's disease has been a matter of debate. We report the case of a 27-year-old woman operated for Crohn's disease with a Michelassi stricturoplasty presenting with anaemia. We tested the patient with a patency capsule before undertaking a wireless capsule endoscopy. Although the absorbable capsule was successfully expelled, the wireless capsule was retained next to the distal edge of the Michelassi stricturoplasty, where it revealed an otherwise undetected stenotic recurrence. We successfully treated the recurrence with a Heineke-Mikulicz stricturoplasty on the stenotic outlet of the previous Michelassi, extracting the capsule. We found our treatment effective. We believe that capsule endoscopy can be performed in patients operated on for Crohn's disease, although further studies are needed to clarify its role in patients with long-stricturoplasties and to establish which examination could be the most effective in selecting patients.

  2. Is there an application for wireless capsule endoscopy in horses?

    Science.gov (United States)

    Montgomery, Julia B; Bracamonte, Jose L; Alam, Mohammad Wajih; Khan, Alimul H; Mohammed, Shahed K; Wahid, Khan A

    2017-12-01

    This pilot study assessed wireless capsule endoscopy in horses. Image transmission was achieved with good image quality. Time to exit the stomach was variable and identified as one limitation, together with gaps in image transmission, capsule tumbling, and inability to accurately locate the capsule. Findings demonstrate usefulness and current limitations.

  3. [Wireless capsule endoscopy: basic principles and clinical utility].

    Science.gov (United States)

    González-Suárez, Begoña; Galter, Sara; Balanzó, Joaquín

    2007-06-01

    Wireless capsule endoscopy (PillCam) represents a major advance in the study of small bowel disease since this procedure allows images of hitherto unreachable areas to be obtained. Approved for use by the Food and Drug Administration in August 2000, capsule endoscopy is currently a first line procedure in the study of small bowel disease. This technique consists of a non-reusable swallowable capsule (length 26 x 11 mm) that acquires video images while moving through the gastrointestinal tract propelled by natural peristalsis. The main indications of capsule endoscopy are evaluation of obscure gastrointestinal bleeding, chronic anemia, and inflammatory bowel disease. Contraindications are swallowing disorders and known or suspected small bowel strictures of any etiology. Consequently, small bowel follow through is useful prior to capsule endoscopy when these lesions are suspected.

  4. Capsule Endoscopy: A Single Centre Experience with the First 226 Capsules

    Directory of Open Access Journals (Sweden)

    R Enns

    2004-01-01

    Full Text Available BACKGROUND: Capsule endoscopy (CE refers to a novel diagnostic method of imaging the gastrointestinal tract using a wireless capsule that transmits images to a data recorder while the device traverses the small intestine.

  5. Evaluation of capsule endoscopy to detect mucosal lesions associated with gastrointestinal bleeding in dogs.

    Science.gov (United States)

    Davignon, D L; Lee, A C Y; Johnston, A N; Bowman, D D; Simpson, K W

    2016-03-01

    The objective of this study was to examine the utility of capsule endoscopy to detect mucosal abnormalities in dogs with gastrointestinal haemorrhage. Capsules were administered to 2 healthy controls and 8 patients with gastrointestinal haemorrhage. Images were evaluated for quality, gastric emptying time, small intestinal transit time and presence of lesions. There were no adverse effects of capsule endoscopy in dogs weighing from 7·7 to 58 kg. The capsule traversed the entire gastrointestinal tract in 5 of 8 patients, with high quality images obtained in the stomach and small intestine. Gastric emptying time and small intestinal transit time ranged from 1 to 270 and 15 to 180 minutes, respectively. In 3 of 8 patients, the capsule remained in the stomach despite pro-kinetics. Gastric lesions included mild haemorrhage and pinpoint erosion (4 of 8), a mass (1) and thickened bleeding pyloric mucosa (2). Two of 3 dogs with capsule retention had gastric lesions. Intestinal lesions included a healing duodenal ulcer, abnormal villi, ileal ulceration and colonic bleeding. Lesions identified by capsule endoscopy were considered a significant source of haemorrhage in 4 of 7 dogs with active bleeding. The relevance of pinpoint gastric mucosal erosions to blood loss is unclear. Capsule endoscopy can enable the non-invasive detection of gastric and small intestinal mucosal lesions in dogs presenting for evaluation of gastrointestinal bleeding. © 2016 British Small Animal Veterinary Association.

  6. A UWB wireless capsule endoscopy device.

    Science.gov (United States)

    Thotahewa, Kasun M S; Redoute, Jean-Michel; Yuce, Mehmet Rasit

    2014-01-01

    Wireless capsule endoscopy (WCE) presents many advantages over traditional wired endoscopic methods. The performance of WCE devices can be improved using high-frequency communication systems such as Impulse Radio-Ultra-Wideband (IR-UWB) to enable a high data rate transmission with low-power consumption. This paper presents the hardware implementation and experimental evaluation of a WCE device that uses IR-UWB signals in the frequency range of 3.5 GHz to 4.5 GHz to transmit image data from inside the body to a receiver placed outside the body. Key components of the IR-UWB transmitter, such as the narrow pulse generator and up-conversion based RF section are described in detail. This design employs a narrowband receiver in the WCE device to receive a control signal externally in order to control and improve the data transmission from the device in the body. The design and performance of a wideband implantable antenna that operates in the aforementioned frequency range is also described. The operation of the WCE device is demonstrated through a proof-of-concept experiment using meat.

  7. Capsule Endoscopy for Portal Hypertensive Enteropathy

    Directory of Open Access Journals (Sweden)

    Seong Ran Jeon

    2016-01-01

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

  8. Utility of capsule endoscopy for evaluating anthelmintic efficacy in fully conscious dogs.

    Science.gov (United States)

    Lee, Alice C Y; Epe, Christian; Simpson, Kenneth W; Bowman, Dwight D

    2011-11-01

    The current accepted standard for evaluating the efficacy of gastrointestinal anthelmintic drugs is necropsy of infected animals followed by a comparison of worm counts between treated and non-treated groups. In this study capsule endoscopy, a minimally invasive method of imaging the small intestine of humans, is evaluated as a possible alternative to necropsy for the purposes of worm quantification in dogs. Eighteen Beagle dogs were included in this study. These dogs were part of a separate trial intended to determine the efficacy of various candidate parasiticides against Ancylostoma caninum via the necropsy standard. Dogs were inoculated with A. caninum L3s 4 weeks prior to treatment with one of the candidate compounds; a control group (n=8) received no treatment. Capsule endoscopy was performed 6-14 days post-treatment, followed by necropsy the following day. Seventeen dogs had complete examinations, i.e. the capsule traversed the small intestine and reached the colon within the battery life of the capsule. A strong correlation (r(s)=0.87, Pcapsule endoscopy and necropsy. There was no clear relationship between the ability of the capsule endoscope to detect hookworms and either visibility of the intestinal lumen or small intestinal transit time. Generation of a virtual spatial record of hookworm location from the capsule endoscopy data revealed a temporal trend, with the majority of worms present in the proximal small intestine in the morning versus the central to distal small intestine in the afternoon. Worm distribution as determined by capsule endoscopy closely resembled post-mortem findings. In conclusion, capsule endoscopy shows promise as an alternative to necropsy for the enumeration of A. caninum in the canine small intestine, although further work is required to improve completion rates and optimise intestinal examination. Copyright © 2011 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

  9. Capsule endoscopy compared with conventional colonoscopy for detection of colorectal neoplasms

    OpenAIRE

    Sieg, Andreas

    2011-01-01

    Colon capsule endoscopy (CCE) may be a means to overcome the low adherence to colorectal cancer screening. The device is an ingestible capsule with a video camera at both ends that can take photographs as it progresses through the gastrointestinal tract. PillCam colon (PCC1) may be used for structural evaluation of the large bowel following an adequate cleaning procedure. PCC1 measures 11 mm × 31 mm and has dual cameras that enable the device to acquire video images from both ends with a wide...

  10. Computer aided wireless capsule endoscopy video segmentation.

    Science.gov (United States)

    Li, Baopu; Xu, Guoqing; Zhou, Ran; Wang, Tianfu

    2015-02-01

    Wireless capsule endoscopy (WCE) opens a new door for the digestive tract examination and diagnosis. However, the examination of its video data is tedious. This study aims to assist a physician to interpret a WCE video by segmenting it into different anatomic parts in the digestive tract. A two level WCE video segmentation scheme is proposed to locate the boundary between the stomach, small intestine, and large intestine. In the rough level, the authors utilize color feature to draw a dissimilarity curve for a WCE video and obtain an approximate boundary. Meanwhile, training data for the fine level segmentation can be collected automatically between the two approximate boundaries of organs to overcome the difficulty of training data collection in traditional approaches. In the fine level, color histogram in the HSI color space is used to segment the stomach and small intestine. Then, color uniform local binary pattern (CULBP) algorithm is applied for discrimination of the small intestine and large intestine, which includes two patterns, namely, color norm and color angle pattern. The CULBP feature is robust to variation of illumination and discriminative for classification. In order to increase the performance of support vector machine, the authors integrate it with the Adaboost approach. Finally, the authors refine the classification results to segment a WCE video into different parts, that is, the stomach, small intestine, and large intestine. The average precision and recall are 91.2% and 90.6% for the stomach/small intestine classification, 89.2% and 88.7% for the small/large intestine discrimination. Paired t-test also demonstrates a significant better performance of the proposed scheme compared to some traditional methods. The average segmentation error is 8 frames for the stomach/small intestine discrimination, and 14 frames for the small/large intestine segmentation. The results have demonstrated that the new video segmentation method can accurately locate

  11. The application value of capsule endoscopy in diagnosing small intestinal carcinoma

    Directory of Open Access Journals (Sweden)

    Xiaohuan Li

    2018-01-01

    Conclusion: Capsule endoscopy demonstrated a high diagnostic value for various small bowel diseases, including both tumor and inflammatory lesions. Given its simplicity, safety, and reliability, capsule endoscopy was an important examination tool for the diagnosis of small bowel diseases.

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

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

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

  13. Flexible and capsule endoscopy for screening, diagnosis and treatment.

    Science.gov (United States)

    Sliker, Levin J; Ciuti, Gastone

    2014-11-01

    Endoscopy dates back to the 1860s, but many of the most significant advancements have been made within the past decade. With the integration of robotics, the ability to precisely steer and advance traditional flexible endoscopes has been realized, reducing patient pain and improving clinician ergonomics. Additionally, wireless capsule endoscopy, a revolutionary alternative to traditional scopes, enables inspection of the digestive system with minimal discomfort for the patient or the need for sedation, mitigating some of the risks of flexible endoscopy. This review presents a research update on robotic endoscopic systems, including both flexible scope and capsule technologies, detailing actuation methods and therapeutic capabilities. A future perspective on endoscopic potential for screening, diagnostic and therapeutic gastrointestinal procedures is also presented.

  14. 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.

  15. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    Science.gov (United States)

    Pan, Guobing; Wang, Litong

    2012-01-01

    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. PMID:22253621

  16. Overview of technical solutions and assessment of clinical usefulness of capsule endoscopy.

    Science.gov (United States)

    Koprowski, Robert

    2015-12-01

    The paper presents an overview of endoscopic capsules with particular emphasis on technical aspects. It indicates common problems in capsule endoscopy such as: (1) limited wireless communication (2) the use of capsule endoscopy in the case of partial patency of the gastrointestinal tract, (3) limited imaging area, (4) external capsule control limitations. It also presents the prospects of capsule endoscopy, the most recent technical solutions for biopsy and the mobility of the capsule in the gastrointestinal tract. The paper shows the possibilities of increasing clinical usefulness of capsule endoscopy resulting from technological limitations. Attention has also been paid to the current role of capsule endoscopy in screening tests and the limitations of its effectiveness. The paper includes the author's recommendations concerning the direction of further research and the possibility of enhancing the scope of capsule endoscopy.

  17. Wireless capsule endoscopy of the small intestine: a review with future directions.

    Science.gov (United States)

    Neumann, Helmut; Fry, Lucía C; Nägel, Andreas; Neurath, Markus F

    2014-09-01

    Here, we review the clinical applications of small bowel capsule endoscopy. Moreover, we provide an outlook on the exceptional future developments of small bowel capsule endoscopy. We discuss clinical algorithms for diagnosis of small bowel diseases. Multiple studies have shown the potential of capsule endoscopy for identification of the bleeding source located in the small bowel and the increased diagnostic yield over radiographic studies. Capsule endoscopy could detect villous atrophy and severe complications in patients with nonresponsive celiac disease. In addition, small bowel capsule endoscopy was proven as a valid tool to diagnose polyps and tumors and Crohn's disease. Major current clinical indications of capsule endoscopy in the small bowel include evaluation of obscure gastrointestinal bleeding, diagnosis and surveillance of small bowel polyps and tumors, celiac disease and Crohn's disease. Recent developments have also passed the way for small bowel capsule endoscopy to become a therapeutic instrument.

  18. Accuracy and safety of second-generation PillCam COLON capsule for colorectal polyp detection

    OpenAIRE

    Spada, Cristiano; De Vincentis, Fabio; Cesaro, Paola; Hassan, Cesare; Riccioni, Maria Elena; Minelli Grazioli, Leonardo; Bolivar, Santiago; Zurita, Andrade; Costamagna, Guido

    2012-01-01

    PillCam COLON capsule endoscopy (CCE) (Given Imaging Ltd, Yoqneam, Israel) is one of the most recent diagnostic, endoscopic technologies designed to explore the colon. CCE is a noninvasive, patient-friendly technique that is able to explore the colon without requiring sedation and air insufflation. The first generation of CCE was released onto the market in 2006 and although it generated great enthusiasm, it showed suboptimal accuracy. Recently, a second-generation system (PillCam COLON 2) (C...

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

    Directory of Open Access Journals (Sweden)

    I. Xinias

    2012-10-01

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

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

    Science.gov (United States)

    Xinias, I; Mavroudi, A; Fotoulaki, M; Tsikopoulos, G; Kalampakas, A; Imvrios, G

    2012-09-01

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

  1. Technology Insight: current status of video capsule endoscopy.

    Science.gov (United States)

    Cave, David R

    2006-03-01

    Video capsule endoscopy (VCE) is the most recent major practical and conceptual development in the field of endoscopy. The video capsule endoscope-a small, pill-sized, passive imaging device-has been demonstrated to be the pre-eminent imaging device for disorders of the small intestine. The initial use for VCE was to detect the origin of obscure gastrointestinal bleeding. Several other indications have now been justified, or are in the process of evaluation. More than 200,000 of these disposable devices have been used worldwide, with an extraordinarily good safety record: indeed, the device has been approved for use in children as young as 10 years of age. In addition, a double-ended capsule has now been approved for the evaluation of mucosal disease in the esophagus. The now-widespread deployment of the device into gastrointestinal practice in the US and many other countries suggests that VCE has achieved mainstream utility. The development of similar competitor devices, and devices whose movement can be controlled, is in progress.

  2. A modular and programmable development platform for capsule endoscopy system.

    Science.gov (United States)

    Khan, Tareq Hasan; Shrestha, Ravi; Wahid, Khan A

    2014-06-01

    The state-of-the-art capsule endoscopy (CE) technology offers painless examination for the patients and the ability to examine the interior of the gastrointestinal tract by a noninvasive procedure for the gastroenterologists. In this work, a modular and flexible CE development system platform consisting of a miniature field programmable gate array (FPGA) based electronic capsule, a microcontroller based portable data recorder unit and computer software is designed and developed. Due to the flexible and reprogrammable nature of the system, various image processing and compression algorithms can be tested in the design without requiring any hardware change. The designed capsule prototype supports various imaging modes including white light imaging (WLI) and narrow band imaging (NBI), and communicates with the data recorder in full duplex fashion, which enables configuring the image size and imaging mode in real time during examination. A low complexity image compressor based on a novel color-space is implemented inside the capsule to reduce the amount of RF transmission data. The data recorder contains graphical LCD for real time image viewing and SD cards for storing image data. Data can be uploaded to a computer or Smartphone by SD card, USB interface or by wireless Bluetooth link. Computer software is developed that decompresses and reconstructs images. The fabricated capsule PCBs have a diameter of 16 mm. An ex-vivo animal testing has also been conducted to validate the results.

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    Autoimmune enteropathy (AE) is an immune mediated illness of the intestinal mucosa. The cause is unknown, and the diagnosis is based on typical characteristics displayed. There is no gold standard for treatment. We present two adult cases of AE and demonstrate the challenges in establishing...... the diagnosis. The extensive diagnostic work up excluded other more common causes of protracted diarrhoea. Wireless capsule endoscopy (WCE) displayed universal small intestinal mucosal damage with shortened villi that led to the suspicion of AE in both patients. The diagnosis was confirmed with microscopy....... Use of WCE as a diagnostic tool was invaluable in establishing the diagnosis of AE....

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

    DEFF Research Database (Denmark)

    Rondonotti, E; Pennazio, M; Toth, E

    2008-01-01

    BACKGROUND AND STUDY AIM: Small-bowel tumors account for 1% - 3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency...... of the neoplasm seen in 29 centers of 10 European Countries. RESULTS: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm...

  5. Wireless capsule endoscopy of the small intestine in children.

    Science.gov (United States)

    Zevit, Noam; Shamir, Raanan

    2015-06-01

    Wireless capsule endoscopy (CE) for the diagnosis of small-bowel disease has been in clinical use for more than a decade, and is no longer an emerging technology, but rather one that has reached fruition. This noninvasive technology has been readily embraced by both physicians and patients. Used in the diagnosis of inflammatory bowel disease, for locating sources of obscure gastrointestinal bleeding, and for assessing small-bowel polyp burden in polyposis syndromes as well as for less common indications, CE has transformed the diagnostic algorithms of small-bowel investigations. Although already in widespread use, the technology incorporated into the various CE platforms continues to improve and expand. Here, we briefly review the indications, limitations, and advances in video capsule technology, with an emphasis on its use in pediatrics.

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

    Science.gov (United States)

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

    2011-03-01

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

  7. 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.

  8. Generic feature learning for wireless capsule endoscopy analysis.

    Science.gov (United States)

    Seguí, Santi; Drozdzal, Michal; Pascual, Guillem; Radeva, Petia; Malagelada, Carolina; Azpiroz, Fernando; Vitrià, Jordi

    2016-12-01

    The interpretation and analysis of wireless capsule endoscopy (WCE) recordings is a complex task which requires sophisticated computer aided decision (CAD) systems to help physicians with video screening and, finally, with the diagnosis. Most CAD systems used in capsule endoscopy share a common system design, but use very different image and video representations. As a result, each time a new clinical application of WCE appears, a new CAD system has to be designed from the scratch. This makes the design of new CAD systems very time consuming. Therefore, in this paper we introduce a system for small intestine motility characterization, based on Deep Convolutional Neural Networks, which circumvents the laborious step of designing specific features for individual motility events. Experimental results show the superiority of the learned features over alternative classifiers constructed using state-of-the-art handcrafted features. In particular, it reaches a mean classification accuracy of 96% for six intestinal motility events, outperforming the other classifiers by a large margin (a 14% relative performance increase). Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Capsule endoscopy in acute upper gastrointestinal hemorrhage: a prospective cohort study.

    Science.gov (United States)

    Gralnek, I M; Ching, J Y L; Maza, I; Wu, J C Y; Rainer, T H; Israelit, S; Klein, A; Chan, F K L; Ephrath, H; Eliakim, R; Peled, R; Sung, J J Y

    2013-01-01

    Capsule endoscopy may play a role in the evaluation of patients presenting with acute upper gastrointestinal hemorrhage in the emergency department. We evaluated adults with acute upper gastrointestinal hemorrhage presenting to the emergency departments of two academic centers. Patients ingested a wireless video capsule, which was followed immediately by a nasogastric tube aspiration and later by esophagogastroduodenoscopy (EGD). We compared capsule endoscopy with nasogastric tube aspiration for determination of the presence of blood, and with EGD for discrimination of the source of bleeding, identification of peptic/inflammatory lesions, safety, and patient satisfaction. The study enrolled 49 patients (32 men, 17 women; mean age 58.3 ± 19 years), but three patients did not complete the capsule endoscopy and five were intolerant of the nasogastric tube. Blood was detected in the upper gastrointestinal tract significantly more often by capsule endoscopy (15 /18 [83.3 %]) than by nasogastric tube aspiration (6 /18 [33.3 %]; P = 0.035). There was no significant difference in the identification of peptic/inflammatory lesions between capsule endoscopy (27 /40 [67.5 %]) and EGD (35 /40 [87.5 %]; P = 0.10, OR 0.39 95 %CI 0.11 - 1.15). Capsule endoscopy reached the duodenum in 45 /46 patients (98 %). One patient (2.2 %) had self-limited shortness of breath and one (2.2 %) had coughing on capsule ingestion. In an emergency department setting, capsule endoscopy appears feasible and safe in people presenting with acute upper gastrointestinal hemorrhage. Capsule endoscopy identifies gross blood in the upper gastrointestinal tract, including the duodenum, significantly more often than nasogastric tube aspiration and identifies inflammatory lesions, as well as EGD. Capsule endoscopy may facilitate patient triage and earlier endoscopy, but should not be considered a substitute for EGD. © Georg Thieme Verlag KG Stuttgart · New York.

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

    Science.gov (United States)

    Zhiwei, Jia; Guozheng, Yan; Bingquan, Zhu

    2014-10-01

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

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

    Science.gov (United States)

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

    2015-07-06

    Autoimmune enteropathy (AE) is an immune mediated illness of the intestinal mucosa. The cause is unknown, and the diagnosis is based on typical characteristics displayed. There is no gold standard for treatment. We present two adult cases of AE and demonstrate the challenges in establishing the diagnosis. The extensive diagnostic work up excluded other more common causes of protracted diarrhoea. Wireless capsule endoscopy (WCE) displayed universal small intestinal mucosal damage with shortened villi that led to the suspicion of AE in both patients. The diagnosis was confirmed with microscopy, showing shortened villi, villous blunting and hyperplasia of crypts in both patients. In one patient, deep crypt lymphocytosis with minimal intraepithelial lymphocytosis was found as well. Both patients were successfully treated with high-dose immunosuppressant therapy to induce and maintain remission. Use of WCE as a diagnostic tool was invaluable in establishing the diagnosis of AE. 2015 BMJ Publishing Group Ltd.

  12. Saliency-Based Bleeding Localization for Wireless Capsule Endoscopy Diagnosis

    Directory of Open Access Journals (Sweden)

    Hongda Chen

    2017-01-01

    Full Text Available Stomach bleeding is a kind of gastrointestinal disease which can be diagnosed noninvasively by wireless capsule endoscopy (WCE. However, it requires much time for physicians to scan large amount of WCE images. Alternatively, computer-assisted bleeding localization systems are developed where color, edge, and intensity features are defined to distinguish lesions from normal tissues. This paper proposes a saliency-based localization system where three saliency maps are computed: phase congruency-based edge saliency map derived from Log-Gabor filter bands, intensity histogram-guided intensity saliency map, and red proportion-based saliency map. Fusing the three maps together, the proposed system can detect bleeding regions by thresholding the fused saliency map. Results demonstrate the accuracy of 98.97% for our system to mark bleeding regions.

  13. 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.

  14. Wireless capsule endoscopy and double-balloon enteroscopy for the diagnosis of obscure gastrointestinal bleeding.

    Science.gov (United States)

    Gerson, Lauren B; Van Dam, Jacques

    2004-09-01

    Standard endoscopic examination (upper gastrointestinal endoscopy and colonoscopy) fails to detect the cause of gastrointestinal hemorrhage in approximately 5% of patients. Before the availability of wireless capsule endoscopy and double-balloon enteroscopy, imaging modalities for the small intestine distal to the ligament of Treitz included barium contrast examination and/or enteroclysis, push, passive, or intraoperative enteroscopy, technetium 99m labeled sulfur colloid scanning, angiography, and computed tomography, although the diagnostic yield of all of these imaging modalities was low. In 2001, wireless capsule endoscopy became available for the evaluation of patients with probable small intestinal hemorrhage. Advantages of wireless capsule endoscopy include that the procedure is noninvasive, requires no sedation, and does not expose the patient to ionizing radiation. In patients with obscure gastrointestinal hemorrhage, studies have demonstrated an additional 25 to 50% diagnostic yield using wireless capsule endoscopy when compared to other diagnostic modalities. The major limitations of capsule endoscopy were its inability to obtain a biopsy, precisely localize a lesion, or perform therapeutic endoscopy. In 2001, the double-balloon enteroscope was introduced. This new endoscopic technique provides the gastroenterologist with an opportunity for further evaluation and treatment of abnormalities detected on wireless capsule endoscopy or other small intestinal imaging studies.

  15. Reduction of capsule endoscopy reading times by unsupervised image mining.

    Science.gov (United States)

    Iakovidis, D K; Tsevas, S; Polydorou, A

    2010-09-01

    The screening of the small intestine has become painless and easy with wireless capsule endoscopy (WCE) that is a revolutionary, relatively non-invasive imaging technique performed by a wireless swallowable endoscopic capsule transmitting thousands of video frames per examination. The average time required for the visual inspection of a full 8-h WCE video ranges from 45 to 120min, depending on the experience of the examiner. In this paper, we propose a novel approach to WCE reading time reduction by unsupervised mining of video frames. The proposed methodology is based on a data reduction algorithm which is applied according to a novel scheme for the extraction of representative video frames from a full length WCE video. It can be used either as a video summarization or as a video bookmarking tool, providing the comparative advantage of being general, unbounded by the finiteness of a training set. The number of frames extracted is controlled by a parameter that can be tuned automatically. Comprehensive experiments on real WCE videos indicate that a significant reduction in the reading times is feasible. In the case of the WCE videos used this reduction reached 85% without any loss of abnormalities.

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

    Directory of Open Access Journals (Sweden)

    Dimitrios Christodoulou

    2007-01-01

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

  17. A retrospective analysis comparing small bowel follow-through with wireless capsule endoscopy in the evaluation of obscure gastrointestinal bleeding.

    Science.gov (United States)

    Nutter, Melanie; Dunston, Diana; Ieyoub, Jonathan; Hart, Albert; Harper, Jeannie; Burke, Mary S

    2010-01-01

    A comparative retrospective study was conducted to evaluate diagnostic findings between small bowel follow-through (SBFT) and wireless capsule endoscopy in the presence of obscure gastrointestinal bleeding. A convenience sample of 31 patients with previous negative upper and lower endoscopy was included in the study. Wireless capsule endoscopy established a significant source of obscure gastrointestinal bleeding 53% of the time. The diagnostic capacity of radiographic SBFT was measured at 17% as compared with that of the wireless capsule endoscopy. The clinical findings along with the digital images obtained from the wireless capsule endoscopy was found to be the optimum diagnostic tool in the evaluation of obscure gastrointestinal bleeding in the small bowel.

  18. Preoperative wireless capsule endoscopy does not predict outcome after ileal pouch-anal anastomosis.

    Science.gov (United States)

    Murrell, Zuri; Vasiliauskas, Eric; Melmed, Gil; Lo, Simon; Targan, Stephan; Fleshner, Phillip

    2010-03-01

    The extent of preoperative small-bowel mucosal inflammation may be an important predictor of pouchitis after ileal pouch-anal anastomosis. This study examined the value of preoperative wireless capsule endoscopy in predicting outcome of ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. Patients undergoing complete wireless capsule endoscopy before ileal pouch-anal anastomosis were identified. Findings on wireless capsule endoscopy were classified as positive (erosions, ulcers or erythema) or negative. Outcome was assessed prospectively and included no pouchitis, acute pouchitis, chronic pouchitis, or de novo Crohn disease. Patients with acute pouchitis, chronic pouchitis, or de novo Crohn disease were considered to have pouch inflammation. The 68 study patients (48 ulcerative colitis; 20 indeterminate colitis) had a median age of 38 years and included 34 males. Median follow-up time after ileostomy closure was 12 months (range, 3-63 months). Wireless capsule endoscopy was positive in 15 patients (22%) and negative in 53 patients (78%). Pouch inflammation was observed in 23 patients (34%), and included 8 patients with acute pouchitis, 3 patients with chronic pouchitis, and 12 patients with de novo Crohn disease. The incidence of acute pouchitis, chronic pouchitis, de novo Crohn disease, and pouch inflammation in the wireless capsule endoscopy-positive patient group was 7%, 7%, 20%, and 33% compared with 13%, 4%, 17%, and 34% in the wireless capsule endoscopy-negative patient group (all P = NS). There was no statistical association between the results of preoperative wireless capsule endoscopy and outcome after ileal pouch-anal anastomosis in patients with ulcerative colitis or indeterminate colitis. There seems to be little value of wireless capsule endoscopy in the preoperative evaluation of these patients.

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

    Directory of Open Access Journals (Sweden)

    Shou-jiang Tang

    2004-01-01

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

  20. A general framework for wireless capsule endoscopy study synopsis.

    Science.gov (United States)

    Zhao, Qian; Mullin, Gerard E; Meng, Max Q-H; Dassopoulos, Themistocles; Kumar, Rajesh

    2015-04-01

    We present a general framework for analysis of wireless capsule endoscopy (CE) studies. The current available workstations provide a time-consuming and labor-intense work-flow for clinicians which requires the inspection of the full-length video. The development of a computer-aided diagnosis (CAD) CE workstation will have a great potential to reduce the diagnostic time and improve the accuracy of assessment. We propose a general framework based on hidden Markov models (HMMs) for study synopsis that forms the computational engine of our CAD workstation. Color, edge and texture features are first extracted and analyzed by a Support Vector Machine classifier, and then encoded as the observations for the HMM, uniquely combining the temporal information during the assessment. Experiments were performed on 13 full-length CE studies, instead of selected images previously reported. The results (e.g. 0.933 accuracy with 0.933 recall for detection of polyps) show that our framework achieved promising performance for multiple classification. We also report the patient-level CAD assessment of complete CE studies for multiple abnormalities, and the patient-level validation demonstrates the effectiveness and robustness of our methods. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Automatic Hookworm Detection in Wireless Capsule Endoscopy Images.

    Science.gov (United States)

    Wu, Xiao; Chen, Honghan; Gan, Tao; Chen, Junzhou; Ngo, Chong-Wah; Peng, Qiang

    2016-07-01

    Wireless capsule endoscopy (WCE) has become a widely used diagnostic technique to examine inflammatory bowel diseases and disorders. As one of the most common human helminths, hookworm is a kind of small tubular structure with grayish white or pinkish semi-transparent body, which is with a number of 600 million people infection around the world. Automatic hookworm detection is a challenging task due to poor quality of images, presence of extraneous matters, complex structure of gastrointestinal, and diverse appearances in terms of color and texture. This is the first few works to comprehensively explore the automatic hookworm detection for WCE images. To capture the properties of hookworms, the multi scale dual matched filter is first applied to detect the location of tubular structure. Piecewise parallel region detection method is then proposed to identify the potential regions having hookworm bodies. To discriminate the unique visual features for different components of gastrointestinal, the histogram of average intensity is proposed to represent their properties. In order to deal with the problem of imbalance data, Rusboost is deployed to classify WCE images. Experiments on a diverse and large scale dataset with 440 K WCE images demonstrate that the proposed approach achieves a promising performance and outperforms the state-of-the-art methods. Moreover, the high sensitivity in detecting hookworms indicates the potential of our approach for future clinical application.

  2. Engineering Micromechanical Systems for the Next Generation Wireless Capsule Endoscopy.

    Science.gov (United States)

    Woods, Stephen; Constandinou, Timothy

    2015-01-01

    Wireless capsule endoscopy (WCE) enables the detection and diagnosis of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. However treatment of these pathologies can only be achieved through conventional means. This paper describes the next generation WCE with increased functionality to enable targeted drug delivery in the small intestinal tract. A prototype microrobot fabricated in Nylon 6 is presented which is capable of resisting peristaltic pressure through the deployment of an integrated holding mechanism and delivering targeted therapy. The holding action is achieved by extending an "anchor" spanning a 60.4 mm circumference, for an 11.0 mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0 mm(3) volume, including mechanics and actuator. A micropositioning mechanism is described which utilises a single micromotor to radially position and then deploy a needle 1.5 mm outside the microrobot's body to deliver a 1 mL dose of medication to a targeted site. An analysis of the mechanics required to drive the holding mechanism is presented and an overview of microactuators and the state of the art in WCE is discussed. It is envisaged that this novel functionality will empower the next generation of WCE to help diagnose and treat pathologies of the GI tract.

  3. Engineering Micromechanical Systems for the Next Generation Wireless Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Stephen Woods

    2015-01-01

    Full Text Available Wireless capsule endoscopy (WCE enables the detection and diagnosis of inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis. However treatment of these pathologies can only be achieved through conventional means. This paper describes the next generation WCE with increased functionality to enable targeted drug delivery in the small intestinal tract. A prototype microrobot fabricated in Nylon 6 is presented which is capable of resisting peristaltic pressure through the deployment of an integrated holding mechanism and delivering targeted therapy. The holding action is achieved by extending an “anchor” spanning a 60.4 mm circumference, for an 11.0 mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0 mm3 volume, including mechanics and actuator. A micropositioning mechanism is described which utilises a single micromotor to radially position and then deploy a needle 1.5 mm outside the microrobot’s body to deliver a 1 mL dose of medication to a targeted site. An analysis of the mechanics required to drive the holding mechanism is presented and an overview of microactuators and the state of the art in WCE is discussed. It is envisaged that this novel functionality will empower the next generation of WCE to help diagnose and treat pathologies of the GI tract.

  4. Hookworm Detection in Wireless Capsule Endoscopy Images With Deep Learning.

    Science.gov (United States)

    He, Jun-Yan; Wu, Xiao; Jiang, Yu-Gang; Peng, Qiang; Jain, Ramesh

    2018-05-01

    As one of the most common human helminths, hookworm is a leading cause of maternal and child morbidity, which seriously threatens human health. Recently, wireless capsule endoscopy (WCE) has been applied to automatic hookworm detection. Unfortunately, it remains a challenging task. In recent years, deep convolutional neural network (CNN) has demonstrated impressive performance in various image and video analysis tasks. In this paper, a novel deep hookworm detection framework is proposed for WCE images, which simultaneously models visual appearances and tubular patterns of hookworms. This is the first deep learning framework specifically designed for hookworm detection in WCE images. Two CNN networks, namely edge extraction network and hookworm classification network, are seamlessly integrated in the proposed framework, which avoid the edge feature caching and speed up the classification. Two edge pooling layers are introduced to integrate the tubular regions induced from edge extraction network and the feature maps from hookworm classification network, leading to enhanced feature maps emphasizing the tubular regions. Experiments have been conducted on one of the largest WCE datasets with WCE images, which demonstrate the effectiveness of the proposed hookworm detection framework. It significantly outperforms the state-of-the-art approaches. The high sensitivity and accuracy of the proposed method in detecting hookworms shows its potential for clinical application.

  5. Capsule endoscopy in young patients with iron deficiency anaemia and negative bidirectional gastrointestinal endoscopy

    Science.gov (United States)

    Rondonotti, Emanuele; Giannakou, Andry; Avni, Tomer; Rosa, Bruno; Toth, Ervin; Lucendo, Alfredo J; Sidhu, Reena; Beaumont, Hanneke; Ellul, Pierre; Negreanu, Lucian; Jiménez-Garcia, Victoria Alejandra; McNamara, Deidre; Kopylov, Uri; Elli, Luca; Triantafyllou, Konstantinos; Shibli, Fahmi; Riccioni, Maria Elena; Bruno, Mauro; Dray, Xavier; Plevris, John N; Koulaouzidis, A; Argüelles-Arias, Federico; Becq, Aymeric; Branchi, Federica; Tejero-Bustos, María Ángeles; Cotter, Jose; Eliakim, Rami; Ferretti, Francesca; Gralnek, Ian M; Herrerias-Gutierrez, Juan Manuel; Hussey, Mary; Jacobs, Maarten; Johansson, Gabriele Wurm; McAlindon, Mark; Montiero, Sara; Nemeth, Artur; Pennazio, Marco; Rattehalli, Deepa; Stemate, Ana; Tortora, Annalisa; Tziatzios, Georgios

    2017-01-01

    Background Recent data imply young patients (age ≤50 years) undergoing small-bowel (SB) capsule endoscopy (CE) for iron deficiency anaemia (IDA) show higher diagnostic yield (DY) for sinister pathology. We aimed to investigate DY of CE in a large cohort of young IDA patients, and evaluate factors predicting significant SB pathology. Materials and methods This was a retrospective, multicentre study (2010–2015) in consecutive, young patients (≤50 years) from 18 centres/12 countries, with negative bidirectional gastrointestinal (GI) endoscopy undergoing SBCE for IDA. Exclusion criteria: previous/ongoing obscure-overt GI bleeding; age 50 years; comorbidities associated with IDA. Data retrieved: SBCE indications; prior investigations; medications; SBCE findings; final diagnosis. Clinical and laboratory data were analysed by multivariate logistic regression. Results Data on 389 young IDA patients were retrieved. In total, 169 (43.4%) were excluded due to incomplete clinical data; data from 220 (122F/98M; mean age 40.5 ± 8.6 years) patients were analysed. Some 71 patients had at least one clinically significant SBCE finding (DY: 32.3%). They were divided into two groups: neoplastic pathology (10/220; 4.5%), and non-neoplastic but clinically significant pathology (61/220; 27.7%). The most common significant but non-neoplastic pathologies were angioectasias (22/61) and Crohn’s disease (15/61). On multivariate analysis, weight loss and lower mean corpuscular volume(MCV) were associated with significant SB pathology (OR: 3.87; 95%CI: 1.3–11.3; p = 0.01; and OR: 0.96; 95%CI: 0.92–0.99; p = 0.03; respectively). Our model also demonstrates association between use of antiplatelets and significant SB pathology, although due to the small number of patients, definitive conclusions cannot be drawn. Conclusion In IDA patients ≤50 years with negative bidirectional GI endoscopy, overall DY of SBCE for clinically significant findings was 32.3%. Some 5% of our

  6. [Clinical value of wireless capsule endoscopy in diagnosis of small bowel disease in children].

    Science.gov (United States)

    Ma, Ming; Zhang, Bing-ling; Chen, Chun-xiao; Li, Fu-bang; Huang, Xiao-lei; Wang, Pei-xin; Chen, Jie

    2009-10-01

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

  7. Saliency based ulcer detection for wireless capsule endoscopy diagnosis.

    Science.gov (United States)

    Yuan, Yixuan; Wang, Jiaole; Li, Baopu; Meng, Max Q-H

    2015-10-01

    Ulcer is one of the most common symptoms of many serious diseases in the human digestive tract. Especially for the ulcers in the small bowel where other procedures cannot adequately visualize, wireless capsule endoscopy (WCE) is increasingly being used in the diagnosis and clinical management. Because WCE generates large amount of images from the whole process of inspection, computer-aided detection of ulcer is considered an indispensable relief to clinicians. In this paper, a two-staged fully automated computer-aided detection system is proposed to detect ulcer from WCE images. In the first stage, we propose an effective saliency detection method based on multi-level superpixel representation to outline the ulcer candidates. To find the perceptually and semantically meaningful salient regions, we first segment the image into multi-level superpixel segmentations. Each level corresponds to different initial region sizes of the superpixels. Then we evaluate the corresponding saliency according to the color and texture features in superpixel region of each level. In the end, we fuse the saliency maps from all levels together to obtain the final saliency map. In the second stage, we apply the obtained saliency map to better encode the image features for the ulcer image recognition tasks. Because the ulcer mainly corresponds to the saliency region, we propose a saliency max-pooling method integrated with the Locality-constrained Linear Coding (LLC) method to characterize the images. Experiment results achieve promising 92.65% accuracy and 94.12% sensitivity, validating the effectiveness of the proposed method. Moreover, the comparison results show that our detection system outperforms the state-of-the-art methods on the ulcer classification task.

  8. Deep learning for polyp recognition in wireless capsule endoscopy images.

    Science.gov (United States)

    Yuan, Yixuan; Meng, Max Q-H

    2017-04-01

    Wireless capsule endoscopy (WCE) enables physicians to examine the digestive tract without any surgical operations, at the cost of a large volume of images to be analyzed. In the computer-aided diagnosis of WCE images, the main challenge arises from the difficulty of robust characterization of images. This study aims to provide discriminative description of WCE images and assist physicians to recognize polyp images automatically. We propose a novel deep feature learning method, named stacked sparse autoencoder with image manifold constraint (SSAEIM), to recognize polyps in the WCE images. Our SSAEIM differs from the traditional sparse autoencoder (SAE) by introducing an image manifold constraint, which is constructed by a nearest neighbor graph and represents intrinsic structures of images. The image manifold constraint enforces that images within the same category share similar learned features and images in different categories should be kept far away. Thus, the learned features preserve large intervariances and small intravariances among images. The average overall recognition accuracy (ORA) of our method for WCE images is 98.00%. The accuracies for polyps, bubbles, turbid images, and clear images are 98.00%, 99.50%, 99.00%, and 95.50%, respectively. Moreover, the comparison results show that our SSAEIM outperforms existing polyp recognition methods with relative higher ORA. The comprehensive results have demonstrated that the proposed SSAEIM can provide descriptive characterization for WCE images and recognize polyps in a WCE video accurately. This method could be further utilized in the clinical trials to help physicians from the tedious image reading work. © 2017 American Association of Physicists in Medicine.

  9. Wireless capsule endoscopy for obscure small-bowel disorders: final results of the first pediatric controlled trial.

    Science.gov (United States)

    Guilhon de Araujo Sant'Anna, Ana Maria; Dubois, Josée; Miron, Marie-Claude; Seidman, Ernest G

    2005-03-01

    Obscure small-bowel disorders are jejunal and ileal lesions undiagnosed by traditional imaging techniques (endoscopic, radiologic). We evaluated the diagnostic usefulness and safety of capsule endoscopy for obscure small-bowel disorders in children and adolescents. Comparative, prospective, self-controlled trials in patients (age, 10-18 y) suspected to have either small-bowel Crohn's disease, polyps, or obscure gastrointestinal (GI) bleeding. Capsule results were compared with the diagnostic imaging studies normally used in this age group. Among 20 patients suspected of Crohn's disease, multiple lesions consistent with this diagnosis were observed by capsule endoscopy in 50%. Small-bowel Crohn's disease was ruled out in 8 patients. Eosinophilic enteropathy was found in 2 others. For polyp detection (n = 6), capsule endoscopy yielded 100% concordance with the control studies when analyzed per patient. However, capsule endoscopy revealed a greater number (50%) of polyps. Among patients with obscure bleeding (n = 4), the capsule examination confirmed a diagnosis of vascular malformations in 3. Capsule endoscopy more accurately identified the precise source of bleeding compared with angiography. All 30 capsule studies were well tolerated, although 1 capsule was retained owing to an inflammatory stenosis. The capsule eventually was expelled after corticosteroid therapy. Capsule endoscopy correctly diagnosed or excluded a bleeding source, small-bowel polyps, or Crohn's disease of the small bowel in 29 of 30 patients. Capsule endoscopy permits an accurate, noninvasive approach for diagnosing obscure small bowel lesions in children over the age of 10.

  10. 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.

  11. Wireless Capsule Gastrointestinal Endoscopy: Direction-of-Arrival Estimation Based Localization Survey.

    Science.gov (United States)

    Dey, Nilanjan; Ashour, Amira S; Shi, Fuqian; Sherratt, R Simon

    2017-01-01

    One of the significant challenges in capsule endoscopy (CE) is to precisely determine the pathologies location. The localization process is primarily estimated using the received signal strength (RSS) from sensors in the capsule system through its movement in the gastrointestinal (GI) tract. Consequently, the wireless CE (WCE) system requires improvement to handle the lack of the capsule instantaneous localization information and to solve the relatively low transmission data rate challenges. Furthermore, the association among the capsule's transmitter position, capsule location, signal reduction, and the capsule direction should be assessed. These measurements deliver significant information for the instantaneous capsule localization systems based on time-of-arrival approach, phase difference of arrival, RSS, electromagnetic, direction of arrival (DOA), and video tracking approaches are developed to locate the WCE precisely. This review introduces the acquisition concept of the GI medical images using the endoscopy with a comprehensive description of the endoscopy system components. Capsule localization and tracking are considered to be the most important features of the WCE system, thus this paper emphasizes the most common localization systems generally, highlighting the DOA-based localization systems and discusses the required significant research challenges to be addressed.

  12. A new complication from a new technology: what a general surgeon should know about wireless capsule endoscopy.

    Science.gov (United States)

    Chang, Phillip K; Holt, Elizabeth G; De Villiers, Willem J S; Boulanger, Bernard R

    2005-05-01

    Wireless capsule endoscopy has revolutionized the diagnostic evaluation of the small intestine and is increasingly used by gastroenterologists. However, complications can occur with this seemingly safe procedure. We report two cases of Crohn's disease in which capsule endoscopy was performed with retention of the capsules. Both patients were taken to the operating room electively after careful preoperative planning to address both the surgical aspect of Crohn's disease and the retained capsule. We reviewed the literature on the use of wireless capsule endoscopy in patients with Crohn's disease and discuss the approach to a new surgical complication.

  13. The evolution of endoscopy: wireless capsule cameras for the diagnosis of occult gastrointestinal bleeding and inflammatory bowel disease.

    Science.gov (United States)

    Davis, Brian R; Harris, Hobart; Vitale, Gary C

    2005-06-01

    Occult gastrointestinal bleeding and lesions associated with inflammatory bowel disease represent a diagnostic dilemma because they often lie in areas of the small bowel that are difficult to access with flexible fiberoptic endoscopy. Capsule endoscopy has been developed to access these areas in a way that avoids the pain and anesthesia risks of push endoscopy. The diagnostic yield of capsule endoscopy has proven to be superior to both flexible small-bowel endoscopy and radiologic studies in several prospective trials. Capsule endoscopy transmits a large number of images that do not correlate well with the standard endoscopic view, creating a diagnostic challenge for the endoscopist. Complications of this procedure include capsule retention in diverticulae or at stricture sites. The technology of this procedure continues to evolve through improving image resolution and diagnostic accuracy. Capsule endoscopy also represents an overall economic saving despite a high unit price compared with the expense of repeat diagnostic testing. Because the diagnostic yield of capsule endoscopy is nearly twofold greater than conventional endoscopy, it has become the procedure of choice for the dilemma of assessing small-bowel pathology for many clinicians. Further studies are needed to determine whether the capsule endoscope can replace conventional endoscopy in the first-line diagnosis of pathology in other parts of the alimentary tract.

  14. A wireless capsule endoscopy steering mechanism using magnetic field platform.

    Science.gov (United States)

    Alsunaydih, Fahad N; Redoute, Jean-Michel; Yuce, Mehmet R

    2017-07-01

    In this paper, a new steering mechanism for wireless capsule devices is presented. The proposed system consists of a platform generating a magnetic field to direct and control the motion of a capsule. The platform contains an upper and a lower set of electromagnets. A permanent magnet is implanted inside the capsule to initiate the movement, which is set by the magnetic field delivered by the electromagnets. The total magnetic field at the capsule's location is the sum of the contributions of each electromagnet. An experimental setup has been designed for testing and comparing between the performance of the capsule mobility in practice and simulations.

  15. Indications for and diagnostic yield of capsule endoscopy in the elderly.

    Science.gov (United States)

    Pérez-Cuadrado-Robles, E; Zamora-Nava, L E; Jiménez-García, V A; Pérez-Cuadrado-Martínez, E

    2018-02-15

    The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients. All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed. Of 2311 patients (mean age: 59.5 ± 19.23 years, 44.48% male), 648 were in the older group and 1663 in the younger group. Gastric transit time was shorter in the older patients (p=0.001), whereas small bowel transit time was shorter in the younger patients (p<0.001). Overall diagnostic yield in the elderly was higher (50.66% vs. 41.19%, p<0.001). Obscure gastrointestinal bleeding was the most frequent indication for capsule endoscopy in the elderly (90.4% vs. 53.77%, p<0.001), achieving a higher diagnostic yield than in the younger population (51.47% vs. 42.76%, p=0.002), whereas Crohn's disease, suspected or known neoplasms/polyps, malabsorption syndrome, and abdominal pain were the indications in the younger patient group. Such indications were rare in the older group. Vascular lesions and active bleeding were more frequently diagnosed in the older patients, whereas ulcers/erosions and mucosal atrophy were more common in the younger patients (p<0.001). Capsule endoscopy achieved a higher overall diagnostic yield in the elderly patients. Obscure gastrointestinal bleeding indication for capsule endoscopy was much more frequent in the advanced-age group and had a higher diagnostic yield. Copyright © 2018 Asociación Mexicana de Gastroenterología. Publicado por Masson Doyma México S.A. All rights reserved.

  16. Suspected blood indicator in capsule endoscopy: a valuable tool for gastrointestinal bleeding diagnosis

    Directory of Open Access Journals (Sweden)

    Pedro BOAL CARVALHO

    Full Text Available ABSTRACT BACKGROUND Small bowel bleeding is a leading indication for small bowel capsule endoscopy. The Suspected Blood Indicator (SBI is a software feature directed to automatically detect bleeding lesions during small bowel capsule endoscopy. OBJECTIVE We aimed to assess SBI diagnostic accuracy for small bowel haemorrhage or potentially bleeding lesions during small bowel capsule endoscopy for small bowel bleeding. Methods - Single-centre retrospective study including 281 consecutive small bowel capsule endoscopy performed for small bowel bleeding during 6 years. The investigators marked lesions with high bleeding potential (P2, such as angioectasias, ulcers and tumours, as well as active bleeding during regular small bowel capsule endoscopy viewing with PillCam SB2(r. All small bowel capsule endoscopy were independently reviewed by another central reader using SBI. RESULTS Among the 281 patients, 29 (10.3% presented with active haemorrhage while 81 (28.9% presented with a P2 lesion. The most frequently observed P2 lesions were angioectasias (52, ulcers (15, polyps (7 and ulcerated neoplasias (7. SBI showed a 96.6% (28/29 sensitivity for active small bowel bleeding, with a 97.7% negative predictive value. Regarding P2 lesions, the SBI displayed an overall sensitivity of 39.5%, being highest for ulcerated neoplasias (100%, but significantly lower for angioectasias (38.5% or ulcers (20.0%. CONCLUSION Although SBI sensitivity for the automatic detection of potentially bleeding lesions was low, it effectively detected active small bowel bleeding with very high sensitivity and negative predictive value.

  17. Feasibility and safety of string, wireless capsule endoscopy in the diagnosis of Barrett's esophagus.

    Science.gov (United States)

    Ramirez, Francisco C; Shaukat, Masud S; Young, Michele A; Johnson, David A; Akins, Rodney

    2005-05-01

    Capsule endoscopy is a major technological advancement in the visualization of the small bowell. Its utility in the evaluation of the esophagus is mainly limited by its rapid and unpredictable transmission, thus limiting the number of pictures of the esophagus, in particular, the distal esophagus. Strings were attached to the wireless capsule endoscopy device to allow its controlled movement up and down the esophagus. Microbiologic cultures of the capsule's surface after high-level disinfection were carried out after the procedure. At the time of recording, discomfort associated with the procedure was documented. Patient preference compared with conventional EGD was recorded. An independent endoscopist blinded to the EGD diagnoses assessed the diagnostic accuracy of pictures obtained. Fifty patients with Barrett's esophagus were enrolled: 28 with short-segment Barrett's and 22 with long-segment Barrett's. The procedure was safe (no strings were disrupted, and no capsule was lost), and it rendered negative microbiologic cultures after high-level disinfection. The mean recording time was 7.9 minutes; all patients with both short- and long-segment Barrett's esophagus were successfully identified. The difficulty/discomfort associated with swallowing the device, throat discomfort, gagging, moving the capsule (up and down and upon retrieval of the capsule) was none or minimal in 74%, 98%, 96%, 94%, and 76%, respectively. A single capsule was used in 24 studies, and the majority of patients (92%) preferred string-capsule endoscopy to EGD. String-capsule endoscopy was feasible, safe, and highly acceptable, and was preferred by patients and may prove to be more cost effective than screening EGD.

  18. Diagnostic value of OMOM capsule endoscopy for small bowel diseases in adults.

    Science.gov (United States)

    Zhang, Lili; Shen, Junsong; Guo, Linchun; Cheng, Fenggan; Fan, Qi; Ni, Keqian; Xia, Shujing; Zhou, Detong

    2018-04-01

    The present study aimed to determine the diagnostic yield of OMOM capsule endoscopy for small bowel diseases in adults. A total of 89 patients, including 45 cases of obscure abdominal pain, 22 of chronic diarrhea, 18 of obscure gastrointestinal bleeding and 4 of obscure anemia were enrolled in the present study. The transit time of the endoscopy capsule in the digestive tract was recorded and the testing results were analyzed. All detections were completed except for four capsule retentions and the completion rate was 95.51%. The average transit time of the endoscopy capsule in the esophagus, stomach and small intestine was 62.18±64.23 sec, 67.46±63.13 and 346.53±102.81 min, respectively. Of the 89 patients, 54 (60.67%) were found to have lesions, among which 19 had mucosal erosion (21.35%), 15 had anabrosis (16.85%), 9 were diagnosed with polyps (10.11%), 5 with angiodysplasia (5.62%); furthermore, tumors were identified in 5 patients (5.62%) and ancylostomiasis in 1 patient (1.12%). The results confirmed the feasibility and validity of OMOM capsule endoscopy for diagnosing small bowel diseases in adults.

  19. A Machine Learning Approach for Intestinal Motility Assessment with Capsule Endoscopy

    OpenAIRE

    Vilariño Freire, Fernando Luis

    2006-01-01

    Consultable des del TDX Intestinal motility assessment with video capsule endoscopy arises as a novel and challenging clinical fieldwork. This technique is based on the analysis of the patterns of intestinal contractions obtained by labelling all the motility events present in a video provided by a capsule with a wireless micro-camera, which is ingested by the patient. However, the visual analysis of these video sequences presents several important drawbacks, mainly related to both the lar...

  20. Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding.

    Science.gov (United States)

    Huprich, James E; Fletcher, Joel G; Fidler, Jeff L; Alexander, Jeffrey A; Guimarães, Luís S; Siddiki, Hassan A; McCollough, Cynthia H

    2011-09-01

    To compare the performance of multiphase computed tomographic (CT) enterography with that of capsule endoscopy in a group of patients with obscure gastrointestinal bleeding (OGIB). This prospective HIPAA-compliant study was approved by the institutional review board and the institutional conflict of interest committee. All patients provided written informed consent. Two radiologists, blinded to clinical data and results of capsule endoscopy, interpreted images from CT enterography independently, with discordant interpretations resolved by consensus. Results were compared with those from a reference standard (surgery or endoscopy) and clinical follow-up. Sensitivity and 95% confidence intervals were calculated for each modality. Fifty-eight adult patients, referred for the evaluation of OGIB (occult, 25 patients [43%]; overt, 33 patients [57%]), underwent both tests. A small bowel bleeding source was identified in 16 of the 58 patients (28%). The sensitivity of CT enterography was significantly greater than that of capsule endoscopy (88% [14 of 16 patients] vs 38% [six of 16 patients], respectively; P = .008), largely because it depicted more small bowel masses (100% [nine of nine patients] vs 33% [three of nine patients], respectively; P = .03). No additional small bowel tumors were discovered during the follow-up period (range, 5.6-45.9 months; mean, 16.6 months). In this referral population, the sensitivity of CT enterography for detecting small bowel bleeding sources and small bowel masses was significantly greater than that of capsule endoscopy. On the basis of these findings, the addition of multiphase CT enterography to the routine diagnostic work-up of patients with OGIB should be considered, particularly in patients with negative findings at capsule endoscopy.

  1. Agile patency system eliminates risk of capsule retention in patients with known intestinal strictures who undergo capsule endoscopy.

    Science.gov (United States)

    Herrerias, Juan M; Leighton, Jonathan A; Costamagna, Guido; Infantolino, Anthony; Eliakim, Rami; Fischer, Doron; Rubin, David T; Manten, Howard D; Scapa, Eitan; Morgan, Douglas R; Bergwerk, Ari J; Koslowsky, Binyamin; Adler, Samuel N

    2008-05-01

    Capsule endoscopy (CE) of the small bowel has become a standard diagnostic tool, but there have been concerns regarding the risk of capsule retention in certain high-risk groups. The Agile patency system, an ingestible and dissolvable capsule with an external scanner, was developed to allow physicians to perform CE with greater confidence that the capsule will be safely excreted in patients at risk for capsule retention. Our purpose was to assess the ability of the device to help physicians identify which patients with known strictures may safely undergo CE. Patients with known strictures ingested the new patency capsule and underwent periodic scanning until it was excreted. The intestinal tract was considered to be sufficiently patent if the capsule was excreted intact or if the capsule was not detected by the scanner at 30 hours after ingestion. If patency was established, then standard CE was performed. International multicenter study. A total of 106 patients with known strictures. Agile patency system. Performance and safety of Agile patency system. A total of 106 patients ingested the patency capsule. Fifty-nine (56%) excreted it intact and subsequently underwent CE. There were no cases of capsule retention. Significant findings on CE were found in 24 (41%). There were 3 severe adverse events. These results suggest that the Agile patency system is a useful tool for physicians to use before CE in patients with strictures to avoid retention. This group of patients may have a high yield of clinically significant findings at CE. This capsule may determine whether patients who have a contraindication to CE may safely undergo CE and obtain useful diagnostic information.

  2. Correlation between predicted and actual consequences of capsule endoscopy on patient management

    NARCIS (Netherlands)

    Westerhof, J.; Weersma, R. K.; Thijs, W. J.; Limburg, A. J.; Koornstra, J. J.; de Graaf, A.P.

    Background. Capsule endoscopy (CE) is a relatively new diagnostic modality in the evaluation of patients with suspected small bowel pathology. It is unclear to what extent physicians are able to predict the clinical consequences of CE on patient management. Methods. In this prospective study, 180

  3. 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.

  4. 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...

  5. Video summarization based tele-endoscopy: a service to efficiently manage visual data generated during wireless capsule endoscopy procedure.

    Science.gov (United States)

    Mehmood, Irfan; Sajjad, Muhammad; Baik, Sung Wook

    2014-09-01

    Wireless capsule endoscopy (WCE) has great advantages over traditional endoscopy because it is portable and easy to use. More importantly, WCE combined with mobile computing ensures rapid transmission of diagnostic data to hospitals and enables off-site senior gastroenterologists to offer timely decision making support. However, during this WCE process, video data are produced in huge amounts, but only a limited amount of data is actually useful for diagnosis. The sharing and analysis of this video data becomes a challenging task due the constraints such as limited memory, energy, and communication capability. In order to facilitate efficient WCE data collection and browsing tasks, we present a video summarization-based tele-endoscopy service that estimates the semantically relevant video frames from the perspective of gastroenterologists. For this purpose, image moments, curvature, and multi-scale contrast are computed and are fused to obtain the saliency map of each frame. This saliency map is used to select keyframes. The proposed tele-endoscopy service selects keyframes based on their relevance to the disease diagnosis. This ensures the sending of diagnostically relevant frames to the gastroenterologist instead of sending all the data, thus saving transmission costs and bandwidth. The proposed framework also saves storage costs as well as the precious time of doctors in browsing patient's information. The qualitative and quantitative results are encouraging and show that the proposed service provides video keyframes to the gastroenterologists without discarding important information.

  6. OdoCapsule: next-generation wireless capsule endoscopy with accurate lesion localization and video stabilization capabilities.

    Science.gov (United States)

    Karargyris, Alexandros; Koulaouzidis, Anastastios

    2015-01-01

    In this paper, we propose a platform to achieve accurate localization of small-bowel lesions and endoscopic video stabilization in wireless capsule endoscopy. Current research modules rely on the use of external magnetic fields and triangulation methods to calculate the position vector of the capsule, leading to considerable error margins. Our platform, entitled OdoCapsule (a synthesis of the words Odometer and Capsule), provides real-time distance information from the point of duodenal entry to the point of exit from the small bowel. To achieve this, OdoCapsule is equipped with three miniature legs. Each leg carries a soft rubber wheel, which is made with human-compliant material. These legs are extendable and retractable thanks to a micromotor and three custom-made torsion springs. The wheels are specifically designed to function as microodometers: each rotation they perform is registered. Hence, the covered distance is measured accurately in real time. Furthermore, with its legs fully extended, OdoCapsule can stabilize itself inside the small-bowel lumen thus offering smoother video capture and better image processing. Recent ex vivo testing of this concept, using porcine small bowel and a commercially available (custom-modified) capsule endoscope, has proved its viability.

  7. A resource-efficient tool for training novices in wireless capsule endoscopy.

    Science.gov (United States)

    Brock, Andrew S; Freeman, Janice; Roberts, Jason; Dantzler, Todd E; Hoffman, Brenda J

    2012-09-01

    Nurses often function as capsule endoscopy "pre-readers" to save physicians' time and potentially increase diagnostic yield. Training pre-readers is time consuming, not standardized, and may not be feasible during regular business hours. A way to evaluate the progress and accuracy of pre-readers is needed to ensure competency. The aim of this study was to introduce a feedback and progress assessment tool for training novice capsule endoscopy pre-readers. We created a 1-page form with listings of potential findings for each segment of the examination. Findings could be circled or written in. The trainee reviewed capsule studies and filled out the form on each of 220 patients. The physician reviewers subsequently critiqued the data forms, providing feedback regarding missed lesions, overcalls, and overall agreement. Our trainee achieved consistent agreement with the physician reviewers, after reading 80 studies. In conclusion, a simple, 1-page standardized data sheet can be used to facilitate training of novice capsule pre-readers without significant time commitment from the supervising physician. Future studies may validate this resource-efficient instrument as a training and assessment tool for nurses, physicians, and other practitioners learning capsule endoscopy.

  8. Wireless endoscopy in 2020: Will it still be a capsule?

    Science.gov (United States)

    Koulaouzidis, Anastasios; Iakovidis, Dimitris K; Karargyris, Alexandros; Rondonotti, Emanuele

    2015-05-07

    Currently, the major problem of all existing commercial capsule devices is the lack of control of movement. In the future, with an interface application, the clinician will be able to stop and direct the device into points of interest for detailed inspection/diagnosis, and therapy delivery. This editorial presents current commercially-available new designs, European projects and delivery capsule and gives an overview of the progress required and progress that will be achieved -according to the opinion of the authors- in the next 5 year leading to 2020.

  9. Advances in pediatric gastroenterology: introducing video camera capsule endoscopy.

    Science.gov (United States)

    Siaw, Emmanuel O

    2006-04-01

    The video camera capsule endoscope is a gastrointestinal endoscope approved by the U.S. Food and Drug Administration in 2001 for use in diagnosing gastrointestinal disorders in adults. In 2003, the agency approved the device for use in children ages 10 and older, and the endoscope is currently in use at Arkansas Children's Hospital. A capsule camera, lens, battery, transmitter and antenna together record images of the small intestine as the endoscope makes its way through the bowel. The instrument is used with minimal risk to the patient while offering a high degree of accuracy in diagnosing small intestine disorders.

  10. Quantitative analysis of patients with celiac disease by video capsule endoscopy: A deep learning method.

    Science.gov (United States)

    Zhou, Teng; Han, Guoqiang; Li, Bing Nan; Lin, Zhizhe; Ciaccio, Edward J; Green, Peter H; Qin, Jing

    2017-06-01

    Celiac disease is one of the most common diseases in the world. Capsule endoscopy is an alternative way to visualize the entire small intestine without invasiveness to the patient. It is useful to characterize celiac disease, but hours are need to manually analyze the retrospective data of a single patient. Computer-aided quantitative analysis by a deep learning method helps in alleviating the workload during analysis of the retrospective videos. Capsule endoscopy clips from 6 celiac disease patients and 5 controls were preprocessed for training. The frames with a large field of opaque extraluminal fluid or air bubbles were removed automatically by using a pre-selection algorithm. Then the frames were cropped and the intensity was corrected prior to frame rotation in the proposed new method. The GoogLeNet is trained with these frames. Then, the clips of capsule endoscopy from 5 additional celiac disease patients and 5 additional control patients are used for testing. The trained GoogLeNet was able to distinguish the frames from capsule endoscopy clips of celiac disease patients vs controls. Quantitative measurement with evaluation of the confidence was developed to assess the severity level of pathology in the subjects. Relying on the evaluation confidence, the GoogLeNet achieved 100% sensitivity and specificity for the testing set. The t-test confirmed the evaluation confidence is significant to distinguish celiac disease patients from controls. Furthermore, it is found that the evaluation confidence may also relate to the severity level of small bowel mucosal lesions. A deep convolutional neural network was established for quantitative measurement of the existence and degree of pathology throughout the small intestine, which may improve computer-aided clinical techniques to assess mucosal atrophy and other etiologies in real-time with videocapsule endoscopy. Copyright © 2017 Elsevier Ltd. All rights reserved.

  11. A robust real-time abnormal region detection framework from capsule endoscopy images

    Science.gov (United States)

    Cheng, Yanfen; Liu, Xu; Li, Huiping

    2009-02-01

    In this paper we present a novel method to detect abnormal regions from capsule endoscopy images. Wireless Capsule Endoscopy (WCE) is a recent technology where a capsule with an embedded camera is swallowed by the patient to visualize the gastrointestinal tract. One challenge is one procedure of diagnosis will send out over 50,000 images, making physicians' reviewing process expensive. Physicians' reviewing process involves in identifying images containing abnormal regions (tumor, bleeding, etc) from this large number of image sequence. In this paper we construct a novel framework for robust and real-time abnormal region detection from large amount of capsule endoscopy images. The detected potential abnormal regions can be labeled out automatically to let physicians review further, therefore, reduce the overall reviewing process. In this paper we construct an abnormal region detection framework with the following advantages: 1) Trainable. Users can define and label any type of abnormal region they want to find; The abnormal regions, such as tumor, bleeding, etc., can be pre-defined and labeled using the graphical user interface tool we provided. 2) Efficient. Due to the large number of image data, the detection speed is very important. Our system can detect very efficiently at different scales due to the integral image features we used; 3) Robust. After feature selection we use a cascade of classifiers to further enforce the detection accuracy.

  12. Wireless capsule endoscopy of the small bowel: development, testing, and first human trials

    Science.gov (United States)

    Swain, Paul; Iddan, Gavriel J.; Meron, Gavriel; Glukhovsky, Arkady

    2001-01-01

    Small bowel endoscopy with existing endoscopes is limited by problems of discomfort and the technical difficulty of advancing far into the small-bowel. Our aim has been to develop and test wireless capsule endoscopy. Wireless endoscopes, in the form of capsules (11 x 33 mm), were constructed by Given Imaging. These were powered by silver oxide batteries and each contained a CMOS imaging chip and miniature processor, white light emitting diodes (LEDs), a short focal length lens, and a miniature transmitter and antenna. Two video frames per second were transmitted, using radio-frequency (approx. 410 MHz), to an array of aerials attached to the body. The array of aerials can also be used to calculate the position of the capsule in the body. The images were stored on a portable recorder carried on a belt and subsequently downloaded for analysis. The batteries allow more than 5 hours of recording, although the capsule generally passes through the whole small bowel in under two hours. Clear video images of the human bowel were recorded from the pylorus to the caecum. Wireless endoscopy, for the first time, allows painless optical imaging of the whole of the small bowel.

  13. 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...

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

    International Nuclear Information System (INIS)

    Soyer, Philippe

    2012-01-01

    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.)

  15. Superpixel Based Segmentation and Classification of Polyps in Wireless Capsule Endoscopy

    OpenAIRE

    Maghsoudi, Omid Haji

    2017-01-01

    Wireless Capsule Endoscopy (WCE) is a relatively new technology to record the entire GI trace, in vivo. The large amounts of frames captured during an examination cause difficulties for physicians to review all these frames. The need for reducing the reviewing time using some intelligent methods has been a challenge. Polyps are considered as growing tissues on the surface of intestinal tract not inside of an organ. Most polyps are not cancerous, but if one becomes larger than a centimeter, it...

  16. Capsule Endoscopy in a Patient with an Implanted CCM System and an Implantable Defibrillator

    Directory of Open Access Journals (Sweden)

    Florian Streitner

    2011-01-01

    Full Text Available Wireless video capsule endoscopy (CE is a modern diagnostic tool. Because of its use of digital radiofrequency, it is still relatively contraindicated in patients with implanted cardiac devices. We report the case of a patient with an Optimizer III system delivering cardiac contractility modulating signals (CCM for heart failure therapy and an implantable cardioverter defibrillator (ICD who underwent CE. No interferences between the devices were found.

  17. Gastrointestinal bleeding detection in wireless capsule endoscopy images using handcrafted and CNN features.

    Science.gov (United States)

    Xiao Jia; Meng, Max Q-H

    2017-07-01

    Gastrointestinal (GI) bleeding detection plays an essential role in wireless capsule endoscopy (WCE) examination. In this paper, we present a new approach for WCE bleeding detection that combines handcrafted (HC) features and convolutional neural network (CNN) features. Compared with our previous work, a smaller-scale CNN architecture is constructed to lower the computational cost. In experiments, we show that the proposed strategy is highly capable when training data is limited, and yields comparable or better results than the latest methods.

  18. 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

  19. Validation of SmartPill®wireless motility capsule for gastrointestinal transit time: Intra-subject variability, software accuracy and comparison with video capsule endoscopy.

    Science.gov (United States)

    Diaz Tartera, H O; Webb, D-L; Al-Saffar, A Kh; Halim, M A; Lindberg, G; Sangfelt, P; Hellström, P M

    2017-10-01

    There is interest in ultimately combining endoscopy and motility assessments. Gastric emptying (GET), small bowel (SBTT), colon (CTT) and whole gut transit (WGTT) times are conveniently obtained by SmartPill ® wireless motility capsule (WMC) that records luminal pH, temperature and pressure. Reproducibility within same subjects and accuracy of software derived times (MotiliGI ® ) were investigated for diagnostic application. GET and SBTT were separately measured using video capsule endoscopy (VCE). The aim of this investigation was to assess same subject reproducibility of WMC, accuracy of software derived transit times and relate to Pillcam ® SB (small bowel) VCE motility data. Seventy three healthy adults ingested a 260 kcal mixed meal followed by WMC tests. Food intake was permitted after 6 hours. Regional transit data was obtained for GET, SBTT and CTT, the sum yielding WGTT. Nineteen subjects repeated WMC tests 2 or 4 weeks later; a separate 70 underwent VCE while fasted. Visually derived data from WMC yielded GET 3.46±0.27, SBTT 5.15±0.21, CTT 20.76±1.19 and WGTT 29.53±1.28 hours (mean±SEM). Pearson's correlation coefficients (r) against software derived results were: GET 0.78 (P<.0001), SBTT 0.28 (P<.05), CTT 0.96 (P<.0001), WGTT 0.99 (P<.0001). VCE yielded lower GET (0.71±0.08 hours) and SBTT (4.15±0.13 hours). GET, SBTT, CTT and WGTT obtained by WMC are commensurate with literature values, including by other methods. Visually and software derived transit times have strongest correlations for CTT and WGTT. WMC yields longer GET and SBTT than VCE, perhaps due to meal related effects on motility. © 2017 John Wiley & Sons Ltd.

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

    Directory of Open Access Journals (Sweden)

    Masanao Nakamura

    2016-01-01

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

  1. 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. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  2. The role of wireless capsule endoscopy (WCE) in the detection of occult primary neuroendocrine tumors.

    Science.gov (United States)

    Furnari, Manuele; Buda, Andrea; Delconte, Gabriele; Citterio, Davide; Voiosu, Theodor; Ballardini, Giovanni; Cavallaro, Flaminia; Savarino, Edoardo; Mazzaferro, Vincenzo; Meroni, Emanuele

    2017-06-01

    Neuroendocrine tumors (NETs) are a heterogeneous group of neoplasms with unclear etiology that may show functioning or non-functioning features. Primary tumor localization often requires integrated imaging. The European Neuroendocrine Tumors Society (ENETS) guidelines proposed wireless-capsule endoscopy (WCE) as a possible diagnostic tool for NETs, if intestinal origin is suspected. However, its impact on therapeutic management is debated. We aimed to evaluate the yield of WCE in detecting intestinal primary tumors in patients showing liver NET metastases when first-line investigations are inconclusive. Twenty-four patients with a histological diagnosis of metastatic NET from liver biopsy and no evidence of primary lesions at first-line investigations were prospectively studied in an ENETS-certified tertiary care center. Wireless-capsule endoscopy was requested before explorative laparotomy and intra-operative ultrasound. The diagnostic yield of WCE was compared to the surgical exploration. Sixteen subjects underwent surgery; 11/16 had positive WCE identifying 16 bulging lesions. Mini-laparotomy found 13 NETs in 11/16 patients (9 small bowel, 3 pancreas, 1 bile ducts). Agreement between WCE and laparotomy was recorded in 9 patients (Sensitivity=75%; Specificity=37.5%; PPV=55%; NPV=60%). Correspondence assessed per-lesions produced similar results (Sensitivity=70%; Specificity=25%; PPV=44%; NPV=50%). No capsule retentions were recorded. Wireless-capsule endoscopy is not indicated as second-line investigation for patients with gastro-entero-pancreatic NETs. In the setting of a referral center, it might provide additional information when conventional investigations are inconclusive about the primary site.

  3. Unsuspected Small-Bowel Crohn’s Disease in Elderly Patients Diagnosed by Video Capsule Endoscopy

    Directory of Open Access Journals (Sweden)

    Che-Yung Chao

    2018-01-01

    Full Text Available Background. Video capsule endoscopy (VCE is increasingly performed among the elderly for obscure bleeding. Our aim was to report on the utility of VCE to uncover unsuspected Crohn’s disease (CD in elderly patients. Methods. Retrospective review of VCE performed in elderly patients (≥70 y at a tertiary hospital (2010–2015. All underwent prior negative bidirectional endoscopies. CD diagnosis was based on consistent endoscopic findings, exclusion of other causes, and a Lewis endoscopic score (LS > 790 (moderate-to-severe inflammation. Those with lower LS (350–790 required histological confirmation. Known IBD cases were excluded. Results. 197 VCE were performed (mean age 78; range 70–93. Main indications were iron deficiency anemia (IDA, occult GI bleeding (OGIB, chronic abdominal pain, or diarrhea. Eight (4.1% were diagnosed as CD based on the aforementioned criteria. Fecal calprotectin (FCP was elevated in 7/8 (mean 580 μg/g. Mean LS was 1824. Small-bowel CD detected by VCE led to a change in management in 4/8. One patient had capsule retention secondary to NSAID induced stricture, requiring surgical retrieval. Conclusions. VCE can be safely performed in the elderly. A proportion of cases may have unsuspected small-bowel CD despite negative endoscopies. FCP was the best screening test. Diagnosis frequently changed management.

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

    Science.gov (United States)

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

    2016-11-01

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

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

    Science.gov (United States)

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

    2014-06-19

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

  6. 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.

  7. 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.

  8. A computer-aided diagnostic system for intestinal polyps identified by wireless capsule endoscopy.

    Science.gov (United States)

    Constantinescu, Adriana Florentina; Ionescu, Mihaela; Iovănescu, Vlad Florin; Ciurea, Marius Eugen; Ionescu, Alin Gabriel; Streba, Costin Teodor; Bunescu, Marius Gabriel; Rogoveanu, Ion; Vere, Cristin Constantin

    2016-01-01

    Small bowel polyps present in images acquired by wireless capsule endoscopy are more difficult to detect using computer-aided diagnostic (CAD) systems. We aimed to identify the optimum morphological characteristics that best describe a polyp and convert them into feature vectors used for automatic detection of polyps present in images acquired by wireless capsule endoscopy (WCE). We prospectively included 54 patients with clinical indications for WCE. Initially, physicians analyzed all images acquired, identifying the frames that contained small bowel polyps. Subsequently, all images were analyzed using an automated computer-aided diagnostic system designed and implemented to convert physical characteristics into vectors of numeric values. The data set was completed with texture and color information, and then analyzed by a feed forward back propagation artificial neural network (ANN) trained to identify the presence of polyps in WCE frames. Overall, the neural network had 93.75% sensitivity, 91.38% specificity, 85.71% positive predictive value (PPV) and 96.36% negative predictive value (NPV). In comparison, physicians' diagnosis indicated 94.79% sensitivity, 93.68% specificity, 89.22% PPV and 97.02% NPV, thus showing that ANN diagnosis was similar to that of human interpretation. Computer-aided diagnostic of small bowel polyps, based on morphological features detection methods, emulation and neural networks classification, seems efficient, fast and reliable for physicians.

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

    Directory of Open Access Journals (Sweden)

    Vahid Faghih Dinevari

    2016-01-01

    Full Text Available 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.

  10. Acoustic Sensing and Ultrasonic Drug Delivery in Multimodal Theranostic Capsule Endoscopy

    Science.gov (United States)

    Stewart, Fraser R.; Qiu, Yongqiang; Newton, Ian P.; Cox, Benjamin F.; Al-Rawhani, Mohammed A.; Beeley, James; Liu, Yangminghao; Huang, Zhihong; Cumming, David R. S.; Näthke, Inke

    2017-01-01

    Video capsule endoscopy (VCE) is now a clinically accepted diagnostic modality in which miniaturized technology, an on-board power supply and wireless telemetry stand as technological foundations for other capsule endoscopy (CE) devices. However, VCE does not provide therapeutic functionality, and research towards therapeutic CE (TCE) has been limited. In this paper, a route towards viable TCE is proposed, based on multiple CE devices including important acoustic sensing and drug delivery components. In this approach, an initial multimodal diagnostic device with high-frequency quantitative microultrasound that complements video imaging allows surface and subsurface visualization and computer-assisted diagnosis. Using focused ultrasound (US) to mark sites of pathology with exogenous fluorescent agents permits follow-up with another device to provide therapy. This is based on an US-mediated targeted drug delivery system with fluorescence imaging guidance. An additional device may then be utilized for treatment verification and monitoring, exploiting the minimally invasive nature of CE. While such a theranostic patient pathway for gastrointestinal treatment is presently incomplete, the description in this paper of previous research and work under way to realize further components for the proposed pathway suggests it is feasible and provides a framework around which to structure further work. PMID:28671642

  11. 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.

  12. Impact of the endoscopist's experience on the negative predictive value of capsule endoscopy.

    Science.gov (United States)

    Velayos Jiménez, Benito; Alcaide Suárez, Noelia; González Redondo, Guillermo; Fernández Salazar, Luis; Aller de la Fuente, Rocío; Del Olmo Martínez, Lourdes; Ruiz Rebollo, Lourdes; González Hernández, José Manuel

    2017-01-01

    The impact of the accumulated experience of the capsule endoscopy (CE) reader on the accuracy of this test is discussed. To determine whether the negative predictive value of CE findings changes along the learning curve. We reviewed the first 900 CE read by 3 gastroenterologists experienced in endoscopy over 8 years. These 900 CE were divided into 3 groups (300 CE each): group 1 consisted of the sum of the first 100 CE read by each of the 3 endoscopists; group 2, the sum of the second 100 and groups 3, the sum of the third 100. Patients with normal CE were monitored for at least 28 months to estimate the negative predictive value. A total of 54 (18%) CE in group 1, 58 (19.3%) in group 2 and 47 (15.6%) in group 3 were normal, although only 34 patients in group 1, 38 in group 2 and 36 in group 3 with normal CE completed follow up and were eventually studied. The negative predictive value was 88.2% in group 1, 89.5% in group 2 and 97% in group 3 (P>.05). The negative predictive value tended to increase, but remained high and did not change significantly after the first 100 when readers are experienced in conventional endoscopy and have preliminary specific training. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  13. Small bowel involvement in Crohn’s disease: a prospective comparison of wireless capsule endoscopy and computed tomography enteroclysis

    Science.gov (United States)

    Voderholzer, W A; Beinhoelzl, J; Rogalla, P; Murrer, S; Schachschal, G; Lochs, H; Ortner, M-A

    2005-01-01

    Background: Wireless capsule endoscopy (WCE) offers endoscopic access to the small bowel and may therefore change diagnostic and therapeutic strategies in small bowel diseases. Aim: The aim of this prospective study was to validate the gain in information and therapeutic impact of WCE in patients with Crohn’s disease. Methods: Fifty six consecutive patients with Crohn’s disease underwent computed tomography (CT) enteroclysis, and if stenoses Capsule endoscopy improves the diagnosis of small bowel Crohn’s disease. This may have significant therapeutic impact. PMID:15710985

  14. 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, p<0.001). Calculated anthelmintic efficacy was essentially identical for the two enumeration methods, ranging from 94% to 100% for the three research compounds. CE may therefore be a viable alternative to necropsy for T. canis parasiticide trials. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Wireless capsule endoscopy for the detection of small bowel diseases in HIV-1-infected patients

    Directory of Open Access Journals (Sweden)

    Oette M

    2009-05-01

    Full Text Available Abstract Background and Aims In HIV-infected patients, manifestations of the disease are common in the gastrointestinal tract. The objective of our study was to evaluate the diagnostic yield of the Given® Video Capsule System (Given Imaging, Yoqneam, Israel in these patients. Methods After exclusion of GI-tract stenosis by anamnestic exploration, 49 patients were included into the study. Stratification: Group A (n = 19: HIV-positive, CD4 cell count 4 Results In group A there was a total of 30 pathological findings, 15 of which with therapeutic implications. In group B, there was a total of 22 pathological findings, 5 relevant for therapy. In group C there was a total of 13 pathological findings, 3 with therapeutic relevance. In 89% (group A vs. 26% (group B, pathological findings were detected distal the ligament of Treitz (p = 0.001. All capsules were recovered without complications after 12 to 96 h from the stool. Conclusion Wireless capsule endoscopy of the small intestine should be considered for HIV-infected patients with marked immunosuppression and gastrointestinal symptoms.

  16. Domperidone prolongs oral to duodenal transit time in video capsule endoscopy.

    Science.gov (United States)

    Mcfarlane, Michael; Liu, B; Nwokolo, C

    2018-04-01

    Domperidone is thought to accelerate gastric emptying via D2 receptor antagonism at the gastro-oesophageal and gastro-duodenal junctions. Listed in the BNF as a prokinetic anti-emetic, it has been used in video capsule endoscopy (VCE) to accelerate capsule delivery to the small intestine. We audited VCEs performed at UHCW from 2011, when as standard practice, domperidone was given pre-VCE, to 2012, after its discontinuation due to doubts about its effectiveness. Thirty-one patients received oral domperidone 20 mg pre-VCE. Thirty-three patients underwent VCE without domperidone pre-treatment. After 2 h, if the capsule remained intra-gastric, gastroscopy-assisted duodenal delivery was performed. Data was analysed using Mann-Whitney testing. Median oro-duodenal transit was 13 and 30 min in the untreated and domperidone groups, respectively (p = 0.01). Median oro-caecal transit was 242 and 267 min in the untreated and domperidone groups, respectively (p = 0.02). No difference in duodenal-caecal transit was seen (p = 0.60). Six percent of untreated and 13% of domperidone VCEs required gastroscopy-assisted duodenal capsule delivery (p = 0.65). Unexpectedly domperidone delayed VCE gastric transit. Most studies on domperidone prokinetic effects have been in diabetic gastroparesis, demonstrating that domperidone can achieve good symptomatic relief, but with mixed results for gastric emptying. Our study suggests that any antiemetic effects of domperidone are not mediated through accelerated gastric transit.

  17. 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.

  18. 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.

  19. Manipulation of permanent magnetic polymer micro-robots: a new approach towards guided wireless capsule endoscopy

    Science.gov (United States)

    Hilbich, D.; Rahbar, A.; Khosla, A.; Gray, B. L.

    2012-10-01

    We present the initial experimental results for manipulating micro-robots featuring permanent magnetic polymer magnets for guided wireless endoscopy applications. The magnetic polymers are fabricated by doping polydimethylsiloxane (PDMS) with permanent isotropic rare earth magnetic powder (MQFP 12-5) with an average particle size of 6 μm. The prepared magnetic nanocomposite polymer (M-NCP) is patterned in the desired shape against a plexiglass mold via soft lithography techniques. It is observed that the fabricated micro-robot magnets have a magnetic field strength of 50 mT and can easily be actuated by applying a field of 8.3 mT (field measured at the capsule's position) and moved at a rate of 5 inches/second.

  20. Organic Boundary Location Based on Color-Texture of Visual Perception in Wireless Capsule Endoscopy Video

    Directory of Open Access Journals (Sweden)

    Chengliang Wang

    2018-01-01

    Full Text Available This paper addresses the problem of automatically locating the boundary between the stomach and the small intestine (the pylorus in wireless capsule endoscopy (WCE video. For efficient image segmentation, the color-saliency region detection (CSD method is developed for obtaining the potentially valid region of the frame (VROF. To improve the accuracy of locating the pylorus, we design the Monitor-Judge model. On the one hand, the color-texture fusion feature of visual perception (CTVP is constructed by grey level cooccurrence matrix (GLCM feature from the maximum moments of the phase congruency covariance and hue-saturation histogram feature in HSI color space. On the other hand, support vector machine (SVM classifier with the CTVP feature is utilized to locate the pylorus. The experimental results on 30 real WCE videos demonstrate that the proposed location method outperforms the related valuable techniques.

  1. A novel holding mechanism for next generation active wireless capsule endoscopy.

    Science.gov (United States)

    Woods, Stephen P; Constandinou, Timothy G

    2015-08-01

    This paper proposes that next generation wireless capsule endoscopy (WCE) technology will feature active mechanical components (i.e. actuated) as opposed to current systems that are predominantly passive (e.g. for imaging purposes). Future systems will integrate microsystems that use micro-actuators to, for example, perform micro-surgery, take tissue samples, deliver medication, etc. In this paper we detail a novel, ultra-compact integrated mechanism for resisting peristalsis and describe how this can be fabricated in Nylon 6 using CNC milling. The holding action is achieved by extending an "anchor" spanning an effective 60.4mm circumference, for a 11.0mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0mm(3) volume, including mechanics and actuator. This shows how exploiting conventional manufacturing processes can result in a radical change in the capabilities of WCE systems and empower the next generation of active devices.

  2. Global-constrained hidden Markov model applied on wireless capsule endoscopy video segmentation

    Science.gov (United States)

    Wan, Yiwen; Duraisamy, Prakash; Alam, Mohammad S.; Buckles, Bill

    2012-06-01

    Accurate analysis of wireless capsule endoscopy (WCE) videos is vital but tedious. Automatic image analysis can expedite this task. Video segmentation of WCE into the four parts of the gastrointestinal tract is one way to assist a physician. The segmentation approach described in this paper integrates pattern recognition with statiscal analysis. Iniatially, a support vector machine is applied to classify video frames into four classes using a combination of multiple color and texture features as the feature vector. A Poisson cumulative distribution, for which the parameter depends on the length of segments, models a prior knowledge. A priori knowledge together with inter-frame difference serves as the global constraints driven by the underlying observation of each WCE video, which is fitted by Gaussian distribution to constrain the transition probability of hidden Markov model.Experimental results demonstrated effectiveness of the approach.

  3. A deep convolutional neural network for bleeding detection in Wireless Capsule Endoscopy images.

    Science.gov (United States)

    Xiao Jia; Meng, Max Q-H

    2016-08-01

    Wireless Capsule Endoscopy (WCE) is a standard non-invasive modality for small bowel examination. Recently, the development of computer-aided diagnosis (CAD) systems for gastrointestinal (GI) bleeding detection in WCE image videos has become an active research area with the goal of relieving the workload of physicians. Existing methods based primarily on handcrafted features usually give insufficient accuracy for bleeding detection, due to their limited capability of feature representation. In this paper, we present a new automatic bleeding detection strategy based on a deep convolutional neural network and evaluate our method on an expanded dataset of 10,000 WCE images. Experimental results with an increase of around 2 percentage points in the Fi score demonstrate that our method outperforms the state-of-the-art approaches in WCE bleeding detection. The achieved Fi score is of up to 0.9955.

  4. Wireless capsule endoscopy for diagnosis of acute intestinal graft-versus-host disease.

    Science.gov (United States)

    Neumann, Susanne; Schoppmeyer, Konrad; Lange, Thoralf; Wiedmann, Marcus; Golsong, Johannes; Tannapfel, Andrea; Mossner, Joachim; Niederwieser, Dietger; Caca, Karel

    2007-03-01

    The small intestine is the most common location of intestinal graft-versus-host disease (GVHD). EGD with duodenal biopsies yields the highest diagnostic sensitivity, but the jejunum and ileum are not accessible by regular endoscopy. In contrast, wireless capsule endoscopy (WCE) is a noninvasive imaging procedure offering complete evaluation of the small intestine. The objective was to compare the diagnostic value of EGD, including biopsies, with the results of WCE in patients with acute intestinal symptoms who received allogeneic blood stem cell transplantation and to analyze the appearance and distribution of acute intestinal GVHD lesions in these patients. An investigator-blinded, single-center prospective study. Patients with acute intestinal symptoms after allogeneic stem cell transplantation underwent both EGD and WCE within 24 hours. Clinical data were recorded during 2 months of follow-up. Fourteen consecutive patients with clinical symptoms of acute intestinal GVHD were recruited. In 1 patient, the capsule remained in the stomach and was removed endoscopically. In 7 of 13 patients who could be evaluated, acute intestinal GVHD was diagnosed by EGD with biopsies, but 3 of these would have been missed by EGD alone. In all 7 patients with histologically confirmed acute intestinal GVHD, WCE revealed typical signs of GVHD. Lesions were scattered throughout the small intestine, but were most accentuated in the ileum. This study had a small number of patients. WCE, which is less invasive than EGD with biopsies, showed a comparable sensitivity and a high negative predictive value for diagnosing acute intestinal GVHD. It may be helpful to avoid repeated endoscopic procedures in patients who have undergone stem cell transplantation.

  5. Wireless capsule endoscopy: a comparison with push enteroscopy in patients with gastroscopy and colonoscopy negative gastrointestinal bleeding

    Science.gov (United States)

    Mylonaki, M; Fritscher-Ravens, A; Swain, P

    2003-01-01

    Background: The development of wireless capsule endoscopy allows painless imaging of the small intestine. Its clinical use is not yet defined. The aim of this study was to compare the clinical efficacy and technical performance of capsule endoscopy and push enteroscopy in a series of 50 patients with colonoscopy and gastroscopy negative gastrointestinal bleeding. Methods: A wireless capsule endoscope was used containing a CMOS colour video imager, transmitter, and batteries. Approximately 50 000 transmitted images are received by eight abdominal aerials and stored on a portable solid state recorder, which is carried on a belt. Push enteroscopy was performed using a 240 cm Olympus video enteroscope. Results: Studies in 14 healthy volunteers gave information on normal anatomical appearances and preparation. In 50 patients with gastrointestinal bleeding and negative colonoscopy and gastroscopy, push enteroscopy was compared with capsule endoscopy. A bleeding source was discovered in the small intestine in 34 of 50 patients (68%). These included angiodysplasia (16), focal fresh bleeding (eight), apthous ulceration suggestive of Crohn’s disease (three), tumour (two), Meckel’s diverticulum (two), ileal ulcer (one), jejunitis (one), and ulcer due to intussusception (one). One additional intestinal diagnosis was made by enteroscopy. The yield of push enteroscopy in evaluating obscure bleeding was 32% (16/50). The capsule identified significantly more small intestinal bleeding sources than push enteroscopy (pcapsule endoscopy to push enteroscopy (pcapsule endoscopy was superior to push enteroscopy in the diagnosis of recurrent bleeding in patients who had a negative gastroscopy and colonoscopy. It was safe and well tolerated. PMID:12865269

  6. [Diagnostic yield of video capsule endoscopy in premenopausal women with iron-deficiency anemia].

    Science.gov (United States)

    Garrido Durán, Carmen; Iyo Miyashiro, Eduardo; Páez Cumpa, Claudia; Khorrami Minaei, Sam; Erimeiku Barahona, Alicia; Llompart Rigo, Alfredo

    2015-01-01

    Clinical practice guidelines recommend video capsule endoscopy (VCE) studies in patients with iron-deficiency anemia (IDA) after conventional upper and lower endoscopies but there is a need for studies demonstrating the diagnostic yield, clinical impact, and cost in some patient subgroups. 1.To determine the diagnostic yield of VCE in premenopausal women with IDA compared with that in men and postmenopausal women. 2. To identify the presence of VCE predictors in premenopausal women. 3. To estimate the cost-clinical impact relationship associated with VCE in this indication. We retrospectively analyzed 408 patients who underwent VCE. Patients with IDA were enrolled (premenopausal, postmenopausal women, and men), with previous normal work-up by conventional endoscopies. A total of 249 patients were enrolled: 131 women (52.6%), of which 51 were premenopausal and 80 were post-menopausal, and 118 men. The mean age was 60.7±16 years. The diagnostic yield of VCE for the diagnosis of IDA was 44.6% (95% CI 39.9 - 50.8). Diagnostic yield was 50.8% vs 38.9% in men vs women (p=0.05) and was 55% vs 13.7% in postmenopausal vs premenopausal women (p<0.001). No predictors of small bowel lesions were found in premenopausal women. The most common findings in the postmenopausal group were angioectasias (70.5%) and erosions (57.1%) in the premenopausal group. The cost in premenopausal women was 44.727€ and 86.3% of the procedures had no clinical impact. The diagnostic yield of VCE is low in the etiological study of IDA in premenopausal women and there is no cost-effectiveness in relation to clinical impact. No predictors of small bowel lesions were found in this group. Copyright © 2015 Elsevier España, S.L.U. and AEEH y AEG. All rights reserved.

  7. A review of machine-vision-based analysis of wireless capsule endoscopy video.

    Science.gov (United States)

    Chen, Yingju; Lee, Jeongkyu

    2012-01-01

    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.

  8. 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.

  9. 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.)

  10. [Design of extracorporeal apparatus of capsule endoscopy based on ARM+FPGA].

    Science.gov (United States)

    Wang, Shenghua; Zhang, Sijie; Wang, Yue; Wang, Zhenxing

    2011-10-01

    Considering that the patients would bear the annoyance of fixed posture for long time when they are examined with gastrointestinal wireless endoscopy, even though portable devices have been developed, the treatments still depend on PC so much, we proposed an embedded solution based on ARM + FPGA. It used embedded ARM9 S3C2440 as processor core, collected images from digestive tract through capsule endoscopy which can be swallowed down there, and wirelessly transferred these images to the receiving system, then used video decoder chip SAA7114H for analog of NTSC video image decode. And under FPGA's logic controlling, effective digital video signal was transferred to S3C2440 for further treatment. Finally within the embedded Linux environment, we programmed the visual user interfaces using the QT/Embedded, realizing the offline record of the real-time video images of digestive tract portable and preferences. It can make patients move more freely and even without PC when examining. In addition, the method greatly improves the efficiency of the doctor, and is more intelligent and with more humane nature.

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

    International Nuclear Information System (INIS)

    Khalife, Samer; Vahedi, Kouroche; Dray, Xavier; Marteau, Philippe; Soyer, Philippe; Hamzi, Lounis; Place, Vinciane; Boudiaf, Mourad; Alatawi, Abdullah

    2011-01-01

    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.)

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

    Science.gov (United States)

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

    2016-08-01

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

  13. Cecal perforation with an ascending colon cancer caused by upper gastrointestinal endoscopy

    Directory of Open Access Journals (Sweden)

    Hiroyuki Miyatani

    2009-04-01

    Full Text Available Hiroyuki Miyatani1, Yukio Yoshida1, Hirokazu Kiyozaki21Department of Gastroenterology, Jichi Medical University, Saitama Medical Center, Saitama, Japan; 2Department of Surgery, Jichi Medical University, Saitama Medical Center, Saitama, JapanAbstract: Colonic perforation caused by upper gastrointestinal (GI endoscopy is extremely rare. A 69-year-old woman was referred to our hospital because of abdominal fullness. Colonoscopy could be performed only up to the hepatic flexure due to an elongated colon and residual stools. Because her symptoms improved, upper GI endoscopy was performed 11 days later. The patient developed severe abdominal pain two hours after the examination. Abdominal X-ray and computed tomography showed massive free air. Immediate laparotomy was performed for the intestinal perforation. After removal of stool, a perforation site was detected in the cecum with an invasive ascending colon cancer. Therefore, a right hemicolectomy, ileostomy, and transverse colostomy were performed. Although she developed postoperative septicemia, the patient was discharged 38 days after admission. Seven months postoperatively, the patient died of lung, liver, and brain metastases. Even in cases with a lesion that is not completely obstructed, it is important to note that air insufflations during upper GI endoscopy can perforate the intestinal wall in patients with advanced colon cancer.Keywords: colonic perforation, colon cancer, upper gastrointestinal endoscopy, fecal peritonitis

  14. A simple method for preparing radioactive capsules in colon transit study

    International Nuclear Information System (INIS)

    Wang Shyhjen; Lin Wanyu; Tsai Shihchuan; Chen Granhun

    2000-01-01

    Colon transit study is currently performed by delivering technetium-99m or indium-111 labelled activated charcoal to the colon in a methacrylate-coated capsule (coated capsule). However, the coating procedure is complicated and methacrylate has not been approved by the Food and Drug Administration. Therefore, a simpler method is needed for the clinical routine use of colon transit study. In this study, we used a commercial empty enteric capsule and a coated capsule for the measurement of colon transit time. We compared the in vitro stability and in vivo scintigraphy of 99m Tc-labelled activated charcoal in the coated capsule and the enteric capsule to evaluate the possibility of clinical usage of the enteric capsule for colon transit time study. Activated charcoal powder was mixed with 99m Tc-diethylene triamine penta-acetic acid (DTPA) and vaporized to dryness. The dry 99m Tc-DTPA activated charcoal was loaded into the coated capsule and the enteric capsule. In vitro stability study was performed by immersing these capsules in a colourless buffer of variable pH which mimicked the conditions in the stomach and the small bowel. Capsule disruption was determined. Colon transit scintigraphy with 99m Tc-DTPA charcoal was performed in five normal volunteers using these two capsules. The in vitro stability of these two types of capsule was similar and the colon transit scintigraphy findings were almost identical. Most capsules dissolved in the ascending colon and very few in the terminal ileum. It is concluded that enteric capsule is a suitable alternative to coated capsule for measurement of colon transit. (orig.)

  15. Semantic and topological classification of images in magnetically guided capsule endoscopy

    Science.gov (United States)

    Mewes, P. W.; Rennert, P.; Juloski, A. L.; Lalande, A.; Angelopoulou, E.; Kuth, R.; Hornegger, J.

    2012-03-01

    Magnetically-guided capsule endoscopy (MGCE) is a nascent technology with the goal to allow the steering of a capsule endoscope inside a water filled stomach through an external magnetic field. We developed a classification cascade for MGCE images with groups images in semantic and topological categories. Results can be used in a post-procedure review or as a starting point for algorithms classifying pathologies. The first semantic classification step discards over-/under-exposed images as well as images with a large amount of debris. The second topological classification step groups images with respect to their position in the upper gastrointestinal tract (mouth, esophagus, stomach, duodenum). In the third stage two parallel classifications steps distinguish topologically different regions inside the stomach (cardia, fundus, pylorus, antrum, peristaltic view). For image classification, global image features and local texture features were applied and their performance was evaluated. We show that the third classification step can be improved by a bubble and debris segmentation because it limits feature extraction to discriminative areas only. We also investigated the impact of segmenting intestinal folds on the identification of different semantic camera positions. The results of classifications with a support-vector-machine show the significance of color histogram features for the classification of corrupted images (97%). Features extracted from intestinal fold segmentation lead only to a minor improvement (3%) in discriminating different camera positions.

  16. 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%.

  17. A complexity-efficient and one-pass image compression algorithm for wireless capsule endoscopy.

    Science.gov (United States)

    Liu, Gang; Yan, Guozheng; Zhao, Shaopeng; Kuang, Shuai

    2015-01-01

    As an important part of the application-specific integrated circuit (ASIC) in wireless capsule endoscopy (WCE), the efficient compressor is crucial for image transmission and power consumption. In this paper, a complexity-efficient and one-pass image compression method is proposed for WCE with Bayer format images. The algorithm is modified from the standard lossless algorithm (JPEG-LS). Firstly, a causal interpolation is used to acquire the context template of a current pixel to be encoded, thus determining different encoding modes. Secondly, a gradient predictor, instead of the median predictor, is designed to improve the accuracy of the predictions. Thirdly, the gradient context is quantized to obtain the context index (Q). Eventually, the encoding process is achieved in different modes. The experimental and comparative results show that our proposed near-lossless compression method provides a high compression rate (2.315) and a high image quality (46.31 dB) compared with other methods. It performs well in the designed wireless capsule system and could be applied in other image fields.

  18. An artificial neural network architecture for non-parametric visual odometry in wireless capsule endoscopy

    Science.gov (United States)

    Dimas, George; Iakovidis, Dimitris K.; Karargyris, Alexandros; Ciuti, Gastone; Koulaouzidis, Anastasios

    2017-09-01

    Wireless capsule endoscopy is a non-invasive screening procedure of the gastrointestinal (GI) tract performed with an ingestible capsule endoscope (CE) of the size of a large vitamin pill. Such endoscopes are equipped with a usually low-frame-rate color camera which enables the visualization of the GI lumen and the detection of pathologies. The localization of the commercially available CEs is performed in the 3D abdominal space using radio-frequency (RF) triangulation from external sensor arrays, in combination with transit time estimation. State-of-the-art approaches, such as magnetic localization, which have been experimentally proved more accurate than the RF approach, are still at an early stage. Recently, we have demonstrated that CE localization is feasible using solely visual cues and geometric models. However, such approaches depend on camera parameters, many of which are unknown. In this paper the authors propose a novel non-parametric visual odometry (VO) approach to CE localization based on a feed-forward neural network architecture. The effectiveness of this approach in comparison to state-of-the-art geometric VO approaches is validated using a robotic-assisted in vitro experimental setup.

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

    Science.gov (United States)

    Pan, Guobing; Xin, Wenhui; Yan, Guozheng; Chen, Jiaoliao

    2011-06-01

    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.

  20. 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.

  1. An artificial neural network architecture for non-parametric visual odometry in wireless capsule endoscopy

    International Nuclear Information System (INIS)

    Dimas, George; Iakovidis, Dimitris K; Karargyris, Alexandros; Ciuti, Gastone; Koulaouzidis, Anastasios

    2017-01-01

    Wireless capsule endoscopy is a non-invasive screening procedure of the gastrointestinal (GI) tract performed with an ingestible capsule endoscope (CE) of the size of a large vitamin pill. Such endoscopes are equipped with a usually low-frame-rate color camera which enables the visualization of the GI lumen and the detection of pathologies. The localization of the commercially available CEs is performed in the 3D abdominal space using radio-frequency (RF) triangulation from external sensor arrays, in combination with transit time estimation. State-of-the-art approaches, such as magnetic localization, which have been experimentally proved more accurate than the RF approach, are still at an early stage. Recently, we have demonstrated that CE localization is feasible using solely visual cues and geometric models. However, such approaches depend on camera parameters, many of which are unknown. In this paper the authors propose a novel non-parametric visual odometry (VO) approach to CE localization based on a feed-forward neural network architecture. The effectiveness of this approach in comparison to state-of-the-art geometric VO approaches is validated using a robotic-assisted in vitro experimental setup. (paper)

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

    International Nuclear Information System (INIS)

    Pan, Guobing; Chen, Jiaoliao; Xin, Wenhui; Yan, Guozheng

    2011-01-01

    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

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

    Directory of Open Access Journals (Sweden)

    Shabana F. Pasha

    2007-08-01

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

  4. Safety and Feasibility of Using the Second-Generation Pillcam Colon Capsule to Assess Active Colonic Crohn's Disease

    NARCIS (Netherlands)

    D'Haens, Geert; Löwenberg, Mark; Samaan, Mark A.; Franchimont, Denis; Ponsioen, Cyriel; van den Brink, Gijs R.; Fockens, Paul; Bossuyt, Peter; Amininejad, Leila; Rajamannar, Gopalan; Lensink, Elsemieke M.; van Gossum, Andre M.

    2015-01-01

    The second-generation Pillcam Colon Capsule Endoscope (PCCE-2; Given Imaging Ltd, Yoqneam, Israel) is an ingestible capsule for visualization of the colon. We performed a multicenter pilot study to assess its safety and feasibility in evaluating the severity of Crohn's disease (CD). In a prospective

  5. Clinical usefulness of novel tag-less Agile patency capsule prior to capsule endoscopy for patients with suspected small bowel stenosis.

    Science.gov (United States)

    Nakamura, Masanao; Hirooka, Yoshiki; Yamamura, Takeshi; Miyahara, Ryoji; Watanabe, Osamu; Ando, Takafumi; Ohmiya, Naoki; Goto, Hidemi

    2015-01-01

    The Agile patency capsule (PC; Given Imaging Ltd, Yoqneam, Israel) is used as a dummy prior to capsule endoscopy (CE) to avoid retention of the CE capsule. However, impaction of the PC's inner radio frequency identification (RFID) tag in a stricture could cause small-bowel ileus. Recently, the RFID tag-less PC was introduced into clinical practice. Herein, we aimed to retrospectively evaluate the usefulness of the tag-less PC. Of 154 patients who were scheduled to undergo CE, 100 consecutive patients (65%) who underwent PC evaluation were enrolled in the present study. Primary study end point was the retention rate of the CE capsule after successful passage of the PC. Secondary end point was analysis of the significant factors affecting the passage of the PC. In total, 87 patients (87%) had bowel patency confirmed by PC evaluation. There was no capsule retention in any of these 87 patients during CE. Abnormal findings were obtained from 60 CE, and 41 patients received new or modified treatment. Multivariate analysis of factors related to the confirmation of patency demonstrated that stenosis on imaging was the most influential factor (P = 0.002, odds ratio 16.387). The results confirmed that passage of the PC depends on stenosis on imaging. Use of the tag-less PC confirmed gastrointestinal tract patency for most of the patients who did not have stenosis on imaging and allowed estimation of the patency for patients who did have stenosis on imaging. © 2014 The Authors. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  6. Factors predicting the diagnostic yield and intervention in obscure gastrointestinal bleeding investigated using capsule endoscopy.

    Science.gov (United States)

    Sidhu, Reena; Sanders, David S; Kapur, Kapil; Leeds, John S; McAlindon, Mark E

    2009-09-01

    In patients with obscure gastrointestinal bleeding (OGB), capsule endoscopy (CE) is the investigation of choice after negative conventional endoscopy. However, there is paucity of data on which clinical factors predict the ability of CE to detect pathology and alter management. To investigate clinical factors which predict a higher diagnostic yield and a change in management in patients presenting with OGB. Data was collected in patients with OGB for type of OGB [overt (OB) or iron deficiency anaemia (IDA)], co-morbidity, use of anticoagulants, transfusion dependence, subsequent CE diagnosis and follow up data. Factors that predicted a higher yield and a change in management were identified using logistic regression. There were 427 patients (IDA 74%) with a mean age of 58 years (range 17-92).The diagnostic yield was 50% with a change in management in 30% of patients. The commonest finding was angiodysplasia in 52% of patients. There was no significant difference in the diagnostic yield between the two groups (OB: 56%, IDA 48%, p=0.15). On logistic regression, age (p=0.001), the use of warfarin (p=0.02) and liver co-morbidity (p=0.001) were significant factors which predicted a higher yield with CE. Factors which predicted a change in management included the presence of co-morbidity (p=0.02) and having a diagnosis of angiodysplasia on CE (p=0.001). This is a large series of CE in OGB. Increasing age, anti-coagulation and liver co-morbidity are significant predictors of a positive diagnostic yield whilst the presence of co-morbidity or a diagnosis of angiodysplasia may predict a change in management.

  7. 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)

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

    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

  8. 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

  9. CHOBS: Color Histogram of Block Statistics for Automatic Bleeding Detection in Wireless Capsule Endoscopy Video.

    Science.gov (United States)

    Ghosh, Tonmoy; Fattah, Shaikh Anowarul; Wahid, Khan A

    2018-01-01

    Wireless capsule endoscopy (WCE) is the most advanced technology to visualize whole gastrointestinal (GI) tract in a non-invasive way. But the major disadvantage here, it takes long reviewing time, which is very laborious as continuous manual intervention is necessary. In order to reduce the burden of the clinician, in this paper, an automatic bleeding detection method for WCE video is proposed based on the color histogram of block statistics, namely CHOBS. A single pixel in WCE image may be distorted due to the capsule motion in the GI tract. Instead of considering individual pixel values, a block surrounding to that individual pixel is chosen for extracting local statistical features. By combining local block features of three different color planes of RGB color space, an index value is defined. A color histogram, which is extracted from those index values, provides distinguishable color texture feature. A feature reduction technique utilizing color histogram pattern and principal component analysis is proposed, which can drastically reduce the feature dimension. For bleeding zone detection, blocks are classified using extracted local features that do not incorporate any computational burden for feature extraction. From extensive experimentation on several WCE videos and 2300 images, which are collected from a publicly available database, a very satisfactory bleeding frame and zone detection performance is achieved in comparison to that obtained by some of the existing methods. In the case of bleeding frame detection, the accuracy, sensitivity, and specificity obtained from proposed method are 97.85%, 99.47%, and 99.15%, respectively, and in the case of bleeding zone detection, 95.75% of precision is achieved. The proposed method offers not only low feature dimension but also highly satisfactory bleeding detection performance, which even can effectively detect bleeding frame and zone in a continuous WCE video data.

  10. Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease

    Directory of Open Access Journals (Sweden)

    Yonghyun Kim

    2017-10-01

    Full Text Available Background/Aims: Although the role of capsule endoscopy (CE in Crohn's disease (CD has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients.Methods: Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD and 14 cases of established CD (eCD.Results: In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%. Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%. In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%, non-steroidal anti-inflammatory drug-induced enteropathy (5.3%, and other enteritis (17.5%. Only 11.5% of patients with eCD (14/122 underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings.Conclusions: In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.

  11. Diagnostic yield and clinical impact of wireless capsule endoscopy in patients with chronic abdominal pain with or without diarrhea: a Greek multicenter study.

    Science.gov (United States)

    Katsinelos, Panagiotis; Fasoulas, Kostas; Beltsis, Athanasios; Chatzimavroudis, Grigoris; Paroutoglou, George; Maris, Theofanis; Mimidis, Kostas; Koufokotsios, Alexandros; Terzoudis, Sotiris; Atmatzidis, Stefanos; Kaltsa, Agoritsa; Kapetanos, Dimitris; Kamperis, Eustathios; Zavos, Christos; Kountouras, Jannis; Belou, Aristea

    2011-10-01

    Wireless capsule endoscopy has become the gold standard for the examination of small bowel. However, its role in the evaluation of patients suffering from chronic abdominal pain is not yet clearly defined. We conducted an open-label prospective multi-center study to evaluate the yield and clinical outcome of capsule endoscopy in patients with chronic abdominal pain with/without diarrhea. Seventy-two patients with chronic (>3months) abdominal pain with/without diarrhea in whom the underlying pathology could not be diagnosed by conventional modalities, underwent capsule endoscopy in either of the 6 participating centers. Patients were then followed up for clinical outcomes. The overall diagnostic yield of capsule endoscopy was 44.4%. More specifically, its diagnostic yield was 21.4% in patients with abdominal pain and negative inflammatory markers (C-reactive protein and erythrocyte sedimentation rate), 66.7% in patients with abdominal pain and positive inflammatory markers, 0% in patients with abdominal pain, diarrhea and negative inflammatory markers, and 90.1% in patients with abdominal pain, diarrhea and positive inflammatory markers. Both univariate and multivariate regression analyses showed that abnormal C-reactive protein and erythrocyte sedimentation rate were significant factors related with positive capsule endoscopy findings. Chronic abdominal pain with/without diarrhea should be accompanied by elevated inflammatory markers to be regarded as a valid indication for capsule endoscopy. The yield of capsule endoscopy in such patients is reasonably high and clinical outcomes of patients treated with capsule endoscopy findings as a guide are significant. Copyright © 2011 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  12. Innovative video capsule endoscopy for detection of ubiquitously elongated small intestinal villi in Cronkhite-Canada syndrome

    OpenAIRE

    Heinzow, Hauke Sebastian; Domschke, Wolfram; Meister, Tobias

    2013-01-01

    Cronkhite-Canada syndrome (CCS) is a rare non-familial disorder with multiple gastrointestinal polyps and ectodermal changes. Adenomatous and carcinomatous changes have been reported. Video capsule endoscopy is a useful non-invasive tool to reveal polypoid lesions of the gastrointestinal tract suspicious for malignancy. We report a case of a patient with CCS with excessively elongated intestinal villi resembling dense sea grass under water as well as multiple polyps of the intestinal mucosa r...

  13. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

    OpenAIRE

    Albert, J.G.; Humbla, O.; McAlindon, M.E.; Davison, C.; Seitz, U.; Fraser, C.; Hagenm?ller, F.; Noetzel, E.; Spada, C.; Riccioni, M.E.; Barnert, J.; Filmann, N.; Keuchel, M.

    2015-01-01

    Abstract Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse. Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n?=?2), Italy (n?=?2), Germany (n?=?2), Finland (n?=?1), and nationally in Germany (n?=?10), applying similar 8-hour curricula with 50% lectures and 50% hands-on t...

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

    Science.gov (United States)

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

    2016-04-01

    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.  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 capsules. Limitations included transient Smartpill(®) signal loss (5/10 studies). 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.

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

    Science.gov (United States)

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

    2008-01-01

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

  16. 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

    2014-11-04

    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.

  17. 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.

  18. Small bowel preparations for capsule endoscopy with mannitol and simethicone: a prospective, randomized, clinical trial.

    Science.gov (United States)

    Chen, Hong-bin; Huang, Yue; Chen, Su-yu; Song, Hui-wen; Li, Xiao-lin; Dai, Dong-lin; Xie, Jia-tia; He, Song; Zhao, Yuan-yuan; Huang, Chun; Zhang, Sheng-jun; Yang, Lin-na

    2011-04-01

    There is no consensus concerning small bowel preparation before capsule endoscopy (CE). This study evaluated the effects of 4 regimens on small bowel cleansing and diagnostic yield. Patients were randomly divided into 4 groups. Group A consumed a clear liquid diet after lunch on the day before CE, followed by overnight fasting. Group B took 250 mL 20% mannitol and 1 L 0.9% saline orally at 05:00 hours on the day of the procedure. In group C, the same regimen was taken at 20:00 hours on the day before and at 05:00 hours on the day of CE. In group D, in addition to the group C regimen, 20 mL oral simethicone was taken 30 minutes before CE. Two hundred patients were prospectively enrolled, and 7 were excluded from the final analysis because of incomplete small bowel transit. No significant difference was noted among the 4 groups for small bowel transit time. Bowel preparation in group D was significantly better than for the other regimens for overall cleansing of the proximal small bowel, and showed improved overall cleansing of the distal small bowel when compared with 10-hours overnight fasting. Pathological lesions of the proximal and distal small bowel were, respectively, achieved in 82 and 74 patients, mostly distributed in group D. Small bowel preparation that involves split-dose oral mannitol plus single-dose simethicone for CE can improve mucosal visualization and subsequent diagnostic yield when compared with 10-hours overnight fasting.

  19. Evaluation of portal hypertensive enteropathy by scoring with capsule endoscopy: is transient elastography of clinical impact?

    Science.gov (United States)

    Abdelaal, Usama M; Morita, Eijiro; Nouda, Sadaharu; Kuramoto, Takanori; Miyaji, Katsuhiko; Fukui, Hideo; Tsuda, Yasuhiro; Fukuda, Akira; Murano, Mitsuyuki; Tokioka, Satoshi; Arafa, Usama A; Kassem, Ali M; Umegaki, Eiji; Higuchi, Kazuhide

    2010-07-01

    There is limited data about the mucosal lesions of portal hypertensive enteropathy (PHE) detected by capsule endoscopy, and there is no scoring system to evaluate their severity. Our aim is to create a reliable scoring system for PHE, and to explore the possible usefulness of using transient elastograhy (TE) in that field. We compared the medical records of 31 patients with liver cirrhosis and portal hypertension with 29 control patients. We found that the mucosal lesions compatible with PHE were significantly more common in cirrhotic patients than in control patients (67.7% vs 6.9%, pEVL) were significantly associated with PHE. Using our scoring system, we found that patients with higher TE score (p = 0.004), high Child-Pugh score (p = 0.011), larger EV (p = 0.006), and prior EIS/EVL (p = 0.006) were significantly associated with higher PHE score. We concluded that using our scoring system might be helpful in grading PHE severity, and TE might be a new non-invasive method for detecting the presence and severity of PHE in cirrhotic patients.

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

    Science.gov (United States)

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

    2010-01-01

    AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn’s disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidal anti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum. PMID:20614486

  1. Capsule Endoscopy for Obscure Gastrointestinal Bleeding in Patients with Comorbid Rheumatic Diseases

    Directory of Open Access Journals (Sweden)

    Neal Shahidi

    2014-01-01

    Full Text Available Background and Aim. We evaluated the association between patients with rheumatic diseases (RD suffering from obscure gastrointestinal bleeding (OGIB and positive capsule endoscopy (CE findings. Methods. All CE procedures performed on patients with RD and OGIB were assessed from a large database at St. Paul’s Hospital (Vancouver, BC, Canada between December 2001 and April 2011. A positive finding on CE was defined as any pathology, including ulcers/erosions, vascular lesions, and mass lesions, perceived to be the source of bleeding. Results. Of the 1133 CEs performed, 41 (4% complete CEs were for OGIB in patients with RD. Of these, 54% presented with overt bleeding. Mean age was 66 years. Positive findings were seen in 61% of patients. Ulcerations/erosions (36% and vascular lesions (36% were the most common findings. Significant differences between the RD versus non-RD populations included: inpatient status, nonsteroidal anti-inflammatory drug (NSAIDs use, oral steroid use, and mean Charlson index score (all P≤0.008. Similar nonsignificant trends were seen between positive and negative CEs among the RD population. Conclusions. The correlation between RD and positive CE findings is likely influenced by ongoing anti-inflammatory drug use, poorer health status, and a predisposition for angiodysplastic lesions.

  2. Developing assessment system for wireless capsule endoscopy videos based on event detection

    Science.gov (United States)

    Chen, Ying-ju; Yasen, Wisam; Lee, Jeongkyu; Lee, Dongha; Kim, Yongho

    2009-02-01

    Along with the advancing of technology in wireless and miniature camera, Wireless Capsule Endoscopy (WCE), the combination of both, enables a physician to diagnose patient's digestive system without actually perform a surgical procedure. Although WCE is a technical breakthrough that allows physicians to visualize the entire small bowel noninvasively, the video viewing time takes 1 - 2 hours. This is very time consuming for the gastroenterologist. Not only it sets a limit on the wide application of this technology but also it incurs considerable amount of cost. Therefore, it is important to automate such process so that the medical clinicians only focus on interested events. As an extension from our previous work that characterizes the motility of digestive tract in WCE videos, we propose a new assessment system for energy based events detection (EG-EBD) to classify the events in WCE videos. For the system, we first extract general features of a WCE video that can characterize the intestinal contractions in digestive organs. Then, the event boundaries are identified by using High Frequency Content (HFC) function. The segments are classified into WCE event by special features. In this system, we focus on entering duodenum, entering cecum, and active bleeding. This assessment system can be easily extended to discover more WCE events, such as detailed organ segmentation and more diseases, by using new special features. In addition, the system provides a score for every WCE image for each event. Using the event scores, the system helps a specialist to speedup the diagnosis process.

  3. Diagnosis and Treatment of Small Bowel Cancers Using Radioactive Gold Nanoparticles and Wireless Fluorescence Capsule Endoscopy.

    Science.gov (United States)

    Alizadeh, M; Qaradaghi, V

    2016-03-01

    Therapeutic and diagnosis properties of radioactive gold nanoparticle (198-AuNPs) cause them to be suitable for detection and treatment of tumors. Electrical and optical properties of PEG-198AuNPs were examined in this paper. Polyethylene Glycol (PEG)-198 AuNPs can be used for treatment and diagnosis of small intestine tumors. Wireless fluorescence capsule endoscopy will be able to detect emission lights of triggered Au by external light. First, the output electrical field was calculated by DDSCAT software. Secondly, tumor and distribution of PEG-198 gold nanoparticles were modeled using Monte Carlo simulation and finally dose delivered throughout a solid tumor when the PEG-198 gold nanoparticles linked to each cell was calculated. Polyethylene Glycol functionalized gold nanoparticles (AuNPs) possess optimized sizes (30 nm core diameter and 70 nm hydrodynamic diameters) to target individual tumor cells. Surface distribution to receive doses of up to 50Gy was simulated.  Activities and absorbed doses by the tumors with 0.25cm and 0.5cm radius were 187.9mCi and 300mCi and 72 and 118 Gy,respectively. Therapeutic and diagnosis properties of 198-AuNPs show that it can be used for treatment and detection of small bowel tumors in early stage of growing.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Diagnosis and Treatment of Small Bowel Cancers Using Radioactive Gold Nanoparticles and Wireless Fluorescence Capsule Endoscopy

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    Alizadeh M.

    2015-03-01

    Full Text Available Background: Therapeutic and diagnosis properties of radioactive gold nanoparticle (198-AuNPs cause them to be suitable for detection and treatment of tumors. Objective: Electrical and optical properties of PEG-198AuNPs were examined in this paper. Polyethylene Glycol (PEG-198 AuNPs can be used for treatment and diagnosis of small intestine tumors. Methods: Wireless fluorescence capsule endoscopy will be able to detect emission lights of triggered Au by external light. First, the output electrical field was calculated by DDSCAT software. Secondly, tumor and distribution of PEG-198 gold nanoparticles were modeled using Monte Carlo simulation and finally dose delivered throughout a solid tumor when the PEG-198 gold nanoparticles linked to each cell was calculated. Results: Polyethylene Glycol functionalized gold nanoparticles (AuNPs possess optimized sizes (30 nm core diameter and 70 nm hydrodynamic diameters to target individual tumor cells. Surface distribution to receive doses of up to 50Gy was simulated. Activities and absorbed doses by the tumors with 0.25cm and 0.5cm radius were 187.9mCi and 300mCi and 72 and 118 Gy,respectively. Conclusion: Therapeutic and diagnosis properties of 198-AuNPs show that it can be used for treatment and detection of small bowel tumors in early stage of growing.

  6. A novel method for automatically locating the pylorus in the wireless capsule endoscopy.

    Science.gov (United States)

    Zhou, Shangbo; Yang, Han; Siddique, Muhammad Abubakar; Xu, Jie; Zhou, Ping

    2017-02-01

    Wireless capsule endoscopy (WCE) is a non-invasive technique used to examine the interiors of digestive tracts. Generally, the digestive tract can be divided into four segments: the entrance; stomach; small intestine; and large intestine. The stomach and the small intestine have a higher risk of infections than the other segments. In order to locate the diseased organ, an appropriate classification of the WCE images is necessary. In this article, a novel method is proposed for automatically locating the pylorus in WCE. The location of the pylorus is determined on two levels: rough-level and refined-level. In the rough-level, a short-term color change at the boundary between stomach and intestine can help us to find approximately 70-150 positions. In the refined-level, an improved Weber local descriptor (WLD) feature extraction method is designed for gray-scale images. Compared to the original WLD calculation method, the method for calculating the differential excitation is improved to give a higher level of robustness. A K-nearest neighbor (KNN) classifier is incorporated to segment these images around the approximate position into different regions. The proposed algorithm locates three most probable positions of the pylorus that were marked by the clinician. The experimental results indicate that the proposed method is effective.

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

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    Kleinman, Bryan; Stanich, Peter P.; Betkerur, Kavita; Porter, Kyle; Meyer, Marty M.

    2014-01-01

    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. PMID:25214757

  8. Cluster based statistical feature extraction method for automatic bleeding detection in wireless capsule endoscopy video.

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    Ghosh, Tonmoy; Fattah, Shaikh Anowarul; Wahid, Khan A; Zhu, Wei-Ping; Ahmad, M Omair

    2018-03-01

    Wireless capsule endoscopy (WCE) is capable of demonstrating the entire gastrointestinal tract at an expense of exhaustive reviewing process for detecting bleeding disorders. The main objective is to develop an automatic method for identifying the bleeding frames and zones from WCE video. Different statistical features are extracted from the overlapping spatial blocks of the preprocessed WCE image in a transformed color plane containing green to red pixel ratio. The unique idea of the proposed method is to first perform unsupervised clustering of different blocks for obtaining two clusters and then extract cluster based features (CBFs). Finally, a global feature consisting of the CBFs and differential CBF is used to detect bleeding frame via supervised classification. In order to handle continuous WCE video, a post-processing scheme is introduced utilizing the feature trends in neighboring frames. The CBF along with some morphological operations is employed to identify bleeding zones. Based on extensive experimentation on several WCE videos, it is found that the proposed method offers significantly better performance in comparison to some existing methods in terms of bleeding detection accuracy, sensitivity, specificity and precision in bleeding zone detection. It is found that the bleeding detection performance obtained by using the proposed CBF based global feature is better than the feature extracted from the non-clustered image. The proposed method can reduce the burden of physicians in investigating WCE video to detect bleeding frame and zone with a high level of accuracy. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Computer-aided gastrointestinal hemorrhage detection in wireless capsule endoscopy videos.

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    Hassan, Ahnaf Rashik; Haque, Mohammad Ariful

    2015-12-01

    Wireless Capsule Endoscopy (WCE) can image the portions of the human gastrointestinal tract that were previously unreachable for conventional endoscopy examinations. A major drawback of this technology is that a large volume of data are to be analyzed in order to detect a disease which can be time-consuming and burdensome for the clinicians. Consequently, there is a dire need of computer-aided disease detection schemes to assist the clinicians. In this paper, we propose a real-time, computationally efficient and effective computerized bleeding detection technique applicable for WCE technology. The development of our proposed technique is based on the observation that characteristic patterns appear in the frequency spectrum of the WCE frames due to the presence of bleeding region. Discovering these discriminating patterns, we develop a texture-feature-descriptor-based-algorithm that operates on the Normalized Gray Level Co-occurrence Matrix (NGLCM) of the magnitude spectrum of the images. A new local texture descriptor called difference average that operates on NGLCM is also proposed. We also perform statistical validation of the proposed scheme. The proposed algorithm was evaluated using a publicly available WCE database. The training set consisted of 600 bleeding and 600 non-bleeding frames. This set was used to train the SVM classifier. On the other hand, 860 bleeding and 860 non-bleeding images were selected from the rest of the extracted images to form the test set. The accuracy, sensitivity and specificity obtained from our method are 99.19%, 99.41% and 98.95% respectively which are significantly higher than state-of-the-art methods. In addition, the low computational cost of our method makes it suitable for real-time implementation. This work proposes a bleeding detection algorithm that employs textural features from the magnitude spectrum of the WCE images. Experimental outcomes backed by statistical validations prove that the proposed algorithm is superior

  10. 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).

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

    2015-12-01

    Capsule Endoscopy (CE) in children has limitations based mainly on age. The objective of this consensus was reviewing the scientific evidence. 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. 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. 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.

  11. 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

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    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.

  12. Spectrophotometric methods and magnifying endoscopy for differential diagnosis of colon lesions

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    А. А. Razgivina

    2013-01-01

    Full Text Available The review of recent development in diagnosis of premalignancy and early cancer in colon is represented. The results of several diagnostic methods which are supplemental for convenient colonoscopy, are described. Thus, NBI system (narrow spectrum endoscopy and FICE combined with system for magnifying endoscopy significantly improve sensitivity and specifity of diagnostic method. However, the serious disadvantage is coloration of intestinal contents into different shades of red, impeding visualization of small structures and lesions. For detection of dysplasia of different degree in patients with colon polyps high levels of sensitivity and specifity were shown in the methods of magnifying and zoom-endoscopy (93.8% and 64.6%, respectively, confocal laser endomicroscopy (81% and 82%, perspectively, and optic coherent tomography (92% and 84%, respectively. The one of the most recent method – immunophotodiagnosis, showed high efficiency for detection of dysplasia and early cancer in patients with colon polyps: the sensitivity was 78.6%, specifity – 100%. Autofluorescence and fluorescence diagnostics with exogenous photosensitizers. The studies showed that autofluorescence diagnosis was valuable method for differential diagnosis of colon tumors (sensitivity was 85%, specifity – 81%. 

  13. 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.

  14. A prospective trial comparing wireless capsule endoscopy and barium contrast series for small-bowel surveillance in hereditary GI polyposis syndromes.

    Science.gov (United States)

    Mata, Alfredo; Llach, Josep; Castells, Antoni; Rovira, Josep M; Pellisé, María; Ginès, Angels; Fernández-Esparrach, Gloria; Andreu, Montserrat; Bordas, Josep M; Piqué, Josep M

    2005-05-01

    Capsule endoscopy has demonstrated its clinical utility in the evaluation of the small bowel, and, accordingly, it has been suggested that it could be useful for the identification of small-intestinal polyps in patients with polyposis syndromes. The objective was to establish the effectiveness of wireless capsule endoscopy for detecting small-bowel polyps in patients with hereditary GI polyposis syndromes in comparison with barium contrast series. Consecutive patients with GI polyposis syndromes were included. Small-bowel follow-through series and capsule endoscopy were performed within 1 week, in a blind fashion. The number and the location of polyps were analyzed. Twenty-four patients with familial adenomatous polyposis (n = 20) or Peutz-Jeghers syndrome (n = 4) were included. Capsule endoscopy detected small-bowel polyps in 7 of 24 patients (29%), whereas a barium contrast study identified small-intestinal polyps in only 3 of these 7 patients. In the 4 remaining patients, all of them with familial adenomatous polyposis, polyps detected by the capsule but missed in radiographic series were located at either ileum (2 patients), jejunum (1), or duodenum (1). No procedure-related complication was observed in any patient. Wireless capsule endoscopy is a highly accurate technique for the detection of small-bowel polyps in patients with hereditary GI polyposis syndromes, and it represents a valuable alternative to barium contrast series in the surveillance of patients with Peutz-Jeghers syndrome.

  15. 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.

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

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    Lahat A

    2016-06-01

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

  17. Capsule endoscopy in a network cooperation: assessment of the experience in 822 patients.

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    Farnbacher, Michael Julius; Keles, Murat; Meier, Michael; Hagel, Alexander; Schneider, Thomas

    2013-09-01

    Capsule endoscopy (CE) is firmly established as a standard procedure in the diagnostic algorithm of occult or obscure gastrointestinal bleeding and Crohn's disease. Despite its excellent diagnostic yield, missing expertise, reading time and financial expenditure limit an area-wide availability. A multicentric cooperation might compensate these disadvantages. CE device was bought by a central hospital (CH). Requested equipment is transported to the network partner (NP) and the procedure performed at the spot in personal responsibility. Video reading is exclusively done in the CH. Within 10 years, 822 CE (438 m., 384 f.; 63 ± 17 (13-92) years) were performed by 18 cooperating gastroenterological departments. 587/822 (71%) CE were done at NP, 235/822 (29%) in the CH. Between 2002 (n = 39) and 2011 (n = 123) the annual number of CE increased threefold. 95% of the capital investment in each cooperating hospital could be avoided by sharing one workstation within the network. Leading indication for CE was suspected mid-GI-bleeding (80%). Mean latencies between requested date and actual examination were 0 and between equipment's return and report 2 days. 45/191(24%) flexible enteroscopies performed in the CH followed CE findings from NP. Our 10 years experience show that mobile use of CE is feasible providing quality parameters similar to a single center solution, increases the number of CE investigations, therefore, improves reading expertise and enables both an area-wide and economic offer for this technique. Additionally, patients with the need for invasive enteroscopy are identified and attracted to that NP who provides an invasive SB endocopy device.

  18. [Capsule endoscopy in a supra-regional network corporation: experience in more than 1000 cases].

    Science.gov (United States)

    Farnbacher, M J; Hagel, A F; Keles, M; Meier, M; Schneider, T

    2014-09-01

    Capsule endoscopy (CE) is firmly established as a standard procedure in the diagnostic algorithm of mid gastrointestinal (GI) bleeding. Despite its excellent diagnostic yield, missing expertise, reading time and financial expenditure limit an area-wide availability. A multicentric cooperation might compensate these disadvantages. The CE device was bought by a centrally located hospital (CH). CE-equipment is transported to the network partner (NP) on request and the procedure performed at the spot. Video reading is exclusively done in the CH. Between January 2002 and July 2013, 1026 CE (548 m, 478f; 64 ± 16, 13 - 93 yrs.) were performed within the network. 744/1026 (73 %) CE were done at 17 NP, 282/1026 (27 %) in the CH. Between 2002 (n = 39) and 2012 (n = 136) the annual number of CE increased threefold. Leading indication for CE was suspected mid GI-bleeding (80 %). Mean latencies between requested date and actual examination were less than 24 h and 2 days between CE performance and report. 95 % of the capital investment in each cooperating hospital could be avoided by sharing one workstation within the network. The experience from more than 1000 CE show that long-term multicentric utilization of CE equipment is feasible. Such a network runs at stable procedural quality levels similar to an in-house supply, allows an economic as well as area-wide availability of CE and improves reading expertise by centralized video evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Physical activity during video capsule endoscopy correlates with shorter bowel transit time.

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    Stanich, Peter P; Peck, Joshua; Murphy, Christopher; Porter, Kyle M; Meyer, Marty M

    2017-09-01

     Video capsule endoscopy (VCE) is limited by reliance on bowel motility for propulsion, and lack of physical activity has been proposed as a cause of incomplete studies. Our aim was to prospectively investigate the association between physical activity and VCE bowel transit.  Ambulatory outpatients receiving VCE were eligible for the study. A pedometer was attached at the time of VCE ingestion and step count was recorded at the end of the procedure. VCE completion was assessed by logistic regression models, which included step count (500 steps as one unit). Total transit time was analyzed by Cox proportional hazards models. The hazard ratios (HR) with 95 % confidence interval (CI) indicated the "hazard" of completion, such that HRs > 1 indicated a reduced transit time.  A total of 100 patients were included. VCE was completed in 93 patients (93 %). The median step count was 2782 steps. Step count was not significantly associated with VCE completion (odds ratio 1.45, 95 %CI 0.84, 2.49). Pedometer step count was significantly associated with shorter total, gastric, and small-bowel transit times (HR 1.09, 95 %CI 1.03, 1.16; HR 1.05, 95 %CI 1.00, 1.11; HR 1.07, 95 %CI 1.01, 1.14, respectively). Higher body mass index (BMI) was significantly associated with VCE completion (HR 1.87, 95 %CI 1.18, 2.97) and shorter bowel transit times (HR 1.05, 95 %CI 1.02, 1.08).  Increased physical activity during outpatient VCE was associated with shorter bowel transit times but not with study completion. In addition, BMI was a previously unreported clinical characteristic associated with VCE completion and should be included as a variable of interest in future studies.

  20. Bleeding detection in wireless capsule endoscopy using adaptive colour histogram model and support vector classification

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    Mackiewicz, Michal W.; Fisher, Mark; Jamieson, Crawford

    2008-03-01

    Wireless Capsule Endoscopy (WCE) is a colour imaging technology that enables detailed examination of the interior of the gastrointestinal tract. A typical WCE examination takes ~ 8 hours and captures ~ 40,000 useful images. After the examination, the images are viewed as a video sequence, which generally takes a clinician over an hour to analyse. The manufacturers of the WCE provide certain automatic image analysis functions e.g. Given Imaging offers in their Rapid Reader software: The Suspected Blood Indicator (SBI), which is designed to report the location in the video of areas of active bleeding. However, this tool has been reported to have insufficient specificity and sensitivity. Therefore it does not free the specialist from reviewing the entire footage and was suggested only to be used as a fast screening tool. In this paper we propose a method of bleeding detection that uses in its first stage Hue-Saturation-Intensity colour histograms to track a moving background and bleeding colour distributions over time. Such an approach addresses the problem caused by drastic changes in blood colour distribution that occur when it is altered by gastrointestinal fluids and allow detection of other red lesions, which although are usually "less red" than fresh bleeding, they can still be detected when the difference between their colour distributions and the background is large enough. In the second stage of our method, we analyse all candidate blood frames, by extracting colour (HSI) and texture (LBP) features from the suspicious image regions (obtained in the first stage) and their neighbourhoods and classifying them using Support Vector Classifier into Bleeding, Lesion and Normal classes. We show that our algorithm compares favourably with the SBI on the test set of 84 full length videos.

  1. Quality assessment for wireless capsule endoscopy videos compressed via HEVC: From diagnostic quality to visual perception.

    Science.gov (United States)

    Usman, Muhammad Arslan; Usman, Muhammad Rehan; Shin, Soo Young

    2017-12-01

    Maintaining the quality of medical images and videos is an essential part of the e-services provided by the healthcare sector. The convergence of modern communication systems and the healthcare industry necessitates the provision of better quality of service and experience by the service provider. Recent inclusion and standardization of the high efficiency video coder (HEVC) has made it possible for medical data to be compressed and transmitted over wireless networks with minimal compromise of the quality. Quality evaluation and assessment of these medical videos transmitted over wireless networks is another important research area that requires further exploration and attention. In this paper, we have conducted an in-depth study of video quality assessment for compressed wireless capsule endoscopy (WCE) videos. Our study includes the performance evaluation of several state-of-the-art objective video quality metrics in terms of determining the quality of compressed WCE videos. Subjective video quality experiments were conducted with the assistance of experts and non-experts in order to predict the diagnostic and visual quality of these medical videos, respectively. The evaluation of the metrics is based on three major performance metrics that include, correlation between the subjective and objective scores, relative statistical performance and computation time. Results show that the metrics information fidelity criterion (IFC), visual information fidelity-(VIF) and especially pixel based VIF stand out as best performing metrics. Furthermore, our paper reports the performance of HEVC compression on medical videos and according to the results, it performs optimally in preserving the diagnostic and visual quality of WCE videos at Quantization Parameter (QP) values of up to 35 and 37 respectively. Copyright © 2017 Elsevier Ltd. All rights reserved.

  2. Bleeding Frame and Region Detection in the Wireless Capsule Endoscopy Video.

    Science.gov (United States)

    Yuan, Yixuan; Li, Baopu; Meng, Max Q-H

    2016-03-01

    Wireless capsule endoscopy (WCE) enables noninvasive and painless direct visual inspection of a patient's whole digestive tract, but at the price of long time reviewing large amount of images by clinicians. Thus, an automatic computer-aided technique to reduce the burden of physicians is highly demanded. In this paper, we propose a novel color feature extraction method to discriminate the bleeding frames from the normal ones, with further localization of the bleeding regions. Our proposal is based on a twofold system. First, we make full use of the color information of WCE images and utilize K-means clustering method on the pixel represented images to obtain the cluster centers, with which we characterize WCE images as words-based color histograms. Then, we judge the status of a WCE frame by applying the support vector machine (SVM) and K-nearest neighbor methods. Comprehensive experimental results reveal that the best classification performance is obtained with YCbCr color space, cluster number 80 and the SVM. The achieved classification performance reaches 95.75% in accuracy, 0.9771 for AUC, validating that the proposed scheme provides an exciting performance for bleeding classification. Second, we propose a two-stage saliency map extraction method to highlight bleeding regions, where the first-stage saliency map is created by means of different color channels mixer and the second-stage saliency map is obtained from the visual contrast. Followed by an appropriate fusion strategy and threshold, we localize the bleeding areas. Quantitative as well as qualitative results show that our methods could differentiate the bleeding areas from neighborhoods correctly.

  3. Is there a role for capsule endoscopy in the staging work-up of patients with gastric marginal zone B-cell lymphoma of MALT?

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    Al-Taie, O; Dietrich, C G; Flieger, D; Katzenberger, T; Fischbach, W

    2013-08-01

    In earlier studies, involvement of the small intestine was reported in patients with gastrointestinal lymphoma. Prospective data on the involvement of the small intestine in patients suffering from gastric extranodal MZBCL of MALT do not exist so far. In this study, we investigated the frequency of the involvement of the small intestine and the role of capsule endoscopy in patients with gastrointestinal extranodal MZBCL of MALT and of follicular lymphoma. 40 consecutive patients with gastrointestinal extranodal MZBCL of MALT (26 men, 14 women, aged 27 - 80 years), and 7 patients with known follicular lymphoma of the small intestine (5 men, 2 women, aged 34 - 63 years) underwent capsule endoscopy. Involvement of the small intestine was identified by capsule endoscopy in all 7 patients with known follicular lymphoma of the small intestine. In 6 of 40 patients with gastric extranodal MZBCL of MALT abnormal findings could be observed, three of these findings indicative for lymphoma involvement of the small intestine. However, in each of these 3 cases, intestinal involvement had been already diagnosed by conventional GI endoscopy before capsule endoscopy. Capsule endoscopy is able to detect involvement of the small intestine in patients with gastrointestinal lymphoma. However, involvement of the small intestine seems to be rare in patients with gastric extranodal MZBCL of MALT. In summary, routine diagnostic work-up of the small intestine, e. g. by capsule endoscopy seems unnecessary because of the rare involvement of the small intestine and an excellent long-term outcome irrespective of a possible intestinal manifestation. © Georg Thieme Verlag KG Stuttgart · New York.

  4. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses

    Science.gov (United States)

    Albert, J.G.; Humbla, O.; McAlindon, M.E.; Davison, C.; Seitz, U.; Fraser, C.; Hagenmüller, F.; Noetzel, E.; Spada, C.; Riccioni, M.E.; Barnert, J.; Filmann, N.; Keuchel, M.

    2015-01-01

    Abstract Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse. Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course. Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P endoscopy may be useful before attending an SBCE course. PMID:26512623

  5. [A case of lymphoproliferative disorder in the entire small intestine after renal transplantation detected by wireless capsule endoscopy].

    Science.gov (United States)

    Sonoda, Akira; Katsuta, Makoto; Yada, Mika; Mizukami, Kazuhiro; Okamoto, Kazuhisa; Ogawa, Ryo; Okimoto, Tadayoshi; Kodama, Masaaki; Murakami, Kazunari

    2015-04-01

    A 42-year-old woman underwent renal transplantation in 200X. After the transplant, she received tacrolimus as immunosuppressant therapy. Eleven years after the transplant, diffuse large B-cell lymphomas were detected in the duodenum and terminal ileum. Wireless capsule endoscopy (WCE) revealed multiple lymphoma lesions in the entire small intestine. The patient achieved complete response through the administration of R-CHOP therapy and discontinuation of immunosuppressant therapy. Post-transplant lymphoproliferative disorder (PTLD) is a rare complication and WCE may be useful for diagnosing PTLD of the small intestine.

  6. Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

    Science.gov (United States)

    Gheorghe, Andrada; Zahiu, Denise Carmen Mihaela; Voiosu, Theodor Alexandru; Mateescu, Bogdan Radu; Voiosu, Mihail Radu; Rimbaş, Mihai

    2017-06-01

    As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn's disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis. 64 consecutive patients (33 males; mean age 38 ± 11 years) that fulfilled the AMOR criteria for seronegative spondyloarthropathy (59.4% ankylosing spondylitis) lacking symptoms or signs of intestinal stenosis were enrolled and submitted to an AGILE™ capsule patency test followed by a video capsule endoscopy (PillCam SB2™), as part of a protocol investigating the presence of intestinal inflammatory lesions. After reviewing the VCE recordings, the Lewis score (of small bowel inflammatory involvement) was computed. In only 5 patients (7.8%) of the study group, the luminal patency test was negative. However, there was no retention of the videocapsule in any of the patients. From the 59 patients with a positive patency test, 3 patients presented single small bowel stenoses (two with ulcerated overlying inflamed mucosa, one cicatricial), all being traversed by the videocapsule along the length of the recording. None of the patients with a negative test had bowel stenoses. There was no correlation between the patency test and the Lewis score, the C reactive protein value, diagnosis of inflammatory bowel disease, or the family history of spondyloarthritis, psoriasis or inflammatory bowel disease. The AGILE patency capsule does not seem to be a useful tool for all patients with spondyloarthritis prior to small bowel videocapsule endoscopy (ClinicalTrial.gov ID NCT 00768950).

  7. Klebsiella pneumoniae capsule expression is necessary for colonization of large intestines of streptomycin-treated mice

    DEFF Research Database (Denmark)

    Favre-Bonte, S.; Licht, Tine Rask; Forestier, C.

    1999-01-01

    The role of the Klebsiella pneumoniae capsular polysaccharide (K antigen) during colonization of the mouse large intestine was assessed with mild-type K. pneumoniae LM21 and its isogenic capsule-defective mutant. When bacterial strains were fed alone to mice, the capsulated bacteria persisted...... in the intestinal tract at levels of 10(8) CFU/g of feces while the capsule-defective strain colonized at low levels, 10(4) CFU/g of feces. In mixed-infection experiments, the mutant was rapidly outcompeted by the wild type. In situ hybridization on colonic sections revealed that bacterial cells of both strains...... were evenly distributed in the mucus layer at day 1 after infection, while at day 20 the wild type remained dispersed and the capsule-defective strain was seen in clusters in the mucus layer. These results suggest that capsular polysaccharide plays an important role in the gut colonization ability of K...

  8. Successful wireless capsule endoscopy for a 2.5-year-old child: obscure gastrointestinal bleeding from mixed, juvenile, capillary hemangioma-angiomatosis of the jejunum.

    Science.gov (United States)

    Kavin, Hymie; Berman, James; Martin, Thomas L; Feldman, Ansley; Forsey-Koukol, Kimberly

    2006-02-01

    The lesion responsible for obscure gastrointestinal bleeding in the pediatric population may not be determined with standard primary endoscopic methods. Wireless capsule endoscopy, now a first-line modality for evaluation of the small bowel in the adult population, is a tool that may be useful among children. We report a case of a 2.5-year-old girl who presented with melenic stools. Upper and lower endoscopy, Meckel scans, and mesenteric angiography yielded negative results. Wireless capsule endoscopy identified numerous abnormal, dilated, blood vessels in the proximal jejunum, with associated fresh blood. The patient underwent surgical exploration, with resection of the affected portion of the jejunum. Pathologically, the dilated blood vessels were consistent with mixed, juvenile, capillary hemangioma-angiomatosis of developmental or congenital origin. The patient fared well postoperatively, with no additional bleeding in 9 months of follow-up monitoring. This case report highlights the use of capsule endoscopy in the diagnosis and successful treatment of gastrointestinal bleeding in a young infant. This is the youngest reported patient treated with the use of wireless capsule endoscopy in the pediatric population.

  9. Development and Testing of a Magnetically Actuated Capsule Endoscopy for Obesity Treatment.

    Directory of Open Access Journals (Sweden)

    Thanh Nho Do

    Full Text Available Intra-gastric balloons (IGB have become an efficient and less invasive method for obesity treatment. The use of traditional IGBs require complex insertion tools and flexible endoscopes to place and remove the balloon inside the patient's stomach, which may cause discomfort and complications to the patient. This paper introduces a new ingestible weight-loss capsule with a magnetically remote-controlled inflatable and deflatable balloon. To inflate the balloon, biocompatible effervescent chemicals are used. As the source of the actuation is provided via external magnetic fields, the magnetic capsule size can be significantly reduced compared to current weight-loss capsules in the literature. In addition, there are no limitations on the power supply. To lose weight, the obese subject needs only to swallow the magnetic capsule with a glass of water. Once the magnetic capsule has reached the patient's stomach, the balloon will be wirelessly inflated to occupy gastric space and give the feeling of satiety. The balloon can be wirelessly deflated at any time to allow the magnetic capsule to travel down the intestine and exit the body via normal peristalsis. The optimal ratio between the acid and base to provide the desired gas volume is experimentally evaluated and presented. A prototype capsule (9.6mm x 27mm is developed and experimentally validated in ex-vivo experiments. The unique ease of delivery and expulsion of the proposed magnetic capsule is slated to make this development a good treatment option for people seeking to lose excess weight.

  10. Novel anti-biofilm mechanism for wireless capsule endoscopy in the urinary tract: preliminary study in a sheep model.

    Science.gov (United States)

    Neheman, Amos; Schulman, Claude; Yossepowitch, Ofer

    2013-06-01

    To develop and test the safety and feasibility of a novel anti-biofilm mechanism configured for wireless capsule endoscopy (WCE) in a sheep bladder model. A WCE mechanism, designed for long-term bladder monitoring, was developed and introduced into a sheep bladder for 5 months. The transparency of the surface was assessed by evaluating a resolution target placed inside the capsule at serial intervals using cystoscopy under general anaesthesia. Animal behaviour, voiding patterns and urine cultures were monitored throughout the study. At study termination, the capsule was extracted and assessed using scanning electron microscopy. The resolution target was visualized clearly at all investigation points. No notable adverse effects were noted during the entire follow-up period and no urinary tract infection occurred. Scanning electron microscopy confirmed the efficacy of the technology to prevent biofilm formation and surface encrustation. We report a novel technology that effectively prevents biofilm formation on the outer surface of foreign objects in the urinary tract. Further studies are under way to test the applicability of this technology in bladder WCE to enable high-quality wireless image transmission. © 2013 BJU International.

  11. 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)

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

    2009-01-01

    To systematically evaluate the feasibility and methodology to carry out wireless capsule endoscopy (WCE) in children <8 years to define small intestinal pathology. Prospective European multicentre study with negative prior investigation. Patients and 83 children aged 1.5-7.9 years were recruited.

  12. Report of video-capsule endoscopy disruption producing episodic small bowel obstruction after prolonged retention

    Directory of Open Access Journals (Sweden)

    Nelson A. Royall

    2014-01-01

    CONCLUSION: Patients should therefore be carefully selected for monitoring based upon treatment compliance and offered early endoscopic or surgical intervention in the setting of questionable compliance due to the risk for capsule disruption and subsequent intestinal perforation.

  13. An Automated Self-Learning Quantification System to Identify Visible Areas in Capsule Endoscopy Images.

    Science.gov (United States)

    Hashimoto, Shinichi; Ogihara, Hiroyuki; Suenaga, Masato; Fujita, Yusuke; Terai, Shuji; Hamamoto, Yoshihiko; Sakaida, Isao

    2017-08-01

    Visibility in capsule endoscopic images is presently evaluated through intermittent analysis of frames selected by a physician. It is thus subjective and not quantitative. A method to automatically quantify the visibility on capsule endoscopic images has not been reported. Generally, when designing automated image recognition programs, physicians must provide a training image; this process is called supervised learning. We aimed to develop a novel automated self-learning quantification system to identify visible areas on capsule endoscopic images. The technique was developed using 200 capsule endoscopic images retrospectively selected from each of three patients. The rate of detection of visible areas on capsule endoscopic images between a supervised learning program, using training images labeled by a physician, and our novel automated self-learning program, using unlabeled training images without intervention by a physician, was compared. The rate of detection of visible areas was equivalent for the supervised learning program and for our automatic self-learning program. The visible areas automatically identified by self-learning program correlated to the areas identified by an experienced physician. We developed a novel self-learning automated program to identify visible areas in capsule endoscopic images.

  14. Wireless capsule endoscopy video segmentation using an unsupervised learning approach based on probabilistic latent semantic analysis with scale invariant features.

    Science.gov (United States)

    Shen, Yao; Guturu, Parthasarathy Partha; Buckles, Bill P

    2012-01-01

    Since wireless capsule endoscopy (WCE) is a novel technology for recording the videos of the digestive tract of a patient, the problem of segmenting the WCE video of the digestive tract into subvideos corresponding to the entrance, stomach, small intestine, and large intestine regions is not well addressed in the literature. A selected few papers addressing this problem follow supervised leaning approaches that presume availability of a large database of correctly labeled training samples. Considering the difficulties in procuring sizable WCE training data sets needed for achieving high classification accuracy, we introduce in this paper an unsupervised learning approach that employs Scale Invariant Feature Transform (SIFT) for extraction of local image features and the probabilistic latent semantic analysis (pLSA) model used in the linguistic content analysis for data clustering. Results of experimentation indicate that this method compares well in classification accuracy with the state-of-the-art supervised classification approaches to WCE video segmentation.

  15. 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.

  16. 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.

  17. An integrated system for wireless capsule endoscopy in a liquid-distended stomach.

    Science.gov (United States)

    De Falco, Iris; Tortora, Giuseppe; Dario, Paolo; Menciassi, Arianna

    2014-03-01

    The design and development of a functional integrated system for gastroscopy is reported in this paper. The device takes advantage of four propellers enabling locomotion in a liquid environment and generating a maximum propulsive force of 25.5 mN. The capsule has been equipped with a miniaturized wireless vision system that acquires images with a frame rate of 30 fps (frames per second). The overall size of the capsule is 32 mm in length and 22 mm in diameter, with the possibility of decreasing the diameter to swallowable dimensions. The capsule is remotely controlled by the user who can intuitively drive the device by looking at the video streaming on the graphical interface. The average speed of the device is 1.5 cm/s that allows for a fine control of the capsule motion as demonstrated in experimental tasks consisting of passing through circular targets. The video system performances have been characterized by evaluating the contrast, the focus, and the capability of acquiring and perceiving different colors. The usability of the device has been tested on bench and on explanted tissues by three users in real time target-identification tasks, in order to assess the success of the integration process. The lifetime of the capsule with active motors and vision system is 13 min, that is, a timeframe consistent with traditional gastroscopic examinations.

  18. 3D magnetic-resonance-coupling (MRC) localization of wireless capsule endoscopy

    DEFF Research Database (Denmark)

    Xia, Yongming; Zhang, Lihui; Lu, Kaiyuan

    2016-01-01

    Wireless Capsule Endoscope (WCE) enables developing actively controlled capsule for potential complex surgeries, imaging, and new medicine tests. These tasks of WCE need safe, efficient, and precise 3D localization techniques. In this paper, a new application of the magnetic resonance coupling (MRC......) technique, which has been widely developed for efficient wireless power transfer, is introduced. It is proposed that the distance dependent signal strength in a MRC system can be beneficially used for 3D localization. The new 3D-MRC localization system consists of three orthogonal emitting coils which...... are powered by a battery in the capsule, and three pairs of orthogonal receiving coils which are placed outside human body. The distances between the WCE and the receiving coils can be estimated with good accuracy by studying the signal strengths in individual receiving coils. The proposed new 3D-MRC...

  19. Video Capsule Endoscopy in Patients with Chronic Abdominal Pain with or without Associated Symptoms: A Retrospective Study.

    Directory of Open Access Journals (Sweden)

    Jeremy Egnatios

    Full Text Available Chronic abdominal pain (CAP is a common indication for gastroenterology referrals. More insidious causes of CAP isolated to the small bowel, such as malignancies and Crohn's disease, are rising in incidence and causing more gastroenterologists to evaluate their patients with video capsule endoscopy (VCE. However, the role of VCE in patients with CAP is still unclear.We assessed the efficacy of VCE in patients with CAP and whether it led to findings that contributed to disease management and meaningful interventions.This retrospective study evaluated 607 capsule endoscopy studies at an open referral endoscopy unit. Ninety of the studies were for CAP. These studies were compared to those performed for other indications to compare diagnostic yield. In addition, we investigated whether VCE led to an intervention that improved clinical outcomes.Overall, the number of abnormal findings in CAP patients was significantly lower than VCE performed for other indications (24.4% vs 39.0%, respectively p = 0.009. When patients with CAP presented with other pertinent clinical findings (e.g. nausea, weight loss, anemia, history of in inflammatory bowel disease, etc., the likelihood of an abnormal finding increased to a level that was not different from those who received VCE for other indications (27.1%, p = 0.10. The findings from VCE lead to changed management and improved outcomes in 16.2% of CAP patients with associated symptoms. However, the subgroup that benefited the most were those who had a prior history of Crohn's disease. Patients with CAP who did not have any associated symptoms continued to have a significantly lower abnormal finding rate compared to those who received VCE for other indications (19.4%, p = 0.03 and VCE rarely led to a change in management that would improve outcomes (5.6%.VCE for CAP has a lower rate of abnormal findings than other indications. However, VCE is a useful diagnostic tool that can help provide a possible etiology of

  20. Video Capsule Endoscopy in Patients with Chronic Abdominal Pain with or without Associated Symptoms: A Retrospective Study.

    Science.gov (United States)

    Egnatios, Jeremy; Kaushal, Khushboo; Kalmaz, Denise; Zarrinpar, Amir

    2015-01-01

    Chronic abdominal pain (CAP) is a common indication for gastroenterology referrals. More insidious causes of CAP isolated to the small bowel, such as malignancies and Crohn's disease, are rising in incidence and causing more gastroenterologists to evaluate their patients with video capsule endoscopy (VCE). However, the role of VCE in patients with CAP is still unclear. We assessed the efficacy of VCE in patients with CAP and whether it led to findings that contributed to disease management and meaningful interventions. This retrospective study evaluated 607 capsule endoscopy studies at an open referral endoscopy unit. Ninety of the studies were for CAP. These studies were compared to those performed for other indications to compare diagnostic yield. In addition, we investigated whether VCE led to an intervention that improved clinical outcomes. Overall, the number of abnormal findings in CAP patients was significantly lower than VCE performed for other indications (24.4% vs 39.0%, respectively p = 0.009). When patients with CAP presented with other pertinent clinical findings (e.g. nausea, weight loss, anemia, history of in inflammatory bowel disease, etc.), the likelihood of an abnormal finding increased to a level that was not different from those who received VCE for other indications (27.1%, p = 0.10). The findings from VCE lead to changed management and improved outcomes in 16.2% of CAP patients with associated symptoms. However, the subgroup that benefited the most were those who had a prior history of Crohn's disease. Patients with CAP who did not have any associated symptoms continued to have a significantly lower abnormal finding rate compared to those who received VCE for other indications (19.4%, p = 0.03) and VCE rarely led to a change in management that would improve outcomes (5.6%). VCE for CAP has a lower rate of abnormal findings than other indications. However, VCE is a useful diagnostic tool that can help provide a possible etiology of CAP in

  1. Use of Wireless Capsule Endoscopy for the Diagnosis and Grading of Esophageal Varices in Patients With Portal Hypertension: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    McCarty, Thomas R; Afinogenova, Yuliya; Njei, Basile

    2017-02-01

    Esophageal variceal bleeding is a severe complication of portal hypertension with significant morbidity and mortality. Although traditional screening and grading of esophageal varices has been performed by endogastroduodenoscopy (EGD), wireless video capsule endoscopy provides a minimally invasive alternative that may improve screening and surveillance compliance. The aim of the study was to perform a systematic review and structured meta-analysis of all eligible studies to evaluate the efficacy of wireless capsule endoscopy for screening and diagnosis of esophageal varices among patients with portal hypertension. Searches of PubMed, EMBASE, Web of Science, and the Cochrane Library databases were performed through December 2015. Bivariate and hierarchical models were used to compute the pooled sensitivity and specificity, and to plot the summary receiver operating characteristics curve with summary point and corresponding 95% confidence region. Bias of included studies was assessed using the quality assessment of diagnostic accuracy studies-2. Seventeen studies from 2005 to 2015 were included in this meta-analysis (n=1328). The diagnostic accuracy of wireless capsule endoscopy in the diagnosis of esophageal varices was 90% [95% confidence interval (CI), 0.88-0.93]. The diagnostic pooled sensitivity and specificity were 83% (95% CI, 0.76-0.89) and 85% (95% CI, 0.75-0.91), respectively. The diagnostic accuracy of wireless capsule endoscopy for the grading of medium to large varices was 92% (95% CI, 0.90-0.94). The pooled sensitivity and specificity were 72% (95% CI, 0.54-0.85) and 91% (95% CI, 0.86-0.94), respectively, for the grading of medium to large varices. The use of capsule demonstrated only mild adverse events. A sensitivity analysis limited to only high quality studies revealed similar results. Wireless esophageal capsule endoscopy is well tolerated and safe in patients with liver cirrhosis and suspicion of portal hypertension. The sensitivity of capsule

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

    Directory of Open Access Journals (Sweden)

    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. Wireless capsule endoscopy for evaluation of phenotypic expression of small-bowel polyps in patients with Peutz-Jeghers syndrome and in symptomatic first-degree relatives.

    Science.gov (United States)

    Soares, J; Lopes, L; Vilas Boas, G; Pinho, C

    2004-12-01

    Peutz-Jeghers syndrome (PJS) is an inherited gastrointestinal hamartomatous polyposis disorder. Small-bowel intussusception and bleeding are the most common complications, and malignancy may also occur. Survey of the gastrointestinal tract, particularly of the small bowel, is difficult and current recommendations for management syndrome are ambiguous. We evaluated the feasibility of capsule endoscopy for identifying phenotypic expression of small-bowel polyps in patients with full-blown PJS and a previous diagnosis of gastrointestinal polyposis, and in symptomatic kindred of PJS patients with no previous diagnosis of gastrointestinal polyposis. Two groups were studied: group A consisted of 14 patients with gastrointestinal polyposis, eight of whom had undergone previous small-intestine surgery; group B consisted of six symptomatic first-degree relatives of PJS patients; these patients had previous negative gastrointestinal endoscopic examinations. Numerous polyps were detected in all patients in group A. Most polyps were sessile, but the larger polyps tended to be pedunculated. Polyp density was highest in the jejunum (greater than in the ileum and duodenum). Seven patients had at least one large polyp (> 11 mm) and five of these patients subsequently underwent enteroscopy, which revealed that capsule endoscopy had correctly identified all the patients with large polyps, but had missed 20 % of the total number of large polyps in these patients. No polyps were detected by capsule endoscopy in group B patients, despite the excellent visualization of the small intestine. In all patients, the capsules were expelled within 24 hours, without complications, and the procedure was well tolerated. Capsule endoscopy is an effective and well-tolerated method for evaluating small-bowel pathology in patients with PJS.

  4. A System for an Accurate 3D Reconstruction in Video Endoscopy Capsule

    Directory of Open Access Journals (Sweden)

    Anthony Kolar

    2009-01-01

    Full Text Available Since few years, the gastroenterologic examinations could have been realised by wireless video capsules. Although the images make it possible to analyse some diseases, the diagnosis could be improved by the use of the 3D Imaging techniques implemented in the video capsule. The work presented here is related to Cyclope, an embedded active vision system that is able to give in real time both 3D information and texture. The challenge is to realise this integrated sensor with constraints on size, consumption, and computational resources with inherent limitation of video capsule. In this paper, we present the hardware and software development of a wireless multispectral vision sensor which allows to transmit, a 3D reconstruction of a scene in realtime. multispectral acquisitions grab both texture and IR pattern images at least at 25 frames/s separately. The different Intellectual Properties designed allow to compute specifics algorithms in real time while keeping accuracy computation. We present experimental results with the realization of a large-scale demonstrator using an SOPC prototyping board.

  5. Automatic small bowel tumor diagnosis by using multi-scale wavelet-based analysis in wireless capsule endoscopy images.

    Science.gov (United States)

    Barbosa, Daniel C; Roupar, Dalila B; Ramos, Jaime C; Tavares, Adriano C; Lima, Carlos S

    2012-01-11

    Wireless capsule endoscopy has been introduced as an innovative, non-invasive diagnostic technique for evaluation of the gastrointestinal tract, reaching places where conventional endoscopy is unable to. However, the output of this technique is an 8 hours video, whose analysis by the expert physician is very time consuming. Thus, a computer assisted diagnosis tool to help the physicians to evaluate CE exams faster and more accurately is an important technical challenge and an excellent economical opportunity. The set of features proposed in this paper to code textural information is based on statistical modeling of second order textural measures extracted from co-occurrence matrices. To cope with both joint and marginal non-Gaussianity of second order textural measures, higher order moments are used. These statistical moments are taken from the two-dimensional color-scale feature space, where two different scales are considered. Second and higher order moments of textural measures are computed from the co-occurrence matrices computed from images synthesized by the inverse wavelet transform of the wavelet transform containing only the selected scales for the three color channels. The dimensionality of the data is reduced by using Principal Component Analysis. The proposed textural features are then used as the input of a classifier based on artificial neural networks. Classification performances of 93.1% specificity and 93.9% sensitivity are achieved on real data. These promising results open the path towards a deeper study regarding the applicability of this algorithm in computer aided diagnosis systems to assist physicians in their clinical practice.

  6. Automatic small bowel tumor diagnosis by using multi-scale wavelet-based analysis in wireless capsule endoscopy images

    Directory of Open Access Journals (Sweden)

    Barbosa Daniel C

    2012-01-01

    Full Text Available Abstract Background Wireless capsule endoscopy has been introduced as an innovative, non-invasive diagnostic technique for evaluation of the gastrointestinal tract, reaching places where conventional endoscopy is unable to. However, the output of this technique is an 8 hours video, whose analysis by the expert physician is very time consuming. Thus, a computer assisted diagnosis tool to help the physicians to evaluate CE exams faster and more accurately is an important technical challenge and an excellent economical opportunity. Method The set of features proposed in this paper to code textural information is based on statistical modeling of second order textural measures extracted from co-occurrence matrices. To cope with both joint and marginal non-Gaussianity of second order textural measures, higher order moments are used. These statistical moments are taken from the two-dimensional color-scale feature space, where two different scales are considered. Second and higher order moments of textural measures are computed from the co-occurrence matrices computed from images synthesized by the inverse wavelet transform of the wavelet transform containing only the selected scales for the three color channels. The dimensionality of the data is reduced by using Principal Component Analysis. Results The proposed textural features are then used as the input of a classifier based on artificial neural networks. Classification performances of 93.1% specificity and 93.9% sensitivity are achieved on real data. These promising results open the path towards a deeper study regarding the applicability of this algorithm in computer aided diagnosis systems to assist physicians in their clinical practice.

  7. Evaluation and comparison of capsule endoscopy scores for assessment of inflammatory activity of small-bowel in Crohn's disease.

    Science.gov (United States)

    Ponte, Ana; Pinho, Rolando; Rodrigues, Adélia; Silva, Joana; Rodrigues, Jaime; Sousa, Mafalda; Carvalho, João

    2018-04-01

    Capsule endoscopy (CE) has the highest sensitivity in the evaluation of small-bowel mucosa in Crohn's disease (CD). Recent guidelines recommend the use of validated CE scores to assess small-bowel inflammatory activity in CD. Lewis score (LS) and Capsule Endoscopy Crohn's Disease Activity Index (CECDAI) are the currently available validated scores, but comparative studies are scarce. Moreover, correlation of these endoscopic scores with biomarkers and clinical activity is lacking. This study aims to compare LS with CECDAI, to determine cutoff values for CECDAI similar to those of LS (135-790), and to correlate LS and CECDAI with biomarkers and symptoms. All patients with CD who underwent CE between March/2010 and February/2016 were included. LS and CECDAI were determined after analysis of each CE. In patients with small-bowel CD, C-reactive protein (CRP) and Harvey-Bradshaw index (HBI) were evaluated. descriptive statistics, Spearman's correlation coefficient and linear regression analysis. p<0.05. Fifty-three patients were included and the mean values obtained for LS were 1147±1453, CECDAI 11.3±6.9, CRP 0.92±1.5mg/dL and HBI 2.4±2.8. There was a very strong correlation between LS and CECDAI (r s =0.878; p<0.0001) and thresholds values of 135-790 in LS corresponded to 7.7-10.3 cutoff values in CECDAI, respectively. Neither CRP correlated with LS (r s =0.068; p=0.72) or CECDAI (r s =-0.004; p=0.98), nor HBI with LS (r s =-0.15; p=0.40) or CECDAI (r s =-0.10; p=0.23). Correlation between the two CE activity scores was very strong, with LS thresholds of 135-790 corresponding to CECDAI values of 7.7-10.3. HBI and CRP had no correlation with CECDAI and LS. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  8. Sham Feeding with Bacon Does Not Alter Transit Time or Complete Examination Rate During Small Bowel Capsule Endoscopy.

    Science.gov (United States)

    Prichard, David; Ou, George; Galorport, Cherry; Enns, Robert

    2018-02-01

    During capsule endoscopy (CE) studies, the complete examination rate (CER) can be increased by prolonging capsule battery life or reducing gastric transit time (GTT) and/or small bowel transit time (SBTT). However, despite enhanced battery life, 10% of studies remain incomplete. Previously studied interventions to reduce SBTT and enhance CER have produced conflicting results. We hypothesize that this may be a consequence of an insufficiently potent stimulus of small bowel motility. To examine whether potent stimulation of the cephalic response of digestion during small bowel CE reduces GTT and/or SBTT and thus increases the CER. A single-blind randomized trial was performed to evaluate the effect of bacon sham feeding on GTT, SBTT and CER. Baseline characteristics were similar between 63 sham fed patients and 59 controls. The median GTT was 17 min (9-65) in the bacon group and 25 min (14-55) in the control group. The median SBTT was 199 min (119-316) and 222 min (151-287), respectively. Cox proportional hazards model demonstrated no significant difference between groups for GTT (rate ratio 1.03, 95% CI 0.71-1.51, P = 0.87) or SBTT (rate ratio 1.02, 95% CI 0.70-1.49, P = 0.93). Although the taste of bacon was considered favorably by 72% of participants, taste did not correlate with GTT (ρ = 0.03, P = 0.83) or SBTT (ρ = - 0.115, P = 0.33). The CER was 91 and 95% in the bacon and control groups, respectively (P = 0.35). Bacon sham feeding has no effect on GTT, SBTT or CER and cannot be recommended in clinical practice.

  9. Small bowel capsule endoscopy in the management of established Crohn's disease: clinical impact, safety, and correlation with inflammatory biomarkers.

    Science.gov (United States)

    Kopylov, Uri; Nemeth, Artur; Koulaouzidis, Anastasios; Makins, Richard; Wild, Gary; Afif, Waqqas; Bitton, Alain; Johansson, Gabriele Wurm; Bessissow, Talat; Eliakim, Rami; Toth, Ervin; Seidman, Ernest G

    2015-01-01

    Multiple studies have established the superior diagnostic accuracy of video capsule endoscopy (VCE) for the diagnosis of small bowel (SB) Crohn's disease (CD). However, data on the clinical impact of VCE in patients with established CD are scarce. The aim of this study was to examine the impact and safety of VCE on the clinical management of patients with established CD. A retrospective, multicenter, cross-sectional study. The study cohort included consecutive patients with established SB CD who underwent VCE in 4 tertiary referral centers (1 Canada, 1 Sweden, and 2 United Kingdom) from January 2008 to October 2013. Patients were excluded if VCE was performed as a part of the initial diagnostic workup. The presence of SB mucosal inflammation was quantified using the Lewis score. Inflammatory biomarkers (C-reactive protein and fecal calprotectin) were measured and correlated with the Lewis score. The study included 187 patients. No SB inflammation was observed in 28.4%, mild-to-moderate inflammation in 26.6%, and moderate-to-severe inflammation in 45% of the patients (median Lewis score, 662; range, 0-6400). A change in management was recommended in 52.3% of the patients based on VCE findings. Elevated C-reactive protein, fecal calprotectin, or the combination of both were poorly correlated with significant SB inflammation. SB capsule retention occurred in 4 patients (2.1%). VCE in patients with established CD is safe, and the results often have a significant clinical impact. VCE should not be limited to CD patients with positive inflammatory markers because their predictive value for significant SB inflammation is poor.

  10. 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.

  11. Laparoscopic treatment of hemorrhagic Meckel diverticulum after diagnosis with wireless capsule endoscopy and double-balloon enteroscopy.

    Science.gov (United States)

    Yu, Haibo; Song, Hongliang; Cai, Jing

    2017-04-01

    Meckel diverticulum (MD) is a common small intestinal malformation. The difficulty of MD with hemorrhage treatment lies in preoperative diagnosis. Wireless capsule endoscopy (WCE) and double-balloon enteroscopy (DBE) have been widely used to diagnose and treat diseases of the small intestine, but only rarely have they been used in combination to diagnose and treat bleeding MD. We successfully diagnosed and treated a patient with MD with hemorrhage with a combination of WCE, DBE, and laparoscopy. A 17-year-old man presented to the emergency room with hematochezia and was admitted for testing. Abdominal computed tomography, gastroscopy, and colonoscopy did not reveal hemorrhage, but WCE showed MD combined with ulceration. DBE was conducted to confirm the presence of the lesion and showed MD combined with ulceration 1 m proximal to the ileocecal valve. The patient underwent emergency laparoscopic surgery, which confirmed MD. The patient recovered well after the operation.MD with hemorrhage poses diagnostic and therapeutic challenges and can be missed on examination using standard modalities. Laparoscopy combined with WCE and DBE can be efficacious in the treatment of MD with hemorrhage.

  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. Accuracy of Magnetically Controlled Capsule Endoscopy, Compared With Conventional Gastroscopy, in Detection of Gastric Diseases.

    Science.gov (United States)

    Liao, Zhuan; Hou, Xi; Lin-Hu, En-Qiang; Sheng, Jian-Qiu; Ge, Zhi-Zheng; Jiang, Bo; Hou, Xiao-Hua; Liu, Ji-Yong; Li, Zhen; Huang, Qi-Yang; Zhao, Xiao-Jun; Li, Na; Gao, Yun-Jie; Zhang, Yao; Zhou, Jie-Qiong; Wang, Xin-Ying; Liu, Jun; Xie, Xiao-Ping; Yang, Cong-Mei; Liu, Hua-Lin; Sun, Xiao-Tian; Zou, Wen-Bin; Li, Zhao-Shen

    2016-09-01

    Diseases of the stomach, including gastric cancer and peptic ulcer, are the most common digestive diseases. It is impossible to visualize the entire stomach with the passive capsule currently used in practice because of the large size of the gastric cavity. A magnetically controlled capsule endoscopy (MCE) system has been designed to explore the stomach. We performed a prospective study to compare the accuracy of detection of gastric focal lesions by MCE vs conventional gastroscopy (the standard method). We performed a multicenter blinded study comparing MCE with conventional gastroscopy in 350 patients (mean age, 46.6 y), with upper abdominal complaints scheduled to undergo gastroscopy at a tertiary center in China from August 2014 through December 2014. All patients underwent MCE, followed by conventional gastroscopy 2 hours later, without sedation. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of detection of gastric focal lesions by MCE, using gastroscopy as the standard. MCE detected gastric focal lesions in the whole stomach with 90.4% sensitivity (95% confidence interval [CI], 84.7%-96.1%), 94.7% specificity (95% CI, 91.9%-97.5%), a positive predictive value of 87.9% (95% CI, 81.7%-94.0%), a negative predictive value of 95.9% (95% CI, 93.4%-98.4%), and 93.4% accuracy (95% CI, 90.83%-96.02%). MCE detected focal lesions in the upper stomach (cardia, fundus, and body) with 90.2% sensitivity (95% CI, 82.0%-98.4%) and 96.7% specificity (95% CI, 94.4%-98.9%). MCE detected focal lesions in the lower stomach (angulus, antrum, and pylorus) with 90.6% sensitivity (95% CI, 82.7%-98.4%) and 97.9% specificity (95% CI, 96.1%-99.7%). MCE detected 1 advanced gastric carcinoma, 2 malignant lymphomas, and 1 early stage gastric tumor. MCE did not miss any lesions of significance (including tumors or large ulcers). Among the 350 patients, 5 reported 9 adverse events (1.4%) and 335 preferred MCE over gastroscopy (95

  14. Optimal use of polyethylene glycol for preparation of small bowel video capsule endoscopy: a network meta-analysis.

    Science.gov (United States)

    Wu, Shan; Gao, Yun-Jie; Ge, Zhi-Zheng

    2017-06-01

    Standardized strategy of bowel preparation before video capsule endoscopy (VCE) remains controversial. This study aimed to assess the ideal dose of PEG, based on small bowel visualization quality (SBVQ), diagnostic yield (DY), and complete rate (CR) of VCE using a network meta-analysis (NMA) of randomized controlled trials (RCTs). This NMA included RCTs comparing any of the following bowel preparation interventions for VCE: fasting overnight ("Fast"), 1 liter PEG ("PEG 1L"), 2-liter PEG ("PEG 2L"), or 4-liter PEG ("PEG 4L"). The authors searched papers in PubMed, Cochrane Library, and Embase as of June 2016. The cumulative ranking (SUCRA) probabilities to rank different doses of PEG and Fast were used. The search engine provided 102 studies. Nine RCTs including 982 patients were incorporated into this analysis. All studies showed low risk of bias of blinding. SUCRA provided an initial ranking among these strategies, in which PEG 2 L showed the best score in SBVQ (PEG 2 L, 89.4%; PEG 1 L, 62.5%; PEG 4 L, 44.0%; Fast, 4.1%) and DY (PEG 2 L, 74.6%; PEG 1 L 28.1%; PEG 4 L 65.9%; Fast 31.4%) of VCE. No significant difference was shown in the analysis of CR. This study recommends PEG 2 L as the ideal dose, which may improve the SBVQ of VCE and, therefore, diagnostic accuracy. Multi-center randomized controlled trials are required to verify these findings.

  15. Efficacy of Repeat Review with Flexible Spectral Imaging Color Enhancement in Patients with no Findings by Capsule Endoscopy

    Science.gov (United States)

    Minami-Kobayashi, Yuka; Yamada, Atsuo; Watabe, Hirotsugu; Suzuki, Hirobumi; Hirata, Yoshihiro; Yamaji, Yutaka; Yoshida, Haruhiko; Koike, Kazuhiko

    2016-01-01

    Background/Aim: The efficacy of flexible spectral imaging color enhancement (FICE) ch. 1 (F1) for the detection of ulcerative lesions and angioectasias in the small intestine with capsule endoscopy (CE) has been reported. In the present study, we evaluated whether F1 could detect incremental findings in patients with no findings in a standard review mode. Patients and Methods: In total, 52 patients (age: 60.1 ± 15.3 years; 30 males) with obscure gastrointestinal bleeding (OGIB) who underwent CE and in whom no lesion was detected in the small intestine in the standard mode (first review) were enrolled. Two experienced endoscopists independently reviewed CE videos again by F1 (second review). The following findings were defined to be significant: Ulcers, erosions, aphthas, angioectasias, tumors, and bleeding. Incremental findings at the second review were checked at F1 and in standard mode by the two reviewers (third review). Finally, the findings were confirmed by the agreement of the two reviewers at the third review. Results: F1 detected five significant lesions in three patients with overt OGIB; three erosions, one aphtha, and one angioectasia. For nonsignificant lesions, F1 detected 12 red mucosas and 16 red spots. Moreover, 29 patients with 71 findings were considered false positives. Conclusion: F1 detected incremental significant findings in a small percentage of patients with no findings in the standard review mode. In addition, F1 showed many false-positive findings. The incremental effect of a repeated review by F1 in patients with no findings in the first review is limited. PMID:27748326

  16. Diagnostic Yield and Clinical Impact of Video Capsule Endoscopy in Patients with Chronic Diarrhea: A Korean Multicenter CAPENTRY Study.

    Science.gov (United States)

    Song, Hyun Joo; Moon, Jeong Seop; Jeon, Seong Ran; Kim, Jin-Oh; Kim, Jinsu; Cheung, Dae Young; Choi, Myung-Gyu; Lim, Yun Jeong; Shim, Ki-Nam; Ye, Byong Duk; Cheon, Jae Hee; Park, Cheol Hee; Kim, Hyun-Soo; Kim, Ji Hyun; Chang, Dong Kyung; Do, Jae Hyuk; Kim, Kyeong Ok; Jang, Byung Ik; Shin, Sung-Jae

    2017-03-15

    In some cases, chronic diarrhea is unexplained, and small bowel disorders may be one of the causes. The aim of this study was to assess the diagnostic yield and clinical impact of video capsule endoscopy (VCE) in patients with chronic diarrhea. We retrospectively analyzed records from October 2002 to August 2013 in the VCE nationwide database registry (n=2,964). Ninety-one patients from 15 medical centers (60 males and 31 females; mean age, 47±19 years) were evaluated for VCE as a result of chronic diarrhea. The duration of chronic diarrhea was 8.3±14.7 months. The positive diagnostic yield of VCE was 42.9% (39/91). However, 15.4% (14/91) exhibited an inconsistent result, and 41.8% (38/91) were negative. Abnormal findings consistent with chronic diarrhea included erosions/aphthous ulcers (19.8%), ulcers (17.6%), mucosal erythema (3.3%), edema (1.1%), and luminal narrowing (1.1%). The most common diagnoses were functional diarrhea associated with irritable bowel syndrome in 37 patients (40.7%) and Crohn's disease in 18 patients (19.8%). After VCE examination, the diagnosis was changed in 34.1% of the patients (31/91). Hematochezia (odds ratio [OR], 8.802; 95% confidence interval [CI], 2.126 to 36.441) and hypoalbuminemia (OR, 4.811; 95% CI, 1.241 to 18.655) are predictive factors of a positive diagnostic yield. VCE had a favorable diagnostic yield and clinical impact on the management of patients with chronic diarrhea.

  17. Wireless capsule endoscopy versus ileocolonoscopy for the diagnosis of postoperative recurrence of Crohn's disease: a prospective study

    Science.gov (United States)

    Bourreille, A; Jarry, M; D'Halluin, P N; Ben‐Soussan, E; Maunoury, V; Bulois, P; Sacher‐Huvelin, S; Vahedy, K; Lerebours, E; Heresbach, D; Bretagne, J F; Colombel, J F; Galmiche, J P

    2006-01-01

    Background and aims Following ileocolonic resection for Crohn's disease (CD), early endoscopic recurrence predicts recurrence of symptoms. The aim of the study was to compare ileocolonoscopy and wireless capsule endoscopy (WCE) for the detection of postoperative recurrence in CD. Methods WCE and ileocolonoscopy were performed within six months following surgery in 32 prospectively enrolled patients. Two independent observers interpreted the results of WCE. Recurrence in the neoterminal ileum was defined by a Rutgeerts score ⩾1. When observers at WCE did not concur, WCE results were considered as either true negative or true positive and sensitivity and specificity were calculated according to both assumptions. Results Recurrence occurred in 21 patients (68%) and was detected by ileocolonoscopy in 19 patients. Sensitivity was 90% and specificity 100%. Sensitivity of WCE was 62% and 76% and specificity was 100% and 90%, respectively, depending on assumptions. There was a correlation between the severity of the lesions measured by both methods (pendoscopy were detected by WCE in two thirds of patients with excellent interobserver agreement (kappa >0.9) for all lesions with the exception of ulceration (kappa = 0.7). Conclusions The sensitivity of WCE in detecting recurrence in the neoterminal ileum was inferior to that of ileocolonoscopy. In contrast, WCE detected lesions outside the scope of ileocolonoscopy in more than two thirds of patients. Additional follow up studies are needed to assess the clinical relevance of such lesions. At the present time, it seems that WCE cannot systematically replace ileocolonoscopy in the regular management of patients after surgery. PMID:16401689

  18. Double-balloon enteroscopy and capsule endoscopy have comparable diagnostic yield in small-bowel disease: a meta-analysis.

    Science.gov (United States)

    Pasha, Shabana F; Leighton, Jonathan A; Das, Ananya; Harrison, M Edwyn; Decker, G Anton; Fleischer, David E; Sharma, Virender K

    2008-06-01

    The aim of this study was to compare the diagnostic yield of capsule endoscopy (CE) with double-balloon enteroscopy (DBE) in small-bowel (SB) disease using meta-analysis. We performed a search of studies comparing CE with DBE in SB disease. Data on diagnostic yield of CE and DBE were extracted, pooled, and analyzed. The weighted incremental yield (IY(W)) (yield of CE--yield of DBE) of CE over DBE and 95% confidence intervals (95% CIs) for pooled data were calculated using a fixed-effect model (FEM) for analyses without, and a random-effect model (REM) for analyses with, significant heterogeneity. Eleven studies compared CE and DBE; the pooled overall yield for CE and DBE was 60% (n = 397) and 57% (n = 360), respectively (IY(W), 3%; 95% CI, -4% to 10%; P = .42; FEM). Ten studies reported vascular findings; the pooled yield for CE and DBE was 24% (n = 371) and 24% (n = 364), respectively (IY(W), 0%; 95% CI, -5% to 6%; P = .88; REM). Nine studies reported inflammatory findings; the pooled yield for CE and DBE was 18% (n = 343) and 16% (n = 336), respectively (IY(W), 0%; 95% CI, -5% to 6%; P = .89; FEM). Nine studies reported polyps/tumors; the pooled yield for CE and DBE was 11% (n = 343) and 11% (n = 336), respectively (IY(W), -1%; 95% CI, -5% to 4%; P = .76; FEM). CE and DBE have comparable diagnostic yield in SB disease, including obscure gastrointestinal bleeding. CE should be the initial diagnostic test because of its noninvasive quality, tolerance, ability to view the entire SB, and for determining the initial route of DBE. Because of its therapeutic capabilities, DBE may be indicated in patients with a positive finding on CE requiring a biopsy or therapeutic intervention, if suspicion for a SB lesion is high despite a negative CE, and in patients with active bleeding.

  19. A Simple Evaluation Tool (ET-CET) Indicates Increase of Diagnostic Skills From Small Bowel Capsule Endoscopy Training Courses: A Prospective Observational European Multicenter Study.

    Science.gov (United States)

    Albert, J G; Humbla, O; McAlindon, M E; Davison, C; Seitz, U; Fraser, C; Hagenmüller, F; Noetzel, E; Spada, C; Riccioni, M E; Barnert, J; Filmann, N; Keuchel, M

    2015-10-01

    Small bowel capsule endoscopy (SBCE) has become a first line diagnostic tool. Several training courses with a similar format have been established in Europe; however, data on learning curve and training in SBCE remain sparse.Between 2008 and 2011, different basic SBCE training courses were organized internationally in UK (n = 2), Italy (n = 2), Germany (n = 2), Finland (n = 1), and nationally in Germany (n = 10), applying similar 8-hour curricula with 50% lectures and 50% hands-on training. The Given PillCam System was used in 12 courses, the Olympus EndoCapsule system in 5, respectively. A simple evaluation tool for capsule endoscopy training (ET-CET) was developed using 10 short SBCE videos including relevant lesions and normal or irrelevant findings. For each video, delegates were required to record a diagnosis (achievable total score from 0 to 10) and the clinical relevance (achievable total score 0 to 10). ET-CET was performed at baseline before the course and repeated, with videos in altered order, after the course.Two hundred ninety-four delegates (79.3% physicians, 16.3% nurses, 4.4% others) were included for baseline analysis, 268 completed the final evaluation. Forty percent had no previous experience in SBCE, 33% had performed 10 or less procedures. Median scores for correct diagnosis improved from 4.0 (IQR 3) to 7.0 (IQR 3) during the courses (P endoscopy may be useful before attending an SBCE course.

  20. Previously unknown stricture due to radiation therapy diagnosed by capsule endoscopy Estenosis de origen actínico no conocida diagnosticada mediante capsuloendoscopia

    Directory of Open Access Journals (Sweden)

    J. Romero Vázquez

    2005-06-01

    Full Text Available Radiation enteritis is a complex clinical entity secondary to the affectation of intestinal epithelial cells as a result of radiation in the management of pelvic malignancies that may occasionally cause intestinal strictures. We present the case of a 60 year-old woman who had been diagnosed ten years before with endometrial adenocarcinoma, and who underwent hysterectomy with double adnexectomy and subsequent radiation therapy. The patient consulted for abdominal pain and ferropenic anemia of several years' standing, and had negative results following radiographic and endoscopic conventional techniques, reason why she was subjected to a capsule endoscopy study that revealed the presence of an ulcerated ileal stricture, which caused the asymptomatic retention of the capsule within the ileum. A laparotomy was subsequently performed - the strictured segment was resected and the capsule retrieved. The histologic examination of the resected segment confirmed the capsule endoscopy-raised suspicion of radiation enteritis. This case shows the role capsule endoscopy may play in the diagnosis of this condition.La enteritis actínica es una entidad producida por la afectación de las células intestinales como consecuencia del tratamiento radioterápico de tumores abdomino-ginecológicos, que en ocasiones puede causar áreas estenóticas. Presentamos el caso de una mujer de 60 años, diagnosticada diez años antes de adenocarcinoma de endometrio, que fue tratada con resección intestinal y radioterapia abdomino-pélvica. La paciente acudió por dolor abdominal y anemia ferropénica de años de evolución, con técnicas radiológicas y endoscópicas convencionales negativas. La realización de una capsuloendoscopia reveló la presencia de una estenosis ileal ulcerada, que causó la retención asintomática de la cápsula en íleon. Se indicó de forma electiva la realización de una laparotomía con resección del segmento estenótico y extracción de la c

  1. Gallium-67 activated charcoal: a new method for preparation of radioactive capsules for colonic transit study

    International Nuclear Information System (INIS)

    Cheng, Kai-Yuan; Tsai, Shih-Chuan; Lin, Wan-Yu.

    2003-01-01

    Indium-111 is currently the radionuclide of choice for colonic transit study. However, it is expensive and not available in many hospitals. Technetium-99m has been proposed for colonic transit study but the short half-life has limited its use. Gallium-67 citrate is inexpensive and available in most countries. Most importantly, it has a suitable half-life for colonic transit study. Attempts have been made in some studies to use 67 Ga citrate to label activated charcoal, but the results have not been good because of poor stability. In this study, we successfully labelled activated charcoal with 67 Ga citrate by adding alcohol and 5% glucose solution. To evaluate the in vitro stability, the 67 Ga-activated charcoal was incubated in a milieu mimicking the intestinal content, containing lipase, trypsin and glycochenodeoxycholate at different pH values (6.0, 7.0, 7.4 and 8.0) and for different durations (0 h, 24 h, 48 h, 72 h and 96 h). For the in vivo study, the 67 Ga-activated charcoal was loaded into a commercial empty enteric capsule. Colonic transit scintigraphy was performed in five volunteers, including three healthy people and two constipated patients, after intake of the radioactive capsule. Images were obtained at 2 h, 4 h, 6 h, 8 h, 24h, 48 h, 72 h etc. until no radioactivity was detected in the bowel. Our data show that the in vitro stability of 67 Ga-activated charcoal was good. The labelling efficiency still exceeded 91% at 96 h at pH values of 6.0, 7.0 and 7.4. In the group with a pH value of 8.0, the labelling efficiency gradually fell during the 4-day incubation but was still higher than 88% at the end of the fourth day. In the in vivo study, most capsules disintegrated in the caecum/colon region, and the 67 Ga-activated charcoal mixed very well with bowel content. In addition, the radioactive charcoal could be detected clearly on the 72-h image, which is very important for the evaluation of colonic transit time in patients with constipation. In

  2. Gallium-67 activated charcoal: a new method for preparation of radioactive capsules for colonic transit study

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, Kai-Yuan [Department of Radiological Technology, ChungTai Institute of Health Sciences and Technology, Taichung (Taiwan); Tsai, Shih-Chuan [Department of Nuclear Medicine, Show Chwan Memorial Hospital, Changhua (Taiwan); Lin, Wan-Yu. [Department of Nuclear Medicine, Taichung Veterans General Hospital, 160 Taichung Harbor Road, Section 3, 40705, Taichung (Taiwan)

    2003-06-01

    Indium-111 is currently the radionuclide of choice for colonic transit study. However, it is expensive and not available in many hospitals. Technetium-99m has been proposed for colonic transit study but the short half-life has limited its use. Gallium-67 citrate is inexpensive and available in most countries. Most importantly, it has a suitable half-life for colonic transit study. Attempts have been made in some studies to use {sup 67}Ga citrate to label activated charcoal, but the results have not been good because of poor stability. In this study, we successfully labelled activated charcoal with {sup 67}Ga citrate by adding alcohol and 5% glucose solution. To evaluate the in vitro stability, the {sup 67}Ga-activated charcoal was incubated in a milieu mimicking the intestinal content, containing lipase, trypsin and glycochenodeoxycholate at different pH values (6.0, 7.0, 7.4 and 8.0) and for different durations (0 h, 24 h, 48 h, 72 h and 96 h). For the in vivo study, the {sup 67}Ga-activated charcoal was loaded into a commercial empty enteric capsule. Colonic transit scintigraphy was performed in five volunteers, including three healthy people and two constipated patients, after intake of the radioactive capsule. Images were obtained at 2 h, 4 h, 6 h, 8 h, 24h, 48 h, 72 h etc. until no radioactivity was detected in the bowel. Our data show that the in vitro stability of {sup 67}Ga-activated charcoal was good. The labelling efficiency still exceeded 91% at 96 h at pH values of 6.0, 7.0 and 7.4. In the group with a pH value of 8.0, the labelling efficiency gradually fell during the 4-day incubation but was still higher than 88% at the end of the fourth day. In the in vivo study, most capsules disintegrated in the caecum/colon region, and the {sup 67}Ga-activated charcoal mixed very well with bowel content. In addition, the radioactive charcoal could be detected clearly on the 72-h image, which is very important for the evaluation of colonic transit time in patients

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

    Science.gov (United States)

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

    2012-11-01

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

  4. Current applications and potential future role of wireless capsule technology in Crohn's disease.

    Science.gov (United States)

    Hall, Barry; Holleran, Grainne; McNamara, Deirdre

    2014-11-01

    The development of capsule technology has modified our approach to the diagnosis of gastrointestinal disease. The relatively rapid uptake of capsule endoscopy as an important clinical tool can be largely ascribed to a number of key factors, including the fact that it is a relatively easy examination to perform in an outpatient setting. It has been established as an integral part of the investigation pathway for obscure gastrointestinal bleeding and suspected small bowel Crohn's disease (CD). CURRENT USE OF CAPSULE ENDOSCOPY: Small bowel CD can be a challenging entity to diagnose. Capsule endoscopy has been shown to be both useful and safe in patients with both suspected and established small bowel CD. In suspected disease, capsule endoscopy has both a high diagnostic yield and negative predictive value. Capsule findings lead to changes in management in up to 73% of patients with established CD. However, while the technology appears capable of detecting subtle mucosal changes not readily apparent on alternate imaging modalities, the question of what actually constitutes small bowel CD as described by capsule is an issue that remains unresolved to date. Thus, capsule endoscopy is best utilised in tandem with advanced imaging and endoscopic techniques such as balloon- assisted enteroscopy. The development of a capsule capable of viewing the colon coupled with improvements in image quality and battery life are likely to lead to the increasing uptake of this technology. In the future, 'interactive' capsules with the ability to view the entire gastrointestinal tract may be a reality.

  5. Papel da cápsula endoscópica na reclassificação da doença inflamatória intestinal em crianças Role of wireless capsule endoscopy in reclassifying inflammatory bowel disease in children

    Directory of Open Access Journals (Sweden)

    Jodie Ouahed

    2013-04-01

    Full Text Available OBJETIVO: Avaliar o papel da cápsula endoscópica na identificação de lesões no intestino delgado em pacientes pediátricos com DII inespecífica (DIII diagnosticada recentemente e avaliar se os achados da cápsula endoscópica resultam em alterações no tratamento dos pacientes. MÉTODOS: Dez pacientes pediátricos recém-diagnosticados com DIII por meio de investigações padrão foram recrutados da clínica de gastroenterologia pediátrica no McMaster Children's Hospital, para serem submetidos a exame com a cápsula endoscópica Pillcam SB TM (Given Imaging. Achados compatíveis com o diagnóstico da doença de Crohn exigiram a identificação de pelo menos três ulcerações. RESULTADOS: De 10 pacientes, três apresentaram achados novos com a cápsula endoscópica que satisfizeram o critério para a doença de Crohn. Outros três apresentaram achados com suspeita de doença de Crohn, porém não atenderam nossos critérios de diagnóstico. Apresentaram achados mais compatíveis com colite ulcerativa outros três pacientes, e um apresentava possível gastrite com intestino normal. Os achados da cápsula endoscópica possibilitaram mudanças no tratamento médico de três pacientes. Em todos os dez casos, a cápsula endoscópica permitiu uma melhor caracterização do tipo e da extensão da doença. Não houve resultado adverso em nossa coorte. CONCLUSÃO: Este estudo prospectivo revela que a cápsula endoscópica é viável, útil e não invasiva, que oferece a possibilidade de melhor caracterização de casos de DIII pediátricos recém-diagnosticados ao identificar lesões no intestino delgado e reclassificá-las como doença de Crohn.OBJECTIVE: To evaluate the role of wireless capsule endoscopy in identifying small bowel lesions in pediatric patients with newly diagnosed colonic inflammatory bowel disease (IBD type unclassified (IBDU, and to assess whether capsule endoscopy findings result in altered patient management. METHODS: Ten

  6. In Vivo Characterization of a Wireless Telemetry Module for a Capsule Endoscopy System Utilizing a Conformal Antenna.

    Science.gov (United States)

    Faerber, Julia; Cummins, Gerard; Pavuluri, Sumanth Kumar; Record, Paul; Rodriguez, Adrian R Ayastuy; Lay, Holly S; McPhillips, Rachael; Cox, Benjamin F; Connor, Ciaran; Gregson, Rachael; Clutton, Richard Eddie; Khan, Sadeque Reza; Cochran, Sandy; Desmulliez, Marc P Y

    2018-02-01

    This paper describes the design, fabrication, packaging, and performance characterization of a conformal helix antenna created on the outside of a capsule endoscope designed to operate at a carrier frequency of 433 MHz within human tissue. Wireless data transfer was established between the integrated capsule system and an external receiver. The telemetry system was tested within a tissue phantom and in vivo porcine models. Two different types of transmission modes were tested. The first mode, replicating normal operating conditions, used data packets at a steady power level of 0 dBm, while the capsule was being withdrawn at a steady rate from the small intestine. The second mode, replicating the worst-case clinical scenario of capsule retention within the small bowel, sent data with stepwise increasing power levels of -10, 0, 6, and 10 dBm, with the capsule fixed in position. The temperature of the tissue surrounding the external antenna was monitored at all times using thermistors embedded within the capsule shell to observe potential safety issues. The recorded data showed, for both modes of operation, a low error transmission of 10 -3 packet error rate and 10 -5 bit error rate and no temperature increase of the tissue according to IEEE standards.

  7. A critical analysis of the effect of view mode and frame rate on reading time and lesion detection during capsule endoscopy.

    Science.gov (United States)

    Nakamura, Masanao; Murino, Alberto; O'Rourke, Aine; Fraser, Chris

    2015-06-01

    Factors influencing reading time and detection of lesions include the view mode (VM) and frame rate (FR) applied during reading of small bowel capsule endoscopy images. The aims of this study were to examine the impact of VM and FR on reading time and lesion detection using a standardized, single-type lesion model. A selected video clip containing a known number of positive images (n = 60) of small bowel angioectasias was read using nine different combinations of VM and FR (VM1, VM2, and VM4 × FR10, FR15, and FR25) in randomized order by six capsule endoscopists. Readers were asked to count all positive images of angioectasias (maximum number of positive images, MPIs) seen during reading. The main outcome measurements were effect of VM and FR on reading time and lesion detection. Mean MPIs for all VM2 and VM4 were 36 (60 %) and 38 (64 %). They were significantly higher than VM1 of 24 (40 %) (P = 0.011, 0.008). A statistical difference was found when the total MPIs at FR10 were compared to FR15 (P = 0.008) and to FR25 (P reading.

  8. A single-center, prospective, double-blind, sham-controlled, randomized study of the effect of a vibrating capsule on colonic transit in patients with chronic constipation.

    Science.gov (United States)

    Nelson, A D; Camilleri, M; Acosta, A; Boldingh, A; Busciglio, I; Burton, D; Ryks, M; Zinsmeister, A R

    2017-07-01

    In an open-label study of 26 patients with IBS-C and chronic constipation, treatment with a vibrating (VIBRANT) capsule twice a week for 7.5 weeks resulted in 88.5% responders. Effects on colonic transit are unclear. We aimed to compare effects of VIBRANT and sham capsule treatment on colonic transit in patients with functional constipation. Patients with functional constipation (Rome III criteria) were randomized to VIBRANT or sham capsule treatment for 8 weeks and underwent scintigraphic colonic transit measurements during week 8. We estimated the overall rate of colonic transit from the slope of progression of colonic geometric center over 48 hours. The capsule was activated 8 hours after ingestion, and the vibration sequence included 240 cycles. There were no significant group differences in overall colonic transit [GC48, 2.76 (IQR 2.42-4.03) for sham group and 3.46 (2.55-4.61) for active treatment group (P=.13)]. Additionally, the progression of the isotope through the colon was numerically faster, though not significantly different (slope, P=.14) in the VIBRANT capsule group compared to the sham group. Three participants in the VIBRANT capsule group had accelerated colonic transit at 32 hours and faster colonic transit slope compared to the 95th percentile of the sham group. Although there were no group differences between VIBRANT and sham capsule treatment on colonic transit, at least one (and possibly three) of 12 patients receiving the VIBRANT capsule had faster colonic transit. The vibration parameters to accelerate colonic transit in patients with functional constipation require further optimization. © 2017 John Wiley & Sons Ltd.

  9. 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 ...

  10. Is the use of AGILE patency capsule prior to videocapsule endoscopy useful in all patients with spondyloarthritis?

    Directory of Open Access Journals (Sweden)

    Gheorghe Andrada

    2017-06-01

    Full Text Available Background and aims. As already known, spondyloarthritis patients present a striking resemblance in intestinal inflammation with early Crohn’s disease. Moreover, the frequent use of nonsteroidal anti-inflammatory drugs is an important part of their treatment. Both conditions could lead to intestinal stenoses. Therefore we proposed to investigate the usefulness of the patency capsule test in patients with spondyloarthritis.

  11. The capsule endoscopy "suspected blood indicator" (SBI) for detection of active small bowel bleeding: no active bleeding in case of negative SBI.

    Science.gov (United States)

    Tal, Andrea Oliver; Filmann, Natalie; Makhlin, Konstantin; Hausmann, Johannes; Friedrich-Rust, Mireen; Herrmann, Eva; Zeuzem, Stefan; Albert, Jörg G

    2014-09-01

    Capsule endoscopy (CE) is the gold standard to diagnose small bowel bleeding. The "suspected blood indicator" (SBI) offers an automated detection of active small bowel bleeding but validity of this technique is unknown. The objective was to analyze specificity and sensitivity of the SBI using the second small bowel capsule generation for the detection of active bleeding. This is a retrospective analysis of all patients (199) who attended our clinic for CE from June 2008 through March 2013. The second-generation PillCam SB 2 capsule was used for detection of (1) luminal blood content and (2) potentially responsible small bowel lesions. The findings of an independent investigator were correlated to SBI findings and a number of SBI markings were analyzed by a receiver operating characteristic (ROC). In 157/199 cases, no sign of active bleeding or altered blood was detected. One hundred and thirty-seven of these 157 cases provided at least one SBI marking and a mean of 18.4 positive SBI markings per record were found. In 20 cases, neither SBI nor the human investigator detected abnormalities. Thirteen patients showed investigator-detected minor bleeding with mean SBI findings of 36 positive screenshots per record. When major bleeding was diagnosed by the investigator (n = 29), SBI detected a mean of 46.6 SBI-positive markings. SBI turned positive in 179 patients, whereas the investigator detected active bleeding in 42 cases. All patients with active bleeding were detected by SBI (sensitivity 100%, specificity 13%). ROC analysis revealed 51.0 SBI markings being the optimal cutoff for active versus no bleeding (sensitivity 79.1%, specificity 90.4%, misclassification of 15.3%). The new SBI software is a reliable tool to exclude active bleeding and/or major lesions but analysis of the CE video by a trained investigator is still important for the detection of lesions responsible for past bleeding.

  12. Detection of small bowel tumor in wireless capsule endoscopy images using an adaptive neuro-fuzzy inference system

    Science.gov (United States)

    Alizadeh, Mahdi; Maghsoudi, Omid Haji; Sharzehi, Kaveh; Hemati, Hamid Reza; Asl, Alireza Kamali; Talebpour, Alireza

    2017-01-01

    Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate. The purpose of this study was to evaluate the validity and reliability of an automatic post-processing method for identifying and classifying wireless capsule endoscopic images, and investigate statistical measures to differentiate normal and abnormal images. The proposed technique consists of two main stages, namely, feature extraction and classification. Primarily, 32 features incorporating four statistical measures (contrast, correlation, homogeneity and energy) calculated from co-occurrence metrics were computed. Then, mutual information was used to select features with maximal dependence on the target class and with minimal redundancy between features. Finally, a trained classifier, adaptive neuro-fuzzy interface system was implemented to classify endoscopic images into tumor, healthy and unhealthy classes. Classification accuracy of 94.2% was obtained using the proposed pipeline. Such techniques are valuable for accurate detection characterization and interpretation of endoscopic images. PMID:28959000

  13. Detection of small bowel tumor in wireless capsule endoscopy images using an adaptive neuro-fuzzy inference system.

    Science.gov (United States)

    Alizadeh, Mahdi; Maghsoudi, Omid Haji; Sharzehi, Kaveh; Reza Hemati, Hamid; Kamali Asl, Alireza; Talebpour, Alireza

    2017-09-26

    Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate. The purpose of this study was to evaluate the validity and reliability of an automatic post-processing method for identifying and classifying wireless capsule endoscopic images, and investigate statistical measures to differentiate normal and abnormal images. The proposed technique consists of two main stages, namely, feature extraction and classification. Primarily, 32 features incorporating four statistical measures (contrast, correlation, homogeneity and energy) calculated from co-occurrence metrics were computed. Then, mutual information was used to select features with maximal dependence on the target class and with minimal redundancy between features. Finally, a trained classifier, adaptive neuro-fuzzy interface system was implemented to classify endoscopic images into tumor, healthy and unhealthy classes. Classification accuracy of 94.2% was obtained using the proposed pipeline. Such techniques are valuable for accurate detection characterization and interpretation of endoscopic images.

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

    Directory of Open Access Journals (Sweden)

    Pedro Boal Carvalho

    2014-01-01

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

  15. Feasibility and diagnostic utility of video capsule endoscopy for the detection of small bowel polyps in patients with hereditary polyposis syndromes.

    Science.gov (United States)

    Schulmann, Karsten; Hollerbach, Stephan; Kraus, Katja; Willert, Jörg; Vogel, Tilman; Möslein, Gabriela; Pox, Christian; Reiser, Markus; Reinacher-Schick, Anke; Schmiegel, Wolff

    2005-01-01

    At present, surveillance of premalignant small bowel polyps in hereditary polyposis syndromes has a number of limitations. Capsule endoscopy (CE) is a promising new method to endoscopically assess the entire length of the small bowel. We prospectively examined 40 patients with hereditary polyposis syndromes (29 familial adenomatous polyposis (FAP), 11 Peutz-Jeghers syndrome (PJS)). Results were compared with push-enteroscopy (PE) results in FAP and with esophagogastroduodenoscopy, PE, (MR)-enteroclysis, and surgical specimen in PJS patients. A total of 76% of the patients with FAP with duodenal adenomas (n = 21) had additional adenomas in the proximal jejunum that could be detected by CE and PE. Moreover, 24% of these FAP patients had further polyps in the distal jejunum or ileum that could only be detected by CE. In contrast, in FAP patients without duodenal polyps (n = 8), jejunal or ileal polyps occurred rarely (12%). CE detected polyps in 10 of 11 patients with PJS, a rate superior to all other reference procedures employed. Importantly, the findings of CE had immediate impact on further clinical management in all PJS patients. Our results suggest that CE may be of clinical value in selected patients with FAP, whereas in PJS, CE could be used as first line surveillance procedure.

  16. An Automatic Bleeding Frame and Region Detection Scheme for Wireless Capsule Endoscopy Videos Based on Interplane Intensity Variation Profile in Normalized RGB Color Space

    Directory of Open Access Journals (Sweden)

    Amit Kumar Kundu

    2018-01-01

    Full Text Available Wireless capsule endoscopy (WCE is an effective video technology to diagnose gastrointestinal (GI disease, such as bleeding. In order to avoid conventional tedious and risky manual review process of long duration WCE videos, automatic bleeding detection schemes are getting importance. In this paper, to investigate bleeding, the analysis of WCE images is carried out in normalized RGB color space as human perception of bleeding is associated with different shades of red. In the proposed method, at first, from the WCE image frame, an efficient region of interest (ROI is extracted based on interplane intensity variation profile in normalized RGB space. Next, from the extracted ROI, the variation in the normalized green plane is presented with the help of histogram. Features are extracted from the proposed normalized green plane histograms. For classification purpose, the K-nearest neighbors classifier is employed. Moreover, bleeding zones in a bleeding image are extracted utilizing some morphological operations. For performance evaluation, 2300 WCE images obtained from 30 publicly available WCE videos are used in a tenfold cross-validation scheme and the proposed method outperforms the reported four existing methods having an accuracy of 97.86%, a sensitivity of 95.20%, and a specificity of 98.32%.

  17. Early detection of acute graft-versus-host disease by wireless capsule endoscopy and probe-based confocal laser endomicroscopy: results of a pilot study.

    Science.gov (United States)

    Coron, Emmanuel; Laurent, Valerie; Malard, Florent; Le Rhun, Marc; Chevallier, Patrice; Guillaume, Thierry; Mosnier, Jean-François; Galmiche, Jean-Paul; Mohty, Mohamad

    2014-06-01

    Acute gastrointestinal graft-versus-host disease (GI-GVHD) is usually diagnosed using endoscopic examinations and biopsies for conventional histology. The aim of this pilot study was to determine whether mini-invasive techniques such as probe-based confocal laser endomicroscopy (pCLE) combined with wireless capsule endoscopy (WCE) could detect early lesions of GI-GVHD prior to symptoms. Fifteen patients undergoing allogeneic haematopoietic stem cell transplantation (allo-HSCT) were prospectively examined with a small bowel WCE, duodenal and colorectal pCLE, and standard biopsies. Per study protocol, all these examinations were scheduled between day 21 and day 28 after allo-HSCT, independently of the presence or absence of digestive symptoms. During follow up, eight patients developed acute GI-GVHD. Sensitivity of WCE, pCLE, and histology were 50, 87.5, and 50%, respectively. Specificity of WCE, pCLE, and histology were 80, 71.5, and 80%, respectively. We showed a positive correlation between the Glücksberg scoring system and WCE (rho = 0.543, p = 0.036) and pCLE (rho = 0.727, p = 0.002) but not with standard histology (rho = 0.481, p = 0.069). The results from this pilot study suggest that novel methods such as pCLE and WCE could be part of a mini-invasive algorithm for early detection of GI-GVHD.

  18. 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.

  19. 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

  20. Enteric coated HPMC capsules plugged with 5-FU loaded microsponges: a potential approach for treatment of colon cancer

    Directory of Open Access Journals (Sweden)

    Ankita Gupta

    2015-09-01

    Full Text Available The work was aimed at developing novel enteric coated HPMC capsules (ECHC plugged with 5 Florouracil (5-FU loaded Microsponges in combination with calcium pectinate beads. Modified quasi-emulsion solvent diffusion method was used to formulate microsponges based on 32 factorial design and the effects of independent variables (volume of organic solvent and Eudragit RS100 content on the dependent variables (Particle size, %EE & % CDR were determined. The optimized microsponges (F4 were characterized by SEM, PXRD, TGA and were plugged along with calcium pectinate beads in HPMC capsules and the HPMC capsules were further coated with enteric polymer Eudragit L 100 (Ed-L100 and/ or Eudrgit S 100 (Ed-S 100 in different proportions. In vitro release study of ECHC was performed in various release media sequentially SGF for 2 h, followed by SIF for the next 6 h and then in SCF (in the presence and absence of pectinase enzyme for further 16 h. Drug release was retarded on coating with EdS-100 in comparison to blend of EdS-100: EdL-100 coating. The percentage of 5-FU released at the end of 24 h from ECHC 3 was 97.83 ± 0.12% in the presence of pectinase whereas in control study it was 40.08 ± 0.02% drug. The optimized formulation was subjected to in vivo Roentgenographic studies in New Zealand white rabbits to analyze the in vivo behavior of the developed colon targeted capsules. Pharmacokinetic studies in New Zealand white rabbits were conducted to determine the extent of systemic exposure provided by the developed formulation in comparison to 5-FU aqueous solutions. Thus, enteric coated HPMC capsules plugged with 5-FU loaded microsponges and calcium pectinate beads proved to be promising dosage form for colon targeted drug delivery to treat colorectal cancer.

  1. Magnifying endoscopy with indigo carmine contrast for differential diagnosis of neoplastic and nonneoplastic colonic polyps.

    Science.gov (United States)

    Su, Ming-Yao; Ho, Yu-Pin; Chen, Pang-Chi; Chiu, Cheng-Tang; Wu, Cheng-Shyong; Hsu, Chen-Ming; Tung, Shui-Yi

    2004-08-01

    This study describes the feasibility of magnifying colonoscopy with indigo carmine dye contrast to distinguish neoplastic and nonneoplastic colonic polyps. This study sampled consecutive patients undergoing colonoscopy using an Olympus CF240ZI from January to October 2000 at Chang-Gung Memorial Hospital, Lin-Kou Medical Center. This study analyzed a total of 270 polyps. Indigo carmine (0.2%) was sprayed directly on the mucosa surface before observing the crypts using a magnifying colonoscope (1.5x-100x). The pit patterns were described using the classification proposed by Kudo. Finally, polypectomy or biopsy was performed for histological diagnosis. The study identified 155 adenomas, 99 hyperplastic polyps, 9 adenocarcinomas, and 7 other nonneoplastic lesions (harmatoma, inflammatory polyps, and mucosal tag). The pit pattern was analyzed for all lesions. Further classification into neoplastic (adenoma and adenocarcinoma) and nonneoplastic (hyperplastic and others) polyps revealed 156 neoplastic and 14 nonneoplastic polyps among the type III to type V pits and 92 nonneoplastic and 8 neoplastic polyps among the type I and II pits. The sensitivity of type III to type V pits in detecting neoplastic polyps was 95.1%, with a specificity of 86.8% and diagnostic accuracy of 91.9%. The positive likelihood ratio was 7.3, and the negative likelihood ratio was 0.06. Magnifying colonoscopy with indigo carmine dye contrast provides morphological detail that correlates well with polyp histology. Small flat lesions with typical type II pit pattern should have minimal neoplastic risk, thus endoscopic resection is not necessary.

  2. Feasibility of video capsule endoscopy in the management of children with Peutz-Jeghers syndrome: a blinded comparison with barium enterography for the detection of small bowel polyps.

    Science.gov (United States)

    Postgate, Aymer; Hyer, Warren; Phillips, Robin; Gupta, Arun; Burling, David; Bartram, Clive; Marshall, Michelle; Taylor, Stuart; Brown, Gregor; Schofield, Gill; Bassett, Paul; Spray, Christine; Fitzpatrick, Aine; Latchford, A; Fraser, Chris

    2009-10-01

    Peutz-Jeghers syndrome (PJS) in children may present with anaemia, intussusception, or obstruction from an early age and surgery is common. Prophylactic polypectomy may reduce subsequent complications. Traditional barium enterography (BE) has poor sensitivity and requires significant radiation. We compared the performance of capsule endoscopy (CE) with BE in children with PJS. Children with PJS (ages 6.0-16.5 years) were prospectively recruited and underwent BE followed by CE, each reported by expert reviewers blinded to the alternate modality. Number of "significant" (>10 mm) and total number of polyps were recorded. Child preference was assessed using a visual analogue questionnaire. Definitive findings were assessed at laparotomy or enteroscopy, when performed. There was no significant difference for >10 mm polyp detection. Six polyps were found in 3 children by both modalities: 3 polyps in 2 children at CE, 3 polyps in 1 child at BE (P=0.50). Re-review of 1 CE identified 3 polyps that were missed in 1 child at initial reading. Significantly more polyps were identified by CE than BE: 61 vs 6 (P=0.02). CE was significantly more comfortable than BE (median score CE 76 [interquartile range 69-87] vs BE 37 [interquartile range 31-68], P=0.03) and was the preferred investigation in 90% (P=0.02). CE is a feasible, safe, and sensitive test for small bowel polyp surveillance in children with PJS. It is significantly more comfortable than BE and is the preferred test of most children for future surveillance. There is a learning curve for reporting CE studies in PJS and appropriate training is essential.

  3. Robotics in endoscopy.

    Science.gov (United States)

    Klibansky, David; Rothstein, Richard I

    2012-09-01

    The increasing complexity of intralumenal and emerging translumenal endoscopic procedures has created an opportunity to apply robotics in endoscopy. Computer-assisted or direct-drive robotic technology allows the triangulation of flexible tools through telemanipulation. The creation of new flexible operative platforms, along with other emerging technology such as nanobots and steerable capsules, can be transformational for endoscopic procedures. In this review, we cover some background information on the use of robotics in surgery and endoscopy, and review the emerging literature on platforms, capsules, and mini-robotic units. The development of techniques in advanced intralumenal endoscopy (endoscopic mucosal resection and endoscopic submucosal dissection) and translumenal endoscopic procedures (NOTES) has generated a number of novel platforms, flexible tools, and devices that can apply robotic principles to endoscopy. The development of a fully flexible endoscopic surgical toolkit will enable increasingly advanced procedures to be performed through natural orifices. The application of platforms and new flexible tools to the areas of advanced endoscopy and NOTES heralds the opportunity to employ useful robotic technology. Following the examples of the utility of robotics from the field of laparoscopic surgery, we can anticipate the emerging role of robotic technology in endoscopy.

  4. Symptomatic retention of the Agile® patency capsule.

    Science.gov (United States)

    Egea Valenzuela, Juan; Estrella Díez, Esther; Alberca de Las Parras, Fernando

    2017-06-01

    The Agile® capsule has shown to be useful when evaluating the patency of the small bowel in patients prior to capsule endoscopy studies. It is a safe tool and a low rate of complications have been reported, highlighting symptomatic retention, although references in literature are scarce and it is only observed in 1.2% of the procedures. We present the case of a symptomatic retention of this device in a patient with previously known colonic Crohn's disease in who a small bowel study was indicated and was sent for prior patency test.

  5. PillCam© Colon Capsule for the study of colonic pathology in clinical practice: Study of agreement with colonoscopy Capsula colónica PillCam© para el estudio de la patología del colon en la práctica clínica

    Directory of Open Access Journals (Sweden)

    J. M. Herrerías-Gutiérrez

    2011-02-01

    Full Text Available Introduction: several studies have pointed out the effectiveness of the PillCam© colon capsule endoscopy (CCE compared with the colonoscopy in the study of the colonic pathology. Aims and methods: the objective of our study was to assess the agreement in the diagnosis of CCE with conventional colonoscopy as well as its sensitivity and specificity, and to describe the findings of the CCE in our clinical practice. Consecutive patients with abdominal symptoms were included in the study. The CCE was performed as previously reported (with PEG and sodium phosphate as laxative agents. The nature and location of the findings, colonic transit time, complications, cleanliness degree and consistency with diagnostic colonoscopy, when performed, were analyzed. Results: a total of 144 subjects (67 women and 77 men; (52.17±16.71 years with the following indications were included: screening of Colorectal cancer (88 patients, control after polipectomy (24, incomplete colonoscopy (7, rectal bleeding (10, anemia (8, diarrhea (7. The CCE exploration was complete in 134/144 cases (93%, with no case of retention. The preparation was good-very good in 88/134 (65,6%, fair in 26/134 (19,4% and poor in 20/134 (15% of the cases. The average colonic transit was of 140.76 min (9-603. Any adverse effect was notified. In 44 cases a colonoscopy was carried out after CCE (results were hidden from another endoscopist. Compared to colonoscopy, the rate of agreement was 75,6%, the sensitivity was 84% and the specificity 62,5%, PPV was 77,7% and NPV was 71,4 %. The colonic findings in 134 CCE were: in 34 cases CCE it did not show lesions, diverticulosis in 63 explorations, polyps in 43, angiodysplasias in 15, Crohn's Disease in 9 and ulcerative colitis in other 8 cases. Conclusions: the CCE is an effective and reliable technique for the detection of lesions in colon, and because of its high agree-ment with the colonoscopy, it could be useful in clinical practice. Further studies

  6. Interpretación de la cápsula endoscópica: el papel del personal no especializado Capsule endoscopy interpretation: The role of physician extenders

    Directory of Open Access Journals (Sweden)

    I. Fernández-Urién

    2008-04-01

    Full Text Available Introducción y objetivos: la cápsula endoscópica (CE ha supuesto una nueva era en el estudio del intestino delgado. No obstante, el tiempo empleado por el gastroenterólogo en este procedimiento es mayor del deseable y no se han evaluado completamente alternativas al personal especializado. El objetivo de este estudio es evaluar la precisión de personal no especializado en la interpretación de la CE. Material y métodos: un gastroenterólogo con experiencia en CE y personal no especializado revisaron independientemente 20 procedimientos. Los hallazgos de cada participante eran desconocidos por el resto. Un consenso formado por los participantes y un segundo gastroenterólogo fue empleado como gold standard. Se analizaron número, tipo y localización de las imágenes seleccionadas y tiempo de evacuación gástrica (tEG, tiempo de tránsito en intestino delgado (tTID y tiempo empleado por los participantes. Resultados: la sensibilidad y la especificidad global fueron del 79 y 99% para el gastroenterólogo; del 86 y 43% para la enfermera; y del 80 y 57% para el residente. Las 34 lesiones "mayores" consideradas por consenso fueron detectadas por los tres participantes. El acuerdo entre consenso y participantes para clasificar e interpretar las imágenes fue de buena a excelente (κ de 0,55 a 1. No se encontraron diferencias estadísticamente significativas en el tEG y tTID obtenido por consenso y participantes. El gastroenterólogo fue el más rápido en revisar los procedimientos (51,9 ± 13,5 minutos versus 62,2 ± 19 y 60,9 ± 17,1 para enfermera y residente, respectivamente; p Background and aims: capsule endoscopy (CE allows for a new era in small-bowel examination. Nevertheless, physicians' time for CE-interpretation remains longer than desirable. Alternative strategies to physicians have not been widely investigated. The aim of this study was to evaluate the accuracy of physician extenders in CE-interpretation. Material and methods: one

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

    Directory of Open Access Journals (Sweden)

    D. Martínez Ares

    2004-02-01

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

  8. 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

  9. The Importance of Wireless Capsule Endoscopy for Research into the Intestin al Absorption Window of 5-Aminosalicylic Acid in Experimental Pigs.

    Science.gov (United States)

    Kvetina, Jaroslav; Tacheci, Ilja; Nobilis, Milan; Kopacova, Marcela; Kunes, Martin; Bures, Jan

    2017-01-01

    Absorption windows in particular segments of the small intestine can contribute to the development of orally administered drug formulations and can limit the bioavailability of released compounds. The aim of this study was to evaluate use of wireless capsule enteroscopy regarding the disintegration kinetic process of tablets in the small intestine and its comparison with the levels of the model drug (5- aminosalicylic acid; 5-ASA), and its majority metabolite (N-acetyl-5-aminosalicylic acid; N-acetyl-5-ASA) in blood plasma. Tablets were endoscopically introduced into the duodenum and their disintegration was monitored using wireless capsule enteroscopy in anaesthetised pigs. In parallel, blood plasma time profiles of the model drug (5-ASA) released from tablets and its metabolite (N-acetyl-5-ASA) were detected. The disintegration of tablets was evident in the proximal jejunum (until the 90-minute mark) and culminated at the 3rd hour. The maximum plasmatic concentration of 5-ASA was reached at the 3rd hour and in the case of its metabolite (N-acetyl-5-ASA) at the 4th hour. The study demonstrated the advantage of combination of wireless capsule enteroscopy and bioanalytical determination of pharmacokinetic parameters in an animal experiment to localise the disintegration site of solid dosage form and following kinetics of intestinal absorption of the released active agent. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  10. Technical endoscopy

    International Nuclear Information System (INIS)

    Cavalar, K.O.

    1988-01-01

    A survey is provided on different versions of endoscopes, taking into account the new developments of video endoscopy. With a variety of practical examples it is shown that technical tests using endoscopy are a demanding task for nondestructive testing, whose requirements can only be met on a customized basis. (orig./HP) [de

  11. 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.

  12. Hindfoot endoscopy

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

    Hindfoot pain can be caused by a variety of pathologies; most of these can be diagnosed and treated by means of endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a peroneus brevis length rupture, peroneal tendon athesiolysis, flexor hallucis longus release, os

  13. 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. 

  14. Staphylococcus aureus Colonization of the Mouse Gastrointestinal Tract Is Modulated by Wall Teichoic Acid, Capsule, and Surface Proteins.

    Directory of Open Access Journals (Sweden)

    Yoshiki Misawa

    2015-07-01

    Full Text Available Staphylococcus aureus colonizes the nose, throat, skin, and gastrointestinal (GI tract of humans. GI carriage of S. aureus is difficult to eradicate and has been shown to facilitate the transmission of the bacterium among individuals. Although staphylococcal colonization of the GI tract is asymptomatic, it increases the likelihood of infection, particularly skin and soft tissue infections caused by USA300 isolates. We established a mouse model of persistent S. aureus GI colonization and characterized the impact of selected surface antigens on colonization. In competition experiments, an acapsular mutant colonized better than the parental strain Newman, whereas mutants defective in sortase A and clumping factor A showed impaired ability to colonize the GI tract. Mutants lacking protein A, clumping factor B, poly-N-acetyl glucosamine, or SdrCDE showed no defect in colonization. An S. aureus wall teichoic acid (WTA mutant (ΔtagO failed to colonize the mouse nose or GI tract, and the tagO and clfA mutants showed reduced adherence in vitro to intestinal epithelial cells. The tagO mutant was recovered in lower numbers than the wild type strain in the murine stomach and duodenum 1 h after inoculation. This reduced fitness correlated with the in vitro susceptibility of the tagO mutant to bile salts, proteases, and a gut-associated defensin. Newman ΔtagO showed enhanced susceptibility to autolysis, and an autolysin (atl tagO double mutant abrogated this phenotype. However, the atl tagO mutant did not survive better in the mouse GI tract than the tagO mutant. Our results indicate that the failure of the tagO mutant to colonize the GI tract correlates with its poor adherence and susceptibility to bactericidal factors within the mouse gut, but not to enhanced activity of its major autolysin.

  15. Capsule endoscopy: new technology | Schneider | South African ...

    African Journals Online (AJOL)

    South African Gastroenterology Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 1 (2004) >. Log in or Register to get access to full text downloads.

  16. Rgg-Shp regulators are important for pneumococcal colonization and invasion through their effect on mannose utilization and capsule synthesis

    NARCIS (Netherlands)

    Zhi, Xiangyun; Abdullah, Iman Tajer; Gazioglu, Ozcan; Manzoor, Irfan; Shafeeq, Sulman; Kuipers, Oscar P; Hiller, N Luisa; Andrew, Peter W; Yesilkaya, Hasan

    2018-01-01

    Microbes communicate with each other by using quorum sensing (QS) systems and modulate their collective 'behavior' for in-host colonization and virulence, biofilm formation, and environmental adaptation. The recent increase in genome data availability reveals the presence of several putative QS

  17. Rgg-Shp regulators are important for pneumococcal colonization and invasion through their effect on mannose utilization and capsule synthesis.

    Science.gov (United States)

    Zhi, Xiangyun; Abdullah, Iman Tajer; Gazioglu, Ozcan; Manzoor, Irfan; Shafeeq, Sulman; Kuipers, Oscar P; Hiller, N Luisa; Andrew, Peter W; Yesilkaya, Hasan

    2018-04-23

    Microbes communicate with each other by using quorum sensing (QS) systems and modulate their collective 'behavior' for in-host colonization and virulence, biofilm formation, and environmental adaptation. The recent increase in genome data availability reveals the presence of several putative QS sensing circuits in microbial pathogens, but many of these have not been functionally characterized yet, despite their possible utility as drug targets. To increase the repertoire of functionally characterized QS systems in bacteria, we studied Rgg144/Shp144 and Rgg939/Shp939, two putative QS systems in the important human pathogen Streptococcus pneumoniae. We find that both of these QS circuits are induced by short hydrophobic peptides (Shp) upon sensing sugars found in the respiratory tract, such as galactose and mannose. Microarray analyses using cultures grown on mannose and galactose revealed that the expression of a large number of genes is controlled by these QS systems, especially those encoding for essential physiological functions and virulence-related genes such as the capsular locus. Moreover, the array data revealed evidence for cross-talk between these systems. Finally, these Rgg systems play a key role in colonization and virulence, as deletion mutants of these QS systems are attenuated in the mouse models of colonization and pneumonia.

  18. 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.

  19. Upper GI Endoscopy

    Science.gov (United States)

    ... Upper GI Series Urinary Tract Imaging Urodynamic Testing Virtual Colonoscopy Upper GI Endoscopy What is upper gastrointestinal ( ... endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to obtain a small piece ...

  20. Nanotechnology in gastrointestinal endoscopy: A primer

    Directory of Open Access Journals (Sweden)

    Ashish Kumar Jha

    2012-01-01

    Full Text Available Nanotechnology is the understanding, control of matter and development of engineered devices in nanometer range (1-100 nm. Nanoparticles have different physicochemical properties (small size, large surface area to volume ratio, and high reactivity in comparison to bulk materials of the same composition. The nanotechnology has proved its usefulness in early diagnosis, proteonomics, imaging diagnostics and multifunctional therapeutics. Recent studies have shown its role in early diagnosis and targeted therapy of various gastrointestinal disorders such as hepatitis B virus and hepatitis C virus related liver disease, inflammatory bowel disease, gastric ulcer, and malignancy. Application of this technology appears promising in diagnostic and therapeutic endoscopy such as the endoscopic hemostasis of peptic ulcer bleeding, prevention of clogging of plastic stent and advance capsule endoscopy. This article will highlight the basic concepts of nanotechnology and its potential application in gastrointestinal endoscopy.

  1. Wireless Capsule Enteroscopy in Healthy Volunteers.

    Science.gov (United States)

    Tachecí, Ilja; Bradna, Petr; Douda, Tomáš; Baštecká, Drahomíra; Kopáčová, Marcela; Rejchrt, Stanislav; Lutonský, Martin; Soukup, Tomáš; Bureš, Jan

    The aim of our prospective study was to define endoscopy appearance of the small bowel in healthy volunteers. Forty-two healthy volunteers underwent wireless capsule endoscopy, clinical investigation, laboratory tests, and completed a health-status questionnaire. All subjects were available for a 36-month clinical follow-up. Eleven subjects (26%) had fully normal endoscopy findings. Remaining 31 persons (74%), being asymptomatic, with normal laboratory results, had some minor findings at wireless capsule endoscopy. Most of those heterogeneous findings were detected in the small intestine (27/31; 87%), like erosions and/or multiple red spots, diminutive polyps and tiny vascular lesions. During a 36-month clinical follow-up, all these 42 healthy volunteers remained asymptomatic, with fully normal laboratory control. Significant part of healthy subjects had abnormal findings at wireless capsule endoscopy. These findings had no clinical relevance, as all these persons remained fully asymptomatic during a 36-month follow-up. Such an endoscopic appearance would be previously evaluated as "pathological". This is a principal report alerting that all findings of any control group of wireless capsule endoscopic studies must be evaluated with caution.

  2. Wireless Capsule Enteroscopy in Healthy Volunteers

    Directory of Open Access Journals (Sweden)

    Ilja Tachecí

    2016-09-01

    Full Text Available Introduction: The aim of our prospective study was to define endoscopy appearance of the small bowel in healthy volunteers. Method: Forty-two healthy volunteers underwent wireless capsule endoscopy, clinical investigation, laboratory tests, and completed a health-status questionnaire. All subjects were available for a 36-month clinical follow-up. Results: Eleven subjects (26% had fully normal endoscopy findings. Remaining 31 persons (74%, being asymptomatic, with normal laboratory results, had some minor findings at wireless capsule endoscopy. Most of those heterogeneous findings were detected in the small intestine (27/31; 87%, like erosions and/or multiple red spots, diminutive polyps and tiny vascular lesions. During a 36-month clinical follow-up, all these 42 healthy volunteers remained asymptomatic, with fully normal laboratory control. Conclusions: Significant part of healthy subjects had abnormal findings at wireless capsule endoscopy. These findings had no clinical relevance, as all these persons remained fully asymptomatic during a 36-month follow-up. Such an endoscopic appearance would be previously evaluated as “pathological”. This is a principal report alerting that all findings of any control group of wireless capsule endoscopic studies must be evaluated with caution.

  3. 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 ...

  4. High-definition vs. standard-definition endoscopy with indigo carmine for the in vivo diagnosis of colonic polyps.

    Science.gov (United States)

    Longcroft-Wheaton, Gaius; Brown, James; Cowlishaw, David; Higgins, Bernard; Bhandari, Pradeep

    2013-12-01

    There is growing evidence that indigo carmine chromoendoscopy is effective for the in vivo diagnosis of colonic polyps. However, the impact of colonoscope resolution on diagnostic accuracy has not been investigated. We aimed to compare the effectiveness of in vivo diagnosis of small colonic polyps using indigo carmine dye spray with standard-definition and high-definition colonoscopes. Procedures were performed using Fujinon colonoscopes and EPX 4400 processor. Fujinon standard-definition (SD) and high-definition (HD) colonoscopes were used, with the endoscopist blinded to colonoscope definition. Polyps indigo carmine dye spray, with the predicted diagnosis recorded. In each case the kind of colonoscope (SD or HD) was recorded. Polyps were removed and sent for histological analysis, with the pathologist blinded to the diagnosis made by the endoscopist. The predicted diagnosis was compared with the true histology to calculate the accuracy, sensitivity and specificity of in vivo assessment using either SD or HD scopes. In total 237 polyps indigo carmine dye spray is excellent with standard-definition colonoscopes and is not improved with high-definition colonoscopes.

  5. Wireless communication link for capsule endoscope at 600 MHz.

    Science.gov (United States)

    Khaleghi, A; Balasingham, I

    2015-01-01

    Simulation of a wireless communication link for a capsule endoscopy is presented for monitoring of small intestine in humans. The realized communication link includes the transmitting capsule antenna, the outside body receiving antenna and the model of the human body. The capsule antenna is designed for operating at the frequency band of 600 MHz with an impedance bandwidth of 10 MHz and omnidirectional radiation pattern. The quality of the communication link is improved by using directive antenna outside body inside matching layer for electromagnetic wave tuning to the body. The outside body antenna has circular polarization that guaranteeing the communication link for different orientations of the capsule inside intestine. It is shown that the path loss for the capsule in 60 mm from the abdomen surface varies between 37-47 dB in relation to the antenna orientation. This link can establish high data rate wireless communications for capsule endoscopy.

  6. 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...

  7. Colon and rectal cancer

    International Nuclear Information System (INIS)

    Saldombide, L.; Cordoba, A.

    2010-01-01

    This study is about the diagnosis, therapy and monitoring of colon cancer. The techniques used are the endoscopy with biopsy in the pre and post operative colon surgery, abdominal ultrasound, chest X-ray studies of hemogram as well as liver and renal function

  8. 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. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. opened capsule

    African Journals Online (AJOL)

    The accuracy of the off-label opened capsule dosing method for stavudine is acceptable. There is no need to instruct caregivers to include sediment in the aliquot given to the infant. However, studies that confirm adequate bioavailability and efficacy are needed. In addition, it is important to avoid supplying generic capsules ...

  10. 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.

  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. A randomized, phase I, double-blind, crossover study on pharmacokinetics of peppermint oil capsules in healthy volunteers : Enteric-coating versus colon-targeted-delivery

    NARCIS (Netherlands)

    Weerts, Z.Z.R.M.; Keszthelyi, D.; Frijlink, H.W.; Brouwers, J.R.B.J.; Vork, L.; Jonkers, D.M.A.E.; Masclee, A.A.M.

    2016-01-01

    Peppermint oil (PO) has been shown to reduce abdominal pain in patients with Irritable Bowel Syndrome (IBS). Menthol, the main constituent of PO, induces intestinal smooth muscle relaxation and desensitizes nociceptive nerve afferents. Enteric-coated (EC PO) capsules that release PO mainly in the

  13. Quality metrics in endoscopy.

    Science.gov (United States)

    Gurudu, Suryakanth R; Ramirez, Francisco C

    2013-04-01

    Endoscopy has evolved in the past 4 decades to become an important tool in the diagnosis and management of many digestive diseases. Greater focus on endoscopic quality has highlighted the need to ensure competency among endoscopists. A joint task force of the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy has proposed several quality metrics to establish competence and help define areas of continuous quality improvement. These metrics represent quality in endoscopy pertinent to pre-, intra-, and postprocedural periods. Quality in endoscopy is a dynamic and multidimensional process that requires continuous monitoring of several indicators and benchmarking with local and national standards. Institutions and practices should have a process in place for credentialing endoscopists and for the assessment of competence regarding individual endoscopic procedures.

  14. Comprehensive approach to endoscopies in children and adolescents

    Directory of Open Access Journals (Sweden)

    Klavdija Medja

    2013-10-01

    Full Text Available For children, endoscopies are very unpleasant and difficult to cope with. Endoscopies require a very good teamwork.The objective of the endoscopic team is to perform endoscopic procedures skillfully, safely, quickly, and as painlessly for children as possible.To perform a good endoscopic procedure, good preparation of the child and parents is essential. They should all be actively involved in all phases of the procedure, including during the endoscopy. We have to provide children holistic care. We have to abide physiological, developmental, social and cultural aspects of the child.Sedation of children during endoscopy minimizes bad experience for them, and allows better performance of the procedure or intervention. We perform gastroscopy under sedation in children younger than ten years of age, with rare exceptions. Colonoscopies are always performed under sedation.Capsule endoscopy is a newer diagnostic method in gastroenterology that enables examination of the whole small bowel. In children, it is an important and safe diagnostic method that is being successfully used in young children as well.A child scheduled for capsule endoscopy receives nursing care from admission onwards. The primary care nurse and graduate nurse work together in all phases of the diagnostic procedure: in the preparation of the child for the procedure, and in the introduction of capsule (with or without an endoscope. The nurse is responsible for the child’s safety during the procedure, for his correct timing of feeding, his well-being, regular defecation, and for monitoring the child for any side effects following the procedure. The child’s parents, when necessary, are included in all these activities.The aim of nursing care is good preparation of the child for the procedure, inclusion of his parents and teamwork to provide a safe, child-friendly and well-performed procedure.

  15. Endoscopic placement of the small-bowel video capsule by using a capsule endoscope delivery device.

    Science.gov (United States)

    Holden, Jeremy P; Dureja, Parul; Pfau, Patrick R; Schwartz, Darren C; Reichelderfer, Mark; Judd, Robert H; Danko, Istvan; Iyer, Lalitha V; Gopal, Deepak V

    2007-05-01

    Capsule endoscopy performed via the traditional peroral route is technically challenging in patients with dysphagia, gastroparesis, and/or abnormal upper-GI (UGI) anatomy. To describe the indications and outcomes of cases in which the AdvanCE capsule endoscope delivery device, which has recently been cleared by the Food and Drug Administration, was used. Retrospective, descriptive, case series. Tertiary care, university hospital. We report a case series of 16 consecutive patients in whom the AdvanCE delivery device was used. The study period was May 2005 through July 2006. Endoscopic delivery of the video capsule to the proximal small bowel by using the AdvanCE delivery device. Indications, technique, and completeness of small bowel imaging in patients who underwent endoscopic video capsule delivery. The AdvanCE delivery device was used in 16 patients ranging in age from 3 to 74 years. The primary indications for endoscopic delivery included inability to swallow the capsule (10), altered UGI anatomy (4), and gastroparesis (2). Of the 4 patients with altered UGI anatomy, 3 had dual intestinal loop anatomy (ie, Bilroth-II procedure, Whipple surgery, Roux-en-Y gastric bypass) and 1 had a failed Nissen fundoplication. In all cases, the capsule was easily deployed without complication, and complete small intestinal imaging was achieved. Small patient size. Endoscopic placement of the Given PillCam by use of the AdvanCE delivery device was safe and easily performed in patients for whom capsule endoscopy would otherwise have been contraindicated or technically challenging.

  16. Ingestible wireless capsules for enhanced diagnostic inspection of gastrointestinal tract

    Science.gov (United States)

    Rasouli, Mahdi; Kencana, Andy Prima; Huynh, Van An; Ting, Eng Kiat; Lai, Joshua Chong Yue; Wong, Kai Juan; Tan, Su Lim; Phee, Soo Jay

    2011-03-01

    Wireless capsule endoscopy has become a common procedure for diagnostic inspection of gastrointestinal tract. This method offers a less-invasive alternative to traditional endoscopy by eliminating uncomfortable procedures of the traditional endoscopy. Moreover, it provides the opportunity for exploring inaccessible areas of the small intestine. Current capsule endoscopes, however, move by peristalsis and are not capable of detailed and on-demand inspection of desired locations. Here, we propose and develop two wireless endoscopes with maneuverable vision systems to enhance diagnosis of gastrointestinal disorders. The vision systems in these capsules are equipped with mechanical actuators to adjust the position of the camera. This may help to cover larger areas of the digestive tract and investigate desired locations. The preliminary experimental results showed that the developed platform could successfully communicate with the external control unit via human body and adjust the position of camera to limited degrees.

  17. Low power design of wireless endoscopy compression/communication architecture

    Directory of Open Access Journals (Sweden)

    Zitouni Abdelkrim

    2018-05-01

    Full Text Available A wireless endoscopy capsule represents an efficient device interesting on the examination of digestive diseases. Many performance criteria’s (silicon area, dissipated power, image quality, computational time, etc. need to be deeply studied.In this paper, our interest is the optimization of the indicated criteria. The proposed methodology is based on exploring the advantages of the DCT/DWT transforms by combining them into single architecture. For arithmetic operations, the MCLA technique is used. This architecture integrates also a CABAC entropy coder that supports all binarization schemes. AMBA/I2C architecture is developed for assuring optimized communication.The comparisons of the proposed architecture with the most popular methods explained in related works show efficient results in terms dissipated power, hardware cost, and computation speed. Keywords: Wireless endoscopy capsule, DCT/DWT image compression, CABAC entropy coder, AMBA/I2C multi-bus architecture

  18. Gastric cancer missed at endoscopy

    African Journals Online (AJOL)

    Ahmed Gado

    2012-09-21

    Sep 21, 2012 ... fore endoscopy taking into account risk factors for cancer and the clinical presentation. Careful examination of the stomach during endoscopy should be performed in order not to miss any lesion. All gastric ulcers must be biopsied and a repeat endoscopy be performed following a course of acid suppres-.

  19. Intermittent Bowel Obstruction Due to a Retained Wireless Capsule Endoscope in a Patient with a Small Bowel Carcinoid Tumour

    Directory of Open Access Journals (Sweden)

    Jonathan R Strosberg

    2007-01-01

    Full Text Available A 43-year-old man with a history of metastatic carcinoid disease is presented. The patient had symptoms of chronic intermittent abdominal pain two years after undergoing a wireless capsule endoscopy procedure. Radiological examinations revealed a retained capsule endoscope, and the patient underwent exploratory laparotomy with capsule retrieval. To the authors’ knowledge, this is the first case presentation of chronic, partial small bowel obstruction caused by unrecognized retention of a capsule endoscope.

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

    Science.gov (United States)

    Makmun, Dadang

    2014-04-01

    Recently, Indonesia was ranked as the fourth most populous country in the world. Based on 2012 data, 85000 general practitioners and 25000 specialists are in service around the country. Gastrointestinal (GI) disease remains the most common finding in daily practise, in both outpatient and inpatient settings, and ranks fifth in causing mortality in Indonesia. Management of patients with GI disease involves all health-care levels with the main portion in primary health care. Some are managed by specialists in secondary health care or are referred to tertiary health care. GI endoscopy is one of the main diagnostic and therapeutic modalities in the management of GI disease. Development of GI endoscopy in Indonesia started before World War II and, today, many GI endoscopy procedures are conducted in Indonesia, both diagnostic and therapeutic. Based on August 2013 data, there are 515 GI endoscopists in Indonesia. Most GI endoscopists are competent in carrying out basic endoscopy procedures, whereas only a few carry out advanced endoscopy procedures, including therapeutic endoscopy. Recently, the GI endoscopy training system in Indonesia consists of basic GI endoscopy training of 3-6 months held at 10 GI endoscopy training centers. GI endoscopy training is also eligible as part of a fellowship program of consultant gastroenterologists held at six accredited fellowship centers in Indonesia. Indonesian Society for Digestive Endoscopy in collaboration with GI endoscopy training centers in Indonesia and overseas has been working to increase quality and number of GI endoscopists, covering both basic and advanced GI endoscopy procedures. © 2014 The Author. Digestive Endoscopy © 2014 Japan Gastroenterological Endoscopy Society.

  1. Endoscopy in endodontics.

    Science.gov (United States)

    Moshonov, Joshua; Nahlieli, Oded

    2011-01-01

    A successful outcome of endodontic treatment depends to a large extent on accurate intraoperative findings. Conventionally, micromirrors and microprobes have been used for this purpose. The dental operating microscope (DOM) has been implemented to enhance visibility during dental procedures. However, the microscope, a sizable tool, remains between operating field and the dental practitioner, making his ability to manipulate more complicated. Also, the interference of the hands and the handpiece with the visualization of the surgical field and inaccurate observation of the endodontic instruments during the procedure. Endoscopy reportedly provides the dentist with excellent vision and ease of use. It also provides a better intraoperative visualization in comparison with micromirrors. Further development of endoscopy made it possible to combine magnification, light, irrigation/suction and surgical microinstruments in one device. This combination could lead to an advanced root canal treatment technique.

  2. Development of a flexible cryo-instrument for gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    Lifton, L.J.

    1986-01-01

    Recent advances in therapeutic gastrointestinal endoscopy and cryosurgical techniques have caused an interest in creating a cryo-instrument for endoscopic use. The development of a prototype instrument for use in both upper gastrointestinal endoscopy and colonoscopy is described. This instrument is based on the expansion of high pressure carbon dioxide in a series of flexible tubes designed to fit through a 2.6 mm endoscopic accessory channel. This self-enclosed system has been used clinically for cryo-extraction of cauterized colonic polyps. Its potential use for treatment of gastrointestinal malignancies is discussed

  3. Wireless capsule endoscopy at Lagos State University Teaching ...

    African Journals Online (AJOL)

    Nigerian Journal of Gastroenterology and Hepatology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2013) >. Log in or Register to get access to full text downloads.

  4. Motion analysis in terms of wireless video capsule endoscopy

    OpenAIRE

    Autengruber, Markus

    2009-01-01

    El treball presentat suposa una visió general de l'"Endoscopia amb Càpsula de Vídeo Wireless" i la inspecció de sequències de contraccions intestinals amb les últimes tecnologies de visió per computador. Després de la observació preliminar dels fonaments mèdics requerits, la aplicació de visió per computador es presenta en aquestos termes. En essència, aquest treball proveïx una exhaustiva selecció, descripció i avaluació de cert conjunt de mètodes de processament d'imatges respecte a l'anàli...

  5. Endoscopy and surgery for obesity

    International Nuclear Information System (INIS)

    Mejia, Andres Felipe; Unigarro, Ivan; Bolanos, Eduardo; Chaux, Carlos Felipe

    2006-01-01

    Actually bariatric surgery appears to be a secure, feasible and durable option for patients with morbid obesity. Most of the complications that arise from bariatric surgery can be solved with the use of endoscopy avoiding the morbidity and mortality of a surgical intervention. This group of patients has become a challenge for the endoscopist and favours the development of interventional endoscopy

  6. [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.

  7. Capsule colonoscopy increases uptake of colorectal cancer screening

    Directory of Open Access Journals (Sweden)

    Groth Stefan

    2012-06-01

    Full Text Available Abstract Background Screening colonoscopy effectiveness is hampered by limited adherence by the general population. The present prospective study was performed to evaluate whether adding capsule colonoscopy to the endoscopic screening options increases uptake. Methods Invitation letters were sent to 2150 persons above the age of 55 insured with a German medical insurance company in the area of Rinteln, Lower Saxony with a baseline spontaneous annual screening colonoscopy uptake of 1 %. Both capsule or conventional colonoscopy were offered. Interested persons were given information about the two screening options by four local gastroenterologists and examinations were then performed according to screenees’ final choice. Results 154 persons sought further information, and 34 and 90 underwent conventional and capsule colonoscopy, respectively. Colonoscopy uptake was thus increased by the invitation process by 60 % (1.6 % vs. 1 %; p = 0.075, while the option of capsule endoscopy led to a fourfold increase of screening uptake (4.2 % vs. 1 %, p  Conclusions The present study suggests that offering the option of capsule colonoscopy increases uptake of endoscopic colorectal cancer screening. However, capsule endoscopy sensitivity for adenoma detection needs to be improved.

  8. Successful Treatment of Early-Stage Jejunum Adenocarcinoma by Endoscopic Mucosal Resection Using Double-Balloon Endoscopy: A Case Report

    Directory of Open Access Journals (Sweden)

    Hirobumi Suzuki

    2012-01-01

    Full Text Available Small bowel adenocarcinoma (SBA has generally been considered to have a poor prognosis because of nonspecific presentations and difficulties in detection of the disease. The advent of capsule endoscopy (CE and double-balloon endoscopy (DBE makes it possible to access to the small intestine for endoscopic interventions. We describe a successful case of early jejunum adenocarcinoma completely resected by endoscopic mucosal resection (EMR using double-balloon endoscopy (DBE. Early diagnosis and EMR using new technologies such as CE and DBE may improve the recognition of this disease that, at present, has a poor prognosis.

  9. Successful retrieval of retained video capsule endoscope using double balloon enteroscope: A case report and review of literature

    Directory of Open Access Journals (Sweden)

    Sudhir Jagdishprasad Gupta

    2017-01-01

    Full Text Available Video capsule endoscopy is now the first-line tool in evaluating and diagnosing obscure gastrointestinal bleeding, inflammatory bowel disease, and small bowel neoplasms. Capsule retention is an uncommon but clinically significant complication. How to best retrieve these retained capsules is currently being debated. In this case report, we describe a retained capsule successfully retrieved using double-balloon enteroscopy. This case also highlights the fact that capsule retention can occur even in the absence of signs and symptoms suggestive of intestinal obstruction.

  10. [Emergency endoscopy in children: experience of a digestive endoscopy department].

    Science.gov (United States)

    Pacchione, D; Mortilla, M G; Ricci, E; Bertoni, G; Conigliaro, R; Orsi, P; Bedogni, G; Lamborghini, A; Banchini, G

    1992-01-01

    Many changes and advances have been achieved in the last years, so that emergency endoscopy has now a definite role also in the diagnosis and treatment of diseases in childhood. In order to determinate main indications to endoscopic examination, and which are the most useful diagnostic and therapeutic measures that should be performed, we examined the records of 202 patients (aged 1 day-14 years) undergone emergency endoscopy from June 1979 to January 1990. Patients were referred to endoscopy because of foreign bodies or caustic ingestion, hematemesis, and in one patient a suspected intussusception. We didn't record any complication. Our study shows that emergency endoscopy has a definite role also in pediatric age and gives a diagnostic and therapeutic gain in the management of many diseases.

  11. Diamagnetically stabilized levitation control of an intraluminal magnetic capsule

    International Nuclear Information System (INIS)

    Lam, Michael; Mintchev, Martin

    2009-01-01

    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. 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 × 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

  12. Colonic motility and enema spreading

    International Nuclear Information System (INIS)

    Hardy, J.G.; Wood, E.; Clark, A.G.; Reynolds, J.R.; Queen's Medical Centre, Nottingham

    1986-01-01

    Radiolabelled enema solution was administered to eight healthy subjects, both in fasted and fed states. Enema spreading was monitored over a 4-h period using gamma scintigraphy and colonic motility was recorded simultaneously using a pressure sensitive radiotelemetry capsule. The rate and extent of enema dispersion were unaffected by eating. Spreading could be correlated with colonic motility and was inhibited by aboral propulsion of the colonic contents. (orig.)

  13. Real-time holographic endoscopy

    Science.gov (United States)

    Smigielski, Paul; Albe, Felix; Dischli, Bernard

    1992-08-01

    Some new experiments concerning holographic endoscopy are presented. The quantitative measurements of deformations of objects are obtained by the double-exposure and double- reference beam method, using either a cw-laser or a pulsed laser. Qualitative experiments using an argon laser with time-average holographic endoscopy are also presented. A video film on real-time endoscopic holographic interferometry was recorded with the help of a frequency-doubled YAG-laser working at 25 Hz for the first time.

  14. 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.

  15. 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

  16. [Endonasal skull base endoscopy].

    Science.gov (United States)

    Simal-Julián, Juan Antonio; Miranda-Lloret, Pablo; Pancucci, Giovanni; Evangelista-Zamora, Rocío; Pérez-Borredá, Pedro; Sanromán-Álvarez, Pablo; Perez-de-Sanromán, Laila; Botella-Asunción, Carlos

    2013-01-01

    The endoscopic endonasal techniques used in skull base surgery have evolved greatly in recent years. Our study objective was to perform a qualitative systematic review of the likewise systematic reviews in published English language literature, to examine the evidence and conclusions reached in these studies comparing transcranial and endoscopic approaches in skull base surgery. We searched the references on the MEDLINE and EMBASE electronic databases selecting the systematic reviews, meta-analyses and evidence based medicine reviews on skull based pathologies published from January 2000 until January 2013. We focused on endoscopic impact and on microsurgical and endoscopic technique comparisons. Full endoscopic endonasal approaches achieved gross total removal rates of craniopharyngiomas and chordomas higher than those for transcranial approaches. In anterior skull base meningiomas, complete resections were more frequently achieved after transcranial approaches, with a trend in favour of endoscopy with respect to visual prognosis. Endoscopic endonasal approaches minimised the postoperative complications after the treatment of cerebrospinal fluid (CSF) leaks, encephaloceles, meningoceles, craniopharyngiomas and chordomas, with the exception of postoperative CSF leaks. Randomized multicenter studies are necessary to resolve the controversy over endoscopic and microsurgical approaches in skull base surgery. Copyright © 2013 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  17. Colon cancer

    Science.gov (United States)

    Colorectal cancer; Cancer - colon; Rectal cancer; Cancer - rectum; Adenocarcinoma - colon; Colon - adenocarcinoma; Colon carcinoma ... eat may play a role in getting colon cancer. Colon cancer may be linked to a high-fat, ...

  18. Use of debridat in therapy of irritable colon syndrome

    International Nuclear Information System (INIS)

    Parfenov, A.I.

    1996-01-01

    It is shown that debridat is an effective means for treatment of patients with irritable colon syndrome. All patients underwent roentgenological and endoscopy examinations for determination of diagnosis and effect of their treatment

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

    OpenAIRE

    Lin, Meng-Chun; Dung, Lan-Rong; Weng, Ping-Kuo

    2006-01-01

    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 res...

  20. A New Concept for Magnetic Capsule Colonoscopy Based on an Electromagnetic System

    Directory of Open Access Journals (Sweden)

    Gioia Lucarini

    2015-03-01

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

  1. Electromagnetic Control System for Capsule Navigation: Novel Concept for Magnetic Capsule Maneuvering and Preliminary Study.

    Science.gov (United States)

    Lucarini, Gioia; Mura, Marco; Ciuti, Gastone; Rizzo, Rocco; Menciassi, Arianna

    The gastrointestinal tract is home of some of the most deadly human diseases. The main problems are related to the difficulty of accessing it for diagnosis or intervention and concomitant patient discomfort. The flexible endoscopy technique has established itself in medical practice due to its high diagnostic accuracy and reliability; however, several technical limitations still remain and the procedure is poorly tolerated by patients. The use of magnetic fields to control and steer endoscopic capsules is increasing in minimally invasive procedures. In fact, magnetic coupling is one of the few physical phenomena capable of transmitting motion beyond a physical barrier, allowing for the compact design of the device itself. In this framework, the authors present the preliminary design and assessment of a magnetic coupling for magnetic endoscopic capsules considering an electromagnetic approach. In particular, a novel toroidal electromagnet is proposed as the control and driving system. The system concept, design, and preliminary results are reported.

  2. 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

  3. Digestive Endoscopy in Morocco: What Future Perspectives?

    Directory of Open Access Journals (Sweden)

    Professor Adil Ibrahimi

    2016-12-01

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

  4. Wireless pH capsule--yield in clinical practice.

    Science.gov (United States)

    Roman, S; Mion, F; Zerbib, F; Benamouzig, R; Letard, J C; Bruley des Varannes, S

    2012-03-01

    Wireless pH monitoring is one of the recent technologies that focus on improving the diagnosis of gastroesophageal reflux disease (GERD). The capsule, which is fixed within the esophagus, transmits data via telemetry to an external receiver. The capsule is usually inserted 6 cm above the squamocolumnar junction during an upper endoscopy. The standard recording duration is 48 hours but this can be extended to 96 hours. The wireless capsule has been shown to be at least as accurate as the conventional catheter for the monitoring of esophageal pH. Normal pH values have been established in three different series. The use of a wireless capsule provides an increased diagnostic yield for GERD compared with the conventional catheter. The increased yield is the result of higher sensitivity to detect both abnormal acid esophageal exposure and positive symptom-reflux association. This may be related both to the prolonged recording duration and to fewer dietary modifications and restrictions on activities. Several studies have shown that the pH capsule was better tolerated by patients than the conventional pH catheter. Mild-to-moderate chest pain represents the main side effect of the pH capsule: severe chest pain requiring endoscopic removal of the capsule is rare. The main indication for wireless capsule application is monitoring of distal esophageal pH for diagnostic purpose, particularly in patients with a normal endoscopic examination. The capsule technique has some limitations: costs are higher than conventional pH monitoring, misplacement may occur, and the sampling rate is lower. Finally, compared with pH-impedance monitoring, only acid reflux events can be evaluated. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Use of a real-time viewer for endoscopic deployment of capsule endoscope in the pediatric population.

    Science.gov (United States)

    Bass, Lee M; Misiewicz, Lawrence

    2012-11-01

    Wireless capsule endoscopy (WCE) is an increasingly used procedure for visualization of the small intestine. One challenge in pediatric WCE is the placement of the capsule in a population unable to swallow it for a variety of reasons. Here we present a novel use of the real-time (RT) viewer in the endoscopic deployment of the capsule endoscope. We performed a retrospective chart review on all WCE completed at the Children's Memorial Hospital from February 2010 to May 2011. Following a diagnostic upper endoscopy, the RT viewer was attached to the capsule recorder and image was noted before insertion. The endoscope and AdvanCE capsule delivery device were slowly advanced into duodenum while maintaining visualization on the RT viewer. A total of 17 patients who underwent a WCE with endoscopic placement were identified. They ranged in ages from 2 to 19 years. Thirteen patients required endoscopic placement because of the inability to swallow the capsule, whereas 4 were placed during a scheduled procedure to take advantage of sedation and airway protection. All of the 17 patients had successful deployment of the capsule into the duodenal lumen. In each case, the endoscopist was able to confirm capsule location in duodenum during scope withdrawal. There was no evidence of iatrogenic trauma or bleeding in any patient. There were 5 incomplete studies, a completion rate consistent with that described in the literature. The use of the RT viewer for endoscopic deployment of WCE is an effective technique to improve visualization of capsule placement in the pediatric population.

  6. Polydopamine-coated capsules

    Energy Technology Data Exchange (ETDEWEB)

    White, Scott R.; Sottos, Nancy R.; Kang, Sen; Baginska, Marta B.

    2018-04-17

    One aspect of the invention is a polymer material comprising a capsule coated with PDA. In certain embodiments, the capsule encapsulates a functional agent. The encapsulated functional agent may be an indicating agent, healing agent, protecting agent, pharmaceutical drug, food additive, or a combination thereof.

  7. Dual-head wireless powered video capsule based on new type of receiving coils.

    Science.gov (United States)

    Liu, Gang; Yan, Guozheng; Xu, Wenming; Kuang, Shuai

    2015-05-01

    Wireless capsule endoscopy (WCE) has been a great breakthrough in visually detecting the pathological changes of gastrointestinal (GI) wall, but the limit of viewing angle and power by batteries still hinder the wide application of WCE. In order to address these shortcomings, a dual-head video capsule system based on new type of receiving coils is presented. First, the dual-head video capsule system is designed, which could capture images of the whole GI tract in two channels, transforming the images into NTSC videos at a frame rate of 30 f s(-1) and transmitting the signals outside the body. Second, the wireless power transmission platform with new type of receiving coils is established to provide at least 108 mW of continuous, stable energy for the capsule. Then a prototype was fabricated and applied in animal experiments. The designed dual-head video capsule system is proved to be feasible and a potential solution for future clinical application.

  8. Colonic diseases: The value of US examination

    International Nuclear Information System (INIS)

    Hollerweger, Alois

    2007-01-01

    The colon is affected by a number of diseases, mainly inflammatory, ischemic, and neoplastic conditions. Depending upon clinical indications endoscopy, US, CT, or other radiological methods are used for evaluation. The fact that US is frequently used as the initial imaging method in patients with non-specific clinical symptoms allows for greater influence in further diagnostic evaluation and with treatment, provided the investigator is familiar with the features of different intestinal diseases. This article will describe the anatomical characteristics of the colon, the US technique for examination of the colon, and the typical US features of the more common diagnoses of the colon

  9. Fast volume rendering algorithm in a virtual endoscopy system

    Science.gov (United States)

    Kim, Sang H.; Kim, Jin K.; Ra, Jong Beom

    2002-05-01

    Recently, 3D virtual endoscopy has been used as an alternative noninvasive procedure for visualization of a hollow organ. In this paper, we propose a fast volume rendering scheme based on perspective ray casting for virtual endoscopy. As a pre-processing step, the algorithm divides a volume into hierarchical blocks and classifies them into opaque or transparent blocks. Then, the rendering procedure is as follows. In the first step, we perform ray casting only for sub-sampled pixels on the image plane, and determine their pixel values and depth information. In the second step, by reducing the sub-sampling factor by half, we repeat ray casting for newly added pixels, and their pixel values and depth information are determined. Here, the previously obtained depth information is utilized to reduce the processing time. This step is performed recursively until the full-size rendering image is acquired. Experiments conducted on a PC shows that the proposed algorithm can reduce the rendering time by 70-80% for the bronchus and colon endoscopy, compared with the brute-force ray casting scheme. Thereby, interactive rendering becomes more realizable in a PC environment without any specific hardware.

  10. Clinicoepidemiologic characterization and endoscopy in patients with colorectal cancer

    International Nuclear Information System (INIS)

    Hano Garcia, Olga Marina; Wood Rodriguez, Lisette; Villa Jimenez, Oscar Manuel

    2010-01-01

    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

  11. Schwannoma of the sigmoid colon

    OpenAIRE

    Çakır, Tuğrul; Aslaner, Arif; Yaz, Müjgan; Gündüz, Umut rıza

    2015-01-01

    Colonic schwannomas are very rare gastrointestinal tumours originating from Schwann cells, which form the neural sheath. Primary schwannomas of the lower gastrointestinal tract are very rare and usually benign in nature. However, if they are not surgically removed, malign degeneration can occur. We report a case of a 79-year-old woman who presented to our clinic with rectal bleeding and constipation. She underwent a lower gastrointestinal tract endoscopy. A mass subtotally obstructing the lum...

  12. [Endoscopy of the middle ear].

    Science.gov (United States)

    Ayache, Stéphane

    2010-12-20

    The otoscopy is a major point in a daily practice. The otoscope is usually used. In an ENT practice, the microscope is the main instrument but presents limits. The use of rigid endoscopes allows to refine considerably this otoscopy. In ear surgery, the endoscopy of the middle ear for ear chronic diseases has evolved, from an additional tool to the microscope towards an exclusive surgical procedure with its own indications, advantages and limits.

  13. Colonic Polyps

    Science.gov (United States)

    ... Colonic polyps grow in the large intestine, or colon. Most polyps are not dangerous. However, some polyps ... member with polyps Have a family history of colon cancer Most colon polyps do not cause symptoms. ...

  14. Radiologic and endoscopic correlation in Crohn's disease of the colon

    International Nuclear Information System (INIS)

    Czembirek, H.; Poetzi, R.; Tscholakoff, D.; Salomonowitz, E.; Wittich, G.; Vienna Univ.; Vienna Univ.

    1983-01-01

    A comparative assessment was carried out in 47 patients with double-contrast irrigoscopy (DCI), colonos-copy and edoscopy, the confirmed diagnosis being Crohn's disease in each of the patients. However, the histological finding of Crohn's disease was established in 19% only of the endoscopic biopsies. DCI enabled a more comprehensive assessment of the entire colon than was possible via endoscopy, since the right half of the colon could be visualized in less than 50% of the patients by the endoscopic method, whereas roentgenologic visualization of this part of the colon was possible in more than 90% of the patients. There was good agreement in respect of parts of the colon visualized both via endoscopy and via X-ray examination. As far as the assessment of deeper mucosal lesions was concerned, radiology proved superior, whereas endoscopy offered advantages in respect of changes on the level of the mucosa. (orig.) [de

  15. 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.

  16. 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.

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

    Science.gov (United States)

    Lin, Meng-Chun; Dung, Lan-Rong; Weng, Ping-Kuo

    2006-02-25

    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. 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. 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.

  18. Multidetector CT of the colon

    International Nuclear Information System (INIS)

    Luboldt, W.; Hoepffner, N.; Holzer, K.

    2003-01-01

    Multidetector technology, enabling faster imaging, higher spatial resolution and reduction in radiation dose, increases the role of CT in colonic diagnostic. The higher spatial resolution in the z-direction also changes the way to analyze the images. Instead of reading axial sections, now the colon can be systematically assessed in 3D by scrolling through multiplanar reconstructions or in CT colonography by virtual endoscopy. With ongoing improvements in computer-aided diagnosis CT colonography becomes an alternative to fiberoptic colonocopy for screening (http://www.multiorganscreening.org). In this article we propose a CT examination protocol for the colon, describe the typical imaging findings of different colonic diseases, and summarize the current status of CT colonography. (orig.)

  19. An x-ray-based capsule for colorectal cancer screening incorporating single photon counting technology

    Science.gov (United States)

    Lifshitz, Ronen; Kimchy, Yoav; Gelbard, Nir; Leibushor, Avi; Golan, Oleg; Elgali, Avner; Hassoon, Salah; Kaplan, Max; Smirnov, Michael; Shpigelman, Boaz; Bar-Ilan, Omer; Rubin, Daniel; Ovadia, Alex

    2017-03-01

    An ingestible capsule for colorectal cancer screening, based on ionizing-radiation imaging, has been developed and is in advanced stages of system stabilization and clinical evaluation. The imaging principle allows future patients using this technology to avoid bowel cleansing, and to continue the normal life routine during procedure. The Check-Cap capsule, or C-Scan ® Cap, imaging principle is essentially based on reconstructing scattered radiation, while both radiation source and radiation detectors reside within the capsule. The radiation source is a custom-made radioisotope encased in a small canister, collimated into rotating beams. While traveling along the human colon, irradiation occurs from within the capsule towards the colon wall. Scattering of radiation occurs both inside and outside the colon segment; some of this radiation is scattered back and detected by sensors onboard the capsule. During procedure, the patient receives small amounts of contrast agent as an addition to his/her normal diet. The presence of contrast agent inside the colon dictates the dominant physical processes to become Compton Scattering and X-Ray Fluorescence (XRF), which differ mainly by the energy of scattered photons. The detector readout electronics incorporates low-noise Single Photon Counting channels, allowing separation between the products of these different physical processes. Separating between radiation energies essentially allows estimation of the distance from the capsule to the colon wall, hence structural imaging of the intraluminal surface. This allows imaging of structural protrusions into the colon volume, especially focusing on adenomas that may develop into colorectal cancer.

  20. Deep Learning in Gastrointestinal Endoscopy.

    Science.gov (United States)

    Patel, Vivek; Armstrong, David; Ganguli, Malika; Roopra, Sandeep; Kantipudi, Neha; Albashir, Siwar; Kamath, Markad V

    2016-01-01

    Gastrointestinal (GI) endoscopy is used to inspect the lumen or interior of the GI tract for several purposes, including, (1) making a clinical diagnosis, in real time, based on the visual appearances; (2) taking targeted tissue samples for subsequent histopathological examination; and (3) in some cases, performing therapeutic interventions targeted at specific lesions. GI endoscopy is therefore predicated on the assumption that the operator-the endoscopist-is able to identify and characterize abnormalities or lesions accurately and reproducibly. However, as in other areas of clinical medicine, such as histopathology and radiology, many studies have documented marked interobserver and intraobserver variability in lesion recognition. Thus, there is a clear need and opportunity for techniques or methodologies that will enhance the quality of lesion recognition and diagnosis and improve the outcomes of GI endoscopy. Deep learning models provide a basis to make better clinical decisions in medical image analysis. Biomedical image segmentation, classification, and registration can be improved with deep learning. Recent evidence suggests that the application of deep learning methods to medical image analysis can contribute significantly to computer-aided diagnosis. Deep learning models are usually considered to be more flexible and provide reliable solutions for image analysis problems compared to conventional computer vision models. The use of fast computers offers the possibility of real-time support that is important for endoscopic diagnosis, which has to be made in real time. Advanced graphics processing units and cloud computing have also favored the use of machine learning, and more particularly, deep learning for patient care. This paper reviews the rapidly evolving literature on the feasibility of applying deep learning algorithms to endoscopic imaging.

  1. New Trends in Acute Management of Colonic Diverticular Bleeding

    OpenAIRE

    Cirocchi, Roberto; Grassi, Veronica; Cavaliere, Davide; Renzi, Claudio; Tabola, Renata; Poli, Giulia; Avenia, Stefano; Farinella, Eleonora; Arezzo, Alberto; Vettoretto, Nereo; D?Andrea, Vito; Binda, Gian Andrea; Fingerhut, Abe

    2015-01-01

    Abstract Colonic diverticular disease is the most common cause of lower gastrointestinal bleeding. In the past, this condition was usually managed with urgent colectomy. Recently, the development of endoscopy and interventional radiology has led to a change in the management of colonic diverticular bleeding. The aim of this systematic review is to define the best treatment for colonic diverticular bleeding. A systematic bibliographic research was performed on the online databases for studies ...

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

    NARCIS (Netherlands)

    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.

    2016-01-01

    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

  3. Appropriateness of Referrals for Upper Gastrointestinal Endoscopy ...

    African Journals Online (AJOL)

    Background: Uncomplicated dyspepsia has a low predictive value in diagnosing upper gastrointestinal organic disease making early endoscopy essential. Objective: To assess the reliability of clinical information in the diagnosis of organic disease in patients referred for upper gastrointestinal endoscopy. Methods: Patients ...

  4. Unsedated Flexible Upper Gastrointestinal Endoscopy: Need for ...

    African Journals Online (AJOL)

    Background: To determine the incidence of oxygen desaturation and whether routine oxygen monitoring is necessary during unsedated diagnostic flexible upper gastrointestinal endoscopy. Methods: A prospective study involving 54 consecutive in and out patients who had diagnostic upper gastrointestinal endoscopy at ...

  5. Diagnostic indications for upper gastrointestinal endoscopy ...

    African Journals Online (AJOL)

    Background/Aim: Upper gastrointestinal (GI) endoscopy now assumes a prominent role in the diagnosis and therapy of upper GI diseases. Some indications for upper gastrointestinal endoscopy include dyspepsia, dysphagia, peptic ulcer disease (PUD) and upper gastrointestinal bleeding. This study aimed to review the ...

  6. 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.

  7. Capsule enteroscopy and radiology of the small intestine

    International Nuclear Information System (INIS)

    Fork, Frans-Thomas; Aabakken, Lars

    2007-01-01

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

  8. 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.

  9. 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

  10. 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.

  11. 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.

  12. Hollow Microporous Organic Capsules

    Science.gov (United States)

    Li, Buyi; Yang, Xinjia; Xia, Lingling; Majeed, Muhammad Irfan; Tan, Bien

    2013-01-01

    Fabrication of hollow microporous organic capsules (HMOCs) could be very useful because of their hollow and porous morphology, which combines the advantages of both microporous organic polymers and non-porous nanocapsules. They can be used as storage materials or reaction chambers while supplying the necessary path for the design of controlled uptake/release systems. Herein, the synthesis of HMOCs with high surface area through facile emulsion polymerization and hypercrosslinking reactions, is described. Due to their tailored porous structure, these capsules possessed high drug loading efficiency, zero-order drug release kinetics and are also demonstrated to be used as nanoscale reactors for the prepareation of nanoparticles (NPs) without any external stabilizer. Moreover, owing to their intrinsic biocompatibility and fluorescence, these capsules exhibit promising prospect for biomedical applications. PMID:23820511

  13. Video-based measurements for wireless capsule endoscope tracking

    International Nuclear Information System (INIS)

    Spyrou, Evaggelos; Iakovidis, Dimitris K

    2014-01-01

    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)

  14. Video-based measurements for wireless capsule endoscope tracking

    Science.gov (United States)

    Spyrou, Evaggelos; Iakovidis, Dimitris K.

    2014-01-01

    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.

  15. Gelatin capsule in stomach (image)

    Science.gov (United States)

    ... detect the presence of intestinal parasites. A weighted gelatin capsule attached to a string is swallowed and left in place. After about 4 hours, the gelatin capsule is pulled out of the stomach by ...

  16. Stray energy transfer during endoscopy.

    Science.gov (United States)

    Jones, Edward L; Madani, Amin; Overbey, Douglas M; Kiourti, Asimina; Bojja-Venkatakrishnan, Satheesh; Mikami, Dean J; Hazey, Jeffrey W; Arcomano, Todd R; Robinson, Thomas N

    2017-10-01

    Endoscopy is the standard tool for the evaluation and treatment of gastrointestinal disorders. While the risk of complication is low, the use of energy devices can increase complications by 100-fold. The mechanism of increased injury and presence of stray energy is unknown. The purpose of the study was to determine if stray energy transfer occurs during endoscopy and if so, to define strategies to minimize the risk of energy complications. A gastroscope was introduced into the stomach of an anesthetized pig. A monopolar generator delivered energy for 5 s to a snare without contacting tissue or the endoscope itself. The endoscope tip orientation, energy device type, power level, energy mode, and generator type were varied to mimic in vivo use. The primary outcome (stray current) was quantified as the change in tissue temperature (°C) from baseline at the tissue closest to the tip of the endoscope. Data were reported as mean ± standard deviation. Using the 60 W coag mode while changing the orientation of the endoscope tip, tissue temperature increased by 12.1 ± 3.5 °C nearest the camera lens (p energy transfer (p = 0.04 and p = 0.002, respectively) as did utilizing the low-voltage cut mode (6.6 ± 0.5 °C, p energy transfer compared to a standard generator (1.5 ± 3.5 °C vs. 9.5 ± 0.8 °C, p energy is transferred within the endoscope during the activation of common energy devices. This could result in post-polypectomy syndrome, bleeding, or perforation outside of the endoscopist's view. Decreasing the power, utilizing low-voltage modes and/or an impedance-monitoring generator can decrease the risk of complication.

  17. 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

  18. Clinical applications of endoscopy in otology

    Science.gov (United States)

    Poe, Dennis S.

    1993-07-01

    The role of endoscopes in otologic surgery is growing as optical systems become increasingly sophisticated with smaller diameters and improved resolution. This author has performed 52 transtympanic middle ear endoscopic procedures in the office since 1990. Endoscopy, as a diagnostic procedure, was found to be a valuable technique yielding high quality examinations that eliminated the need for surgical exploration in all but one patient. Examinations were well tolerated, and no complications have occurred. It is anticipated that endoscopy will become an important technique for diagnostic middle ear exploration. Surgical intervention by endoscopy may prove useful in the future as dedicated otologic instruments become available, and laser systems are integrated.

  19. Comparison of esophageal placement of Bravo capsule system under direct endoscopic guidance with conventional placement method

    Directory of Open Access Journals (Sweden)

    Aijaz A Sofi

    2010-10-01

    Full Text Available Aijaz A Sofi, Charles Filipiak, Thomas Sodeman, Usman Ahmad, Ali Nawras, Isam DaboulDepartment of Medicine, Division of Gastroenterology, University of Toledo Medical Center, Toledo, Ohio, USABackground: Conventional placement of a wireless esophageal pH monitoring device in the esophagus requires initial endoscopy to determine the distance to the gastroesophageal junction. Blind placement of the capsule by the Bravo delivery system is followed by repeat endoscopy to confirm placement. Alternatively, the capsule can be placed under direct vision during endoscopy. Currently there are no published data comparing the efficiency of one method over the other. The objective of this study was to compare the method of Bravo wireless pH deviceplacement under direct visualization with the conventional method.Methods: A retrospective study involving 58 patients (29 patients with indirect and 29 patients with direct visualization who had Bravo capsule placement. The physician endoscopy procedure notes, nurse’s notes, postprocedure notes, recovery notes, and pH monitoring results were reviewed. The safety of the procedures, length of the procedures, and patient tolerability were evaluated.Results: None of the 58 patients had early detachment of the device and had no immediate procedure-related complications. The overall incidence of complications in both the groups was similar. No failures due to the technique were noted in either group. Average amount of time taken for the procedure was similar in both groups.Conclusion: The technique of placing a Bravo pH device under direct visualization is as safe and effective as the conventional method. In addition, there is an added advantage of avoiding a second endoscopic intubation in the direct visualization technique.Keywords: Bravo capsule, technique, esophageal pH monitoring

  20. Motion Analysis for Duplicate Frame Removal in Wireless Capsule Endoscope Video

    OpenAIRE

    Min Kook Choi; Hyun Gyu Lee; Ryan You; Byeong-Seok Shin; Sang-Chul Lee

    2010-01-01

    Wireless capsule Endoscopy (WCE) has rapidly shown its wide applications in medical domain last ten years thanks to its noninvasiveness for patients and support for thorough inspection through a patient-s entire digestive system including small intestine. However, one of the main barriers to efficient clinical inspection procedure is that it requires large amount of effort for clinicians to inspect huge data collected during the examination, i.e., over 55,000 frames in vi...

  1. Pediatric Patient and Parental Anxiety and Impressions Related to Initial Gastrointestinal Endoscopy: A Japanese Multicenter Questionnaire Study

    Directory of Open Access Journals (Sweden)

    Shin-ichiro Hagiwara

    2015-01-01

    Full Text Available Objective. To assess anxiety among pediatric patients and their parents related to initial gastrointestinal endoscopy. Methods. Patients aged <19 years undergoing initial gastrointestinal (GI endoscopy and their parents were invited to complete a self-administered questionnaire related to endoscopy in 13 institutions in Japan. Results. The subjects were 128 children, aged 1 month to 17 years. Forty-eight patients (37.5% underwent esophagogastroduodenoscopy (EGD, 32 (25% underwent colonoscopy (CS, 39 (30.5% underwent both EGD and CS, 3 (2.3% underwent balloon enteroscopy (BE, 3 (2.3% underwent capsule endoscopy (CE, and 3 (2.3% underwent CE and other endoscopic procedures. In the preendoscopy questionnaire, the most common concerns of the patients and parents before undergoing the procedure were “Pain” (45% of the patients underwent EGD or BE via the oral approach, and 52% of the patients underwent CS or BE via the anal approach and “Procedural accidents related to the endoscopy” (63% of parents. In the postendoscopy questionnaire, the most common difficulty that patients and parents actually experienced before and after undergoing the procedure was “Hunger.” Conclusion. A preparatory intervention including an explanation regarding specific concerns before initial GI endoscopy, which this study revealed, could reduce anxiety experienced by both pediatric patients and parents.

  2. CT of colonic diverticulitis

    International Nuclear Information System (INIS)

    Doringer, E.; Ferner, R.

    1990-01-01

    33 patients with clinically suspected diverticulitis of the colon were studied prospectively by CT. The predictive value of symptoms, such as thickening of the colonic wall (86.6%), inflammatory changes of the pericolic fatty tissue (87.5%), the presence of diverticula (73.3%) and abscess formation (100%), were examined separately and their significance was evaluated. Our study was performed mainly on clinically less severe cases of diverticulitis. True positive results by CT were reached in 20/21 cases (sensitivity = 95.2%), true negative findings in 9/12 (specificity = 75.0%). The results of CT examinations were compared with those of contrast enemas (n=24) and/or endoscopy (n=6). The number of cases was too low to achieve statistic significance; the relatively high percentage of questionably positive results shows the difficulties inherent in these methods. Our study shows that CT is a good means to demonstrate even less severe forms of colonic diverticulitis with sufficient reliability. (orig.) [de

  3. Development of Bariatric and Metabolic Endoscopy

    Directory of Open Access Journals (Sweden)

    Shi-Han Li

    2018-01-01

    Conclusions: Bariatric and metabolic endoscopy would help obese people lose weight or prepare for bariatric surgery and hopefully alleviate some of the complications of bariatric procedures. Adequate studies and data are still needed for the new endoscopic devices.

  4. Indicators of Safety Compromise in Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Mark R Borgaonkar

    2012-01-01

    Full Text Available The growth in the use of endoscopy to diagnose and treat many gastointestinal disorders, and its central role in cancer screening programs, has led to a significant increase in the number of procedures performed. This growth, however, has also led to many variations in, among others, the provision of services, the choice of sedative medications and the training of providers. The recognition of the significance of quality in endoscopy has prompted several countries, including Canada, to initiate efforts to adopt nationwide quality improvement programs. The Canadian Association of Gastroenterology formed a committee to review endoscopy and quality with the aim of stimulating improvement. This article focuses specifically on patient safety indicators that were developed at a consensus conference aimed at generating a broad range of recommendations for selected endoscopic procedures, which if adopted, could lead to significant changes in how endoscopy services are provided.

  5. 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.

  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. Microrobotics for future gastrointestinal endoscopy.

    Science.gov (United States)

    Menciassi, Arianna; Quirini, Marco; Dario, Paolo

    2007-01-01

    The impulse given by robotic technologies and imaging techniques to the development of a new way to conceive and perform surgery is clearly visible. Nowadays, minimally invasive surgical (MIS) procedures are often performed with the assistance of robots, such as the Da Vinci master-slave system, the AESOP robot with voice control, etc. In addition, mechatronic technologies are becoming the elective technologies for designing advanced hand-held surgical tools. The introduction of robotic technologies in endoscopy has been slower than in MIS, since the development of miniaturized robotic components for entering the small orifices of the human body is difficult. On the other hand, the large contribution that robotic technologies could bring to endoluminal techniques has been evident since the first development of instrumented catheters. In the 1990s, there was an increasing activity in the application of robotic technologies to improve endoscopic procedures in the gastrointestinal tract. The objective of robotic colonoscopy and gastroscopy was to obtain more effective diagnoses in terms of reduced pain for the patients, and to make uniform the diagnostic procedures, which too often depended on the manual abilities of the endoscopist. Currently, the availability of more reliable robotic technologies for miniaturization of size and integration of functions has allowed to conceive and develop robotic pills for the early screening of the digestive tract, with dramatic potential advantages for patients, endoscopists, and healthcare system.

  8. Virtual MR endoscopy of the ventricles prior to neurosurgical interventional endoscopy - evaluation of different presentation techniques

    International Nuclear Information System (INIS)

    Lemke, A.J.; Schurig-Urbaniak, A.M.; Niehues, S.M.; Felix, R.; Liebig, T.

    2004-01-01

    Purpose: In the past, virtual endoscopies have been performed for planning of endoscopic interventions or for diagnostic purposes in various organ systems with increasing frequency. This study evaluates the ability of virtual ventricular endoscopy to depict anatomical structures and the use for planning of real endoscopy. Materials and Methods: In a prospective study, 4 volunteers and 8 patients were examined with MRI. In 3 of the patients endoscopy was performed by our neurosurgeons thereafter. The calculation of the virtual endoscopy was based on 1 mm sagittal T2-weighted images. Comparison of surface rendering and volume rendering was made by means of video sequencing of individual views, and these were compared with the intraoperative endoscopic videos concerning the depictability of anatomical landmarks. Results: The reconstructions using volume rendering were more significant and easier to calculate than those based on surface rendering. Virtual endoscopy in the transparent mode allowed visualization of hazardous structures outside the ventricular system such as the basilar artery tip. Transparent 3D images of the ventricles gave a good overview on the depicted structures and enabled a better orientation during the virtual camera flight than surface rendered views. Conclusion: MR-based virtual endoscopy of the ventricular system can be obtained on the basis of surface- and volume-rendered views of sagittal T2-weighted thin sections. Preoperative utilization of this method simplifies the planning of endoscopy by visualization of anatomical structures. (orig.)

  9. 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.

  10. Abundance and co-occurrence of extracellular capsules increase environmental breadth: Implications for the emergence of pathogens.

    Science.gov (United States)

    Rendueles, Olaya; Garcia-Garcerà, Marc; Néron, Bertrand; Touchon, Marie; Rocha, Eduardo P C

    2017-07-01

    Extracellular capsules constitute the outermost layer of many bacteria, are major virulence factors, and affect antimicrobial therapies. They have been used as epidemiological markers and recently became vaccination targets. Despite the efforts to biochemically serotype capsules in a few model pathogens, little is known of their taxonomic and environmental distribution. We developed, validated, and made available a computational tool, CapsuleFinder, to identify capsules in genomes. The analysis of over 2500 prokaryotic genomes, accessible in a database, revealed that ca. 50% of them-including Archaea-encode a capsule. The Wzx/Wzy-dependent capsular group was by far the most abundant. Surprisingly, a fifth of the genomes encode more than one capsule system-often from different groups-and their non-random co-occurrence suggests the existence of negative and positive epistatic interactions. To understand the role of multiple capsules, we queried more than 6700 metagenomes for the presence of species encoding capsules and showed that their distribution varied between environmental categories and, within the human microbiome, between body locations. Species encoding capsules, and especially those encoding multiple capsules, had larger environmental breadths than the other species. Accordingly, capsules were more frequent in environmental bacteria than in pathogens and, within the latter, they were more frequent among facultative pathogens. Nevertheless, capsules were frequent in clinical samples, and were usually associated with fast-growing bacteria with high infectious doses. Our results suggest that capsules increase the environmental range of bacteria and make them more resilient to environmental perturbations. Capsules might allow opportunistic pathogens to profit from empty ecological niches or environmental perturbations, such as those resulting from antibiotic therapy, to colonize the host. Capsule-associated virulence might thus be a by-product of environmental

  11. Abundance and co-occurrence of extracellular capsules increase environmental breadth: Implications for the emergence of pathogens.

    Directory of Open Access Journals (Sweden)

    Olaya Rendueles

    2017-07-01

    Full Text Available Extracellular capsules constitute the outermost layer of many bacteria, are major virulence factors, and affect antimicrobial therapies. They have been used as epidemiological markers and recently became vaccination targets. Despite the efforts to biochemically serotype capsules in a few model pathogens, little is known of their taxonomic and environmental distribution. We developed, validated, and made available a computational tool, CapsuleFinder, to identify capsules in genomes. The analysis of over 2500 prokaryotic genomes, accessible in a database, revealed that ca. 50% of them-including Archaea-encode a capsule. The Wzx/Wzy-dependent capsular group was by far the most abundant. Surprisingly, a fifth of the genomes encode more than one capsule system-often from different groups-and their non-random co-occurrence suggests the existence of negative and positive epistatic interactions. To understand the role of multiple capsules, we queried more than 6700 metagenomes for the presence of species encoding capsules and showed that their distribution varied between environmental categories and, within the human microbiome, between body locations. Species encoding capsules, and especially those encoding multiple capsules, had larger environmental breadths than the other species. Accordingly, capsules were more frequent in environmental bacteria than in pathogens and, within the latter, they were more frequent among facultative pathogens. Nevertheless, capsules were frequent in clinical samples, and were usually associated with fast-growing bacteria with high infectious doses. Our results suggest that capsules increase the environmental range of bacteria and make them more resilient to environmental perturbations. Capsules might allow opportunistic pathogens to profit from empty ecological niches or environmental perturbations, such as those resulting from antibiotic therapy, to colonize the host. Capsule-associated virulence might thus be a by

  12. Colonic localization of indium-111 labeled leukocytes in active Behcet's disease

    International Nuclear Information System (INIS)

    Harre, R.G.; Conrad, G.R.; Seabold, J.E.

    1988-01-01

    A patient with known Behcet's disease demonstrated intense colonic localization of In-111 labeled leukocytes. Gastrointestinal involvement had not been previously manifested, but extensive colonic inflammation was documented by endoscopy. This case illustrates the utility of In-111 labeled leukocyte imaging for detecting active bowel disease in a debilitated patient with documented Behcet's vasculitis

  13. Adhesive capsulitis of the shoulder.

    Science.gov (United States)

    Neviaser, Andrew S; Neviaser, Robert J

    2011-09-01

    Adhesive capsulitis is characterized by painful, gradual loss of active and passive shoulder motion resulting from fibrosis and contracture of the joint capsule. Other shoulder pathology can produce a similar clinical picture, however, and must be considered. Management is based on the underlying cause of pain and stiffness, and determination of the etiology is essential. Subtle clues in the history and physical examination can help differentiate adhesive capsulitis from other conditions that cause a stiff, painful shoulder. The natural history of adhesive capsulitis is a matter of controversy. Management of true capsular restriction of motion (ie, true adhesive capsulitis) begins with gentle, progressive stretching exercises. Most patients improve with nonsurgical treatment. Indications for surgery should be individualized. Failure to obtain symptomatic improvement and continued functional disability following ≥6 months of physical therapy is a general guideline for surgical intervention. Diligent postoperative therapy to maintain motion is required to minimize recurrence of adhesive capsulitis.

  14. Colonic Diseases

    Science.gov (United States)

    ... Ulcerative colitis - ulcers of the colon and rectum Diverticulitis - inflammation or infection of pouches in the colon Irritable bowel syndrome - an uncomfortable condition causing abdominal cramping and other symptoms Treatment for colonic diseases varies greatly depending on the disease and its ...

  15. A Technical Review and Clinical Assessment of the Wireless Motility Capsule

    OpenAIRE

    Saad, Richard J.; Hasler, William L.

    2011-01-01

    The wireless motility/pH capsule (WMC) is an orally ingested, nondigestible, data recording device that enables the simultaneous assessment of regional and whole gut transit. Approved by the US Food and Drug Administration for the evaluation of patients with suspected delayed gastric emptying and the evaluation of colonic transit time in patients with chronic idiopathic constipation, this capsule continuously measures the temperature, pH, and pressure of its surrounding environment while trav...

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

    Science.gov (United States)

    Liedlgruber, Michael; Uhl, Andreas

    2011-01-01

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

  17. [Value of deep small-bowel endoscopy in the diagnosis of Crohn's disease].

    Science.gov (United States)

    Zhang, Shao-Heng; Xu, Jun; Qing, Qing; Zhi, Fa-Chao; Bai, Yang; Xu, Zhi-Min; Jiang, Bo; Zhang, Ya-Li; Chen, Ye

    2011-04-01

    To evaluate the value of deep small-bowel endoscopy (DSBE) in the diagnosis of Crohns disease (CD). The endoscopic and clinical data of 54 patients with CD receiving capsule endoscopy (CE) and double-balloon enteroscopy (DBE) between January, 2004 and December, 2008 were summarized and analyzed retrospectively. The main indications for DSBE in our series were suspected CD (42.6%) and obscure gastrointestinal bleeding (25.9%). DSBE was obviously superior to barium imaging. The detection rate of CD was significantly higher with DSBE (92.6%) than with ileocolonoscopy (75.9%, P=0.017), and DSBE provides much more detailed descriptions of specific endoscopic features such as segmental distribution and lumen changes. DSBE significantly improve the diagnostic efficiency, giving priority to offer a guide and raise suspected diagnosis for CD. DSBE is a valuable modality for detecting CD lesions in the jejunum and ileum and for evaluating lesion involvement and severity. The combination with a comprehensive analysis of routine imaging findings, gastro endoscopy, and clinical data can further enhance the diagnostic efficiency of DSBE.

  18. Virtual reality simulators for gastrointestinal endoscopy training

    Science.gov (United States)

    Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

    2014-01-01

    The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees’ learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application. PMID:24527175

  19. Virtual reality simulators for gastrointestinal endoscopy training.

    Science.gov (United States)

    Triantafyllou, Konstantinos; Lazaridis, Lazaros Dimitrios; Dimitriadis, George D

    2014-01-16

    The use of simulators as educational tools for medical procedures is spreading rapidly and many efforts have been made for their implementation in gastrointestinal endoscopy training. Endoscopy simulation training has been suggested for ascertaining patient safety while positively influencing the trainees' learning curve. Virtual simulators are the most promising tool among all available types of simulators. These integrated modalities offer a human-like endoscopy experience by combining virtual images of the gastrointestinal tract and haptic realism with using a customized endoscope. From their first steps in the 1980s until today, research involving virtual endoscopic simulators can be divided in two categories: investigation of the impact of virtual simulator training in acquiring endoscopy skills and measuring competence. Emphasis should also be given to the financial impact of their implementation in endoscopy, including the cost of these state-of-the-art simulators and the potential economic benefits from their usage. Advances in technology will contribute to the upgrade of existing models and the development of new ones; while further research should be carried out to discover new fields of application.

  20. [Colonic polyps in children. Experience with polypectomy].

    Science.gov (United States)

    Güitrón, A; Adalid, R; Nares, J; Mena, G; Gutiérrez, J A

    1999-01-01

    Colonic polyp, the most common gastrointestinal tumor in children, is considered a cause of rectal bleeding in the pediatric population. Colonoscopy is the "gold standard" procedure in diagnosis and therapeutic. To know the incidence and symptomatology of colonic polyps in children to remark on the usefulness of the endoscopic examination. PATIENTS-METHODS AND RESULTS: Between 1985 and 1996, over 1,000 colonoscopies were performed on 50 children between 8 months and 14 years old. The patients had colonic polyps and lower gastrointestinal bleeding. In 40 cases polyps were solitary, 82% were located in rectum sigmoid, and 80% of polyps were found to be juvenile (retention). There were no complications associated with diagnostic and therapeutic endoscopy. The endoscopic method was shown to be very useful for diagnosis as well as treatment of the colonic polyps in children.

  1. 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.

  2. 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.

  3. Development of capsule assembling apparatus

    International Nuclear Information System (INIS)

    Tayama, Yoshinobu; Kanazawa, Yoshiharu; Sozawa, Shizuo; Kawamata, Kazuo; Shizuoka, Yoshihiro; Onizawa, Satoshi; Nakagawa, Tetsuya

    2012-01-01

    The service of JMTR hot laboratory, associated with the Japan Materials Testing Reactor, was started on 1971 to examine specimens irradiated mainly in the JMTR. A wide variety of post irradiation examinations for research and development of nuclear fuels and materials are available in the JMTR hot laboratory. This laboratory has an advantage that its hot cell is connected with JMTR by a canal directly, and it is easy to transport irradiated capsule and specimens. New power ramping test for the high burn-up fuels by using the JMTR has been planed. The power ramping test using a boiling water capsule facility needs a re-capsuling of fuel rods for re-irradiation, and a modification of the facility up to about 100 GWD/t were necessary. This report introduces the new handling techniques and capsule assembling apparatus for the boiling water capsule facility. (author)

  4. Gastrointestinal endoscopy at Amana Municipal Referral Hospital in ...

    African Journals Online (AJOL)

    Gastrointestinal endoscopy at Amana Municipal Referral Hospital in Tanzania: reasons for referral and findings. ... endoscopy findings observed falls within normal range. These findings are important for further development of the endoscopy unit, for streamlining services, training of the required skills, and for planning.

  5. 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.

  6. Colon interposition

    International Nuclear Information System (INIS)

    Isolauri, J.; Tampere Univ. Central Hospital; Paakkala, T.; Arajaervi, P.; Markkula, H.

    1987-01-01

    Colon interposition was carried out in 12 patients with oesophageal carcinoma and on 38 patients with benign oesophageal disease an average of 71 months before the radiographic examination. Various ischaemic changes including 'jejunization', loss of haustration and stricture formation were observed in 15 cases. In 12 patients one or several diverticula were seen in the colon graft. Reflux was observed in 17 cases in supine position. Double contrast technique in the examination of interposed colon is recommended. (orig.)

  7. An Innovative Wireless Endoscopic Capsule With Spherical Shape.

    Science.gov (United States)

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

    2017-02-01

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

  8. 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,

  9. Three-dimensional endoscopy in sinus surgery.

    Science.gov (United States)

    Singh, Ameet; Saraiya, Rupali

    2013-02-01

    Surgical endoscopy revolutionized the management of disease in nearly every surgical field, including rhinology. Endoscopy offered several advantages for the surgical management of rhinologic disease. However, it had a distinct disadvantage compared to direct vision, namely loss of binocular vision. Two-dimensional (2D) endoscopy limited depth perception, widely regarded as an important parameter for accurate and efficient movements during surgery. Three-dimensional (3D) endoscopic visualization has been actively pursued for decades by endoscopic surgeons in multiple surgical specialties. However, its clinical role has been limited due to technical limitations as well as successful adaptation by endoscopic surgeons to monocular cues offered by 2D technology. Until recently, stereoscopic technology included variations of dual channel video, dual chip-on-the-tip, and shutter mechanism, as well as various 3D displays. Over the past decade a novel 3D endoscopic technology was introduced. This technology used a lenticular array of lenses in front of a single video chip at the distal end of an endoscope to generate a stereoscopic view of the surgical field. Also known as the 'insect eye' technology since it mimics the compound eye of arthropods, this endoscope has reinvigorated the field of 3D endoscopic surgery. Recent developments in 3D endoscopy hold much promise for all surgical subspecialties, particularly endoscopic sinus and skull-base surgery.

  10. Zoonotic Ancylostoma ceylanicum Infection Detected by Endoscopy

    Science.gov (United States)

    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. PMID:24891471

  11. Hindfoot endoscopy for posterior ankle pain

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

    Hindfoot pain can be caused by a variety of pathologies, most of which can be diagnosed and treated with endoscopy. The main indications are posterior tibial tenosynovectomy, diagnosis of a longitudinal peroneus brevis rupture, peroneal tendon adhesiolysis, flexor hallucis longus release, os

  12. 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...

  13. upper gastrointestinal endoscopy findings in patients referred

    African Journals Online (AJOL)

    2014-08-01

    Aug 1, 2014 ... quartz fibers a concept used by Hopkins in 1954 to build a model of a flexible fibre imaging device (2) the precursor of fibre-optic endoscope. Since then endoscopes and endoscopy have undergone great technical developments to the current new dimension in imaging of endoscopic ultrasonography ...

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

    NARCIS (Netherlands)

    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.

    2016-01-01

    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

  15. Esophageal Capsule Endoscopy for Screening Esophageal Varices among Japanese Patients with Liver Cirrhosis

    Directory of Open Access Journals (Sweden)

    Haruya Ishiguro

    2012-01-01

    Methods. We examined 29 patients with cirrhosis (20 males and 9 females; mean age 60 years; Child-Pugh classification A/B/C; 14/14/1 using ECE followed by esophagogastroduodenoscopy (EGD. High-risk EV were defined as F2 and/or RC2 and above. Results. The sensitivity and specificity of ECE for the diagnosis of high-risk EV were 92% and 80%, respectively. Conclusions. The findings showed that ECE is a highly sensitive method of diagnosing high-risk EV that requires endoscopic or pharmacological therapy. Thus, ECE might be a useful method for the screening and followup of EV in patients with cirrhosis.

  16. 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.

  17. Comparative evaluation of esophageal Barrett's epithelium through esophageal capsule endoscopy and methylene blue chromoendoscop

    Directory of Open Access Journals (Sweden)

    T.A. Domingos

    2013-04-01

    Conclusions: ECE appears to be a good method for detecting lesions in which there is suspicion of esophageal cancer and it had modest results in regard to the accurate identification of BE length and pattern. ECE is not a good method for detecting hiatal hernia. Further studies are needed in order to define the definitive role of ECE in BE monitoring.

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

    Directory of Open Access Journals (Sweden)

    Harunobu Kawamura

    2013-01-01

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

  19. Capsule endoscopy for the diagnosis and follow up of crohn’s disease

    DEFF Research Database (Denmark)

    Jensen, Michael Dam; Brodersen, Jacob; Kjeldsen, Jens

    2017-01-01

    a low specificity compared to other diagnostic modalities. Important questions about the optimal bowel preparation, selection of patients for CE and the optimal reading protocol remain to be clarified. the aim of this review is to evaluate the performance of CE for diagnosing CD and assess disease...

  20. Colonic angiodysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Vallee, C.; Legmann, P.; Garnier, T.; Levesque, M.; Favriel, J.M.

    1984-11-01

    The main clinical, endoscopic and radiographic findings in thirty documented cases of colonic angiodysplasia or vacular ectasia are described. We emphasise the association with colonic diverticulosis and cardiovascular pathology, describe the histological changes, summarize the present physiopathological hypothesis, and consider the various therapeutic approaches.

  1. Colonic angiodysplasia

    International Nuclear Information System (INIS)

    Vallee, C.; Legmann, P.; Garnier, T.; Levesque, M.

    1984-01-01

    The main clinical, endoscopic and radiographic findings in thirty documented cases of colonic angiodysplasia or vacular ectasia are described. We emphasise the association with colonic diverticulosis and cardiovascular pathology, describe the histological changes, summarize the present physiopathological hypothesis, and consider the various therapeutic approaches. (orig.)

  2. Colonic locomotion

    NARCIS (Netherlands)

    Dodou, D.

    2006-01-01

    The most effective screening method for colonic cancer is colonoscopy. However, colonoscopy cannot be easily embraced by the population because of the related pain intensity. Robotic devices that pull themselves forward through the colon are a possible alternative. The main challenge for such

  3. Colonic lipoma

    International Nuclear Information System (INIS)

    Siddiqui, M.S.; Khatri, A.R.; Quraishy, M.S.; Fatima, L.; Muzaffar, S.

    2003-01-01

    Lipoma of the colon is rare and may lead to intestinal obstruct. We have presented two cases of colonic lipoma. Both were elderly females, one presented with diarrhea and the other with sub-acute intestinal obstruction. After colonoscopy surgical removal was done. Histopathology revealed lipoma. (author)

  4. Assessment of patency capsule retention using MR diffusion-weighted imaging

    Energy Technology Data Exchange (ETDEWEB)

    Klang, Eyal; Rozendorn, Noa; Amitai, Michal Marianne [Sheba Medical Center, Department of Diagnostic Imaging, Ramat Gan (Israel); Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Kopylov, Uri; Ben-Horin, Shomron; Lahat, Adi; Yablecovitch, Doron; Eliakim, Rami [Tel Aviv University, Sackler Faculty of Medicine, Tel Aviv (Israel); Sheba Medical Center, Department of Gastroenterology, Ramat Gan (Israel)

    2017-12-15

    Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm{sup 2}/s showed 90.0% sensitivity and 50.0% specificity for retention. Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. (orig.)

  5. Assessment of patency capsule retention using MR diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Klang, Eyal; Rozendorn, Noa; Amitai, Michal Marianne; Kopylov, Uri; Ben-Horin, Shomron; Lahat, Adi; Yablecovitch, Doron; Eliakim, Rami

    2017-01-01

    Evaluate the ability of MR diffusion-weighted imaging (DWI) to predict patency capsule retention in Crohn's disease (CD). Clinical and imaging data were prospectively reviewed for 80 CD patients following patency capsule administration and MR-DWI under institutional review board (IRB) approval with informed consent. Two radiologists separately assessed the presence/absence of restricted diffusion in the distal ileum. Apparent diffusion coefficients (ADC) from three regions of interest on the ileal wall were averaged. The association between restricted diffusion and retention, and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated. Ability of ADC to predict retention was assessed with receiver operating characteristic (ROC) curve analysis. Restricted diffusion in the distal ileum was associated with capsule retention (p = 0.001, p < 0.0001). Sensitivity, specificity, PPV and NPV of restricted diffusion for capsule retention were 100.0%, 46.2%, 30.0%, 100% and 100.0%, 56.9%, 34.9%, 100%, respectively, for two radiologists. Accuracy of ADC to predict retention was high (area under the curve = 0.851, p < 0.0001). An ADC of 1.47 mm 2 /s showed 90.0% sensitivity and 50.0% specificity for retention. Sensitivity and NPV of restricted diffusion for patency capsule retention were 100%, suggesting that DWI may predict gastrointestinal tract capability to pass video camera endoscopy. (orig.)

  6. Capsulitis of the Second Toe

    Science.gov (United States)

    ... arch that is structurally unstable and a tight calf muscle. Symptoms Because capsulitis of the second toe is ... may be prescribed for patients who have tight calf muscles. Shoe modifications. Supportive shoes with stiff soles are ...

  7. Status of irradiation capsule design

    International Nuclear Information System (INIS)

    Nagata, Hiroshi; Yamaura, Takayuki; Nagao, Yoshiharu

    2013-01-01

    For the irradiation test after the restart of JMTR, further precise temperature control and temperature prediction are required. In the design of irradiation capsule, particularly sophisticated irradiation temperature prediction and evaluation are urged. Under such circumstance, among the conventional design techniques of irradiation capsule, the authors reviewed the evaluation method of irradiation temperature. In addition, for the improvement of use convenience, this study examined and improved FINAS/STAR code in order to adopt the new calculation code that enables a variety of analyses. In addition, the study on the common use of the components for radiation capsule enabled the shortening of design period. After the restart, the authors will apply this improved calculation code to the design of irradiation capsule. (A.O.)

  8. Adhesive capsulitis: a review.

    Science.gov (United States)

    Ewald, Anthony

    2011-02-15

    Adhesive capsulitis is a common, yet poorly understood, condition causing pain and loss of range of motion in the shoulder. It can occur in isolation or concomitantly with other shoulder conditions (e.g., rotator cuff tendinopathy, bursitis) or diabetes mellitus. It is often self-limited, but can persist for years and may never fully resolve. The diagnosis is usually clinical, although imaging can help rule out other conditions. The differential diagnosis includes acromioclavicular arthropathy, autoimmune disease (e.g., systemic lupus erythematosus, rheumatoid arthritis), biceps tendinopathy, glenohumeral osteoarthritis, neoplasm, rotator cuff tendinopathy or tear (with or without impingement), and subacromial and subdeltoid bursitis. Several treatment options are commonly used, but few have high-level evidence to support them. Because the condition is often self-limited, observation and reassurance may be considered; however, this may not be acceptable to many patients because of the painful and debilitating nature of the condition. Nonsurgical treatments include analgesics (e.g., acetaminophen, nonsteroidal anti-inflammatory drugs), oral prednisone, and intra-articular corticosteroid injections. Home exercise regimens and physical therapy are often prescribed. Surgical treatments include manipulation of the joint under anesthesia and capsular release.

  9. Detecting inflammation in the unprepared pediatric colon - how reliable is magnetic resonance enterography?

    Energy Technology Data Exchange (ETDEWEB)

    Barber, Joy L.; Watson, Tom A. [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Radiology, London (United Kingdom); Lozinsky, Adriana Chebar; Kiparissi, Fevronia; Shah, Neil [Great Ormond Street Hospital for Children NHS Foundation Trust, Department of Gastroenterology, London (United Kingdom)

    2016-05-15

    Pediatric inflammatory bowel disease frequently affects the colon. MR enterography is used to assess the small bowel but it also depicts the colon. To compare the accuracy of MR enterography and direct visualization at endoscopy in assessing the colon in pediatric inflammatory bowel disease. We included children with inflammatory bowel disease who had undergone both MR enterography and endoscopy, and we restrospectively assessed the imaging and endoscopic findings. We scored the colonic appearance at MR using a total colon score. We then compared scores for the whole colon and for its individual segments with endoscopy and histology. We included 15 children. An elevated MR colonic segmental score predicted the presence of active inflammation on biopsy with a specificity of 90% (95% confidence interval [CI] 79.5-96.2%) and sensitivity of 60% (CI 40.6-77.3%); this compares reasonably with the predictive values for findings at colonoscopy - specificity 85% (CI 73.4 - 92.9%) and sensitivity 53.3% (CI 34.3%-71.6%). Accuracy did not change significantly with increasing bowel distension. MR-derived scores had comparable accuracy to those derived during visualization at colonoscopy for detecting biopsy-proven inflammation in our patient group. MR enterography might prove useful in guiding biopsy or monitoring treatment response. Collapse of a colonic segment did not impair assessment of inflammation. (orig.)

  10. 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

  11. Sedation-related complications in gastrointestinal endoscopy

    OpenAIRE

    Amornyotin, Somchai

    2013-01-01

    Sedation practices for gastrointestinal endoscopic (GIE) procedures vary widely in different countries depending on health system regulations and local circumstances. The goal of procedural sedation is the safe and effective control of pain and anxiety, as well as to provide an appropriate degree of memory loss or decreased awareness. Sedation-related complications in gastrointestinal endoscopy, once occurred, can lead to significant morbidity and occasional mortality in patients. The risk fa...

  12. Imaging efficacy of a targeted imaging agent for fluorescence endoscopy

    Science.gov (United States)

    Healey, A. J.; Bendiksen, R.; Attramadal, T.; Bjerke, R.; Waagene, S.; Hvoslef, A. M.; Johannesen, E.

    2008-02-01

    Colorectal cancer is a major cause of cancer death. A significant unmet clinical need exists in the area of screening for earlier and more accurate diagnosis and treatment. We have identified a fluorescence imaging agent targeted to an early stage molecular marker for colorectal cancer. The agent is administered intravenously and imaged in a far red imaging channel as an adjunct to white light endoscopy. There is experimental evidence of preclinical proof of mechanism for the agent. In order to assess potential clinical efficacy, imaging was performed with a prototype fluorescence endoscope system designed to produce clinically relevant images. A clinical laparoscope system was modified for fluorescence imaging. The system was optimised for sensitivity. Images were recorded at settings matching those expected with a clinical endoscope implementation (at video frame rate operation). The animal model was comprised of a HCT-15 xenograft tumour expressing the target at concentration levels expected in early stage colorectal cancer. Tumours were grown subcutaneously. The imaging agent was administered intravenously at a dose of 50nmol/kg body weight. The animals were killed 2 hours post administration and prepared for imaging. A 3-4mm diameter, 1.6mm thick slice of viable tumour was placed over the opened colon and imaged with the laparoscope system. A receiver operator characteristic analysis was applied to imaging results. An area under the curve of 0.98 and a sensitivity of 87% [73, 96] and specificity of 100% [93, 100] were obtained.

  13. Motion analysis for duplicate frame removal in wireless capsule endoscope

    Science.gov (United States)

    Lee, Hyun-Gyu; Choi, Min-Kook; Lee, Sang-Chul

    2011-03-01

    Wireless capsule endoscopy (WCE) has been intensively researched recently due to its convenience for diagnosis and extended detection coverage of some diseases. Typically, a full recording covering entire human digestive system requires about 8 to 12 hours for a patient carrying a capsule endoscope and a portable image receiver/recorder unit, which produces 120,000 image frames on average. In spite of the benefits of close examination, WCE based test has a barrier for quick diagnosis such that a trained diagnostician must examine a huge amount of images for close investigation, normally over 2 hours. The main purpose of our work is to present a novel machine vision approach to reduce diagnosis time by automatically detecting duplicated recordings caused by backward camera movement, typically containing redundant information, in small intestine. The developed technique could be integrated with a visualization tool which supports intelligent inspection method, such as automatic play speed control. Our experimental result shows high accuracy of the technique by detecting 989 duplicate image frames out of 10,000, equivalently to 9.9% data reduction, in a WCE video from a real human subject. With some selected parameters, we achieved the correct detection ratio of 92.85% and the false detection ratio of 13.57%.

  14. Colon neoplasm

    International Nuclear Information System (INIS)

    Kimura F, K.

    1991-01-01

    The main aspects of colon neoplasms are described, including several factors that predispose the disease, the occurrence, the main biomedical radiography and the evaluation after the surgery. (C.G.C.)

  15. 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.

  16. 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.

  17. Endoscopy in Canada: Proceedings of the National Roundtable

    Directory of Open Access Journals (Sweden)

    Noah Switzer

    2015-01-01

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

  18. 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.

  19. Genome-Wide Discovery of Genes Required for Capsule Production by UropathogenicEscherichia coli.

    Science.gov (United States)

    Goh, Kelvin G K; Phan, Minh-Duy; Forde, Brian M; Chong, Teik Min; Yin, Wai-Fong; Chan, Kok-Gan; Ulett, Glen C; Sweet, Matthew J; Beatson, Scott A; Schembri, Mark A

    2017-10-24

    Uropathogenic Escherichia coli (UPEC) is a major cause of urinary tract and bloodstream infections and possesses an array of virulence factors for colonization, survival, and persistence. One such factor is the polysaccharide K capsule. Among the different K capsule types, the K1 serotype is strongly associated with UPEC infection. In this study, we completely sequenced the K1 UPEC urosepsis strain PA45B and employed a novel combination of a lytic K1 capsule-specific phage, saturated Tn 5 transposon mutagenesis, and high-throughput transposon-directed insertion site sequencing (TraDIS) to identify the complement of genes required for capsule production. Our analysis identified known genes involved in capsule biosynthesis, as well as two additional regulatory genes ( mprA and lrhA ) that we characterized at the molecular level. Mutation of mprA resulted in protection against K1 phage-mediated killing, a phenotype restored by complementation. We also identified a significantly increased unidirectional Tn 5 insertion frequency upstream of the lrhA gene and showed that strong expression of LrhA induced by a constitutive Pcl promoter led to loss of capsule production. Further analysis revealed loss of MprA or overexpression of LrhA affected the transcription of capsule biosynthesis genes in PA45B and increased sensitivity to killing in whole blood. Similar phenotypes were also observed in UPEC strains UTI89 (K1) and CFT073 (K2), demonstrating that the effects were neither strain nor capsule type specific. Overall, this study defined the genome of a UPEC urosepsis isolate and identified and characterized two new regulatory factors that affect UPEC capsule production. IMPORTANCE Urinary tract infections (UTIs) are among the most common bacterial infections in humans and are primarily caused by uropathogenic Escherichia coli (UPEC). Many UPEC strains express a polysaccharide K capsule that provides protection against host innate immune factors and contributes to survival

  20. Colonofluorography in diagnosis of small-size colon tumors

    International Nuclear Information System (INIS)

    Dvojris, M.S.; Popovich, V.V.

    1988-01-01

    The authors investigated the potentialities of colonofluorography (CFG) in the recognition of small-size colon tumors (not exceeding 3 cm). Among 1029 examinees were persons followedup for colitis, nonspecific ulcerative colitis, diverticulosis and colon polyps, patients after radical colon operations, patients with complaints of colon discomfort, blood and mucus in the stools, and cancer patients. 98 timors not exceeding 3 cm were detected. Comparison of the results of CFG whith those of endoscopy, surgery, and histology demonstrated high resolution of the method in the detection of primary and secondary small-size colon tumors. The simplicity, low cost, short duration, and low radiation exposure in combination with effectiveness make CFG appropriate in prophylactic medical examination of patients identified as high risk groups

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

    Science.gov (United States)

    Mostafalu, Pooria; Sonkusale, Sameer

    2014-04-15

    In this paper, we present the potential to harvest energy directly from the digestive system for powering a future wireless endoscopy capsule. A microfabricated electrochemical cell on flexible parylene film is proposed as a gastric battery. This electrochemical cell uses gastric juice as a source of unlimited electrolyte. Planar fabricated zinc [Zn] and palladium [Pd] electrodes serve as anode and cathode respectively. Due to planar geometry, no separator is needed. Moreover the annular structure of the electrodes provides lower distance between cathode and anode reducing the internal resistance. Both electrodes are biocompatible and parylene provides flexibility to the system. For a surface area of 15 mm(2), 1.25 mW is generated which is sufficient for most implantable endoscopy applications. Open circuit output voltage of this battery is 0.75 V. Since this gastric battery does not require any external electrolyte, it has low intrinsic weight, and since it is flexible and is made of biocompatible materials, it offers a promising solution for power in implantable applications. © 2013 Published by Elsevier B.V.

  2. Synchronous colon and gastric advanced carcinomas

    Energy Technology Data Exchange (ETDEWEB)

    Giuliani, A.; Demoro, M.; Corona, M.; Di Bari, M.; Ricciardulli, T.; Galati, G. [La Sapienza Univ., Rome (Italy). Dept. of Surgery Pietro Valdoni; Ciardi, A. [La Sapienza Univ., Rome (Italy). Dept. of Experimental Medicine and Pathology

    2005-03-15

    An unusual case of advanced synchronous colon and gastric carcinoma is described. A 36 year old female was admitted to our Department with a stenosing right colon cancer diagnosed at endoscopy which was performed for lower crampy abdominal pain and gross blood in the stool. Multiple colon polyps, distal to the tumor, were also detected. On preoperative abdominal computed tomography, a stenosing right colon cancer, without evidence of abdominal diffusion, was confirmed. At laparotomy, in addition to colon cancer, an antral gastric cancer was incidentally found. En bloc hemi gastrectomy and subtotal colectomy were performed. Digestive continuity was restored by gastrojejunal and ileosigmoid anastomoses. At histology, a poorly differentiated gastric adenocarcinoma with signet ring-cell component (pT2, pN0; stage IB) and a moderately differentiated colon adenocarcinoma with a tubulovillous component (pT3, pN1; stage III, Stage Dukes C) were revealed. Both tumors showed a low expression of p53 and c-erb2 oncoproteins. No genetic defect was identified in the APC and MMR genes. The patient is alive, without recurrence, two years after the operation.

  3. Synchronous colon and gastric advanced carcinomas

    International Nuclear Information System (INIS)

    Giuliani, A.; Demoro, M.; Corona, M.; Di Bari, M.; Ricciardulli, T.; Galati, G.; Ciardi, A.

    2005-01-01

    An unusual case of advanced synchronous colon and gastric carcinoma is described. A 36 year old female was admitted to our Department with a stenosing right colon cancer diagnosed at endoscopy which was performed for lower crampy abdominal pain and gross blood in the stool. Multiple colon polyps, distal to the tumor, were also detected. On preoperative abdominal computed tomography, a stenosing right colon cancer, without evidence of abdominal diffusion, was confirmed. At laparotomy, in addition to colon cancer, an antral gastric cancer was incidentally found. En bloc hemi gastrectomy and subtotal colectomy were performed. Digestive continuity was restored by gastrojejunal and ileosigmoid anastomoses. At histology, a poorly differentiated gastric adenocarcinoma with signet ring-cell component (pT2, pN0; stage IB) and a moderately differentiated colon adenocarcinoma with a tubulovillous component (pT3, pN1; stage III, Stage Dukes C) were revealed. Both tumors showed a low expression of p53 and c-erb2 oncoproteins. No genetic defect was identified in the APC and MMR genes. The patient is alive, without recurrence, two years after the operation

  4. Stress Analysis of Cyrano Capsule Hanger

    International Nuclear Information System (INIS)

    Hasibuan, Djaruddin

    2000-01-01

    Base on the requirement criteria on nuclear installation, and to complete the document of the cyrano capsule facility the analysis of the cyrano capsule hanger has been done. The cyrano capsule hanger by the overhang installation on the main support of fixed bridge is a main support of whole of the cyrano capsule and frame. By using W 4 x 13 shave as main hanger of cyrano capsule, the maximum allowable stress was found to be bigger than the actual stress. From the final analysis it can be concluded that the hanger of the cyrano capsule is in safe condition

  5. Endurance test for DUPIC capsule

    International Nuclear Information System (INIS)

    Chung, Heung June; Bae, K. K.; Lee, C. Y.; Park, J. M.; Ryu, J. S.

    1999-07-01

    This report presents the pressure drop, vibration and endurance test results for mini-plate fuel rig which were designed fabricately by KAERI. From the pressure drop test results, it is noted that the flow rate across the capsule corresponding to the pressure drop of 200 kPa is measured to be about 9.632 kg/sec. Vibration frequency for the capsule ranges from 14 to 18.5 Hz. RMS (Root Mean Square) displacement for the fuel rig is less than 14 μm, and the maximum displacement is less than 54 μm. Based on the endurance test results, the appreciable fretting wear for the DUPIC capsule was not detected. Oxidation on the support tube is observed, also tiny trace of wear between contact points observed. (author). 4 refs., 10 tabs., 45 figs

  6. 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.

  7. WEO position statement on hygiene in digestive endoscopy: Focus on endoscopy units in Asia and the Middle East.

    Science.gov (United States)

    Murdani, Abdullah; Kumar, Ajay; Chiu, Han-Mo; Goh, Khean-Lee; Jang, Byung Ik; Khor, Christopher J L; Lau, James; Mostafa, Ibrahim; Ramchandani, Mohan; Ratanalert, Siriporn; Tajiri, Hisao; Yuen, Minghwa; Zhang, Shu Tian; Duforest-Rey, Dianelle; Rey, Jean-Francois

    2017-01-01

    The aim of this position statement is to reinforce the key points of hygiene in digestive endoscopy. The present article details the minimum hygiene requirements for reprocessing of endoscopes and endoscopic devices, regardless of the reprocessing method (automated washer-disinfector or manual cleaning) and the endoscopy setting (endoscopy suite, operating room, elective or emergency procedures). These minimum requirements are mandatory for patient safety. Both advanced diagnostic and therapeutic endoscopies should be carried out in an environment that is safe for patients and staff. Particular attention is given to contaminants. Procedural errors in decontamination, defective equipment, and failure to follow disinfection guidelines are major factors contributing to transmission of infection during endoscopy. Other important risk factors include inadequate cleaning, use of older endoscopes with surface and working channel irregularities, and contamination of water bottles or irrigating solutions. Infections by multidrug-resistant organisms have become an increasing problem in health-care systems worldwide. Since 2010, outbreaks of multidrug-resistant bacteria associated with endoscopic retrograde cholangiopancreatography have been reported from the USA, France, Germany, and The Netherlands. In many endoscopy units in Asia and the Middle East, reprocessing procedures have lagged behind those of Western countries for cultural reasons or lack of financial resources. This inconsistency in standards is now being addressed, and the World Endoscopy Organization has prepared this position statement to highlight key points for quality assurance in any endoscopy unit in any country. © 2016 Japan Gastroenterological Endoscopy Society.

  8. Kombineret endoskopisk-laparoskopisk polypektomi i colon

    DEFF Research Database (Denmark)

    Jensen, Sandra; Rud, Bo

    2017-01-01

    Combined endoscopic laparoscopic surgery (CELS) is a novel technique for resection of benign colon polyps, which are not amenable for endoscopic resection. A review of ten studies including 416 patients shows that polyps were successfully resected in 65-97% of the patients. Polyp recurrence after...... CELS is low, and the frequency of adenocarcinoma is comparable with the frequency in large polyps (> 2 cm) resected endoscopically. CELS can be performed for a variety of indications but should be done after renewed endoscopy. Due to the risk of cancer it should only be performed in specialized centres....

  9. Effects of yogurt and bifidobacteria supplementation on the colonic microbiota in lactose-intolerant subjects

    NARCIS (Netherlands)

    He, T.; Priebe, M. G.; Zhong, Y.; Huang, C.; Harmsen, H. J. M.; Raangs, G. C.; Antoine, J. -M.; Welling, G. W.; Vonk, R. J.

    Aims: Colonic metabolism of lactose may play a role in lactose intolerance. We investigated whether a 2-week supplementation of Bifidobacterium longum (in capsules) and a yogurt enriched with Bifidobacterium animalis could modify the composition and metabolic activities of the colonic microbiota in

  10. Osmotic buckling of spherical capsules.

    Science.gov (United States)

    Knoche, Sebastian; Kierfeld, Jan

    2014-11-07

    We study the buckling of elastic spherical shells under osmotic pressure with the osmolyte concentration of the exterior solution as a control parameter. We compare our results for the bifurcation behavior with results for buckling under mechanical pressure control, that is, with an empty capsule interior. We find striking differences for the buckling states between osmotic and mechanical buckling. Mechanical pressure control always leads to fully collapsed states with opposite sides in contact, whereas uncollapsed states with a single finite dimple are generic for osmotic pressure control. For sufficiently large interior osmolyte concentrations, osmotic pressure control is qualitatively similar to buckling under volume control with the volume prescribed by the osmolyte concentrations inside and outside the shell. We present a quantitative theory which also captures the influence of shell elasticity on the relationship between osmotic pressure and volume. These findings are relevant for the control of buckled shapes in applications. We show how the osmolyte concentration can be used to control the volume of buckled shells. An accurate analytical formula is derived for the relationship between the osmotic pressure, the elastic moduli and the volume of buckled capsules. This also allows use of elastic capsules as osmotic pressure sensors or deduction of elastic properties and the internal osmolyte concentration from shape changes in response to osmotic pressure changes. We apply our findings to published experimental data on polyelectrolyte capsules.

  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. New Trends in Acute Management of Colonic Diverticular Bleeding

    Science.gov (United States)

    Cirocchi, Roberto; Grassi, Veronica; Cavaliere, Davide; Renzi, Claudio; Tabola, Renata; Poli, Giulia; Avenia, Stefano; Farinella, Eleonora; Arezzo, Alberto; Vettoretto, Nereo; D’Andrea, Vito; Binda, Gian Andrea; Fingerhut, Abe

    2015-01-01

    Abstract Colonic diverticular disease is the most common cause of lower gastrointestinal bleeding. In the past, this condition was usually managed with urgent colectomy. Recently, the development of endoscopy and interventional radiology has led to a change in the management of colonic diverticular bleeding. The aim of this systematic review is to define the best treatment for colonic diverticular bleeding. A systematic bibliographic research was performed on the online databases for studies (randomized controlled trials [RCTs], observational trials, case series, and case reports) published between 2005 and 2014, concerning patients admitted with a diagnosis of diverticular bleeding according to the PRISMA methodology. The outcomes of interest were: diagnosis of diverticulosis as source of bleeding; incidence of self-limiting diverticular bleeding; management of non self-limiting bleeding (endoscopy, angiography, surgery); and recurrent diverticular bleeding. Fourteen studies were retrieved for analysis. No RCTs were found. Eleven non-randomized clinical controlled trials (NRCCTs) were included in this systematic review. In all studies, the definitive diagnosis of diverticular bleeding was always made by urgent colonoscopy. The colonic diverticular bleeding stopped spontaneously in over 80% of the patients, but a re-bleeding was not rare. Recently, interventional endoscopy and angiography became the first-line approach, thus relegating emergency colectomy to patients presenting with hemodynamic instability or as a second-line treatment after failure or complications of hemostasis with less invasive treatments. Colonoscopy is effective to diagnose diverticular bleeding. Nowadays, interventional endoscopy and angiographic treatment have gained a leading role and colectomy should only be entertained in case of failure of the former. PMID:26554768

  13. Gastrointestinal endoscopy in Nigeria - a prospective two year audit ...

    African Journals Online (AJOL)

    Lower gastrointestinal endoscopy findings included 7 cases of polyps, 3 cases of colorectal cancer and 2 cases of diverticulosis. Commonest lesion on lower GI endoscopy was haemorrhoids (41.7%). Adjusted caecal intubation was 81.4% for colonoscopies performed. Overall adenoma detection rate for male and female ...

  14. The validity of nasal endoscopy in patients with chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Larsen, K. L.; Lange, B.; Darling, P.

    2018-01-01

    Objectives: Nasal endoscopy is a cornerstone in diagnosing sinonasal disease, but different raters might generate different results using the technique. Our study aims to evaluate the agreement between multiple raters to assess the validity of nasal endoscopy. Design/Participants: Three independe...

  15. Upper gastrointestinal endoscopy findings in patients referred with ...

    African Journals Online (AJOL)

    Background: Dyspepsia is one of the major indications for upper gastrointestinal endoscopy. Other indications include dysphagia, odynophagia and gastrointestinal bleeding. Endoscopy is an expensive procedure that is out of reach of many patients in resource constrained region such as western Kenya. We reviewed ...

  16. Upper gastrointestinal endoscopy in children: The Lagos University ...

    African Journals Online (AJOL)

    both diagnostic and therapeutic upper GI endoscopy services to both adult and paediatric populations from all over .... positive and had triple therapy with amoxicillin, clarithromycin and omeprazole. Four of the six subjects with .... Khan MR, Ahmed S, Ali SR, Maheshwari PK, Jamal MS. Spectrum of upper GI endoscopy in ...

  17. Therapeutic upper gastrointestinal tract endoscopy in Paediatric Gastroenterology.

    Science.gov (United States)

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

    2015-03-16

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

  18. Effectiveness of a novel endoscopy training concept.

    Science.gov (United States)

    Götzberger, M; Rösch, T; Geisenhof, S; Gülberg, V; Schmitt, W; Niemann, G; Kopp, V M; Faiss, S; Heldwein, W; Fischer, M R

    2011-09-01

    Training standards in gastrointestinal endoscopy are poorly defined even though different simulators are increasingly used for skills training. In 2001 a new training concept called "GATE--gastroenterological education-training endoscopy" was established, which provides a combination of background theory, video demonstrations, and simulator training. We aimed to evaluate the acceptance and training effect of this training model. In total, 98 physicians participating in four training courses were included. Data were collected on baseline characteristics, acceptance (5-point Likert scale), and pre- and post-course knowledge through a structured questionnaire (A-type and Pick-N multiple choice questions). A total of 13 trainees were randomly selected for additional simulator assessment of training effects on manual skills (5-point Likert scale). A total of 78 trainees (80%) provided complete data sets. The evaluation showed a positive acceptance of the training program (value 1 and 2, Likert scale); for example, 88% of participants suggested the inclusion of the GATE course as an obligatory part of endoscopic education. There was a significant improvement in theoretical knowledge in the post-test set compared with the pre-test set (mean 3.27 ±1.30 vs. 1.69 ±1.01 points; PLikert scale ( P=0.085). The integrated GATE training improved theoretical knowledge and manual skill. The GATE courses have been accredited by the German Society of Gastroenterology, underlining the demand for implementing preclinical training courses in endoscopic training. © Georg Thieme Verlag KG Stuttgart · New York.

  19. 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.

  20. Sensor capsule for diagnosis of gastric disorders

    Science.gov (United States)

    Holen, J. T.

    1972-01-01

    Motility and pH sensor capsule is developed to monitor gastric acidity, pressure, and temperature. Capsule does not interfere with digestion. Sensor is capsule which includes pH electrode, Pitran pressure transducer, and thermistor temperature sensor all potted in epoxy and enclosed in high density polyethylene sheath.

  1. Learning about Colon Cancer

    Science.gov (United States)

    ... What do we know about heredity and colon cancer? Colon cancer, a malignant tumor of the large intestine, ... page Additional Resources for Information on Hereditary Colon Cancer Colon and Rectal Cancer Information [cancer.gov] The most ...

  2. Endoscopy training in Canadian general surgery residency programs.

    Science.gov (United States)

    Bradley, Nori L; Bazzerelli, Amy; Lim, Jenny; Wu Chao Ying, Valerie; Steigerwald, Sarah; Strickland, Matt

    2015-06-01

    Currently, general surgeons provide about 50% of endoscopy services across Canada and an even greater proportion outside large urban centres. It is essential that endoscopy remain a core component of general surgery practice and a core competency of general surgery residency training. The Canadian Association of General Surgeons Residents Committee supports the position that quality endoscopy training for all Canadian general surgery residents is in the best interest of the Canadian public. However, the means by which quality endoscopy training is achieved has not been defined at a national level. Endoscopy training in Canadian general surgery residency programs requires standardization across the country and improved measurement to ensure that competency and basic credentialing requirements are met.

  3. Symptomatic endometriosis of the colon - a case report

    International Nuclear Information System (INIS)

    Leutloff, U.C.; Roeren, T.; Feldmann, K.; Sillem, M.; Rabe, T.; Kauffmann, G.

    1996-01-01

    The intestinal endometriosis in need of treatment is a rare case in the surgical department. Preoperative diagnosis is very difficult and in any case must be based on histologic findings; endoscopy-guided biopsy very frequently yields negative results. Dual-contrast scanning of the colon still is a major examination method, but the findings make it difficult to rule out malignomas. Cyclic, recurrent abdominal complaints reported in the case history strongly indicate the possibility of endometriosis. Typing can be done in general only after surgery. The article reports the clinical and diagnostic parameters of a symptomatic endometriosis of the colon. (orig.) [de

  4. Angiodysplasia of the colon: A report of two cases and review of ...

    African Journals Online (AJOL)

    2011-04-22

    Apr 22, 2011 ... Non hereditary colonic angiodysplasias: Histomorphometric approach to their pathogenesis. Dig Dis Sci 1993;40:839‑42. 8. Kakushimi N, Fujishiro M, Yahaji N, Oka M, Kobayashi K, Hashimoto T, et al. An unusual case of polypoid angiodysplasia. Endoscopy 2004;36:379. 9. Duchini A, Godino J, Wong P, ...

  5. Probing cell internalisation mechanics with polymer capsules.

    Science.gov (United States)

    Chen, Xi; Cui, Jiwei; Ping, Yuan; Suma, Tomoya; Cavalieri, Francesca; Besford, Quinn A; Chen, George; Braunger, Julia A; Caruso, Frank

    2016-10-06

    We report polymer capsule-based probes for quantifying the pressure exerted by cells during capsule internalisation (P in ). Poly(methacrylic acid) (PMA) capsules with tuneable mechanical properties were fabricated through layer-by-layer assembly. The P in was quantified by correlating the cell-induced deformation with the ex situ osmotically induced deformation of the polymer capsules. Ultimately, we found that human monocyte-derived macrophage THP-1 cells exerted up to approximately 360 kPa on the capsules during internalisation.

  6. [Acute secondary pseudo-obstruction of the colon (Ogilvie syndrome): experiences with endoscopic therapy].

    Science.gov (United States)

    Scheurer, U; Wälchli, P

    1985-09-07

    Twenty-seven patients with acute secondary colonic pseudoobstruction have been studied before and after endoscopic decompression of the colon. 19 patients were treated by single endoscopic decompression and 8 patients who had, or were expected to have, recurrent pseudoobstruction were treated by endoscopy-assisted introduction of a double-lumen tube into the colon. 17 out of 27 patients had massive dilatation of the right hemicolon. 19 patients completely retained stools and had a dilated colon the day before the endoscopic treatment, while 8 out of 27 patients still had passage of stool despite threatening dilatation of the colon. Initial decompression of the colon was achieved in all patients with both techniques, but cecal perforation developed in 1 patient. Normal colonic function returned in all patients who underwent single endoscopic decompression within three days, and in all patients treated with a colonic tube within 4 days (mean value). The success of endoscopic therapy of acute pseudoobstruction could not be explained by drugs administered before and after the endoscopic treatment. It is concluded that endoscopic decompression of the colon is an effective treatment for acute pseudoobstruction. Repeated colonoscopic decompression in refractory cases may be avoided by endoscopy-assisted placement of large caliber drainage tubes.

  7. Oral chlorhexidine and microbial contamination during endoscopy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  8. Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

    Science.gov (United States)

    Ellingson, Derek; Miick, Ronald; Chang, Faye; Hillard, Robert; Choudhary, Abhishek; Ashraf, Imran; Bechtold, Matthew; Diaz-Arias, Alberto

    2011-08-01

    The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist. A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist. Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%). The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

  9. DIABETES AND SHOULDER ADHESIVE CAPSULITIS

    OpenAIRE

    J. Mohanakrishnan; Bhanumathy Mohanakrishnan

    2016-01-01

    Background: Adhesive capsulitis (AC) of shoulder is a common condition encountered by physical therapists in their routine outpatient care services; AC of shoulder is as by itself being a self limiting disorder lasts from months to years causing pain and discomfort to the patients. The condition is commonly associated with Diabetes mellitus or other co morbidities. The incidence of AC is high among diabetic individuals and it becomes mandatory on the part of physical therapists and other heal...

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

    Science.gov (United States)

    Desmarchelier, Marion R; Ferrell, Shannon T

    2015-09-01

    Although endoscopy is part of the basic standard of care in most avian practices, many wildlife rehabilitation centers do not have access to the equipment or do not use it on a regular basis. Endoscopic equipment is easily available at a lower cost on the used market or can be acquired through donations from local human hospitals. Several medical conditions encountered in wild raptors have an improved prognosis if they are diagnosed or treated early with the aid of endoscopy. In many cases, endoscopy provides a noninvasive alternative to exploratory surgery, saving cost and time and decreasing postoperative pain. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Preclinical Evaluation of Raman Nanoparticle Biodistribution for their Potential Use in Clinical Endoscopy Imaging

    DEFF Research Database (Denmark)

    Zavaleta, Cristina L; Hartman, Keith B; Miao, Zheng

    2011-01-01

    toxicity. In this study, the natural biodistribution of gold surface-enhanced Raman scattering (SERS) nanoparticles is evaluated by radiolabeling them with (64) Cu and imaging their localization over time using micropositron emission tomography (PET). Mice are injected either intravenously (IV...... intestine (5 h = 10.37% ID g(-1) ; 24 h = 0.42% ID g(-1) ) with minimal uptake in other organs. Raman imaging of excised tissues correlate well with biodistribution data. These results suggest that the topical application of SERS nanoparticles in the mouse colon appears to minimize their systemic...... with endoscopy. The use of an accessory Raman endoscope in conjunction with topically administered tumor-targeting Raman nanoparticles during a routine colonoscopy could offer a new way to sensitively detect dysplastic lesions while circumventing Raman's limited depth of penetration and avoiding systemic...

  12. Endoscopy and cross-sectional imaging for assessing Crohn׳s disease activity.

    Science.gov (United States)

    Stidham, Ryan W; Cross, Raymond K

    2016-07-01

    Crohn's disease (CD) is principally characterized by chronic and recurrent inflammation of the gastrointestinal tract, most commonly found in the ileo-colonic region. The chronicity and severity of intestinal inflammation together contribute to progressive, cumulative, deep, transmural intestinal damage, including stricturing, obstruction, abscesses, and fistulae. Both intestinal inflammation and its chronic complications result in a range of symptoms subsequently leading to patient presentations with diarrhea, abdominal pain, and anemia related to intestinal blood loss. Measuring disease activity and severity are essential for decision of treatment intensity early in the disease course and longitudinal monitoring of therapeutic efficacy. This review will summarize the transition from subjective symptoms driving disease activity indices, into increasingly objective and quantitative measures of intestinal injury by direct mucosal assessment (endoscopy), cross-sectional imaging, and surrogate biomarkers. Specific commentary on intestinal stricture and perianal fistula assessment and management are presented in accompanying sections of this series.

  13. Gastric cancer missed at endoscopy | Gado | Alexandria Journal of ...

    African Journals Online (AJOL)

    with biopsies) is the gold standard for its diagnosis but missed oesophageal and gastric cancers are not infrequent in patients who have undergone previous endoscopy. Errors by the endoscopist account for the majority of these missed lesions.

  14. Endoscopists’ Opinions of Indications for Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lloyd R Sutherland

    1997-01-01

    Full Text Available OBJECTIVE: To determine whether endoscopists and general internists agreed with the characterization of appropriateness for endoscopy of various clinical scenarios, as previously reported by the RAND Corporation.

  15. Image Documentation in Gastrointestinal Endoscopy: Review of Recommendations.

    Science.gov (United States)

    Marques, Susana; Bispo, Miguel; Pimentel-Nunes, Pedro; Chagas, Cristina; Dinis-Ribeiro, Mário

    2017-11-01

    In recent years, endoscopic image documentation has gained an important role in gastrointestinal (GI) endoscopic reporting and has become an integral aspect of quality control. Since 2001, several important guidelines and statements, some from major endoscopic societies, have been published to standardize endoscopic image documentation. Therefore, and according to the most recent recommendations of the European Society of Gastrointestinal Endoscopy, we propose a set of images to be routinely captured in upper and lower GI endoscopy. Systematic acquisition of 10 and 9 photographs of specific landmarks is recommended in upper-GI endoscopy and colonoscopy, respectively. In addition to photo documentation of the normal endoscopic features, imaging of pathologic findings is also advocated. Considering accurate and adequate image documentation as an essential part of endoscopic reporting, it should be systematically performed in upper and lower GI endoscopy.

  16. 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

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

    OpenAIRE

    Groenen, Marcel; Kuipers, Ernst; Berge Henegouwen, Gerard; Fockens, Paul; 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 epidemiology. We therefore aimed for a report system which would be quick, easy to learn, and suitable for use in busy daily practice. METHODS: Endobase III is an endoscopy information system offering three different way...

  18. Epitomized summarization of wireless capsule endoscopic videos for efficient visualization.

    Science.gov (United States)

    Chu, Xinqi; Poh, Chee Khun; Li, Liyuan; Chan, Kap Luk; Yan, Shuicheng; Shen, Weijia; Htwe, That Mon; Liu, Jiang; Lim, Joo Hwee; Ong, Eng Hui; Ho, Khek Yu

    2010-01-01

    A video recording of an examination by Wireless Capsule Endoscopy (WCE) may typically contain more than 55,000 video frames, which makes the manual visual screening by an experienced gastroenterologist a highly time-consuming task. In this paper, we propose a novel method of epitomized summarization of WCE videos for efficient visualization to a gastroenterologist. For each short sequence of a WCE video, an epitomized frame is generated. New constraints are introduced into the epitome formulation to achieve the necessary visual quality for manual examination, and an EM algorithm for learning the epitome is derived. First, the local context weights are introduced to generate the epitomized frame. The epitomized frame preserves the appearance of all the input patches from the frames of the short sequence. Furthermore, by introducing spatial distributions for semantic interpretation of image patches in our epitome formulation, we show that it also provides a framework to facilitate the semantic description of visual features to generate organized visual summarization of WCE video, where the patches in different positions correspond to different semantic information. Our experiments on real WCE videos show that, using epitomized summarization, the number of frames have to be examined by the gastroenterologist can be reduced to less than one-tenth of the original frames in the video.

  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. Diagnostic and therapeutic radio pharmaceutical capsules

    International Nuclear Information System (INIS)

    Haney, T.A.; Wedeking, P.W.; Morcos, N.A.

    1981-01-01

    An improved pharmaceutical radioactive capsule consisting of a non-toxic, water soluble material adapted to being ingested and rapidly disintegrating on contact with fluids of the gastro-intestinal tract is described. Each capsule is provided with filler material supporting a pharmaceutically useful radioactive compound absorbable from the gastro-intestinal tract. The capsule is preferably of gelatin, methyl cellulose or polyvinyl alcohol and the filler is a polyethylene glycol. The radioactive compound may be iodine e.g. sodium radioiodide I-131 or 123. The capsule may also contain a reducing agent e.g. sodium thiosulphate, sulphite, or bisulphite. (author)

  1. Self-expandable metal stents for obstructing colonic and extracolonic cancer

    DEFF Research Database (Denmark)

    van Hooft, Jeanin E; van Halsema, Emo E; Vanbiervliet, Geoffroy

    2014-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and Eva......This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development......, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations The following recommendations should only be applied after a thorough diagnostic evaluation including a contrast-enhanced computed tomography (CT) scan. 1 Prophylactic colonic...... stent placement is not recommended. Colonic stenting should be reserved for patients with clinical symptoms and imaging evidence of malignant large-bowel obstruction, without signs of perforation (strong recommendation, low quality evidence). 2 Colonic self-expandable metal stent (SEMS) placement...

  2. Critical swelling of fluctuating capsules

    Science.gov (United States)

    Diamant, Haim; Haleva, Emir

    2009-03-01

    In many natural transport processes the solute molecules to be transported are encapsulated in semipermeable, flexible membrane vesicles of micron size. We study the swelling of such fluctuating capsules, as the number of encapsulated particles is increased, or the concentration of the outer solution is decreased. The approach to the maximum volume-to-area ratio and the associated buildup of membrane tension involve a continuous phase transition and follow universal scaling laws. The criticality and its features are model-independent, arising solely from the interplay between volume and surface degrees of freedom.ootnotetextE. Haleva and H. Diamant, Phys. Rev. Lett. 101, 078104 (2008).

  3. Angiodysplasia of the colon

    Science.gov (United States)

    Vascular ectasia of the colon; Colonic arteriovenous malformation; Hemorrhage - angiodysplasia; Bleed - angiodysplasia ... Angiodysplasia of the colon is mostly related to the aging and breakdown of the blood vessels. It is more common in older adults. ...

  4. What Kind of Capsule Endoscope Is Suitable for a Controllable Self-Propelling Capsule Endoscope? Experimental Study Using a Porcine Stomach Model for Clinical Application (with Videos).

    Science.gov (United States)

    Ota, Kazuhiro; Nouda, Sadaharu; Takeuchi, Toshihisa; Iguchi, Munetaka; Kojima, Yuichi; Kuramoto, Takanori; Inoue, Takuya; Shindo, Yasunori; Uesugi, Kenshiro; Fujito, Yoshiaki; Nishihara, Hironori; Ohtsuka, Naotake; Higuchi, Kazuhide

    2015-01-01

    We have been developing the Self-Propelling Capsule Endoscope (SPCE) that allows for controllability from outside of the body and real-time observation. What kind of capsule endoscope (CE) is suitable for a controllable SPCE is unclear and a very critical point for clinical application. We compared observing ability of three kinds of SPCEs with different viewing angles and frame rates. Eleven buttons were sewed in an excised porcine stomach. Four examiners controlled the SPCE using PillCamSB2, -ESO2, and -COLON2 (Given Imaging Ltd., Israel), for 10 minutes each with the aim of detecting as many buttons and examining them as closely as possible. The ability to find lesions was assessed based on the number of detected buttons. The SPCE-performance score (SPS) was used to evaluate the ability to examine the lesions in detail. The SPCE-ESO2, -COLON2, and -SB2 detected 11 [interquartile range (IQR): 0], 10.5 (IQR, 0.5), and 8 (IQR, 1.0) buttons, respectively. The SPCE-ESO2 and -COLON2 had a significantly better ability to detect lesions than the -SB2 (p < 0.05). The SPCE-ESO2, -COLON2, and -SB2 had significantly different SPS values of 22 (IQR, 0), 16.5 (IQR, 1.5), and 14 (IQR, 1.0), respectively (p < 0.05 for all comparisons; SPCE-SB2 vs. -ESO2, -SB2 vs. -COLON2, and -ESO2 vs. -COLON2). PillCamESO2 is most suitable in different three CEs for SPCE for examining lesions in detail of the stomach.

  5. Effects of coating layer and release medium on release profile from coated capsules with Eudragit FS 30D: an in vitro and in vivo study.

    Science.gov (United States)

    Moghimipour, Eskandar; Rezaei, Mohsen; Kouchak, Maryam; Fatahiasl, Jafar; Angali, Kambiz Ahmadi; Ramezani, Zahra; Amini, Mohsen; Dorkoosh, Farid Abedin; Handali, Somayeh

    2018-05-01

    The aim of the present research was to evaluate the impact of coating layers on release profile from enteric coated dosage forms. Capsules were coated with Eudragit FS 30D using dipping method. The drug profile was evaluated in both phosphate buffer and Hank's solutions. Utilization X-ray imaging, gastrointestinal transmission of enteric coated capsules was traced in rats. According to the results, no release of the drug was found at pH 1.2, and the extent of release drug in pH 6.8 medium was decreased by adding the coating layers. The results indicated single-layer coated capsules in phosphate buffer were significantly higher than that in Hank's solution. However, no significant difference was observed from capsules with three coating layers in two different dissolution media. X-ray imaging showed that enteric coated capsules were intact in the stomach and in the small intestine, while disintegrated in the colon.

  6. Genomic analysis reveals the molecular basis for capsule loss in the group B Streptococcus population.

    Directory of Open Access Journals (Sweden)

    Roberto Rosini

    Full Text Available The human and bovine bacterial pathogen Streptococcus agalactiae (Group B Streptococcus, GBS expresses a thick polysaccharide capsule that constitutes a major virulence factor and vaccine target. GBS can be classified into ten distinct serotypes differing in the chemical composition of their capsular polysaccharide. However, non-typeable strains that do not react with anti-capsular sera are frequently isolated from colonized and infected humans and cattle. To gain a comprehensive insight into the molecular basis for the loss of capsule expression in GBS, a collection of well-characterized non-typeable strains was investigated by genome sequencing. Genome based phylogenetic analysis extended to a wide population of sequenced strains confirmed the recently observed high clonality among GBS lineages mainly containing human strains, and revealed a much higher degree of diversity in the bovine population. Remarkably, non-typeable strains were equally distributed in all lineages. A number of distinct mutations in the cps operon were identified that were apparently responsible for inactivation of capsule synthesis. The most frequent genetic alterations were point mutations leading to stop codons in the cps genes, and the main target was found to be cpsE encoding the portal glycosyl transferase of capsule biosynthesis. Complementation of strains carrying missense mutations in cpsE with a wild-type gene restored capsule expression allowing the identification of amino acid residues essential for enzyme activity.

  7. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

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

    2011-01-01

    BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both for endosco......BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both...... for endoscopists and for endoscopy nurses who were administering propofol sedation. The nurses' program comprised a 6-week course including theoretical and practical training in airway management, and the endoscopists' program consisted of 2.5 h of theory and a short course in practical airway management....... In the implementation phase, data from 1822 endoscopic procedures in 1764 patients were prospectively collected. All adverse events related to sedation were recorded (defined as oxygen saturation change in blood pressure > 20 mmHg). RESULTS: 78 cases...

  8. Electropermanent magnetic anchoring for surgery and endoscopy.

    Science.gov (United States)

    Tugwell, Josef; Brennan, Philip; O'Shea, Conor; O'Donoghue, Kilian; Power, Timothy; O'Shea, Michael; Griffiths, James; Cahill, Ronan; Cantillon-Murphy, Padraig

    2015-03-01

    The use of magnets for anchoring of instrumentation in minimally invasive surgery and endoscopy has become of increased interest in recent years. Permanent magnets have significant advantages over electromagnets for these applications; larger anchoring and retraction force for comparable size and volume without the need for any external power supply. However, permanent magnets represent a potential hazard in the operating field where inadvertent attraction to surgical instrumentation is often undesirable. The current work proposes an interesting hybrid approach which marries the high forces of permanent magnets with the control of electromagnetic technology including the ability to turn the magnet OFF when necessary. This is achieved through the use of an electropermanent magnet, which is designed for surgical retraction across the abdominal and gastric walls. Our electropermanent magnet, which is hand-held and does not require continuous power, is designed with a center lumen which may be used for trocar or needle insertion. The device in this application has been demonstrated successfully in the porcine model where coupling between an intraluminal ring magnet and our electropermanent magnet facilitated guided insertion of an 18 Fr Tuohy needle for guidewire placement. Subsequent investigations have demonstrated the ability to control the coupling distance of the system alleviating shortcomings with current methods of magnetic coupling due to variation in transabdominal wall thicknesses. With further refinement, the magnet may find application in the anchoring of endoscopic and surgical instrumentation for minimally invasive interventions in the gastrointestinal tract.

  9. Diagnosis by endoscopy and advanced imaging.

    Science.gov (United States)

    Swager, A; Curvers, W L; Bergman, J J

    2015-02-01

    Evaluation of patients with Barrett's oesophagus (BO) using dye-based chromoendoscopy, optical chromoendoscopy, autofluorescence imaging, or confocal laser endomicroscopy does not significantly increase the number of patients with a diagnosis of early neoplasia compared with high-definition white light endoscopy (HD-WLE) with random biopsy analysis. These newer imaging techniques are not more effective in standard surveillance of patients with BO because the prevalence of early neoplasia is low and HD-WLE with random biopsy analysis detects most cases of neoplasia. The evaluation and treatment of patients with BO and early-stage neoplasia should be centralized in tertiary referral centers, where procedures are performed under optimal conditions, by expert endoscopists. Lesions that require resection are almost always detected by HD-WLE, although advanced imaging techniques can detect additional flat lesions. However, these are of limited clinical significance because they are effectively eradicated by ablation therapy. No endoscopic imaging technique can reliably assess submucosal or lymphangio-invasion. Endoscopic resection of early-stage neoplasia in patients with BO is important for staging and management. Optical chromoendoscopy can also be used to evaluate lesions before endoscopic resection and in follow-up after successful ablation therapy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

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

  11. Sedation and monitoring for gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-02-16

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

  12. Vibration measurements by pulsed digital holographic endoscopy

    Science.gov (United States)

    Schedin, Staffan; Pedrini, Giancarlo; Perez-Lopez, Carlos; Mendoza Santoyo, Fernando

    2005-02-01

    Digital holographic interferometry in combination with a flexible fiber endoscope allows high precision measurements of deformations on hidden objects surfaces, inside cavities and objects with small access apertures. A digital holographic endoscopy system is described with a frequency-doubled, twin oscillator Q-switched pulsed Nd:YAG laser as light source. A sequence of digital hologram pairs are recorded with a maximum repetition rate of 260 ms. Each digital hologram is captured at separate video frames of a CCD-camera. The time separation between the laser pulses from each cavity can be set in the range from 50 to 500 μs. The digital holograms are transferred to a PC via a frame grabber and evaluated quantitatively by the Fourier transform method. The resulting phase fringe pattern has the information needed to evaluate quantitatively the amount of the deformation. Experimental results of vibration measurements of hidden mechanical and biological object surfaces are presented. The quality of the results obtained by mechanical object surfaces is usually higher than for biological surfaces. This can be explained easily by the fact that a biological surface is much more complex than a mechanical surface in the sense that some parts of the surface may reflect the light well whereas other parts may absorb the light. Also, biological surfaces are translucent, which means that part of the light may enter inside the sample where it may be absorbed or reflected.

  13. Diagnostic and Therapeutic Yield of Endoscopy in Patients with Elevated INR and Gastrointestinal Bleeding.

    Science.gov (United States)

    Peloquin, Joanna M; Seraj, Siamak M; King, Lindsay Y; Campbell, Emily J; Ananthakrishnan, Ashwin N; Richter, James M

    2016-06-01

    Gastrointestinal bleeding is a well-known risk of systemic anticoagulation. However, bleeding in the setting of supratherapeutic anticoagulation may have a milder natural history than unprovoked bleeding. It is a common clinical gestalt that endoscopy is common, but bleeding source identification or intervention is uncommon, yet few data exist to inform this clinical impression. Consequently, we sought to examine our institutional experience with gastrointestinal bleeding in the setting of supratherapeutic international normalized ratio (INR) with the aim of identifying predictors of endoscopically identifiable lesions, interventions, and outcomes. A retrospective review was conducted at a tertiary referral academic medical center to identify patients presenting with gastrointestinal bleeding in the setting of warfarin and a supratherapeutic INR (>3.5) who underwent an endoscopic procedure. Relevant clinical covariates, endoscopic findings, need for intervention, and outcomes were collected by review of the medical record. Logistic regression adjusting for potential confounders identified predictors of endoscopically significant lesions as well as intervention and outcomes. A total of 134 patients with INR 3.5 or greater (mean 5.5, range 3.5-17.1) presented with symptoms of gastrointestinal bleeding, most commonly as melena or symptomatic anemia. Antiplatelet agents were used by 54% of patients, and 60% of patients were on concomitant acid suppression on admission. Procedures included esophagogastroduodenoscopy (upper endoscopy; EGD) (n = 128), colonoscopy (n = 73), and video capsule endoscopy (n = 32). Active bleeding at first EGD or colonoscopy was found in only 19 patients (18%), with endoscopic intervention in only 26 patients (25%). At a critical threshold of INR 7.5 at presentation, the likelihood of finding an endoscopically significant lesion fell to therapy (odds ratio [OR] 2.59; 95% confidence interval [CI], 1.13-5.94), timing of EGD within 12 hours of

  14. Indirect MR arthrographic findings of adhesive capsulitis.

    Science.gov (United States)

    Song, Kyoung Doo; Kwon, Jong Won; Yoon, Young Cheol; Choi, Sang-Hee

    2011-12-01

    The objective of our study was to compare the indirect MR arthrographic findings of patients with adhesive capsulitis and patients without adhesive capsulitis. Indirect MR arthrograms of 35 patients (21 women, 14 men; mean age, 50.1 years) diagnosed with adhesive capsulitis clinically were compared with indirect MR arthrograms of 45 patients (23 women, 22 men; mean age, 48.9 years) without adhesive capsulitis. Joint capsule thickness in the axillary recess and the thicknesses of the enhancing portion of the axillary recess and the rotator interval were, respectively, evaluated on coronal T2-weighted images and coronal and sagittal fat-suppressed enhanced T1-weighted images by two radiologists independently. Reliability was studied using the intraclass correlation coefficient (ICC). Receiver operating characteristic (ROC) curves were compared. Patients with adhesive capsulitis had significantly thickened joint capsules in the axillary recess and a thickened enhancing portion in the axillary recess and in the rotator interval. The difference in the thicknesses of the enhancing portion in the axillary recess and in the rotator interval were significantly greater than the difference in joint capsule thicknesses in the axillary recess between the adhesive capsulitis group and the control group (p capsule in the axillary recess and the thicknesses of the enhancing portion of the axillary recess and the rotator interval were 0.797, 0.861, and 0.847, respectively. An abundance of enhancing tissue in the rotator interval and thickening and enhancement of the axillary recess are signs suggestive of adhesive capsulitis on indirect MR arthrography.

  15. DIABETES AND SHOULDER ADHESIVE CAPSULITIS

    Directory of Open Access Journals (Sweden)

    J. Mohanakrishnan

    2016-08-01

    Full Text Available Background: Adhesive capsulitis (AC of shoulder is a common condition encountered by physical therapists in their routine outpatient care services; AC of shoulder is as by itself being a self limiting disorder lasts from months to years causing pain and discomfort to the patients. The condition is commonly associated with Diabetes mellitus or other co morbidities. The incidence of AC is high among diabetic individuals and it becomes mandatory on the part of physical therapists and other health professionals to approach this issue on a holistic manner. This paper deals with the importance of a physiotherapist role in prevention and dealing with the causative factors of AC and not merely its symptom. Methods: Extensive literature review was done from the electronic data bases, Systematic reviews and critical reviews from Pub med indexed journals and other peer reviewed publications across the globe. Results: It was not the type of diabetes but the duration of the disease and the glycemic index, marking the causative factor for adhesive capsulitis of shoulder. Conclusion: It may be concluded that physiotherapist play a vital role in identifying the pre-diabetic or a diabetic state of an individual reporting in a multi disciplinary set up with a AC of shoulder, and also has a role in the prevention of AC by helping the individual to maintain a good glycemic control with a holistic approach which includes aerobic exercises, General Flexibility exercises, Weight management and Yoga therapy.

  16. Tethered SECM endoscopic capsule for the diagnosis of eosinophilic esophagitis (Conference Presentation)

    Science.gov (United States)

    Do, Dukho; Kang, DongKyun; Tabatabaei, Nima; Grant, Catriona N.; Nishioka, Norman S.; Rosenberg, Mireille; Hesterberg, Paul E.; Yuan, Qian; Garber, John J.; Katz, Aubrey J.; Shreffler, Wayne G.; Tearney, Guillermo J.

    2017-02-01

    Eosinophilic Esophagitis (EoE) is an inflammatory disease caused by inhaled or ingested food allergies, and characterized by the infiltration of eosinophils in the esophagus. The gold standard for diagnosing EoE is to conduct endoscopy and obtain multiple biopsy specimens from different portions of the esophagus; an exam is considered positive if more than 15 eosinophils per high power field (HPF) in any of the biopsies. This method of diagnosis is problematic because endoscopic biopsy is expensive and poorly tolerated and the esophageal eosinophil burden needs to be monitored frequently during the course of the disease. Spectrally encoded confocal microscopy (SECM) is a high-speed confocal microscopy technology that can visualize individual eosinophils in large microscopic images of the human esophagus, equivalent to more than 30,000 HPF. Previously, we have demonstrated that tethered capsule SECM can be conducted in unsedated subjects with diagnosed EoE. However, speckle noise and the relatively low resolution in images obtained with the first capsule prototypes made it challenging to distinguish eosinophils from other cells. In this work, we present a next-generation tethered SECM capsule, which has been modified to significantly improve image quality. First, we substituted the single mode fiber with a dual-clad fiber to reduce speckle noise. A gradient-index multimode fiber was fusion spliced at the tip of the dual-clad fiber to increase the effective numerical aperture of the fiber from 0.09 to 0.15, expanding the beam more rapidly to increase the illumination aperture at the objective. These modifications enabled the new SECM capsule to achieve a lateral resolution of 1.8 µm and an axial resolution of 16.1 µm, which substantially improves the capacity of this probe to visualize cellular features in human tissue. The total size of the SECM capsule remained 6.75 mm in diameter and 31 mm in length. We are now in the process of testing this new SECM capsule in

  17. Colon dissection: a new three-dimensional reconstruction tool for computed tomography colonography

    International Nuclear Information System (INIS)

    Roettgen, R.; Fischbach, F.; Plotkin, M.; Herzog, H.; Freund, T.; Schroeder, R. J.; Felix, R.

    2005-01-01

    Purpose: To improve the sensitivity of computed tomography (CT) colonography in the detection of polyps by comparing the 3D reconstruction tool 'colon dissection' and endoluminal view (virtual colonoscopy) with axial 2D reconstructions. Material and Methods: Forty-eight patients (22 M, 26 F, mean age 57±21) were studied after intra-anal air insufflation in the supine and prone positions using a 16-slice helical CT (16x0.625 mm, pitch 1.7; detector rotation time 0.5 s; 160 mAs und 120 kV) and conventional colonoscopy. Two radiologists blinded to the results of the conventional colonoscopy analyzed the 3D reconstruction in virtual-endoscopy mode, in colon-dissection mode, and axial 2D slices. Results: Conventional colonoscopy revealed a total of 35 polyps in 15 patients; 33 polyps were disclosed by CT methods. Sensitivity and specificity for detecting colon polyps were 94% and 94%, respectively, when using the 'colon dissection', 89% and 94% when using 'virtual endoscopy', and 62% and 100% when using axial 2D reconstruction. Sensitivity in relation to the diameter of colon polyps with 'colon dissection', 'virtual colonoscopy', and axial 2D-slices was: polyps with a diameter >5.0 mm, 100%, 100%, and 71%, respectively; polyps with a diameter of between 3 and 4.9 mm, 92%, 85%, and 46%; and polyps with a diameter <3 mm, 89%, 78%, and 56%. The difference between 'virtual endoscopy' and 'colon dissection' in diagnosing polyps up to 4.9 mm in diameter was statistically significant. Conclusion: 3D reconstruction software 'colon dissection' improves sensitivity of CT colonography compared with the endoluminal view

  18. The Effects of Irreversible Electroporation on the Colon in a Porcine Model.

    Science.gov (United States)

    Luo, Xiaomei; Liang, Xianjun; Li, Jiannan; Shi, Jian; Zhang, Wenlong; Chai, Wei; Wu, Jiuping; Guo, Shuai; Fang, Gang; Zhou, Xulong; Zhang, Jianhua; Xu, Kecheng; Zeng, Jianying; Niu, Lizhi

    2016-01-01

    Irreversible electroporation (IRE) is a method of targeted cell ablation which has been suggested as a potential cancer therapy as it leaves structures such as blood vessels and the extracellular matrix intact, thereby allowing the rapid recovery of healthy tissue. Here, we investigated the effects of IRE on the colon in vivo in a porcine model. IRE ablation was performed on the colon walls of 12 female Tibet mini-pigs, creating a total of 24 lesions. Lesions were monitored periodically by endoscopy. The pigs were euthanized 7, 14, 21 or 28 days after IRE ablation and the colons harvested for gross and histological analysis. Sections were stained with hematoxylin and eosin (H&E), Masson's trichrome (MT) stain and terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) assay. All pigs tolerated the ablation procedure without serious clinical symptoms or complications. There was no evidence of perforation by endoscopy or gross postmortem examination. All lesions were characterized by necrotic cell death with mild inflammation and hyperemia, with a sharp demarcation between ablated and adjacent normal tissue. A fibrous scar was observed in the ablated colon tissue. Histological analysis revealed damage to each layer of the colon. Histopathology findings also showed the preservation of extracellular structures and the recovery of the ablated colon. The complete ablation of the target area, its rapid recovery and the lack of posttreatment symptoms suggest that IRE ablation may be a promising therapy for tumors located adjacent to or violating the colon wall.

  19. Passive sorting of capsules by deformability

    Science.gov (United States)

    Haener, Edgar; Juel, Anne

    We study passive sorting according to deformability of liquid-filled ovalbumin-alginate capsules. We present results for two sorting geometries: a straight channel with a half-cylindrical obstruction and a pinched flow fractioning device (PFF) adapted for use with capsules. In the half-cylinder device, the capsules deform as they encounter the obstruction, and travel around the half-cylinder. The distance from the capsule's centre of mass to the surface of the half-cylinder depends on deformability, and separation between capsules of different deformability is amplified by diverging streamlines in the channel expansion downstream of the obstruction. We show experimentally that capsules can be sorted according to deformability with their downstream position depending on capillary number only, and we establish the sensitivity of the device to experimental variability. In the PFF device, particles are compressed against a wall using a strong pinching flow. We show that capsule deformation increases with the intensity of the pinching flow, but that the downstream capsule position is not set by deformation in the device. However, when using the PFF device like a T-Junction, we achieve improved sorting resolution compared to the half-cylinder device.

  20. Hygiene: The Looming Achilles Heel in Endoscopy.

    Science.gov (United States)

    Jung, Michael; Beilenhoff, Ulrike

    2016-02-01

    Since the late 1970s there have been sporadic reports of nosocomial infections linked to endoscopic procedures. Infections by multidrug-resistant organisms (MDRO) have an increasing impact on healthcare systems worldwide. Since 2010 outbreaks involving MDRO have been reported as a result of endoscopic retrograde cholangiopancreatography (ERCP) from the USA, France, Germany and the Netherlands. This article evaluates the recent outbreaks and developments and demonstrates a structural approach to how to prevent future infections. Current national and international guidelines were used as a basis for discussions. In some cases insufficient cleaning or drying supported the outbreak. In the majority of cases, outbreaks occurred despite the apparently appropriate reprocessing protocols being in use. Microlesions were identified on a number of endoscopes, which supported the growth of bacteria and represented a vehicle for the transmission of infectious material. National official bodies responded with warnings. Manufacturers informed their customers accordingly. Separate, purpose-designed reprocessing rooms and a sufficient number of competent staff provide the structural quality for a safe reprocessing. The process quality includes a thorough cleaning of all endoscope channels and crucial instrument components, followed by an automated and validated reprocessing procedure. Strict adherence to manufacturers' recommendations is essential. The outcome quality should be evaluated by regular audits, validation of reprocessing procedures and microbiological surveillance. If outbreaks occur, a close co-operation with official bodies and manufacturers is essential. Health care professionals and manufacturers should be aware of their responsibility to ensure patient safety. A structural approach is key in prevention of endoscopy-associated infections.

  1. Adhesive capsulitis of the shoulder: MR arthrography

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jeong; Han, Tae Il; Lee, Kwang Won; Choi, Youn Seon; Kim, Dae Hong; Han, Hyun Young; Song, Mun Kab [Eulji Univ. School of Medicine, Taejon (Korea, Republic of); Kwon, Soon Tae [Chungnam National Univ. College of Medicine, Taejon (Korea, Republic of)

    2001-07-01

    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.

  2. Thermoregulation of Capsule Production by Streptococcus pyogenes

    Science.gov (United States)

    Kang, Song Ok; Wright, Jordan O.; Tesorero, Rafael A.; Lee, Hyunwoo; Beall, Bernard; Cho, Kyu Hong

    2012-01-01

    The capsule of Streptococcus pyogenes serves as an adhesin as well as an anti-phagocytic factor by binding to CD44 on keratinocytes of the pharyngeal mucosa and the skin, the main entry sites of the pathogen. We discovered that S. pyogenes HSC5 and MGAS315 strains are further thermoregulated for capsule production at a post-transcriptional level in addition to the transcriptional regulation by the CovRS two-component regulatory system. When the transcription of the hasABC capsular biosynthetic locus was de-repressed through mutation of the covRS system, the two strains, which have been used for pathogenesis studies in the laboratory, exhibited markedly increased capsule production at sub-body temperature. Employing transposon mutagenesis, we found that CvfA, a previously identified membrane-associated endoribonuclease, is required for the thermoregulation of capsule synthesis. The mutation of the cvfA gene conferred increased capsule production regardless of temperature. However, the amount of the capsule transcript was not changed by the mutation, indicating that a post-transcriptional regulator mediates between CvfA and thermoregulated capsule production. When we tested naturally occurring invasive mucoid strains, a high percentage (11/53, 21%) of the strains exhibited thermoregulated capsule production. As expected, the mucoid phenotype of these strains at sub-body temperature was due to mutations within the chromosomal covRS genes. Capsule thermoregulation that exhibits high capsule production at lower temperatures that occur on the skin or mucosal surface potentially confers better capability of adhesion and invasion when S. pyogenes penetrates the epithelial surface. PMID:22615992

  3. High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

    Science.gov (United States)

    Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

    2016-06-01

    Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. What Kind of Capsule Endoscope Is Suitable for a Controllable Self-Propelling Capsule Endoscope? Experimental Study Using a Porcine Stomach Model for Clinical Application (with Videos)

    Science.gov (United States)

    Ota, Kazuhiro; Nouda, Sadaharu; Takeuchi, Toshihisa; Iguchi, Munetaka; Kojima, Yuichi; Kuramoto, Takanori; Inoue, Takuya; Shindo, Yasunori; Uesugi, Kenshiro; Fujito, Yoshiaki; Nishihara, Hironori; Ohtsuka, Naotake; Higuchi, Kazuhide

    2015-01-01

    Background We have been developing the Self-Propelling Capsule Endoscope (SPCE) that allows for controllability from outside of the body and real-time observation. What kind of capsule endoscope (CE) is suitable for a controllable SPCE is unclear and a very critical point for clinical application. We compared observing ability of three kinds of SPCEs with different viewing angles and frame rates. Methods Eleven buttons were sewed in an excised porcine stomach. Four examiners controlled the SPCE using PillCamSB2, -ESO2, and -COLON2 (Given Imaging Ltd., Israel), for 10 minutes each with the aim of detecting as many buttons and examining them as closely as possible. The ability to find lesions was assessed based on the number of detected buttons. The SPCE-performance score (SPS) was used to evaluate the ability to examine the lesions in detail. Results The SPCE-ESO2, -COLON2, and -SB2 detected 11 [interquartile range (IQR): 0], 10.5 (IQR, 0.5), and 8 (IQR, 1.0) buttons, respectively. The SPCE-ESO2 and -COLON2 had a significantly better ability to detect lesions than the -SB2 (p stomach. PMID:26447694

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    the field of endoscopy and prioritizing those that are important enables researchers and funders to appropriately allocate resources. Methods: Over 2 years, the ESGE Research Committee gathered information on research priorities and refined them through a modified Delphi approach. Consultations were held...... with the ESGE Governing Board and Quality Improvement Committee to identify important unanswered questions. Research workshops were held at the 21st United European Gastroenterology Week. Research questions were refined by the ESGE Research Committee and Governing Board, compiled into an online survey...... %) and were specialist endoscopists (51 %). Responses were analyzed with weighted rankings, resulting in prioritization of 26 key unanswered questions. The top ranked generic questions were: 1) How do we define the correct surveillance interval following endoscopic diagnosis? 2) How do we correctly utilize...

  6. [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.

  7. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, Jean-Marc; Riphaus, Andrea; Schreiber, Florian

    2015-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). It addresses the administration of propofol by non-anesthesiologists for gastrointestinal (GI) endoscopy....... Main Recommendations 1 We recommend that the type of endoscopic procedure and the patient's American Society of Anesthesiologists (ASA) physical status, age, body mass index, Mallampati's classification, and risk factors for obstructive sleep apnea (OSA) be assessed before each procedure with non...... deep sedation, and long procedures (weak recommendation, high quality evidence). 4 We suggest propofol monotherapy except in particular situations (weak recommendation, high quality evidence). 5 We recommend administering propofol through intermittent bolus infusion or perfusor systems, including...

  8. 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...... and piston from an intrauterine device. Six complete capsules and parts of two other capsules were expelled. None of the women became pregnant, compared with a pregnancy rate of 21% per aspiration following in vitro fertilization and embryo transfer during the same period....

  9. The environmental psychology of capsule habitats.

    Science.gov (United States)

    Suedfeld, P; Steel, G D

    2000-01-01

    Capsule habitats make it possible for human beings to survive and function in environments that would otherwise be lethal, such as space, the ocean depths, and the polar regions. The number of people entering capsules in the course of their work or for purposes of recreation is constantly increasing. However, long-term living in such habitats imposes physical and psychological risks as well as offering opportunities and benefits. This paper reviews what is known about the environmental, social, and personality aspects of adaptation to capsules, including sources of stress, selection criteria, obstacles to and facilitators of adequate coping, changes in group interaction, the role of temporal factors, and post-mission consequences.

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

    Directory of Open Access Journals (Sweden)

    Donald MacIntosh

    2013-01-01

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

  11. 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.

  12. Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

    Science.gov (United States)

    Somers, S; Stevenson, G W; Thompson, G

    1986-06-01

    Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

  13. Gastrointestinal endoscopy- An emerging soft power in health care

    Directory of Open Access Journals (Sweden)

    G V Rao

    2012-01-01

    Full Text Available "Soft power" is a relatively new concept that describes an entity′s ability to influence and alter the behavior of other entities through attraction and co-option, in contrast to hard power which uses incentives and coercion. Assessment of the role of GI GI (Gastrointestinal Endoscopy in present day′s health care shows it to have the required attractive and influential properties of a soft power. In this article we examine the diagnostic and therapeutic roles that GI endoscopy, as a soft power, has taken over, and the further evolution of this field into a smart power.

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

    Directory of Open Access Journals (Sweden)

    Héctor Julian Canaval-Zuleta

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

  15. Polyamide capsules via soft templating with oil drops-1. Morphological studies of the capsule wall.

    Science.gov (United States)

    Essawy, Hisham; Tauer, Klaus

    2010-02-01

    Poly(terephthalamide) microcapsules can be reproducibly and easily prepared by interfacial polycondensation around emulsion droplets in water. Oil drops of cyclohexane/chloroform mixture stabilized with poly(vinyl alcohol) containing terephthaloylchloride serve as soft template. The interfacial polycondensation starts immediately after addition of an amine mixture (hexamethylenediamine/diethylenetriamine). Light and scanning electron microscopy prove the formation of capsules with size distribution in the range from a few up to 100 microm depending on particular composition of the reaction mixture. The morphology of the capsule wall is characterized by precipitated particles. If instead of pure organic solvents a reactive oil phase is used as template, the capsules can serve in subsequent reactions as templates for the synthesis of composite particles. In this way, styrene can be radically polymerized inside the capsule leading to composite capsules. The capsule morphology is determined by the partition of all components between all phases.

  16. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer.

    Science.gov (United States)

    Yagi, Kazuyoshi; Saka, Akiko; Nozawa, Yujiro; Nakamura, Atsuo

    2014-04-01

    To reduce the incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer, Helicobacter pylori eradication therapy has been endorsed. It is not unusual for such patients to be H. pylori negative after eradication or for other reasons. If it were possible to predict H. pylori status using endoscopy alone, it would be very useful in clinical practice. To clarify the accuracy of endoscopic judgment of H. pylori status, we evaluated it in the stomach after endoscopic submucosal dissection (ESD) of gastric cancer. Fifty-six patients treated by ESD were enrolled. The diagnostic criteria for H. pylori status by conventional endoscopy and narrow-band imaging (NBI)-magnifying endoscopy were decided, and H. pylori status was judged by two endoscopists. Based on the H. pylori stool antigen test as a diagnostic gold standard, conventional endoscopy and NBI-magnifying endoscopy were compared for their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Interobserver agreement was assessed in terms of κ value. Interobserver agreement was moderate (0.56) for conventional endoscopy and substantial (0.77) for NBI-magnifying endoscopy. The sensitivity, specificity, PPV, and NPV were 0.79, 0.52, 0.70, and 0.63 for conventional endoscopy and 0.91, 0.83, 0.88, and 0.86 for NBI-magnifying endoscopy, respectively. Prediction of H. pylori status using NBI-magnifying endoscopy is practical, and interobserver agreement is substantial. © 2013 John Wiley & Sons Ltd.

  17. 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

    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....

  18. Comparison of esomeprazole enteric-coated capsules vs esomeprazole magnesium in the treatment of active duodenal ulcer: A randomized, double-blind, controlled study

    Science.gov (United States)

    Liang, Xiao-Yan; Gao, Qing; Gong, Neng-Ping; Tang, Li-Ping; Wang, Pi-Long; Tao, Xiao-Hong

    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. PMID:18350637

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

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    of this evidence- and consensus-based set of guideline is to provide non-anaesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE......), 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....

  20. Endoscopy services in KwaZulu-Natal Province, South Africa, are ...

    African Journals Online (AJOL)

    There were 0.06 registered gastroenterologists (GEs) per 100 000 population. Each endoscopist performed an average of 263 endoscopies per annum. There were 1.18 endoscopy rooms available per unit, and two units had on-site fluoroscopy available. The average waiting period for an upper endoscopy was 27 (range 7 ...