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Sample records for fiberoptic endoscopic evaluation

  1. Fiber-optic endoscopic evaluation of swallowing (FEES): predictor of swallowing-related complications in the head and neck cancer population.

    Science.gov (United States)

    Deutschmann, Michael W; McDonough, Alanna; Dort, Joseph C; Dort, Erika; Nakoneshny, Steve; Matthews, T Wayne

    2013-07-01

    The treatment of head and neck cancer is associated with significant dysphagia and morbidity. Prescribing a safe oral diet in this population is challenging. Data from 116 consecutive patients having 189 fiber-optic endoscopic evaluation of swallowing (FEES) examinations over a 3-year period were analyzed. All patients had been treated for head and neck cancer and subsequently were assessed by FEES. The primary outcome was the incidence of swallowing-related adverse events resulting from the FEES-based dietary recommendations. There were 10 episodes of aspiration pneumonia, 4 episodes of airway obstruction, 3 unanticipated insertions of gastrostomy tubes, and 2 unexplained deaths within the study period. The overall rate of adverse events was 10.1%. The only statistically significant predictor of adverse events was the Rosenbek score (p = .03). Our experience is that FEES guides appropriate and safe diet recommendations in this population. Copyright © 2012 Wiley Periodicals, Inc.

  2. Relationship between swallow-specific quality of life and fiber-optic endoscopic evaluation of swallowing findings in patients with head and neck cancer.

    Science.gov (United States)

    Florie, Michelle; Baijens, Laura; Kremer, Bernd; Kross, Kenneth; Lacko, Martin; Verhees, Femke; Winkens, Bjorn

    2016-04-01

    The purpose of this study was to determine the relationship between swallow-specific quality of life (QOL) using the MD Anderson Dysphagia Inventory (MDADI) and the swallowing function using a standardized fiber-optic endoscopic evaluation of swallowing (FEES) protocol in patients with dysphagia with head and neck cancer. Sixty-three patients with dysphagia and head and neck cancer were enrolled in the study. Patients completed the MDADI questionnaire and underwent a standardized FEES examination. Ordinal FEES variables were measured. Descriptive statistics and 1-way analysis of variance tests were carried out. For all FEES variables, the observer agreement level was sufficient (kappa ≥0.7).These preliminary results show statistically significant mean differences of MDADI subscales between the ordinal scale levels for several FEES variables. The MDADI questionnaire can be used to assess the impact of dysphagia on the patients' health-related QOL. Despite clear trends, it remains unclear if the MDADI questionnaire can be used as an indicator for the severity of oropharyngeal dysphagia. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1848-E1856, 2016. © 2015 Wiley Periodicals, Inc.

  3. Combined neuromuscular electrical stimulation (NMES) with fiberoptic endoscopic evaluation of swallowing (FEES) and traditional swallowing rehabilitation in the treatment of stroke-related dysphagia.

    Science.gov (United States)

    Sun, Shu-Fen; Hsu, Chien-Wei; Lin, Huey-Shyan; Sun, Hsien-Pin; Chang, Ping-Hsin; Hsieh, Wan-Ling; Wang, Jue-Long

    2013-12-01

    Dysphagia is common after stroke. Neuromuscular electrical stimulation (NMES) and fiberoptic endoscopic evaluation of swallowing (FEES) for the treatment of dysphagia have gained in popularity, but the combined application of these promising modalities has rarely been studied. We aimed to evaluate whether combined NMES, FEES, and traditional swallowing rehabilitation can improve swallowing functions in stroke patients with moderate to severe dysphagia. Thirty-two patients with moderate to severe dysphagia poststroke (≥3 weeks) were recruited. Patients received 12 sessions of NMES for 1 h/day, 5 days/week within a period of 2-3 weeks. FEES was done before and after NMES for evaluation and to guide dysphagic therapy. All patients subsequently received 12 sessions of traditional swallowing rehabilitation (50 min/day, 3 days/week) for 4 weeks. Primary outcome measure was the Functional Oral Intake Scale (FOIS). Secondary outcome measures included clinical degree of dysphagia, the patient's self-perception of swallowing ability, and the patient's global satisfaction with therapy. Patients were assessed at baseline, after NMES, at 6-month follow-up, and at 2-year follow-up. Twenty-nine patients completed the study. FOIS, degree of dysphagia, and patient's self-perception of swallowing improved significantly after NMES, at the 6-month follow-up, and at the 2-year follow-up (p rehabilitation showed promise for improving swallowing functions in stroke patients with moderate-to-severe dysphagia. The benefits were maintained for up to 2 years. The results are promising enough to justify further studies.

  4. High Resolution Sub-MM Fiberoptic Endoscope Final Report CRADA No. TSB-1447-97

    Energy Technology Data Exchange (ETDEWEB)

    Stone, Gary F. [Univ. of California, Livermore, CA (United States); Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Smith, John [CML Fiberoptics, Inc., Auburn, NY (United States)

    2018-01-22

    At the time of the CRADA, LLNL needed to develop a sub-mm outer diameter fiberoptic endoscope with 25pm or better resolution at 3-lOmm working distance to support the Enhanced Surveillance Program (ESP) and the Core Surveillance Program for DOE. The commercially available systems did not meet the image resolution requirements and development work was needed to reach three goals. We also needed to perform preliminary investigations into the production of such an endoscope with a steerable-articulated distal end. The goal of such an endoscope was to allow for a 45 degree inspection cone including the lens field of view.

  5. Improving quality and performance practices using fiberoptic endoscopes in perioperative areas: a case study.

    Science.gov (United States)

    Howard, B J

    1998-01-01

    In response to the impact of healthcare reform, a re-engineering of problem areas within the University of Maryland's Medical System needed to be initiated. A critical issue to be addressed, within the perioperative areas of the hospital, was the delay in service because of the unavailability of functional fiberoptic endoscopes. This resulted in spiraling operating costs and compromised quality of care of patients. Analysis of the situation using fiberscope inventory data revealed unreliable quality-controlled reprocessing systems and lack of knowledge by the staff in handling and caring for the fiberscopes. A number of actions were taken to improve staff patterns of performance. Graphs, spreadsheets, and diagrams were used to pinpoint the problem areas for each perioperative area and were presented to the staff. These data were up-dated monthly to inform staff and inspire further improvements in performance. This re-engineering of the fiberoptic scope delivery system resulted in economic, operational, customers, and quality of care benefits. Fiberoptic endoscopes are increasingly used is surgical fields outside of the traditional endoscopy unit. Endoscopic nurses need to share expertise to improve the quality of performance in all areas of the hospital where fiberoptic scopes are used.

  6. Miniaturized fiber-optic ultrasound probes for endoscopic tissue analysis by micro-opto-mechanical technology.

    Science.gov (United States)

    Vannacci, E; Belsito, L; Mancarella, F; Ferri, M; Veronese, G P; Roncaglia, A; Biagi, E

    2014-06-01

    A new Micro-Opto-Mechanical System (MOMS) technology for the fabrication of optoacoustic probes on optical fiber is presented. The technology is based on the thermoelastic emission of ultrasonic waves from patterned carbon films for generation and on extrinsic polymer Fabry-Perot acousto-optical transducers for detection, both fabricated on miniaturized single-crystal silicon frames used to mount the ultrasonic transducers on the tip of an optical fiber. Thanks to the fabrication process adopted, high miniaturization levels are reached in the MOMS devices, demonstrating fiber-optic emitters and detectors with minimum diameter around 350 and 250 μm respectively. A thorough functional testing of the ultrasound emitters mounted on 200 and 600 μm diameter optical fibers is presented, in which the fiber-optic emitter with a diameter of 200 μm shows generated acoustic pressures with peak-to-peak value up to 2.8 MPa with rather flat emission spectra extended beyond 150 MHz. The possibility to use the presented optoacoustic sources in conjunction with the fiber-optic acousto-optical detectors within a minimally invasive probe is also demonstrated by successfully measuring the ultrasonic echo reflected from a rigid surface immersed in water with various concentration of scatterers. The resulting spectra highlight the possibility to discriminate the effects due to frequency selective attenuation in a very wide range of frequencies within a biological medium using the presented fiber-optic probes.

  7. Comparative study of the endoscope-based bevelled and volume fiber-optic Raman probes for optical diagnosis of gastric dysplasia in vivo at endoscopy.

    Science.gov (United States)

    Wang, Jianfeng; Lin, Kan; Zheng, Wei; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; Huang, Zhiwei

    2015-11-01

    This study aims to compare the diagnostic performance of the two different endoscope-based fiber-optic Raman probe designs (i.e., bevelled and volume Raman probes) for real-time, in vivo detection of gastric dysplasia at endoscopy. To conduct the clinical comparison, a total of 1,050 in vivo tissue Raman spectra (normal: n = 864; dysplasia: n = 186) were acquired from 66 gastric patients (normal: n = 48; dysplasia: n = 18) by using bevelled Raman probe, while a total of 1,913 in vivo tissue Raman spectra (normal: n = 1,786; dysplasia: n = 127) were acquired from 98 gastric patients (normal: n = 87; dysplasia: n = 11) by using volume Raman probe. The bevelled Raman probe provides approximately twofold improvements in tissue Raman-to-autofluorescence intensity ratios as compared to the use of volume Raman probe. Partial least squares discriminant analysis together with leave-one patient-out cross-validation on in vivo tissue Raman spectra acquired yields a diagnostic accuracy of 93.0 % (sensitivity of 92.5 %; specificity of 93.1 %) for differentiating gastric dysplasia from normal gastric tissue by using the bevelled fiber-optic Raman probe, which is superior to the diagnostic performance (accuracy of 88.4 %; sensitivity of 85.8 %; specificity of 88.6 %) by using the volume Raman probe. This work demonstrates that the Raman spectroscopic technique coupled with bevelled fiber-optic Raman probe has great potential to enhance in vivo diagnosis of gastric precancer and early cancer at endoscopy. Graphical Abstract Comparison of in vivo gastric tissue Raman spectra acquired by using bevelled and volume fiber-optic Raman probes.

  8. Scoping the scope: endoscopic evaluation of endoscope working channels with a new high-resolution inspection endoscope (with video).

    Science.gov (United States)

    Barakat, Monique T; Girotra, Mohit; Huang, Robert J; Banerjee, Subhas

    2018-02-06

    Outbreaks of transmission of infection related to endoscopy despite reported adherence to reprocessing guidelines warrant scrutiny of all potential contributing factors. Recent reports from ambulatory surgery centers indicated widespread significant occult damage within endoscope working channels, raising concerns regarding the potential detrimental impact of this damage on the adequacy of endoscope reprocessing. We inspected working channels of all 68 endoscopes at our academic institution using a novel flexible inspection endoscope. Inspections were recorded and videos reviewed by 3 investigators to evaluate and rate channel damage and/or debris. Working channel rinsates were obtained from all endoscopes, and adenosine triphosphate (ATP) bioluminescence was measured. Overall endoscope working channel damage was rated as minimal and/or mild and was consistent with expected wear and tear (median 1.59 on our 5-point scale). Our predominant findings included superficial scratches (98.5%) and scratches with adherent peel (76.5%). No channel perforations, stains, or burns were detected. The extent of damage was not predicted by endoscope age. Minor punctate debris was common, and a few small drops of fluid were noted in 42.6% of endoscopes after reprocessing and drying. The presence of residual fluid predicted higher ATP bioluminescence values. The presence of visualized working channel damage or debris was not associated with elevated ATP bioluminescence values. The flexible inspection endoscope enables high-resolution imaging of endoscope working channels and offers endoscopy units an additional modality for endoscope surveillance, potentially complementing bacterial cultures and ATP values. Our study, conducted in a busy academic endoscopy unit, indicated predominately mild damage to endoscope working channels, which did not correlate with elevated ATP values. Copyright © 2018 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights

  9. Endoscopic vs. tactile evaluation of subgingival calculus.

    Science.gov (United States)

    Osborn, Joy B; Lenton, Patricia A; Lunos, Scott A; Blue, Christine M

    2014-08-01

    Endoscopic technology has been developed to facilitate imagery for use during diagnostic and therapeutic phases of periodontal care. The purpose of this study was to compare the level of subgingival calculus detection using a periodontal endoscope with that of conventional tactile explorer in periodontitis subjects. A convenience sample of 26 subjects with moderate periodontitis in at least 2 quadrants was recruited from the University of Minnesota School of Dentistry to undergo quadrant scaling and root planing. One quadrant from each subject was randomized for tactile calculus detection alone and the other quadrant for tactile detection plus the Perioscope ™ (Perioscopy Inc., Oakland, Cali). A calculus index on a 0 to 3 score was performed at baseline and at 2 post-scaling and root planing visits. Sites where calculus was detected at visit 1 were retreated. T-tests were used to determine within-subject differences between Perioscope™ and tactile measures, and changes in measures between visits. Significantly more calculus was detected using the Perioscope™ vs. tactile explorer for all 3 subject visits (pcalculus detection from baseline to visit 1 were statistically significant for both the Perioscope™ and tactile quadrants (pcalculus detection from visit 1 to visit 2 was only significant for the Perioscope™ quadrant (pcalculus at this visit. It was concluded that the addition of a visual component to calculus detection via the Perioscope™ was most helpful in the re-evaluation phase of periodontal therapy. Copyright © 2014 The American Dental Hygienists’ Association.

  10. Evaluation of the Detection Efficiency of LYSO Scintillator in the Fiber-Optic Radiation Sensor

    Directory of Open Access Journals (Sweden)

    Chan Hee Park

    2014-01-01

    Full Text Available The aim of this study was to develop and evaluate fiber-optic sensors for the remote detection of gamma rays in areas that are difficult to access, such as a spent fuel pool. The fiber-optic sensor consists of a light-generating probe, such as scintillators for radiation detection, plastic optical fibers, and light-measuring devices, such as PMT. The (Lu,Y2SiO5:Ce(LYSO:Ce scintillator was chosen as the light-generating probe. The (Lu,Y2SiO5:Ce(LYSO:Ce scintillator has higher scintillation efficiency than the others and transmits light well through an optical fiber because its refraction index is similar to the refractive index of the optical fiber. The fiber-optic radiation sensor using the (Lu,Y2SiO5:Ce(LYSO:Ce scintillator was evaluated in terms of the detection efficiency and reproducibility for examining its applicability as a radiation sensor.

  11. Fiber-Optic Sensor Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Constructs and evaluates fiber-optic sensors for a variety of measurands. These measurands include acoustic, pressure, magnetic, and electric field as well...

  12. Evaluation of an endoscopic liver biopsy technique in green iguanas.

    Science.gov (United States)

    Hernandez-Divers, Stephen J; Stahl, Scott J; McBride, Michael; Stedman, Nancy L

    2007-06-15

    To establish a safe and effective endoscopic technique for collection of liver biopsy specimens from lizards by use of a 2.7-mm rigid endoscope system that is commonly available in zoologic veterinary practice. Prospective study. 11 subadult male green iguanas (Iguana iguana). Each lizard was anesthetized, and right-sided coelioscopic examination of the right liver lobe and gallbladder was performed. Three liver biopsy specimens were collected from each lizard by use of a 2.7-mm rigid endoscope and 1.7-mm (5-F) biopsy forceps. Biopsy samples were evaluated histologically for quality and crush artifact. Ten days following surgery, all iguanas were euthanatized and underwent full necropsy examination. For all 11 iguanas, the right liver lobe and gallbladder were successfully examined endoscopically, and 3 biopsy specimens of the liver were collected without complications. Mean +/- SD durations of anesthesia and surgery were 24 +/- 7 minutes and 6.8 +/- 1.0 minutes, respectively. At necropsy, there was no evidence of trauma or disease associated with the skin or muscle entry sites, liver, or any visceral structures in any iguana. All 33 biopsy specimens were considered acceptable for histologic interpretation; in most samples, the extent of crush artifact was considered minimal. By use of a 2.7-mm rigid endoscope, liver biopsy procedures can be performed safely, swiftly, and easily in green iguanas. Biopsy specimens obtained by this technique are suitable for histologic examination. For evaluation of the liver and biopsy specimen collection in lizards, endoscopy is recommended.

  13. Evaluation of Subepithelial Abnormalities of the Appendix by Endoscopic Ultrasound

    Directory of Open Access Journals (Sweden)

    Lance T. Uradomo

    2009-01-01

    Full Text Available Background. The use of through-the-scope (TTS miniprobe catheter endoscopic ultrasound is a valuable technique for evaluating subepithelial lesions in the proximal colon. Few reports include the evaluation of the appendix by EUS. Objective. To describe endoscopic and endosonographic characteristics of subepithelial lesions of the appendix. Methods. Retrospective case series in a single academic medical center. Adult patients referred for evaluation of subepithelial lesions of the appendix identified by colonoscopy between April 1, 2003 to February 29, 2008. Data were abstracted from an electronic endoscopic database for all patients undergoing miniprobe endoscopic ultrasound examination of the appendix. Medical records were reviewed for patient followup and outcomes. Results. Nine cases were identified. Seven (78% patients were female. Seven (78% utilized the 12 MHz miniprobe device and two (22% used the 20 MHz device. Three mucoceles were described and confirmed by surgical resection. Cases also included one inverted appendix, one gastrointestinal stromal tumor, and one lipoma. In three cases, no abnormality was found. Conclusions. EUS evaluation of the appendix is feasible with standard miniprobe devices and may assist in the selection of patients who may benefit from surgical management.

  14. Dexmedetomidine premedication for fiberoptic intubation in patients of temporomandibular joint ankylosis: A randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Kumkum Gupta

    2012-01-01

    Full Text Available Background : Fiberoptic intubation is the gold standard technique for difficult airway management in patients of temporomandibular joint. This study was aimed to evaluate the clinical efficacy and safety of dexmedetomidine as premedication with propofol infusion for fiberoptic intubation. Methods: Consent was obtained from 46 adult patients of temporomandibular joint ankylosis, scheduled for gap arthroplasty. They were enrolled for thisdouble-blind, randomized, prospective clinical trial with two treatment groups - Group D and Group P, of 23 patients each. Group D patients had received premedication of dexmedetomidine 1 μg/kg infused over 10 min followed by sedative propofol infusion and the control Group P patients were given only propofol infusion to achieve sedation. Condition achieved at endoscopy, intubating conditions, hemodynamic changes and postoperative events were evaluated as primary outcome. Results : The fiberoptic intubation was successful with satisfactory endoscopic and intubating condition in all patients. Dexmedetomidine premedication has provided satisfactory conditions for fiberoptic intubation and attenuated the hemodynamic response of fiberoptic intubation than the propofol group. Conclusion : Fiberoptic intubation was found to be easier with dexmedetomidine premedication along with sedative infusion of propofol with complete amnesia of the procedure, hemodynamic stability and preservation of patent airway.

  15. Endoscopic ultrasound, endoscopic sonoelastography, and strain ratio evaluation of lymph nodes with histology as gold standard

    DEFF Research Database (Denmark)

    Larsen, Michael Hareskov; Fristrup, Claus Wilki; Hansen, Tine Plato

    2012-01-01

    . Endoscopic sonoelastography (ESE) assesses the elasticity of lymph nodes and has been used to differentiate lymph nodes with promising results. The aim of this study was to evaluate the use of EUS, EUS - FNA, ESE, and ESE-strain ratio using histology as the gold standard. PATIENTS AND METHODS: Patients...... - FNM technique enabled the identification of a specific lymph node and thereby the use of histology as gold standard. ESE and ESE-strain ratio were no better than standard EUS in differentiating between malignant and benign lymph nodes in patients with resectable upper gastrointestinal cancer....

  16. A novel fiber-optic measurement system for the evaluation of performances of neonatal pulmonary ventilators

    Science.gov (United States)

    Battista, L.; Scorza, A.; Botta, F.; Sciuto, S. A.

    2016-02-01

    Published standards for the performance evaluation of pulmonary ventilators are mainly directed to manufacturers rather than to end-users and often considered inadequate or not comprehensive. In order to contribute to overcome the problems above, a novel measurement system was proposed and tested with waveforms of mechanical ventilation by means of experimental trials carried out with infant ventilators typically used in neonatal intensive care units: the main quantities of mechanical ventilation in newborns are monitored, i.e. air flow rate, differential pressure and volume from infant ventilator are measured by means of two novel fiber-optic sensors (OFSs) developed and characterized by the authors, while temperature and relative humidity of air mass are obtained by two commercial transducers. The proposed fiber-optic sensors (flow sensor Q-OFS, pressure sensor P-OFS) showed measurement ranges of air flow and pressure typically encountered in neonatal mechanical ventilation, i.e. the air flow rate Q ranged from 3 l min-1 to 18 l min-1 (inspiratory) and from  -3 l min-1 to  -18 l min-1 (expiratory), the differential pressure ΔP ranged from  -15 cmH2O to 15 cmH2O. In each experimental trial carried out with different settings of the ventilator, outputs of the OFSs are compared with data from two reference sensors (reference flow sensor RF, reference pressure sensor RP) and results are found consistent: flow rate Q showed a maximum error between Q-OFS and RF up to 13 percent, with an output ratio Q RF/Q OFS of not more than 1.06  ±  0.09 (least square estimation, 95 percent confidence level, R 2 between 0.9822 and 0.9931). On the other hand the maximum error between P-OFS and RP on differential pressure ΔP was lower than 10 percent, with an output ratio ΔP RP/ΔP OFS between 0.977  ±  0.022 and 1.0  ±  0.8 (least square estimation, 95 percent confidence level, R 2 between 0.9864 and 0.9876). Despite the possible improvements

  17. A novel fiber-optic measurement system for the evaluation of performances of neonatal pulmonary ventilators

    International Nuclear Information System (INIS)

    Battista, L; Scorza, A; Botta, F; Sciuto, S A

    2016-01-01

    Published standards for the performance evaluation of pulmonary ventilators are mainly directed to manufacturers rather than to end-users and often considered inadequate or not comprehensive. In order to contribute to overcome the problems above, a novel measurement system was proposed and tested with waveforms of mechanical ventilation by means of experimental trials carried out with infant ventilators typically used in neonatal intensive care units: the main quantities of mechanical ventilation in newborns are monitored, i.e. air flow rate, differential pressure and volume from infant ventilator are measured by means of two novel fiber-optic sensors (OFSs) developed and characterized by the authors, while temperature and relative humidity of air mass are obtained by two commercial transducers. The proposed fiber-optic sensors (flow sensor Q-OFS, pressure sensor P-OFS) showed measurement ranges of air flow and pressure typically encountered in neonatal mechanical ventilation, i.e. the air flow rate Q ranged from 3 l min −1 to 18 l min −1 (inspiratory) and from  −3 l min −1 to  −18 l min −1 (expiratory), the differential pressure ΔP ranged from  −15 cmH 2 O to 15 cmH2O. In each experimental trial carried out with different settings of the ventilator, outputs of the OFSs are compared with data from two reference sensors (reference flow sensor RF, reference pressure sensor RP) and results are found consistent: flow rate Q showed a maximum error between Q-OFS and RF up to 13 percent, with an output ratio Q RF /Q OFS of not more than 1.06  ±  0.09 (least square estimation, 95 percent confidence level, R 2 between 0.9822 and 0.9931). On the other hand the maximum error between P-OFS and RP on differential pressure ΔP was lower than 10 percent, with an output ratio ΔP RP /ΔP OFS between 0.977  ±  0.022 and 1.0  ±  0.8 (least square estimation, 95 percent confidence level, R 2 between 0.9864 and 0.9876). Despite the

  18. Endoscopic ultrasound, endoscopic sonoelastography, and strain ratio evaluation of lymph nodes with histology as gold standard

    DEFF Research Database (Denmark)

    Larsen, Michael Hareskov; Fristrup, Claus Wilki; Hansen, Tine Plato

    2012-01-01

    . Endoscopic sonoelastography (ESE) assesses the elasticity of lymph nodes and has been used to differentiate lymph nodes with promising results. The aim of this study was to evaluate the use of EUS, EUS - FNA, ESE, and ESE-strain ratio using histology as the gold standard. PATIENTS AND METHODS: Patients......, EUS - FNA and EUS - FNM were performed. The marked lymph node was isolated during surgery for histological examination. RESULTS: The marked lymph node was isolated for separate histological examination in 56 patients, of whom 22 (39 %) had malignant lymph nodes and 34 (61 %) had benign lymph nodes...... - FNM technique enabled the identification of a specific lymph node and thereby the use of histology as gold standard. ESE and ESE-strain ratio were no better than standard EUS in differentiating between malignant and benign lymph nodes in patients with resectable upper gastrointestinal cancer....

  19. Evaluation of endoscopic entire 3D image acquisition of the digestive tract using a stereo endoscope

    Science.gov (United States)

    Yoshimoto, Kayo; Watabe, Kenji; Fujinaga, Tetsuji; Iijima, Hideki; Tsujii, Masahiko; Takahashi, Hideya; Takehara, Tetsuo; Yamada, Kenji

    2017-02-01

    Because the view angle of the endoscope is narrow, it is difficult to get the whole image of the digestive tract at once. If there are more than two lesions in the digestive tract, it is hard to understand the 3D positional relationship among the lesions. Virtual endoscopy using CT is a present standard method to get the whole view of the digestive tract. Because the virtual endoscopy is designed to detect the irregularity of the surface, it cannot detect lesions that lack irregularity including early cancer. In this study, we propose a method of endoscopic entire 3D image acquisition of the digestive tract using a stereo endoscope. The method is as follows: 1) capture sequential images of the digestive tract by moving the endoscope, 2) reconstruct 3D surface pattern for each frame by stereo images, 3) estimate the position of the endoscope by image analysis, 4) reconstitute the entire image of the digestive tract by combining the 3D surface pattern. To confirm the validity of this method, we experimented with a straight tube inside of which circles were allocated at equal distance of 20 mm. We captured sequential images and the reconstituted image of the tube revealed that the distance between each circle was 20.2 +/- 0.3 mm (n=7). The results suggest that this method of endoscopic entire 3D image acquisition may help us understand 3D positional relationship among the lesions such as early esophageal cancer that cannot be detected by virtual endoscopy using CT.

  20. Evaluation of a storage cabinet for heat-sensitive endoscopes in a clinical setting.

    Science.gov (United States)

    Grandval, P; Hautefeuille, G; Marchetti, B; Pineau, L; Laugier, R

    2013-05-01

    In most countries, endoscopes must be disinfected or fully reprocessed before the beginning of each session, even if they were cleaned and disinfected after their last use. Several storage cabinets for heat-sensitive endoscopes (SCHE) are commercially available. They are designed to maintain the microbiological quality of reprocessed endoscopes for a predefined period of time validated by the SCHE manufacturer. Use of an SCHE increases the acceptable storage time before it is necessary to re-disinfect the endoscope. To evaluate the efficacy of an SCHE (DSC8000, Soluscope, SAS Marseilles, France) in a clinical setting. The microbiological quality of endoscopes was assessed after 72 h of storage in an SCHE (Group I), and compared with the microbiological quality of endoscopes stored for 72 h in a clean, dry, dedicated cupboard without morning disinfection (Group II) and the microbiological quality of endoscopes stored for 72 h in a clean, dry, dedicated cupboard with morning disinfection (Group III). Forty-one endoscopes in each group were sampled for microbiological quality. Endoscope contamination levels were analysed according to guidelines published by the National Technical Committee on Nosocomial Infection in 2007. Use of an SCHE helps to maintain the microbiological quality of endoscopes, provided that staff members are well trained and all practices are framed by a proven quality assurance process. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  1. Endoscopic retrograde cholangiopancreatographic evaluation of patients with obstructive jaundice

    International Nuclear Information System (INIS)

    Khurram, M.; Durrani, A.A.; Butt, A.A.; Ashfaq, S.

    2003-01-01

    Objective: To evaluate the role of endoscopic retrograde cholangiopancreatography (ERCP) in patients with obstructive jaundice. Results: Of the 226 patients, 117 (51.8%) were males, and 109 (48.2%) females, their mean age being 51.8 plus minus 16.6 years. Common bile and pancreatic ducts were visualized in 81.8% and 68.1% patients respectively. Growth/masses and stones were commonest causes of obstructive jaundice. Choledocholithias was common in males, while biliary channel related growth/masses were common in females (p-value = 0.03). Common bile duct stone clearance rate was 88%, stenting was highly successful in patients with growth and strictures. ERCP related complications were noted in 11 (4.8%) patients. Conclusion: ERCP is an important diagnostic and therapeutic modality for evaluation of patients with obstructive jaundice. Growth/masses and stones are common causes of obstructive jaundice, which can be diagnosed and treated with ERCP. (author)

  2. Development and evaluation of an endoscopic surgery course for medical students

    DEFF Research Database (Denmark)

    Nilsson, Cecilia; Bjerrum, Flemming; Stadeager, Morten

    2017-01-01

    INTRODUCTION: Surgical training has changed with the introduction of endoscopic surgery. However, a gap in undergraduate medical training has become evident regarding theoretical principles of and basic skills training in endoscopic surgery. The objective of this study was to develop and evaluate...... a course in endoscopic surgery for medical students. METHODS: Kern's six-step approach in curriculum development was used. A course including interactive, faculty-led didactic sessions (14 hours, distributed over three days) and simulation-based basic skills training in endoscopic surgery (nine hours......, distributed over four sessions) was developed. Knowledge was tested using a 35-item test before and after the course, and finally the course was evaluated electronically. The project group in cooperation with the faculty -developed the goals and objectives, the test and the evaluation questionnaire. RESULTS...

  3. To evaluate the results of endoscopic variceal band ligation (EVBL)

    African Journals Online (AJOL)

    hi-tech

    2004-04-04

    Apr 4, 2004 ... (emergency treatment), and to prevent re-bleeding. (secondary prophylaxis). The modalities used for the ... interventional radiology(8,11) and laser therapy(12). Endoscopic therapy, in places where the .... pressure and variceal size which in turn will diminish the problems of variceal bleeding altogether.

  4. Prospective evaluation of early endoscopic ultrasonography for triage in suspected choledocholithiasis: results from a large single centre series.

    Science.gov (United States)

    Anderloni, Andrea; Ballarè, Marco; Pagliarulo, Michela; Conte, Dario; Galeazzi, Marianna; Orsello, Marco; Andorno, Silvano; Del Piano, Mario

    2014-04-01

    Endoscopic ultrasonography is accurate, safe, and cost-effective in diagnosing common bile duct stones, thus suggesting the possibility to avoid invasive endoscopic retrograde cholangiopancreatography. To prospectively evaluate the diagnostic and therapeutic performance of early endoscopic ultrasonography in suspected choledocholithiasis. All consecutive patients presenting to the Emergency Department with suspicion of choledocholithiasis between January 2010 and January 2012 were evaluated and categorized as low, moderate, or high probability of choledocholithiasis, according to accepted criteria. Endoscopic endosonography was carried out within 48 h from the admission and endoscopic retrograde cholangiopancreatography was performed soon in case of confirmed choledocholithiasis. Overall 179 patients were included: 48 (26.8%) were classified as low, 65 (36.3%) as moderate, and 66 (36.9%) as high probability of choledocholithiasis. Of the 86 patients with common bile duct stones at endoscopic endosonography, endoscopic retrograde cholangiopancreatography confirmed the finding in 79 (92%). By multivariate analysis only the common bile duct diameter proved an independent predictor of common bile duct stones. Early endoscopic endosonography is accurate in identifying choledocholithiasis allowing immediate endoscopic treatment and significant spare of unnecessary endoscopic retrograde cholangiopancreatography. This approach can be useful as a triage test to select patients not needing endoscopic retrograde cholangiopancreatography, allowing, in selected cases, their early discharge. Copyright © 2013 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  5. Endoscopic laser Doppler flowmetry in evaluation of human gastric blood flow

    International Nuclear Information System (INIS)

    Lunde, O.C.

    1988-01-01

    The aims of the present study were to evaluate laser Doppler flowmetry (LDF) for endoscopic mesasurement of gastric blood flow. The study gave the following results: LDF is a reliable method for continuous measurement of gastrointestinal blood perfusion. This technique can be used endoscopically for measurement of gastric blood flow in conscious man. By means of endoscopic technique, relative blood flow changes can be measured in all parts of the stomach. The recorded blood flow values usually represent blood perfusion in all layers in the gastric wall. A slight contact pressure between the measuring probe and the mucosa is necessary to obtain stable recordings. To heavy pressure provokes reduction of flow values. Angulation of the probe and moderate air insufflation do not interfere with a constant flow level. Endoscopic measurements should be performed with a recording band-width of 4 kHz, since this frequency limit reduces the disturbing signals. Within the range of flow levels recorded in patients and healthy subjects, relative blood flow changes are measured with this band-width. Endoscopic LDF is safe and easy to handle. However, peristalsis and uneasy patients may sometime provoke disturbances which render blood flow measurements impossible. Endoscopic LDF is suitable for clinical studies such as investigation of the effect of drugs on gastric blood flow and examination of local blood flow in patients with gastric diseases

  6. Endoscopic laser Doppler flowmetry in evaluation of human gastric blood flow

    Energy Technology Data Exchange (ETDEWEB)

    Lunde, O.C. (Aker Sykehus, Oslo (Norway))

    1988-12-01

    The aims of the present study were to evaluate laser Doppler flowmetry (LDF) for endoscopic mesasurement of gastric blood flow. The study gave the following results: LDF is a reliable method for continuous measurement of gastrointestinal blood perfusion. This technique can be used endoscopically for measurement of gastric blood flow in conscious man. By means of endoscopic technique, relative blood flow changes can be measured in all parts of the stomach. The recorded blood flow values usually represent blood perfusion in all layers in the gastric wall. A slight contact pressure between the measuring probe and the mucosa is necessary to obtain stable recordings. To heavy pressure provokes reduction of flow values. Angulation of the probe and moderate air insufflation do not interfere with a constant flow level. Endoscopic measurements should be performed with a recording band-width of 4 kHz, since this frequency limit reduces the disturbing signals. Within the range of flow levels recorded in patients and healthy subjects, relative blood flow changes are measured with this band-width. Endoscopic LDF is safe and easy to handle. However, peristalsis and uneasy patients may sometime provoke disturbances which render blood flow measurements impossible. Endoscopic LDF is suitable for clinical studies such as investigation of the effect of drugs on gastric blood flow and examination of local blood flow in patients with gastric diseases. 64 refs.

  7. The Evaluation of Endoscopic Balloon Dilation Treatment for

    Directory of Open Access Journals (Sweden)

    Shokri-Shirvani Javad

    2009-10-01

    Full Text Available Balloon dilatation of stricture is one of the new treatment methods among patients with gastric outlet obstruction (GOO. However, the prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that would affect its success rate patients with benign etiology for GOO. Forty-five patients with the symptoms of benign GOO were randomly selected. Gastric outlet was delineated using double channel videoendoscopy. The information of initial balloon dilation was collected from recorded files. Balloon dilatation was repeated during the mean follow up of 9.9 ± 5.8 months. The severity of gastric pain was measured immediately before balloon dilatation and one month after procedure and was rated on a 10 cm visual analogue scale. The mean age of patients was 43.7 ± 18.1 years and 86.7% of them were men. Furthermore, 71.1% were H pylori positive. Response rate to endoscopic balloon dilatation was 80% and 8 patients underwent surgical resection. Weight loss was more frequent in non-responding group. The pain severity was significantly reduced more in responding subjects. No meaningful relationships were found between the responses to balloon dilatation and positive H pylori and cigarette smoking. Endoscopic balloon dilation is safe and effective for most patients with benign gastric outlet obstruction and has favorable long-term outcome.

  8. Development of the local magnification method for quantitative evaluation of endoscope geometric distortion

    Science.gov (United States)

    Wang, Quanzeng; Cheng, Wei-Chung; Suresh, Nitin; Hua, Hong

    2016-05-01

    With improved diagnostic capabilities and complex optical designs, endoscopic technologies are advancing. As one of the several important optical performance characteristics, geometric distortion can negatively affect size estimation and feature identification related diagnosis. Therefore, a quantitative and simple distortion evaluation method is imperative for both the endoscopic industry and the medical device regulatory agent. However, no such method is available yet. While the image correction techniques are rather mature, they heavily depend on computational power to process multidimensional image data based on complex mathematical model, i.e., difficult to understand. Some commonly used distortion evaluation methods, such as the picture height distortion (DPH) or radial distortion (DRAD), are either too simple to accurately describe the distortion or subject to the error of deriving a reference image. We developed the basic local magnification (ML) method to evaluate endoscope distortion. Based on the method, we also developed ways to calculate DPH and DRAD. The method overcomes the aforementioned limitations, has clear physical meaning in the whole field of view, and can facilitate lesion size estimation during diagnosis. Most importantly, the method can facilitate endoscopic technology to market and potentially be adopted in an international endoscope standard.

  9. Fiber-Optic Ultrasound Sensors for Smart Structures Applications

    National Research Council Canada - National Science Library

    Krishnaswamy, Sridhar

    2000-01-01

    The project addressed the development of an important nondestructive evaluation tool utilizing fiber-optic ultrasonic sensors which can be permanently mounted in inaccessible regions of an airframe...

  10. Clinical evaluation of endoscopic ligation with nylon snares for adenoma of the major duodenal papilla

    Directory of Open Access Journals (Sweden)

    ZHANG Yingchun

    2015-11-01

    Full Text Available ObjectiveTo evaluate the feasibility, safety, and follow-up results of endoscopic ligation with nylon snares for adenoma of the major duodenal papilla. MethodsTwenty-three patients with adenoma of the major papilla who were treated in our hospital from January 2012 to June 2014 were enrolled as subjects. All patients had biliary and pancreatic duct stents placed by endoscopic cholangiopancreatography, followed by complete ligation of tumors with nylon snares. Endoscopic follow-up evaluation of recurrence was performed regularly. ResultsAll patients had biliary and pancreatic duct stents successfully placed and tumors successfully ligated with nylon snares in their first surgery. Endoscopic reexamination at two weeks after surgery showed that tumors were removed in all patients. Postoperative complications, cholangitis and pancreatitis, were found in one (4.3% and two (8.7% patients, respectively, and there were no bleeding, perforation, or death. A follow-up of more than one year in all patients showed that two patients had local recurrence of adenoma. ConclusionEndoscopic ligation with nylon snares is a safe and effective approach for treating adenoma of the major duodenal papilla.

  11. The Evaluation of Endoscopic Balloon Dilation Treatment for Benign

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    H. Ghofrani

    2008-04-01

    Full Text Available Background and ObjectiveBalloon dilatation of stricture is one of the new treatment methods for patients with Gastric Outlet Obstruction (GOO. Prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that could affect method advantage among patients with benign etiology for GOO. Methods Forty-five patients with symptoms of benign GOO were randomly selected. The mean age of patients was 43.7±18.1 years and 86.7% of them were men. Gastric outlet was delineated using double channel videoendoscopy. The severity of gastric pain was measured by VAS test immediately before and one month after balloon dilatation. Patients were followed after procedure weekly (for the first month and then monthly. Balloon dilatation was repeated for 27% patients during the follow up period.ResultsPatients were followed for 9.9±5.8 months. Furthermore, 71.1% were H. pylori positive. Positive response percent to endoscopic balloon dilatation was 80% and eight patients were took under surgical resection. Weight loss was seen frequently in the non-respondent group. The pain severity was significantly reduced in respondent subjects. No meaningful correlations were found between the response to balloon dilatation and positive H. pylori and cigarette smoking.ConclusionEndoscopic balloon dilatation is a safe and effective method for treating most of patients with benign gastric outlet obstruction and has favorable long-term outcome. Keywords: Endoscopy, Gastric Outlet Obstruction (GOO, Balloon Dilatation

  12. Evaluation of the tip-bending response in clinically used endoscopes.

    Science.gov (United States)

    Rozeboom, Esther D; Reilink, Rob; Schwartz, Matthijs P; Fockens, Paul; Broeders, Ivo A M J

    2016-04-01

    Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current technique of endoscope tip control is adequate for a future of high precision procedures, steerable accessories, and add-on robotics. The aim of this study was to determine the status of the tip response of endoscopes used in clinical practice. We evaluated 20 flexible colonoscopes and five gastroscopes, used in the endoscopy departments of a Dutch university hospital and two Dutch teaching hospitals, in a bench top setup. First, maximal tip bending was determined manually. Next, the endoscope navigation wheels were rotated individually in a motor setup. Tip angulation was recorded with a USB camera. Cable slackness was derived from the resulting hysteresis plot. Only two of the 20 colonoscopes (10 %) and none of the five gastroscopes reached the maximal tip angulation specified by the manufacturer. Four colonoscopes (20 %) and none of the gastroscopes demonstrated the recommended cable tension. Eight colonoscopes (40 %) had undergone a maintenance check 1 month before the measurements were made. The tip responses of these eight colonoscopies did not differ significantly from the tip responses of the other colonoscopes. This study suggests that the majority of clinically used endoscopes are not optimally tuned to reach maximal bending angles and demonstrate adequate tip responses. We suggest a brief check before procedures to predict difficulties with bending angles and tip responses.

  13. Evaluation of endoscopic hemostasis in upper gastrointestinal bleeding related to Mallory-Weiss syndrome.

    Science.gov (United States)

    Chung, I K; Kim, E J; Hwang, K Y; Kim, I H; Kim, H S; Park, S H; Lee, M H; Kim, S J

    2002-06-01

    The endoscopic hemostatic method has been introduced as a safe and effective mechanical approach to hemostasis for upper gastrointestinal bleeding related to Mallory-Weiss syndrome (MWS). However, the indications for when to use endoscopic treatment are debatable because many patients need only medical observation. The study was designed to evaluate the necessity and efficacy of endoscopic hemostasis in upper gastrointestinal bleeding related to MWS. From July 1994 to May 2000, we conducted a clinical trial in 76 patients who were found by endoscopy to have active bleeding (I, spurting; II, oozing), protruding visible vessels (III), and/or adherent clots (IV). Two study periods can be differentiated: in the first 3 years endoscopic treatment (n = 30) was prospectively analyzed and in the final 3 years medical treatment (n = 46) was analyzed in both cases to compare the outcome in MWS bleeding II-IV. In the first study period, in addition, endoscopic treatment was randomised to an injection method, using a mixture of hypertonic saline and epinephrine (HSE) (n = 14) and a hemoclipping or band ligation method (n = 16). Rebleeding was observed in four of 14 patients who had received endoscopic hemostasis with HSE injection and one of 46 patients who had been managed with medical treatment. No rebleeding was found following hemoclipping or band ligation. While all rebleeding was in bleeding stigmata of the I (1) and II (4) grades, there was no rebleeding in protruding visible vessels (III) or in adherent clots (IV), regardless of treatment methods. Our results suggested that endoscopic hemostasis is not necessary in patients without active bleeding stigmata, and the mechanical hemostatic method is more effective than HSE injection in patients with active bleeding stigmata.

  14. Evaluating outcomes of endoscopic full-thickness plication for gastroesophageal reflux disease (GERD) with impedance monitoring.

    Science.gov (United States)

    von Renteln, Daniel; Schmidt, Arthur; Riecken, Bettina; Caca, Karel

    2010-05-01

    Endoscopic full-thickness plication allows transmural suturing at the gastroesophageal junction to recreate the antireflux barrier. Multichannel intraluminal impedance monitoring (MII) can be used to detect nonacid or weakly acidic reflux, acidic swallows, and esophageal clearance time. This study used MII to evaluate the outcome of endoscopic full-thickness plication. In this study, 12 subsequent patients requiring maintenance proton pump inhibitor therapy underwent endoscopic full-thickness plication for treatment of gastroesophageal reflux disease. With patients off medication, MII was performed before and 6-months after endoscopic full-thickness plication. The total median number of reflux episodes was significantly reduced from 105 to 64 (p = 0.016). The median number of acid reflux episodes decreased from 73 to 43 (p = 0.016). Nonacid reflux episodes decreased from 23 to 21 (p = 0.306). The median bolus clearance time was 12 s before treatment and 11 s at 6 months (p = 0.798). The median acid exposure time was reduced from 6.8% to 3.4% (p = 0.008), and the DeMeester scores were reduced from 19 to 12 (p = 0.008). Endoscopic full-thickness plication significantly reduced total reflux episodes, acid reflux episodes, and total reflux exposure time. The DeMeester scores and total acid exposure time for the distal esophagus were significantly improved. No significant changes in nonacid reflux episodes and median bolus clearance time were encountered.

  15. Cytology evaluation for brushing in biliary and pancreatic stenosis during endoscopic cholangiopancreatography

    International Nuclear Information System (INIS)

    Ruiz, Mario H; Castano, Rodrigo; Alvarez, Oscar A; Velez, Alejandro; Munera, Veronica

    2002-01-01

    No surgical pathologic confirmation of malignant bile duct strictures is desirable for defining subsequent treatment and prognosis. Endoscopic retrograde cholangiopancreatography is frequently performed in patients suspected of having pancreaticobiliary obstruction, but there exists no standardized method or instruments for defining benign or malignant nature of obstructing lesions by ERCP. We prospectively evaluated the yields of endoscopic retrograde brush cytology for the diagnosis of malignant bile and pancreatic duct strictures. Fluoroscopically guided endobiliary brush cytology was performed during endoscopic retrograde cholangiopancreatography in 29 consecutive patients, 20 with malignant strictures and 9 with benign stricture. A single pathologist classified the results of these studies as positive, or negative for malignancy. The sensitivities of the procedure were 69%. Specificity proved excellent, 100%. Two major complications that occurred in the same patient were acute pancreatitis in a patient with chronic pancreatitis and bleeding from pancreatic duct. Both were managed medically and improved. This study indicates that endoscopic retrograde brush cytology alone may be sufficient in daily practice, to differentiate against benign and malignant biliary or pancreatic stenosis

  16. A STUDY ON ENDOSCOPIC EVALUATION OF UPPER GASTROINTESTINAL BLEEDING

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    Pranaya Kumar

    2016-03-01

    Full Text Available CONTEXT Upper gastrointestinal bleeding (UGIB is one of the commonest gastrointestinal emergencies encountered by clinicians. Peptic ulcers are the most common cause of UGIB. Endoscopy has become the preferred method for diagnosis in patients with acute UGIB. This study is done in a diagnostic upper gastrointestinal endoscopy (UGIE setup of a tertiary care hospital to ascertain the causes of UGIB prevalent in this part of our country which might differ from other studies. AIM To ascertain prevalent causes of UGIB in patients of this part of India admitted to a Govt. Tertiary Hospital with a provisional diagnosis of UGIB. METHOD One hundred consecutive patients with UGIB were subjected to UGIE to find out the aetiology. The clinical profile and endoscopic findings were analysed and compared with the data on UGIB from other studies. RESULTS The mean age of patients was 47.03 years with male: female ratio of 2.33:1. 58% of patients were first time bleeders. Majority of patients presented with melaena. Visualisation of active bleeding achieved to 85.7% when endoscopy was done within first 24 hrs. The commonest cause of UGIB was duodenal ulcer (DU which accounted for 41% cases. Gastric ulcer was responsible in 13% of cases. Portal hypertension was responsible for bleed in only 13%. Neoplasms accounted for 25% of cases. Other less common causes were erosive gastritis (3%, gastric polyp (3%, Mallory-Weiss tear (1%, and Dieulafoy’s lesion (1%. Among bleeding peptic ulcers, 27.8% of cases were classified as Forrest IIa and 20.4% in Forrest IIb & IIc each. Acid peptic disease was past history elicited in majority (33% followed by NSAID (26% and alcohol (26%. CONCLUSION The present study has diagnosed various causes of upper gastrointestinal bleeding in this part of country. The incidence of gastric carcinoma as a cause of upper gastrointestinal bleeding is significantly high compared to those in other studies. UGI endoscopy should be done in every case

  17. Monometric and scintiscanning evaluation of esophageal function after endoscopic sclerosis of esophageal varices. Controlled prospective study

    International Nuclear Information System (INIS)

    Bastos, J.L.A.

    1990-01-01

    Esophageal function was studied in twenty-one patients with esophageal varices of different etiology submitted to endoscopic sclerosis for the detection of possible alterations in the functional pattern of the organ after this treatment. The endoscopic injection sclerosis (EIS) was performed electively in 14 patients (Group I) and in the presence of bleeding in 07 (Group II). The sclerotizing agent used was a solution of equal parts of ethanolamine oleate (Ethamolin R ) and 50% glucose. The injections were preferentially performed by the perivascular technique at weekly intervals. Esophageal function was studied by manometry, and esophageal transit time by scintillography. Group I patients were evaluated before and two to three months and five to nine months after EIS, and Group II patients were only evaluated six to nine months after EIS. The manometry and scintillography procedures were performed in sequence on the same day. The scintillographic examinations were performed with the patient in the supine and sitting positions. (author)

  18. Design and Evaluation of a Fiber-Optic Grip Force Sensor with Compliant 3D-Printable Structure for (fMRI Applications

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    Tobias L. Bützer

    2016-01-01

    Full Text Available Grip force sensors compatible with magnetic resonance imaging (MRI are used in human motor control and decision-making research, providing objective and sensitive behavioral outcome measures. Commercial sensors are expensive, cover limited force ranges, rely on pneumatic force transmission that cannot detect fast force changes, or are electrically active, which increases the risk of electromagnetic interference. We present the design and evaluation of a low-cost, 3D-printed, inherently MRI-compatible grip force sensor based on a commercial intensity-based fiber-optic sensor. A compliant monobloc structure with flexible hinges transduces grip force to a linear displacement captured by the fiber-optic sensor. The structure can easily be adapted for different force ranges by changing the hinge thickness. A prototype designed for forces up to 800 N was manufactured and showed a highly linear behavior (nonlinearity of 2.37% and an accuracy of 1.57% in a range between zero and 500 N. It can be printed and assembled within one day and for less than $300. Accurate performance was confirmed, both inside and outside a 3 T MRI scanner within a pilot study. Given its simple design allowing for customization of sensing properties and ergonomics for different applications and requirements, the proposed grip force handle offers researchers a valuable scientific tool.

  19. External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations.

    Science.gov (United States)

    Ghasemi, Hassan; Asghari Asl, Sajedeh; Yarmohammadi, Mohammad Ebrahim; Jafari, Farhad; Izadi, Pupak

    2017-01-01

    External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery.

  20. Neurological Study of Radial Nerve Conduction During Endoscopic Radial Artery Harvesting:An Intra‐Operative Evaluation

    Directory of Open Access Journals (Sweden)

    Gianluigi Bisleri

    2014-08-01

    Full Text Available Endoscopic radial artery harvesting (ERAH is a feasible and attractive minimally invasive approach for conduit procurement, however there have been concerns about a potential neurological damage occurring at the harvest limb site secondary to injury of the radial nerve during endoscopic harvesting. We present a case of ERAH in which we evaluated intraoperatively the characteristics of radial nerve conduction by means of electroneuromyography (ENM during harvesting. No pathological changes of nerve conduction were detected at the harvest limb site during surgery and postoperatively, thereby supporting the benefits of the endoscopic approach in terms of neurological outcomes following radial artery procurements with a less invasive approach.

  1. The role of endoscopic ultrasonography in the evaluation of pancreatico-biliary cancer.

    Science.gov (United States)

    Varadarajulu, Shyam; Eloubeidi, Mohamad A

    2010-04-01

    Accurate staging of pancreatico-biliary cancer is essential for surgical planning and for identification of locally advanced and metastatic disease that is incurable by surgery. The complex regional anatomy of the pancreatico-biliary system makes histologic diagnosis of malignancy at this region difficult. The ability to position the endoscopic ultrasound transducer at endoscopy in direct proximity to the pancreas and the bile duct, combined with the use of fine-needle aspiration, enables accurate preoperative staging of cancer, especially cancer too small to be characterized by CT or MRI. Endoscopic ultrasonography (EUS) identifies patients unlikely to be cured by surgery due to vascular invasion or regional nodal metastasis, thereby limiting procedure-related morbidity and mortality. This article focuses on the utility and recent advances of EUS in the evaluation of pancreatico-biliary cancer.

  2. Surgical evaluation of a novel tethered robotic capsule endoscope using micro-patterned treads.

    Science.gov (United States)

    Sliker, Levin J; Kern, Madalyn D; Schoen, Jonathan A; Rentschler, Mark E

    2012-10-01

    The state-of-the-art technology for gastrointestinal (GI) tract exploration is a capsule endoscope (CE). Capsule endoscopes are pill-sized devices that provide visual feedback of the GI tract as they move passively through the patient. These passive devices could benefit from a mobility system enabling maneuverability and controllability. Potential benefits of a tethered robotic capsule endoscope (tRCE) include faster travel speeds, reaction force generation for biopsy, and decreased capsule retention. In this work, a tethered CE is developed with an active locomotion system for mobility within a collapsed lumen. Micro-patterned polydimethylsiloxane (PDMS) treads are implemented onto a custom capsule housing as a mobility method. The tRCE housing contains a direct current (DC) motor and gear train to drive the treads, a video camera for visual feedback, and two light sources (infrared and visible) for illumination. The device was placed within the insufflated abdomen of a live anesthetized pig to evaluate mobility performance on a planar tissue surface, as well as within the cecum to evaluate mobility performance in a collapsed lumen. The tRCE was capable of forward and reverse mobility for both planar and collapsed lumen tissue environments. Also, using an onboard visual system, the tRCE was capable of demonstrating visual feedback within an insufflated, anesthetized porcine abdomen. Proof-of-concept in vivo tRCE mobility using micro-patterned PDMS treads was shown. This suggests that a similar method could be implemented in future smaller, faster, and untethered RCEs.

  3. Simultaneous fingerprint and high-wavenumber fiber-optic Raman spectroscopy improves in vivo diagnosis of esophageal squamous cell carcinoma at endoscopy

    Science.gov (United States)

    Wang, Jianfeng; Lin, Kan; Zheng, Wei; Yu Ho, Khek; Teh, Ming; Guan Yeoh, Khay; Huang, Zhiwei

    2015-08-01

    This work aims to evaluate clinical value of a fiber-optic Raman spectroscopy technique developed for in vivo diagnosis of esophageal squamous cell carcinoma (ESCC) during clinical endoscopy. We have developed a rapid fiber-optic Raman endoscopic system capable of simultaneously acquiring both fingerprint (FP)(800-1800 cm-1) and high-wavenumber (HW)(2800-3600 cm-1) Raman spectra from esophageal tissue in vivo. A total of 1172 in vivo FP/HW Raman spectra were acquired from 48 esophageal patients undergoing endoscopic examination. The total Raman dataset was split into two parts: 80% for training; while 20% for testing. Partial least squares-discriminant analysis (PLS-DA) and leave-one patient-out, cross validation (LOPCV) were implemented on training dataset to develop diagnostic algorithms for tissue classification. PLS-DA-LOPCV shows that simultaneous FP/HW Raman spectroscopy on training dataset provides a diagnostic sensitivity of 97.0% and specificity of 97.4% for ESCC classification. Further, the diagnostic algorithm applied to the independent testing dataset based on simultaneous FP/HW Raman technique gives a predictive diagnostic sensitivity of 92.7% and specificity of 93.6% for ESCC identification, which is superior to either FP or HW Raman technique alone. This work demonstrates that the simultaneous FP/HW fiber-optic Raman spectroscopy technique improves real-time in vivo diagnosis of esophageal neoplasia at endoscopy.

  4. Ergonomic design and evaluation of the handle for an endoscopic dissector.

    Science.gov (United States)

    Shimomura, Yoshihiro; Minowa, Keita; Kawahira, Hiroshi; Katsuura, Tetsuo

    2016-05-01

    The purpose of this study was to design an endoscopic dissector handle and objectively assess its usability. The handles were designed with increased contact area between the fingers and thumb and the eye rings, and the eye rings were modified to have a more perpendicular insertion angle to the finger midline. Four different handle models were compared, including a conventional product. Subjects performed dissection, exclusion, grasping, precision manipulation and precision handling tasks. Electromyography and subjective evaluations were measured. Compared to conventional handles, the designated handle reduced the muscle load in the extensor and flexor muscles of the forearm and increased subjective stability. The activity of the first dorsal interosseous muscle was sometimes influenced by the shape of the other parts. The ergonomically designed endoscopic dissector handle used in this study achieved high usability. Medical instrument designs based on ergonomic concepts should be assessed with objective indices. Practitioner Summary: The endoscopic dissector handles were designed with increased contact area and more suitable insertion angle between the fingers and thumb and the eye rings. Compared to conventional handles, the designated handle reduced the muscle load in the extensor and flexor muscles of the forearm and increased subjective stability.

  5. Development and evaluation of a light-emitting diode endoscopic light source

    Science.gov (United States)

    Clancy, Neil T.; Li, Rui; Rogers, Kevin; Driscoll, Paul; Excel, Peter; Yandle, Ron; Hanna, George; Copner, Nigel; Elson, Daniel S.

    2012-03-01

    Light-emitting diode (LED) based endoscopic illumination devices have been shown to have several benefits over arclamp systems. LEDs are energy-efficient, small, durable, and inexpensive, however their use in endoscopy has been limited by the difficulty in efficiently coupling enough light into the endoscopic light cable. We have demonstrated a highly homogenised lightpipe LED light source that combines the light from four Luminus LEDs emitting in the red, green, blue and violet using innovative dichroics that maximise light throughput. The light source spectrally combines light from highly divergent incoherent sources that have a Lambertian intensity profile to provide illumination matched to the acceptance numerical aperture of a liquid light guide or fibre bundle. The LED light source was coupled to a standard laparoscope and performance parameters (power, luminance, colour temperature) compared to a xenon lamp. Although the total illuminance from the endoscope was lower, adjustment of the LEDs' relative intensities enabled contrast enhancement in biological tissue imaging. The LED light engine was also evaluated in a minimally invasive surgery (MIS) box trainer and in vivo during a porcine MIS procedure where it was used to generate 'narrowband' images. Future work using the violet LED could enable photodynamic diagnosis of bladder cancer.

  6. Non-destructive evaluation of fiber-reinforced composites with a fast 2D fiber-optic laser-ultrasound scanner

    Science.gov (United States)

    Pelivanov, Ivan; Buma, Takashi; Xia, Jinjun; Wei, Chen-Wei; Shtokolov, Alex; O'Donnell, Matthew

    2015-03-01

    Laser ultrasonic (LU) inspection represents an attractive, non-contact method to evaluate composite materials. Current non-contact systems, however, have relatively low sensitivity compared to contact piezoelectric detection. They are also difficult to adjust, very expensive, and strongly influenced by environmental noise. Here, we demonstrate that most of these drawbacks can be eliminated by combining a new generation of compact, inexpensive fiber lasers with new developments in fiber telecommunication optics and an optimally designed balanced probe scheme. In particular, a new type of a balanced fiber-optic Sagnac interferometer is presented as part of an all-optical LU pump-probe system for high speed non-destructive testing and evaluation (NDT&E) of aircraft composites. The performance of the LU system is demonstrated on a composite sample typically used in the aircraft industry. Wide-band ultrasound probe signals are generated directly at the sample surface with a pulsed diode-pumped laser delivering nanosecond laser pulses at a 1 kHz repetition rate with a pulse energy of 2 mJ. A balanced fiber-optic Sagnac interferometer is employed to detect pressure signals in a 1-10 MHz frequency range at the same point (an 8 μm focal spot) on the composite surface. A fast (up to 100 mm/s) 2D translation system is employed to move the sample during scanning and produce a complete B-scan consisting of one thousand A-scans in less than a second. The sensitivity of this system, in terms of the noise equivalent pressure, is found to be only 10 dB above the Nyquist thermal noise limit. To our knowledge, this is the best reported sensitivity for a non-contact ultrasonic detector of this dimension.

  7. Long-term evaluation after endoscopic sinus surgery for chronic pediatric sinusitis with polyps.

    Science.gov (United States)

    Tsukidate, Toshiharu; Haruna, Shinichi; Fukami, Satoshi; Nakajima, Itsuo; Konno, Wataru; Moriyama, Hiroshi

    2012-12-01

    Long-term retrospective evaluation was performed of computed tomography (CT) images and endoscopic findings after endoscopic sinus surgery for 88 cases of chronic pediatric sinusitis with nasal polyps. The objective was to determine the appropriate duration of such postoperative evaluation for children. Fifty-one patients had both sinusitis and nasal polyps (BSP group), and the surgical procedure was decided in consideration of each patient's age (for less than 10 years of age, polypectomy (n=12); for 10-13 years old, anterior ethmoidectomy plus opening of the fontanelle and nasofrontal duct (n=20); and for serious cases older than 13 years, total sinusectomy (n=19)). On the other hand, for cases of unilateral sinusitis with antrochoanal polyps (USP group), anterior ethmoidectomy plus opening of the fontanelle was performed regardless of the patient's age (n=37, 5-15 years old). The postoperative endoscopic findings indicated that the polyps had been eliminated in approximately 91% of total patients. Good postoperative findings of CT images in most patients of USP group are observed at one year after the operation like the same of the postoperative course of adult chronic sinusitis. On the other hand CT images in BSP group evaluated one year after the operation were rated as unchanged or worsened in approximately half of the patients. However, at 4 years after the operation nearly all the patients were rated as improved or better. In addition, comparison of the age at final observation and the postoperative course found a striking decrease in the proportion of unchanged and worsened patients aged 12 and above. Accordingly, it was concluded that there is difference of healing process after the operation between USP and BSP group. Postoperative evaluation of BSP group should be performed for 4 years and up to an age of at least 12 years although post-ESS following of USP group is similar to that of adult sinusitis. Copyright © 2012 Elsevier Ireland Ltd. All rights

  8. Endoscopic Evaluation of Peptic Ulcer Disease During Ramadan Fasting

    Directory of Open Access Journals (Sweden)

    G. M. Malik

    1996-01-01

    Full Text Available The effects of fasting on peptic ulcer disease were evaluated in a prospective study, involving 23 fasting patients who underwent endoscopy before and after Ramadan. Eighteen patients took an H2-blocker (ranitidine, 150 mg twice daily regularly at “Suhur” and “Iftar” as prescribed, while 5 were drug defaulters. On the first endoscopy the diagnosis in 4 patients was active acute duodenal ulcer (AADU, in 8 patients was active chronic duodenal ulcer (ACDU in 8 patients was healed duodenal ulcer (HDU, in 2 patients was erosive duodenitis (ED, and in 1 patient was chronic gastric ulcer (CGU. All of the patients with AADU showed signs of healing on repeat endoscopy. None of the ACDU patients showed signs of healing on repeat endoscopy. Instead, 7 patients in this group bled during fasting. All of the 5 drug defaulters belonged to the ACDU group. One patient in the HDU group had developed an active ulcer near the previous scar, as which was seen on repeat endoscopy. The 2 patients with ED showed signs of healing, while the only patient with CGU had bled from the same ulcer as seen on repeat endoscopy. The results were compared with those of 15 nonfasting control subjects (6 patients with ACDU, 3 with HDU, and 6 with ED as diagnosed on the first endoscopy, who took an H2-blocker regularly. The repeat endoscopy did not show any change in these patients. In conclusion, we inferred that Ramadan fasting may prove hazardous in patients with peptic ulcer disease in general and with active chronic ulcers in particular, although the fact that only 23 patients volunteered for this study, of whom 5 were drug defaulters, is a limitation.

  9. A STERILIZATION STANDARD FOR ENDOSCOPES AND OTHER DIFFICULT TO CLEAN MEDICAL DEVICES

    Science.gov (United States)

    An array of difficult to clean devices are used for diagnostic and surgical procedures involving various degrees of invasiveness. These range from prophylaxis angles used for cleaning and polishing teeth to flexible fiberoptic endoscopes for surgical procedures that penetrate the...

  10. Evaluation of the tip-bending response in clinically used endoscopes

    NARCIS (Netherlands)

    Rozeboom, Esther D.; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo A. M. J.

    2016-01-01

    Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current

  11. Evaluation of the tip-bending response in clinically used endoscopes

    NARCIS (Netherlands)

    Rozeboom, Esther; Reilink, Rob; Schwartz, Matthijs P.; Fockens, Paul; Broeders, Ivo Adriaan Maria Johannes

    Background and study aims: Endoscopic interventions require accurate and precise control of the endoscope tip. The endoscope tip response depends on a cable pulling system, which is known to deliver a significantly nonlinear response that eventually reduces control. It is unknown whether the current

  12. Epidemic Trends of Upper Gastrointestinal Tract Abnormalities: Hospital-based study on Endoscopic Data Evaluation.

    Science.gov (United States)

    Mohiuddin, Mohammed Khaliq; Chowdavaram, Suman; Bogadi, Varun; Prabhakar, Boddu; Rao, Kondadasula Pandu Ranga; Devi, Suneetha; Mohan, Vasavi

    2015-01-01

    To understand the epidemiology of different upper gastrointestinal (UGI) tract related abnormalities through endoscopic data analysis. A retrospective study of three years from January 2009 to December 2011 was conducted with data from endoscopic surveillance of upper GI tract problems, collected from the Gastroenterology Unit, Osmania General Hospital, Hyderabad. MS excel and Medcalc software (comparison of proportions) were used for data analysis. A total of 10,029 (6,468 in males and 3,561 in females) endoscopies were performed during this three-year period. The male to female ratio was 1.8:1. Overall, ~30% of endoscopies evaluated showed patients with acid peptic disorders, 13.6% with vascular- related abnormalities, 10.6% showed structural abnormalities, followed by 6.3% with malignancies. Burden of malignancies was mostly observed in the older age group (60-69 years). Esophageal cancer cases decreased (p=0.0001) whereas stomach cancers increased over this period (p=0.0345). We also observed an increased incidence of acid peptic disease (APD) (p=0.0036) and gastroesophageal reflux disease (GERD) (p=0.0002) cases during this period. Endoscopic diagnosis is useful for early detection of UGI anomalies and helpful for physicians to manage and treat varied kinds of UGI disorders. Analysis of data revealed changing trends in the incidence of various pathologies of the UGI tract. Functional dyspepsia and GERD definitely reduce the quality of life of the individual. The role of our diverse dietary habits and lifestyle associated with these problems have not yet been established, though there have been reports on the effect of coffee, spicy food, wheat-based diet, screening of UGI pathologies along with collection of complete personal and medical history details, can help in correlating the patients' condition with various aspects of lifestyle and diet.

  13. Routine colonic endoscopic evaluation following resolution of acute diverticulitis: Is it necessary?

    Science.gov (United States)

    Agarwal, Amit K; Karanjawala, Burzeen E; Maykel, Justin A; Johnson, Eric K; Steele, Scott R

    2014-01-01

    Diverticular disease incidence is increasing up to 65% by age 85 in industrialized nations, low fiber diets, and in younger and obese patients. Twenty-five percent of patients with diverticulosis will develop acute diverticulitis. This imposes a significant burden on healthcare systems, resulting in greater than 300000 admissions per year with an estimated annual cost of $3 billion USD. Abdominal computed tomography (CT) is the diagnostic study of choice, with a sensitivity and specificity greater than 95%. Unfortunately, similar CT findings can be present in colonic neoplasia, especially when perforated or inflamed. This prompted professional societies such as the American Society of Colon Rectal Surgeons to recommend patients undergo routine colonoscopy after an episode of acute diverticulitis to rule out malignancy. Yet, the data supporting routine colonoscopy after acute diverticulitis is sparse and based small cohort studies utilizing outdated technology. While any patient with an indication for a colonoscopy should undergo appropriate endoscopic evaluation, in the era of widespread use of high-resolution computed tomography, routine colonic endoscopic evaluation following resolution of acute uncomplicated diverticulitis poses additional costs, comes with inherent risks, and may require further study. In this manuscript, we review the current data related to this recommendation. PMID:25253951

  14. Endoscopic dacryocystorhinostomy

    Directory of Open Access Journals (Sweden)

    Milojević Milanko

    2010-01-01

    Full Text Available Background/Aim. Intensive epiphora (lacrimal apparatus disease can make difficult daily routine and cause ocular refraction disturbances. In most cases ethiology is unknown, rarely occurs after nose surgical procedures, face fractures, in Wegener granulomatosis, sarcoidosis and malignancies. The aim of this study was to evaluate efficacy of endonasal endoscopic surgical procedure with the conventional surgical instruments in treatment of nasolacrimal obstructions. Methods. This retrospective study included 12 female patients with endonasal endoscopic surgical procedure from Otorhinological and Ophtalmological Departments of Military Medical Academy, Belgrade from September 2007 to April 2009. Preoperative nasal endoscopy was performed in order to reveal concomitant pathological conditions and anatomic anomalies which could make surgical procedure impossible. Computerized tomography was performed only in suspect nose diseases. Surgical endonasal endoscopic procedure was performed by otorhinolaryngologist and ophtalmologist in all patients. The patients had regular controls from 2 to 20 months. Results. A total of 12 female patients, age 34-83 years, were included in our study. Epiphora was a dominant symptom in all patients. In two patients deviation of nasal septum was found, and in other one conha bulosa at the same side as chronic dacryocystitis. All patients were subjected to endonasal dacryocystorhinostomy (DCR by endoscopic surgical technique using conventional instruments. Concomitantly with DCR septoplastics in two patients and lateral lamictetomy in one patient were performed. There were no complications intraoperatively as well as in the immediate postoperative course. In two patients the need for reoperation occurred. Conclusion. Endoscopic DCR is minimally invasive and efficacious procedure for nasolacrymal obstructions performed by otorhinolaryngologist and ophtalmologist. Postoperative recovery is very fast.

  15. EVOTECH® endoscope cleaner and reprocessor (ECR simulated-use and clinical-use evaluation of cleaning efficacy

    Directory of Open Access Journals (Sweden)

    DeGagne Pat

    2010-07-01

    Full Text Available Abstract Background The objective of this study was to perform simulated-use testing as well as a clinical study to assess the efficacy of the EVOTECH® Endoscope Cleaner and Reprocessor (ECR cleaning for flexible colonoscopes, duodenoscopes, gastroscopes and bronchoscopes. The main aim was to determine if the cleaning achieved using the ECR was at least equivalent to that achieved using optimal manual cleaning. Methods Simulated-use testing consisted of inoculating all scope channels and two surface sites with Artificial Test Soil (ATS containing 108 cfu/mL of Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans. Duodenoscopes, colonoscopes, and bronchoscopes (all Olympus endoscopes were included in the simulated use testing. Each endoscope type was tested in triplicate and all channels and two surface sites were sampled for each scope. The clinical study evaluated patient-used duodenoscopes, bronchoscopes, colonoscopes, and gastroscopes (scopes used for emergency procedures were excluded that had only a bedside flush prior to being processed in the ECR (i.e. no manual cleaning. There were 10 to 15 endoscopes evaluated post-cleaning and to ensure the entire ECR cycle was effective, 5 endoscopes were evaluated post-cleaning and post-high level disinfection. All channels and two external surface locations were sampled to evaluate the residual organic and microbial load. Effective cleaning of endoscope surfaces and channels was deemed to have been achieved if there was 2 of residual protein, 2 of residual hemoglobin and 10 viable bacteria/cm2. Published data indicate that routine manual cleaning can achieve these endpoints so the ECR cleaning efficacy must meet or exceed these to establish that the ECR cleaning cycle could replace manual cleaning Results In the clinical study 75 patient-used scopes were evaluated post cleaning and 98.8% of surfaces and 99.7% of lumens met or surpassed the cleaning endpoints set for protein

  16. Scintigraphic and Endoscopic Evaluation of Radiation-induced Acute Gastrointestinal Syndrome in Micro-pig Model

    International Nuclear Information System (INIS)

    Lee, Seung-Sook; Kim, Kyung-Min; Kim, Jin; Jang, Won-Suk; Lee, Jung-Eun; Kim, Noo-Ri; Lee, Sun-Joo; Kim, Mi-Sook; Ji, Young-Hoon; Cheon, Gi-Jeong; Lim, Sang-Moo

    2007-01-01

    Micro-pig model can be served as a proper substitute for humans in studying acute radiation syndrome following radiation-exposure accidents, especially showing similar clinico-pathologic response of hematopoietic and gastrointestinal (GI) syndrome to human. Among acute GI syndrome induced by radiation, GI motility disturbance has not been studied, however, it would be important in a viewpoint of affecting infectious progression from GI tract. Here, we employed scintigraphy of GI transit time and sequential endoscopic examination and tissue sampling in micropigs followed by abdominal radiation exposure. The specific aims of this study are to evaluate objective evidence of GI motility disturbance by scintigraphic evaluation and to find corresponding clinicoapthologic changes in radiation-induced acute GI syndrome

  17. IMPROVED EXPERIMENTAL MODEL TO EVALUATE SUBMUCOSAL INJECTION SOLUTIONS FOR ENDOSCOPIC SUBMUCOSAL DISSECTION.

    Science.gov (United States)

    Yamazaki, Kendi; Maluf-Filho, Fauze; da Costa, Vitor Alves Pessoa; Pessorrusso, Fernanda Cristina Simões; Hondo, Fabio Yuji; Sakai, Paulo; de Figueiredo, Luis Francisco Poli

    2015-01-01

    Endoscopic submucosal dissection carries an increased risk of bleeding and perforation. The creation of a long lasting submucosal cushion is essential for the safe and complete removal of the lesion. There is not a suitable experimental model for evaluation of the durability of the cushioning effect of different solutions. To describe an improved experimental model to evaluate submucosal injection solutions. A total of four domestic pigs were employed to evaluate two different submucosal fluid solutions in the gastric submucosa. After midline laparotomy, the anterior gastric wall was incised from the gastric body to the antrum and its mucosal surface was exposed by flipping inside out the incised gastric wall. Two different solutions (10% mannitol and normal saline) were injected in the submucosa of the anterior wall of the distal gastric body. All submucosal cushions were injected until they reach the same size, standardized as 1.0 cm in height and 2.0 cm in diameter. A caliper and a ruler were employed to guarantee accuracy of the measurements. All four animal experiments were completed. All submucosal cushions had the exact same size measured with caliper and a ruler. By using the mannitol solution, the mean duration of the submucosal cushion was longer than the saline solution: 20 and 22 min (mean, 21 min) vs 5 and 6 min (mean, 5.5 min) This experimental model is simple and evaluate the duration, size, and effect of the submucosal cushion, making it more reliable than other models that employ resected porcine stomachs or endoscopic images in live porcine models.

  18. Evaluation of patient nasal saline irrigation practices following endoscopic sinus surgery.

    Science.gov (United States)

    Yoo, Frederick; Ference, Elisabeth H; Kuan, Edward C; Lee, Jivianne T; Wang, Marilene B; Suh, Jeffrey D

    2018-01-01

    Functional endoscopic sinus surgery (FESS) is an effective treatment for chronic rhinosinusitis (CRS). Postoperative management strategies after FESS often vary from surgeon to surgeon. Recent data suggests that nasal saline irrigation following FESS is almost universally recommended; however, patient adherence has not been formally evaluated. The purpose of this study is to evaluate postoperative nasal irrigation practices and its effects on short-term outcomes in post-FESS patients. Eighty-two patients were followed prospectively following FESS at a tertiary-academic medical institution for 3 postoperative visits. Patients were surveyed on their irrigation practices (start date, frequency, and volume per irrigation per side), and adherence to prescribed antibiotic and steroid regimens. At each visit, 22-item Sino-Nasal Outcome Test (SNOT-22) questionnaires and endoscopic examinations were evaluated by the Lund-Kennedy Endoscopy Score (LKES). Factors evaluated include: patient demographics (age, sex, ethnicity), preoperative Lund-Mackay and SNOT-22 scores, comorbidities, extent of procedure, and use of nasal packing and/or spacers. Adherence to irrigation instructions was 82.9%. Factors significantly associated with compliance with irrigation instructions included younger age (p = 0.0022), prior irrigation (p < 0.0001), revision surgery (p = 0.0014), and non-native English language speaking (p = 0.0095). Patients were more likely to irrigate with larger volumes if they were younger (p = 0.0284), had prior irrigation (p < 0.0001), or had revision surgery (p = 0.0056). Multiple factors are associated with patient compliance with nasal saline irrigation after FESS. Ethnic and cultural considerations, such as language barriers, should also be considered to improve outcomes. Identification of patients who may be noncompliant could potentially benefit from increased preoperative counseling to improve adherence rates. © 2017 ARS-AAOA, LLC.

  19. A prospective study to evaluate the utility of bronchoalveolar lavage by fiberoptic bronchoscopy in sputum smear negative patients with high suspicion of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Ritesh Kamal

    2012-01-01

    Full Text Available Aim: To evaluate the utility of bronchoalveolar lavage (BAL by flexible fiberoptic bronchoscopy (FOB in sputum smear negative patients with clinical and radiological characteristics of pulmonary tuberculosis (PTB. Materials and Methods: This prospective study was carried out in 30 sputum smear negative patients of age group 20 to 70 years, who were highly suspicious for PTB by clinical and radiographic criteria. All patients were subjected to sputum culture, BAL stains and cultures, and cytopathology. Patients with moderate to massive pleural effusion, obvious accessible lymph node, history of antitubercular therapy (ATT, and contraindication to FOB were excluded. Results: Sputum culture for acid fast bacilli (AFB was positive in four (12% patients, BAL fluid was positive for Ziehl-Neelsen (ZN stain in nine (27% patients, including four sputum culture patients, while BAL culture for AFB on Lowenstein-Jensen (LJ medium was positive in 18 (60%, including 9 BAL fluid ZN stain positive patients. Six (20% patients had growth on pyogenic culture, while two (7% patients had malignant cell on cytological examination of BAL fluid. Remaining four (13% patients were empirically started on ATT. They had complete response to ATT at 2 months and were retrospectively diagnosed with pulmonary tuberculosis (PTB. All the bacteriologically confirmed PTB patients were given ATT for 6 months and all patients had complete response. Conclusion: We concluded that FOB guided BAL is extremely useful for establishing diagnosis of PTB or other pulmonary diseases in sputum smear negative patients, who have high suspicion for PTB by clinical and radiographic criteria.

  20. Performance evaluation of one-dimensional fiber-optic radiation sensor for measuring high energy electron beam using a charge-coupled device

    International Nuclear Information System (INIS)

    Cho, Dong Hyun; Jang, Kyoung Won; Yoo, Wook Jae; Chung, Soon Cheol; Tack, Gye Rae; Eom, Gwang Moon; Lee, Bongsoo; Cho, Hyosung; Kim, Sin

    2008-01-01

    In this study, we have fabricated one-dimensional fiber-optic radiation sensor array for high energy electron beam therapy dosimetry. Fiber-optic radiation sensor comprises an organic scintillator as a sensing volume, optical fiber as a light guider and photo-detector as a light measuring device. Usually, photomultiplier tube or photodiode is used as a photo-detector however we have tried to use a charge-coupled device as a scintillating light measuring system for one-dimensional fiber-optic radiation sensor array. This system can take an image of the proximal ends of one-dimensional fiber-optic sensor array and can measure light intensities of individual image of optical fibers simultaneously using simple imaging software. Charge-coupled device as a light measuring detector has many advantages which are easy in multi-dimensional measurements, high spatial resolution and relatively low cost. We have measured one-dimensional electron beam distributions in a PMMA phantom with different energies and field sizes of electron beam using a fiber-optic sensor and a charge-coupled device. Also, the percentage depth dose curves for high energy electron beams are obtained. (author)

  1. Endoscopic biopsies in Ussing chambers evaluated for studies of macromolecular permeability in the human colon.

    Science.gov (United States)

    Wallon, Conny; Braaf, Ylva; Wolving, Mats; Olaison, Gunnar; Söderholm, Johan D

    2005-05-01

    Studies of mucosal permeability to protein antigens in humans are limited to in vitro techniques. The use of surgical specimens for such studies has major shortcomings. Endoscopic biopsies in Ussing chambers have been introduced as a means of studying secretion and transepithelial permeability, but have not been evaluated for studies of protein antigen uptake in human intestine. Standard forceps biopsies from the sigmoid colon of 24 healthy volunteers were mounted in Ussing chambers with an exposed tissue area of 1.76 mm2. 51Cr-EDTA (paracellular probe) and horseradish peroxidase (HRP; 45 kDa protein antigen) were used as permeability markers. Mucosal permeability, electrophysiology, histology and energy contents of the biopsies were studied over time. To evaluate the ability of the technique to detect permeability changes, the mucosa was modulated with capric acid, a medium-chain fatty acid, known to affect tight junctions. In the Ussing chamber the mucosal biopsies were viable for 160 min with stable levels of ATP and lactate, and only minor changes in morphology. Steady-state permeability with low variability was seen for both markers during the 30-90 min period. Exposure to capric acid induced a rapid decrease in short-circuit current (Isc) and a slower reversible decrease in transepithelial resistance (TER), as well as an increased permeability to 51Cr-EDTA and HRP. Endoscopic biopsies of human colon are viable in Ussing chambers and are reliable tools for studies of mucosal permeability to protein antigens. The technique offers a broad potential for studies of mucosal function in the pathophysiology of human gastrointestinal diseases.

  2. Evaluation of early endoscopic realignment of post-traumatic complete posterior urethral rupture

    Directory of Open Access Journals (Sweden)

    Yaser M Abdelsalam

    2013-01-01

    Full Text Available Introduction: to report our experience with 41 patients treated by early endoscopic realignment of complete post-traumatic rupture urethra. Materials and Methods: The study includes patients presented to our institute, between May 2004 and April 2009, with post-traumatic complete posterior urethral disruption. Preoperative retrograde urethrography, voiding cystourethrography and abdominopelvic CT were performed to evaluate the urethral defect length, the bladder neck competence, the prostate position, and the extent of the pelvic hematoma. Within the first week after trauma, antegrade and retrograde urethroscopy were performed to identify both urethral ends and insert urethral catheter. Patients were followed up by pericatheter retrograde urethrogram monthly postoperatively till catheter removal on disappearance of extravasation. Retrograde urethrography, voiding cystourethrography and urethroscopy were performed 1 month after the removal of the catheter. Follow-up abdominal ultrasound and uroflowmetry monthly till 6 months, bimonthly till 1 year, and every 3 months thereafter were encouraged. Urinary continence and postoperative erectile dysfunction were assessed by direct patient interview. Results: Forty one patients in the age group 17-61 years (mean 37.9 were treated. Patients were followed up for 12-36 months (mean 17 months. Complete healing of the urethra occurred in 18 patients (43.9%. Passable urethral stricture developed in 15 patients (36.6%. Complete urethral obstruction occurred in eight patients (19.5%. Conclusions: Early endoscopic realignment for complete posterior urethral rupture is a feasible technique with no or minimal intraoperative complications. The technique is successful as the definitive line of therapy in reasonable number of patients and seems to render further future interventions for inevitable urethral stricture easier.

  3. Evaluation of Dyspnea Outcomes After Endoscopic Airway Surgery for Laryngotracheal Stenosis.

    Science.gov (United States)

    Samad, Idris; Akst, Lee; Karatayli-Özgürsoy, Selmin; Teets, Kristine; Simpson, Marissa; Sharma, Ashwyn; Best, Simon R A; Hillel, Alexander T

    2016-11-01

    Endoscopic airway surgery is a frequently used procedure in the management of laryngotracheal stenosis (LTS); however, no established outcome measures are available to assess treatment response. To assess acoustics and aerodynamic measures and voice- and dyspnea-related quality of life (QOL) in adult patients with LTS who undergo endoscopic airway surgery. This case series compared preoperative measures and postoperative outcomes among adult patients who underwent endoscopic airway surgery for LTS from September 1, 2013, to September 30, 2015, at the tertiary care Johns Hopkins Voice Center. Patients were excluded if they did not undergo balloon dilation or if they had multilevel or glottic stenosis. The Phonatory Aerodynamic System was used to quantify laryngotracheal aerodynamic changes after surgery. Final follow-up was completed 2 to 6 weeks after surgery. The voice-related QOL instrument (V-RQOL), Dyspnea Index, and Clinical Chronic Obstructive Pulmonary Disease Questionnaire were completed before and after endoscopic surgery. Consensus auditory perceptual evaluation of voice, acoustic measurements, and aerodynamic outcomes were also assessed. Fourteen patients (1 man and 13 women; mean [SD] age, 45.4 [4.3] years) were enrolled. The mean postoperative V-RQOL scores (n = 14) increased from 74.3 to 85.5 (mean of difference, 11.3; 95% CI, 2.2 to 20.3). The mean postoperative Dyspnea Index (n = 14) decreased from 26.9 to 6.6 (mean of difference, -20.3; 95% CI, -27.9 to -12.7); the mean postoperative Clinical Chronic Obstructive Pulmonary Disease Questionnaire scores (n = 9) decreased from 3.2 to 1.0 (mean of difference, -2.2; 95% CI, -3.4 to -0.9). Postoperative mean vital capacity (n = 14) increased from 2.5 to 3.1 L (mean of difference, 0.6 L; 95% CI, 0.3-1.0 L), whereas mean laryngeal resistance (n = 14) decreased from 73.9 to 46.4 cm H2O/L/s (mean of difference, -27.5 cm H2O/L/s; 95% CI, -44.8 to -10.3 cm H2O/L/s) postoperatively. Patients

  4. Endoscopic tattooing.

    Science.gov (United States)

    Kethu, Sripathi R; Banerjee, Subhas; Desilets, David; Diehl, David L; Farraye, Francis A; Kaul, Vivek; Kwon, Richard S; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Wong Kee Song, Louis-Michel; Tierney, William M

    2010-10-01

    The American Society for Gastrointestinal Endoscopy (ASGE) Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases, data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through January 2010 for articles related to endoscopic tattooing by using the Keywords tattooing, colonic, endoscopic, India ink, indocyanine green in different search term combinations. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by

  5. Evaluation of motion compensation method for assessing the gastrointestinal motility using three dimensional endoscope

    Science.gov (United States)

    Yoshimoto, Kayo; Yamada, Kenji; Watabe, Kenji; Fujinaga, Tetsuji; Kido, Michiko; Nagakura, Toshiaki; Takahashi, Hideya; Iijima, Hideki; Tsujii, Masahiko; Takehara, Tetsuo; Ohno, Yuko

    2016-03-01

    Functional gastrointestinal disorders (FGID) are the most common gastrointestinal disorders. The term "functional" is generally applied to disorders where there are no structural abnormalities. Gastrointestinal dysmotility is one of the several mechanisms that have been proposed for the pathogenesis of FGID and is usually examined by manometry, a pressure test. There have been no attempts to examine the gastrointestinal dysmotility by endoscopy. We have proposed an imaging system for the assessment of gastric motility using a three-dimensional endoscope. After we newly developed a threedimensional endoscope and constructed a wave simulated model, we established a method of extracting three-dimensional contraction waves derived from a three-dimensional profile of the wave simulated model obtained with the endoscope. In the study, the endoscope and the wave simulated model were fixed to the ground. However, in a clinical setting, it is hard for endoscopists to keep the endoscope still. Moreover, stomach moves under the influence of breathing. Thus, three-dimensional registration of the position between the endoscope and the gastric wall is necessary for the accurate assessment of gastrointestinal motility. In this paper, we propose a motion compensation method using three-dimensional scene flow. The scene flow of the feature point calculated by obtained images in a time series enables the three-dimensional registration of the position between the endoscope and the gastric wall. We confirmed the validity of a proposed method first by a known-movement object and then by a wave simulated model.

  6. Endoscopic injection therapy

    Directory of Open Access Journals (Sweden)

    Sang Woon Kim

    2017-06-01

    Full Text Available Since the U.S. Food and Drug Administration approved dextranomer/hyaluronic acid copolymer (Deflux for the treatment of vesicoureteral reflux, endoscopic injection therapy using Deflux has become a popular alternative to open surgery and continuous antibiotic prophylaxis. Endoscopic correction with Deflux is minimally invasive, well tolerated, and provides cure rates approaching those of open surgery (i.e., approximately 80% in several studies. However, in recent years a less stringent approach to evaluating urinary tract infections (UTIs and concerns about long-term efficacy and complications associated with endoscopic injection have limited the use of this therapy. In addition, there is little evidence supporting the efficacy of endoscopic injection therapy in preventing UTIs and vesicoureteral reflux-related renal scarring. In this report, we reviewed the current literature regarding endoscopic injection therapy and provided an updated overview of this topic.

  7. Endoscopic injection therapy

    Science.gov (United States)

    Kim, Sang Woon; Lee, Yong Seung

    2017-01-01

    Since the U.S. Food and Drug Administration approved dextranomer/hyaluronic acid copolymer (Deflux) for the treatment of vesicoureteral reflux, endoscopic injection therapy using Deflux has become a popular alternative to open surgery and continuous antibiotic prophylaxis. Endoscopic correction with Deflux is minimally invasive, well tolerated, and provides cure rates approaching those of open surgery (i.e., approximately 80% in several studies). However, in recent years a less stringent approach to evaluating urinary tract infections (UTIs) and concerns about long-term efficacy and complications associated with endoscopic injection have limited the use of this therapy. In addition, there is little evidence supporting the efficacy of endoscopic injection therapy in preventing UTIs and vesicoureteral reflux-related renal scarring. In this report, we reviewed the current literature regarding endoscopic injection therapy and provided an updated overview of this topic. PMID:28612059

  8. Comparison between Microscopic and Endoscopic Approaches for Evaluation of Anatomic Areas in Surgically Treated Chronic Otitis Media

    Directory of Open Access Journals (Sweden)

    M.T. Goodarzi

    2013-07-01

    Full Text Available Introduction & Objective: The diagnostic value of endoscopic and microscopic procedures for viewing different structures of middle ear has been widely assessed however, no published study is available for comparing the diagnostic value of them in chronic otitis media patients. The present study conducted to compare diagnostic value of these two procedures for as-sessment of middle ear normal structures and possible defects in these patients. Materials & Methods: In a prospective descriptive analytical study, fifty eight consecutive pa-tients older than 15 years who suffered from chronic otitis media and were candidates for tympanoplasty with or without mastoidectomy were included into the study and underwent operation. After entering the middle ear by post auricular incision and elevation of a tym-panomeatal flap, and prior to surgery , the middle ear was first examined by an operating mi-croscope in different bed and microscope positions and by performing gentle maneuvers on the head and then was reevaluated using a rigid 0 & 30 degree sinoscope. The visible areas of middle ear were separately noted. Results: Structures of epitympanum, posterior mesotympanum, and hypotympanum structures were more visible using endoscope compared with microscope(P0.05. Conclusion: Endoscopic and microscopic procedures had similar diagnostic values to view ossicular chain mobility and reflexes of round window as well as to detect ossicular chain erosions, but different anatomical parts and more hidden pits of the middle ear such as epitympanum, posterior mesotympanum, and hypotympanum are more visible by an endoscopic tool.In case of pathologic conditions, endoscopic approach is recommended for better observation and adequate evaluation of the location before and after the removal of the lesion. (Sci J Hamadan Univ Med Sci 2013; 20 (2:95-100

  9. Evaluation of endoscopic laser excision of polypropylene mesh/sutures following anti-incontinence procedures.

    LENUS (Irish Health Repository)

    Davis, N F

    2012-11-01

    We reviewed our experience with and outcome of the largest series to our knowledge of patients who underwent endoscopic laser excision of eroded polypropylene mesh or sutures as a complication of previous anti-incontinence procedures.

  10. Endoscopic ultrasound-guided fine-needle aspiration cytology in the evaluation of suspected tuberculosis in patients with isolated mediastinal lymphadenopathy

    DEFF Research Database (Denmark)

    Puri, R.; Vilmann, P.; Sud, R.

    2010-01-01

    Patients with suspected tuberculosis without pulmonary lesions and with mediastinal lymphadenopathy often pose a diagnostic challenge. Endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) cytology is an established modality to evaluate mediastinal and abdominal lesions. The aim...

  11. Radiological evaluation of percutaneous endoscopic lumbar discectomy: a three-year follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Seung Eun; Lee, Sang Ho; Ahn, Yong; Shin, Song Woo; Jo, Byung June; Park, Jee Young [Wooridul Spine Hospital, Seoul (Korea, Republic of); Kim, Tae Hong [Inje University College of Medicine, Seoul (Korea, Republic of)

    2006-05-15

    We wanted to analyze the radiological changes of the patients who underwent percutaneous endoscopic lumbar discectomy (PELD) for treating soft disc herniation. We retrospectively reviewed 30 patients (32 cases) who were observed for a minimum of 3 years after they underwent PELD. The authors investigated the postoperative radiological changes after PELD and the related clinical outcomes. All the patients received plain X-rays, CT and MRI both preoperatively and at the final follow-up. The radiological parameters were evaluated, including the disc height, the disc signal intensity, the subchondral marrow signal intensity, the sagittal plane instability and the facet joint osteoarthritis. The average amount of removed disc was 1.363 g and a significant correlation was detected between the narrowing of disc height and the amount of removed disc. Although the disc height and the disc height ratio were significantly decreased (-0.97 mm and 86.9%, respectively), the angle of sagittal rotation was well maintained. There were 18 (56.3%) cases of disc signal changes, six cases (18.8%) of subchondral marrow signal changes, and three cases (9.4%) of facet joint osteoarthritis. The success rate was 90.6%. Although disc height narrowing was observed, there was no postoperative instability and the overall clinical outcome was satisfactory. Our results show that PELD is a useful and minimal invasive procedure for the selected patients who are suffering with lumbar disc herniation.

  12. Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr.

    Science.gov (United States)

    Afane, J S; Olweny, E O; Bercowsky, E; Sundaram, C P; Dunn, M D; Shalhav, A L; McDougall, E M; Clayman, R V

    2000-10-01

    Flexible ureteroscopes smaller than 9Fr are widely used in endourology. We systematically evaluated the functional durability of these instruments in the clinical setting. We performed ureteronephroscopy 92 consecutive times in 84 patients at our hospital using a flexible Storz model 11274AA,double dagger Circon-ACMI model AUR-7, section sign Wolf model 7325.172 parallel and Olympus model URF/P3 ureteroscope paragraph sign. Preoperatively and postoperatively we evaluated all flexible ureteroscopes for luminosity, irrigant flow at 100 mm. Hg, number of broken image fibers and active deflection range. During the procedure a record was kept of the duration that the endoscope remained in the urinary tract, average irrigation pressure, method of insertion, various devices used within the working channel, need for lower pole access, and surgeon overall impression of visibility and maneuverability. The luminosity and irrigant flow of all endoscopes remained relatively unchanged during consecutive applications, while active deflection deteriorated 2% to 28%. Endoscopes were used for an average of 3 to 13 hours before they needed repair. The most fragile part of these instruments was the deflection unit. Small diameter flexible ureteroscopes are effective for diagnosing and treating upper urinary tract pathology but improved durability is required. Currently they represent a highly effective but high maintenance means of achieving retrograde access to the ureter and kidney with a need for repair after only 6 to 15 uses.

  13. GI endoscopes.

    Science.gov (United States)

    Varadarajulu, Shyam; Banerjee, Subhas; Barth, Bradley A; Desilets, David J; Kaul, Vivek; Kethu, Sripathi R; Pedrosa, Marcos C; Pfau, Patrick R; Tokar, Jeffrey L; Wang, Amy; Wong Kee Song, Louis-Michel; Rodriguez, Sarah A

    2011-07-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, performing a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the Committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through September 2010 for articles related to endoscopy by using the key words "gastroscope," "colonoscope," "echoendoscope," "duodenoscope," "choledochoscope," "ultraslim endoscope," "variable stiffness colonoscope," and "wide-angle colonoscope." Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright © 2011 American Society for Gastrointestinal

  14. Evaluation by biliary scintigraphy of recurrence of choledocholithiasis after endoscopic sphincterotomy

    International Nuclear Information System (INIS)

    Shimura, Junichi; Sakai, Yoshihiro; Igarashi, Yoshinori

    2004-01-01

    It is difficult to predict recurrence of choledocholithiasis after endoscopic sphincterotomy (EST). Because cholestasis is considered to cause recurrence of choledocholithiasis, it may be possible to predict recurrence by objective evaluation of cholestasis. The aim of the present study was to examine the relationship between cholestasis and recurrence of choledocholithiasis by biliary scintigraphy in post-EST cases. Seventy-five patients who had undergone EST were tested by biliary scintigraphy. Cases with positive and negative detection of hot spots in the duodenum within 60 min after isotope infusion were categorized as 'maintained bile excretion' (Group M) and 'delayed bile excretion' (Group D), respectively. Age, gender, biliary tract enzyme levels, diameter of the common bile duct, presence of the gallbladder, presence of juxtapapillary duodenal diverticula, and the recurrence rates of choledocholithiasis were compared between the two groups. Seventy-five cases were distributed into 66 cases (88%) in Group M and nine cases (12%) in Group D. There was no statistical differences in age, gender, biliary tract enzyme levels, diameter of the common bile duct, and presence of juxtapapillary diverticula. In Group D, all the cases had retained the gallbladder. Of 41 cases who had been followed up for more than 1 year, 35 cases (85%) were assigned to Group M and six (15%) to Group D. Recurrence of choledocholithiasis was observed in five cases, with two in Group M and three in Group D. The recurrence rate was significantly higher in Group D than in Group M. Biliary scintigraphy was considered useful for objectively predicting recurrence of choledocholithiasis. (author)

  15. Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses: a multicenter study.

    Science.gov (United States)

    Giovannini, Marc; Thomas, Botelberge; Erwan, Bories; Christian, Pesenti; Fabrice, Caillol; Benjamin, Esterni; Geneviève, Monges; Paolo, Arcidiacono; Pierre, Deprez; Robert, Yeung; Walter, Schimdt; Hanz, Schrader; Carl, Szymanski; Christoph, Dietrich; Pierre, Eisendrath; Jean-Luc, Van Laethem; Jacques, Devière; Peter, Vilmann; Andrian, Saftoiu

    2009-04-07

    To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass (n = 121) or lymph node (n = 101). The classification as benign or malignant, based on the real time elastography pattern, was compared with the classification based on the B-mode EUS images and with the final diagnosis obtained by EUS-guided fine needle aspiration (EUS-FNA) and/or by surgical pathology. An interobserver study was performed. The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%, respectively, compared to 92.3% and 68.9%, respectively, for the conventional B-mode images. The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%, respectively, compared to 78.6% and 50.0%, respectively, for the B-mode images. The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes. EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity, specificity and accuracy. It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes.

  16. Feasibility of fiber-optic radiation sensor using Cerenkov effect for detecting thermal neutrons.

    Science.gov (United States)

    Jang, Kyoung Won; Yagi, Takahiro; Pyeon, Cheol Ho; Yoo, Wook Jae; Shin, Sang Hun; Misawa, Tsuyoshi; Lee, Bongsoo

    2013-06-17

    In this research, we propose a novel method for detecting thermal neutrons with a fiber-optic radiation sensor using the Cerenkov effect. We fabricate a fiber-optic radiation sensor that detects thermal neutrons with a Gd-foil, a rutile crystal, and a plastic optical fiber. The relationship between the fluxes of electrons inducing Cerenkov radiation in the sensor probe of the fiber-optic radiation sensor and thermal neutron fluxes is determined using the Monte Carlo N-particle transport code simulations. To evaluate the fiber-optic radiation sensor, the Cerenkov radiation generated in the fiber-optic radiation sensor by irradiation of pure thermal neutron beams is measured according to the depths of polyethylene.

  17. Endoscopic retrograde cholangiopancreatography and endoscopic ...

    African Journals Online (AJOL)

    An approach to suspected gallstone pancreatitis'based on endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (ES) was adopted in 1976 and was followed in 29 patients. ERCp became the routine method of early biliary tract assessment when gallstone pancreatitis was suspected on ...

  18. The evaluation of Lugol's iodine solution staining combined with endoscope for diagnosis of non-erosive reflux disease in clinic.

    Science.gov (United States)

    Zhao, H; Xue, L; Liu, J; Zhang, H-Y; Zhang, D; Song, X-H; He, Y-X; Yang, T; Li, C-Q; Li, Y-Q

    2013-11-01

    To evaluate the value of Lugol's iodine solution staining combined with endoscope on the diagnosis of non-erosive reflux disease (NERD). A total of 96 gastroesophageal reflux disease patients were selected to participate in this study. The patients were stained on esophageal mucosa by Lugol's iodine solution and examined at routine endoscopy. The shallow staining and/or non-staining group patients were treated with esomeprazole and mosapride citrate, and then the changes in Lugol's iodine staining, Gerd Q (Gerd questionnaire) scoring and histological characters of esophageal mucosa were recorded before and after treatment. As the results, a total of 68 patients were diagnosed as NERD, and 36 of 68 patients were observed with uniform staining and 32 of 68 patients were observed with shallow staining and/or non-staining. After 4 weeks for treatment, 28 of 32 patients with shallow staining and/or non-staining became uniform staining and 4 of 32 patients were still with shallow staining and/or non-staining. Before and after treatment, the Gerd Q scoring of uniform staining groups and shallow staining and/or non-staining groups all had a significant difference (p Lugol's iodine solution staining combined with endoscope. Lugol's iodine solution staining combined with routine endoscopy, Gerd Q scoring and histomorphology can be used to evaluate the diagnosis and therapeutic effect of NERD.

  19. The Evaluation of Endoscopic Balloon Dilation Treatment for Benign Gastric Outlet Obstruction

    Directory of Open Access Journals (Sweden)

    J Sokri Shirvani

    2012-05-01

    Full Text Available

    Background and Objective

    Balloon dilatation of stricture is one of the new treatment methods for patients with Gastric Outlet Obstruction (GOO. Prevalence and underlying etiologies of GOO in various populations are different. The goal of the present study was to determine the effectiveness of endoscopic balloon dilatation and factors that could affect method advantage among patients with benign etiology for GOO.

     

    Methods

     Forty-five patients with symptoms of benign GOO were randomly selected. The mean age of patients was 43.7±18.1 years and 86.7% of them were men. Gastric outlet was delineated using double channel videoendoscopy. The severity of gastric pain was measured by VAS test immediately before and one month after balloon dilatation. Patients were followed after procedure weekly (for the first month and then monthly. Balloon dilatation was repeated for 27% patients during the follow up period.

     

    Results

    Patients were followed for 9.9±5.8 months. Furthermore, 71.1% were H. pylori positive. Positive response percent to endoscopic balloon dilatation was 80% and eight patients were took under surgical resection. Weight loss was seen frequently in the non-respondent group. The pain severity was significantly reduced in respondent subjects. No meaningful correlations were found between the response to balloon dilatation and positive H. pylori and cigarette smoking.

     

    Conclusion

    Endoscopic balloon dilatation is a safe and effective method for treating most of patients with benign gastric outlet obstruction and has favorable long-term outcome. 

  20. Sphenoid mucocele; Diagnostic evaluation end endoscopic sinus surgery. Mucocele i sinus sphenoidalis; Diagnostikk og endoskopisk kirurgi

    Energy Technology Data Exchange (ETDEWEB)

    Elverland, H.H.; Melheim, I.; Anke, I.M.; Wideroee, E. (Regional Hospital, Tromsoe (Norway)); Rinck, P.A. (Regional Hospital, Trondheim (Norway))

    1991-02-01

    Two cases of sphenoid sinus mucocele are described. Diagnosis was based on insidious orbital symptoms, apex orbital syndrome, followed by CT and MRI examinations. In one case the mucocele was preceded by seven years of a successfully treated undifferentiated nasopharyngeal carcionma. Simple transnasal endoscopic drainage of the mucoceles gave good results, although a monocular blindness of long standing was irreversible. A high level of suspicion, combined with modern imaging techniques and prompt surgical intervention, are the prerequisites for avoiding persisting sequelae. 28 refs., 5 figs.

  1. Evaluation of endoscopically obtained duodenal biopsy samples from cats and dogs in an adapter-modified Ussing chamber

    Science.gov (United States)

    DeBiasio, John V.; Suchodolski, Jan S.; Newman, Shelley; Musch, Mark W.; Steiner, Jörg M.

    2014-01-01

    This study was conducted to evaluate an adapter-modified Ussing chamber for assessment of transport physiology in endoscopically obtained duodenal biopsies from healthy cats and dogs, as well as dogs with chronic enteropathies. 17 duodenal biopsies from five cats and 51 duodenal biopsies from 13 dogs were obtained. Samples were transferred into an adapter-modified Ussing chamber and sequentially exposed to various absorbagogues and secretagogues. Overall, 78.6% of duodenal samples obtained from cats responded to at least one compound. In duodenal biopsies obtained from dogs, the rate of overall response ranged from 87.5% (healthy individuals; n = 8), to 63.6% (animals exhibiting clinical signs of gastrointestinal disease and histopathological unremarkable duodenum; n = 15), and 32.1% (animals exhibiting clinical signs of gastrointestinal diseases and moderate to severe histopathological lesions; n = 28). Detailed information regarding the magnitude and duration of the response are provided. The adapter-modified Ussing chamber enables investigation of the absorptive and secretory capacity of endoscopically obtained duodenal biopsies from cats and dogs and has the potential to become a valuable research tool. The response of samples was correlated with histopathological findings. PMID:24378587

  2. Fiber-optic gyro for space applications

    Science.gov (United States)

    Otaguro, W. S.; Udd, E.; Cahill, R. F.

    1986-01-01

    State-of-the-art fiber-optic gyro modules can be environmentalized to withstand a wide range of vibration, shock and temperature effects; this modular approach to fiber-optic gyro design has improved reliability to the point where rate control device applications in spacecraft can be confidently considered. In order to arrive at a benchmark for such applications, performance and technology readiness comparisons are presently undertaken of both digital and analog fiber-optic gyros with the ring laser gyro. As mass production of key subassemblies for the fiber-optic gyro proceeds, critical cost advantages relative to the ring laser gyro may be achieved.

  3. A cost-effectiveness analysis evaluating endoscopic surveillance for gastric cancer for populations with low to intermediate risk.

    Directory of Open Access Journals (Sweden)

    Hui Jun Zhou

    Full Text Available BACKGROUND: Gastric cancer (GC surveillance based on oesophagogastroduodenoscopy (OGD appears to be a promising strategy for GC prevention. By evaluating the cost-effectiveness of endoscopic surveillance in Singaporean Chinese, this study aimed to inform the implementation of such a program in a population with a low to intermediate GC risk. METHODS: USING A REFERENCE STRATEGY OF NO OGD INTERVENTION, WE EVALUATED FOUR STRATEGIES: 2-yearly OGD surveillance, annual OGD surveillance, 2-yearly OGD screening and 2-yearly screening plus annual surveillance in Singaporean Chinese aged 50-69 years. From a perspective of the healthcare system, Markov models were built to simulate the life experience of the target population. The models projected discounted lifetime costs ($, quality adjusted life year (QALY, and incremental cost-effectiveness ratio (ICER indicating the cost-effectiveness of each strategy against a Singapore willingness-to-pay of $46,200/QALY. Deterministic and probabilistic sensitivity analyses were used to identify the influential variables and their associated thresholds, and to quantify the influence of parameter uncertainties respectively. RESULTS: With an ICER of $44,098/QALY, the annual OGD surveillance was the optimal strategy while the 2-yearly surveillance was the most cost-effective strategy (ICER = $25,949/QALY. The screening-based strategies were either extendedly dominated or cost-ineffective. The cost-effectiveness heterogeneity of the four strategies was observed across age-gender subgroups. Eight influential parameters were identified each with their specific thresholds to define the choice of optimal strategy. Accounting for the model uncertainties, the probability that the annual surveillance is the optimal strategy in Singapore was 44.5%. CONCLUSION: Endoscopic surveillance is potentially cost-effective in the prevention of GC for populations at low to intermediate risk. Regarding program implementation, a detailed

  4. Pretherapeutic evaluation of patients with upper gastrointestinal tract cancer using endoscopic and laparoscopic ultrasonography.

    Science.gov (United States)

    Mortensen, Michael Bau

    2012-12-01

    A detailed and correct pretherapeutic evaluation of stage and resectability is mandatory for an optimal treatment strategy and results in patients with cancer of the esophagus, stomach or pancreas (UGIC). Curative surgery should only be attempted in patients with limited extent of their disease, patients with locally advanced disease should be allocated for neo-adjuvant therapy, while the remaining patients should be referred for palliative measures following a quick, lenient and correct pretherapeutic evaluation. This thorough evaluation and subsequent treatment assignment is also valuable in the identification of uniform patient cohorts for new treatment protocols as well as for the continuing comparison of research data. But despite the importance of accurate pretherapeutic assessment being repeatedly emphasized insufficient staging has been - and is still accepted as - leading to high rates of explorative surgery as well as heterogeneous selection of patients for new treatment trials. Based on the results from the authors PhD thesis he concluded that endoscopic ultrasonography (EUS) as a single imaging modality provided detailed information that hitherto had been inaccessible. EUS was considered a significant progress regarding the loco-regional assessment of stage and resectability, but it was also evident that EUS alone was incapable of providing all the necessary information. In addition, there were no evidence regarding the EUS safety profile, patient tolerance of the procedure and no data on the clinical impact of both EUS and EUS guided fine-needle aspiration biopsy (EUS-FNA) in UGIC patients. Therefore, the author chose to conduct additional EUS trials and to test the use of EUS-FNA, laparoscopy (LAP), laparoscopic ultrasonography (LUS) and LUS guided biopsy in order to improve the overall pretherapeutic evaluation and thus the patient selection. The aim of this thesis was to describe the sequential development, testing and clinical results of a new

  5. Functional endoscopic analysis of beatbox performers.

    Science.gov (United States)

    Sapthavee, Andrew; Yi, Paul; Sims, H Steven

    2014-05-01

    Beatboxing is a form of vocal percussion in which performers imitate drum sounds, interspersed with vocalization and other sounds, using their vocal tracts. Although similarities between beatboxing and singing are expected because of the anatomy involved, the medical literature has a wealth of information on singing and minimal studies on beatboxing. The objective of our study was to report on a case series of functional endoscopic evaluation of the anatomy involved in beatboxing and determine whether beatboxing may be a risk factor for phonotrauma or if this form of vocalization might be protective of the vocal folds. We reviewed the flexible fiberoptic data collected from four beatbox artists who were evaluated at an outpatient Laryngology clinic. These records included videos of a standard flexible laryngoscopic evaluation during which the beatboxers performed beatbox sounds in isolation and in various combinations ("beats"), both standardized and improvised. All four participants were males aged 22-32 years. We found that voicing during beatboxing was not the same as full voice to have sustained phonation interlaced with percussive sounds. Performers overall demonstrated similarities in delivery of the same beatbox sounds, although subtle differences were noted between performers. Beatboxing is a complex form of vocal percussion using the entire vocal tract. Although similarities with singing in the anatomical structures and positioning are noted in beatboxing, there are several unique and interesting anatomical processes occurring. Use of the entire vocal tract, including the pharyngeal constrictors, may actually protect against glottic injury. Copyright © 2014 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  6. Endoscopic ultrasound and pancreas divisum

    DEFF Research Database (Denmark)

    Rana, Surinder S; Gonen, Can; Vilmann, Peter

    2012-01-01

    cholangiopancreatography is the gold standard for its diagnosis, but is invasive and associated with significant adverse effects. Endoscopic ultrasound (EUS) allows the detailed evaluation of the pancreaticobiliary ductal system without injecting contrast in these ducts. Moreover, it provides detailed images...

  7. Diagnosis of a complication of endoscopic variceal sclerotherapy by combined use of radiology and endoscopy

    International Nuclear Information System (INIS)

    Kulke, H.; Auer, I.O.; Burghardt, W.; Braun, H.

    1982-01-01

    A case is reported of an intramural oesophageal fistula developing after fiberoptic injection sclerotherapy for oesophageal varices in a patient with alcoholic cirrhosis of the liver. Only the combined use of endoscopic application of radiographic contrast medium and detailed radiological investigation allowed the definite diagnosis. (orig.) [de

  8. Feasibility Study on Fiber-optic Radiation Sensor for Remote Gamma-ray Spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Hyesu; Jang, Kyoung Won; Shin, Sang Hun and others

    2014-05-15

    In this study, we fabricated a fiber-optic radiation sensor using an optical fiber and various scintillators. To select an adequate inorganic scintillator for the sensing probe of fiber-optic radiation sensor, 5 types of scintillators were evaluated. The spectra of gamma-rays emitted from a Na-22 radiation source were measured by using the manufactured sensors. As a result, the BGO was suitable for the sensing probe of fiber-optic radiation sensor due to its high scintillation output and exact photoelectric peak for the gamma-ray energy. The basic principle of radiation detection is to detect the signals caused by interactions between radiations and materials. There are various types of radiation detectors depending on types of radiation to be detected and physical quantities to be measured. As one of the radiation detectors, a fiber-optic radiation sensor using a scintillator and an optical fiber has two advantages such as no space restraint and remote sensing. Moreover, in nuclear environments, this kind of sensor has immunities for electromagnetic field, temperature, and pressure. Thus, the fiber-optic radiation sensor can be used in various fields including nondestructive inspection, radioactive waste management, nuclear safety, radiodiagnosis and radiation therapy. As a fundamental study of the fiber-optic radiation sensor for remote gamma-ray spectroscopy, in this study, we fabricated a fiber-optic radiation sensor using an optical fiber and various scintillators. To select an adequate inorganic scintillator for the sensing probe of fiber-optic radiation sensor, 5 types of scintillators were evaluated. The spectra of gamma-rays emitted from a Na-22 radiation source were measured by using the manufactured sensors.

  9. Feasibility Study on Fiber-optic Radiation Sensor for Remote Gamma-ray Spectroscopy

    International Nuclear Information System (INIS)

    Jeon, Hyesu; Jang, Kyoung Won; Shin, Sang Hun and others

    2014-01-01

    In this study, we fabricated a fiber-optic radiation sensor using an optical fiber and various scintillators. To select an adequate inorganic scintillator for the sensing probe of fiber-optic radiation sensor, 5 types of scintillators were evaluated. The spectra of gamma-rays emitted from a Na-22 radiation source were measured by using the manufactured sensors. As a result, the BGO was suitable for the sensing probe of fiber-optic radiation sensor due to its high scintillation output and exact photoelectric peak for the gamma-ray energy. The basic principle of radiation detection is to detect the signals caused by interactions between radiations and materials. There are various types of radiation detectors depending on types of radiation to be detected and physical quantities to be measured. As one of the radiation detectors, a fiber-optic radiation sensor using a scintillator and an optical fiber has two advantages such as no space restraint and remote sensing. Moreover, in nuclear environments, this kind of sensor has immunities for electromagnetic field, temperature, and pressure. Thus, the fiber-optic radiation sensor can be used in various fields including nondestructive inspection, radioactive waste management, nuclear safety, radiodiagnosis and radiation therapy. As a fundamental study of the fiber-optic radiation sensor for remote gamma-ray spectroscopy, in this study, we fabricated a fiber-optic radiation sensor using an optical fiber and various scintillators. To select an adequate inorganic scintillator for the sensing probe of fiber-optic radiation sensor, 5 types of scintillators were evaluated. The spectra of gamma-rays emitted from a Na-22 radiation source were measured by using the manufactured sensors

  10. Comparison of ultrasound evaluation of patients of obstructive jaundice with endoscopic retrograde cholangio-pancreatography findings

    International Nuclear Information System (INIS)

    Farrukh, S.Z.U.I.; Siddiqui, A.R.; Haqqi, S.A.; Muhammad, A.J.

    2017-01-01

    Ultrasonography has proven to be quite effective in differentiating hepatocellular from obstructive cause of jaundice in various studies. This study was conducted with the aim to determine the efficacy of ultrasonography and Endoscopic Retrograde Cholangio-Pancreatography (ERCP) in the diagnosis of obstructive reason of jaundice. Methods: In this descriptive case series, 200 patients with >15 years age of either gender with cholestatic liver enzymes were included, i.e., those patients who had an ultrasound prior to ERCP at the department of gastroenterology of Patel Hospital, Karachi. Patients known to have liver disease with cholestatic jaundice had imaging other than ultrasound were excluded. The results of ultrasonography and ERCPs were compared in particularly looking for the cause of obstruction. Results: Out of total 200 patients, mean age was 41.22+-12.46 years with 107 (53.5 percent) females. Ability of ultrasound in correctly diagnosing obstructive reason for stone CBD was found to be 72.5 percent, dilated CBD without reason 41.7 percent, proximal obstruction, 63.15 percent, distal CBD obstruction 60 percent, and sludge 66.7 percent. Overall ability of ultrasound in correctly diagnosing the cause of obstruction was 64.17 percent. Conclusion: Ultrasound is recommended as the initial examination, which provides a guide to choose patients for either a more advanced non-invasive imaging like MRCP or to an invasive procedure like ERCP. (author)

  11. Evaluation of radiation doses in patient and medical staff during endoscopic retrograde cholangio-pancreatography procedures

    International Nuclear Information System (INIS)

    Seo, Deoknam; Kim, Kie Hwan; Park, Kyung; Kim, Jung-Su; Han, Seonggyu; Kim, Jungmin

    2016-01-01

    The radiation exposure dose must be optimised because the hazard resulting from an interventional radiology procedure is long term depending on the patient. The aim of this study was to measure the radiation doses received by the patients and medical staff during endoscopic retrograde cholangio-pancreatography (ERCP) procedures. Data were collected during 126 ERCP procedures, including the dose-area product (DAP), entrance dose (ED), effective dose (E), fluoroscopy time (T) and number of digital radiographs (F). The medical staff members each wore a personal thermoluminescence dosemeter to monitor exposure during ERCP procedures. The mean DAP, ED, E and T were 47.06 Gy cm 2 , 196.06 mGy, 8.93 mSv, 7.65 min and 9.21 images, respectively. The mean dose to the staff was 0.175 mSv and that to the assistant was 0.069 mSv. The dose to the medical staff was minimal when appropriate protective measures were used. The large variation in the patient doses must be further investigated. (authors)

  12. Automated endoscope reprocessors.

    Science.gov (United States)

    Desilets, David; Kaul, Vivek; Tierney, William M; Banerjee, Subhas; Diehl, David L; Farraye, Francis A; Kethu, Sripathi R; Kwon, Richard S; Mamula, Petar; Pedrosa, Marcos C; Rodriguez, Sarah A; Wong Kee Song, Louis-Michel

    2010-10-01

    The ASGE Technology Committee provides reviews of existing, new, or emerging endoscopic technologies that have an impact on the practice of GI endoscopy. Evidence-based methodology is used, with a MEDLINE literature search to identify pertinent clinical studies on the topic and a MAUDE (U.S. Food and Drug Administration Center for Devices and Radiological Health) database search to identify the reported complications of a given technology. Both are supplemented by accessing the "related articles" feature of PubMed and by scrutinizing pertinent references cited by the identified studies. Controlled clinical trials are emphasized, but in many cases data from randomized, controlled trials are lacking. In such cases, large case series, preliminary clinical studies, and expert opinions are used. Technical data are gathered from traditional and Web-based publications, proprietary publications, and informal communications with pertinent vendors. Technology Status Evaluation Reports are drafted by 1 or 2 members of the ASGE Technology Committee, reviewed and edited by the committee as a whole, and approved by the Governing Board of the ASGE. When financial guidance is indicated, the most recent coding data and list prices at the time of publication are provided. For this review, the MEDLINE database was searched through February 2010 for articles related to automated endoscope reprocessors, using the words endoscope reprocessing, endoscope cleaning, automated endoscope reprocessors, and high-level disinfection. Technology Status Evaluation Reports are scientific reviews provided solely for educational and informational purposes. Technology Status Evaluation Reports are not rules and should not be construed as establishing a legal standard of care or as encouraging, advocating, requiring, or discouraging any particular treatment or payment for such treatment. Copyright © 2010 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  13. Optimal duration of fasting period after endoscopic submucosal dissection for gastric epithelial neoplasia: A prospective evaluation.

    Science.gov (United States)

    Oh, Kwang Hoon; Lee, Sang Jin; Park, Jong Kyu

    2017-08-01

    There are currently no standardized guidelines for adequately determining the fasting period following gastric endoscopic submucosal dissection (ESD). The aim of this study was to determine the appropriate fasting period. The enrolled patients were randomized into a short and a long-fasting group. In the short-fasting group, patients had fasted until the day after the ESD. In the long-fasting group, patients had fasted until 2 days after the ESD. A second-look endoscopy was performed immediately prior to starting to eat meals. The primary end-point was the measurement of discomfort-related ESD after starting meals such as epigastric pain, heartburn, regurgitation, nausea and vomiting. Secondary end-points included the bleeding rate after starting meals, hospital stay, patient satisfaction and hemostasis upon second-look endoscopy. We analyzed data from 101 of 110 randomized patients. Both groups demonstrated similar baseline characteristics. There were no significant differences in reports of epigastric pain, heartburn, regurgitation, nausea and vomiting after starting meals. Both groups demonstrated similar hemostasis rates upon second-look endoscopy (26% vs 31.4%, P = 0.551) and bleeding rate (4% vs 0%, P = 0.149). The duration of hospital stay was significantly shorter in the short-fasting group (4.3 days vs 5.1 days, P fasting group. A short fasting protocol does not cause discomfort related to ESD or influence post-ESD bleeding. Moreover, the short fasting protocol results in shorter hospital stays and greater patient satisfaction. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  14. Evaluation of piroxicam-β-cyclodextrin as a preemptive analgesic in functional endoscopic sinus surgery

    Directory of Open Access Journals (Sweden)

    G.T. Keleş

    2010-08-01

    Full Text Available The preemptive analgesic efficacy and adverse effects of preoperatively administered piroxicam-β-cyclodextrin for post-endoscopic sinus surgery pain was determined in a prospective, double-blind, randomized, clinical study. Seventy-five American Society of Anesthesiologists status I-II patients, aged 18-65 years, were divided into three groups with similar demographic characteristics: group 1 received 20 mg piroxicam-β-cyclodextrin, group 2 received 40 mg piroxicam-β-cyclodextrin and group 3 received placebo orally before induction of general anesthesia. A blinded observer recorded the incidence and severity of pain at admission to the post-anesthesia care unit (PACU, at 15, 30, and 45 min in the PACU, and 1, 2, 4, 6, and 24 h postoperatively. All patients received patient-controlled morphine analgesia during the postoperative period and consumption was recorded for 24 h. During the PACU period, mean visual analogue scale values were significantly lower in groups 1 and 2 compared to group 3 (P < 0.05. During the postoperative period, morphine consumption was 3.03 ± 2.54, 2.7 ± 2.8, and 5.56 ± 3.12 mg for each group, respectively (P < 0.05. As a side effect, bleeding was observed in groups 1 and 3, nausea and vomiting in all groups, and edema only in group 3. However, no significant differences were detected in any of the parameters analyzed, which also included epigastric pain, constipation/diarrhea and headache. Similar hematological test results were obtained for all groups. Preemptive administration of piroxicam-β-cyclodextrin effectively reduced analgesic consumption, and 40 mg of the drug was more effective than 20 mg piroxicam-β-cyclodextrin without side effects during the postoperative period.

  15. High-quality endoscope reprocessing decreases endoscope contamination.

    Science.gov (United States)

    Decristoforo, P; Kaltseis, J; Fritz, A; Edlinger, M; Posch, W; Wilflingseder, D; Lass-Flörl, C; Orth-Höller, D

    2018-02-24

    Several outbreaks of severe infections due to contamination of gastrointestinal (GI) endoscopes, mainly duodenoscopes, have been described. The rate of microbial endoscope contamination varies dramatically in literature. The aim of this multicentre prospective study was to evaluate the hygiene quality of endoscopes and automated endoscope reprocessors (AERs) in Tyrol/Austria. In 2015 and 2016, a total of 463 GI endoscopes and 105 AERs from 29 endoscopy centres were analysed by a routine (R) and a combined routine and advanced (CRA) sampling procedure and investigated for microbial contamination by culture-based and molecular-based analyses. The contamination rate of GI endoscopes was 1.3%-4.6% according to the national guideline, suggesting that 1.3-4.6 patients out of 100 could have had contacts with hygiene-relevant microorganisms through an endoscopic intervention. Comparison of R and CRA sampling showed 1.8% of R versus 4.6% of CRA failing the acceptance criteria in phase I and 1.3% of R versus 3.0% of CRA samples failing in phase II. The most commonly identified indicator organism was Pseudomonas spp., mainly Pseudomonas oleovorans. None of the tested viruses were detected in 40 samples. While AERs in phase I failed (n = 9, 17.6%) mainly due to technical faults, phase II revealed lapses (n = 6, 11.5%) only on account of microbial contamination of the last rinsing water, mainly with Pseudomonas spp. In the present study the contamination rate of endoscopes was low compared with results from other European countries, possibly due to the high quality of endoscope reprocessing, drying and storage. Copyright © 2018 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  16. Post-bariatric surgery weight regain: evaluation of nutritional profile of candidate patients for endoscopic argon plasma coagulation.

    Science.gov (United States)

    Cambi, Maria Paula Carlini; Marchesini, Simone Dallegrave; Baretta, Giorgio Alfredo Pedroso

    2015-01-01

    Bariatric surgery is effective treatment for weight loss, but demand continuous nutritional care and physical activity. They regain weight happens with inadequate diets, physical inactivity and high alcohol consumption. To investigate in patients undergoing Roux-Y-of gastroplasty weight regain, nutritional deficiencies, candidates for the treatment with endoscopic argon plasma, the diameter of the gastrojejunostomy and the size of the gastric pouch at the time of treatment with plasma. A prospective 59 patients non-randomized study with no control group undergoing gastroplasty with recurrence of weight and candidates for the endoscopic procedure of argon plasma was realized. The surgical evaluation consisted of investigation of complications in the digestive system and verification of the increased diameter of the gastrojejunostomy. Nutritional evaluation was based on body mass index at the time of operation, in the minimum BMI achieved after and in which BMI was when making the procedure with plasma. The laboratory tests included hemoglobin, erythrocyte volume, ferritin, vitamin D, B12, iron, calcium, zinc and serum albumin. Clinical analysis was based on scheduled follow-up. Of the 59 selected, five were men and 51 women; were included 49 people (four men and 44 women) with all the complete data. The exclusion was due to the lack of some of the laboratory tests. Of this total 19 patients (38.7%) had a restrictive ring, while 30 (61.2%) did not. Iron deficiency anemia was common; 30 patients (61.2%) were below 30 with ferritin (unit); 35 (71.4%) with vitamin B12 were below 300 pg/ml; vitamin D3 deficiency occurred in more than 90%; there were no cases of deficiency of protein, calcium and zinc; glucose levels were above 99 mg/dl in three patients (6.12%). Clinically all had complaints of labile memory, irritability and poor concentration. All reported that they stopped treatment with the multidisciplinary team in the first year after the operation. The profile of

  17. Prospective, randomized evaluation of endoscopic versus open carpal tunnel release in bilateral carpal tunnel syndrome: an interim analysis.

    Science.gov (United States)

    Michelotti, Brett; Romanowsky, Diane; Hauck, Randy M

    2014-12-01

    Most randomized trials have shown similar results with endoscopic carpal tunnel release (ECTR) and open carpal tunnel release (OCTR); however, there are studies suggesting less postoperative pain, faster improvement in grip and pinch strength, and earlier return to work with the endoscopic technique. The goal of this study was to prospectively examine subjective and functional outcomes, satisfaction, and complications after both ECTR and OCTR in the opposite hands of the same patient, serving as their own control. This was a prospective, randomized study in which patients underwent surgery for bilateral carpal tunnel syndrome. The first carpal tunnel release was performed on the most symptomatic hand-determined by the patient. Operative approach was randomly assigned and, approximately 1 month later, the alternative technique was performed on the contralateral side. Demographic data were obtained, and functional outcomes were recorded preoperatively and postoperatively, including pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength, and overall grip strength. The carpal tunnel syndrome-functional status score and carpal tunnel syndrome-symptom severity score were recorded before surgery and at 2, 4, 8, 12, and 24 weeks postoperatively. Overall satisfaction with each technique was recorded at the conclusion of the study. Currently, 25 subjects have completed final visit testing. There were no differences in pain score, 2-point discrimination, Semmes-Weinstein monofilament testing, thenar strength, or overall grip strength at any of the postoperative time points. Carpal tunnel syndrome-symptom severity score and carpal tunnel syndrome-functional status score were not significantly different between groups at any of the evaluations. Overall satisfaction, where patients recorded a number from 0 to 100, was significantly greater in the ECTR group (95.95 vs 91.60, P = 0.04). There were no complications with either technique. This

  18. A Prospective Multicenter Study Evaluating Bleeding Risk after Endoscopic Ultrasound-Guided Fine Needle Aspiration in Patients Prescribed Antithrombotic Agents.

    Science.gov (United States)

    Kawakubo, Kazumichi; Yane, Kei; Eto, Kazunori; Ishiwatari, Hirotoshi; Ehira, Nobuyuki; Haba, Shin; Matsumoto, Ryusuke; Shinada, Keisuke; Yamato, Hiroaki; Kudo, Taiki; Onodera, Manabu; Okuda, Toshinori; Taya-Abe, Yoko; Kawahata, Shuhei; Kubo, Kimitoshi; Kubota, Yoshimasa; Kuwatani, Masaki; Kawakami, Hiroshi; Katanuma, Akio; Ono, Michihiro; Hayashi, Tsuyoshi; Uebayashi, Minoru; Sakamto, Naoya

    2018-02-08

    Although the risk of bleeding after endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is low, the safety of EUS-FNA in patients prescribed antithrombotic agents is unclear. Therefore, this study evaluated the incidence of bleeding after EUS-FNA in those patients. Between September 2012 and September 2015, patients who were prescribed antithrombotic agents underwent EUS-FNA at 13 institutions in Japan were prospectively enrolled in the study. The antithrombotic agents were managed according to the guidelines of the Japanese Gastrointestinal Endoscopy Society. The rate of bleeding events, thromboembolic events and other complications within 2 weeks after EUS-FNA were analyzed. Of the 2,629 patients who underwent EUS-FNA during the study period, 85 (62 males; median age, 74 years) patients were included in this stduy. Two patients (2.4%; 95% confidence interval [CI], 0.6% to 8.3%) experienced bleeding events. One patient required surgical intervention for hemothorax 5 hours after EUS-FNA, and the other experienced melena 8 days after EUS-FNA and required red blood cell transfusions. No thromboembolic events occurred (0%; 95% CI, 0.0% to 4.4%). Three patients (3.5%; 95% CI, 1.2% to 10.0%) experienced peri-puncture abscess formation. The rate of bleeding after EUS-FNA in patients prescribed antithrombotic agents might be considerable.

  19. Smell impairment in chronic rhinosinusitis – evaluation of endoscopic sinus surgery results and review of literature concerning olfactory function predictors.

    Science.gov (United States)

    Szaleniec, Joanna; Wróbel, Agnieszka; Stręk, Paweł; Kowalczyk, Monika; Bylica, Ewa; Przeklasa, Maria; Żyła, Małgorzata; Składzień, Jacek

    2015-01-01

    Endoscopic sinus surgery (ESS) is the treatment of choice for patients with chronic rhinosinusitis (CRS) refractory to medical therapy. ESS successfully reduces most symptoms of CRS, but its effect on olfaction is always uncertain. The aim of this study was to assess the influence of sinus surgery on olfaction and to analyze the predictors of olfactory function before and after ESS in the context of a literature review. The study group comprised of 153 patients with CRS refractory to medical treatment. The patients evaluated their olfactory function before ESS, 3-6 months after ESS (121 individuals) and 12 months after ESS (58 individuals). Statistical analysis concerned the postoperative olfactory improvement as well as the influence of various predictors on the impairment of smell before and after surgery. Olfactory dysfunction was significantly reduced after ESS. The smell impairment before and after surgery depended on different predictors. Patients with severe preoperative olfactory dysfunction and extensive pathological changes in the nose and sinuses, including nasal polyps, reported most pronounced improvement after ESS. However, severely hyposmic subjects with nasal polyposis, asthma or aspirin intolerance as well as older patients reported worse postoperative smell scores.

  20. Clinically evaluated procedure for the reconstruction of vocal fold vibrations from endoscopic digital high-speed videos.

    Science.gov (United States)

    Lohscheller, Jörg; Toy, Hikmet; Rosanowski, Frank; Eysholdt, Ulrich; Döllinger, Michael

    2007-08-01

    Investigation of voice disorders requires the examination of vocal fold vibrations. State of the art is the recording of endoscopic high-speed movies which capture vocal fold vibrations in real-time. It enables investigating the interrelation between disturbances of vocal fold vibrations and voice disorders. However, the lack of clinical studies and of a standardized procedure to reconstruct vocal fold vibrations from high-speed videos constrain the clinical acceptance of the high-speed technique. An image processing approach is presented that extracts the vibrating vocal fold edges from digital high-speed movies. The initial segmentation is principally based on a seeded region-growing algorithm. Even in movies with low image quality the algorithm segments successfully the glottal area by an introduced two-dimensional threshold matrix. Following segmentation, the vocal fold edges are reconstructed from the computed time-varying glottal area. The performance of the procedure was objectively evaluated within a study comprising 372 high-speed recordings. The accuracy of vocal fold reconstruction exceeds manual segmentation results obtained by clinical experts. The algorithm reaches an information flow-rate of up to 98 images per second. The robustness and high accuracy of the procedure makes it suitable for the application in clinical routine. It enables an objective and highly accurate description of vocal fold vibrations which is essential to realize extensive clinical studies which focus on the classification of voice disorders.

  1. Comparative evaluation between re-irradiation and demand endoscopic dilatation vs endoscopic dilatation alone in patients with recurrent/reactivated residual in-field esophageal malignancies

    Directory of Open Access Journals (Sweden)

    Teli Mohmad

    2008-01-01

    Full Text Available Background: Esophageal cancer has emerged as a major health challenge in many regions of the world, including the valley of Kashmir, which is situated adjacent to the esophageal cancer belt on its Southern side. Radiotherapy is one of the main modalities of treatment. However, residual/recurrent disease is common and salvage options for these patients are limited. Scarce literature is available regarding the use of re-irradiation in this setting though re-irradiation has been successfully used in recurrent tumors at various other anatomical sites. Aim: In the present study, external beam re-irradiation with demand dilatation vs per-oral endoscopic dilatation alone were compared with regard to the impact of these modalities on symptom control, survival, and quality of life of the patients. Treatment-related sequelae were also compared. Setting and Design: Prospective and randomized. Materials and Methods: The study included 34 cases who were palliated with re-irradiation and 35 cases who refused to enter the experimental protocol and, therefore, received per-oral demand dilatation alone, with the disease being allowed to follow its natural course. Both groups were statistically cross-matched with regard to their demographic and clinical parameters. Statistical Method Used: Mann-Whitney U-test, Chi-square test, Student′s t-test, and Kaplan-Meier test for survival analysis. Results: The results favor the use of re-irradiation as it significantly improves dysphagia-free survival and quality of life. The treatment-related complications/morbidity of this protocol was acceptable. Conclusion: A trial of re-irradiation with external beam is justified in selected patients.

  2. Endoscopic Microscopy

    Directory of Open Access Journals (Sweden)

    Konstantin Sokolov

    2002-01-01

    Full Text Available In vivo endoscopic optical microscopy provides a tool to assess tissue architecture and morphology with contrast and resolution similar to that provided by standard histopathology – without need for physical tissue removal. In this article, we focus on optical imaging technologies that have the potential to dramatically improve the detection, prevention, and therapy of epithelial cancers. Epithelial pre-cancers and cancers are associated with a variety of morphologic, architectural, and molecular changes, which currently can be assessed only through invasive, painful biopsy. Optical imaging is ideally suited to detecting cancer-related alterations because it can detect biochemical and morphologic alterations with sub-cellular resolution throughout the entire epithelial thickness. Optical techniques can be implemented non-invasively, in real time, and at low cost to survey the tissue surface at risk. Our manuscript focuses primarily on modalities that currently are the most developed: reflectance confocal microscopy (RCM and optical coherence tomography (OCT. However, recent advances in fluorescence-based endoscopic microscopy also are reviewed briefly. We discuss the basic principles of these emerging technologies and their current and potential applications in early cancer detection. We also present research activities focused on development of exogenous contrast agents that can enhance the morphological features important for cancer detection and that have the potential to allow vital molecular imaging of cancer-related biomarkers. In conclusion, we discuss future improvements to the technology needed to develop robust clinical devices.

  3. A combined approach of bedside clinical examination and flexible endoscopic evaluation of swallowing in poststroke dysphagia: A pilot study

    Directory of Open Access Journals (Sweden)

    Sureshkumar Radhakrishnan

    2013-01-01

    Full Text Available Background: As with most neurologic conditions, stroke involves impairment of the swallowing mechanism. This could be a spectrum of issues, the worst of which is aspiration. At the same time, the prolonged presence of a naso-gastric tube (NGT has its own morbidity. Flexible endoscopic evaluation of swallowing (FEES is one reliable method to assess the structural and functional status of the oropharynx and larynx, during the swallowing process. Objective: To study the utility of FEES in decision-making with respect to resumption of oral intake in stroke patients. To document the findings of FEES in stroke patients, and to look for correlations between these and the site of stroke. Materials and Methods: Protocol insertion of naso-gastric tube in all stroke patients, at presentation. Initial assessment by a neurologist and swallowing therapist, depending on cognitive status of the patient. All patients underwent MRI Brain with diffusion weighted sequences. After detailed clinical examination, they underwent swallow exercises under the supervision of a trained swallowing therapist. The decision to remove NGT was taken clinically by the combined decision of neurologist and swallowing therapist. Then all patients underwent FEES by the ENT surgeon. The final decision for NGT removal was taken as per the FEES findings. Result: Sixteen stroke patients underwent the FEES procedure during a period of six months. The oropharyngeal and laryngeal findings varied depending on the area of stroke involvement. Of these, change in decision regarding swallowing rehabilitation or NGT removal was needed in four patients, following the FEES findings. Conclusions: FEES is an easy, efficient and reliable method to evaluate the swallowing status in stroke patients. In combination with good bedside clinical examination and swallow exercises, it can be a good tool in assessing patients with post- stroke dysphagia. Post-stroke rehabilitation and prevention of aspiration

  4. Fiber-optic Raman spectroscopy for in vivo diagnosis of gastric dysplasia.

    Science.gov (United States)

    Wang, Jianfeng; Lin, Kan; Zheng, Wei; Ho, Khek Yu; Teh, Ming; Yeoh, Khay Guan; Huang, Zhiwei

    2016-06-23

    This study aims to assess the clinical utility of a rapid fiber-optic Raman spectroscopy technique developed for enhancing in vivo diagnosis of gastric precancer during endoscopic examination. We have developed a real-time fiber-optic Raman spectroscopy system capable of simultaneously acquiring both fingerprint (FP) (i.e., 800-1800 cm(-1)) and high-wavenumber (HW) (i.e., 2800-3600 cm(-1)) Raman spectra from gastric tissue in vivo at endoscopy. A total of 5792 high-quality in vivo FP/HW Raman spectra (normal (n = 5160); dysplasia (n = 155), and adenocarcinoma (n = 477)) were acquired in real-time from 441 tissue sites (normal (n = 396); dysplasia (n = 11), and adenocarcinoma (n = 34)) of 191 gastric patients (normal (n = 172); dysplasia (n = 6), and adenocarcinoma (n = 13)) undergoing routine endoscopic examinations. Partial least squares discriminant analysis (PLS-DA) together with leave-one-patient-out cross validation (LOPCV) were implemented to develop robust spectral diagnostic models. The FP/HW Raman spectra differ significantly between normal, dysplasia and adenocarcinoma of the stomach, which can be attributed to changes in proteins, lipids, nucleic acids, and the bound water content. PLS-DA and LOPCV show that the fiber-optic FP/HW Raman spectroscopy provides diagnostic sensitivities of 96.0%, 81.8% and 88.2%, and specificities of 86.7%, 95.3% and 95.6%, respectively, for the classification of normal, dysplastic and cancerous gastric tissue, superior to either the FP or HW Raman techniques alone. Further dichotomous PLS-DA analysis yields a sensitivity of 90.9% (10/11) and specificity of 95.9% (380/396) for the detection of gastric dysplasia using FP/HW Raman spectroscopy, substantiating its clinical advantages over white light reflectance endoscopy (sensitivity: 90.9% (10/11), and specificity: 51.0% (202/396)). This work demonstrates that the fiber-optic FP/HW Raman spectroscopy technique has great promise for enhancing in vivo diagnosis of gastric

  5. [The recent development of fiber-optic chemical sensor].

    Science.gov (United States)

    Wang, Jian; Wei, Jian-ping; Yang, Bo; Gao, Zhi-yang; Zhang, Li-wei; Yang, Xue-feng

    2014-08-01

    The present article provides a brief review of recent research on fiber-optic chemical sensor technology and the future development trends. Especially, fiber-optic pH chemical sensor, fiber-optic ion chemicl sensor, and fiber-optic gas chemical sensor are introduced respectively. Sensing film preparation methods such as chemical bonding method and sol-gel method were briefly reviewed. The emergence of new type fiber-microstructured optical fiber opened up a new development direction for fiber-optic chemical sensor. Because of its large inner surface area, flexible design of structure, having internal sensing places in fibers, it has rapidly become an important development direction and research focus of the fiber-optic chemical sensors. The fiber-optic chemical sensor derived from microstructured optical fiber is also discussed in detail. Finally, we look to the future of the fiber-optic chemical sensor.

  6. Preliminary field demonstration of a fiber-optic TCE sensor

    International Nuclear Information System (INIS)

    Angel, S.M.; Langry, K.; Roe, J.; Colston, B.W. Jr.; Daley, P.F.; Milanovich, F.P.

    1991-02-01

    We have developed a differential-absorption fiber-optic sensor for use in groundwater and vadose zone monitoring of certain volatile organochlorines. The principle of detection is a quantitative, irreversible chemical reaction that forms visible light-absorbing products. The sensor has been evaluated against gas chromatographic (GC) standard measurements and has demonstrated accuracy and sensitivity sufficient for the environmental monitoring of trace levels of trichloroethylene (TCE) and chloroform. This sensor is currently under evaluation in monitoring well and vadose zone applications. In this paper, we describe the principles of the existing single measurement sensor technology and show preliminary field-test results. 3 refs., 8 figs

  7. An endoscopic evaluation of the effects of etodolac and diclofenac on the gastric and duodenal mucosa

    NARCIS (Netherlands)

    van Eeden, A.; Schotborgh, R. H.; Tytgat, G. N.

    1990-01-01

    The effects of two nonsteroidal anti-inflammatory drugs on the gastroduodenal mucosa were evaluated by endoscopy and direct photography in 36 healthy men who were randomly assigned to receive 150 mg of diclofenac, 1,200 mg of etodolac, or 600 mg of etodolac daily for seven days. Endoscopy was

  8. Which Flexible Ureteroscopes (Digital vs. Fiber-Optic) Can Easily Reach the Difficult Lower Pole Calices and Have Better End-Tip Deflection: In Vitro Study on K-Box. A PETRA Evaluation.

    Science.gov (United States)

    Dragos, Laurian B; Somani, Bhaskar K; Sener, Emre T; Buttice, Salvatore; Proietti, Silvia; Ploumidis, Achilles; Iacoboaie, Catalin T; Doizi, Steeve; Traxer, Olivier

    2017-07-01

    Modern flexible ureteroscopes (fURSs) have good deflection, but despite this, approaching an acute angled calix can still be difficult. The goals of our in vitro study were to assess the ability of the available modern fURSs to effectively access the sharp angled calices and to compare the end-tip deflection of the various fiber-optic and digital fURSs. Using a bench-training model for FURS (K-Box, Porgès-Coloplast), we tried to access an acute angled calix with nine different fURSs (BOA vision, COBRA vision, R.Wolf; FLEX X 2 , FLEX Xc, K.Storz; LithoVue, Boston Scientific; URF-P5, URF-P6, URF-V, URF-V2, Olympus). Passing the fURSs through a ureteral access sheath (ReTrace, Porgès-Coloplast), the maximum end-tip deflection for every fURS was measured with the tip extended out from the sheath at 1, 2, 3, and 4 cm. Two ranking methods were designed for scoring the fURSs, one based on total ranking points and the other on total degrees of deflection. While all fiber-optic fURSs (except URF-P6) were able to access the sharp angled calix, none of the digital fURSs (except FLEX Xc) reached the difficult angled calix. Similarly, all fiber-optic fURSs had better end-tip deflection compared with the digital fURSs, except FLEX Xc, which was as deflectable as the fiber-optic fURSs. The fURSs showed an end-tip deflection (median difference of almost 21°) in favor of fiber-optic fURSs. Based on the scoring, the highest ranked fURS (best deflection) was FLEX X2 and the lowest ranked fURS (worst deflection) was URF-V2. Digital fURSs were less effective in accessing the sharp angled calix and they had lesser end-tip deflection compared with the fiber-optic counterparts. When approaching a difficult lower pole calix, it might be better to use a fiber-optic fURS.

  9. New flexible endoscope for otologic application

    Science.gov (United States)

    Marchan, Mark L.

    1993-07-01

    Endoscopy has become an important procedure in many medical specialties. For the Otologist, however, space limitations within the ear have restricted development of endoscopic procedures. The desire for minimally invasive techniques in Otology has demonstrated itself through the work of numerous physicians who have performed procedures ranging from diagnostic inspection of the middle ear to viewing the interior of the cochlea. To assist in performing such endoscopic procedures, Xomed-Treace has developed a line of flexible fiberoptic endoscopes for use by the Otologist. These scopes combine illumination and imaging fiber bundles within a small diameter unit ranging in size from 0.8 mm to 1.2 mm. The 1.2 mm scope is produced with an angled, rigid stainless steel sheath. The 0.8 mm scope is flexible with the ability to articulate 120 degree(s) in one direction. The fiberscopes have been designed for the Otologist to produce a good resolution image while allowing ease of operation through ergonomics and consideration of the surgical anatomy.

  10. In vitro comparison and evaluation of seven gastric closure modalities for natural orifice transluminal endoscopic surgery (NOTES)

    NARCIS (Netherlands)

    Voermans, R. P.; Worm, A. M.; van Berge Henegouwen, M. I.; Breedveld, P.; Bemelman, W. A.; Fockens, P.

    2008-01-01

    BACKGROUND AND STUDY AIMS: Secure transluminal closure is the most fundamental prerequisite for the safe introduction of natural orifice transluminal endoscopic surgery (NOTES). The aim was to compare acute strength of various gastrotomy closure techniques in an in vitro porcine stomach model by

  11. Flexible fiberoptic bronchoscopy in respiratory care: Diagnostic yield ...

    African Journals Online (AJOL)

    Introduction: Flexible fiberoptic bronchoscopy (FOB) is a key diagnostic and therapeutic procedure in pulmonology. Experience with fiberoptic bronchoscopy is scanty in most developing countries. Objectives: The goal of this study was to report our experience and clinical utility of fiberoptic bronchoscopy. Methods: A review ...

  12. Evaluation of early visual recovery in pituitary macroadenomas after endoscopic endonasal transphenoidal surgery: Quantitative assessment with diffusion tensor imaging (DTI).

    Science.gov (United States)

    Anik, Ihsan; Anik, Yonca; Koc, Kenan; Ceylan, Savas; Genc, Hamza; Altintas, Ozgul; Ozdamar, Dilek; Baykal Ceylan, Duygu

    2011-04-01

    Visual field analyses reflect the degree of the compression to the optic nerve that results the structural damage of the nerve. These structural damages can be evaluated by diffusion tensor imaging (DTI), which assesses the structural integrity of white matter tracts. Thus, we evaluated the quantitative assessment of early visual recovery in patients with pituitary macroadenomas, corresponding DTI with visual field analyses. Seventy-two patients who had pituitary macroadenomas with visual field defects were included in the study retrospectively. All patients were operated on by pure endoscopic transphenoidal approach. Visual field assessment using Humphrey field analyzer and DTI with 3T magnet were performed in the preoperative and postoperative second day and sixth month. Mean symptom duration was 14.7 ± 10.5 weeks in the full recovery group patients, 50.1 ± 29.1 weeks in partial recovery patients, and 92.4 ± 15.4 weeks in the ones with no recovery. There was a significant difference at p < 0.001 among the groups. On visual field analysis, the visual lost was mostly recognized at upper temporal levels preoperatively. Visual field findings of both eyes were improved in 80% of the patients. Among these, 25% revealed full recovery, 55.6% partial recovery, and 19.4% did not demonstrate significant changes. DTI assessments of affected sides revealed preoperative fractional anisotropy (FA) values below 0.400 and mean diffusivity (MD) values over 1,400 × 10(-6) mm(2) s(-1) were related with no visual improvement in the postoperative 6 months period. The percentage increase of mean FA values of the affected areas postoperatively were found to be 21.9% in totally responded patients, 20.6% in partial responded patients, and 9.8% in patients that did not respond. There is a correlation between DTI-derived FA values of the optic nerves and visual parameters. DTI assessments of the affected sides with FA and MD values may help to estimate the response

  13. Development of a beveled fiber-optic confocal Raman probe for enhancing in vivo epithelial tissue Raman measurements at endoscopy.

    Science.gov (United States)

    Wang, Jianfeng; Bergholt, Mads Sylvest; Zheng, Wei; Huang, Zhiwei

    2013-07-01

    We report on the development of a beveled fiber-optic confocal Raman probe coupled with a ball lens for enhancing in vivo epithelial tissue Raman measurements at endoscopy. Our Monte Carlo simulations show that by selecting a proper fiber-ball lens distance and beveled angle of collection fibers, the confocal Raman probe design can be optimized for maximizing shallower tissue Raman measurements in epithelial tissue; in addition, the ratio of epithelium to stromal Raman photons collected using an optimized confocal Raman probe is approximately 19-fold higher than that using a volume-type Raman probe. Further experiments confirm that the confocal Raman endoscopic probe developed is in favor of probing superficial tissue Raman signals from a two-layer tissue phantom as well as esophagus tissue in vivo during endoscopy. This work suggests the great potential of applying the beveled fiber-optic confocal Raman probe for improving in vivo diagnosis of precancer occurring in epithelial tissue at endoscopy.

  14. Fiberoptic microphone using a polymeric cavity

    Science.gov (United States)

    Wang, Wei-Chih; Soetanto, William; Gu, Kebin

    2011-04-01

    The fabrication and experimental investigation of a fiberoptic microphone is described. The sensing element is a silicon diaphragm with gold thin film coating that is positioned inside a silicone rubber mold at the end of a single mode optical fiber. Thus, a Fabry-Perot interferometer is formed between the inner fiber and the diaphragm. An acoustic pressure change is detected by using the developed microphone. The polymeric cavity and silicon diaphragm-based system exhibits excellent physicochemical properties with a small, simple, low cost, and lightweight design. The system is also electromagnetic interference / radio frequency interference immunity due to the use of fiberoptics.

  15. Mobile fiber-optic laser Doppler anemometer.

    Science.gov (United States)

    Stieglmeier, M; Tropea, C

    1992-07-20

    A laser Doppler anemometer (LDA) has been developed that combines the compactness and low power consumption of laser diodes and avalanche photodiodes with the flexibility and possibility of miniaturization by using fiber-optic probes. The system has been named DFLDA for laser diode fiber LDA and is especially suited for mobile applications, for example, in trains, airplanes, or automobiles. Optimization considerations of fiber-optic probes are put forward and several probe examples are described in detail. Measurement results from three typical applications are given to illustrate the use of the DFLDA. Finally, a number of future configurations of the DFLDA concept are discussed.

  16. Endoscopic dacryocystrhinostomy.

    Science.gov (United States)

    Araujo Filho, Bernardo Cunha; Voegels, Richard Louis; Butugan, Ossamu; Pinheiro Neto, Carlos Diogenes; Lessa, Marcus Miranda

    2005-01-01

    Endonasal endoscopic dacryocystorhinostomy (EN-DCR) is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming its domain for the ENT surgeons indispensable. The aim of the present study is to report the experience of the Otorhinolaryngology Department of the University of São Paulo Medical School in the management of the obstruction of the drainage of the nasolacrimal system by EN-DCR, comparing with the results in literature. clinical retrospective. We reviewed the medical records of 17 patients (17 eyes) that were submitted to EN-DCR between april 2001 and july 2004. We analysed: sex, age at the time of diagnosis, etiology, clinical findings, surgical technique, use of silicone tubes, follow-up and complications. Eight men and nine women, the age range was from 29 to 79 years (mean 42.6413.1 years), mean follow-up time: 15 months, presented a lacrimal clinic with epiphora. Powered DCR was performed in 06 cases and YAG LASER in 01 patient. Silicone tubes were used in all cases and left in place mean 7.9 weeks. The surgical success rate was 82,3%. EN-DCR showed one safe technique, with advantages in relation to the external technique. So ophthalmologists and ENT physicians must work in harmony to offer more benefits to its patients.

  17. Endoscopic evaluation of upper abdominal symptoms in adult patients, Saudi Aramco-Ai Hasa Health Center, Saudi Arabia.

    Science.gov (United States)

    Nkrumah, K N

    2002-01-01

    Upper oesophago-gastro-duodenoscopies (UGI endoscopies) were performed on adult patients who attended Saudi Aramco Health Centre at Al Hasa, Saudi Arabia, between June 1986 and December 1993, with complaint of upper abdominal pain. During this period, three hundred and fifteen (315) patients were examined. Sixty one percent were females and the rest males. Peptic ulcer disease including gastritis was the most common diagnosis made. Helicobacter pylori-like organisms were documented historically in biopsy samples in 113 of 178 (63%) patients. Nearly all were associated with gastritis; no organisms were reported in normal histology specimens. This confirms the association of this organism with gastritis. Gastric cancer suspected radiologically were not confirmed endoscopically or histologically. It is important to endoscope and biopsy for histology suspected gastric cancer and ulcer; a negative result may save the patient from unnecessary surgery, ideally all normal looking gastric mucosa should be biopsied so that histological gastritis is not missed.

  18. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs.

    OpenAIRE

    Panos, M Z; Reilly, H; Moran, A; Reilly, T; Wallis, P J; Wears, R; Chesner, I M

    1994-01-01

    The indications for percutaneous endoscopic gastrostomy (PEG) and patient outcome, were examined prospectively in the setting of a general hospital. In the course of 26 months, 76 patients underwent PEG (median age 62 years (range 18-99)) and were followed up for 6887 patient days. The median (range) duration of PEG feeding was 93 (3-785) days. The procedure was carried out for neurological indications in 76% of cases (stroke 51%) and 53% of patients were severely malnourished (body mass inde...

  19. An in vivo investigation of photoplethysmographic signals and preliminary pulse oximetry estimation from the bowel using a new fiberoptic sensor.

    Science.gov (United States)

    Hickey, Michelle; Samuels, Neal; Randive, Nilesh; Langford, Richard M; Kyriacou, Panayiotis A

    2011-05-01

    The continuous monitoring of splanchnic organ oxygen saturation could make the early detection of inadequate tissue oxygenation feasible, reducing the risk of hypoperfusion, severe ischemia, multiple organ failure, and, ultimately, death. Current methods for assessing splanchnic perfusion have not been widely accepted for use in the clinical care environment. In an attempt to overcome the limitations of the current techniques, a new fiberoptic photoplethysmographic (PPG)/pulse oximetry sensor was developed as a means of assessing splanchnic organ perfusion during surgery in humans. A new fiberoptic splanchnic pulse oximeter and an optically identical fiberoptic finger pulse oximeter have been developed. Simultaneous PPG signals and preliminary estimates of arterial oxygen saturation from the bowel (small and large) and finger were obtained in 17 patients (3 men and 14 women) undergoing open laparotomy. Good quality PPG signals were obtained from the small and large bowel and from the finger in all patients (lower 95% confidence limit for the proportion was 0.64). Comparisons of blood oxygen saturation values acquired when using the splanchnic and the finger fiberoptic sensors and a commercial finger pulse oximeter indicated that there was no statistically significant difference between them (all P>0.454). A Bland and Altman plot of the difference between blood oxygen saturation values from the bowel fiberoptic pulse oximeter and the fiberoptic finger pulse oximeter against their mean showed that the limits of agreement between the 2 pulse oximeters were -3.8% and 4.2% for small bowel measurements, and -3.4% and 4.3% for large bowel measurements. The 95% prediction interval for the difference between the 2 devices was between -4.2% and 4.7%. This study demonstrated that good quality PPG signals can be obtained from the bowel using a new fiberoptic sensor. Further evaluation is required to determine whether fiberoptic pulse oximetry of the bowel may provide a

  20. Fiber-optic coupled pressure transducer

    International Nuclear Information System (INIS)

    Tallman, C.R.; Wingate, F.P.; Ballard, E.O.

    1979-01-01

    A fiber-optic coupled pressure transducer was developed for measurement of pressure transients produced by fast electrical discharges in laser cavities. A detailed description of the design and performance will be given. Shock tube performance and measurements in direct electrical discharge regions will be presented

  1. Stabilizing Fiber-Optic Transmission Lines

    Science.gov (United States)

    Lutes, G. F.; Lau, K. Y.

    1984-01-01

    Voltage-controlled optical phase shifter is key. Optical phase shifter stabilizes propagation delay of fiber-optic transmission line by compensating for temperature and pressure effects. Applicable to phased array antenna systems and very-long-baseline interferometer distribution systems.

  2. Standing waves in fiber-optic interferometers

    NARCIS (Netherlands)

    De Haan, V.; Santbergen, R.; Tijssen, M.; Zeman, M.

    2011-01-01

    A study is presented giving the response of three types of fiber-optic interferometers by which a standing wave through an object is investigated. The three types are a Sagnac, Mach–Zehnder and Michelson–Morley interferometer. The response of the Mach–Zehnder interferometer is similar to the Sagnac

  3. [Effect of spectrum distortion on modulation transfer function in imaging fiber-optic spectrometer].

    Science.gov (United States)

    Cheng, Xin; Wang, Jing; Zhang, Bao; Hong, Yong-Feng

    2011-10-01

    Imaging fiber bundles were introduced to dispersion imaging spectrometer and substituted for slit, connecting the telescope and spectrometer to yield the imaging fiber-optic spectrometer. It is a double sampling system, the misalignment between image of optical fiber and detector pixel has arisen because of the spectrum distortion of spectrometer, which affected the second sampling process, and the modulation transfer function (MTF) therefore degraded. Optical transfer function of sampling process was derived from line spread function. The effect of spectrum distortion on system MTF was analyzed, and a model evaluating the MTF of imaging fiber-optic spectrometer was developed. Compared to the computation model of MTF of slit imaging spectrometer, a MTF item of sampling by optical fiber and a MTF item of misalignment arising from spectrum distortion were added in this model. Employing this, the MTF of an airborne imaging fiber-optic spectrometer for visible near infrared band was evaluated. The approach ro deriving and developing the MTF model has a reference signification for the computation of MTF of double sampling system, which can direct the design of imaging fiber-optic spectrometer also.

  4. A quantitative performance measure for a clinical evaluation of comb structure removal algorithms in flexible endoscopy

    Science.gov (United States)

    Rupp, Stephan

    2008-03-01

    Modern techniques for technical inspection as well as medical diagnostics and therapy in keyhole-surgery scenarios make use of flexible endoscopes. Common to both application fields are very small natural or manmade entry points to the observed scene, as well as the complexity of the hollow itself. These make the use of rigid lens-based endoscopes or tip chip videoscopes impossible. Due to the fact that the fiber-optic image guide of a flexible endoscope introduces a comb structure to the acquired images, many research has been devoted to algorithms for an effective removal of such artifacts. Oftentimes, this research has been motivated by the fact, that the comb structure prevents an application of some well-established methods offered by the computer vision and image processing community. Unfortunately, the performance of the presented approaches are commonly visually evaluated or with respect to proprietary, non-standardized metrics. Thus, the performances of individual algorithms are hard to compare with each other. For this reasons, we propose a performance measure for fiber-optic imaging devices that has been motivated by the physics of optics. In this field, an optical system is frequently described by linear systems theory and the system's quality can be expressed by its transfer function. The determination of this transfer function has been standardized by the ISO for lens based imaging systems and represents a widely accepted measure for the quality of such systems. In this contribution, we present methods that account for fiber-optic imaging systems and thus enable a standardized performance evaluation. Finally, we demonstrate its use by comparing two recent state of the art comb structure removal algorithms, each of them being a representative of a spatial and a frequency domain method, respectively.

  5. Fast fiber-optic multi-wavelength pyrometer.

    Science.gov (United States)

    Fu, Tairan; Tan, Peng; Pang, Chuanhe; Zhao, Huan; Shen, Yi

    2011-06-01

    A fast fiber-optic multi-wavelength pyrometer was developed for the ultraviolet-visible-near infrared spectra from 200 nm to 1700 nm using a CCD detector and an InGaAs detector. The pyrometer system conveniently and quickly provides the sufficient choices of multiple measurement wavelengths using optical diffraction, which avoids the use of narrow-band filters. Flexible optical fibers are used to transmit the radiation so the pyrometer can be used for temperature measurements in harsh environments. The setup and calibrations (wavelength calibration, nonlinearity calibration, and radiation response calibration) of this pyrometer system were described. Development of the multi-wavelength pyrometer involved optimization of the bandwidth and temperature discrimination of the multiple spectra data. The analysis results showed that the wavelength intervals, Δλ(CCD) = 30 nm and Δλ(InGaAs) = 50 nm, are the suitable choices as a tradeoff between the simple emissivity model assumption and the multiple signal discrimination. The temperature discrimination was also quantificationally evaluated for various wavelengths and temperatures. The measurement performance of the fiber-optic multi-wavelength pyrometer was partially verified through measurements with a high-temperature blackbody and actual hot metals. This multi-wavelength pyrometer can be used for remote high-temperature measurements. © 2011 American Institute of Physics

  6. Endoscopic retrograde cholanglopancreatography

    International Nuclear Information System (INIS)

    Horii, S.C.; Garra, B.S.; Zeman, R.K.; Krasner, B.H.; Lo, S.C.B.; Davros, W.J.; Silverman, P.M.; Cattau, E.L.; Fleischer, D.E.; Benjamin, S.B.S.B.

    1989-01-01

    As part of the clinical evaluation of image management and communications system (IMACS), the authors undertook a prospective study to compare conventional film versus digitized film viewed on a workstation. Twenty-five each of normal and abnormal endoscopic retrograde cholangiopancreatographic (ERCP) studies were digitized with a 1,684 x 2,048-pixel matrix and evaluated in a single-blind fashion on the workstation. The resulting interpretations were then compared with those resulting from interpretation of film (spot film and 100-mm photospot) images. They report that no significant differences were found in ability to see anatomic detail or pathology. A second study involved performing 10 ERCP studies in a lithotripsy suite equipped with biplane digital fluoroscopy. The digital video displays were comparable in quality to that of film. Progress is being made in using the IMACS for archiving and retrieval of all current ERCP images

  7. Foot-controlled robotic-enabled endoscope holder for endoscopic sinus surgery: A cadaveric feasibility study.

    Science.gov (United States)

    Chan, Jason Y K; Leung, Iris; Navarro-Alarcon, David; Lin, Weiyang; Li, Peng; Lee, Dennis L Y; Liu, Yun-hui; Tong, Michael C F

    2016-03-01

    To evaluate the feasibility of a unique prototype foot-controlled robotic-enabled endoscope holder (FREE) in functional endoscopic sinus surgery. Cadaveric study. Using human cadavers, we investigated the feasibility, advantages, and disadvantages of the robotic endoscope holder in performing endoscopic sinus surgery with two hands in five cadaver heads, mimicking a single nostril three-handed technique. The FREE robot is relatively easy to use. Setup was quick, taking less than 3 minutes from docking the robot at the head of the bed to visualizing the middle meatus. The unit is also relatively small, takes up little space, and currently has four degrees of freedom. The learning curve for using the foot control was short. The use of both hands was not hindered by the presence of the endoscope in the nasal cavity. The tremor filtration also aided in the smooth movement of the endoscope, with minimal collisions. The FREE endoscope holder in an ex-vivo cadaver test corroborated the feasibility of the robotic prototype, which allows for a two-handed approach to surgery equal to a single nostril three-handed technique without the holder that may reduce operating time. Further studies will be needed to evaluate its safety profile and use in other areas of endoscopic surgery. NA. Laryngoscope, 126:566-569, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Role of endoscopic ultrasound and endoscopic resection for the treatment of gastric schwannoma.

    Science.gov (United States)

    Hu, Jinlong; Liu, Xiang; Ge, Nan; Wang, Sheng; Guo, Jintao; Wang, Guoxin; Sun, Siyu

    2017-06-01

    Endoscopic ultrasound (EUS) and endoscopic resection play an important role in gastric submucosal tumor. However, there were few articles regarding EUS and endoscopic resection of gastric schwannomas. Our aim was to evaluate the role of EUS and endoscopic resection in treating gastric schwannomas.We retrospectively reviewed 14 patients between March 2012 and April 2016 with gastric schwannomas and who received EUS and endoscopic resection. EUS characteristics, endoscopic resection, tumor features, and follow-up were evaluated in all the patients.Fourteen patients were enrolled in the present study. The patients' ages ranged from 25 to 72 years (mean age, 52.6 years). On EUS, all tumors were originating from muscularis propria and hypoechoic. Ten tumors have the extraluminal growth patterns and 4 tumors have the intraluminal growth patterns. Marginal halos were observed in 7 lesions. No cystic change and calcification were found inside the lesions. Complete endoscopic resection was performed in all the patients with no complications occurring in any patients. No recurrence or metastases was found in all patients during the follow-up period.Gastric schwannoma has some characteristics on EUS, but it is difficult to differentiate gastric schwannoma from gastrointestinal stromal tumor. Endoscopic resection is an effective and safe treatment for gastric schwannoma with an excellent follow-up outcome.

  9. The Transition Of Fiber-Optic Gyro Technology Into Products

    Science.gov (United States)

    Udd, E.; Wagoner, R. E.

    1986-01-01

    Substantial progress has been made in recent years toward the development of producible fiber-optic rotation sensors. An overview is presented of the movement of the fiber-optic gyro into a product at McDonnell Douglas from early developments to a fieldable oil drilling tool. The current state-of-the-art of fiber-optic gyro technology with respect to near term product prospects is assessed.

  10. Systematic Review of Endoscopic Middle Ear Surgery Outcomes

    Science.gov (United States)

    Kozin, Elliott D.; Gulati, Shawn; Lehmann, Ashton; Remenschneider, Aaron K.; Kaplan, Alyson; Landegger, Lukas D.; Cohen, Michael S.; Lee, Daniel J.

    2015-01-01

    Objective Middle ear surgery increasingly employs endoscopes as an adjunct to or replacement for the operative microscope. Superior visualization and transcanal access to disease normally managed with a transmastoid approach are touted as advantages with the endoscope. No study, however, has systemically reviewed the literature to evaluate outcomes of endoscopic ear surgery (EES). We provide a systematic review of endoscope applications in middle ear surgery with an emphasis on outcomes. Data Sources PubMed, Embase, and Cochrane Methods A literature review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations. Articles were categorized based on study design, indication, and use of an endoscope either as an adjunct to or as a replacement for a microscope. Quantitative and descriptive analyses were performed. Results Ninety-one articles published between 1967 and 2014 met inclusion and exclusion criteria. The main indication for the use of an endoscope was cholesteatoma or myringoplasty. Of the identified articles, 40 provided a discrete discussion of outcomes. In cholesteatoma surgery, the endoscope has been mainly employed as an adjunct to the microscope, and although outcomes assessments vary across studies, the endoscope identified residual cholesteatoma in up to 50% of cases. Conclusion Endoscopes have been predominately used as an observational adjunct to the microscope to improve visualization of the tympanic cavity. Recent reports utilize the endoscope exclusively during surgical dissection; however, data comparing patient outcomes following the use of an operative endoscope versus a microscope are lacking. Areas in need of additional research are highlighted. PMID:25418475

  11. Percutaneous endoscopic gastrostomy in a general hospital: prospective evaluation of indications, outcome, and randomised comparison of two tube designs.

    Science.gov (United States)

    Panos, M Z; Reilly, H; Moran, A; Reilly, T; Wallis, P J; Wears, R; Chesner, I M

    1994-11-01

    The indications for percutaneous endoscopic gastrostomy (PEG) and patient outcome, were examined prospectively in the setting of a general hospital. In the course of 26 months, 76 patients underwent PEG (median age 62 years (range 18-99)) and were followed up for 6887 patient days. The median (range) duration of PEG feeding was 93 (3-785) days. The procedure was carried out for neurological indications in 76% of cases (stroke 51%) and 53% of patients were severely malnourished (body mass index tube blockage 12%, and tube connector leak 5%. During seven days of observation, demands on nursing time for routine care of the PEG were the same as for nasogastric tube feeding, median (range) 21 (4-42) v 16 (4-40) min/day respectively, but in about half the latter cases the tube had to be replaced at least once. Over 15 months, 29 patients were randomised to receive a 1.9 mm inner, 2.9 mm (9F) outer diameter Fresenius and 27 a 3.0 mm inner, 4.0 mm (12F) outer diameter Bower polyurethane tube and were followed for 2920 and 2388 patient days respectively. There was no difference in the insertion time (median (range) 20 (10-45) v 24 (10-45) min respectively) or number of patients with complications (three v eight patients NS), although there were more minor mechanical problems (three v 12, p tube. The internal anchoring device of the 12F tube allowed its non-endoscopic removal, a method applicable too 16% of cases. No tubes were removed because of blockage.

  12. Ex vivo evaluation of femtosecond pulse laser incision of urinary tract tissue in a liquid environment: implications for endoscopic treatment of benign ureteral strictures.

    Science.gov (United States)

    Liang, Jun-Hao; Kang, Jian; Pan, Yu-Long; Zhang, Liang; Qi, Jun

    2011-08-01

    The femtosecond (FS) pulse laser incises soft tissues with minimal peripheral damage and is a promising cutting tool for ureteroscopic endoureterotomy of benign ureteral strictures. To evaluate the feasibility of applying the FS laser to ureteroscopic endoureterotomy. A commercial Ti:Sapphire regenerative amplifier system (Coherent, RegA 9050, USA) was used in this study. Normal saline, 5% glucose solution, 4% mannitol solution, distilled water, and a 1% (v/v) suspension of whole blood with each of these solutions were tested for their attenuation rate (AR) of the FS laser's power. Bladder specimens from Sprague-Dawley (SD) rats were used as a surrogate model. The laser incised slots of 2 mm in length at bladder samples using three power grades (5×, 10×, and 20× the threshold power) combined with five effective pulse rates (40, 20, 10, 5, and 2.5 kHz), both in air and in normal saline. After samples were processed with standard hematoxylin-eosin staining procedures, the incision depth and collateral damage range were determined microscopically. The ARs of blood suspensions with each of the three isosmotic solutions were significantly higher than the other five solutions (P laser's cutting depth and the collateral damage were increased with the laser power or power density but the collateral damages were less than 100 µm. Microbubble formation was detected in the liquid environments tested and influenced the effective laser power. Endoscopic application of the FS laser is feasible. Microbubble formation with the laser incision, however, may influence cutting effects. Proposed methods to address these issues include increasing the irrigation rate, using distilled water as irrigation or using gas insufflation instead of irrigation. It is necessary to evaluate these methods, as well as the long-term biologic response to laser incision, on living animal models in endoscopic settings before use on humans. Copyright © 2011 Wiley-Liss, Inc.

  13. Double-lumen endotracheal tube positioning: Bag compliance Vs. fiberoptic bronchoscopy

    Directory of Open Access Journals (Sweden)

    Noyan Ashraf MA

    2012-11-01

    Full Text Available Background: Lung separation is the basis of thoracic anesthesia, which is performed by different instruments. Checking probable malpositioning of tracheal tube needs fiberoptic bronchoscopy. The aim of this study was to compare respirator suggested compliance with fiberoptic findings in detecting major tracheal tube malpositioning.Methods: A total of 256 patients undergoing thoracic surgery with double-lumen tracheal tube insertion in Imam Khomeini Hospital, Tehran, Iran, during 2010-11 were divided into three groups (n=86. We used left-sided double-lumen tube (DLT for left or right-sided surgeries (groups 1 and 2, and right-sided DLT for left-sided surgeries (group 3. The position of the tubes was evaluated and compared using bag compliance versus fiberoptic bronchoscopy.Results: The mean age of the study population was 44.7±13.4 (16-73 years, while 155 (59.9% were male. The sensitivity, specificity, positive and negative predictive values, and the accuracy of bag compliance test for left-sided DLT in supine position were 40% (95% CI: 20-60%, 99% (95% CI: 96-99%, 84% (95% CI: 54-94% 92% (95% CI: 88-95% and 92% (95% CI: 87-95%, respectively. The above-mentioned variables for lateral decubitus position respectively were 27%, 98%, 76%, 89%, and 88%. Malpositioning was more prevalent in right-sided DLTs (P=0.02.Conclusion: Based on the results of this study, and the high specificity, positive predictive value, and accuracy of bag compliance test, its use is encouraged as an alternative to fiberoptic bronchoscopy for checking DLT position, specially, in emergent surgeries or when fiberoptic bronchoscopy is unreachable due to lack of expertise or personnel.

  14. Fiber-optic demultiplexers with high mechanical resistance

    Directory of Open Access Journals (Sweden)

    Yakovlev M. Ya.

    2011-04-01

    Full Text Available The paper observes possibilities of fused fiber-optic multiplexer-demultiplexer creation with resistance to mechanical effect. Fabrication method and the equipment for their production are presented. Resonant frequency of weld area mechanical oscillations dependences from fused fiber-optic demultiplexer design characteristics are investigated.

  15. Distributed fiber?optic temperature sensing for hydrologic systems

    NARCIS (Netherlands)

    Selker, J.S.; Thévenaz, L.; Huwald, H.; Mallet, A.; Luxemburg, W.M.J.; Van de Giesen, N.; Stejskal, M.; Zeman, J.; Westhoff, M.; Parlange, M.B.

    2006-01-01

    Instruments for distributed fiber-optic measurement of temperature are now available with temperature resolution of 0.01°C and spatial resolution of 1 m with temporal resolution of fractions of a minute along standard fiber-optic cables used for communication with lengths of up to 30,000 m. We

  16. Distributed fiber-optic temperature sensing for hydrologic systems

    NARCIS (Netherlands)

    Selker, John S.; Thévenaz, Luc; Huwald, Hendrik; Mallet, Alfred; Luxemburg, Wim; van de Giesen, Nick C.; Stejskal, Martin; Zeman, Josef; Westhoff, Martijn; Parlange, Marc B.

    2006-01-01

    Instruments for distributed fiber-optic measurement of temperature are now available with temperature resolution of 0.01°C and spatial resolution of 1 m with temporal resolution of fractions of a minute along standard fiber-optic cables used for communication with lengths of up to 30,000 m. We

  17. Novel Fiber-Optic Ring Acoustic Emission Sensor

    Directory of Open Access Journals (Sweden)

    Peng Wei

    2018-01-01

    Full Text Available Acoustic emission technology has been applied to many fields for many years. However, the conventional piezoelectric acoustic emission sensors cannot be used in extreme environments, such as those with heavy electromagnetic interference, high pressure, or strong corrosion. In this paper, a novel fiber-optic ring acoustic emission sensor is proposed. The sensor exhibits high sensitivity, anti-electromagnetic interference, and corrosion resistance. First, the principle of a novel fiber-optic ring sensor is introduced. Different from piezoelectric and other fiber acoustic emission sensors, this novel sensor includes both a sensing skeleton and a sensing fiber. Second, a heterodyne interferometric demodulating method is presented. In addition, a fiber-optic ring sensor acoustic emission system is built based on this method. Finally, fiber-optic ring acoustic emission experiments are performed. The novel fiber-optic ring sensor is glued onto the surface of an aluminum plate. The 150 kHz standard continuous sinusoidal signals and broken lead signals are successfully detected by the novel fiber-optic ring acoustic emission sensor. In addition, comparison to the piezoelectric acoustic emission sensor is performed, which shows the availability and reliability of the novel fiber-optic ring acoustic emission sensor. In the future, this novel fiber-optic ring acoustic emission sensor will provide a new route to acoustic emission detection in harsh environments.

  18. Novel Fiber-Optic Ring Acoustic Emission Sensor.

    Science.gov (United States)

    Wei, Peng; Han, Xiaole; Xia, Dong; Liu, Taolin; Lang, Hao

    2018-01-13

    Acoustic emission technology has been applied to many fields for many years. However, the conventional piezoelectric acoustic emission sensors cannot be used in extreme environments, such as those with heavy electromagnetic interference, high pressure, or strong corrosion. In this paper, a novel fiber-optic ring acoustic emission sensor is proposed. The sensor exhibits high sensitivity, anti-electromagnetic interference, and corrosion resistance. First, the principle of a novel fiber-optic ring sensor is introduced. Different from piezoelectric and other fiber acoustic emission sensors, this novel sensor includes both a sensing skeleton and a sensing fiber. Second, a heterodyne interferometric demodulating method is presented. In addition, a fiber-optic ring sensor acoustic emission system is built based on this method. Finally, fiber-optic ring acoustic emission experiments are performed. The novel fiber-optic ring sensor is glued onto the surface of an aluminum plate. The 150 kHz standard continuous sinusoidal signals and broken lead signals are successfully detected by the novel fiber-optic ring acoustic emission sensor. In addition, comparison to the piezoelectric acoustic emission sensor is performed, which shows the availability and reliability of the novel fiber-optic ring acoustic emission sensor. In the future, this novel fiber-optic ring acoustic emission sensor will provide a new route to acoustic emission detection in harsh environments.

  19. Fiber-Optic Chemical Sensors and Fiber-Optic Bio-Sensors

    Czech Academy of Sciences Publication Activity Database

    Pospíšilová, M.; Kuncová, Gabriela; Trögl, J.

    2015-01-01

    Roč. 15, č. 10 (2015), s. 25208-25259 ISSN 1424-8220 Institutional support: RVO:67985858 Keywords : fiber-optic sensor * chemical sensors * enzymatic sensor Subject RIV: JB - Sensors, Measurment, Regulation Impact factor: 2.033, year: 2015

  20. Economic analysis of combined endoscopic and endobronchial ultrasound in the evaluation of patients with suspected non-small cell lung cancer.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2010-03-01

    Lung cancer remains the most common cause of cancer-related death in the United States. This study evaluated the costs of alternative diagnostic evaluations for patients with suspected non-small cell lung cancer (NSCLC). Researchers used a cost-minimization model to compare various diagnostic approaches in the evaluation of patients with NSCLC. It was less expensive to use an initial endoscopic ultrasound (EUS) with fine needle aspiration (FNA) to detect a mediastinal lymph node metastasis ($18,603 per patient), compared with combined EUS FNA and endobronchial ultrasound (EBUS) with FNA ($18,753). The results were sensitive to the prevalence of malignant mediastinal lymph nodes; EUS FNA remained least costly, if the probability of nodal metastases was <32.9%, as would occur in a patient without abnormal lymph nodes on computed tomography (CT). While EUS FNA combined with EBUS FNA was the most economical approach, if the rate of nodal metastases was higher, as would be the case in patients with abnormal lymph nodes on CT. Both of these strategies were less costly than bronchoscopy or mediastinoscopy. The pre-test probability of nodal metastases can determine the most cost-effective testing strategy for evaluation of a patient with NSCLC. Pre-procedure CT may be helpful in assessing probability of mediastinal nodal metastases.

  1. Endoscopic third ventriculocisternostomies in the infant: Pre- and post-operative Magnetic resonance imaging evaluation elective project undergraduate prize 2000

    Energy Technology Data Exchange (ETDEWEB)

    Sharman, Anna

    2000-12-01

    PURPOSE: To determine whether it is possible to select patients with obstructive hydrocephalus, in the under 1 age group for endoscopic third ventriculocisternostomy (ETV) using pre-operative T2 weighted turbo spin echo (T2W-TSE) sagittal sequence Magnetic Resonance (MR) imaging; and to assess ventriculocisternostomy patency using post-operative T2W-TSE MR. PATIENTS AND METHODS: A retrospective review of MR examinations and clinical notes of 11 patients under 1 year of age who had ETV, was performed. The post-operative flow MR images were divided into the presence or absence of flow-related signal changes. RESULTS: In 6 of the 11 patients, ETV was successful (54.5%) i.e. no VP shunt or revision of the ETV was required. 9 patients had post-operative T2W-TSE MR examinations -- 8 of these 9 MR studies correlated to the clinical situation (89%). The remaining MR examination showed a CSF flow void but the ETV failed at 3 weeks. CONCLUSION: Pre-operative MR using T2W-TSE to select suitable candidates for ETV improves the success rate from < 40% to 54.5%. Post-operatively MRI is a good predictor of whether the ETV has been successful or not. Sharman, A. (2000)

  2. A new robotic endoscope manipulator. A preliminary trial to evaluate the performance of a voice-operated industrial robot and a human assistant in several simulated and real endoscopic operations.

    Science.gov (United States)

    Vara-Thorbeck, C; Muñoz, V F; Toscano, R; Gomez, J; Fernández, J; Felices, M; Garcia-Cerezo, A

    2001-09-01

    We report our learning experience in simulated and real surgical tasks with a new voice-controlled robotic endoscope manipulator: an industrial robot with the tool-holder arm modified to support the optic and camera. The manipulator control-card programs have been rewritten to meet the needs of endoscopic surgeons. For this preliminary work, systems engineers with an additional monitor monitored, recorded, and compared the percentage effectiveness and precision of the responses of the robotic and human assistant to successive oral commands during the several different experimental surgical tasks. Simultaneously, to help develop this voice-commanded system for future, more precise robotic manipulation of surgical instruments, they measured the cartesian and spherical coordinates of successive positions of the optic. In unexpectedly difficult experimental conditions, the tireless robot proved more precise and effective than the demonstrably fatigable human: the steadier screen images of the robotic manipulations helped the surgeon tie knots in 7-0 sutures.

  3. Wavelength switchable fiber-optic Sagnac filter

    Science.gov (United States)

    Su, Dan; Qiao, Xueguang; Rong, Qiangzhou; Shao, Zhihua

    2018-03-01

    A wavelength switchable fiber-optic comb filter based on an in-line Sagnac interference is proposed and demonstrated. The proposed filter consists of a polarizer, two polarization controllers (PCs) and two sections of polarization maintaining fiber (PMFs). The output comb spectrum characteristics of the configuration are theoretically analyzed by Jones matrix, and then numerically simulated and experimentally demonstrated, of which the results present four comb filter-types (sinusoidal, flat-top and narrow-band superposition, and line-shaped spectra) by adjusting the polarizations of light with PCs.

  4. Endoscopic versus open bursectomy of lateral malleolar bursitis.

    Science.gov (United States)

    Choi, Jae Hyuck; Lee, Kyung Tai; Lee, Young Koo; Kim, Dong Hyun; Kim, Jeong Ryoul; Chung, Woo Chull; Cha, Seung Do

    2012-06-01

    Compare the result of endoscopic versus open bursectomy in lateral malleolar bursitis. Prospective evaluation of 21 patients (22 ankles) undergoing either open or endoscopic excision of lateral malleolar bursitis. The median age was 64 (38-79) years old. The median postoperative follow-up was 15 (12-18) months. Those patients undergoing endoscopic excision showed a higher satisfaction rate (excellent 9, good 2) than open excision (excellent 4, good 3, fair 1). The wounds also healed earlier in the endoscopic group although the operation time was slightly longer. One patient in the endoscopic group had recurrence of symptoms but complications in the open group included one patient with skin necrosis, one patient with wound dehiscence, and two patients of with superficial peroneal nerve injury. Endoscopic resection of the lateral malleolar bursitis is a promising technique and shows favorable results compared to the open resection. Therapeutic studies-Investigating the result of treatment, Level II.

  5. Impact of a Multidisciplinary Round Visit for the Management of Dysphagia Utilizing a Wi-Fi-Based Wireless Flexible Endoscopic Evaluation of Swallowing.

    Science.gov (United States)

    Sakakura, Koichi; Tazawa, Masayuki; Otani, Natsuko; Takagi, Masato; Morita, Mariko; Kurosaki, Minori; Chiyoda, Tomoko; Kanai, Yuri; Endo, Ayaka; Murata, Takaaki; Shino, Masato; Yokobori, Yuki; Shirakura, Kenji; Wada, Naoki; Chikamatsu, Kazuaki

    2017-01-01

    The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi-based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. We conducted novel Wi-Fi-based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively. Using the wireless system, we could visit more patients in a short period of time. Furthermore, a large multidisciplinary team was able to be present at the bedside, which made it easy to hold discussions and rapidly devise appropriate rehabilitation strategies. Aspiration pneumonia recurred in a few cases following our intervention with wireless FEES. Functional oral intake score was significantly increased following the intervention. Moreover, the number of deaths during hospitalization using wireless FEES evaluation was lower than those observed using the conventional system. Wi-Fi-based wireless FEES system, the first of its kind, allowed our multidisciplinary team to easily and effectively assess inpatients with dysphagia by facilitating simple examinations and intensive transprofessional discussions for patient rehabilitation. © The Author(s) 2016.

  6. Comparative Study between Digital Tomosynthesis and Endoscopic Retrograde Cholangio pancreatography for the Evaluation of Common Bile Duct Stones: Focus on Detection and Stone Conspicuity

    International Nuclear Information System (INIS)

    Huh, Ji Mi; Baek, Seung Yon; Hwang, Yun Mi; Lee, Jeong Kyong; Kim, Yoo Kyung; Yi, Sun Young

    2011-01-01

    To compare digital tomosynthesis with endoscopic retrograde cholangiopancreatography (ERCP) for the evaluation of common bile duct (CBD) stones as a complementary diagnostic tool. Ninety six consecutive patients clinically suspected of having CBD stones underwent ERCP and digital tomosynthesis over 22 months, from December, 2008 to May, 2010. Fourteen patients were excluded. Therefore 82 patients were included in this study. The images were retrospectively reviewed to compare the results with the final analysis based on the consensus of two abdominal radiologists. An evaluation of the presence of CBD stones was followed by a determination of the margins for the stones, scored with a five-point conspicuity scale. Among the 82 patients, 54 collectively had 89 CBD stones and 28 had no stones. The sensitivity and specificity for the detection of CBD stones were 91.0% and 80.6% for ERCP, 92.1% and 93.5% for digital tomosynthesis, respectively. The average score was 3.29 for ERCP and 3.89 for digital tomosynthesis in 77 similar detected stones. Digital tomosynthesis demonstrated significantly better conspicuity than ERCP (p = 0.001). Digital tomosynthesis is an effective and complementary diagnostic method for the evaluation of CBD stones.

  7. Validity of digital imaging of fiber-optic transillumination in caries detection on proximal tooth surfaces

    OpenAIRE

    Laitala, M.-L. (Marja-Liisa); Piipari, L. (Liina); Sämpi, N. (Noora); Korhonen, M. (Maria); Pesonen, P. (Paula); Joensuu, T. (Tiina); Anttonen, V. (Vuokko)

    2017-01-01

    Objective The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI) method in comparison with clinical visual examination (CV) and bitewing (BW) radiography on detecting caries lesions on proximal surfaces of teeth. Materials and Methods Proximal tooth surfaces of premolars and molars (n = 2,103) of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. Results DIFOTI detecte...

  8. Preparing to perform an awake fiberoptic intubation.

    LENUS (Irish Health Repository)

    Walsh, M E

    2012-02-03

    Fiberoptically guided tracheal intubation represents one of the most important advances in airway management to occur in the past thirty years. Perhaps its most important role is in management of the anticipated difficult airway. This is a situation in which the dangers of encountering the life-threatening "can\\'t intubate, can\\'t ventilate" situation can be avoided by placement of an endotracheal tube while the patient is awake. Although skill at the procedure of endoscopy is obviously necessary in this setting, these authors hold that success or failure of the technique frequently depends on the adequacy of preparation. These measures include 1) pre-operative assessment of the patient; 2) careful explanation of what lies in store; 3) "setting the stage"; 4) preparing the equipment to be used; and 5) preparing the patient (antisialogue, sedation, application of topical anesthesia to the upper airway). If these preparatory measures are carried out meticulously, the likelihood of performing a successful and comfortable awake fiberoptic tracheal intubation is greatly increased.

  9. Flexible endoscopic evaluation of swallowing (FEES) for neurogenic dysphagia: training curriculum of the German Society of Neurology and the German stroke society.

    Science.gov (United States)

    Dziewas, Rainer; Glahn, Jörg; Helfer, Christine; Ickenstein, Guntram; Keller, Jochen; Ledl, Christian; Lindner-Pfleghar, Beate; G Nabavi, Darius; Prosiegel, Mario; Riecker, Axel; Lapa, Sriramya; Stanschus, Sönke; Warnecke, Tobias; Busse, Otto

    2016-02-25

    Neurogenic dysphagia is one of the most frequent and prognostically relevant neurological deficits in a variety of disorders, such as stroke, parkinsonism and advanced neuromuscular diseases. Flexible endoscopic evaluation of swallowing (FEES) is now probably the most frequently used tool for objective dysphagia assessment in Germany. It allows evaluation of the efficacy and safety of swallowing, determination of appropriate feeding strategies and assessment of the efficacy of different swallowing manoeuvres. The literature furthermore indicates that FEES is a safe and well-tolerated procedure. In spite of the huge demand for qualified dysphagia diagnostics in neurology, a systematic FEES education has not yet been established. The structured training curriculum presented in this article aims to close this gap and intends to enforce a robust and qualified FEES service. As management of neurogenic dysphagia is not confined to neurologists, this educational programme is applicable to other clinicians and speech-language therapists with expertise in dysphagia as well. The systematic education in carrying out FEES across a variety of different professions proposed by this curriculum will help to spread this instrumental approach and to improve dysphagia management.

  10. Rapid On-Site Evaluation by Endosonographers during Endoscopic Ultrasonography-Guided Fine-Needle Aspiration for Diagnosis of Gastrointestinal Stromal Tumors

    Science.gov (United States)

    Tamura, Takashi; Yamashita, Yasunobu; Ueda, Kazuki; Kawaji, Yuki; Itonaga, Masahiro; Murata, Shin-ichi; Yamamoto, Kaori; Yoshida, Takeichi; Maeda, Hiroki; Maekita, Takao; Iguchi, Mikitaka; Tamai, Hideyuki; Ichinose, Masao; Kato, Jun

    2017-01-01

    Background/Aims Endoscopic ultrasonography-guided fine-needle aspiration (EUS-FNA) has been used to diagnose gastrointestinal submucosal tumors (SMTs). Although rapid on-site evaluation (ROSE) has been reported to improve the diagnostic accuracy of EUS-FNA for pancreatic lesions, on-site cytopathologists are not routinely available. Given this background, the usefulness of ROSE by endosonographers themselves for pancreatic tumors has also been reported. However, ROSE by endosonographers for diagnosis of SMT has not been reported. The aim of this study was to evaluate the diagnostic accuracy of EUS-FNA with ROSE by endosonographers for SMT, focusing on diagnosis of gastrointestinal stromal tumor (GIST), compared with that of EUS-FNA alone. Methods Twenty-two consecutive patients who underwent EUS-FNA with ROSE by endosonographers for SMT followed by surgical resection were identified. Ten historical control subjects who underwent EUS-FNA without ROSE were used for comparison. Results The overall diagnostic accuracy for SMT was significantly higher in cases with than without ROSE (100% vs. 80%, p=0.03). The number of needle passes by FNA with ROSE by endosonographers tended to be fewer, although accuracy was increased (3.3±1.3 vs. 5.9±3.8, p=0.06). Conclusions ROSE by endosonographers during EUS-FNA for SMT is useful for definitive diagnosis, particularly for GIST. PMID:28103654

  11. Endoscopic evaluation of therapeutic effects of “Anuloma-Viloma Pranayama” in Pratishyaya w.s.r. to mucociliary clearance mechanism and Bernoulli's principle

    Science.gov (United States)

    Bhardwaj, Atul; Sharma, Mahendra Kumar; Gupta, Manoj

    2013-01-01

    The current endeavor intended to evaluate the effectiveness and mode of action of Anuloma-Viloma Pranayama (AVP), i.e., alternate nasal breathing exercise, in resolving clinical features of Pratishyaya, i.e., rhinosinusitis. The present study was directed to validate the use of classical “saccharin test” in measuring the nasal health by measuring mucociliary clearance time. This study also highlights the effects of AVP by application of Bernoulli principle in ventilation of paranasal sinuses and surface oxygenation of nasal and paranasal sinuses ciliary epithelium. Clinically, endoscopically and radiologically diagnosed patients of Pratishyaya, i.e., rhinosinusitis, satisfying the inclusion criteria were selected to perform AVP as a breathing exercise regularly for 30 min every day in order to evaluate the effectiveness of AVP in resolving features of rhinosinusitis. Saccharin test was performed before and after completion of 40 days trial to assess the nasal ciliary activity, which has been proved to be directly related to the health of ciliary epithelium and nasal health overall as well. AVP may be regarded as a catalyst to conspicuously enhance ventilation and oxygenation of the paranasal sinuses and the positively effect the nasal respiratory epithelium by increasing better surface availability of oxygen and negative pressure in the nasal cavity itself. PMID:24696572

  12. Ultrasound techniques in the evaluation of the mediastinum, part I: endoscopic ultrasound (EUS), endobronchial ultrasound (EBUS) and transcutaneous mediastinal ultrasound (TMUS), introduction into ultrasound techniques

    NARCIS (Netherlands)

    Dietrich, Christoph Frank; Annema, Jouke Tabe; Clementsen, Paul; Cui, Xin Wu; Borst, Mathias Maximilian; Jenssen, Christian

    2015-01-01

    Ultrasound imaging has gained importance in pulmonary medicine over the last decades including conventional transcutaneous ultrasound (TUS), endoscopic ultrasound (EUS), and endobronchial ultrasound (EBUS). Mediastinal lymph node staging affects the management of patients with both operable and

  13. An international multicenter study evaluating the clinical efficacy and safety of per-oral endoscopic myotomy in octogenarians.

    Science.gov (United States)

    Chen, Yen-I; Inoue, Haruhiro; Ujiki, Michael; Draganov, Peter V; Colavita, Paul; Mion, Francois; Romanelli, John; Chiu, Philip; Balassone, Valerio; Patel, Lava; Abbas, Ali; Yang, Dennis; Dunst, Christy; Pioche, Mathieu; Roman, Sabine; Rivory, Jérôme; Ponchon, Thierry; Desilets, David; Maselli, Roberta; Onimaru, Manabu; Nakamura, Jun; Hata, Yoshitaka; Hajiyeva, Gulara; Ismail, Amr; Ngamruengphong, Saowanee; Bukhari, Majidah; Chavez, Yamile Haito; Kumbhari, Vivek; Repici, Alessandro; Khashab, Mouen A

    2017-02-21

    Per-oral endoscopic myotomy (POEM) for achalasia is particularly appealing in the elderly because it is minimally invasive. However, data in patients aged ≥80 years are scarce. The aim of this study was to assess the clinical outcome of POEM in octogenarians. This was a multicenter retrospective study at 8 centers. Consecutive octogenarians with achalasia who underwent POEM between 2010 and 2016 were included. Rates of technical success (completion of myotomy), clinical response (Eckardt score ≤3), and adverse events (severity graded as per American Society for Gastrointestinal Endoscopy lexicon) were assessed. A total of 76 patients (47.4% female, mean age 84 years) underwent POEM for treatment of achalasia: type I, 17.1%; type II, 35.5%; type III, 17.1%; and unspecified, 30.3%. Overall, 41.1% were treatment naïve, whereas others had previous botulinum toxin injection and/or pneumatic dilation. The mean (± standard deviation [SD]) age-adjusted Charlson comorbidity index score was 6.2 ± 2.4, with the majority of patients having American Society of Anesthesiologists Physical Status Classification System (ASA) scores of II/III. Technical success was 93.4%, with a median follow-up of 256 days. Fourteen adverse events occurred in 11 patients (14.5%). There were 3 inadvertent mucosotomies, 6 cases of symptomatic capnoperitoneum and/or capnomediastinum, 2 esophageal leaks, 1 cardiac arrhythmia, and 2 other). The severities of these adverse events were mild (78.6%), moderate (14.3%), and severe (7.1%). Clinical success was achieved in 90.8% of patients, with a mean (± SD) Eckardt score reduction from 7.0 ± 2.3 to 0.8 ± 0.1 (P < .001), a median follow-up of 256 days, and interquartile range of 66 to 547. Although the rate of technical success may be somewhat lower and the rate of adverse events slightly higher than previously reported, our data suggest that POEM in octogenarians is safe and effective, supporting its role as a primary modality for achalasia in

  14. Modulated-splitting-ratio fiber-optic temperature sensor

    Science.gov (United States)

    Beheim, Glenn; Anthan, Donald J.; Rys, John R.; Fritsch, Klaus; Ruppe, Walter R.

    1989-06-01

    A fiber-optic temperature sensor is described that uses a small silicon beamsplitter whose splitting ratio varies as a function of temperature. A four-beam technique is used to measure the sensor's temperature-indicating splitting ratio. This referencing method provides a measurement that is largely independent of the transmission properties of the sensor's optical fiber link. A significant advantage of this sensor, relative to other fiber-optic sensors, is its high stability, which permits the fiber-optic components to be readily substituted, thereby simplifying the sensor's installation and maintenance.

  15. Endoscopic treatment of pancreatic stones in patients with chronic pancreatitis

    NARCIS (Netherlands)

    Smits, M. E.; Rauws, E. A.; Tytgat, G. N.; Huibregtse, K.

    1996-01-01

    The aim of our study was to evaluate the long-term results of endoscopic pancreatic stone removal in patients with chronic pancreatitis. We retrospectively included 53 patients with chronic pancreatitis, in whom an attempt was made at endoscopic stone removal between 1984 and 1993. Patients

  16. Endoscopic Lung Volume Reduction : An Expert Panel Recommendation - Update 2017

    NARCIS (Netherlands)

    Herth, Felix J. F.; Slebos, Dirk-Jan; Criner, Gerard J.; Shah, Pallav L.

    2017-01-01

    Interest in endoscopic lung volume reduction (ELVR) technologies for emphysema is consistently growing. In the last couple of months, several endoscopic options (e.g., endo-or intrabronchial valves, coil implants, and thermal vapor ablation) that have been evaluated in randomized controlled trials

  17. Fiber-Optic Chemical Sensors and Fiber-Optic Bio-Sensors

    Science.gov (United States)

    Pospíšilová, Marie; Kuncová, Gabriela; Trögl, Josef

    2015-01-01

    This review summarizes principles and current stage of development of fiber-optic chemical sensors (FOCS) and biosensors (FOBS). Fiber optic sensor (FOS) systems use the ability of optical fibers (OF) to guide the light in the spectral range from ultraviolet (UV) (180 nm) up to middle infrared (IR) (10 µm) and modulation of guided light by the parameters of the surrounding environment of the OF core. The introduction of OF in the sensor systems has brought advantages such as measurement in flammable and explosive environments, immunity to electrical noises, miniaturization, geometrical flexibility, measurement of small sample volumes, remote sensing in inaccessible sites or harsh environments and multi-sensing. The review comprises briefly the theory of OF elaborated for sensors, techniques of fabrications and analytical results reached with fiber-optic chemical and biological sensors. PMID:26437407

  18. Fiber-Optic Chemical Sensors and Fiber-Optic Bio-Sensors

    Directory of Open Access Journals (Sweden)

    Marie Pospíšilová

    2015-09-01

    Full Text Available This review summarizes principles and current stage of development of fiber-optic chemical sensors (FOCS and biosensors (FOBS. Fiber optic sensor (FOS systems use the ability of optical fibers (OF to guide the light in the spectral range from ultraviolet (UV (180 nm up to middle infrared (IR (10 μm and modulation of guided light by the parameters of the surrounding environment of the OF core. The introduction of OF in the sensor systems has brought advantages such as measurement in flammable and explosive environments, immunity to electrical noises, miniaturization, geometrical flexibility, measurement of small sample volumes, remote sensing in inaccessible sites or harsh environments and multi-sensing. The review comprises briefly the theory of OF elaborated for sensors, techniques of fabrications and analytical results reached with fiber-optic chemical and biological sensors.

  19. Fiber-Optic Chemical Sensors and Fiber-Optic Bio-Sensors.

    Science.gov (United States)

    Pospíšilová, Marie; Kuncová, Gabriela; Trögl, Josef

    2015-09-30

    This review summarizes principles and current stage of development of fiber-optic chemical sensors (FOCS) and biosensors (FOBS). Fiber optic sensor (FOS) systems use the ability of optical fibers (OF) to guide the light in the spectral range from ultraviolet (UV) (180 nm) up to middle infrared (IR) (10 μm) and modulation of guided light by the parameters of the surrounding environment of the OF core. The introduction of OF in the sensor systems has brought advantages such as measurement in flammable and explosive environments, immunity to electrical noises, miniaturization, geometrical flexibility, measurement of small sample volumes, remote sensing in inaccessible sites or harsh environments and multi-sensing. The review comprises briefly the theory of OF elaborated for sensors, techniques of fabrications and analytical results reached with fiber-optic chemical and biological sensors.

  20. Endoscopic submucosal dissection (ESD) of early neoplastic gastric lesions using a new double-channel endoscope (the "R-scope")

    NARCIS (Netherlands)

    Neuhaus, H.; Costamagna, G.; Devière, J.; Fockens, P.; Ponchon, T.; Rösch, T.

    2006-01-01

    BACKGROUND AND STUDY AIM: Endoscopic submucosal dissection (ESD) allows en bloc resection of lesions > 2 cm in diameter. However the procedure is difficult because of limited visualization of the cutting area. The aim of this study was to evaluate a new endoscope (the "R-scope") for ESD; this

  1. Residual moisture and waterborne pathogens inside flexible endoscopes: Evidence from a multisite study of endoscope drying effectiveness.

    Science.gov (United States)

    Ofstead, Cori L; Heymann, Otis L; Quick, Mariah R; Eiland, John E; Wetzler, Harry P

    2018-03-30

    Endoscopy-associated infection transmission is frequently linked to inadequate reprocessing. Residual organic material and moisture may foster biofilm development inside endoscopes. This study evaluated the effectiveness of endoscope drying and storage methods and assessed associations between retained moisture and contamination. Endoscope reprocessing, drying, and storage practices were assessed at 3 hospitals. Researchers performed visual examinations and tests to detect fluid and contamination on patient-ready endoscopes. Fluid was detected in 22 of 45 (49%) endoscopes. Prevalence of moisture varied significantly by site (5%; 83%; 85%; P < .001). High adenosine triphosphate levels were found in 22% of endoscopes, and microbial growth was detected in 71% of endoscopes. Stenotrophomonas maltophilia, Citrobacter freundii, and Lecanicillium lecanii/Verticillium dahliae were found. Retained fluid was associated with significantly higher adenosine triphosphate levels (P < .01). Reprocessing and drying practices conformed with guidelines at 1 site and were substandard at 2 sites. Damaged endoscopes were in use at all sites. Inadequate reprocessing and insufficient drying contributed to retained fluid and contamination found during this multisite study. More effective methods of endoscope reprocessing, drying, and maintenance are needed to prevent the retention of fluid, organic material, and bioburden that could cause patient illness or injury. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Nasal encephalocele: endoscopic excision with anesthetic consideration.

    Science.gov (United States)

    Abdel-Aziz, Mosaad; El-Bosraty, Hussam; Qotb, Mohamed; El-Hamamsy, Mostafa; El-Sonbaty, Mohamed; Abdel-Badie, Hazem; Zynabdeen, Mustapha

    2010-08-01

    Nasal encephalocele may presents as a nasal mass, its treatment is surgical and it should be done early in life. When removal is indicated, there are multiple surgical approaches; including lateral rhinotomy, a transnasal approach and a coronal flap approach. However, the treatment of a basal intranasal encephalocele using transnasal endoscopic approach could obviates the possible morbidity associated with other approaches. The aim of this study was to evaluate the efficacy of endoscopic removal of intranasal encephalocele, also to document the role of anesthetist in the operative and postoperative periods. Nine cases with nasal encephalocele were included in this study; CT and/or MRI were used in their examination. The lesions were removed via transnasal endoscopic approach. Preoperative evaluation, intervention and postoperative follow-up were presented with discussion of anesthesia used for those children. The lesions of all patients were removed successfully with no recurrence through the follow-up period of at least 21 months. No cases showed morbidity or mortality intra- or post-operatively. Endoscopic excision of intranasal encephalocele is an effective method with high success rate. Anesthetist plays an important role in the operative and postoperative period, even during the endoscopic follow up; sedation of the children is usually needed. Copyright (c) 2010 Elsevier Ireland Ltd. All rights reserved.

  3. Fiber-optic dosimeters for radiation therapy

    Science.gov (United States)

    Li, Enbang; Archer, James

    2017-10-01

    According to the figures provided by the World Health Organization, cancer is a leading cause of death worldwide, accounting for 8.8 million deaths in 2015. Radiation therapy, which uses x-rays to destroy or injure cancer cells, has become one of the most important modalities to treat the primary cancer or advanced cancer. The newly developed microbeam radiation therapy (MRT), which uses highly collimated, quasi-parallel arrays of x-ray microbeams (typically 50 μm wide and separated by 400 μm) produced by synchrotron sources, represents a new paradigm in radiotherapy and has shown great promise in pre-clinical studies on different animal models. Measurements of the absorbed dose distribution of microbeams are vitally important for clinical acceptance of MRT and for developing quality assurance systems for MRT, hence are a challenging and important task for radiation dosimetry. On the other hand, during the traditional LINAC based radiotherapy and breast cancer brachytherapy, skin dose measurements and treatment planning also require a high spatial resolution, tissue equivalent, on-line dosimeter that is both economical and highly reliable. Such a dosimeter currently does not exist and remains a challenge in the development of radiation dosimetry. High resolution, water equivalent, optical and passive x-ray dosimeters have been developed and constructed by using plastic scintillators and optical fibers. The dosimeters have peak edge-on spatial resolutions ranging from 50 to 500 microns in one dimension, with a 10 micron resolution dosimeter under development. The developed fiber-optic dosimeters have been test with both LINAC and synchrotron x-ray beams. This work demonstrates that water-equivalent and high spatial resolution radiation detection can be achieved with scintillators and optical fiber systems. Among other advantages, the developed fiber-optic probes are also passive, energy independent, and radiation hard.

  4. A fiber-optic magnetic-force microscope

    Science.gov (United States)

    Kozel, S. M.; Listvin, V. N.; Churenkov, A. V.

    1991-03-01

    A fiber-optic magnetic-force microscope is proposed in which the excitation and readout channels are closed through an automatic phase frequency tuning loop, resulting in the excitation of oscillations at the probe resonance frequency. The output frequency signal does not require longitudinal probe positioning and is not distorted with changes in the optical power level. The use of fiber-optic technology for oscillation excitation and detection provides for a miniature size and noise immunity.

  5. Fiber-optic Cerenkov radiation sensor for proton therapy dosimetry.

    Science.gov (United States)

    Jang, Kyoung Won; Yoo, Wook Jae; Shin, Sang Hun; Shin, Dongho; Lee, Bongsoo

    2012-06-18

    In proton therapy dosimetry, a fiber-optic radiation sensor incorporating a scintillator must undergo complicated correction processes due to the quenching effect of the scintillator. To overcome the drawbacks of the fiber-optic radiation sensor, we proposed an innovative method using the Cerenkov radiation generated in plastic optical fibers. In this study, we fabricated a fiber-optic Cerenkov radiation sensor without an organic scintillator to measure Cerenkov radiation induced by therapeutic proton beams. Bragg peaks and spread-out Bragg peaks of proton beams were measured using the fiber-optic Cerenkov radiation sensor and the results were compared with those of an ionization chamber and a fiber-optic radiation sensor incorporating an organic scintillator. From the results, we could obtain the Bragg peak and the spread-out Bragg peak of proton beams without quenching effects induced by the scintillator, and these results were in good agreement with those of the ionization chamber. We also measured the Cerenkov radiation generated from the fiber-optic Cerenkov radiation sensor as a function of the dose rate of the proton beam.

  6. Raman fiber-optical method for colon cancer detection: Cross-validation and outlier identification approach.

    Science.gov (United States)

    Petersen, D; Naveed, P; Ragheb, A; Niedieker, D; El-Mashtoly, S F; Brechmann, T; Kötting, C; Schmiegel, W H; Freier, E; Pox, C; Gerwert, K

    2017-06-15

    Endoscopy plays a major role in early recognition of cancer which is not externally accessible and therewith in increasing the survival rate. Raman spectroscopic fiber-optical approaches can help to decrease the impact on the patient, increase objectivity in tissue characterization, reduce expenses and provide a significant time advantage in endoscopy. In gastroenterology an early recognition of malign and precursor lesions is relevant. Instantaneous and precise differentiation between adenomas as precursor lesions for cancer and hyperplastic polyps on the one hand and between high and low-risk alterations on the other hand is important. Raman fiber-optical measurements of colon biopsy samples taken during colonoscopy were carried out during a clinical study, and samples of adenocarcinoma (22), tubular adenomas (141), hyperplastic polyps (79) and normal tissue (101) from 151 patients were analyzed. This allows us to focus on the bioinformatic analysis and to set stage for Raman endoscopic measurements. Since spectral differences between normal and cancerous biopsy samples are small, special care has to be taken in data analysis. Using a leave-one-patient-out cross-validation scheme, three different outlier identification methods were investigated to decrease the influence of systematic errors, like a residual risk in misplacement of the sample and spectral dilution of marker bands (esp. cancerous tissue) and therewith optimize the experimental design. Furthermore other validations methods like leave-one-sample-out and leave-one-spectrum-out cross-validation schemes were compared with leave-one-patient-out cross-validation. High-risk lesions were differentiated from low-risk lesions with a sensitivity of 79%, specificity of 74% and an accuracy of 77%, cancer and normal tissue with a sensitivity of 79%, specificity of 83% and an accuracy of 81%. Additionally applied outlier identification enabled us to improve the recognition of neoplastic biopsy samples. Copyright

  7. Focus scanning with feedback control for fiber-optic nonlinear endomicroscopy (Conference Presentation)

    Science.gov (United States)

    Li, Ang; Liang, Wenxuan; Li, Xingde

    2017-02-01

    Fiber-optic nonlinear endomicroscopy represents a strong promise to enable translation of nonlinear microscopy technologies to in vivo applications, particularly imaging of internal organs. Two-dimensional imaging beam scanning has been accomplished by using fiber-optic scanners or MEMS scanners. Yet nonlinear endomicroscopy still cannot perform rapid and reliable depth or focus scanning while maintaining a small form factor. Shape memory alloy (SMA) wire had shown promise in extending 2D endoscopic imaging to the third dimension. By Joule heating, the SMA wire would contract and move the endomicroscope optics to change beam focus. However, this method suffered from hysteresis, and was susceptible to change in ambient temperature, making it difficult to achieve accurate and reliable depth scanning. Here we present a feedback-controlled SMA actuator which addressed these challenges. The core of the feedback loop was a Hall effect sensor. By measuring the magnetic flux density from a tiny magnet attached to the SMA wire, contraction distance of the SMA wire could be tracked in real time. The distance was then fed to the PID algorithm running in a microprocessor, which computed the error between the command position and the current position of the actuator. The current running through the SMA wire was adjusted accordingly. Our feedback-controlled SMA actuator had a tube-like shape with outer diameter of 5.5 mm and length of 25 mm, and was designed to house the endomicroscope inside. Initial test showed that it allowed more than 300 microns of travel distance, with an average positioning error of less than 2 microns. 3D imaging experiments with the endomicroscope is underway, and its imaging performance will be assessed and discussed.

  8. Raman fiber-optical method for colon cancer detection: Cross-validation and outlier identification approach

    Science.gov (United States)

    Petersen, D.; Naveed, P.; Ragheb, A.; Niedieker, D.; El-Mashtoly, S. F.; Brechmann, T.; Kötting, C.; Schmiegel, W. H.; Freier, E.; Pox, C.; Gerwert, K.

    2017-06-01

    Endoscopy plays a major role in early recognition of cancer which is not externally accessible and therewith in increasing the survival rate. Raman spectroscopic fiber-optical approaches can help to decrease the impact on the patient, increase objectivity in tissue characterization, reduce expenses and provide a significant time advantage in endoscopy. In gastroenterology an early recognition of malign and precursor lesions is relevant. Instantaneous and precise differentiation between adenomas as precursor lesions for cancer and hyperplastic polyps on the one hand and between high and low-risk alterations on the other hand is important. Raman fiber-optical measurements of colon biopsy samples taken during colonoscopy were carried out during a clinical study, and samples of adenocarcinoma (22), tubular adenomas (141), hyperplastic polyps (79) and normal tissue (101) from 151 patients were analyzed. This allows us to focus on the bioinformatic analysis and to set stage for Raman endoscopic measurements. Since spectral differences between normal and cancerous biopsy samples are small, special care has to be taken in data analysis. Using a leave-one-patient-out cross-validation scheme, three different outlier identification methods were investigated to decrease the influence of systematic errors, like a residual risk in misplacement of the sample and spectral dilution of marker bands (esp. cancerous tissue) and therewith optimize the experimental design. Furthermore other validations methods like leave-one-sample-out and leave-one-spectrum-out cross-validation schemes were compared with leave-one-patient-out cross-validation. High-risk lesions were differentiated from low-risk lesions with a sensitivity of 79%, specificity of 74% and an accuracy of 77%, cancer and normal tissue with a sensitivity of 79%, specificity of 83% and an accuracy of 81%. Additionally applied outlier identification enabled us to improve the recognition of neoplastic biopsy samples.

  9. A comparison of a fiberoptic stylet and a bougie as adjuncts to direct laryngoscopy in a manikin-simulated difficult airway.

    Science.gov (United States)

    Kovacs, George; Law, J Adam; McCrossin, Chris; Vu, Mark; Leblanc, Derek; Gao, Jun

    2007-12-01

    We compare the effectiveness of an endotracheal tube introducer ("bougie") with a new fiberoptic stylet as an adjunct to direct laryngoscopy in facilitating simulated difficult tracheal intubation in a manikin. Inexperienced laryngoscopists were recruited for this randomized, crossover study. After brief training, participants were randomized to first use either the bougie or fiberoptic stylet as an adjunct to direct laryngoscopy for attempted tracheal intubation of a manikin presenting a fixed, simulated, Cormack-Lehane grade IIIA view. Two attempts at tracheal intubation were allowed, each limited to 60 seconds. The participant then crossed over and used the other device. The same procedure was then repeated on a second manikin presenting a simulated Cormack-Lehane grade IIIB view. Primary outcomes were time to tracheal intubation and successful endotracheal tube placement. One hundred three study participants performed a total of 533 tracheal intubations for evaluation. For the Cormack-Lehane grade IIIA view, correct placement of the endotracheal tube was achieved in 101 (98%) of the fiberoptic stylet-facilitated and all 103 (100%) of the bougie-facilitated tracheal intubations. The time to successful tracheal intubation was similar for both devices (difference in mean time 1.8 seconds; 95% confidence interval [CI] -2.5 to 6.1 seconds). In the Cormack-Lehane grade IIIB view manikin, use of the fiberoptic stylet significantly increased success rate (fiberoptic stylet 98% versus bougie 9%), and a trend was observed toward a decrease in the mean time required for successful tracheal intubation compared to the bougie (fiberoptic stylet 31.0 seconds versus bougie 45.6 seconds; difference in mean time -14.6 seconds; 95% CI -31.4 to 2.3 seconds). In a manikin model, with inexperienced clinicians, both the bougie and the fiberoptic stylet were effective in facilitating tracheal intubation of a simulated Cormack-Lehane grade IIIA view. For a Cormack-Lehane IIIB view, the

  10. [Per-oral endoscopic myotomy in achalasia].

    Science.gov (United States)

    Ponds, Fraukje A M; Smout, André J P M; Bredenoord, Albert J; Fockens, Paul

    2015-01-01

    The treatment of patients with achalasia is complex due to a considerably high recurrence rate and risk of treatment-related complications. The per-oral endoscopic myotomy (POEM) is a new endoscopic technique that combines the benefits of a minimally invasive endoscopic procedure with the efficacy of a surgical myotomy. Implementation of the POEM technique may lead to fewer complications, a lower recurrence rate and reduced costs. During the procedure, a myotomy of the circular muscle layer of the oesophagus is performed after creating a submucosal tunnel in the oesophagus. The first studies of this new technique show promising results. Experienced therapeutic endoscopists can learn to perform the POEM technique relatively easily. Further studies are needed to compare this technique with the current standard treatments and to evaluate long-term effects.

  11. Endoscopic and Photodynamic Therapy of Cholangiocarcinoma.

    Science.gov (United States)

    Meier, Benjamin; Caca, Karel

    2016-12-01

    Most patients with cholangiocarcinoma (CCA) have unresectable disease. Endoscopic bile duct drainage is one of the major objectives of palliation of obstructive jaundice. Stent implantation using endoscopic retrograde cholangiography is considered to be the standard technique. Unilateral versus bilateral stenting is associated with different advantages and disadvantages; however, a standard approach is still not defined. As there are various kinds of stents, there is an ongoing discussion on which stent to use in which situation. Palliation of obstructive jaundice can be augmented through the use of photodynamic therapy (PDT). Studies have shown a prolonged survival for the combinations of PDT and different stent applications as well as combinations of PDT and additional systemic chemotherapy. More well-designed studies are needed to better evaluate and standardize endoscopic treatment of unresectable CCA.

  12. Modified Endoscopic Removal of Foreign Objects from the Forestomach of a Common Bottlenose Dolphin (Tursiops truncatus

    Directory of Open Access Journals (Sweden)

    Kyung-Yeon Eo, Yong-Gu Yeo and Oh-Deog Kwon*

    2013-04-01

    Full Text Available We report on the removal of foreign objects from the forestomach of a 200 kg adult male common bottlenose dolphin (Tursiops truncatus in the Seoul zoo using a modified stainless steel hook and flexible wire snare attached to a gastrointestinal fiberoptic endoscope. The foreign bodies included a 10 × 3.5 cm plastic tube, 4 × 2.0 cm stainless steel pipe, brush, and concrete debris. Our technique using a stainless steel wire hook and snare attached to a gastroscope can be used to remove foreign objects from the forestomach of common bottlenose dolphins.

  13. Training course on optical telecommunication and multimedia technologies for specialists in endoscopic video surgery

    Science.gov (United States)

    Agliullin, Arthur F.; Gusev, Valery F.; Morozov, Oleg G.; Samigullin, Rustem R.; Akul'shin, Alexander, Iv.; Bagapov, Nail N.

    2011-04-01

    The program of courses is recommended for the experts working in endoscopy area, surgery, diagnostics, to developers of optical, optoelectronic and electronic equipment, and also for students and the post-graduate students of telecommunication high schools in addition trained on specializations of biomedical engineering. It urged to help the future researcher, engineer and doctor to understand mechanisms of images formation and display, to understand more deeply procedures of their processing and transfer on telecommunication channels of the various natures, to master modern reports of record and video and audio information reproduction. The separate section is devoted to questions of designing of surgical toolkit compatible with fiber-optical endoscopes.

  14. Endoscopic third ventriculostomy and choroid plexus cauterization ...

    African Journals Online (AJOL)

    Background: Endoscopic third ventriculostomy (ETV) and Choroid Plexus Cauterization (CPC) have been recommended as reliable surgical options in developing countries for childhood hydrocephalus owing to reported shunt failures in shunt dependency. Objective: To evaluate outcomes of the ETV and ETV-CPC ...

  15. Subcutaneous endoscopically assisted ligation using miniport for ...

    African Journals Online (AJOL)

    Background This report describes the first miniport method using subcutaneous endoscopically assisted ligation (SEAL) for the treatment of girls with inguinal hernia. To validate its safety and efficacy, the authors evaluated their early experiences. Methods Between April 2014 and December 2014, 19 SEALs using miniport ...

  16. Is endoscopic nodular gastritis associated with premalignant lesions?

    Science.gov (United States)

    Niknam, R; Manafi, A; Maghbool, M; Kouhpayeh, A; Mahmoudi, L

    2015-06-01

    Nodularity on the gastric mucosa is occasionally seen in general practice. There is no consensus about the association of nodular gastritis and histological premalignant lesions. This study is designed to investigate the prevalence of histological premalignant lesions in dyspeptic patients with endoscopic nodular gastritis. Consecutive patients with endoscopic nodular gastritis were compared with an age- and sex-matched control group. Endoscopic nodular gastritis was defined as a miliary nodular appearance of the gastric mucosa on endoscopy. Biopsy samples of stomach tissue were examined for the presence of atrophic gastritis, intestinal metaplasia, and dysplasia. The presence of Helicobacter pylori infection was determined by histology. From 5366 evaluated patients, a total of 273 patients with endoscopic nodular gastritis and 1103 participants as control group were enrolled. H. pylori infection was detected in 87.5% of the patients with endoscopic nodular gastritis, whereas 73.8% of the control group were positive for H. pylori (p gastritis were significantly higher than in the control group. Prevalence of atrophic gastritis and complete intestinal metaplasia were also more frequent in patients with endoscopic nodular gastritis than in the control group. Dysplasia, incomplete intestinal metaplasia and H. pylori infection are significantly more frequent in patients with endoscopic nodular gastritis. Although further studies are needed before a clear conclusion can be reached, we suggest that endoscopic nodular gastritis might serve as a premalignant lesion and could be biopsied in all patients for the possibility of histological premalignancy, in addition to H. pylori infection.

  17. A novel multipurpose modular mini-endoscope for otology.

    Science.gov (United States)

    Bozzato, Alessandro; Bozzato, Victoria; Al Kadah, Basel; Schick, Bernhard

    2014-12-01

    Transtympanic access to the round window membrane (RWM) for drug delivery is in the focus of otology and has stimulated development of various endoscopes. These endoscopes are tasked to enable best visualization at a low diameter and to offer a working channel for various instruments. The specific aspect of sterilization is a major issue especially in regard to the diameter of the endoscope with its integrated working channel. We evaluated a new multi-purpose modular semi-rigid optical fiber endoscope (10,000 pixel resolution) for minimal invasive middle ear endoscopy focusing on access to the RWM and micro instruments in 12 cadaver specimens. Microscopic visualization was compared to endoscopy. With the modular mini ear endoscope (MMEE) we were able to visualize the RWM in 3 specimens directly and in 8 specimens after removal of a mucous membrane using micro instruments. A bony overhang prevented visualization of the RWM in one case. The endoscope enabled minimal invasive RWM access initially in a higher number of cases compared to microscope investigation. The designed MMEE is suited to access transtympanic the round window membrane even in situations of an obstructed round window niche. The modular concept of the endoscope is attractive for different types of indications, various instruments and with regard to the aspects of sterilization. Experiences in humans are the next necessary step to define the possible role of this endoscope in otology.

  18. Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

    Directory of Open Access Journals (Sweden)

    Valentin Favier

    Full Text Available Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training.Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor, polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling.All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error. Local accuracy was better in polycarbonate (0.09mm and polyamide (0.15mm than in Multicolor (0.90mm and resin (0.86mm. Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor.Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

  19. Gastric per-oral endoscopic myotomy with antropyloromyotomy in the treatment of refractory gastroparesis: clinical experience with follow-up and scintigraphic evaluation (with video).

    Science.gov (United States)

    Gonzalez, Jean-Michel; Lestelle, Valentin; Benezech, Alban; Cohen, Jonah; Vitton, Véronique; Grimaud, Jean-Charles; Barthet, Marc

    2017-01-01

    Gastroparesis is a chronic, debilitating condition. We report an experience conducting gastric per-oral endoscopic pyloromyotomy (G-POEM) with objectives to assess clinical efficacy, gastric emptying evolution, and procedural adverse events. This was a clinical pilot series on 12 consecutive patients who underwent G-POEM for refractory gastroparesis in our tertiary center between February 2014 and August 2015. Patients included had severe disease as defined by elevated Gastroparesis Cardinal Symptoms Index (GCSI) score and delayed gastric emptying scintigraphy (GES). G-POEM was performed by mucosal incision upstream the pylorus followed by submucosal tunnel and antropyloromyotomy with subsequent access closure. Efficacy was assessed at 5 days, 1 month, and 3 months, based on GCSI score, and individualizing (Likert scale) the main symptoms (nausea, vomiting, abdominal pain, early satiety, and anorexia). GES was performed 2 months after the procedure. G-POEM was successfully performed in all 12 patients, yielding a technical success rate of 100%. Significant improvements in GCSI were observed: 3.5 ± .8 versus .9 ± .9 (1 month) and 1.1 ± 1.5 (3 months), respectively (P < .001), as well as the severity of main symptoms at 3 months. Clinical efficacy was 85% (10/12). GES normalized in 75% of cases, with improvement of half emptying time (222 ± 90 minutes vs 133 ± 90 minutes; P = .03) and retention at 2 hours (76% ± 20% vs 44% ± 26%; P = .009). There were no adverse events related to the procedure. We report a single-center study evaluating G-POEM for refractory gastroparesis, demonstrating its feasibility, reproducibility, and safety with promising clinical and scintigraphic efficacy. Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  20. Evaluation of a new endoscopic ultrasound-guided multi-fiducial delivery system: a prospective non-survival study in a live porcine model.

    Science.gov (United States)

    Draganov, Peter V; Chavalitdhamrong, Disaya; Wagh, Mihir S

    2013-11-01

    Endoscopic ultrasound (EUS) is an excellent tool for implanting fiducials for gastrointestinal malignancies, but a dedicated delivery system for EUS-guided fiducial placement is not available. The aim of the present study was to evaluate the performance characteristics of a new dedicated EUS-guided multi-fiducial delivery system. This was a prospective live porcine study using prototype 22-G EUS needles preloaded with four fiducials. Primary outcomes were technical success and accuracy of fiducial placement. Secondary outcomes were ease of passage of delivery system, ease of deployment, EUS visualization of the needle, visual appearance of fiducials on EUS, fluoroscopy and computed tomography (CT) scans, time taken for fiducial placement and adverse events. Outcomes were scored on a predetermined 5-point Likert scale (1 = best, 5 = worst). Fiducial deployment was successful in 43 out of 45 needles (95.6%). All 172 fiducials (43 needles, four fiducials each)were successfully deployed on target. Fiducial placement accuracy score was 1.30 ± 0.64. All needles passed with ease (score 1.0 ± 0.0). Ease of fiducial deployment score was 1.85 ± 1.02. Mean scores for EUS visualization of the needle and fiducial were 1.02 ± 0.15 and 2.10 ± 0.91, respectively. Fluoroscopic and CT visualization of fiducials was excellent. Time for placement of four fiducials was <1 min (0.86 ± 0.50 min). No adverse events were seen. The new EUS-guided multi-fiducial delivery system provided quick, easy, and accurate fiducial deployment without adverse events. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  1. Laparo-Endoscopic Single-Site Surgery for Radical and Cytoreductive Nephrectomy, Renal Vein Thrombectomy, and Partial Nephrectomy: A Prospective Pilot Evaluation

    Directory of Open Access Journals (Sweden)

    Ithaar H. Derweesh

    2010-01-01

    Full Text Available Introduction. Laparo-endoscopic single-site surgery (LESS may diminish morbidity of laparoscopic surgery. We prospectively evaluated feasibility and outcomes of LESS-Radical Nephrectomy (LESS-RN and Partial Nephrectomy (LESS-PN. Methods. 10 patients underwent LESS-RN (6 and LESS-PN (4 between 2/2009-5/2009. LESS-RN included 2 with renal vein thrombectomy, one of which was also cytoreductive. Transperitoneal LESS access was obtained by periumbilical incision. Patient/tumor characteristics, oncologic, and quality of life (QoL outcomes were analyzed. Results. 3 Men/7 Women (mean age 58.7 years, median follow-up 9.8 months underwent LESS. 9/10 cases were completed successfully. All had negative margins. Mean operative time was 161 minutes, estimated blood loss was 125 mL, and incision size was 4.4 cm. Median tumor size for LESS-RN and -PN was 5.0 and 1.7 cm (=.045. Median LESS-PN ischemia time was 24 minutes; mean preoperative/postoperative creatinine were 0.7/0.8 mg/dL (=.19. Mean pain score at discharge was 1.3. Mean preoperative, 3-, and 6-month postoperative SF-36 QoL Score was 73.8, 74.4 and 77.1 (=.222. All patients are currently alive. Conclusions. LESS-RN, renal vein thrombectomy, and PN are technically feasible and safe while maintaining adherence to oncologic principles, with excellent QoL preservation and low discharge pain scores. Further study is requisite.

  2. Geometric and mechanical evaluation of 3D-printing materials for skull base anatomical education and endoscopic surgery simulation - A first step to create reliable customized simulators.

    Science.gov (United States)

    Favier, Valentin; Zemiti, Nabil; Caravaca Mora, Oscar; Subsol, Gérard; Captier, Guillaume; Lebrun, Renaud; Crampette, Louis; Mondain, Michel; Gilles, Benjamin

    2017-01-01

    Endoscopic skull base surgery allows minimal invasive therapy through the nostrils to treat infectious or tumorous diseases. Surgical and anatomical education in this field is limited by the lack of validated training models in terms of geometric and mechanical accuracy. We choose to evaluate several consumer-grade materials to create a patient-specific 3D-printed skull base model for anatomical learning and surgical training. Four 3D-printed consumer-grade materials were compared to human cadaver bone: calcium sulfate hemihydrate (named Multicolor), polyamide, resin and polycarbonate. We compared the geometric accuracy, forces required to break thin walls of materials and forces required during drilling. All materials had an acceptable global geometric accuracy (from 0.083mm to 0.203mm of global error). Local accuracy was better in polycarbonate (0.09mm) and polyamide (0.15mm) than in Multicolor (0.90mm) and resin (0.86mm). Resin and polyamide thin walls were not broken at 200N. Forces needed to break Multicolor thin walls were 1.6-3.5 times higher than in bone. For polycarbonate, forces applied were 1.6-2.5 times higher. Polycarbonate had a mode of fracture similar to the cadaver bone. Forces applied on materials during drilling followed a normal distribution except for the polyamide which was melted. Energy spent during drilling was respectively 1.6 and 2.6 times higher on bone than on PC and Multicolor. Polycarbonate is a good substitute of human cadaver bone for skull base surgery simulation. Thanks to short lead times and reasonable production costs, patient-specific 3D printed models can be used in clinical practice for pre-operative training, improving patient safety.

  3. Endoscopic management of colorectal adenomas.

    Science.gov (United States)

    Meier, Benjamin; Caca, Karel; Fischer, Andreas; Schmidt, Arthur

    2017-01-01

    Colorectal adenomas are well known precursors of invasive adenocarcinoma. Colonoscopy is the gold standard for adenoma detection. Colonoscopy is far more than a diagnostic tool, as it allows effective treatment of colorectal adenomas. Endoscopic resection of colorectal adenomas has been shown to reduce the incidence and mortality of colorectal cancer. Difficult resection techniques are available, such as endoscopic mucosal resection, endoscopic submucosal dissection and endoscopic full-thickness resection. This review aims to provide an overview of the different endoscopic resection techniques and their indications, and summarizes the current recommendations in the recently published guideline of the European Society of Gastrointestinal Endoscopy.

  4. Achados de fibrobroncoscopia em pacientes com diagnóstico de neoplasia pulmonar Fiberoptic bronchoscopy findings in patients diagnosed with lung cancer

    Directory of Open Access Journals (Sweden)

    Marcelo Fouad Rabahi

    2012-08-01

    involving 212 patients with a confirmed diagnosis of lung cancer by cytological evaluation of BAL specimens or by histopathological evaluation of endobronchial or transbronchial biopsy specimens. The data were collected at the Respiratory Endoscopy Sector of Hospital São Salvador, located in the city of Goiânia, Brazil, between 2005 and 2010. The endoscopic findings were classified as endoscopically visible tumor, endoscopically invisible tumor, mucosal injury, as well as being classified by the presence/type of secretion. The visible tumors were also classified according to their location in the tracheobronchial tree. RESULTS: Endobronchial mass (64% and mucosal infiltration (35% were the main endoscopic findings. The histological type was determined in 199 cases, the most prevalent types being squamous carcinoma, in 78 (39%, adenocarcinoma, in 42 (21% small cell carcinoma, in 24 (12%, and large cell carcinoma, in 2 (1%. More than 45% of the visible tumors were at the upper bronchi. Squamous carcinoma (n = 78 was most commonly visualized as an endobronchial mass (in 74%, mucosal infiltration (in 36%, luminal narrowing (in 10%, or external compression (in 6%. CONCLUSIONS: Our results show that the endobronchial mass is the most common bronchoscopic finding that is suggestive of malignancy. Proportionally, mucosal infiltration is the most common finding in small cell carcinoma. In adenocarcinoma, luminal narrowing, external compression, mucosal injury, and endobronchial secretion prevail.

  5. Fiber-optic diagnostic for energy measurements

    Science.gov (United States)

    Lockwood, G. L.; Muron, D. J.; Ruggles, L. E.; Chang, J.; Bloomquist, D. D.; Babcock, S. R.

    A fiber-optic diagnostic system based on calorime try to measure the total energy deposited in a liquid-filled load resistor is developed. Thermodynamic calculations show the fluid temperature to come to equilibrium in about two seconds and to remain there for several tens of seconds. Thus fluid temperature can determine the energy deposited. Using a fluoroptic thermometer, the change in temperature of a copper sulfate solution load resistor was measured as a function of the energy stored in a capacitor bank. A comparison of these results with the calculated temperature rise shows agreement to + or - 3% over the energy range from 1.4 kJ to 5.9 kJ. Measurements were then made of the energy deposited in a sodium chloride solution load resistor on the Ripple accelerator. These were made as a function of energy stored in the Marx generator from 7.4 kJ to 21.2 kJ. Electrical measurements of the energy deposited were made at the same time. These were high on the average by 8%.

  6. Twenty-Year Outcome of a Longitudinal Prospective Evaluation of Isolated Endoscopic Anterior Cruciate Ligament Reconstruction With Patellar Tendon or Hamstring Autograft.

    Science.gov (United States)

    Thompson, Simon Michael; Salmon, Lucy J; Waller, Alison; Linklater, James; Roe, Justin P; Pinczewski, Leo A

    2016-12-01

    Long-term prospective studies of isolated endoscopic anterior cruciate ligament (ACL) reconstruction are limited and may include confounding factors. This study aimed to compare the outcomes of isolated ACL reconstruction using the patellar tendon (PT) autograft and the hamstring (HT) autograft in 180 patients over 20 years. Cohort study; Level of evidence, 2. A total of 180 participants undergoing isolated ACL reconstruction between 1993 and 1994 were prospectively recruited. Evaluation was performed at 1, 2, 5, 7, 10, 15, and 20 years after surgery and included the International Knee Documentation Committee (IKDC) knee ligament evaluation with radiographic evaluation, KT-1000 arthrometer side-to-side difference, and subjective scores. Over 20 years, there were 16 patients (18%) and 9 patients (10%) with an ACL graft rupture in the HT and PT groups, respectively (P = .13). ACL graft rupture was associated with male sex (odds ratio [OR], 3.9; P = .007), nonideal tunnel position (OR, 3.6; P = .019), and age <18 years at the time of surgery (OR, 4.6; P = .003). The odds of a contralateral ACL rupture were increased in patients with the PT graft compared with patients with the HT graft (OR, 2.2; P = .02) and those aged <18 years at the time of surgery (OR, 3.4; P = .001). The mean IKDC scores at 20-year follow-up were 86 and 89 for the PT and HT groups, respectively (P = .18). At 20 years, 53% and 57% of the PT and HT groups participated in strenuous or very strenuous activities (P = .55), kneeling pain was present in 63% and 20% of the PT and HT groups (P = .018), and radiographic osteoarthritic change was found in 61% and 41% of the PT and HT groups (P = .008), respectively. Compared with patients who received the HT graft, patients who received the PT graft had significantly worse outcomes with regard to radiologically detectable osteoarthritis, kneeling pain, and contralateral ACL injury. At 20-year follow-up, both HT and PT autografts continued to provide good

  7. Cardiac arrhythmias during fiberoptic bronchoscopy and relation with oxygen saturation

    Directory of Open Access Journals (Sweden)

    Hassan G

    2005-01-01

    Full Text Available To evaluate the occurrence of electrocardiographic abnormalities during fiberoptic bronchoscopy, in relation to specific stages of the procedures, patients′ age, sex, smoking, pre-existing lung disease, premedication and oxygen saturation, a prospective study was conducted on 56 patients aged 35 to 75 (mean 62 years without pre-existing cardiovascular disease. Patients were connected to a 12-lead computerized electrocardiographic recorder and pulse oximeter. Fall of oxygen saturation from mean of 95.12% before the procedure to below 80% was observed in 12 (21.4% patients and below 75% in 5 (8.9% patients, at various stages. Statistically highly significant (p < 0.001 fall of oxygen saturation was observed during the procedures while bronchoscope was introduced into the airways and tracheobronchial tree examined. Major disturbances of cardiac rhythm (i.e. atrial, ventricular or both developed in 23 (41.07% patients. Out of these, sinus tachycardia was noted in 16 (69.5%, ventricular premature complexes in 5 (21.7% and paroxysmal supraventricular tachycardia in 2 (8.6% patients. Arrhythmias were most frequent in association with periods of maximum oxygen desaturation in 18 (78.2% of these 23 patients. Oxygen desaturation persisted for more than half an hour in 38 (67.8% of the 56 patients. However, no correlation was observed between the frequency of arrhythmias during bronchoscopy and patients′ age, sex pre-medication or pre-existing pulmonary disease.

  8. Evaluation of the effect of presence of blood in the stomach on endoscopic diagnostic tests for Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    S Mittal

    2011-01-01

    Full Text Available Introduction: Presence of blood in the stomach has been thought to affect the performance of diagnostic tests used in detecting Helicobacter pylori (H. pylori in the stomach. This study evaluated the effect of blood on the efficacy of rapid urease test (RUT and microscopic appearance of the biopsy after staining with Giemsa stain. Materials and Methods: Patients with bleeding oesophageal varices who met the inclusion criteria were tested for H. pylori by RUT and microscopic examination of the biopsy. A repeat endoscopy, RUT and histology were done one month following initial presentation. The performance of the diagnostic tests was evaluated with and without the presence of intraluminal blood. A combined result of the two tests, RUT and histology, carried out in presence or absence of blood for the diagnosis of H. pylori, when considered together was considered as the gold standard. Results: Thirty six patients included in the study were in the ages ranging between 15-60 years (mean age = 44.14 years ±2.1. The combination of tests at both visits showed 20/36 (55.6% patients were positive for H. pylori. The decrease in H. pylori positivity in the presence of blood was significant for RUT (8.3% vs. 38.9%; P=0.005 and combined test (19.4% vs. 47.2%; P=0.02 but the decrease in positivity for histology (11.1% vs 30.6% was not significant (P=0.08. In the presence of blood, the sensitivity of RUT, histology and combined tests were 15%, 20% and 35%, respectively. In the absence of blood, the sensitivity of RUT, histology and combination of tests was 70%, 55% and 85%, respectively. Conclusion: Blood in the stomach significantly decreased the sensitivity of RUT, histology and the combination of both. Negative results of these tests in acute upper gastro intestinal (GI bleeding should therefore be interpreted carefully.

  9. Dual-Fiberoptic Microcantilever Proximity Sensor

    International Nuclear Information System (INIS)

    Goedeke, S.M.

    2001-01-01

    Microcantilevers are key components of many Micro-Electro-Mechanical Systems (MEMS) and Micro-Optical-Electro-Mechanical Systems (MOEMS) because slight changes to them physically or chemically lead to changes in mechanical characteristics. An inexpensive dual-fiberoptic microcantilever proximity sensor and model to predict its performance are reported here. Motion of a magnetic-material-coated cantilever is the basis of a system under development for measuring magnetic fields. The dual fiber proximity sensor will be used to monitor the motion of the cantilever. The specific goal is to sense induction fields produced by a current carrying conductor. The proximity sensor consists of two fibers side by side with claddings in contact. The fiber core diameter, 50 microns, and cladding thickness, 10 microns, are as small as routinely available commercially with the exception of single mode fiber. Light is launched into one fiber from a light-emitting diode (LED). It emerges from that fiber and reflects from the cantilever into the adjacent receiving fiber connected to a detector. The sensing end is cast molded with a diameter of 3-mm over the last 20-mm, yielding a low profile sensor. This reflective triangulation approach is probably the oldest and simplest fiber proximity sensing approach, yet the novelty here is in demonstrating high sensitivity at low expense from a triangular microstructure with amorphous magnetic coatings of iron, cobalt, permalloy, etc. The signal intensity versus distance curve yields an approximate gaussian shape. For a typical configuration, the signal grows from 10% to 90% of maximum in traversing from 6 to 50 microns from a coated cantilever. With signal levels exceeding a volt, nanometer resolution should be readily achievable for periodic signals

  10. Choledocholithiasis diagnostics – endoscopic ultrasound or endoscopic retrograde cholangiopancreatography?

    Directory of Open Access Journals (Sweden)

    Jarosław Leszczyszyn

    2014-06-01

    Full Text Available It is estimated that 3.4% of patients qualified for cholecystectomy due to cholelithiasis have a coexisting choledocholithiasis. For decades, endoscopic ascending retrograde cholangiopancreatography has been the golden diagnostic standard in cases of suspected choledocholithiasis. The method is associated with a relatively high rate of complications, including acute pancreatitis, the incidence of which is estimated to range between 0.74% and 1.86%. The mechanism of this ERCP-induced complication is not fully understood, although factors increasing the risk of acute pancreatitis, such as sphincter of Oddi dysfunction, previous acute pancreatitis, narrow bile ducts or difficult catheterization of Vater’s ampulla are known. It has been suggested to discontinue the diagnostic endoscopic retrograde ascending cholangiopancreatography and replace it with endoscopic ultrasonography due to possible and potentially dangerous complications. Endoscopic ultrasonography has sensitivity of 94% and specificity of 95% regardless of gallstone diameter, as opposed to magnetic resonance cholangiography. However, both of these parameters depend on the experience of the performing physician. The use of endoscopic ultrasonography allows to limit the number of performed endoscopic retrograde cholangiopancreatography procedures by more than 2/3. Ascending endoscopic retrograde cholangiopancreatography combined with an endoscopic incision into the Vater’s ampulla followed by a mechanical evacuation of stone deposits from the ducts still remains a golden standard in the treatment of choledocholithiasis. Despite some limitations such as potentially increased treatment costs as well as the necessity of the procedure to be performed by a surgeon experienced in both endoscopic retrograde cholangiopancreatography as well as endoscopic ultrasonography, the diagnostic endoscopic ultrasonography followed by a simultaneous endoscopic retrograde cholangiopancreatography

  11. Fiber-optic technologies in laser-based therapeutics: threads for a cure.

    Science.gov (United States)

    Wang, Zheng; Chocat, Noémie

    2010-06-01

    In the past decade, novel fiber structures and material compositions have led to the introduction of new diagnostic and therapeutic tools. We review the structure, the material composition and the fabrication processes behind these novel fiber systems. Because of their structural flexibility, their compatibility with endoscopic appliances and their efficiency in laser delivery, these fiber systems have greatly extended the reach of a wide range of surgical lasers in minimally invasive procedures. Much research in novel fiber-optics delivery systems has been focused on the accommodation of higher optical powers and the extension to a broader wavelength range. Until recently, CO2 laser surgery, renowned for its precision and efficiency, was limited to open surgeries by the lack of delivery fibers. Hollow-core photonic bandgap fibers are assessed for their ability to transmit CO2 laser at surgical power level and for their applications in a range of clinical areas. Current fiber-delivery technologies for a number of laser surgery modalities and wavelengths are compared.

  12. Fiber-Optic Terahertz Data-Communication Networks

    Science.gov (United States)

    Chua, Peter L.; Lambert, James L.; Morookian, John M.; Bergman, Larry A.

    1994-01-01

    Network protocols implemented in optical domain. Fiber-optic data-communication networks utilize fully available bandwidth of single-mode optical fibers. Two key features of method: use of subpicosecond laser pulses as carrier signals and spectral phase modulation of pulses for optical implementation of code-division multiple access as multiplexing network protocol. Local-area network designed according to concept offers full crossbar functionality, security of data in transit through network, and capacity about 100 times that of typical fiber-optic local-area network in current use.

  13. Successful Endoscopic Therapy of Traumatic Bile Leaks

    Directory of Open Access Journals (Sweden)

    Matthew P. Spinn

    2013-02-01

    Full Text Available Traumatic bile leaks often result in high morbidity and prolonged hospital stay that requires multimodality management. Data on endoscopic management of traumatic bile leaks are scarce. Our study objective was to evaluate the efficacy of the endoscopic management of a traumatic bile leak. We performed a retrospective case review of patients who were referred for endoscopic retrograde cholangiopancreatography (ERCP after traumatic bile duct injury secondary to blunt (motor vehicle accident or penetrating (gunshot trauma for management of bile leaks at our tertiary academic referral center. Fourteen patients underwent ERCP for the management of a traumatic bile leak over a 5-year period. The etiology included blunt trauma from motor vehicle accident in 8 patients, motorcycle accident in 3 patients and penetrating injury from a gunshot wound in 3 patients. Liver injuries were grade III in 1 patient, grade IV in 10 patients, and grade V in 3 patients. All patients were treated by biliary stent placement, and the outcome was successful in 14 of 14 cases (100%. The mean duration of follow-up was 85.6 days (range 54-175 days. There were no ERCP-related complications. In our case review, endoscopic management with endobiliary stent placement was found to be successful and resulted in resolution of the bile leak in all 14 patients. Based on our study results, ERCP should be considered as first-line therapy in the management of traumatic bile leaks.

  14. Radiological findings after endoscopic incision of ureterocele

    International Nuclear Information System (INIS)

    Cheon, Jung Eun; Kim, In One; Seok, Eul Hye; Cha, Joo Hee; Choi, Gook Myung; Kim, Woo Sun; Yeon, Kyung Mo; Kim, Kwang Myung; Choi, Hwang; Cheon, Jung Eun; Seok, Eul Hye; Cha, Joo Hee; Choi, Guk Myung

    2001-01-01

    Endoscopic incision of ureterocele is considered a simple and safe method for decompression of urinary tract obstruction above ureterocele. The purpose of this study was to evaluate the radiological findings after endoscopic incision of ureterocele. We retrospectively reviewed the radiological findings (ultrasonography (US), intravenous urography, and voiding cystourethrography(VCU)) in 16 patients with ureterocele who underwent endoscopic incision (mean age at surgery, 15 months; M:F 3:13; 18 ureteroceles). According to the postoperative results, treatment was classified as successful when medical treatment was still required, and second operation when additional surgical treatment was required. Postoperative US (n=10) showed that in all patients, urinary tract obstruction was relieved: the kidney parenchima was thicker and the ureterocele was smaller. Intravenous urography (n=8), demonstrated that in all patients, urinary tract obstruction and the excretory function of the kidney had improved. Postoperative VCU indicated that in 92% of patients (12 of 13), endoscopic incision of the ureterocele led to vesicoureteral reflux(VUR). Of these twelve, seven (58%) showed VUR of more than grade 3, while newly developed VUR was seen in five of eight patients (63%) who had preoperative VCU. Surgery was successful in four patients (25%), partially successful in three (19%), and a second operation-on account of recurrent urinary tract infection and VUR of more than grase 3 during the follow-up period-was required by nine (56%). Although endoscopic incision of a ureterocele is a useful way of relieving urinary tract obstruction, an ensuing complication may be VUR. Postoperative US and intravenous urography should be used to evaluate parenchymal change in the kidney and improvement of uronary tract obstructon, while to assess the extend of VUR during the follow-up period , postoperative VCU is required

  15. Sensitivity and Specificity of Cardiac Tissue Discrimination Using Fiber-Optics Confocal Microscopy.

    Science.gov (United States)

    Huang, Chao; Sachse, Frank B; Hitchcock, Robert W; Kaza, Aditya K

    2016-01-01

    Disturbances of the cardiac conduction system constitute a major risk after surgical repair of complex cases of congenital heart disease. Intraoperative identification of the conduction system may reduce the incidence of these disturbances. We previously developed an approach to identify cardiac tissue types using fiber-optics confocal microscopy and extracellular fluorophores. Here, we applied this approach to investigate sensitivity and specificity of human and automated classification in discriminating images of atrial working myocardium and specialized tissue of the conduction system. Two-dimensional image sequences from atrial working myocardium and nodal tissue of isolated perfused rodent hearts were acquired using a fiber-optics confocal microscope (Leica FCM1000). We compared two methods for local application of extracellular fluorophores: topical via pipette and with a dye carrier. Eight blinded examiners evaluated 162 randomly selected images of atrial working myocardium (n = 81) and nodal tissue (n = 81). In addition, we evaluated the images using automated classification. Blinded examiners achieved a sensitivity and specificity of 99.2 ± 0.3% and 98.0 ± 0.7%, respectively, with the dye carrier method of dye application. Sensitivity and specificity was similar for dye application via a pipette (99.2 ± 0.3% and 94.0 ± 2.4%, respectively). Sensitivity and specificity for automated methods of tissue discrimination were similarly high. Human and automated classification achieved high sensitivity and specificity in discriminating atrial working myocardium and nodal tissue. We suggest that our findings facilitate clinical translation of fiber-optics confocal microscopy as an intraoperative imaging modality to reduce the incidence of conduction disturbances during surgical correction of congenital heart disease.

  16. In Vivo Fiber-Optic Raman Mapping Of Metastases In Mouse Brains

    Science.gov (United States)

    Stelling, A.; Kirsch, M.; Steiner, G.; Krafft, C.; Schackert, G.; Salzer, R.

    2010-08-01

    Vibrational spectroscopy, in particular Raman spectroscopy, has potential applications in the field of in vivo diagnostics. Raman and FT-IR spectroscopy analyze the complete biochemical information at any given pixel within the visual field. Here we demonstrate the feasibility of performing Raman spectroscopic measurements on living mice brains using a fiber-optic probe with a nominal spatial resolution of 60 μm. The objectives of this study were to 1) evaluate preclinical models, namely murine brain slices containing experimental tumors, 2) optimize the preparation of pristine brain tissue to obtain reference information, to 3) optimize the conditions for introducing a fiber-optic probe to acquire Raman maps in vivo, and 4) to transfer results obtained from human brain tumors to an animal model. Disseminated brain metastases of malignant melanomas were induced by injecting tumor cells into the carotid artery of mice. The procedure mimicked hematogenous tumor spread in one brain hemisphere while the other hemisphere remained tumor free. Three series of sections were prepared consecutively from whole mouse brains: pristine, 2-mm thick sections for Raman mapping and dried, thin sections for FT-IR imaging, hematoxylin and eosin-stained thin sections for histopathological assessment. Raman maps were collected serially using a spectrometer coupled to a fiber-optic probe. FT-IR images were recorded using a spectrometer with a multi-channel detector. The FT-IR images and the Raman maps were evaluated by multivariate data analysis. The results obtained from the thin section studies were employed to guide measurements of murine brains in vivo. Raman maps with an acquisition time of over an hour could be performed on the living animals. No damage to the tissue was observed.

  17. A new robotic-assisted flexible endoscope with single-hand control: endoscopic submucosal dissection in the ex vivo porcine stomach.

    Science.gov (United States)

    Iwasa, Tsutomu; Nakadate, Ryu; Onogi, Shinya; Okamoto, Yasuharu; Arata, Jumpei; Oguri, Susumu; Ogino, Haruei; Ihara, Eikichi; Ohuchida, Kenoki; Akahoshi, Tomohiko; Ikeda, Tetsuo; Ogawa, Yoshihiro; Hashizume, Makoto

    2018-04-17

    Difficulties in endoscopic operations and therapeutic procedures seem to occur due to the complexity of operating the endoscope dial as well as difficulty in performing synchronized movements with both hands. We developed a prototype robotic-assisted flexible endoscope that can be controlled with a single hand in order to simplify the operation of the endoscope. The aim of this study was to confirm the operability of the robotic-assisted flexible endoscope (RAFE) by performing endoscopic submucosal dissection (ESD). Study 1: ESD was performed manually or with RAFE by an expert endoscopist in ex vivo porcine stomachs; six operations manually and six were performed with RAFE. The procedure time per unit circumferential length/area was calculated, and the results were statistically analyzed. Study 2: We evaluated how smoothly a non-endoscopist can move a RAFE compared to a manual endoscope by assessing the designated movement of the endoscope. Study 1: En bloc resection was achieved by ESD using the RAFE. The procedure time was gradually shortened with increasing experience, and the procedure time of ESD performed with the RAFE was not significantly different from that of ESD performed with a manual endoscope. Study 2: The time for the designated movement of the endoscope was significantly shorter with a RAFE than that with a manual endoscope as for a non-endoscopist. The RAFE that we developed enabled an expert endoscopist to perform the ESD procedure without any problems and allowed a non-endoscopist to control the endoscope more easily and quickly than a manual endoscope. The RAFE is expected to undergo further development.

  18. [GERD: endoscopic antireflux therapies].

    Science.gov (United States)

    Caca, K

    2006-08-02

    A couple of minimally-invasive, endoscopic antireflux procedures have been developed during the last years. Beside endoscopic suturing these included injection/implantation technique of biopolymers and application of radiofrequency. Radiofrequency (Stretta) has proved only a very modest effect, while implantation techniques have been abandoned due to lack of long-term efficacy (Gatekeeper) or serious side effects (Enteryx). While first generation endoluminal suturing techniques (EndoCinch, ESD) demonstrated a proof of principle their lack of durability, due to suture loss, led to the development of a potentially durable transmural plication technique (Plicator). In a prospective-randomized, sham-controlled trial the Plicator procedure proved superiority concerning reflux symptoms, medication use and esophageal acid exposure (24-h-pH-metry). While long-term data have to be awaited to draw final conclusions, technical improvements will drive innovation in this field.

  19. [Functional endoscopic sinus surgery].

    Science.gov (United States)

    Han, D M

    1992-01-01

    Eighty-two cases of functional endoscopic sinus surgery were analyzed. It include 62 males and 20 females; the oldest was 72 years of age and the youngest eight years of age. A hard endoscope with a diameter of 4mm and the CCD micro-videorecorder produced by Circon and Olympus Company were used. Operations were done under general anesthesia in all cases. Twenty-three cases (28.1%) recovered in one stage and recovery was delayed in 28 cases (34.2%); late inflammation occurred in 23 cases (28.1%); 8 cases failed (9.8%). The cure rate was 62.2%. Two cases (2.4%) had operative complications namely injury to the lamina papyracea and anterior ethmoidal artery, all recovered uneventfully.

  20. Novel methods for endoscopic training.

    Science.gov (United States)

    Gessner, C E; Jowell, P S; Baillie, J

    1995-04-01

    The development of past, present, and future endoscopic training methods is described. A historical perspective of endoscopy training guidelines and devices is used to demonstrate support for the use of novel endoscopic training techniques. Computer simulation of endoscopy, interactive learning, and virtual reality applications in endoscopy and surgery are reviewed. The goals of endoscopic simulation and challenges facing investigators in this field are discussed, with an emphasis on current and future research.

  1. Endoscopic tissue diagnosis of cholangiocarcinoma.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2008-09-01

    The extremely poor outcome in patients with cholangiocarcinoma, in large part, reflects the late presentation of these tumors and the challenging nature of establishing a tissue diagnosis. Establishing a diagnosis of cholangiocarcinoma requires obtaining evidence of malignancy from sampling of the epithelium of the biliary tract, which has proven to be challenging. Although endoscopic ultrasound-guided fine needle aspiration performs slightly better than endoscopic retrograde cholangiopancreatography in diagnosing cholangiocarcinoma, both endoscopic approaches demonstrate disappointing performance characteristics.

  2. Fiber-Optical Sensors: Basics and Applications in Multiphase Reactors

    Directory of Open Access Journals (Sweden)

    Guozheng Li

    2012-09-01

    Full Text Available This work presents a brief introduction on the basics of fiber-optical sensors and an overview focused on the applications to measurements in multiphase reactors. The most commonly principle utilized is laser back scattering, which is also the foundation for almost all current probes used in multiphase reactors. The fiber-optical probe techniques in two-phase reactors are more developed than those in three-phase reactors. There are many studies on the measurement of gas holdup using fiber-optical probes in three-phase fluidized beds, but negative interference of particles on probe function was less studied. The interactions between solids and probe tips were less studied because glass beads etc. were always used as the solid phase. The vision probes may be the most promising for simultaneous measurements of gas dispersion and solids suspension in three-phase reactors. Thus, the following techniques of the fiber-optical probes in multiphase reactors should be developed further: (1 online measuring techniques under nearly industrial operating conditions; (2 corresponding signal data processing techniques; (3 joint application with other measuring techniques.

  3. Distributed Fiber-Optic Sensors for Vibration Detection

    Science.gov (United States)

    Liu, Xin; Jin, Baoquan; Bai, Qing; Wang, Yu; Wang, Dong; Wang, Yuncai

    2016-01-01

    Distributed fiber-optic vibration sensors receive extensive investigation and play a significant role in the sensor panorama. Optical parameters such as light intensity, phase, polarization state, or light frequency will change when external vibration is applied on the sensing fiber. In this paper, various technologies of distributed fiber-optic vibration sensing are reviewed, from interferometric sensing technology, such as Sagnac, Mach–Zehnder, and Michelson, to backscattering-based sensing technology, such as phase-sensitive optical time domain reflectometer, polarization-optical time domain reflectometer, optical frequency domain reflectometer, as well as some combinations of interferometric and backscattering-based techniques. Their operation principles are presented and recent research efforts are also included. Finally, the applications of distributed fiber-optic vibration sensors are summarized, which mainly include structural health monitoring and perimeter security, etc. Overall, distributed fiber-optic vibration sensors possess the advantages of large-scale monitoring, good concealment, excellent flexibility, and immunity to electromagnetic interference, and thus show considerable potential for a variety of practical applications. PMID:27472334

  4. Flexible fiberoptic bronchoscopy in respiratory care: Diagnostic yield ...

    African Journals Online (AJOL)

    2016-03-08

    Mar 8, 2016 ... OO Adewole, UU Onakpoya1, AB Ogunrombi1, A Komolafe2, AD Odeyemi, S Adeniran2, G Erhabor. Department of Medicine, Pulmonary ... Komolafe A, Odeyemi AD, Adeniran S, et al. Flexible fiberoptic bronchoscopy ... FOB (Pentax FB 18X; Pentax, Japan) under local anesthesia, through nasal route with ...

  5. Phase-nulling fiber-optic laser gyro.

    Science.gov (United States)

    Cahill, R F; Udd, E

    1979-03-01

    A fiber-optic gyro is described that employs closed-loop phase compensation. Preliminary experimental results are reported of the sensing of rotation rates down to 0.5 degrees /sec for a 135-mm-radius, 100-m-length fiber coil.

  6. Self-pumped phase-conjugate fiber-optic gyro.

    Science.gov (United States)

    McMichael, I; Yeh, P

    1986-10-01

    We describe a new type of phase-conjugate fiber-optic gyro that uses self-pumped phase conjugation. The selfpumped configuration is simpler than externally pumped configurations and permits the use of sensing fibers longer than the coherence length of the laser. A proof-of-principle demonstration of rotation sensing with the device is presented.

  7. Distributed Fiber-Optic Sensors for Vibration Detection.

    Science.gov (United States)

    Liu, Xin; Jin, Baoquan; Bai, Qing; Wang, Yu; Wang, Dong; Wang, Yuncai

    2016-07-26

    Distributed fiber-optic vibration sensors receive extensive investigation and play a significant role in the sensor panorama. Optical parameters such as light intensity, phase, polarization state, or light frequency will change when external vibration is applied on the sensing fiber. In this paper, various technologies of distributed fiber-optic vibration sensing are reviewed, from interferometric sensing technology, such as Sagnac, Mach-Zehnder, and Michelson, to backscattering-based sensing technology, such as phase-sensitive optical time domain reflectometer, polarization-optical time domain reflectometer, optical frequency domain reflectometer, as well as some combinations of interferometric and backscattering-based techniques. Their operation principles are presented and recent research efforts are also included. Finally, the applications of distributed fiber-optic vibration sensors are summarized, which mainly include structural health monitoring and perimeter security, etc. Overall, distributed fiber-optic vibration sensors possess the advantages of large-scale monitoring, good concealment, excellent flexibility, and immunity to electromagnetic interference, and thus show considerable potential for a variety of practical applications.

  8. End-tidal carbon dioxide monitoring during flexible fiberoptic ...

    African Journals Online (AJOL)

    In recent years, flexible fiberoptic bronchoscopy (FFB) has been applied for diagnostic and some therapeutic purposes. During FFB and even in the presence of supplemental oxygen, hypoventilation leading to hypoxia and desaturation may occur; this is aggravated by the use of suction. Arterial oxygen saturation is usually ...

  9. Kansas Communication and Instruction System through Fiber-Optic Transmission.

    Science.gov (United States)

    Kansas State Dept. of Education, Topeka.

    Schools and communities will restructure as they move into the next decade. The success of this restructuring will be dependent upon access to and sharing of quality teaching and information through an expanded communication system. One of the major two-way interactive technologies is the fiber-optic cable: a delivery system that will provide…

  10. [The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy].

    Science.gov (United States)

    Umutoglu, Tarik; Gedik, Ahmet Hakan; Bakan, Mefkur; Topuz, Ufuk; Daskaya, Hayrettin; Ozturk, Erdogan; Cakir, Erkan; Salihoglu, Ziya

    2015-01-01

    Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy. In this randomized, controlled, crossover study; patients aged between 0 and 15 years who underwent flexible fiberoptic bronchoscopy procedure having American Society of Anesthesiologists I-II risk score were included. Patients having risk of difficult intubation, intubated or patients with tracheostomy, and patients with reduced neck mobility or having cautions for neck mobility were excluded from this study. After obtaining best glottic view at the neutral position, patients were positioned jaw trust with open mouth, jaw trust with teeth prottution, head tilt chin lift and triple airway maneuvers and best glottis scores were recorded. Total of 121 pediatric patients, 57 girls and 64 boys, were included in this study. Both jaw trust with open mouth and jaw trust with teeth prottution maneuvers improved the glottis view compared with neutral position (p0.05). Head tilt chin lift and triple airway maneuvers improved glottis view when compared with both jaw trust with open mouth and jaw trust with teeth prottution maneuvers and neutral position (ptriple airway maneuvers (p>0.05). All airway supporting maneuvers improved glottic view during pediatric flexible fiberoptic bronchoscopy; however head tilt chin lift and triple airway maneuvers were found to be the most effective maneuvers. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Publicado por Elsevier Editora Ltda. All rights reserved.

  11. The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy.

    Science.gov (United States)

    Umutoglu, Tarik; Gedik, Ahmet Hakan; Bakan, Mefkur; Topuz, Ufuk; Daskaya, Hayrettin; Ozturk, Erdogan; Cakir, Erkan; Salihoglu, Ziya

    2015-01-01

    Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy. In this randomized, controlled, crossover study; patients aged between 0 and 15 years who underwent flexible fiberoptic bronchoscopy procedure having American Society of Anesthesiologists I-II risk score were included. Patients having risk of difficult intubation, intubated or patients with tracheostomy, and patients with reduced neck mobility or having cautions for neck mobility were excluded from this study. After obtaining best glottic view at the neutral position, patients were positioned jaw trust with open mouth, jaw trust with teeth prottution, head tilt chin lift and triple airway maneuvers and best glottis scores were recorded. Total of 121 pediatric patients, 57 girls and 64 boys, were included in this study. Both jaw trust with open mouth and jaw trust with teeth prottution maneuvers improved the glottis view compared with neutral position (p0.05). Head tilt chin lift and triple airway maneuvers improved glottis view when compared with both jaw trust with open mouth and jaw trust with teeth prottution maneuvers and neutral position (ptriple airway maneuvers (p>0.05). All airway supporting maneuvers improved glottic view during pediatric flexible fiberoptic bronchoscopy; however head tilt chin lift and triple airway maneuvers were found to be the most effective maneuvers. Copyright © 2015 Sociedade Brasileira de Anestesiologia. Published by Elsevier Editora Ltda. All rights reserved.

  12. Fiber-optic triggered release of liposome in vivo: implication of personalized chemotherapy.

    Science.gov (United States)

    Huang, Huei-Ling; Lu, Pei-Hsuan; Yang, Hung-Chih; Lee, Gi-Da; Li, Han-Ru; Liao, Kuo-Chih

    2015-01-01

    The aim of this research is to provide proof of principle by applying the fiber-optic triggered release of photo-thermally responsive liposomes embedded with gold nanoparticles (AuNPs) using a 200 μm fiber with 65 mW and 532 nm excitation for topical release in vivo. The tunable delivery function can be paired with an apoptosis biosensor based on the same fiber-optic configuration for providing real-time evaluation of chemotherapy efficacy in vivo to perform as a personalized chemotherapy system. The pattern of topical release triggered by laser excitation conveyed through optical fibers was monitored by the increase in fluorescence resulting from the dilution of self-quenching (75 mM) fluorescein encapsulated in liposomes. In in vitro studies (in 37°C phosphate buffer saline), the AuNP-embedded liposomes showed a more efficient triggered release (74.53%±1.63% in 40 minutes) than traditional temperature-responsive liposomes without AuNPs (14.53%±3.17%) or AuNP-liposomes without excitation (21.92%±2.08%) by spectroscopic measurements. Using the mouse xenograft studies, we first demonstrated that the encapsulation of fluorescein in liposomes resulted in a more substantial content retention (81%) in the tumor than for free fluorophores (14%) at 120 minutes after administration from in vivo fluorescence imaging. Furthermore, the preliminary results also suggested the tunable release capability of the system by demonstrating consecutive triggered releases with fiber-optic guided laser excitation.

  13. Thermal injury secondary to laparoscopic fiber-optic cables.

    Science.gov (United States)

    Hindle, A Katharine; Brody, Fred; Hopkins, Vernon; Rosales, Greg; Gonzalez, Florencia; Schwartz, Arnold

    2009-08-01

    Laparoscopy requires a reliable light source to provide adequate visualization. However, thermal energy is produced as a by-product from the optical cable. This study attempts to quantify the degree of possible thermal damage secondary to the fiber-optic light source. Using a digital thermometer, temperature measurements were recorded at the tip of optical cables from five different light sources (Karl Storz, Inc., Tuttlingen, Germany). Temperature measurements were recorded with new and old bulbs. The tip of the cable was applied to surgical drapes and the time to charring was recorded. Subsequently, the tip of the optical cable was applied to a porcine model and tissue samples were obtained after varying amounts of time (5, 15, 30, 60, and 90 s). Sections of the damaged tissue were prepared for microscopic evaluation. Parameters for thermal injury included extent of epidermal, dermal, and subcutaneous fat damage and necrosis. The lateral extent and depth of injury were measured. The maximum temperature at the tip of the optical cable varied between 119.5 degrees C and 268.6 degrees C. When surgical drapes were exposed to the tip of the light source, the time to char was 3-6 s. The degree and volume of injury increased with longer exposure times, and significant injury was recorded with the optical cable 3 mm from the skin. This study demonstrates that the temperature at the tip of the optical light cord can induce extensive damage. The by-product of light, heat, can produce immediate superficial tissue necrosis that can extend into the subcutaneous fat even when the optical tip is not in direct contact with the skin. In addition, our study shows the variation in temperature that exists between light sources and bulb status. Overall, surgeons must realize and respect the potential complications associated with optical technology.

  14. Fiber-optic triggered release of liposome in vivo: implication of personalized chemotherapy

    Directory of Open Access Journals (Sweden)

    Huang HL

    2015-08-01

    Full Text Available Huei-Ling Huang,1 Pei-Hsuan Lu,1 Hung-Chih Yang,1 Gi-Da Lee,1,2 Han-Ru Li,1 Kuo-Chih Liao1 1Graduate Institute of Biomedical Engineering, National Chung Hsing University, 2Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan Abstract: The aim of this research is to provide proof of principle by applying the fiber-optic triggered release of photo-thermally responsive liposomes embedded with gold nanoparticles (AuNPs using a 200 µm fiber with 65 mW and 532 nm excitation for topical release in vivo. The tunable delivery function can be paired with an apoptosis biosensor based on the same fiber-optic configuration for providing real-time evaluation of chemotherapy efficacy in vivo to perform as a personalized chemotherapy system. The pattern of topical release triggered by laser excitation conveyed through optical fibers was monitored by the increase in fluorescence resulting from the dilution of self-quenching (75 mM fluorescein encapsulated in liposomes. In in vitro studies (in 37°C phosphate buffer saline, the AuNP-embedded liposomes showed a more efficient triggered release (74.53%±1.63% in 40 minutes than traditional temperature-responsive liposomes without AuNPs (14.53%±3.17% or AuNP-liposomes without excitation (21.92%±2.08% by spectroscopic measurements. Using the mouse xenograft studies, we first demonstrated that the encapsulation of fluorescein in liposomes resulted in a more substantial content retention (81% in the tumor than for free fluorophores (14% at 120 minutes after administration from in vivo fluorescence imaging. Furthermore, the preliminary results also suggested the tunable release capability of the system by demonstrating consecutive triggered releases with fiber-optic guided laser excitation. Keywords: fiber-optic guided excitation, light excitation triggered release, photo-thermal responsive liposome, gold nanoparticles, tunable release in vivo

  15. Corrosion monitoring of rock bolt by using a low coherent fiber-optic interferometry

    Science.gov (United States)

    Wei, Heming; Zhao, Xuefeng; Li, Dongsheng; Zhang, Pinglei; Sun, Changsen

    2015-04-01

    Corrosion of rock bolts is a major cause for deterioration of the anchor-reinforced concrete slopes structures. In order to evaluate this corrosion-based deterioration in an early stage, a nondestructive technique was required. However, until now, there are no commercialized solutions that are straightforwardly available. Here, a low-coherent fiber-optic sensing technique was developed. This method can carry out the monitoring of the corrosion-caused expansion at the accuracy of sub-microstrains by circled the sensing optical fiber in two ways. One was wound the fiber on the surface of steel rock bolt directly, and thereby generated a nonuniformity in the interface of cement with rock bolt. The other was circled the fiber on a cement mortar cushion without destroying the interface any way. The sensing fiber was configured as one arm of the fiber-optic Michelson interferometer. The acceleration corrosion experiments demonstrated that a uniform interface between cement and rock bolt determined the progress of corrosion development. An early stage evaluation of the corrosion development in rock bolts was monitored.

  16. Endoscopic capacity in West Africa.

    African Journals Online (AJOL)

    patients who received endoscopy, 7 required endoscopic intervention with 6 having gastric or esophageal varices. Currently the ... are living longer3. Chronic GI illnesses, such as non-infec- tious gastric ulcer disease, cancer, dyspepsia and cirrhosis, are on the rise and have created an increased demand for endoscopic ...

  17. Endoscopic transmission of Helicobacter pylori

    NARCIS (Netherlands)

    Tytgat, G. N.

    1995-01-01

    The contamination of endoscopes and biopsy forceps with Helicobacter pylori occurs readily after endoscopic examination of H. pylori-positive patients. Unequivocal proof of iatrogenic transmission of the organism has been provided. Estimates for transmission frequency approximate to 4 per 1000

  18. Robot-assisted endoscopic surgery

    NARCIS (Netherlands)

    Ruurda, J.P.

    2003-01-01

    During the last three years, robot-assisted surgery systems are increasingly being applied in endoscopic surgery. They were introduced with the objective to overcome the challenges of standard endoscopic surgery. With the improvements in manipulation and visualisation that robotic-assistance offers,

  19. Endoscopic resection of subepithelial tumors.

    Science.gov (United States)

    Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; Caca, Karel

    2014-12-16

    Management of subepithelial tumors (SETs) remains challenging. Endoscopic ultrasound (EUS) has improved differential diagnosis of these tumors but a definitive diagnosis on EUS findings alone can be achieved in the minority of cases. Complete endoscopic resection may provide a reasonable approach for tissue acquisition and may also be therapeutic in case of malignant lesions. Small SET restricted to the submucosa can be removed with established basic resection techniques. However, resection of SET arising from deeper layers of the gastrointestinal wall requires advanced endoscopic methods and harbours the risk of perforation. Innovative techniques such as submucosal tunneling and full thickness resection have expanded the frontiers of endoscopic therapy in the past years. This review will give an overview about endoscopic resection techniques of SET with a focus on novel methods.

  20. A fiber-optic fluorescence microscope using a consumer-grade digital camera for in vivo cellular imaging.

    Directory of Open Access Journals (Sweden)

    Dongsuk Shin

    Full Text Available BACKGROUND: Early detection is an essential component of cancer management. Unfortunately, visual examination can often be unreliable, and many settings lack the financial capital and infrastructure to operate PET, CT, and MRI systems. Moreover, the infrastructure and expense associated with surgical biopsy and microscopy are a challenge to establishing cancer screening/early detection programs in low-resource settings. Improvements in performance and declining costs have led to the availability of optoelectronic components, which can be used to develop low-cost diagnostic imaging devices for use at the point-of-care. Here, we demonstrate a fiber-optic fluorescence microscope using a consumer-grade camera for in vivo cellular imaging. METHODS: The fiber-optic fluorescence microscope includes an LED light, an objective lens, a fiber-optic bundle, and a consumer-grade digital camera. The system was used to image an oral cancer cell line labeled with 0.01% proflavine. A human tissue specimen was imaged following surgical resection, enabling dysplastic and cancerous regions to be evaluated. The oral mucosa of a healthy human subject was imaged in vivo, following topical application of 0.01% proflavine. FINDINGS: The fiber-optic microscope resolved individual nuclei in all specimens and tissues imaged. This capability allowed qualitative and quantitative differences between normal and precancerous or cancerous tissues to be identified. The optical efficiency of the system permitted imaging of the human oral mucosa in real time. CONCLUSION: Our results indicate this device as a useful tool to assist in the identification of early neoplastic changes in epithelial tissues. This portable, inexpensive unit may be particularly appropriate for use at the point-of-care in low-resource settings.

  1. Endoscopic band ligation therapy for upper gastrointestinal bleeding related to Mallory-Weiss syndrome.

    Science.gov (United States)

    Higuchi, N; Akahoshi, K; Sumida, Y; Kubokawa, M; Motomura, Y; Kimura, M; Matsumoto, M; Nakamura, K; Nawata, H

    2006-09-01

    No consensus exists as to the best endoscopic treatment for Mallory-Weiss syndrome. Endoscopic band ligation is a readily available and easily learned technique. This prospective study evaluated the efficacy and safety of endoscopic band ligation therapy for Mallory-Weiss syndrome. From August 1998 to June 2005, a clinical trial assessed 37 patients with a diagnosis of Mallory-Weiss syndrome who had active bleeding, exposed vessels, or both. Their lesions were treated using endoscopic band ligation. Endoscopic band ligation was successful in 36 of 37 cases, with a follow-up period ranging from 1 to 24 months. The remaining patient had severe liver failure and disseminated intravascular coagulation. The patient bled again at 12 h and subsequently died. Except for this case, no recurrent bleeding, perforation, or other complications occurred. The study results suggest that endoscopic band ligation is an effective, safe, and easily learned procedure for treating upper gastrointestinal bleeding related to Mallory-Weiss syndrome.

  2. Emerging indications of endoscopic radiofrequency ablation

    Science.gov (United States)

    Becq, Aymeric; Camus, Marine; Rahmi, Gabriel; de Parades, Vincent; Marteau, Philippe

    2015-01-01

    Introduction Radiofrequency ablation (RFA) is a well-validated treatment of dysplastic Barrett's esophagus. Other indications of endoscopic RFA are under evaluation. Results Four prospective studies (total 69 patients) have shown that RFA achieved complete remission of early esophageal squamous intra-epithelial neoplasia at a rate of 80%, but with a substantial risk of stricture. In the setting of gastric antral vascular ectasia, two prospective monocenter studies, and a retrospective multicenter study, (total 51 patients), suggest that RFA is efficacious in terms of reducing transfusion dependency. In the setting of chronic hemorrhagic radiation proctopathy, a prospective monocenter study and a retrospective multicenter study (total 56 patients) suggest that RFA is an efficient treatment. A retrospective comparative study (64 patients) suggests that RFA improves stents patency in malignant biliary strictures. Conclusions Endoscopic RFA is an upcoming treatment modality in early esophageal squamous intra-epithelial neoplasia, as well as in gastric, rectal, and biliary diseases. PMID:26279839

  3. Fundus imaging with a nasal endoscope

    Directory of Open Access Journals (Sweden)

    P Mahesh Shanmugam

    2015-01-01

    Full Text Available Wide field fundus imaging is needed to diagnose, treat, and follow-up patients with retinal pathology. This is more applicable for pediatric patients as repeated evaluation is a challenge. The presently available imaging machines though provide high definition images, but carry the obvious disadvantages of either being costly or bulky or sometimes both, which limits its usage only to large centers. We hereby report a technique of fundus imaging using a nasal endoscope coupled with viscoelastic. A regular nasal endoscope with viscoelastic coupling was placed on the cornea to image the fundus of infants under general anesthesia. Wide angle fundus images of various fundus pathologies in infants could be obtained easily with readily available instruments and without the much financial investment for the institutes.

  4. [Endoscopic dacryocystorhinostomy: role of the ophthalmologist].

    Science.gov (United States)

    Nogueira, A; Zaragoza, P; Toledano, N; Genol, I; Plaza, G

    2014-04-01

    To evaluate the results of endoscopic dacryocystorhinostomy (DCR) with or without support of the ophthalmologist. A retrospective study of 100 cases of endoscopic DCR surgery conducted by an otolaryngologist between June 2008 and December 2009. Of the 100 cases, 50 were operated with surgical support of the ophthalmologist, who inserted Bowman probes in the upper and lower canaliculi, while in the other 50 cases it was the otolaryngologist who performed this, without support of the ophthalmologist. The evaluation of the results after 2 years included the subjective perception, the lacrimal patency after lacrimal syringing, and lacrimal functional test after modified Jones test. Of the 100 DCR reviewed, more than 50% required complementary treatment by the otolaryngologist, mainly septoplasty. As for the resolution of epiphora, without support of the ophthalmologist, 75% the patients reported an overall subjective improvement, but this reached 92% in the surgical group with support of the ophthalmologist, which was a statistically significant difference. Endoscopic DCR is effective in the treatment of epiphora, but its results improve when the ophthalmologist inserts the probes in the lacrimal canaliculi during the surgical procedure. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  5. The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy

    Directory of Open Access Journals (Sweden)

    Tarik Umutoglu

    2015-10-01

    Full Text Available ABSTRACTINTRODUCTION:Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy.MATERIALS AND METHODS:In this randomized, controlled, crossover study; patients aged between 0 and 15 years who underwent flexible fiberoptic bronchoscopy procedure having American Society of Anesthesiologists I---II risk score were included. Patients having risk of difficult intubation, intubated or patients with tracheostomy, and patients with reduced neck mobility or having cautions for neck mobility were excluded from this study. After obtaining best glottic view at the neutral position, patients were positioned jaw trust with open mouth, jaw trust with teeth prottution, head tilt chin lift and triple airway maneuvers and best glottis scores were recorded.RESULTS:Total of 121 pediatric patients, 57 girls and 64 boys, were included in this study. Both jaw trust with open mouth and jaw trust with teeth prottution maneuvers improved the glottis view compared with neutral position (p 0.05. Head tilt chin lift and triple airway maneuvers improved glottis view when compared with both jaw trust with open mouth and jaw trust with teeth prottution maneuvers and neutral position (p 0.05.

  6. Monitoring of railway embankment settlement with fiber-optic pulsed time-of-flight radar.

    Science.gov (United States)

    Kilpelä, Ari; Lyöri, Veijo; Duan, Guoyong

    2012-12-01

    This paper deals with a fiber-optic pulsed time-of-flight (PTOF) laser radar used for monitoring the settlement of a railway embankment. The operating principle is based on evaluating the changes in the lengths of the fiber-optic cables embedded in the embankment by measuring the time separation of the optical pulses reflected from both ends of the sensor fiber. The advantage of this method is that it integrates the elongation of the whole sensor, and many sensor fibers can be connected in series. In a field test, seven polyurethane-coated optical cables were installed in a railway embankment and used as 20-m long sensors. The optical timing pulses were created using specially polished optical connectors. The measured precision was 0.28 ps, which corresponds 1.8 μstrain elongation using a 20 m long sensor fiber, using an averaged value of 10,000 pulses for a single measurement value. The averaged elongation value of all sensors was used for cancelling out the effect of temperature variation on the elongation value of each individual sensor. The functionality of the method was tested by digging away a 7.5 m long and approximately 18 mm high section of sand below one sensor. It was measured as a +3 mm change in the length of the sensor fiber, which matched well with the theoretically calculated elongation value, 2.9 mm. The sensor type proved to be strong but flexible enough for this type of use.

  7. Characterizing Thermal Augmentation of Convection-Enhanced Drug Delivery with the Fiberoptic Microneedle Device

    Directory of Open Access Journals (Sweden)

    R. Lyle Hood

    2015-09-01

    Full Text Available Convection-enhanced delivery (CED is a promising technique leveraging pressure-driven flow to increase penetration of infused drugs into interstitial spaces. We have developed a fiberoptic microneedle device for inducing local sub-lethal hyperthermia to further improve CED drug distribution volumes, and this study seeks to quantitatively characterize this approach in agarose tissue phantoms. Infusions of dye were conducted in 0.6% (w/w agarose tissue phantoms with isothermal conditions at 15 °C, 20 °C, 25 °C, and 30 °C. Infusion metrics were quantified using a custom shadowgraphy setup and image-processing algorithm. These data were used to build an empirical predictive temporal model of distribution volume as a function of phantom temperature. A second set of proof-of-concept experiments was conducted to evaluate a novel fiberoptic device capable of generating local photothermal heating during fluid infusion. The isothermal infusions showed a positive correlation between temperature and distribution volume, with the volume at 30 °C showing a 7-fold increase at 100 min over the 15 °C isothermal case. Infusions during photothermal heating (1064 nm at 500 mW showed a similar effect with a 3.5-fold increase at 4 h over the control (0 mW. These results and analyses serve to provide insight into and characterization of heat-mediated enhancement of volumetric dispersal.

  8. [Treatment of pain in chronic pancreatitis by an endoscopic method].

    Science.gov (United States)

    Seicean, Andrada; Burtin, Pascal; Boyer, Jean; Pascu, Oliviu

    2002-06-01

    The epigastric pain is the most frequent manifestation in chronic pancreatitis. It is due to intraductal pancreatic pressure, presence of compressive pseudocysts and probably to neuroinflammatory process caused by alcohol. The aim of our study was to assess the influence of endoscopic treatment on pain in chronic pancreatitis and the correlation between residual pain after endoscopic treatment and pancreatic morphology. Forty-four patients from the Gastroenterology Department of Angers (France) with chronic pancreatitis were included in our retrospective clinical study. Thirty-seven patients underwent a diagnostic ERCP and only 28 needed an endoscopic treatment. The pain was evaluated semi-quantitatively before and after the endoscopic treatment. The mean follow-up was 28.6 months. Among the 28 patients with endoscopic treatment, 18 had a complete improvement of the pain, 4 an incomplete improvement and 6 had no improvement; these last were submitted to pancreatic surgery. The pain evolution had a good correlation with the reduction of Wirsung diameter; there was no correlation with ductal stenosis, residual lithiasis and pseudocysts presence. Alcohol consumption had no influence on the pain evolution. The endoscopic treatment of intraductal lithiasis and pseudocysts is a useful method for Wirsung decompression, improving the pain in chronic pancreatitis.

  9. Approaching time is important for assessment of endoscopic surgical skills.

    Science.gov (United States)

    Tokunaga, Masakazu; Egi, Hiroyuki; Hattori, Minoru; Yoshimitsu, Masanori; Sumitani, Daisuke; Kawahara, Tomohiro; Okajima, Masazumi; Ohdan, Hideki

    2012-05-01

    This study aimed to verify whether the approaching time (the time taken to reach the target point from another point, a short distance apart, during point-to-point movement in endoscopic surgery), assessed using the Hiroshima University Endoscopic Surgical Assessment Device (HUESAD), could distinguish the skill level of surgeons. Expert surgeons (who had performed more than 50 endoscopic surgeries) and novice surgeons (who had no experience in performing endoscopic surgery) were tested using the HUESAD. The approaching time, total time, and intermediate time (total time--approaching time) were measured and analyzed using the trajectory of the tip of the instrument. The approaching time and total time were significantly shorter in the expert group than in the novice group (p time did not significantly differ between the groups (p > 0.05). The approaching time, which is a component of the total time, is very mportant in the measurement of the total time to assess endoscopic surgical skills. Further, the approaching time was useful for skill assessment by the HUESAD for evaluating the skill of surgeons performing endoscopic surgery.

  10. Endoscopical appearances of nonsteroidal anti inflammatory drug (NSAID- enteropathy

    Directory of Open Access Journals (Sweden)

    Marcellus Simadibrata

    2005-12-01

    Full Text Available Non Steroidal Anti Inflammatory Drugs (NSAID have been associated with a sudden and sustained rise in the incidence of gastrointestinal ulcer complications. The aim of the study was to reveal the endoscopical abnormalities found in the duodenum & proximal jejunum due to NSAID. Thirty eight patients taking NSAID for their arthritis or rheumatism were included in this study. Gastro-duodeno-jejunoscopy was done with Olympus PCF-10. The endoscopical appearances of NSAID entero gastropathy were evaluated with a scoring system. The NSAID-entero-gastropathy appearances were endoscopically seen as hyperemia, erosion and ulcer. From all patient recruited, 7.9% complaint of diarrhea and 71.1% complaint of dyspepsia. Endoscopically, in the duodenal bulb we found 79% cases of hyperemia, 39.5% cases of erosion and 7.9% cases of ulcer. In the second part (descending part of the duodenum we found 28.9% cases of hyperemia, 15.8% cases of erosion and 2.6% case of ulcer. In the jejunum, we found 7.9% cases of hyperemia, 2.6% case of erosion and no ulcer. It is concluded that the most frequent abnormal endoscopical appearances in NSAID- enteropathy was hyperemia. The most frequent site of NSAID-enteropathy abnormal findings was in the duodenal bulb. (Med J Indones 2005; 14: 225-9Keywords: NSAID-enteropathy, endoscopical appearances.

  11. Biliary transpapillary endoscopic balloon dilation for treating choledocholithiasis.

    Science.gov (United States)

    Daniel, Lubia B; Favaro, Gabriel M; Filho, Tiago F V; Cunha, Marco A B; AparÍcio, Dayse S P; Uemura, Ricardo S; Furuya, Carlos K; Artifon, Everson L A

    2015-01-01

    To evaluate the efficacy and safety of transpapillary papilloplasty in patients with choledocholithiasis. All endoscopic retrograde cholangiopancreatography (ERCP) procedures performed at Hospital Ana Costa, in the city of Santos, Brazil, over the last five years were retrospectively evaluated using the hospital's information database. The success of the procedure and complications due to residual calculi, pancreatitis, bleeding and perforation were evaluated. From January 2010 to May 2014, 1860 ERCP procedures were performed. Fifty-five patients were evaluated here. Their ages ranged from 12 to 98 years (mean, 66.3; standard deviation, 19.34; median, 71). Thirty-two patients (58.2%) were women. Sixteen (29.1%) presented giant choledocholithiasis, with calculi larger than 12 mm. Twenty-seven (49.1%) had mul-tiple choledocholithiasis. In view of the therapeutic efficacy and low complication rate among our patients, we can conclude that endoscopic papilloplasty is a safe and effective method for endoscopic treatment of choledocolithiasis in selected cases.

  12. Endoscopic management of pancreatic duct injury by endoscopic stent placement: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Ito Yasuhiro

    2012-07-01

    Full Text Available Abstract Recently, the diagnostic evaluation of pancreatic injury has improved dramatically. On the other hand, it is occasionally difficult to diagnose pancreatic injury, because there are no specific signs, symptoms, or laboratory findings. Radiological imaging also often fails to identify pancreatic injury in the acute phase. Delayed diagnosis results in significant morbidity and mortality. Most cases of pancreatic injury with suspicion or pancreatic duct disruption require surgery. Endoscopic retrograde cholangiopancreatography is one of the most accurate modalities for ductal evaluation and therapy and might enable one to avoid unnecessary surgery. We describe endoscopic management of pancreatic duct injury by endoscopic stent placement. A 45-year-old woman was admitted after a traffic accident. A computed tomography scan showed pancreatic parenchyma disruption at the pancreatic head. Endoscopic retrograde cholangiopancreatography demonstrated disruption of the pancreatic duct with extravasation into the peripancreatic fluid collection. A 5-French endoscopic nasopancreatic drainage (ENPD tube was placed. Her symptoms dramatically improved. ENPD tube was exchanged for a 5-French 5-cm pancreatic stent. Subsequent follow-up CT revealed remarkable improvement. On the 26th day, the patient was discharged from the hospital without symptoms or complications. In this report, a pancreatic stent may lead to rapid clinical improvement and enable surgery to be avoided. On the other hand, the reported complications of long-term follow-up make the role of stenting uncertain. Thus, close attention should be paid to stenting management in the follow-up period. A pancreatic stent is useful for pancreatic ductal injury. If pancreatic ductal injury is managed appropriately, a pancreatic stent may improve the clinical condition, and also prevent unnecessary surgery.

  13. Hepatic applications of endoscopic ultrasound

    DEFF Research Database (Denmark)

    Srinivasan, Indu; Tang, Shou-Jiang; Vilmann, Andreas S

    2015-01-01

    The diagnosis and staging of various gastrointestinal malignancies have been made possible with the use of endoscopic ultrasound, which is a relatively safe procedure. The field of endoscopic ultrasound is fast expanding due to advancements in therapeutic endoscopic ultrasound. Though various...... studies have established its role in gastrointestinal malignancies and pancreatic conditions, its potential in the field of hepatic lesions still remains vastly untapped. In this paper the authors attempt to review important and landmark trials, case series and case studies involving hepatic applications...

  14. New interferometric fiber-optic gyroscope with amplified optical feedback.

    Science.gov (United States)

    Shi, C X; Yuhara, T; Iizuka, H; Kajioka, H

    1996-01-20

    A novel interferometric fiber-optic gyroscope with amplified optical feedback by an Er-doped fiber amplifier (EDFA) is proposed and theoretically investigated (the proposed gyroscope is named the feedback EDFA-FOG, FE-FOG in what follows). The FE-FOG functions like a resonant fiber-optic gyro (R-FOG) because of its multiple utilization of the Sagnac loop; however, it is completely different because a low-coherence light source is used. In addition, the gyro output signal is pulsed because the modulation frequency of the phase modulator placed in the Sagnac loop is selected to match the total round-trip time delay of the light, which includes the Sagnac-loop delay plus that of the feedback loop of the fiber amplifier. The sharpness of the output pulse can be adjusted by both the gain of an EDFA and the modulation depth of the phase modulator. When rotation occurs the peak position of the output pulse is shifted as a result of the Sagnac effect. The resolution of the rotation measurement depends on the sharpness of the output pulse. The techniques of both the open-loop and closed-loop methods are described in detail, which shows the great advantage of the proposed gyroscope over the to the conventional interferometric fiber-optical gyroscope (I-FOG).

  15. Fiber-Optic Micrometeoroid/Orbital Debris Impact Detector System

    Science.gov (United States)

    Christiansen, Eric L.; Tennyson, R. C.; Morison, W. D.

    2012-01-01

    A document describes a reliable, lightweight micrometeoroid/orbital debris (MMOD) detection system that can be located at strategic positions of "high consequence" to provide real-time warning of a penetration, its location, and the extent of the damage to a spacecraft. The concept is to employ fiber-optic sensors to detect impact damage and penetration of spacecraft structures. The fibers are non-electrical, employ light waves, and are immune to electromagnetic interference. The fiber-optic sensor array can be made as a stand-alone product, being bonded to a flexible membrane material or a structure that is employed as a MMOD shield material. The optical sensors can also be woven into hybrid MMOD shielding fabrics. The glass fibers of the fiber-optic sensor provide a dual purpose in contributing to the breakup of MMOD projectiles. The grid arrays can be made in a modular configuration to provide coverage over any area desired. Each module can be connected to a central scanner instrument and be interrogated in a continuous or periodic mode.

  16. Reoperative thyroid surgery: can endoscopic areola approach be used?

    Science.gov (United States)

    Guan, Bingsheng; Li, Jinyi; Yang, Wah; Yang, Jingge; Cao, Guo; Sun, Peng; Wang, Cunchuan

    2017-03-01

    Reoperative thyroid surgery is associated with a higher morbidity and has traditionally been done in conventional open approach. This study aimed to evaluate the safety and effectiveness of endoscopic areola approach for reoperative thyroid surgery. A retrospective study was conducted in 46 patients undergoing reoperative thyroid surgery with endoscopic areola approach (endoscopic group) and 70 patients with conventional open approach (open group). Perioperative and follow-up outcomes were compared between the two groups. Baseline characteristics were comparable between the two groups. Except for two cases of the endoscopic group intraoperatively converted to open surgery, all the other surgery was successfully completed. No significant difference was found between two groups concerning operation time, drainage volume, drainage time and postoperative hospital stay (all P > 0.05). Estimated blood loss was more in the open group than the endoscopic group (P = 0.000). Although not statistically significant, the overall complication rate was less in the endoscopic group than in the open group (21.7 vs. 37.1 %, P = 0.079). Of these complications, transient hypocalcemia was the most common (endoscopic group, 17.4 %; open group, 21.4 %; P = 0.594). One patient of the endoscopic group and 7 patients of the open group suffered from transient recurrent laryngeal nerve (RLN) paralysis (P = 0.210). Moreover, 2 patients of open group experienced permanent RLN paralysis. During the follow-up period (range 1-6 years), no recurrent case was encountered, but the endoscopic group had a higher cosmetic score (9.0 ± 0.9 vs. 5.9 ± 0.9, P = 0.000). In high-volume centers, with strict operation indication, sufficient preoperative evaluation and careful surgical maneuvers, endoscopic areola approach is a safe and effective method for reoperative thyroid surgery, allowing to provide a better cosmetic result and reduce intraoperative blood loss compared with open

  17. High Temperature Fiberoptic Thermal Imaging System, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — The proposed Phase 1 program will fabricate and demonstrate a small diameter single fiber endoscope that can perform high temperature thermal imaging in a jet engine...

  18. Endoscopic characteristics of colorectal serrated lesions.

    Science.gov (United States)

    Kashida, Hiroshi; Ikehara, Nobunao; Hamatani, Shigeharu; Kudo, Shin-ei; Kudo, Masatoshi

    2011-01-01

    With the recent changes of pathological concepts, colorectal serrated lesions can be now divided into traditional serrated adenoma, typical hyperplastic polyp and sessile serrated polyp. The aim of this study is to clarify the endoscopic differences among these three groups. A total number of 362 serrated lesions larger than 5mm were evaluated. These were detected with ordinary view and observed also with magnifying chromoendoscopic view. The final pathologic diagnosis of the resected specimens was made blinded. There were significant differences between traditional serrated adenoma and sessile serrated polypconcerning location, configuration and color. In chromoendoscopy, most of sessile serrated polyps and typical hyperplastic polyps showed star-like pattern, in contrast with traditional serrated adenomas most of which had fernor pinecone-like pattern. The differential diagnosis between traditional sessile polyp and the other two was possible with high accuracy. On the other hand, endoscopic distinction between sessile serrated polyp and typical hyperplastic polyp was not easy, except that the location and size were significantly different. We can endoscopically differentiate between traditional serrated adenoma and sessile serrated polyp or typical hyperplastic polyp, but it is difficult to differentiate between the latter two.

  19. Revision endoscopic sinonasal surgery.

    Science.gov (United States)

    Cantillano, Pablo; Rubio, Fabián; Naser, Alfredo; Nazar, Rodolfo

    Endoscopic sinonasal surgery is the procedure of choice in the treatment of chronic rhinosinusitis and sinonasal polyposis refractory to medical treatment, with high rates of success (76% to 97.5%). However, 2.5%-24% of those patients will require revision surgery (RESS). In this study, we present the clinical, anatomical, radiological and histological features of patients receiving RESS in our centre during a 3-year period. A retrospective review of clinical, anatomical, radiological and histopathological data of patients receiving revision endoscopic sinonasal surgery between 2012 and 2014 was carried out. From 299 surgery procedures performed, 27 (9%) were revision surgeries. The mean patient age was 46 years, with a male/female ratio of 1.4/1. The most frequent preoperative and postoperative diagnosis was chronic polypoid rhinosinusitis. The mean time since the previous surgery was 6.1 years, with 11.9 months of mean follow-up since that surgery. Stenotic antrostomy was found during revision in 81.5% of the patients and incomplete anterior ethmoidectomy and persistent uncinate process, in 59.3%. In radiology, 70.4% of patients had persistent anterior ethmoidal cells. Antrostomy or widening of antrostomy was performed in 96.3% of cases and anterior ethmoidectomy or completion of it was performed in 66.7%. Polyps, stenotic antrostomy and incomplete ethmoidectomy were the most frequent causes of revision surgery, in concordance with the procedures performed. The patients had long periods of time without follow-up between surgeries. Further investigation is necessary to generate measures to reduce the number of revision surgeries. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  20. Endoscopic third ventriculostomy

    Directory of Open Access Journals (Sweden)

    Yad Ram Yadav

    2012-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is considered as a treatment of choice for obstructive hydrocephalus. It is indicated in hydrocephalus secondary to congenital aqueductal stenosis, posterior third ventricle tumor, cerebellar infarct, Dandy-Walker malformation, vein of Galen aneurism, syringomyelia with or without Chiari malformation type I, intraventricular hematoma, post infective, normal pressure hydrocephalus, myelomeningocele, multiloculated hydrocephalus, encephalocele, posterior fossa tumor and craniosynostosis. It is also indicated in block shunt or slit ventricle syndrome. Proper Pre-operative imaging for detailed assessment of the posterior communicating arteries distance from mid line, presence or absence of Liliequist membrane or other membranes, located in the prepontine cistern is useful. Measurement of lumbar elastance and resistance can predict patency of cranial subarachnoid space and complex hydrocephalus, which decides an ultimate outcome. Water jet dissection is an effective technique of ETV in thick floor. Ultrasonic contact probe can be useful in selected patients. Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery. Magnetic resonance ventriculography and cine phase contrast magnetic resonance imaging are effective in assessing subarachnoid space and stoma patency after ETV. Proper case selection, post-operative care including monitoring of ICP and need for external ventricular drain, repeated lumbar puncture and CSF drainage, Ommaya reservoir in selected patients could help to increase success rate and reduce complications. Most of the complications develop in an early post-operative, but fatal complications can develop late which indicate an importance of

  1. Investigation of fiberoptic behaviour during gamma irradiation. Part of a coordinated programme on non-destructive techniques for reactor fuel characterization

    International Nuclear Information System (INIS)

    Boeck, H.

    1981-03-01

    Radiation induced effects in glass-rods and fiberoptics have been studied to determine parameters affecting the application of these materials in endoscopes operating in severe radiation environments such as the core of a nuclear power plant or the spent fuel element storage pool. Different glass and fiber types have been investigated and various transmission properties were found. The samples were irradiated in the thermal column of the TRIGA Mark II reactor, Vienna. The radiation induced transmission loss was measured approximately 1 hour after the reactor shutdown. Saturation effects in the transmission loss were observed and changes in glass and fiber recovery vs time as a function of radiation dose and photo bleaching methods were studied. Photo bleaching was investigated with a quartz lamp, an arc lamp and an UV-laser light. (author)

  2. Endoscopic therapy and beta-blockers for secondary prevention in adults with cirrhosis and oesophageal varices

    DEFF Research Database (Denmark)

    Gluud, Lise Lotte; Morgan, Marsha Y.

    2017-01-01

    This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To evaluate the beneficial and harmful effects of endoscopic therapy and beta-blockers used as a combination therapy versus monotherapy with either endoscopic therapy or beta-blockers for secondary prevention ...... in people with cirrhosis and oesophageal varices....

  3. Validity of the Pre-endoscopic Scoring Systems for the Prediction of the Failure of Endoscopic Hemostasis in Bleeding Gastroduodenal Peptic Ulcers.

    Science.gov (United States)

    Iino, Chikara; Shimoyama, Tadashi; Igarashi, Takasato; Aihara, Tomoyuki; Ishii, Kentaro; Sakamoto, Jyuichi; Tono, Hiroshi; Fukuda, Shinsaku

    2018-01-11

    Background and Aim Although several pre-endoscopic scoring systems have been used to predict the mortality or the need for intervention for upper gastrointestinal bleeding, their usefulness to predict the failure of endoscopic hemostasis in bleeding gastroduodenal peptic ulcers has not yet been fully investigated. In this study, we evaluated the usefulness of the Glasgow-Blatchford score (GBS), the clinical Rockall score (CRS), and the AIMS65 score in predicting the failure of endoscopic hemostasis in patients with bleeding gastroduodenal peptic ulcers. Methods We retrospectively evaluated 226 consecutive emergency endoscopic cases with bleeding gastroduodenal peptic ulcers between April 2010 and September 2016. The study outcome was the failure of first endoscopic hemostasis. The GBS, CRS, and AIMS65 scores were assessed for their ability to predict the failure of endoscopic hemostasis using a receiver-operating characteristic curve. Results Eight cases (3.5%) failed to achieve first endoscopic hemostasis. Surgery was required in six cases, and interventional radiology was required in two cases. The GBS was superior to both the CRS and the AIMS65 score in predicting the failure of endoscopic hemostasis (area under the curve, 0.77 [95% confidence interval, 0.64-0.90], 0.65 [0.56-0.74] and 0.75 [0.56-0.95], respectively). No failure of endoscopic hemostasis was noted in cases in which the patient scored less than GBS 10 and CRS 2. Conclusion The GBS was the most useful scoring system for the prediction of failure of endoscopic hemostasis in patients with bleeding gastroduodenal peptic ulcers. The GBS was also useful in identifying the patients who did not require surgery or interventional radiology.

  4. State of the art in advanced endoscopic imaging for the detection and evaluation of dysplasia and early cancer of the gastrointestinal tract

    Directory of Open Access Journals (Sweden)

    Coda S

    2014-05-01

    Full Text Available Sergio Coda,1,2 Andrew V Thillainayagam1,2 1Section of Gastroenterology and Hepatology, Department of Medicine and Photonics Group, Department of Physics, Imperial College London, London, UK; 2Endoscopy Unit, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK Abstract: Ideally, endoscopists should be able to detect, characterize, and confirm the nature of a lesion at the bedside, minimizing uncertainties and targeting biopsies and resections only where necessary. However, under conventional white-light inspection – at present, the sole established technique available to most of humanity – premalignant conditions and early cancers can frequently escape detection. In recent years, a range of innovative techniques have entered the endoscopic arena due to their ability to enhance the contrast of diseased tissue regions beyond what is inherently possible with standard white-light endoscopy equipment. The aim of this review is to provide an overview of the state-of-the-art advanced endoscopic imaging techniques available for clinical use that are impacting the way precancerous and neoplastic lesions of the gastrointestinal tract are currently detected and characterized at endoscopy. The basic instrumentation and the physics behind each method, followed by the most influential clinical experience, are described. High-definition endoscopy, with or without optical magnification, has contributed to higher detection rates compared with white-light endoscopy alone and has now replaced ordinary equipment in daily practice. Contrast-enhancement techniques, whether dye-based or computed, have been combined with white-light endoscopy to further improve its accuracy, but histology is still required to clarify the diagnosis. Optical microscopy techniques such as confocal laser endomicroscopy and endocytoscopy enable in vivo histology during endoscopy; however, although of invaluable assistance for tissue characterization, they have not

  5. Percutaneous endoscopic gastrostomy in children.

    Science.gov (United States)

    Park, Jye Hae; Rhie, Seonkyeong; Jeong, Su Jin

    2011-01-01

    Percutaneous endoscopic gastrostomy (PEG) can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6) months. Mean patient age was 9.4 (4.5) years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD). The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87%) had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  6. Training in Endoscopy: Endoscopic Ultrasound.

    Science.gov (United States)

    Cho, Chang Min

    2017-07-01

    Endoscopic ultrasound (EUS) has been recently established as an indispensable modality for the diagnosis and management of pancreatobiliary and gastrointestinal (GI) disorders. EUS proficiency requires both cognitive and technical abilities, including an understanding of the appropriate indications, the performance of appropriate evaluations before and after the procedure, and the management of procedure-related complications. An increasing demand for skills to handle a growing range of interventional EUS procedures and a continual shortage of EUS training programs are two major obstacles for EUS training. Acquiring the skills necessary to comprehend and conduct EUS often requires training beyond the scope of a standard GI fellowship program. In addition to traditional formal EUS training and preceptorships, regular short-term intensive EUS training programs that provide training at various levels may help EUS practitioners improve and maintain EUS-related knowledges and skills. Theoretical knowledge can be acquired from lectures, textbooks, atlases, slides, videotapes, digital video discs, interactive compact discs, and websites. Informal EUS training is generally based on 1- or 2-day intensive seminars, including didactic lectures, skills demonstrated by expert practitioners through live video-streaming of procedures, and hands-on learning using animal or phantom models.

  7. Side effects of endoscopic variceal ligation by using Indonesian Endoscopic Ligator versus Endoscopic Variceal Sclerotherapy.

    Science.gov (United States)

    Simadibrata, Marcellus; Syam, Ari F; Fauzi, Achmad; Abdullah, Murdani; Rani, Abdul A

    2011-01-01

    to investigate the side effects and survival of endoscopic variceal ligation by using Indonesian Endoscopic Ligator versus Endoscopic Variceal Sclerotherapy. we studied the medical records and endoscopy reports of patients who underwent endoscopic variceal ligation (EVL) or endoscopic sclerotherapy (EST) from January 2003 until December 2006. EST was done using ethoxysclerol injection; and ligation was done using a home-made Indonesian endoscopic ligating device. Patient characteristics, side effects of EVL and EST, as well as survival and length of stay were collected. Data of side effects was analyzed by chi-square test. there were no statistically significant differences of patients characteristics among both groups. The side effects in EVL group (29.2%) were less frequent than the EST group (60.9%) (p = 0.009). The death side effect in the EVL group (1.0%) was less frequent than in the EST group (21.7%) (pEVL and EST were 91.7% and 16.7%, respectively (pEVL had fewer side effects than EST in the treatment of esophageal varices bleeding. Death in the EVL group was lower than in the EST group.

  8. Helicobacter pylori-associated upper gastrointestinal disease in Saudi Arabia: a pathologic evaluation of 298 endoscopic biopsies from 201 consecutive patients.

    Science.gov (United States)

    Satti, M B; Twum-Danso, K; al-Freihi, H M; Ibrahim, E M; al-Gindan, Y; al-Quorain, A; al-Ghassab, G; al-Hamdan, A; al-Idrissi, H Y

    1990-05-01

    In a prospective study, histopathological examination 298 upper gastrointestinal (UGI) biopsies, obtained from 201 consecutive patients, was made. Patients were referred with mild to severe dyspeptic symptoms. The aim of the study was to compare the rate of identification of Helicobacter pylori (H. pylori) in the histologically normal gastric mucosa with that in histologically confirmed gastritis or peptic ulcer disease. The gastroduodenal mucosa was histologically normal in 35 patients (17.4%); among those patients, H. pylori was identified in only three (9%). Chronic gastritis was histologically confirmed in 162 patients (80.6%). H. pylori was identified in 123 (76%) of those patients. The difference was statistically significant (p less than 0.00001). Furthermore, when cases with a histological diagnosis of superficial chronic active gastritis (SCAG) are considered separately, the identification rate of H. pylori increases to 88% (121 of 137). When this rate is compared with that of 8% (two of 25), found in superficial chronic quiescent gastritis (SCQG), the difference is highly significant (p less than 0.00001). Of 38 endoscopically diagnosed peptic ulcers, H. pylori was identified in the gastric mucosa of 34 (89%). The organisms were always seen in the antral gastric mucosa, but never in duodenal mucosa. Identification of H. pylori correlates significantly with the histologic activity of chronic gastritis, in both peptic ulcer disease and non-ulcer dyspepsia.

  9. Evaluation of staff, patient and foetal radiation doses due to endoscopic retrograde cholangio-pancreatography (ERCP) procedures in a pregnant patient

    International Nuclear Information System (INIS)

    Huda, A.; Garzon, W.J.; Kramer, R.; Khoury, H.J.; Filho, G.C.L.; Vieira, B.; Xu, X.G.; Gao, Y.

    2016-01-01

    The use of endoscopic retrograde cholangio-pancreatography (ERCP) in pregnant patients is not rare. Most studies on the safety and efficacy of these procedures report short- and long-term pregnancy outcomes and but not foetal absorbed doses. This investigation reports on an ERCP procedure for a 40-y-old woman who was 32-34 weeks pregnant. Thermoluminescent dosemeters (TLD 100) were used to measure doses received by the patient and the staff. Additionally, Monte Carlo calculations were performed using a 3D computational phantom representing a 9-month pregnant patient to estimate the foetal absorbed dose. The results show that the spleen of the mother received the largest absorbed dose of 12.18 mGy since it was closer to the source than other internal organs. For the foetus and uterus, the lowest absorbed dose was found to be 0.01 mGy to the foetal brain, while the largest absorbed dose was estimated to be 0.13 mGy to the placenta. (authors)

  10. Awake nasotracheal fiber-optic intubation in a patient with severe ...

    African Journals Online (AJOL)

    using a flexible fiber-optic choledochoscope (1) The technique is indicated in patients with difficult airways in whom losing the airway following induction of anes- thesia is deemed dangerous or fatal. Successful awake fiber-optic intubation requires con-. Introduction. Trauma to the face presents considerable challenges to.

  11. Water-equivalent one-dimensional scintillating fiber-optic dosimeter for measuring therapeutic photon beam

    International Nuclear Information System (INIS)

    Moon, Jinsoo; Won Jang, Kyoung; Jae Yoo, Wook; Han, Ki-Tek; Park, Jang-Yeon; Lee, Bongsoo

    2012-01-01

    In this study, we fabricated a one-dimensional scintillating fiber-optic dosimeter, which consists of 9 scintillating fiber-optic dosimeters, septa, and PMMA blocks for measuring surface and percentage depth doses of a therapeutic photon beam. Each dosimeter embedded in the 1-D scintillating fiber-optic dosimeter is composed of square type organic scintillators and plastic optical fibers. Also black PVC films are used as septa to minimize cross-talk between the scintillating fiber-optic dosimeters. To construct a dosimeter system, a 1-D scintillating fiber-optic dosimeter and a CMOS image sensor were combined with 20 m-length plastic optical fibers. Using the dosimeter system, we measured surface and percentage depth doses of 6 and 15 MV photon beams and compared the results with those of EBT films and an ionization chamber. - Highlights: ► Fabrication of a one-dimensional scintillating fiber-optic dosimeter. ► The one-dimensional scintillating fiber-optic dosimeter has 9 scintillating fiber-optic dosimeters. ► Measurements of surface and percentage depth doses of a therapeutic photon beam. ► The results were compared with those of EBT films and an ionization chamber.

  12. Feasibility of Ultra-Thin Fiber-Optic Dosimeters for Radiotherapy Dosimetry.

    Science.gov (United States)

    Lee, Bongsoo; Kwon, Guwon; Shin, Sang Hun; Kim, Jaeseok; Yoo, Wook Jae; Ji, Young Hoon; Jang, Kyoung Won

    2015-11-17

    In this study, prototype ultra-thin fiber-optic dosimeters were fabricated using organic scintillators, wavelength shifting fibers, and plastic optical fibers. The sensor probes of the ultra-thin fiber-optic dosimeters consisted of very thin organic scintillators with thicknesses of 100, 150 and 200 μm. These types of sensors cannot only be used to measure skin or surface doses but also provide depth dose measurements with high spatial resolution. With the ultra-thin fiber-optic dosimeters, surface doses for gamma rays generated from a Co-60 therapy machine were measured. Additionally, percentage depth doses in the build-up regions were obtained by using the ultra-thin fiber-optic dosimeters, and the results were compared with those of external beam therapy films and a conventional fiber-optic dosimeter.

  13. CATV Fiberoptic Cable Markets In The U.S.

    Science.gov (United States)

    Kessler, John N.

    1984-03-01

    "Bandwidth on a metropolitan CATV cable plant is a resource that may be compared today with the crude oil beneath the Arabian desert at the turn of the century. It will provide a radically new two-way communications medium for homes and businesses, and it will change not only the way we communicate but possibly even the way we live." This prediction was made last year by William Zachman, vice president of research for International Data Corp. If Zachman is right, and our research tends to indicate he is, then fiberoptics will become the transmission medium that will facilitate two-way broadband communication. However, many of the multiple system CATV operators in the U.S. as well as many of the manufacturers of fiberoptic waveguide and cable believe that interactive video systems are not really very important. They are wrong. Broadband fiberoptic systems have just begun to impact the U.S. communications market. And within 5 years, tremendous changes will occur not only with regard to growth, but with regard to the supplier industry structure. Interactive, switched, video systems in the U.S. go back to the early 1960s, and the experiments at Bell Laboratories with what was then called Picturephone. This was com-pressed video transmission via telephone lines from one subscriber to another. Field trials were conducted in several U.S. cities for a period of years. But the commercial response to Picturephone at that time was so lacking that AT&T discontinued the trials and the work. But that is changing. Part of the reason for the change is due to the changing communication needs of the U.S. and of the world: the increase in the amount of information used by large numbers of people, the concurrent rise in the use of computers, the digitization of communications media, the rise in the level of experience with electronic communications, and perhaps most importantly the convergence of audio, data, image and video communications. There are technological reasons for the slow

  14. Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

    Directory of Open Access Journals (Sweden)

    Jan Plzák

    Full Text Available OBJECTIVES: Access to the pterygopalatine fossa is very difficult due to its complex anatomy. Therefore, an open approach is traditionally used, but morbidity is unavoidable. To overcome this problem, an endoscopic endonasal approach was developed as a minimally invasive procedure. The surgical aim of the present study was to evaluate the utility of the endoscopic endonasal approach for the management of both benign and malignant tumors of the pterygopalatine fossa. METHOD: We report our experience with the endoscopic endonasal approach for the management of both benign and malignant tumors and summarize recent recommendations. A total of 13 patients underwent surgery via the endoscopic endonasal approach for pterygopalatine fossa masses from 2014 to 2016. This case group consisted of 12 benign tumors (10 juvenile nasopharyngeal angiofibromas and two schwannomas and one malignant tumor. RESULTS: No recurrent tumor developed during the follow-up period. One residual tumor (juvenile nasopharyngeal angiofibroma that remained in the cavernous sinus was stable. There were no significant complications. Typical sequelae included hypesthesia of the maxillary nerve, trismus, and dry eye syndrome. CONCLUSION: The low frequency of complications together with the high efficacy of resection support the use of the endoscopic endonasal approach as a feasible, safe, and beneficial technique for the management of masses in the pterygopalatine fossa.

  15. Intraoperatory endoscopic papillectomy during cholecystectomy in the cholecystocholedocolithiasis treatment

    International Nuclear Information System (INIS)

    Arbelaez M, Victor; Pineda O, Luis F; Gonzalez, Raul and others

    2002-01-01

    Patients with symptomatic cholelithiasis and suspected choledocolithiasis are a frequent clinical problem and there are different strategies for their treatment. This study evaluated the efficacy of a single cholecystocholedocolithiasis treatment by endoscopic papillotamy during cholecystectomy. Thirty-four patients 30 female and 4 male; average age 40.1 years, range 14 to 78) underwent cholecystectomy and endoscopic papillotomy Intra-operative transcystic cholangiography (IOC) confirmed choledocholithiasis or obstruction of the passage of the contrast medium to the duodenum. Through a hydrophilic guide passed through the cystic, a papillotomy was inserted endoscopically and papillotomy and removal if calculi with canastilla were carried out, as well as transcystic irrigation. choledocholithiasis was found in 32 patients (94%) and obstruction of the passage of the contrast medium in 2 (6%). Papillectomy was possible in all the cases and calculi were successfully removed in 28 patients (87.5%). Three patients required additional endoscopic procedures for the extraction if the calculi. One patient underwent open surgery Two patients had complications relating to the papillotomy 5.8%) with no mortality/morbidity. The average stay in hospital was 2.8 day and follow-up at 38 day. The combined endoscopic and surgical technique is useful in the treatment of patients with choledocholithasis

  16. Endoscopic Management of a Primary Duodenal Carcinoid Tumor

    Directory of Open Access Journals (Sweden)

    Albin Abraham

    2012-03-01

    Full Text Available Carcinoids are rare, slow-growing tumors originating from a variety of different neuroendocrine cell types. They are identified histologically by their affinity for silver salts and by positive reactions to neuroendocrine markers such as neuron-specific enolase, synaptophysin and chromogranin. They can present with various clinical symptoms and are difficult to diagnose. We present the case of a 43-year-old woman who was referred for evaluation of anemia. Upper endoscopy showed a duodenal bulb mass around 1 cm in size. Histopathological and immunohistochemistry staining were consistent with the diagnosis of a carcinoid tumor. Further imaging and endoscopic studies showed no other synchronous carcinoid lesions. Endoscopic ultrasound (EUS revealed a 1 cm lesion confined to the mucosa and no local lymphadenopathy. Successful endoscopic mucosal resection of the mass was performed. Follow-up surveillance 6 months later with EUS and Octreoscan revealed no new lesions suggestive of recurrence. No consensus guidelines exist for the endoscopic management of duodenal carcinoid tumors. However, endoscopic resection is safe and preferred for tumors measuring 1 cm or less with no evidence of invasion of the muscularis layer.

  17. Gastric schwannomas: radiological features with endoscopic and pathological correlation

    Energy Technology Data Exchange (ETDEWEB)

    Hong, H.S. [Department of Radiology, Severance Hospital, Yonsei University College of Medicine, Seodaemoon-gu, Seoul (Korea, Republic of); Ha, H.K. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)], E-mail: hkha@amc.seoul.kr; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G. [Department of Radiology, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Lee, G.H. [Internal Medicine, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of); Kim, M.J. [Pathology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, Seoul (Korea, Republic of)

    2008-05-15

    Aim: To describe the radiological, endoscopic, and pathological findings of gastric schwannomas in 16 patients. Materials and methods: The radiological, endoscopic, and pathological findings of 16 surgically proven cases of gastric schwannoma were retrospectively reviewed. All patients underwent computed tomography (CT) and four patients were evaluated with upper gastrointestinal series. Two radiologists reviewed the CT and upper gastrointestinal series images by consensus with regard to tumour size, contour, margin, and growth pattern, the presence or absence of ulcer, cystic change, and the CT enhancement pattern. Endoscopy was performed in eight of these 16 patients. Six patients underwent endoscopic ultrasonography. Pathological specimens were obtained from and reviewed in all 16 patients. Immunohistochemistry was performed for c-kit, CD34, smooth muscle actin, and S-100 protein. Results: On radiographic examination, gastric schwannomas appeared as submucosal tumours with the CT features of well-demarcated, homogeneous, and uncommonly ulcerated masses. Endoscopy with endoscopic ultrasonography demonstrated homogeneous, submucosal masses contiguous with the muscularis propria in all six examined cases. On pathological examination, gastric schwannomas appeared as well-circumscribed and homogeneous tumours in the muscularis propria and consisted microscopically of interlacing bundles of spindle cells. Strong positivity for S-100 protein was demonstrated in all 16 cases on immunohistochemistry. Conclusion: Gastric schwannomas appear as submucosal tumours of the stomach and have well-demarcated and homogeneous features on CT, endoscopic ultrasonography, and gross pathology. Immunohistochemistry consistently reveals positivity for S-100 protein in the tumours.

  18. Antibiotic prophylaxis for patients undergoing elective endoscopic ...

    African Journals Online (AJOL)

    Antibiotic prophylaxis for patients undergoing elective endoscopic retrograde cholangiopancreatography. M Brand, D Bisoz. Abstract. Background. Antibiotic prophylaxis for endoscopic retrograde cholangiopancreatography (ERCP) is controversial. We set out to assess the current antibiotic prescribing practice among ...

  19. Endoscopic retrograde cholangiopancreatography and stent placement via gastrostomy: technical aspects and clinical application.

    Science.gov (United States)

    Holderman, W H; Etzkorn, K P; Harig, J M; Watkins, J L

    1995-01-01

    Significant advances in the field of enteral nutrition (1), combined with technical advances in percutaneous access, have increased the indications for, and safety of, enteral alimentation (2). A mature gastrostomy stoma not only provides access to the gastrointestinal lumen for nutrition, but in selected cases, provides access for the diagnostic and therapeutic endoscopist. In 1971, Wiendl first reported diagnostic fiberoptic stomal endoscopy (3). This has since been followed by reports of diagnostic endoscopic retrograde cholangiopancreatography (ERCP) (4), and more recently, the first case of therapeutic ERCP by Gray et al. (5). We report here on the second case of therapeutic ERCP in a patient with metastatic squamous-cell carcinoma of the head and neck, with liver metastasis. We discuss the technical aspects, indications, and future of therapeutic stomal endoscopy.

  20. Endoscopic Transaxillary Near Total Thyroidectomy

    Science.gov (United States)

    Ejeh, Ijeoma Acholonu; Speights, Fredne; Rashid, Qammar N.; Ideis, Mustafa

    2006-01-01

    Background: Since first reported in 1996, endoscopic minimally invasive surgery of the cervical region has been shown to be safe and effective in the treatment of benign thyroid and parathyroid disease. The endoscopic transaxillary technique uses a remote lateral approach to the thyroid gland. Because of the perceived difficulty in accessing the contralateral anatomy of the thyroid gland, this technique has typically been reserved for patients with unilateral disease. Objectives: The present study examines the safety and feasibility of the transaxillary technique in dissecting and assessment of both thyroid lobes in performing near total thyroidectomy. Methods: Prior to this study we successfully performed endoscopic transaxillary thyroid lobectomy in 32 patients between August 2003 and August 2005. Technical feasibility in performing total thyroidectomy using this approach was accomplished first utilizing a porcine model followed by three human cadaver models prior to proceeding to human surgery. After IRB approval three female patients with histories of enlarging multinodular goiter were selected to undergo endoscopic near total thyroidectomy. Results: The average operative time for all models was 142 minutes (range 57–327 min). The three patients in this study had clinically enlarging multinodular goiters with an average size of 4 cm. The contralateral recurrent laryngeal nerve and parathyroid glands were identified in all cases. There was no post-operative bleeding, hoarseness or subcutaneous emphysema. Conclusion: Endoscopic transaxillary near total thyroidectomy is feasible and can be performed safely in human patients with bilateral thyroid disease. PMID:16882421

  1. [Endoscopic full-thickness resection].

    Science.gov (United States)

    Meier, B; Schmidt, A; Caca, K

    2016-08-01

    Conventional endoscopic resection techniques such as endoscopic mucosal resection (EMR) or endoscopic submucosal dissection (ESD) are powerful tools for the treatment of gastrointestinal (GI) neoplasms. However, those techniques are limited to the superficial layers of the GI wall (mucosa and submucosa). Lesions without lifting sign (usually arising from deeper layers) or lesions in difficult anatomic positions (appendix, diverticulum) are difficult - if not impossible - to resect using conventional techniques, due to the increased risk of complications. For larger lesions (>2 cm), ESD appears to be superior to the conventional techniques because of the en bloc resection, but the procedure is technically challenging, time consuming, and associated with complications even in experienced hands. Since the development of the over-the-scope clips (OTSC), complications like bleeding or perforation can be endoscopically better managed. In recent years, different endoscopic full-thickness resection techniques came to the focus of interventional endoscopy. Since September 2014, the full-thickness resection device (FTRD) has the CE marking in Europe for full-thickness resection in the lower GI tract. Technically the device is based on the OTSC system and combines OTSC application and snare polypectomy in one step. This study shows all full-thickness resection techniques currently available, but clearly focuses on the experience with the FTRD in the lower GI tract.

  2. Endoscopic corpus callosotomy and hemispherotomy.

    Science.gov (United States)

    Sood, Sandeep; Marupudi, Neena I; Asano, Eishi; Haridas, Abilash; Ham, Steven D

    2015-12-01

    Corpus callosotomy and hemispherotomy are conventionally performed via a large craniotomy with the aid of a microscope for children with intractable epilepsy. Primary technical considerations include completeness of disconnection and blood loss. The authors describe an endoscopic technique performed through a microcraniotomy for these procedures. Four patients with drop attacks and 2 with intractable seizures related to a neonatal stroke underwent endoscopic complete corpus callosotomy and hemispherotomy, respectively. The surgeries were performed through a 2- to 3-cm precoronal microcraniotomy. Interhemispheric dissection to the corpus callosum was done using the standard technique. Subsequently, the bimanual technique with a suction device mounted on an endoscope was used to perform a complete corpus callosotomy, including interforniceal and anterior commissure disconnection. In patients who had hemispherotomy, the fornix was resected posteriorly and lateral disconnection was done by unroofing the temporal horn. Anteriorly, endoscopic corticectomy was done along the ipsilateral anterior cerebral artery to reach the bifurcation of the internal carotid artery to complete the anterior disconnection. Postoperative MRI and diffusion tensor imaging (DTI) of the brain were performed to confirm complete disconnection. The procedure was accomplished successfully in all patients, with excellent visualization secured. None of the patients required a blood transfusion. Postoperative MRI and DTI confirmed completeness of the disconnection. Patients who underwent corpus callosotomy had complete resolution of drop attacks at a mean follow-up of 6 months, and patients who underwent hemispherotomy became seizure free. Endoscopic corpus callosotomy and hemispherotomy are surgically feasible procedures associated with minimal blood loss, minimal risk, and excellent visualization.

  3. Fiber-Optic Monitoring System of Particle Counters

    Directory of Open Access Journals (Sweden)

    A. A. Titov

    2016-01-01

    Full Text Available The article considers development of a fiber-optic system to monitor the counters of particles. Presently, optical counters of particles, which are often arranged at considerable distance from each other, are used to study the saltation phenomenon. For monitoring the counters, can be used electric communication lines.However, it complicates and raises the price of system Therefore, we offered a fiber-optic system and the counter of particles, free from these shortcomings. The difference between the offered counter of particles and the known one is that the input of radiation to the counter and the output of radiation scattering on particles are made by the optical fibers, and direct radiation is entered the optical fiber rather than is delayed by a light trap and can be used for lighting the other counters thereby allowing to use their connection in series.The work involved a choice of the quartz multimode optical fiber for communication, defining the optical fiber and lenses parameters of the counter of particles, and a selection of the radiation source and the photo-detector.Using the theory of light diffraction on a particle, a measuring range of the particle sizes has been determined. The system speed has been estimated, and it has been shown that a range of communication can reach 200km.It should be noted that modulation noise of counters of particles connected in series have the impact on the useful signal. To assess the extent of this influence we have developed a calculation procedure to illustrate that with ten counters connected in series this influence on the signal-to-noise ratio will be insignificant.Thus, it has been shown that the offered fiber-optic system can be used for monitoring the counters of particles across the desertified territories. 

  4. A retrospective matched cohort study evaluating the effects of percutaneous endoscopic gastrostomy feeding tubes on nutritional status and survival in patients with advanced gastroesophageal malignancies undergoing systemic anti-cancer therapy.

    Science.gov (United States)

    Mitchell, Scott; Williams, John P; Bhatti, Harsimrandeep; Kachaamy, Toufic; Weber, Jeffrey; Weiss, Glen J

    2017-01-01

    Many patients with cancer or other systemic illnesses can experience malnutrition. One way to mitigate malnutrition is by insertion of a percutaneous endoscopic gastrostomy feeding tube (PEG tube). The goal of this retrospective matched cohort study is to evaluate if PEG tube placement improved nutritional status and overall survival (OS) in advanced gastroesophageal (GE) cancer patients who are undergoing anti-neoplastic therapy. GE cancer patients who were treated and evaluated by a nutritionist and had at least 2 nutritionist follow-up visits were identified. Patients with PEG tube were matched to patients that did not undergo PEG placement (non-PEG). Clinical characteristics, GE symptoms reported at nutrition follow-up visits, and OS were recorded. 20 PEG and 18 non-PEG cases met criteria for further analyses. After correction for multiple testing, there were no OS differences between PEG and non-PEG, treatment naive and previously treated. However, PEG esophageal carcinoma has statistically significant inferior OS compared with non-PEG esophageal carcinoma. PEG placement did not significantly reduce the proportion of patients with weight loss between the initial nutrition assessment and 12-week follow-up. In this small study, PEG placement had inferior OS outcome for GE esophageal carcinoma, no improvement in OS for other evaluated groups, and did not reduce weight loss between baseline and 12-week follow-up. Unless there is prospective randomized trial that can show superiority of PEG placement in this population, PEG placement in this group cannot be endorsed.

  5. Development of plasma bolometers using fiber-optic temperature sensors

    Energy Technology Data Exchange (ETDEWEB)

    Reinke, M. L., E-mail: reinkeml@ornl.gov [Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831 (United States); Han, M.; Liu, G. [University of Nebraska-Lincoln, Lincoln, Nebraska 68588 (United States); Eden, G. G. van [Dutch Institute for Fundamental Energy Research, De Zaale 20, 5612 AJ Eindhoven (Netherlands); Evenblij, R.; Haverdings, M. [Technobis, Pyrietstraat 2, 1812 SC Alkmaar (Netherlands); Stratton, B. C. [Princeton Plasma Physics Laboratory, P.O. Box 451, Princeton, New Jersey 08543 (United States)

    2016-11-15

    Measurements of radiated power in magnetically confined plasmas are important for exhaust studies in present experiments and expected to be a critical diagnostic for future fusion reactors. Resistive bolometer sensors have long been utilized in tokamaks and helical devices but suffer from electromagnetic interference (EMI). Results are shown from initial testing of a new bolometer concept based on fiber-optic temperature sensor technology. A small, 80 μm diameter, 200 μm long silicon pillar attached to the end of a single mode fiber-optic cable acts as a Fabry–Pérot cavity when broadband light, λ{sub o} ∼ 1550 nm, is transmitted along the fiber. Changes in temperature alter the optical path length of the cavity primarily through the thermo-optic effect, resulting in a shift of fringes reflected from the pillar detected using an I-MON 512 OEM spectrometer. While initially designed for use in liquids, this sensor has ideal properties for use as a plasma bolometer: a time constant, in air, of ∼150 ms, strong absorption in the spectral range of plasma emission, immunity to local EMI, and the ability to measure changes in temperature remotely. Its compact design offers unique opportunities for integration into the vacuum environment in places unsuitable for a resistive bolometer. Using a variable focus 5 mW, 405 nm, modulating laser, the signal to noise ratio versus power density of various bolometer technologies are directly compared, estimating the noise equivalent power density (NEPD). Present tests show the fiber-optic bolometer to have NEPD of 5-10 W/m{sup 2} when compared to those of the resistive bolometer which can achieve <0.5 W/m{sup 2} in the laboratory, but this can degrade to 1-2 W/m{sup 2} or worse when installed on a tokamak. Concepts are discussed to improve the signal to noise ratio of this new fiber-optic bolometer by reducing the pillar height and adding thin metallic coatings, along with improving the spectral resolution of the interrogator.

  6. Fiber-Optic Gratings for Lidar Measurements of Water Vapor

    Science.gov (United States)

    Vann, Leila B.; DeYoung, Russell J.

    2006-01-01

    Narrow-band filters in the form of phase-shifted Fabry-Perot Bragg gratings incorporated into optical fibers are being developed for differential-absorption lidar (DIAL) instruments used to measure concentrations of atmospheric water vapor. The basic idea is to measure the relative amounts of pulsed laser light scattered from the atmosphere at two nearly equal wavelengths, one of which coincides with an absorption spectral peak of water molecules and the other corresponding to no water vapor absorption. As part of the DIAL measurement process, the scattered light is made to pass through a filter on the way to a photodetector. Omitting other details of DIAL for the sake of brevity, what is required of the filter is to provide a stop band that: Surrounds the water-vapor spectral absorption peaks at a wavelength of 946 nm, Has a spectral width of at least a couple of nanometers, Contains a pass band preferably no wider than necessary to accommodate the 946.0003-nm-wavelength water vapor absorption peak [which has 8.47 pm full width at half maximum (FWHM)], and Contains another pass band at the slightly shorter wavelength of 945.9 nm, where there is scattering of light from aerosol particles but no absorption by water molecules. Whereas filters used heretofore in DIAL have had bandwidths of =300 pm, recent progress in the art of fiber-optic Bragg-grating filters has made it feasible to reduce bandwidths to less than or equal to 20 pm and thereby to reduce background noise. Another benefit of substituting fiber-optic Bragg-grating filters for those now in use would be significant reductions in the weights of DIAL instruments. Yet another advantage of fiber-optic Bragg-grating filters is that their transmission spectra can be shifted to longer wavelengths by heating or stretching: hence, it is envisioned that future DIAL instruments would contain devices for fine adjustment of transmission wavelengths through stretching or heating of fiber-optic Bragg-grating filters

  7. Endoscopic Treatment for Early Gastric Cancer

    OpenAIRE

    Kim, Sang Gyun

    2011-01-01

    Endoscopic resection has been accepted as a curative modality for early gastric cancer (EGC). Since conventional endoscopic mucosal resection (EMR) has been introduced, many improvements in endoscopic accessories and techniques have been achieved. Recently, endoscopic submucosal dissection (ESD) using various electrosurgical knives has been performed for complete resection of EGC and enables complete resection of EGC, which is difficult to completely resect in the era of conventional EMR. Cur...

  8. Endoscopic Treatment of Recurrent Acute Pancreatitis and Smoldering Acute Pancreatitis.

    Science.gov (United States)

    Das, Rohit; Yadav, Dhiraj; Papachristou, Georgios I

    2015-10-01

    Recurrent acute pancreatitis (RAP) is a challenging condition that can lead to chronic pancreatitis and long-term morbidity. Etiology-based treatment can potentially have an impact on the natural history of RAP and its progression to chronic pancreatitis. In cases of divisum-associated RAP and idiopathic RAP, several studies have been performed to evaluate the efficacy of endoscopic therapy in alleviation of symptoms and frequency of AP events. This review discusses the literature available on these topic as well as touching on the role of endoscopic therapy in smoldering acute pancreatitis. Published by Elsevier Inc.

  9. Endoscopic gastrostomy for enteral nutrition in neurogenic dysphagia: Application of a nasogastric tube or percutaneous endoscopic gastrostomy.

    Science.gov (United States)

    Maitines, Gennaro; Ugenti, Ippazio; Memeo, Riccardo; Clemente, Nicola; Iambrenghi, Onofrio Caputi

    2009-01-01

    Enteral nutrition can be administered via a nasogastric tube or, in selected patients, via a percutaneous endoscopic gastrostomy. In patients with neurogenic dysphagia, the choice of nutritional administration, and above all the timing, are crucial. Our aim was to retrospectively assess the impact of new guidelines for percutaneous endoscopic gastrostomy insertion adopted since January 2002 and compare them with our previous experience. From January 1992 to June 2007, 285 gastrostomies (168 M, 117 F) were positioned in our institute. We analysed 232 patients (139 M, 93 F) in whom a percutaneous endoscopic gastrostomy was applied for neurogenic dysphagia: Group A (from January 1992 to December 2001) consisting of 174 patients; Group B (from January 2002 to June 2007) consisting of 58 patients. The percutaneous endoscopic gastrostomy was positioned in all the cases with neurogenic dysphagia after a period of not less than 3 weeks of nutrition by nasogastric tube. A total of 6 major complications (2.3 %) occurred, almost all in group A. The mortality rate (3 patients, 2%) correlated with the complications in group A. In cases of neurogenic dysphagia we believe that greater methodological rigour in the multidisciplinary decision-making process, and a period of about 6-8 weeks' nutrition by nasogastric tube after the acute neurological damage may be useful to ensure a better prognostic evaluation of the patient and hence of the indications for percutaneous endoscopic gastrostomy.

  10. Overview of Photogrammetric Measurement Techniques in Minimally Invasive Surgery Using Endoscopes

    Science.gov (United States)

    Conen, N.; Luhmann, T.

    2017-05-01

    This contribution provides an overview of various photogrammetric measurement techniques in minimally invasive surgery and presents a self-developed prototypical trinocular endoscope for reliable surface measurements. Most of the presented techniques focus on applications regarding laparoscopy, which mean endoscopic operations in the abdominal or pelvic cavities. Since endoscopic operations are very demanding to the surgeon, various assistant systems have been developed. Imaging systems may use photogrammetric techniques in order to perform 3D measurements during operation. The intra-operatively acquired 3D data may be used for analysis, model registration, guidance or documentation. Passive and active techniques have been miniaturised, integrated into endoscopes and investigated by several research groups. The main advantages and disadvantages of several active and passive techniques adapted to laparoscopy are described in this contribution. Additionally, a self-developed trinocular endoscope is described and evaluated.

  11. Endoscopic Palliation for Pancreatic Cancer

    Directory of Open Access Journals (Sweden)

    Mihir Bakhru

    2011-04-01

    Full Text Available Pancreatic cancer is devastating due to its poor prognosis. Patients require a multidisciplinary approach to guide available options, mostly palliative because of advanced disease at presentation. Palliation including relief of biliary obstruction, gastric outlet obstruction, and cancer-related pain has become the focus in patients whose cancer is determined to be unresectable. Endoscopic stenting for biliary obstruction is an option for drainage to avoid the complications including jaundice, pruritus, infection, liver dysfunction and eventually failure. Enteral stents can relieve gastric obstruction and allow patients to resume oral intake. Pain is difficult to treat in cancer patients and endoscopic procedures such as pancreatic stenting and celiac plexus neurolysis can provide relief. The objective of endoscopic palliation is to primarily address symptoms as well improve quality of life.

  12. Accuracy of endoscopic ultrasonography for diagnosing ulcerative early gastric cancers

    Science.gov (United States)

    Park, Jin-Seok; Kim, Hyungkil; Bang, Byongwook; Kwon, Kyesook; Shin, Youngwoon

    2016-01-01

    Abstract Although endoscopic ultrasonography (EUS) is the first-choice imaging modality for predicting the invasion depth of early gastric cancer (EGC), the prediction accuracy of EUS is significantly decreased when EGC is combined with ulceration. The aim of present study was to compare the accuracy of EUS and conventional endoscopy (CE) for determining the depth of EGC. In addition, the various clinic-pathologic factors affecting the diagnostic accuracy of EUS, with a particular focus on endoscopic ulcer shapes, were evaluated. We retrospectively reviewed data from 236 consecutive patients with ulcerative EGC. All patients underwent EUS for estimating tumor invasion depth, followed by either curative surgery or endoscopic treatment. The diagnostic accuracy of EUS and CE was evaluated by comparing the final histologic result of resected specimen. The correlation between accuracy of EUS and characteristics of EGC (tumor size, histology, location in stomach, tumor invasion depth, and endoscopic ulcer shapes) was analyzed. Endoscopic ulcer shapes were classified into 3 groups: definite ulcer, superficial ulcer, and ill-defined ulcer. The overall accuracy of EUS and CE for predicting the invasion depth in ulcerative EGC was 68.6% and 55.5%, respectively. Of the 236 patients, 36 patients were classified as definite ulcers, 98 were superficial ulcers, and 102 were ill-defined ulcers, In univariate analysis, EUS accuracy was associated with invasion depth (P = 0.023), tumor size (P = 0.034), and endoscopic ulcer shapes (P = 0.001). In multivariate analysis, there is a significant association between superficial ulcer in CE and EUS accuracy (odds ratio: 2.977; 95% confidence interval: 1.255–7.064; P = 0.013). The accuracy of EUS for determining tumor invasion depth in ulcerative EGC was superior to that of CE. In addition, ulcer shape was an important factor that affected EUS accuracy. PMID:27472672

  13. Deferred endoscopic urethral realignment: Role in management of ...

    African Journals Online (AJOL)

    M.A. Elgammal

    Abstract. Objectives: The aim of our study is to assess the value of deferred endoscopic urethral realignment after traumatic posterior urethral disruption. Patients and methods: Between June 2001 and August 2011, we evaluated 28 patients who presented 3–6 weeks (mean 27 ± 6 days) after experiencing traumatic ...

  14. Sonographic and Endoscopic Findings in Cocaine-Induced Ischemic Colitis

    DEFF Research Database (Denmark)

    Leth, Thomas; Wilkens, Rune; Bonderup, Ole Kristian

    2015-01-01

    Cocaine-induced ischemic colitis is a recognized entity. The diagnosis is based on clinical and endoscopic findings. However, diagnostic imaging is helpful in the evaluation of abdominal symptoms and prior studies have suggested specific sonographic findings in ischemic colitis. We report...

  15. Endoscopic variceal band ligation: a local experience | Jani | East ...

    African Journals Online (AJOL)

    Objective: To evaluate the results of endoscopic variceal band ligation (EVBL) in the local set-up. Design: Retrospective analysis of data of all patients who had EVBL. Setting: Patients having EVBL at the office endoscopy suite. The Nairobi Hospital, the Aga Khan Hospital and M.P Shah Hospital. Methods: The varices were ...

  16. Endoscopic retrograde cholangiopancreatography causes reduced myocardial blood flow

    DEFF Research Database (Denmark)

    Christensen, M; Hendel, H W; Rasmussen, V

    2002-01-01

    BACKGROUND AND STUDY AIMS: Previous studies have shown that up to 50% of healthy patients may develop ST-segment changes during upper gastrointestinal endoscopy. The aim of the study was to evaluate myocardial blood flow in patients during endoscopic retrograde cholangiopancreatography (ERCP...

  17. Cytologic features of solid pseudopapillary neoplasms of the pancreas: a single institutional experience based on evaluation of diagnostic utility of endoscopic ultrasound-guided fine needle aspiration (EUS-FNA).

    Science.gov (United States)

    Gilani, S M; Tashjian, R; Barawi, M; Al-Khafaji, B

    2014-06-01

    Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) is an important modality for diagnosing solid and cystic pancreatic lesions. The objectives of this retrospective study are to review the cytologic criteria used to diagnose pancreatic solid pseudopapillary neoplasms (SPNs) and to evaluate the utility of EUS-FNA by correlating cytologic and histologic samples. Of the 924 pancreatic FNAs performed at our institution from January 2002 through February 2013, four histologically confirmed cases of SPN were identified; three had an initial cytologic diagnosis of SPN. All four cases lacked on-site evaluation. Cytologic smears were assessed by two reviewers for the presence of a cellular aspirate, fibrovascular stalks lined by neoplastic cells with pale to finely granular cytoplasm, and monotonous, oval nuclei containing delicate chromatin, inconspicuous nucleoli, and grooves and inclusions. Three cases were diagnosed as SPN on cytologic examination and confirmed histologically. The remaining case was deemed a pancreatic endocrine neoplasm on cytology, but SPN on final histology. The most consistent cytologic feature we encountered was the presence of a cellular aspirate containing fibrovascular stalks lined by monotonous neoplastic cells with oval nuclei and nuclear grooves. We conclude that EUS-FNA is an effective diagnostic tool in the diagnosis of pancreatic SPNs.

  18. Balancing the shortcomings of microscope and endoscope: endoscope-assisted technique in microsurgical removal of recurrent epidermoid cysts in the posterior fossa.

    Science.gov (United States)

    Ebner, F H; Roser, F; Thaher, F; Schittenhelm, J; Tatagiba, M

    2010-10-01

    We report about endoscope-assisted surgery of epidermoid cysts in the posterior fossa focusing on the application of neuro-endoscopy and the clinical outcome in cases of recurrent epidermoid cysts. 25 consecutively operated patients with an epidermoid cyst in the posterior fossa were retrospectively analysed. Surgeries were performed both with an operating microscope (OPMI Pentero or NC 4, Zeiss Company, Oberkochen, Germany) and endoscopic equipment (4 mm rigid endoscopes with 30° and 70° optics; Karl Storz Company, Tuttlingen, Germany) under continuous intraoperative monitoring. Surgical reports and DVD-recordings were evaluated for identification of adhesion areas and surgical details. 7 (28%) of the 25 patients were recurrences of previously operated epidermoid cysts. Mean time to recurrence was 17 years (8-22 years). In 5 cases the endoscope was used as an adjunctive tool for inspection/endoscope-assisted removal of remnants. The effective time of use of the endoscope was limited to the end stage of the procedure, but was very effective. In a modern operative setting and with the necessary surgical experience recurrent epidermoid cysts may be removed with excellent clinical results. The combined use of microscope and endoscope offers relevant advantages in demanding anatomic situations. © Georg Thieme Verlag KG Stuttgart · New York.

  19. Fiber-optic control of the ZT-P experiment

    International Nuclear Information System (INIS)

    Caudill, L.D.; Chandler, G.I.; Hall, C.R.; Trujillo, J.F.

    1986-01-01

    The computer control system for the ZT-P experiment has been implemented using a fiber-optic link in all 161 control signal paths. Four classes of control signals are used in this design. These are: (a) digital-out, an on-off signal from computer to machine actuator, (b) digital-in, an on-off signal from machine sensor to computer, (c) analog-out, a 0 to 10 volt analog signal from computer to machine actuator, (d) analog-in, a 0 to +1 milliampere analog signal from machine sensor to computer. The digital-in and the digital-out class of signals require no control power at the machine. The analog-out and the analog-in class of signals use available machine power for control. This unique power arrangement and the use of fiber-optic links totally isolate the electrically noisy machine areas from the sensitive electronics in the computer control. Advantages of this system including low cost, small size, personnel safety, and ease of maintenance and modification are discussed

  20. Computational imaging through a fiber-optic bundle

    Science.gov (United States)

    Lodhi, Muhammad A.; Dumas, John Paul; Pierce, Mark C.; Bajwa, Waheed U.

    2017-05-01

    Compressive sensing (CS) has proven to be a viable method for reconstructing high-resolution signals using low-resolution measurements. Integrating CS principles into an optical system allows for higher-resolution imaging using lower-resolution sensor arrays. In contrast to prior works on CS-based imaging, our focus in this paper is on imaging through fiber-optic bundles, in which manufacturing constraints limit individual fiber spacing to around 2 μm. This limitation essentially renders fiber-optic bundles as low-resolution sensors with relatively few resolvable points per unit area. These fiber bundles are often used in minimally invasive medical instruments for viewing tissue at macro and microscopic levels. While the compact nature and flexibility of fiber bundles allow for excellent tissue access in-vivo, imaging through fiber bundles does not provide the fine details of tissue features that is demanded in some medical situations. Our hypothesis is that adapting existing CS principles to fiber bundle-based optical systems will overcome the resolution limitation inherent in fiber-bundle imaging. In a previous paper we examined the practical challenges involved in implementing a highly parallel version of the single-pixel camera while focusing on synthetic objects. This paper extends the same architecture for fiber-bundle imaging under incoherent illumination and addresses some practical issues associated with imaging physical objects. Additionally, we model the optical non-idealities in the system to get lower modelling errors.

  1. Percutaneous endoscopic gastrostomy in children

    Directory of Open Access Journals (Sweden)

    Jye Hae Park

    2011-01-01

    Full Text Available Purpose: Percutaneous endoscopic gastrostomy (PEG can improve nutritional status and reduce the amount of time needed to feed neurologically impaired children. We evaluated the characteristics, complications, and outcomes of neurologically impaired children treated with PEG. Methods: We retrospectively reviewed the records of 32 neurologically impaired children who underwent PEG between March 2002 and August 2008 at our medical center. Forty-two PEG procedures comprising 32 PEG insertions and 10 PEG exchanges, were performed. The mean follow-up time was 12.2 (6.6 months. Results: Mean patient age was 9.4 (4.5 years. The main indications for PEG insertion were swallowing difficulty with GI bleeding due to nasogastric tube placement and/or the presence of gastroesophageal reflux disease (GERD. The overall rate of complications was 47%, with early complications evident in 25% of patients and late complications in 22%. The late complications included one gastro-colic fistula, two cases of aggravated GERD, and four instances of wound infection. Among the 15 patients with histological evidence of GERD before PEG, 13 (87% had less severe GERD, experienced no new aspiration events, and showed increased body weight after PEG treatment. Conclusion: PEG is a safe, effective, and relatively simple technique affording long-term enteral nutritional support in neurologically impaired children. Following PEG treatment, the body weight of most patients increased and the levels of vomiting, GI bleeding, and aspiration fell. We suggest that PEG with post-procedural observation be considered for enteral nutritional support of neurologically impaired children.

  2. Rare Endoscopic Manifestation of Pancreatic Adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Haritha Chelimilla

    2012-07-01

    Full Text Available Gastric ulcer secondary to direct invasion from pancreatic adenocarcinoma is rare. Metastases to the stomach have been commonly reported with melanoma and with primary tumors of the breast, lung, ovary, liver, colon and testis. We report a patient who presented with epigastric pain and in whom subsequently upper endoscopy showed a malignant gastric ulcer secondary to direct invasion from pancreatic adenocarcinoma of the body. An 81-year-old female presented to our hospital with epigastric pain and subsequently underwent endoscopy with endoscopic ultrasound for evaluation of a pancreatic body mass. She had a large gastric ulcer in the fundus which was in direct continuity with the pancreatic mass. Pathology from biopsy of the ulcer revealed invasive well-to-moderately-differentiated adenocarcinoma, and immunohistochemical stains were strongly positive for CA19-9, CK7, CK19 and carcinoembryonic antigen. These findings were consistent with a histopathological diagnosis of metastatic carcinoma of the pancreas. Patients with gastrointestinal metastases usually have advanced malignancy with poor prognosis. Endoscopic evaluation with adequate biopsies should be performed for symptomatic patients.

  3. Endoscopic Third Ventriculostomy in Previously Shunted Children

    Directory of Open Access Journals (Sweden)

    Eva Brichtova

    2013-01-01

    Full Text Available Endoscopic third ventriculostomy (ETV is a routine and safe procedure for therapy of obstructive hydrocephalus. The aim of our study is to evaluate ETV success rate in therapy of obstructive hydrocephalus in pediatric patients formerly treated by ventriculoperitoneal (V-P shunt implantation. From 2001 till 2011, ETV was performed in 42 patients with former V-P drainage implantation. In all patients, the obstruction in aqueduct or outflow parts of the fourth ventricle was proved by MRI. During the surgery, V-P shunt was clipped and ETV was performed. In case of favourable clinical state and MRI functional stoma, the V-P shunt has been removed 3 months after ETV. These patients with V-P shunt possible removing were evaluated as successful. In our group of 42 patients we were successful in 29 patients (69%. There were two serious complications (4.7%—one patient died 2.5 years and one patient died 1 year after surgery in consequence of delayed ETV failure. ETV is the method of choice in obstructive hydrocephalus even in patients with former V-P shunt implantation. In case of acute or scheduled V-P shunt surgical revision, MRI is feasible, and if ventricular system obstruction is diagnosed, the hydrocephalus may be solved endoscopically.

  4. Is endoscopic retrograde cholangiopancreatography valuable and safe in children of all ages?

    NARCIS (Netherlands)

    Vegting, I.L.; Tabbers, M.M.; Taminiau, J.A.; Aronson, D.C.; Benninga, M.A.; Rauws, E.A.

    2009-01-01

    OBJECTIVE: To evaluate indications, findings, therapies, safety, and technical success of endoscopic retrograde cholangiopancreatography (ERCP) in children of the Emma Children's Hospital Academic Medical Centre in Amsterdam, the Netherlands. DESIGN: Descriptive. Retrospective analysis by medical

  5. Solitary rectal ulcer syndrome: demographic, clinical, endoscopic and histological panorama

    International Nuclear Information System (INIS)

    Abbasi, A.; Bhutto, K. A.R.; Baloch, A.

    2015-01-01

    To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome (SRUS). Study Design: Cross-sectional observational study. Place and Duration of Study: Medical Unit-III, Civil Hospital Karachi (CHK) and Ward 7, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January 2009 to June 2012. Methodology: Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions (neoplasm, infection, inflammatory bowel disease, and trauma). Endoscopically, lesions were divided on the basis of number (solitary or multiple) and appearance (ulcerative, polypoidal/nodular or erythematous mucosa). Demographic, clinical and endoscopic characteristics of subjects were evaluated. Results: Forty-four patients met the inclusion criteria; 21 (47.7%) were females and 23 (52.3%) were males with overall mean age of 33.73 ±13.28 years. Symptom-wise 41 (93.2%) had bleeding per rectum, 39 (88.6%) had mucous discharge, 34 (77.3%) had straining, 34 (77.3%) had constipation, 32 (72.7%) had tenesmus, 5 (11.4%) had rectal prolapse and 2 (4.5%) had fecal incontinence. Twelve (27.27%) patients presented with hemoglobin less 10 gm/dl, 27 (61.36%) with 10 - 12 gm/dl and 05 (11.36%) subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 (59.1%) patients had mucosal ulceration, 11 (25.0%) had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 (15.9%) subjects. Conclusion: Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features. (author)

  6. Solitary Rectal Ulcer Syndrome: Demographic, Clinical, Endoscopic and Histological Panorama.

    Science.gov (United States)

    Abbasi, Amanullah; Bhutto, Abdul Rabb; Taj, Ali; Aurangzaib; Baloch, Akhtar; Masroor, Muhammad; Munir, S M

    2015-12-01

    To assess the demographic, clinical, endoscopic and histological spectrum of Solitary Rectal Ulcer Syndrome (SRUS). Cross-sectional observational study. Medical Unit-III, Civil Hospital Karachi (CHK) and Ward 7, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from January 2009 to June 2012. Patients with SRUS, based on characteristic endoscopic and histological findings, were enrolled. Patients were excluded if they had other causes of the rectal lesions (neoplasm, infection, inflammatory bowel disease, and trauma). Endoscopically, lesions were divided on the basis of number (solitary or multiple) and appearance (ulcerative, polypoidal/nodular or erythematous mucosa). Demographic, clinical and endoscopic characteristics of subjects were evaluated. Forty-four patients met the inclusion criteria; 21 (47.7%) were females and 23 (52.3%) were males with overall mean age of 33.73 ±13.28 years. Symptom-wise 41 (93.2%) had bleeding per rectum, 39 (88.6%) had mucous discharge, 34 (77.3%) had straining, 34 (77.3%) had constipation, 32 (72.7%) had tenesmus, 5 (11.4%) had rectal prolapse and 2 (4.5%) had fecal incontinence. Twelve (27.27%) patients presented with hemoglobin less 10 gm/dl, 27 (61.36%) with 10 - 12 gm/dl and 05 (11.36%) subjects had hemoglobin more than 12 gm/dl. Endoscopically, 26 (59.1%) patients had mucosal ulceration, 11 (25.0%) had mucosal ulceration with polypoid characteristics; while only polypoid features were found in 7 (15.9%) subjects. Solitary rectal ulcer syndrome affects adults of both genders with diverse clinical presentation and nonspecific endoscopic features.

  7. enter endoscopic third ventriculostomy (ETV)

    African Journals Online (AJOL)

    Ventriculoperitoneal 78. Point of View: Exit ventriculoperitoneal shunt; enter endoscopic third ventriculostomy (ETV): contemporary views on hydrocephalus and their implications on management. Abstract. Hydrocephalus has been known to affect humans since the birth of human medicine as it is described by Hippocrates.

  8. Peroral endoscopic myotomy for achalasia

    NARCIS (Netherlands)

    Bredenoord, A. J.; Rösch, T.; Fockens, P.

    2014-01-01

    Treatment of achalasia is complicated by symptom recurrence and a significant risk for severe complications. Endoscopic myotomy was developed in the search for a highly efficacious treatment with lower risks. Since its introduction in 2010, several centers have adopted the technique and published

  9. Endoscopic treatment of orbital tumors.

    Science.gov (United States)

    Signorelli, Francesco; Anile, Carmelo; Rigante, Mario; Paludetti, Gaetano; Pompucci, Angelo; Mangiola, Annunziato

    2015-03-16

    Different orbital and transcranial approaches are performed in order to manage orbital tumors, depending on the location and size of the lesion within the orbit. These approaches provide a satisfactory view of the superior and lateral aspects of the orbit and the optic canal but involve risks associated with their invasiveness because they require significant displacement of orbital structures. In addition, external approaches to intraconal lesions may also require deinsertion of extraocular muscles, with subsequent impact on extraocular mobility. Recently, minimally invasive techniques have been proposed as valid alternative to external approaches for selected orbital lesions. Among them, transnasal endoscopic approaches, "pure" or combined with external approaches, have been reported, especially for intraconal lesions located inferiorly and medially to the optic nerve. The avoidance of muscle detachment and the shortness of the surgical intraorbital trajectory makes endoscopic approach less invasive, thus minimizing tissue damage. Endoscopic surgery decreases the recovery time and improves the cosmetic outcome not requiring skin incisions. The purpose of this study is to review and discuss the current surgical techniques for orbital tumors removal, focusing on endoscopic approaches to the orbit and outlining the key anatomic principles to follow for safe tumor resection.

  10. Colonic perforation following endoscopic retrograde ...

    African Journals Online (AJOL)

    We highlight a potentially lethal complication of acute severe pancreatitis that may not be suspected in severely ill patients. A 41-year-old woman developed acute severe pancreatitis following endoscopic retrograde cholangiopancreatography (ERCP) for suspected choledocholithiasis. When her condition deteriorated ...

  11. Quantitative cognitive-test characterization of reconnectable implantable fiber-optic neurointerfaces for optogenetic neurostimulation.

    Science.gov (United States)

    Fedotov, I V; Ivashkina, O I; Pochechuev, M S; Roshchina, M A; Toropova, K A; Fedotov, A B; Anokhin, K V; Zheltikov, A M

    2017-11-01

    Cognitive tests on representative groups of freely behaving transgenic mice are shown to enable a quantitative characterization of reconnectable implantable fiber-optic neurointerfaces for optogenetic neurostimulation. A systematic analysis of such tests provides a robust quantitative measure for the cognitive effects induced by fiber-optic neurostimulation, validating the performance of fiber-optic neurointerfaces for long-term optogenetic brain stimulations and showing no statistically significant artifacts in the behavior of transgenic mice due to interface implantation. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Beveled fiber-optic probe couples a ball lens for improving depth-resolved fluorescence measurements of layered tissue: Monte Carlo simulations

    International Nuclear Information System (INIS)

    Jaillon, Franck; Zheng Wei; Huang Zhiwei

    2008-01-01

    In this study, we evaluate the feasibility of designing a beveled fiber-optic probe coupled with a ball lens for improving depth-resolved fluorescence measurements of epithelial tissue using Monte Carlo (MC) simulations. The results show that by using the probe configuration with a beveled tip collection fiber and a flat tip excitation fiber associated with a ball lens, discrimination of fluorescence signals generated in different tissue depths is achievable. In comparison with a flat-tip collection fiber, the use of a large bevel angled collection fiber enables a better differentiation between the shallow and deep tissue layers by changing the excitation-collection fiber separations. This work suggests that the beveled fiber-optic probe coupled with a ball lens has the potential to facilitate depth-resolved fluorescence measurements of epithelial tissues

  13. Beveled fiber-optic probe couples a ball lens for improving depth-resolved fluorescence measurements of layered tissue: Monte Carlo simulations.

    Science.gov (United States)

    Jaillon, Franck; Zheng, Wei; Huang, Zhiwei

    2008-02-21

    In this study, we evaluate the feasibility of designing a beveled fiber-optic probe coupled with a ball lens for improving depth-resolved fluorescence measurements of epithelial tissue using Monte Carlo (MC) simulations. The results show that by using the probe configuration with a beveled tip collection fiber and a flat tip excitation fiber associated with a ball lens, discrimination of fluorescence signals generated in different tissue depths is achievable. In comparison with a flat-tip collection fiber, the use of a large bevel angled collection fiber enables a better differentiation between the shallow and deep tissue layers by changing the excitation-collection fiber separations. This work suggests that the beveled fiber-optic probe coupled with a ball lens has the potential to facilitate depth-resolved fluorescence measurements of epithelial tissues.

  14. Transforaminal versus endoscopic epiduroplasty in post-lumbar laminectomy syndrome: a prospective, controlled, randomized study

    OpenAIRE

    EL MOLLA AHMED FAWZI

    2016-01-01

    The study primary goal was to evaluate the efficacy of non-endoscopic and endoscopic epiduroplasty on chronic leg pain severity in post-lumbar laminectomy syndrome (PLS) patients. The secondary goals were to evaluate low back pain, functional abilities, satisfaction, and complications after the procedures. Seventy-two patients were allocated randomly into two groups. The Trans group ( n = 35) in whom patients underwent transforaminal epiduroplasty and EDS group ( n = 37) in whom patients unde...

  15. Development and testing of a compact endoscope manipulator for minimally invasive surgery.

    Science.gov (United States)

    Berkelman, Peter; Cinquin, Philippe; Boidard, Eric; Troccaz, Jocelyne; Létoublon, Christian; Long, Jean-Alexandre

    2005-01-01

    This report describes the design, development, and testing of a novel compact surgical assistant robot to control the orientation and insertion depth of a laparoscopic endoscope during minimally invasive abdominal surgery. In contrast to typical endoscope manipulators, the described robot is particularly compact and lightweight, is simple to set up and use, occupies no floor or operating table space, and does not limit access to the patient in any way. The sterilizable endoscope manipulator is sufficiently small and lightweight at 625 g and 110 mm in diameter that it can be placed directly on the abdomen of the patient without interfering with other handheld instruments during minimally invasive surgery. It consists of an annular base, a clamp to hold an endoscope trocar, and two joints which enable azimuth rotation and inclination of the endoscope about a pivot point at the incision. The endoscope insertion depth is controlled by a cable winding acting against a compression spring on the endoscope shaft. Voice recognition and miniature keypad user command interfaces are provided, and the manipulator motors are backdriveable for manual repositioning. Endoscope camera trajectory-following accuracy and response-time results were measured using an optical localizer. Experimental results are given comparing the current prototype with the previous cable-driven prototype. The endoscope manipulator and its user interface were tested and evaluated by several surgeons during a series of minimally invasive surgical training procedures on cadavers and animals. The endoscope manipulator described has been shown to be a viable, practical device with performance and functionality equivalent to those of commercially available models, yet with greatly reduced size, weight, and cost.

  16. Landmark-based augmented reality system for paranasal and transnasal endoscopic surgeries.

    Science.gov (United States)

    Thoranaghatte, Ramesh; Garcia, Jaime; Caversaccio, Marco; Widmer, Daniel; Gonzalez Ballester, Miguel A; Nolte, Lutz-P; Zheng, Guoyan

    2009-12-01

    In this paper we present a landmark-based augmented reality (AR) endoscope system for endoscopic paranasal and transnasal surgeries along with fast and automatic calibration and registration procedures for the endoscope. Preoperatively the surgeon selects natural landmarks or can define new landmarks in CT volume. These landmarks are overlaid, after proper registration of preoperative CT to the patient, on the endoscopic video stream. The specified name of the landmark, along with selected colour and its distance from the endoscope tip, is also augmented. The endoscope optics are calibrated and registered by fast and automatic methods. Accuracy of the system is evaluated in a metallic grid and cadaver set-up. Root mean square (RMS) error of the system is 0.8 mm in a controlled laboratory set-up (metallic grid) and was 2.25 mm during cadaver studies. A novel landmark-based AR endoscope system is implemented and its accuracy is evaluated. Augmented landmarks will help the surgeon to orientate and navigate the surgical field. Studies prove the capability of the system for the proposed application. Further clinical studies are planned in near future. Copyright (c) 2009 John Wiley & Sons, Ltd.

  17. Correlation between Histological Activity and Endoscopic, Clinical, and Serologic Activities in Patients with Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Dae Bum Kim

    2016-01-01

    Full Text Available Objectives. Recent studies suggest that histological healing is a treatment goal in ulcerative colitis (UC. We aimed to evaluate the correlation between histological activity and clinical, endoscopic, and serologic activities in patients with UC. Methods. We retrospectively reviewed medical records from patients with UC who underwent colonoscopy or sigmoidoscopy with biopsies. The Mayo endoscopic subscore was used to assess endoscopic activity. Biopsy specimens were reviewed by two blinded pathologists and scored using the Geboes scoring system. Results. We analyzed 154 biopsy specimens from 82 patients with UC. Histological scores exhibited strong correlation with endoscopic subscores (Spearman’s rank correlation coefficient r=0.774, p<0.001 and moderate correlation with C-reactive protein levels (r=0.422, p<0.001 and partial Mayo scores (r=0.403, p<0.001. Active histological inflammation (Geboes score ≥ 3.1 was observed in 6% (2 of 33 of the endoscopically normal mucosa samples, 66% (19 of 29 of mild disease samples, and 98% (90 of 92 of moderate-to-severe disease samples. Conclusions. Histological activity was closely correlated with the endoscopic, clinical, and serologic UC activities. However, several patients with mild or normal endoscopic findings exhibited histological evidence of inflammation. Therefore, histological assessment may be helpful in evaluating treatment outcomes and determining follow-up strategies.

  18. Posterior endoscopic discectomy: Results in 300 patients

    Directory of Open Access Journals (Sweden)

    Mohinder Kaushal

    2012-01-01

    Full Text Available Background: Posterior endoscopic discectomy is an established method for treatment of lumbar disc herniation. Many studies have not been reported in literature for lumbar discectomy by Destandau Endospine System. We report a series of 300 patients operated for lumbar dissectomy by Destandau Endospine system. Materials and Methods: A total of 300 patients suffering from lumbar disc herniations were operated between January 2002 and December 2008. All patients were operated as day care procedure. Technique comprised localization of symptomatic level followed by insertion of an endospine system devise through a 15 mm skin and fascial incision. Endoscopic discectomy is then carried out by conventional micro disc surgery instruments by minimal invasive route. The results were evaluated by Macnab′s criteria after a minimum followup of 12 months and maximum up to 24 months. Results: Based on modified Macnab′s criteria, 90% patients had excellent to good, 8% had fair, and 2% had poor results. The complications observed were discitis and dural tear in five patients each and nerve root injury in two patients. 90% patients were able to return to light and sedentary work with an average delay of 3 weeks and normal physical activities after 2 months. Conclusion: Edoscopic discectomy provides a safe and minimal access corridor for lumbar discectomy. The technique also allows early postoperative mobilization and faster return to work.

  19. Emphysema. Imaging for endoscopic lung volume reduction

    International Nuclear Information System (INIS)

    Storbeck, B.; Oldigs, M.; Rabe, K.F.; Weber, C.; University Medical Center Hamburg-Eppendorf

    2015-01-01

    Chronic obstructive pulmonary disease (COPD) is characterized by two entities, the more airway-predominant type (''bronchitis'') on the one hand, and emphysema-predominant type on the other. Imaging via high-resolution computed tomography plays an important role in phenotyping COPD. For patients with advanced lung emphysema, new endoscopic lung volume reduction therapies (ELVR) have been developed. Proper selection of suitable patients requires thin-section reconstruction of volumetric CT image data sets also in coronal and sagittal orientation are required. In the current manuscript we will describe emphysema subtypes (centrilobular, paraseptal, panlobular), options for quantifying emphysema and this importance of regional distribution (homogeneous or heterogeneous, target area) as this is crucial for patient selection. Analysis of the interlobular fissures is obligatory despite the lack of standardization, as incomplete fissures indicate collateral ventilation (CV) via parenchymal bridges, which is an important criterion in choosing endoscopic methods of LVR. Every radiologist should be familiar with modern LVR therapies such as valves and coils, and furthermore should know what a lung doctor expects from radiologic evaluation (before and after ELVR). Finally we present a checklist as a quick reference for all steps concerning imaging for ELVR.

  20. Endoscopic Full-Thickness Resection of a Colonic Lateral Spreading Tumor.

    Science.gov (United States)

    Bucalau, Ana-Maria; Lemmers, Arnaud; Arvanitakis, Marianna; Blero, Daniel; Neuhaus, Horst

    2018-01-17

    The Full-Thickness Resection Device (FTRD; Ovesco Endoscopy, Tübingen, Germany) combines endoscopic full-thickness resection (EFTR) of gastrointestinal lesions with closure and cutting of the tissue in one integrated procedure. It provides en-bloc resection with an integral wall specimen for histopathological evaluation. This resection technique is partially filling of the gaps between the current procedures of choice in endoscopy (endoscopic mucosal resection and endoscopic submucosal dissection) and surgery. We present the case of an EFTR procedure performed for a periappendicular lateral spreading tumor. © 2018 S. Karger AG, Basel.

  1. Endoscopic sphincterotomy for common bile duct stones during laparoscopic cholecystectomy is safe and effective

    DEFF Research Database (Denmark)

    Jakobsen, Henrik Loft; Vilmann, Peter; Rosenberg, Jacob

    2011-01-01

    Management strategy for common bile duct (CBD) stones is controversial with several treatment options if stones in the CBD are recognized intraoperatively. The aim of this study was to report our experience with same-session combined endoscopic-laparoscopic treatment of gallbladder and CBD stones....... We retrospectively evaluated 31 patients with cholecystolithiasis and CBD stones undergoing same-session combined endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and endoscopic stone extraction and laparoscopic cholecystectomy. Same-session ERCP and sphincterotomy were...... pancreatitis postoperatively and no other morbidity or mortality. In conclusion, same-session ERCP with stone extraction and laparoscopic cholecystectomy seems to be a safe and effective treatment strategy for CBD stones....

  2. Fiber-optic gyro location of dome azimuth

    Science.gov (United States)

    Kuehne, John W.

    2016-07-01

    The 2.1-m Otto Struve Telescope, world's second largest in 1939, today has modern motion control and superb tracking, yet the 19-m-diameter Art Deco dome has resisted many attempts to record its azimuth electronically. Demonstrated in January 2016, a small tactical-grade fiber-optic gyro located anywhere on the rotating structure, aided by a few fiducial points to zero gyro drift, adequately locates the azimuth. The cost of a gyro is practically independent of dome size, offering an economical solution for large domes that cannot be easily encoded with conventional systems. The 100-Hz sampling is capable of revealing anomalies in the rotation rate, valuable for preventive maintenance on any dome. I describe software methods and time series analysis to integrate angular velocity to dome azimuth; transformation of telescope hour angle and declination into required dome azimuth, using a formula that accounts for a cross-axis mount inside an offset dome; and test results.

  3. Transoral tracheal intubation of rodents using a fiberoptic laryngoscope.

    Science.gov (United States)

    Costa, D L; Lehmann, J R; Harold, W M; Drew, R T

    1986-06-01

    A fiberoptic laryngoscope which allows direct visualization of the deep pharynx and epiglottis has been developed for transoral tracheal intubation of small laboratory mammals. The device has been employed in the intubation and instillation of a variety of substances into the lungs of rats, and with minor modification, has had similar application in mice, hamsters, and guinea pigs. The simplicity and ease of handling of the laryngoscope permits one person to intubate large numbers of enflurane anesthetized animals either on an open counter top or in a glove-box, as may be required for administration of carcinogenic materials. Instillation of 7Be-labeled carbon particles into the lungs of mice, hamsters, rats, and guinea pigs resulted in reasonably consistent interlobal distribution of particles for each test animal species with minimal tracheal deposition. However, actual lung tissue doses of carbon exhibited some species dependence.

  4. Fiber-Optic Vibration Sensor Based on Multimode Fiber

    Directory of Open Access Journals (Sweden)

    I. Lujo

    2008-06-01

    Full Text Available The purpose of this paper is to present a fiberoptic vibration sensor based on the monitoring of the mode distribution in a multimode optical fiber. Detection of vibrations and their parameters is possible through observation of the output speckle pattern from the multimode optical fiber. A working experimental model has been built in which all used components are widely available and cheap: a CCD camera (a simple web-cam, a multimode laser in visible range as a light source, a length of multimode optical fiber, and a computer for signal processing. Measurements have shown good agreement with the actual frequency of vibrations, and promising results were achieved with the amplitude measurements although they require some adaptation of the experimental model. Proposed sensor is cheap and lightweight and therefore presents an interesting alternative for monitoring large smart structures.

  5. High-Frequency Flush Mounted Miniature LOX Fiber-Optic Pressure Sensor II, Phase II

    Data.gov (United States)

    National Aeronautics and Space Administration — Luna Innovations has teamed with the University of Alabama, Huntsville, to develop a miniature flush-mounted fiber-optic pressure sensor that will allow accurate,...

  6. High-Frequency Flush Mounted Miniature LOX Fiber-Optic Pressure Sensor, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Luna Innovations is teaming with the University of Alabama, Huntsville, to develop a miniature flush-mounted fiber-optic pressure sensor that will allow accurate,...

  7. Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

    DEFF Research Database (Denmark)

    Orholm, M; Lundgren, Jens Dilling; Nielsen, T L

    1990-01-01

    During a six-month period, 40 consecutive fiberoptic bronchoscopic procedures including bronchoalveolar lavage, bronchial brushing and forceps biopsy were performed in local anaesthesia on 34 HIV-infected males presenting symptoms compatible with Pneumocystis carinii pneumonia. In 23 examinations...

  8. Frequency-Shifted Interferometry — A Versatile Fiber-Optic Sensing Technique

    Directory of Open Access Journals (Sweden)

    Fei Ye

    2014-06-01

    Full Text Available Fiber-optic sensing is a field that is developing at a fast pace. Novel fiber-optic sensor designs and sensing principles constantly open doors for new opportunities. In this paper, we review a fiber-optic sensing technique developed in our research group called frequency-shifted interferometry (FSI. This technique uses a continuous-wave light source, an optical frequency shifter, and a slow detector. We discuss the operation principles of several FSI implementations and show their applications in fiber length and dispersion measurement, locating weak reflections along a fiber link, fiber-optic sensor multiplexing, and high-sensitivity cavity ring-down measurement. Detailed analysis of FSI system parameters is also presented.

  9. Fiber-Optic Shape Sensing for Intelligent Solar Sail Deployment, Phase I

    Data.gov (United States)

    National Aeronautics and Space Administration — Luna Innovations proposes to develop a distributed fiber-optic shape sensor to provide a control system for the deployment of ultra-lightweight inflatable support...

  10. FIBER-OPTIC BIOSENSOR FOR DIRECT DETERMINATION OF ORGANOPHOSPHATE NERVE AGENTS. (R823663)

    Science.gov (United States)

    A fiber-optic enzyme biosensor for the direct measurement of organophosphate nerveagents was developed. The basic element of this biosensor is organophosphorus hydrolaseimmobilized on a nylon membrane and attached to the common end of a bifurcated optical fiberbundle....

  11. The evaluation of disphagic syndrome, in patients with previously acquired brain damages.

    Science.gov (United States)

    Bartuli, F N; Luciani, F; Marino, S; Bramanti, E; Cecchetti, F; Arcuri, C

    2010-04-01

    Recently clinical studies have proved without doubts that in patients affect by neurological diseases, like stroke, parkinsonism syndromes and others neurodegenerative pathologies, there is a very elevated incidence of swallowing disorders even severe. The disease can show up in a full blown way, with clinical evident signs like suffocation or frequent and sudden cough, at the moment in which the patient tries to feed or to drink; or it can appear in a less clear way, through an unable protection of the low airway and with possible pathologies ab ingestis. The first signals are represented by frequent resulting of cough reflex at nutrition or hydratation. Important is to assess the validity of this reflection, monitoring the amount of food reflux in the mouth after swallowing, which then could be perceived like foreign body and be aspired. The main diagnostic tests are the pHmetry in 24h, ultrasound, esophagography, videofluoroscopy, endoscopic examination and scintigraphy. Through the FEES (Fiberoptic Endoscopic Evaluation of Swallowing) we can then identify the time of swallowing deficit. Early diagnosis of Dysphagia Syndrome is important to improve living condition and survival of patients.

  12. Fiber-optic displacement sensors on the Hunters Trophy UGT impulse gauge experiments

    Energy Technology Data Exchange (ETDEWEB)

    Green, R.E.L.; Poutiatine, A.I.

    1995-03-01

    As part of a program to develop gauges for measurement of various mechanical properties in hostile environments, the authors fielded purely optical displacement sensors at the ends of long fiber-optic cables as supplements to the regular displacement sensors of four impulse gauges fielded as part of a materials study on the Hunters Trophy underground effects test at the Nevada Test Site. These fiber-optic sensor systems and their performance on the Hunters Trophy test are described in this report.

  13. Fiber-optic fluorometer for microscale mapping of photosynthetic pigments in microbial communities

    DEFF Research Database (Denmark)

    Thar, Roland Matthias; Kühl, Michael; Holst, Gerhard

    2001-01-01

    Microscale fluorescence measurements were performed in photosynthetic biofilms at a spatial resolution of 100 to 200 µm with a new fiber-optic fluorometer which allowed four different excitation and emission wavelengths and was configured for measuring phycobiliproteins, chlorophylls, and bacteri......Microscale fluorescence measurements were performed in photosynthetic biofilms at a spatial resolution of 100 to 200 µm with a new fiber-optic fluorometer which allowed four different excitation and emission wavelengths and was configured for measuring phycobiliproteins, chlorophylls...

  14. Update on endoscopic management of gastric outlet obstruction in children.

    Science.gov (United States)

    Chao, Hsun-Chin

    2016-10-16

    Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD, advanced treatments like local steroid injection, electrocauterization, and stent have been added recently. The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis, peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis; antral web, duplication cyst, ectopic pancreas, and other rare conditions. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with complimentary histopathologic studies. EBD are used in exceptional cases, some with advantages over surgical intervention depending on each patient in particular and on the characteristics and etiology of the gastric outlet obstruction. Local steroid injection and electrocauterization can augment the effect of EBD. The future of endoscopic treatment seems to be aimed at the use of endoscopic electrocauterization and balloon dilatations.

  15. Update on endoscopic management of gastric outlet obstruction in children

    Science.gov (United States)

    Chao, Hsun-Chin

    2016-01-01

    Endoscopic balloon dilatation (EBD) and surgical intervention are two most common and effective treatments for gastric outlet obstruction. Correction of gastric outlet obstruction without the need for surgery is an issue that has been tried to be resolved in these decades; this management has developed with EBD, advanced treatments like local steroid injection, electrocauterization, and stent have been added recently. The most common causes of pediatric gastric outlet obstruction are idiopathic hypertrophic pyloric stenosis, peptic ulcer disease followed by the ingestion of caustic substances, stenosis secondary to surgical anastomosis; antral web, duplication cyst, ectopic pancreas, and other rare conditions. A complete clinical, radiological and endoscopic evaluation of the patient is required to make the diagnosis, with complimentary histopathologic studies. EBD are used in exceptional cases, some with advantages over surgical intervention depending on each patient in particular and on the characteristics and etiology of the gastric outlet obstruction. Local steroid injection and electrocauterization can augment the effect of EBD. The future of endoscopic treatment seems to be aimed at the use of endoscopic electrocauterization and balloon dilatations. PMID:27803770

  16. Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

    Directory of Open Access Journals (Sweden)

    Javier Sola-Vera

    2014-01-01

    Full Text Available Background: Cholangioscopy is a useful tool for the study and treatment of biliary pathology. Ultrathin upper endoscopes allow direct peroral cholangioscopy (DPC but have some drawbacks. Objective: The aim of the study was to evaluate the success rate of DPC with an ultrathin endoscope using a balloon catheter to reach the biliary confluence. Material and methods: Prospective observational study. An ultrathin endoscope (Olympus XP180N, outer diameter 5.5 mm, working channel 2 mm was used. To access the biliary tree, free-hand technique was used. To reach the biliary confluence an intraductal balloon catheter (Olympus B5-2Q diameter 1.9 mm and a 0.025 inch guide wire was used. In all cases sphincterotomy and/or sphincteroplasty was performed. The success rate was defined as the percentage of cases in which the biliary confluence could be reached with the ultrathin endoscope. Results: Fifteen patients (8 men/7 women were included. Mean age was 77.7 ± 10.8 years (range 45-91. The indications for cholangioscopy were suspected bile duct stones (n = 9, electrohydraulic lithotripsy for the treatment of difficult choledocholithiasis (n = 5 and evaluation of biliary stricture (n = 1. Access to the bile duct was achieved in 14/15 cases (93.3 %. Biliary confluence was reached in 13/15 cases (86.7 %. One complication was observed in one patient (oxigen desaturation. Conclusions: DPC with an ultrathin endoscope can be done with the free-hand technique. Intraductal balloon-guided DPC allows full examination of the common bile duct in most cases.

  17. Technique of endoscopic biopsy of islet allografts transplanted into the gastric submucosal space in pigs.

    Science.gov (United States)

    Fujita, Minoru; McGrath, Kevin M; Bottino, Rita; Dons, Eefje M; Long, Cassandra; Kumar, Goutham; Ekser, Burcin; Echeverri, Gabriel J; Hata, Jiro; Haruma, Ken; Cooper, David K C; Hara, Hidetaka

    2013-01-01

    Currently, islet cells are transplanted into the liver via portal vein infusion. One disadvantage of this approach is that it is not possible to adequately biopsy the islets in the liver to assess for rejection. Islet transplantation (Tx) into the gastric submucosal space (GSMS) can be performed endoscopically and has the potential advantage of histological evaluation by endoscopic biopsy. The aim of this study was to determine whether a representative allograft sample could be obtained endoscopically. We performed islet Tx into the GSMS in nonimmunosuppressed pigs using simple endoscopic submucosal injection. Islets were transplanted at four sites. Endoscopic ultrasonography and biopsy of the transplanted islets at two sites by modified endoscopic submucosal dissection were carried out successfully in all pigs 5 days after islet Tx. Tissue obtained at both biopsy and necropsy (including full-thickness sections of the gastric wall around the sites of the remaining islets and biopsies) were examined by histology and immunohistochemistry to confirm the presence of the islet grafts and any features of rejection. Representative allograft sampling was successfully obtained from all biopsy sites. All biopsies included islets with insulin-positive staining. There was significant CD3(+) and CD68(+) cell infiltration in the islet masses obtained at biopsy and from sections taken at necropsy, with similar histopathological features. Endoscopic biopsy of islet allografts in the GSMS is feasible, provides accurate histopathological data, and would provide a significant advance if translated into clinical practice.

  18. A pilot study on using chlorine dioxide gas for disinfection of gastrointestinal endoscopes.

    Science.gov (United States)

    Yi, Ying; Hao, Li-Mei; Ma, Shu-Ren; Wu, Jin-Hui; Wang, Tao; Lin, Song; Zhang, Zong-Xing; Qi, Jian-Cheng

    2016-07-01

    This pilot study of employing chlorine dioxide (CD) gas to disinfect gastrointestinal endoscopes was conducted to meet the expectations of many endoscopy units in China for a high-efficiency and low-cost disinfectant. An experimental prototype with an active circulation mode was designed to use CD gas to disinfect gastrointestinal endoscopes. One type of testing device composed of polytetrafluoroethylene (PTFE) tubes (2 m long, inner diameter 1 mm) and bacterial carrier containers was used to simulate the channel of the endoscope. PTFE bacterial carriers inoculated with Bacillus atrophaeus with or without organic burden were used to evaluate the sporicidal activity of CD gas. Factors including exposure dosage, relative humidity (RH), and flow rate (FR) influencing the disinfection effect of CD gas were investigated. Moreover, an autoptic disinfecting test on eight real gastrointestinal endoscopes after clinical use was performed using the experimental prototype. RH, exposure dosage, organic burden, and the FR through the channel significantly (Pgas for a long and narrow lumen. The log reduction increased as FR decreased. Treatment with 4 mg/L CD gas for 30 min at 0.8 L/min FR and 75% RH, resulted in complete inactivation of spores. Furthermore, all eight endoscopes with a maximum colony-forming unit of 915 were completely disinfected. The cost was only 3 CNY (0.46 USD) for each endoscope. The methods and results reported in this study could provide a basis for further studies on using CD gas for the disinfection of endoscopes.

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

    Science.gov (United States)

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

    2016-01-01

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

  20. Low pepsinogen I level predicts multiple gastric epithelial neoplasias for endoscopic resection.

    Science.gov (United States)

    Park, Seon Young; Lim, Sung Ook; Ki, Ho Seok; Jun, Chung Hwan; Park, Chang Hwan; Kim, Hyun Soo; Choi, Sung Kyu; Rew, Jong Sun

    2014-05-01

    Synchronous/metachronous gastric epithelial neoplasias (GENs) in the remaining lesion can develop at sites other than the site of endoscopic resection. In the present study, we aimed to investigate the predictive value of serum pepsinogen for detecting multiple GENs in patients who underwent endoscopic resection. In total, 228 patients with GEN who underwent endoscopic resection and blood collection for pepsinogen I and II determination were evaluated retrospectively. The mean period of endoscopic follow-up was 748.8±34.7 days. Synchronous GENs developed in 46 of 228 (20.1%) and metachronous GENs in 27 of 228 (10.6%) patients during the follow-up period. Multiple GENs were associated with the presence of pepsinogen I <30 ng/mL (p<0.001). Synchronous GENs were associated with the presence of pepsinogen I <30 ng/mL (p<0.001). Low pepsinogen I levels predict multiple GENs after endoscopic resection, especially synchronous GENs. Cautious endoscopic examination prior to endoscopic resection to detect multiple GENs should be performed for these patients.

  1. Endoscopic full-thickness resection of gastric subepithelial tumors: a single-center series.

    Science.gov (United States)

    Schmidt, Arthur; Bauder, Markus; Riecken, Bettina; von Renteln, Daniel; Muehleisen, Helmut; Caca, Karel

    2015-02-01

    Endoscopic full-thickness resection of gastric subepithelial tumors with a full-thickness suturing device has been described as feasible in two small case series. The aim of this study was to evaluate the efficacy, safety, and clinical outcome of this resection technique. After 31 patients underwent endoscopic full-thickness resection, the data were analyzed retrospectively. Before snare resection, 1 to 3 full-thickness sutures were placed underneath each tumor with a device originally designed for endoscopic anti-reflux therapy. All tumors were resected successfully. Bleeding occurred in 12 patients (38.7 %); endoscopic hemostasis could be achieved in all cases. Perforation occurred in 3 patients (9.6 %), and all perforations could be managed endoscopically. Complete resection was histologically confirmed in 28 of 31 patients (90.3 %). Mean follow-up was 213 days (range, 1 - 1737), and no tumor recurrences were observed. Endoscopic full-thickness resection of gastric subepithelial tumors with the suturing technique described above is feasible and effective. After the resection of gastrointestinal stromal tumors (GISTs), we did not observe any recurrences during follow-up, indicating that endoscopic full-thickness resection may be an alternative to surgical resection for selected patients. © Georg Thieme Verlag KG Stuttgart · New York.

  2. Influences of optical-spectrum errors on excess relative intensity noise in a fiber-optic gyroscope

    Science.gov (United States)

    Zheng, Yue; Zhang, Chunxi; Li, Lijing

    2018-03-01

    The excess relative intensity noise (RIN) generated from broadband sources degrades the angular-random-walk performance of a fiber-optic gyroscope dramatically. Many methods have been proposed and managed to suppress the excess RIN. However, the properties of the excess RIN under the influences of different optical errors in the fiber-optic gyroscope have not been systematically investigated. Therefore, it is difficult for the existing RIN-suppression methods to achieve the optimal results in practice. In this work, the influences of different optical-spectrum errors on the power spectral density of the excess RIN are theoretically analyzed. In particular, the properties of the excess RIN affected by the raised-cosine-type ripples in the optical spectrum are elaborately investigated. Experimental measurements of the excess RIN corresponding to different optical-spectrum errors are in good agreement with our theoretical analysis, demonstrating its validity. This work provides a comprehensive understanding of the properties of the excess RIN under the influences of different optical-spectrum errors. Potentially, it can be utilized to optimize the configurations of the existing RIN-suppression methods by accurately evaluating the power spectral density of the excess RIN.

  3. Fiber-optic Raman probe couples ball lens for depth-selected Raman measurements of epithelial tissue.

    Science.gov (United States)

    Mo, Jianhua; Zheng, Wei; Huang, Zhiwei

    2010-06-28

    In this study, we present a fiber-optic ball lens Raman probe design for improving depth-selected Raman measurements of epithelial tissue. The Monte Carlo simulation results show that tissue Raman collection efficiency can be improved by properly selecting the refractive index and the diameter of the ball lens for the Raman probe design and the depth-selectivity of Raman measurements can also be improved by either increasing the refractive index or reducing the diameter of the ball lens. An appropriate arrangement of the Raman probe-tissue distance can also optimize the collection efficiency for depth-resolved Raman measurements. Experimental evaluation of a ball lens Raman probe design on a two-layer tissue phantom confirms the potential of the ball lens Raman probe design for efficient depth-selected measurement on epithelial tissue. This work suggests that the fiber-optic Raman probe coupled with a ball lens can facilitate the depth-selected Raman measurements of epithelial tissue, which may improve the diagnosis of epithelial precancer and early cancer at the molecular level.

  4. Assessment of quality parameters in grapes during ripening using a miniature fiber-optic near-infrared spectrometer.

    Science.gov (United States)

    Fernández-Novales, Juan; López, María-Isabel; Sánchez, María-Teresa; García-Mesa, José-Antonio; González-Caballero, Virginia

    2009-01-01

    Changes in the chemical properties of wine grapes during ripening were studied using near-infrared (NIR) spectroscopy. A miniature fiber-optic NIR spectrometer system working in transmission mode in the spectral region (700 - 1,060 nm) was evaluated for this purpose. Spectra and analytical data were used to develop partial least square calibration models to quantify changes in the major parameters used to chart ripening in this fruit. NIR spectroscopy provided excellent precision for soluble solid content and for reducing sugars, and good precision for maturity index, while for pH and titratable acidity the miniature NIR spectroscopy instrument proved less accurate. The performance of the instrument in classifying wine grapes by grape type and by irrigation regime was also studied. Percentages of correctly classified samples ranged from 82.7% to 96.2%. The results show that the monitoring of soluble solid content and reducing sugars' changes in wine grape quality parameters during ripening, as well as the classification of grapes, can be performed non-destructively using a miniature fiber-optic NIR spectrometer.

  5. Contrast-enhanced endoscopic ultrasonography

    DEFF Research Database (Denmark)

    Reddy, Nischita K; Ioncică, Ana Maria; Săftoiu, Adrian

    2011-01-01

    Contrast agents are increasingly being used to characterize the vasculature in an organ of interest, to better delineate benign from malignant pathology and to aid in staging and directing therapeutic procedures. We review the mechanisms of action of first, second and third generation contrast...... agents and their use in various endoscopic procedures in the gastrointestinal tract. Various applications of contrast-enhanced endoscopic ultrasonography include differentiating benign from malignant mediastinal lymphadenopathy, assessment of depth of invasion of esophageal, gastric and gall bladder...... cancers and visualization of the portal venous system and esophageal varices. In addition, contrast agents can be used to differentiate pancreatic lesions. The use of color Doppler further increases the ability to diagnose and differentiate various pancreatic malignancies. The sensitivity of power Doppler...

  6. [Endoscopic surgery of hemorrhagic stroke].

    Science.gov (United States)

    Dash'ian, V G; Korshikova, A N; Godkov, I M; Krylov, V V

    2014-01-01

    Objectives. Demonstration and analysis of possibilities of video-endoscopy in the surgical treatment of hypertensive hemorrhages Materials and methods. We analyzed the results of surgical treatment of 35 patients with hypertensive intracranial hematomas which were removed using endoscopic method. Twenty-eight patients had putamen, 3 thalamic, 3 cerebellar and 1 subcortical hematoma; the volume of hematomas ranged from 14 to 84 cm3. Results. Neurological lesions completely disappeared in 7 patients, 6 patients had moderate and 17 severe disability. Five (14%) patients died. Outcome of treatment was significantly (psurgery, localization of the hemorrhage, presence and degree of transverse brain dislocation, repeated hemorrhages. Risk factors for poor outcome were depressed consciousness, recurrent hemorrhages, the transverse dislocation >6 mm and deep intracranial hematoma. Conclusions. The efficacy of endoscopic aspiration of hematomas is comparable to open surgical interventions but less traumatic.

  7. Endoscopic Management of Posterior Epistaxis

    OpenAIRE

    Paul, J.; Kanotra, Sohit Paul; Kanotra, Sonika

    2011-01-01

    The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26–50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of ...

  8. Endoscopic Aspects of Gastric Syphilis

    Directory of Open Access Journals (Sweden)

    Mariana Souza Varella Frazão

    2012-01-01

    Full Text Available Introduction. Considered as a rare event, gastric syphilis (GS is reported as an organic form of involvement. Low incidence of GS emphasizes the importance of histopathological analysis. Objective. We aim to characterize GS endoscopic aspects in an immunocompetent patient. Case Report. A 23-year-old man presented with epigastric pain associated with nausea, anorexia, generalized malaise and 11 kg weight loss that started 1 month prior to his clinical consultation. Physical examination was normal except for mild abdominal tenderness in epigastrium. Endoscopy observed diminished gastric expandability and diffuse mucosal lesions, from cardia to pylorus. Gastric mucosa was thickened, friable, with nodular aspect, and associated with ulcers lesions. Gastric biopsies were performed, and histopathological analysis resulted in dense inflammatory infiltration rich in plasmocytes. Syphilis serologies were positive for VDRL and Treponema pallidum reagents. Immunohistochemical tests were positive for Treponema pallidum and CD138. The patient was treated with penicillin, leading to resolution of his clinical complaints and endoscopic findings. Conclusion. Diagnosis suspicion of GS is important in view of its nonspecific presentation. Patients with gastric symptoms that mimic neoplastic disease should be investigated thoroughly based on the fact that clinical, endoscopic, and histological findings can easily be mistaken for lymphoma or plastic linitis.

  9. Endoscopic treatment of esophageal achalasia

    Science.gov (United States)

    Esposito, Dario; Maione, Francesco; D’Alessandro, Alessandra; Sarnelli, Giovanni; De Palma, Giovanni D

    2016-01-01

    Achalasia is a motility disorder of the esophagus characterized by dysphagia, regurgitation of undigested food, chest pain, weight loss and respiratory symptoms. The most common form of achalasia is the idiopathic one. Diagnosis largely relies upon endoscopy, barium swallow study, and high resolution esophageal manometry (HRM). Barium swallow and manometry after treatment are also good predictors of success of treatment as it is the residue symptomatology. Short term improvement in the symptomatology of achalasia can be achieved with medical therapy with calcium channel blockers or endoscopic botulin toxin injection. Even though few patients can be cured with only one treatment and repeat procedure might be needed, long term relief from dysphagia can be obtained in about 90% of cases with either surgical interventions such as laparoscopic Heller myotomy or with endoscopic techniques such pneumatic dilatation or, more recently, with per-oral endoscopic myotomy. Age, sex, and manometric type by HRM are also predictors of responsiveness to treatment. Older patients, females and type II achalasia are better after treatment compared to younger patients, males and type III achalasia. Self-expandable metallic stents are an alternative in patients non responding to conventional therapies. PMID:26839644

  10. Endoscopic management of posterior epistaxis.

    Science.gov (United States)

    Paul, J; Kanotra, Sohit Paul; Kanotra, Sonika

    2011-04-01

    The traditional method of management of posterior epistaxis has been with anteroposterior nasal packing. Apart from the high failure rate of 26-50% reported in various series, nasal packing is associated with marked discomfort and several complications. In order to avoid nasal packing, we started doing endoscopic cauterization in cases of posterior epistaxis. A total of 23 patients with posterior epistaxis were subjected to nasal endoscopy with the intent to stop bleeding by cauterization of the bleeding vessel. Of these, in four cases unsuspected diagnosis was made. Of the remaining 19, in three patients, the bleeding point could not be localized accurately and these patients were managed by anteroposterior packing. The rest of the 16 patients were managed by endoscopic cauterization. In four patients, there was recurrence of bleeding within 24 h. In one of these, cauterization controlled the bleeding while in the rest nasal packing had to be resorted to. Thus, of the 23 patients of posterior epistaxis subjected to nasal endoscopy, we could avoid nasal packing in 17 (74%). To conclude, endoscopic nasal cauterization is recommended as the first line to treatment in all cases of posterior epistaxis. This will not only prevent the uncomfortable and potentially dangerous nasal packing but also help in finding the underlying pathology.

  11. Endoscopically removed giant submucosal lipoma

    Directory of Open Access Journals (Sweden)

    Jovanović Ivan

    2007-01-01

    Full Text Available Background. Although uncommon, giant submucosal colon lipomas merit attention as they are often presented with dramatic clinical features such as bleeding, acute bowel obstruction, perforation and sometimes may be mistaken for malignancy. There is a great debate in the literature as to how to treat them. Case report. A patient, 67-year old, was admitted to the Clinic due to a constipation over the last several months, increasing abdominal pain mainly localized in the left lower quadrant accompanied by nausea, vomiting and abdominal distension. Physical examination was unremarkable and the results of the detailed laboratory tests and carcinoembryonic antigen remained within normal limits. Colonoscopy revealed a large 10 cm long, and 4 to 5 cm in diameter, mobile lesion in his sigmoid colon. Conventional endoscopic ultrasound revealed 5 cm hyperechoic lesion of the colonic wall. Twenty MHz mini-probe examination showed that lesion was limited to the submucosa. Since polyp appeared too large for a single transaction, it was removed piecemeal. Once the largest portion of the polyp has been resected, it was relatively easy to place the opened snare loop around portions of the residual polyp. Endoscopic resection was carried out safely without complications. Histological examination revealed the common typical histological features of lipoma elsewhere. The patient remained stable and eventually discharged home. Four weeks later he suffered no recurrent symptoms. Conclusion. Colonic lipomas can be endoscopically removed safely eliminating unnecessary surgery.

  12. Management of Nodular Neoplasia in Barrett's Esophagus: Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection

    NARCIS (Netherlands)

    Belghazi, Kamar; Bergman, Jacques J. G. H. M.; Pouw, Roos E.

    2017-01-01

    Endoscopic resection has proven highly effective and safe in the removal of focal early neoplastic lesions in Barrett's esophagus and is considered the cornerstone of endoscopic treatment. Several techniques are available for endoscopic resection in Barrett's esophagus. The most widely used

  13. The clinical and radiological observation of endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Park, Choong Shik; Park, Byoung Lan; Chun, Hyun Woo; Kim, Byung Geun; Park, Hong Bae

    1981-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) is a new diagnostic method for pancreatic and biliary disease which has been made possible by the development of fiberoptic duodenoscopy. It has been thought that ERCP will serve an important role in the early detection of pancreatic cancer, but in order to detect minor lesions of the pancreas and improve the diagnostic accuracy of resectable pancreatic cancer, Endoscopic Retrograde Parenchymography of the pancreas (ERPP) was developed recently. The authors analyzed 117 cases of ERCP performed at the Kwangju Christian Hospital between January and December 1980, and compared them with the final diagnosis. The results were as follows: 1. One of 117 cases, successful visualization of the duct of concern was achieved in 105 cases. Of these, 25 cases were ERPP. 2. The ratio of males to females was 1.44 : 1. Most patients were in the 4th to 6th decade. 3. The commonest clinical manifestations were upper abdominal pain (77 cases), jaundice (23 cases), indigestion, vomiting and abdominal mass, in order of frequency. 4. Out of 46 cases of suspected pancreatic diseases, the pancreatic duct was visualized in 36 cases, and 24 cases revealed pathognomonic findings. These were diagnosed as 16 cases of pancreatic cancer, 4 cases of chronic pancreatitis, 2 cases of pancreatic pseudocyst and 2 cases of periampullary cancer with pancreas invasion. In pancreatic cancer findings were; encasement, local dilatation, delayed excretion, poor filling, obstruction of pancreatic duct, accompanying C.B.D. obstruction or stenosis and so called double duct sign. The chronic pancreatitis findings included; ductal dilatation (with or without) obstruction, tortuosity with dilated saccular lateral branching, stone formation and the parenchymal filling defect. 5. Out of 71 cases of suspected biliary tract disease, the biliary tract was visualized in 57 cases, and in 31 cases abnormalities were suggested; such as 20 cases of biliary stone, 1 case

  14. Asymptomatic Esophageal Varices Should Be Endoscopically Treated

    Directory of Open Access Journals (Sweden)

    Nib Soehendra

    1998-01-01

    Full Text Available Endoscopic treatment has generally been accepted in the management of bleeding esophageal varices. Both the control of acute variceal bleeding and elective variceal eradication to prevent recurrent bleeding can be achieved via endoscopic methods. In contrast to acute and elective treatment, the role of endoscopic therapy in asymptomatic patients who have never had variceal bleeding remains controversial because of the rather disappointing results obtained from prophylactic sclerotherapy. Most published randomized controlled trials showed that prophylactic sclerotherapy had no effect on survival. In some studies, neither survival rate nor bleeding risk was improved. In this article, the author champions the view that asymptomatic esophageal varices should be endoscopically treated.

  15. Endoscopic full-thickness resection: Current status.

    Science.gov (United States)

    Schmidt, Arthur; Meier, Benjamin; Caca, Karel

    2015-08-21

    Conventional endoscopic resection techniques such as endoscopic mucosal resection or endoscopic submucosal dissection are powerful tools for treatment of gastrointestinal neoplasms. However, those techniques are restricted to superficial layers of the gastrointestinal wall. Endoscopic full-thickness resection (EFTR) is an evolving technique, which is just about to enter clinical routine. It is not only a powerful tool for diagnostic tissue acquisition but also has the potential to spare surgical therapy in selected patients. This review will give an overview about current EFTR techniques and devices.

  16. Use of prototype two-channel endoscope with elevator enables larger lift-and-snare endoscopic mucosal resection in a porcine model.

    Science.gov (United States)

    Atkinson, Matthew; Chukwumah, Chike; Marks, Jeffrey; Chak, Amitabh

    2014-02-01

    Flat and depressed lesions are becoming increasingly recognized in the esophagus, stomach, and colon. Various techniques have been described for endoscopic mucosal resection (EMR) of these lesions. To evaluate the efficacy of lift-grasp-cut EMR using a prototype dual-channel forward-viewing endoscope with an instrument elevator in one accessory channel (dual-channel elevator scope) as compared to standard dual-channel endoscopes. EMR was performed using a lift-grasp-cut technique on normal flat rectosigmoid or gastric mucosa in live porcine models after submucosal injection of 4 mL of saline using a dual-channel elevator scope or a standard dual-channel endoscope. With the dual-channel elevator scope, the elevator was used to attain further lifting of the mucosa. The primary endpoint was size of the EMR specimen and the secondary endpoint was number of complications. Twelve experiments were performed (six gastric and six colonic). Mean specimen diameter was 2.27 cm with the dual-channel elevator scope and 1.34 cm with the dual-channel endoscope (P = 0.018). Two colonic perforations occurred with the dual-channel endoscope, vs no complications with the dual-channel elevator scope. The increased lift of the mucosal epithelium, through use of the dual-channel elevator scope, allows for larger EMR when using a lift-grasp-cut technique. Noting the thin nature of the porcine colonic wall, use of the elevator may also make this technique safer.

  17. Endoscopic Solution to Rhinogenic Contact Headaches

    Directory of Open Access Journals (Sweden)

    Hasan Abdul Cader Segana

    2016-08-01

    Full Text Available Introduction Headache is a common complaint that brings patients to multidisciplinary clinics. It is utmost important to have meticulous clinical diagnosis of patients with rhinogenic and non sinusogenic headaches. The diagnosis has become easier with the advent of modern endoscopy and endoscopic sinus surgical techniques. This study aims to investigate the role of some anatomical nasal abnormalities in rhinogenic contact headache and to evaluate response to endoscopic surgery.   Materials and Method A prospective study was conducted at a secondary level regional referral Hospital in the Sultanate of Oman. Patients with long-lasting, frequent, severe headaches not amenable to medical treatment, above 20 years of age were taken into consideration. Routine nasal endoscopy, Computerized tomography scan of the paranasal sinuses, Nasal decongestion and various surgical techniques to correct the anatomical abnormalities were included in our study and results were correlated statistically.   Result There was a male predominance in our study with duration of headache ranging from 2 weeks to 5 years. There was a preponderance of headache in frontal region in our study group. Diagnostic nasal endoscopy and CT scan of PNS revealed Deviated nasal septum / septal spur, concha bullosa, Haller cell, pneumatised uncinate process and agar nasi cells. The overall success rate of the surgery in relieving headaches, measured by the MIDAS- VAS score, was approximately 75 %. The non-parametric Wilcoxon signed rank test, Chi square and paired T tests shows that the following study has rejected the null hypothesis as statistically significant where the P value <0.05.   Discussion Researchers have examined the contact points as a source of rhinogenic / contact headache. Intranasal mucosal contact released substance P, causing pain and headache, Substance P has a potent vasodilator effect. Vasodilatation and perivascular inflammation are the final common pathways in

  18. The Efficacy of Endoscopic Palliation of Obstructive Jaundice in Hepatocellular Carcinoma

    Science.gov (United States)

    Park, Semi; Park, Jeong Youp; Chung, Moon Jae; Chung, Jae Bock; Park, Seung Woo; Han, Kwang-Hyub; Song, Si Young

    2014-01-01

    Purpose Obstructive jaundice in patients with hepatocellular carcinoma (HCC) is uncommon (0.5-13%). Unlike other causes of obstructive jaundice, the role of endoscopic intervention in obstructive jaundice complicated by HCC has not been clearly defined. The aim of this study was to evaluate the clinical characteristics of obstructive jaundice caused by HCC and predictive factors for successful endoscopic intervention. Materials and Methods From 1999 to 2009, 54 patients with HCC who underwent endoscopic intervention to relieve obstructive jaundice were included. We defined endoscopic intervention as a clinical success when the obstructive jaundice was relieved within 4 weeks. Results Clinical success was achieved in 23 patients (42.6%). Patients in the clinical success group showed better Child-Pugh liver function (C-P grade A or B/C; 17/6 vs. 8/20), lower total bilirubin levels (8.1±5.3 mg/dL vs. 23.1±10.4 mg/dL) prior to the treatment, and no history of alcohol consumption. The only factor predictive of clinical success by multivariate analysis was low total bilirubin level at the time of endoscopic intervention, regardless of history of alcohol consumption [odds ratio 1.223 (95% confidence interval, 1.071-1.396), p=0.003]. The cut-off value of pre-endoscopic treatment total bilirubin level was 12.8 mg/dL for predicting the clinical prognosis. Median survival after endoscopic intervention in the clinical success group was notably longer than that in the clinical failure group (5.6 months vs. 1.5 months, p≤0.001). Conclusion Before endoscopic intervention, liver function, especially total bilirubin level, should be checked to achieve the best clinical outcome. Endoscopic intervention can be helpful to relieve jaundice in well selected patients with HCC. PMID:25048484

  19. Lower incidence of complications in endoscopic nasobiliary drainage for hilar cholangiocarcinoma.

    Science.gov (United States)

    Kawakubo, Kazumichi; Kawakami, Hiroshi; Kuwatani, Masaki; Haba, Shin; Kudo, Taiki; Taya, Yoko A; Kawahata, Shuhei; Kubota, Yoshimasa; Kubo, Kimitoshi; Eto, Kazunori; Ehira, Nobuyuki; Yamato, Hiroaki; Onodera, Manabu; Sakamoto, Naoya

    2016-05-10

    To identify the most effective endoscopic biliary drainage technique for patients with hilar cholangiocarcinoma. In total, 118 patients with hilar cholangiocarcinoma underwent endoscopic management [endoscopic nasobiliary drainage (ENBD) or endoscopic biliary stenting] as a temporary drainage in our institution between 2009 and 2014. We retrospectively evaluated all complications from initial endoscopic drainage to surgery or palliative treatment. The risk factors for biliary reintervention, post-endoscopic retrograde cholangiopancreatography (post-ERCP) pancreatitis, and percutaneous transhepatic biliary drainage (PTBD) were also analyzed using patient- and procedure-related characteristics. The risk factors for bilateral drainage were examined in a subgroup analysis of patients who underwent initial unilateral drainage. In total, 137 complications were observed in 92 (78%) patients. Biliary reintervention was required in 83 (70%) patients. ENBD was significantly associated with a low risk of biliary reintervention [odds ratio (OR) = 0.26, 95%CI: 0.08-0.76, P = 0.012]. Post-ERCP pancreatitis was observed in 19 (16%) patients. An absence of endoscopic sphincterotomy was significantly associated with post-ERCP pancreatitis (OR = 3.46, 95%CI: 1.19-10.87, P = 0.023). PTBD was required in 16 (14%) patients, and Bismuth type III or IV cholangiocarcinoma was a significant risk factor (OR = 7.88, 95%CI: 1.33-155.0, P = 0.010). Of 102 patients with initial unilateral drainage, 49 (48%) required bilateral drainage. Endoscopic sphincterotomy (OR = 3.24, 95%CI: 1.27-8.78, P = 0.004) and Bismuth II, III, or IV cholangiocarcinoma (OR = 34.69, 95%CI: 4.88-736.7, P < 0.001) were significant risk factors for bilateral drainage. The endoscopic management of hilar cholangiocarcinoma is challenging. ENBD should be selected as a temporary drainage method because of its low risk of complications.

  20. Endoscopic mucosal resection for staging and treatment of early esophageal carcinoma: a single institution experience.

    Science.gov (United States)

    Huntington, Justin T; Walker, Jon P; Meara, Michael P; Hazey, Jeffrey W; Melvin, W Scott; Perry, Kyle A

    2015-08-01

    Endoscopic mucosal resection (EMR) has emerged for evaluation and treatment of esophageal nodules. We report our initial experience with EMR for T staging and management of early esophageal cancer. We reviewed patients undergoing EMR for esophageal adenocarcinoma between 2008 and 2013. The primary outcome measure was needed for esophagectomy. Secondary outcomes included complete eradication of adenocarcinoma, recurrence or persistence of cancer, nodal status for those undergoing esophagectomy, and complications of endoscopic treatment. During the study period, 24 patients underwent EMR demonstrating carcinoma, and a grossly margin negative endoscopic resection was achieved in all cases. Ten patients (42 %) had evidence of submucosal invasion and were referred for esophagectomy. Patients with margin negative EMR (n = 10, 42 %) or positive radial margins (n = 4, 16 %) underwent endoscopic surveillance and treatment with radiofrequency ablation or repeat EMR as needed. Thirteen patients (93 %) with intramucosal cancer (IMC) have been successfully managed with ongoing endoscopic surveillance and treatment with a median follow-up of 15.5 months. One patient underwent esophagectomy due to recurrent IMC in the setting of long-segment multifocal high-grade dysplasia. There were no esophageal perforations, one patient developed a self-limited gastrointestinal hemorrhage following EMR, and one had an esophageal stricture following endoscopic management. IMC can be successfully managed endoscopically and thus esophagectomy is avoided in a significant proportion of patients. Endoscopic management may be utilized in the setting of complete resection or radial margin involvement without evidence of submucosal invasion. Close endoscopic follow-up is of paramount importance even in those with negative margins, because recurrent disease may occur following EMR in these patients.

  1. Endoscopic band ligation and endoscopic hemoclip placement for patients with Mallory-Weiss syndrome and active bleeding

    OpenAIRE

    Cho, Young-Seok; Chae, Hiun-Suk; Kim, Hyung-Keun; Kim, Jin-Soo; Kim, Byung-Wook; Kim, Sung-Soo; Han, Sok-Won; Choi, Kyu-Yong

    2008-01-01

    AIM: To compare the hemostatic efficacy and safety of two mechanical endoscopic methods: endoscopic band ligation (EBL) and endoscopic hemoclip placement (EHP) in patients with actively bleeding Mallory-Weiss syndrome (MWS).

  2. Anesthesia for Routine and Advanced Upper Gastrointestinal Endoscopic Procedures.

    Science.gov (United States)

    Sharp, Christopher D; Tayler, Ezekiel; Ginsberg, Gregory G

    2017-12-01

    This article aims to detail the breadth and depth of advanced upper gastrointestinal endoscopic procedures. It will focus on sedation and airway management concerns pertaining to this emerged and emerging class of minimally invasive interventions. The article will also cover endoscopic hemostasis, endoscopic resection, stenting and Barrett eradication therapy plus endoscopic ultrasound. It additionally will address the nuances of endoscopic retrograde cholangiopancreatography and new natural orifice transluminal endoscopic surgery procedures including endoscopic cystgastrostomy and the per-oral endoscopic myotomy procedure. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Novel endoscopic activity index is useful for choosing treatment in severe active ulcerative colitis patients.

    Science.gov (United States)

    Naganuma, Makoto; Ichikawa, Hitoshi; Inoue, Nagamu; Kobayashi, Taku; Okamoto, Susumu; Hisamatsu, Tadakazu; Kanai, Takanori; Ogata, Haruhiko; Iwao, Yasushi; Hibi, Toshifumi

    2010-09-01

    Clinical symptoms are the most important factors used by physicians to evaluate the severity and extent of ulcerative colitis (UC). In this context, colonoscopy is also a useful diagnostic tool. We have recently developed an endoscopic activity index (EAI) to assess the severity of UC. Here, we assess the correlations among the EAI, other endoscopic indices, and clinical scores. The usefulness of the EAI for choosing treatment options, such as intravenous corticosteroid or cyclosporine A (CsA), in severe UC patients was also evaluated. Clinical symptoms and endoscopic finding were evaluated in 396 patients with UC (454 colonoscopies). The EAI was scored using the following six items: ulcer size, ulcer depth, redness, bleeding, edema, and mucus exudates. The patients were also scored using Matts' grade, Rachmilewitz's endoscopic index, and the Lichtiger index. Our results showed that (1) the EAI scores were closely correlated with those of the Lichtiger index, Matts' grade, and Rachmilewitz's endoscopic index; (2) the EAI scores significantly decreased in patients who responded to treatment, while Matts' grade did not change in some responders treated with intravenous CsA and steroid; (3) patients with a higher EAI (14-16) tended to be refractory to corticosteroid therapy (responders 19%) compared to CsA (77%), while steroid treatment was effective in 58% of patients with EAI scores of 11-13. The EAI is equivalent to other endoscopic indices and relatively more useful in choosing a treatment for patients with severe UC.

  4. Endoscope-assisted supraorbital approach to the retroinfundibular area: a cadaveric study.

    Science.gov (United States)

    Tang, Chi-Tun; Baidya, Nishanta B; Ammirati, Mario

    2013-04-01

    The purpose of this study is to investigate and evaluate the exposure and maneuverability of this areas provided by an endoscope-assisted supraorbital approach and to compare that to a microscopic supraorbital approach. We exposed microscopically the optico-carotid and the infrachiasmatic windows after a supraorbital craniotomy executed using an eyebrow incision. We then proceeded to explore the retroinfundibular area using these two windows either using the microscope alone or using the endoscope-microscope combination where the microscope was used to (1) guide instrument and endoscope insertion into the surgical field, and (2) explore (with microscopic 3-d vision) subsegments of the endoscopic field of view. We compared the exposure and surgical maneuverability of the approach utilizing the microscopic mode alone with the endoscope-assisted mode. We evaluated the exposure and the surgical maneuverability of key anatomical structures of the retroinfundibular area. The structures evaluated included the diaphragma sellae, the dorsum sellae, the posterior clinoid process, the pituitary stalk, the mammillary bodies, the tuber cinereum, the oculomotor nerves, the basal pons, the upper trunk of the basilar artery, the superior cerebellar arteries, the posterior cerebral arteries, the posterior communicating arteries and the basilar bifurcation. The exposure and the surgical maneuverability were significantly higher in the endoscope-assisted mode (P microscopic approach. Further clinical information is required to verify the results of this study.

  5. A systematic review of cost-effectiveness evidence of endoscopic saphenous vein harvesting: is it efficient?

    Science.gov (United States)

    García-Altés, A; Peiró, S

    2011-06-01

    Greater saphenous vein harvest for coronary and lower extremity bypass requires the longest incision of any surgical procedure. Endoscopic vein harvest allows better results in some clinical variables compared to open harvesting techniques. The objective of this study is to present the results of a systematic review of the scientific evidence about the efficiency of endoscopic saphenous vein harvest. We performed a systematic review in the bibliographical databases Pubmed, National Health Service Economic Evaluation Database, and NHS Health Technology Assessment Database. The search strategy was "endoscopic AND harvesting", in the period January 1970-December 2009. We identified only 3 economic evaluation studies, 2 cost analyses with some methodological limitations, and 1 cost-utility analysis. All of them suggest lower hospital costs for endoscopic harvesting. Available evidence does not allow recommendations to be made based on the efficiency of endoscopic saphenous vein harvest, although it suggests lower costs for endoscopic harvesting. More scientific evidence about the long-term efficacy and the effectiveness of this technique is necessary, with studies measuring final outcomes, and carrying out complete and rigorous economic evaluations. Copyright © 2011 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.

  6. A feasibility study of an integrated NIR/gamma/visible imaging system for endoscopic sentinel lymph node mapping.

    Science.gov (United States)

    Kang, Han Gyu; Lee, Ho-Young; Kim, Kyeong Min; Song, Seong-Hyun; Hong, Gun Chul; Hong, Seong Jong

    2017-01-01

    The aim of this study is to integrate NIR, gamma, and visible imaging tools into a single endoscopic system to overcome the limitation of NIR using gamma imaging and to demonstrate the feasibility of endoscopic NIR/gamma/visible fusion imaging for sentinel lymph node (SLN) mapping with a small animal. The endoscopic NIR/gamma/visible imaging system consists of a tungsten pinhole collimator, a plastic focusing lens, a BGO crystal (11 × 11 × 2 mm 3 ), a fiber-optic taper (front = 11 × 11 mm 2 , end = 4 × 4 mm 2 ), a 122-cm long endoscopic fiber bundle, an NIR emission filter, a relay lens, and a CCD camera. A custom-made Derenzo-like phantom filled with a mixture of 99m Tc and indocyanine green (ICG) was used to assess the spatial resolution of the NIR and gamma images. The ICG fluorophore was excited using a light-emitting diode (LED) with an excitation filter (723-758 nm), and the emitted fluorescence photons were detected with an emission filter (780-820 nm) for a duration of 100 ms. Subsequently, the 99m Tc distribution in the phantom was imaged for 3 min. The feasibility of in vivo SLN mapping with a mouse was investigated by injecting a mixture of 99m Tc-antimony sulfur colloid (12 MBq) and ICG (0.1 mL) into the right paw of the mouse (C57/B6) subcutaneously. After one hour, NIR, gamma, and visible images were acquired sequentially. Subsequently, the dissected SLN was imaged in the same way as the in vivo SLN mapping. The NIR, gamma, and visible images of the Derenzo-like phantom can be obtained with the proposed endoscopic imaging system. The NIR/gamma/visible fusion image of the SLN showed a good correlation among the NIR, gamma, and visible images both for the in vivo and ex vivo imaging. We demonstrated the feasibility of the integrated NIR/gamma/visible imaging system using a single endoscopic fiber bundle. In future, we plan to investigate miniaturization of the endoscope head and simultaneous NIR/gamma/visible imaging with

  7. Endoscopic ultrasound-guided endoscopic necrosectomy of the pancreas: is irrigation necessary?

    Science.gov (United States)

    Jürgensen, Christian; Neser, Frank; Boese-Landgraf, Joachim; Schuppan, Detlef; Stölzel, Ulrich; Fritscher-Ravens, Annette

    2012-05-01

    Findings have shown endoscopic necrosectomy to be beneficial for patients with symptomatic pancreatic necrosis accessible for an endoscopic approach. The available studies show that endoscopic necrosectomy requires a multitude of subsequent procedures including repeat irrigation for removal of the necrotic material. This study aimed to investigate the need for additional irrigation in patients with necrotizing pancreatitis treated by endoscopic necrosectomy. The study enrolled 35 consecutive patients (27 men) with a median age of 59 years who had pancreatic necrosis treated with endoscopic necrosectomy. Endoscopic ultrasound-guided internal drainage and consecutive endoscopic necrosectomy was combined with interval multistenting of the cavity. Neither endoscopic nor external irrigation was part of the procedure. An average of 6.2 endoscopy sessions per patient were needed for access, necrosectomy, and stent management. The in-hospital mortality rate was 6% (2/35), including one procedure-related death resulting from postinterventional aspiration. The immediate morbidity rate was 9% (3/35). It was possible to achieve clinical remission for all the surviving patients with no additional surgery needed for management of the necroses. The median follow-up period was 23 months. Neither endoscopic nor external flushing is needed for successful endoscopic treatment of symptomatic necroses. Even without irrigation, the outcome for patients treated with endoscopic necrosectomy is comparable to that described in the published data.

  8. Robot-assisted endoscope guidance versus manual endoscope guidance in functional endonasal sinus surgery (FESS).

    Science.gov (United States)

    Eichhorn, Klaus Wolfgang; Westphal, Ralf; Rilk, Markus; Last, Carsten; Bootz, Friedrich; Wahl, Friedrich; Jakob, Mark; Send, Thorsten

    2017-10-01

    Having one hand occupied with the endoscope is the major disadvantage for the surgeon when it comes to functional endoscopic sinus surgery (FESS). Only the other hand is free to use the surgical instruments. Tiredness or frequent instrument changes can thus lead to shaky endoscopic images. We collected the pose data (position and orientation) of the rigid 0° endoscope and all the instruments used in 16 FESS procedures with manual endoscope guidance as well as robot-assisted endoscope guidance. In combination with the DICOM CT data, we tracked the endoscope poses and workspaces using self-developed tracking markers. All surgeries were performed once with the robot and once with the surgeon holding the endoscope. Looking at the durations required, we observed a decrease in the operating time because one surgeon doing all the procedures and so a learning curve occurred what we expected. The visual inspection of the specimens showed no damages to any of the structures outside the paranasal sinuses. Robot-assisted endoscope guidance in sinus surgery is possible. Further CT data, however, are desirable for the surgical analysis of a tracker-based navigation within the anatomic borders. Our marker-based tracking of the endoscope as well as the instruments makes an automated endoscope guidance feasible. On the subjective side, we see that RASS brings a relief for the surgeon.

  9. Mallory-Weiss syndrome with severe bleeding: treatment by endoscopic ligation.

    Science.gov (United States)

    Terada, R; Ito, S; Akama, F; Kidogawa, H; Kashima, K; Yamayoshi, T; Ooe, H

    2000-11-01

    There is no consensus as to the best treatment for Mallory-Weiss tears with severe bleeding. Endoscopic ligation is an inexpensive, readily available, and easily learned technique, in contrast to conventional thermocoagulation or hemoclipping. To evaluate the utility of endoscopic ligation, we performed this technique during emergency endoscopy to treat severe bleeding from Mallory-Weiss tears in four patients in our hospital with continuous active bleeding from Mallory-Weiss tears. The patients were all male with an average age of 40.5 years. Symptoms associated with increased intra-abdominal pressure, including retching and vomiting were reported by all patients. The bleeding points were aspirated and controlled by endoscopic ligation, and complete hemostasis was achieved in all cases. We conclude that endoscopic ligation is easy to perform and may provide an alternative treatment for severe bleeding from Mallory-Weiss tears.

  10. Per Oral Endoscopic Myotomy in Children with Achalasia Cardia

    OpenAIRE

    Nabi, Zaheer; Ramchandani, Mohan; Reddy, D Nageshwar; Darisetty, Santosh; Kotla, Rama; Kalapala, Rakesh; Chavan, Radhika

    2016-01-01

    Background/Aims Achalasia cardia (AC) is a motility disorder, characterized by impaired lower esophageal sphincter relaxation and absence of esophageal peristalsis. AC is rare in children with unclear optimum management strategies. Per oral endoscopic myotomy (POEM) is a novel technique for management of achalasia with encouraging results in adult patients. The efficacy and safety of POEM is not known for pediatric AC. The aim of our study was to evaluate the safety and efficacy of POEM in ch...

  11. RESEARCH Endoscopic injection sclerotherapy for bleeding varices ...

    African Journals Online (AJOL)

    RESEARCH. 884 November 2012, Vol. 102, No. 11 SAMJ. Endoscopic injection sclerotherapy for bleeding varices in children with intrahepatic and extrahepatic portal venous ... Progress has been made in developing newer endoscopic techniques ... a sclerosant, usually 0.5 - 0.75 ml per injection, at multiple (up to.

  12. Towards automated visual flexible endoscope navigation

    NARCIS (Netherlands)

    van der Stap, N.; van der Heijden, Ferdinand; Broeders, Ivo Adriaan Maria Johannes

    2013-01-01

    Background The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now

  13. Duodenal diverticular bleeding: an endoscopic challenge

    Directory of Open Access Journals (Sweden)

    Eduardo Valdivielso-Cortázar

    Full Text Available Duodenal diverticula are an uncommon cause of upper gastrointestinal bleeding. Until recently, it was primarily managed with surgery, but advances in the field of endoscopy have made management increasingly less invasive. We report a case of duodenal diverticular bleeding that was endoscopically managed, and review the literature about the various endoscopic therapies thus far described.

  14. Endoscopic third ventriculostomy in idiopathic normal pressure ...

    African Journals Online (AJOL)

    Objective: To determine the efficacy of endoscopic fenestration of the third ventricle in the treatment of idiopathic normal pressure hydrocephalus. Methods: 16 patients with idiopathic normal pressure hydrocephalus were treated by endoscopic third ventriculostomy. This study lasted three years. All patients were over 50 ...

  15. Endoscopic management of bile leaks after laparoscopic ...

    African Journals Online (AJOL)

    Of 84 patients managed endoscopically, 44 had a cystic duct (CD) leak, 26 a CD leak and common bile duct (CBD) stones, and 14 a CBD injury amenable to endoscopic stenting. Of the 70 patients with CD leaks (group A), 24 underwent sphincterotomy only (including 8 stone extractions), 43 had a sphincterotomy with stent ...

  16. Endoscopic submucosal dissection

    DEFF Research Database (Denmark)

    Pimentel-Nunes, Pedro; Dinis-Ribeiro, Mário; Ponchon, Thierry

    2015-01-01

    UNLABELLED: This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system 1 2 was adopted to define the strength of recommendations and the quality of evidence. MAIN...... lesions (strong recommendation, moderate quality evidence). 4 ESGE states that the majority of colonic and rectal superficial lesions can be effectively removed in a curative way by standard polypectomy and/or by EMR (strong recommendation, moderate quality evidence). ESD can be considered for removal...... of colonic and rectal lesions with high suspicion of limited submucosal invasion that is based on two main criteria of depressed morphology and irregular or nongranular surface pattern, particularly if the lesions are larger than 20 mm; or ESD can be considered for colorectal lesions that otherwise cannot...

  17. Advanced endoscopic imaging: European Society of Gastrointestinal Endoscopy (ESGE) Technology Review.

    Science.gov (United States)

    East, James E; Vleugels, Jasper L; Roelandt, Philip; Bhandari, Pradeep; Bisschops, Raf; Dekker, Evelien; Hassan, Cesare; Horgan, Gareth; Kiesslich, Ralf; Longcroft-Wheaton, Gaius; Wilson, Ana; Dumonceau, Jean-Marc

    2016-11-01

    Background and aim: This technical review is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the utilization of advanced endoscopic imaging in gastrointestinal (GI) endoscopy. Methods: This technical review is based on a systematic literature search to evaluate the evidence supporting the use of advanced endoscopic imaging throughout the GI tract. Technologies considered include narrowed-spectrum endoscopy (narrow band imaging [NBI]; flexible spectral imaging color enhancement [FICE]; i-Scan digital contrast [I-SCAN]), autofluorescence imaging (AFI), and confocal laser endomicroscopy (CLE). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) system was adopted to define the strength of recommendation and the quality of evidence. Main recommendations: 1. We suggest advanced endoscopic imaging technologies improve mucosal visualization and enhance fine structural and microvascular detail. Expert endoscopic diagnosis may be improved by advanced imaging, but as yet in community-based practice no technology has been shown consistently to be diagnostically superior to current practice with high definition white light. (Low quality evidence.) 2. We recommend the use of validated classification systems to support the use of optical diagnosis with advanced endoscopic imaging in the upper and lower GI tracts (strong recommendation, moderate quality evidence). 3. We suggest that training improves performance in the use of advanced endoscopic imaging techniques and that it is a prerequisite for use in clinical practice. A learning curve exists and training alone does not guarantee sustained high performances in clinical practice. (Weak recommendation, low quality evidence.) Conclusion: Advanced endoscopic imaging can improve mucosal visualization and endoscopic diagnosis; however it requires training and the use of validated classification systems. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Percutaneous endoscopic gastrostomy following previous abdominal surgery.

    Science.gov (United States)

    Stellato, T A; Gauderer, M W; Ponsky, J L

    1984-01-01

    During a 36-month period, 89 patients have undergone percutaneous endoscopic gastrostomy without mortality. Of these patients, 25 (13 infants and children, 12 adults) had prior abdominal procedures that increased their risk for the endoscopic procedure. With two exceptions, all gastrostomies were performed utilizing local anesthesia. There was one major complication, a gastrocolic fistula, which was successfully managed by repeating the endoscopic gastrostomy procedure at a location more cephalad in the stomach. Twenty-two of the gastrostomies were placed for feeding purposes and all of these patients were able to leave the hospital with alimentation accomplished via the tube. Three of the endoscopically placed gastrostomies were for gastrointestinal tract decompression. A total of 255 patient months have been accumulated in these patients with the endoscopically placed gastrostomy in situ. The technique can be safely performed in patients with prior abdominal surgery and in the majority of cases is the technique of choice for establishing a tube gastrostomy. PMID:6428334

  19. Endoscopic palliation in gastric cancer

    International Nuclear Information System (INIS)

    Valdivieso, Eduardo

    2010-01-01

    The integral search for improved living conditions for those patients with gastric cancer who have not received curative surgical treatment continues to challenge the knowledge, dexterity and ethical foundations of medical teams. The justification for palliative treatment must be based on a thorough consideration of the available options and the particular situation in each case. This article reviews endoscopic therapy with auto expandable prosthetics for palliative treatment of gastric cancer, as well as the scientific evidence that supports its use and the factors that determine its indication.

  20. Portable fiber-optic taper coupled optical microscopy platform

    Science.gov (United States)

    Wang, Weiming; Yu, Yan; Huang, Hui; Ou, Jinping

    2017-04-01

    The optical fiber taper coupled with CMOS has advantages of high sensitivity, compact structure and low distortion in the imaging platform. So it is widely used in low light, high speed and X-ray imaging systems. In the meanwhile, the peculiarity of the coupled structure can meet the needs of the demand in microscopy imaging. Toward this end, we developed a microscopic imaging platform based on the coupling of cellphone camera module and fiber optic taper for the measurement of the human blood samples and ascaris lumbricoides. The platform, weighing 70 grams, is based on the existing camera module of the smartphone and a fiber-optic array which providing a magnification factor of 6x.The top facet of the taper, on which samples are placed, serves as an irregular sampling grid for contact imaging. The magnified images of the sample, located on the bottom facet of the fiber, are then projected onto the CMOS sensor. This paper introduces the portable medical imaging system based on the optical fiber coupling with CMOS, and theoretically analyzes the feasibility of the system. The image data and process results either can be stored on the memory or transmitted to the remote medical institutions for the telemedicine. We validate the performance of this cell-phone based microscopy platform using human blood samples and test target, achieving comparable results to a standard bench-top microscope.

  1. Changes in abnormal muscle tension pattern after fiberoptic injection laryngoplasty.

    Science.gov (United States)

    Ziade, Georges; Haddad, Ghassan; Assaad, Sarah; Kasti, Maher; Hamdan, Abdul-Latif

    2017-12-01

    We performed a retrospective chart review to compare the presence and types of abnormal muscle tension patterns (MTPs) in patients who had been diagnosed with glottal insufficiency before and after fiberoptic injection laryngoplasty. The main cause of glottal insufficiency had been unilateral vocal fold paralysis. Our review included an analysis of the medical records and laryngeal videostroboscopic recordings of 16 patients-9 men and 7 women, aged 25 to 87 years (mean: 59). Stroboscopic frames were analyzed for the presence of one or more types of abnormal MTP. Statistical analysis was performed to determine the significance of the change in scores for type II and type III MTP before injection and 1 month after injection. Before injection laryngoplasty, 15 of the 16 patients exhibited evidence of an abnormal MTP; 10 patients had MTP II only, 2 had MTP III only, and 3 patients had both. The mean percentage of frames showing MTP (i.e., MTP score) in patients with MTP II was 66.2% before the injection and 28.9% 1 month after; the decrease was statistically significant (p = 0.001). For MTP III, the corresponding figures were 71.6 and 37.7% (p = 0.043). We conclude that injection laryngoplasty has a positive effect on reducing muscle tension in patients with glottal insufficiency.

  2. Assessing carotid atherosclerosis by fiber-optic multispectral photoacoustic tomography

    Science.gov (United States)

    Hui, Jie; Li, Rui; Wang, Pu; Phillips, Evan; Bruning, Rebecca; Liao, Chien-Sheng; Sturek, Michael; Goergen, Craig J.; Cheng, Ji-Xin

    2015-03-01

    Atherosclerotic plaque at the carotid bifurcation is the underlying cause of the majority of ischemic strokes. Noninvasive imaging and quantification of the compositional changes preceding gross anatomic changes within the arterial wall is essential for diagnosis of disease. Current imaging modalities such as duplex ultrasound, computed tomography, positron emission tomography are limited by the lack of compositional contrast and the detection of flow-limiting lesions. Although high-resolution magnetic resonance imaging has been developed to characterize atherosclerotic plaque composition, its accessibility for wide clinical use is limited. Here, we demonstrate a fiber-based multispectral photoacoustic tomography system for excitation of lipids and external acoustic detection of the generated ultrasound. Using sequential ultrasound imaging of ex vivo preparations we achieved ~2 cm imaging depth and chemical selectivity for assessment of human arterial plaques. A multivariate curve resolution alternating least squares analysis method was applied to resolve the major chemical components, including intravascular lipid, intramuscular fat, and blood. These results show the promise of detecting carotid plaque in vivo through esophageal fiber-optic excitation of lipids and external acoustic detection of the generated ultrasound. This imaging system has great potential for serving as a point-ofcare device for early diagnosis of carotid artery disease in the clinic.

  3. Fiber-Optic Network Observations of Earthquake Wavefields

    Science.gov (United States)

    Lindsey, Nathaniel J.; Martin, Eileen R.; Dreger, Douglas S.; Freifeld, Barry; Cole, Stephen; James, Stephanie R.; Biondi, Biondo L.; Ajo-Franklin, Jonathan B.

    2017-12-01

    Our understanding of subsurface processes suffers from a profound observation bias: seismometers are sparse and clustered on continents. A new seismic recording approach, distributed acoustic sensing (DAS), transforms telecommunication fiber-optic cables into sensor arrays enabling meter-scale recording over tens of kilometers of linear fiber length. We analyze cataloged earthquake observations from three DAS arrays with different horizontal geometries to demonstrate some possibilities using this technology. In Fairbanks, Alaska, we find that stacking ground motion records along 20 m of fiber yield a waveform that shows a high degree of correlation in amplitude and phase with a colocated inertial seismometer record at 0.8-1.6 Hz. Using an L-shaped DAS array in Northern California, we record the nearly vertically incident arrival of an earthquake from The Geysers Geothermal Field and estimate its backazimuth and slowness via beamforming for different phases of the seismic wavefield. Lastly, we install a fiber in existing telecommunications conduits below Stanford University and show that little cable-to-soil coupling is required for teleseismic P and S phase arrival detection.

  4. Fiber-Optic Surface Temperature Sensor Based on Modal Interference

    Directory of Open Access Journals (Sweden)

    Frédéric Musin

    2016-07-01

    Full Text Available Spatially-integrated surface temperature sensing is highly useful when it comes to controlling processes, detecting hazardous conditions or monitoring the health and safety of equipment and people. Fiber-optic sensing based on modal interference has shown great sensitivity to temperature variation, by means of cost-effective image-processing of few-mode interference patterns. New developments in the field of sensor configuration, as described in this paper, include an innovative cooling and heating phase discrimination functionality and more precise measurements, based entirely on the image processing of interference patterns. The proposed technique was applied to the measurement of the integrated surface temperature of a hollow cylinder and compared with a conventional measurement system, consisting of an infrared camera and precision temperature probe. As a result, the optical technique is in line with the reference system. Compared with conventional surface temperature probes, the optical technique has the following advantages: low heat capacity temperature measurement errors, easier spatial deployment, and replacement of multiple angle infrared camera shooting and the continuous monitoring of surfaces that are not visually accessible.

  5. Novel adaptive fiber-optics collimator for coherent beam combination.

    Science.gov (United States)

    Zhi, Dong; Ma, Pengfei; Ma, Yanxing; Wang, Xiaolin; Zhou, Pu; Si, Lei

    2014-12-15

    In this manuscript, we experimentally validate a novel design of adaptive fiber-optics collimator (AFOC), which utilizes two levers to enlarge the movable range of the fiber end cap. The enlargement of the range makes the new AFOC possible to compensate the end-cap/tilt aberration in fiber laser beam combining system. The new AFOC based on flexible hinges and levers was fabricated and the performance of the new AFOC was tested carefully, including its control range, frequency response and control accuracy. Coherent beam combination (CBC) of two 5-W fiber amplifiers array with simultaneously end-cap/tilt control and phase-locking control was implemented successfully with the novel AFOC. Experimental results show that the average normalized power in the bucket (PIB) value increases from 0.311 to 0.934 with active phasing and tilt aberration compensation simultaneously, and with both controls on, the fringe contrast improves to more than 82% from 0% for the case with both control off. This work presents a promising structure for tilt aberration control in high power CBC system.

  6. 1st International Conference on Fiber-Optic Rotation Sensors

    CERN Document Server

    Arditty, Hervé

    1982-01-01

    Currently there is considerable interest in the application of optical meth­ ods for the measurement of absolute rotation. Active approaches, so-called ring laser gyros, have been under serious development for at least 15 years. More recently, passive approaches using ring resonators or multi turn fiber interferometers have also demonstrated much pro~ise. The only previous conference devoted exclusively to optical rotation sensors, held in 1978 in San Diego, California, was organized by the Society of Photo-optical Instru­ mentation Engineers(S.P.I.E.J. Although the main emphasis at that conference was on ring laser gyros, a number of papers were also included that described the early development of fiber gyroscopes. Since then the field of fiber optic rotation sensors has grown so rapidly that a conference devoted primarily to this subject was needed. The First International Conference on Fiber-Optic Rotation Sensors was held at the Massachusetts Institute of Technology, Cambridge, Massachusetts, Nove~­ b...

  7. Flexible fiberoptic bronchoscopy service; an aid to patient management

    LENUS (Irish Health Repository)

    Marathe, N

    2016-02-01

    The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Luke’s General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Luke’s Hospital were studied. In total, 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before bronchoscopy services were started locally. Fifteen (14%) patients were referred for Endobronchial Ultrasound (EBUS) after diagnostic procedure performed at St. Luke’s Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic bronchoscopies performed for malignancy at St. Luke’s Hospital have rightly increased references for EBUS at Tertiary care Unit

  8. A Fiber-Optic Aircraft Lightning Current Measurement Sensor

    Science.gov (United States)

    Nguyen, Truong X.; Ely, Jay J.; Szatkowski, George N.

    2013-01-01

    A fiber-optic current sensor based on the Faraday Effect is developed for aircraft installations. It can measure total lightning current amplitudes and waveforms, including continuing current. Additional benefits include being small, lightweight, non-conducting, safe from electromagnetic interference, and free of hysteresis and saturation. The Faraday Effect causes light polarization to rotate in presence of magnetic field in the direction of light propagation. Measuring the total induced light polarization change yields the total current enclosed. The system operates at 1310nm laser wavelength and can measure approximately 300 A - 300 kA, a 60 dB range. A reflective polarimetric scheme is used, where the light polarization change is measured after a round-trip propagation through the fiber. A two-detector setup measures the two orthogonal polarizations for noise subtraction and improved dynamic range. The current response curve is non-linear and requires a simple spline-fit correction. Effects of high current were achieved in laboratory using combinations of multiple fiber and wire loops. Good result comparisons against reference sensors were achieved up to 300 kA. Accurate measurements on a simulated aircraft fuselage and an internal structure illustrate capabilities that maybe difficult with traditional sensors. Also tested at a commercial lightning test facility from 20 kA to 200 kA, accuracy within 3-10% was achieved even with non-optimum setups.

  9. Lightning Current Measurement with Fiber-Optic Sensor

    Science.gov (United States)

    Nguyen, Truong X.; Ely, Jay J.; Szatkowski, George N.; Mata, Carlos T.; Mata, Angel G.; Snyder, Gary P.

    2014-01-01

    A fiber-optic current sensor is successfully developed with many potential applications for electric current measurement. Originally developed for in-flight lightning measurement, the sensor utilizes Faraday Effect in an optical fiber. The Faraday Effect causes linear light polarization in a fiber to rotate when the fiber is exposed to a magnetic field. The polarization change is detected using a reflective polarimetric scheme. Forming fiber loops and applying Ampere's law, measuring the total light rotation results in the determination of the total current enclosed. The sensor is conformable to complex structure geometry. It is also non-conductive and immune to electromagnetic interference, saturation or hysteresis. Installation is non-intrusive, and the sensor can be safely routed through flammable areas. Two similar sensor systems are described in this paper. The first system operates at 1310nm laser wavelength and is capable of measuring approximately 300 A - 300 kA, a 60 dB range. Laboratory validation results of aircraft lighting direct and in-direct effect current amplitudes are reported for this sensor. The second system operates at 1550nm wavelength and can measure about 400 A - 400 kA. Triggered-lightning measurement data are presented for this system. Good results are achieved in all cases.

  10. Dexmedetomidine versus Remifentanil for Sedation during Awake Fiberoptic Intubation

    Directory of Open Access Journals (Sweden)

    Davide Cattano

    2012-01-01

    Full Text Available This study compared remifentanil and dexmedetomidine as awake fiberoptic intubation (AFOI anesthetics. Thirty-four adult ASA I-III patients were enrolled in a double-blinded randomized pilot study to receive remifentanil (REM or dexmedetomidine (DEX for sedation during AFOI (nasal and oral. Thirty patients completed the study and received 2 mg midazolam IV and topical anesthesia. The REM group received a loading dose of 0.75 mcg/kg followed by an infusion of 0.075 mcg/kg/min. The DEX group received a loading dose of 0.4 mcg/kg followed by an infusion of 0.7 mcg/kg/hr. Time to sedation, number of intubation attempts, Ramsay sedation scale (RSS score, bispectral index (BIS, and memory recall were recorded. All thirty patients were successfully intubated by AFOI (22 oral intubations/8 nasal. First attempt success rate with AFOI was higher in the REM group than the DEX group, 72% and 38% (P=0.02, respectively. The DEX group took longer to attain RSS of ≥3 and to achieve BIS <80, as compared to the REM group. Postloading dose verbal recall was poorer in the DEX group. Dexmedetomidine seems a useful adjunct for patients undergoing AFOI but is dependent on dosage and time. Further studies in the use of dexmedetomidine for AFOI are warranted.

  11. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces.

    Science.gov (United States)

    Laitala, Marja-Liisa; Piipari, Liina; Sämpi, Noora; Korhonen, Maria; Pesonen, Paula; Joensuu, Tiina; Anttonen, Vuokko

    2017-01-01

    The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI) method in comparison with clinical visual examination (CV) and bitewing (BW) radiography on detecting caries lesions on proximal surfaces of teeth. Proximal tooth surfaces of premolars and molars ( n = 2,103) of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. DIFOTI detected more initial and manifested caries lesions compared with CV and BW. Of the analyzed tooth surfaces, 69.8% were classified as sound by DIFOTI, 80.3% by BW, and 91.6% by CV. Initial caries lesions were found in 21.2% of the surfaces by DIFOTI, in 14.1% by BW, and in 6.2% by CV, whereas the proportions for manifested dental caries lesions were 9.0%, 5.6%, and 2.2%, respectively. The interexaminer agreement regarding the DIFOTI findings between an experienced clinician and a fifth-year dental student was high: κ = 0.67 for initial and κ = 0.91 for manifested caries lesions. The noninvasive DIFOTI method seems to offer a potential tool for everyday clinical practice. In clinical use, DIFOTI finds well even initial caries lesions on proximal surfaces, thus providing an instrument for detecting lesions potential for arresting as well as for monitoring the outcome after preventive measures.

  12. Validity of Digital Imaging of Fiber-Optic Transillumination in Caries Detection on Proximal Tooth Surfaces

    Directory of Open Access Journals (Sweden)

    Marja-Liisa Laitala

    2017-01-01

    Full Text Available Objective. The aim of our study was to evaluate the validity of the digital imaging fiber-optic transillumination (DIFOTI method in comparison with clinical visual examination (CV and bitewing (BW radiography on detecting caries lesions on proximal surfaces of teeth. Materials and Methods. Proximal tooth surfaces of premolars and molars (n=2,103 of 91 voluntary university students aged from 18 to 30 years were examined with CV, BW radiography, and the DIFOTI method. Results. DIFOTI detected more initial and manifested caries lesions compared with CV and BW. Of the analyzed tooth surfaces, 69.8% were classified as sound by DIFOTI, 80.3% by BW, and 91.6% by CV. Initial caries lesions were found in 21.2% of the surfaces by DIFOTI, in 14.1% by BW, and in 6.2% by CV, whereas the proportions for manifested dental caries lesions were 9.0%, 5.6%, and 2.2%, respectively. The interexaminer agreement regarding the DIFOTI findings between an experienced clinician and a fifth-year dental student was high: κ=0.67 for initial and κ=0.91 for manifested caries lesions. Conclusions. The noninvasive DIFOTI method seems to offer a potential tool for everyday clinical practice. In clinical use, DIFOTI finds well even initial caries lesions on proximal surfaces, thus providing an instrument for detecting lesions potential for arresting as well as for monitoring the outcome after preventive measures.

  13. Incidence of Fever and Bacteriemia Following Flexible Fiberoptic Bronchoscopy: A Prospective Study

    Directory of Open Access Journals (Sweden)

    Babak Sharif-Kashani

    2010-12-01

    Full Text Available The latest American Heart Association (AHA statement for preventing infectious endocarditis, has not recommended prophylactic antibiotic therapy prior to fiberoptic bronchoscopy (FB except for patients with preexisting predisposing cardiac conditions. Our aim was to determine the incidence of bacteriemia and fever following FB in our experience and compare with those which have been mentioned in AHA guideline as well as other studies. Venous blood of 85 consecutive patients was evaluated for both aerobic and anaerobic cultures before (for detecting possible previous bacteriemia and after FB. None of the patients were treated with antibiotics prior to the procedure. All the patients were examined during the first 24 hours after FB for detecting fever defined as temperature more than 38 °C. Positive hemocultures were noted in 7 (8.2 % patients after FB examination. Coagulase negative Staphylococcus, coagulase positive Staphylococcus, beta haemolytic Streptococcus, Citrobacter freundii and Streptococcus viridans were found in 4, 1, 1 and 1 cultures of patients, respectively. By excluding 6 contaminated samples, the rate of bacteriemia reduced to 1 (1.1% patient in whom the identical pathogen (Streptococcus viridans was found both in bronchial lavage and venous blood culture. We also found fever in 9 (10.5 % cases in the first 24 hours following the bronchoscopy. Our results were in consistent with AHA recommendations regarding prevention of infectious endocarditis as a practical gridline in patients who schedule for FB. Besides, transient fever following bronchoscopy is a common self-limited event which does not need medical intervention.

  14. [Therapeutic aspects of endoscopic polypectomy].

    Science.gov (United States)

    Kratzsch, K H; Stibenz, J; Fürstenau, M; Winkelvoss, H; Büttner, W; Jacobasch, K H; Gütz, H J; Irro, F

    1980-02-15

    466 endoscopic polypectomies of the upper and lower gastrointestinal tract were analysed according to their curative value. In 254 removed polyps of the upper gastrointestinal tract the result of the histological examination was twice a proof of a carcinoma. One it had to be after-resected, once a carcinoid, five times bleeding polyps were removed. Four times prolapsing gastric polyps were removed in the bulbus duodeni. In these cases intermittent disturbances of the passage could be repaired. Thus the endoscopic polypectomy in the upper gastrointestinal tract was of therapeutic value in 4.3%. In the lower intestinal tract in 204 polypectomies 16 focal carcinomas or invasive carcinomas removed in the healthy tissue, 1 carcinoid and 98 bleeding adenomas were cut away. Thus the coloscopic polypectomy was connected with a therapeutic use in 56.3%. 81.8% of the polyps was tubular, papillary or villous adenomas. Taking into consideration the "adenoma-cancer-sequence", the coloscopic polypectomy must thus be regarded as a prophylactic and curative method, while in the polypectomy in the upper gastrointestinal tract the diagnostic value is in the first place.

  15. A physical simulator for endoscopic endonasal drilling techniques: technical note.

    Science.gov (United States)

    Tai, Bruce L; Wang, Anthony C; Joseph, Jacob R; Wang, Page I; Sullivan, Stephen E; McKean, Erin L; Shih, Albert J; Rooney, Deborah M

    2016-03-01

    In this paper, the authors present a physical model developed to teach surgeons the requisite drilling techniques when using an endoscopic endonasal approach (EEA) to the skull base. EEA is increasingly used for treating pathologies of the ventral and ventrolateral cranial base. Endonasal drilling is a unique skill in terms of the instruments used, the long reach required, and the restricted angulation, and gaining competency requires much practice. Based on the successful experience in creating custom simulators, the authors used 3D printing to build an EEA training model from post-processed thin-cut head CT scans, formulating the materials to provide realistic haptic feedback and endoscope handling. They performed a preliminary assessment at 2 institutions to evaluate content validity of the simulator as the first step of the validation process. Overall results were positive, particularly in terms of bony landmarks and haptic response, though minor refinements were suggested prior to use as a training device.

  16. Endoscopic submucosal dissection of gastric adenomas using the clutch cutter.

    Science.gov (United States)

    Akahoshi, Kazuya; Kubokawa, Masaru; Gibo, Junya; Osada, Shigeki; Tokumaru, Kayo; Yamaguchi, Eriko; Ikeda, Hiroko; Sato, Takao; Miyamoto, Kazuaki; Kimura, Yusuke; Shiratsuchi, Yuki; Akahoshi, Kazuaki; Oya, Masafumi; Koga, Hidenobu; Ihara, Eikichi; Nakamura, Kazuhiko

    2017-07-16

    To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) using the clutch cutter (CC) (ESD-CC) for gastric adenoma (GA). From June 2007 to August 2015, 122 consecutive patients with histological diagnoses of GA from specimens resected by ESD-CC were enrolled in this prospective study. The CC was used for all ESD steps (marking, mucosal incision, submucosal dissection, and hemostatic treatment), and its therapeutic efficacy and safety were assessed. Both the en-bloc resection rate and the R0 resection rate were 100% (122/122). The mean surgical time was 77.4 min, but the time varied significantly according to tumor size and location. No patients suffered perforation. Post-ESD-CC bleeding occurred in six cases (4.9%) that were successfully resolved by endoscopic hemostatic treatment. ESD-CC is a technically efficient, safe, and easy method for resecting GA.

  17. Fiber-optic thermometry using thermal radiation from Tm end doped SiO2 fiber sensor.

    Science.gov (United States)

    Morita, Kentaro; Katsumata, Toru; Komuro, Shuji; Aizawa, Hiroaki

    2014-04-01

    Fiber-optic thermometry based on temperature dependence of thermal radiation from Tm(3+) ions was studied using Tm end doped SiO2 fiber sensor. Visible light radiation peaks due to f-f transition of Tm(3+) ion were clearly observed at λ = 690 and 790 nm from Tm end doped SiO2 fibers sensor at the temperature above 600 °C. Thermal radiation peaks are assigned with f-f transition of Tm(3+) ion, (1)D2-(3)H6, and (1)G4-(3)H6. Peak intensity of thermal radiation from Tm(3+) ion increases with temperature. Intensity ratio of thermal radiation peaks at λ = 690 nm against that at λ = 790 nm, I790/690, is suitable for the temperature measurement above 750 °C. Two-dimensional temperature distribution in a flame is successfully evaluated by Tm end doped SiO2 fiber sensor.

  18. Short-term safety and efficacy of the Trans-oral Endoscopic Restrictive Implant System for the treatment of obesity

    NARCIS (Netherlands)

    de Jong, Koen; Mathus-Vliegen, Elisabeth M. H.; Veldhuyzen, Elisabeth A. M. L.; Eshuis, Jan H.; Fockens, Paul

    2010-01-01

    Background: Medical treatment of obesity often fails, and surgical treatment, although successful, is aggressive. Objective: To evaluate the short-term safety and efficacy of an endoscopic restrictive implant procedure in the treatment of obesity. Design: Prospective, observational study. Setting:

  19. Value of a new pathological classification of lumbar intervertebral disc herniation based on transforaminal endoscopic observations.

    Science.gov (United States)

    Yang, Lin; Lu, Hong-Hui

    2017-05-01

    Removal of herniated disc materials based on an imaging only method may not relieve symptoms in many patients. Therefore, the aim of the present study was to develop a transforaminal endoscopic method of classifying the pathological type of lumber intervertebral disc herniation and to compare the outcomes of surgery based on the pathological type with those of conventional endoscopic disc removal. The records of patients who received endoscopic transforaminal nucleotomy with foraminoplasty for symptomatic lumbar disc herniation between 2009 and 2013 were retrospectively reviewed. Patients were then divided into two groups: Group A, which consisted of 275 patients who received conventional endoscopic transforaminal nucleotomy with foraminoplasty between 2009 and 2011 and group B, which consisted of 316 patients who received 'targeted' endoscopic transforaminal nucleotomy with foraminoplasty between 2011 and 2013 (based on the pathological type of disc herniation identified at surgery, including fresh, calcified and scar type based on intraoperative observations). The results showed that there were no significant differences in age, gender, body mass index, symptom duration, operated segments or previous invasive therapies between the two groups. Moreover, evaluation of visual analogue scale pain scores and Oswestry disability index scores revealed that the patients in group B had a greater improvement in symptoms than those in group A (P40 years and a longer symptom duration were associated with the calcified type, and previous invasive therapy was associated with the scar type. Therefore, specific surgical treatment based on the transforaminal endoscopic pathological type can result in better outcomes for patients with lumbar disc herniation.

  20. High pressure air jet in the endoscopic preparation room: risk of noise exposure on occupational health.

    Science.gov (United States)

    Chiu, King-Wah; Lu, Lung-Sheng; Wu, Cheng-Kun

    2015-01-01

    After high-level disinfection of gastrointestinal endoscopes, they are hung to dry in order to prevent residual water droplets impact on patient health. To allow for quick drying and clinical reuse, some endoscopic units use a high pressure air jet (HPAJ) to remove the water droplets on the endoscopes. The purpose of this study was to evaluate the excessive noise exposure with the use of HPAJ in endoscopic preparation room and to investigate the risk to occupational health. Noise assessment was taken during 7 automatic endoscopic reprocessors (AERs) and combined with/without HPAJ use over an 8-hour time-weighted average (TWA). Analytical procedures of the NIOSH and the ISO for noise-induced hearing loss were estimated to develop analytic models. The peak of the noise spectrum of combined HPAJ and 7 AERs was significantly higher than that of the 7 AERs alone (108.3 ± 1.36 versus 69.3 ± 3.93 dBA, P  2.5 dB) was 2.15% at 90 dBA, 11.6% at 95 dBA, and 51.3% at 100 dBA. The odds ratio was 49.1 (95% CI: 11.9 to 203.6). The noise generated by the HPAJ to work over TWA seriously affected the occupational health and safety of those working in an endoscopic preparation room.

  1. Can endoscopic atrophy predict histological atrophy? Historical study in United Kingdom and Japan.

    Science.gov (United States)

    Kono, Shin; Gotoda, Takuji; Yoshida, Shigeaki; Oda, Ichiro; Kondo, Hitoshi; Gatta, Luigi; Naylor, Greg; Dixon, Michael; Moriyasu, Fuminori; Axon, Anthony

    2015-12-14

    To assess the diagnostic concordance between endoscopic and histological atrophy in the United Kingdom and Japan. Using published data, a total of 252 patients, 126 in the United Kingdom and 126 in Japan, aged 20 to 80 years, were evaluated. The extent of endoscopic atrophy was classified into five subgroups according to a modified Kimura-Takemoto classification system and was compared with histological findings of atrophy at five biopsy sites according to the updated Sydney system. The strength of agreement of the extent of atrophy between histology and visual endoscopic inspection showed good reproducibility, with a weighted kappa value of 0.76 (P atrophy (OR = 0.10, 95%CI: 0.03-0.36). The strength of agreement between endoscopic and histological atrophy, assessed by cancer risk-oriented grading, was reproducible, with a kappa value of 0.81 (95%CI: 0.75-0.87). Only nine patients (3.6%) were endoscopically underdiagnosed with antral predominant rather than extensive atrophy and were considered false negatives. Endoscopic grading can predict histological atrophy with few false negatives, indicating that precancerous conditions can be identified during screening endoscopy, particularly in patients in western countries.

  2. Optical biopsies by confocal endomicroscopy prevent additive endoscopic biopsies before endoscopic submucosal dissection in gastric epithelial neoplasias: a prospective, comparative study.

    Science.gov (United States)

    Jeon, Seong Ran; Cho, Won Young; Jin, So Young; Cheon, Young Koog; Choi, Seok Reyol; Cho, Joo Young

    2011-10-01

    Confocal laser endomicroscopy (CLE) allows real-time in vivo histologic evaluation of GI lesions. To our knowledge, there is no reported prospective study comparing endoscopic and optical biopsy using CLE before endoscopic submucosal dissection (ESD) with post-ESD histopathology. We compared endoscopic and optical biopsy before ESD and thereby assessed the ability of CLE to effectively diagnose and differentiate gastric epithelial neoplasia. Single tertiary-care center, prospective comparative study. Soonchunhyang University Hospital, between September 2009 and April 2010. This study involved 31 patients with 35 gastric epithelial neoplasias, previously diagnosed by endoscopic biopsy, who were scheduled for ESD. Target lesions were imaged in vivo by using CLE. The overall accuracy of endoscopic and CLE diagnosis was compared with post-ESD histopathology. In histopathology after ESD, 11 of 35 lesions (31.5%) were adenomas and 24 (68.5%) were adenocarcinomas. The overall accuracy of CLE diagnosis of gastric adenomas and adenocarcinomas was significantly higher at 94.2% (95% confidence interval [CI], 81.3-98.4), versus 85.7% (95% CI, 70.6-93.7) for endoscopic biopsy (P = .031). The overall accuracy of CLE diagnosis of differentiated and undifferentiated adenocarcinomas also was higher (95.4%; 95% CI, 78.2-99.1) than that of endoscopic biopsy (84.2%; 95% CI, 62.4-94.4) but did not differ significantly (P = .146). Single tertiary-care center experience and small patient number. This study demonstrates the high accuracy of diagnosis of gastric epithelial neoplasia by using CLE. The use of CLE could possibly thus reduce the number of unnecessary biopsies and mistaken diagnoses before ESD. Copyright © 2011 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  3. Extruded contents of colloid cysts after endoscopic removal.

    Science.gov (United States)

    Abdel Latif, Assem M; Souweidane, Mark M

    2016-09-01

    OBJECTIVE Mineralized or desiccated colloid cysts pose some unique challenges to endoscopic removal. The extrusion of the solid matrix into the intraventricular compartment has not been previously reported and, as such, no guidance exists regarding its predilection, prevention, and fate. METHODS Postoperative imaging studies in a registry of patients undergoing endoscopic removal of colloid cyst were reviewed to detect any solid matrix within the ventricular compartment. Preoperative images and operative notes were used to determine if any features were predictive. Serial postoperative images and clinical notes were used to characterize the implications of these findings. RESULTS From a review of 94 patients, 10 (10.6%) patients had evidence of an extruded intraventricular solid fragment (median follow-up 4 months; range 0.5-115 months). Of the evaluable patients, 7 of 9 patients had T1-weighted hyperintense and T2-weighted hypointense cysts on preoperative scans. Seventy-eight percent of the extrusions were on the same side as the endoscopic entry. Three patients demonstrated early fragment migration, but not after 8 months of radiological follow-up. All evaluable patients demonstrated improvement in their hydrocephalus, and none suffered a complication attributable to the intraventricular extruded fragments. CONCLUSIONS Intraventricular extruded colloid fragments can occur after endoscopic resection, with the possible risk demonstrated as cyst hypointensity on preoperative T2-weighted images. The finding does not seem to result in any clinical morbidity, and radiographic involution is the rule. Migratory capacity, however, does exist and justifies a more frequent imaging surveillance schedule and consideration for removal.

  4. OUTCOMES OF TRANSFORAMINAL ENDOSCOPIC DISCECTOMY FOR LUMBOSACRAL DISC HERNIATION

    Directory of Open Access Journals (Sweden)

    I. V. Volkov

    2017-01-01

    Full Text Available Introduction. Lumbar disc herniation is a frequent pathology and surgical target. Endoscopic discectomy becomes more popular due to minimally invasive surgical technique. There is a deficit of scientific papers dedicated to analysis of potential for endoscopic discectomy depending on the specifics of spinal anatomy and degenerative changes.The purpose of the study was to evaluate the efficacy of transforaminal endoscopic discectomy (TED in comparison with microdiscectomy (MD and to specify factors determining complications and failures.Materials and methods. The authors performed randomized controlled study where main group of patients included data on prospective examination of 101 patients after TED procedure for lumbar intervertebral disc herniation. Age of patients ranged from 19 to 81 years with average of 41,4±12,6 years. Control group included data of retrospective examination of 153 patients that were operated by the same surgeon in the period from 201 till 2104 with microdiscectomy procedure. Age of patients ranged from 18 to 77 years with average of 47,8±11,3 years. Inclusion criteria were as follows: surgical procedure at the same level of the primary intervertebral herniation. Exclusion criteria were: degenerative spinal canal stenosis, spondylolisthesis, spine deformity.Results. Clinical outcomes after TED demonstrated no difference from MD procedure. No factors of significant influence on outcomes after surgical procedure were observed. The main group was characterized by more cases of revisions and conversions of endoscopic into open procedures (13,9% which was related to mistakes in transforaminal approach due to features of intervertebral joints and foramina anatomy resulting in impossibility to achieve adequate spinal canal decompression.Conclusion. Transforaminal endoscopic discectomy is an effective and safe method of lumbar intervertebral herniation treatment. Complications and failures during learning curve of endoscopic

  5. Fiber-optical sensor with intensity compensation model in college teaching of physics experiment

    Science.gov (United States)

    Su, Liping; Zhang, Yang; Li, Kun; Zhang, Yu

    2017-08-01

    Optical fiber sensor technology is one of the main contents of modern information technology, which has a very important position in modern science and technology. Fiber optic sensor experiment can improve students' enthusiasm and broaden their horizons in college physics experiment. In this paper the main structure and working principle of fiberoptical sensor with intensity compensation model are introduced. And thus fiber-optical sensor with intensity compensation model is applied to measure micro displacement of Young's modulus measurement experiment and metal linear expansion coefficient measurement experiment in the college physics experiment. Results indicate that the measurement accuracy of micro displacement is higher than that of the traditional methods using fiber-optical sensor with intensity compensation model. Meanwhile this measurement method makes the students understand on the optical fiber, sensor and nature of micro displacement measurement method and makes each experiment strengthen relationship and compatibility, which provides a new idea for the reform of experimental teaching.

  6. Constellation Shaping for Fiber-optic Channels with QAM and High Spectral Efficiency

    DEFF Research Database (Denmark)

    Yankov, Metodi Plamenov; Zibar, Darko; Larsen, Knud J.

    2014-01-01

    In this letter the fiber-optic communication channel with Quadrature Amplitude Modulation (QAM) input constella- tion is treated. Using probabilistic shaping, we show that high order QAM constellations can achieve and slightly exceed the lower bound on the channel capacity, set by ring constellat......In this letter the fiber-optic communication channel with Quadrature Amplitude Modulation (QAM) input constella- tion is treated. Using probabilistic shaping, we show that high order QAM constellations can achieve and slightly exceed the lower bound on the channel capacity, set by ring...... channel long-haul fiber-optical link excluding the pilot overhead, used for synchronization, and taking into account frequency and phase mismatch impairments, as well as laser phase noise and analog-to-digital conversion quantization impairments. The simulations suggest that major improvements can...... be expected in the achievable rates of optical networks with high order QAM....

  7. Endoscopic management of bleeding peptic ulcers

    International Nuclear Information System (INIS)

    Farooqi, J.I.; Farooqi, R.J.

    2001-01-01

    Peptic ulcers account for more than half of the cases of non variceal upper gastrointestinal (GI) bleeding and therefore, are the focus of most of the methods of endoscopic hemostasis. Surgical intervention is now largely reserved for patients in whom endoscopic hemostasis has failed. A variety of endoscopic techniques have been employed to stop bleeding and reduce the risk of rebleeding, with no major differences in outcome between these methods. These include injection therapy, fibrin injection, heater probe, mono polar electrocautery, bipolar electrocautery, lasers and mechanical hemo clipping. The most important factor in determining outcome after gastrointestinal bleeding is rebleeding or persistent bleeding. The endoscopic appearance of an ulcer, however, provides the most useful prognostic information for bleeding. Recurrent bleeding after initial endoscopic hemostasis occurs in 15-20% of patients with a bleeding peptic ulcer. The best approach to these patients remains controversial; the current options are repeat endoscopic therapy with the same or a different technique, emergency surgery or semi elective surgery after repeat endoscopic hemostasis. The combination of epinephrine injection with thermal coagulation may be more effective than epinephrine injection alone. Newer modalities such as fibrin injection or the application of hemo clips appear promising and comparative studies are awaited. (author)

  8. Endoscopic approaches to treatment of achalasia

    Science.gov (United States)

    Friedel, David; Modayil, Rani; Iqbal, Shahzad; Grendell, James H.

    2013-01-01

    Endoscopic therapy for achalasia is directed at disrupting or weakening the lower esophageal sphincter (LES). The two most commonly utilized endoscopic interventions are large balloon pneumatic dilation (PD) and botulinum toxin injection (BTI). These interventions have been extensively scrutinized and compared with each other as well as with surgical disruption (myotomy) of the LES. PD is generally more effective in improving dysphagia in achalasia than BTI, with the latter reserved for infirm older people, and PD may approach treatment results attained with myotomy. However, PD may need to be repeated. Small balloon dilation and endoscopic stent placement for achalasia have only been used in select centers. Per oral endoscopic myotomy is a newer endoscopic modality that will likely change the treatment paradigm for achalasia. It arose from the field of natural orifice transluminal endoscopic surgery and represents a scarless endoscopic approach to Heller myotomy. This is a technique that requires extensive training and preparation and thus there should be rigorous accreditation and monitoring of outcomes to ensure safety and efficacy. PMID:23503707

  9. Rectal bleeding in children: endoscopic evaluation revisited

    NARCIS (Netherlands)

    de Ridder, Lissy; van Lingen, Anna V.; Taminiau, Jan A. J. M.; Benninga, Marc A.

    2007-01-01

    Objectives Rectal bleeding is an alarming event both for the child and parents. It is hypothesized that colonoscopy instead of sigmoidoscopy and adding esophago-gastro-duodenoscopy in case of accompanying complaints, improves the diagnostic accuracy in children with prolonged rectal bleeding. Study

  10. An endoscopic Doppler probe: preliminary clinical evaluation

    NARCIS (Netherlands)

    Silverstein, F. E.; Deltenre, M.; Tytgat, G.; Martin, R. W.; Lesterhuis, W.; Burette, A.; Gilbert, D. A.

    1985-01-01

    A new pulsed Doppler catheter has been developed for use during gastrointestinal fiberendoscopy. Modern gastrointestinal endoscopy allows inspection of the wall of the entire esophagus, stomach, duodenum, and colon. Diagnosis is performed by inspecting the surface of the mucosa, biopsy, and

  11. Fiber-Optic Continuous Liquid Sensor for Cryogenic Propellant Gauging

    Science.gov (United States)

    Xu. Wei

    2010-01-01

    An innovative fiber-optic sensor has been developed for low-thrust-level settled mass gauging with measurement uncertainty optical fiber to measure liquid level and liquid distribution of cryogenic propellants. Every point of the sensing fiber is a point sensor that not only distinguishes liquid and vapor, but also measures temperature. This sensor is able to determine the physical location of each point sensor with 1-mm spatial resolution. Acting as a continuous array of numerous liquid/vapor point sensors, the truly distributed optical sensing fiber can be installed in a propellant tank in the same manner as silicon diode point sensor stripes using only a single feedthrough to connect to an optical signal interrogation unit outside the tank. Either water or liquid nitrogen levels can be measured within 1-mm spatial resolution up to a distance of 70 meters from the optical interrogation unit. This liquid-level sensing technique was also compared to the pressure gauge measurement technique in water and liquid nitrogen contained in a vertical copper pipe with a reasonable degree of accuracy. It has been demonstrated that the sensor can measure liquid levels in multiple containers containing water or liquid nitrogen with one signal interrogation unit. The liquid levels measured by the multiple fiber sensors were consistent with those virtually measured by a ruler. The sensing performance of various optical fibers has been measured, and has demonstrated that they can survive after immersion at cryogenic temperatures. The fiber strength in liquid nitrogen has also been measured. Multiple water level tests were also conducted under various actual and theoretical vibration conditions, and demonstrated that the signal-to-noise ratio under these vibration conditions, insofar as it affects measurement accuracy, is manageable and robust enough for a wide variety of spacecraft applications. A simple solution has been developed to absorb optical energy at the termination of

  12. Robotic endoscope motor module and gearing design.

    Science.gov (United States)

    Oliveira, Jillian M; Chen, Yi; Hunter, Ian W

    2011-01-01

    Actuation of a robotic endoscope with increased torque output is presented. This paper will specifically focus on the motor module section of a robotic endoscope, which comprises of a pair of motors and gear reduction assemblies. The results for the endoscope and biopsy tool stiffness, as well as the stall force and force versus speed characteristics of the motor module assembly are shown. The scope stiffness was found to be 0.006 N/degree and additional stiffness of the biopsy tools were found to be in the range of 0.09 to 0.13 N/degree. Calculations for worm gearing and efficiency are discussed.

  13. [PACS-based endoscope image acquisition workstation].

    Science.gov (United States)

    Liu, J B; Zhuang, T G

    2001-01-01

    A practical PACS-based Endoscope Image Acquisition Workstation is here introduced. By a Multimedia Video Card, the endoscope video is digitized and captured dynamically or statically into computer. This workstation realizes a variety of functions such as the endoscope video's acquisition and display, as well as the editing, processing, managing, storage, printing, communication of related information. Together with other medical image workstation, it can make up the image sources of PACS for hospitals. In addition, it can also act as an independent endoscopy diagnostic system.

  14. OPTICAL PHENOMENA IN FIBER WAVEGUIDES: Determination of the optical characteristics of infrared fiber-optic waveguides

    Science.gov (United States)

    Vasil'ev, A. V.; Plotnichenko, V. G.

    1987-04-01

    A description is given of the features distinguishing determination of the optical characteristics of fiber-optic waveguides in the middle infrared region. The spectral dependences are given of the overall optical losses for single-crystal two-layer fiber-optic waveguides utilizing cesium bromide and single-layer waveguides made of a chalcogenide glass of the Ge-As-Se system in an F-42 fluoroplastic polymer cladding. In the case of the latter waveguides, a study was made of the angular dependences of the radiation power distribution inside the waveguide when CO laser radiation was coupled in at different angles.

  15. Digital phase demodulation for low-coherence interferometry-based fiber-optic sensors

    Science.gov (United States)

    Liu, Y.; Strum, R.; Stiles, D.; Long, C.; Rakhman, A.; Blokland, W.; Winder, D.; Riemer, B.; Wendel, M.

    2018-03-01

    We describe a digital phase demodulation scheme for low-coherence interferometry-based fiber-optic sensors by employing a simple generation of phase-shifted signals at the interrogation interferometer. The scheme allows a real-time calibration process and offers capability of measuring large variations (up to the coherence of the light source) at the bandwidth that is only limited by the data acquisition system. The proposed phase demodulation method is analytically derived and its validity and performance are experimentally verified using fiber-optic Fabry-Perot sensors for measurement of strains and vibrations.

  16. Physical layer security in fiber-optic MIMO-SDM systems: An overview

    Science.gov (United States)

    Guan, Kyle; Cho, Junho; Winzer, Peter J.

    2018-02-01

    Fiber-optic transmission systems provide large capacities over enormous distances but are vulnerable to simple eavesdropping attacks at the physical layer. We classify key-based and keyless encryption and physical layer security techniques and discuss them in the context of optical multiple-input-multiple-output space-division multiplexed (MIMO-SDM) fiber-optic communication systems. We show that MIMO-SDM not only increases system capacity, but also ensures the confidentiality of information transmission. Based on recent numerical and experimental results, we review how the unique channel characteristics of MIMO-SDM can be exploited to provide various levels of physical layer security.

  17. An analog modulation and demodulation method employing LVDT signal conditioner for fiber-optic interferometric sensors

    Science.gov (United States)

    Zhou, Kejiang; Rao, Qi; Zhang, Minjie; Hu, Keke; Ruan, Yefeng

    2017-09-01

    An analog method to modulate and demodulate fiber-optic interferometric sensors employing a linear variable differential transformer signal conditioner to generate sine modulation wave and demodulate phase-modulated signal from the photodetector’s output is presented in this letter. No external lock-in amplifiers or digital components are used in this design. All the necessary components for signal processing are integrated in a single analog electronic microchip AD698, which reduces the system’s complexity significantly. After implementation on an interferometric fiber-optic gyroscope as an example, this method demonstrates a bias stability of 0.063 deg h-1 (i.e. 0.220 µrad).

  18. Modeling of Thermal Phase Noise in a Solid Core Photonic Crystal Fiber-Optic Gyroscope.

    Science.gov (United States)

    Song, Ningfang; Ma, Kun; Jin, Jing; Teng, Fei; Cai, Wei

    2017-10-26

    A theoretical model of the thermal phase noise in a square-wave modulated solid core photonic crystal fiber-optic gyroscope has been established, and then verified by measurements. The results demonstrate a good agreement between theory and experiment. The contribution of the thermal phase noise to the random walk coefficient of the gyroscope is derived. A fiber coil with 2.8 km length is used in the experimental solid core photonic crystal fiber-optic gyroscope, showing a random walk coefficient of 9.25 × 10 -5 deg/√h.

  19. Management of Nodular Neoplasia in Barrett's Esophagus: Endoscopic Mucosal Resection and Endoscopic Submucosal Dissection.

    Science.gov (United States)

    Belghazi, Kamar; Bergman, Jacques J G H M; Pouw, Roos E

    2017-07-01

    Endoscopic resection has proven highly effective and safe in the removal of focal early neoplastic lesions in Barrett's esophagus and is considered the cornerstone of endoscopic treatment. Several techniques are available for endoscopic resection in Barrett's esophagus. The most widely used technique for piecemeal resection of early Barrett's neoplasia is the ligate-and-cut technique. Newer techniques such as endoscopic submucosal dissection may also play a role in the treatment of neoplastic Barrett's esophagus. Treatment of early Barrett's neoplasia should be centralized and limited to expert centers with a high-volume load and sufficient expertise in the detection and treatment of esophageal neoplasia. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Avalia��ão da disfagia no pós-operatório de amigdalectomia através de videoendoscopia da deglutição Evaluation of disphagia in the post operatory of tonsillectomy using fiberoptic endoscopy of swallowing

    Directory of Open Access Journals (Sweden)

    Gilberto Silva Neto

    2003-01-01

    Full Text Available A deglutição em pacientes pós amigdalectomia é muito pouco estudada, não tendo os autores encontrado nenhuma publicação. OBJETIVO: Determinar se há e quais são as alterações da deglutição pós amigdalectomia. FORMA DE ESTUDO: Clínico prospectivo. MATERIAL E MÉTODO: Dezesseis pacientes foram submetidos à amigdalectomia pela mesma técnica e posteriormente à vídeo endoscopia da deglutição oferecendo líquido grosso (iogurte não diet entre o sétimo e décimo pós-operatório, sendo todos os exames gravados e revistos pelos autores para melhor controle e observação do exame. Comparamos com um grupo controle usado em outro estudo realizado no mesmo serviço. RESULTADOS: aumento do número de deglutições necessárias para sensação de limpeza (média de 4,8 deglutições em comparação com exames normais (de 1 a 2 deglutições, e ainda assim 66,6% dos pacientes apresentavam resíduos em seios piriformes.Os autores mostram neste estudo as alterações e aspectos relevantes da vídeo endoscopia da deglutição nos pacientes relatados, ponderando cuidados na indicação de amigdalectomia em pacientes potencialmente disfágicos. CONCLUSÕES: Os autores observaram que no pós-operatório de amigdalectomia há uma diminuição do clearance durante as deglutições.Swallowing in post-tonsillectomy patients has been poorly studied, since no publications were found by the authors. AIM: To determinate if there are and which are the alterations of swallowing after tonsillectomy. STUDY DESIGN: Clinical prospective. MATERIAL AND METHOD: Sixteen patients were submitted to tonsillectomy by the same technique and afterwards to fiberoptic endoscopy of swallowing, being offered thick liquid (non-diet yogurt, between the seventh and tenth postoperative day, being all the exams taped and reviewed by the authors for better control and observation; next, we compared with a control group used in another study conducted by the same center

  1. Endoscopic Excision of Symptomatic Os Trigonum in Professional Dancers.

    Science.gov (United States)

    Morelli, Federico; Mazza, Daniele; Serlorenzi, Pierluigi; Guidi, Marco; Camerucci, Emanuela; Calderaro, Cosma; Iorio, Raffaele; Guzzini, Matteo; Ferretti, Andrea

    The present study reports the clinical results of excision of a symptomatic os trigonum using an endoscopic procedure in professional ballet dancers. The hypothesis was that posterior endoscopic excision of the os trigonum would be safe and effective in treating posterior ankle impingement syndrome related to the os trigonum. Twelve professional dancers underwent excision of a symptomatic os trigonum for PAIS using a posterior endoscopic technique after failure of conservative treatment. The patients were evaluated pre- and postoperatively according to the American Orthopaedic Foot and Ankle Society hindfoot scale score, the Tegner activity scale score, and the visual analog scale score. The surgical time, timing of a return to sports, patient satisfaction, and any complications related to the procedure were recorded. The average postoperative follow-up duration was 38.9 ± 20.6 (range 12 to 72) months. The mean Tegner activity scale score increased from 4.3 ± 0.8 (range 3 to 5) preoperatively to 9 ± 0.2 postoperatively (p os trigonum using a 2-portal technique after failure of conservative treatment is characterized by excellent results with low morbidity. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  2. Advanced esophageal cancer and esophageal stenosis endoscopic treatment

    International Nuclear Information System (INIS)

    Piazze, A. E mail: apiazze@hc.edu.uy

    2005-01-01

    Advanced esophageal cancer (AEC) is diagnosed during those stages in which surgery is possible, it is palliative for disphagia, with high morbimortality.In inoperable or irresectable cases, resorting to alternative treatment such as radiotherapy or endoscopy may palliate dsphagia.Endoscopically it is possible to place a transtumoral nasogastric catheter (NGC) for preoperative nutrition or branchial therapy (intratumoral iridium).It is possible to dilate the tumor and place and indwelling plastic or auto expandable prosthesis or to inject absolute intratumoral alcohol.There is and evaluation of results and morbimortality of personal case material through the retrospective study of 54 patients in whom 120 procedures such as those referred to above were carried out.The series includes 41 men and 13 women (3-1), 79.5% of which were of ages between 61 and 90.Optic fiber endoscopes or video endoscopes, coaxial dilators, hydro-pneumatic balloons, metallic guides and non industrial and autoexpandable plastic prosthesis were used; 34.1% of procedures were performed under used; 34.1% of procedures were performed under radioscopy.Eleven patient (8 for nutritional purposes and 3 for brachiotherapy)form part of Groups 1 and 2 of NGC.Group 3 consist of:dilations of radicular stenosis with or without neopasic recurrence, or neoplasic infiltration of esophagus, 6 patient; Group 4: 14 patients for the purpose of dilation of esophageal neoplasm; Group 5:prosthesis, 12 patients; Group 6: 11 patients with anastomotic stenosis.In patients in Group 1-2-3 solution was achieved.In Group 3 there was 1 perforation.In Group 4, out of 14 patient 13 were dilated.In Group 5 it proved impossible to place prosthesis in 2 patient, (3.7%).The conclusion arrived at is that various endoscopic techniques may palliate disphagia in patient with AEC, collaborate with preoperative nutrition through enteral path, with brachioterapy or by treating post surgical stenosis, with low mortality

  3. Hemorrhage from the Major Duodenal Papilla after Endoscopic Retrograde Cholecystopancreatography

    Directory of Open Access Journals (Sweden)

    M. P. Mantserov

    2007-01-01

    Full Text Available Hemorrhage from the major duodenal papilla (MDP is a most common complication of endoscopic retrograde cholecystopancreatography (ERCPG with/without papillosphincterotomy (PST.The objective of the present study was to estimate the frequency of this complication and to evaluate the efficiency of methods for its prevention.Subjects and methods: In 1994 to 2005, the N. N. Burdenko Main Military Hospital performed 1373 ERCPGs with/without PST. The patients were divided into 2 groups: 1 326 patients (males, 75.1%; mean age, 58.2±16.1 years who had no drug preventive therapy for postmanipulation complications and PST was performed by the routine procedure; 2 1047 patients (males, 71.9%; mean age, 56.3±14.5 years who had endoscopic (PST being performed, by using atypical or combined procedures and drug (octreotide and protease inhibitors prevention of complications. The incidence of hemorrhage from MDP and a need for endoscopic bleeding arrest were estimated.Results: Just after the manipulation, hemorrhage requiring endoscopic arrest occurred in 24 (7.3% and 43 (4.1% patients in Groups 1 and 2, respectively (p<0.001. Following 24 hours, hemorrhage developed in 6 (13.9% and 3 (3.9% patients (p<0.001, this requiring surgical intervention in 1 (2.3% and 2 (26% patients from Groups 1 and 2, respectively. After 48 hours, hemorrhage recurred in 1 patient in each of the study groups and the signs of unstable hemostasis in esogaso-duodenoscopy (Forrest 2 a,b were detected in 6 (139% and 5 (6.6% patients in Groups 1 and 2, respectively (p<0.05.Conclusion: After ERCPG with PST, hemorrhage occurs in 4.9% of the patients. PST by atypical and combined procedures and the administration of octreotide and protease inhibitors effectively reduce the risk of this complication. 

  4. Endoscopic hemostasis state of the art - Nonvariceal bleeding.

    Science.gov (United States)

    Goelder, Stefan Karl; Brueckner, Juliane; Messmann, Helmut

    2016-02-25

    New endoscopic techniques for hemostasis in nonvariceal bleeding were introduced and known methods further improved. Hemospray and Endoclot are two new compounds for topical treatment of bleeding. Initial studies in this area have shown a good hemostatic effect, especially in active large scale oozing bleeding, e.g., tumor bleedings. For further evaluation larger prospective studies comparing the substanced with other methods of endoscopic hemostasis are needed. For localized active arterial bleeding primary injection therapy in the area of ​​bleeding as well as in the four adjacent quadrants offers a good method to reduce bleeding activity. The injection is technically easy to learn and practicable. After bleeding activity is reduced the bleeding source can be localized more clearly for clip application. Today many different through-the-scope (TTS) clips are available. The ability to close and reopen a clip can aid towards good positioning at the bleeding site. Even more important is the rotatability of a clip before application. Often multiple TTS clips are required for secure closure of a bleeding vessel. One model has the ability to use three clips in series without changing the applicator. Severe arterial bleeding from vessels larger than 2 mm is often unmanageable with these conventional methods. Here is the over-the-scope-clip system another newly available method. It is similar to the ligation of esophageal varices and involves aspiration of tissue into a transparent cap before closure of the clip. Thus a greater vascular occlusion pressure can be achieved and larger vessels can be treated endoscopically. Patients with severe arterial bleeding from the upper gastrointestinal tract have a very high rate of recurrence after initial endoscopic treatment. These patients should always be managed in an interdisciplinary team of interventional radiologist and surgeons.

  5. Endoscopic-assisted treatment of trigonocephaly.

    Science.gov (United States)

    Hinojosa, J

    2012-09-01

    Minimally invasive, endoscopic repair of metopic craniosynostosis has emerged as a potentially efficacious, safe, and aesthetically acceptable alternative to open procedures. Potential advantages of an early endoscopic approach to repair metopic craniosynostosis include a reduction in blood loss and consequent decreases in transfusion volumes, decreased hospital costs, shorter operative times, and limited duration of hospitalization. Other benefits of minimally invasive techniques would be avoidance of anaesthetic surgical scarring, decrease in postoperative swelling and discomfort, and lower rate of complications such as duramater tears, postoperative hyperthermia, or infection. However, a concern is usually raised about the achievements of the "endoscopic" techniques when compared to "standard" open approaches. The indications for endoscopic-assisted surgery in the treatment of trigonocephaly remain controversial and further series and follow-up of these patients are necessary to set up the role of these approaches.

  6. Cholangiography and endoscopic sphincterotomy in the ...

    African Journals Online (AJOL)

    Cholangiography and endoscopic sphincterotomy in the management of severe acute gallstone pancreatitis discovered at diag~osticlaparotomy. ... in these cases Included cholecystectomy and Ttube drainage (2 patients) cholecystostomy drainage (3 patients), and closure of the abdomen without drainage (2 patients).

  7. Endoscopic appearance of irradiated gastric mucosa

    Energy Technology Data Exchange (ETDEWEB)

    De Sagher, L.I.; Van den Heule, B.; Van Houtte, P.; Engelholm, L.; Balikdjan, D.; Bleiberg, H.

    1979-09-01

    Irradiation of the epigastric area for gastric cancer may induce actinic lesions of the stomach characterized on endoscopic examination by ulcerations, haemorrhagic gastritis, fragility of the mucosa, thickening and congestion of the gastric folds.

  8. Vagal withdrawal during endoscopic retrograde cholangiopancreatography

    DEFF Research Database (Denmark)

    Christensen, M; Rasmussen, Verner; Schulze, S

    2000-01-01

    BACKGROUND: Patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) are at risk of developing cardiorespiratory complications, but the mechanism is still unknown. Treatment with metoprolol 2 h before the endoscopy has been shown to decrease the incidence of myocardial ischaemia...

  9. Diagnosis and management of iatrogenic endoscopic perforations

    DEFF Research Database (Denmark)

    Paspatis, Gregorios A; Dumonceau, Jean-Marc; Barthet, Marc

    2014-01-01

    center implements a written policy regarding the management of iatrogenic perforation, including the definition of procedures that carry a high risk of this complication. This policy should be shared with the radiologists and surgeons at each center. 2 In the case of an endoscopically identified......This Position Paper is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). It addresses the diagnosis and management of iatrogenic perforation occurring during diagnostic or therapeutic digestive endoscopic procedures. Main recommendations 1 ESGE recommends that each...... management should be based on the estimated success of the endoscopic closure and on the general clinical condition of the patient. In the case of no or failed endoscopic closure of the iatrogenic perforation, and in patients whose clinical condition is deteriorating, hospitalization and surgical...

  10. TV endoscope system for composite clinical application

    International Nuclear Information System (INIS)

    Endo, Noriaki; Shimura, Yasushi

    1994-01-01

    Toshiba developed a third-generation TV endoscope system in 1992, model TRE-3000, featuring high image quality. The concept of 'pursuit of a system for composite clinical application' was fully taken into account in the development of the system. This paper describes the new system, which has the capability to display both endoscopic images and X-ray images on the same TV monitor. (author)

  11. Endoscopic approaches to treatment of achalasia

    OpenAIRE

    Stavropoulos, Stavros N.; Friedel, David; Modayil, Rani; Iqbal, Shahzad; Grendell, James H.

    2013-01-01

    Endoscopic therapy for achalasia is directed at disrupting or weakening the lower esophageal sphincter (LES). The two most commonly utilized endoscopic interventions are large balloon pneumatic dilation (PD) and botulinum toxin injection (BTI). These interventions have been extensively scrutinized and compared with each other as well as with surgical disruption (myotomy) of the LES. PD is generally more effective in improving dysphagia in achalasia than BTI, with the latter reserved for infir...

  12. An unusual experience with endoscopic retrograde cholangiopancreatography

    Directory of Open Access Journals (Sweden)

    Mallikarjun Patil

    2013-01-01

    Full Text Available The endoscopic retrograde cholangiopancreatography (ERCP is known for its varied diagnostic and therapeutic utility for a variety of disorders. However it has greater likelihood of procedure related complications among the endoscopic procedures of gastrointestinal tract. The extraluminal hemorrhagic complications following ERCP are potentially life threatening though relatively rare. We present a 50 year patient with choledocholithiasis and cholelithiasis developing rare complication of subcapsular hepatic hematoma, following ERCP due to guide wire injury.

  13. The appearance of the pre-Achilles fat pad after endoscopic calcaneoplasty

    NARCIS (Netherlands)

    Wiegerinck, Johannes I.; Zwiers, Ruben; van Sterkenburg, Maayke N.; Maas, Mario M.; van Dijk, C. Niek

    2015-01-01

    To evaluate whether the imaging features of the retrocalcaneal recess normalize on a conventional radiograph after surgery for retrocalcaneal bursitis and evaluate whether it can be reused if complaints reoccur. Patients who underwent an endoscopic calcaneoplasty at least 2 years before were

  14. Highly Sensitive Temperature Sensors Based on Fiber-Optic PWM and Capacitance Variation Using Thermochromic Sensing Membrane.

    Science.gov (United States)

    Khan, Md Rajibur Rahaman; Kang, Shin-Won

    2016-07-09

    In this paper, we propose a temperature/thermal sensor that contains a Rhodamine-B sensing membrane. We applied two different sensing methods, namely, fiber-optic pulse width modulation (PWM) and an interdigitated capacitor (IDC)-based temperature sensor to measure the temperature from 5 °C to 100 °C. To the best of our knowledge, the fiber-optic PWM-based temperature sensor is reported for the first time in this study. The proposed fiber-optic PWM temperature sensor has good sensing ability; its sensitivity is ~3.733 mV/°C. The designed temperature-sensing system offers stable sensing responses over a wide dynamic range, good reproducibility properties with a relative standard deviation (RSD) of ~0.021, and the capacity for a linear sensing response with a correlation coefficient of R² ≈ 0.992 over a wide sensing range. In our study, we also developed an IDC temperature sensor that is based on the capacitance variation principle as the IDC sensing element is heated. We compared the performance of the proposed temperature-sensing systems with different fiber-optic temperature sensors (which are based on the fiber-optic wavelength shift method, the long grating fiber-optic Sagnac loop, and probe type fiber-optics) in terms of sensitivity, dynamic range, and linearity. We observed that the proposed sensing systems have better sensing performance than the above-mentioned sensing system.

  15. Highly Sensitive Temperature Sensors Based on Fiber-Optic PWM and Capacitance Variation Using Thermochromic Sensing Membrane

    Science.gov (United States)

    Khan, Md. Rajibur Rahaman; Kang, Shin-Won

    2016-01-01

    In this paper, we propose a temperature/thermal sensor that contains a Rhodamine-B sensing membrane. We applied two different sensing methods, namely, fiber-optic pulse width modulation (PWM) and an interdigitated capacitor (IDC)-based temperature sensor to measure the temperature from 5 °C to 100 °C. To the best of our knowledge, the fiber-optic PWM-based temperature sensor is reported for the first time in this study. The proposed fiber-optic PWM temperature sensor has good sensing ability; its sensitivity is ~3.733 mV/°C. The designed temperature-sensing system offers stable sensing responses over a wide dynamic range, good reproducibility properties with a relative standard deviation (RSD) of ~0.021, and the capacity for a linear sensing response with a correlation coefficient of R2 ≈ 0.992 over a wide sensing range. In our study, we also developed an IDC temperature sensor that is based on the capacitance variation principle as the IDC sensing element is heated. We compared the performance of the proposed temperature-sensing systems with different fiber-optic temperature sensors (which are based on the fiber-optic wavelength shift method, the long grating fiber-optic Sagnac loop, and probe type fiber-optics) in terms of sensitivity, dynamic range, and linearity. We observed that the proposed sensing systems have better sensing performance than the above-mentioned sensing system. PMID:27409620

  16. [Endoscopic Doppler ultrasonography in lower intestinal bleeding:vascular diagnosis and monitoring of therapy].

    Science.gov (United States)

    Jaspersen, D

    1992-05-30

    Endoscopic Doppler sonography is a relatively new method for evaluating the sources of intestinal bleeding. For the most part our experiences derived from cases of gastroduodenal ulcer bleedings, in which Doppler sonography permits the identification of arterial vessels relevant for recurrent ulcer bleedings as well as follow-up of therapy after sclerosing. In the lower intestinal tract endoscopic Doppler has, however, only rarely been used, e.g. for diagnosing vascular malformations. This method is of theoretical interest for evaluating colorectal sources of bleeding but is nonetheless of some practical importance, as our investigations of angiodysplasias, ulcers of the rectum and polyps demonstrate.

  17. Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study

    Directory of Open Access Journals (Sweden)

    Geldof Han

    2009-03-01

    Full Text Available Abstract Background Recent non-randomized studies suggest that extended endoscopic mucosal resection (EMR is equally effective in removing large rectal adenomas as transanal endoscopic microsurgery (TEM. If equally effective, EMR might be a more cost-effective approach as this strategy does not require expensive equipment, general anesthesia and hospital admission. Furthermore, EMR appears to be associated with fewer complications. The aim of this study is to compare the cost-effectiveness and cost-utility of TEM and EMR for the resection of large rectal adenomas. Methods/design Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma ≥ 3 cm, located between 1–15 cm ab ano, will be randomized to a TEM- or EMR-treatment strategy. For TEM, patients will be treated under general anesthesia, adenomas will be dissected en-bloc by a full-thickness excision, and patients will be admitted to the hospital. For EMR, no or conscious sedation is used, lesions will be resected through the submucosal plane in a piecemeal fashion, and patients will be discharged from the hospital. Residual adenoma that is visible during the first surveillance endoscopy at 3 months will be removed endoscopically in both treatment strategies and is considered as part of the primary treatment. Primary outcome measure is the proportion of patients with recurrence after 3 months. Secondary outcome measures are: 2 number of days not spent in hospital from initial treatment until 2 years afterwards; 3 major and minor morbidity; 4 disease specific and general quality of life; 5 anorectal function; 6 health care utilization and costs. A cost-effectiveness and cost-utility analysis of EMR against TEM for large rectal adenomas will be performed from a societal perspective with respectively the costs per recurrence free patient and the cost per quality adjusted life year as outcome measures. Based on comparable recurrence rates for TEM and EMR

  18. Evaluation of Swallowing Functions in Patients with Sjögren's Syndrome.

    Science.gov (United States)

    Eyigör, Sibel; Sezgin, Baha; Karabulut, Gonca; Öztürk, Kerem; Göde, Sercan; Kirazlı, Tayfun

    2017-04-01

    Patients with Sjögren's syndrome (SS) manifest symptoms such as dry eyes, dry mouth, and dysphagia. This study aims to evaluate the swallowing functions of the patients with SS. 69 patients with SS (65 females, 4 males) and 40 healthy individuals (33 females, 7 males) were included as study and control groups, respectively. Mean ages were 52.86 and 48.25 years for study and control groups, respectively. Swallowing functions were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES). All the patients underwent FEES and were given 3, 5, and 10 ml water, yogurt, and fish-shaped crackers twice, respectively. The presence of bolus control, residue, penetration, and aspiration were evaluated. Additionally, certain types of foods triggering the dysphagia, any difficulties in bolus control, need to clean the throat, sensation of having a lump in the throat, sensation of choking, and xerostomia were included in the questionnaire. The MD Anderson Dysphagia Inventory and the Beck Depression Inventory were administered to patients. Considering the presence of residue with yogurt and fish cracker, there was a significant difference between groups (P  0.05). Regarding the MD Anderson Dysphagia Inventory, the average scores were 48.18 ± 13.21 and 87.6 ± 10.67 for study and control groups, respectively, and a statistically significant difference was detected (P quality of life in patients with SS.

  19. Using Distributed Fiber-Optic Sensing Systems to Estimate Inflow and Reservoir Properties

    NARCIS (Netherlands)

    Farshbaf Zinati, F.

    2014-01-01

    Recent developments in the deployment of distributed fiber-optic sensing systems in horizontal wells carry the promise to lead to a new, cheap and reliable way of monitoring production and reservoir performance. Practical applicability of distributed pressure sensing for quantitative inflow

  20. Awake fiberoptic or awake video laryngoscopic tracheal intubation in patients with anticipated difficult airway management

    DEFF Research Database (Denmark)

    Rosenstock, Charlotte Vallentin; Thøgersen, Bente; Afshari, Arash

    2012-01-01

    Awake flexible fiberoptic intubation (FFI) is the gold standard for management of anticipated difficult tracheal intubation. The purpose of this study was to compare awake FFI to awake McGrath® video laryngoscope, (MVL), (Aircraft Medical, Edinburgh, Scotland, United Kingdom) intubation in patients...

  1. A fiber-optic setup for quantification of root surface demineralization

    NARCIS (Netherlands)

    vanderVeen, MH; tenBosch, JJ

    A fiber-optic fluorescence observation (FOFO) technique has been developed for the quantification of demineralized root dentin, The method was tested on 40 specimens of in vitro demineralized parts of human root dentin, Fluorescein sodium salt was used as a penetrating dye, The fluorescein sodium

  2. Complex approach to the investigation of short fiber-optic comunication lines

    Science.gov (United States)

    Sukhoivanov, I. A.; Kontar', A. A.; Kublik, A. V.; Makarevich, V. S.

    The paper proposes a method of complex measurements based on the consideration of the parameters of all the elements used in a specific multimode fiber-optic communication line. It is shown that the error in measuring losses in waveguides up to 20 m long can reach a value of 60 percent.

  3. Influence of quarter-wave retarder parameters on performance of fiber-optic current sensor

    Science.gov (United States)

    Kostritskii, S. M.; Korkishko, Yu. N.; Fedorov, V. A.; Mitrokhin, V. P.

    2014-05-01

    Temperature stability of magneto-optic sensor at a marked transient temperature gradient has been investigated. Our experimental study leads to the conclusion that the polarized gyro architecture with two quarter-wave retarders on the opposite sides of the fiber loop of Sagnac interferometer must be used to obtain a fiber-optic current sensor with the lowdrift behavior.

  4. Synthetic heterodyne detection in a fiber-optic ring-laser gyro.

    Science.gov (United States)

    Huang, S; Nicati, P A; Toyama, K; Kim, B Y; Shaw, H J

    1993-01-01

    A synthetic heterodyne detection scheme for ring-laser gyros to sense both rotation rate and direction is presented. This scheme is compatible with the sinusoidal push-pull phase-modulation technique for suppressing frequency locking. The good experimental results achieved in a fiber-optic Brillouin ring-laser gyro show the potential of this detection scheme in applications.

  5. Monitoring the Evaporation of Fluids from Fiber-Optic Micro-Cell Cavities

    Directory of Open Access Journals (Sweden)

    Borut Preloznik

    2013-11-01

    Full Text Available Fiber-optic sensors provide remote access, are readily embedded within structures, and can operate in harsh environments. Nevertheless, fiber-optic sensing of liquids has been largely restricted to measurements of refractive index and absorption spectroscopy. The temporal dynamics of fluid evaporation have potential applications in monitoring the quality of water, identification of fuel dilutions, mobile point-of-care diagnostics, climatography and more. In this work, the fiber-optic monitoring of fluids evaporation is proposed and demonstrated. Sub-nano-liter volumes of a liquid are applied to inline fiber-optic micro-cavities. As the liquid evaporates, light is refracted out of the cavity at the receding index boundary between the fluid and the ambient surroundings. A sharp transient attenuation in the transmission of light through the cavity, by as much as 50 dB and on a sub-second time scale, is observed. Numerical models for the transmission dynamics in terms of ray-tracing and wavefront propagation are provided. Experiments show that the temporal transmission profile can distinguish between different liquids.

  6. Awake nasotracheal fiber-optic intubation in a patient with severe ...

    African Journals Online (AJOL)

    Facial trauma significantly increases the difficulty in airway management in the emergency department or during the provision of anesthesia for surgery. We present airway management in a patient with severe facial trauma that necessitated awake nasotracheal fiber-optic intubation for safe induction of anesthesia.

  7. Mobile fiber-optic sensor for detection of oral and cervical cancer in the developing world.

    Science.gov (United States)

    Yu, Bing; Nagarajan, Vivek Krishna; Ferris, Daron G

    2015-01-01

    Oral and cervical cancers are a growing global health problem that disproportionately impacts women and men living in the developing world. The high death rate in developing countries is largely due to the fact that these countries do not have the appropriate medical infrastructure and resources to support the organized screening and diagnostic programs that are available in the developed world. Diffuse reflectance spectroscopy (DRS) with a fiber-optic probe can noninvasively quantify the optical properties of epithelial tissues and has shown the potential as a cost-effective, easy-to-use, and sensitive tool for diagnosis of early precancerous changes in the cervix and oral cavity. However, current fiber-optic DRS systems have not been designed to be robust and reliable for use in developing countries. They are subject to various sources of systematic or random errors, arising from the uncontrolled probe-tissue interface and lack of real-time calibration, use bulky and expensive optical components, and require extensive training. This chapter describes a portable DRS device that is specifically designed for detection of oral and cervical cancers in resource-poor settings. The device uses an innovative smart fiber-optic probe to eliminate operator bias, state-of-the-art photonics components to reduce size and power consumption, and automated software to reduce the need of operator training. The size and cost of the smart fiber-optic DRS system may be further reduced by incorporating a smartphone based spectrometer.

  8. The fiber-optic imaging and manipulation of neural activity during animal behavior.

    Science.gov (United States)

    Miyamoto, Daisuke; Murayama, Masanori

    2016-02-01

    Recent progress with optogenetic probes for imaging and manipulating neural activity has further increased the relevance of fiber-optic systems for neural circuitry research. Optical fibers, which bi-directionally transmit light between separate sites (even at a distance of several meters), can be used for either optical imaging or manipulating neural activity relevant to behavioral circuitry mechanisms. The method's flexibility and the specifications of the light structure are well suited for following the behavior of freely moving animals. Furthermore, thin optical fibers allow researchers to monitor neural activity from not only the cortical surface but also deep brain regions, including the hippocampus and amygdala. Such regions are difficult to target with two-photon microscopes. Optogenetic manipulation of neural activity with an optical fiber has the advantage of being selective for both cell-types and projections as compared to conventional electrophysiological brain tissue stimulation. It is difficult to extract any data regarding changes in neural activity solely from a fiber-optic manipulation device; however, the readout of data is made possible by combining manipulation with electrophysiological recording, or the simultaneous application of optical imaging and manipulation using a bundle-fiber. The present review introduces recent progress in fiber-optic imaging and manipulation methods, while also discussing fiber-optic system designs that are suitable for a given experimental protocol. Copyright © 2015 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  9. A wideband connection to sperm whales: A fiber-optic, deep-sea hydrophone array

    DEFF Research Database (Denmark)

    Heerfordt, Anders; Møhl, Bertel; Wahlberg, Magnus

    2007-01-01

    A 10-element, 950 m long, vertical hydrophone array based on fiber-optic data transmission has been developed primarily for studying the beam pattern from deep diving cetaceans emitting sonar pulses. The array elements have a configurable sampling rate and resolution with a maximum signal bandwidth...

  10. Safety of flexible endoscopic biopsy of the pharynx and larynx under topical anesthesia.

    Science.gov (United States)

    Wellenstein, David J; de Witt, Joey K; Schutte, Henrieke W; Honings, Jimmie; van den Hoogen, Frank J A; Marres, Henri A M; Takes, Robert P; van den Broek, Guido B

    2017-09-01

    Recent advancements in transnasal endoscopy enable a shift in diagnostic workup of lesions in the pharynx and larynx, from an examination with biopsy under general anesthesia to an office-based examination with flexible endoscopic biopsy under topical anesthesia. Procedural complications were evaluated to assess the safety of office-based flexible endoscopic biopsy in patients with benign and malignant laryngopharyngeal lesions. Patients who underwent flexible endoscopic biopsy from 2012 to 2016 were evaluated retrospectively. Complications were classified using the Clavien-Dindo classification of surgical complications. A total of 201 flexible endoscopic biopsies were performed in 187 patients. Two Clavien-Dindo grade I (laryngospasm and anterior epistaxis), one grade II (laryngeal bleeding), and one grade IIIb (laryngeal edema) complication were observed. The first complication was self-limiting and the other three required an intervention. All patients fully recovered without sequelae. Flexible endoscopic biopsy appears to be a safe office-based procedure for the diagnosis of benign and malignant laryngopharyngeal lesions.

  11. Advances in Endoscope Reprocessing Technology and Its Impact on Pathogen Transmission.

    Science.gov (United States)

    Shellnutt, Cathleen

    Pathogen transmissions via flexible endoscopes have been documented in the literature and have been historically related to human error or omission of steps in the reprocessing cycle. The 2008 Centers for Disease Control and Prevention report challenged manufacturers of automated endoscope reprocessors to improve and advance technology to automate more of the reprocessing steps. A review and synthesis of the literature following the 2008 Centers for Disease Control and Prevention report was performed to evaluate whether advances in reprocessing technology have occurred and whether these have had an impact on pathogen transmission via flexible endoscopes. The Iowa Model of Evidence-Based Practice to Promote Quality Care was used to guide the project. The literature search regarding pathogen transmission related to flexible endoscopes yielded 10 documents citing infections from 2008 to 2015. A total of 353 patients were identified as having been infected with a contaminated gastroscope, bronchoscope, or duodenoscope. An evaluation of reprocessing technology identified 3 automated endoscope reprocessors with enhanced capabilities and flushing devices intended to automate portions of the manual cleaning step.

  12. [Standardized development of transanal endoscopic microsurgery].

    Science.gov (United States)

    Lin, Guole

    2017-08-25

    Transanal endoscopic microsurgery (TEM) is currently the only one-port system in endoscopic surgery, which a direct endoluminal approach can lead to the target organ through a natural opening of human body. TEM has been applied in colorectal surgery for over 3 decades. Compared with radical surgery, TEM has the advantages, such as quicker recovery, shorter hospital stay and fewer complications. One perfect TEM surgical system, which mainly consists of three parts, namely peculiar rectoscope for surgery, special surgical instruments and imaging system, is the foundation of standardized development of TEM. Accurate preoperative evaluation and staging is the key for good outcomes in TEM technology. In addition to digital examination of rectum, rigid sigmoidoscopy(or rectoscopy) should be routinely performed to confirm the location of the lesion and record it in a "time-in-clock" form. For lesions with undetermined nature, biopsy should be performed. For patients with rectal tumor, pelvic MRI examination can be used on the basis of routine endorectal ultrasonography (ERUS). Endoluminal suture is the challenge for standardized development of TEM, especially for those with large intestinal wall defects. Professional training is required to master suture technique. In 2016, the consensus of experts on TEM technology was formulated by TEM Study Group of Colorectal Cancer Specialty Committee of Chinese Anticancer Association. The recommended surgical indications for TEM include (1)rectal adenoma; (2)early rectal cancer with good histopathological features; (3)extended resection of locally malignant polyps by colonoscopy; (4)other rectal tumors suitable for local resection; (5)benign stricture or anastomotic stricture of the rectum; (6)repair of anastomotic leakage after low anterior resection of rectum; (7)diagnosis of rectal hemorrhage; (8)biopsy of rectum and surrounding lesions; (9)repair of rectovaginal fistula or mucosal flap transposition of the internal mouth of anal

  13. Endoscopic evaluation and histological findings in graft-versus-host disease Evaluación endoscópica y hallazgos histológicos en la enfermedad de injerto contra huésped

    Directory of Open Access Journals (Sweden)

    Antonio Velasco-Guardado

    2012-06-01

    Full Text Available Background: the gastrointestinal (GI tract is the major target site of the graft-versus-host disease (GVHD. Diagnosis is based on endoscopic and histological findings. Material and methods: we performed a retrospective study from January 1st, 1990 to December 31st, 2008 on 338 upper gastrointestinal endoscopies (gastroscopies performed to 197 patients that underwent an allogeneic transplant with clinical suspicion of GI-GVHD. Results: endoscopic findings to the diagnosis of GVHD have a sensitivity (S of 34%, specificity levels (SP of 65%, a positive predictive value (PPV of 73% and a negative predictive value (NPV of 48%. The histological study of the endoscopic biopsies has a global sensibility of 85.6% SP = 34.6% PPV = 64.2% and NPV = 63.7%. Histological grade was correlated with the clinical grade of acute GVHD (p = 0.018. Conclusion: upper gastrointestinal endoscopy is useful for the diagnosis of GVHD, as it allows biopsies that can ultimately lead to the diagnosis, but with limited accuracy because the histological findings have low sensitivity and specificity, while the endoscopic findings are generally nonspecific.Introducción: el tracto gastrointestinal es la diana principal de afectación en la enfermedad de injerto contra huésped (EICH. Su diagnóstico se basa en los hallazgos endoscópicos e histológicos. Material y métodos: hemos realizado un estudio retrospectivo, desde el 1 de enero de 1990 hasta el 30 de diciembre de 2008, de 338 endoscopias digestivas altas realizadas a 197 pacientes sometidos a trasplante alogénico de células hematopoyéticas con sospecha de EICH gastrointestinal. Resultados: los hallazgos endoscópicos tienen una sensibilidad (S del 34%, especificidad (E del 65%, valor predictivo positivo (VPP del 73% y valor predictivo negativo (VPN del 48% para el diagnóstico de EICH. El estudio histológico de las biopsias tiene una S del 85,6%, E del 34,6%, VPP del 64,2% y VPN del 63,7%. El grado histológico se

  14. Transgastric pure-NOTES peritoneoscopy and endoscopic ultrasonography for staging of gastrointestinal cancers

    DEFF Research Database (Denmark)

    Donatsky, Anders Meller; Vilmann, Peter; Meisner, Søren

    2012-01-01

    BACKGROUND: Human natural orifice transluminal endoscopic surgery (NOTES) has mainly been based on simultaneous laparoscopic assistance (hybrid NOTES), forgoing the theoretical benefits of the NOTES technique. This is due to a lack of NOTES-specific instruments and endoscopes, making pure-NOTES...... procedures difficult and time consuming. An area where pure NOTES could be adopted at its present stage of development is minimally invasive staging of gastrointestinal (GI) cancer. The aim of this study is to evaluate the feasibility of combining transgastric (TG) pure-NOTES peritoneoscopy...... and intraperitoneal endoscopic ultrasonography (ip-EUS) with intraluminal EUS (il-EUS) for peritoneal evaluation. METHODS: This was a feasibility and survival study where il-EUS followed by ip-EUS and peritoneoscopy was performed in 10 pigs subjected to TG pure NOTES. A score was given with regard to achieved...

  15. Detection and Mapping of the September 2017 Mexico Earthquakes Using DAS Fiber-Optic Infrastructure Arrays

    Science.gov (United States)

    Karrenbach, M. H.; Cole, S.; Williams, J. J.; Biondi, B. C.; McMurtry, T.; Martin, E. R.; Yuan, S.

    2017-12-01

    Fiber-optic distributed acoustic sensing (DAS) uses conventional telecom fibers for a wide variety of monitoring purposes. Fiber-optic arrays can be located along pipelines for leak detection; along borders and perimeters to detect and locate intruders, or along railways and roadways to monitor traffic and identify and manage incidents. DAS can also be used to monitor oil and gas reservoirs and to detect earthquakes. Because thousands of such arrays are deployed worldwide and acquiring data continuously, they can be a valuable source of data for earthquake detection and location, and could potentially provide important information to earthquake early-warning systems. In this presentation, we show that DAS arrays in Mexico and the United States detected the M8.1 and M7.2 Mexico earthquakes in September 2017. At Stanford University, we have deployed a 2.4 km fiber-optic DAS array in a figure-eight pattern, with 600 channels spaced 4 meters apart. Data have been recorded continuously since September 2016. Over 800 earthquakes from across California have been detected and catalogued. Distant teleseismic events have also been recorded, including the two Mexican earthquakes. In Mexico, fiber-optic arrays attached to pipelines also detected these two events. Because of the length of these arrays and their proximity to the event locations, we can not only detect the earthquakes but also make location estimates, potentially in near real time. In this presentation, we review the data recorded for these two events recorded at Stanford and in Mexico. We compare the waveforms recorded by the DAS arrays to those recorded by traditional earthquake sensor networks. Using the wide coverage provided by the pipeline arrays, we estimate the event locations. Such fiber-optic DAS networks can potentially play a role in earthquake early-warning systems, allowing actions to be taken to minimize the impact of an earthquake on critical infrastructure components. While many such fiber-optic

  16. Local delivery of fluorescent dye for fiber-optics confocal microscopy of the living heart.

    Science.gov (United States)

    Huang, Chao; Kaza, Aditya K; Hitchcock, Robert W; Sachse, Frank B

    2014-01-01

    Fiber-optics confocal microscopy (FCM) is an emerging imaging technology with various applications in basic research and clinical diagnosis. FCM allows for real-time in situ microscopy of tissue at sub-cellular scale. Recently FCM has been investigated for cardiac imaging, in particular, for discrimination of cardiac tissue during pediatric open-heart surgery. FCM relies on fluorescent dyes. The current clinical approach of dye delivery is based on systemic injection, which is associated with high dye consumption, and adverse clinical events. In this study, we investigated approaches for local dye delivery during FCM imaging based on dye carriers attached to the imaging probe. Using three-dimensional confocal microscopy, automated bench tests, and FCM imaging we quantitatively characterized dye release of carriers composed of open-pore foam only and foam loaded with agarose hydrogel. In addition, we compared local dye delivery with a model of systemic dye delivery in the isolated perfused rodent heart. We measured the signal-to-noise ratio (SNR) of images acquired in various regions of the heart. Our evaluations showed that foam-agarose dye carriers exhibited a prolonged dye release vs. foam-only carriers. Foam-agarose dye carriers allowed reliable imaging of 5-9 lines, which is comparable to 4-8 min of continuous dye release. Our study in the living heart revealed that the SNR of FCM images using local and systemic dye delivery is not different. However, we observed differences in the imaged tissue microstructure with the two approaches. Structural features characteristic of microvasculature were solely observed for systemic dye delivery. Our findings suggest that local dye delivery approach for FCM imaging constitutes an important alternative to systemic dye delivery. We suggest that the approach for local dye delivery will facilitate clinical translation of FCM, for instance, for FCM imaging during pediatric heart surgery.

  17. Local Delivery of Fluorescent Dye For Fiber-Optics Confocal Microscopy of the Living Heart

    Directory of Open Access Journals (Sweden)

    Chao eHuang

    2014-09-01

    Full Text Available Fiber-optics confocal microscopy (FCM is an emerging imaging technology with various applications in basic research and clinical diagnosis. FCM allows for real-time in situ microscopy of tissue at sub-cellular scale. Recently FCM has been investigated for cardiac imaging, in particular, for discrimination of cardiac tissue during pediatric open-heart surgery. FCM relies on fluorescent dyes. The current clinical approach of dye delivery is based on systemic injection, which is associated with high dye consumption and adverse clinical events. In this study, we investigated approaches for local dye delivery during FCM imaging based on dye carriers attached to the imaging probe. Using three-dimensional confocal microscopy, automated bench tests, and FCM imaging we quantitatively characterized dye release of carriers composed of open-pore foam only and foam loaded with agarose hydrogel. In addition, we compared local dye delivery with a model of systemic dye delivery in the isolated perfused rodent heart. We measured the signal-to-noise ratio of images acquired in various regions of the heart. Our evaluations showed that foam-agarose dye carriers exhibited a prolonged dye release versus foam-only carriers. Foam-agarose dye carriers allowed reliable imaging of 5-9 lines, which is comparable to 4-8 min of continuous dye release. Our study in the living heart revealed that the SNR of FCM images using local and systemic dye delivery is not different. However, we observed differences in the imaged tissue microstructure with the two approaches. Structural features characteristic of microvasculature were solely observed for systemic dye delivery. Our findings suggest that local dye delivery approach for FCM imaging constitutes an important alternative to systemic dye delivery. We suggest that the approach for local dye delivery will facilitate clinical translation of FCM, for instance, for FCM imaging during pediatric heart surgery.

  18. Development of a durable fiber-optic oxygen sensor for harsh underground environments.

    Science.gov (United States)

    Koshiba, Yusuke; Nakamura, Yuki; Ito, Daisuke; Yokoyama, Takashi; Okazaki, Shinji; Nakagawa, Hidemoto; Arai, Takashi

    2010-09-15

    This paper focuses on effects of protection with a silicone resin to develop a fiber-optic oxygen sensor with long-term stability and durability in harsh underground environments. Ruthenium (II) complexes were used as oxygen-sensing compounds. A uniform composite film composed of silicone resin and the Ru complex was prepared with spin coating technique. A comparison of dissolved-oxygen (DO) sensitivity between the composite film and a Ru complex film was made by exposing to hot water (80 degrees C). The result of the accelerated degradation test showed that sensitivity of the Ru complex film was stable; meanwhile that of the composite film increased with exposure time in a short period. In order to improve stability, the Ru complex film overcoated with silicone resin was prepared. Differences in sensitivity for saturated DO (8.5 ppm) between with and without the silicone resin overcoating on the Ru complex film were investigated by exposing to the hot water and simulated underground water. These results revealed that the sensitivities and response times of the overcoated films were stable and slow, respectively, compared to those of non-overcoated films. Then, optodes were evaluated for effects of the overcoating on sensing properties by exposing to 100 vol.% oxygen gas. The experiment showed that: (1) the response time was significantly influenced by the thickness of the overcoating; and (2) response speed of the overcoated optode was slow by a factor of about 35 compared to that of the non-overcoated. We concluded that the overcoating was effective in the application to mid- and long-term oxygen monitoring in the harsh environments. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  19. Large aperture CCD x-ray detector for protein crystallography using a fiberoptic taper

    Energy Technology Data Exchange (ETDEWEB)

    Strauss, M.G.; Westbrook, E.M.; Naday, I.; Coleman, T.A.; Westbrook, M.L.; Travis, D.J. (Argonne National Lab., IL (USA)); Sweet, R.M. (Brookhaven National Lab., Upton, NY (USA)); Pflugrath, J.W. (Cold Spring Harbor Lab., NY (USA)); Stanton, M. (Brandeis Univ., Waltham, MA (USA))

    1991-01-01

    A detector with a 114 mm aperture, based on a charge-coupled device (CCD), has been designed for x-ray diffraction studies in protein crystallography. The detector was tested on a beamline of the National Synchrotron Light Source at Brookhaven National Laboratory with a beam intensity greater than 10{sup 9} x-ray photons/s. A fiberoptic taper, an image intensifier and a lens demagnify, intensify, and focus the image onto a CCD having 512 {times} 512 pixels. A detective quantum efficiency (DOE) of 0.36 was obtained by evaluating the statistical uncertainty in the detector output. The dynamic range of a 4 {times} 4 pixel resolution element, comparable in size to a diffraction peak, was 10{sup 4}. The point-spread function shows FWHM resolution of approximately 1 pixel, where a pixel on the detector face is 160 {mu}m. A complete data set, consisting of forty-five 1{degree} rotation frames, was obtained in just 36 s of x-ray exposure to a crystal of chicken egg-white lysozyme. In a separate experiment, a lysozyme data set consisting of 495 0.1{degree} frames, was processed by the MADNES data reduction program, yielding symmetry R-factors for the data of 3.2--3.5%. Diffraction images from crystals of the myosin S1 head (a = 275 {Angstrom}) were also recorded. The Bragg spots, only 5 pixels apart, were resolved but were not sufficiently separated to process these data. Changes in the detector design which will improve the DQE and spatial resolution are outlined. The overall performance showed that this type of detector is well suited for x-ray scattering investigations with synchrotron sources. 23 refs., 11 figs.

  20. Large aperture CCD x ray detector for protein crystallography using a fiberoptic taper

    Science.gov (United States)

    Strauss, M. G.; Westbrook, E. M.; Naday, I.; Coleman, T. A.; Westbrook, M. L.; Travis, D. J.; Sweet, R. M.; Pflugrath, J. W.

    A detector with a 114 mm aperture, based on a charge-coupled device (CCD), has been designed for x-ray diffraction studies in protein crystallography. The detector was tested on a beamline of the National Synchrotron Light Source at Brookhaven National Laboratory with a beam intensity greater than 10(exp 9) x-ray photons/s. A fiberoptic taper, an image intensifier and a lens demagnify, intensify, and focus the image onto a CCD having 512 x 512 pixels. A detective quantum efficiency (DOE) of 0.36 was obtained by evaluating the statistical uncertainty in the detector output. The dynamic range of a 4 x 4 pixel resolution element, comparable in size to a diffraction peak, was 10(exp 4). The point-spread function shows FWHM resolution of approximately 1 pixel, where a pixel on the detector face is 160 microns. A complete data set, consisting of forty-five 1 deg rotation frames, was obtained in just 36 s of x-ray exposure to a crystal of chicken egg-white lysozyme. In a separate experiment, a lysozyme data set consisting of 495 0.1 deg frames, was processed by the MADNES data reduction program, yielding symmetry R-factors for the data of 3.2 to 3.5 percent. Diffraction images from crystals of the myosin S1 head (a = 275 A) were also recorded. The Bragg spots, only 5 pixels apart, were resolved but were not sufficiently separated to process these data. Changes in the detector design which will improve the DOE and spatial resolution are outlined. The overall performance showed that this type of detector is well suited for x-ray scattering investigations with synchrotron sources.

  1. New endoscopic ultrasonography techniques for pancreticobiliary diseases

    Energy Technology Data Exchange (ETDEWEB)

    Kamata, Ken; Kitano, Masayuki; Omoto, Shunsuke; Kadosaka, Kumpei; Miyata, Takeshi; Minaga, Kosuke; Yamao, Kentaro; Imai, Hajime; Kudo, Masatoshii [Dept. of Gastroenterology and Hepatology, Kinki University Faculty of Medicine, Osaka (Japan)

    2016-07-15

    Endoscopic ultrasonography (EUS) is widely used to evaluate pancreaticobiliary diseases, especially pancreatic masses. EUS has a good ability to detect pancreatic masses, but it is not sufficient for the differential diagnosis of various types of lesions. In order to address the limitations of EUS, new techniques have been developed to improve the characterization of the lesions detected by EUS. EUS-guided fine needle aspiration (EUS-FNA) has been used for diagnosing pancreatic tumors. In order to improve the histological diagnostic yield, a EUS-FNA needle with a core trap has recently been developed. Contrast-enhanced harmonic EUS is a new imaging modality that uses an ultrasonographic contrast agent to visualize blood flow in fine vessels. This technique is useful in the diagnosis of pancreatic solid lesions and in confirming the presence of vascularity in mural nodules for cystic lesions. EUS elastography analyzes several different variables to measure tissue elasticity, color patterns, and strain ratio, using analytical techniques such as hue-histogram analysis, and artificial neural networks, which are useful for the diagnosis of chronic pancreatitis and pancreatic cancer.

  2. Hernia repair during endoscopic (laparoscopic) radical prostatectomy.

    Science.gov (United States)

    Stolzenburg, Jens-Uwe; Rabenalt, Robert; Dietel, Anja; Do, Minh; Pfeiffer, Heidemarie; Schwalbe, Steffen; Dorschner, Wolfgang

    2003-02-01

    We retrospectively reviewed our experience in performing endoscopic extraperitoneal radical prostatectomy (EERPE) and totally extraperitoneal (TEP) hernia repair in one procedure to evaluate its feasibility and safety. Based on our experience of 70 laparoscopic radical prostatectomies, a total of 60 patients underwent EERPE. Eight of these had 10 hernias repaired with Prolene mesh. The median total operating time for EERPE was 165 minutes. Mesh placement required an additional 15 minutes for a unilateral hernia and 25 minutes for bilateral hernias. The conversion rate and the reoperation rate were 0%. The median duration of vesical catheterization was 8.3 days. One patient required a blood transfusion. The most common minor complications, occurring in eight patients, were edema and hematoma of the penis. No wound infection occurred. The only major complication was a deep venous thrombosis in one patient. No additional complications developed in the hernioplasty group. We conclude that the extraperitoneal approach for radical prostatectomy allows concomitant inguinal hernia repair with a low morbidity rate and within an acceptable operating time.

  3. Transorbital endoscopic amygdalohippocampectomy: a feasibility investigation.

    Science.gov (United States)

    Chen, H Isaac; Bohman, Leif-Erik; Loevner, Laurie A; Lucas, Timothy H

    2014-06-01

    Resection of the hippocampus is the standard of care for medically intractable epilepsy in patients with mesial temporal sclerosis. Although temporal craniotomy in this setting is highly successful, the procedure carries certain immutable risks and may be associated with cognitive deficits related to cortical and white matter disruption. Alternative surgical approaches may reduce some of these risks by preserving the lateral temporal lobe. This study examined the feasibility of transorbital endoscopic amygdalohippocampectomy (TEA) as an alternative to open craniotomy in cadaveric specimens. TEA dissections were performed in 4 hemispheres from 2 injected cadaveric specimens fixed in alcohol. Quantitative predictions of the limits of exposure based on predissection imaging were compared with intradissection measurements. The extent of resection and angles of exposure during the dissection and on postdissection imaging were recorded. These measurements were validated with MRI studies from 10 epilepsy patients undergoing standard surgical evaluations. The transorbital approach permitted direct access to the mesial temporal structures through the lateral orbital wall. Up to 97% of the hippocampal formation was resected with no brain retraction and minimal (mean 6.0 ± 1.4 mm) globe displacement. Lateral temporal lobe white matter tracts were preserved. TEA permits hippocampectomy comparable to standard surgical approaches without disrupting the lateral temporal cortex or white matter. This novel approach is feasible in cadaveric specimens and warrants clinical investigation in carefully selected cases.

  4. Selective Embolization for Post-Endoscopic Sphincterotomy Bleeding: Technical Aspects and Clinical Efficacy

    Energy Technology Data Exchange (ETDEWEB)

    So, Young Ho; Choi, Young Ho [Seoul National University Boramae Medical Center, Seoul (Korea, Republic of); Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung [Seoul National University Hospital, Seoul (Korea, Republic of); Song, Soon Young [Hanyang University Hospital, Seoul (Korea, Republic of)

    2012-01-15

    The objective of this study was to evaluate the technical aspects and clinical efficacy of selective embolization for post-endoscopic sphincterotomy bleeding. We reviewed the records of 10 patients (3%; M:F 6:4; mean age, 63.3 years) that underwent selective embolization for post-endoscopic sphincterotomy bleeding among 344 patients who received arteriography for nonvariceal upper gastrointestinal bleeding from 2000 to 2009. We analyzed the endoscopic procedure, onset of bleeding, underlying clinical condition, angiographic findings, interventional procedure, and outcomes in these patients. Among the 12 bleeding branches, primary success of hemostasis was achieved in 10 bleeding branches (83%). Secondary success occurred in two additional bleeding branches (100%) after repeated embolization. In 10 patients, post-endoscopic sphincterotomy bleedings were detected during the endoscopic procedure (n = 2, 20%) or later (n = 8, 80%), and the delay was from one to eight days (mean, 2.9 days; {+-} 2.3). Coagulopathy was observed in three patients. Eight patients had a single bleeding branch, whereas two patients had two branches. On the selective arteriography, bleeding branches originated from the posterior pancreaticoduodenal artery (n = 8, 67%) and anterior pancreaticoduodenal artery (n = 4, 33%), respectively. Superselection was achieved in four branches and the embolization was performed with n-butyl cyanoacrylate. The eight branches were embolized by combined use of coil, n-butyl cyanoacrylate, or Gelfoam. After the last embolization, there was no rebleeding or complication related to embolization. Selective embolization is technically feasible and an effective procedure for post-endoscopic sphincterotomy bleeding. In addition, the posterior pancreaticoduodenal artery is the main origin of the causative vessels of post-endoscopic sphincterotomy bleeding.

  5. Laparoscopic sleeve gastrectomy with endoscopic versus bougie calibration: results of a prospective study.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Sola-Vera, Javier; Miranda, Elena; Muñoz, José Luis; Perez-Rabasco, Estefania; Arroyo, Antonio; Calpena, Rafael

    2014-10-01

    The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim of this study was to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure. A prospective, nonrandomized study was performed at the General University Hospital of Elche (Alicante, Spain) between 2010 and 2013. The patients were divided into the bougie calibration group and the endoscopic calibration group. The decision of which method to use depended on the availability of an endoscopist at the time of the surgery. Fifty patients were included in the study, 44 females (88%) and 6 males (12%), with a mean age of 43.3 years and a preoperative mean body mass index of 50.6 kg/m(2). In the endoscopic calibration group, a bleeding point in the staple line was detected and sclerosed with adrenaline in 1 patient. In the bougie calibration group there were no cases of postoperative digestive bleeding. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group was negative in all the patients. In the endoscopic calibration group the check with blue dye was also negative in all cases, but the second test with air detected the exit of air bubbles in 1 case. There were no significant differences in the operation time between groups. A significant reduction in the major complications rate was observed in the endoscopic calibration group (odds ratio=0.9; P=.034). Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy.

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

    Directory of Open Access Journals (Sweden)

    Yoo Jin Lee

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

  7. Comparison of Endoscopic Variceal Ligation and Endoscopic Variceal Obliteration in Patients with GOV1 Bleeding.

    Science.gov (United States)

    Hong, Hyoung Ju; Jun, Chung Hwan; Lee, Du Hyeon; Cho, Eun Ae; Park, Seon Young; Cho, Sung Bum; Park, Chang Hwan; Joo, Young Eun; Kim, Hyunsoo; Choi, Sung Kyu; Rew, Jong Sun

    2013-04-01

    The aim of this study was to compare the efficacy, rebleeding rates, survival, and complications of endoscopic variceal ligation (EVL) with those of endoscopic variceal obliteration (EVO) in patients with acute type 1 gastroesophageal variceal (GOV1) bleeding. Data were collected retrospectively at a single center. A total of 84 patients were selected (20 patients underwent EVL; 64 patients underwent EVO) from February 2004 to September 2011. Their clinical characteristics, laboratory results, vital signs, Child-Pugh score, Model for End-stage Liver Disease (MELD) score, and overall mortality were evaluated. There were no significant differences in baseline characteristics between the two groups. The success rate in initial control of active bleeding was not significantly different between the EVL and EVO groups (18/20 EVL, or 90.0%, compared with 62/64 EVO, or 96.9%; p=0.239). The early rebleeding rate was also not significantly different between the groups (3/18 EVL, or 16.7% compared with 17/62 EVO, or 27.4%; p=0.422). The late rebleeding rate of the EVL group was lower than that of the EVO group (3/18 EVL, or 16.7%, compared with 26/59 EVO, or 44.1%; p=0.042). The time-to-rebleeding was 594 days for the EVL group and 326 days for the EVO group (p=0.054). In the multivariate analysis, portal vein thrombosis (PVT) was a significant risk factor for early rebleeding. Hepatocellular carcinoma (HCC) and previous history of bleeding were significant risk factors for very late rebleeding. In conclusion, EVL is better than EVO in reducing late rebleeding in acute GOV1 bleeding. HCC, PVT, and previous bleeding history were significant risk factors for rebleeding.

  8. Design of a fiber-optic interrogator module for telecommunication satellites

    Science.gov (United States)

    Putzer, Philipp; Koch, Alexander W.; Plattner, Markus; Hurni, Andreas; Manhart, Markus

    2017-11-01

    In this paper we present the results of the radiation tests performed on the optical components of the fiber-optic interrogator module as a part of the Hybrid Sensor Bus (HSB) system. The HSB-system is developed in the frame of an ESAARTES program and will be verified as flight demonstrator onboard the German Heinrich Hertz satellite in 2016. The HSB system is based on a modular concept which includes sensor interrogation modules based on I2C electrical and fiber Bragg grating (FBG) fiber-optical sensor elements. Onboard fiber-optic sensing allows the implementation of novel control and monitoring methods. For read-out of multiple FBG sensors, a design based on a tunable laser diode as well as a design based on a spectrometer is considered. The expected and tested total ionizing dose (TID) applicable to the HSB system is in the range between 100 krad and 300 krad inside the satellite in the geostationary orbit over a life time of 15 years. We present radiation test results carried out on critical optical components to be used in the fiber-optic interrogation module. These components are a modulated grating Y-branch (MGY) tunable laser diode acting as light source for the tuning laser approach, the line detector of a spectrometer, photodetectors and the FBG sensors acting as sensor elements. A detailed literature inquiry of radiation effects on optical fibers and FBG sensors, is also included in the paper. The fiber-optic interrogator module implemented in the HSB system is based on the most suitable technology, which sustains the harsh environment in the geostationary orbit.

  9. Towards automated visual flexible endoscope navigation.

    Science.gov (United States)

    van der Stap, Nanda; van der Heijden, Ferdinand; Broeders, Ivo A M J

    2013-10-01

    The design of flexible endoscopes has not changed significantly in the past 50 years. A trend is observed towards a wider application of flexible endoscopes with an increasing role in complex intraluminal therapeutic procedures. The nonintuitive and nonergonomical steering mechanism now forms a barrier in the extension of flexible endoscope applications. Automating the navigation of endoscopes could be a solution for this problem. This paper summarizes the current state of the art in image-based navigation algorithms. The objectives are to find the most promising navigation system(s) to date and to indicate fields for further research. A systematic literature search was performed using three general search terms in two medical-technological literature databases. Papers were included according to the inclusion criteria. A total of 135 papers were analyzed. Ultimately, 26 were included. Navigation often is based on visual information, which means steering the endoscope using the images that the endoscope produces. Two main techniques are described: lumen centralization and visual odometry. Although the research results are promising, no successful, commercially available automated flexible endoscopy system exists to date. Automated systems that employ conventional flexible endoscopes show the most promising prospects in terms of cost and applicability. To produce such a system, the research focus should lie on finding low-cost mechatronics and technologically robust steering algorithms. Additional functionality and increased efficiency can be obtained through software development. The first priority is to find real-time, robust steering algorithms. These algorithms need to handle bubbles, motion blur, and other image artifacts without disrupting the steering process.

  10. Noninvasive Fetal Heart Rate Monitoring: Validation of Phonocardiography-Based Fiber-Optic Sensing and Adaptive Filtering Using the NLMS Algorithm

    Directory of Open Access Journals (Sweden)

    Jan Nedoma

    2017-01-01

    Full Text Available Here we present the evaluation results of our novel noninvasive phonocardiographic-based fiber-optic sensor for fetal Heart Rate (fHR detection using adaptive filtering and the NLMS Algorithm. The sensor uses two interferometric probes encapsulated inside a PolyDiMethylSiloxane (PDMS polymer. Based on real data acquired from pregnant women in a suitable research laboratory environment, once they had given their written informed consents, we created a simplified dynamic signal model of the distribution of maternal and fetal heart sounds inside the maternal body. Building upon this signal model, we verified the functionality of our novel fiber-optic sensor and its associated adaptive filtering system using the NLMS Algorithm. The main reason why we chose this technology to develop our system was that it allows monitoring the fHR without exposing the fetus to any external energies or radiation (in contrast to the ultrasound-based Cardiotocography Method. We used objective criteria such as: Signal to Noise Ratios: SNR_in, SNR_out and Percentage Root-mean-square Difference (PRD for our evaluations.

  11. Selection of fiber-optical components for temperature measurement for satellite applications

    Science.gov (United States)

    Putzer, P.; Kuhenuri Chami, N.; Koch, A. W.; Hurni, A.; Roner, M.; Obermaier, J.; Lemke, N. M. K.

    2017-11-01

    The Hybrid Sensor Bus (HSB) is a modular system for housekeeping measurements for space applications. The focus here is the fiber-optical module and the used fiber-Bragg gratings (FBGs) for temperature measurements at up to 100 measuring points. The fiber-optial module uses a tunable diode laser to scan through the wavelength spectrum and a passive optical network for reading back the reflections from the FBG sensors. The sensors are based on FBGs which show a temperature dependent shift in wavelength, allowing a high accuracy of measurement. The temperature at each sensor is derivated from the sensors Bragg wavelength shift by evaluating the measured spectrum with an FBG peak detection algorithm and by computing the corresponding temperature difference with regard to the calibration value. It is crucial to eliminate unwanted influence on the measurement accuracy through FBG wavelength shifts caused by other reasons than the temperature change. The paper presents gamma radiation test results up to 25 Mrad for standard UV-written FBGs in a bare fiber and in a mechanically housed version. This high total ionizing dose (TID) load comes from a possible location of the fiber outside the satellite's housing, like e.g. on the panels or directly embedded into the satellites structure. Due to the high shift in wavelength of the standard written gratings also the femto-second infrared (fs- IR) writing technique is investigated in more detail. Special focus is given to the deployed fibers for the external sensor network. These fibers have to be mechanically robust and the radiation induced attenuation must be low in order not to influence the system's performance. For this reason different fiber types have been considered and tested to high dose gamma radiation. Dedicated tests proved the absence of enhanced low dose rate sensitivity (ELDRS). Once the fiber has been finally selected, the fs-IR grating will be written to these fibers and the FBGs will be tested in order to

  12. Clinical outcomes of endoscope-assisted vitrectomy for treatment of rhegmatogenous retinal detachment

    Directory of Open Access Journals (Sweden)

    Yokoyama S

    2017-11-01

    Full Text Available Sho Yokoyama,1 Takashi Kojima,2 Toshio Mori,3 Taisuke Matsuda,1 Hiroyuki Sato,3 Norihiko Yoshida,4 Tatsushi Kaga,1 R Theodore Smith,5 Kazuo Ichikawa6 1Department of Ophthalmology, Japan Community Healthcare Organization Chukyo Hospital, Nagoya, Japan; 2Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan; 3Department of Ophthalmology, Iida Municipal Hospital, Iida, Japan; 4Department of Ophthalmology, Japanese Red Cross Gifu Hospital, Gifu, Japan; 5Department of Ophthalmology, New York University School of Medicine, New York, NY, USA; 6Chukyo Eye Clinic, Nagoya, Japan Summary: We evaluated the clinical outcomes for ophthalmic endoscope-assisted vitrectomy in consecutive patients with uncomplicated rhegmatogenous retinal detachment (RRD. The primary success rate was 98.4% (125/127 without performing a posterior drainage retinotomy or using perfluorocarbon liquids (PFCL for subretinal fluid drainage.Purpose: To investigate the clinical outcomes of endoscope-assisted vitrectomy in patients with uncomplicated RRD.Methods: We examined 127 eyes from consecutive patients who underwent repair of RRD by 23- or 25-gauge endoscope-assisted vitrectomy, with a minimum follow-up of 3 months. Eyes with the following criteria were excluded: Giant retinal tears, grade C proliferative vitreoretinopathy, dense vitreous hemorrhage, retinal detachment secondary to other ocular diseases, and prior retinal or vitreous surgery. All cases underwent subretinal fluid drainage, endolaser photocoagulation and fundus inspection were performed under ophthalmic endoscopic observation. Success rate, visual acuity, surgery time and complications were evaluated.Results: Primary and final success rate was 98.4% (125/127 and 100% (127/127, respectively, Surgery time was 59.6±26.3 minutes. The best-corrected visual acuity significantly improved from 20/100 to 20/20 (P<0.0001. There were 2 cases (1.6% of creation of a peripheral drainage retinotomy and 4

  13. Endoscopic treatment of prepatellar bursitis.

    Science.gov (United States)

    Huang, Yu-Chih; Yeh, Wen-Lin

    2011-03-01

    Operative treatment of prepatellar bursitis is indicated in intractable bursitis. The most common complication of surgical treatment for prepatellar bursitis is skin problems. For traumatic prepatellar bursitis, we propose a protocol of outpatient endoscopic surgery under local anaesthesia. From September 1996 to February 2001, 60 cases of failed nonoperative treatment for prepatellar bursitis were included. The average age was 33.5 ± 11.1 years (range 21-55). The average operation duration was 18 minutes. Two to three mini-arthroscopic portals were used in our series. No sutures or a simple suture was needed for the portals after operation. After follow-up for an average of 36.3 months, all patients are were symptom-free and had regained knee function. None of the population had local tenderness or hypo-aesthesia around their wound. Their radiographic and sonographic examinations showed no recurrence of bursitis. Outpatient arthroscopic bursectomy under local anaesthesia is an effective procedure for the treatment of post-traumatic prepatellar bursitis after failed conservative treatments. Both the cosmetic results and functional results were satisfactory.

  14. Endoscopic Recurrence 6 Months After Ileocecal Resection in Children With Crohn Disease Treated With Azathioprine.

    Science.gov (United States)

    Zarubova, Kristyna; Hradsky, Ondrej; Copova, Ivana; Rouskova, Blanka; Pos, Lucie; Skaba, Richard; Bronsky, Jiri

    2017-08-01

    Intestinal surgery is an important part of Crohn disease (CD) treatment in children. The aim of the present study was to compare the rate of endoscopic recurrence at the sixth month after ileocecal resection (ICR) in children with CD treated with azathioprine between patients who received prior antitumor necrosis factor alpha (anti-TNF-α) therapy and those who were not administered this therapy. Moreover, we tried to identify the potential risk factors for disease recurrence and describe the schedule of long-term follow-up after surgery. We prospectively collected data from pediatric patients with CD, who underwent ICR between October 2011 and June 2015 at our hospital and were treated with azathioprine monotherapy after ICR. We evaluated the endoscopic recurrence (Rutgeerts score) at the sixth month after ICR in all included patients. Among 21 included patients, 13 achieved endoscopic remission (Rutgeerts score factors associated with endoscopic recurrence rate at the sixth month. Prior anti-TNF-α therapy does not seem to be a strong risk factor for endoscopic recurrence within 6 months after ICR. Further studies on large sample of patients are needed to identify potential predictors of disease recurrence.

  15. Initial experience of direct-to-test endoscopic ultrasonography for suspected choledocholithiasis.

    Science.gov (United States)

    Lochhead, Paul; Phull, Perminder

    2015-05-01

    Endoscopic ultrasound has become an invaluable tool in the investigation of patients with suspected pancreatobiliary disease. We set out to determine whether a "direct-to-test" endoscopic ultrasound procedure could be offered to selected patients with suspected choledocholithiasis. We included patients referred to our general gastroenterology service with clinical history, symptomatology and/or laboratory results compatible with choledocholithiais. Almost all patients had already had a transabdominal ultrasound performed at the request of their general practitioner. All patients underwent direct-to-test day-case endoscopic ultrasound under conscious sedation. Procedures were performed by a single practitioner using an oblique-viewing radial echoendoscope. The diagnostic yield and frequencies of discharge, onward referral and follow-up were determined. Overall diagnostic yield of direct-to-test endoscopic ultrasound was 61%. The most common diagnoses were cholelithiasis (18%) and choledocholithiasis (11%); one periampullary cancer was also detected. A definitive outcome (discharge or referral for a therapeutic procedure) occurred in 14 of 28 patients (50%). The remaining 14 patients underwent further out-patient evaluation. Eventual diagnoses in this group included autoimmune hepatitis, primary biliary cirrhosis and drug-induced hepatitis. For patients with suspected biliary disease, direct-to-test endoscopic ultrasound has a high diagnostic yield, and may be an appropriate mode of investigation. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  16. The round window region and contiguous areas: endoscopic anatomy and surgical implications.

    Science.gov (United States)

    Marchioni, Daniele; Alicandri-Ciufelli, Matteo; Pothier, David D; Rubini, Alessia; Presutti, Livio

    2015-05-01

    The round window region is a critical area of the middle ear; the aim of this paper is to describe its anatomy from an endoscopic perspective, emphasizing some structures, the knowledge of which could have important implications during surgery, as well as to evaluate what involvement cholesteatoma may have with these structures. Retrospective review of video recordings of endoscopic ear surgeries and retrospective database review were conducted in Tertiary university referral center. Videos from endoscopic middle ear procedures carried out between June 2010 and September 2012 and stored in a shared database were reviewed retrospectively. Surgeries in which an endoscopic magnification of the round window region and the inferior retrotympanum area was performed intraoperatively were included in the study. Involvement by cholesteatoma of those regions was also documented based on information obtained from the surgical database. Conformation of the tegmen of the round window niche may influence the surgical view of round window membrane. A structure connecting the round window area to the petrous apex, named the subcochlear canaliculus, is described. Cholesteatoma can invade the round window areas in some patients. Endoscopic approaches can guarantee a very detailed view and allow the exploration of the round window region. Exact anatomical knowledge of this region can have important advantages during surgery, since some pathology can invade inside cavities or tunnels otherwise not seen by instrumentation that produces a straight-line view (e.g. microscope).

  17. Endoscopic ultrasound-guided drainage of pancreatic pseudocysts

    DEFF Research Database (Denmark)

    Saftoiu, Adrian; Vilmann, Andreas; Vilmann, Peter

    2015-01-01

    Pancreatic pseudocysts are fluid collections in the peripancreatic tissues associated with acute or chronic pancreatitis. Endoscopic ultrasound (EUS)-guided drainage has become an established indication, having better results as compared to percutaneous drainage, nonguided endoscopic drainage...

  18. [Natural Orifice Transluminal Endoscopic Surgery (NOTES)].

    Science.gov (United States)

    Kim, Yong Sik; Kim, Chul Young; Chun, Hoon Jai

    2008-03-01

    Recently, the field of gastrointestinal endoscopy is developing rapidly. Once limited to the gastroinstestinal lumen, the endoscopic technology is now breaking the barriers and extending its boundary to peritoneal and pleural space. In 2004, Dr. Kalloo, a gastroenterologist, observed intraperitoneal organs of a pig using a conventional endoscope through the stomach wall. Since then, new endoscopic technique of intraperitoneal intervention with transluminal approach named the Natural Orifice Transluminal Endoscopic Surgery or NOTES has been introduced. NOTES reaches the target organ by inserting the endoscope through a natural orifice (e.g. mouth, anus, vagina, urethra) and entering the peritoneal lumen by means of making an incision on the luminal wall. After a series of successful experiences in animal studies, NOTES are now being tried on human subjects. There are still many obstacles to overcome, but bright future for this new technology is expected because of its proposed advantages of less pain, lower complication rate, short recovery time, and scarless access. In this review, we plan to learn about NOTES.

  19. Endoscopic techniques in oral and maxillofacial surgery.

    Science.gov (United States)

    Pedroletti, Fred; Johnson, Brad S; McCain, Joseph P

    2010-02-01

    Oral and maxillofacial surgery is entering a new era. Surgeons can use the latest technological advances in equipment in an attempt to improve patient outcomes. Minimally invasive surgery with the use of the endoscope has improved in recent years because of technological advancements in optics and associated instrumentation. Trauma, orthognathic, sialoendoscopy, and temporomandibular joint surgery are commonly performed with the assistance of the endoscope. From an educational standpoint, surgical anatomy and various other principles can easily be taught to trainees with the assistance of the endoscope. The operating surgeon can visualize an area via the endoscope, and instruct regarding the surgical maneuvers on the monitor, without obstructions to view. This technique also allows others in and out of the room to view the image. Endoscopically assisted surgery is gaining popularity and is becoming a tool frequently used by surgeons to assist in and simplify some of the more difficult techniques that often require more extensive surgical exposure for visualization. Copyright (c) 2010 Elsevier Inc. All rights reserved.

  20. Design and demonstration of ultra high speed fiber-optic links for EO/IR sensors for tethered robotic applications

    Science.gov (United States)

    Bell, Robert A.; Sood, Ashok K.; Puri, Yash R.

    2006-05-01

    High Speed Multi-Channel Fiber-Optic Transmitter (Tx) and Receiver (Rx) modules have been developed for Next Generation Ground Vehicle Applications. These fiber-optic multi-channel modules take advantage of the high speeds (10 Gb/Sec/Channel) and have the ability to connect multiple sensors and systems using a rugged fiber-optic cable capable of working with very high data rates for real time information. In this paper we present design, development and application of these high Speed modules for Tethered Robotic Applications. We will present design, development and performance results for 12 channels - Tx and Rx fiber-optic module capable of providing 120 Gb/Module operations for Army's Manned and Unmanned Vehicle Applications. This technology enables the application of very high data rates and multiple channels of real time, high-resolution visible and thermal IR streaming video that enhances the ability for real time information without any bandwidth limitations.

  1. Fiber-optic transmission system information for the testing of active phased antenna arrays in an anechoic chamber.

    Science.gov (United States)

    Saveleiv, I. K.; Sharova, N. V.; Tarasenko, M. Yu; Yalunina, T. R.; Davydov, V. V.; Rud’, V. Yu

    2017-11-01

    The results of the research of the developed fiber-optic transmission systems for analog high frequency signal are represented. On its basis, a new method to identify various structural defects in the active phased antenna arrays is elaborated.

  2. Effect of fiberoptic intubation on myocardial ischemia and hormonal stress response in diabetics with ischemic heart disease

    Directory of Open Access Journals (Sweden)

    Nashwa Nabil Mohamed

    2014-01-01

    Conclusion: The optimum use of fiberoptic bronchoscope with avoidance of jaw thrust maneuver attenuates the hemodynamic response to intubation which is beneficial in diabetic patients with ischemic heart disease. Stress response hormones showed no statistically significant difference between groups.

  3. Multi-Stress Monitoring System with Fiber-Optic Mandrels and Fiber Bragg Grating Sensors in a Sagnac Loop.

    Science.gov (United States)

    Kim, Hyunjin; Sampath, Umesh; Song, Minho

    2015-07-29

    Fiber Bragg grating sensors are placed in a fiber-optic Sagnac loop to combine the grating temperature sensors and the fiber-optic mandrel acoustic emission sensors in single optical circuit. A wavelength-scanning fiber-optic laser is used as a common light source for both sensors. A fiber-optic attenuator is placed at a specific position in the Sagnac loop in order to separate buried Bragg wavelengths from the Sagnac interferometer output. The Bragg wavelength shifts are measured with scanning band-pass filter demodulation and the mandrel output is analyzed by applying a fast Fourier transform to the interference signal. This hybrid-scheme could greatly reduce the size and the complexity of optical circuitry and signal processing unit, making it suitable for low cost multi-stress monitoring of large scale power systems.

  4. Successful application of laparoscopic and endoscopic cooperative surgery (LECS) for a lateral-spreading mucosal gastric cancer.

    Science.gov (United States)

    Nunobe, Souya; Hiki, Naoki; Gotoda, Takuji; Murao, Takahisa; Haruma, Ken; Matsumoto, Hideo; Hirai, Toshihiro; Tanimura, Shinya; Sano, Takeshi; Yamaguchi, Toshiharu

    2012-07-01

    In the current era of endoscopic submucosal dissection (ESD) for early gastric cancer, which carries a negligible risk of lymph node metastasis, local resection of the stomach remains an option for these lesions. This is particularly so for a large intramucosal lesion or a lesion with a strong ulcer scar, for which ESD becomes a difficult option. Here, we describe a case of lateral-spreading intramucosal gastric cancer of 6-cm diameter located at the fornix of the stomach, which was successfully treated by laparoscopic and endoscopic cooperative surgery (LECS) because of the expected risk of complications during ESD. In the LECS procedure, the resection margin was appropriately determined by the endoscopic evaluation in detail and by the ESD technique. If early gastric cancer fits the criteria for endoscopic resection but would present difficulty if performing ESD, this is a good indication for the LECS procedure.

  5. Developing Modularized Virtual Reality Simulators for Natural Orifice Translumenal Endoscopic Surgery (NOTES).

    Science.gov (United States)

    Ahn, Woojin; Dorozhkin, Denis; Schwaitzberg, Steven; Jones, Daniel B; De, Suvranu

    2016-01-01

    Natural orifice translumenal endoscopic surgery (NOTES) procedures are rapidly being developed in diverse surgical fields. We are developing a Virtual Translumenal Endoscopic Surgery Trainer (VTEST™) built on a modularized platform that facilitates rapid development of virtual reality (VR) NOTES simulators. Both the hardware interface and software components consist of independent reusable and customizable modules. The developed modules are integrated to build a VR-NOTES simulator for training in the hybrid transvaginal NOTES cholecystectomy. The simulator was demonstrated and evaluated by expert NOTES surgeons at the 2015 Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR) summit.

  6. Hyaluronic acid solution injection for upper and lower gastrointestinal bleeding after failed conventional endoscopic therapy.

    Science.gov (United States)

    Lee, Jin Wook; Kim, Hyung Hun

    2014-03-01

    Hyaluronic acid solution injection can be an additional endoscopic modality for controlling bleeding in difficult cases when other techniques have failed. We evaluated 12 cases in which we used hyaluronic acid solution injection for stopping bleeding. Immediately following hyaluronic acid solution injection, bleeding was controlled in 11 out of 12 cases. There was no clinical evidence of renewed bleeding in 11 cases during follow up.Hyaluronic acid solution injection can be a simple and efficient additional method for controlling upper and lower gastrointestinal bleeding after failed endoscopic therapy. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  7. Novel and safer endoscopic cholecystectomy using only a flexible endoscope via single port.

    Science.gov (United States)

    Mori, Hirohito; Kobayashi, Nobuya; Kobara, Hideki; Nishiyama, Noriko; Fujihara, Shintaro; Chiyo, Taiga; Ayaki, Maki; Nagase, Takashi; Masaki, Tsutomu

    2016-04-07

    To apply the laparoscopic and endoscopic cooperative surgery concept, we investigated whether endoscopic cholecystectomy could be performed more safely and rapidly via only 1 port or not. Two dogs (11 and 13-mo-old female Beagle) were used in this study. Only 1 blunt port was created, and a flexible endoscope with a tip attachment was inserted between the fundus of gallbladder and liver. After local injection of saline to the gallbladder bed, resection of the gallbladder bed from the liver was performed. After complete resection of the gallbladder bed, the gallbladder was pulled up to resect its neck using the Ring-shaped thread technique. The neck of the gallbladder was cut using scissor forceps. Resected gallbladder was retrieved using endoscopic net forceps via a port. The operation times from general anesthetizing with sevoflurane to finishing the closure of the blunt port site were about 50 min and 60 min respectively. The resection times of gallbladder bed were about 15 min and 13 min respectively without liver injury and bleeding at all. Feed were given just after next day of operation, and they had a good appetite. Two dogs are in good health now and no complications for 1 mo after endoscopic cholecystectomy using only a flexible endoscope via one port. We are sure of great feasibility of endoscopic cholecystectomy via single port for human.

  8. Risk factors of open converted cholecystectomy for cholelithiasis after endoscopic removal of choledocholithiasis.

    Science.gov (United States)

    Kwon, Yong Hwan; Cho, Chang-Min; Jung, Min Kyu; Kim, Sang Gul; Yoon, Young Kook

    2015-02-01

    Open converted cholecystectomy could occur in patients who planned for laparoscopic cholecystectomy after endoscopic removal of choledocholithiasis. To evaluate the risk factors associated with open converted cholecystectomy. The data for all patients who underwent cholecystectomy after endoscopic removal of choledocholithiasis were retrospectively reviewed. Factors predictive for conversion to open cholecystectomy were analyzed. The rate of open converted cholecystectomy was 15.7 %. In multivariate analysis, cholecystitis (OR 1.908, 95 % CI 1.390-6.388, p = 0.005), mechanical lithotripsy (OR 6.129, 95 % CI 1.867-20.123, p choledocholithiasis, endoscopic retrograde cholangiography-related factors predictive for open converted cholecystectomy are helpful in planning the appropriate timing of surgery.

  9. Endoscopic treatment of the fistulas after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass

    Directory of Open Access Journals (Sweden)

    Luís Gustavo Santos Périssé

    Full Text Available OBJECTIVE: to evaluate the use of endoscopic self-expandable metallic prostheses in the treatment of fistulas from sleeve gastrectomy and Roux en y gastric bypass.METHODS: all patients were treated with fully coated auto-expandable metallic prostheses and were submitted to laparoscopic or CT-guided drainage, except for those with intracavitary drains. After 6-8 weeks the prosthesis was removed and if the fistula was still open a new prostheses were positioned and kept for the same period.RESULTS: the endoscopic treatment was successful in 25 (86.21% patients. The main complication was the migration of the prosthesis in seven patients. Other complications included prosthesis intolerance, gastrointestinal bleeding and adhesions. The treatment failed in four patients (13.7% one of which died (3.4%.CONCLUSION: endoscopic treatment with fully coated self-expandable prosthesis was effective in treating most patients with fistula after sleeve gastrectomy and roux en y gastric bypass.

  10. Clonidine Reduce Bleeding Of Endoscopic Sinus Surgery Amir Alam Hospital (1398-2000

    Directory of Open Access Journals (Sweden)

    Hajy Mohammadi F

    2002-09-01

    Full Text Available This study was conducted to evaluate effect of clonidine as a premedication on endoscopic sinus surgery bleeding."nMethods and Materials: during a randomized double blind clinical trial we compared two groups of patients who scheduled for endoscopic sinus surgery for polypectomy and etmoidectomy. 216 patients randomly assigned in two groups.In first group 2 hours befor surgery a 0.2mg tablet of clonidine orally adminestered to patients and in second group a 100 mg tablet of vit Bj(with same size and color- as"nplacebowas adminestered to patients. The amount of bleeding measured in two groups."nResults: mean bleeding volume in clonidine group was 113+76 ml and in control group was 211 + 113 ml. There was a significant statistical difference between two groups (pO.0001."nConclusion: Clonidine as premedication can reduce bleeding of endoscopic sinus surgery significantly.

  11. Lingual traction to facilitate fiber-optic intubation of difficult airways: a single-anesthesiologist randomized trial.

    Science.gov (United States)

    Ching, Yiu-Hei; Karlnoski, Rachel A; Chen, Henian; Camporesi, Enrico M; Shah, Vimal V; Padhya, Tapan A; Mangar, Devanand

    2015-04-01

    Flexible fiber-optic bronchoscope-guided orotracheal intubation is a valuable technique with demonstrated benefits in the management of difficult airways. Despite its popularity with anesthesia providers, the technique is not fail-safe and airway-related complications secondary to failed intubation attempts remain an important problem. We sought to determine the effect of incorporating lingual traction on the success rate of fiber-optic bronchoscope-guided intubation in patients with anticipated difficult airways. In this prospective, randomized, cohort study, we enrolled 91 adult patients with anticipated difficult airways scheduled for elective surgery to undergo fiber-optic bronchoscope-guided orotracheal intubation alone or with lingual traction by an individual anesthesiologist after induction of general anesthesia and neuromuscular blockade. A total of 78 patients were randomized: 39 patients to the fiber-optic bronchoscope-guided intubation with lingual traction group and 39 patients to the fiber-optic bronchoscope-guided intubation alone group. The primary endpoint was the rate of successful first attempt intubations. The secondary outcome was sore throat grade on post-operative day 1. Fiber-optic intubation with lingual traction compared to fiber-optic intubation alone resulted in a higher success rate (92.3 vs. 74.4 %, χ (2) = 4.523, p = 0.033) and greater odds for successful first attempt intubation (OR 4.138, 95 % CI 1.041-16.444, p = 0.044). Sore throat severity on post-operative day 1 was not significantly different but trended towards worsening grades with lingual traction. In this study, lingual traction was shown to be a valuable maneuver for facilitating fiber-optic bronchoscope-guided intubation in the management of patients with anticipated difficult airways.

  12. Cost-effectiveness of endoscopic ultrasonography, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography in patients suspected of pancreaticobiliary disease

    DEFF Research Database (Denmark)

    Ainsworth, A P; Rafaelsen, S R; Wamberg, P A

    2004-01-01

    BACKGROUND: It is not known whether initial endoscopic ultrasonography (EUS) or magnetic resonance cholangiopancreatography (MRCP) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP). METHODS: A cost-effectiveness analysis of EUS, MRCP and ERCP was performed on 163...

  13. Post-endoscopic biliary sphincterotomy bleeding: an interventional radiology approach.

    LENUS (Irish Health Repository)

    Dunne, Ruth

    2013-12-01

    Endoscopic sphincterotomy is an integral component of endoscopic retrograde cholangiopancreatography. Post-sphincterotomy hemorrhage is a recognized complication. First line treatment involves a variety of endoscopic techniques performed at the time of sphincterotomy. If these are not successful, transcatheter arterial embolization or open surgical vessel ligation are therapeutic considerations.

  14. A 12 years audit of upper gastrointestinal endoscopic procedures

    International Nuclear Information System (INIS)

    Khurram, M.; Khaar, H.B.; Hasan, Z.; Umar, M.; Javed, S.; Asghar, T.; Minhas, Z.; Akbar, A.; Atta, N.; Nassar, F.; Sultana, Q.; Pervaiz, A.; Masoom, A.

    2003-01-01

    Objective: Evaluation of upper gastrointestinal (GI) endoscopy in terms of indications, diagnostic efficacy, and diseases diagnosed. Results: Of the 8481 patients, 4935 (58.2%) were female and 3546 (41.8%) male. Mean patient age was 40.5 years. Dyspepsia (42.6%), upper GI bleed (32.8%), and evaluation of chronic liver disease (10.2%) were common indications of the procedure. An endoscopic diagnosis was possible in 82.6% patients. Varices, gastritis, duodenitis, and combined lesions were common endoscopic diagnosis. Gastritis and duodenitis were most frequent causes of upper GI bleed. We noted more gastric ulcers compared to duodenal ulcers. Females had significantly more normal endoscopies, p-value = 0.02. Conclusion: Upper GI endoscopy is an effective procedure. Dyspepsia evaluation is commonest indication for upper GI endoscopy in our patients. Etiology of upper GI bleed, and incidence of duodenal ulcer compared to gastric ulcer in our patients are different than described in literature. Females have significantly more normal endoscopies. (author)

  15. Endoscopic Third Ventriculostomy: Outcome Analysis of an Anterior Entry Point.

    Science.gov (United States)

    Aref, Mohammed; Martyniuk, Amanda; Nath, Siddharth; Koziarz, Alex; Badhiwala, Jetan; Algird, Almunder; Farrokhyar, Forough; Almenawer, Saleh A; Reddy, Kesava

    2017-08-01

    Endoscopic third ventriculostomy (ETV) is a safe and effective treatment for hydrocephalus. An entry point located 4 cm anterior to the coronal suture, 3 cm anterior to Kocher point, and approximately 9 cm from the pupil at the midpupillary line has been used successfully for the last 20 years in our center. We aimed to evaluate this alternative anterior entry point routinely used for ETV, with or without concurrent endoscopic biopsy. Patients undergoing this proposed entry point were examined to evaluate its safety and efficacy. Factors such as patients' age, sex, hydrocephalus etiology, tumor location and pathology, and complication rate were examined through regression analyses to evaluate their impact on tumor biopsy and ETV success rates, and the need for subsequent ventricular shunting. A total of 131 patients were included in the study. ETV was successful in 125 (95.4%) patients. Of these, 26 (19.8%) patients required a biopsy, which was successful in 21 (80.8%) cases. A complication was observed in 10 (7.6%) patients, with a trend toward complications occurring after ETV failure. There was no association between ETV success rate and patients' age (P = 0.5) or sex (P = 0.99). The anterior entry point is a safe and effective method for ETV, especially when considering concurrent ventricular tumor biopsy. This entry point may be considered as a more minimally invasive procedure when using rigid endoscopy and may also eliminate the need for a flexible scope. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. [Endoscopic classification of colon and rectal neoplasias].

    Science.gov (United States)

    Zavoral, Miroslav; Vojtěchová, Gabriela; Suchánek, Stěpán

    2014-01-01

    Along with the dynamic evolution of the new field of digestive endoscopy, the need of unified and unambiguous terms for endoscopic findings arose in the second half of the 20th century. In collaboration with the OMED members, professor Zdeněk Mařatka drew up the first internationally acknowledged terminology for digestive endoscopy which was used in the full range for a period of almost 20 years. The technical progress later brought with it endoscopes which made it possible to view flat lesions, frequently overlooked until then. The classification of the surface lesions was further specified by the Paris Classification which drew from the experience of Japanese endoscopists. Thanks to the new endoscopic methods of imaging mucosa in vivo and the pit-pattern and vascular-pattern classification, we can currently estimate the biological nature of lesion with great accuracy and therefore choose the best therapeutic procedure.

  17. Diagnosis and treatment with endoscopic retrograde cholangiopancreatography

    International Nuclear Information System (INIS)

    Soendenaa, K.; Horn, A.; Viste, A.

    1994-01-01

    Endoscopic retrograde cholangiopancreatography (ERCP) was carried out for the first time in 1968. Five years later endoscopic sphincterotomy was performed. Since then both modalities have become established as necessary adjuncts in the diagnosis and treatment of patients with pathology in the bile duct or pancreas. The main indication is common bile duct stone, and as a consequence of this treatment fewer patients are now treated surgically. Patients with malignant bile duct obstruction can be given reasonable palliation of both jaundice and pruritus and therefore improved quality of life. Some reports indicate that endoscopic drainage may be useful for pancreatic stenosis. Complications are few, but vigilance and prompt treatment is necessary to keep morbidity at a minimum. Follow-up after several years shows that sphincterotomy is successful also in the long term. The authors discuss the present diagnostic and therapeutic situation. 31 refs., 2 tabs

  18. A Study on the Response Characteristics of a Fiber-Optic Radiation Sensor Model Based on Cerenkov Principle

    International Nuclear Information System (INIS)

    Han, Hwa Jeong; Kim, Beom Kyu; Park, Byung Gi

    2016-01-01

    In recent year, various fiber-optic radiation sensors using Cerenkov principle have been developed without employing any scintillators for measuring high-energy photon, electron, etc. The main advantages of the optical fibers are the remote transmission of the light signal and immunity to pressure and electromagnetic waves. Therefore, the sensors utilizing the optical fibers can be used in hazardous radiation environments, such as the high-level radiation areas of a nuclear facility. The study to be simulated a fiber-optic radiation sensor based on Cerenkov principle and to be analyzed the response characteristics of the sensor. For the aforementioned study, the GEANT simulation toolkit was used. It is able to take into all the optical properties of fibers and is found to be appropriate to realistically describe the response of fiber-optic radiation sensor. In the recently, the fiber-optic radiation sensor have been developed in nuclear industry. Because sensor can detect gamma ray in harsh nuclear environments. In this study, we analyzed response characteristics of the fiber-optic radiation sensor. We have simulated the Monte Carlo model, for detecting the Cerenkov radiation using the fiber-optic radiation sensor. And the y-axis distribution of Cerenkov photons was obtained using output file. Simulation is performed with reference to the method of the previous research, and then the simulation results exhibited a good agreement with the previous research

  19. Endoscopic simulator curriculum improves colonoscopy performance in novice surgical interns as demonstrated in a swine model.

    Science.gov (United States)

    Telem, Dana A; Rattner, David W; Gee, Denise W

    2014-05-01

    The purpose of this study was to determine whether independent virtual endoscopic training accelerates the acquisition of endoscopic skill by novice surgical interns. Nine novice surgical interns participated in a prospective study comparing colonoscopy performance in a swine model before and after an independent simulator curriculum. An independent observer evaluated each intern for the ability to reach the cecum within 20 min and technical ability as determined by Global Assessment of Gastrointestinal Endoscopic Skills--Colonoscopy (GAGES-C) score and performance compared. In addition, at the conclusion of training, a post test of two basic simulated colonoscopy modules was completed and metrics evaluated. As a control, three attending physicians who routinely perform colonoscopy also completed colonoscopy in the swine model. Prior to endoscopic training, one (11 %) intern successfully intubated the cecum in 19.56 min. Following training, six (67 %) interns reached the cecum with mean time of 9.2 min (p curriculum intern times demonstrated the experts to be significantly faster (p curriculum demonstrated significantly improved GI Mentor™ performance in the efficiency (79 vs. 67.1 %, p = 0.05) and time to cecum (3.37 vs. 5.59 min, p = 0.01) metrics. No other significant difference was demonstrated in GAGES-C categories or other simulator parameter. Simulator training on the GI Mentor™ alone significantly improved endoscopic skills in novice surgical interns as demonstrated in a swine model. This study also identified parameters on the GI Mentor™ that could indicate 'clinical readiness'. This study supports the role for endoscopic simulator training in surgical resident education as an adjunct to clinical experience.

  20. Endoscopic ultrasound guided biopsy performed routinely in lung cancer staging spares futile thoracotomies

    DEFF Research Database (Denmark)

    Larsen, Soeren S; Vilmann, Peter; Krasnik, Mark

    2005-01-01

    BACKGROUND: Up to 45% of operations with curative intent for non-small-cell lung cancer (NSCLC) can be regarded as futile, apparently because the stage of the disease is more advanced than expected preoperatively. During the past decade several studies have evaluated the usefulness of endoscopic ...

  1. Endoscopic plantar fascia release, calcaneal drilling and calcaneal spur removal for management of painful heel syndrome.

    Science.gov (United States)

    El Shazly, Ossama; El Beltagy, Atef

    2010-12-01

    The pathogenesis of painful heel syndrome is multifactorial including plantar fasciitis, increased intra-osseous pressure of the os calcis, calcaneal periostitis and presence of calcaneal spur. The currently used endoscopic treatment of painful heel syndromes involves endoscopic plantar fascia release alone without addressing other pathological changes. To evaluate the clinical outcome of endoscopic plantar fascia release, calcaneal drilling and calcaneal spur removal. The study was conducted on 22 cases/24 feet with idiopathic painful heel syndrome resistant to conservative treatment. All cases were treated by plantar fasciotomy; calcaneal drilling and calcaneal spur removal using a modified cannula trocar system. Evaluation of pain was done using VAS and functional evaluation was done using the Modified Mayo Scoring System for Plantar Fasciotomy. Also patient's satisfaction was evaluated by direct questionnaire. There was statistically significant improvement in the mean VAS from 82.81 (±7.8 std) preoperative to 6.63 (±2.75 std) and the Mayo score form 7.05 (±3.67 std) preoperative to 87.5 (±4.81 std) at 2 years follow up (Pcalcaneal drilling and calcaneal spur removal has high success rate and patient's satisfaction rate when compared to published reports on isolated endoscopic plantar release. Copyright © 2010 Elsevier Ltd. All rights reserved.

  2. Is the 'Trondsen Discriminant Function' useful in patients referred for endoscopic retrograde cholangiopancreatography?

    DEFF Research Database (Denmark)

    Ainsworth, A P; Pless, T; Mortensen, M B

    2003-01-01

    BACKGROUND: Ideally, patients should only be referred to endoscopic retrograde cholangiopancreatography (ERCP) if therapy is indicated. The aim of this study was to evaluate whether or not the 'Trondsen Discriminant Function' (DF) could be used for selecting patients directly for ERCP. METHODS...

  3. Validity Evidence for the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT)

    NARCIS (Netherlands)

    Breimer, Gerben E.; Haji, Faizal A.; Cinalli, Giuseppe; Hoving, Eelco W.; Drake, James M.

    BACKGROUND: Growing demand for transparent and standardized methods for evaluating surgical competence prompted the construction of the Neuro-Endoscopic Ventriculostomy Assessment Tool (NEVAT). OBJECTIVE: To provide validity evidence of the NEVAT by reporting on the tool's internal structure and its

  4. Simulation-based Education for Endoscopic Third Ventriculostomy : A Comparison Between Virtual and Physical Training Models

    NARCIS (Netherlands)

    Breimer, Gerben E.; Haji, Faizal A.; Bodani, Vivek; Cunningham, Melissa S.; Lopez-Rios, Adriana-Lucia; Okrainec, Allan; Drake, James M.

    BACKGROUND: The relative educational benefits of virtual reality (VR) and physical simulation models for endoscopic third ventriculostomy (ETV) have not been evaluated "head to head." OBJECTIVE: To compare and identify the relative utility of a physical and VR ETV simulation model for use in

  5. Endoscopic management of glabellar frown lines.

    Science.gov (United States)

    Hamas, R S

    1995-10-01

    Resection of the corrugator muscles has been done for years as a routine adjunct to open coronal browlifts. The new endoscopic procedure described here permits endoscopic resection of the corrugator muscles through three 5-mm hairline incisions in those patients who do not need or want a browlift. The primary benefit is that of reducing the subconscious tendency to frown that some patients exhibit whenever concentrating or conversing. Although patients typically seek plastic surgery procedures to improve how they see themselves, these patients seek a reduction in the subconscious frown to improve how others see them and react to this unattractive facial expression.

  6. ENDOSCOPIC TECHNOLOGIES IN EARLY RECTAL CANCER TREATMENT

    Directory of Open Access Journals (Sweden)

    D. V. Samsonov

    2015-01-01

    Full Text Available Total mesorectal excision is the “golden standard” of surgical treatment for rectal cancer. Development of endoscopic technologies allowed to implement the benefits of minimally invasive surgery in early rectal cancer treatment, decrease morbidity and mortality, improve functional outcome and quality of life. Oncological safety of this method is still a subject for discussion due to lack of lymph node harvest. Endoscopic operations for early rectal cancer are being actively implemented in daily practice, but lack of experience does not allow to include this method in national clinical prac-tice guidelines.

  7. Endoscopic release for carpal tunnel syndrome.

    Science.gov (United States)

    Vasiliadis, Haris S; Georgoulas, Petros; Shrier, Ian; Salanti, Georgia; Scholten, Rob J P M

    2014-01-31

    Carpal tunnel syndrome (CTS) is the most common compressive neuropathy of the upper extremity. It is caused by increased pressure on the median nerve between the transverse carpal ligament and the carpal bones. Surgical treatment consists of the release of the nerve by cutting the transverse carpal ligament. This can be done either with an open approach or endoscopically. To assess the effectiveness and safety of the endoscopic techniques of carpal tunnel release compared to any other surgical intervention for the treatment of CTS. More specifically, to evaluate the relative impact of endoscopic techniques in relieving symptoms, producing functional recovery (return to work and return to daily activities) and reducing complication rates. This review fully incorporates the results of searches conducted up to 5 November 2012, when we searched the Cochrane Neuromuscular Disease Group Specialized Register, CENTRAL, MEDLINE and EMBASE. There were no language restrictions. We reviewed the reference lists of relevant articles and contacted trial authors. We also searched trial registers for ongoing trials. We performed a preliminary screen of searches to November 2013 to identify any additional recent publications. We included any randomised controlled trials (RCTs) and quasi-RCTs comparing endoscopic carpal tunnel release (ECTR) with any other surgical intervention for the treatment of CTS. We used standard methodological procedures expected by the Cochrane Collaboration. Twenty-eight studies (2586 hands) were included. Twenty-three studies compared ECTR to standard open carpal tunnel release (OCTR), five studies compared ECTR with OCTR using a modified incision, and two studies used a three-arm design to compare ECTR, standard OCTR and modified OCTR.At short-term follow-up (three months or less), only one study provided data for overall improvement. We found no differences on the Symptom Severity Scale (SSS) (scale zero to five) (five studies, standardised mean

  8. From an urologist view: are we safe with endoscopic surgery? Overview of ergonomic problems encountered by the urologist during video endoscopic surgery.

    Science.gov (United States)

    Sataa, Sallami; Benzarti, Aida; Ben Jemaa, Abdelmajid

    2012-12-01

    The importance of minimally invasive surgery in urology has constantly increased in the last 20 years. Endoscopic resection of prostate and bladder tumors is actually a gold standard with many advantages for patients. To analyze the problems related to the ergonomic conditions faced by urologist during video endoscopic surgery by review of the recent literature. All evidence-based experimental ergonomic studies conducted in the fields of urology endoscopic surgery and applied ergonomics for other professions working with a display were identified by PubMed searches. Data from ergonomic studies were evaluated in terms of efficiency as well as comfort and safety aspects. Constraint postures for urologists are described and ergonomic requirements for optimal positions are discussed. The ergonomics of urological endoscopic surgery place urologists at risk for potential injury. The amount of neck flexion or extension, the amount of shoulder girdle adduction or abduction used, and stability of the upper extremities during surgery; which are maintained in a prolonged static posture; are the main risk factors. All these constraints may lead to muscle and joint fatigue, pain, and eventual musculoskeletal injury. Moreover, these issues may impact surgical accuracy. Urologist posture, operating period, training are important ergonomic factor during video surgery to prevent musculoskeletal disorders.

  9. Fiber-optic sensor demonstrator (FSD) for the monitoring of spacecraft subsystems on ESA's PROBA-2

    Science.gov (United States)

    Kruzelecky, Roman V.; Zou, Jing; Mohammed, Najeeb; Haddad, Emile; Jamroz, Wes; Ricci, Francesco; Lamorie, Joshua; Edwards, Eric; McKenzie, Iain; Vuilleumier, Pierrik

    2017-11-01

    MPB Communications (MPBC) is developing solutions to the monitoring requirements of spacecraft based on its fiber-laser and Fiber Bragg Grating expertise. This is cumulating in the Fiber Sensor Demonstrator for ESA's Proba-2 that is scheduled for launch in 2007. The advantages of the MPBC approach include a central interrogation system that can be used to control a variety of different fiber-optic sensors including temperature, pressure, actuator status, and propellant leakage. This paper reviews the design and ground qualification of the FSD system in preparation for integration with Proba-2. The FSD will provide monitoring for various Proba-2 subsystems, including a hybrid propulsion system. Some of the challenges associated with using fiber-optics in space are discussed.

  10. Microminiaturized minimally invasive intravascular micro-mechanical systems powered and controlled via fiber-optic cable

    Science.gov (United States)

    Fitch, Joseph P.; Hagans, Karla; Clough, Robert; Matthews, Dennis L.; Lee, Abraham P.; Krulevitch, Peter A.; Benett, William J.; Da Silva, Luiz; Celliers, Peter M.

    1998-01-01

    A micro-mechanical system for medical procedures is constructed in the basic form of a catheter having a distal end for insertion into and manipulation within a body and a near end providing for a user to control the manipulation of the distal end within the body. A fiberoptic cable is disposed within the catheter and having a distal end proximate to the distal end of the catheter and a near end for external coupling of laser light energy. A microgripper is attached to the distal end of the catheter and providing for the gripping or releasing of an object within the body. A laser-light-to-mechanical-power converter is connected to receive laser light from the distal end of the fiberoptic cable and connected to mechanically actuate the microgripper.

  11. Fiber-Optical Parametric Amplification of Sub-Picosecond Pulses for High-Speed Optical Communications

    DEFF Research Database (Denmark)

    Lali-Dastjerdi, Zohreh; Cristofori, Valentina; Rottwitt, Karsten

    2015-01-01

    This article reviews recent results of amplification of short optical pulses using fiber-optical parametric amplifiers. This includes chirped-pulse amplification of 400 fs pulses, error-free amplification of a 640-Gbit/s optical time-division multiplexed signal with less than a 1-dB power penalty......, and all-optical phase-preserving amplitude regeneration of a 640-Gbit/s return-to-zero differential phase-shift keying optical time-division multiplexed signal.......This article reviews recent results of amplification of short optical pulses using fiber-optical parametric amplifiers. This includes chirped-pulse amplification of 400 fs pulses, error-free amplification of a 640-Gbit/s optical time-division multiplexed signal with less than a 1-dB power penalty...

  12. Simple and Low-cost Fiber-optic Sensors for Detection of UV Radiation

    Directory of Open Access Journals (Sweden)

    M. B. Živanov

    2012-11-01

    Full Text Available In this paper two simple and low-cost fiberoptic sensors for detection of UV radiation are presented. A U-shaped sensor covered with an UV marker for UV radiation detection and a fiber-optic sensor with one end covered with powder from a mercury lamp are produced and described in details. Both sensors are made of large-core PMMA plastic optical fibers. As UV sources, a solar simulator and four different UV lamps are used. The light spectrum on the fiber output is measured by using an USB spectrometer. Dependence of output light intensity on the distance of end-type sensor with powder from a mercury lamp from UV lamp is investigated as well. On the output of the sensor covered with powder from a mercury lamp are obtained peaks of fluorescent emission at approximately 616 nm and 620 nm wavelengths.

  13. An air flow sensor for neonatal mechanical ventilation applications based on a novel fiber-optic sensing technique.

    Science.gov (United States)

    Battista, L; Sciuto, S A; Scorza, A

    2013-03-01

    In this work, a simple and low-cost air flow sensor, based on a novel fiber-optic sensing technique has been developed for monitoring air flows rates supplied by a neonatal ventilator to support infants in intensive care units. The device is based on a fiber optic sensing technique allowing (a) the immunity to light intensity variations independent by measurand and (b) the reduction of typical shortcomings affecting all biomedical fields (electromagnetic interference and patient electrical safety). The sensing principle is based on the measurement of transversal displacement of an emitting fiber-optic cantilever due to action of air flow acting on it; the fiber tip displacement is measured by means of a photodiode linear array, placed in front of the entrance face of the emitting optical fiber in order to detect its light intensity profile. As the measurement system is based on a detection of the illumination pattern, and not on an intensity modulation technique, it results less sensitive to light intensity fluctuation independent by measurand than intensity-based sensors. The considered technique is here adopted in order to develop two different configurations for an air flow sensor suitable for the measurement of air flow rates typically occurring during mechanical ventilation of newborns: a mono-directional and a bi-directional transducer have been proposed. A mathematical model for the air flow sensor is here proposed and a static calibration of two different arrangements has been performed: a measurement range up to 3.00 × 10(-4) m(3)∕s (18.0 l∕min) for the mono-directional sensor and a measurement range of ±3.00 × 10(-4) m(3)∕s (±18.0 l∕min) for the bi-directional sensor are experimentally evaluated, according to the air flow rates normally encountered during tidal breathing of infants with a mass lower than 10 kg. Experimental data of static calibration result in accordance with the proposed theoretical model: for the mono

  14. Bilateral same-day endoscopic transcanal cartilage tympanoplasty: initial results.

    Science.gov (United States)

    Daneshi, Ahmad; Jahandideh, Hesam; Daneshvar, Ali; Safdarian, Mahdi

    Same-day closure of bilateral tympanic membrane perforations is a quick and more comfortable procedure for the patients. However, conventional bilateral same-day tympanoplasty or myringoplasty has been rarely performed because of the theoretical risk of postoperative complications. To evaluate the advantages and outcomes of bilateral simultaneous endoscopic cartilage tympanoplasty in patients with bilateral tympanic membrane perforations. From February 2012 to March 2013, patients with bilateral dry tympanic membrane perforations who had some degree of hearing loss corresponding to the size and location of the perforation entered the study. There was no suspicion to disrupted ossicular chain, mastoid involvement or other middle or inner ear pathology. Endoscopic transcanal cartilage tympanoplasty was done using the underlay (medial) technique. The graft was harvested from cymba cartilage in just one ear with preservation of perichondrium in one side. A 1.5cm×1.5cm cartilage seemed to be enough for tympanoplasty in both sides. Nine patients (4 males and 5 females) with the mean age of 37.9 years underwent bilateral transcanal cartilage tympanoplasty in a same-day surgery. The mean duration of follow up was 15.8 months. There were detected no complications including hearing loss, otorrhea and wound complication with no retraction pocket or displaced graft during follow-up period. The grafts take rate was 94.44% (only one case of unilateral incomplete closure). The mean of air-bone gap overall improved from 13.88dB preoperatively to 9.16dB postoperatively (p<0.05). Bilateral endoscopic transcanal cartilage tympanoplasty can be considered as a safe minimally invasive procedure that can be performed in a same-day surgery. It reduces the costs and operation time and is practical with a low rate of postoperative complications. Copyright © 2017 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights

  15. Role of endoscopic retrograde cholangiopancreatography before and after laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Sbeih, F.; Aljohani, M.; Altraif, I.; Khan, H.

    1998-01-01

    While the role of endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic sphincterotomy (EST) in the diagnosis and management of choledocholithiasis is well established, this study evaluates the usefulness of ERCP and EST patients with symptomatic cholecystolithiasis and suspected choledocholithiasis before undergoing laparoscopic cholecystectomy (LC), and the role of ERCP-EST in the management of complications resulting from LC. This paper reviews retrospectively our experience from 1992 to 1995. A total of 1221 LCs and 717 ERCPs were performed on 225 patients who underwent LC (230 ERCPs before and 27 after). The age range was 10-85 years (mean 43.5. The study group comprised 148 (66%) females and 77 males (34%). The overall success rate for ERCP was 92% (96% for diagnostic and 88% for therapeutic). Choledocholithiasis was found at preoperative ERCP in 45% cases. Prediction of cholecoledocholithiasis was accurate in 46%, based on abnormal liver chemistry, and 70% when based on a combination of abnormal liver tests and dilated main bile duct (>7 mm) by ultrasound. In 40 cases of acute biliary pancreatitis, choledocholithiasis was found at ERCP in eight cases (20%). In the post LC-group, all eight cases with residual stones and seven of eight cases with bile leaks were successfully treated endoscopically. There were four cases with major duct injuries that required surgical management. The complications related to ERCP-EST included two cases of bleeding post-EST (one was controlled with injection therapy and the second one was managed surgically) and three cases of mild pancreatitis. ERCP and EST are effective and safe in the diagnosis and management of choledocholithiasis and facilitate LC for symptomatic cholelithiasis. The procedures are also valuable in the diagnosis and management of most complications resulting from LC. (author)

  16. Duodenal endoscopic full-thickness resection (with video).

    Science.gov (United States)

    Schmidt, Arthur; Meier, Benjamin; Cahyadi, Oscar; Caca, Karel

    2015-10-01

    Endoscopic resection of duodenal non-lifting adenomas and subepithelial tumors is challenging and harbors a significant risk of adverse events. We report on a novel technique for duodenal endoscopic full-thickness resection (EFTR) by using an over-the-scope device. Data of 4 consecutive patients who underwent duodenal EFTR were analyzed retrospectively. Main outcome measures were technical success, R0 resection, histologic confirmation of full-thickness resection, and adverse events. Resections were done with a novel, over-the-scope device (full-thickness resection device, FTRD). Four patients (median age 60 years) with non-lifting adenomas (2 patients) or subepithelial tumors (2 patients) underwent EFTR in the duodenum. All lesions could be resected successfully. Mean procedure time was 67.5 minutes (range 50-85 minutes). Minor bleeding was observed in 2 cases; blood transfusions were not required. There was no immediate or delayed perforation. Mean diameter of the resection specimen was 28.3 mm (range 22-40 mm). Histology confirmed complete (R0) full-thickness resection in 3 of 4 cases. To date, 2-month endoscopic follow-up has been obtained in 3 patients. In all cases, the over-the-scope clip was still in place and could be removed without adverse events; recurrences were not observed. EFTR in the duodenum with the FTRD is a promising technique that has the potential to spare surgical resections. Modifications of the device should be made to facilitate introduction by mouth. Prospective studies are needed to further evaluate efficacy and safety for duodenal resections. Copyright © 2015 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  17. ENDOSCOPIC SURGICAL TREATMENT OF RECURRENT BAKER’S CYSTS

    Directory of Open Access Journals (Sweden)

    A. K. Dulaev

    2014-01-01

    Full Text Available Purpose of the study - to study the causes of synovitis in patients with recurrent Baker’s cyst, to evaluate the effectiveness of endoscopic treatment of popliteal cysts . Materials and methods. From 2009 till 2013 we observed 34 patients with Baker's cyst. In 18 (52.9% patients of the main group endoscopic technique was applied, in 16 (47.1% patients of the comparison group a cystic bag was isolated and dissected with open technique, and then cystic gate was sutured. Results. In 10 (55,6% patients of the main group the pain disappeared in the first postoperative day (p<0,05, the average hospital stay was 3,5±0,6 days (p<0,05, and the knee function completely recovered in 16 (88.9% patients in 2 weeks postoperatively (p<0,05. A year later in 1 (5.6% patients of the main group the signs of knee function disorders of 1 degree on a Rauschning & Lindgren scale were revealed, and in the comparison group - in 6 (37.5% patients - disorders of varying severity (p <0.05. In 4 (25,0% patients of the comparison group the recurrence of Baker’s cyst developed that required arthroscopic treatment, followed by complete recovery. Conclusions: Formation of Baker’s cyst is associated with an excess formation and accumulation of a synovial fluid in the knee joint owing to chronic damage of the meniscus and synovial membrane disease (p <0,05. Endoscopic technique allows to eliminate the causes of synovitis and the valve mechanism of fluid flow in the gastrocnemius-semimembranosus bag, to stop pain at earlier date, to restore the amplitude of active movement in the knee, to reduce the hospital stay and the risk of cyst recurrence, to prevent scarring in popliteal region (p <0,05.

  18. ENDOSCOPIC DIAGNOSIS AND TREATMENT OF UPPER GASTROINTESTINAL BLEEDING

    Directory of Open Access Journals (Sweden)

    Daniela Benedeto-Stojanov

    2015-06-01

    Full Text Available Upper gastrointestinal bleeding (UGB is a common medical emergency problem with significant morbidity and mortality. The aim of this paper is to establish the incidence of upper gastrointestinal bleeding in relation to sex and age, determine the prevalence of bleeding lesions and perform analysis of bleeding peptic ulcer in relation to the location, age, gender, Forrest classification and the need for endoscopic hemostasis. Thе prospective study included 70 patients with UGB, 42 men and 28 women, mean age 68.64±13.66 years. The diagnosis of bleeding lesions was made exclusively by means of esophagogastroduodenoscopy. Forrest classification was used in the evaluation of the activity of bleeding ulcers of the stomach and duodenum. The largest number of bleeding patients was of male sex (60%. Bleeding most commonly occurred in patients older than 60 years (84.29%. Statistically, female patients were significantly older than patients of male gender (p=0.001. The most common cause of bleeding was peptic ulcer (65.71%. The average age of patients with gastric ulcer was 70.57±15.68 years, with a duodenal ulcer 63.78±16.70 years. In the duodenum, Forrest Ib, IIa and IIb ulcers were usually confirmed, whereas Forrest IIc ulcers were identified in the stomach. Endoscopic hemostasis was required in 55.56% of patients with duodenal and in 23.81% of patients with gastric ulcer. The incidence of UGB is higher in men and it increases with age. The most common cause of bleeding is ulcer disease. Patients with gastric ulcer are older than patients with duodenal ulcer, while both gastric and duodenal ulcers are found in the oldest patients. Duodenal ulcers cause serious bleeding and more often require endoscopic hemostasis.

  19. Per-oral endoscopic myotomy: major advance in achalasia treatment and in endoscopic surgery.

    Science.gov (United States)

    Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

    2014-12-21

    Per-oral endoscopic myotomy (POEM) represents a natural orifice endoscopic surgery (NOTES) approach to laparoscopy Heller myotomy (LHM). POEM is arguably the most successful clinical application of NOTES. The growth of POEM from a single center in 2008 to approximately 60 centers worldwide in 2014 with several thousand procedures having been performed attests to the success of POEM. Initial efficacy, safety and acid reflux data suggest at least equivalence of POEM to LHM, the previous gold standard for achalasia therapy. Adjunctive techniques used in the West include impedance planimetry for real-time intraprocedural luminal assessment and endoscopic suturing for challenging mucosal defect closures during POEM. The impact of POEM extends beyond the realm of esophageal motility disorders as it is rapidly popularizing endoscopic submucosal dissection in the West and spawning offshoots that use the submucosal tunnel technique for a host of new indications ranging from resection of tumors to pyloromyotomy for gastroparesis.

  20. Endoscopic colostomy with percutaneous colopexy: an animal feasibility study

    Directory of Open Access Journals (Sweden)

    Leonardo Alfonso Bustamante-López

    Full Text Available Background: Indications for colostomy in colorectal diseases are obstruction of the large bowel, such as in cancer, diverticular disease in the acute phase, post-radiotherapy enteritis, complex perirectal fistulas, anorectal trauma and severe anal incontinence. Some critically ill patients cannot tolerate an exploratory laparotomy, and laparoscopic assisted colostomy also requires general anesthesia. Objective: To evaluate the feasibility, safety and efficacy of performing colostomy assisted by colonoscopy and percutaneous colopexy. Materials and methods: Five pigs underwent endoscopic assisted colostomy with percutaneous colopexy. Animals were evaluated in post-operative days 1, 2, 5 and 7 for feeding acceptance and colostomy characteristics. On day 7 full colonoscopy was performed on animals followed by exploratory laparotomy. Results: Average procedure time was 27 minutes (21-54 min. Postoperative mobility and feeding of animals were immediate after anesthesia recovery. Position of the colostomy, edges color, appearance of periostomal area, as well as its function was satisfactory in four animals. Retraction of colostomy was present in one pig. The colonoscopy and laparotomy control on the seventh day were considered as normal. A bladder perforation that was successfully repaired through the colostomy incision occurred in one pig. The main limitation of this study is its experimental nature. Conclusion: Endoscopic assisted colostomy with percutaneous colopexy proves to be a safe and effective method with low morbidity for performing colostomy in experimental animals, with possible clinical application in humans.