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

In-Use Evaluation of Peracetic Acid for High-Level Disinfection of Endoscopes.

Science.gov (United States)

Chenjiao, Wu; Hongyan, Zhang; Qing, Gu; Xiaoqi, Zhong; Liying, Gu; Ying, Fang

2016-01-01

Many high-level disinfectants have been used for disinfection of endoscopes such as 2% glutaraldehyde (GA), 0.55% ortho-phthalaldehyde (OPA), and peracetic acid (PAA). Both GA and OPA are widely used in disinfection of endoscopes and have been previously discussed, but there is little research on the practical use of PAA as an endoscope disinfectant. An experimental model of a flexible gastrointestinal endoscope being contaminated with 9 strains of microorganism was designed. After the cleaning and disinfecting procedure was completed, we evaluated the biocidal activity (850 ppm PAA, 2% GA, and 0.55% OPA) on our flexible gastrointestinal endoscope model. We also evaluated sterilization effectiveness of PAA on other bacteria, including some antibiotic-resistant bacteria (methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile). The residual bacterial colony count number of the PAA-disinfected endoscope was significantly lower than that of the GA- and OPA-disinfected endoscopes. The biocidal effect and efficiency of the endoscope disinfection by PAA appeared to be better than either the GA- or OPA-disinfected endoscope. PAA has demonstrated a good sterilization effect on other bacterial species; of particular note are common antibiotic-resistant bacteria such as methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and Clostridium difficile. The results of this study demonstrate that PAA is a fast and effective high-level disinfectant for use in the reprocessing of flexible endoscopes.

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

[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.

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.

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.

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.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea

Directory of Open Access Journals (Sweden)

Luciana Almeida Moreira da Paz Oliveira

2015-06-01

Full Text Available INTRODUCTION: Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. OBJECTIVE: To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. METHODS: This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. RESULTS: The dysphagia group consisted of 17 patients (77.3% in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n = 15; 68.2% and/or in the questionnaire (n = 7; 31.8%. The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. CONCLUSION: Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia.

Clinical endoscopic management and outcome of post-endoscopic sphincterotomy bleeding.

Directory of Open Access Journals (Sweden)

Wei-Chen Lin

Full Text Available Post-endoscopic sphincterotomy bleeding is a common complication of biliary sphincterotomy, and the incidence varies from 1% to 48%. It can be challenging to localize the bleeder or to administer various interventions through a side-viewing endoscope. This study aimed to evaluate the risk factors of post-endoscopic sphincterotomy bleeding and the outcome of endoscopic intervention therapies. We retrospectively reviewed the records of 513 patients who underwent biliary sphincterotomy in Mackay Memorial Hospital between 2011 and 2016. The blood biochemistry, comorbidities, indication for sphincterotomy, severity of bleeding, endoscopic features of bleeder, and type of endoscopic therapy were analyzed. Post-endoscopic sphincterotomy bleeding occurred in 65 (12.6% patients. Forty-five patients had immediate bleeding and 20 patients had delayed bleeding. The multivariate analysis of risk factors associated with post-endoscopic sphincterotomy bleeding were liver cirrhosis (P = 0.029, end-stage renal disease (P = 0.038, previous antiplatelet drug use (P<0.001, and duodenal ulcer (P = 0.023. The complications of pancreatitis and cholangitis were higher in the bleeding group, with statistical significance. Delayed bleeding occurred within 1 to 7 days (mean, 2.5 days, and 60% (12/20 of the patients received endoscopic evaluation. In the delayed bleeding group, the successful hemostasis rate was 71.4% (5/7, and 65% (13/20 of the patients had ceased bleeding without endoscopic hemostasis therapy. Comparison of different therapeutic modalities showed that cholangitis was higher in patients who received epinephrine spray (P = 0.042 and pancreatitis was higher in patients who received epinephrine injection and electrocoagulation (P = 0.041 and P = 0.039 respectively. Clinically, post-endoscopic sphincterotomy bleeding and further endoscopic hemostasis therapy increase the complication rate of pancreatitis and cholangitis. Realizing the effectiveness of each

21 CFR 876.4530 - Gastroenterology-urology fiberoptic retractor.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gastroenterology-urology fiberoptic retractor. 876... SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4530 Gastroenterology-urology fiberoptic retractor. (a) Identification. A gastroenterology-urology fiberoptic retractor...

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 ...

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

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.

Swallowing and pharyngo-esophageal manometry in obstructive sleep apnea.

Science.gov (United States)

Oliveira, Luciana Almeida Moreira da Paz; Fontes, Luiz Henrique de Souza; Cahali, Michel Burihan

2015-01-01

Upper airway nerve and muscle damage associated with obstructive sleep apnea may impair the strength and dynamics of pharyngeal and esophageal contractions during swallowing. To evaluate the presence of alterations in pharyngoesophageal manometry in patients with obstructive sleep apnea with and without oropharyngeal dysphagia. This study prospectively evaluated 22 patients with obstructive sleep apnea without spontaneous complaints of dysphagia, using a questionnaire, fiberoptic endoscopic evaluation of swallowing, and pharyngoesophageal manometry, including measurement of the upper and lower esophageal sphincter pressures and mean pharyngeal pressures at three levels during swallowing. The dysphagia group consisted of 17 patients (77.3%) in whom swallowing abnormalities were detected on fiberoptic endoscopic evaluation of swallowing (n=15; 68.2%) and/or in the questionnaire (n=7; 31.8%). The five remaining cases comprised a control group without oropharyngeal dysphagia. In all cases of abnormalities on fiberoptic endoscopic evaluation of swallowing, there was premature bolus leakage into the pharynx. There was no statistically significant difference between the groups regarding any of the pharyngoesophageal manometry measurements, age, or severity of obstructive sleep apnea. Pharyngoesophageal manometry detected no statistically significant difference between the groups with and without oropharyngeal dysphagia. Copyright © 2015 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

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

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.

A fiber-optic polarimetric demonstration kit

International Nuclear Information System (INIS)

Eftimov, T; Dimitrova, T L; Ivanov, G

2012-01-01

A simple and multifunctional fiber-optic polarimetric kit on the basis of highly birefringent single-mode fibers is presented. The fiber-optic polarimetric kit allows us to perform the following laboratory exercises: (i) fiber excitation and the measurement of numerical aperture, (ii) polarization preservation and (iii) obtain polarization-sensitive fiberized interferometers.

Evaluation of fiberoptic dermofluorometry as a means of clinically assessing tissue perfusion.

Science.gov (United States)

Leopold, P W; Chang, B B; Shah, D M; Corson, J D; Shandall, A A; Young, H L; Leather, R P; Karmody, A M

1987-01-01

Fiberoptic dermofluorometry (FDF) transcutaneously measures fluorescence, following an intravenous injection of sodium fluorescein (NaFl), which is transmitted along a fiberoptic bundle to a photomultiplier tube and converted into dermofluorescence units (DFU). In five normal subjects studied, the plasma concentration of NaFl peaked at 5-15 minutes before decaying with first order kinetics and corresponding dermofluorescence (DF) rose to a peak between 10-20 minutes before decaying. Peak DF in the head and neck was significantly higher (P less than .001) compared to other skin sites which were similar. Application to patients (n = 16) undergoing successful lower limb revascularization showed a significant (P less than 0.01) improvement in perfusion at the foot level only. The reproducibility of FDF was poor when studied on the control limbs. We conclude that FDF does not, at present, constitute a valid measure of skin perfusion.

Evaluation of a novel multi-articulated endoscope: proof of concept through a virtual simulation.

Science.gov (United States)

Karvonen, Tuukka; Muranishi, Yusuke; Yamamoto, Goshiro; Kuroda, Tomohiro; Sato, Toshihiko

2017-07-01

In endoscopic surgery such as video-assisted thoracoscopic surgery and laparoscopic surgery, providing the surgeon a good view of the target is important. Rigid endoscope has for years been the go-to tool for this purpose, but it has certain limitations like the inability to work around obstacles. To improve on current tools, a novel multi-articulated endoscope (MAE) is currently under development. To investigate its feasibility and possible value, we performed a user test using virtual prototype of the MAE with the intent to show that it outperforms the conventional endoscope while bringing minimal additional burden to the operator. To evaluate the prototype, we built a virtual model of the MAE and a rigid oblique-viewing endoscope. Through a comparative user study we evaluate the ability of each device to visualize certain targets placed inside the virtual chest cavity by the angle between the visual axis of the scope and the normal of the plane of the target, while accounting for the usability of each endoscope by recording the time taken for each task. In addition, we collected a questionnaire from each participant to obtain feedback. The angles obtained using the MAE were smaller on average ([Formula: see text]), indicating that better visualization can be achieved through the proposed method. A nonsignificant difference in mean time taken for each task in favor of the rigid endoscope was also found ([Formula: see text]). We have demonstrated that better visualization for endoscopic surgery can be achieved through our novel MAE. The scope may bring about a paradigm shift in the field of minimally invasive surgery by providing more freedom in viewpoint selection, enabling surgeons to perform more elaborate procedures in minimally invasive settings.

Evaluation of robotically controlled advanced endoscopic instruments

NARCIS (Netherlands)

Reilink, Rob; Kappers, Astrid M.L.; Stramigioli, Stefano; Misra, Sarthak

Background Advanced flexible endoscopes and instruments with multiple degrees of freedom enable physicians to perform challenging procedures such as the removal of large sections of mucosal tissue. However, these advanced endoscopes are difficult to control and require several physicians to

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.

Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

Directory of Open Access Journals (Sweden)

Diego Palladino

2016-01-01

Full Text Available Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation versus surgical (Heller myotomy treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before and after endoscopic or surgical treatment. Results. The mean variation of oesophageal diameter before and after treatment is −2.1 mm for surgery and 1.74 mm for pneumatic dilation (OR 0.167, CI 95% 0.02–1.419, and P: 0.10. The variations of all variables, with the exception of the oesophageal diameter variation, are strongly related to the treatment performed. Conclusions. The barium X-ray study of the digestive tract, performed before and after different treatment approaches, demonstrates that the surgical treatment has to be considered as the treatment of choice of achalasia, reserving endoscopic treatment to patients with high operative risk and refusing surgery.

Comparison between videofluoroscopy, fiberoptic endoscopy and scintigraphy for diagnosis of oro-pharyngeal dysphagia.

Science.gov (United States)

Fattori, B; Giusti, P; Mancini, V; Grosso, M; Barillari, M R; Bastiani, L; Molinaro, S; Nacci, A

2016-10-01

The purpose of this study was to compare videofluoroscopy (VFS), fiberoptic endoscopic evaluation of swallowing (FEES) and oro-pharyngo- oesophageal scintigraphy (OPES) with regards to premature spillage, post-swallowing residue and aspiration to assess the reliability of these tests for detection of oro-pharyngeal dysphagia. Sixty patients affected with dysphagia of various origin were enrolled in the study and submitted to VFS, FEES and OPES using a liquid and semi-solid bolus. As a reference, we used VFS. Both the FEES and the OPES showed good sensitivity with high overall values (≥ 80% and ≥ 90% respectively). The comparison between FEES vs VFS concerning drop before swallowing showed good specificity (84.4% for semi-solids and 86.7% for liquids). In the case of post-swallowing residue, FEES vs VFS revealed good overall validity (75% for semi-solids) with specificity and sensitivity well balanced for the semi-solids. OPES vs. VFS demonstrated good sensitivity (88.6%) and overall validity (76.7%) for liquids. The analysis of FEES vs. VFS for aspiration showed that the overall validity was low (≤ 65%). On the other hand, OPES demonstrated appreciable overall validity (71.7%). VFS, FEES and OPES are capable of detecting oro-pharyngeal dysphagia. FEES gave significant results in the evaluation of post-swallowing residues. © Copyright by Società Italiana di Otorinolaringologia e Chirurgia Cervico-Facciale, Rome, Italy.

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

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.

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.

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.

Evaluation of flexible endoscope steering using haptic guidance

NARCIS (Netherlands)

Reilink, Rob; Stramigioli, Stefano; Kappers, Astrid M L; Misra, Sarthak

Background: Steering the tip of a flexible endoscope relies on the physician's dexterity and experience. For complex flexible endoscopes, conventional controls may be inadequate. Methods: A steering method based on a multi-degree-of-freedom haptic device is presented. Haptic cues are generated based

Evaluation of flexible endoscope steering using haptic guidance

NARCIS (Netherlands)

Reilink, Rob; Stramigioli, Stefano; Kappers, Astrid M.L.; Misra, Sarthak

2011-01-01

Background - Steering the tip of a flexible endoscope relies on the physician’s dexterity and experience. For complex flexible endoscopes, conventional controls may be inadequate. Methods - A steering method based on a multi-degree-of-freedom haptic device is presented. Haptic cues are generated

Assessment of test methods for evaluating effectiveness of cleaning flexible endoscopes.

Science.gov (United States)

Washburn, Rebecca E; Pietsch, Jennifer J

2018-06-01

Strict adherence to each step of reprocessing is imperative to removing potentially infectious agents. Multiple methods for verifying proper reprocessing exist; however, each presents challenges and limitations, and best practice within the industry has not been established. Our goal was to evaluate endoscope cleaning verification tests with particular interest in the evaluation of the manual cleaning step. The results of the cleaning verification tests were compared with microbial culturing to see if a positive cleaning verification test would be predictive of microbial growth. This study was conducted at 2 high-volume endoscopy units within a multisite health care system. Each of the 90 endoscopes were tested for adenosine triphosphate, protein, microbial growth via agar plate, and rapid gram-negative culture via assay. The endoscopes were tested in 3 locations: the instrument channel, control knob, and elevator mechanism. This analysis showed substantial level of agreement between protein detection postmanual cleaning and protein detection post-high-level disinfection at the control head for scopes sampled sequentially. This study suggests that if protein is detected postmanual cleaning, there is a significant likelihood that protein will also be detected post-high-level disinfection. It also infers that a cleaning verification test is not predictive of microbial growth. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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

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

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.

Endoscopic Criteria for Evaluating Tumor Stage after Preoperative Chemoradiation Therapy in Locally Advanced Rectal Cancer.

Science.gov (United States)

Han, Kyung Su; Sohn, Dae Kyung; Kim, Dae Yong; Kim, Byung Chang; Hong, Chang Won; Chang, Hee Jin; Kim, Sun Young; Baek, Ji Yeon; Park, Sung Chan; Kim, Min Ju; Oh, Jae Hwan

2016-04-01

Local excision may be an another option for selected patients with markedly down-staged rectal cancer after preoperative chemoradiation therapy (CRT), and proper evaluation of post-CRT tumor stage (ypT) is essential prior to local excision of these tumors. This study was designed to determine the correlations between endoscopic findings and ypT of rectal cancer. In this study, 481 patients with locally advanced rectal cancer who underwent preoperative CRT followed by surgical resection between 2004 and 2013 at a single institution were evaluated retrospectively. Pathological good response (p-GR) was defined as ypT ≤ 1, and pathological minimal or no response (p-MR) as ypT ≥ 2. The patients were randomly classified according to two groups, a testing (n=193) and a validation (n=288) group. Endoscopic criteria were determined from endoscopic findings and ypT in the testing group and used in classifying patients in the validation group as achieving or not achieving p-GR. Based on findings in the testing group, the endoscopic criteria for p-GR included scarring, telangiectasia, and erythema, whereas criteria for p-MR included nodules, ulcers, strictures, and remnant tumors. In the validation group, the kappa statistic was 0.965 (p < 0.001), and the sensitivity, specificity, positive predictive value, and negative predictive value were 0.362, 0.963, 0.654, and 0.885, respectively. The endoscopic criteria presented are easily applicable for evaluation of ypT after preoperative CRT for rectal cancer. These criteria may be used for selection of patients for local excision of down-staged rectal tumors, because patients with p-MR could be easily ruled out.

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.

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

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

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.

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.

Evaluation of an endoscopically assisted gastropexy technique in dogs.

Science.gov (United States)

Dujowich, Mauricio; Reimer, S Brent

2008-04-01

To evaluate the use of endoscopy in conjunction with a gastropexy technique in dogs as a potential means to aid prevention of gastric dilatation-volvulus. 12 healthy adult medium- and large-breed dogs. 12 adult research dogs that had no abnormal physical examination findings each underwent an endoscopically assisted gastropexy procedure. On completion of the procedure, the dogs were euthanized and exploratory laparotomies were performed to evaluate the surgical site. Data recorded included anatomic location of the gastropexy, gastropexy length, and duration of procedure as well as any complications. Mean+/-SD gastropexy length was 3.3+/-0.25 cm, and mean duration of surgery was 18+/-7 minutes. In each dog, the stomach was located in its normal anatomic position and all gastropexies were sutured to the abdominal wall at the level of the pyloric antrum. The only complications during the procedure were needle bending and breakage at the time of stay suture placement. On the basis of these findings, it appears that endoscopically assisted gastropexy is a simple, fast, safe, and reliable method of performing a prophylactic gastropexy in dogs when undertaken by a person who is skilled in endoscopy. Such a procedure maximizes the benefits of decreased morbidity and shorter duration of anesthesia associated with minimally invasive surgery. Further clinical studies are warranted to evaluate the long-term efficacy of this procedure in dogs at risk for development of gastric dilatation-volvulus.

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.

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.

Experimental evaluation of an automated endoscope reprocessor with in situ generation of peracetic acid for disinfection of semicritical devices.

Science.gov (United States)

Sattar, Syed A; Kibbee, Richard J; Tetro, Jason A; Rook, Tony A

2006-11-01

To evaluate the effectiveness of a high-level disinfection solution generated inside an endoscope processing system for decontaminating external and internal surfaces of experimentally contaminated heat-sensitive medical devices. The American Society for Testing and Materials Simulated-Use Test protocol (E1837-02), which incorporates a soil load in each inoculum, was used to evaluate the efficacy of the system when processing 4 common types of endoscopes contaminated separately with 5 types of nosocomial pathogens: Pseudomonas aeruginosa (ATCC 15442), spores of Clostridium difficile (ATCC 9689), a glutaraldehyde-resistant strain of Mycobacterium chelonae, a vancomycin-resistant strain of Enterococcus faecalis, and a methicillin-resistant strain of Staphylococcus aureus. Rinse solution samples from channels and from surfaces of the processed endoscopes were tested for any microbicidal residues. For all organisms tested, the baseline level of contamination of the endoscopes ranged from 5 log(10) to greater than 7 log(10) at each external surface site and internal channel. All tests showed reductions in viability of the test organisms to undetectable levels. All rinse solution samples from external and internal sites of the endoscopes proved to be free of any residual microbicidal activity. The endoscope reprocessor, with its processor-generated high-level disinfection solution, successfully reduced the numbers of selected, clinically relevant pathogens to undetectable levels both in the channels and on the outside surfaces of the 4 representative endoscopes tested in this study.

Imaging in the Evaluation of Endoscopic or Surgical Treatment for Achalasia

OpenAIRE

Diego Palladino; Andrea Mardighian; Marilina D’Amora; Luca Roberto; Francesco Lassandro; Claudia Rossi; Gianluca Gatta; Mariano Scaglione; Guglielmi Giuseppe

2016-01-01

Purpose. Aim of the study is to evaluate the efficacy of the endoscopic (pneumatic dilation) versus surgical (Heller myotomy) treatment in patients affected by esophageal achalasia using barium X-ray examination of the digestive tract performed before and after the treatment. Materials and Methods. 19 patients (10 males and 9 females) were enrolled in this study; each patient underwent a barium X-ray examination to evaluate the esophageal diameter and the height of the barium column before a...

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.

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.

Fiberoptic bronchoscopy in the diagnosis and therapeutic decision for respiratory infections in hematological febrile neutropenic patients

Directory of Open Access Journals (Sweden)

Luiza Bento

2014-06-01

Full Text Available Background: Febrile neutropenia is a common complication in patients undergoing chemotherapy or hematopoietic Stem Cell Transplantation (HSCT. Flexible fiberoptic bronchoscopy has been used to aid in the diagnosis of pulmonary diseases. However, there is no consensus regarding the benefit of the exam in establishing diagnosis and in changing the treatment of lung disease in this context. Previous retrospective studies, quite heterogeneous and with non-HIV immunocompromised patients, showed that the yield of fiberoptic bronchoscopy in establishing etiology ranges from 13% to 81%, and in changing therapy, from 5% to 51%. Aim: To evaluate the efficiency of Fiberoptic bronchoscopy and the procedure-related risk for neutropenic patients with hematologic malignancy. Methods: This retrospective cross-sectional study analyzed the medical records of patients with hematologic malignancy with febrile neutropenia who had undergone diagnostic fiberoptic bronchoscopy between January 2011 and December 2012 at the Hospital de Clínicas de Porto Alegre. Results: A total of 45 patients were included: 18 (36% tested positive for bronchoalveolar lavage, with change in therapeutic management occurring for 95% of them. The procedure-related risk was 2.2%, with one patient showing desaturation immediately after the procedure. Conclusion:  Despite the limited number of patients, our findings indicate that fiberoptic bronchoscopy in neutropenic patients is safe, and the results are similar to those previously reported.

Endoscopic submucosal dissection for locally recurrent colorectal lesions after previous endoscopic mucosal resection.

Science.gov (United States)

Zhou, Pinghong; Yao, Liqing; Qin, Xinyu; Xu, Meidong; Zhong, Yunshi; Chen, Weifeng

2009-02-01

The objective of this study was to determine the efficacy and safety of endoscopic submucosal dissection for locally recurrent colorectal cancer after previous endoscopic mucosal resection. A total of 16 patients with locally recurrent colorectal lesions were enrolled. A needle knife, an insulated-tip knife and a hook knife were used to resect the lesion along the submucosa. The rate of the curative resection, procedure time, and incidence of complications were evaluated. Of 16 lesions, 15 were completely resected with endoscopic submucosal dissection, yielding an en bloc resection rate of 93.8 percent. Histologic examination confirmed that lateral and basal margins were cancer-free in 14 patients (87.5 percent). The average procedure time was 87.2 +/- 60.7 minutes. None of the patients had immediate or delayed bleeding during or after endoscopic submucosal dissection. Perforation in one patient (6.3 percent) was the only complication and was managed conservatively. The mean follow-up period was 15.5 +/- 6.8 months; none of the patients experienced lesion residue or recurrence. Endoscopic submucosal dissection appears to be effective for locally recurrent colorectal cancer after previous endoscopic mucosal resection, making it possible to resect whole lesions and provide precise histologic information.

Real-time in vivo diagnosis of laryngeal carcinoma with rapid fiber-optic Raman spectroscopy

Science.gov (United States)

Lin, Kan; Zheng, Wei; Lim, Chwee Ming; Huang, Zhiwei

2016-01-01

We assess the clinical utility of a unique simultaneous fingerprint (FP) (i.e., 800-1800 cm−1) and high-wavenumber (HW) (i.e., 2800-3600 cm−1) fiber-optic Raman spectroscopy for in vivo diagnosis of laryngeal cancer at endoscopy. A total of 2124 high-quality in vivo FP/HW Raman spectra (normal = 1321; cancer = 581) were acquired from 101 tissue sites (normal = 71; cancer = 30) of 60 patients (normal = 44; cancer = 16) undergoing routine endoscopic examination. FP/HW Raman spectra differ significantly between normal and cancerous laryngeal tissue that could be attributed to changes of proteins, lipids, nucleic acids, and the bound water content in the larynx. Partial least squares-discriminant analysis and leave-one tissue site-out, cross-validation were employed on the in vivo FP/HW tissue Raman spectra acquired, yielding a diagnostic accuracy of 91.1% (sensitivity: 93.3% (28/30); specificity: 90.1% (64/71)) for laryngeal cancer identification, which is superior to using either FP (accuracy: 86.1%; sensitivity: 86.7% (26/30); specificity: 85.9% (61/71)) or HW (accuracy: 84.2%; sensitivity: 76.7% (23/30); specificity: 87.3% (62/71)) Raman technique alone. Further receiver operating characteristic analysis reconfirms the best performance of the simultaneous FP/HW Raman technique for laryngeal cancer diagnosis. We demonstrate for the first time that the simultaneous FP/HW Raman spectroscopy technique can be used for improving real-time in vivo diagnosis of laryngeal carcinoma during endoscopic examination. PMID:27699131

Endoscopic findings following retroperitoneal pancreas transplantation.

Science.gov (United States)

Pinchuk, Alexey V; Dmitriev, Ilya V; Shmarina, Nonna V; Teterin, Yury S; Balkarov, Aslan G; Storozhev, Roman V; Anisimov, Yuri A; Gasanov, Ali M

2017-07-01

An evaluation of the efficacy of endoscopic methods for the diagnosis and correction of surgical and immunological complications after retroperitoneal pancreas transplantation. From October 2011 to March 2015, 27 patients underwent simultaneous retroperitoneal pancreas-kidney transplantation (SPKT). Diagnostic oesophagogastroduodenoscopy (EGD) with protocol biopsy of the donor and recipient duodenal mucosa and endoscopic retrograde pancreatography (ERP) were performed to detect possible complications. Endoscopic stenting of the main pancreatic duct with plastic stents and three-stage endoscopic hemostasis were conducted to correct the identified complications. Endoscopic methods showed high efficiency in the timely diagnosis and adequate correction of complications after retroperitoneal pancreas transplantation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

NARCIS (Netherlands)

Burgmans, J.P.J.

2015-01-01

The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

Clinical usefulness of endoscopic ultrasonography for the evaluation of ulcerative colitis-associated tumors

Science.gov (United States)

Kobayashi, Kiyonori; Kawagishi, Kana; Ooka, Shouhei; Yokoyama, Kaoru; Sada, Miwa; Koizumi, Wasaburo

2015-01-01

AIM: To evaluate the clinical usefulness of endoscopic ultrasonography (EUS) for the diagnosis of the invasion depth of ulcerative colitis-associated tumors. METHODS: The study group comprised 13 patients with 16 ulcerative colitis (UC)-associated tumors for which the depth of invasion was preoperatively estimated by EUS. The lesions were then resected endoscopically or by surgical colectomy and were examined histopathologically. The mean age of the subjects was 48.2 ± 17.1 years, and the mean duration of UC was 15.8 ± 8.3 years. Two lesions were treated by endoscopic resection and the other 14 lesions by surgical colectomy. The depth of invasion of UC-associated tumors was estimated by EUS using an ultrasonic probe and was evaluated on the basis of the deepest layer with narrowing or rupture of the colonic wall. RESULTS: The diagnosis of UC-associated tumors by EUS was carcinoma for 13 lesions and dysplasia for 3 lesions. The invasion depth of the carcinomas was intramucosal for 8 lesions, submucosal for 2, the muscularis propria for 2, and subserosal for 1. Eleven (69%) of the 16 lesions arose in the rectum. The macroscopic appearance was the laterally spreading tumor-non-granular type for 4 lesions, sessile type for 4, laterally spreading tumor-granular type for 3, semi-pedunculated type (Isp) for 2, type 1 for 2, and type 3 for 1. The depth of invasion was correctly estimated by EUS for 15 lesions (94%) but was misdiagnosed as intramucosal for 1 carcinoma with high-grade submucosal invasion. The 2 lesions treated by endoscopic resection were intramucosal carcinoma and dysplasia, and both were diagnosed as intramucosal lesions by EUS. CONCLUSION: EUS provides a good estimation of the invasion depth of UC-associated tumors and may thus facilitate the selection of treatment. PMID:25759538

The diagnostic significance of endoscopic cytology in evaluating pancreatic and biliary lesions

OpenAIRE

Nilüfer ONAK KANDEMİR; Banu DOĞAN GÜN; Sibel BEKTAŞ; Figen BARUT1; Burak BAHADIR; Gamze YURDAKAN; Şükrü Oğuz ÖZDAMAR; Gamze MOCAN KUZEY

2007-01-01

Cytology is a widely performed technique in evaluating biliary and pancreatic ductal lesions. The contribution of cytological methods to the diagnosis of the disorders causing biliary stricture, and biopsy diagnoses of the cases were evaluated together with clinical follow-up outcomes and the results presented in this study.From January 2005 to December 2006, in Zonguldak Karaelmas University, Faculty of Medicine, Department of Gastroenterology, 20 biliary endoscopic brush cytology and 2 exfo...

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.

Fiberoptic microneedles: novel optical diffusers for interstitial delivery of therapeutic light.

Science.gov (United States)

Kosoglu, Mehmet A; Hood, Robert L; Rossmeisl, John H; Grant, David C; Xu, Yong; Robertson, John L; Rylander, Marissa Nichole; Rylander, Christopher G

2011-11-01

Photothermal therapies have limited efficacy and application due to the poor penetration depth of light inside tissue. In earlier work, we described the development of novel fiberoptic microneedles to provide a means to mechanically penetrate dermal tissue and deliver light directly into a localized target area.This paper presents an alternate fiberoptic microneedle design with the capability of delivering more diffuse, but therapeutically useful photothermal energy. Laser lipolysis is envisioned as a future clinical application for this design. A novel fiberoptic microneedle was developed using hydrofluoric acid etching of optical fiber to permit diffuse optical delivery. Microneedles etched for 10, 30, and 50 minutes, and an optical fiber control were compared with three techniques. First, red light delivery from the microneedles was evaluated by imaging the reflectance of the light from a white paper.Second, spatial temperature distribution of the paper in response to near-IR light (1,064 nm, 1 W CW) was recorded using infrared thermography. Third, ex vivo adipose tissue response during 1,064 nm, (5 W CW)irradiation was recorded with bright field microscopy. Acid etching exposed a 3 mm length of the fiber core, allowing circumferential delivery of light along this length. Increasing etching time decreased microneedle diameter, resulting in increased uniformity of red and 1,064 nm light delivery along the microneedle axis. For equivalent total energy delivery, thinner microneedles reduced carbonization in the adipose tissue experiments. We developed novel microscale optical diffusers that provided a more homogeneous light distribution from their surfaces, and compared performance to a flat-cleaved fiber, a device currently utilized in clinical practice. These fiberoptic microneedles can potentially enhance clinical laser procedures by providing direct delivery of diffuse light to target chromophores, while minimizing undesirable photothermal damage in adjacent

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.

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)

Limits of the endoscopic transnasal transtubercular approach.

Science.gov (United States)

Gellner, Verena; Tomazic, Peter V

2018-06-01

The endoscopic transnasal trans-sphenoidal transtubercular approach has become a standard alternative approach to neurosurgical transcranial routes for lesions of the anterior skull base in particular pathologies of the anterior tubercle, sphenoid plane, and midline lesions up to the interpeduncular cistern. For both the endoscopic and the transcranial approach indications must strictly be evaluated and tailored to the patients' morphology and condition. The purpose of this review was to evaluate the evidence in literature of the limitations of the endoscopic transtubercular approach. A PubMed/Medline search was conducted in January 2018 entering following keywords. Upon initial screening 7 papers were included in this review. There are several other papers describing the endoscopic transtubercular approach (ETTA). We tried to list the limitation factors according to the actual existing literature as cited. The main limiting factors are laterally extending lesions in relation to the optic canal and vascular encasement and/or unfavorable tumor tissue consistency. The ETTA is considered as a high level transnasal endoscopic extended skull base approach and requires excellent training, skills and experience.

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

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.

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.

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 �

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 ...

Online analysis by a fiber-optic diode array spectrophotometer

International Nuclear Information System (INIS)

Van Hare, D.R.; Prather, W.S.; O'Rourke, P.E.

1987-01-01

An online photometric analyzer has been developed which can make remote measurements over the 350 to 900 nm region at distances of up to 100 feet. The analyzer consists of a commercially available diode array spectrophotometer interfaced to a fiber-optic multiplexer to allow online monitoring of up to ten locations sequentially. The development of the fiber-optic interface is discussed and data from several online applications are presented to demonstrate the capabilities of the measurement system

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.

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

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.

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

Ling classification describes endoscopic progressive process of achalasia and successful peroral endoscopy myotomy prevents endoscopic progression of achalasia.

Science.gov (United States)

Zhang, Wen-Gang; Linghu, En-Qiang; Chai, Ning-Li; Li, Hui-Kai

2017-05-14

To verify the hypothesis that the Ling classification describes the endoscopic progressive process of achalasia and determine the ability of successful peroral endoscopic myotomy (POEM) to prevent endoscopic progression of achalasia. We retrospectively reviewed the endoscopic findings, symptom duration, and manometric data in patients with achalasia. A total of 359 patients (197 women, 162 men) with a mean age of 42.1 years (range, 12-75 years) were evaluated. Symptom duration ranged from 2 to 360 mo, with a median of 36 mo. Patients were classified with Ling type I ( n = 119), IIa ( n = 106), IIb ( n = 60), IIc ( n = 60), or III ( n = 14), according to the Ling classification. Of the 359 patients, 349 underwent POEM, among whom 21 had an endoscopic follow-up for more than 2 years. Pre-treatment and post-treatment Ling classifications of these 21 patients were compared. Symptom duration increased significantly with increasing Ling classification (from I to III) ( P achalasia and may be able to serve as an endoscopic assessment criterion for achalasia. Successful POEM (Eckardt score ≤ 3) seems to have the ability to prevent endoscopic evolvement of achalasia. However, studies with larger populations are warranted to confirm our findings.

New endoscope shaft for endoscopic transsphenoidal pituitary surgery.

NARCIS (Netherlands)

Lindert, E.J. van; Grotenhuis, J.A.

2005-01-01

OBJECTIVE: To describe a new endoscope shaft developed for suction-aspiration during endoscopic transsphenoidal pituitary surgery. METHODS: A custom-made shaft for a Wolf endoscope (Richard Wolf GmbH, Knittlingen, Germany) was developed with a height of 10 mm and a width of 5 mm, allowing an

A fiber-optic tiltmeter system based on the moiré-fringe effect

International Nuclear Information System (INIS)

Kim, Dae-Hyun

2009-01-01

This paper presents a novel fiber-optic tiltmeter system for the health monitoring of large-size structures. The system is composed of a sensor head, a light control unit and a signal processing unit. The sensing mechanism of the sensor head is based on an integration of the moiré-fringe phenomenon with fiber optics to achieve a robust performance in addition to its immunity to EM interference, easy cabling and low cost. In this paper, a prototype of the fiber-optic tiltmeter system has been developed successfully. From an experimental test, the fiber-optic tiltmeter was proven to be a prospective sensor for the monitoring of the tilt angle of a civil structure with good stability and linearity. Finally, the test also successfully demonstrates the performance and the potential of the novel fiber-optic tiltmeter system to monitor the health of civil structures

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

Detection of polyaromatic compounds using antibody-based fiberoptics fluoroimmunosensors

International Nuclear Information System (INIS)

Vo-Dinh, T.; Tromberg, B.J.; Griffin, G.D.; Ambrose, K.R.; Sepaniak, M.J.; Alarie, J.P.

1987-01-01

In this work we have investigated the performance of an antibody-based fiberoptics sensor for the detection of the carcinogen benzo(a)pyrene and its DNA-adduct product BP-tetrol. The excellent sensitivity of this device - femtomole limits of detection for BP - illustrates that it has considerable potential to perform analyses of chemical and biological samples at trace levels in complex matrices. The results indicate that fiberoptics-based fluoroimmunosensors can be useful in a wide spectrum of biochemical and clinical analyses. 17 refs., 4 figs., 1 tab

Detection of polyaromatic compounds using antibody-based fiberoptics fluoroimmunosensors

Energy Technology Data Exchange (ETDEWEB)

Vo-Dinh, T.; Tromberg, B.J.; Griffin, G.D.; Ambrose, K.R.; Sepaniak, M.J.; Alarie, J.P.

1987-01-01

In this work we have investigated the performance of an antibody-based fiberoptics sensor for the detection of the carcinogen benzo(a)pyrene and its DNA-adduct product BP-tetrol. The excellent sensitivity of this device - femtomole limits of detection for BP - illustrates that it has considerable potential to perform analyses of chemical and biological samples at trace levels in complex matrices. The results indicate that fiberoptics-based fluoroimmunosensors can be useful in a wide spectrum of biochemical and clinical analyses. 17 refs., 4 figs., 1 tab.

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.

Endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles.

Science.gov (United States)

Fukatsu, H; Nohara, K; Kotani, Y; Tanaka, N; Matsuno, K; Sakai, T

2015-08-01

It is known that solid food is transported to the pharynx actively in parallel to it being crushed by chewing and mixed with saliva in the oral cavity. Therefore, food bolus formation should be considered to take place from the oral cavity to the pharynx. In previous studies, the chewed food was evaluated after the food had been removed from the oral cavity. However, it has been pointed out that spitting food out of the oral cavity interferes with natural food bolus formation. Therefore, we observed food boluses immediately before swallowing using an endoscope to establish a method to evaluate the food bolus-forming function, and simultaneously performed endoscopic evaluation of food bolus formation and its relationship with the number of chewing cycles. The subject was inserted the endoscope nasally and instructed to eat two coloured samples of boiled rice simultaneously in two ingestion conditions ('as usual' and 'chewing well'). The condition of the food bolus was graded into three categories for each item of grinding, mixing and aggregation and scored 2, 1 and 0. The score of aggregation was high under both ingestion conditions. The scores of grinding and mixing tended to be higher in subjects with a high number of chewing cycles, and the score of aggregation was high regardless of the number of chewing cycles. It was suggested that food has to be aggregated, even though the number of chewing cycles is low and the food is not ground or mixed for a food bolus to reach the swallowing threshold. © 2015 John Wiley & Sons Ltd.

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.

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

Overview of Fiber-Optical Sensors

Science.gov (United States)

Depaula, Ramon P.; Moore, Emery L.

1987-01-01

Design, development, and sensitivity of sensors using fiber optics reviewed. State-of-the-art and probable future developments of sensors using fiber optics described in report including references to work in field. Serves to update previously published surveys. Systems incorporating fiber-optic sensors used in medical diagnosis, navigation, robotics, sonar, power industry, and industrial controls.

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)

Architecture for fiber-optic sensors and actuators in aircraft propulsion systems

Science.gov (United States)

Glomb, W. L., Jr.

1990-01-01

This paper describes a design for fiber-optic sensing and control in advanced aircraft Electronic Engine Control (EEC). The recommended architecture is an on-engine EEC which contains electro-optic interface circuits for fiber-optic sensors. Size and weight are reduced by multiplexing arrays of functionally similar sensors on a pairs of optical fibers to common electro-optical interfaces. The architecture contains interfaces to seven sensor groups. Nine distinct fiber-optic sensor types were found to provide the sensing functions. Analysis revealed no strong discriminator (except reliability of laser diodes and remote electronics) on which to base a selection of preferred common interface type. A hardware test program is recommended to assess the relative maturity of the technologies and to determine real performance in the engine environment.

Role of endoscopic ultrasonography in evaluation of metastatic lesions to the pancreas: a tertiary cancer center experience.

Science.gov (United States)

Atiq, Muslim; Bhutani, Manoop S; Ross, William A; Raju, Gottumukkala S; Gong, Yun; Tamm, Eric P; Javle, Milind; Wang, Xuemei; Lee, Jeffrey H

2013-04-01

Metastatic lesions to the pancreas pose diagnostic challenges with regards to their differentiation from primary pancreatic cancer. Data on the yield of endoscopic ultrasonography (EUS)-guided fine-needle aspiration in detection of these lesions are limited. This is a retrospective review of 23 patients referred to a tertiary referral center for further evaluation of suspected pancreatic metastases. Main outcome measures were diagnostic yield of endoscopic ultrasonography-guided fine-needle aspiration in evaluation of metastatic lesions to the pancreas. Of 644 patients, 23 (3.6%) undergoing EUS of the pancreas were diagnosed to have metastatic disease to the pancreas based on clinical, radiological, and cytological results. Mean (SD) age was 64.3 (11.7) years. Of the 23 patients, 18 (78.3%) were asymptomatic. Mean (SD) size of lesion on EUS was 39.1 (19.9) mm. A diagnosis of malignant lesion was made in 21 of 23 cases, with a diagnostic accuracy of 91.3%. Metastatic lesions to the pancreas present as incidental, solitary mass lesions on staging or surveillance imaging. Endoscopic ultrasonography-guided fine-needle aspiration is an important tool in the characterization and further differentiation of metastatic lesions to the pancreas from primary pancreatic cancer.

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.

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.

Engineering surface plasmon based fiber-optic sensors

International Nuclear Information System (INIS)

Dhawan, Anuj; Muth, John F.

2008-01-01

Ordered arrays of nanoholes with subwavelength diameters, and submicron array periodicity were fabricated on the tips of gold-coated optical fibers using focused ion beam (FIB) milling. This provided a convenient platform for evaluating extraordinary transmission of light through subwavelength apertures and allowed the implementation of nanostructures for surface plasmon engineered sensors. The fabrication procedure was straightforward and implemented on single mode and multimode optical fibers as well as etched and tapered fiber tips. Control of the periodicity and spacing of the nanoholes allowed the wavelength of operation to be tailored. Large changes in optical transmission were observed at the designed wavelengths, depending on the surrounding refractive index, allowing the devices to be used as fiber-optic sensors

Engineering surface plasmon based fiber-optic sensors

Energy Technology Data Exchange (ETDEWEB)

Dhawan, Anuj [Department of Electrical and Computer Engineering, NC State University, Raleigh, NC 27606 (United States); Muth, John F. [Department of Electrical and Computer Engineering, NC State University, Raleigh, NC 27606 (United States)], E-mail: muth@unity.ncsu.edu

2008-04-15

Ordered arrays of nanoholes with subwavelength diameters, and submicron array periodicity were fabricated on the tips of gold-coated optical fibers using focused ion beam (FIB) milling. This provided a convenient platform for evaluating extraordinary transmission of light through subwavelength apertures and allowed the implementation of nanostructures for surface plasmon engineered sensors. The fabrication procedure was straightforward and implemented on single mode and multimode optical fibers as well as etched and tapered fiber tips. Control of the periodicity and spacing of the nanoholes allowed the wavelength of operation to be tailored. Large changes in optical transmission were observed at the designed wavelengths, depending on the surrounding refractive index, allowing the devices to be used as fiber-optic sensors.

Gastroesophageal reflux disease. Scintigraphic, endoscopic and histologic considerations

Energy Technology Data Exchange (ETDEWEB)

Kault, B.; Halvorsen, T.; Petersen, H.; Grette, K.; Myrvold, H.E.

1986-01-01

Radionucleotide scintigraphy and esophagoscopy with biopsy were carried out in 101 patients with symptoms strongly suggestive of gastroesophageal reflux (GER) disease. GER was visualized by scintigraphy in 86.1% of the patients. Endoscopic and histologic esophagitis were found in 68.1% and 58.4% of the patients, respectively, whereas both examinations taken together showed evidence of esophagitis in 82%. Histologic evidence of esophagitis was found in nearly all patients with severe endoscopic changes, and in 43.7% of the patients with no endoscopic abnormality. Scintigraphic reflux was demonstrated more frequently in the patients with severe endoscopic esophagitis (97.5%) than in those with no or only mild endoscopic changes (78.6%). Scintigraphic reflux was found in 91.5% and 78.5% of the patients with and without histologic evidence of esophagitis. 15 of the 18 patients (83.3%) without endoscopic and histologic abnormalities in the esophagus had scintigraphic evidence of reflux. The present study strongly supports the clinical significance of scintigraphy in GER disease and confirms that esophageal biopsy specimens increase the sensitivity of endoscopic evaluation. 31 refs.

Comparative evaluation of structural and functional changes in pancreas after endoscopic and surgical management of pancreatic necrosis.

Science.gov (United States)

Rana, Surinder Singh; Bhasin, Deepak Kumar; Rao, Chalapathi; Sharma, Ravi; Gupta, Rajesh

2014-01-01

Patients with acute necrotizing pancreatitis may develop pancreatic insufficiency and this is commonly seen in patients who have undergone surgery for pancreatic necrosis. Owing to the paucity of relative data, we retrospectively evaluated the structural and functional changes in the pancreas after endoscopic and surgical management of pancreatic necrosis. The records of patients who underwent endoscopic transmural drainage of walled off pancreatic necrosis (WOPN) over the last 3 years and who completed at least 6 months of follow up were analyzed. Structural and functional changes in these patients were compared with 25 historical surgical controls (operated in 2005-2006). Twenty six patients (21 M; mean age 35.4±8.1 years) who underwent endoscopic drainage for WOPN were followed up for 22.3±8.6 months. During the follow up, five (19.2%) patients developed diabetes with 3 patients requiring insulin and 1 patient with steatorrhea requiring pancreatic enzyme supplementation. The pancreatic fluid collection (PFC) recurred in 1 patient whose stents spontaneously migrated out. On follow up, in the surgery group, 2 (8%) patients developed steatorrhea and 11 (44%) developed diabetes. Five (20%) of these patients had recurrence of PFC. On comparison of follow up results of endoscopic drainage with surgery, recurrence rates as well as frequency of endocrine and exocrine insufficiency was lower in the endoscopic group but difference was not significant. Structural and functional impairment of pancreas is seen less frequently in patients with pancreatic necrosis treated endoscopically compared to patients undergoing surgery, although the difference was insignificant. Further studies with large sample size are needed to confirm these initial results.

Fiber-optic seismic sensor

International Nuclear Information System (INIS)

Finch, G. W.; Udd, E.

1985-01-01

A vibration sensor is constructed by providing two preferably matched coils of fiber-optic material. When the sensor experiences vibration, a differential pressure is exerted on the two fiber coils. The differential pressure results in a variation in the relative optical path lengths between the two fibers so that light beams transmitted through the two fibers are differently delayed, the phase difference therebetween being a detectable indication of the vibration applied to the sensor

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.

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.

Fiber-Optic Pressure Sensor With Dynamic Demodulation Developed

Science.gov (United States)

Lekki, John D.

2002-01-01

Researchers at the NASA Glenn Research Center developed in-house a method to detect pressure fluctuations using a fiber-optic sensor and dynamic signal processing. This work was in support of the Intelligent Systems Controls and Operations project under NASA's Information Technology Base Research Program. We constructed an optical pressure sensor by attaching a fiber-optic Bragg grating to a flexible membrane and then adhering the membrane to one end of a small cylinder. The other end of the cylinder was left open and exposed to pressure variations from a pulsed air jet. These pressure variations flexed the membrane, inducing a strain in the fiber-optic grating. This strain was read out optically with a dynamic spectrometer to record changes in the wavelength of light reflected from the grating. The dynamic spectrometer was built in-house to detect very small wavelength shifts induced by the pressure fluctuations. The spectrometer is an unbalanced interferometer specifically designed for maximum sensitivity to wavelength shifts. An optimum pathlength difference, which was determined empirically, resulted in a 14-percent sensitivity improvement over theoretically predicted path-length differences. This difference is suspected to be from uncertainty about the spectral power difference of the signal reflected from the Bragg grating. The figure shows the output of the dynamic spectrometer as the sensor was exposed to a nominally 2-kPa peak-to-peak square-wave pressure fluctuation. Good tracking, sensitivity, and signal-to-noise ratios are evident even though the sensor was constructed as a proof-of-concept and was not optimized in any way. Therefore the fiber-optic Bragg grating, which is normally considered a good candidate as a strain or temperature sensor, also has been shown to be a good candidate for a dynamic pressure sensor.

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

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

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

Highly Sensitive Temperature Sensors Based on Fiber-Optic PWM and Capacitance Variation Using Thermochromic Sensing Membrane

Directory of Open Access Journals (Sweden)

Md. Rajibur Rahaman Khan

2016-07-01

Full Text Available 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.

Multi-dimensional fiber-optic radiation sensor for ocular proton therapy dosimetry

International Nuclear Information System (INIS)

Jang, K.W.; Yoo, W.J.; Moon, J.; Han, K.T.; Park, B.G.; Shin, D.; Park, S-Y.; Lee, B.

2012-01-01

In this study, we fabricated a multi-dimensional fiber-optic radiation sensor, which consists of organic scintillators, plastic optical fibers and a water phantom with a polymethyl methacrylate structure for the ocular proton therapy dosimetry. For the purpose of sensor characterization, we measured the spread out Bragg-peak of 120 MeV proton beam using a one-dimensional sensor array, which has 30 fiber-optic radiation sensors with a 1.5 mm interval. A uniform region of spread out Bragg-peak using the one-dimensional fiber-optic radiation sensor was obtained from 20 to 25 mm depth of a phantom. In addition, the Bragg-peak of 109 MeV proton beam was measured at the depth of 11.5 mm of a phantom using a two-dimensional sensor array, which has 10×3 sensor array with a 0.5 mm interval.

Effect of endoscopic transpapillary biliary drainage with/without endoscopic sphincterotomy on post-endoscopic retrograde cholangiopancreatography pancreatitis in patients with biliary stricture (E-BEST): a protocol for a multicentre randomised controlled trial.

Science.gov (United States)

Kato, Shin; Kuwatani, Masaki; Sugiura, Ryo; Sano, Itsuki; Kawakubo, Kazumichi; Ono, Kota; Sakamoto, Naoya

2017-08-11

The effect of endoscopic sphincterotomy prior to endoscopic biliary stenting to prevent post-endoscopic retrograde cholangiopancreatography pancreatitis remains to be fully elucidated. The aim of this study is to prospectively evaluate the non-inferiority of non-endoscopic sphincterotomy prior to stenting for naïve major duodenal papilla compared with endoscopic sphincterotomy prior to stenting in patients with biliary stricture. We designed a multicentre randomised controlled trial, for which we will recruit 370 patients with biliary stricture requiring endoscopic biliary stenting from 26 high-volume institutions in Japan. Patients will be randomly allocated to the endoscopic sphincterotomy group or the non-endoscopic sphincterotomy group. The main outcome measure is the incidence of pancreatitis within 2 days of initial transpapillary biliary drainage. Data will be analysed on completion of the study. We will calculate the 95% confidence intervals (CIs) of the incidence of pancreatitis in each group and analyse weather the difference in both groups with 95% CIs is within the non-inferiority margin (6%) using the Wald method. This study has been approved by the institutional review board of Hokkaido University Hospital (IRB: 016-0181). Results will be submitted for presentation at an international medical conference and published in a peer-reviewed journal. The University Hospital Medical Information Network ID: UMIN000025727 Pre-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Fiberoptic laryngoscopy under general anesthesia in neonates

NARCIS (Netherlands)

L.J. Hoeve (Hans); R.H.M. van Poppelen

1990-01-01

textabstractAbstract In the Sophia Children's Hospital we perform fiberoptic laryngoscopy in neonates under general anesthesia without the use of muscle relaxants in the diagnostics of functional laryngeal disorders. The necessary diagnostic and anesthetic equipment is described. Special attention

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

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.

Surgical gastrointestinal endoscopy in Ibadan, Nigeria

African Journals Online (AJOL)

DAVID

Introduction. Fiberoptic colonoscoscopy is about 43 years old now1. Improvement in instruments led rapidly to wide acceptance of colonoscopy in diagnosis and therapy of colorectal diseases1. The diagnosis of benign and malignant neoplasms was revolutionized by colonoscopy. Flexible fiberoptic endoscopes have now.

A Targeted Swallow Screen for the Detection of Postoperative Dysphagia.

Science.gov (United States)

Gee, Erica; Lancaster, Elizabeth; Meltzer, Jospeh; Mendelsohn, Abie H; Benharash, Peyman

2015-10-01

Postoperative dysphagia leads to aspiration pneumonia, prolonged hospital stay, and is associated with increased mortality. A simple and sensitive screening test to identify patients requiring objective dysphagia evaluation is presently lacking. In this study, we evaluated the efficacy of a novel targeted swallow screen evaluation. This was a prospective trial involving all adult patients who underwent elective cardiac surgery with cardiopulmonary bypass at our institution over an 8-week period. Within 24 hours of extubation and before the initiation of oral intake, all postsurgical patients were evaluated using the targeted swallow screen. A fiberoptic endoscopic evaluation of swallowing was requested for failed screenings. During the study, 50 postcardiac surgery patients were screened. Fifteen (30%) failed the targeted swallow screen, and ten of the fifteen (66%) failed the subsequent fiberoptic endoscopic evaluation of swallowing exam and were confirmed to have dysphagia. The screening test had 100 per cent sensitivity for detecting dysphagia in our patient population, and a specificity of 87.5 per cent. The overall incidence of dysphagia was 20 per cent. We have shown that a targeted swallow evaluation can efficiently screen patients during the postcardiac surgery period. Furthermore, we have shown that the true incidence of dysphagia after cardiac surgery is significantly higher than previously recognized in literature.

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....

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)

Endoscopic root canal treatment.

Science.gov (United States)

Moshonov, Joshua; Michaeli, Eli; Nahlieli, Oded

2009-10-01

To describe an innovative endoscopic technique for root canal treatment. Root canal treatment was performed on 12 patients (15 teeth), using a newly developed endoscope (Sialotechnology), which combines an endoscope, irrigation, and a surgical microinstrument channel. Endoscopic root canal treatment of all 15 teeth was successful with complete resolution of all symptoms (6-month follow-up). The novel endoscope used in this study accurately identified all microstructures and simplified root canal treatment. The endoscope may be considered for use not only for preoperative observation and diagnosis but also for active endodontic treatment.

Evaluation of oropharyngeal dysphagia: which diagnostic tool is superior?

Science.gov (United States)

Langmore, Susan E

2003-12-01

As flexible endoscopic examinations of swallowing become more widely used to evaluate patients with oropharyngeal dysphagia, it is important to be aware of research regarding the efficacy of this procedure as compared with the videofluoroscopy procedure. A recent evidence-based review of the field threw some long-held findings into question and has stimulated a surge of new research studying the sensitivity of the two instrumental examinations, health outcomes of patients who receive each procedure, and a look at different patient outcomes. Since 1999, one quasi-randomized clinical trial has directly compared outcomes of patients given a fluoroscopy versus a fiberoptic endoscopic evaluation of swallowing (FEES) examination. This study showed no significant difference in pneumonia rates between the two groups of patients. A multitude of studies have shown a high level of agreement between the two instrumental examinations, and the use of the term gold standard as applied to fluoroscopy is no longer appropriate. The attempt to standardize each examination has been slow, and inter-judge reliability of results has come under fire. Several new scales for quality of life and functional status are now ready to be applied to research that can measure outcomes other than pneumonia. Research to date has suggested that both instrumental examinations are valuable. It is likely that both will continue to be used and will be seen as complementary rather than competitors.

Endoscopic ultrasound-guided evaluation of the pleura and cases of pleural effusion.

Science.gov (United States)

Sharma, Malay; Rameshbabu, Chittapuram Srinivasan

2017-01-01

The most efficient and cost-effective approach for the diagnosis of pleural exudates remains uncertain and is a subject of controversy. Essential factors to be considered include the respective diagnostic yields of thoracocentesis, closed pleural biopsy, and thoracoscopy. The role of endoscopic ultrasound (EUS) of the esophagus as a modality for the evaluation of pleural exudates has not yet been evaluated. The applied anatomy of the pleura has been discussed. The techniques involved in the EUS imaging of different aspects of the pleura in normal cases and in cases with pleural effusion are elaborated. The practical application of this knowledge can be useful in EUS-guided sampling of the pleural wall, pleural nodules, and in cases of pleural effusion.

Quantitative evaluation of vision-related and health-related quality of life after endoscopic transsphenoidal surgery for pituitary adenoma.

Science.gov (United States)

Wolf, Amparo; Coros, Alexandra; Bierer, Joel; Goncalves, Sandy; Cooper, Paul; Van Uum, Stan; Lee, Donald H; Proulx, Alain; Nicolle, David; Fraser, J Alexander; Rotenberg, Brian W; Duggal, Neil

2017-08-01

OBJECTIVE Endoscopic resection of pituitary adenomas has been reported to improve vision function in up to 80%-90% of patients with visual impairment due to these adenomas. It is unclear how these reported rates translate into improvement in visual outcomes and general health as perceived by the patients. The authors evaluated self-assessed health-related quality of life (HR-QOL) and vision-related QOL (VR-QOL) in patients before and after endoscopic resection of pituitary adenomas. METHODS The authors prospectively collected data from 50 patients who underwent endoscopic resection of pituitary adenomas. This cohort included 32 patients (64%) with visual impairment preoperatively. Twenty-seven patients (54%) had pituitary dysfunction, including 17 (34%) with hormone-producing tumors. Patients completed the National Eye Institute Visual Functioning Questionnaire and the 36-Item Short Form Health Survey preoperatively and 6 weeks and 6 months after surgery. RESULTS Patients with preoperative visual impairment reported a significant impact of this condition on VR-QOL preoperatively, including general vision, near activities, and peripheral vision; they also noted vision-specific impacts on mental health, role difficulties, dependency, and driving. After endoscopic resection of adenomas, patients reported improvement across all these categories 6 weeks postoperatively, and this improvement was maintained by 6 months postoperatively. Patients with preoperative pituitary dysfunction, including hormone-producing tumors, perceived their general health and physical function as poorer, with some of these patients reporting improvement in perceived general health after the endoscopic surgery. All patients noted that their ability to work or perform activities of daily living was transiently reduced 6 weeks postoperatively, followed by significant improvement by 6 months after the surgery. CONCLUSIONS Both VR-QOL and patient's perceptions of their ability to do work and

A new method for evaluating gastric ulcer healing by endoscopic ultrasonography

Energy Technology Data Exchange (ETDEWEB)

Niwa, Y.; Nakazawa, S.; Tsukamoto, Y. (and others) (Ichinomiya Municipal Hospital (JP))

1991-01-01

The authors observed the quantitative estimation of the transmural changes associated with gastric ulcer healing by using endoscopic ultrasonography (EUS). It was possible to diagnose the depth of ulcer by EUS. 48 patients were divided into three treatment groups. Group A (n=16) was treated with 800 mg cimetidine daily, group B (n=22) with 20 mg omeprazole daily, and group C (n=10) with 400 mg cimetidine + 300 mg gefarnate daily. EUS was performed before and after 2, 4 and 8 weeks of treatment. The groups were compared from the viewpoints of endoscopic findings and contraction rate of the length and the cross-sectional area of the ulcer in EUS pictures. The best healing of both the endoscopic and EUS findings was seen in group B. By estimating the changes inside the ulcer, EUS may provide useful information for choice of anti-ulcer agents. 21 refs., 5 figs., 3 tabs.

Transbronchial Catheter Drainage via Fiberoptic Bronchoscope in Intractable Lung Abscess

Science.gov (United States)

Jeong, Man Pyo; Kim, Woo Sung; Han, Sung Koo; Shim, Young Soo; Kim, Keun Youl; Han, Yong Chol

1989-01-01

The use of the fiberoptic bronchoscope as a drainage procedure for lung abscess has become more and more widespread. We have recently adopted the technique of inserting a simple polyethylene catheter through the flexible fiberoptic bronchoscope into the abscess cavity of 11 patients with lung absess. All cases had not responded to aggressive postural drainage and adequate antibiotic therapy for at least a week. The results were as follows: Among 11 patients, the therapeutic response was dramatic in 6 patients.In the successful group, the abscess sizes were greater than 8cm in diameter and the air-fluid levels were higher than two-thirds of the cavity.Additional diagnoses, other than bacterial lung abscess, could be made in 2 cases when otherwise the diagnosis would have remained in doubt. The authors suggest that catheter drainage via fiberoptic bronchoscpope is an effective treatment modality in the large lung abscess with a high air-fluid level which is intractable to other medical approaches, and it is also a safe procedure. PMID:2487405

The new Olympus digital flexible ureteroscope (URF-V: Initial experience

Directory of Open Access Journals (Sweden)

Saeed M Al-Qahtani

2011-01-01

Conclusion: New ODF-URS (URF-V is a reliable and durable device, with a good success rate and improved functional parameters. It is a superior device compared to predecessor generations of conventional fiberoptic endoscopes for the light source and the image quality; however, randomized comparative studies are necessary to evaluate performances and durability of this device.

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.

Endoscopic Radiofrequency Ablation-Assisted Resection of Juvenile Nasopharyngeal Angiofibroma: Comparison with Traditional Endoscopic Technique.

Science.gov (United States)

McLaughlin, Eamon J; Cunningham, Michael J; Kazahaya, Ken; Hsing, Julianna; Kawai, Kosuke; Adil, Eelam A

2016-06-01

To evaluate the feasibility of radiofrequency surgical instrumentation for endoscopic resection of juvenile nasopharyngeal angiofibroma (JNA) and to test the hypothesis that endoscopic radiofrequency ablation-assisted (RFA) resection will have superior intraoperative and/or postoperative outcomes as compared with traditional endoscopic (TE) resection techniques. Case series with chart review. Two tertiary care pediatric hospitals. Twenty-nine pediatric patients who underwent endoscopic transnasal resection of JNA from January 2000 to December 2014. Twenty-nine patients underwent RFA (n = 13) or TE (n = 16) JNA resection over the 15-year study period. Mean patient age was not statistically different between the 2 groups (P = .41); neither was their University of Pittsburgh Medical Center classification stage (P = .79). All patients underwent preoperative embolization. Mean operative times were not statistically different (P = .29). Mean intraoperative blood loss and the need for a transfusion were also not statistically different (P = .27 and .47, respectively). Length of hospital stay was not statistically different (P = .46). Recurrence rates did not differ between groups (P = .99) over a mean follow-up period of 2.3 years. There were no significant differences between RFA and TE resection in intraoperative or postoperative outcome parameters. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

Oropharyngeal dysphagia in older persons – from pathophysiology to adequate intervention: a review and summary of an international expert meeting

Science.gov (United States)

Wirth, Rainer; Dziewas, Rainer; Beck, Anne Marie; Clavé, Pere; Hamdy, Shaheen; Heppner, Hans Juergen; Langmore, Susan; Leischker, Andreas Herbert; Martino, Rosemary; Pluschinski, Petra; Rösler, Alexander; Shaker, Reza; Warnecke, Tobias; Sieber, Cornel Christian; Volkert, Dorothee

2016-01-01

Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies. PMID:26966356

Oropharyngeal dysphagia in older persons - from pathophysiology to adequate intervention: a review and summary of an international expert meeting.

Science.gov (United States)

Wirth, Rainer; Dziewas, Rainer; Beck, Anne Marie; Clavé, Pere; Hamdy, Shaheen; Heppner, Hans Juergen; Langmore, Susan; Leischker, Andreas Herbert; Martino, Rosemary; Pluschinski, Petra; Rösler, Alexander; Shaker, Reza; Warnecke, Tobias; Sieber, Cornel Christian; Volkert, Dorothee

2016-01-01

Oropharyngeal dysphagia (OD) is a highly prevalent and growing condition in the older population. Although OD may cause very severe complications, it is often not detected, explored, and treated. Older patients are frequently unaware of their swallowing dysfunction which is one of the reasons why the consequences of OD, ie, aspiration, dehydration, and malnutrition, are regularly not attributed to dysphagia. Older patients are particularly vulnerable to dysphagia because multiple age-related changes increase the risk of dysphagia. Physicians in charge of older patients should be aware that malnutrition, dehydration, and pneumonia are frequently caused by (unrecognized) dysphagia. The diagnosis is particularly difficult in the case of silent aspiration. In addition to numerous screening tools, videofluoroscopy was the traditional gold standard of diagnosing OD. Recently, the fiberoptic endoscopic evaluation of swallowing is increasingly utilized because it has several advantages. Besides making a diagnosis, fiberoptic endoscopic evaluation of swallowing is applied to evaluate the effectiveness of therapeutic maneuvers and texture modification of food and liquids. In addition to swallowing training and nutritional interventions, newer rehabilitation approaches of stimulation techniques are showing promise and may significantly impact future treatment strategies.

Evaluation of diode endoscopic cyclophotocoagulation in bovine cadaver eyes.

Science.gov (United States)

Harrington, Jay T; McMullen, Richard J; Cullen, John M; Gilger, Brian C

2012-09-01

To evaluate the anterior chamber approach and energy levels for endoscopic cyclophotocoagulation (ECPC) and assess ECPC-induced tissue damage in phakic eyes of bovine cadavers. 12 bovine cadaver eyes. Angle of reach was measured in 6 eyes following placement of a curved endoscopic probe through multiple corneal incisions. In another 6 eyes, each ocular quadrant underwent ECPC at 1 of 3 energy levels (0.75, 0.90, and 1.05 J) or remained untreated. Visible effects on tissues (whitening and contraction of ciliary processes) were scored (scale of 0 [no effects] to 6 [severe effects]), and severity and extent of histologic damage to the pigmented and nonpigmented ciliary epithelium and fibromuscular stroma were each scored (scale of 0 [no effect] to 3 [severe effect]) and summed for each quadrant. Overall mean scores for 6 quadrants/treatment were calculated. Mean ± SD combined angle of reach was 148 ± 24° (range, 123 ± 23° [ventromedial] to 174 ± 11° [dorsolateral]). At the 0.75-, 0.90-, and 1.05-J levels, mean visible tissue effect scores were 3.12 ± 0.47, 3.86 ± 0.35, and 4.68 ± 0.58, respectively; mean histologic damage scores were 4.79 ± 1.38 (mild damage), 6.82 ± 1.47 (moderate damage), and 9.37 ± 1.42 (severe damage), respectively. Occasional popping noises (venting of vaporized interstitial water) were heard at the 1.05-J level. Multiple incisions were necessary to facilitate 360° ECPC treatment in bovine eyes. For ECPC in vivo, the 0.75- and 0.90-J energy levels had the potential to effectively treat the ciliary epithelium.

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.

Evaluation of short- and long-term complications after endoscopically assisted gastropexy in dogs.

Science.gov (United States)

Dujowich, Mauricio; Keller, Mattew E; Reimer, S Brent

2010-01-15

To determine short- and long-term complications in clinically normal dogs after endoscopically assisted gastropexy. Prospective case series. 24 dogs. Endoscopically assisted gastropexy was performed on each dog. Dogs were evaluated laparoscopically at 1 or 6 months after surgery to assess integrity of the gastropexy. Long-term outcome was determined via telephone conversations conducted with owners > or = 1 year after surgery. Mean +/- SD gastropexy length was 4.5 +/- 0.9 cm, and mean duration of surgery was 22 +/- 5 minutes. One dog had a partially rotated stomach at the time of insufflation, which was corrected by untwisting the stomach with Babcock forceps. Two dogs vomited within 4 weeks after surgery, but the vomiting resolved in both dogs. Four dogs had diarrhea within 4 weeks after surgery, which resolved without medical intervention. In all dogs, the gastropexy site was firmly adhered to the abdominal wall at the level of the pyloric antrum. Long-term follow-up information was available for 23 dogs, none of which had any episodes of gastric dilatation-volvulus a mean of 1.4 years after gastropexy. Endoscopically assisted gastropexy can be a simple, fast, safe, and reliable method for performing prophylactic gastropexy in dogs. At 1 and 6 months after gastropexy, adequate placement and adhesion of the gastropexy site to the body wall was confirmed. Such a procedure could maximize the benefits of minimally invasive surgery, such as decreases in morbidity rate and anesthetic time. This technique appeared to be suitable as an alternative to laparoscopic-assisted gastropexy.

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.

Endoscopic Evaluation of Upper and Lower Gastro‑Intestinal Bleeding

African Journals Online (AJOL)

measures before an endoscopic intervention are essential to decrease the morbidity and .... or tabs bisacodyl and castor oil or colostomy washout with 2 days dietary restriction .... sparing patients the trauma of open surgery. Hemorrhoids were.

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.

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

Importance of radiographic monitoring of endoscopic sphincterotomy

International Nuclear Information System (INIS)

Greenberg, H.M.; Goldberg, H.I.; Shapiro, H.A.

1981-01-01

The radiographic features of endoscopic sphincterotomies performed in 44 patients were evaluated. Radiographic landmarks aided in proper sphincterotome placement and also disclosed conditions and anatomic variations that made catheter placement difficult. Fluoroscopic and radiographic monitoring not only assisted the performance of endoscopic sphincterotomy, but also confirmed successful results and revealed reasons for failure. Radiographic changes in the biliary tract after sphincterotomy, as well as potential complications of sphincterotomy, are discussed and illustrated

Usefulness of combined percutaneous-endoscopic rendezvous techniques after failed therapeutic endoscopic retrograde cholangiography in the era of endoscopic ultrasound guided rendezvous.

Science.gov (United States)

Yang, Min Jae; Kim, Jin Hong; Hwang, Jae Chul; Yoo, Byung Moo; Kim, Soon Sun; Lim, Sun Gyo; Won, Je Hwan

2017-12-01

The rendezvous approach is a salvage technique after failure of endoscopic retrograde cholangiography (ERC). In certain circumstances, percutaneous-endoscopic rendezvous (PE-RV) is preferred, and endoscopic ultrasound-guided rendezvous (EUS-RV) is difficult to perform. We aimed to evaluate PE-RV outcomes, describe the PE-RV techniques, and identify potential indications for PE-RV over EUS-RV.Retrospective analysis was conducted of a prospectively designed ERC database between January 2005 and December 2016 at a tertiary referral center including cases where PE-RV was used as a salvage procedure after ERC failure.During the study period, PE-RV was performed in 42 cases after failed therapeutic ERC; 15 had a surgically altered enteric anatomy. The technical success rate of PE-RV was 92.9% (39/42), with a therapeutic success rate of 88.1% (37/42). Potential indications for PE-RV over EUS-RV were identified in 23 cases, and either PE-RV or EUS-RV could have effectively been used in 19 cases. Endoscopic bile duct access was successfully achieved with PE-RV in 39 cases with accessible biliary orifice using one of PE-RV cannulation techniques (classic, n = 11; parallel, n = 19; and adjunctive maneuvers, n = 9).PE-RV uses a unique technology and has clinical indications that distinguish it from EUS-RV. Therefore, PE-RV can still be considered a useful salvage technique for the treatment of biliary obstruction after ERC failure.

Distributed fiber-optic temperature sensing: recent improvements and Nagra's applications in the Mont Terri URL

International Nuclear Information System (INIS)

Vogt, Tobias; Mueller, Herwig R.; Vietor, Tim; Frieg, Bernd

2012-01-01

Document available in extended abstract form only. Full text of publication follows: The application of fiber-optic sensors in large experiments in underground rock laboratories (URL) and for monitoring of pilot repositories offers several advantages in contrast to conventional sensors. By means of optical fibers distributed temperature and deformation measurements can be performed without electric or mechanical components at the measurement location reducing the risk of corrosion and sensor failure. As fiber-optic strain sensors are to some extend still in a prototype stage, we focus here on Raman spectra distributed fiber-optic temperature sensing (DTS). In DTS a fiber-optic cable, which is the temperature sensor, is connected to a light reading unit that sends laser-pulses into the fiber. The backscattered light is detected with high temporal resolution. From the two-way-light-travel-time the location of backscattering is determined. For the temperature information the amplitude ratio of the Stokes and anti-Stokes signals is analyzed. The Stokes and anti- Stokes signals are the result of the Raman effect. The ratio of these signals provides a quantity that depends only on the temperature of the fiber at the location of backscatter. With commercial DTS setups it is possible to measure the temperature distribution along several kilometer long cables with a temperature resolution of 0.01 C and a spatial resolution of 1 m. Recent developments in DTS focus on better temperature precision and resolution. This advancement can be achieved by experiment-specific calibration techniques and sensor-layout as well as improved instruments. To realize high spatial resolution (cm range) wrapped fiber-optic cables can be applied. Another promising approach to monitor moisture along a fiber-optic cable installed in unconsolidated material are heatable cables. We will present a selection of the most recent advancements which may improve temperature monitoring in natural and

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.

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

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

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...

Miniature fiber-optic multiphoton microscopy system using frequency-doubled femtosecond Er-doped fiber laser.

Science.gov (United States)

Huang, Lin; Mills, Arthur K; Zhao, Yuan; Jones, David J; Tang, Shuo

2016-05-01

We report on a miniature fiber-optic multiphoton microscopy (MPM) system based on a frequency-doubled femtosecond Er-doped fiber laser. The femtosecond pulses from the laser source are delivered to the miniature fiber-optic probe at 1.58 µm wavelength, where a standard single mode fiber is used for delivery without the need of free-space dispersion compensation components. The beam is frequency-doubled inside the probe by a periodically poled MgO:LiNbO3 crystal. Frequency-doubled pulses at 786 nm with a maximum power of 80 mW and a pulsewidth of 150 fs are obtained and applied to excite intrinsic signals from tissues. A MEMS scanner, a miniature objective, and a multimode collection fiber are further used to make the probe compact. The miniature fiber-optic MPM system is highly portable and robust. Ex vivo multiphoton imaging of mammalian skins demonstrates the capability of the system in imaging biological tissues. The results show that the miniature fiber-optic MPM system using frequency-doubled femtosecond fiber laser can potentially bring the MPM imaging for clinical applications.

Fiber-optic couplers as displacement sensors

Science.gov (United States)

Baruch, Martin C.; Gerdt, David W.; Adkins, Charles M.

2003-04-01

We introduce the novel concept of using a fiber-optic coupler as a versatile displacement sensor. Comparatively long fiber-optic couplers, with a coupling region of approximately 10 mm, are manufactured using standard communication SM fiber and placed in a looped-back configuration. The result is a displacement sensor, which is robust and highly sensitive over a wide dynamic range. This displacement sensor resolves 1-2 μm over distances of 1-1.5 mm and is characterized by the essential absence of a 'spring constant' plaguing other strain gauge-type sensors. Consequently, it is possible to couple to extremely weak vibrations, such as the skin displacement affected by arterial heart beat pulsations. Used as a wrist-worn heartbeat monitor, the fidelity of the arterial pulse signal has been shown to be so high that it is possible to not only determine heartbeat and breathing rates, but to implement a new single-point blood pressure measurement scheme which does not squeeze the arm. In an application as a floor vibration sensor for the non-intrusive monitoring of independently living elderly, the sensor has been shown to resolve the distinct vibration spectra of different persons and different events.

Comparison of Distributed Acoustic Sensing (DAS) from Fiber-Optic Cable to Three Component Geophones in an Underground Mine

Science.gov (United States)

Speece, M. A.; Nesladek, N. J.; Kammerer, C.; Maclaughlin, M.; Wang, H. F.; Lord, N. E.

2017-12-01

We conducted experiments in the Underground Education Mining Center on the Montana Tech campus, Butte, Montana, to make a direct comparison between Digital Acoustic Sensing (DAS) and three-component geophones in a mining setting. The sources used for this project where a vertical sledgehammer, oriented shear sledgehammer, and blasting caps set off in both unstemmed and stemmed drillholes. Three-component Geospace 20DM geophones were compared with three different types of fiber-optic cable: (1) Brugg strain, (2) Brugg temperature, and (3) Optical Cable Corporation strain. We attached geophones to the underground mine walls and on the ground surface above the mine. We attached fiber-optic cables to the mine walls and placed fiber-optic cable in boreholes drilled through an underground pillar. In addition, we placed fiber-optic cables in a shallow trench at the surface of the mine. We converted the DAS recordings from strain rate to strain prior to comparison with the geophone data. The setup of the DAS system for this project led to a previously unknown triggering problem that compromised the early samples of the DAS traces often including the first-break times on the DAS records. Geophones clearly recorded the explosives; however, the large amount of energy and its close distance from the fiber-optic cables seemed to compromise the entire fiber loop. The underground hammer sources produced a rough match between the DAS records and the geophone records. However, the sources on the surface of the mine, specifically the sources oriented inline with the fiber-optic cables, produced a close match between the fiber-optic traces and the geophone traces. All three types of fiber-optic cable that were in the mine produced similar results, and one type did not clearly outperform the others. Instead, the coupling of the cable to rock appears to be the most important factor determining DAS data quality. Moreover, we observed the importance of coupling in the boreholes, where

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.

Responsiveness of Endoscopic Indices of Disease Activity for Crohn's Disease

NARCIS (Netherlands)

Khanna, Reena; Zou, Guangyong; Stitt, Larry; Feagan, Brian G.; Sandborn, William J.; Rutgeerts, Paul; McDonald, John W. D.; Dubcenco, Elena; Fogel, Ronald; Panaccione, Remo; Jairath, Vipul; Nelson, Sigrid; Shackelton, Lisa M.; Huang, Bidan; Zhou, Qian; Robinson, Anne M.; Levesque, Barrett G.; D'Haens, Geert

2017-01-01

The Crohn's Disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's Disease (SES-CD) are commonly used to assess Crohn's disease (CD) activity; however neither instrument is fully validated. We evaluated the responsiveness to change of the SES-CD and CDEIS using data

Early Primary Endoscopic Realignment of Posterior Urethral Injury- Evaluation and Follow-Up

Directory of Open Access Journals (Sweden)

Prasad Mylarappa

2013-07-01

Full Text Available Background: The management of complete orpartial posterior urethral disruption is contro-versial and much debate continues regarding theimmediate, early and delayed definitive therapy.Objective: We report our institutional experi-ence and long term result of early endoscopicrealignment of traumatic posterior urethral in-jury. Method and Materials: Between Septem-ber 1996 and March 2012, ninety six men witheither complete (84 or partial (12 posteriorurethral injury secondary to blunt trauma (11or pelvic fractures (85, presented to our insti-tution and these patients underwent immediatesuprapubic cystostomy followed by early pri-mary endoscopic realignment done 3-8 daysafter injury. Result: Seventy four patients(92.5% were continent after catheter removal.Urethral stricture was seen in seventy two pa-tients (90% of which fifty patients (69.4%had simple urethral stricture who were managedby urethral dilatation on outpatient basis. Four-teen patients (19.4% developed short stric-tures which were successfully treated with vi-sual internal urethrotomy. Eight patients(11.1% required anastomotic urethroplasty fordense stricture. Potency was retained in sev-enty five patients (93.75%. Urinary flow mea-surements at follow-up evaluation were satis-factory.Conclusion:Early primary endoscopic realign-ment in our experience reduces time to spon-taneous voiding, decrease the need for majorreconstructive surgery and long term supra pub-lic urinary diversion.

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.

Ultrafast Fabry-Perot fiber-optic pressure sensors for multimedia blast event measurements.

Science.gov (United States)

Zou, Xiaotian; Wu, Nan; Tian, Ye; Zhang, Yang; Fitek, John; Maffeo, Michael; Niezrecki, Christopher; Chen, Julie; Wang, Xingwei

2013-02-20

A shock wave (SW) is characterized as a large pressure fluctuation that typically lasts only a few milliseconds. On the battlefield, SWs pose a serious threat to soldiers who are exposed to explosions, which may lead to blast-induced traumatic brain injuries. SWs can also be used beneficially and have been applied to a variety of medical treatments due to their unique interaction with tissues and cells. Consequently, it is important to have sensors that can quantify SW dynamics in order to better understand the physical interaction between body tissue and the incident acoustic wave. In this paper, the ultrafast fiber-optic sensor based on the Fabry-Perot interferometric principle was designed and four such sensors were fabricated to quantify a blast event within different media, simultaneously. The compact design of the fiber-optic sensor allows for a high degree of spatial resolution when capturing the wavefront of the traveling SW. Several blast event experiments were conducted within different media (e.g., air, rubber membrane, and water) to evaluate the sensor's performance. This research revealed valuable knowledge for further study of SW behavior and SW-related applications.

Role of endoscopic ultrasonography in treatment and prognostic evaluation of esophageal and gastric varices

Directory of Open Access Journals (Sweden)

LI Shuang

2016-12-01

Full Text Available Through a comprehensive evaluation of collateral circulation establishment in portal hypertension, endoscopic ultrasonography (EUS not only helps to predict and evaluate the risks of first bleeding from esophageal and gastric varices and recurrence and rebleeding after treatment, but also guides and participates in the treatment of varices. This article introduces the unique advantages of EUS in the treatment and prognostic evaluation of esophageal and gastric varices and provides an important reference for individualized treatment of patients with liver cirrhosis complicated by esophageal and gastric varices. EUS also helps to improve treatment safety and response rate. EUS for the systematic treatment of portal hypertension has become a hot research topic in recent years.

Fiber-optic communication systems

CERN Document Server

Agrawal, Govind P

2010-01-01

This book provides a comprehensive account of fiber-optic communication systems. The 3rd edition of this book is used worldwide as a textbook in many universities. This 4th edition incorporates recent advances that have occurred, in particular two new chapters. One deals with the advanced modulation formats (such as DPSK, QPSK, and QAM) that are increasingly being used for improving spectral efficiency of WDM lightwave systems. The second chapter focuses on new techniques such as all-optical regeneration that are under development and likely to be used in future communication systems. All othe

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...

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.

A Study on the Response Characteristics of a Fiber-Optic Radiation Sensor Model Based on Cerenkov Principle

Energy Technology Data Exchange (ETDEWEB)

Han, Hwa Jeong; Kim, Beom Kyu; Park, Byung Gi [Soonchunhyang Univ., Asan (Korea, Republic of)

2016-10-15

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.

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

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.

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. 

Duodenal endoscopic findings and histopathologic confirmation of intestinal lymphangiectasia in dogs.

Science.gov (United States)

Larson, R N; Ginn, J A; Bell, C M; Davis, M J; Foy, D S

2012-01-01

The diagnosis of intestinal lymphangiectasia (IL) has been associated with characteristic duodenal mucosal changes. However, the sensitivity and specificity of the endoscopic duodenal mucosal appearance for the diagnosis of IL are not reported. To evaluate the utility of endoscopic images of the duodenum for diagnosis of IL. Endoscopic appearance of the duodenal mucosal might predict histopathologic diagnosis of IL with a high degree of sensitivity and specificity. 51 dogs that underwent upper gastrointestinal (GI) endoscopy and endoscopic biopsies. Retrospective review of images acquired during endoscopy. Dogs were included if adequate biopsies were obtained during upper GI endoscopy and digital images were saved during the procedure. Images were assessed for the presence and severity of IL. Using histopathology as the gold standard, the sensitivity and specificity of endoscopy for diagnosing IL were calculated. Intestinal lymphangiectasia (IL) was diagnosed in 25/51 dogs. Gross endoscopic appearance of the duodenal mucosa had a sensitivity and specificity (95% confidence interval) of 68% (46%, 84%) and 42% (24%, 63%), respectively for diagnosis of IL. Endoscopic images in cases with lymphopenia, hypocholesterolemia, and hypoalbuminemia had a sensitivity of 80%. Endoscopic duodenal mucosa appearance alone lacks specificity and has only a moderate sensitivity for diagnosis of IL. Evaluation of biomarkers associated with PLE improved the sensitivity; however, poor specificity for diagnosis of IL supports the need for histopathologic confirmation. Copyright © 2012 by the American College of Veterinary Internal Medicine.

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...... of the present study was to evaluate the role of EUS-FNA in isolated mediastinal lymphadenopathy in patients suspected of having tuberculosis....

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.

New endoscopic indicator of esophageal achalasia: "pinstripe pattern".

Science.gov (United States)

Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

2015-01-01

Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, "pinstripe pattern (PSP)" was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. The prevalence rates of the above-mentioned findings (1-5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history achalasia were 83.8%, 64.7%, and 100%, respectively. "Pinstripe pattern" could be a reliable indicator for early discrimination of primary esophageal achalasia.

Common-path low-coherence interferometry fiber-optic sensor guided microincision

Science.gov (United States)

Zhang, Kang; Kang, Jin U.

2011-09-01

We propose and demonstrate a common-path low-coherence interferometry (CP-LCI) fiber-optic sensor guided precise microincision. The method tracks the target surface and compensates the tool-to-surface relative motion with better than +/-5 μm resolution using a precision micromotor connected to the tool tip. A single-fiber distance probe integrated microdissector was used to perform an accurate 100 μm incision into the surface of an Intralipid phantom. The CP-LCI guided incision quality in terms of depth was evaluated afterwards using three-dimensional Fourier-domain optical coherence tomography imaging, which showed significant improvement of incision accuracy compared to free-hand-only operations.

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.

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.

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--10-V analog signal from computer to machine actuator, (d) analog-in, a 0--1-mA 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

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

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: digital-out; an on-off signal from computer to machine actuator, digital-in, and on-off signal from machine sensor to computer, analog-out, a 0 - 10 volt analog signal from computer to machine actuator, analog-in, 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 end. 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 serve to totally isolate electrically noisy machine areas from the sensitive electronics in the computer control. Advantages, including low cost, small size, personnel safety, and ease of maintenance and modification are discussed

Fiber-optic evanescent-field sensor for attitude measurement

Science.gov (United States)

Liu, Yun; Chen, Shimeng; Liu, Zigeng; Guang, Jianye; Peng, Wei

2017-11-01

We proposed a new approach to attitude measurement by an evanescent field-based optical fiber sensing device and demonstrated a liquid pendulum. The device consisted of three fiber-optic evanescent-filed sensors which were fabricated by tapered single mode fibers and immersed in liquid. Three fiber Bragg gratings were used to measure the changes in evanescent field. And their reflection peaks were monitored in real time as measurement signals. Because every set of reflection responses corresponded to a unique attitude, the attitude of the device could be measured by the three fiber-optic evanescent-filed sensors. After theoretical analysis, computerized simulation and experimental verification, regular responses were obtained using this device for attitude measurement. The measurement ranges of dihedral angle and direction angle were 0°-50° and 0°-360°. The device is based on cost-effective power-referenced scheme. It can be used in electromagnetic or nuclear radiation environment.

Combined pulsed dye laser and fiberoptic Nd-YAG laser for the treatment of hypertrophic port wine stain.

Science.gov (United States)

Radmanesh, Mohammed; Radmanesh, Ramin

2017-10-01

The hypertrophic Port Wine Stain (PWS) is only partially and superficially treated with the Pulsed dye laser (PDL) because of its limited depth of penetration. We used combined PDL and fiberoptic 1444-nm Nd-YAG laser to treat a case with hypertrophic PWS. After tumescent anesthesia, few holes were made by a 16-gauge needle on different sides of the lesion. The fiberoptic tip of 1444-nm Nd-YAG laser was inserted within the holes and was pushed forward while triggering. In a fan pattern and by a back and forth movement, the subcutaneous and deep dermal areas were coagulated. The skin and outer mucosal surfaces were then treated by PDL. The fiberoptic system used was Accusculpt 1444-nm Nd-YAG laser (Lutronic lasers, South Korea), and the PDL used was 585 nm Nlite system (Chromogenex UK). The parameters used for PDL were fluence = 9 Joules/cm 2 and the spot size was 5 mm. The parameters used for fiberoptic 1444-nm Nd-YAG laser were: Pulse rate = 30 Hz, pulse energy = 300 mJ, power = 6 W, and the total energy = 4000 J for the whole face and mucosa. Little sign of regression and moderate purpura were detected immediately after combined fiberoptic Nd-YAG and PDL therapy. The lesion gradually regressed within 4 months with satisfactory color and volume change. Combined fiberoptic Nd-YAG laser and PDL can be used for the treatment of deeper and superficial layers of hypertrophic PWS.

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...... did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed...

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

Current Innovations in Endoscopic Therapy for the Management of Colorectal Cancer: From Endoscopic Submucosal Dissection to Endoscopic Full-Thickness Resection

Directory of Open Access Journals (Sweden)

Shintaro Fujihara

2014-01-01

Full Text Available Endoscopic submucosal dissection (ESD is accepted as a minimally invasive treatment for colorectal cancer. However, due to technical difficulties and an increased rate of complications, ESD is not widely used in the colorectum. In some cases, endoscopic treatment alone is insufficient for disease control, and laparoscopic surgery is required. The combination of laparoscopic surgery and endoscopic resection represents a new frontier in cancer treatment. Recent developments in advanced polypectomy and minimally invasive surgical techniques will enable surgeons and endoscopists to challenge current practice in colorectal cancer treatment. Endoscopic full-thickness resection (EFTR of the colon offers the potential to decrease the postoperative morbidity and mortality associated with segmental colectomy while enhancing the diagnostic yield compared to current endoscopic techniques. However, closure is necessary after EFTR and natural transluminal endoscopic surgery (NOTES. Innovative methods and new devices for EFTR and suturing are being developed and may potentially change traditional paradigms to achieve minimally invasive surgery for colorectal cancer. The present paper aims to discuss the complementary role of ESD and the future development of EFTR. We focus on the possibility of achieving EFTR using the ESD method and closing devices.

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

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.

Clinical application of endoscopic ultrasonography for esophageal achalasia.

Science.gov (United States)

Minami, Hitomi; Inoue, Haruhiro; Isomoto, Hajime; Urabe, Shigetoshi; Nakao, Kazuhiko

2015-04-01

Endoscopic ultrasonography (EUS) has been widely used for evaluating the nature of diseases of various organs. The possibility of applying EUS for esophageal motility diseases has not been well discussed despite its versatility. At present, peroral endoscopic myotomy (POEM) for esophageal achalasia and related diseases has brought new attention to esophageal diseases because POEM provides a more direct approach to the inner structures of the esophageal wall. In the present study, we discuss the clinical utility of EUS in evaluating and treating esophageal motility diseases such as esophageal achalasia and related diseases. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

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 ...

Endoscope disinfection and its pitfalls--requirement for retrograde surveillance cultures.

Science.gov (United States)

Buss, A J; Been, M H; Borgers, R P; Stokroos, I; Melchers, W J; Peters, F T; Limburg, A J; Degener, J E

2008-04-01

Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to trace disinfection problems to individual endoscopes or washer-disinfectors. Our surveillance protocol included anterograde and retrograde sampling, a decision algorithm, genetic fingerprinting, and scanning electron microscopy. Over a period of 29 months we found an increasing number of patient-ready endoscopes testing positive for Candida species other than albicans, especially C. parapsilosis. These yeasts were also isolated from the washer-disinfectors. The number of positive tests for Candida species varied from 1 out of 21 to 14 out of 27 samples from nine frequently used endoscopes. The number of colony-forming units per milliliter ranged from 1 - 10 to 3000 for endoscopes and 0.002 to 0.06 for the washer disinfectors. DNA fingerprinting was not able to discriminate different strains within C. parapsilosis. Our protocol was able to detect a structural problem in the endoscope disinfection process. Retrograde sampling was crucial for this purpose, because it has much higher sensitivity than anterograde sampling. Endoscopes with damaged working channels are probably the source of the contamination problem with Candida species.

Endoscopic submucosal dissection

DEFF Research Database (Denmark)

Pimentel-Nunes, Pedro; Dinis-Ribeiro, Mário; Ponchon, Thierry

2015-01-01

evidence). 2 ESGE recommends endoscopic resection with a curative intent for visible lesions in Barrett's esophagus (strong recommendation, moderate quality evidence). ESD has not been shown to be superior to EMR for excision of mucosal cancer, and for that reason EMR should be preferred. ESD may...... RECOMMENDATIONS: 1 ESGE recommends endoscopic en bloc resection for superficial esophageal squamous cell cancers (SCCs), excluding those with obvious submucosal involvement (strong recommendation, moderate quality evidence). Endoscopic mucosal resection (EMR) may be considered in such lesions when...

Rescue endoscopic bleeding control for nonvariceal upper gastrointestinal hemorrhage using clipping and detachable snaring.

Science.gov (United States)

Lee, J H; Kim, B K; Seol, D C; Byun, S J; Park, K H; Sung, I K; Park, H S; Shim, C S

2013-06-01

Nonvariceal upper gastrointestinal (UGI) bleeding recurs after appropriate endoscopic therapy in 10 % - 15 % of cases. The mortality rate can be as high as 25 % when bleeding recurs, but there is no consensus about the best modality for endoscopic re-treatment. The aim of this study was to evaluate clipping and detachable snaring (CDS) for rescue endoscopic control of nonvariceal UGI hemorrhage. We report a case series of seven patients from a Korean tertiary center who underwent endoscopic hemostasis using the combined method of detachable snares with hemoclips. The success rate of endoscopic hemostasis with CDS was 86 %: six of the seven patients who had experienced primary endoscopic treatment failure or recurrent bleeding after endoscopic hemostasis were treated successfully. In conclusion, rescue endoscopic bleeding control by means of CDS is an option for controlling nonvariceal UGI bleeding when no other method of endoscopic treatment for recurrent bleeding and primary hemostatic failure is possible. © Georg Thieme Verlag KG Stuttgart · New York.

Endoscopic Devices for Obesity.

Science.gov (United States)

Sampath, Kartik; Dinani, Amreen M; Rothstein, Richard I

2016-06-01

The obesity epidemic, recognized by the World Health Organization in 1997, refers to the rising incidence of obesity worldwide. Lifestyle modification and pharmacotherapy are often ineffective long-term solutions; bariatric surgery remains the gold standard for long-term obesity weight loss. Despite the reported benefits, it has been estimated that only 1% of obese patients will undergo surgery. Endoscopic treatment for obesity represents a potential cost-effective, accessible, minimally invasive procedure that can function as a bridge or alternative intervention to bariatric surgery. We review the current endoscopic bariatric devices including space occupying devices, endoscopic gastroplasty, aspiration technology, post-bariatric surgery endoscopic revision, and obesity-related NOTES procedures. Given the diverse devices already FDA approved and in development, we discuss the future directions of endoscopic therapies for obesity.

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...... constellations in [1]. We then propose a mapping function for turbo coded bit interleaved coded modulation based on optimization of the mu- tual information between the channel input and output. Using this mapping, spectral efficiency as high as 6.5 bits/s/Hz/polarization is achieved on a simulated single...... 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...

endoscope-i: an innovation in mobile endoscopic technology transforming the delivery of patient care in otolaryngology.

Science.gov (United States)

Mistry, N; Coulson, C; George, A

2017-11-01

Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting. Areas covered: This article gives a detailed overview of the endoscope-i system together with its applications. A review and comparison of alternative devices on the market offering smartphone adapted endoscopic viewing systems is also presented. Expert commentary: The endoscope-i fulfils unmet needs by providing a compact, highly portable, simple to use endoscopic viewing system which is cost-effective and which makes use of smartphone technology most clinicians have in their pocket. The system allows real-time feedback to the patient and has the potential to transform the way that healthcare is delivered in ENT as well as having applications further afield.

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.

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.

Revisional laparoscopic antireflux surgery after unsuccessful endoscopic fundoplication

NARCIS (Netherlands)

Witteman, Bart P. L.; Kessing, Boudewijn F.; Snijders, Gitte; Koek, Ger H.; Conchillo, José M.; Bouvy, Nicole D.

2013-01-01

Transoral incisionless fundoplication (TIF), a novel endoscopic procedure for treating gastroesophageal reflux disease (GERD), currently is under evaluation. In case of treatment failure, subsequent revisional laparoscopic antireflux surgery (rLARS) may be required. This study aimed to evaluate the

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

Endoscopic Management of Bile Leakage after Liver Transplantation

Science.gov (United States)

Oh, Dongwook; Lee, Sung Koo; Song, Tae Jun; Park, Do Hyun; Lee, Sang Soo; Seo, Dong-Wan; Kim, Myung-Hwan

2015-01-01

Background/Aims Endoscopic retrograde cholangiopancreatography (ERCP) can be an effective treatment for bile leakage after liver transplantation. We evaluated the efficacy of endoscopic treatment in liver transplantation in patients who developed bile leaks. Methods Forty-two patients who developed bile leaks after liver transplantation were included in the study. If a bile leak was observed on ERCP, a sphincterotomy was performed, and a nasobiliary catheter was then inserted. If a bile leak was accompanied by a bile duct stricture, either the stricture was dilated with balloons, followed by nasobiliary catheter insertion across the bile duct stricture, or endoscopic retrograde biliary drainage was performed. Results In the bile leakage alone group (22 patients), endoscopic treatment was technically successful in 19 (86.4%) and clinically successful in 17 (77.3%) cases. Among the 20 patients with bile leaks with bile duct strictures, endoscopic treatment was technically successful in 13 (65.0%) and clinically successful in 10 (50.0%) cases. Among the 42 patients who underwent ERCP, technical success was achieved in 32 (76.2%) cases and clinical success was achieved in 27 (64.3%) cases. Conclusions ERCP is an effective and safe therapeutic modality for bile leaks after liver transplantation. ERCP should be considered as an initial therapeutic modality in post-liver transplantation patients. PMID:25717048

Advances in the endoscopic management of pancreatic collections.

Science.gov (United States)

Ruiz-Clavijo, David; de la Higuera, Belen González; Vila, Juan J

2015-04-16

Treatment of pancreatic collections has experienced great progress in recent years with the emergence of alternative minimally invasive techniques comparing to the classic surgical treatment. Such techniques have been shown to improve outcomes of morbidity vs surgical treatment. The recent emergence of endoscopic drainage is noteworthy. The advent of endoscopic ultrasonography has been crucial for treatment of these specific lesions. They can be characterized, their relationships with neighboring structures can be evaluated and the drainage guided by this technique has been clearly improved compared with the conventional endoscopic drainage. Computed tomography is the technique of choice to characterize the recently published new classification of pancreatic collections. For this reason, the radiologist's role establishing and classifying in a rigorously manner the collections according to the new nomenclature is essential to making therapeutic decisions. Ideal scenario for comprehensive treatment of these collections would be those centers with endoscopic ultrasound and interventional radiology expertise together with hepatobiliopancreatic surgery. This review describes the different types of pancreatic collections: acute peripancreatic fluid collection, pancreatic pseudocysts, acute necrotic collection and walled-off necrosis; the indications and the contraindications for endoscopic drainage, the drainage technique and their outcomes. The integrated management of pancreatic collections according to their type and evolution time is discussed.

Single-session endoscopic resection and focal radiofrequency ablation for short-segment Barrett's esophagus with early neoplasia

NARCIS (Netherlands)

Barret, Maximilien; Belghazi, Kamar; Weusten, Bas L. A. M.; Bergman, Jacques J. G. H. M.; Pouw, Roos E.

2016-01-01

The management of early neoplasia in Barrett's esophagus (BE) requires endoscopic resection of visible lesions, followed by radiofrequency ablation (RFA) of the remaining BE. We evaluated the safety and efficacy of combining endoscopic resection and focal RFA in a single endoscopic session in

Learning endoscopic resection in the esophagus

NARCIS (Netherlands)

van Vilsteren, Frederike G. I.; Pouw, Roos E.; Herrero, Lorenza Alvarez; Bisschops, Raf; Houben, Martin; Peters, Frans T. M.; Schenk, B. E.; Weusten, Bas L. A. M.; Schoon, Erik J.; Bergman, Jacques J. G. H. M.

Background: Endoscopic resection is the cornerstone of endoscopic management of esophageal early neoplasia. However, endoscopic resection is a complex technique requiring knowledge and expertise. Our aims were to identify the most important learning points in performing endoscopic resection in a

Selective binding of sucralfate to endoscopic mucosal resection-induced gastric ulcer: evaluation of aluminium adherence.

Science.gov (United States)

Itoh, T; Kusaka, K; Kawaura, K; Kashimura, K; Yamakawa, J; Takahashi, T; Kanda, T

2004-01-01

We evaluated the effect of sucralfate in patients with early gastric cancer in endoscopic mucosal resection (EMR)-induced gastric ulcers, and in rats with acetic acid-induced ulcers, by measuring concentrations of aluminium adhering to mucosal lesions. Twenty-two patients who underwent EMR received sucralfate with or without ranitidine and were examined endoscopically after 1 week, 2 weeks and 3 weeks. Gastric juice pH and concentration of aluminium in samples of ulcerated and normal mucosa were measured at various time-points. Good ulcer healing was observed in all patients. Significantly higher concentrations of aluminium were found in ulcerated tissue compared with normal mucosa. This selective binding of sucralfate was even found 12 h after drug administration and was confirmed in acetic acid-induced ulcers in 40 rats. Neutral rather than acid gastric juice was observed up to 12 h after the administration of sucralfate alone. These results suggest that sucralfate with or without ranitidine may contribute to the healing of EMR-induced ulcers by selectively binding to lesions.

Study on multi-detector computed tomography in the virtual endoscope mode to phantom of saliva gland duct application. Image quality evaluation of geometry

International Nuclear Information System (INIS)

Ozawa, Tomonori; Innami, Hisashi; Oyake, Reira; Shinohara, Yuki; Yamaaki, Fumi; Koizumi, Nobuhide; Okumura, Yasuhiko

2009-01-01

The diagnosis ability of the radiographic imaging has been greatly improved by the advent of multi-detector computed tomography (MDCT), Which is now a the prerequisite to the diagnosis and treatment of a variety of diseases. MDCT conducted in the virtual endoscope mode can be used for various image compositions, and the space in a structure such as the large intestines can be visualized similarly as with an actual endoscope. Using a phantom of a salivary gland duct, I performed the image analysis to determine whether this endoscope mode could able to be applied to the oral cavity. I searched for the optimum conditions and the best position for taking pictures, and evaluated whether the salivary gland ducts could be reproducibly imitated by the phantom. Modulation transfer function (MTF), Wiener spectrum (WS) analysis were used to examined the utility of MDCT in the virtual endoscope mode for use in the oral cavity. As a result, the following conclusions were made: The best image was obtained within 40 mm from the center part of the gantry by the MTF and the WS analyses. Decreases in the MTF and the WS as the decrease were seen at 20 mAs and 80 kV, and the decrease were seen in the sharpness of the image decreased as the value of the reconstruction function became smaller. The image was somewhat distorted when pictures were taken of the parallel or the direction of the slice by the inclination within 90 deg±15 deg as much as possible Z axially for running of the duct in the evaluation of internal reproducibility. The influence was admitted to go out easily in an inside form as the inside diameter became thin. The salivary gland phantom was evaluated geometrically by MDCT in the virtual endoscope mode, and the optimal conditions were obtained from the above-mentioned results. The utility of MDCT in the mode was thus suggested. (author)

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.

Falloposcopy.

Science.gov (United States)

Milad, M P; Corfman, R S

1992-06-01

This review discusses advances in falloposcopy over the past 10 years. Refinements in instrumentation, including fiberoptics, have allowed visualization of the endosalpinx, a portion of the reproductive tract that has evaded endoscopic evaluation. A coaxial system of falloposcopic placement may give way to a linear everting catheter that does not require hysteroscopic guidance. Tubal endoscopic applications are discussed, including correlating hysterosalpingogram findings with those findings at salpingoscopy. Endosalpingeal changes can be quantitated in the presence of hydrosalpinges, and possibly with endometriosis. A scoring system to measure changes has been described. Using this scoring system, endosalpingeal findings at salpingoscopy have been compared with histologic and electron microscopic findings.

Solo-Surgeon Retroauricular Approach Endoscopic Thyroidectomy.

Science.gov (United States)

Lee, Doh Young; Baek, Seung-Kuk; Jung, Kwang-Yoon

2017-01-01

This study aimed to evaluate the feasibility and efficacy of solo-surgeon retroauricular thyroidectomy. For solo-surgery, we used an Endoeye Flex Laparo-Thoraco Videoscope (Olympus America, Inc.). A Vitom Karl Storz holding system (Karl Storz GmbH & Co.) composed of several bars connected by a ball-joint system was used for fixation of endoscope. A snake retractor and a brain-spoon retractor were used on the sternocleidomastoid. Endoscopic thyroidectomy using the solo-surgeon technique was performed in 10 patients having papillary thyroid carcinoma. The mean patient age was 36.0 ± 11.1 years, and all patients were female. There were no postoperative complications such as vocal cord paralysis and hematoma. When compared with the operating times and volume of drainage of a control group of 100 patients who underwent surgery through the conventional retroauricular approach between May 2013 and December 2015, the operating times and volume of drainage were not significantly different (P = .781 and .541, respectively). Solo-surgeon retroauricular thyroidectomy is safe and feasible when performed by a surgeon competent in endoscopic thyroidectomy.

[Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess].

Science.gov (United States)

Yu, Huanxin; Liu, Gang

2014-01-01

To evaluate the effectiveness of transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess. Eighteen pathologically diagnosed pituitary abscess were resected through transsphenoidal endoscopic endonasal approach at Tianjing Huanhu hospital between January 2000 and December 2011.Retrospective analysis was done upon clinical presentations and imaging features. There were 6 males and 12 females. The average age was 48.5 years old and the average disease course was 5.8 years. The typical clinical manifestations included headache (13 cases), pituitary dysfunction (10 cases), Diabetes Insipidus (4 cases) visual interference (8 cases) and fever (4 cases). All cases were resected by transsphenoidal endoscopic endonasal approach with general anesthesia. The postoperative symptoms and follow-up results were recorded. All patients were followed up from 6 months to 6 years. Postoperatively, headache was recovered in 13 cases, visual was improved in 6 cases, hypopituitarism was relieved in 8 cases and polyuria was disappeared in 3 cases. One case was recurrent and cured by transsphenoidal endoscopic endonasal approach. Transsphenoidal endoscopic endonasal approach for the surgery of pituitary abscess is effective.

Fiber-optic intra-aortic balloon therapy and its role within cardiac surgery.

Science.gov (United States)

Yarham, G; Clements, A; Morris, C; Cumberland, T; Bryan, M; Oliver, M; Burrows, H; Mulholland, J

2013-03-01

The patient population has changed and the cardiothoracic team are now operating on patients with more co-morbidity. One of the significant aspects of this increased co-morbidity, which affects both short- and long-term outcomes, is compromised left ventricular function. Intra-aortic balloon pump (IABP) technology offers these patients and the cardiac team an easily accessible, cost-effective, mechanical assist device. Arterial pressure monitoring for IABP therapy: Fluid-filled transducers used to measure the aortic waveform can be unreliable and inconsistent. Fiber-optic manometers located in the very tip of the IAB catheters provide accurate and fast, high quality measurements. This, in turn, presents the opportunity for the hardware and algorithm to measure key markers on the arterial waveform and optimise left ventricular support. It also provides the potential for automatic in vivo calibration, further increasing the accuracy and quality of the IAB support. The effect of fiber-optic IABP therapy on clinical management: A dual centre prospective audit comparing fluid-filled versus fiber-optic arterial pressure monitoring showed a 96% reduction in IAB-related perfusion on-site call-outs (17 vs. 1, respectively) and a 94% reduction in sub-optimal timing (55/98 vs. 2/94, respectively). The improved timing algorithms utilise the pressure information received 50 msecs faster than with fluid-filled transducers, measuring key markers on the pressure waveform and adjusting inflation and deflation accurately on a beat per beat basis. Fiber-optic IAB technology and, specifically, these improved algorithms provide better beat per beat mechanical support. Given our evolving patient population, this technology will not only play an increased role, but will have a significant impact on cardiac surgery.

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

Endoscopic therapy of neoplasia related to Barrett's esophagus and endoscopic palliation of esophageal cancer.

Science.gov (United States)

Vignesh, Shivakumar; Hoffe, Sarah E; Meredith, Kenneth L; Shridhar, Ravi; Almhanna, Khaldoun; Gupta, Akshay K

2013-04-01

Barrett's esophagus (BE) is the most important identifiable risk factor for the progression to esophageal adenocarcinoma. This article reviews the current endoscopic therapies for BE with high-grade dysplasia and intramucosal cancer and briefly discusses the endoscopic palliation of advanced esophageal cancer. The diagnosis of low-grade or high-grade dysplasia (HGD) is based on several cytologic criteria that suggest neoplastic transformation of the columnar epithelium. HGD and carcinoma in situ are regarded as equivalent. The presence of dysplasia, particularly HGD, is also a risk factor for synchronous and metachronous adenocarcinoma. Dysplasia is a marker of adenocarcinoma and also has been shown to be the preinvasive lesion. Esophagectomy has been the conventional treatment for T1 esophageal cancer and, although debated, is an appropriate option in some patients with HGD due to the presence of occult cancer in over one-third of patients. Endoscopic ablative modalities (eg, photodynamic therapy and cryoablation) and endoscopic resection techniques (eg, endoscopic mucosal resection) have demonstrated promising results. The significant morbidity and mortality of esophagectomy makes endoscopic treatment an attractive potential option.

Development of a Meso-Scale Fiberoptic Rotation Sensor for a Torsion Actuator.

Science.gov (United States)

Sheng, Jun; Desai, Jaydev P

2018-01-01

This paper presents the development of a meso-scale fiberoptic rotation sensor for a shape memory alloy (SMA) torsion actuator for neurosurgical applications. Within the sensor, a rotary head with a reflecting surface is capable of modulating the light intensity collected by optical fibers when the rotary head is coupled to the torsion actuator. The mechanism of light intensity modulation is modeled, followed by experimental model verification. Meanwhile, working performances for different rotary head designs, optical fibers, and fabrication materials are compared. After the calibration of the fiberoptic rotation sensor, the sensor is capable of precisely measuring rotary motion and controlling the SMA torsion actuator with feedback control.

Endoscope-Assisted Transoral Fixation of Mandibular Condyle Fractures: Submandibular Versus Transoral Endoscopic Approach.

Science.gov (United States)

Hwang, Na-Hyun; Lee, Yoon-Hwan; You, Hi-Jin; Yoon, Eul-Sik; Kim, Deok-Woo

2016-07-01

In recent years, endoscope-assisted transoral approach for condylar fracture treatment has attracted much attention. However, the surgical approach is technically challenging: the procedure requires specialized instruments and the surgeons experience a steep learning curve. During the transoral endoscopic (TE) approach several instruments are positioned through a narrow oral incision making endoscope maneuvering very difficult. For this reason, the authors changed the entry port of the endoscope from transoral to submandibular area through a small stab incision. The aim of this study is to assess the advantage of using the submandibular endoscopic intraoral approach (SEI).The SEI approach requires intraoral incision for fracture reduction and fixation, and 4 mm size submandibular stab incision for endoscope and traction wires. Fifteen patients with condyle neck and subcondyle fractures were operated under the submandibular approach and 15 patients with the same diagnosis were operated under the standard TE approach.The SEI approach allowed clear visualization of the posterior margin of the ramus and condyle, and the visual axis was parallel to the condyle ramus unit. The TE approach clearly shows the anterior margin of the condyle and the sigmoid notch. The surgical time of the SEI group was 128 minutes and the TE group was 120 minutes (P >0.05). All patients in the TE endoscope group were fixated with the trocar system, but only 2 lower neck fracture patients in the SEI group required a trocar. The other 13 subcondyle fractures were fixated with an angulated screw driver (P <0.05). There were no differences in complication and surgical outcomes.The submandibular endoscopic approach has an advantage of having more space with good visualization, and facilitated the use of an angulated screw driver.

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...

Transnasal endoscopic evaluation of swallowing: a bedside technique to evaluate ability to swallow pureed diets in elderly patients with dysphagia.

Science.gov (United States)

Sakamoto, Torao; Horiuchi, Akira; Nakayama, Yoshiko

2013-08-01

Endoscopic evaluation of swallowing (EES) is not commonly used by gastroenterologists to evaluate swallowing in patients with dysphagia. To use transnasal endoscopy to identify factors predicting successful or failed swallowing of pureed foods in elderly patients with dysphagia. EES of pureed foods was performed by a gastroenterologist using a small-calibre transnasal endoscope. Factors related to successful versus unsuccessful swallowing of pureed foods were analyzed with regard to age, comorbid diseases, swallowing activity, saliva pooling, vallecular residues, pharyngeal residues and airway penetration⁄aspiration. Unsuccessful swallowing was defined in patients who could not eat pureed foods at bedside during hospitalization. Logistic regression analysis was used to identify independent predictors of swallowing of pureed foods. During a six-year period, 458 consecutive patients (mean age 80 years [range 39 to 97 years]) were considered for the study, including 285 (62%) men. Saliva pooling, vallecular residues, pharyngeal residues and penetration⁄aspiration were found in 240 (52%), 73 (16%), 226 (49%) and 232 patients (51%), respectively. Overall, 247 patients (54%) failed to swallow pureed foods. Multivariate logistic regression analysis demonstrated that the presence of pharyngeal residues (OR 6.0) and saliva pooling (OR 4.6) occurred significantly more frequently in patients who failed to swallow pureed foods. Pharyngeal residues and saliva pooling predicted impaired swallowing of pureed foods. Transnasal EES performed by a gastroenterologist provided a unique bedside method of assessing the ability to swallow pureed foods in elderly patients with dysphagia.

New Endoscopic Indicator of Esophageal Achalasia: “Pinstripe Pattern”

Science.gov (United States)

Minami, Hitomi; Isomoto, Hajime; Miuma, Satoshi; Kobayashi, Yasutoshi; Yamaguchi, Naoyuki; Urabe, Shigetoshi; Matsushima, Kayoko; Akazawa, Yuko; Ohnita, Ken; Takeshima, Fuminao; Inoue, Haruhiro; Nakao, Kazuhiko

2015-01-01

Background and Study Aims Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia. Patients and Methods This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1) esophageal dilatation, (2) abnormal retention of liquid and/or food, (3) whitish change of the mucosal surface, (4) functional stenosis of the esophago-gastric junction, and (5) abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, “pinstripe pattern (PSP)” was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding. Results The prevalence rates of the above-mentioned findings (1–5) were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5%) of 35 cases with shorter history achalasia were 83.8%, 64.7%, and 100%, respectively. Conclusion “Pinstripe pattern” could be a reliable indicator for early discrimination of primary esophageal achalasia. PMID:25664812

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

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.

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.

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.

Virtual endoscopic images by 3D FASE cisternography for neurovascular compression

International Nuclear Information System (INIS)

Ishimori, Takashi; Nakano, Satoru; Kagawa, Masahiro

2003-01-01

Three-dimensional fast asymmetric spin echo (3D FASE) cisternography provides high spatial resolution and excellent contrast as a water image acquisition technique. It is also useful for the evaluation of various anatomical regions. This study investigated the usefulness and limitations of virtual endoscopic images obtained by 3D FASE MR cisternography in the preoperative evaluation of patients with neurovascular compression. The study included 12 patients with neurovascular compression: 10 with hemifacial spasm and two with trigeminal neuralgia. The diagnosis was surgically confirmed in all patients. The virtual endoscopic images obtained were judged to be of acceptable quality for interpretation in all cases. The areas of compression identified in preoperative diagnosis with virtual endoscopic images showed good agreement with those observed from surgery, except in one case in which the common trunk of the anterior inferior cerebellar artery and posterior inferior cerebellar artery (AICA-PICA) bifurcated near the root exit zone of the facial nerve. The veins are displayed in some cases but not in others. The main advantage of generating virtual endoscopic images is that such images can be used for surgical simulation, allowing the neurosurgeon to perform surgical procedures with greater confidence. (author)

Resident simulation training in endoscopic endonasal surgery utilizing haptic feedback technology.

Science.gov (United States)

Thawani, Jayesh P; Ramayya, Ashwin G; Abdullah, Kalil G; Hudgins, Eric; Vaughan, Kerry; Piazza, Matthew; Madsen, Peter J; Buch, Vivek; Sean Grady, M

2016-12-01

Simulated practice may improve resident performance in endoscopic endonasal surgery. Using the NeuroTouch haptic simulation platform, we evaluated resident performance and assessed the effect of simulation training on performance in the operating room. First- (N=3) and second- (N=3) year residents were assessed using six measures of proficiency. Using a visual analog scale, the senior author scored subjects. After the first session, subjects with lower scores were provided with simulation training. A second simulation served as a task-learning control. Residents were evaluated in the operating room over six months by the senior author-who was blinded to the trained/untrained identities-using the same parameters. A nonparametric bootstrap testing method was used for the analysis (Matlab v. 2014a). Simulation training was associated with an increase in performance scores in the operating room averaged over all measures (p=0.0045). This is the first study to evaluate the training utility of an endoscopic endonasal surgical task using a virtual reality haptic simulator. The data suggest that haptic simulation training in endoscopic neurosurgery may contribute to improvements in operative performance. Limitations include a small number of subjects and adjudication bias-although the trained/untrained identity of subjects was blinded. Further study using the proposed methods may better describe the relationship between simulated training and operative performance in endoscopic Neurosurgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

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.

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...

New endoscopic indicator of esophageal achalasia: "pinstripe pattern".

Directory of Open Access Journals (Sweden)

Hitomi Minami

Full Text Available Endoscopic diagnosis of esophageal achalasia lacking typical endoscopic features can be extremely difficult. The aim of this study was to identify simple and reliable early indicator of esophageal achalasia.This single-center retrospective study included 56 cases of esophageal achalasia without previous treatment. As a control, 60 non-achalasia subjects including reflux esophagitis and superficial esophageal cancer were also included in this study. Endoscopic findings were evaluated according to Descriptive Rules for Achalasia of the Esophagus as follows: (1 esophageal dilatation, (2 abnormal retention of liquid and/or food, (3 whitish change of the mucosal surface, (4 functional stenosis of the esophago-gastric junction, and (5 abnormal contraction. Additionally, the presence of the longitudinal superficial wrinkles of esophageal mucosa, "pinstripe pattern (PSP" was evaluated endoscopically. Then, inter-observer diagnostic agreement was assessed for each finding.The prevalence rates of the above-mentioned findings (1-5 were 41.1%, 41.1%, 16.1%, 94.6%, and 43.9%, respectively. PSP was observed in 60.7% of achalasia, while none of the control showed positivity for PSP. PSP was observed in 26 (62.5% of 35 cases with shorter history < 10 years, which usually lacks typical findings such as severe esophageal dilation and tortuosity. Inter-observer agreement level was substantial for food/liquid remnant (k = 0.6861 and PSP (k = 0.6098, and was fair for abnormal contraction and white change. The accuracy, sensitivity, and specificity for achalasia were 83.8%, 64.7%, and 100%, respectively."Pinstripe pattern" could be a reliable indicator for early discrimination of primary esophageal achalasia.

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.

Submucosal tunnel endoscopy: Peroral endoscopic myotomy and peroral endoscopic tumor resection

Science.gov (United States)

Eleftheriadis, Nikolas; Inoue, Haruhiro; Ikeda, Haruo; Onimaru, Manabu; Maselli, Roberta; Santi, Grace

2016-01-01

Peroral endoscopic myotomy (POEM) is an innovative, minimally invasive, endoscopic treatment for esophageal achalasia and other esophageal motility disorders, emerged from the natural orifice transluminal endoscopic surgery procedures, and since the first human case performed by Inoue in 2008, showed exciting results in international level, with more than 4000 cases globally up to now. POEM showed superior characteristics than the standard 100-year-old surgical or laparoscopic Heller myotomy (LHM), not only for all types of esophageal achalasia [classical (I), vigorous (II), spastic (III), Chicago Classification], but also for advanced sigmoid type achalasia (S1 and S2), failed LHM, or other esophageal motility disorders (diffuse esophageal spasm, nutcracker esophagus or Jackhammer esophagus). POEM starts with a mucosal incision, followed by submucosal tunnel creation crossing the esophagogastric junction (EGJ) and myotomy. Finally the mucosal entry is closed with endoscopic clip placement. POEM permitted relatively free choice of myotomy length and localization. Although it is technically demanding procedure, POEM can be performed safely and achieves very good control of dysphagia and chest pain. Gastroesophageal reflux is the most common troublesome side effect, and is well controllable with proton pump inhibitors. Furthermore, POEM opened the era of submucosal tunnel endoscopy, with many other applications. Based on the same principles with POEM, in combination with new technological developments, such as endoscopic suturing, peroral endoscopic tumor resection (POET), is safely and effectively applied for challenging submucosal esophageal, EGJ and gastric cardia tumors (submucosal tumors), emerged from muscularis propria. POET showed up to know promising results, however, it is restricted to specialized centers. The present article reviews the recent data of POEM and POET and discussed controversial issues that need further study and future perspectives. PMID

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.

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.

Study of distributed fiber-optic laser-ultrasound generation based on ghost-mode of tilted fiber Bragg gratings

Science.gov (United States)

Tian, Jiajun; Zhang, Qi; Han, Ming

2013-05-01

Fiber-optic ultrasonic transducers are an important component of an active ultrasonic testing system for structural health monitoring. Fiber-optic transducers have several advantages such as small size, light weight, and immunity to electromagnetic interference that make them much more attractive than the current available piezoelectric transducers, especially as embedded and permanent transducers in active ultrasonic testing for structural health monitoring. In this paper, a distributed fiber-optic laser-ultrasound generation based on the ghost-mode of tilted fiber Bragg gratings is studied. The influences of the laser power and laser pulse duration on the laser-ultrasound generation are investigated. The results of this paper are helpful to understand the working principle of this laser-ultrasound method and improve the ultrasonic generation efficiency.

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

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

Magnetic control system targeted for capsule endoscopic operations in the stomach--design, fabrication, and in vitro and ex vivo evaluations.

Science.gov (United States)

Lien, Gi-Shih; Liu, Chih-Wen; Jiang, Joe-Air; Chuang, Cheng-Long; Teng, Ming-Tsung

2012-07-01

This paper presents a novel solution of a hand-held external controller to a miniaturized capsule endoscope in the gastrointestinal (GI) tract. Traditional capsule endoscopes move passively by peristaltic wave generated in the GI tract and the gravity, which makes it impossible for endoscopists to manipulate the capsule endoscope to the diagnostic disease areas. In this study, the main objective is to present an endoscopic capsule and a magnetic field navigator (MFN) that allows endoscopists to remotely control the locomotion and viewing angle of an endoscopic capsule. The attractive merits of this study are that the maneuvering of the endoscopic capsule can be achieved by the external MFN with effectiveness, low cost, and operation safety, both from a theoretical and an experimental point of view. In order to study the magnetic interactions between the endoscopic capsule and the external MFN, a magnetic-analysis model is established for computer-based finite-element simulations. In addition, experiments are conducted to show the control effectiveness of the MFN to the endoscopic capsule. Finally, several prototype endoscopic capsules and a prototype MFN are fabricated, and their actual capabilities are experimentally assessed via in vitro and ex vivo tests using a stomach model and a resected porcine stomach, respectively. Both in vitro and ex vivo test results demonstrate great potential and practicability of achieving high-precision rotation and controllable movement of the capsule using the developed MFN.

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…

Prevalence of Visible and Occult Blood on the Surfaces of Fiberoptic Bronchoscopes

National Research Council Canada - National Science Library

McKamey, Jeffrey

2000-01-01

.... This study was conducted to determine if current cleaning, disinfection and sterilization procedures used at one medical center was adequate to remove visible and occult blood from fiberoptic bronchoscopes...

[Endoscopic extraction of gallbladder calculi].

Science.gov (United States)

Kühner, W; Frimberger, E; Ottenjann, R

1984-06-29

Endoscopic extraction of gallbladder stones were performed, as far as we know for the first time, in three patients with combined choledochocystolithiasis. Following endoscopic papillotomy (EPT) and subsequent mechanical lithotripsy of multiple choledochal concrements measuring up to 3 cm the gallbladder stones were successfully extracted with a Dormia basket through the cystic duct. The patients have remained free of complications after the endoscopic intervention.

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

Using external magnet guidance and endoscopically placed magnets to create suture-free gastro-enteral anastomoses.

Science.gov (United States)

Myers, Christopher; Yellen, Benjamin; Evans, John; DeMaria, Eric; Pryor, Aurora

2010-05-01

To facilitate endolumenal and natural orifice procedures, this study evaluated a novel technique using external and endoscopically placed magnets to create suture-free gastroenteral anastomoses. Seven anesthetized adult swine underwent endoscopic placement of magnets into the small bowel and stomach. Using external magnets, the endoscopically placed internal magnets were brought into opposition under endoscopic view. After 1-2 weeks, the pigs were killed and analyzed. At laparotomy and under sterile conditions, peritoneal cultures were obtained. The anastomoses were evaluated endoscopically and tested using an air insufflation test. Finally, the anastomoses were resected and evaluated microscopically. The average operative time for endoscopic placement of the magnets was 34.3 +/- 14.8 min. Successful placement and creation of anastomoses occurred in six of the pigs. One pig did not form an anastomosis because the magnets were too large to pass through the pylorus at the time of attempted magnet placement. Six swine experienced uncomplicated postoperative courses. One pig's postoperative course involved constipation for several days, requiring additional fluids and fiber supplementation. The findings at endoscopy showed that the magnets were adhered to the anastomosis, which were easily freed, or within the stomach. The air insufflation test results were negative for all the pigs. At laparotomy, there was no evidence of infection, abscess, or leak, but two peritoneal culture results were positive with scant growth of Staphylococcus aureus and coagulase-negative staphylococcus, presumably contaminants. Microscopically, the anastomoses illustrated granulation and fibrous connective tissue without evidence of infection or leak. Endoscopically placed magnets with external magnet guidance is a feasible and novel approach to creating patent gastroenteral anastomoses without abdominal incisions or sutures.

Surgical Reimplantation for the Correction of Vesicoureteral Reflux following Failed Endoscopic Injection

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Boris Chertin

2011-01-01

Full Text Available Purpose. In recent years, endoscopic injection became the procedure of choice for the correction of vesicoureteral reflux in the majority of the centers. Unfortunately, endoscopic treatment is not always successful and sometimes requires more than one trial to achieve similar results to that of an open reimplantation surgery. Our aim of this study is to evaluate the feasibility and success rate of open ureteral reimplantation following failed endoscopic procedure. Patients and Methods. During 2004–2010, we evaluated 16 patients with persistent vesicoureteral reflux (grades II–IV following failed endoscopic treatment. All patients underwent open ureteral reimplantation. All patients were followed with an ultrasound 6 weeks following surgery and every 6 months thereafter for an average of 22 months. Voiding cystography was performed at 3 months after surgery. Results. During unilateral open ureteral reimplantation, the implanted deposit from previous procedures was either excised, drained, or incorporated into the neotunnel with the ureter. Vesicoureteral reflux was resolved in all patients with 100% success rate. No new hydronephrosis or signs of obstruction developed in any of the patients. qDMSA renal scan was available in 8 patients showing improvement of function in 5 and stable function in 3, and no new scars were identified. Conclusions. Open ureteral reimplantation is an excellent choice for the correction of failed endoscopic treatment in children with vesicoureteral reflux.

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

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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,...

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

NARCIS (Netherlands)

F.J.C. van den Broek (Frank); E.J.R. de Graaf (Eelco); M.G.W. Dijkgraaf (Marcel); J.B. Reitsma (Johannes); J. Haringsma (Jelle); R. Timmer (Robin); B.L. Weusten (Bas); M.F. Gerhards (Michael); E.C. Consten (Esther); M.P. Schwartz (Matthijs); M.J. Boom (Maarten); E.J. Derksen (Erik); A.B. Bijnen (Bart); P.H.P. Davids (Paul); C. Hoff (Christiaan); H.M. van Dullemen (Hendrik); G.D.N. Heine (Dimitri); K. van der Linde (Klaas); J.M. Jansen (Jeroen); R.C.H. Mallant-Hent (Rosalie); R. Breumelhof (Ronald); H. Geldof (Han); J.C. Hardwick (James); P. Doornebosch (Pascal); A.C.T.M. Depla (Annekatrien); M.F. Ernst (Miranda); I.P. van Munster (Ivo); I.H.J.T. de Hingh (Ignace); E.J. Schoon (Erik); W.A. Bemelman (Willem); P. Fockens (Paul); E. Dekker (Evelien)

2009-01-01

textabstractBackground: 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

Linearization of Positional Response Curve of a Fiber-optic Displacement Sensor

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Babaev, O. G.; Matyunin, S. A.; Paranin, V. D.

2018-01-01

Currently, the creation of optical measuring instruments and sensors for measuring linear displacement is one of the most relevant problems in the area of instrumentation. Fiber-optic contactless sensors based on the magneto-optical effect are of special interest. They are essentially contactless, non-electrical and have a closed optical channel not subject to contamination. The main problem of this type of sensors is the non-linearity of their positional response curve due to the hyperbolic nature of the magnetic field intensity variation induced by moving the magnetic source mounted on the controlled object relative to the sensing element. This paper discusses an algorithmic method of linearizing the positional response curve of fiber-optic displacement sensors in any selected range of the displacements to be measured. The method is divided into two stages: 1 - definition of the calibration function, 2 - measurement and linearization of the positional response curve (including its temperature stabilization). The algorithm under consideration significantly reduces the number of points of the calibration function, which is essential for the calibration of temperature dependence, due to the use of the points that randomly deviate from the grid points with uniform spacing. Subsequent interpolation of the deviating points and piecewise linear-plane approximation of the calibration function reduces the microcontroller storage capacity for storing the calibration function and the time required to process the measurement results. The paper also presents experimental results of testing real samples of fiber-optic displacement sensors.

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

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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.

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

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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.

A challenge-response endoscopic sinus surgery specific checklist as an add-on to standard surgical checklist: an evaluation of potential safety and quality improvement issues.

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Sommer, Doron D; Arbab-Tafti, Sadaf; Farrokhyar, Forough; Tewfik, Marc; Vescan, Allan; Witterick, Ian J; Rotenberg, Brian; Chandra, Rakesh; Weitzel, Erik K; Wright, Erin; Ramakrishna, Jayant

2018-02-27

The goal of this study was to develop and evaluate the impact of an aviation-style challenge and response sinus surgery-specific checklist on potential safety and equipment issues during sinus surgery at a tertiary academic health center. The secondary goal was to assess the potential impact of use of the checklist on surgical times during, before, and after surgery. This initiative is designed to be utilized in conjunction with the "standard" World Health Organization (WHO) surgical checklist. Although endoscopic sinus surgery is generally considered a safe procedure, avoidable complications and potential safety concerns continue to occur. The WHO surgical checklist does not directly address certain surgery-specific issues, which may be of particular relevance for endoscopic sinus surgery. This prospective observational pilot study monitored compliance with and compared the occurrence of safety and equipment issues before and after implementation of the checklist. Forty-seven consecutive endoscopic surgeries were audited; the first 8 without the checklist and the following 39 with the checklist. The checklist was compiled by evaluating the patient journey, utilizing the available literature, expert consensus, and finally reevaluation with audit type cases. The final checklist was developed with all relevant stakeholders involved in a Delphi method. Implementing this specific surgical checklist in 39 cases at our institution, allowed us to identify and rectify 35 separate instances of potentially unsafe, improper or inefficient preoperative setup. These incidents included issues with labeling of topical vasoconstrictor or injectable anesthetics (3, 7.7%) and availability, function and/or position of video monitors (2, 5.1%), endoscope (6, 15.4%), microdebrider (6, 15.4%), bipolar cautery (6, 15.4%), and suctions (12, 30.8%). The design and integration of this checklist for endoscopic sinus surgery, has helped improve efficiency and patient safety in the operating

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

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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 hilar cholangiocarcinoma is challenging. ENBD should be selected as a temporary drainage method because of its low risk of complications.

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

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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.

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 ...

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study)

NARCIS (Netherlands)

van den Broek, Frank J. C.; de Graaf, Eelco J. R.; Dijkgraaf, Marcel G. W.; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L. A. M.; Gerhards, Michael F.; Consten, Esther C. J.; Schwartz, Matthijs P.; Boom, Maarten J.; Derksen, Erik J.; Bijnen, A. Bart; Davids, Paul H. P.; Hoff, Christiaan; van Dullemen, Hendrik M.; Heine, G. Dimitri N.; van der Linde, Klaas; Jansen, Jeroen M.; Mallant-Hent, Rosalie C. H.; Breumelhof, Ronald; Geldof, Han; Hardwick, James C. H.; Doornebosch, Pascal G.; Depla, Annekatrien C. T. M.; Ernst, Miranda F.; van Munster, Ivo P.; de Hingh, Ignace H. J. T.; Schoon, Erik J.; Bemelman, Willem A.; Fockens, Paul; Dekker, Evelien; Reitsma, J.

2009-01-01

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

[Endoscopic full-thickness resection].

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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.

Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

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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.

Endoscopic endonasal approach for mass resection of the pterygopalatine fossa

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Plzák, Jan; Kratochvil, Vít; Kešner, Adam; Šurda, Pavol; Vlasák, Aleš; Zvěřina, Eduard

2017-01-01

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. PMID:29069259

Cap-assisted endoscopic sclerotherapy for hemorrhoids: Methods, feasibility and efficacy

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Zhang, Ting; Xu, Li-Juan; Xiang, Jie; He, Zhi; Peng, Zhao-Yuan; Huang, Guang-Ming; Ji, Guo-Zhong; Zhang, Fa-Ming

2015-01-01

AIM: To evaluate the methodology, feasibility, safety and efficacy of a novel method called cap-assisted endoscopic sclerotherapy (CAES) for internal hemorrhoids. METHODS: A pilot study on CAES for grade I to III internal hemorrhoids was performed. Colon and terminal ileum examination by colonoscopy was performed for all patients before starting CAES. Polypectomy and excision of anal papilla fibroma were performed if polyps or anal papilla fibroma were found and assessed to be suitable for resection under endoscopy. CAES was performed based on the requirement of the cap, endoscope, disposable endoscopic long injection needle, enough insufflated air and sclerosing agent. RESULTS: A total of 30 patients with grade I to III internal hemorrhoids was included. The follow-up was more than four weeks. No bleeding was observed after CAES. One (3.33%) patient claimed mild tenesmus within four days after CAES in that an endoscopist performed this procedure for the first time. One hundred percent of patients were satisfied with this novel procedure, especially for those patients who underwent CAES in conjunction with polypectomy or excision of anal papilla fibroma. CONCLUSION: CAES as a novel endoscopic sclerotherapy should be a convenient, safe and effective flexible endoscopic therapy for internal hemorrhoids. PMID:26722615

Endoscopic management of pancreatic pseudocysts at atypical locations.

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Bhasin, Deepak Kumar; Rana, Surinder Singh; Nanda, Mohit; Chandail, Vijant Singh; Masoodi, Ibrahim; Kang, Mandeep; Kalra, Navin; Sinha, Saroj Kant; Nagi, Birinder; Singh, Kartar

2010-05-01

There is paucity of data on endoscopic management of pseudocysts at atypical locations. We evaluated the efficacy of endoscopic transpapillary nasopancreatic drain (NPD) placement in the management of pseudocysts of pancreas at atypical locations. Eleven patients with pseudocysts at atypical locations were treated with attempted endoscopic transpapillary nasopancreatic drainage. On endoscopic retrograde pancreatography (ERP), a 5-F NPD was placed across/near the site of duct disruption. Three patients each had mediastinal, intrahepatic, and intra/perisplenic pseudocysts and one patient each had renal and pelvic pseudocyst. Nine patients had chronic pancreatitis whereas two patients had acute pancreatitis. The size of the pseudocysts ranged from 2 to 15 cm. On ERP, the site of ductal disruption was in the body of pancreas in five patients (45.4%), and tail of pancreas in six patients (54.6%). All the patients had partial disruption of pancreatic duct. The NPD was successfully placed across the disruption in 10 of the 11 patients (90.9%) and pseudocysts resolved in 4-8 weeks. One of the patients developed fever, 5 days after the procedure, which was successfully treated by intravenous antibiotics. In another patient, NPD became blocked 12 days after the procedure and was successfully opened by aspiration. The NPD slipped out in one of the patient with splenic pseudocyst and was replaced with a stent. There was no recurrence of symptoms or pseudocysts during follow-up of 3-70 months. Pancreatic pseudocysts at atypical locations with ductal communication and partial ductal disruption that is bridged by NPD can also be effectively treated with endoscopic transpapillary NPD placement.

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

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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.

Evaluaion of Contammation of Upper Gi Endoscopes with Common Nosocomial Agents in a Hospital of Hamadan

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M Hajilooi

2005-01-01

Full Text Available Introduction: Fiberoptic techniques have been used for diagnosis and also for treatment of gastrointestinal disorders very largely. Infection is a complication of endoscopy and fiberoptic endoscopy may serve as vehicle for transmission of infection. Methods: Before doing gastroscopy, all parts of the endoscope were disinfected (as normally done in the ward. Then, samples for culture were taken from the device and at the end of the procedure, again samples from all parts of gastroscope (outer surface, internal canal, water – air pump were taken and cultured in Blood agar and E.M.B media. Microbiology species and colony count as standard protocol were identified and reported. Results: 954 Samples were prepared before and after upper gastrointestinal endoscopy. In samples from outer surface of the device before procedure, culture was negative in 90.6% and positive in 9.4% (15 cases, while in samples from the same region after endoscopy, culture was negative in 32.7% and positive in 67.3%. Staphylococcus epidermis was the most common organism. Before endoscopy, sampling and culture from internal canal of device was reported as 88.7% negative culture and 11.3% positive culture with pseudomonas aeruginosa being the most common organism. After endoscopy, internal canal culture was 52.7% negative and 47.2% positive culture. Staphylococcus epidermidis was the most common organism. Air – water Canal samples before endoscopy were 51.6% negative and 48.4% positive. Non fermented gram negative bacilli were the most common organisms. After endoscopy, these samples were 22% negative and 78% positive. Non- fermented gram negative bacilli were the most common organisms. Conclusion: The microbial contamination of the air-water canal (78% and outer surface of the device (67.3% after endoscopy was due to inadequate cleaning and disinfection after completion of procedures.

Endoscopic full-thickness resection: Current status.

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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.

Mobile fiber-optic sensor for detection of oral and cervical cancer in the developing world.

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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.

Endoscopic biliary sphincterotomy : results, complications and contra-indications

NARCIS (Netherlands)

J. Boender (Johannes)

1995-01-01

textabstractIn 1986 the departments of Radiology and Internal Medicine II/Gastroenterology initiated a prospective study of therapeutic endoscopic retrograde cholangiopancreatography (TERCP). The project was designed to obtain information which could be used to evaluate immediate and medium-term

Comparative cost-efficiency of the EVOTECH endoscope cleaner and reprocessor versus manual cleaning plus automated endoscope reprocessing in a real-world Canadian hospital endoscopy setting

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Shum Cynthia

2011-10-01

Full Text Available Abstract Background Reprocessing of endoscopes generally requires labour-intensive manual cleaning followed by high-level disinfection in an automated endoscope reprocessor (AER. EVOTECH Endoscope Cleaner and Reprocessor (ECR is approved for fully automated cleaning and disinfection whereas AERs require manual cleaning prior to the high-level disinfection procedure. The purpose of this economic evaluation was to determine the cost-efficiency of the ECR versus AER methods of endoscopy reprocessing in an actual practice setting. Methods A time and motion study was conducted at a Canadian hospital to collect data on the personnel resources and consumable supplies costs associated with the use of EVOTECH ECR versus manual cleaning followed by AER with Medivators DSD-201. Reprocessing of all endoscopes was observed and timed for both reprocessor types over three days. Laboratory staff members were interviewed regarding the consumption and cost of all disposable supplies and equipment. Exact Wilcoxon rank sum test was used for assessing differences in total cycle reprocessing time. Results Endoscope reprocessing was significantly shorter with the ECR than with manual cleaning followed by AER. The differences in median time were 12.46 minutes per colonoscope (p Conclusions The EVOTECH ECR was more efficient and less costly to use for the reprocessing of endoscopes than manual cleaning followed by AER disinfection. Although the cost of consumable supplies required to reprocess endoscopes with EVOTECH ECR was slightly higher, the value of the labour time saved with EVOTECH ECR more than offset the additional consumables cost. The increased efficiency with EVOTECH ECR could lead to even further cost-savings by shifting endoscopy laboratory personnel responsibilities but further study is required.

Novel methods for endoscopic training.

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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.

Predictors for the need for endoscopic therapy in patients with presumed acute upper gastrointestinal bleeding.

Science.gov (United States)

Kim, Su Sun; Kim, Kyung Up; Kim, Sung Jun; Seo, Seung In; Kim, Hyoung Su; Jang, Myoung Kuk; Kim, Hak Yang; Shin, Woon Geon

2017-12-15

Selecting patients with an urgent need for endoscopic hemostasis is difficult based only on simple parameters of presumed acute upper gastrointestinal bleeding. This study assessed easily applicable factors to predict cases in need of urgent endoscopic hemostasis due to acute upper gastrointestinal bleeding. The consecutively included patients were divided into the endoscopic hemostasis and nonendoscopic hemostasis groups. We reviewed the enrolled patients' medical records and analyzed various variables and parameters for acute upper gastrointestinal bleeding outcomes such as demographic factors, comorbidities, symptoms, signs, laboratory findings, rebleeding rate, and mortality to evaluate simple predictive factors for endoscopic treatment. A total of 613 patients were analyzed, including 329 patients in the endoscopic hemostasis and 284 patients in the non-endoscopic hemostasis groups. In the multivariate analysis, a bloody nasogastric lavage (adjusted odds ratio [AOR], 6.786; 95% confidence interval [CI], 3.990 to 11.543; p upper gastrointestinal bleeding.

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

Energy Technology Data Exchange (ETDEWEB)

Ferretti, G.R.; Kocier, M.; Calaque, O.; Coulomb, M. [Service Central de Radiologie et Imagerie Medicale, INSERM EMI 9924, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Arbib, F.; Pison, C. [Departement de Medecine Aigue Specialisee (DMAS), CHU Grenoble, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Righini, C. [Service d' Oto Rhino Laryngologie, CHU Grenoble, BP 217, 38043, Grenoble Cedex 9 (France)

2003-05-01

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

International Nuclear Information System (INIS)

Ferretti, G.R.; Kocier, M.; Calaque, O.; Coulomb, M.; Arbib, F.; Pison, C.; Righini, C.

2003-01-01

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

Fabrication and optimization of a fiber-optic radiation sensor for proton beam dosimetry

International Nuclear Information System (INIS)

Jang, K.W.; Yoo, W.J.; Seo, J.K.; Heo, J.Y.; Moon, J.; Park, J.-Y.; Hwang, E.J.; Shin, D.; Park, S.-Y.; Cho, H.-S.; Lee, B.

2011-01-01

In this study, we fabricated a fiber-optic radiation sensor for proton therapy dosimetry and measured the output and the peak-to-plateau ratio of scintillation light with various kinds of organic scintillators in order to select an organic scintillator appropriate for measuring the dose of a proton beam. For the optimization of an organic scintillator, the linearity between the light output and the stopping power of a proton beam was evaluated for two different diameters of the scintillator, and the angular dependency and standard deviation of the light pulses were investigated for four different scintillator lengths. We also evaluated the linearity between the light output and the dose rate and monitor units of a proton generator, respectively. The relative depth-dose curve of the proton beam was obtained and corrected using Birk's theory.

Endoscopic endonasal transsphenoidal surgery: implementation of an operative and perioperative checklist.

Science.gov (United States)

Christian, Eisha; Harris, Brianna; Wrobel, Bozena; Zada, Gabriel

2014-01-01

Endoscopic endonasal surgery relies heavily on specialized operative instrumentation and optimization of endocrinological and other critical adjunctive intraoperative factors. Several studies and worldwide initiatives have previously established that intraoperative and perioperative surgical checklists can minimize the incidence of and prevent adverse events. The aim of this article was to outline some of the most common considerations in the perioperative and intraoperative preparation for endoscopic endonasal transsphenoidal surgery. The authors implemented and prospectively evaluated a customized checklist at their institution in 25 endoscopic endonasal operations for a variety of sellar and skull base pathological entities. Although no major errors were detected, near misses pertaining primarily to missing components of surgical equipment or instruments were identified in 9 cases (36%). The considerations in the checklist provided in this article can serve as a basic template for further customization by centers performing endoscopic endonasal surgery, where their application may reduce the incidence of adverse or preventable errors associated with surgical treatment of sellar and skull base lesions.

Fiber-Optic Magnetic-Field-Strength Measurement System for Lightning Detection

Science.gov (United States)

Gurecki, Jay; Scully, Robert; Davis, Allen; Kirkendall, Clay; Bucholtz, Frank

2011-01-01

A fiber-optic sensor system is designed to measure magnetic fields associated with a lightning stroke. Field vector magnitudes are detected and processed for multiple locations. Since physical limitations prevent the sensor elements from being located in close proximity to highly conductive materials such as aluminum, the copper wire sensor elements (3) are located inside a 4-cubic-in. (.66-cubic-cm) plastic housing sensor head and connected to a fiber-optic conversion module by shielded cabling, which is limited to the shortest length feasible. The signal path between the conversion module and the avionics unit which processes the signals are fiber optic, providing enhanced immunity from electromagnetic radiation incident in the vicinity of the measurements. The sensors are passive, lightweight, and much smaller than commercial B-dot sensors in the configuration which measures a three-dimensional magnetic field. The system is expandable, and provides a standard-format output signal for downstream processing. Inside of the sensor head, three small search coils, each having a few turns on a circular form, are mounted orthogonally inside the non-metallic housing. The fiber-optic conversion module comprises three interferometers, one for each search coil. Each interferometer has a high bandwidth optical phase modulator that impresses the signal received from its search coil onto its output. The output of each interferometer travels by fiber optic cable to the avionics unit, and the search coil signal is recovered by an optical phase demodulator. The output of each demodulator is fed to an analog-to-digital converter, whose sampling rate is determined by the maximum expected rate of rise and peak signal magnitude. The output of the digital processor is a faithful reproduction of the coil response to the incident magnetic field. This information is provided in a standard output format on a 50-ohm port that can be connected to any number of data collection and processing

Endoscopic medial maxillectomy breaking new frontiers.

Science.gov (United States)

Mohanty, Sanjeev; Gopinath, M

2013-07-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management of benign sino-nasal tumours. We present our experience of endoscopic medial maxillectomy in the management of sinonasal pathologies.

Videolaryngoscopy versus Fiber-optic Intubation through a Supraglottic Airway in Children with a Difficult Airway: An Analysis from the Multicenter Pediatric Difficult Intubation Registry.

Science.gov (United States)

Burjek, Nicholas E; Nishisaki, Akira; Fiadjoe, John E; Adams, H Daniel; Peeples, Kenneth N; Raman, Vidya T; Olomu, Patrick N; Kovatsis, Pete G; Jagannathan, Narasimhan; Hunyady, Agnes; Bosenberg, Adrian; Tham, See; Low, Daniel; Hopkins, Paul; Glover, Chris; Olutoye, Olutoyin; Szmuk, Peter; McCloskey, John; Dalesio, Nicholas; Koka, Rahul; Greenberg, Robert; Watkins, Scott; Patel, Vikram; Reynolds, Paul; Matuszczak, Maria; Jain, Ranu; Khalil, Samia; Polaner, David; Zieg, Jennifer; Szolnoki, Judit; Sathyamoorthy, Kumar; Taicher, Brad; Riveros Perez, N Ricardo; Bhattacharya, Solmaletha; Bhalla, Tarun; Stricker, Paul; Lockman, Justin; Galvez, Jorge; Rehman, Mohamed; Von Ungern-Sternberg, Britta; Sommerfield, David; Soneru, Codruta; Chiao, Franklin; Richtsfeld, Martina; Belani, Kumar; Sarmiento, Lina; Mireles, Sam; Bilen Rosas, Guelay; Park, Raymond; Peyton, James

2017-09-01

The success rates and related complications of various techniques for intubation in children with difficult airways remain unknown. The primary aim of this study is to compare the success rates of fiber-optic intubation via supraglottic airway to videolaryngoscopy in children with difficult airways. Our secondary aim is to compare the complication rates of these techniques. Observational data were collected from 14 sites after management of difficult pediatric airways. Patient age, intubation technique, success per attempt, use of continuous ventilation, and complications were recorded for each case. First-attempt success and complications were compared in subjects managed with fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway and videolaryngoscopy had similar first-attempt success rates (67 of 114, 59% vs. 404 of 786, 51%; odds ratio 1.35; 95% CI, 0.91 to 2.00; P = 0.16). In subjects less than 1 yr old, fiber-optic intubation via supraglottic airway was more successful on the first attempt than videolaryngoscopy (19 of 35, 54% vs. 79 of 220, 36%; odds ratio, 2.12; 95% CI, 1.04 to 4.31; P = 0.042). Complication rates were similar in the two groups (20 vs. 13%; P = 0.096). The incidence of hypoxemia was lower when continuous ventilation through the supraglottic airway was used throughout the fiber-optic intubation attempt. In this nonrandomized study, first-attempt success rates were similar for fiber-optic intubation via supraglottic airway and videolaryngoscopy. Fiber-optic intubation via supraglottic airway is associated with higher first-attempt success than videolaryngoscopy in infants with difficult airways. Continuous ventilation through the supraglottic airway during fiber-optic intubation attempts may lower the incidence of hypoxemia.

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.

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)

Endoscopic Retrograde Cholangiopancreatography Using a Dual-Lumen Endogastroscope for Patients with Billroth II Gastrectomy

Directory of Open Access Journals (Sweden)

Wei Yao

2013-01-01

Full Text Available Objective. To evaluate the safety and efficacy of a dual-lumen forward-viewing endoscope for ERCP in patients with prior Billroth II gastrectomy. Methods. The records of 46 patients treated with ERCP by a dual-lumen forward-viewing endoscope after Billroth II gastrectomy from 2007 to 2012 were reviewed. Results. The success rate of selective cannulation was 82.6% (38/46. Of the 38 cases with successful selective cannulation, endoscopic sphincterotomy was achieved in 23 cases by placing the needle knife through the 2nd lumen, while endoscopic papillary balloon dilatation was conducted in the other 15 cases. Of the 8 failed cases of selective cannulation, 6 had failed afferent loop intubation, and 3 of these 6 patients had Braun’s anastomosis. The safety and efficacy of catheter-assisted endoscopic sphincterotomy were increased by placing the needle knife through the 2nd lumen without altering the conventional endoscopic sphincterotomy procedure. Conclusions. A dual-lumen forward-viewing endoscope can be safely and effectively used to perform ERCP in patients with a Billroth II gastrectomy, except for patients with additional Braun’s anastomosis.

Per-oral endoscopic myotomy: Major advance in achalasia treatment and in endoscopic surgery

Science.gov (United States)

Friedel, David; Modayil, Rani; Stavropoulos, Stavros N

2014-01-01

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. PMID:25548473

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.

Partially reduced graphene oxide based FRET on fiber-optic interferometer for biochemical detection.

Science.gov (United States)

Yao, B C; Wu, Y; Yu, C B; He, J R; Rao, Y J; Gong, Y; Fu, F; Chen, Y F; Li, Y R

2016-03-24

Fluorescent resonance energy transfer (FRET) with naturally exceptional selectivity is a powerful technique and widely used in chemical and biomedical analysis. However, it is still challenging for conventional FRET to perform as a high sensitivity compact sensor. Here we propose a novel 'FRET on Fiber' concept, in which a partially reduced graphene oxide (prGO) film is deposited on a fiber-optic modal interferometer, acting as both the fluorescent quencher for the FRET and the sensitive cladding for optical phase measurement due to refractive index changes in biochemical detection. The target analytes induced fluorescence recovery with good selectivity and optical phase shift with high sensitivity are measured simultaneously. The functionalized prGO film coated on the fiber-optic interferometer shows high sensitivities for the detections of metal ion, dopamine and single-stranded DNA (ssDNA), with detection limits of 1.2 nM, 1.3 μM and 1 pM, respectively. Such a prGO based 'FRET on fiber' configuration, bridging the FRET and the fiber-optic sensing technology, may serve as a platform for the realization of series of integrated 'FRET on Fiber' sensors for on-line environmental, chemical, and biomedical detection, with excellent compactness, high sensitivity, good selectivity and fast response.

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...

Dysphagia in the Elderly

Science.gov (United States)

Aslam, Muhammad

2013-01-01

Elderly patients are inherently predisposed to dysphagia predominately because of comorbid health conditions. With the aging of the population in the United States, along with the increased prevalence of obesity and gastroesophageal reflux disease, healthcare providers will increasingly encounter older patients with either oropharyngeal or esophageal disease and complaints of dysphagia. Useful tests to evaluate dysphagia include the videofluoroscopic swallowing study and the fiberoptic endoscopic evaluation of swallowing. Swallow rehabilitation is useful to help patients compensate for swallowing difficulty and ultimately help strengthen the neuromusculature involved in swallowing. PMID:24772045

Current Status of Peroral Endoscopic Myotomy

Science.gov (United States)

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders. PMID:29397656

Current Status of Peroral Endoscopic Myotomy.

Science.gov (United States)

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

Current Status of Peroral Endoscopic Myotomy

Directory of Open Access Journals (Sweden)

Young Kwan Cho

2018-01-01

Full Text Available Peroral endoscopic myotomy (POEM has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic Heller myotomy, and hypertensive motor disorders such as diffuse esophageal spasm, jackhammer esophagus. Contraindications include prior radiation therapy to the esophagus and prior extensive esophageal mucosal resection/ablation involving the POEM field. Most of the complications are minor and self-limited and can be managed conservatively. As POEM emerged as the main treatment for achalasia, various adaptations to tunnel endoscopic surgery have been attempted. Tunnel endoscopic surgery includes POEM, peroral endoscopic tumor resection, gastric peroral endoscopic pyloromyotomy. POEM has been widely accepted as a treatment for all types of achalasia, even for specific cases such as achalasia with failed prior treatments, and hypertensive motor disorders.

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.

Gastric schwannomas: radiological features with endoscopic and pathological correlation

International Nuclear Information System (INIS)

Hong, H.S.; Ha, H.K.; Won, H.J.; Byun, J.H.; Shin, Y.M.; Kim, A.Y.; Kim, P.N.; Lee, M.-G.; Lee, G.H.; Kim, M.J.

2008-01-01

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

Quantitative evaluation of headache severity before and after endoscopic transsphenoidal surgery for pituitary adenoma.

Science.gov (United States)

Wolf, Amparo; Goncalves, Sandy; Salehi, Fateme; Bird, Jeff; Cooper, Paul; Van Uum, Stan; Lee, Donald H; Rotenberg, Brian W; Duggal, Neil

2016-06-01

OBJECT The relationship between headaches, pituitary adenomas, and surgical treatment of pituitary adenomas remains unclear. The authors assessed the severity and predictors of self-reported headaches in patients referred for surgery of pituitary adenomas and evaluated the impact of endoscopic transsphenoidal surgery on headache severity and quality of life (QOL). METHODS In this prospective study, 79 patients with pituitary adenomas underwent endoscopic transsphenoidal resection and completed the Headache Impact Test (HIT-6) and the 36-Item Short Form Health Survey (SF-36) QOL questionnaire preoperatively and at 6 weeks and 6 months postoperatively. RESULTS Preoperatively, 49.4% of patients had mild headache severity, 13.9% had moderate severity, 13.9% had substantial severity, and 22.8% had intense severity. Younger age and hormone-producing tumors predisposed greater headache severity, while tumor volume, suprasellar extension, chiasmal compression, and cavernous sinus invasion of the pituitary tumors did not. Preoperative headache severity was found to be significantly associated with reduced scores across all SF-36 QOL dimensions and most significantly associated with mental health. By 6 months postoperatively, headache severity was reduced in a significant proportion of patients. Of the 40 patients with headaches causing an impact on daily living (moderate, substantial, or intense headache), 70% had improvement of at least 1 category on HIT-6 by 6 months postoperatively, while headache worsened in 7.6% of patients. The best predictors of headache response to surgery included younger age, poor preoperative SF-36 mental health score, and hormone-producing microadenoma. CONCLUSIONS The results of this study confirm that surgery can significantly improve headaches in patients with pituitary adenomas by 6 months postoperatively, particularly in younger patients whose preoperative QOL is impacted. A larger multicenter study is underway to evaluate the long

Development and Testing of a Post-Installable Deepwater Monitoring System Using Fiber-Optic Sensors

Science.gov (United States)

Seaman, Calvin H.; Brower, David V.; Le, Suy Q.; Tang, Henry H.

2015-01-01

This paper addresses the design and development of a fiber-optic monitoring system that can be deployed on existing deepwater risers and flowlines; and provides a summary of test article fabrication and the subsequent laboratory testing performed at the National Aeronautics and Space Administration-Johnson Space Center (NASA-JSC). A major challenge of a post-installed instrumentation system is to ensure adequate coupling between the instruments and the riser or flowline of interest. This work investigates the sensor coupling for pipelines that are suspended in a water column (from topside platform to seabed) using a fiber-optic sensor clamp and subsea bonding adhesive. The study involved the design, fabrication, and test of several prototype clamps that contained fiber-optic sensors. A mold was produced by NASA using 3-D printing methods that allowed the casting of polyurethane clamp test articles to accommodate 4-inch and 8-inch diameter pipes. The prototype clamps were installed with a subsea adhesive in a "wet" environment and then tested in the NASA Structures Test Laboratory (STL). The tension, compression, and bending test data showed that the prototype sensor clamps achieved good structural coupling, and could provide high quality strain measurement for active monitoring.

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.

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...

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

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.

Theoretical Analysis of the Optical Propagation Characteristics in a Fiber-Optic Surface Plasmon Resonance Sensor

Directory of Open Access Journals (Sweden)

Xiaolin Zheng

2013-06-01

Full Text Available Surface plasmon resonance (SPR sensor is widely used for its high precision and real-time analysis. Fiber-optic SPR sensor is easy for miniaturization, so it is commonly used in the development of portable detection equipment. It can also be used for remote, real-time, and online detection. In this study, a wavelength modulation fiber-optic SPR sensor is designed, and theoretical analysis of optical propagation in the optical fiber is also done. Compared with existing methods, both the transmission of a skew ray and the influence of the chromatic dispersion are discussed. The resonance wavelength is calculated at two different cases, in which the chromatic dispersion in the fiber core is considered. According to the simulation results, a novel multi-channel fiber-optic SPR sensor is likewise designed to avoid defaults aroused by the complicated computation of the skew ray as well as the chromatic dispersion. Avoiding the impact of skew ray can do much to improve the precision of this kind of sensor.

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)

Risk Factors for Perioperative Complications in Endoscopic Surgery with Irrigation

Directory of Open Access Journals (Sweden)

João Manoel Silva, Jr.

2013-07-01

Full Text Available Background and objectives: Currently, endoscopic medicine is being increasingly used, albeit not without risks. Therefore, this study evaluated the factors associated with perioperative complications in endoscopic surgery with intraoperative irrigation. Method: A cohort study of six months duration. Patients aged ≥ 18 years undergoing endoscopic surgery with the use of irrigation fluids during the intraoperative period were included. Exclusion criteria were: use of diuretics, kidney failure, cognitive impairment, hyponatremia prior to surgery, pregnancy, and critically ill. The patients who presented with or without complications during the perioperative period were allocated into two groups. Complications evaluated were related to neurological, cardiovascular and renal changes, and perioperative bleeding. Results: In total, 181 patients were enrolled and 39 excluded; therefore, 142 patients met the study criteria. Patients with complications amounted to 21.8%, with higher prevalence in endoscopic prostate surgery, followed by hysteroscopy, bladder, knee, and shoulder arthroscopy (58.1%, 36.9%, 19.4%, 3.8%, 3.2% respectively. When comparing both groups, we found association with complications in univariate analysis: age, sex, smoking, heart disease, ASA, serum sodium at the end of surgery, total irrigation fluid administered, TURP, and hysteroscopy. However, in multiple regression analysis for complications, only age (OR = 1.048, serum sodium (OR = 0.962, and volume of irrigation fluid administered during surgery (OR = 1.001 were independent variables. Keywords: Anesthesia, Endoscopy, Hyponatremia, Postoperative Complications, Risk Assessment, Risk Factors.

21 CFR 884.4100 - Endoscopic electrocautery and accessories.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endoscopic electrocautery and accessories. 884... Surgical Devices § 884.4100 Endoscopic electrocautery and accessories. (a) Identification. An endoscopic electrocautery is a device used to perform female sterilization under endoscopic observation. It is designed to...

Passive (self-powered) fiber-optic sensors

International Nuclear Information System (INIS)

McElhaney, S.A.; Falter, D.D.; Todd, R.A.; Simpson, M.L.; Mihalczo, J.T.

1992-01-01

ORNL is developing new group of fiber-optic sensors for characterizing physical aspects such as ambient temperature. These sensors exploit the inherent property of thermographic materials that the lifetime and/or intensity of the emitted fluorescence decreases with increasing temperature. Unlike current fluorescent temperature sensors that use a light source for excitation, these sensors are totally passive (self-powered) and use either an embedded or external radiation source. A proof-of-principle temperature sensor was developed, based on this concept, using a well-known thermographic material, magnesium fluorogermanate. Experimental results showed that the radiation-induced fluorescence resulted in an intensity change but no significant decay rate change with increasing temperature

Engineering aspects of a fully mirrored endoscope

International Nuclear Information System (INIS)

Terra, A.; Huber, A.; Schweer, B.; Mertens, Ph.; Arnoux, G.; Balshaw, N.; Brezinsek, S.; Egner, S.; Hartl, M.; Kampf, D.; Klammer, J.; Lambertz, H.T.; Morlock, C.; Murari, A.; Reindl, M.; Sanders, S.; Sergienko, G.; Spencer, G.

2013-01-01

Highlights: ► Replacement of JET diagnostics to match the new ITER-like Wall. ► The endoscope test ITER-like design with only mirror based optics. ► Withstanding and diagnostic capability during Plasma operation and disruptions. ► Engineering process from design to installation and procurement. -- Abstract: The development of optical diagnostics, like endoscopes, compatible with the ITER environment (metallic plasma facing components, neutron proof optics, etc.) is a challenge, but current tokamaks such as JET provide opportunities to test fully working concepts. This paper describes the engineering aspects of a fully mirrored endoscope that has recently been designed, procured and installed on JET. The system must operate in a very strict environment with high temperature, high magnetic fields up to B = 4 T and rapid field variations (∂B/∂t ∼ 100 T/s) that induce high stresses due to eddy currents in the front mirror assembly. It must be designed to withstand high mechanical loads especially during disruptions, which lead to acceleration of about 7 g at 14 Hz. For the JET endoscope, when the plasma thermal loading, direct and indirect, was added to the assumed disruption loads, the reserve factor, defined as a ratio of yield strength over summed up von Mises stresses, was close to 1 for the mirror components. To ensure reliable operation, several analyses were performed to evaluate the thermo-mechanical performance of the endoscope and a final validation was obtained from mechanical and thermal tests, before the system's final installation in May 2011. During the tests, stability of the field of view angle variation was kept below 1° despite the high thermal gradient on endoscope head (∂T/∂x ∼ 500 K/m). In parallel, to ensure long time operation and to prevent undesirable performance degradation, a shutter system was also implemented in order to reduce impurity deposition on in-vessel mirrors but also to allow in situ transmission calibration

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,...

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)

Fiber-optic pH sensor for in-situ applications

International Nuclear Information System (INIS)

Michels, M.H.; Dureault, B.

1992-01-01

An evaluation of the feasibility of a fiber-optic pH sensor was carried out. The pH sensor is composed of an optode connected to the transmitter-receiver apparatus (Optolec H) through a 100 m-long fiber. Three diodes of carefully chosen wavelengths are located in the Optolec H and emit through a bundle of nine fibers to the end of the optode where the oncoming light is reflected on an immobilized pH-indicator-based spherical bead of resin and sent back for analysis to the Optolec H through a central fiber. The influence of ionic strength as well as precision, response time, and lifetime have been determined. This device is to be used for routine in-situ measurements in an underground laboratory devoted to studies in connection with nuclear waste repositories where harsh conditions are encountered for direct collection of waters and traditional post-determination with a pH-meter

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....

Endoscopic management of hilar biliary strictures

Science.gov (United States)

Singh, Rajiv Ranjan; Singh, Virendra

2015-01-01

Hilar biliary strictures are caused by various benign and malignant conditions. It is difficult to differentiate benign and malignant strictures. Postcholecystectomy benign biliary strictures are frequently encountered. Endoscopic management of these strictures is challenging. An endoscopic method has been advocated that involves placement of increasing number of stents at regular intervals to resolve the stricture. Malignant hilar strictures are mostly unresectable at the time of diagnosis and only palliation is possible.Endoscopic palliation is preferred over surgery or radiological intervention. Magnetic resonance cholangiopancreaticography is quite important in the management of these strictures. Metal stents are superior to plastic stents. The opinion is divided over the issue of unilateral or bilateral stenting.Minimal contrast or no contrast technique has been advocated during endoscopic retrograde cholangiopancreatography of these patients. The role of intraluminal brachytherapy, intraductal ablation devices, photodynamic therapy, and endoscopic ultrasound still remains to be defined. PMID:26191345

Endoscopes with latest technology and concept.

Science.gov (United States)

Gotoh

2003-09-01

Endoscopic imaging systems that perform as the "eye" of the operator during endoscopic surgical procedures have developed rapidly due to various technological developments. In addition, since the most recent turn of the century robotic surgery has increased its scope through the utilization of systems such as Intuitive Surgical's da Vinci System. To optimize the imaging required for precise robotic surgery, a unique endoscope has been developed, consisting of both a two dimensional (2D) image optical system for wider observation of the entire surgical field, and a three dimensional (3D) image optical system for observation of the more precise details at the operative site. Additionally, a "near infrared radiation" endoscopic system is under development to detect the sentinel lymph node more readily. Such progress in the area of endoscopic imaging is expected to enhance the surgical procedure from both the patient's and the surgeon's point of view.

Highly sensitive fiber-optic oxygen sensor based on palladium tetrakis (4-carboxyphenyl)porphyrin doped in ormosil

International Nuclear Information System (INIS)

Chu, Cheng-Shane; Chuang, Chih-Yung

2014-01-01

A simple, low-cost technique for fabrication of highly sensitive fiber-optic oxygen sensor is described. An organically modified silicate (ORMOSIL) as a matrix for the fabrication of oxygen sensing film was produced. The technique is based on coating the end of a plastic optical fiber with ormosil composite xerogel film sequestered with luminophore palladium (II) meso-tetra(4-carboxyphenyl)porphyrin (PdTCPP) prepared by a sol–gel process. The composite xerogel studied is tetraethylorthosilane (TEOS)/n-octyltriethoxysilane (Octyl-triEOS). Result shows that, expect for PdTCPP-doped TEOS/Octyl-triEOS composite xerogel show the high sensitivity and linear Stern–Volmer relationship which indicate the homogenous environment of the luminophore. The sensitivity of the optical oxygen sensor is quantified in terms of the ratio I N2 /I O2 , where I N2 and I O2 represent the detected fluorescence intensities in pure nitrogen and pure oxygen environments, respectively. The experimental result reveals that the PdTCPP-doped TEOS/Octyl-triEOS oxygen sensor has sensitivity of 153. - Highlights: • A simple, low-cost technique for fabrication of highly sensitive fiber-optic oxygen sensor is described. • ORMOSIL was produced to serve as a matrix for the fabrication of oxygen sensing film. • The fiber-optic oxygen sensor has sensitivity of I N2 /I 100O2 =153. • The stable and reproducible signals were obtained with the fiber-optic oxygen sensor

[Surveillance cultures after high-level disinfection of flexible endoscopes in a general hospital].

Science.gov (United States)

Robles, Christian; Turín, Christie; Villar, Alicia; Huerta-Mercado, Jorge; Samalvides, Frine

2014-04-01

Flexible endoscopes are instruments with a complex structure which are used in invasive gastroenterological procedures, therefore high-level disinfection (HLD) is recommended as an appropriate reprocessing method. However, most hospitals do not perform a quality control to assess the compliance and results of the disinfection process. To evaluate the effectiveness of the flexible endoscopes’ decontamination after high-level disinfection by surveillance cultures and to assess the compliance with the reprocessing guidelines. Descriptive study conducted in January 2013 in the Gastroenterological Unit of a tertiary hospital. 30 endoscopic procedures were randomly selected. Compliance with guidelines was evaluated and surveillance cultures for common bacteria were performed after the disinfection process. On the observational assessment, compliance with the guidelines was as follows: pre-cleaning 9 (30%), cleaning 5 (16.7%), rinse 3 (10%), first drying 30 (100%), disinfection 30 (100%), final rinse 0 (0%) and final drying 30 (100%), demonstrating that only 3 of 7 stages of the disinfection process were optimally performed. In the microbiological evaluation, 2 (6.7%) of the 30 procedures had a positive culture obtained from the surface of the endoscope. Furthermore, 1 (4.2%) of the 24 biopsy forcepsgave a positive culture. The organisms isolated were different Pseudomonas species. High-level disinfection procedures were not optimally performed, finding in 6.7% positive cultures of Pseudomonas species.

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.

Locoregional mitomycin C injection for esophageal stricture after endoscopic submucosal dissection.

Science.gov (United States)

Machida, H; Tominaga, K; Minamino, H; Sugimori, S; Okazaki, H; Yamagami, H; Tanigawa, T; Watanabe, K; Watanabe, T; Fujiwara, Y; Arakawa, T

2012-06-01

This prospective study aimed to evaluate the feasibility and safety of locoregional mitomycin C (MMC) injection to treat refractory esophageal strictures after endoscopic submucosal dissection (ESD) for superficial esophageal carcinoma. Patients with dysphagia and strictures that were refractory to repeated endoscopic balloon dilation (EBD) were eligible. After EBD, MMC was injected into the dilated site. Between June 2009 and August 2010, five patients were recruited. The treatment was performed once in two patients and twice in three patients with recurrent dysphagia or restenosis. In all patients, passing a standard endoscope through the site was easy and the dysphagia grade improved (grade 3→1 in 3 patients, grade 4→2 in 2 patients). No serious complications were noted. During the observation period of 4.8 months, neither recurrent dysphagia nor re-stricture appeared in any of the patients. The combination of locoregional MMC injections and EBD is feasible and safe for the treatment of esophageal strictures after ESD.Recently, endoscopic submucosal dissection (ESD) has been developed and accepted as a new endoscopic treatment for gastrointestinal tumors. ESD is a promising treatment for superficial esophageal carcinoma (SEC), and it has a reliable en bloc resection rate. However, the application of ESD for widespread lesions is challenging because of the high risk of the development of severe strictures, which lead to a low quality of life after ESD. Although endoscopic balloon dilation (EBD) is effective for benign strictures, it needs to be performed frequently until the dysphagia disappears 1. Mitomycin C (MMC), which is a chemotherapeutic agent derived from some Streptomyces species 2, reduces scar formation when topically applied to a surgical lesion. MMC has been applied to treat strictures in a variety of anatomical locations, including a variety of organs 3. The aim of this study was to prospectively evaluate both the feasibility and the safety of

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

Long-term results of endoscopic stenting and surgical drainage for biliary stricture due to chronic pancreatitis

NARCIS (Netherlands)

Smits, M. E.; Rauws, E. A.; van Gulik, T. M.; Gouma, D. J.; Tytgat, G. N.; Huibregtse, K.

1996-01-01

A retrospective evaluation was made of the long-term results of endoscopic stenting in 58 patients with benign biliary stricture due to chronic pancreatitis. Immediate relief of jaundice and cholestasis was achieved in all patients after endoscopic stent insertion. Median follow-up was 49 months.

Flexible endoscopic procedure in children with foreign bodies in their upper gastrointestinal system

Directory of Open Access Journals (Sweden)

Kaan Demirören

2014-03-01

Full Text Available Objective: Foreign body ingestion is an important public health problem. We pointed to this subject and aimed to determine the effectiveness of flexible endoscopic procedure in this study. Methods: We evaluated retrospectively fifty children having foreign body in their upper gastrointestinal system, who underwent flexible endoscopic procedure. Results: Of the patients, mean age was 5.5 ± 4 years old (range: 0.5-16 years, 64% was female. Ingested foreign bodies were coin (58%, pin (10%, battery (6%, nail (6%, necklace (6%, safety pin (4% and sewing pin, wire hairclip, ring, button and chicken skin. In endoscopic procedure, foreign bodies were seen in upper esophagus (32%, middle esophagus (26%, lower esophagus (8%, stomach (18%, bulbus (4% and second part of duodenum (8%, but were not seen in 4% of the cases. While 94% of foreign bodies were endoscopically removed, 6% of them were pushed to stomach with gastroscope from esophagus and left for spontaneous passage. Any important complication was developed. Conclusion: Flexible endoscopic procedure is an effective and safe method for removal of gastrointestinal system foreign bodies in children.

Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series.

Science.gov (United States)

Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J

2018-01-01

Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

Fiber-Optic Temperature and Pressure Sensors Applied to Radiofrequency Thermal Ablation in Liver Phantom: Methodology and Experimental Measurements

Directory of Open Access Journals (Sweden)

Daniele Tosi

2015-01-01

Full Text Available Radiofrequency thermal ablation (RFA is a procedure aimed at interventional cancer care and is applied to the treatment of small- and midsize tumors in lung, kidney, liver, and other tissues. RFA generates a selective high-temperature field in the tissue; temperature values and their persistency are directly related to the mortality rate of tumor cells. Temperature measurement in up to 3–5 points, using electrical thermocouples, belongs to the present clinical practice of RFA and is the foundation of a physical model of the ablation process. Fiber-optic sensors allow extending the detection of biophysical parameters to a vast plurality of sensing points, using miniature and noninvasive technologies that do not alter the RFA pattern. This work addresses the methodology for optical measurement of temperature distribution and pressure using four different fiber-optic technologies: fiber Bragg gratings (FBGs, linearly chirped FBGs (LCFBGs, Rayleigh scattering-based distributed temperature system (DTS, and extrinsic Fabry-Perot interferometry (EFPI. For each instrument, methodology for ex vivo sensing, as well as experimental results, is reported, leading to the application of fiber-optic technologies in vivo. The possibility of using a fiber-optic sensor network, in conjunction with a suitable ablation device, can enable smart ablation procedure whereas ablation parameters are dynamically changed.

Conjugation of fiber-coupled wide-band light sources and acousto-optical spectral elements

Science.gov (United States)

Machikhin, Alexander; Batshev, Vladislav; Polschikova, Olga; Khokhlov, Demid; Pozhar, Vitold; Gorevoy, Alexey

2017-12-01

Endoscopic instrumentation is widely used for diagnostics and surgery. The imaging systems, which provide the hyperspectral information of the tissues accessible by endoscopes, are particularly interesting and promising for in vivo photoluminescence diagnostics and therapy of tumour and inflammatory diseases. To add the spectral imaging feature to standard video endoscopes, we propose to implement acousto-optical (AO) filtration of wide-band illumination of incandescent-lamp-based light sources. To collect maximum light and direct it to the fiber-optic light guide inside the endoscopic probe, we have developed and tested the optical system for coupling the light source, the acousto-optical tunable filter (AOTF) and the light guide. The system is compact and compatible with the standard endoscopic components.

Gynaecological Endoscopic Surgical Education and Assessment. A diploma programme in gynaecological endoscopic surgery.

Science.gov (United States)

Campo, Rudi; Wattiez, Arnaud; Tanos, Vasilis; Di Spiezio Sardo, Attilio; Grimbizis, Grigoris; Wallwiener, Diethelm; Brucker, Sara; Puga, Marco; Molinas, Roger; O'Donovan, Peter; Deprest, Jan; Van Belle, Yves; Lissens, Ann; Herrmann, Anja; Tahir, Mahmood; Benedetto, Chiara; Siebert, Igno; Rabischong, Benoit; De Wilde, Rudy Leon

2016-04-01

In recent years, training and education in endoscopic surgery has been critically reviewed. Clinicians, both surgeons as gynaecologist who perform endoscopic surgery without proper training of the specific psychomotor skills are at higher risk to increased patient morbidity and mortality. Although the apprentice-tutor model has long been a successful approach for training of surgeons, recently, clinicians have recognised that endoscopic surgery requires an important training phase outside the operating theatre. The Gynaecological Endoscopic Surgical Education and Assessment programme (GESEA), recognises the necessity of this structured approach and implements two separated stages in its learning strategy. In the first stage, a skill certificate on theoretical knowledge and specific practical psychomotor skills is acquired through a high stake exam; in the second stage, a clinical programme is completed to achieve surgical competence and receive the corresponding diploma. Three diplomas can be awarded: (a) the Bachelor in Endoscopy; (b) the Minimally Invasive Gynaecological Surgeon (MIGS); and (c) the Master level. The Master level is sub-divided into two separate diplomas: the Master in Laparoscopic Pelvic Surgery and the Master in Hysteroscopy. The complexity of modern surgery has increased the demands and challenges to surgical education and the quality control. This programme is based on the best available scientific evidence and it counteracts the problem of the traditional surgical apprentice tutor model. It is seen as a major step toward standardization of endoscopic surgical training in general. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Numerical Investigations on a Distributed Fiber-Optic Lighting System with an End Reflector

International Nuclear Information System (INIS)

Li Shuhua; Gong Huaping; Tu Yumeng; Meng Ying

2011-01-01

A novel distributed fiber-optic decorative lighting system with the reflection coating on the extremity of fiber-optic is designed, which used the multi-mold optical fiber made up of large core diameter(Diameter of core and cladding is 105μm and 125μm, respectly). After introducing the distributional optical fiber decorative lighting system briefly, the ralationship between corrosion depth of the optical fiber core and the leakage of fiber-optic has been analyzed with the Rsoft, and then the relationship of the lighting power and the uniformity of lighting power with the leakage rate of optical fiber lamp, the reflective of reflection coating has been discussed.The simulation analysis shows that, when the core diameter is corroded to 80∼85 μm, the leakage rate of optical fiber may achieve 5.0%, which suits the optical fiber decorative lighting. Considering all kinds of factors, when optical fiber lamp's quantity is 20, the coating index of reflection is 95%, optical fiber lamp's leakage of light rate is 5.0%, and the optical fiber lamp's distance is 1 meter, the quite high illuminating power may be achieved, as well as the good lighting uniformity.Finally the experimental study of decorative lighting system is given. And the experimental result is in keeping well with the theory simulation conclusion.

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

Clinical observation of the treatment for chronic dacryocystitis under lacrimal endoscope

Directory of Open Access Journals (Sweden)

Hong-Ling Lü

2013-08-01

Full Text Available AIM:To evaluate the clinical efficacy of lacrimal dredge under lacrimal endoscope for treating chronic dacryocystitis. METHODS: Sixty patients(64 eyeswith chronic dacryocystitis were examined and treated by lacrimal endoscope combined with full lacrimal intubation. All patients were followed up for 3-6 months postoperatively. RESULTS: Forty-five eyes of 64 eyes were cured, no tears, irrigation of lacrimal passage unobstructed. Thirteen eyes get partly recover, but there were still mild overflow tears, and although lacrimal passages can be flushed, but there were still partly lacrimal duct obstruction. The rest 6 eyes were invalid and still tears, irrigation of lacrimal passage obstructed. The total effective rate was 90.6%. CONCLUSION: The diagnosis and treatment of nasolacrimal duct obstruction under lacrimal endoscope is a safe and effective way.

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

Endoscopic electrocautery dilation of benign anastomotic colonic strictures: a single-center experience.

Science.gov (United States)

Bravi, Ivana; Ravizza, Davide; Fiori, Giancarla; Tamayo, Darina; Trovato, Cristina; De Roberto, Giuseppe; Genco, Chiara; Crosta, Cristiano

2016-01-01

Benign anastomotic colonic stenosis sometimes occur after surgery and usually require surgical or endoscopic dilation. Endoscopic dilation of anastomotic colonic strictures by using balloon or bougie-type dilators has been demonstrated to be safe and effective in multiple uncontrolled series. However, few data are available on safety and efficacy of endoscopic electrocautery dilation. The aim of our study was to retrospectively investigate safety and efficacy of endoscopic electrocautery dilation of postsurgical benign anastomotic colonic strictures. Sixty patients (37 women; median age 63.6 years, range 22.6-81.7) with benign anastomotic colonic or rectal strictures treated with endoscopic electrocautery dilation between June 2001 and February 2013 were included in the study. Anastomotic stricture was defined as a narrowed anastomosis through which a standard colonoscope could not be passed. Only annular anastomotic strictures were considered suitable for electrocautery dilation which consisted of radial incisions performed with a precut sphincterotome. Treatment was considered successful if the colonic anastomosis could be passed by a standard colonoscope immediately after dilation. Recurrence was defined as anastomotic stricture reappearance during follow-up. The time interval between colorectal surgery and the first endoscopic evaluation or symptoms development was 7.3 months (1.3-60.7). Electrocautery dilation was successful in all the patients. There were no procedure-related complications. Median follow-up was 35.5 months (2.0-144.0). Anastomotic stricture recurrence was observed in three patients who were successfully treated with electrocautery dilation and Savary dilation. Endoscopic electrocautery dilation is a safe and effective treatment for annular benign anastomotic postsurgical colonic strictures.

Endoscopic Medial Maxillectomy Breaking New Frontiers

OpenAIRE

Mohanty, Sanjeev; Gopinath, M.

2011-01-01

Endoscopy has changed the perspective of rhinologist towards the nose. It has revolutionised the surgical management of sinonasal disorders. Sinus surgeries were the first to get the benefit of endoscope. Gradually the domain of endoscopic surgery extended to the management of sino nasal tumours. Traditionally medial maxillectomy was performed through lateral rhinotomy or mid facial degloving approach. Endoscopic medial maxillectomy has been advocated by a number of authors in the management ...

INITIAL EXPERIENCE WITH ENDOSCOPIC ULTRASOUND-GUIDED FINE NEEDLE ASPIRATION OF RENAL MASSES: indications, applications and limitations

Directory of Open Access Journals (Sweden)

Renata Nobre MOURA

2014-12-01

Full Text Available Context Tissue sampling of renal masses is traditionally performed via the percutaneous approach or laparoscopicaly. The utility of endoscopic ultrasound to biopsy renal lesions it remains unclear and few cases have been reported. Objectives To evaluate the feasibility and outcome of endoscopic ultrasound fine needle aspiration of renal tumors. Methods Consecutive subjects undergoing attempted endoscopic ultrasound fine needle aspiration of a kidney mass after evaluation with computerized tomography or magnetic resonance. Results Ten procedures were performed in nine male patients (median age 54.7 years on the right (n = 4 and left kidney (n = 4 and bilaterally (n = 1. Kidney masses (median diameter 55 mm ; range 13-160 mm were located in the upper pole (n = 3, the lower pole (n = 2 and the mesorenal region (n = 3. In two cases, the mass involved more than one kidney region. Surgical resection confirmed renal cell carcinoma in six patients in whom pre-operative endoscopic ultrasound fine needle aspiration demonstrated renal cell carcinoma. No complications were reported. Conclusions Endoscopic ultrasound fine needle aspiration appears as a safe and feasible procedure with good results and minimal morbidity.

Full optical model of micro-endoscope with optical coherence microscopy, multiphoton microscopy and visible capabilities

Science.gov (United States)

Vega, David; Kiekens, Kelli C.; Syson, Nikolas C.; Romano, Gabriella; Baker, Tressa; Barton, Jennifer K.

2018-02-01

While Optical Coherence Microscopy (OCM), Multiphoton Microscopy (MPM), and narrowband imaging are powerful imaging techniques that can be used to detect cancer, each imaging technique has limitations when used by itself. Combining them into an endoscope to work in synergy can help achieve high sensitivity and specificity for diagnosis at the point of care. Such complex endoscopes have an elevated risk of failure, and performing proper modelling ensures functionality and minimizes risk. We present full 2D and 3D models of a multimodality optical micro-endoscope to provide real-time detection of carcinomas, called a salpingoscope. The models evaluate the endoscope illumination and light collection capabilities of various modalities. The design features two optical paths with different numerical apertures (NA) through a single lens system with a scanning optical fiber. The dual path is achieved using dichroic coatings embedded in a triplet. A high NA optical path is designed to perform OCM and MPM while a low NA optical path is designed for the visible spectrum to navigate the endoscope to areas of interest and narrowband imaging. Different tests such as the reflectance profile of homogeneous epithelial tissue were performed to adjust the models properly. Light collection models for the different modalities were created and tested for efficiency. While it is challenging to evaluate the efficiency of multimodality endoscopes, the models ensure that the system is design for the expected light collection levels to provide detectable signal to work for the intended imaging.

Endoscopic management of intraoperative small bowel laceration during natural orifice translumenal endoscopic surgery: a blinded porcine study.

Science.gov (United States)

Fyock, Christopher J; Forsmark, Chris E; Wagh, Mihir S

2011-01-01

Natural orifice translumenal endoscopic surgery (NOTES) has recently gained great enthusiasm, but there is concern regarding the ability to endoscopically manage complications purely via natural orifices. To assess the feasibility of endoscopically managing enteral perforation during NOTES using currently available endoscopic accessories. Twelve pigs underwent transgastric or transcolonic endoscopic exploration. Full-thickness enterotomies were intentionally created to mimic accidental small bowel lacerations during NOTES. These lacerations were then closed with endoclips. In the blinded arm of the study, small bowel repair was performed by a second blinded endoscopist. Adequate closure of the laceration was confirmed with a leak test. Primary access sites were closed with endoclips or T-anchors. At necropsy, the peritoneal cavity was inspected for abscesses, bleeding, or damage to surrounding structures. The enterotomy site was examined for adequacy of closure, adhesions, or evidence of infection. Fifteen small bowel lacerations were performed in 12 animals. Successful closure was achieved in all 10 cases in the nonblinded arm. Survival animals had an uncomplicated postoperative course and all enterotomy sites were well healed without evidence of necrosis, adhesions, abscess, or bleeding at necropsy. Leak test was negative in all animals. In the blinded arm, both small intestinal lacerations could not be identified by the blinded endoscopist. Necropsy revealed open small bowel lacerations. Small intestinal injuries are difficult to localize with currently available flexible endoscopes and accessories. Endoscopic clips, however, may be adequate for closure of small bowel lacerations if the site of injury is known.

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

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...

Optical Coupling Structures of Fiber-Optic Mach-Zehnder Interferometers Using CO2 Laser Irradiation

Directory of Open Access Journals (Sweden)

Chien-Hsing Chen

2014-01-01

Full Text Available The Mach-Zehnder interferometer (MZI can be used to test changes in the refractive index of sucrose solutions at different concentrations. However, the popularity of this measurement tool is limited by its substantial size and portability. Therefore, the MZI was integrated with a small fiber-optic waveguide component to develop an interferometer with fiber-optic characteristics, specifically a fiber-optic Mach-Zehnder interferometer (FO-MZI. Optical fiber must be processed to fabricate two optical coupling structures. The two optical coupling structures are a duplicate of the beam splitter, an optical component of the interferometer. Therefore, when the sensor length and the two optical coupling structures vary, the time or path for optical transmission in the sensor changes, thereby influencing the back-end interference signals. The researchers successfully developed an asymmetrical FO-MZI with sensing abilities. The spacing value between the troughs of the sensor length and interference signal exhibited an inverse relationship. In addition, image analysis was employed to examine the size-matching relationship between various sensor lengths and the coupling and decoupling structure. Furthermore, the spectral wavelength shift results measured using a refractive index sensor indicate that FO-MZIs with a sensor length of 38 mm exhibited excellent sensitivity, measuring 59.7 nm/RIU.

Implantable fiber-optic interface for parallel multisite long-term optical dynamic brain interrogation in freely moving mice

Science.gov (United States)

Doronina-Amitonova, L. V.; Fedotov, I. V.; Ivashkina, O. I.; Zots, M. A.; Fedotov, A. B.; Anokhin, K. V.; Zheltikov, A. M.

2013-01-01

Seeing the big picture of functional responses within large neural networks in a freely functioning brain is crucial for understanding the cellular mechanisms behind the higher nervous activity, including the most complex brain functions, such as cognition and memory. As a breakthrough toward meeting this challenge, implantable fiber-optic interfaces integrating advanced optogenetic technologies and cutting-edge fiber-optic solutions have been demonstrated, enabling a long-term optogenetic manipulation of neural circuits in freely moving mice. Here, we show that a specifically designed implantable fiber-optic interface provides a powerful tool for parallel long-term optical interrogation of distinctly separate, functionally different sites in the brain of freely moving mice. This interface allows the same groups of neurons lying deeply in the brain of a freely behaving mouse to be reproducibly accessed and optically interrogated over many weeks, providing a long-term dynamic detection of genome activity in response to a broad variety of pharmacological and physiological stimuli. PMID:24253232

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.

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.

Endoscopic Ultrasound-guided Rendezvous Technique after Failed Endoscopic Retrograde Cholangiopancreatography: Which Approach Route Is the Best?

Science.gov (United States)

Okuno, Nozomi; Hara, Kazuo; Mizuno, Nobumasa; Hijioka, Susumu; Tajika, Masahiro; Tanaka, Tsutomu; Ishihara, Makoto; Hirayama, Yutaka; Onishi, Sachiyo; Niwa, Yasumasa; Yamao, Kenji

2017-12-01

Objective The endoscopic ultrasound-guided rendezvous technique (EUS-RV) is a salvage method for failed selective biliary cannulation. Three puncture routes have been reported, with many comparisons between the intra-hepatic and extra-hepatic biliary ducts. We used the trans-esophagus (TE) and trans-jejunum (TJ) routes. In the present study, the utility of EUS-RV for biliary access was evaluated, focusing on the approach routes. Methods and Patients In 39 patients, 42 puncture routes were evaluated in detail. EUS-RV was performed between January 2010 and December 2014. The patients were prospectively enrolled, and their clinical data were retrospectively collected. Results The patients' median age was 71 (range 29-84) years. The indications for endoscopic retrograde cholangiopancreatography (ERCP) were malignant biliary obstruction in 24 patients and benign biliary disease in 15. The technical success rate was 78.6% (33/42) and was similar among approach routes (p=0.377). The overall complication rate was 16.7% (7/42) and was similar among approach routes (p=0.489). However, mediastinal emphysema occurred in 2 TE route EUS-RV patients. No EUS-RV-related deaths occurred. Conclusion EUS-RV proved reliable after failed ERCP. The selection of the appropriate route based on the patient's condition is crucial.

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.

[Endoscopic endonasal detection of cerebrospinal fluid leakage with topical fluorescein].

Science.gov (United States)

Sato, Taku; Kishida, Yugo; Watanabe, Tadashi; Tani, Akiko; Tada, Yasuhiro; Tamura, Takamitsu; Ichikawa, Masahiro; Sakuma, Jun; Omori, Koichi; Saito, Kiyoshi

2013-08-01

We evaluated the effectiveness of intraoperative topical application of fluorescein to detect the leakage point of cerebrospinal fluid(CSF)rhinorrhea. Three patients with CSF rhinorrhea were treated with an endoscopic endonasal technique. Ten percent fluorescein was topically used for intraoperative localization of the leak site. A change of the fluorescein color from brown to green due to dilation of CSF were recognized as evidence of CSF rhinorrhea. We repeated the procedure to detect any small defects. All CSF rhinorrheas were successfully repaired by this endoscopic endonasal approach. Topical application of fluorescein is simple and sensitive for identifying intraoperative CSF rhinorrhea.

Multipoint fiber-optic laser-ultrasonic actuator based on fiber core-opened tapers.

Science.gov (United States)

Tian, Jiajun; Dong, Xiaolong; Gao, Shimin; Yao, Yong

2017-11-27

In this study, a novel fiber-optic, multipoint, laser-ultrasonic actuator based on fiber core-opened tapers (COTs) is proposed and demonstrated. The COTs were fabricated by splicing single-mode fibers using a standard fiber splicer. A COT can effectively couple part of a core mode into cladding modes, and the coupling ratio can be controlled by adjusting the taper length. Such characteristics are used to obtain a multipoint, laser-ultrasonic actuator with balanced signal strength by reasonably controlling the taper lengths of the COTs. As a prototype, we constructed an actuator that generated ultrasound at four points with a balanced ultrasonic strength by connecting four COTs with coupling ratios of 24.5%, 33.01%, 49.51%, and 87.8% in a fiber link. This simple-to-fabricate, multipoint, laser-ultrasonic actuator with balanced ultrasound signal strength has potential applications in fiber-optic ultrasound testing technology.

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

Design and evaluation of a new synthetic brain simulator for endoscopic third ventriculostomy

NARCIS (Netherlands)

Breimer, Gerben E.; Bodani, Vivek; Looi, Thomas; Drake, James M.

OBJECT Endoscopic third ventriculostomy (ETV) is an effective but technically demanding procedure with significant risk. Current simulators, including human cadavers, animal models, and virtual reality systems, are expensive, relatively inaccessible, and can lack realistic sensory feedback. The

Peculiarities of the Perioperative Care of Elderly Patients Undergoing Endoscopic Transsphenoidal Removal of Tumors in the Chiasmatic-Sellar Area

Directory of Open Access Journals (Sweden)

Alexey B. Kurnosov

2017-01-01

Full Text Available Nowadays, in the age of rapid introduction of digital and fiber-optic technologies in neurosurgery, a technique for removal of tumors in the chiasmatic-sellar area via an endoscopic transsphenoidal endonasal approach is actively developed; this technique is considered less invasive and is well tolerated by patients, thus permitting to operate patients with somatic complications, as well as the elderly. Taking into account these facts, as well as world statistic data indicating a continuous trend of population aging in developed countries, including Russia, optimization of the perioperative care of elderly patients with a tumor of the chiasmatic-sellar area becomes the problem of highest priority. In order to solve it, this review discusses the basic peculiarities of the perioperative management of elderly patients (characteristics of their somatic status and possible variants of the pre-operational state with a pathology in the chiasmatic-sellar region; it also presents the modern and most acceptable alternative solutions of this difficult problem (introduction of modern methods of anesthesia, management of the postoperative cognitive dysfunction, postoperative pain syndrome, and postoperative nausea and vomiting. 

Experience in colon sparing surgery in North America: advanced endoscopic approaches for complex colorectal lesions.

Science.gov (United States)

Gorgun, Emre; Benlice, Cigdem; Abbas, Maher A; Steele, Scott

2018-07-01

Need for colon sparing interventions for premalignant lesions not amenable to conventional endoscopic excision has stimulated interest in advanced endoscopic approaches. The aim of this study was to report a single institution's experience with these techniques. A retrospective review was conducted of a prospectively collected database of all patients referred between 2011 and 2015 for colorectal resection of benign appearing deemed endoscopically unresectable by conventional endoscopic techniques. Patients were counseled for endoscopic submucosal dissection (ESD) with possible combined endoscopic-laparoscopic surgery (CELS) or alternatively colorectal resection if unable to resect endoscopically or suspicion for cancer. Lesion characteristic, resection rate, complications, and outcomes were evaluated. 110 patients were analyzed [mean age 64 years, female gender 55 (50%), median body mass index 29.4 kg/m 2 ]. Indications for interventions were large polyp median endoscopic size 3 cm (range 1.5-6.5) and/or difficult location [cecum (34.9%), ascending colon (22.7%), transverse colon (14.5%), hepatic flexure (11.8%), descending colon (6.3%), sigmoid colon (3.6%), rectum (3.6%), and splenic flexure (2.6%)]. Lesion morphology was sessile (N = 98, 93%) and pedunculated (N = 12, 7%). Successful endoscopic resection rate was 88.2% (N = 97): ESD in 69 patients and CELS in 28 patients. Complication rate was 11.8% (13/110) [delayed bleeding (N = 4), perforation (N = 3), organ-space surgical site infection (SSI) (N = 2), superficial SSI (N = 1), and postoperative ileus (N = 3)]. Out of 110 patients, 13 patients (11.8%) required colectomy for technical failure (7 patients) or carcinoma (6 patients). During a median follow-up of 16 months (range 6-41 months), 2 patients had adenoma recurrence. Advanced endoscopic surgery appears to be a safe and effective alternative to colectomy for patients with complex premalignant lesions deemed

New techniques in gastrointestinal endoscopic surgery

Directory of Open Access Journals (Sweden)

Rafael Antonio Luengas Tello

2012-09-01

Full Text Available Gastrointestinal endoscopic surgery has been making great progress since the seventies in the management paradigms of conditions such as gastrointestinal bleeding, polyp resection and diagnostic and therapeutic management of the biliary tract. The current challenge is the development of techniques that allow endoscopic treatment of emerging diseases such as cancer, morbid obesity, gastro-esophageal reflux and achalasia. This article reports on new techniques and expectations for the future in the endoscopic management of these diseases.

The Correlation of Endoscopic Findings and Clinical Features in Korean Patients with Scrub Typhus: A Cohort Study.

Science.gov (United States)

Lee, Jun; Kim, Dong-Min; Yun, Na Ra; Kim, Young Dae; Park, Chan Guk; Kim, Man Woo

2016-01-01

Scrub typhus is an infectious disease caused by Orientia tsutsugamushi-induced systemic vasculitis, but the involvement of the gastrointestinal tract and the endoscopic findings associated with scrub typhus are not well understood. We performed a prospective study and recommend performing esophagogastroduodenoscopy (EGD) for all possible scrub typhus patients, regardless of gastrointestinal symptoms. Gastrointestinal symptoms, endoscopic findings and clinical severity based on organ involvement and ICU admission were analyzed. Gastrointestinal symptoms occurred in up to 76.4% of scrub typhus patients. The major endoscopic findings were ulcers (43/127, 33.9%). Interestingly, 7.1% (9/127) of the patients presented with esophageal candidiasis. There was no correlation between the presence or absence of gastrointestinal symptoms and the endoscopic grade (P = 0.995). However, there was a positive correlation between the clinical severity and the endoscopic findings (P = 0.001). Sixty-three percent of the patients presented with erosion or ulcers on prospectively performed endoscopic evaluations, irrespective of gastrointestinal symptoms. Gastrointestinal symptoms did not reflect the need for endoscopy. Scrub typhus patients could have significant endoscopic abnormalities even in the absence of gastrointestinal symptoms.

Spatial Frequency Multiplexing of Fiber-Optic Interferometric Refractive Index Sensors Based on Graded-Index Multimode Fibers

Science.gov (United States)

Liu, Li; Gong, Yuan; Wu, Yu; Zhao, Tian; Wu, Hui-Juan; Rao, Yun-Jiang

2012-01-01

Fiber-optic interferometric sensors based on graded-index multimode fibers have very high refractive-index sensitivity, as we previously demonstrated. In this paper, spatial-frequency multiplexing of this type of fiber-optic refractive index sensors is investigated. It is estimated that multiplexing of more than 10 such sensors is possible. In the multiplexing scheme, one of the sensors is used to investigate the refractive index and temperature responses. The fast Fourier transform (FFT) of the combined reflective spectra is analyzed. The intensity of the FFT spectra is linearly related with the refractive index and is not sensitive to the temperature.

[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.

[Tracheotomy-endoscop for dilatational percutaneous tracheotomy (TED)].

Science.gov (United States)

Klemm, Eckart

2006-09-01

While surgical tracheotomies are currently performed using state-of-the-art operative techniques, percutaneous dilatational tracheostomy (PDT) is in a rapidly evolving state with regard to its technology and the number of techniques available. This has resulted in a range of new complications that are difficult to quantify on a scientific basis, given the fact that more than half of the patients who are tracheotomized in intensive care units die from their underlying disease. The new Tracheotomy Endoscope (TED) is designed to help prevent serious complications in dilatational tracheotomies and facilitate their management. The endoscope has been specifically adapted to meet the require-ments of percutaneous dilatational tracheotomies. It is fully compatible with all current techniques of PDT. The method is easy to learn. The percutaneous dilatational tracheotomy with the Tracheotomy Endoscope is a seven-step procedure: Advantages of the Tracheotomy Endoscope: Injuries to the posterior tracheal wall ar impossible (tracheoesophageal fistulas, pneumothorax). Minor bleeding sites on the tracheal mucosa can be controlled with a specially curved suction-coagulation tube introudeced through the Tracheotomy Endoscope. In cases with heavy bleeding and a risk of aspiration, the rigid indwelling Tracheotomy Endoscope provides a secure route for reintubating the patient with a cuffed endotracheal tube. It also allows for rapid conversion to an open surgical procedure if necessary. All the parts are easy to clean and are autoclavable. This type of endoscopically guided PDT creates an optimal link between the specialties of intensive care medicine and otorhinolaryngology. The Tracheotomy Endoscope (TED) increases the standard of safety in PDT.

Dynamics analysis of microsphere in a dual-beam fiber-optic trap with transverse offset.

Science.gov (United States)

Chen, Xinlin; Xiao, Guangzong; Luo, Hui; Xiong, Wei; Yang, Kaiyong

2016-04-04

A comprehensive dynamics analysis of microsphere has been presented in a dual-beam fiber-optic trap with transverse offset. As the offset distance between two counterpropagating beams increases, the motion type of the microsphere starts with capture, then spiral motion, then orbital rotation, and ends with escape. We analyze the transformation process and mechanism of the four motion types based on ray optics approximation. Dynamic simulations show that the existence of critical offset distances at which different motion types transform. The result is an important step toward explaining physical phenomena in a dual-beam fiber-optic trap with transverse offset, and is generally applicable to achieving controllable motions of microspheres in integrated systems, such as microfluidic systems and lab-on-a-chip systems.

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.

Selective Embolization for Post-Endoscopic Sphincterotomy Bleeding: Technical Aspects and Clinical Efficacy

International Nuclear Information System (INIS)

So, Young Ho; Choi, Young Ho; Chung, Jin Wook; Jae, Hwan Jun; Park, Jae Hyung; Song, Soon Young

2012-01-01

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.

Endoscopic therapy of posttransplant biliary stenoses after right-sided adult living donor liver transplantation.

Science.gov (United States)

Zoepf, Thomas; Maldonado-Lopez, Evelyn J; Hilgard, Philip; Schlaak, Joerg; Malago, Massimo; Broelsch, Christoph E; Treichel, Ulrich; Gerken, Guido

2005-11-01

Endoscopic treatment of biliary strictures after liver transplantation is a therapeutic challenge. In particular, outcomes of endoscopic therapy of biliary complications in the case of duct-to-duct anastomosis after living related liver transplantation are limited. The aim of this study was to evaluate the feasibility and success of an endoscopic treatment approach to posttransplant biliary strictures (PTBS) after right-sided living donor liver transplantation (RLDLT) with duct-to-duct anastomosis. Ninety patients who received adult-to-adult RLDLT in our center were screened retrospectively with respect to endoscopic treatment of PTBS. Therapy was judged as successful when cholestasis parameters returned to normal and bile duct narrowing was reduced significantly after the completion of therapy. Forty of 90 RLDLT patients received duct-to-duct anastomosis, 12 (30%) showed PTBS. Seven of 12 patients were treated successfully by endoscopy; the remaining 5 patients were treated primarily by surgery. Most patients were treated by balloon dilatation followed by insertion of endoprostheses. A median of 2.5 dilatation sessions were necessary and the median treatment duration was 8 months. One patient developed endoscopy-treatable recurrent stenosis, no surgical intervention was necessary. Mild pancreatitis occurred in 7.9% and cholangitis in 5.3% of the procedures. One minor bleeding episode occurred during sphincterotomy. Bleeding was managed endoscopically. Endoscopic therapy of adult-to-adult right living related liver transplantation with duct-to-duct anastomosis is feasible and frequently is successful. The duct-to-duct anastomosis offers the possibility of endoscopic treatment. Endoscopic treatment of posttransplant biliary strictures is safe, with a low specific complication rate.

A novel lumen-apposing metal stent for endoscopic ultrasound-guided drainage of pancreatic fluid collections

DEFF Research Database (Denmark)

Walter, Daisy; Will, Uwe; Sanchez-Yague, Andres

2015-01-01

BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate the effi......BACKGROUND AND STUDY AIMS: A novel large-diameter, lumen-apposing, self-expanding metal stent with bilateral flanges was recently developed for endoscopic ultrasound (EUS)-guided transmural drainage of symptomatic pancreatic fluid collections (PFCs). The aim of this study was to evaluate...

Dosimetry in endoscopic examinations

International Nuclear Information System (INIS)

Aldred, Martha Aurelia; Paes, Walter Siqueira; Fausto, Agnes M.F.; Nucci, Jose Roberto; Yoshimura, Elisabeth Mateus; Okuno, Emico; Maruta, Luis Massuo

1996-01-01

Equivalent and effective doses in occupational exposures are evaluated considering that some specific endoscopic examinations, radiographic and fluoroscopic images of patients are taken with the medical staff near to the radiation field. Examinations are simulated using an anthropomorphic phantom as a member of the medical staff. Thermoluminescent dosemeters are attached in several positions of the phantom in order to determine some organ doses. From the comparison between the doses experimentally determined and the International and the Brazilian recommended occupational dose limits, the maximum number of examination that any member of the staff can perform was calculated

Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum

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Joana Soares

2017-09-01

Full Text Available Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

Endoscopic Mucosectomy in a Child Presenting with Gastric Heterotopia of the Rectum.

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Soares, Joana; Ferreira, Carla; Marques, Margarida; Corujeira, Susana; Tavares, Marta; Lopes, Joanne; Carneiro, Fátima; Amil Dias, Jorge; Trindade, Eunice

2017-11-01

Gastric mucosal heterotopia has been described in all levels of the gastrointestinal tract. Its occurrence in the rectum is uncommon. We report the case of a 4-year-old boy referred to Pediatric Gastroenterology for intermittent rectal bleeding for the past 2 years. Total ileocolonoscopy revealed a flat, well-circumscribed lesion of 4 cm, with elevated margins, localized at 10 cm from the anal verge. Histologic examination showed typical gastric mucosa of the oxyntic type. Treatment with proton pump inhibitors was started without resolution of the symptoms and, therefore, an endoscopic mucosal resection was performed. Heterotopic gastric mucosa represents a rare cause of rectal bleeding in children and endoscopic evaluation is fundamental for diagnosis. Although not usually performed in pediatric ages, endoscopic mucosectomy allows complete resolution of the problem avoiding surgery.

[PACS-based endoscope image acquisition workstation].

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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.

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

[Retrospective evaluation of 500 endoscopic cholangiopancreatographies performed at the Instituto Nacional de la Nutrición "Salvador Zubiran"].

Science.gov (United States)

Elizondo, J; Gallo, S; Valdovinos, M A; Paez, R

1989-01-01

We evaluated 500 endoscopic retrograde cholangiopancreatographies (ERCP) performed on 422 patients during a 5-year period in the Gastrointestinal Endoscopy Department, Instituto Nacional de la Nutrición Salvador Zubirán, México, D.F. ERCP combines endoscopic and radiologic techniques in order to obtain high quality opacification of pancreatic and biliary ducts. The rate of success for cannulation was 90%; desired duct opacification was possible in 89%. The most frequent indication for ERCP was to establish the differential diagnosis for jaundice; biliary stones in the common bile duct was the most frequent diagnosis, followed by normal biliary ducts. Pancreatography was normal in 74% of patients. ERCP complications were detected in 5.6%; fever and transient pain was the most common complaint in 1.6%. Mortality attributable to the procedure was 0.8%. From histological corroboration of cases by surgery or postmortem studies, diagnostic sensitivity was 92%, specificity 76%, positive predictive value 96% and a prevalence of 89%. We conclude that ERCP is highly sensitive and specific in diagnosing bilio-pancreatic-duodenal disease. Our results are comparable to other's experiences published throughout the world.

Endoscopic treatment of vesicoureteral reflux in pediatric patients

Directory of Open Access Journals (Sweden)

Jong Wook Kim

2013-04-01

Full Text Available Endoscopic treatment is a minimally invasive treatment for managing patients with vesicoureteral reflux (VUR. Although several bulking agents have been used for endoscopic treatment, dextranomer/hyaluronic acid is the only bulking agent currently approved by the U.S. Food and Drug Administration for treating VUR. Endoscopic treatment of VUR has gained great popularity owing to several obvious benefits, including short operative time, short hospital stay, minimal invasiveness, high efficacy, low complication rate, and reduced cost. Initially, the success rates of endoscopic treatment have been lower than that of open antireflux surgery. However, because injection techniques have been developed, a recent study showed higher success rates of endoscopic treatment than open surgery in the treatment of patients with intermediate- and high-grade VUR. Despite the controversy surrounding its effectiveness, endoscopic treatment is considered a valuable treatment option and viable alternative to long-term antibiotic prophylaxis.

Feasibility study of natural orifice transluminal endoscopic surgery inguinal hernia repair.

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Sherwinter, Danny A; Eckstein, Jeremy G

2009-07-01

A potentially less-invasive technique, transluminal surgery, may reduce or eliminate pain and decrease time to full return of activities after abdominal operations. Inguinal hernia repair is perfectly suited to the transgastric endoscopic approach and has not been previously reported. Our purpose was to evaluate the feasibility of transgastric bilateral inguinal herniorrhaphy (BIH). Feasibility study with a nonsurvival canine model. Under general anesthesia, male mongrel dogs weighing 20 to 30 kg had a dual-channel endoscope introduced into the peritoneal cavity over a percutaneously placed guidewire. An overtube with an insufflation channel was used. Peritoneoscopy was performed, and bilateral deep and superficial inguinal rings were identified. The endoscope was removed, premounted with a 4 x 6 cm acellular human dermal implant and then readvanced intraperitoneally through the overtube. The implant was then deployed across the entire myopectineal orifice and draped over the cord structures. Bioglue was then applied endoscopically, and the implant was attached to the peritoneum. After completion of bilateral repairs, the animals were killed and necropsy performed. Five dogs underwent pure natural orifice transluminal endoscopic surgery (NOTES) intraperitoneal onlay mesh (IPOM) BIH. Accurate placement and adequate myopectineal coverage was accomplished in all subjects. At necropsy no injuries to the major structures were noted but Bioglue misapplication with contamination of unintended sites did occur. Our study involved only a small number of subjects in nonsurvival experiments, and no gastric closure was used. Many of the characteristics of inguinal hernia repair are especially well suited to the transgastric approach. The repair is in line with the transgastric endoscope vector, bilateral defects are adjacent, and the IPOM technique does not require significant manipulation or novel instrumentation.

Endoscopic versus surgical drainage treatment of calcific chronic pancreatitis.

Science.gov (United States)

Jiang, Li; Ning, Deng; Cheng, Qi; Chen, Xiao-Ping

2018-04-21

Endoscopic therapy and surgery are both conventional treatments to remove pancreatic duct stones that developed during the natural course of chronic pancreatitis. However, few studies comparing the effect and safety between surgery drainage and endoscopic drainage (plus Extracorporeal Shock Wave Lithotripsy, ESWL).The aim of this study was to compare the benefits between endoscopic and surgical drainage of the pancreatic duct for patients with calcified chronic pancreatitis. A total of 86 patients were classified into endoscopic/ESWL (n = 40) or surgical (n = 46) treatment groups. The medical records of these patients were retrospectively analyzed. Pain recurrence and hospital stays were similar between the endoscopic/ESWL treatment and surgery group. However, endoscopic/ESWL treatment yielded significantly lower medical expense and less complications compared with the surgical treatment. In selective patients, endoscopic/ESWL treatment could achieve comparable efficacy to the surgical treatment. With lower medical expense and less complications, endoscopic/ESWL treatment would be much preferred to be the initial treatment of choice for patients with calcified chronic pancreatitis. Copyright © 2018 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Endoscopic and keyhole endoscope-assisted neurosurgical approaches: a qualitative survey on technical challenges and technological solutions.

Science.gov (United States)

Marcus, Hani J; Cundy, Thomas P; Hughes-Hallett, Archie; Yang, Guang-Zhong; Darzi, Ara; Nandi, Dipankar

2014-10-01

The literature reflects a resurgence of interest in endoscopic and keyhole endoscope-assisted neurosurgical approaches as alternatives to conventional microsurgical approaches in carefully selected cases. The aim of this study was to assess the technical challenges of neuroendoscopy, and the scope for technological innovations to overcome these barriers. All full members of the Society of British Neurosurgeons (SBNS) were electronically invited to participate in an online survey. The open-ended structured survey asked three questions; firstly, whether the surgeon presently utilises or has experience with endoscopic or endoscope-assisted approaches; secondly, what they consider to be the major technical barriers to adopting such approaches; and thirdly, what technological advances they foresee improving safety and efficacy in the field. Responses were subjected to a qualitative research method of multi-rater emergent theme analysis. Three clear themes emerged: 1) surgical approach and better integration with image-guidance systems (20%), 2) intra-operative visualisation and improvements in neuroendoscopy (49%), and 3) surgical manipulation and improvements in instruments (74%). The analysis of responses to our open-ended survey revealed that although opinion was varied three major themes could be identified. Emerging technological advances such as augmented reality, high-definition stereo-endoscopy, and robotic joint-wristed instruments may help overcome the technical difficulties associated with neuroendoscopic approaches. Results of this qualitative survey provide consensus amongst the technology end-user community such that unambiguous goals and priorities may be defined. Systems integrating these advances could improve the safety and efficacy of endoscopic and endoscope-assisted neurosurgical approaches.

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.

Endoscopic Management of an Intramural Sinus Leak After Per- Oral Endoscopic Myotomy

Science.gov (United States)

Al Taii, Haider; Confer, Bradley; Gabbard, Scott; Kroh, Matthew; Jang, Sunguk; Rodriguez, John; Parsi, Mansour A.; Vargo, John J.; Ponsky, Jeffrey

2016-01-01

Per-oral endoscopic myotomy (POEM) was developed less than a decade ago for the treatment of achalasia. Its minimally invasive approach and the favorable short-term outcome have led to rapid adoption of the technique throughout the world. As with any new technique, there will be adverse events, and it is important that effective treatments for these adverse events be discussed. We present a case of successful endoscopic management of an intramural sinus leak after a POEM procedure using tandem fully covered esophageal stents. PMID:27921057

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

Ultrasound-assisted endoscopic partial plantar fascia release.

Science.gov (United States)

Ohuchi, Hiroshi; Ichikawa, Ken; Shinga, Kotaro; Hattori, Soichi; Yamada, Shin; Takahashi, Kazuhisa

2013-01-01

Various surgical treatment procedures for plantar fasciitis, such as open surgery, percutaneous release, and endoscopic surgery, exist. Skin trouble, nerve disturbance, infection, and persistent pain associated with prolonged recovery time are complications of open surgery. Endoscopic partial plantar fascia release offers the surgeon clear visualization of the anatomy at the surgical site. However, the primary medial portal and portal tract used for this technique have been shown to be in close proximity to the posterior tibial nerves and their branches, and there is always the risk of nerve damage by introducing the endoscope deep to the plantar fascia. By performing endoscopic partial plantar fascia release under ultrasound assistance, we could dynamically visualize the direction of the endoscope and instrument introduction, thus preventing nerve damage from inadvertent insertion deep to the fascia. Full-thickness release of the plantar fascia at the ideal position could also be confirmed under ultrasound imaging. We discuss the technique for this new procedure.

Endoscopically Assisted Drilling, Exposure of the Fundus through a Presigmoid Retrolabyrinthine Approach: A Cadaveric Feasibility Study.

Science.gov (United States)

Muelleman, Thomas; Shew, Matthew; Alvi, Sameer; Shah, Kushal; Staecker, Hinrich; Chamoun, Roukouz; Lin, James

2018-01-01

The presigmoid retrolabyrinthine approach to the cerebellopontine angle is traditionally described to not provide access to the internal auditory canal (IAC). We aimed to evaluate the extent of the IAC that could be exposed with endoscopically assisted drilling and to measure the percentage of the IAC that could be visualized with the microscope and various endoscopes after drilling had been completed. Presigmoid retrolabyrinthine approaches were performed bilaterally on 4 fresh cadaveric heads. We performed endoscopically assisted drilling to expose the fundus of the IAC, which resulted in exposure of the entire IAC in 8 of 8 temporal bone specimens. The microscope afforded a mean view of 83% (n = 8) of the IAC. The 0°, 30°, 45°, and 70° endoscope each afforded a view of 100% of the IAC in 8 of 8 temporal bone specimens. In conclusion, endoscopic drilling of the IAC of can provide an extradural means of exposing the entire length of the IAC while preserving the labyrinth.

Therapeutic aspects of endoscopic ultrasound

Science.gov (United States)

Woodward, Timothy A.

1999-06-01

Endoscopic ultrasound (EUS) is a technology that had been used primarily as a passive imaging modality. Recent advances have enabled us to move beyond the use of EUS solely as a staging tool to an interventional device. Current studies suggest that interventional applications of EUS will allow for minimally invasive assessment and therapies in a cost-effective manner. Endoscopic ultrasound with fine needle aspiration (EUS-FNA) has been demonstrated to be a technically feasible, relatively safe method of obtaining cytologic specimens. The clinical utility of EUS- FNA appears to be greatest in the diagnosis and staging of pancreatic cancer and in the nodal staging of gastrointestinal and pulmonary malignancies. In addition, EUS-FNA has demonstrated utility in the sampling pleural and ascitic fluid not generally appreciated or assessable to standard interventions. Interventional applications of EUS include EUS-guided pseudocyst drainage, EUS-guided injection of botulinum toxin in the treatment of achalasia, and EUS- guided celiac plexus neurolysis in the treatment of pancreatic cancer pain. Finally, EUS-guided fine-needle installation is being evaluated, in conjunction with recent bimolecular treatment modalities, as a delivery system in the treatment of certain gastrointestinal tumors.

Endoscopic Color Doppler Ultrasonographic Evaluation of GastricVarices Secondary to Left-Sided Portal Hypertension

Science.gov (United States)

Sato, Takahiro; Yamazaki, Katsu; Kimura, Mutsuumi; Toyota, Jouji; Karino, Yoshiyasu

2014-01-01

Gastric varices that arise secondary to the splenic vein occlusion can result in gastrointestinal hemorrhaging. Endoscopic color Doppler ultrasonography (ECDUS) was performed in 16 patients with gastric varices secondary to splenic vein occlusion. This study retrospectively evaluated the role of ECDUS in the diagnosis of gastric varices secondary to splenic vein occlusion. Thirteen patients had co-existing pancreatic diseases: 8 with chronic pancreatitis, 4 with cancer of the pancreatic body or tail and 1 with severe acute pancreatitis. Of the remaining 3 patients, 1 had myeloproliferative disease, 1 had advanced gastric cancer, and the third had splenic vein occlusion due to an obscure cause. The endoscopic findings of gastric varices were: variceal form (F) classified as enlarged tortuous (F2) in 12 cases and large, coil-shaped (F3) in 4 cases, and positive for erosion or red color sign of the variceal surface in 4 cases and negative in 12 cases. ECDUS color flow images of gastric variceal flow clearly depicted a round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body in all 16 cases. The velocities of F3 type gastric varices were significantly higher than those of the F2 type. The wall thickness of varices positive for erosion or red color sign was significantly less than the negative cases. I conclude that ECDUS color flow images of gastric variceal flow depicted specific findings of gastric varices secondary to splenic vein occlusion at the round fundal region at the center, with varices expanding to the curvatura ventriculi major of the gastric body. PMID:26852679

Endoscopic and Histological Findings Are Predicted by Fecal Calprotectin in Acute Intestinal Graft-Versus-Host-Disease.

Science.gov (United States)

Adam, Birgit; Koldehoff, Michael; Ditschkowski, Markus; Gromke, Tanja; Hlinka, Michal; Trenschel, Rudolf; Kordeals, Lambros; Steckel, Nina K; Beelen, Dietrich W; Liebregts, Tobias

2016-07-01

Gastrointestinal graft-versus-host-disease (GI-GVHD) is a major cause of nonrelapse mortality after hematopoietic stem cell transplantation (HSCT) necessitating endoscopic examinations and biopsies for diagnosis. Fecal calprotectin (CPT) has been widely used in gastrointestinal inflammation, but comprehensive data in GI-GVHD are lacking. We aimed to identify an association of CPT with endoscopic findings, mucosal damage and symptoms for diagnosing and monitoring acute GI-GVHD. Symptoms were prospectively evaluated in 110 consecutive HSCT recipients by standardized questionnaires and Bristol Stool Scale (BSS). CPT was assayed by ELISA. Symptom assessment and CPT were performed weekly and with onset of first symptoms. GVHD was diagnosed according to the Glucksberg criteria and by endoscopic biopsies. Patients with GI-GVHD received standard high-dose corticosteroid therapy and follow-up CPT, and symptom evaluation was performed after 28 days. Patients not responding to steroid treatment were re-evaluated by colonoscopy. GI-GVHD was diagnosed in 40 patients. Twelve patients with GI symptoms and CMV colitis and 24 patients with isolated skin GVHD were included as control subjects. CPT was significantly higher in GI-GVHD compared to skin GVHD and CMV colitis. Endoscopic findings, histological grading, abdominal cramps, diarrhea, urgency and BSS correlated with CPT. At follow-up, CPT correlated with abdominal cramps, diarrhea, urgency and BSS. In steroid refractory patients, CPT level was still significantly associated with severity of mucosal damage. CPT predicts endoscopic and histological findings in GI-GVHD and correlates with lower GI symptoms. It enables to discriminate GVHD from CMV colitis and to monitor therapeutic success.

A tilted fiber-optic plate coupled CCD detector for high resolution neutron imaging

Energy Technology Data Exchange (ETDEWEB)

Kim, Jongyul; Cho, Gyuseong [Korea Advanced Institute of Science and Technology, Daejeon (Korea, Republic of); Kim, Jongyul; Hwy, Limchang; Kim, Taejoo; Lee, Kyehong [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of); Lee, Seungwook [Pusan National Univ., Pusan (Korea, Republic of)

2013-05-15

One of these efforts is that a tilted scintillator geometry and lens coupled CCD detector for neutron imaging system were used to improve spatial resolution in one dimension. The increased spatial resolution in one dimension was applied to fuel cell study. However, a lens coupled CCD detector has lower sensitivity than a fiber-optic plate coupled CCD detector due to light loss. In this research, a tilted detector using fiber-optic plate coupled CCD detector was developed to improve resolution and sensitivity. In addition, a tilted detector can prevent an image sensor from direct radiation damage. Neutron imaging has been used for fuel cell study, lithium ion battery study, and many scientific applications. High quality neutron imaging is demanded for more detailed studies of applications, and spatial resolution should be considered to get high quality neutron imaging. Therefore, there were many efforts to improve spatial resolution.

Contrast-enhanced endoscopic ultrasonography

DEFF Research Database (Denmark)

Reddy, Nischita K; Ioncica, Ana Maria; Saftoiu, 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...

Endoscope disinfection and its pitfalls - requirement for retrograde surveillance cultures

NARCIS (Netherlands)

Buss, A. J.; Been, M. H.; Borgers, R. P.; Stokroos, I.; Melchers, W. J. G.; Peters, F. T. M.; Limburg, A. J.; Degener, J. E.

Background and study aims: Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to

Endoscope disinfection and its pitfalls--requirement for retrograde surveillance cultures.

NARCIS (Netherlands)

Buss, A.J.; Been, M.H.; Borgers, R.P.; Stokroos, I.; Melchers, W.J.G.; Peters, F.T.; Limburg, A.J.; Degener, J.E.

2008-01-01

BACKGROUND AND STUDY AIMS: Several endoscopy-related outbreaks of infection have been reported in recent years. For early recognition of inadequate disinfection of endoscopes we designed a microbiological surveillance system to evaluate the efficacy of the cleaning and disinfection procedure, and to

A 15-meter Multi-Gigabit W-band Bidirectional Wireless Bridge in Fiber-Optic Access Networks

DEFF Research Database (Denmark)

Pang, Xiaodan; Vegas Olmos, Juan José; Lebedev, Alexander

2013-01-01

. The down-converted signal is re-modulated on to the lightwave and transmit further through the fiber-optic system. In the uplink, both up-and down-conversion are performed by electrical means. Furthermore, we investigate both passive and active wireless transmitters in this work for both downlink......We present a bidirectional wireless bridge in the W-band enabling the seamless convergence between the wireless and fiber-optic access networks. In the downlink, a 16 Gbit/s QPSK signal is photonically up-converted at the wireless transmitter and electrically down-converted at the wireless receiver...... and uplink transmissions. With an active wireless transmitter, up to 15 meters wireless transmission is successfully achieved with a BER below the 7% FEC limit in the downlink....

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.

A technical review of flexible endoscopic multitasking platforms.

Science.gov (United States)

Yeung, Baldwin Po Man; Gourlay, Terence

2012-01-01

Further development of advanced therapeutic endoscopic techniques and natural orifice translumenal endoscopic surgery (NOTES) requires a powerful flexible endoscopic multitasking platform. Medline search was performed to identify literature relating to flexible endoscopic multitasking platform from year 2004-2011 using keywords: Flexible endoscopic multitasking platform, NOTES, Instrumentation, Endoscopic robotic surgery, and specific names of various endoscopic multitasking platforms. Key articles from articles references were reviewed. Flexible multitasking platforms can be classified as either mechanical or robotic. Purely mechanical systems include the dual channel endoscope (DCE) (Olympus), R-Scope (Olympus), the EndoSamurai (Olympus), the ANUBIScope (Karl-Storz), Incisionless Operating Platform (IOP) (USGI), and DDES system (Boston Scientific). Robotic systems include the MASTER system (Nanyang University, Singapore) and the Viacath (Hansen Medical). The DCE, the R-Scope, the EndoSamurai and the ANUBIScope have integrated visual function and instrument manipulation function. The IOP and DDES systems rely on the conventional flexible endoscope for visualization, and instrument manipulation is integrated through the use of a flexible, often lockable, multichannel access device. The advantage of the access device concept is that it allows optics and instrument dissociation. Due to the anatomical constrains of the pharynx, systems are designed to have a diameter of less than 20 mm. All systems are controlled by traction cable system actuated either by hand or by robotic machinery. In a flexible system, this method of actuation inevitably leads to significant hysteresis. This problem will be accentuated with a long endoscope such as that required in performing colonic procedures. Systems often require multiple operators. To date, the DCE, the R-Scope, the IOP, and the Viacath system have data published relating to their application in human. Alternative forms of

Evaluation of CSF flow in patients after endoscopic ventriculostomy of 3th ventricle with MRI

International Nuclear Information System (INIS)

Petkov, R.

2006-01-01

Full text: Phase-contrast MR imaging is wide used for qualitative assessment and quantification of the CSF flow under normal and pathologic conditions. The increasing popularity of minimally invasive liquor derivation procedures - namely endoscopic ventriculostomy of 3-th ventricle - in neurosurgery raises the question of their actual effect on CSF flow in various types of hydrocephalus. We present our experience with 2D and 3D PC MRI in qualitative assessment and quantification of the CSF flow in 23 patients after endoscopic ventriculostomy of the 3-th ventricle for hyper- or normotensive hydrocephalus of various origins. We compare parameters of the CSF flow (direction, rate and net volume for one cardiac cycle) before and after the ventriculostomy

The clinical and radiological observation of endoscopic retrograde cholangiopancreatography

Energy Technology Data Exchange (ETDEWEB)

Park, Choong Shik; Park, Byoung Lan; Chun, Hyun Woo; Kim, Byung Geun; Park, Hong Bae [Kwangju Christian Hospital, Kwangju (Korea, Republic of)

1981-12-15

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

Guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding.

Science.gov (United States)

Fujishiro, Mitsuhiro; Iguchi, Mikitaka; Kakushima, Naomi; Kato, Motohiko; Sakata, Yasuhisa; Hoteya, Shu; Kataoka, Mikinori; Shimaoka, Shunji; Yahagi, Naohisa; Fujimoto, Kazuma

2016-05-01

Japan Gastroenterological Endoscopy Society (JGES) has compiled a set of guidelines for endoscopic management of non-variceal upper gastrointestinal bleeding using evidence-based methods. The major cause of non-variceal upper gastrointestinal bleeding is peptic gastroduodenal ulcer bleeding. As a result, these guidelines mainly focus on peptic gastroduodenal ulcer bleeding, although bleeding from other causes is also overviewed. From the epidemiological aspect, in recent years in Japan, bleeding from drug-related ulcers has become predominant in comparison with bleeding from Helicobacter pylori (HP)-related ulcers, owing to an increase in the aging population and coverage of HP eradication therapy by national health insurance. As for treatment, endoscopic hemostasis, in which there are a variety of methods, is considered to be the first-line treatment for bleeding from almost all causes. It is very important to precisely evaluate the severity of the patient's condition and stabilize the patient's vital signs with intensive care for successful endoscopic hemostasis. Additionally, use of antisecretory agents is recommended to prevent rebleeding after endoscopic hemostasis, especially for gastroduodenal ulcer bleeding. Eighteen statements with evidence and recommendation levels have been made by the JGES committee of these guidelines according to evidence obtained from clinical research studies. However, some of the statements that are supported by a low level of evidence must be confirmed by further clinical research. © 2016 Japan Gastroenterological Endoscopy Society.

Endoscopic stent suture fixation for prevention of esophageal stent migration during prolonged dilatation for achalasia treatment.

Science.gov (United States)

Rieder, E; Asari, R; Paireder, M; Lenglinger, J; Schoppmann, S F

2017-04-01

The aim of this study is to compare endoscopic stent suture fixation with endoscopic clip attachment or the use of partially covered stents (PCS) regarding their capability to prevent stent migration during prolonged dilatation in achalasia. Large-diameter self-expanding metal stents (30 mm × 80 mm) were placed across the gastroesophageal junction in 11 patients with achalasia. Stent removal was scheduled after 4 to 7 days. To prevent stent dislocation, endoscopic clip attachment, endoscopic stent suture fixation, or PCS were used. The Eckardt score was evaluated before and 6 months after prolonged dilatation. After endoscopic stent suture fixation, no (0/4) sutured stent migrated. When endoscopic clips were used, 80% (4/5) clipped stents migrated (p = 0.02). Of two PCS (n = 2), one migrated and one became embedded leading to difficult stent removal. Technical adverse events were not seen in endoscopic stent suture fixation but were significantly correlated with the use of clips or PCS (r = 0.828, p = 0.02). Overall, 72% of patients were in remission regarding their achalasia symptoms 6 months after prolonged dilatation. Endoscopic suture fixation of esophageal stents but not clip attachment appears to be the best method of preventing early migration of esophageal stents placed at difficult locations such as at the naive gastroesophageal junction. © The Authors 2017. Published by Oxford University Press on behalf of International Society for Diseases of the Esophagus. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

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

DEFF Research Database (Denmark)

Giovannini, Marc; Thomas, Botelberge; Erwan, Bories

2009-01-01

AIM: To evaluate the ability of endoscopic ultrasound (EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes. METHODS: 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. RESULTS: 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...

Combined transoral and endoscopic approach for total maxillectomy: a pioneering report.

Science.gov (United States)

Liu, Zhuofu; Yu, Huapeng; Wang, Dehui; Wang, Jingjing; Sun, Xicai; Liu, Juan

2013-06-01

Total maxillectomy is sometimes necessary especially for malignant tumors originating from the maxillary sinus. Here we describe a combined transoral and endoscopic approach for total maxillectomy for the treatment of malignant maxillary sinus tumors and evaluate its short-term outcome. This approach was evaluated in terms of the physiological function, aesthetic outcome, and complications. Six patients underwent the above-mentioned approach for resection of malignant maxillary sinus tumors from May 2010 to June 2011. This combined transoral and endoscopic approach includes five basic steps: total sphenoethmoidectomy, sublabial incision, incision of the frontal process of the maxilla, incision of the zygomaticomaxillary fissure, and hard palate osteotomy. All patients with malignant maxillary sinus tumors successfully underwent the planned total endoscopic maxillectomy without the need for facial incision or transfixion of the nasal septum; there were no significant complications. Five patients received preoperative radiation therapy. All patients were well and had no recurrence at follow-up from 13 to 27 months. The combined approach is feasible and can be performed in carefully selected patients. The benefit of the absence of facial incisions or transfixion of the nasal septum, potential improvement in hemostasis, and visual magnification may help to decrease the morbidity of traditional open approaches.

Taking NOTES: translumenal flexible endoscopy and endoscopic surgery.

Science.gov (United States)

Willingham, Field F; Brugge, William R

2007-09-01

To review the current state of natural orifice surgery and examine the concerns, challenges, and opportunities presented by translumenal research. Translumenal endoscopic procedures have been the focus of extensive research. Researchers have reported natural orifice translumenal endoscopic surgery in a swine model in several areas involving the abdominal cavity. Diagnostic procedures have included endoscopic peritoneoscopy, liver biopsy, lymphadenectomy, and abdominal exploration. Several gynecologic procedures including tubal ligation, oophorectomy, and partial hysterectomy have been demonstrated using current commercial endoscopes. Gastrointestinal surgical procedures, including gastrojejunostomy, cholecystectomy, splenectomy, and distal pancreatectomy have been performed successfully via transgastric and/or transcolonic approaches. There have been no studies of natural orifice translumenal endoscopic surgery procedures published in humans. While fundamental questions about the emerging technology have not been scrutinized, limitations of the large animal model will pose a challenge to the development of large randomized trials. While natural orifice translumenal endoscopic surgery may represent a paradigm shift and may offer significant benefits to patients, rigorous testing of the techniques is lacking and current data have been drawn from case series.

Endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma: Is it a significant prognostic factor?

Science.gov (United States)

Shin, Hae Jin; Moon, Hee Seok; Kang, Sun Hyung; Sung, Jae Kyu; Jeong, Hyun Yong; Kim, Seok Hyun; Lee, Byung Seok; Kim, Ju Seok; Yun, Gee Young

2017-12-01

The purpose of this study was to evaluate the prognostic impact of endoscopic traversability in patients with locally advanced esophageal squamous cell carcinoma.This retrospective study was based on medical records from a single tertiary medical center. The records of 317 patients with esophageal squamous cell carcinoma treated with surgery or definitive chemoradiotherapy (CRT) between January 2009 and March 2016 were reviewed. Finally, we retrieved the data on 168 consecutive patients. These 168 patients were divided into 2 groups based on their endoscopic traversability findings: Group A (the endoscope traversable group), and Group B (the endoscope non-traversable group). We then retrospectively compared the clinical characteristics of these 2 groups.The endoscope non-traversable group (Group B) revealed an advanced clinical stage, a poor Eastern Cooperative Oncology Group (ECOG) score, a lower serum albumin level, a higher rate of requirement for esophageal stent insertion and definitive CRT as initial treatment than the endoscope traversable group (Group A). Patients with endoscope traversable cancer showed a significantly higher 3-year overall survival and 3-year relapse-free survival than patients who were endoscope non-traversable (53.8% vs 17.3%, P squamous cell carcinoma treated with definitive CRT, the serum albumin level squamous cell carcinoma treated with definitive CRT is a significant prognostic factor. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Analysis of factors in successful nasal endoscopic resection of nasopharyngeal angiofibroma.

Science.gov (United States)

Ye, Dong; Shen, Zhisen; Wang, Guoli; Deng, Hongxia; Qiu, Shijie; Zhang, Yuna

2016-01-01

Endoscopic resection of nasopharyngeal angiofibroma is less traumatic, causes less bleeding, and provides a good curative effect. Using pre-operative embolization and controlled hypotension, reasonable surgical strategies and techniques lead to successful resection tumors of a maximum Andrews-Fisch classification stage of III. To investigate surgical indications, methods, surgical technique, and curative effects of transnasal endoscopic resection of nasopharyngeal angiofibroma, this study evaluated factors that improve diagnosis and treatment, prevent large intra-operative blood loss and residual tumor, and increase the cure rate. A retrospective analysis was performed of the clinical data and treatment programs of 23 patients with nasopharyngeal angiofibroma who underwent endoscopic resection with pre-operative embolization and controlled hypotension. The surgical method applied was based on the size of tumor and extent of invasion. Curative effects were observed. No intra-operative or perioperative complications were observed in 22 patients. Upon removal of nasal packing material 3-7 days post-operatively, one patient experienced heavy bleeding of the nasopharyngeal wound, which was treated compression hemostasis using post-nasal packing. Twenty-three patients were followed up for 6-60 months. Twenty-two patients experienced cure; one patient experienced recurrence 10 months post-operatively, and repeat nasal endoscopic surgery was performed and resulted in cure.

Endoscopic approach to the infratemporal fossa

Directory of Open Access Journals (Sweden)

Ahmed Youssef

2014-06-01

Conclusions: Endoscopic endonasal transpterygoid approach is considered one of the most useful surgical solutions to manage selected tumors that involve the infratemporal fossa. A good understanding of the endoscopic anatomy of infratemporal fossa allows safe and complete resection of lesions arising or extending to infratemporal fossa.

[Endoscopic ultrasound guided rendezvous for biliary drainage].

Science.gov (United States)

Knudsen, Marie Høxbro; Vilmann, Peter; Hassan, Hazem; Karstensen, John Gésdal

2015-04-27

Endoscopic retrograde cholangiography (ERCP) is currently standard treatment for biliary drainage. Endoscopic ultrasound guided rendezvous (EUS-RV) is a novel method to overcome an unsuccessful biliary drainage procedure. Under endoscopic ultrasound guidance a guidewire is passed via a needle from the stomach or duodenum to the common bile duct and from there on to the duodenum enabling ERCP. With a relatively high rate of success EUS-RV should be considered as an alternative to biliary drainage and surgical intervention.

Sonographic assessment of endoscopically-placed biliary endoprostheses. A prospective study

Energy Technology Data Exchange (ETDEWEB)

Mirk, P; Belli, P; Filemi, A; Costamagna, G; Coppola, R; Nuzzo, G; Colagrande, C

1988-01-01

Endoscopic retrograde biliary drainage by means of transtumoral endoprostheses is an effective technique for pallliative decompression of malignant biliary obstruction. However, serial follow-up is required for an early detection of eventual long-term complications. In the present study 37 patients with malignant biliary obstruction, trated by endoscopic insertion of one or more biliary stents, were prospectively evaluated by sonography, with serial clinical and US examinations up to 10 months. In this experience, sonography could correctly identify both the endoprostheses and their location in the biliary tract. Most important, sonography has proved to be a sensitive method to detect possible stent dysfunctions, besides providing with information about the prograssion of the underlying malignancy. 19 refs.

Elimination of high titre HIV from fibreoptic endoscopes.

Science.gov (United States)

Hanson, P J; Gor, D; Jeffries, D J; Collins, J V

1990-06-01

Concern about contamination of fibreoptic endoscopes with human immunodeficiency virus (HIV) has generated a variety of disruptive and possibly unnecessary infection control practices in endoscopy units. Current recommendations on the cleaning and disinfection of endoscopes have been formulated without applied experimental evidence of the effective removal of HIV from endoscopes. To study the kinetics of elimination of HIV from endoscope surfaces, we artificially contaminated the suction-biopsy channels of five Olympus GIF XQ20 endoscopes with high titre HIV in serum. The air and water channels of two instruments were similarly contaminated. Contamination was measured by irrigating channels with viral culture medium and collecting 3 ml at the distal end for antigen immunoassay. Endoscopes were then cleaned manually in neutral detergent according to the manufacturer's recommendations and disinfected in 2% alkaline glutaraldehyde (Cidex, Surgikos) for two, four, and ten minutes. Contamination with HIV antigens was measured before and after cleaning and after each period of disinfection. Initial contamination comprised 4.8 x 10(4) to 3.5 x 10(6) pg HIV antigen/ml. Cleaning in detergent achieved a reduction to 165 pg/ml (99.93%) on one endoscope and to undetectable levels (100%) on four. After two minutes in alkaline glutaraldehyde all samples were negative and remained negative after the longer disinfection times. Air and water channels, where contaminated, were tested after 10 minutes' disinfection and were negative. These findings underline the importance of cleaning in removing HIV from endoscope and indicate that the use of dedicated equipment and long disinfection times are unnecessary.

Fiber-optical accelerometers based on polymer optical fiber Bragg gratings

DEFF Research Database (Denmark)

Yuan, Scott Wu; Stefani, Alessio; Bang, Ole

2010-01-01

Fiber-optical accelerometers based on polymer optical fiber Bragg gratings (FBGs) are reported. We have written 3mm FBGs for 1550nm operation, characterized their temperature and strain response, and tested their performance in a prototype accelerometer.......Fiber-optical accelerometers based on polymer optical fiber Bragg gratings (FBGs) are reported. We have written 3mm FBGs for 1550nm operation, characterized their temperature and strain response, and tested their performance in a prototype accelerometer....

Significance of endoscopic screening and endoscopic resection for esophageal cancer in patients with hypopharyngeal cancer

International Nuclear Information System (INIS)

Morimoto, Masahiro; Nishiyama, Kinji; Nakamura, Satoaki

2010-01-01

The efficacy of endoscopic screening for esophageal cancer in patients with hypopharyngeal cancer remains controversial and its impact on prognosis has not been adequately discussed. We studied the use of endoscopic screening to detect esophageal cancer in hypopharyngeal cancer patients by analyzing the incidence, stage and prognosis. We included 64 patients with hypopharyngeal cancer who received radical radiotherapy at our institute. Chromoendoscopic esophageal examinations with Lugol dye solution were routinely performed at and after treatment for hypopharyngeal cancer. Twenty-eight esophageal cancers were detected in 28 (41%) patients (18 synchronous and 10 metachronous cancers). Of the 28 cancers, 23 were stage 0 or I cancer and 15 of these were treated with endoscopic resection. Local control was achieved in all of these 23 stage 0 or I cancers. The 5-year overall survival rates with esophageal cancer were 83% in stage 0, 47% in stage I and 0% in stage IIA-IVB. This study showed a strikingly high incidence of esophageal cancer in hypopharyngeal cancer patients. We suppose that the combination of early detection by chromoendoscopic examination and endoscopic resection for associated esophageal cancer in hypopharyngeal cancer patients improve prognosis and maintain quality of life. (author)

Serum Zn levels in dysphagic patients who underwent endoscopic gastrostomy for long term enteral nutrition

OpenAIRE

Adriana Santos, Carla; Fonseca, Jorge; Brito, José; Fernandes, Tânia; Gonçalves, Luísa; Sousa Guerreiro, António

2014-01-01

Background and aims: Dysphagic patients who underwent endoscopic gastrostomy (PEG) usually present protein-energy malnutrition, but little is known about micronutrient malnutrition. The aim of the present study was the evaluation of serum zinc in patients who underwent endoscopic gastrostomy and its relationship with serum proteins, whole blood zinc, and the nature of underlying disorder. Methods: From patients that underwent gastrostomy a blood sample was obtained minutes before the procedur...

Laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy in people undergoing laparoscopic cholecystectomy for stones in the gallbladder and bile duct.

Science.gov (United States)

Vettoretto, Nereo; Arezzo, Alberto; Famiglietti, Federico; Cirocchi, Roberto; Moja, Lorenzo; Morino, Mario

2018-04-11

The management of gallbladder stones (lithiasis) concomitant with bile duct stones is controversial. The more frequent approach is a two-stage procedure, with endoscopic sphincterotomy and stone removal from the bile duct followed by laparoscopic cholecystectomy. The laparoscopic-endoscopic rendezvous combines the two techniques in a single-stage operation. To compare the benefits and harms of endoscopic sphincterotomy and stone removal followed by laparoscopic cholecystectomy (the single-stage rendezvous technique) versus preoperative endoscopic sphincterotomy followed by laparoscopic cholecystectomy (two stages) in people with gallbladder and common bile duct stones. We searched The Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE Ovid, Embase Ovid, Science Citation Index Expanded Web of Science, and two trials registers (February 2017). We included randomised clinical trials that enrolled people with concomitant gallbladder and common bile duct stones, regardless of clinical status or diagnostic work-up, and compared laparoscopic-endoscopic rendezvous versus preoperative endoscopic sphincterotomy procedures in people undergoing laparoscopic cholecystectomy. We excluded other endoscopic or surgical methods of intraoperative clearance of the bile duct, e.g. non-aided intraoperative endoscopic retrograde cholangiopancreatography or laparoscopic choledocholithotomy (surgical incision of the common bile duct for removal of bile duct stones). We used standard methodological procedures recommended by Cochrane. We included five randomised clinical trials with 517 participants (257 underwent a laparoscopic-endoscopic rendezvous technique versus 260 underwent a sequential approach), which fulfilled our inclusion criteria and provided data for analysis. Trial participants were scheduled for laparoscopic cholecystectomy because of suspected cholecysto-choledocholithiasis. Male/female ratio was 0.7; age of men and women ranged from 21 years to 87

Multiplexed fluorescent microarray for human salivary protein analysis using polymer microspheres and fiber-optic bundles.

Science.gov (United States)

Nie, Shuai; Benito-Peña, Elena; Zhang, Huaibin; Wu, Yue; Walt, David R

2013-10-10

Herein, we describe a protocol for simultaneously measuring six proteins in saliva using a fiber-optic microsphere-based antibody array. The immuno-array technology employed combines the advantages of microsphere-based suspension array fabrication with the use of fluorescence microscopy. As described in the video protocol, commercially available 4.5 μm polymer microspheres were encoded into seven different types, differentiated by the concentration of two fluorescent dyes physically trapped inside the microspheres. The encoded microspheres containing surface carboxyl groups were modified with monoclonal capture antibodies through EDC/NHS coupling chemistry. To assemble the protein microarray, the different types of encoded and functionalized microspheres were mixed and randomly deposited in 4.5 μm microwells, which were chemically etched at the proximal end of a fiber-optic bundle. The fiber-optic bundle was used as both a carrier and for imaging the microspheres. Once assembled, the microarray was used to capture proteins in the saliva supernatant collected from the clinic. The detection was based on a sandwich immunoassay using a mixture of biotinylated detection antibodies for different analytes with a streptavidin-conjugated fluorescent probe, R-phycoerythrin. The microarray was imaged by fluorescence microscopy in three different channels, two for microsphere registration and one for the assay signal. The fluorescence micrographs were then decoded and analyzed using a homemade algorithm in MATLAB.

Endoscopic inspection of steam turbines

International Nuclear Information System (INIS)

Maliniemi, H.; Muukka, E.

1990-01-01

For over ten years, Imatran Voima Oy (IVO) has developed, complementary inspection methods for steam turbine condition monitoring, which can be applied both during operation and shutdown. One important method used periodically during outages is endoscopic inspection. The inspection is based on the method where the internal parts of the turbine is inspected through access borings with endoscope and where the magnified figures of the internal parts is seen on video screen. To improve inspection assurance, an image-processing based pattern recognition method for cracks has been developed for the endoscopic inspection of turbine blades. It is based on the deduction conditions derived from the crack shape. The computer gives an alarm of a crack detection and prints a simulated image of the crack, which is then checked manually

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.

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...

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 ...

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...

Fiber-optic annular detector array for large depth of field photoacoustic macroscopy

Directory of Open Access Journals (Sweden)

Johannes Bauer-Marschallinger

2017-03-01

Full Text Available We report on a novel imaging system for large depth of field photoacoustic scanning macroscopy. Instead of commonly used piezoelectric transducers, fiber-optic based ultrasound detection is applied. The optical fibers are shaped into rings and mainly receive ultrasonic signals stemming from the ring symmetry axes. Four concentric fiber-optic rings with varying diameters are used in order to increase the image quality. Imaging artifacts, originating from the off-axis sensitivity of the rings, are reduced by coherence weighting. We discuss the working principle of the system and present experimental results on tissue mimicking phantoms. The lateral resolution is estimated to be below 200 μm at a depth of 1.5 cm and below 230 μm at a depth of 4.5 cm. The minimum detectable pressure is in the order of 3 Pa. The introduced method has the potential to provide larger imaging depths than acoustic resolution photoacoustic microscopy and an imaging resolution similar to that of photoacoustic computed tomography.

Fiber-optic annular detector array for large depth of field photoacoustic macroscopy.

Science.gov (United States)

Bauer-Marschallinger, Johannes; Höllinger, Astrid; Jakoby, Bernhard; Burgholzer, Peter; Berer, Thomas

2017-03-01

We report on a novel imaging system for large depth of field photoacoustic scanning macroscopy. Instead of commonly used piezoelectric transducers, fiber-optic based ultrasound detection is applied. The optical fibers are shaped into rings and mainly receive ultrasonic signals stemming from the ring symmetry axes. Four concentric fiber-optic rings with varying diameters are used in order to increase the image quality. Imaging artifacts, originating from the off-axis sensitivity of the rings, are reduced by coherence weighting. We discuss the working principle of the system and present experimental results on tissue mimicking phantoms. The lateral resolution is estimated to be below 200 μm at a depth of 1.5 cm and below 230 μm at a depth of 4.5 cm. The minimum detectable pressure is in the order of 3 Pa. The introduced method has the potential to provide larger imaging depths than acoustic resolution photoacoustic microscopy and an imaging resolution similar to that of photoacoustic computed tomography.

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...... performed in all patients, and stone extraction was successfully performed in 29 patients (93%) with 2 failures (7%) due to impacted stones. In 8 patients (26%), the laparoscopic procedure was converted to open cholecystectomy because of dense adhesions or unclear anatomy. Two patients (7%) developed mild...

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.

Endoscopic management of bile leaks after laparoscopic ...

African Journals Online (AJOL)

Endoscopic management of bile leaks after laparoscopic cholecystectomy. ... endoscopic management at a median of 12 days (range 2 - 104 days) after surgery. Presenting features included intra-abdominal collections with pain in 58 cases ...

Endoscopic Third Ventriculostomy in Previously Shunted Children

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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.

Endoscopic Ultrasonography in the Diagnosis of Gastric Subepithelial Lesions

Directory of Open Access Journals (Sweden)

Eun Jeong Gong

2016-09-01

Full Text Available Subepithelial lesions occasionally found in the stomach of patients undergoing endoscopy may be either benign lesions or tumors with malignant potential. They may also appear due to extrinsic compression. Discrimination of gastric subepithelial lesions begins with meticulous endoscopic examination for size, shape, color, mobility, consistency, and appearance of the overlying mucosa. Accurate diagnosis can be achieved with endoscopic ultrasonography, which provides useful information on the exact size, layer-of-origin, and characteristic morphologic features to support a definitive diagnosis. Endoscopic ultrasonography also aids in the prediction of malignant potential, especially in gastrointestinal stromal tumors. Features of subepithelial lesions identified on endoscopic ultrasonography can be used to determine whether further diagnostic procedures such as endoscopic resection, fine needle aspiration, or core biopsy are required. Endoscopic ultrasonography is a valuable tool for diagnosis and clinical decision making during follow-up of gastric subepithelial lesions.

Endoscopic Management of Tumor Bleeding from Inoperable Gastric Cancer

Science.gov (United States)

Kim, Young-Il

2015-01-01

Tumor bleeding is not a rare complication in patients with inoperable gastric cancer. Endoscopy has important roles in the diagnosis and primary treatment of tumor bleeding, similar to its roles in other non-variceal upper gastrointestinal bleeding cases. Although limited studies have been performed, endoscopic therapy has been highly successful in achieving initial hemostasis. One or a combination of endoscopic therapy modalities, such as injection therapy, mechanical therapy, or ablative therapy, can be used for hemostasis in patients with endoscopic stigmata of recent hemorrhage. However, rebleeding after successful hemostasis with endoscopic therapy frequently occurs. Endoscopic therapy may be a treatment option for successfully controlling this rebleeding. Transarterial embolization or palliative surgery should be considered when endoscopic therapy fails. For primary and secondary prevention of tumor bleeding, proton pump inhibitors can be prescribed, although their effectiveness to prevent bleeding remains to be investigated. PMID:25844339

[Clinical Results of Endoscopic Treatment of Greater Trochanteric Pain Syndrome].

Science.gov (United States)

Zeman, P; Rafi, M; Skala, P; Zeman, J; Matějka, J; Pavelka, T

2017-01-01

PURPOSE OF THE STUDY This retrospective study aims to present short-term clinical outcomes of endoscopic treatment of patients with greater trochanteric pain syndrome (GTPS). MATERIAL AND METHODS The evaluated study population was composed of a total of 19 patients (16 women, 3 men) with the mean age of 47 years (19-63 years). In twelve cases the right hip joint was affected, in the remaining seven cases it was the left side. The retrospective evaluation was carried out only in patients with greater trochanteric pain syndrome caused by independent chronic trochanteric bursitis without the presence of m. gluteus medius tear not responding to at least 3 months of conservative treatment. In patients from the followed-up study population, endoscopic trochanteric bursectomy was performed alone or in combination with iliotibial band release. The clinical results were evaluated preoperatively and with a minimum follow-up period of 1 year after the surgery (mean 16 months). The Visual Analogue Scale (VAS) for assessment of pain and WOMAC (Western Ontario MacMaster) score were used. In both the evaluated criteria (VAS and WOMAC score) preoperative and postoperative results were compared. Moreover, duration of surgery and presence of postoperative complications were assessed. Statistical evaluation of clinical results was carried out by an independent statistician. In order to compare the parameter of WOMAC score and VAS pre- and post-operatively the Mann-Whitney Exact Test was used. The statistical significance was set at 0.05. RESULTS The preoperative VAS score ranged 5-9 (mean 7.6) and the postoperative VAS ranged 0-5 (mean 2.3). The WOMAC score ranged 56.3-69.7 (mean 64.2) preoperatively and 79.8-98.3 (mean 89.7) postoperatively. When both the evaluated parameters of VAS and WOMAC score were compared in time, a statistically significant improvement (ppain syndrome yields statistically significant improvement of clinical results with the concurrent minimum incidence of

Cost utility analysis of endoscopic biliary stent in unresectable hilar cholangiocarcinoma: decision analytic modeling approach.

Science.gov (United States)

Sangchan, Apichat; Chaiyakunapruk, Nathorn; Supakankunti, Siripen; Pugkhem, Ake; Mairiang, Pisaln

2014-01-01

Endoscopic biliary drainage using metal and plastic stent in unresectable hilar cholangiocarcinoma (HCA) is widely used but little is known about their cost-effectiveness. This study evaluated the cost-utility of endoscopic metal and plastic stent drainage in unresectable complex, Bismuth type II-IV, HCA patients. Decision analytic model, Markov model, was used to evaluate cost and quality-adjusted life year (QALY) of endoscopic biliary drainage in unresectable HCA. Costs of treatment and utilities of each Markov state were retrieved from hospital charges and unresectable HCA patients from tertiary care hospital in Thailand, respectively. Transition probabilities were derived from international literature. Base case analyses and sensitivity analyses were performed. Under the base-case analysis, metal stent is more effective but more expensive than plastic stent. An incremental cost per additional QALY gained is 192,650 baht (US$ 6,318). From probabilistic sensitivity analysis, at the willingness to pay threshold of one and three times GDP per capita or 158,000 baht (US$ 5,182) and 474,000 baht (US$ 15,546), the probability of metal stent being cost-effective is 26.4% and 99.8%, respectively. Based on the WHO recommendation regarding the cost-effectiveness threshold criteria, endoscopic metal stent drainage is cost-effective compared to plastic stent in unresectable complex HCA.

Esophageal circumferential en bloc endoscopic submucosal dissection: assessment of a new technique.

Science.gov (United States)

Barret, Maximilien; Pratico, Carlos Alberto; Beuvon, Frédéric; Mangialavori, Luigi; Chryssostalis, Ariane; Camus, Marine; Chaussade, Stanislas; Prat, Frédéric

2013-10-01

Endoscopic esophageal piecemeal mucosectomy for high-grade dysplasia on Barrett's esophagus leads to suboptimal histologic evaluation, as well as recurrence on remaining mucosa. Circumferential en bloc mucosal resection would significantly improve the management of dysplastic Barrett's esophagus. Our aim was to describe a new method of esophageal circumferential endoscopic en bloc submucosal dissection (CESD) in a swine model. After submucosal injection, circumferential incision was performed at each end of the esophageal segment to be removed. Mechanical submucosal dissection was performed from the proximal to the distal incision, using a mucosectomy cap over the endoscope. The removed mucosal ring was retrieved. Clinical, endoscopic, and histologic data were prospectively collected. Esophageal CESD was conducted on 5 pigs. A median mucosal length of 6.5 cm (range, 4 to 8 cm) was removed in the lower third of the esophagus. The mean duration of the procedure was 36 minutes (range, 17 to 80 min). No procedure-related complication, including perforation, was observed. All animals exhibited a mild esophageal stricture at day 7, and a severe symptomatic stricture at day 14. Necropsy confirmed endoscopic findings with cicatricial fibrotic strictures. On histologic examination, an inflammatory cell infiltrate, diffuse fibrosis reaching the muscular layer, and incomplete reepithelialization were observed. CESD enables expeditious resection and thorough examination of large segments of esophageal mucosa in safe procedural conditions, but esophageal strictures occur in the majority of the cases. Efficient methods for stricture prevention are needed for this technique to be developed in humans.

Highly sensitive rotation sensing based on orthogonal fiber-optic structures

Science.gov (United States)

Yang, Yi; Wang, Zi-nan; Xu, Lian-yu; Wang, Cui-yun; Jia, Lei; Yu, Xiao-qi; Shao, Shan; Li, Zheng-bin

2011-08-01

In traditional fiber-optic gyroscopes (FOG), the polarization state of counter propagating waves is critically controlled, and only the mode polarized along one particular direction survives. This is important for a traditional single mode fiber gyroscope as the requirement of reciprocity. However, there are some fatal defects such as low accuracy and poor bias stability in traditional structures. In this paper, based on the idea of polarization multiplexing, a double-polarization structure is put forward and experimentally studied. In highly birefringent fibers or standard single mode fibers with induced anisotropy, two orthogonal polarization modes can be used at the same time. Therefore, in polarization maintaining fibers (PMF), each pair of counter propagating beams preserve reciprocity within their own polarization state. Two series of sensing results are gotten in the fast and slow axes in PMF. The two sensing results have their own systematic drifts and the correlation of random noise in them is approximately zero. So, beams in fast and slow axes work as two independent and orthogonal gyroscopes. In this way, amount of information is doubled, providing opportunity to eliminate noise and improve sensitivity. Theoretically, this double-polarization structure can achieve a sensitivity of 10-18 deg/h. Computer simulation demonstrates that random noise and systematic drifts are largely reduced in this novel structure. In experiment, a forty-hour stability test targeting the earth's rotation velocity is carried out. Experiment result shows that the orthogonal fiber-optic structure has two big advantages compared with traditional ones. Firstly, the structure gets true value without any bias correction in any axis and even time-varying bias does not affect the acquisition of true value. The unbiasedness makes the structure very attractive when sudden disturbances or temperature drifts existing in working environment. Secondly, the structure lowers bias for more than

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 ...

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome.

Science.gov (United States)

Forootan, Mojgan; Shekarchizadeh, Masood; Farmanara, Hamedreza; Esfahani, Ahmad Reza Shekarchizadeh; Esfahani, Mansooreh Shekarchizadeh

2018-01-12

Solitary rectal ulcer syndrome (SRUS) is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9 ± 45.74 months in non-responder group (P=0.22). There were more ulcers in non-responder group than responder group (1.50 ±0.71 versus 1.33±- 0.71 before and 1.30 ± 0.95 versus 0.67 ±0.50 after biofeedback), although the difference was not significant (P=0.604, 0.10 respectively). The most prevalent symptoms were constipation (79%), rectal bleeding (68%) and anorectal pain (53%). The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

Biofeedback efficacy to improve clinical symptoms and endoscopic signs of solitary rectal ulcer syndrome

Directory of Open Access Journals (Sweden)

Mojgan Forootan

2018-03-01

Full Text Available Solitary rectal ulcer syndrome (SRUS is often resistant to medical and surgical treatment. This study assessed the effect of biofeedback in decreasing the symptoms and the healing of endoscopic signs in SRUS patients. Before starting the treatment, endoscopy and colorectal manometry was performed to evaluate dyssynergic defecation. Patients were followed every four weeks, and during each visit their response to treatment was evaluated regarding to manometry pattern. After at least 50% improvement in manometry parameters, recipients underwent rectosigmoidoscopy. Endoscopic response to biofeedback treatment and clinical symptoms were investigated. Duration of symptoms was 43.11±36.42 months in responder and 63.9±45.74 months in non-responder group (P=0.22. There were more ulcers in non-responder group than responder group (1.50±0.71 versus 1.33±-0.71 before and 1.30 ± 0.95 versus 0.67±0.50 after biofeedback, although the difference was not significant (P=0.604, 0.10 respectively. The most prevalent symptoms were constipation (79%, rectal bleeding (68% and anorectal pain (53%. The most notable improvement in symptoms after biofeedback occured in abdominal pain and incomplete evacuation, and the least was seen in mucosal discharge and toilet waiting as shown in the bar chart. Endoscopic cure was observed in 4 of 10 patients of the non-responder group while 8 patients in responder group experienced endoscopic improvement. It seems that biofeedback has significant effect for pathophysiologic symptoms such as incomplete evacuation and obstructive defecation. Improvement of clinical symptoms does not mean endoscopic cure; so to demonstrate remission the patients have to go under rectosigmoidoscopy.

Clinical Evaluation of Endoscopic Trimodal Imaging for the Detection and Differentiation of Colonic Polyps

NARCIS (Netherlands)

van den Broek, Frank J. C.; Fockens, Paul; van Eeden, Susanne; Kara, Mohammed A.; Hardwick, James C. H.; Reitsma, Johannes B.; Dekker, Evelien

2009-01-01

Background & Aims: Endoscopic trimodal imaging (ETMI) incorporates high-resolution endoscopy (HRE) and autofluorescence imaging (AFI) for adenoma detection, and narrow-band imaging (NBI) for differentiation of adenomas from nonneoplastic polyps. The aim of this study was to compare AFI with HRE for

Endoscopic Instruments and Electrosurgical Unit for Colonoscopic Polypectomy

OpenAIRE

Park, Hong Jun

2016-01-01

Colorectal polypectomy is an effective method for prevention of colorectal cancer. Many endoscopic instruments have been used for colorectal polypectomy, such as snares, forceps, endoscopic clips, a Coagrasper, retrieval net, injector, and electrosurgery generator unit (ESU). Understanding the characteristics of endoscopic instruments and their proper use according to morphology and size of the colorectal polyp will enable endoscopists to perform effective polypectomy. I reviewed the characte...

Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

Energy Technology Data Exchange (ETDEWEB)

Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk [Pusan National University School of Medicine, Pusan National University Hospital, Busan (Korea, Republic of); Jeon, Ung Bae; Kang, Dae Hwan [Pusan National University School of Medicine, Yangsan Pusan National University Hospital, Yangsan (Korea, Republic of)

2013-11-15

Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

Percutaneous transhepatic recanalization of malignant hilarobstruction: A possible rescue for early failure of endoscopic y-stenting

International Nuclear Information System (INIS)

Kwon, Hoon; Kim, Chang Won; Lee, Tae Hong; Kim, Dong Uk; Jeon, Ung Bae; Kang, Dae Hwan

2013-01-01

Endoscopic biliary stenting is well known as an optimal method of management of malignant hilar obstruction, but sometimes the result is not satisfactory, with early stent failure. Percutaneous transhepatic biliary drainage (PTBD) has a distinct advantage over endoscopic retrograde cholangiopancreatoscopy in that with ultrasound guidance one or more appropriate segments for drainage can be chosen. We evaluated the effectiveness of percutaneous transhepatic stenting as a rescue of early failure of endoscopic stenting. Ten patients (4 men, 6 women; age range, 52-78 years; mean age, 69 years) with inoperable biliary obstruction (2 patients with gall bladder cancer and hilar invasion, and 8 patients with Klatskin tumor) and with early endoscopic stent failure were included in our study. All of the patients underwent PTBD and percutaneous transhepatic biliary stenting. Metallic stents were placed in all patients for internal drainage. Percutaneous rescue stenting was successful in all the patients technically and clinically. Mean time for the development of biliary obstruction was 13.5 days after endoscopic stenting. The mean patency of the rescue stenting was 122 days. The mean survival time for percutaneous transhepatic rescue stenting was 226.3 days. In early failure of endoscopic biliary stenting, percutaneous transhepatic recanalization can be a possible solution.

Leopard Skin-Like Colonic Mucosa: A Novel Endoscopic Finding of Chronic Granulomatous Disease-Associated Colitis.

Science.gov (United States)

Obayashi, Naho; Arai, Katsuhiro; Nakano, Natsuko; Mizukami, Tomoyuki; Kawai, Toshinao; Yamamoto, Shojiro; Shimizu, Hirotaka; Nunoi, Hiroyuki; Shimizu, Toshiaki; Tang, Julian; Onodera, Masafumi

2016-01-01

Chronic granulomatous disease (CGD) is a rare inherited disorder in which phagocytes are unable to eradicate pathogens because of a deficit of nicotinamide adenine dinucleotide phosphate oxidase. Among CGD patients, ∼ 30% to 50% develop severe gastrointestinal tract symptoms. Although characteristic histologic findings of CGD-associated colitis have been reported, information on endoscopic features remained vague. A total of 8 male patients with CGD (ages 2-23 years) from 2 Japanese institutions underwent colonoscopy for the evaluation of their fever, diarrhea, bloody stool, and abdominal pain. The endoscopic and histologic findings were retrospectively reviewed. The endoscopic findings of CGD-associated colitis appeared varied. Notably, brownish dots over a yellowish edematous mucosa were observed in 3 of the 8 patients. Prominent pigment-laden macrophages were noted histologically on the mucosa. Although nonspecific endoscopic findings of CGD-associated colitis have been reported before, our observation of brownish dots spread across a yellowish edematous mucosa, termed "leopard sign," could be a unique feature of this condition.

Peristomal infection after percutaneous endoscopic gastrostomy: a 7-year surveillance of 297 patients

Directory of Open Access Journals (Sweden)

Helena Duarte

2012-12-01

Full Text Available CONTEXT: Healthcare-associated infection represents the most frequent adverse event during care delivery. Medical advances like percutaneous endoscopic gastrostomy have brought improvement on quality of life to patients but an increased risk of healthcare-associated infection. Predictive risk factors for peristomal wound infection are largely unknown but evidence suggests that antibiotic prophylaxis and preventive strategies related to infection control may reduce infection rates. OBJECTIVES: The primary aim was to evaluate the global prevalence rate of peristomal infection. Secondary objectives were to characterise the positive culture results, to evaluate the prophylactic antibiotic protocol and to identify potential risk factors for peristomal infection. METHODS: Retrospective study of 297 patients with percutaneous endoscopic gastrostomy performed at a general hospital between January 2004 and September 2010. Patients received prophylactic cefazolin before the endoscopic gastrostomy procedure. Medical records were reviewed for demographic data, underling disease conditions to percutaneous endoscopic gastrostomy and patient potential intrinsic risk factors. Statistical analysis was made with the statistical program SPSS 17.0. RESULTS: A total of 297 percutaneous endoscopic gastrostomy tubes were inserted. Wound infection occurred in 36 patients (12.1%. Staphylococcus aureus methicillin resistant was the most frequently isolated microorganism (33.3% followed by Pseudomonas aeruginosa (30.6%. The incidence rate had been rising each year and differ from 4.65% in 2004/2007 to 17.9% in 2008/2010. This finding was consistent with the increasing of prevalence global infection rates of the hospital. Most of the infections (55.6% were detected in the first 10 days post procedure. There was no significant difference in age, body mass index values, mean survival time and duration of percutaneous endoscopic gastrostomy feeding between patients with and

Alpha-fetoprotein detection by using a localized surface plasmon coupled fluorescence fiber-optic biosensor

Science.gov (United States)

Chang, Ying-Feng; Chen, Ran-Chou; Li, Ying-Chang; Yu, Chih-Jen; Hsieh, Bao-Yu; Chou, Chien

2007-11-01

Alpha-fetoprotein (AFP) detection by using a localized surface plasmon coupled fluorescence (LSPCF) fiber-optic biosensor is setup and experimentally demonstrated. It is based on gold nanoparticle (GNP) and coupled with localized surface plasmon wave on the surface of GNP. In this experiment, the fluorophores are labeled on anti-AFP which are bound to protein A conjugated GNP. Thus, LSPCF is excited with high efficiency in the near field of localized surface plasmon wave. Therefore, not only the sensitivity of LSPCF biosensor is enhanced but also the specific selectivity of AFP is improved. Experimentally, the ability of real time measurement in the range of AFP concentration from 0.1ng/ml to 100ng/ml was detected. To compare with conventional methods such as enzyme-linked immunosorbent assay (ELISA) or radioimmunoassay (RIA), the LSPCF fiber-optic biosensor performs higher or comparable detection sensitivity, respectively.

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...

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.

Endoscopic electrosurgical papillotomy and manometry in biliary tract disease.

Science.gov (United States)

Geenen, J E; Hogan, W J; Shaffer, R D; Stewart, E T; Dodds, W J; Arndorfer, R C

1977-05-09

Endoscopic papillotomy was performed in 13 patients after cholecystectomy for retained or recurrent common bile duct calculi (11 patients) and a clinical picture suggesting papillary stenosis (two patients). Following endoscopic papillotomy, ten of the 11 patients spontaneously passed common bile duct (CBD) stones verified on repeated endoscopic retrograde cholangiopancreatography (ERCP) study. One patient failed to pass a large CBD calculus; one patient experienced cholangitis three months after in inadequate papillotomy and required operative intervention. Endoscopic papillotomy substantially decreased the pressure gradient existing between the CBD and the duodenum in all five patients studied with ERCP manometry. Endoscopic papillotomy is a relatively safe and effective procedure for postcholecystectomy patients with retained or recurrent CBD stones. The majority of CBD stones will pass spontaneously if the papillotomy is adequate.

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

Huge biloma after endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy

Directory of Open Access Journals (Sweden)

Harith M. Alkhateeb

2015-01-01

Conclusions: (1 Following endoscopic retrograde cholangiopancreatography, a patient’s complaints should not be ignored. (2 A massive biloma can occur due to such procedures. (3 Conservative treatment with minimal invasive technique can prove to be effective.

Mesenteric findings of CT enterography are well correlated with the endoscopic severity of Crohn’s disease

Energy Technology Data Exchange (ETDEWEB)

Sakurai, Takehiro [Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8670, Chiba (Japan); Katsuno, Tatsuro, E-mail: katsuno@faculty.chiba-u.jp [Kashiwanoha Clinic, Chiba University, 6-2-1 Kashiwanoha, Kashiwa-shi, 277-0882, Chiba (Japan); Saito, Keiko; Yoshihama, Sayuri; Nakagawa, Tomoo; Koseki, Hirotaka; Taida, Takashi; Ishigami, Hideaki; Okimoto, Ken-ichiro; Maruoka, Daisuke; Matsumura, Tomoaki; Arai, Makoto; Yokosuka, Osamu [Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi 260-8670, Chiba (Japan)

2017-04-15

Background: Maintenance of mucosal healing is a primary goal when treating Crohn’s disease (CD). Endoscopy is the most precise method for the assessment of mucosal healing, but is considered overly invasive for patients with CD. In contrast, CT enterography (CTE) is less invasive, but little is known about the correlation between mucosal status and CTE parameters. Methods: We recruited CD patients who underwent CTE and double balloon endoscopy (DBE) on the same day at our hospital between 2012 and 2014. CTE parameters evaluated included bowel-wall thickening, mural hyperenhancement, mural stratification (target sign), submucosal fat deposition, mesenteric hypervascularity (comb sign), increased fat density, mesenteric fibrofatty proliferation, enlarged mesenteric lymph nodes, and stenosis/sacculation. Endoscopic findings were evaluated using the Simple Endoscopic Score for Crohn’s Disease (SES-CD). CTE parameters that were predictive of higher values in the SES-CD were extracted statistically. Results: Forty-one patients were recruited, from which 191 intestinal segments were evaluated. Spearman’s rank correlation coefficients showed that the majority of CTE values exhibited mild to moderate correlations with SES-CD values. Notably, multiple ordinal logistic regression analysis demonstrated that CTE findings obtained from the mesenteric area, such as mesenteric hypervascularity (comb sign) and enlarged mesenteric lymph nodes, were more critical predictors of endoscopic mucosal ulceration than those obtained from the bowel wall. Conclusions: This study was the first of its kind to assess correlations between CTE values and SES-CD values. Mesenteric findings of CTE, rather than mural findings, were highly correlated with the endoscopically evaluated severity of ulceration.

Mesenteric findings of CT enterography are well correlated with the endoscopic severity of Crohn’s disease

International Nuclear Information System (INIS)

Sakurai, Takehiro; Katsuno, Tatsuro; Saito, Keiko; Yoshihama, Sayuri; Nakagawa, Tomoo; Koseki, Hirotaka; Taida, Takashi; Ishigami, Hideaki; Okimoto, Ken-ichiro; Maruoka, Daisuke; Matsumura, Tomoaki; Arai, Makoto; Yokosuka, Osamu

2017-01-01

Background: Maintenance of mucosal healing is a primary goal when treating Crohn’s disease (CD). Endoscopy is the most precise method for the assessment of mucosal healing, but is considered overly invasive for patients with CD. In contrast, CT enterography (CTE) is less invasive, but little is known about the correlation between mucosal status and CTE parameters. Methods: We recruited CD patients who underwent CTE and double balloon endoscopy (DBE) on the same day at our hospital between 2012 and 2014. CTE parameters evaluated included bowel-wall thickening, mural hyperenhancement, mural stratification (target sign), submucosal fat deposition, mesenteric hypervascularity (comb sign), increased fat density, mesenteric fibrofatty proliferation, enlarged mesenteric lymph nodes, and stenosis/sacculation. Endoscopic findings were evaluated using the Simple Endoscopic Score for Crohn’s Disease (SES-CD). CTE parameters that were predictive of higher values in the SES-CD were extracted statistically. Results: Forty-one patients were recruited, from which 191 intestinal segments were evaluated. Spearman’s rank correlation coefficients showed that the majority of CTE values exhibited mild to moderate correlations with SES-CD values. Notably, multiple ordinal logistic regression analysis demonstrated that CTE findings obtained from the mesenteric area, such as mesenteric hypervascularity (comb sign) and enlarged mesenteric lymph nodes, were more critical predictors of endoscopic mucosal ulceration than those obtained from the bowel wall. Conclusions: This study was the first of its kind to assess correlations between CTE values and SES-CD values. Mesenteric findings of CTE, rather than mural findings, were highly correlated with the endoscopically evaluated severity of ulceration.

Averaged subtracted polarization imaging for endoscopic diagnostics of surface microstructures on translucent mucosae

Science.gov (United States)

Kanamori, Katsuhiro

2016-07-01

An endoscopic image processing technique for enhancing the appearance of microstructures on translucent mucosae is described. This technique employs two pairs of co- and cross-polarization images under two different linearly polarized lights, from which the averaged subtracted polarization image (AVSPI) is calculated. Experiments were then conducted using an acrylic phantom and excised porcine stomach tissue using a manual experimental setup with ring-type lighting, two rotating polarizers, and a color camera; better results were achieved with the proposed method than with conventional color intensity image processing. An objective evaluation method that uses texture analysis was developed and used to evaluate the enhanced microstructure images. This paper introduces two types of online, rigid-type, polarimetric endoscopic implementations using a polarized ring-shaped LED and a polarimetric camera. The first type uses a beam-splitter-type color polarimetric camera, and the second uses a single-chip monochrome polarimetric camera. Microstructures on the mucosa surface were enhanced robustly with these online endoscopes regardless of the difference in the extinction ratio of each device. These results show that polarimetric endoscopy using AVSPI is both effective and practical for hardware implementation.

Method for radiometric calibration of an endoscope's camera and light source

Science.gov (United States)

Rai, Lav; Higgins, William E.

2008-03-01

An endoscope is a commonly used instrument for performing minimally invasive visual examination of the tissues inside the body. A physician uses the endoscopic video images to identify tissue abnormalities. The images, however, are highly dependent on the optical properties of the endoscope and its orientation and location with respect to the tissue structure. The analysis of endoscopic video images is, therefore, purely subjective. Studies suggest that the fusion of endoscopic video images (providing color and texture information) with virtual endoscopic views (providing structural information) can be useful for assessing various pathologies for several applications: (1) surgical simulation, training, and pedagogy; (2) the creation of a database for pathologies; and (3) the building of patient-specific models. Such fusion requires both geometric and radiometric alignment of endoscopic video images in the texture space. Inconsistent estimates of texture/color of the tissue surface result in seams when multiple endoscopic video images are combined together. This paper (1) identifies the endoscope-dependent variables to be calibrated for objective and consistent estimation of surface texture/color and (2) presents an integrated set of methods to measure them. Results show that the calibration method can be successfully used to estimate objective color/texture values for simple planar scenes, whereas uncalibrated endoscopes performed very poorly for the same tests.

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.

Maximum-performance fiber-optic irradiation with nonimaging designs.

Science.gov (United States)

Fang, Y; Feuermann, D; Gordon, J M

1997-10-01

A range of practical nonimaging designs for optical fiber applications is presented. Rays emerging from a fiber over a restricted angular range (small numerical aperture) are needed to illuminate a small near-field detector at maximum radiative efficiency. These designs range from pure reflector (all-mirror), to pure dielectric (refractive and based on total internal reflection) to lens-mirror combinations. Sample designs are shown for a specific infrared fiber-optic irradiation problem of practical interest. Optical performance is checked with computer three-dimensional ray tracing. Compared with conventional imaging solutions, nonimaging units offer considerable practical advantages in compactness and ease of alignment as well as noticeably superior radiative efficiency.

Endoscopic versus transcranial procurement of allograft tympano-ossicular systems: a prospective double-blind randomized controlled audit.

Science.gov (United States)

Caremans, Jeroen; Hamans, Evert; Muylle, Ludo; Van de Heyning, Paul; Van Rompaey, Vincent

2016-06-01

Allograft tympano-ossicular systems (ATOS) have proven their use over many decades in tympanoplasty and reconstruction after resection of cholesteatoma. The transcranial bone plug technique has been used in the past 50 years to procure en bloc ATOS (tympanic membrane with malleus, incus and stapes attached). Recently, our group reported the feasibility of the endoscopic procurement technique. The aim of this study was to assess whether clinical outcome is equivalent in ATOS acquired by using the endoscopic procurement technique compared to ATOS acquired by using the transcranial technique. A double-blind randomized controlled audit was performed in a tertiary referral center in patients that underwent allograft tympanoplasty because of chronic otitis media with and without cholesteatoma. Allograft epithelialisation was evaluated at the short-term postoperative visit by microscopic examination. Failures were reported if reperforation was observed. Fifty patients underwent allograft tympanoplasty: 34 received endoscopically procured ATOS and 16 received transcranially procured ATOS. One failed case was observed, in the endoscopic procurement group. We did not observe a statistically significant difference between the two groups in failure rate. This study demonstrates equivalence of the clinical outcome of allograft tympanoplasty using either endoscopic or transcranial procured ATOS and therefore indicates that the endoscopic technique can be considered the new standard procurement technique. Especially because the endoscopic procurement technique has several advantages compared to the former transcranial procurement technique: it avoids risk of prion transmission and it is faster while lacking any noticeable incision.

Endoscopic transnasal odontoidectomy to treat basilar invagination with congenital osseous malformations

Directory of Open Access Journals (Sweden)

YU Yong

2012-08-01

Full Text Available Objective To introduce the surgical techniques of image-guided endoscopic transnasal odontoidectomy to treat basilar invagination with congenital osseous malformations and describe several advantages compared to the traditional transoral procedure. Methods From September 2009 to February 2010, two cases with basilar invagination, of which the etiology was congenital osseous malformations, underwent endoscopic transnasal odontoidectomy. Case 2 also received occipitocervical fixation and bone fusion during the same surgical episode to ensure stability. The clinical symptoms of the two cases were evaluated by using the Japanese Orthopaedic Association (JOA score for the evaluation of cervical myelopathy. Results Both patients were extubated after recovery from anesthesia and allowed oral food intake the next day. Cerebrospinal fluid rhinorrhea was found in the second case and cured by continuous lumber drainage of cerebrospinal fluid. No infection was noted. The average follow?up time was more than 24 months. Remarkable neurological recovery was observed at postoperation in both patients. The JOA scores elevated from preoperative 12 and 8 to postoperative 17 and 15. Conclusion The endoscopic transnasal odontoidectomy is a more minimally invasive approach for anterior decompression of cervicomedullary with basilar invagination. The advantages over the standard transoral odontoidectomy include visualization improvement, elimination of risk of tongue swelling and teeth damaging, alleviation of prolonged intubation, reduction of need for enteral tube feeding, and less risk of affecting phonation.

Endoscopic vs. Microscopic Resection of Sellar Lesions—A Matched Analysis of Clinical and Socioeconomic Outcomes

Directory of Open Access Journals (Sweden)

Tej D. Azad

2017-06-01

Full Text Available BackgroundDirect comparisons of microscopic and endoscopic resection of sellar lesions are scarce, with conflicting reports of cost and clinical outcome advantages.ObjectiveTo determine if the proposed benefits of endoscopic resection are realized on a population level.MethodsWe performed a matched cohort study of 9,670 adult patients in the MarketScan database who underwent either endoscopic or microscopic surgery for sellar lesions. Coarsened matching was applied to estimate the effects of surgical approach on complication rates, length of stay (LOS, costs, and likelihood of postoperative radiation.ResultsWe found that LOS, readmission, and revision rates did not differ significantly between approaches. The overall complication rate was higher for endoscopy (47% compared to 39%, OR 1.37, 95% CI 1.22–1.53. Endoscopic approach was associated with greater risk of neurological complications (OR 1.32, 95% CI 1.11–1.55, diabetes insipidus (OR 1.65, 95% CI 1.37–2.00, and cerebrospinal fluid rhinorrhea (OR 1.83, 95% CI 1.07–3.13 compared to the microscopic approach. Although the total index payment was higher for patients receiving endoscopic resection ($32,959 compared to $29,977 for microscopic resection, there was no difference in long-term payments. Endoscopic surgery was associated with decreased likelihood of receiving post-resection stereotactic radiosurgery (OR 0.67, 95% CI 0.49–0.90 and intensity-modulated radiation therapy (OR 0.78, 95% CI 0.65–0.93.ConclusionOur results suggest that the transition from a microscopic to endoscopic approach to sellar lesions must be subject to careful evaluation. Although there are evident advantages to transsphenoidal endoscopy, our analysis suggests that the benefits of the endoscopic approach are yet to be materialized.

Splenic artery ligature associated with endoscopic banding for schistosomal portal hypertension.

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Colaneri, Renata Potonyacz; Coelho, Fabrício Ferreira; de Cleva, Roberto; Perini, Marcos Vinícius; Herman, Paulo

2014-11-28

To propose a less invasive surgical treatment for schistosomal portal hypertension. Ten consecutive patients with hepatosplenic schistosomiasis and portal hypertension with a history of upper gastrointestinal hemorrhage from esophageal varices rupture were evaluated in this study. Patients were subjected to a small supraumbilical laparotomy with the ligature of the splenic artery and left gastric vein. During the procedure, direct portal vein pressure before and after the ligatures was measured. Upper gastrointestinal endoscopy was performed at the 30(th) postoperative day, when esophageal varices diameter were measured and band ligature performed. During follow-up, other endoscopic procedures were performed according to endoscopy findings. There was no intra-operative mortality and all patients had confirmed histologic diagnoses of schistosomal portal hypertension. During the immediate postoperative period, two of the ten patients had complications, one characterized by a splenic infarction, and the other by an incision hematoma. Mean hospitalization time was 4.1 d (range: 2-7 d). Pre- and post-operative liver function tests did not show any significant changes. During endoscopy thirty days after surgery, a decrease in variceal diameters was observed in seven patients. During the follow-up period (57-72 mo), endoscopic therapy was performed and seven patients had their varices eradicated. Considering the late postoperative evaluation, nine patients had a decrease in variceal diameters. A mean of 3.9 endoscopic banding sessions were performed per patient. Two patients presented bleeding recurrence at the late postoperative period, which was controlled with endoscopic banding in one patient due to variceal rupture and presented as secondary to congestive gastropathy in the other patient. Both bleeding episodes were of minor degree with no hemodynamic consequences or need for blood transfusion. Ligature of the splenic artery and left gastric vein with supraumbilical

Fully endoscopic resection of juvenile nasopharyngeal angiofibroma - own experience and clinical outcomes.

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Kopeć, Tomasz; Borucki, Łukasz; Szyfter, Witold

2014-07-01

The treatment of choice in juvenile nasopharyngeal angiofibroma (JNA) is surgery - nowadays endoscopic techniques. The aim of the study was to present the results of endoscopic treatment in patients diagnosed with juvenile angiofibroma. In this retrospective case series, 10 patients with a diagnosis of JNA treated at the Department of Otolaryngology of the Medical University in Poznań from 2006 to June 2013 were included. The age of patients were between 11 and 19 years old (14.6 on average). In 9 out of 10 patients the treatment was preceded by embolization. The surgery used the endoscopic approach through one nostril and the four-handed technique. Total resection was possible in all cases. Blood loss ranged from 100 to 250 ml. Post-operative hospitalization lasted from 3 to 5 days (3.3 days on average). Recurrence was reported in one patient. The observation lasted from six months to seven years (3.55 on average). Endoscopic resection of juvenile angiofibroma is safe for the patient. Moreover, if the evaluation of the tumour size and staging is correct, the ability of total removal of the tumour is very high. It is also connected with small blood loss, short hospital stay and good cosmetic effects. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Endoscopic minor papilla balloon dilation for the treatment of symptomatic pancreas divisum.

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Yamamoto, Natsuyo; Isayama, Hiroyuki; Sasahira, Naoki; Tsujino, Takeshi; Nakai, Yousuke; Miyabayashi, Koji; Mizuno, Suguru; Kogure, Hirofumi; Sasaki, Takashi; Hirano, Kenji; Tada, Minoru; Koike, Kazuhiko

2014-08-01

A subpopulation of patients with pancreas divisum experience symptomatic events such as recurrent acute pancreatitis and chronic pancreatitis. Minor papilla sphincterotomy has been reported as being an effective treatment. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation for the minor papilla. Between 2000 and 2012, 16 patients were retrospectively included in this study. After endoscopic balloon dilation for the minor papilla was received, a pancreatic stent or a nasal pancreatic drainage catheter was placed for 1 week. If a stricture or obstruction was evident, it was treated with balloon dilation followed by long-term stent placement (1 year). When an outflow of pancreatic juice was disturbed by a pancreatic stone, endoscopic stone extraction was performed. Balloon dilation and stent placement were achieved and were successful in all the cases (16/16; 100%). Clinical improvement was achieved in 7 (84.7%) of the 9 patients with recurrent acute pancreatitis and in 6 (85.7%) of the 7 patients with chronic pancreatitis. Early complications were observed in 1 (6.3%) patient. Pancreatitis or bleeding related to balloon dilation was not observed. Endoscopic balloon dilation for the minor papilla is feasible for the management of symptomatic pancreas divisum.

Correlation of High-Resolution Manometric Findings with Symptoms of Dysphagia and Endoscopic Features in Adults with Eosinophilic Esophagitis.

Science.gov (United States)

von Arnim, Ulrike; Kandulski, Arne; Weigt, Jochen; Malfertheiner, Peter

2017-01-01

Eosinophilic esophagitis (EoE) presents with dysphagia, but data about motility patterns using high-resolution manometry (HRM) are rare. We aimed at evaluating esophageal motility patterns in EoE and their correlation to endoscopic and dysphagia scores. Twenty-six EoE patients and 23 controls were included after 4 weeks of treatment with proton pump inhibitors. Dysphagia and endoscopic scores were evaluated before performing HRM. EoE patients were classified to have fibrostenotic (FS) or inflammatory (IF) type. HRM analysis was performed according to the Chicago classification (CC) system. According to the CC, the HRM findings in EoE and controls were normal in 11 (42%) and 20 (88.5%), p dysphagia scores in EoE subtypes. HRM findings in EoE are often diagnostic, but they are non-specific and do not correlate with the severity of dysphagia or endoscopic appearance. The clinical impact of HRM in EoE needs further evaluation. © 2017 S. Karger AG, Basel.

THERMAL PROTECTION AND THERMAL STABILIZATION OF FIBER-OPTICAL GYROSCOPE INCLUDED IN STRAPDOWN INERTIAL NAVIGATION SYSTEM

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D. S. Gromov

2014-03-01

Full Text Available It is known, that temperature perturbations and thermal modes have significant influence on the accuracy of a fiber-optical gyroscope. Nowadays, thermal perturbations are among the main problems in the field of navigation accuracy. Review of existing methods for decrease of temperature influences on the accuracy of a strapdown inertial navigation system with fiberoptical gyros showed, that the usage of constructive and compensation methods only is insufficient and, therefore, thermostabilization is required. Reversible thermostabilization system is offered, its main executive elements are thermoelectric modules (Peltier’s modules, heat transfer from which is provided by heatsinks at work surfaces of modules. This variant of thermostabilization maintenance is considered; Peltier’s modules and temperature sensors for the system are chosen. Parameters of heatsinks for heat transfer intensification are calculated. Fans for necessary air circulation in the device are chosen and thickness of thermal isolation is calculated. Calculations of thermal modes of navigation system with thermostabilization are made in modern software Autodesk Simulation CFD. Comparison of results for present and previous researches and calculations shows essential decrease in gradients of temperature on gyro surfaces and better uniformity of temperature field in the whole device. Conclusions about efficiency of the given method usage in view of accuracy improvement of navigation system are made. Thermostabilization provision of a strapdown inertial navigation system with fiberoptical gyros is proved. Thermostabilization application in combination with compensational methods can reach a necessary accuracy of navigation system.

[Current Status of Endoscopic Resection of Early Gastric Cancer in Korea].

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Jung, Hwoon Yong

2017-09-25

Endoscopic resection (Endoscopic mucosal resection [EMR] and endoscopic submucosal dissection [ESD]) is already established as a first-line treatment modality for selected early gastric cancer (EGC). In Korea, the number of endoscopic resection of EGC was explosively increased because of a National Cancer Screening Program and development of devices and techniques. There were many reports on the short-term and long-term outcomes after endoscopic resection in patients with EGC. Long-term outcome in terms of recurrence and death is excellent in both absolute and selected expanded criteria. Furthermore, endoscopic resection might be positioned as primary treatment modality replacing surgical gastrectomy. To obtain these results, selection of patients, perfect en bloc procedure, thorough pathological examination of resected specimen, accurate interpretation of whole process of endoscopic resection, and rational strategy for follow-up is necessary.

Multifunctional fiber-optic microwave links based on remote heterodyne detection

DEFF Research Database (Denmark)

Gliese, Ulrik Bo; Nielsen, Torben Nørskov; Nielsen, Søren Nørskov

1998-01-01

The multifunctionality of microwave links based on remote heterodyne detection (RHD) of signals from a dual-frequency laser transmitter is discussed and experimentally demonstrated in this paper. Typically, direct detection (DD) in conjunction with optical intensity modulation is used to implement...... fiber-optic microwave links. The resulting links are inherently transparent. As opposed to DD links, RHD links can perform radio-system functionalities such as modulation and frequency conversion in addition to transparency. All of these three functionalities are presented and experimentally...

Endoscopic Management of Peri-Pancreatic Fluid Collections.

Science.gov (United States)

Yip, Hon Chi; Teoh, Anthony Yuen Bun

2017-09-15

In the past decade, there has been a progressive paradigm shift in the management of peri-pancreatic fluid collections after acute pancreatitis. Refinements in the definitions of fluid collections from the updated Atlanta classification have enabled better communication amongst physicians in an effort to formulate optimal treatments. Endoscopic ultrasound (EUS)-guided drainage of pancreatic pseudocysts has emerged as the procedure of choice over surgical cystogastrostomy. The approach provides similar success rates with low complications and better quality of life compared with surgery. However, an endoscopic "step up" approach in the management of pancreatic walled-off necrosis has also been advocated. Both endoscopic and percutaneous drainage routes may be used depending on the anatomical location of the collections. New-generation large diameter EUS-specific stent systems have also recently been described. The device allows precise and effective drainage of the collections and permits endoscopic necrosectomy through the stents.

Influence of skew rays on the sensitivity and signal-to-noise ratio of a fiber-optic surface-plasmon-resonance sensor: a theoretical study

International Nuclear Information System (INIS)

Dwivedi, Yogendra S.; Sharma, Anuj K.; Gupta, Banshi D.

2007-01-01

We have theoretically analyzed the influence of skew rays on the performance of a fiber-optic sensor based on surface plasmon resonance. The performance of the sensor has been evaluated in terms of its sensitivity and signal-to-noise ratio (SNR). The theoretical model for skewness dependence includes the material dispersion in fiber cores and metal layers, simultaneous excitation of skew rays, and meridional rays in the fiber core along with all guided rays launching from a collimated light source. The effect of skew rays on the SNR and the sensitivity of the sensor with two different metals has been compared. The same comparison is carried out for the different values of design parameters such as numerical aperture, fiber core diameter, and the length of the surface-plasmon-resonance (SPR)active sensing region. This detailed analysis for the effect of skewness on the SNR and the sensitivity of the sensor leads us to achieve the best possible performance from a fiber-optic SPR sensor against the skewness in the optical fiber

Evaluation of fiber-optic connectors

International Nuclear Information System (INIS)

Reedy, R.P.

1981-01-01

Two fiber optic connectors for field use in high efficiency, long distance systems are described and evaluated in this report. The transmission testing arrangement and other considerations are included with the test results. Techniques for optimizing the transmission through these connectors are also described and the results are reported. Many desirable characteristics of connectors for field use are considered and compared to the ITT and Amphenol connectors tested here

EXPERIMENTAL COMPARISON OF HOMODYNE DEMODULATION ALGORITHMS FOR PHASE FIBER-OPTIC SENSOR

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M. N. Belikin

2015-11-01

Full Text Available Subject of Research. The paper presents the results of experimental comparative analysis of homodyne demodulation algorithms based on differential cross multiplying method and on arctangent method under the same conditions. The dependencies of parameters for the output signals on the optical radiation intensity are studied for the considered demodulation algorithms. Method. The prototype of single fiber optic phase interferometric sensor has been used for experimental comparison of signal demodulation algorithms. Main Results. We have found that homodyne demodulation based on arctangent method provides greater (by 7 dB at average signal-to-noise ratio of output signals over the frequency band of acoustic impact from 100 Hz to 500 Hz as compared to differential cross multiplying algorithms. We have demonstrated that no change in the output signal amplitude occurs for the studied range of values of the optical pulses amplitudes. Obtained results indicate that the homodyne demodulation based on arctangent method is most suitable for application in the phase fiber-optic sensors. It provides higher repeatability of their characteristics than the differential cross multiplying algorithm. Practical Significance. Algorithms of interferometric signals demodulation are widely used in phase fiber-optic sensors. Improvement of their characteristics has a positive effect on the performance of such sensors.

Effect of midazolam on memory during fiberoptic gastroscopy under conscious sedation.

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Hong, Yun Jeong; Jang, Eun Hye; Hwang, Jihye; Roh, Jee Hoon; Kwon, Miseon; Lee, Don; Lee, Jae-Hong

2015-01-01

As the fiberoptic gastroscopy using midazolam is being in widespread use, the exact nature of midazolam on memory should be clarified. We intended to examine whether midazolam causes selective anterograde amnesia and what impact it has on other aspects of memory and general cognitive function. We recruited healthy subjects undergoing fiberoptic gastroscopy under conscious sedation. At baseline, history taking for retrograde amnesia and the Korean version of the Montreal Cognitive Assessment were performed. A man's name and address were given immediately after intravenous midazolam administration. After gastroscopy, the subjects were asked to recall those items. By the time they had fully recovered consciousness, the same test was repeated along with the Korean version of the Montreal Cognitive Assessment and a test for retrograde amnesia. A total of 30 subjects were enrolled in this study. Subjects with high-dose midazolam showed lower scores in the immediate and delayed recall of "a man's name and address" compared with those with low-dose midazolam. The midazolam dose was inversely correlated with the delayed recall scores of "a man's name and address." On full recovery of consciousness, the subjects did not exhibit any of anterograde or retrograde amnesia. These findings suggest that midazolam causes transient selective anterograde amnesia in a dose-dependent manner.

Analysis and Design of a Fiber-optic Probe for DNA Sensors Final Report CRADA No. TSB-1147-95

Energy Technology Data Exchange (ETDEWEB)

Molau, Nicole [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Vail, Curtis [Accu.Photonics, Inc., Ann Arbor, MI (United States)

2018-01-24

In 1995, a challenge in the field of genetics dealt with the acquisition of efficient DNA sequencing techniques for reading the 3 billion base-pairs that comprised the human genome. AccuPhotonics, Inc. proposed to develop and manufacture a state-of-the-art near-field scanning optical microscopy (NSOM) fiber-optic probe that was expected to increase probe efficiency by two orders of magnitude over the existing state-of-the-art and to improve resolution to 10Å. The detailed design calculation and optimization of electrical properties of the fiber-optic probe tip geometry would be performed at LLNL, using existing finite-difference time-domain (FDTD) electromagnetic (EM) codes.

Endoscopic monitoring the estrous phase of Arabian mares with assaying its biopsy

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Mohamed Fathi

2017-01-01

Full Text Available Objective: To evaluate the changes occur in the vagina, cervix and endometrium during the pre- ovulatory period in Arabian mares by using endoscope as a diagnostic tool as well as the availability of taking an endoscopic biopsy during this stage.Methods: Ten cyclic and healthy arabian mares were subjected to ultrasound scanning of their ovaries to estimate the diameter of the preovulatory follicles, collection of blood samples for estimating the hormonal levels (Estradiol-17 β and progestrone for confirming the estrous phase, endoscopic monitoring their vagina, cervix and endometrium, the availability of taking biopsical samples and histological examination of the obtained samples.Results: The obtained data revealed that, the mean diameter of the preovulatory follicles was (3.95±0.34 cm, the plasma estradiol and progestrone levels were (85.98±5.26 pg/mL and (0.73±0.23 ng/mL, respectively, endoscopic monitoring the vagina, cervix and endometrium revealed hyperemic vaginal mucous membrane, soft and opened cervical ostium with abundant estrous mucous and folding, hyperemic and edematous appearance of the endometrium, respectively and the histological features of the biopsical endometrial samples revealed that, The lamina propria-sub mucosa was packed with simple or branched tubular glands lined with simple columnar epithelium showing oval or rounded dark nuclei with different degrees of secretory activities of the glands.Conclusions: The endoscope proved to be a reliable tool for confirming the estrous phase in mares and monitoring the gross features of the vagina, the cervix and the endometrium, in addition to the availability of taking biopsical smears.

Endoscopic management of peripancreatic fluid collections.

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Goyal, Jatinder; Ramesh, Jayapal

2015-07-01

Peripancreatic fluid collections are a well-known complication of pancreatitis and can vary from fluid-filled collections to entirely necrotic collections. Although most of the fluid-filled pseudocysts tend to resolve spontaneously with conservative management, intervention is necessary in symptomatic patients. Open surgery has been the traditional treatment modality of choice though endoscopic, laparoscopic and transcutaneous techniques offer alternative drainage approaches. During the last decade, improvement in endoscopic ultrasound technology has enabled real-time access and drainage of fluid collections that were previously not amenable to blind transmural drainage. This has initiated a trend towards use of this modality for treatment of pseudocysts. In this review, we have summarised the existing evidence for endoscopic drainage of peripancreatic fluid collections from published studies.

Transanal endoscopic microsurgery: a New Zealand experience.

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Bloomfield, Ian; Van Dalen, Roelof; Lolohea, Simione; Wu, Linus

2017-12-03

Transanal endoscopic microsurgery (TEMS) is a proven alternative therapy to either radical surgery or endoscopic mucosal resection for rectal neoplasms. It has proven benefits with lower morbidity and mortality compared with total mesorectal excision, and a lower local recurrence rate when compared to endoscopic mucosal techniques. A retrospective data collection of TEMS procedures performed through Waikato District Health Board, New Zealand, from 2010 to 2015 was conducted. Supportive follow-up data were sourced from patient records and from local centres around New Zealand. A total of 137 procedures were performed over the study period, with five being repeat procedures. Procedures were mostly performed for benign lesions (66.4%) with an overall complication rate of 15.3%, only five of which were Clavien-Dindo grade III (3.6%). Our local recurrence rate after resection of benign lesions was 5.1%. Our data set demonstrates the TEMS procedure to be safe compared to radical resection (total mesorectal excision) for sessile rectal lesions. Close endoscopic follow-up is recommended, especially for close or incomplete margins. Good therapeutic results can be obtained for appropriately selected early malignant lesions. TEMS provides better oncological results than endoscopic mucosal resection or transanal excision. © 2017 Royal Australasian College of Surgeons.

Per-oral endoscopic myotomy (POEM) for esophageal achalasia.

Science.gov (United States)

Pescarus, Radu; Shlomovitz, Eran; Swanstrom, Lee L

2014-01-01

Per-oral endoscopic myotomy (POEM) is a new minimally invasive endoscopic treatment for achalasia. Since the first modern human cases were published in 2008, around 2,000 cases have been performed worldwide. This technique requires advanced endoscopic skills and a learning curve of at least 20 cases. POEM is highly successful with over 90 % improvement in dysphagia while offering patients the advantage of a low impact endoscopic access. The main long-term complication is gastroesophageal reflux (GER) with an estimated incidence of 35 %, similar to the incidence of GER post-laparoscopic Heller with fundoplication. Although POEM represents a paradigm shift in the treatment of achalasia, more long-term data are clearly needed to further define its role in the treatment algorithm of this rare disease.

Dysphagia in amyotrophic lateral sclerosis: prevalence and clinical findings.

Science.gov (United States)

Ruoppolo, G; Schettino, I; Frasca, V; Giacomelli, E; Prosperini, L; Cambieri, C; Roma, R; Greco, A; Mancini, P; De Vincentiis, M; Silani, V; Inghilleri, M

2013-12-01

To characterize swallowing deficits in amyotrophic lateral sclerosis (ALS); investigate the delay in dysphagia onset; estimate correlations between dysphagia severity and patients' functional status; identify the symptom(s) most likely to predict dysphagia. A group of 49 consecutive patients with ALS, 14 with bulbar onset and 35 with spinal onset, underwent swallowing evaluation including bedside and fiberoptic endoscopic examination to detect dysphagia. Patients with dysphagia were more likely than those without to have bulbar onset ALS (P = 0.02); more severely impaired chewing (P = 0.01); and tongue muscle deficits (P = 0.001). The only variable measured at first examination significantly associated with dysphagia was a more than mild tongue muscle deficit. The only variable useful in predicting dysphagia was a chewing deficit. In 10 of the 49 patients studied, swallowing evaluation disclosed an impaired cough reflex. Dysphagia in patients with ALS correlates significantly with bulbar onset and with oral swallowing impairment. Fiberoptic swallowing evaluation is a useful tool for detecting swallowing deficits and laryngeal sensitivity in patients with ALS. An impaired cough reflex is an unexpected finding in many patients with ALS. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

New developments in endoscopic treatment of chronic pancreatitis.

Science.gov (United States)

Didden, P; Bruno, M; Poley, J W

2012-12-01

The aim of endoscopic therapy of chronic pancreatitis (CP) is to treat pain by draining the pancreatic duct or managing loco-regional complications. Recent decennia were characterized by continuous improvement of endoscopic techniques and devices, resulting in a better clinical outcome. Novel developments now also provide the opportunity to endoscopically treat refractory CP-related complications. Especially suboptimal surgical candidates could potentially benefit from these new developments, consequently avoiding invasive surgery. The use of fully covered self-expandable metal stents (SEMS) has been explored in pancreatic and CP-related biliary duct strictures, resistant to conventional treatment with plastic endoprotheses. Furthermore, endosonography-guided transmural drainage of the main pancreatic duct via duct-gastrostomy is an alternative treatment option in selected cases. Pancreatic pseudocysts represent an excellent indication for endoscopic therapy with some recent case series demonstrating effective drainage with the use of a fully covered SEMS. Although results of these new endoscopic developments are promising, high quality randomized trials are required to determine their definite role in the management of chronic pancreatitis.

Endoscopic or surgical intervention for painful obstructive chronic pancreatitis.

Science.gov (United States)

Ahmed Ali, Usama; Pahlplatz, Johanna M; Nealon, Wiliam H; van Goor, Harry; Gooszen, Hein G; Boermeester, Marja A

2015-03-19

Endoscopy and surgery are the treatment modalities of choice for patients with chronic pancreatitis and dilated pancreatic duct (obstructive chronic pancreatitis). Physicians face, without clear consensus, the choice between endoscopy or surgery for this group of patients. To assess and compare the effects and complications of surgical and endoscopic interventions in the management of pain for obstructive chronic pancreatitis. We searched the following databases in The Cochrane Library: CENTRAL (2014, Issue 2), the Cochrane Database of Systematic Reviews (2014, Issue 2), and DARE (2014, Issue 2). We also searched the following databases up to 25 March 2014: MEDLINE (from 1950), Embase (from 1980), and the Conference Proceedings Citation Index - Science (CPCI-S) (from 1990). We performed a cross-reference search. Two review authors independently performed the selection of trials. All randomised controlled trials (RCTs) of endoscopic or surgical interventions in obstructive chronic pancreatitis. We included trials comparing endoscopic versus surgical interventions as well as trials comparing either endoscopic or surgical interventions to conservative treatment (i.e. non-invasive treatment modalities). We included relevant trials irrespective of blinding, the number of participants randomised, and the language of the article. We used standard methodological procedures expected by The Cochrane Collaboration. Two authors independently extracted data from the articles. We evaluated the methodological quality of the included trials and requested additional information from study authors in the case of missing data. We identified three eligible trials. Two trials compared endoscopic intervention with surgical intervention and included a total of 111 participants: 55 in the endoscopic group and 56 in the surgical group. Compared with the endoscopic group, the surgical group had a higher proportion of participants with pain relief, both at middle/long-term follow-up (two to

Surgical management of failed endoscopic treatment of pancreatic disease.

Science.gov (United States)

Evans, Kimberly A; Clark, Colby W; Vogel, Stephen B; Behrns, Kevin E

2008-11-01

Endoscopic therapy of acute and chronic pancreatitis has decreased the need for operative intervention. However, a significant proportion of patients treated endoscopically require definitive surgical management for persistent symptoms. Our aim was to determine which patients are likely to fail with endoscopic therapy, and to assess the clinical outcome of surgical management. Patients were identified using ICD-9 codes for pancreatic disease as well as CPT codes for endoscopic therapy followed by surgery. Patients with documented acute or chronic pancreatitis treated endoscopically prior to surgical therapy were included (N = 88). The majority of patients (65%) exhibited chronic pancreatitis due to alcohol abuse. Common indicators for surgery were: persistent symptoms, anatomy not amenable to endoscopic treatment and unresolved common bile duct or pancreatic duct strictures. Surgical salvage procedures included internal drainage of a pseudocyst or an obstructed pancreatic duct (46%), debridement of peripancreatic fluid collections (25%), and pancreatic resection (31%). Death occurred in 3% of patients. The most common complications were hemorrhage (16%), wound infection (13%), and pulmonary complications (11%). Chronic pancreatitis with persistent symptoms is the most common reason for pancreatic surgery following endoscopic therapy. Surgical salvage therapy can largely be accomplished by drainage procedures, but pancreatic resection is common. These complex procedures can be performed with acceptable mortality but also with significant risk for morbidity.

Calibration procedures of the Tore-Supra infrared endoscopes

Science.gov (United States)

Desgranges, C.; Jouve, M.; Balorin, C.; Reichle, R.; Firdaouss, M.; Lipa, M.; Chantant, M.; Gardarein, J. L.; Saille, A.; Loarer, T.

2018-01-01

Five endoscopes equipped with infrared cameras working in the medium infrared range (3-5 μm) are installed on the controlled thermonuclear fusion research device Tore-Supra. These endoscopes aim at monitoring the plasma facing components surface temperature to prevent their overheating. Signals delivered by infrared cameras through endoscopes are analysed and used on the one hand through a real time feedback control loop acting on the heating systems of the plasma to decrease plasma facing components surface temperatures when necessary, on the other hand for physics studies such as determination of the incoming heat flux . To ensure these two roles a very accurate knowledge of the absolute surface temperatures is mandatory. Consequently the infrared endoscopes must be calibrated through a very careful procedure. This means determining their transmission coefficients which is a delicate operation. Methods to calibrate infrared endoscopes during the shutdown period of the Tore-Supra machine will be presented. As they do not allow determining the possible transmittances evolution during operation an in-situ method is presented. It permits the validation of the calibration performed in laboratory as well as the monitoring of their evolution during machine operation. This is possible by the use of the endoscope shutter and a dedicated plasma scenario developed to heat it. Possible improvements of this method are briefly evoked.

Fiber-optic coupling based on nonimaging expanded-beam optics.

Science.gov (United States)

Moslehi, B; Ng, J; Kasimoff, I; Jannson, T

1989-12-01

We have fabricated and experimentally tested low-cost and mass-producible multimode fiber-optic couplers and connectors based on nonimaging beam-expanding optics and Liouville's theorem. Analysis indicates that a pair coupling loss of -0.25 dB can be achieved. Experimentally, we measured insertion losses as low as -0.38 dB. The beam expanders can be mass produced owing to the use of plastic injection-molding fabrication techniques and packaged in standard connector housings. This design is compatible with the fiber geometry and can yield highly stable coupling owing to its high tolerance for misalignments.

Nonlinear fiber-optic strain sensor based on four-wave mixing in microstructured optical fiber

DEFF Research Database (Denmark)

Gu, Bobo; Yuan, Scott Wu; Frosz, Michael H.

2012-01-01

We demonstrate a nonlinear fiber-optic strain sensor, which uses the shifts of four-wave mixing Stokes and anti-Stokes peaks caused by the strain-induced changes in the structure and refractive index of a microstructured optical fiber. The sensor thus uses the inherent nonlinearity of the fiber a...

Endoscopic Rectus Abdominis and Prepubic Aponeurosis Repairs for Treatment of Athletic Pubalgia.

Science.gov (United States)

Matsuda, Dean K; Matsuda, Nicole A; Head, Rachel; Tivorsak, Tanya

2017-02-01

Review of the English orthopaedic literature reveals no prior report of endoscopic repair of rectus abdominis tears and/or prepubic aponeurosis detachment. This technical report describes endoscopic reattachment of an avulsed prepubic aponeurosis and endoscopic repair of a vertical rectus abdominis tear immediately after endoscopic pubic symphysectomy for coexistent recalcitrant osteitis pubis as a single-stage outpatient surgery. Endoscopic rectus abdominis repair and prepubic aponeurosis repair are feasible surgeries that complement endoscopic pubic symphysectomy for patients with concurrent osteitis pubis and expand the less invasive options for patients with athletic pubalgia.

Accuracy of endoscopic and videofluoroscopic evaluations of swallowing for oropharyngeal dysphagia.

Science.gov (United States)

Giraldo-Cadavid, Luis Fernando; Leal-Leaño, Lorena Renata; Leon-Basantes, Guillermo Alfredo; Bastidas, Alirio Rodrigo; Garcia, Rafael; Ovalle, Sergio; Abondano-Garavito, Jorge E

2017-09-01

A systematic review and meta-analysis of the literature was conducted to compare the accuracy with which flexible endoscopic evaluation of swallowing (FEES) and videofluoroscopic swallowing study (VFSS) assessed oropharyngeal dysphagia in adults. PubMed, Embase, and the Latin American and Caribbean Health Sciences Literature (LILACS) database. A review of published studies was conducted in parallel by two groups of researchers. We evaluated the methodological quality, homogeneity, threshold effect, and publication bias. The results are presented as originally published, then with each test compared against the other as a reference and both compared against a composite reference standard, and then pooled using a random effects model. Software use consisted of Meta-DiSc and SPSS. The search yielded 5,697 articles. Fifty-two articles were reviewed in full text, and six articles were included in the meta-analysis. FEES showed greater sensitivity than VFSS for aspiration (0.88 vs. 0.77; P = .03), penetration (0.97 vs. 0.83; P = .0002), and laryngopharyngeal residues (0.97 vs. 0.80; P < .0001). Sensitivity to detect pharyngeal premature spillage was similar for both tests (VFSS: 0.80; FEES: 0.69; P = .28). The specificities of both tests were similar (range, 0.93-0.98). In the sensitivity analysis there were statistically significant differences between the tests regarding residues but only marginally significant differences regarding aspiration and penetration. FEES had a slight advantage over VFSS to detect aspiration, penetration, and residues. Prospective studies comparing both tests against an appropriate reference standard are needed to define which test has greater accuracy. 2a Laryngoscope, 127:2002-2010, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Single-session endoscopic resection and focal radiofrequency ablation for short-segment Barrett's esophagus with early neoplasia.

Science.gov (United States)

Barret, Maximilien; Belghazi, Kamar; Weusten, Bas L A M; Bergman, Jacques J G H M; Pouw, Roos E

2016-07-01

The management of early neoplasia in Barrett's esophagus (BE) requires endoscopic resection of visible lesions, followed by radiofrequency ablation (RFA) of the remaining BE. We evaluated the safety and efficacy of combining endoscopic resection and focal RFA in a single endoscopic session in patients with early BE neoplasia. This was a retrospective analysis of patients with early BE neoplasia and a visible lesion undergoing combined endoscopic resection and focal RFA in a single session. Consecutive ablation procedures were performed every 8 to 12 weeks until complete endoscopic and histologic eradication of dysplasia and intestinal metaplasia were reached. Forty patients were enrolled, with a median C1M2 BE segment, a visible lesion with a median diameter of 15 mm, and invasive carcinoma in 68% of cases. Endoscopic resection was performed by using the multiband mucosectomy technique in 80% of cases, and the Barrx(90) catheter (Barrx Medical, Sunnyvale, Calif) was used for focal ablation. When an intention-to-treat analysis was used, both complete remission of all neoplasia and intestinal metaplasia were 95% after a median follow-up of 19 months. Stenoses occurred in 33% of cases and were successfully managed with a median number of 2 dilations. In 43% of patients, 1 single-session treatment resulted in complete histologic remission of intestinal metaplasia. Combining endoscopic resection and focal RFA in a single session appears to be effective. Less-aggressive RFA regimens could limit the adverse event rates. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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.

Repair of an Endoscopic Retrograde Cholangiopancreatography-Related Large Duodenal Perforation Using Double Endoscopic Band Ligation and Endoclipping

Directory of Open Access Journals (Sweden)

Keunmo Kim

2017-03-01

Full Text Available Endoscopic closure techniques have been introduced for the repair of duodenal wall perforations that occur during endoscopic retrograde cholangiopancreatography (ERCP. We report a case of successful repair of a large duodenal wall perforation by using double endoscopic band ligation (EBL and an endoclip. Lateral duodenal wall perforation occurred during ERCP in a 93-year-old woman with acute calculous cholangitis. We switched to a forward endoscope that had a transparent band apparatus. A 2.0-cm oval-shaped perforation was found at the lateral duodenal wall. We repaired the perforation by sequentially performing double EBL and endoclipping. The first EBL was performed at the proximal edge of the perforation orifice, and two-thirds of the perforation were repaired. The second EBL, which also included the contents covered under the first EBL, repaired the defect almost completely. Finally, to account for the possible presence of a residual perforation, an endoclip was applied at the distal end of the perforation. The detection and closure of the perforation were completed within 10 minutes. We suggest that double EBL is an effective method for closure.

Endoscopic brow lifts uber alles.

Science.gov (United States)

Patel, Bhupendra C K

2006-12-01

Innumerable approaches to the ptotic brow and forehead have been described in the past. Over the last twenty-five years, we have used all these techniques in cosmetic and reconstructive patients. We have used the endoscopic brow lift technique since 1995. While no one technique is applicable to all patients, the endoscopic brow lift, with appropriate modifications for individual patients, can be used effectively for most patients with brow ptosis. We present the nuances of this technique and show several different fixation methods we have found useful.

Micromotor endoscope catheter for in vivo, ultrahigh-resolution optical coherence tomography

Science.gov (United States)

Herz, P. R.; Chen, Y.; Aguirre, A. D.; Schneider, K.; Hsiung, P.; Fujimoto, J. G.; Madden, K.; Schmitt, J.; Goodnow, J.; Petersen, C.

2004-10-01

A distally actuated, rotational-scanning micromotor endoscope catheter probe is demonstrated for ultrahigh-resolution in vivo endoscopic optical coherence tomography (OCT) imaging. The probe permits focus adjustment for visualization of tissue morphology at varying depths with improved transverse resolution compared with standard OCT imaging probes. The distal actuation avoids nonuniform scanning motion artifacts that are present with other probe designs and can permit a wider range of imaging speeds. Ultrahigh-resolution endoscopic imaging is demonstrated in a rabbit with micromotor endoscope catheter probe promises to improve OCT imaging performance in future endoscopic imaging applications.

Evaluating the Ergonomics of Flexible Ureteroscopy.

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Ludwig, Wesley W; Lee, Gyusung; Ziemba, Justin B; Ko, Joan S; Matlaga, Brian R

2017-10-01

To date, the ergonomics of flexible ureteroscopy (URS) have not been well described. We performed a study to assess the biomechanical stresses on urologists performing URS and to investigate the effect of ureteroscope type on these parameters. Electromyography (EMG) was used to quantify the activation level of muscle groups involved in URS. Surface EMG electrodes (Delsys, Boston, MA) were placed on the right and left thenar, flexor carpi ulnaris (FCU), extensor carpi ulnaris (ECU), biceps, triceps, and deltoid. Three endoscopes were studied: single-use digital (Boston Scientific LithoVue), reusable digital (Karl Storz Flex-X c ), and reusable fiber-optic (Karl Storz Flex-X 2 ). Each ureteroscope was used to perform a set sequence of navigation and procedural tasks in a training model. EMG data were processed and normalized to compare the maximum voluntary contractions between muscle groups. Cumulative muscular workload (CMW) and average muscular work per second (AWS) were used for comparative analysis. For navigational tasks, CMW and AWS were greatest for the ECU, followed in descending order by right and left thenar, FCU, biceps, deltoid, and triceps. For procedural tasks, CMW and AWS were greatest for the right thenar, followed in descending order by the left thenar, ECU, FCU, triceps, biceps, and deltoid. During navigational tasks, both LithoVue and Flex-X c had lower CMWs for every muscle group than Flex-X 2 (p ergonomics of URS. Both the single-use and reusable digital ureteroscopes have similar profiles, and both have significantly better ergonomic metrics than the reusable fiber-optic ureteroscope.

Assessment of detection limits of fiber-optic distributed temperature sensing for detection of illicit connections

NARCIS (Netherlands)

Nienhuis, J.; De Haan, C.; Langeveld, J.G.; Klootwijk, M.; Clemens, F.H.L.R.

2012-01-01

Distributed Temperature Sensing (DTS) with fiber-optic cables is a powerful tool to detect illicit connections in storm sewer systems. High frequency temperature measurements along the in-sewer cable create a detailed representation of temperature anomalies due to illicit discharges. The detection

Effect of peroral endoscopic myotomy on esophagogastric junction physiology in patients with achalasia

NARCIS (Netherlands)

Verlaan, Tessa; Rohof, Wout O.; Bredenoord, Albert J.; Eberl, Susanne; Rösch, Thomas; Fockens, Paul

2013-01-01

Pneumatic dilation and laparoscopic Heller myotomy improve parameters of esophageal function such as lower esophageal sphincter (LES) pressure, esophageal emptying, and esophagogastric junction (EGJ) distensibility. To evaluate the effect of peroral endoscopic myotomy (POEM) on esophagogastric

Transanal endoscopic microsurgery versus endoscopic mucosal resection for large rectal adenomas (TREND-study).

Science.gov (United States)

van den Broek, Frank J C; de Graaf, Eelco J R; Dijkgraaf, Marcel G W; Reitsma, Johannes B; Haringsma, Jelle; Timmer, Robin; Weusten, Bas L A M; Gerhards, Michael F; Consten, Esther C J; Schwartz, Matthijs P; Boom, Maarten J; Derksen, Erik J; Bijnen, A Bart; Davids, Paul H P; Hoff, Christiaan; van Dullemen, Hendrik M; Heine, G Dimitri N; van der Linde, Klaas; Jansen, Jeroen M; Mallant-Hent, Rosalie C H; Breumelhof, Ronald; Geldof, Han; Hardwick, James C H; Doornebosch, Pascal G; Depla, Annekatrien C T M; Ernst, Miranda F; van Munster, Ivo P; de Hingh, Ignace H J T; Schoon, Erik J; Bemelman, Willem A; Fockens, Paul; Dekker, Evelien

2009-03-13

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. Multicenter randomized trial among 15 hospitals in the Netherlands. Patients with a rectal adenoma > or = 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 of 3.3% and considering an upper-limit of 10

Supraretinacular endoscopic carpal tunnel release: surgical technique with prospective case series.

Science.gov (United States)

Ecker, J; Perera, N; Ebert, J

2015-02-01

Current techniques for endoscopic carpal tunnel release use an infraretinacular approach, inserting the endoscope deep to the flexor retinaculum. We present a supraretinacular endoscopic carpal tunnel release technique in which a dissecting endoscope is inserted superficial to the flexor retinaculum, which improves vision and the ability to dissect and manipulate the median nerve and tendons during surgery. The motor branch of the median nerve and connections between the median and ulnar nerve can be identified and dissected. Because the endoscope is inserted superficial to the flexor retinaculum, the median nerve is not compressed before division of the retinaculum and, as a result, we have observed no cases of the transient median nerve deficits that have been reported using infraretinacular endoscopic techniques. © The Author(s) 2014.

Endoscopic laser-urethroplasty

Science.gov (United States)

Gilbert, Peter

2006-02-01

The objective was to prove the advantage of endoscopic laser-urethroplasty over internal urethrotomy in acquired urethral strictures. Patients and Method: From January, 1996 to June, 2005, 35 patients with a mean age of 66 years were submitted to endoscopic laser-urethroplasty for strictures of either the bulbar (30) or membranous (5) urethra. The operations were carried out under general anesthesia. First of all, the strictures were incised at the 4, 8 and 12 o'clock position by means of a Sachse-urethrotom. Then the scar flap between the 4 and 8 o'clock position was vaporized using a Nd:YAG laser, wavelength 1060 nm and a 600 pm bare fiber, the latter always being in contact with the tissue. The laser worked at 40W power in continuous mode. The total energy averaged 2574 J. An indwelling catheter was kept in place overnight and the patients were discharged the following day. Urinalysis, uroflowmetry and clinical examination were performed at two months after surgery and from then on every six months. Results: No serious complications were encountered. Considering a mean follow-up of 18 months, the average peak flow improved from 7.3 ml/s preoperatively to 18.7 mVs postoperatively. The treatment faded in 5 patients ( 14.3% ) who finally underwent open urethroplasty. Conclusions: Endoscopic laser-urethroplasty yields better short-term results than internal visual urethrotomy. Long-term follow-up has yet to confirm its superiority in the treatment of acquired urethral strictures.

Gastrointestinal tract volume measurement method using a compound eye type endoscope

Science.gov (United States)

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

2015-03-01

We propose an intestine volume measurement method using a compound eye type endoscope. This method aims at assessment of the gastrointestinal function. Gastrointestinal diseases are mainly based on morphological abnormalities. However, gastrointestinal symptoms are sometimes apparent without visible abnormalities. Such diseases are called functional gastrointestinal disorder, for example, functional dyspepsia, and irritable bowel syndrome. One of the major factors for these diseases is abnormal gastrointestinal motility. For the diagnosis of the gastrointestinal tract, both aspects of organic and functional assessment is important. While endoscopic diagnosis is essential for assessment of organic abnormalities, three-dimensional information is required for assessment of the functional abnormalities. Thus, we proposed the three dimensional endoscope system using compound eye. In this study, we forces on the volume of gastrointestinal tract. The volume of the gastrointestinal tract is thought to related its function. In our system, we use a compound eye type endoscope system to obtain three-dimensional information of the tract. The volume can be calculated by integrating the slice data of the intestine tract shape using the obtained three-dimensional information. First, we evaluate the proposed method by known-shape tube. Then, we confirm that the proposed method can measure the tract volume using the tract simulated model. Our system can assess the wall of gastrointestinal tract directly in a three-dimensional manner. Our system can be used for examination of gastric morphological and functional abnormalities.

CORRELATION OF ENDOSCOPIC AND HISTOLOGICAL FEATURES IN ADULTS WITH SUSPECTED CELIAC DISEASE IN A REFERRAL CENTER OF MINAS GERAIS, BRAZIL

Directory of Open Access Journals (Sweden)

Rodrigo Macedo ROSA

2014-12-01

Full Text Available Context Clinical presentation of celiac disease is extremely variable and the diagnosis relies on serologic tests, mucosal intestinal biopsy and clinic and serologic response to a gluten-free diet. Objectives To correlate the endoscopic and histological aspects of adult patients with suspicion of celiac disease and to evaluate the interobserver histological agreement. Methods Endoscopic aspects of 80 adult patients were evaluated and correlated with the histological features according the Marsh-Oberhuber classification system. The interobserver histological agreement was based on kappa values. Results The symptoms of the patients varied largely, with prominence for chronic diarrhea, present in 48 (60% patients. The endoscopic aspects related with the duodenal villous atrophy had been observed in 32 (40% patients. There were confirmed 46 cases of celiac disease, with prevalence of 57.5%. The sensitivity, specificity, positive predictive value and negative predictive value of the endoscopic markers for celiac disease diagnosis were of 60.9%, 88.2%, 87.5% and 62.5%. There was moderate interobserver histological agreement (kappa = 0.46. Conclusions The endoscopic markers of villous atrophy, although not diagnostic, had assisted in the suspicion and indication of the duodenal biopsies for diagnosis proposal. Histology is sometimes contradictory and new biopsies or opinion of another professional can provide greater diagnostic agreement.

A combination of modified transnasal endoscopic maxillectomy via transnasal prelacrimal recess approach with or without radiotherapy for selected sinonasal malignancies.

Science.gov (United States)

He, Shuangba; Bakst, Richard L; Guo, Tao; Sun, Jingwu

2015-10-01

An external approach for resection of sinonasal tumors is associated with increased morbidity. Therefore, we employed a modified transnasal endoscopic maxillectomy combined with pre and/or postoperative radiotherapy for early stage maxillary carcinomas. It aims to evaluate our early experience with endoscopic resection of selected malignant sinonasal tumors. The medical and radiology records of patients who underwent endonasal endoscopic resection of malignant sinonasal tumors between 2008 and 2012 were retrospectively reviewed. Ten cases of selected malignant tumor were performed to resect by modified transnasal endoscopic maxillectomy. All the patients were without evidence of disease at a mean follow-up of 26.8 months. No major complications were recorded. The mean hospitalization stay was 6.6 days. In very carefully selected cases of malignant tumors, modified transnasal endoscopic maxillectomy is acceptable. The postoperative complication rate is low, cosmetic outcome is excellent and patients do not require a long hospitalization.

Endoscopic surgery of the nose and paranasal sinus.

Science.gov (United States)

Palmer, Orville; Moche, Jason A; Matthews, Stanley

2012-05-01

Mucosal preservation is of paramount importance in the diagnosis and surgical management of the sinonasal tract. The endoscope revolutionized the practice of endoscopic nasal surgery. As a result, external sinus surgery is performed less frequently today, and more emphasis is placed on functional endoscopy and preservation of normal anatomy. Endoscopic surgery of the nose and paranasal sinus has provided improved surgical outcomes and has shortened the length of stay in hospital. It has also become a valuable teaching tool. Copyright © 2012 Elsevier Inc. All rights reserved.

Current Status of Peroral Endoscopic Myotomy

OpenAIRE

Cho, Young Kwan; Kim, Seong Hwan

2018-01-01

Peroral endoscopic myotomy (POEM) has been established as an optional treatment for achalasia. POEM is an endoluminal procedure that involves dissection of esophageal muscle fibers followed by submucosal tunneling. Inoue first attempted to use POEM for the treatment of achalasia in humans. Expanded indications of POEM include classic indications such as type I, type II, type III achalasia, failed prior treatments, including Botulinum toxin injection, endoscopic balloon dilation, laparoscopic ...

Changing the surgical dogma in frontal sinus trauma: transnasal endoscopic repair.

Science.gov (United States)

Grayson, Jessica W; Jeyarajan, Hari; Illing, Elisa A; Cho, Do-Yeon; Riley, Kristen O; Woodworth, Bradford A

2017-05-01

Management of frontal sinus trauma includes coronal or direct open approaches through skin incisions to either ablate or obliterate the frontal sinus for posterior table fractures and openly reduce/internally fixate fractured anterior tables. The objective of this prospective case-series study was to evaluate outcomes of frontal sinus anterior and posterior table trauma using endoscopic techniques. Prospective evaluation of patients undergoing surgery for frontal sinus fractures was performed. Data were collected regarding demographics, etiology, technique, operative site, length involving the posterior table, size of skull base defects, complications, and clinical follow-up. Forty-six patients (average age, 42 years) with frontal sinus fractures were treated using endoscopic techniques from 2008 to 2016. Mean follow-up was 26 (range, 0.5 to 79) months. Patients were treated primarily with a Draf IIb frontal sinusotomies. Draf III was used in 8 patients. Average fracture defect (length vs width) was 17.1 × 9.1 mm, and the average length involving the posterior table was 13.1 mm. Skull base defects were covered with either nasoseptal flaps or free tissue grafts. One individual required Draf IIb revision, but all sinuses were patent on final examination and all closed reductions of anterior table defects resulted in cosmetically acceptable outcomes. Frontal sinus trauma has traditionally been treated using open approaches. Our findings show that endoscopic management should become part of the management algorithm for frontal sinus trauma, which challenges current surgical dogma regarding mandatory open approaches. © 2017 ARS-AAOA, LLC.

Endoscopic Stenting for Colorectal Cancer: Lessons Learned From a 15-Year Experience.

Science.gov (United States)

Fiori, Enrico; Lamazza, Antonietta; Sterpetti, Antonio V; Schillaci, Alberto

The aim of our prospective study was to analyze the results of endoscopic stenting to treat obstruction due to colorectal cancer and complications after colorectal resection for cancer. Endoscopic stenting for obstructing colorectal cancer has become a common place in clinical practice. However, there is a 2% to 5% risk of bowel perforation, and a percentage of technical failure of 2% to 10%. In a 15-year period (August, 1999 to December, 2013), 153 patients with colorectal cancer had endoscopic placement of a self-expandable metal stent for treatment of an obstructing colorectal cancer (133 patients) or for treatment of complications after colorectal resection for cancer (20 patients). They were prospectively evaluated in a database and they form the basis of this report. There was no case of mortality or major morbidity. Overall technical success was 94.8%. After introducing the use of a pediatric nasogastroscope to pass the obstruction (71 patients), technical success was 100%. Complications in patients in whom the stent was left in place during the follow-up were frequent, requiring a close observation. We had 20 patients with fecal obstruction, 4 cases of stent dislodgment, and 8 cases of obstruction from ingrowth of the tumor. All patients were treated successfully endoscopically. Placement of self-expandable metal stents represents a valid technique. A proper training is required.

[Application of lymph node labeling with carbon nanoparticles by preoperative endoscopic subserosal injection in laparoscopic radical gastrectomy].

Science.gov (United States)

Hong, Q; Wang, Y; Wang, J J; Hu, C G; Fang, Y J; Fan, X X; Liu, T; Tong, Q

2017-01-10

Objective: To evaluate the application value of carbon lymph node tracing technique by preoperative endoscopic subserosal injection in laparoscopic radical gastrectomy. Methods: From June 2013 to February 2015, seventy eight patients with gastric cancer were enrolled and randomly divided into trial group and control group. Subserosal injection of carbon nanoparticles around the tumor was performed by preoperative endoscopic subserosal injection one day before the operation in trial group, while the patients routinely underwent laparoscopic gastrectomy in control group. Results of harvested lymph nodes, postoperative complications were compared between the two groups. Carbon nanoparticle-related side effect was also evaluated. Results: The average number of harvested lymph node in trial group was significantly higher than that in control group (35.5±8.5 vs 29.5±6.5, P 0.05), and no carbon nanoparticle-related side effect was observed. Conclusion: Given a higher harvested lymph node number and a similar rate of complications, preoperative endoscopic subserosal injection of carbon nanoparticles was safe and feasible.

Fiberoptic intubation through laryngeal mask airway for management of difficult airway in a child with Klippel-Feil syndrome

Directory of Open Access Journals (Sweden)

Ravi Bhat

2014-01-01

Full Text Available The ideal airway management modality in pediatric patients with syndromes like Klippel-Feil syndrome is a great challenge and is technically difficult for an anesthesiologist. Half of the patients present with the classic triad of short neck, low hairline, and fusion of cervical vertebra. Numerous associated anomalies like scoliosis or kyphosis, cleft palate, respiratory problems, deafness, genitourinary abnormalities, Sprengel′s deformity (wherein the scapulae ride high on the back, synkinesia, cervical ribs, and congenital heart diseases may further add to the difficulty. Fiberoptic bronchoscopy alone can be technically difficult and patient cooperation also becomes very important, which is difficult in pediatric patients. Fiberoptic bronchoscopy with the aid of supraglottic airway devices is a viable alternative in the management of difficult airway in children. We report a case of Klippel-Feil syndrome in an 18-month-old girl posted for cleft palate surgery. Imaging of spine revealed complete fusion of the cervical vertebrae with hypoplastic C3 and C6 vertebrae and thoracic kyphosis. We successfully managed airway in this patient by fiberoptic intubation through classic laryngeal mask airway (LMA. After intubation, we used second smaller endotracheal tube (ETT to stabilize and elongate the first ETT while removing the LMA.

Advances in endoscopic surgery for small animal reproduction.

Science.gov (United States)

Katic, N; Dupré, G

2016-09-01

Although endoscopic surgery entered its "golden era" in the mid-1980s, it is still advancing at a tremendous pace. Novel surgical techniques and devices are continuously developed and applied, and new indications (and/or contraindications) for the use of endoscopic surgery are routinely reported in the literature and subjected to systematic assessments. Although endoscopic surgery (laparoscopy in particular) has already become established as the gold standard in human medicine, it has yet to be proven as a viable alternative to open surgery in the field of veterinary medicine. The advantages of minimally invasive surgery include better intra-operative visualization, reduced postoperative pain, reduced scar formation and increased postoperative mobility. Therefore, it is reasonable to expect that the application of this will continue to expand. Small animal reproduction, a field within the broad discipline of veterinary medicine, has already recognized and begun to reap the benefits of endoscopic surgery. Herein, we retrospectively review the most recent successful novel applications of endoscopic surgery in the small animal reproduction system to provide small animal reproductive surgeons with important knowledge to help improve their own veterinarian medical practice. © 2016 Blackwell Verlag GmbH.

Update on endoscopic pancreatic function testing

Institute of Scientific and Technical Information of China (English)

Tyler Stevens; Mansour A Parsi

2011-01-01

Hormone-stimulated pancreatic function tests (PFTs) are considered the gold standard for measuring pancreatic exocrine function. PFTs involve the administration of intravenous secretin or cholecystokinin, followed by collection and analysis of pancreatic secretions. Because exocrine function may decline in the earliest phase of pancreatic fibrosis, PFTs are considered accurate for diagnosing chronic pancreatitis. Unfortunately, these potentially valuable tests are infrequently performed except at specialized centers, because they are time consuming and complicated. To overcome these limitations, endoscopic PFT methods have been developed which include aspiration of pancreatic secretions through the suction channel of the endoscope. The secretin endoscopic pancreatic function test (ePFT) involves collection of duodenal aspirates at 15, 30, 45 and 60 min after secretin stimulation. A bicarbonate concentration greater than 80 mmol/L in any of the samples is considered a normal result. The secretin ePFT has demonstrated good sensitivity and specificity compared with various reference standards, including the "Dreiling tube" secretin PFT, endoscopic ultrasound, and surgical histology. Furthermore, a standard autoanalyzer can be used for bicarbonate analysis, which allows the secretin ePFT to be performed at any hospital. The secretin ePFT may complement imaging tests like endoscopic ultrasound (EUS) in the diagnosis of early chronic pancreatitis.This paper will review the literature validating the use of ePFT in the diagnosis of exocrine insufficiency and chronic pancreatitis. Newer developments will also be discussed, including the feasibility of combined EUS/ePFT, the use of cholecystokinin alone or in combination with secretin, and the discovery of new protein and lipid pancreatic juice biomarkers which may complement traditionalfluid analysis.

Endoscopic sleeve gastroplasty: the learning curve.

Science.gov (United States)

Hill, Christine; El Zein, Mohamad; Agnihotri, Abhishek; Dunlap, Margo; Chang, Angela; Agrawal, Alison; Barola, Sindhu; Ngamruengphong, Saowanee; Chen, Yen-I; Kalloo, Anthony N; Khashab, Mouen A; Kumbhari, Vivek

2017-09-01

 Endoscopic sleeve gastroplasty (ESG) is gaining traction as a minimally invasive bariatric treatment. Concern that the learning curve may be slow, even among those proficient in endoscopic suturing, is a barrier to widespread implementation of the procedure. Therefore, we aimed to define the learning curve for ESG in a single endoscopist experienced in endoscopic suturing who participated in a 1-day ESG training program.  Consecutive patients who underwent ESG between February 2016 and November 2016 were included. The performing endoscopist, who is proficient in endoscopic suturing for non-ESG procedures, participated in a 1-day ESG training session before offering ESG to patients. The outcome measurements were length of procedure (LOP) and number of plications per procedure. Nonlinear regression was used to determine the learning plateau and calculate the learning rate.  Twenty-one consecutive patients (8 males), with mean age 47.7 ± 11.2 years and mean body mass index 41.8 ± 8.5 kg/m 2 underwent ESG. LOP decreased significantly across consecutive procedures, with a learning plateau at 101.5 minutes and a learning rate of 7 cases ( P  = 0.04). The number of plications per procedure also decreased significantly across consecutive procedures, with a plateau at 8 sutures and a learning rate of 9 cases ( P  < 0.001). Further, the average time per plication decreased significantly with consecutive procedures, reaching a plateau at 9 procedures ( P  < 0.001).  Endoscopists experienced in endoscopic suturing are expected to achieve a reduction in LOP and number of plications per procedure in successive cases, with progress plateauing at 7 and 9 cases, respectively.

Dysphagia management: an analysis of patient outcomes using VitalStim therapy compared to traditional swallow therapy.

Science.gov (United States)

Kiger, Mary; Brown, Catherine S; Watkins, Lynn

2006-10-01

This study compares the outcomes using VitalStim therapy to outcomes using traditional swallowing therapy for deglutition disorders. Twenty-two patients had an initial and a followup videofluoroscopic swallowing study or fiberoptic endoscopic evaluation of swallowing and were divided into an experimental group that received VitalStim treatments and a control group that received traditional swallowing therapy. Outcomes were analyzed for changes in oral and pharyngeal phase dysphagia severity, dietary consistency restrictions, and progression from nonoral to oral intake. Results of chi(2) analysis showed no statistically significant difference in outcomes between the experimental and control groups.

Rad-Tolerant, Thermally Stable, High-Speed Fiber-Optic Network for Harsh Environments

Science.gov (United States)

Leftwich, Matt; Hull, Tony; Leary, Michael; Leftwich, Marcus

2013-01-01

Future NASA destinations will be challenging to get to, have extreme environmental conditions, and may present difficulty in retrieving a spacecraft or its data. Space Photonics is developing a radiation-tolerant (rad-tolerant), high-speed, multi-channel fiber-optic transceiver, associated reconfigurable intelligent node communications architecture, and supporting hardware for intravehicular and ground-based optical networking applications. Data rates approaching 3.2 Gbps per channel will be achieved.

Mesh fixation in endoscopic inguinal hernia repair: evaluation of methodology based on a systematic review of randomised clinical trials.

Science.gov (United States)

Lederhuber, Hans; Stiede, Franziska; Axer, Stephan; Dahlstrand, Ursula

2017-11-01

The issue of mesh fixation in endoscopic inguinal hernia repair is frequently debated and still no conclusive data exist on differences between methods regarding long-term outcome and postoperative complications. The quantity of trials and the simultaneous lack of high-quality evidence raise the question how future trials should be planned. PubMed, EMBASE and the Cochrane Library were searched, using the filters "randomised clinical trials" and "humans". Trials that compared one method of mesh fixation with another fixation method or with non-fixation in endoscopic inguinal hernia repair were eligible. To be included, the trial was required to have assessed at least one of the following primary outcome parameters: recurrence; surgical site infection; chronic pain; or quality-of-life. Fourteen trials assessing 2161 patients and 2562 hernia repairs were included. Only two trials were rated as low risk for bias. Eight trials evaluated recurrence or surgical site infection; none of these could show significant differences between methods of fixation. Two of 11 trials assessing chronic pain described significant differences between methods of fixation. One of two trials evaluating quality-of-life showed significant differences between fixation methods in certain functions. High-quality evidence for differences between the assessed mesh fixation techniques is still lacking. From a socioeconomic and ethical point of view, it is necessary that future trials will be properly designed. As small- and medium-sized single-centre trials have proven unable to find answers, register studies or multi-centre studies with an evident focus on methodology and study design are needed in order to answer questions about mesh fixation in inguinal hernia repair.

Endoscopic removal of a dislocated tomour prothesis from the stomach

International Nuclear Information System (INIS)

Rueckauer, K.; Dinkel, E.

1985-01-01

Endoscopic pertubation of oesophagogustric neoplasms is an established method of palliative treatment. The dislocated plastic prosthesis may be removed with difficulties from the stomach endoscopically. A simple technique for endoscopic removal of the prosthesis is described. The tube can be precisely centred within the oesophageal lumen by use of an intestinal decompression tube and additional guidance by the endoscopic retraction forceps. Thus gross damge of the exophytic tumor tissue with bleeding or perforation sequelae can be avoided. Injury to the patient does not exceed that caused by an ordinary gastroscopy. (orig.) [de

Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance.

Science.gov (United States)