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Sample records for flexible endoscopy saline

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

    African Journals Online (AJOL)

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

  2. Transcervical heller myotomy using flexible endoscopy.

    Science.gov (United States)

    Spaun, Georg O; Dunst, Christy M; Arnold, Brittany N; Martinec, Danny V; Cassera, Maria A; Swanström, Lee L

    2010-12-01

    Esophageal achalasia is most commonly treated by laparoscopic myotomy. Transesophageal approaches using flexible endoscopy have recently been described. We hypothesized that using techniques and flexible instruments from our NOTES experience through a small cervical incision would be a safer and less traumatic route for esophageal myotomy. The purpose of this study was to evaluate the feasibility, safety, and success rate of using flexible endoscopes to perform anterior or posterior Heller myotomy via a transcervical approach. This animal (porcine) and human cadaver study was conducted at the Legacy Research and Technology Center. Mediastinal operations on ten live, anesthetized pigs and two human cadavers were performed using standard flexible endoscopes through a small incision at the supra-sternal notch. The esophagus was dissected to the phreno-esophageal junction using balloon dilatation in the peri-esophageal space followed by either anterior or posterior distal esophageal myotomy. Success rate was recorded of esophageal dissection to the diaphragm and proximal stomach, anterior and posterior myotomy, perforation, and complication rates. Dissection of the esophagus to the diaphragm and performing esophageal myotomy was achieved in 100% of attempts. Posterior Heller myotomy was always extendable onto the gastric wall, while anterior gastric extension of the myotomy was found to be more difficult (4/4 and 2/8, respectively; P = 0.061). Heller myotomy through a small cervical incision using flexible endoscopes is feasible. A complete Heller myotomy was performed with a higher success rate posteriorly possibly due to less anatomic interference.

  3. Challenges in navigational strategies for flexible endoscopy

    NARCIS (Netherlands)

    van der Stap, N.; van der Heijden, Ferdinand; Broeders, Ivo Adriaan Maria Johannes

    Automating flexible endoscope navigation could lead to an increase in patient safety for endoluminal therapeutic procedures. Additionally, it may decrease the costs of diagnostic flexible endoscope procedures by shortening the learning curve and increasing the efficiency of insertion. Earlier

  4. [Flexible ENT endoscopy--video technic].

    Science.gov (United States)

    Rasinger, G A; Horak, F

    1985-02-01

    This study discusses the solutions to the problem of documenting moving processes in the field of otolaryngology. A flexible bronchoscope and video equipment connected to it are presented as a specific solution of the problem, with ample of observations. A technical comparison is used as the basis for a discussion of the pros and cons of the video and film techniques. A successful arrangement of examination facilities illustrates the future of flexible-endoscope techniques in the field of otolaryngology.

  5. Hyperspectral Imaging Using Flexible Endoscopy for Laryngeal Cancer Detection

    Directory of Open Access Journals (Sweden)

    Bianca Regeling

    2016-08-01

    Full Text Available Hyperspectral imaging (HSI is increasingly gaining acceptance in the medical field. Up until now, HSI has been used in conjunction with rigid endoscopy to detect cancer in vivo. The logical next step is to pair HSI with flexible endoscopy, since it improves access to hard-to-reach areas. While the flexible endoscope’s fiber optic cables provide the advantage of flexibility, they also introduce an interfering honeycomb-like pattern onto images. Due to the substantial impact this pattern has on locating cancerous tissue, it must be removed before the HS data can be further processed. Thereby, the loss of information is to minimize avoiding the suppression of small-area variations of pixel values. We have developed a system that uses flexible endoscopy to record HS cubes of the larynx and designed a special filtering technique to remove the honeycomb-like pattern with minimal loss of information. We have confirmed its feasibility by comparing it to conventional filtering techniques using an objective metric and by applying unsupervised and supervised classifications to raw and pre-processed HS cubes. Compared to conventional techniques, our method successfully removes the honeycomb-like pattern and considerably improves classification performance, while preserving image details.

  6. Summary of Guidelines for Infection Prevention and Control for Flexible Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Lawrence Hookey

    2013-01-01

    Full Text Available BACKGROUND: High-quality processes to ensure infection prevention and control in the delivery of safe endoscopy services are essential. In 2010, the Public Health Agency of Canada and the Canadian Association of Gastroenterology (CAG developed a Canadian guideline for the reprocessing of flexible gastrointestinal endoscopy equipment.

  7. [Diagnostic bronchoscopy: contribution of the flexible video endoscopy].

    Science.gov (United States)

    Labbé, A

    2007-12-01

    The author describes the use of paediatric flexible videobronchoscopy. Examinations were performed in newborn, infant and child. In neonatal period, the technique is used for the diagnostic of congenital malformation of airway, upper airway obstruction, pre operative evaluation of tracheooesophageal fistula. In children, more frequent indications are airway obstruction with non clear cause, stridor, chronic cough, congenital malformation of airway, tracheomalacia, follow-up of lung transplantation. In intensive care unit, this technique is very useful in the cases of atelectasis, stridor post extubation, follow-up in prolonged intubation and tracheotomy. The possibility of direct visualization of the anomalies in screen and the function of numeric record are important for diagnosis and teaching procedure.

  8. Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency.

    Science.gov (United States)

    Tseng, Chia-Chen; Hsiao, Tzu-Yu; Hsu, Wei-Chung

    2016-08-01

    Despite the effectiveness of endoscopies in removing ingested foreign bodies (FBs) impacted in the esophagus, the merits and limitations of flexible endoscopy (FE) and rigid endoscopy (RE) remain unclear. Therefore, this study compares the advantages and disadvantages of both endoscopic procedures from a clinical perspective. A retrospective review was made of 273 patients suspected of esophageal FBs in emergency consultations of a tertiary medical referral center from March 2010 to March 2014. All patients received routine physical examinations, otolaryngological examinations, and X-rays of the neck and chest. The door-to-endoscopy time, procedure time, postendoscopic hospital stay, successful removal rates, and complications were analyzed as well. In this study, the most common esophageal FBs were fish and animal bones (76%) in adults and coins (74%) in children. The patients with existing esophageal FBs had significantly more frequent symptoms of dysphagia and signs of linear opacity as detected with lateral neck radiography than those without FB. Additionally, the door-to-endoscopy time, procedure time, and postendoscopic hospital stay was significantly shorter in FE patients than in RE patients. However, both RE and FE patients had high rates of successful FB removal (95%) and low complication rates (2%). Both FE and RE remove esophageal FBs successfully, as evidenced by their high success rates, low complication rates, and high detection rates. Although FE under local anesthesia is a less time-consuming procedure for adults, RE under general anesthesia may be preferable for children and can serve as an alternative to FE. Copyright © 2015. Published by Elsevier B.V.

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

    Science.gov (United States)

    Mostafalu, Pooria; Sonkusale, Sameer

    2014-04-15

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

  10. Application of flexible endoscopy-based biopsy in the diagnosis of tumour pathologies in otorhinolaryngology.

    Science.gov (United States)

    Saga, Carlos; Olalde, Manuel; Larruskain, Ekhiñe; Álvarez, Leire; Altuna, Xabier

    Interventional endoscopy allows us to act on the pathology of the patient with minimal discomfort, low costs and high efficiency. We assessed the validity of flexible endoscopic biopsies in our hospital, in lesions suspected of malignancy in the rhino-pharyngo-laryngeal space. Retrospective study of patients with a pathology suspected of malignancy assessed between 2006-2016 in our centre. We evaluated the effectiveness, the tolerance and the number of complications. We calculated the cost reduction in comparison with direct laryngoscopy in the operating room. We compared our sample with others of similar characteristics described in the literature. Thirty patients were studied with a flexible endoscopic biopsy during that period. Nineteen patients obtained positive results which allowed them to start treatment for their pathology. Seven cases had no evidence of malignancy and required another biopsy under general anaesthesia, which confirmed the carcinoma diagnosis. Two samples ruled out malignancy which was confirmed by laryngeal microsurgery. One case showed inflammation and the lesion was cured after antibiotherapy. It was impossible to collect the sample in one case. Thus, we obtained sensitivity levels of 73% with a specificity of 100%. There were no complications. The cost reduction in our sample was above 80%. Flexible endoscopic biopsy has advantages over direct laryngoscopy that are relevant in the diagnosis of oncological pathology in otorhinolaryngology. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  11. Flexible endoscopy for pediatric tracheobronchial metallic stent placement, maintenance and long-term outcomes

    Science.gov (United States)

    2018-01-01

    Objectives To assess the placement, surveillance management and long-term outcomes of the tracheobronchial (TB) balloon expandable metallic stent (BEMS) managed by therapeutic flexible endoscopy (TFE). Methods This is a retrospective review and analysis of all computerized medical records and related flexible endoscopy videos of pediatric patients who received TB BEMS during 20 years period, from January 1997 to December 2016. TFE techniques with forceps debridement, balloon dilatation and laser ablation were used to implant stents, perform regular surveillance, maintain their functions, and expand the diameters of BEMS. Short-length (30cm-36cm) endoscopes of OD 3.2mm to 5.0mm coupled with the noninvasive ventilation, without ventilation bag, mask or airway tube, supported the whole procedures. Results 146 BEMS were implanted in 87 consecutive children, including 84 tracheal, 15 carinal and 47 bronchial stents. At the time of placement, the mean age was 35.6 ± 54.6 month-old (range 0.3–228) and the mean body weight was 13.9 ± 10.6 kg (range 2.2–60). Surveillance period was 9.4 ± 6.7 years (range, 0.3–18.0). Satisfactory clinical improvements were noted immediately in all but two patients. Seventy-two (82.8%) patients were still alive with stable respiratory status, except two patients necessitating TFE management every two months. Fifty-one stents, including 35 tracheal and 16 bronchial ones, were successfully retrieved mainly with rigid endoscopy. Implanted stents could be significantly (stent diameters were positively correlated to the implanted duration. Altogether, 33 stents expired (15 patients), 51 were retrieved (40 patients), and 62 remained and functioning well (38 patients), with their mean duration of 7.4 ± 9.5, 34.9 ± 36.3 and 82.3 ± 62.5 months, respectively. Conclusion In pediatric patients, TFE with short-length scopes coupled with this NIV support has provided a safe, feasible and effective modality in placing and subsequently managing

  12. Robotics in endoscopy.

    Science.gov (United States)

    Klibansky, David; Rothstein, Richard I

    2012-09-01

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

  13. upper gastrointestinal endoscopy findings in patients referred

    African Journals Online (AJOL)

    2014-08-01

    Aug 1, 2014 ... Objective: To determine the pattern of referral and endoscopy ... build a model of a flexible fibre imaging device (2) ..... a retrospective and prospective audit of all upper ... endoscopy should be reserved for the high risk.

  14. Capsule Endoscopy

    Science.gov (United States)

    ... because experience with it is limited and traditional upper endoscopy is widely available. Why it's done Your doctor might recommend a capsule endoscopy procedure to: Find the cause of gastrointestinal bleeding. If you have unexplained bleeding in your digestive ...

  15. Technical endoscopy

    International Nuclear Information System (INIS)

    Cavalar, K.O.

    1988-01-01

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

  16. Flexible Vesiculovasoscopy Using a Microoptical System in a Human Cadaver Model: An Experimental Approach for Atraumatic Endoscopy of the Seminal Tract.

    Science.gov (United States)

    Schlager, Daniel; Maas, Moritz; Hein, Simon; Adams, Fabian; Schoenthaler, Martin; Wetterauer, Ulrich; Diemer, Thorsten; Weidner, Wolfgang; Miernik, Arkadiusz

    2016-08-01

    The most common pathologies of the seminal tract are persistent hematospermia, seminal vesicle stones, and seminal duct obstruction. Endoscopic diagnostic work-up of the seminal tract is impeded by complex anatomy and lack of technical equipment. To date, there is no standardized endoscopic approach. The purpose of this study was to investigate the applicability and feasibility of a flexible microoptical device for atraumatic endoscopy of the seminal tract in a male human cadaver. The transurethral endoscopic examination was performed on a male cadaver. No premortal interventions or diseases of the genitourinary tract had been reported. The seminal orifice was identified via cystoscopy and accessed by the Seldinger technique using a hydrophilic guidewire and ureteral catheter. Retrograde endoscopic inspection of the distal seminal tract was performed using a miniaturized flexible endoscope. An antegrade endoscopic inspection of the seminal tract was carried out via high scrotal access to the vas deferens. Structures of the seminal tract, such as the ejaculatory duct, seminal vesicles, and distal portion of the ductus deferentes, were visualized using the miniaturized endoscope. Image quality allowed identification of anatomical structures and characterization of tissue properties. The technical limitations we observed involved the system's maneuverability. Initial results of this novel endoscopic approach to the seminal tract using a flexible microoptical system are encouraging. However, considerable anatomical limitations of the targeted organs necessitate further refinements of the technical equipment. This approach might improve diagnostics and treatment of genitourinary diseases. Future surgical techniques may include intraseminal laser therapy or endoocclusion to monitor fertility in men.

  17. Dietary flexibility in three representative waterbirds across salinity and depth gradients in salt ponds of San Francisco Bay

    Science.gov (United States)

    Takekawa, John Y.; Miles, A.K.; Tsao-Melcer, D. C.; Schoellhamer, D.H.; Fregien, S.; Athearn, N.D.

    2009-01-01

    Salt evaporation ponds have existed in San Francisco Bay, California, for more than a century. In the past decade, most of the salt ponds have been retired from production and purchased for resource conservation with a focus on tidal marsh restoration. However, large numbers of waterbirds are found in salt ponds, especially during migration and wintering periods. The value of these hypersaline wetlands for waterbirds is not well understood, including how different avian foraging guilds use invertebrate prey resources at different salinities and depths. The aim of this study was to investigate the dietary flexibility of waterbirds by examining the population number and diet of three feeding guilds across a salinity and depth gradient in former salt ponds of the Napa-Sonoma Marshes. Although total invertebrate biomass and species richness were greater in low than high salinity salt ponds, waterbirds fed in ponds that ranged from low (20 g l-1) to very high salinities (250 g l -1). American avocets (surface sweeper) foraged in shallow areas at pond edges and consumed a wide range of prey types (8) including seeds at low salinity, but preferred brine flies at mid salinity (40-80 g l-1). Western sandpipers (prober) focused on exposed edges and shoal habitats and consumed only a few prey types (2-4) at both low and mid salinities. Suitable depths for foraging were greatest for ruddy ducks (diving benthivore) that consumed a wide variety of invertebrate taxa (5) at low salinity, but focused on fewer prey (3) at mid salinity. We found few brine shrimp, common in higher salinity waters, in the digestive tracts of any of these species. Dietary flexibility allows different guilds to use ponds across a range of salinities, but their foraging extent is limited by available water depths. ?? 2009 USGS, US Government.

  18. Hindfoot endoscopy

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

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

  19. "Endoview" project of intrapartum endoscopy.

    Science.gov (United States)

    Petrikovsky, Boris M; Ravens, Steven

    2002-01-01

    The change in obstetrical practices over the last decade in favor of trials of labor in patients with uterine scars has resulted in increased incidences of uterine ruptures. Although neither repeat cesarean delivery nor a trial of labor is risk free, evidence from a large multicenter study shows vaginal birth after the cesarean (VBAC) is associated with shorter hospital stays, fewer postpartum blood transfusions, and a decreased incidence of postpartum maternal fever. The uterine rupture remains the most serious complication associated with VBAC. Factors associated with uterine rupture include excessive exposure to oxytocin, dysfunctional labor, and a history of more than 1 cesarean delivery.2 Because uterine rupture may be a life-threatening event, intrapartum surveillance and the ability to perform an emergency surgery are both necessary when trial of labor is allowed. Until now, no early symptoms pathognomonic to uterine rupture had been described. We share our experiences with the novel approach to the problem - an intrapartum endoscopy. Endoscopic examination was accomplished by using the intraoperational fiberscope (Olympus and Endoview system (Costa Mesa, CA, USA). A gas-sterilized 25-cm long fiberscope is introduced into the amniotic cavity through the cervical canal after rupture of the membranes. The distance between the fiberscope and the object varies from 3 to 50 mm. The fiberscope has a separate channel for the fluid infusion (normal saline) throughout the procedure; the surgeon looks through the eyepiece directly and exhibits control over the flexible scope. The duration of endoscopy is less than 15 minutes. The inserting of the endoscopic device is very similar to that of insertion of an intrauterine pressure catheter. The IRB Committees of both participating institutions approved the study protocol. Twenty-eight patients with an unknown or poorly documented site of the uterine scar were included in the study. An ultrasound examination had been

  20. Magnetically guided capsule endoscopy.

    Science.gov (United States)

    Shamsudhin, Naveen; Zverev, Vladimir I; Keller, Henrik; Pane, Salvador; Egolf, Peter W; Nelson, Bradley J; Tishin, Alexander M

    2017-08-01

    Wireless capsule endoscopy (WCE) is a powerful tool for medical screening and diagnosis, where a small capsule is swallowed and moved by means of natural peristalsis and gravity through the human gastrointestinal (GI) tract. The camera-integrated capsule allows for visualization of the small intestine, a region which was previously inaccessible to classical flexible endoscopy. As a diagnostic tool, it allows to localize the sources of bleedings in the middle part of the gastrointestinal tract and to identify diseases, such as inflammatory bowel disease (Crohn's disease), polyposis syndrome, and tumors. The screening and diagnostic efficacy of the WCE, especially in the stomach region, is hampered by a variety of technical challenges like the lack of active capsular position and orientation control. Therapeutic functionality is absent in most commercial capsules, due to constraints in capsular volume and energy storage. The possibility of using body-exogenous magnetic fields to guide, orient, power, and operate the capsule and its mechanisms has led to increasing research in Magnetically Guided Capsule Endoscopy (MGCE). This work shortly reviews the history and state-of-art in WCE technology. It highlights the magnetic technologies for advancing diagnostic and therapeutic functionalities of WCE. Not restricting itself to the GI tract, the review further investigates the technological developments in magnetically guided microrobots that can navigate through the various air- and fluid-filled lumina and cavities in the body for minimally invasive medicine. © 2017 American Association of Physicists in Medicine.

  1. Flexibility.

    Science.gov (United States)

    Humphrey, L. Dennis

    1981-01-01

    Flexibility is an important aspect of all sports and recreational activities. Flexibility can be developed and maintained by stretching exercises. Exercises designed to develop flexibility in ankle joints, knees, hips, and the lower back are presented. (JN)

  2. Design of Soil Salinity Policies with Tinamit, a Flexible and Rapid Tool to Couple Stakeholder-Built System Dynamics Models with Physically-Based Models

    Science.gov (United States)

    Malard, J. J.; Baig, A. I.; Hassanzadeh, E.; Adamowski, J. F.; Tuy, H.; Melgar-Quiñonez, H.

    2016-12-01

    Model coupling is a crucial step to constructing many environmental models, as it allows for the integration of independently-built models representing different system sub-components to simulate the entire system. Model coupling has been of particular interest in combining socioeconomic System Dynamics (SD) models, whose visual interface facilitates their direct use by stakeholders, with more complex physically-based models of the environmental system. However, model coupling processes are often cumbersome and inflexible and require extensive programming knowledge, limiting their potential for continued use by stakeholders in policy design and analysis after the end of the project. Here, we present Tinamit, a flexible Python-based model-coupling software tool whose easy-to-use API and graphical user interface make the coupling of stakeholder-built SD models with physically-based models rapid, flexible and simple for users with limited to no coding knowledge. The flexibility of the system allows end users to modify the SD model as well as the linking variables between the two models themselves with no need for recoding. We use Tinamit to couple a stakeholder-built socioeconomic model of soil salinization in Pakistan with the physically-based soil salinity model SAHYSMOD. As climate extremes increase in the region, policies to slow or reverse soil salinity buildup are increasing in urgency and must take both socioeconomic and biophysical spheres into account. We use the Tinamit-coupled model to test the impact of integrated policy options (economic and regulatory incentives to farmers) on soil salinity in the region in the face of future climate change scenarios. Use of the Tinamit model allowed for rapid and flexible coupling of the two models, allowing the end user to continue making model structure and policy changes. In addition, the clear interface (in contrast to most model coupling code) makes the final coupled model easily accessible to stakeholders with

  3. Percutaneous debridement and washout of walled-off abdominal abscess and necrosis using flexible endoscopy: a large single-center experience.

    Science.gov (United States)

    Mathers, Bradley; Moyer, Matthew; Mathew, Abraham; Dye, Charles; Levenick, John; Gusani, Niraj; Dougherty-Hamod, Brandy; McGarrity, Thomas

    2016-01-01

    Direct percutaneous endoscopic necrosectomy has been described as a minimally invasive intervention for the debridement of walled-off pancreatic necrosis (WOPN). In this retrospective cohort study, we aimed to confirm these findings in a US referral center and evaluate the clinical value of this modality in the treatment of pancreatic necrosis as well as other types of intra-abdominal fluid collections and necrosis. Twelve consecutive patients with WOPN or other abdominal abscess requiring debridement and washout underwent computed tomography (CT)-guided drainage catheter placement. Each patient then underwent direct percutaneous endoscopic necrosectomy and washout with repeat debridement performed until complete. Drains were then removed once output fell below 30 mL/day and imaging confirmed resolution. The primary endpoints were time to clinical resolution and sustained resolution at 1-year follow up.  Ten patients were treated for WOPN, one for necrotic hepatic abscesses, and one for omental necrosis. The median time to intervention was 85 days with an average of 2.3 necrosectomies performed. Complete removal of drains was accomplished in 11 patients (92 %). The median time to resolution was 57 days. No serious adverse events occurred; however, one patient developed pancreaticocutaneous fistulas. Ten patients completed 1-year surveillance of which none required drain replacement. No patients required surgery or repeat endoscopy. This series supports the premise that direct percutaneous endoscopic necrosectomy is a safe and effective intervention for intra-abdominal fluid collections and necrosis in appropriately selected patients. Our study demonstrates a high clinical success rate with minimal adverse events. This modality offers several potential advantages over surgical and transgastric approaches including use of improved accessibility, an excellent safety profile, and requirement for only deep or moderate sedation.

  4. Endoscopy in pregnancy.

    LENUS (Irish Health Repository)

    O'mahony, Seamus

    2012-02-03

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

  5. Deep Learning in Gastrointestinal Endoscopy.

    Science.gov (United States)

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

    2016-01-01

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

  6. Flexible Fiberoptic Endoscopy in Difficult Intubations

    NARCIS (Netherlands)

    Edens, E. Th.; Sia, R. L.

    1981-01-01

    Intubation problems sometimes occur very suddenly and can be divided into two groups. The expected ones include the patients with a short neck and long teeth, cellulitis of the tongue, large oropharyngeal tumors, obstructing laryngeal tumors, congenital and acquired maxillofacial deformities,

  7. in upper gastrointestinal endoscopy

    Directory of Open Access Journals (Sweden)

    Sinan Uzman

    2016-07-01

    Full Text Available Introduction : There is increasing interest in sedation for upper gastrointestinal endoscopy (UGE. Prospective randomized studies comparing sedation properties and complications of propofol and midazolam/meperidine in upper gastrointestinal endoscopy (UGE are few. Aim: To compare propofol and midazolam/meperidine sedation for UGE in terms of cardiopulmonary side effects, patient and endoscopist satisfaction and procedure-related times. Material and methods: This was a prospective, randomized, double-blind study of propofol versus midazolam and meperidine in 100 patients scheduled for diagnostic upper gastrointestinal endoscopy. The patients were divided into propofol and midazolam/meperidine groups. Randomization was generated by a computer. Cardiopulmonary side effects (hypotension, bradycardia, hypoxemia, procedure-related times (endoscopy time, awake time, time to hospital discharge, and patient and endoscopist satisfaction were compared between groups. Results: There was no significant difference between the groups with respect to the cost, endoscopy time, or demographic and clinical characteristics of the patients. Awake time and time to hospital discharge were significantly shorter in the propofol group (6.58 ±4.72 vs. 9.32 ±4.26 min, p = 0.030 and 27.60 ±7.88 vs. 32.00 ±10.54 min, p = 0.019. Hypotension incidence was significantly higher in the propofol group (12% vs. 0%, p = 0.027. The patient and endoscopist satisfaction was better with propofol. Conclusions : Propofol may be preferred to midazolam/meperidine sedation, with a shorter awake and hospital discharge time and better patient and endoscopist satisfaction. However, hypotension risk should be considered with propofol, and careful evaluation is needed, particularly in cardiopulmonary disorders.

  8. Photometric stereo endoscopy.

    Science.gov (United States)

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

    2013-07-01

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

  9. Endoscopy and surgery for obesity

    International Nuclear Information System (INIS)

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

    2006-01-01

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

  10. Capsule endoscopy: Beyond small bowel

    Directory of Open Access Journals (Sweden)

    Samuel N Adler

    2012-01-01

    Full Text Available In this article the brief and dramatic history of capsule endoscopy of the digestive tract is reviewed. Capsule endoscopy offers a non invasive method to diagnose diseases that affect the esophagus, small bowel and colon. Technological improvements relating to optics, software, data recorders with two way communication have revolutionized this field. These advancements have produced better diagnostic performance.

  11. Salinization and Saline Environments

    Science.gov (United States)

    Vengosh, A.

    2003-12-01

    One of the most conspicuous phenomena of water-quality degradation, particularly in arid and semi-arid zones, is salinization of water and soil resources. Salinization is a long-term phenomenon, and during the last century many aquifers and river basins have become unsuitable for human consumption owing to high levels of salinity. Future exploitation of thousands of wells in the Middle East and in many other water-scarce regions in the world depends, to a large extent, on the degree and rate of salinization. Moreover, every year a large fraction of agricultural land is salinized and becomes unusable.Salinization is a global environmental phenomenon that affects many different aspects of our life (Williams, 2001a, b): changing the chemical composition of natural water resources (lakes, rivers, and groundwater), degrading the quality of water supply to the domestic and agriculture sectors, contribution to loss of biodiversity, taxonomic replacement by halotolerant species ( Williams, 2001a, b), loss of fertile soil, collapse of agricultural and fishery industries, changing of local climatic conditions, and creating severe health problems (e.g., the Aral Basin). The damage due to salinity in the Colorado River Basin alone, for example, ranges between 500 and 750 million per year and could exceed 1 billion per year if the salinity in the Imperial Dam increases from 700 mg L-1 to 900 mg L-1 (Bureau of Reclamation, 2003, USA). In Australia, accelerating soil salinization has become a massive environmental and economic disaster. Western Australia is "losing an area equal to one football oval an hour" due to spreading salinity ( Murphy, 1999). The annual cost for dryland salinity in Australia is estimated as AU700 million for lost land and AU$130 million for lost production ( Williams et al., 2002). In short, the salinization process has become pervasive.Salinity in water is usually defined by the chloride content (mg L-1) or total dissolved solids content (TDS, mg L-1or g

  12. Real-time holographic endoscopy

    Science.gov (United States)

    Smigielski, Paul; Albe, Felix; Dischli, Bernard

    1992-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Rowena Almeida

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Quantitative ENT endoscopy: the future in the new millennium

    Science.gov (United States)

    Mueller, Andreas; Schubert, Mario

    1999-06-01

    In Otorhinolaryngology the endoscopic appraisal of luminal dimensions of the nose, the throat, the larynx and the trachea is a daily problem. Those concerned with endoscopy know, that endoscopes distort dimensions of examined anatomical structures. To draw conclusions on luminal dimensions from the endoscopic pictures additional measuring devices are required. We developed a new method of measuring luminal dimensions in rigid or flexible endoscopy. For this a laser beam directed radially marks the anatomical lumen of interest in the videoendoscopic vision. The laser ring becomes deformed according to the form of the cavity explored. By keeping the distance defined between the laser ring and the top of the endoscope, the endoscopic video image can be measured. A piece of software developed by us calculates from the pictures the cross sectional area as well as the extension of benign or malign stenosis of the cavity explored. The result of the endoscopic measuring procedure can be visualized 3D on a PC-monitor. We are going to demonstrate the result of our clinical experience in different otorhinolaryngological diseases with the new endoscopic measuring kit in comparison to standard endoscopy. A further perspective is the endoscopic measuring kit in comparison to standard endoscopy. A further perspective is the endoscopic assisted manufacturing (EAM) of anatomical adapted stents, tubes and cannules.

  16. Fully wireless pressure sensor based on endoscopy images

    Science.gov (United States)

    Maeda, Yusaku; Mori, Hirohito; Nakagawa, Tomoaki; Takao, Hidekuni

    2018-04-01

    In this paper, the result of developing a fully wireless pressure sensor based on endoscopy images for an endoscopic surgery is reported for the first time. The sensor device has structural color with a nm-scale narrow gap, and the gap is changed by air pressure. The structural color of the sensor is acquired from camera images. Pressure detection can be realized with existing endoscope configurations only. The inner air pressure of the human body should be measured under flexible-endoscope operation using the sensor. Air pressure monitoring, has two important purposes. The first is to quantitatively measure tumor size under a constant air pressure for treatment selection. The second purpose is to prevent the endangerment of a patient due to over transmission of air. The developed sensor was evaluated, and the detection principle based on only endoscopy images has been successfully demonstrated.

  17. Contraindications for video capsule endoscopy

    OpenAIRE

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

    2016-01-01

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

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

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  19. NASPGHAN Capsule Endoscopy Clinical Report.

    Science.gov (United States)

    Friedlander, Joel A; Liu, Quin Y; Sahn, Benjamin; Kooros, Koorosh; Walsh, Catharine M; Kramer, Robert E; Lightdale, Jenifer R; Khlevner, Julie; McOmber, Mark; Kurowski, Jacob; Giefer, Matthew J; Pall, Harpreet; Troendle, David M; Utterson, Elizabeth C; Brill, Herbert; Zacur, George M; Lirio, Richard A; Lerner, Diana G; Reynolds, Carrie; Gibbons, Troy E; Wilsey, Michael; Liacouras, Chris A; Fishman, Douglas S

    2017-03-01

    Wireless capsule endoscopy (CE) was introduced in 2000 as a less invasive method to visualize the distal small bowel in adults. Because this technology has advanced it has been adapted for use in pediatric gastroenterology. Several studies have described its clinical use, utility, and various training methods but pediatric literature regarding CE is limited. This clinical report developed by the Endoscopic and Procedures Committee of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition outlines the current literature, and describes the recommended current role, use, training, and future areas of research for CE in pediatrics.

  20. The Clinical Risks of Infection Associated with Endoscopy

    Directory of Open Access Journals (Sweden)

    Alistair E Cowen

    2001-01-01

    Full Text Available The cleaning of flexible endoscopes is difficult and time consuming. Any method of attempted sterilization or high level disinfection will fail if prior cleaning has been defective. Inadequate reprocessing of endoscopes may result in patient to patient transmission of serious bacterial and viral diseases or infection with endemic hospital pathogens. Antibiotic prophylaxis is required to prevent septicemia and bacterial endocarditis in high risk patients undergoing specific endoscopic procedures. Prevention of serious endoscopy-associated clinical infections requires strict compliance with detailed reprocessing protocols by specially trained nursing staff.

  1. Vibration measurements by pulsed digital holographic endoscopy

    Science.gov (United States)

    Schedin, Staffan; Pedrini, Giancarlo; Perez-Lopez, Carlos; Mendoza Santoyo, Fernando

    2005-02-01

    Digital holographic interferometry in combination with a flexible fiber endoscope allows high precision measurements of deformations on hidden objects surfaces, inside cavities and objects with small access apertures. A digital holographic endoscopy system is described with a frequency-doubled, twin oscillator Q-switched pulsed Nd:YAG laser as light source. A sequence of digital hologram pairs are recorded with a maximum repetition rate of 260 ms. Each digital hologram is captured at separate video frames of a CCD-camera. The time separation between the laser pulses from each cavity can be set in the range from 50 to 500 μs. The digital holograms are transferred to a PC via a frame grabber and evaluated quantitatively by the Fourier transform method. The resulting phase fringe pattern has the information needed to evaluate quantitatively the amount of the deformation. Experimental results of vibration measurements of hidden mechanical and biological object surfaces are presented. The quality of the results obtained by mechanical object surfaces is usually higher than for biological surfaces. This can be explained easily by the fact that a biological surface is much more complex than a mechanical surface in the sense that some parts of the surface may reflect the light well whereas other parts may absorb the light. Also, biological surfaces are translucent, which means that part of the light may enter inside the sample where it may be absorbed or reflected.

  2. Stochastic Capsule Endoscopy Image Enhancement

    Directory of Open Access Journals (Sweden)

    Ahmed Mohammed

    2018-06-01

    Full Text Available Capsule endoscopy, which uses a wireless camera to take images of the digestive tract, is emerging as an alternative to traditional colonoscopy. The diagnostic values of these images depend on the quality of revealed underlying tissue surfaces. In this paper, we consider the problem of enhancing the visibility of detail and shadowed tissue surfaces for capsule endoscopy images. Using concentric circles at each pixel for random walks combined with stochastic sampling, the proposed method enhances the details of vessel and tissue surfaces. The framework decomposes the image into two detailed layers that contain shadowed tissue surfaces and detail features. The target pixel value is recalculated for the smooth layer using similarity of the target pixel to neighboring pixels by weighting against the total gradient variation and intensity differences. In order to evaluate the diagnostic image quality of the proposed method, we used clinical subjective evaluation with a rank order on selected KID image database and compared it to state-of-the-art enhancement methods. The result showed that the proposed method provides a better result in terms of diagnostic image quality and objective quality contrast metrics and structural similarity index.

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

    NARCIS (Netherlands)

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

    2016-01-01

    To develop standards for high quality of gastrointestinal endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all gastrointestinal endoscopy procedures is

  4. Anesthesia related Complications in Pediatric GI Endoscopy

    Directory of Open Access Journals (Sweden)

    A Sabzevari

    2014-04-01

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

  5. Observation of rat's colon polyps in real time by mini-endoscopy and raman spectroscopy

    Science.gov (United States)

    Andriana, Bibin Bintang; Mahardika, Anggara; Taketani, Akihiro; Sato, Hidetoshi

    2018-02-01

    Colorectal adenoma (CA) is a disease caused by various factors (such as genetic factors or environmental exposures). The appearance of colon polyp (CP) within colorectal might indicate the hint of CA development. Ball-lens hollow fiber Raman probe (BHRP) may has a high capability for detection of CA in living experimental animal and have already tested to rat's CP in this study, which was designed to collaborate between BHRP with mini-endoscopy to observe the biochemical alteration within normal colon tissue and rat's colon polyps in real time. BHRP and mini-endoscopy can distinguish the differences in their finger print spectra and make pictures the control and CP in the real time. At the first step, the real situation of normal colon and Rat's CP were washed by saline and observed with mini-endoscopy. BHRP was introduced to Dextran sodium sulphate (DSS)-induced Rat's CP to detect some of biochemical alteration. The main purpose of this study was to introduce mini-endoscopy to guide the BHRP for diagnosing of CP in real time and to compare it with spectra of normal colon (control group) in living rat. As the result, BHRP can provide the differences in band of control and CP group, which can inform that the biochemical of normal and CP has changed. As a major parameter to distinct normal and CP tissue were phosphatidylinositol, phosphodiester group, lipid, and collagen. Mini endoscopy and BHRP is very sensitive devices for diagnosing of CP in real time.

  6. 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.

  7. Stray energy transfer during endoscopy.

    Science.gov (United States)

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

    2017-10-01

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

  8. Leadership and team building in gastrointestinal endoscopy.

    Science.gov (United States)

    Valori, Roland M; Johnston, Deborah J

    2016-06-01

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

  9. Risk Management for Gastrointestinal Endoscopy in Elderly Patients: Questionnaire for Patients Undergoing Gastrointestinal Endoscopy

    OpenAIRE

    Umegaki, Eiji; Abe, Shinya; Tokioka, Satoshi; Takeuchi, Nozomi; Takeuchi, Toshihisa; Yoda, Yukiko; Murano, Mitsuyuki; Higuchi, Kazuhide

    2009-01-01

    More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of hum...

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

    African Journals Online (AJOL)

    Appropriateness of Referrals for Upper Gastrointestinal Endoscopy. ... Accra between January and December, 2008 were interviewed and evaluated for this study. ... Presentations with bleeding and suspicion of malignancy showed statistical ...

  11. Microrobotics for future gastrointestinal endoscopy.

    Science.gov (United States)

    Menciassi, Arianna; Quirini, Marco; Dario, Paolo

    2007-01-01

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

  12. Upper and Lower Urinary Tract Endoscopy Training on Thiel-embalmed Cadavers.

    Science.gov (United States)

    Bele, Uros; Kelc, Robi

    2016-07-01

    To evaluate Thiel-embalmed cadavers as a new training model for urological endoscopy procedures. Twelve urologists performed upper and lower urinary tract endoscopies on 5 different Thiel-embalmed cadavers to evaluate this potentially new training model in urological endoscopic procedural training. Using a 5-point Likert scale, the participants assessed the quality of the tissue and the overall experience of the endoscopy in comparison to a live patient procedure. Thiel-embalmed cadavers have shown to mimic live patient endoscopy of the upper and lower urinary tract in terms of almost identical overall anatomical conditions and manipulation characteristics of the tissue. The mucosa of the urethra and ureters showed similar colors and consistency in comparison to a live patient, whereas bladder mucosa was lacking the visibility of the vessels, thus was unsuitable for identifying any mucosal abnormalities. The flexibility of the muscles allowed for proper patient positioning, whereas the loss of muscle tonus made ureteroscopy more difficult although sufficiently comparable to the procedure done in a live patient. Thiel-embalmed cadavers have already been proven to be a suitable training model for several medical procedures. They are known for preserving tissue color, consistency, and flexibility without the irritant odors or risk of infection, which make them resemble live patients with real-life surgical challenges. The results of our study strongly suggest that despite some minor drawbacks, Thiel-embalmed cadavers are a suitable simulation model for initial training of urethrocystoscopy and ureteroscopy. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Capsule endoscopy in neoplastic diseases

    Science.gov (United States)

    Pennazio, Marco; Rondonotti, Emanuele; de Franchis, Roberto

    2008-01-01

    Until recently, diagnosis and management of small-bowel tumors were delayed by the difficulty of access to the small bowel and the poor diagnostic capabilities of the available diagnostic techniques. An array of new methods has recently been developed, increasing the possibility of detecting these tumors at an earlier stage. Capsule endoscopy (CE) appears to be an ideal tool to recognize the presence of neoplastic lesions along this organ, since it is non-invasive and enables the entire small bowel to be visualized. High-quality images of the small-bowel mucosa may be captured and small and flat lesions recognized, without exposure to radiation. Recent studies on a large population of patients undergoing CE have reported small-bowel tumor frequency only slightly above that reported in previous surgical series (range, 1.6%-2.4%) and have also confirmed that the main clinical indication to CE in patients with small-bowel tumors is obscure gastrointestinal (GI) bleeding. The majority of tumors identified by CE are malignant; many were unsuspected and not found by other methods. However, it remains difficult to identify pathology and tumor type based on the lesion’s endoscopic appearance. Despite its limitations, CE provides crucial information leading in most cases to changes in subsequent patient management. Whether the use of CE in combination with other new diagnostic (MRI or multidetector CT enterography) and therapeutic (Push-and-pull enteroscopy) techniques will lead to earlier diagnosis and treatment of these neoplasms, ultimately resulting in a survival advantage and in cost savings, remains to be determined through carefully-designed studies. PMID:18785274

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

    International Nuclear Information System (INIS)

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

    2004-01-01

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

  15. Virtual reality simulators for gastrointestinal endoscopy training.

    Science.gov (United States)

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

    2014-01-16

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

  16. Transgastric endoscopy--a new fashion, a new excitement!

    Science.gov (United States)

    Fritscher-Ravens, A

    2007-02-01

    Current flexible gastrointestinal endoscopy has been enriched by a new technique, transluminal endoscopic surgery, which has recently attracted an explosion of interest. To date, the established applications are few, but this review attempts to provide an overview of the present status of the procedures and of the development of the technical devices. The possible risks will be addressed as well as the potential benefits. Ethical issues and safeguards may need exploration. Above all, the principal developments in techniques for closure of incisions will be described here, including each of the methods and devices. Expansion in perspective as well as size is most important both in business and science, as it brings new dimensions to our lives and work. A steady state is a myth, in general, as it will be overtaken by new developments, that transform into new steady states which themselves will be superseded.

  17. Nanotechnology in gastrointestinal endoscopy: A primer

    Directory of Open Access Journals (Sweden)

    Ashish Kumar Jha

    2012-01-01

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

  18. Arteriovenous Malformation Detected by Small Bowel Endoscopy

    Directory of Open Access Journals (Sweden)

    Takaaki Fujii

    2014-10-01

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

  19. Helicobacter pylori as an occupational hazard in the endoscopy room

    African Journals Online (AJOL)

    South African Journal of Surgery ... Background: It remains controversial whether or not healthcare workers on upper ... We were unable to confirm that endoscopy was a risk factor for endoscopy teams with regard to contracting H. pylori.

  20. Robotic Control of a Traditional Flexible Endoscope for Therapy

    NARCIS (Netherlands)

    Ruiter, Jeroen; Bonnema, Gerrit Maarten; van der Voort, Mascha C.; Broeders, Ivo Adriaan Maria Johannes

    2013-01-01

    In therapeutic flexible endoscopy a team of physician and assistant(s) is required to control all independent translations and rotations of the flexible endoscope and its instruments. As a consequence the physician lacks valuable force feedback information on tissue interaction, communication errors

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

    LENUS (Irish Health Repository)

    Harewood, G C

    2009-06-01

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

  2. Upper Gastro-intestinal'Fibre-Optic Endoscopy

    African Journals Online (AJOL)

    1974-04-27

    Apr 27, 1974 ... A 3-YEAR STUDY AT GROOTE SCHUUR HOSPITAL. B. H. NOVIS, S. BANK, 1. .... ever, in 142 cases endoscopy provided a more definitive diagnosis or .... the best interests of the particular patient, related to the facilities and ...

  3. Transnasal endoscopy: Technical considerations, advantages and limitations.

    Science.gov (United States)

    Atar, Mustafa; Kadayifci, Abdurrahman

    2014-02-16

    Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes.

  4. Hindfoot endoscopy for posterior ankle pain

    NARCIS (Netherlands)

    van Dijk, C. Niek

    2006-01-01

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

  5. Virtual endoscopy in neurosurgery: a review.

    Science.gov (United States)

    Neubauer, André; Wolfsberger, Stefan

    2013-01-01

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

  6. Transnasal endoscopy: Technical considerations, advantages and limitations

    Science.gov (United States)

    Atar, Mustafa; Kadayifci, Abdurrahman

    2014-01-01

    Transnasal endoscopy (TNE) is an upper endoscopy method which is performed by the nasal route using a thin endoscope less than 6 mm in diameter. The primary goal of this method is to improve patient tolerance and convenience of the procedure. TNE can be performed without sedation and thus eliminates the risks associated with general anesthesia. In this way, TNE decreases the cost and total duration of endoscopic procedures, while maintaining the image quality of standard caliber endoscopes, providing good results for diagnostic purposes. However, the small working channel of the ultra-thin endoscope used for TNE makes it difficult to use for therapeutic procedures except in certain conditions which require a thinner endoscope. Biopsy is possible with special forceps less than 2 mm in diameter. Recently, TNE has been used for screening endoscopy in Far East Asia, including Japan. In most controlled studies, TNE was found to have better patient tolerance when compared to unsedated endoscopy. Nasal pain is the most significant symptom associated with endoscopic procedures but can be reduced with nasal pretreatment. Despite the potential advantage of TNE, it is not common in Western countries, usually due to a lack of training in the technique and a lack of awareness of its potential advantages. This paper briefly reviews the technical considerations as well as the potential advantages and limitations of TNE with ultra-thin scopes. PMID:24567791

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

    NARCIS (Netherlands)

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

    2016-01-01

    To develop standards for high quality in gastrointestinal (GI) endoscopy, the European Society of Gastrointestinal Endoscopy (ESGE) has established the ESGE Quality Improvement Committee. A prerequisite for quality assurance and improvement for all GI endoscopy procedures is state-of-the-art

  8. Head and neck computed tomography virtual endoscopy: evaluation of a new imaging technique.

    Science.gov (United States)

    Gallivan, R P; Nguyen, T H; Armstrong, W B

    1999-10-01

    To evaluate a new radiographic imaging technique: computed tomography virtual endoscopy (CTVE) for head and neck tumors. Twenty-one patients presenting with head and neck masses who underwent axial computed tomography (CT) scan with contrast were evaluated by CTVE. Comparisons were made with video-recorded images and operative records to evaluate the potential utility of this new imaging technique. Twenty-one patients with aerodigestive head and neck tumors were evaluated by CTVE. One patient had a nasal cylindrical cell papilloma; the remainder, squamous cell carcinomas distributed throughout the upper aerodigestive tract. Patients underwent complete head and neck examination, flexible laryngoscopy, axial CT with contrast, CTVE, and in most cases, operative endoscopy. Available clinical and radiographic evaluations were compared and correlated to CTVE findings. CTVE accurately demonstrated abnormalities caused by intraluminal tumor, but where there was apposition of normal tissue against tumor, inaccurate depictions of surface contour occurred. Contour resolution was limited, and mucosal irregularity could not be defined. There was very good overall correlation between virtual images, flexible laryngoscopic findings, rigid endoscopy, and operative evaluation in cases where oncological resections were performed. CTVE appears to be most accurate in evaluation of subglottic and nasopharyngeal anatomy in our series of patients. CTVE is a new radiographic technique that provides surface-contour details. The technique is undergoing rapid technical evolution, and although the image quality is limited in situations where there is apposition of tissue folds, there are a number of potential applications for this new imaging technique.

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

    Science.gov (United States)

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

    2014-06-01

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

  10. A Novel Telemanipulated Robotic Assistant for Surgical Endoscopy: Preclinical Application to ESD.

    Science.gov (United States)

    Zorn, Lucile; Nageotte, Florent; Zanne, Philippe; Legner, Andras; Dallemagne, Bernard; Marescaux, Jacques; de Mathelin, Michel

    2018-04-01

    Minimally invasive surgical interventions in the gastrointestinal tract, such as endoscopic submucosal dissection (ESD), are very difficult for surgeons when performed with standard flexible endoscopes. Robotic flexible systems have been identified as a solution to improve manipulation. However, only a few such systems have been brought to preclinical trials as of now. As a result, novel robotic tools are required. We developed a telemanipulated robotic device, called STRAS, which aims to assist surgeons during intraluminal surgical endoscopy. This is a modular system, based on a flexible endoscope and flexible instruments, which provides 10 degrees of freedom (DoFs). The modularity allows the user to easily set up the robot and to navigate toward the operating area. The robot can then be teleoperated using master interfaces specifically designed to intuitively control all available DoFs. STRAS capabilities have been tested in laboratory conditions and during preclinical experiments. We report 12 colorectal ESDs performed in pigs, in which large lesions were successfully removed. Dissection speeds are compared with those obtained in similar conditions with the manual Anubiscope platform from Karl Storz. We show significant improvements ( ). These experiments show that STRAS (v2) provides sufficient DoFs, workspace, and force to perform ESD, that it allows a single surgeon to perform all the surgical tasks and those performances are improved with respect to manual systems. The concepts developed for STRAS are validated and could bring new tools for surgeons to improve comfort, ease, and performances for intraluminal surgical endoscopy.

  11. Automatic blood detection in capsule endoscopy video

    Czech Academy of Sciences Publication Activity Database

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

    2016-01-01

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

  12. Sedation-related complications in gastrointestinal endoscopy

    OpenAIRE

    Amornyotin, Somchai

    2013-01-01

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

  13. Monitoring of Intracranial Pressure During Intracranial Endoscopy

    Directory of Open Access Journals (Sweden)

    Rajeev Kumar

    2013-08-01

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

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

    Science.gov (United States)

    Cho, Yu Kyung

    2016-07-01

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

  15. Quality Improvement in Pediatric Endoscopy: A Clinical Report From the NASPGHAN Endoscopy Committee.

    Science.gov (United States)

    Kramer, Robert E; Walsh, Catharine M; Lerner, Diana G; Fishman, Douglas S

    2017-07-01

    The current era of healthcare reform emphasizes the provision of effective, safe, equitable, high-quality, and cost-effective care. Within the realm of gastrointestinal endoscopy in adults, renewed efforts are in place to accurately define and measure quality indicators across the spectrum of endoscopic care. In pediatrics, however, this movement has been less-defined and lacks much of the evidence-base that supports these initiatives in adult care. A need, therefore, exists to help define quality metrics tailored to pediatric practice and provide a toolbox for the development of robust quality improvement (QI) programs within pediatric endoscopy units. Use of uniform standards of quality reporting across centers will ensure that data can be compared and compiled on an international level to help guide QI initiatives and inform patients and their caregivers of the true risks and benefits of endoscopy. This report is intended to provide pediatric gastroenterologists with a framework for the development and implementation of endoscopy QI programs within their own centers, based on available evidence and expert opinion from the members of the NASPGHAN Endoscopy Committee. This clinical report will require expansion as further research pertaining to endoscopic quality in pediatrics is published.

  16. Chromoendoscopy and magnification endoscopy in Barrett's esophagus.

    Science.gov (United States)

    Connor, Michael J; Sharma, Prateek

    2003-04-01

    Chromoendoscopy and magnification endoscopy appear to be a valuable adjuncts for the detection and classification of BE. These techniques may also prove to be useful aids in surveillance protocols for identifying dysplastic epithelium or early cancer within a segment of BE. Ideally, the use of these techniques would enable the endoscopist to rule in or out the presence of IM and of dysplastic or cancerous epithelium by obtaining only a minimal number of targeted biopsy specimens, or potentially performing no biopsies at all. This could transform upper endoscopy into a much more effective screening and surveillance tool for BE. Several problems currently exist for the use of chromoendoscopy for BE. Results of studies reporting the accuracy of chromoendoscopy remain mixed,and are likely explained by the wide range of techniques and materials used in the investigations. Staining adds several steps, and likely several minutes, to an upper endoscopy. Staining within the esophagus is often patchy and uneven. In addition, poor spraying technique exaggerates the irregular uptake by the mucosa. There is a high false-positive rate when staining gastric-type epithelium and denuded epithelium. Areas of dysplasia or cancer may take up stain in an irregular manner, or may not stain at all. Chromoendoscopy is a relatively new technique in the management of BE and depends on the skill and experience of the endoscopist. Magnification, however, only allows the endoscopist to observe small areas of mucosa at a time, increasing the overall complexity and length of the procedure. The learning curve for this procedure is relatively short, however, and endoscopists can usually become proficient in the technique quickly. Currently, the greatest body of literature exists concerning the use of methylene blue for diagnosing BE. At the present time, chromoendoscopy and magnification endoscopy appear to be most beneficial in detecting IM in short segments of esophageal columnar

  17. Endoscopy in Canada: Proceedings of the National Roundtable

    Directory of Open Access Journals (Sweden)

    Noah Switzer

    2015-01-01

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

  18. Jaw Dislocation as an Unusual Complication of Upper Endoscopy

    Directory of Open Access Journals (Sweden)

    Evan S. Dellon

    2016-05-01

    Full Text Available This case report presents an unusual complication of upper endoscopy, resulting in jaw dislocation. Temporomandibular joint dislocation is commonly reported in association with anesthesia and intubation, but it is not widely recognized as a complication of gastrointestinal endoscopy. This report also reviews the current literature regarding this complication and discusses the potential causes of dislocation, differential diagnoses for jaw pain following endoscopy, and recommendations for prevention.

  19. Role of endoscopy in gastroesophageal reflux disease

    Directory of Open Access Journals (Sweden)

    Tarun Rai

    2015-01-01

    Full Text Available Gastroesophageal reflux disease is a condition due to reflux of stomach content in the esophagus causing trouble symptoms or complications or both. GERD is a clinical diagnosis and typically presents with a heartburn and/or regurgitation and a positive response to antacid secretory medications. GERD is the leading outpatient diagnosis among all gastrointestinal disorders in the United States. Approximately 40% of population report occasional symptoms of GERD whereas 10-20% of patients will have symptoms at least once in a week. Recent guidelines from gastrointestinal societies such as American College of Gastroenterology, American Society for Gastrointestinal Endoscopy and American College of Physicians have laid out specific indications regarding role of esophagogastroduodenoscopy in GERD. Despite these recommendations, studies have revealed that one-fifth to two-fifth EGDs may not be clinically indicated, especially where open access endoscopy referral system is used. Traditionally, GERD has been thought to be a disease of the western world. Prevalence rates had been estimated to be lower in Asia when compared to that of the Western Countries. Few recent epidemiological studies in India showed the prevalence of reflux disease in India to be between 8-24%, which is comparable to the western world. The use of EGDs becomes more critical for developing countries such as India where prevalence of GERD and BE is comparable to the western countries but have limited resources. In addition to direct cost for an EGD, it burdens economy with indirect costs such as time off from the work, transportation and any procedural complications. Risk stratifying patients with GERD may therefore prevent unnecessary procedures, harms and costs. The aim of this paper is to review the existing evidence on the role of endoscopy in GERD.

  20. Fibreoptic gastro-intestinal endoscopy at the Korle Bu Teaching Hospital, Accra, Ghana: a historical perspective.

    Science.gov (United States)

    Nkrumah, Kofi N; Archampong, Emmanuel Q

    2017-12-01

    Fibreoptic (or Flexible) endoscopy has revolutionized and completely transformed practice of gastroenterology, and many other medical specialties, over the past half century or so. At the Korle Bu Teaching Hospital, Accra the development of this facility has evolved gradually, especially involving specialists from the Departments of Medicine and Surgery since the 1970s. This article is an attempt to trace and record this journey and to highlight some of the problems and challenges yet to be overcome. It is an anecdotal account based on the authors' recollection with attempts at verification of important dates.

  1. Flexible Bronchoscopy.

    Science.gov (United States)

    Miller, Russell J; Casal, Roberto F; Lazarus, Donald R; Ost, David E; Eapen, George A

    2018-03-01

    Flexible bronchoscopy has changed the course of pulmonary medicine. As technology advances, the role of the flexible bronchoscope for both diagnostic and therapeutic indications is continually expanding. This article reviews the historical development of the flexible bronchoscopy, fundamental uses of the flexible bronchoscope as a tool to examine the central airways and obtain diagnostic tissue, and the indications, complications, and contraindications to flexible bronchoscopy. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Clinical radiology and endoscopy of the colon

    International Nuclear Information System (INIS)

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

    1994-01-01

    Translated from the original 1993 German edition, this comprehensive volume brings together, in a logically integrated, understandable teaching text, expert imaging by radiology, up-to-date ultrasound and MRI; endoscopy, and histology. This text does justice to the importance of the colon. Such integration of disciplines represents the way medicine should be practiced and taught, and this book will be a model for other subjects in gastroenterology and other organ systems in which different complementary diagnostic techniques are used. The illustrations are of high quality, and both the black and white radiographs and the color endoscopy and histology pictures are faithfully reproduced and supported with informative legends. The condensed text, in outline form, is complemented by an abundance of well-conceived, informative, and clear diagrams, tables, and line drawings. Taken together, this format provides rapid access to all the essential facts and appearances of normal and diseased colon for the casual as well as the serious reader. For the teachers and practitioners of gastroenterology or radiology, this book provides a gold mine of facts and ideas. References have been well selected and presented in an appendix. (orig./UHE)

  3. Cerebral gas embolism due to upper gastrointestinal endoscopy

    NARCIS (Netherlands)

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

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

  4. Cerebral gas embolism due to upper gastrointestinal endoscopy

    NARCIS (Netherlands)

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

    2009-01-01

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

  5. The validity of nasal endoscopy in patients with chronic rhinosinusitis

    DEFF Research Database (Denmark)

    Larsen, K. L.; Lange, B.; Darling, P.

    2018-01-01

    Objectives: Nasal endoscopy is a cornerstone in diagnosing sinonasal disease, but different raters might generate different results using the technique. Our study aims to evaluate the agreement between multiple raters to assess the validity of nasal endoscopy. Design/Participants: Three independe...

  6. Autofluorescence endoscopy: feasibility of detection of GI neoplasms unapparent to white light endoscopy with an evolving technology

    NARCIS (Netherlands)

    Haringsma, J.; Tytgat, G. N.; Yano, H.; Iishi, H.; Tatsuta, M.; Ogihara, T.; Watanabe, H.; Sato, N.; Marcon, N.; Wilson, B. C.; Cline, R. W.

    2001-01-01

    Case studies are presented of fluorescence endoscopy in the upper and lower GI tract to illustrate the ability to detect early-stage lesions that were not observable with white light endoscopy or those in which the assessment of the stage or extension of the lesion were equivocal. A new fluorescence

  7. Image-based navigation for a robotized flexible endoscope

    NARCIS (Netherlands)

    van der Stap, N.; Slump, Cornelis H.; Broeders, Ivo Adriaan Maria Johannes; van der Heijden, Ferdinand; Luo, Xiongbiao; Reichl, Tobias; Mirota, Daniel; Soper, Timothy

    2014-01-01

    Robotizing flexible endoscopy enables image-based control of endoscopes. Especially during high-throughput procedures, such as a colonoscopy, navigation support algorithms could improve procedure turnaround and ergonomics for the endoscopist. In this study, we have developed and implemented a

  8. The colon. Clinical radiology and endoscopy

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  9. Oral chlorhexidine and microbial contamination during endoscopy

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  10. On flexibility

    OpenAIRE

    Weiss, Christoph R.; Briglauer, Wolfgang

    2000-01-01

    By building on theoretical work by Mills and Schumann (1985) and Ungern-Sternberg (1990) this paper provides evidence on the determinants of two dimensions of flexibility, the flexibility in adjusting aggregate output over time (tactical flexibility) as well as the ability to switch quickly between products (operational flexibility). Econometric analysis of a sample of 40.000 farms in Upper-Austria for the period 1980 to 1990 suggests that larger full-time farms operated by younger, better ed...

  11. Diagnostic Yield of Microscopic Colitis in Open Access Endoscopy Center.

    Science.gov (United States)

    Ellingson, Derek; Miick, Ronald; Chang, Faye; Hillard, Robert; Choudhary, Abhishek; Ashraf, Imran; Bechtold, Matthew; Diaz-Arias, Alberto

    2011-08-01

    The diagnostic yield in open access endoscopy has been evaluated which generally support the effectiveness and efficiency of open access endoscopy. With a few exceptions, diagnostic yield studies have not been performed in open access endoscopy for more specific conditions. Therefore, we conducted a study to determine the efficiency of open access endoscopy in the detection of microscopic colitis as compared to traditional referral via a gastroenterologist. A retrospective search of the pathology database at the University of Missouri for specimens from a local open access endoscopy center was conducted via SNOMED code using the terms: "microscopic", "lymphocytic", "collagenous", "spirochetosis", "focal active colitis", "melanosis coli" and "histopathologic" in the diagnosis line for the time period between January 1, 2004 and May 25, 2006. Specimens and colonoscopy reports were reviewed by a single pathologist. Of 266 consecutive patients with chronic diarrhea and normal colonoscopies, the number of patients with microscopic disease are as follows: Lymphocytic colitis (n = 12, 4.5%), collagenous colitis (n = 17, 6.4%), focal active colitis (n = 15, 5.6%), and spirochetosis (n = 2, 0.4%). The diagnostic yield of microscopic colitis in this study of an open access endoscopy center does not differ significantly from that seen in major medical centers. In terms of diagnostic yield, open access endoscopy appears to be as effective in diagnosing microscopic colitis.

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

    Science.gov (United States)

    Chung, Hyun Kee; Lightdale, Jenifer R

    2016-07-01

    Sedation is a fundamental component of pediatric gastrointestinal procedures. The 2 main types of sedation for pediatric endoscopy remain general anesthesia and procedural sedation. Although anesthesiologist-administered sedation protocols are more common, there is no ideal regimen for endoscopy in children. This article discusses specific levels of sedation for endoscopy as well as various regimens that can be used to achieve each. Risks and considerations that may be specific to performing gastrointestinal procedures in children are reviewed. Finally, potential future directions for sedation and monitoring that may change the practice of pediatric gastroenterology and ultimately patient outcomes are examined. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Non-anesthesiologist administration of propofol for gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Dumonceau, Jean-Marc; Riphaus, Andrea; Schreiber, Florian

    2015-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA). It addresses the administration of propofol by non-anesthesiologists for gastrointestinal (GI) endoscopy...... driving, drinking alcohol, operating heavy machinery, or engaging in legally binding decisions. Advice should be provided verbally and in written form to the patient, including a 24-hour contact phone number (strong recommendation, low quality evidence). 10 For patients of ASA classes 1 - 2 who have...

  14. Dual-focus Magnification, High-Definition Endoscopy Improves Pathology Detection in Direct-to-Test Diagnostic Upper Gastrointestinal Endoscopy.

    Science.gov (United States)

    Bond, Ashley; Burkitt, Michael D; Cox, Trevor; Smart, Howard L; Probert, Chris; Haslam, Neil; Sarkar, Sanchoy

    2017-03-01

    In the UK, the majority of diagnostic upper gastrointestinal (UGI) endoscopies are a result of direct-to-test referral from the primary care physician. The diagnostic yield of these tests is relatively low, and the burden high on endoscopy services. Dual-focus magnification, high-definition endoscopy is expected to improve detection and classification of UGI mucosal lesions and also help minimize biopsies by allowing better targeting. This is a retrospective study of patients attending for direct-to-test UGI endoscopy from January 2015 to June 2015. The primary outcome of interest was the identification of significant pathology. Detection of significant pathology was modelled using logistic regression. 500 procedures were included. The mean age of patients was 61.5 (±15.6) years; 60.8% of patients were female. Ninety-four gastroscopies were performed using dual-focus magnification high-definition endoscopy. Increasing age, male gender, type of endoscope, and type of operator were all identified as significant factors influencing the odds of detecting significant mucosal pathology. Use of dual-focus magnification, high-definition endoscopy was associated with an odds ratio of 1.87 (95%CI 1.11-3.12) favouring the detection of significant pathology. Subsequent analysis suggested that the increased detection of pathology during dual-focus magnification, high-definition endoscopy also influenced patient follow-up and led to a 3.0 fold (p=0.04) increase in the proportion of patients entered into an UGI endoscopic surveillance program. Dual-focus magnification, high-definition endoscopy improved the diagnostic yield for significant mucosal pathology in patients referred for direct-to-test endoscopy. If this finding is recapitulated elsewhere it will have substantial impact on the provision of UGI endoscopic services.

  15. A cerebrovascular stroke following endoscopy for an elderly patient ...

    African Journals Online (AJOL)

    Ahmed Gado

    2015-02-02

    Feb 2, 2015 ... gastrointestinal bleeding. Not only in upper gastrointestinal bleeding is advanced age a risk of ... plaining of hematemesis of large amount of coffee ground blood. ..... Green J. Complications of gastrointestinal endoscopy. BSG.

  16. Single Nanowire Probe for Single Cell Endoscopy and Sensing

    Science.gov (United States)

    Yan, Ruoxue

    adaptable to average bio-lab environment. These probes are mechanically robust and flexible and can withstand repeated bending and deformation without significant deterioration in optical performance, which offers an ideal instrumental platform for out subsequent effort of using these nanoprobes in chemical sensing as well as single cell endoscopy and spot delivery. Parameters affecting the coupling efficiency and output power of the nanoprobe were studied and chemical etched of single mode fiber with small cone angle was established to be optimized for highly effective optical nanoprobes. The versatility of the nanoprobe design was first tested by transforming the nanowire probe into a pH sensor with near-field photopolymerization of a copolymer containing pH sensitive dye on the tip of the nanowire. The pH-sensitive nanoprobe was able to report the pH difference in micro-droplets containing buffer solution with the excitation of light waveguided on the nanoprobe with internal calibration, fast response time and good photostability and reversibility. Such nanoprobe sensors are ideal for high definition spatial and temporal sensing of concentration profile, especially for the kinetic processes in single cell studies for which chemical probes of minute sizes and fast response are desired. The nanoprobe was then applied into spot cargo delivery and in-situ single cell endoscopy. It was demonstrated that nanowire-based optical probe can deliver payloads into the cell with a high spatiotemporal precision, guide and confine visible light into intracellular compartments selectively and detect optical signals from the subcellular regions with high spatial resolution. The nanoprobe was proven to be biocompatible and non-invasive. The effective optical coupling between the fiber optics and the nanowire enables highly localized excitation and detection, limiting the probe volume to the close proximity of the nanowire. None the less, this versatile technique does not rely on any

  17. Nurse-administered propofol sedation for endoscopy

    DEFF Research Database (Denmark)

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

    2011-01-01

    BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both for endosco......BACKGROUND AND STUDY AIMS: The aim of the present study was to perform a risk analysis during the implementation phase of nurse-administered propofol sedation (NAPS) and to validate our structured training program. PATIENTS AND METHODS: A structured training program was developed both...... pressure was recorded in 451 patients (26%). Independent risk factors were type of intervention and level of experience of the staff performing the sedation. CONCLUSION: These results were obtained after development of a structured training program both for endoscopists and nurses using propofol...... for sedation, and can be used as basis for further comparison. NAPS for endoscopic procedures is safe when performed by personnel properly trained in airway handling and sedation with propofol, and has considerable advantages compared with conventional sedation for endoscopy....

  18. Sedation-related complications in gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-11-16

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

  19. Sedation and monitoring for gastrointestinal endoscopy.

    Science.gov (United States)

    Amornyotin, Somchai

    2013-02-16

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

  20. Remote transmission of live endoscopy over the Internet: Report from the 87th Congress of the Japan Gastroenterological Endoscopy Society.

    Science.gov (United States)

    Shimizu, Shuji; Ohtsuka, Takao; Takahata, Shunichi; Nagai, Eishi; Nakashima, Naoki; Tanaka, Masao

    2016-01-01

    Live demonstration of endoscopy is one of the most attractive and useful methods for education and is often organized locally in hospitals. However, problems have been apparent in terms of cost, preparation, and potential risks to patients. Our aim was to evaluate a new approach to live endoscopy whereby remote hospitals are connected by the Internet for live endoscopic demonstrations. Live endoscopy was transmitted to the Congress of the Japan Gastroenterological Endoscopic Society by 13 domestic and international hospitals. Patients with upper and lower gastrointestinal diseases and with pancreatobiliary disorders were the subjects of a live demonstration. Questionnaires were distributed to the audience and were sent to the demonstrators. Questions concerned the quality of transmitted images and sound, cost, preparations, programs, preference of style, and adverse events. Of the audience, 91.2% (249/273) answered favorably regarding the transmitted image quality and 93.8% (259/276) regarding the sound quality. All demonstrators answered favorably regarding image quality and 93% (13/14) regarding sound quality. Preparations were completed without any outsourcing at 11 sites (79%) and were evaluated as 'very easy' or 'easy' at all but one site (92.3%). Preparation cost was judged as 'very cheap' or 'cheap' at 12 sites (86%). Live endoscopy connecting multiple international centers was satisfactory in image and sound quality for both audience and demonstrators, with easy and inexpensive preparation. The remote transmission of live endoscopy from demonstrators' own hospitals was preferred to the conventional style of locally organized live endoscopy. © 2015 The Authors Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  1. 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.

  2. Conflicting flexibility

    NARCIS (Netherlands)

    De Jong, P.; Schaap, A.

    2011-01-01

    New buildings are designed for first users. For a sustainable approach there are many advantages in designing in flexibility and adjustability in order to enable and facilitate the other sequential users. For the first investor this flexibility is translated into improved exit values due to

  3. High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy.

    Science.gov (United States)

    Penny, Hugo A; Mooney, Peter D; Burden, Mitchell; Patel, Nisha; Johnston, Alexander J; Wong, Simon H; Teare, Julian; Sanders, David S

    2016-06-01

    Celiac disease remains underdiagnosed at endoscopy. We aimed to assess the utility of I-Scan (virtual chromo-endoscopy) to improve sensitivity of endoscopy to detect markers of villous atrophy in this condition. Patients from 2 UK hospitals were studied in 3 groups. Group 1: standard high definition, white light endoscopy (WLE); Group 2: WLE plus I-Scan; Group 3: non-high definition control group. The presence of endoscopic markers was recorded. At least 4 duodenal biopsies were taken from all patients. Serology was performed concurrently and observations were compared with histology. 758 patients (62% female, mean age 52) were recruited (Group 1: 230; Group 2: 228; Group 3: 300). 135 (17.8%) new diagnoses of coeliac disease were made (21 Group 1; 24 Group 2; 89 Group 3). The sensitivity for detection of endoscopic markers of villous atrophy was significantly higher in both Group 1 (85.7%, p=0.0004) and Group 2 (75%, p=0.005) compared to non-high definition controls (41.6%). There was no significant difference between high definition only and I-Scan groups (p=0.47). In non-high definition endoscopy a missed diagnosis was associated with lesser degrees of villous atrophy (p=0.019) and low tTG titre (p=0.007). High definition endoscopy with or without I-Scan increases the detection of celiac disease during routine endoscopy. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  4. Review of musculoskeletal injuries and prevention in the endoscopy practitioner.

    Science.gov (United States)

    Harvin, Glenn

    2014-08-01

    Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces.

  5. How We Do It: A DIY Smart Phone based ENT Endoscopy

    Directory of Open Access Journals (Sweden)

    Shyam Duvvi

    2017-12-01

    Full Text Available We present a simple method of preparing a smart phone based ENT endoscopy for OPD clinic and for on call ENT to provide emergency ENT care in Accident and Emergency department when required. In our experience, this method is efficient, economical and ensures mobility and flexibility of remote visual inspection and documentation. This aids in better care for patients especially where there is no easy access to traditional ENT treatment room facility. This provides a fast and cost-effective solution to simultaneously view capture and save photos and videos with a smartphone and, if required, send these pictures to oncall Consultant. This enables quicker identification, documentation and support regardless of location.

  6. Ultrathin endoscopy versus high-resolution endoscopy for diagnosing superficial gastric neoplasia.

    Science.gov (United States)

    Toyoizumi, Hirobumi; Kaise, Mitsuru; Arakawa, Hiroshi; Yonezawa, Jin; Yoshida, Yukinaga; Kato, Masayuki; Yoshimura, Noboru; Goda, Ken-ichi; Tajiri, Hisao

    2009-08-01

    Ultrathin endoscopy (UTE) is an acceptable and cost-effective alternative to EGD with the patient under sedation, although the diagnostic accuracy of UTE is not well established. To compare the diagnostic accuracy of UTE and high-resolution endoscopy (HRE) for superficial gastric neoplasia. Prospective comparative study. Academic center. Patients with or without superficial gastric neoplasia underwent peroral UTE and HRE, back-to-back in a random order while under standard sedation. The procedures were performed by 2 endoscopists who were blinded to the clinical information. The rate of missed lesions and misdiagnosis, sensitivity, and specificity for the diagnosis of gastric neoplasia when using pathology as the reference standard. In total, 126 lesions (41 superficial gastric neoplasias, 85 nonneoplastic lesions) were recorded in 57 enrolled patients. For the diagnosis of gastric neoplasia, the sensitivity of UTE (58.5%) was significantly (P = .021) lower than that of HRE (78%), and the specificity of UTE (91.8%) was significantly (P = .014) lower than that of HRE (100%). The rate of missed lesions and misdiagnosis of gastric neoplasias when using UTE (41.5%) was significantly (P > .001) higher than that of HRE (22.0%). The corresponding rate of neoplasias at the proximal portion (fornix and corpus) when using UTE (29%) was significantly (P = .002) higher than that of HRE (7.2%), although the rates of neoplasias at the distal portion (angulus and antrum) were comparable for UTE and HRE. Small sample numbers in an enriched population. The diagnostic accuracy of UTE is significantly lower than that of HRE for superficial gastric neoplasia, and this difference is particularly striking for neoplasias in the proximal stomach. For UTE to be used as an alternative modality, improvements in optical quality and the incorporation of additional procedures, including close-range observations and chromoendoscopy, are required to enhance visualization.

  7. Videoscopic Heller Myotomy with Intraoperative Endoscopy Promotes Optimal Outcomes

    Science.gov (United States)

    Bloomston, Mark; Brady, Patrick

    2002-01-01

    Background and Objectives: Minimally invasive surgical techniques are applicable to achalasia, but the optimum approach to intraoperative assessment of adequacy of myotomy remains unestablished. We set out to show that videoscopic Heller myotomy with concurrent endoscopy ensures adequacy of myotomy while limiting postoperative clinically apparent reflux. Methods: Seventy-eight consecutive patients with achalasia underwent videoscopic Heller myotomy with concomitant endoscopy between 1992 and 1998. Fundoplication was not routinely undertaken. Results: Preoperative symptoms consisted of dysphagia (100%), emesis/regurgitation (68%), heartburn (58%), and postprandial chest pain (49%). Following myotomy, significant improvement (P Heller myotomy guides the extent and adequacy of myotomy. By utilizing a focused dissection with preservation of the natural antireflux mechanisms around the gastroesophageal junction and limiting the extent of myotomy along the cardia, postoperative reflux symptoms are minimized. We advocate concomitant endoscopy during Heller myotomy to guide myotomy and submit that routine fundoplication is clinically unnecessary. PMID:12113416

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

    Directory of Open Access Journals (Sweden)

    V. B. Surya Prasath

    2016-12-01

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

  9. [The role of endoscopy in gastroenteropancreatic neuroendocrine tumors].

    Science.gov (United States)

    Magno, L; Sivero, L; Napolitano, V; Ruggiero, S; Fontanarosa, G; Massa, S

    2010-01-01

    Versione italiana Riassunto: Il ruolo dell'endoscopia nei tumori neuroendocrini gastroenteropancreatici. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa I tumori neuroendocrini (NET) gastro-entero-pancreatici (GEP) sono neoplasie rare che originano dalle cellule neuroendocrine del tubo digerente e del pancreas. L'endoscopia digestiva e l'ecoendoscopia rivestono un ruolo importante nella diagnosi, stadiazione e sorveglianza dei pazienti con NET. Inoltre, in casi selezionati, le tecniche endoscopiche operative consentono il trattamento di queste neoplasie in fase precoce. English version Summary: The role of endoscopy in gastroenteropancreatic neuroendocrine tumors. L. Magno, L. Sivero, V. Napolitano, S. Ruggiero, G. Fontanarosa, S. Massa Gastroenteropancreatic (GEP) neuroendocrine tumors (NET) are rare neoplasia arisen from neuroendocrine cells present in the gut mucosa and pancreas. Digestive endoscopy and endoscopic ultrasonography play a relevant role in NET diagnosis, stadiation and surveillance. Moreover, in selected patients, surgical endoscopy allows the tratment of these cancers at an early stage.

  10. Improving the timeliness of procedures in a pediatric endoscopy suite.

    Science.gov (United States)

    Tomer, Gitit; Choi, Steven; Montalvo, Andrea; Sutton, Sheila; Thompson, John; Rivas, Yolanda

    2014-02-01

    Pediatric endoscopic procedures are essential in the evaluation and treatment of gastrointestinal diseases in children. Although pediatric endoscopists are greatly interested in increasing efficiency and through-put in pediatric endoscopy units, there is scarcely any literature on this critical process. The goal of this study was to improve the timeliness of pediatric endoscopy procedures at Children's Hospital at Montefiore. In June 2010, a pediatric endoscopy quality improvement initiative was formed at Children's Hospital at Montefiore. We identified patient-, equipment-, and physician-related causes for case delays. Pareto charts, cause and effect diagrams, process flow mapping, and statistical process control charts were used for analysis. From June 2010 to December 2012, we were able to significantly decrease the first case endoscopy delay from an average of 17 to 10 minutes (P < .001), second case delay from 39 to 25 minutes (P = .01), third case delay from 61 to 45 minutes (P = .05), and fourth case delay from 79 to 51 minutes (P = .05). Total delay time decreased from 196 to 131 minutes, resulting in a reduction of 65 minutes (P = .02). From June 2010 to August 2011 (preintervention period), an average of 36% of first endoscopy cases started within 5 minutes, 51% within 10 minutes, and 61% within 15 minutes of the scheduled time. From September 2011 to December 2012 (postintervention period), the percentage of cases starting within 5 minutes, 10 minutes, and 15 minutes increased to 47% (P = .07), 61% (P = .04), and 79% (P = .01), respectively. Applying quality improvement methods and tools helped improve pediatric endoscopy timeliness and significantly decreased total delays.

  11. Feasibility of Clinical Endoscopy and Stroboscopy in Children With Bilateral Vocal Fold Lesions.

    Science.gov (United States)

    Zacharias, Stephanie R C; Brehm, Susan Baker; Weinrich, Barbara; Kelchner, Lisa; Tabangin, Meredith; de Alarcon, Alessandro

    2016-11-01

    The purpose of this study was to examine the utility of flexible and rigid endoscopy and stroboscopy for the identification of anatomical and physiological features in children with bilateral vocal fold lesions. The secondary purpose was to describe the age distribution of patients who could tolerate use of the different types of endoscopes. This cross-sectional clinic-based study included 38 children (ages 5 to 12 years) diagnosed with bilateral vocal fold lesions via videoendoscopy. Vocal fold vibratory characteristics (e.g., mucosal wave) were rated by 4 clinicians by consensus. Bilateral vocal fold lesions could be well described anatomically after visualization with both flexible and rigid endoscopes and were most commonly described as symmetrical and broad based. However, the clinicians' confidence in the accuracy of stroboscopy for rating vocal fold vibratory characteristics was limited for both flexible and rigid stroboscopes. Videoendoscopy was adequate for viewing and characterizing anatomical structures of bilateral vocal fold lesions in pediatric patients; however, vibratory characteristics were often not fully visualized with videostroboscopy. In view of the importance of visualizing vocal fold vibration in the differential diagnosis and treatment of vocal fold lesions, other imaging modalities, such as high-speed videoendoscopy, may provide more accurate descriptions of vocal fold vibratory characteristics in this population.

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

    Directory of Open Access Journals (Sweden)

    Kazuo Iijima

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

  13. Cerebral gas embolism due to upper gastrointestinal endoscopy.

    Science.gov (United States)

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

    2009-07-01

    Cerebral gas embolism as a result of upper gastrointestinal endoscopy is a rare complication and bares a high morbidity. A patient is presented who underwent an upper endoscopy for evaluation of a gastric-mediastinal fistula after subtotal oesophagectomy and gastric tube reconstruction because of oesophageal cancer. During the procedure, cerebral gas emboli developed resulting in an acute left-sided hemiparesis. After hyperbaric oxygen therapy, the patient recovered almost completely. The aetiology and treatment is discussed based on the reviewed literature. Once cerebral gas emboli are recognized, patient outcome can be improved by hyperbaric oxygen therapy.

  14. Comparison of endoscopy and barium swallow with marshmallow in dysphagia.

    Science.gov (United States)

    Somers, S; Stevenson, G W; Thompson, G

    1986-06-01

    Forty-four patients with dysphagia were examined both by endoscopy and by barium swallow with a marshmallow bolus. In these patients 36 stenoses were found: 34 by radiology and 30 by endoscopy. The radiologic criteria for stenosis included arrest of the marshmallow in a manner to support a column of barium and reproduction of the patient's symptoms at the time this occurred. Radiologic false negative findings were partly due to an inability by patients to swallow an adequate marshmallow bolus; endoscopic failures were associated with small endoscopes and mild stenoses.

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

    Directory of Open Access Journals (Sweden)

    Niv Y

    2013-05-01

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

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Directory of Open Access Journals (Sweden)

    Héctor Julian Canaval-Zuleta

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

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

    Directory of Open Access Journals (Sweden)

    Xiaohuan Li

    2018-01-01

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

  19. Endoscopy services in KwaZulu-Natal Province, South Africa, are ...

    African Journals Online (AJOL)

    is based on the values and principles of primary healthcare, but major discrepancies ... To audit the GI endoscopy services in KZN and compare these with the current guidelines for ..... Quality assurance of endoscopy units. Best Pract Res Clin ...

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

    Directory of Open Access Journals (Sweden)

    Donald MacIntosh

    2013-01-01

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

  1. Prediction of Helicobacter pylori status by conventional endoscopy, narrow-band imaging magnifying endoscopy in stomach after endoscopic resection of gastric cancer.

    Science.gov (United States)

    Yagi, Kazuyoshi; Saka, Akiko; Nozawa, Yujiro; Nakamura, Atsuo

    2014-04-01

    To reduce the incidence of metachronous gastric carcinoma after endoscopic resection of early gastric cancer, Helicobacter pylori eradication therapy has been endorsed. It is not unusual for such patients to be H. pylori negative after eradication or for other reasons. If it were possible to predict H. pylori status using endoscopy alone, it would be very useful in clinical practice. To clarify the accuracy of endoscopic judgment of H. pylori status, we evaluated it in the stomach after endoscopic submucosal dissection (ESD) of gastric cancer. Fifty-six patients treated by ESD were enrolled. The diagnostic criteria for H. pylori status by conventional endoscopy and narrow-band imaging (NBI)-magnifying endoscopy were decided, and H. pylori status was judged by two endoscopists. Based on the H. pylori stool antigen test as a diagnostic gold standard, conventional endoscopy and NBI-magnifying endoscopy were compared for their sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Interobserver agreement was assessed in terms of κ value. Interobserver agreement was moderate (0.56) for conventional endoscopy and substantial (0.77) for NBI-magnifying endoscopy. The sensitivity, specificity, PPV, and NPV were 0.79, 0.52, 0.70, and 0.63 for conventional endoscopy and 0.91, 0.83, 0.88, and 0.86 for NBI-magnifying endoscopy, respectively. Prediction of H. pylori status using NBI-magnifying endoscopy is practical, and interobserver agreement is substantial. © 2013 John Wiley & Sons Ltd.

  2. Endoscopy services in KwaZulu-Natal Province, South Africa, are ...

    African Journals Online (AJOL)

    There were 0.06 registered gastroenterologists (GEs) per 100 000 population. Each endoscopist performed an average of 263 endoscopies per annum. There were 1.18 endoscopy rooms available per unit, and two units had on-site fluoroscopy available. The average waiting period for an upper endoscopy was 27 (range 7 ...

  3. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    International Nuclear Information System (INIS)

    Shigematsu, Y.; Korogi, Y.; Hirai, T.; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-01-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.)

  4. Studying and Incorporating Efficiency into Gastrointestinal Endoscopy Centers

    Directory of Open Access Journals (Sweden)

    Lukejohn W. Day

    2015-01-01

    Full Text Available Efficiency is defined as the use of resources in such a way as to maximize the production of goods and services. Improving efficiency has been the focus of management in many industries; however, it has not been until recently that incorporating efficiency models into healthcare has occurred. In particular, the study and development of improvement projects aimed at enhancing efficiency in GI have been growing rapidly in recent years. This focus on improving efficiency in GI has been spurred by the dramatic rise in the demand for endoscopic procedures as well as the rising number of insured patients requiring GI care coupled at the same time with limited resources in terms of staffing and space in endoscopy centers. This paper will critically review the history of efficiency in endoscopy centers, first by looking at other healthcare industries that have extensively studied and improved efficiency in their fields, examine a number of proposed efficiency metrics and benchmarks in endoscopy centers, and finally discuss opportunities where endoscopy centers could improve their efficiency.

  5. Prevalence of Helicobacter pylori in Northern Jordan: Endoscopy based study

    International Nuclear Information System (INIS)

    Bani-Hani, Kamal E.; Hammouri, Shadi M.

    2001-01-01

    Helicobacter pylori infection is considered the most common infection worldwide and is associated with many other disorders. The aim of this study is to determine the prevalence of this infection among patients undergoing endoscopy in Northern Jordan. Between November 1998 and September 2000, all patients referred from the Gastro-esophageal Clinic to the Endoscopy Unit at Princess Basma Teaching Hospital, Irbid, Northern Jordan were enrolled in this prospective study. For each patient clinical and epidemiological data was collected and endoscopy was performed. At least 3 antral biopsies were obtained from each patient, and these were examined histologically for the presence of gastritis and stained for Helicobacter pylori using modified Giemsa stain. A total of 197 consecutive patients (113 females) with a mean age of 40.2 years (range 15-91 years) were studied. Abdominal pain was the highest presenting symptom. Gastritis 91% and esophagitis 42% were the most frequent endoscopic findings. Gastritis was documented histologically in 183 (93%) of patients. Helicobacter pylori was found in 161 patients (82%), with all of these having histological gastritis. The 11 patients with gastric ulcer, compared to the 51 out of the 59 (86%) patients with duodenal ulcer, showed Helicobacter pylori in their biopsies. The prevalence of Helicobacter pylori infection in patients subjected to an upper gastrointestinal endoscopy in Jordan is high. This study confirms that Helicobacter pylori is significantly associated with gastritis and peptic ulcer. Further studies are needed to determine the types of Helicobacter pylori strains present in Jordan. (author)

  6. Virtual MRI endoscopy of the intracranial cerebrospinal fluid spaces

    Energy Technology Data Exchange (ETDEWEB)

    Shigematsu, Y.; Korogi, Y.; Hirai, T. [Kumamoto Univ. (Japan). Dept. of Radiology; Okuda, T.; Ikushima, I.; Sugahara, T.; Liang, L.; Ge, Y.; Takahashi, M.

    1998-10-01

    We used constructive interference in steady state (CISS) 3D Fourier transform (3DFT) MRI data sets to obtain three-dimensional (3D) virtual MRI endoscopic views of the intracranial cerebrospinal fluid (CSF) spaces, processing them with a commercially available perspective endoscopic algorithm. We investigated the potential of the intracranial virtual MRI endoscopy applied to visualisation of the pathology in 13 patients with surgically confirmed trigeminal neuralgia (3), hemifacial spasm (3), acoustic neuroma (3), suprasellar germinoma (1), Langerhans cell histiocytosis (1), lateral ventricle nodules (1) and pituitary dwarfism (1). All images were acquired using a 1.5-T imager employing a circular polarised head coil. The CISS-3DFT data sets were transferred to a workstation for processing with the perspective endoscopic algorithm. Postprocessing for virtual MRI endoscopy was possible for all data sets. The lesions in 12 patients, and their complex anatomical relationships with the surrounding structures, were well seen on the 3D images. A small acoustic neuroma in the internal auditory meatus was not seen using virtual endoscopy. Although virtual MRI endoscopy has limitations, it provides 3D images which cannot be acquired using any other procedure. (orig.) With 6 figs., 16 refs.

  7. Upper gastrointestinal diseases in patients for endoscopy in South ...

    African Journals Online (AJOL)

    The most common endoscopy finding was gastritis (40.2%), followed by normal examination (15.2%), oesophageal cancer (13.6%), gastric ulcer (7.6%) and gastric cancer (7.1%). Patients older than 40 years (n=110) had significant findings including gastritis (50.9%), oesophageal cancer (22.7%) and gastric cancer ...

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

    NARCIS (Netherlands)

    Groenen, M. J. M.; Kuipers, E. J.; van Berge Henegouwen, G. P.; Fockens, P.; Ouwendijk, R. J. Th

    2006-01-01

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

  9. Workplace flexibility.

    Science.gov (United States)

    Scordato, C; Harris, J

    1990-01-01

    Whether your organization is in a growth pattern or downsizing, you are probably facing change. To gain some insight into your options, here is an in-depth look at the problems and benefits of some flexible work arrangements from a just published study by Catalyst.

  10. Flexibility conflict?

    NARCIS (Netherlands)

    Delsen, L.W.M.; Bauer, F.; Groß, H.; Sieglen, G.

    2002-01-01

    The chapter deals with the presupposed conflict of interests between employers and employees resulting from a decoupling of operating hours and working times. It starts from the notion that both long operating hours and flexibility are relative concepts. As there is some discretion, the ultimate

  11. CT virtual endoscopy: a study of the capability to display the structures and abnormalities in nasal cavity

    International Nuclear Information System (INIS)

    Han Ping; Brambs, H.J.; Sokiranski, R.

    1999-01-01

    Objective: To evaluate display ability of virtual endoscopy and its clinical application in comparison with fiberoptic nasal endoscopy. Methods: 11 patients (22 nasal cavities) were examined by virtual endoscopy after axial spiral CT scanning was performed. Virtual endoscopy was performed by Explorer software package in a computer workstation. 9 patients (18 nasal cavities) underwent fiberoptic endoscopy. Results: Virtual endoscopy could clearly demonstrate the anatomical structures in nasal cavity, septal deviation, nasal meatus narrowing and obstruction, turbinate hyperplasia, and pathological masses larger than 3 mm in diameter. However, 'false adhesions' may appear in virtual endoscopy. The main limitation of virtual endoscopy was inability to evaluate mucosa and lack of histological diagnosis. Conclusions: Virtual endoscopy is a new, non-invasive method for demonstrating anatomical structures and diseases in nasal cavity. Its display ability is comparable with fiberoptic nasal endoscopy and is a supplement to fiberoptic nasal endoscopy

  12. Endoscopy and antiplatelet agents. European Society of Gastrointestinal Endoscopy (ESGE) Guideline.

    Science.gov (United States)

    Boustière, C; Veitch, A; Vanbiervliet, G; Bulois, P; Deprez, P; Laquiere, A; Laugier, R; Lesur, G; Mosler, P; Nalet, B; Napoleon, B; Rembacken, B; Ajzenberg, N; Collet, J P; Baron, T; Dumonceau, J-M

    2011-05-01

    With the increasing use of antiplatelet agents (APA), their management during the periendoscopic period has become a more common and more difficult problem. The increase in use is due to the availability of new drugs and the widespread use of drug-eluting coronary stents. Acute coronary syndromes can occur when APA therapy is withheld for noncardiovascular interventions. Guidelines about APA management during the periendoscopic period are traditionally based on assessments of the procedure-related risk of bleeding and the risk of thrombosis if APA are stopped. New data allow better assessment of these risks, of the necessary duration of APA discontinuation before endoscopy, of the use of alternative procedures (mostly for endoscopic retrograde cholangiopancreatography [ERCP]), and of endoscopic methods that can be used to prevent bleeding (following colonic polypectomy). This guideline makes graded, evidence-based, recommendations for the management of APA for all currently performed endoscopic procedures. A short summary and two tables are included for quick reference. © Georg Thieme Verlag KG Stuttgart · New York.

  13. Appropriateness of upper-GI endoscopy: an Italian survey on behalf of the Italian Society of Digestive Endoscopy.

    Science.gov (United States)

    Hassan, Cesare; Bersani, Gianluca; Buri, Luigi; Zullo, Angelo; Anti, Marcello; Bianco, Maria Antonia; Di Giulio, Emilio; Ficano, Leonardo; Morini, Sergio; Di Matteo, Giovanni; Loriga, Piero; Pietropaolo, Vincenzo; Cipolletta, Livio; Costamagna, Guido

    2007-05-01

    Open-access endoscopy allows physicians to directly schedule endoscopic procedures for their patients without prior consultation. An evaluation of both appropriateness and diagnostic yield of endoscopic procedures is critical when assessing the costs and benefits of endoscopy in an open-access setting. The aim of this Italian multicenter study was to assess the appropriate use of upper endoscopy (EGD) in an open-access system and to establish the yield of diagnostic information relevant to patient care. Cross-sectional, prospective, multicenter study. A total of 6270 patients referred to 44 Italian centers for open-access EGD during 1 month were prospectively enrolled. The American Society for Gastrointestinal Endoscopy (ASGE) guidelines were used to assess the relation between the appropriate use of EGD and the presence of relevant endoscopic findings. The rate for "generally not indicated" EGDs was 22.9%: 29.4% for primary care physicians and 12.9% for specialists (P 20, 99% CI 3 to >100; P < .01). Open-access EGD is an useful procedure for clinical practice. Because most of the relevant findings were detected during examinations performed for appropriate indications, the use of ASGE guidelines emerges as crucial to the cost-effectiveness of an open-access system.

  14. Current status of cleaning and disinfection for gastrointestinal endoscopy in China: a survey of 122 endoscopy units.

    Science.gov (United States)

    Zhang, Xiuli; Kong, Jinyan; Tang, Ping; Wang, Shufang; Hyder, Qurratulain; Sun, Gang; Zhang, Rugang; Yang, Yunsheng

    2011-04-01

    Adequate compliance with the existing guidelines for cleaning and disinfection of gastrointestinal endoscopes and accessories is necessary to obtain high-level disinfection and prevent pathogen transmission. To investigate cleaning and disinfection practice in China. A questionnaire with 21 questions concerning gastrointestinal endoscopy reprocessing was sent by e-mail to 189 endoscopy units in China. One hundred and twenty-two (80.39%) of the 189 units responded. Compared with the low-workload units (disinfectant (88.5%) in all the units. In 23/122 (18.8%) units, the exposure time to glutaraldehyde was <45 min in the case of infectious disease patients. Eighty-six of 122 (70.5%) units reused disposable materials, of which 21/86 (24.4%) reused disposable forceps and disposable polypectomy hooks, and 2/86 (1.6%) reused disposable injection needles intermittently. Although gastrointestinal endoscopy has developed rapidly in China in the past decade, there is still room for improvement in the practice of endoscopy reprocessing, especially in middle-sized and small cities. Copyright © 2011 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  15. Targeted detection of murine colonic dysplasia in vivo with flexible multispectral scanning fiber endoscopy

    Science.gov (United States)

    Joshi, Bishnu P.; Miller, Sharon J.; Lee, Cameron; Gustad, Adam; Seibel, Eric J.; Wang, Thomas D.

    2012-02-01

    We demonstrate a multi-spectral scanning fiber endoscope (SFE) that collects fluorescence images in vivo from three target peptides that bind specifically to murine colonic adenomas. This ultrathin endoscope was demonstrated in a genetically engineered mouse model of spontaneous colorectal adenomas based on somatic Apc (adenomatous polyposis coli) gene inactivation. The SFE delivers excitation at 440, 532, 635 nm with human patients by simultaneously visualizing multiple over expressed molecular targets unique to dysplasia.

  16. Comparison of rigid and flexible endoscopy for removing esophageal foreign bodies in an emergency

    Directory of Open Access Journals (Sweden)

    Chia-Chen Tseng

    2016-08-01

    Conclusion: Both FE and RE remove esophageal FBs successfully, as evidenced by their high success rates, low complication rates, and high detection rates. Although FE under local anesthesia is a less time-consuming procedure for adults, RE under general anesthesia may be preferable for children and can serve as an alternative to FE.

  17. Flexible licensing

    Directory of Open Access Journals (Sweden)

    Martyn Jansen

    2012-07-01

    Full Text Available The case is presented for a more flexible approach to licensing online library resources. Today's distributed education environment creates pressure for UK higher and further education institutions (HEI/FEIs to form partnerships and to develop educational products and roll them out across the globe. Online library resources are a key component of distributed education and yet existing licensing agreements struggle to keep pace with the increasing range of users and purposes for which they are required. This article describes the process of developing a flexible approach to licensing and proposes a new model licence for online library resources which has the adaptability needed in this new global educational landscape. These ideas have been presented and discussed at various workshops across Eduserv's and JISC Collections' higher education and publisher communities, and further consultation is ongoing.

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

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    ), the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA) and the European Society of Anaesthesiology (ESA). These three societies have endorsed the present guideline.The guideline is published simultaneously in the Journals Endoscopy and European Journal of Anaesthesiology....

  19. Simultaneous functional photoacoustic and ultrasonic endoscopy of internal organs in vivo.

    Science.gov (United States)

    Yang, Joon-Mo; Favazza, Christopher; Chen, Ruimin; Yao, Junjie; Cai, Xin; Maslov, Konstantin; Zhou, Qifa; Shung, K Kirk; Wang, Lihong V

    2012-08-01

    At present, clinicians routinely apply ultrasound endoscopy in a variety of interventional procedures that provide treatment solutions for diseased organs. Ultrasound endoscopy not only produces high-resolution images, but also is safe for clinical use and broadly applicable. However, for soft tissue imaging, its mechanical wave-based image contrast fundamentally limits its ability to provide physiologically specific functional information. By contrast, photoacoustic endoscopy possesses a unique combination of functional optical contrast and high spatial resolution at clinically relevant depths, ideal for imaging soft tissues. With these attributes, photoacoustic endoscopy can overcome the current limitations of ultrasound endoscopy. Moreover, the benefits of photoacoustic imaging do not come at the expense of existing ultrasound functions; photoacoustic endoscopy systems are inherently compatible with ultrasound imaging, thereby enabling multimodality imaging with complementary contrast. Here we present simultaneous photoacoustic and ultrasonic dual-mode endoscopy and show its ability to image internal organs in vivo, thus illustrating its potential clinical application.

  20. Endoscopy and sedation: an inseparable binomial for the gastroenterologist.

    Science.gov (United States)

    Crespo, Javier; Terán, Álvaro

    2018-04-01

    The development of endoscopy and its increasing demand among the population have led to a growing need for propofol-based sedation techniques. Benefit is indisputable for both patients and endoscopists, but some aspects require considering the "who" and "how" of sedation as related to safety and health care costs. Propofol is first-choice in endoscopy for the European Society of Gastrointestinal Endoscopy because of its fast onset of action and short half-life, and many reports exist on its safety when used by gastroenterologists rather than anesthesiologists. In this issue of REED several originals support the efficiency and safety of propofol even for complex, high-risk, or protracted procedures such as endoscopic retrograde cholangiopancreatography (ERCP) and enteroscopy. Propofol may be safely and effectively administered by a team with specific skills acquired through education and using a specific procedure. However, difficulties arise in real-world clinical practice that preclude such training, which in Spain should be included in the MIR (médico interno residente) specialization program curriculum. The Comisión Nacional de Digestivo (Spanish National Commission on Digestive Diseases), sensitive to this training gap, has included in their latest version of the MIR program (under assessment) four additional competences, with number 145 (training in deep sedation) being most relevant here. In addition, the Spanish Society of Gastrointestinal Endoscopy (SEED) has invested significant efforts in sedation training, with over 50 courses on sedation for endoscopists and nurses. Continuing education and training in this field (for instance, refresher courses on advanced cardiopulmonary resuscitation) should be a goal for all endoscopy units. Because of the diversity found among hospitals, with single or multiple endoscopy rooms, efforts should be made to persuade those in charge of gastroenterology and anesthesiology departments to establish the necessary care

  1. Saline groundwater in crystalline bedrock

    International Nuclear Information System (INIS)

    Lampen, P.

    1992-11-01

    The State-of-art report describes research made on deep saline groundwaters and brines found in crystalline bedrock, mainly in site studies for nuclear waste disposal. The occurrence, definitions and classifications of saline groundwaters are reviewed with a special emphasis on the different theories concerning the origins of saline groundwaters. Studies of the saline groundwaters in Finland and Sweden have been reviewed more thoroughly. Also the mixing of different bodies of groundwaters, observations of the contact of saline groundwaters and permafrost, and the geochemical modelling of saline groundwaters as well as the future trends of research have been discussed. (orig.)

  2. Computer vision and augmented reality in gastrointestinal endoscopy

    Science.gov (United States)

    Mahmud, Nadim; Cohen, Jonah; Tsourides, Kleovoulos; Berzin, Tyler M.

    2015-01-01

    Augmented reality (AR) is an environment-enhancing technology, widely applied in the computer sciences, which has only recently begun to permeate the medical field. Gastrointestinal endoscopy—which relies on the integration of high-definition video data with pathologic correlates—requires endoscopists to assimilate and process a tremendous amount of data in real time. We believe that AR is well positioned to provide computer-guided assistance with a wide variety of endoscopic applications, beginning with polyp detection. In this article, we review the principles of AR, describe its potential integration into an endoscopy set-up, and envisage a series of novel uses. With close collaboration between physicians and computer scientists, AR promises to contribute significant improvements to the field of endoscopy. PMID:26133175

  3. Swallowable Wireless Capsule Endoscopy: Progress and Technical Challenges

    Directory of Open Access Journals (Sweden)

    Guobing Pan

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Zitouni Abdelkrim

    2018-05-01

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

  5. Flexible Consumption

    DEFF Research Database (Denmark)

    Holm Jacobsen, Peter; Pallesen, Trine

    This report presents the first findings from our qualitative study of consumer behaviour vis-à-vis flexible consumption. The main of objective of this report is to present our first round of data from Bornholm, and to assist the design of products/services designed in WP6. In the report, we adopt...... the perspective of the consumer: what does living in a demand response setup look like to participants – and what kinds of behaviour and interest motivate – and emerge from – their participation in EcoGrid 2.0....

  6. Flexible Capitalism

    DEFF Research Database (Denmark)

    Approaching “work” as at heart a practice of exchange, this volume explores sociality in work environments marked by the kind of structural changes that have come to define contemporary “flexible” capitalism. It introduces anthropological exchange theory to a wider readership, and shows how...... the perspective offers new ways to enquire about the flexible capitalism’s social dimensions. The essays contribute to a trans-disciplinary scholarship on contemporary economic practice and change by documenting how, across diverse settings, “gift-like” socialities proliferate, and even sustain the intensified...

  7. Complementary roles of interventional radiology and therapeutic endoscopy in gastroenterology

    DEFF Research Database (Denmark)

    Ray, David M; Srinivasan, Indu; Tang, Shou-Jiang

    2017-01-01

    radiology have resulted in the paradigm shift in the management of these conditions. In this paper, we discuss the patient's work up, indications, and complementary roles of endoscopic and angiographic management in the settings of gastrointestinal bleeding, enteral feeding, cecostomy tube placement...... and luminal strictures. These conditions often require multidisciplinary approaches involving a team of interventional radiologists, gastroenterologists and surgeons. Further, the authors also aim to describe how the fields of interventional radiology and gastrointestinal endoscopy are overlapping...

  8. First progress report on the Japan Endoscopy Database project.

    Science.gov (United States)

    Kodashima, Shinya; Tanaka, Kiyohito; Matsuda, Koji; Fujishiro, Mitsuhiro; Saito, Yutaka; Ohtsuka, Kazuo; Oda, Ichiro; Katada, Chikatoshi; Kato, Masayuki; Kida, Mitsuhiro; Kobayashi, Kiyonori; Hoteya, Shu; Horimatsu, Takahiro; Matsuda, Takahisa; Muto, Manabu; Yamamoto, Hironori; Ryozawa, Shomei; Iwakiri, Ryuichi; Kutsumi, Hiromu; Miyata, Hiroaki; Kato, Mototsugu; Haruma, Ken; Fujimoto, Kazuma; Uemura, Naomi; Kaminishi, Michio; Tajiri, Hisao

    2018-01-01

    The Japan Endoscopy Database (JED) Project was started to develop the world's largest endoscopic database, capture the actual performance of endoscopic practice, and standardize the terminology and fundamental items needed for a clinical and research registry. This paper presents a progress report on the first phase of this project undertaken at eight endoscopic centers in Japan. The list of data items to be collected was drafted by the MSED-J (Minimal Standard Endoscopic Database) subcommittee. These items were aggregated offline by integrating data from two endoscopic filing systems between July 2015 and December 2015. The study population included all patients who underwent esophagogastroduodenoscopy or colonoscopy at all eight centers, patients who underwent enteroscopy at five of the eight centers, and patients who underwent endoscopic retrograde cholangiopancreatography (ERCP) at four of the eight centers. Data collected in this phase included 61 070 endoscopic procedures, of which 40 475 were esophagogastroduodenoscopies, 215 were enteroscopies, 19 204 were colonoscopies, and 1176 were ERCPs. Frequencies of complications were 0.68% for esophagogastroduodenoscopy, 0% for enteroscopy, 0.43% for colonoscopy, and 13.34% for ERCP. In addition, we obtained various data including Helicobacter pylori infection status, past history of endoscopy in patients who underwent enteroscopy or colonoscopy, and degree of difficulty of ERCP, although the frequencies of reporting were sometimes low, with some items <20%. Results of the first phase suggest that the JED project can provide vast quantities of useful data about endoscopic procedures. © 2017 Japan Gastroenterological Endoscopy Society.

  9. Advanced Therapeutic Gastrointestinal Endoscopy in Children – Today and Tomorrow

    Directory of Open Access Journals (Sweden)

    Zaheer Nabi

    2018-03-01

    Full Text Available Gastrointestinal (GI endoscopy plays an indispensable role in the diagnosis and management of various pediatric GI disorders. While the pace of development of pediatric GI endoscopy has increased over the years, it remains sluggish compared to the advancements in GI endoscopic interventions available in adults. The predominant reasons that explain this observation include lack of formal training courses in advanced pediatric GI interventions, economic constraints in establishing a pediatric endoscopy unit, and unavailability of pediatric-specific devices and accessories. However, the situation is changing and more pediatric GI specialists are now performing complex GI procedures such as endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography for various pancreatico-biliary diseases and more recently, per-oral endoscopic myotomy for achalasia cardia. Endoscopic procedures are associated with reduced morbidity and mortality compared to open surgery for GI disorders. Notable examples include chronic pancreatitis, pancreatic fluid collections, various biliary diseases, and achalasia cardia for which previously open surgery was the treatment modality of choice. A solid body of evidence supports the safety and efficacy of endoscopic management in adults. However, additions continue to be made to literature describing the pediatric population. An important consideration in children includes size of children, which in turn determines the selection of endoscopes and type of sedation that can be used for the procedure.

  10. Gastrointestinal mucosal abnormalities using videocapsule endoscopy in systemic sclerosis.

    Science.gov (United States)

    Marie, I; Antonietti, M; Houivet, E; Hachulla, E; Maunoury, V; Bienvenu, B; Viennot, S; Smail, A; Duhaut, P; Dupas, J-L; Dominique, S; Hatron, P-Y; Levesque, H; Benichou, J; Ducrotté, P

    2014-07-01

    To date, there are no large studies on videocapsule endoscopy in systemic sclerosis (SSc). Consequently, the prevalence and features of gastrointestinal mucosal abnormalities in SSc have not been determined. To determine both prevalence and characteristics of gastrointestinal mucosal abnormalities in unselected patients with SSc, using videocapsule endoscopy. To predict which SSc patients are at risk of developing potentially bleeding gastrointestinal vascular mucosal abnormalities. Videocapsule endoscopy was performed on 50 patients with SSc. Prevalence of gastrointestinal mucosal abnormalities was 52%. Potentially bleeding vascular mucosal lesions were predominant, including: watermelon stomach (34.6%), gastric and/or small intestinal telangiectasia (26.9%) and gastric and/or small intestinal angiodysplasia (38.5%). SSc patients with gastrointestinal vascular mucosal lesions more often exhibited: limited cutaneous SSc (P = 0.06), digital ulcers (P = 0.05), higher score of nailfold videocapillaroscopy (P = 0.0009), anaemia (P = 0.02), lower levels of ferritin (P correlation between gastrointestinal vascular mucosal lesions and presence of severe extra-digestive vasculopathy (digital ulcers and higher nailfold videocapillaroscopy scores). This latter supports the theory that SSc-related diffuse vasculopathy is responsible for both cutaneous and digestive vascular lesions. Therefore, we suggest that nailfold videocapillaroscopy may be a helpful test for managing SSc patients. In fact, nailfold videocapillaroscopy score should be calculated routinely, as it may result in identification of SSc patients at higher risk of developing potentially bleeding gastrointestinal vascular mucosal lesions. © 2014 John Wiley & Sons Ltd.

  11. The Application of Hemospray in Gastrointestinal Bleeding during Emergency Endoscopy

    Directory of Open Access Journals (Sweden)

    Alexander F. Hagel

    2017-01-01

    Full Text Available Introduction. Gastrointestinal bleeding represents the main indication for emergency endoscopy (EE. Lately, several hemostatic powders have been released to facilitate EE. Methods. We evaluated all EE in which Hemospray was used as primary or salvage therapy, with regard to short- and long-term hemostasis and complications. Results. We conducted 677 EE in 474 patients (488 examinations in 344 patients were upper GI endoscopies. Hemospray was applied during 35 examinations in 27 patients (19 males, 33 during upper and 2 during lower endoscopy. It was used after previous treatment in 21 examinations (60% and in 14 (40% as salvage therapy. Short-term success was reached in 34 of 35 applications (97.1%, while long-term success occurred in 23 applications (65.7%. Similar long-term results were found after primary application (64,3% or salvage therapy (66,7%. Rebleeding was found in malignant and extended ulcers. One major adverse event (2.8% occurred with gastric perforation after Hemospray application. Discussion. Hemospray achieved short-term hemostasis in virtually all cases. The long-term effect is mainly determined by the type of bleeding source, but not whether it was applied as first line or salvage therapy. But, even in the failures, patients had benefit from hemodynamic stabilization and consecutive interventions in optimized conditions.

  12. The Results of Upper Gastrointestinal Endoscopy Performed in Bayburt Province

    Directory of Open Access Journals (Sweden)

    Yavuz Ayar

    2013-09-01

    Full Text Available Aim: We analyzed the results of upper gastrointestinal endoscopy performed between November 2011 and January 2013 in the endoscopy unit at Bayburt State Hospital. Methods: Endoscopic analyses were done with a PENTAX EPK 100P equipment. The results were assessed retrospectively. Results: A total of 1008 patients (664 women, 344 men aged between 17 and 88 (mean: 50±18 years have undergone upper gastrointestinal endoscopy. 186 (18.4% patients were diagnosed with pangastritis, 81 - with esophagitis (8%, 68 - with antral gastritis (6.7%, 67 - with duodenal ulcer (6.6%, 57 - with gastric ulcer (5.6%, 35 - with alkaline reflux gastritis (3.6%, 21 - with duodenitis (2.1%, 5 - with gastric cancer (0.5%, 4 - with esophagial cancer (0.4%, 4 - with gastric polyp (0.4% and 3 patients were diagnosed with esophagial ulcer (0.3%. Conclusion: Lesions were most commonly observed in the stomach. Gastritis, esophagitis, duodenal and gastric ulcer were frequently observed in our city. (The Medical Bulletin of Haseki 2013; 51: 116-9

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2006-03-01

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

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

    Science.gov (United States)

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

    2011-04-01

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

  16. Flexible nanovectors

    International Nuclear Information System (INIS)

    Pugno, Nicola M

    2008-01-01

    In this paper we show that the control of adhesion in highly flexible (a property that could be crucial for smart drug delivery but which is still ignored in the literature) nanovectors can help in smartly targeting and delivering the drug. The existence of and the conditions for activating and controlling a super-adhesive state are addressed. Even if such a state has never been observed in nanovectors, our calculations, as well as observations in spiders and geckos, suggest its existence and feasible control. Control of the competition between the drag and the adhesive force is exploited to improve the targeting ability and a hierarchical model is applied to describe a real vasculature. The high flexibility of the nanovector is used to smartly deliver the drug only during adhesion by nanopumping or, as a limiting case, by the new concept of 'adhesion induced nanovector implosion'; a liquid drop analogy is utilized for the calculations. Fast (pumping) and slow (diffusion) drug deliveries can thus be separately controlled by controlling the size and shape of the nanovector. Multiple stage nanovectors are also briefly discussed, mimicking aerospace vector strategies.

  17. Flexible nanovectors

    Science.gov (United States)

    Pugno, Nicola M.

    2008-11-01

    In this paper we show that the control of adhesion in highly flexible (a property that could be crucial for smart drug delivery but which is still ignored in the literature) nanovectors can help in smartly targeting and delivering the drug. The existence of and the conditions for activating and controlling a super-adhesive state are addressed. Even if such a state has never been observed in nanovectors, our calculations, as well as observations in spiders and geckos, suggest its existence and feasible control. Control of the competition between the drag and the adhesive force is exploited to improve the targeting ability and a hierarchical model is applied to describe a real vasculature. The high flexibility of the nanovector is used to smartly deliver the drug only during adhesion by nanopumping or, as a limiting case, by the new concept of 'adhesion induced nanovector implosion'; a liquid drop analogy is utilized for the calculations. Fast (pumping) and slow (diffusion) drug deliveries can thus be separately controlled by controlling the size and shape of the nanovector. Multiple stage nanovectors are also briefly discussed, mimicking aerospace vector strategies.

  18. A literature review of quality in lower gastrointestinal endoscopy from the patient perspective

    OpenAIRE

    Sewitch, Maida J; Gong, Shasha; Dubé, Catherine; Barkun, Alan; Hilsden, Robert; Armstrong, David

    2011-01-01

    BACKGROUND: Given the limited state of health care resources, increased demand for colorectal cancer (CRC) screening raises concerns about the quality of endoscopy services. Little is known about quality in colonoscopy and endoscopy from the patient perspective.OBJECTIVE: To systematically review the literature on quality that is relevant to patients who require colonoscopy or endoscopy services.METHODS: A systematic PubMed search was performed on articles that were published between January ...

  19. Apport de l'endoscopie digestive dans l'hypertension portale de l ...

    African Journals Online (AJOL)

    ... le rôle de l'endoscopie dans le traitement et la surveillance. Méthodes: Notre étude est une analyse rétrospective de 135 endoscopies digestives hautes effectuées chez 68 enfants atteints d'hypertension portale sur une période de 8 ans. Résultats: L'endoscopie a permis de mettre en évidence les varices oesogastriques ...

  20. From POEM to POET: Applications and perspectives for submucosal tunnel endoscopy.

    Science.gov (United States)

    Chiu, Philip W Y; Inoue, Haruhiro; Rösch, Thomas

    2016-12-01

    Recent advances in submucosal endoscopy have unlocked a new horizon for potential development in diagnostic and therapeutic endoscopy. Increasing evidence has demonstrated that peroral endoscopic myotomy (POEM) is not only clinically feasible and safe, but also has excellent results in symptomatic relief of achalasia. The success of submucosal endoscopy in performance of tumor resection has confirmed the potential of this new area in diagnostic and therapeutic endoscopy. This article reviews the current applications and evidence, from POEM to peroral endoscopic tunnel resection (POET), while exploring the possible future clinical applications in this field. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Barium enema and endoscopy for the detection of colorectal neoplasia: Sensitivity, specificity, complications and its determinants

    International Nuclear Information System (INIS)

    Zwart, Ingrid M. de; Griffioen, Gerrit; Shaw, M. Pertaap Chandie; Lamers, Cornelis B.H.W.; Roos, Albert de

    2001-01-01

    AIM: To analyse sensitivity, specificity and complication rate of endoscopy, and barium enema for the detection of colorectal neoplasia. MATERIALS AND METHODS: A MEDLINE search was performed (1980-2000) directed at the endoscopic and radiologic literature on barium enema. Articles were selected based on the type of study, availability of sensitivity and specificity values in sizeable patient groups, and reports on complications. Sixty articles were included in the analysis. RESULTS: Endoscopy proved to have superior sensitivity for polyps in patients at high-risk for colorectal neoplasia. The role of endoscopy and radiology in average-risk screening populations is not known. Sensitivity and specificity rates ranged widely, probably due to bias. For the detection of small polyps endoscopy has superior performance, whereas sensitivity is similar for endoscopy and barium enema for the detection of larger (>1 cm) polyps and tumours. Overall, endoscopy is associated with a higher complication rate. CONCLUSION: Endoscopy is the preferred detection method in high-risk patients. The role of endoscopy and radiology in a screening setting requires evaluation. This review provides the test characteristics of endoscopy and radiology which are relevant for a cost-effectiveness analysis. Double-contrast barium enema may play an important role for screening purposes, owing to its good sensitivity for detecting larger (>1 cm) polyps and its lack of major complications. Zwart, I.M. de et al. (2001)

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

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evi......Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim...... of this evidence- and consensus-based set of guideline is to provide non-anesthesiologists with a comprehensive framework for propofol sedation during digestive endoscopy. This guideline results from a collaborative effort from representatives of the European Society of Gastrointestinal Endoscopy (ESGE...

  3. Alternative Agents to Prevent Fogging in Head and Neck Endoscopy

    Directory of Open Access Journals (Sweden)

    Patorn Piromchai

    2011-01-01

    Full Text Available Background The essential factor for diagnosis and treatment of diseases in head and neck endoscopy is the visibility of the image. An anti-fogging agent can reduce this problem by minimizing surface tension to prevent the condensation of water in the form of small droplets on a surface. There is no report on the use of hibiscrub ® or baby shampoo to reduce fogging in the literature. The objective of this study was to compare the efficacy between commercial anti-fogging agent, hibiscrub ® and baby shampoo to reduce fogging for the use in head and neck endoscopy. Methods The study was conducted at the Department of Otorhinolaryngology, Faculty of Medicine, Khon Kaen University in August 2010. Commercial anti-fogging agent, baby shampoo and hibiscrub ® were applied on rigid endoscope lens before putting them into a mist generator. The images were taken at baseline, 15 seconds, 30 seconds and 1 minute. The images' identifiers were removed before they were sent to two evaluators. A visual analogue scale (VAS was used to rate the image quality from 0 to 10. Results The difference in mean VAS score between anti-fogging agent, baby shampoo and hibiscrub ® versus no agent were 5.46, 4.45 and 2.1 respectively. The commercial anti-fogging agent and baby shampoo had most protective benefit and performed significantly better than no agent ( P < 0.05. Conclusions Baby shampoo is an effective agent to prevent fogging during head and neck endoscopy and compares favourably with commercial anti-fogging agent.

  4. Endoscopy/EUS-guided fiducial marker placement in patients with esophageal cancer: a comparative analysis of 3 types of markers.

    Science.gov (United States)

    Machiels, Melanie; van Hooft, Jeanin; Jin, Peng; van Berge Henegouwen, Mark I; van Laarhoven, Hanneke M; Alderliesten, Tanja; Hulshof, Maarten C

    2015-10-01

    Markers placed at the borders of esophageal tumors are potentially useful to facilitate radiotherapy (RT) target delineation, which offers the possibility of image-guided RT. To evaluate and compare the feasibility and technical benefit of endoscopy/EUS-guided marker placement of 3 different types of markers in patients with esophageal cancer referred for RT. Prospective, single-center, feasibility and comparative study. Tertiary-care medical center. Thirty patients with esophageal cancer who were referred for RT. Patients underwent endoscopy/EUS-guided implantation of 1 type of marker. A solid gold marker (SM) with fixed dimensions, a flexible coil-shaped gold marker (FM) with hand-cut length (2-10 mm), and a radiopaque hydrogel marker (HG) were used. Technical feasibility and adverse events were registered. CT scans and cone-beam CT scans (CBCT) acquired during RT were analyzed to determine and compare the visibility and continuous clear visibility of the implanted markers. Technical feasibility, technical benefit, and adverse events of 3 types of markers. A total of 101 markers were placed in 30 patients. Implantation was technically feasible in all patients without grade 3 to 4 adverse events. Two patients with asymptomatic mediastinitis and one with asymptomatic pneumothorax were seen. Visibility on CT scan of all 3 types of implanted markers was adequate for target delineation. Eighty percent of FMs remained continuously visible over the treatment period on CBCT, significantly better than SMs (63%) and HGs (11%) (P = .015). When we selected FMs ≥5 mm, 90.5% remained visible on CBCT between implantation and the end of RT. Single-center, nonrandomized design. Endoscopy/EUS-guided fiducial marker placement for esophageal cancer is both safe and feasible and can be used for target volume delineation purposes on CT. Our results imply a significant advantage of FMs over SMs and HGs, regarding visibility and continuous clear visibility over the treatment period

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

    DEFF Research Database (Denmark)

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

    2010-01-01

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

  6. New techniques for evaluating the gastrointestinal tract: capsular endoscopy

    Directory of Open Access Journals (Sweden)

    A E Karateyev

    2009-01-01

    Full Text Available The paper describes a procedure for capsular endoscopy (CE, a new high-technology method of evaluating the small bowel, and reports on its use in rheumatological care. Small bowel involvement is noted to be frequently encountered in rheumatic diseases, such as Behcet's disease, diffuse scleroderma, and seronegative spondylitis. According to the data of clinical trials, CE is effective in timely detecting this visceral abnormality. At the same time, CE is actually the only accurate method of diagnosing drug-induced enteropathy, a potentially menacing disease that frequently occurs with the use of nonsteroidal anti-inflammatory drugs.

  7. Oral endoscopy in prosthodontic management of the soft palate defect.

    Science.gov (United States)

    Beery, Q C; Aramany, M A; Katzenberg, B

    1985-08-01

    Telescopic oral endoscopy is an effective aid in the construction and modification of a speech aid prosthesis. The method is noninvasive and easy to perform, permits the prosthodontist to achieve the goal of functional effectiveness in prosthesis construction while keeping the weight and size of the pharyngeal extension at a minimum, decreases the number and length of patient visits required for modification, and when coupled to a fiberoptic teaching arm or a video camera and recording system, it becomes an excellent aid in teaching, patient education and orientation, and record keeping.

  8. [Inspecting the cochlear scala tympanic with flexible and semi-flexible micro-endoscope].

    Science.gov (United States)

    Zhang, Daoxcing; Zhang, Yankun

    2006-02-01

    Flexible and semi-flexible micro-endoscopes were used in cochlear scala tympani inspection , to explore their application in inner ear examination. Fifteen profound hearing loss patients preparing for cochlear implant were included in this study. During the operation, micro-endoscopy was performed after opening the cochlear scala tympani. And 1 mm diameter semi-flexible micro-endoscope could go as deep as 9 mm into the cochlear scala tympani, while 0. 5 mm diameter flexible micro-endoscope could go as deep as 25 mm. The inspecting results were compared with video recording. Using 0.5 mm flexible micro-endoscope, we canould check cochlear scala tympani with depth range of 15-25 mm, but the video imaging was not clear enough to examine the microstructure in the cochlear. With 1 mm diameter semi-flexible micro-endoscope, we could reach 9 mm deep into the cochlear. During the examination, we found 3 cases with calcification deposit in osseous spiral lamina, l case with granulation tissue in the lateral wall of scala tympani, no abnormal findings in the other 11 cases. Inspecting the cochlear scala tympani with 0.5 mm flexible micro-endoscope, even though we can reach the second circuit of the cochlear, it is difficult to find the pathology in the cochlear because of the poor video imaging. With 1 mm semi-flexible micro-endoscope, we can identify the microstructure of the cochlear clearly and find the pathologic changes, but the inserting depth was limited to 9 mm with limitation to examine the whole cochlear.

  9. [Hygiene in endoscopy in clinic and practice 2013 in comparison with 2003--structure and process quality].

    Science.gov (United States)

    Jager, E; Hausemann, A; Hofmann, H; Otto, U; Heudorf, U

    2014-12-01

    Endoscopy is an important part of modern medical diagnostics and therapy. The invasive procedures are however associated with a risk to transmit infections. Against this background the KRINKO has published the "Hygienic requirements for the reprocessing of flexible endoscopes and endoscopic accessories" in 2002 and has updated these recommendations in 2012. In 2003 and 2013 all gastroenterological facilities in Frankfurt am Main using flexible endoscopes were monitored for compliance with the recommendations. The inspections were performed after prior notice by a staff member of the health authority using a checklist which had been developed on the basis of the current KRINKO recommendations. In both years all institutions performing endoscopic procedures were visited: 2003 15 hospitals and 23 practices; 2013 14 clinics and 10 practices. In 2013 (data for 2003 in brackets) 100 % (93 %) of the hospitals and 60 % (22 %) of practices reprocessed their endoscopes by automated methods. The appropriate reprocessing and filling of water bottles for rinsing the scope channels with sterile water and the sterilisation of accessories were satisfactorily performed in 2003 and 2013 by all hospitals. However in 2013 only 90 % (2003: 74 %) of the practices correctly reprocessed water bottles and 80 % (52 %) used sterile water for filling the bottle. In 2013 100 % (2003: 57 %) of the practices correctly sterilised accessory instruments, while 2 practices used disposable, i. e., single-use materials. In 2013 all institutions performed microbiological tests according to KRINKO recommendations, while in 2003 all hospitals but only 43 % of the practices could present such tests. While the gastroenterological departments of Frankfurt hospitals already complied with the KRINKO recommendations in 2003, the inspection of several practices in 2003 had revealed considerable shortcomings in the implementation of these recommendations. Subsequently the practices have

  10. Application of MR virtual endoscopy in children with hydrocephalus.

    Science.gov (United States)

    Zhao, Cailei; Yang, Jian; Gan, Yungen; Liu, Jiangang; Tan, Zhen; Liang, Guohua; Meng, Xianlei; Sun, Longwei; Cao, Weiguo

    2015-12-01

    To evaluate the performance of MR virtual endoscopy (MRVE) in children with hydrocephalus. Clinical and imaging data were collected from 15 pediatric patients with hydrocephalus and 15 normal control children. All hydrocephalus patients were confirmed by ventriculoscopy or CT imaging. The cranial 3D-T1 weighted imaging data from fast spoiled gradient echo scan (FSPGR) were transported to working station. VE images of cerebral ventricular cavity were constructed with Navigator software. Cerebral ventricular MRVE can achieve similar results as ventriculoscopy in demonstrating the morphology of ventricular wall or intracavity lesion. In addition, MRVE can observe the lesion from distal end of obstruction, as well as other areas that are inaccessible to ventriculoscopy. MRVE can also reveal the pathological change of ventricular inner wall surface, and help determine patency of the cerebral aqueduct and fourth ventricle outlet. MR virtual endoscopy provides a non-invasive diagnostic modality that can be used as a supplemental approach to ventriculoscopy. However, its sensitivity and specificity need to be determined in the large study. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Novel disposable transnasal endoscopy for assessment of esophageal motor function.

    Science.gov (United States)

    Lim, Chul-Hyun; Choi, Myung-Gyu; Baeg, Myong-Ki; Moon, Sung Jin; Kim, Jin Su; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Kim, Sang Woo; Choi, Kyu Yong

    2014-01-01

    A novel disposable transnasal endoscopy (DTE) with a portable system has been developed to provide unsedated esophagoscopy by modifying capsule endoscopy. The aim of this study was to assess the feasibility of DTE to evaluate esophageal motor function. Patients with or suspected esophageal motility disorders and healthy volunteers were enrolled. Participants underwent esophageal high-resolution manometry and DTE in random order on different days. Motility was observed with DTE at 1, 8, and 16 cm above the gastroesophageal junction. Twenty healthy volunteers and 20 symptomatic subjects participated (8 achalasia, 5 scleroderma, 3 diffuse esophageal spasm, 1 hypertensive peristalsis, 1 peristaltic dysfunction, and 22 normal esophageal function). The normal findings on DTE were as follows. As the subject swallowed water, swallow-induced relaxation with elevation of the lower esophageal sphincter caused the endoscope to cross the Z-line into the gastric lumen. After the passage of water and air, complete closure of the lower esophageal sphincter occurred, with the return of the endoscope to its previous position. During the resting stage of the esophageal body, an air bubble could be seen in the center of the radially wrinkled and occluded lumen. The endoscopic diagnosis was in agreement with the clinical diagnosis in all but 2. Most of the participants reported acceptable discomfort during DTE and 62.5% of the subjects preferred DTE to manometry. DTE can accurately characterize normal esophageal motor function, allowing the diagnosis of esophageal motility disorders. DTE has potential widespread applications, especially in outpatient clinics.

  12. Opinion of gastroenterologists towards quality assurance in endoscopy.

    Science.gov (United States)

    de Jonge, Vincent; Kuipers, Ernst J; van Leerdam, Monique E

    2011-03-01

    Quality assurance has become an important issue. Many societies are adopting quality assurance programs in order to monitor and improve quality of care. To assess the opinion of gastroenterologists towards quality assurance on the endoscopy department. A survey was sent to all gastroenterologists (n=319) in the Netherlands. It assessed their opinion on a quality assurance program for endoscopy units, including its design, logistics, and content. 200 gastroenterologists (63%) completed the questionnaire. 95% had a positive opinion towards quality assurance and 67% supposed an increase in quality. 28% assumed a negative impact on the time available for patient contact by introducing a quality assurance program and 35% that the capacity would decrease. A negative attitude towards disclosure of results to insurance companies (23%) and media (53%) was reported. Female gastroenterologists were less positive to share the results with other stakeholders (pquality measurements were assessment of complications (97%), standardised reporting (96%), and adequate patient information (95%). Gastroenterologists have a positive attitude towards quality assurance. However, concerns do exist about time investment and disclosure of results to others. Information provision and procedure characteristics were considered the most important aspects of quality assurance. Copyright © 2010 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Jorge Pablo Batista

    2015-01-01

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

  14. Virtual endoscopy post-processing of helical CT data sets

    International Nuclear Information System (INIS)

    Dessl, A.; Giacomuzzi, S.M.; Springer, P.; Stoeger, A.; Pototschnig, C.; Voelklein, C.; Schreder, S.G.; Jaschke, W.

    1997-01-01

    Purpose: The purpose of this work was to test a newly developed, post-processing software for virtual CT endoscopic methods. Virtual endoscopic images were generated from helical CT data sets in the region of the shoulder joint (n=2), the tracheobronchial system (n=3), the nasal sinuses (n=2), the colon (n=2), and the common carotid artery (n=1). Software developed specifically for virtual endoscopy ('Navigator') was used which, after a previous threshold value selection, makes the reconstruction of internal body surfaces possible by an automatic segmentation process. We have evaluated the usage of the software, the reconstruction time for individual images and sequences of images as well as the quality of the reconstruction. All pathological findings of the virtual endoscopy were confirmed by surgery. Results: The post-processing program is easy to use and provides virtual endoscopic images within 50 seconds. Depending of the extent of the data set, virtual tracheobronchoscopy as a cine loop sequence required about 15 minutes. Thorugh use of the threshold value-dependent surface reconstruction the demands on the computer configuration are limited; however, this also created quality problems in image calculation as a consequence of the accompanying loss of data. Conclusions: The Navigator software enables the calculation of virtual endoscopic models with only moderate demands on the hardware. (orig.) [de

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

    Science.gov (United States)

    Cave, David R

    2006-03-01

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

  16. Esophageal stenting for benign and malignant disease : European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

    NARCIS (Netherlands)

    Spaander, Manon C W; Baron, Todd H; Siersema, Peter D; Fuccio, Lorenzo; Schumacher, Brigitte; Escorsell, Àngels; Garcia-Pagán, Juan-Carlos; Dumonceau, Jean-Marc; Conio, Massimo; de Ceglie, Antonella; Skowronek, Janusz; Nordsmark, Marianne; Seufferlein, Thomas; Van Gossum, André; Hassan, Cesare; Repici, Alessandro; Bruno, Marco J

    2016-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN).

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    BACKGROUND AND AIMS: The optimal timing of endoscopy in patients with peptic ulcer bleeding (PUB) remains unclear. The aim of this study was to examine the association between timing of endoscopy and mortality in PUB. METHODS: In a nationwide cohort study based on a database of consecutive patients...

  18. Upper Gastro-Intestinal Endoscopy in Port Harcourt, Nigeria: An Audit

    African Journals Online (AJOL)

    Background: Accurate diagnosis of disease conditions using laboratory, imaging or endoscopic investigation is essential for appropriate treatment. There is paucity of data on upper GI endoscopy in Port-Harcourt. This audit of our early experience is intended to provide data on the pattern of endoscopy findings which is ...

  19. Non-small-bowel abnormalities identified during small bowel capsule endoscopy

    NARCIS (Netherlands)

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

    2014-01-01

    AIM: To investigate the incidence of non-small-bowel abnormalities in patients referred for small bowel capsule endoscopy, this single center study was performed. METHODS: Small bowel capsule endoscopy is an accepted technique to investigate obscure gastrointestinal bleeding. This is defined as

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

    Directory of Open Access Journals (Sweden)

    Ozgur Turk

    2014-12-01

    Full Text Available Aim: Our aim was to identify the characteristics of the patient that performed upper gastrointestinal endoscopy in a new established endoscopy unit of a state hospital. We want to present the spectrum of gastrointestinal diseases in our hospitals region. Material and Method: We analyzed patients upper endoscopy results according to age, sex, complaints, clinical characteristics, type of anesthesia, and the necessity of biopsy. We reviewed 256 patients data between 2013 December-2014 July. All endoscopies were performed by same surgeon. Results: The highest complaint was epigastric pain (n=112, 43, 8%. Other complaints were followed as dyspepsia (n=84, 32.8%, heartburn (n=42, 16.4%, nausea (n=4, 1.6%, vomiting (n=2, 0.8%, dysphagia (n=6, 2.3%. We determined 218 gastritis (85.2%, 64 hiatal hernia (25%, 120 esophagitis (46.9%, 76 duodenitis (29.7%, 4 gastric ulcer (1.6%, 18 duodenal ulcers (7%, 20 bile reflux (7.8%, 26 Gastro esophageal reflux disease (GERD in patients (10.2%. 10 patients reported as normal (3.9%. Biopsy was performed in 186 of the patients. Discussion: Endoscopy can become an early diagnostic examination by increasing the availability of endoscopy. Also alarm symptoms should not be ignored and endoscopy should perform immediately in symptomatic patients. As an early result of upper gastrointestinal endoscopies that performed in this study; gastritis, esophagitis, duodenitis and hiatal hernia are common gastrointestinal diseases in our region.

  1. Flexible Electronics Research Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Flexible Electronics Research Facility designs, synthesizes, tests, and fabricates materials and devices compatible with flexible substrates for Army information...

  2. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

    NARCIS (Netherlands)

    van Hooft, Jeanin E.; van Halsema, Emo E.; Vanbiervliet, Geoffroy; Beets-Tan, Regina G. H.; Dewitt, John M.; Donnellan, Fergal; Dumonceau, Jean-Marc; Glynne-Jones, Robert G. T.; Hassan, Cesare; Jiménez-Perez, Javier; Meisner, Søren; Muthusamy, V. Raman; Parker, Michael C.; Regimbeau, Jean-Marc; Sabbagh, Charles; Sagar, Jayesh; Tanis, Pieter J.; Vandervoort, Jo; Webster, George J.; Manes, Gianpiero; Barthet, Marc A.; Repici, Alessandro

    2014-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and

  3. Self-Expandable Metal Stents for Obstructing Colonic and Extracolonic Cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

    NARCIS (Netherlands)

    van Hooft, J. E.; van Halsema, E. E.; Vanbiervliet, G.; Beets-Tan, R. G. H.; DeWitt, J. M.; Donnellan, F.; Dumonceau, J. M.; Glynne-Jones, R. G. T.; Hassan, C.; Jimenez-Perez, J.; Meisner, S.; Muthusamy, V. Raman; Parker, M. C.; Regimbeau, J. M.; Sabbagh, C.; Sagar, J.; Tanis, P. J.; Vandervoort, J.; Webster, G. J.; Manes, G.; Barthet, M. A.; Repici, A.

    2014-01-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE). This Guideline was also reviewed and endorsed by the Governing Board of the American Society for Gastrointestinal Endoscopy (ASGE). The Grading of Recommendations Assessment, Development, and

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

    OpenAIRE

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

    2008-01-01

    AIM: To investigate in a prospective study whether a simplified clinical score prior to endoscopy in upper gastrointestinal bleeding (UGIB) patients was able to predict endoscopic findings at urgent endoscopy.

  5. PERFORATION AS A COMPLICATION OF THE DIAGNOSTIC UPPER AND LOWER ENDOSCOPY OF THE GASTROINTESTINAL TRACT

    Directory of Open Access Journals (Sweden)

    Ivailo P. Vazharov

    2012-08-01

    Full Text Available Purpose: The purpose of this examination is to evaluate the risk of perforation during endoscopy of upper and lower gastrointestinal tract.Patients and methods used: 1210 diagnostic gastroduodenoscopies and 412 colonoscopies of hospitalized patients were performed by two experienced endoscopists for the period March 2007 – March 2012 at MHAT Varna, MMA. The endoscopies were performed without premedication and sedation. The patients were examined for complications of the procedure during and after the endoscopy. One of the most serious complications is the perforation of the oesophagus, stomach or the large intestine.Results: We had no perforations caused by the examination during the 1210 upper endoscopies performed. We had 2 perforations (0,48% from the 412 colonoscopies performed, which were treated successfully surgically.Conclusions: The perforation is a rare but serious complication of the endoscopy of gastrointestinal tract, which can be healed completely.

  6. Saline agriculture in Mediterranean environments

    Directory of Open Access Journals (Sweden)

    Albino Maggio

    2011-03-01

    Full Text Available Salinization is increasingly affecting world's agricultural land causing serious yield loss and soil degradation. Understanding how we could improve crop productivity in salinized environments is therefore critical to meet the challenging goal of feeding 9.3 billion people by 2050. Our comprehension of fundamental physiological mechanisms in plant salt stress adaptation has greatly advanced over the last decades. However, many of these mechanisms have been linked to salt tolerance in simplified experimental systems whereas they have been rarely functionally proven in real agricultural contexts. In-depth analyses of specific crop-salinity interactions could reveal important aspects of plant salt stress adaptation as well as novel physiological/agronomic targets to improve salinity tolerance. These include the developmental role of root vs. shoot systems respect to water-ion homeostasis, morphological vs. metabolic contributions to stress adaptation, developmental processes vs. seasonal soil salinity evolution, residual effects of saline irrigation in non-irrigated crops, critical parameters of salt tolerance in soil-less systems and controlled environments, response to multiple stresses. Finally, beneficial effects of salinization on qualitative parameters such as stress-induced accumulation of high nutritional value secondary metabolites should be considered, also. In this short review we attempted to highlight the multifaceted nature of salinity in Mediterranean agricultural systems by summarizing most experimental activity carried out at the Department of Agricultural Engineering and Agronomy of University of Naples Federico II in the last few years.

  7. Canadian Association of Gastroenterology consensus guidelines on safety and quality indicators in endoscopy.

    Science.gov (United States)

    Armstrong, David; Barkun, Alan; Bridges, Ron; Carter, Rose; de Gara, Chris; Dube, Catherine; Enns, Robert; Hollingworth, Roger; Macintosh, Donald; Borgaonkar, Mark; Forget, Sylviane; Leontiadis, Grigorios; Meddings, Jonathan; Cotton, Peter; Kuipers, Ernst J

    2012-01-01

    Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality, highlight the need for clearly defined, evidence-based processes to support quality improvement in endoscopy. To identify processes and indicators of quality and safety relevant to high-quality endoscopy service delivery. A multidisciplinary group of 35 voting participants developed recommendation statements and performance indicators. Systematic literature searches generated 50 initial statements that were revised iteratively following a modified Delphi approach using a web-based evaluation and voting tool. Statement development and evidence evaluation followed the AGREE (Appraisal of Guidelines, REsearch and Evaluation) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidelines. At the consensus conference, participants voted anonymously on all statements using a 6-point scale. Subsequent web-based voting evaluated recommendations for specific, individual quality indicators, safety indicators and mandatory endoscopy reporting fields. Consensus was defined a priori as agreement by 80% of participants. Consensus was reached on 23 recommendation statements addressing the following: ethics (statement 1: agreement 100%), facility standards and policies (statements 2 to 9: 90% to 100%), quality assurance (statements 10 to 13: 94% to 100%), training, education, competency and privileges (statements 14 to 19: 97% to 100%), endoscopy reporting standards (statements 20 and 21: 97% to 100%) and patient perceptions (statements 22 and 23: 100%). Additionally, 18 quality indicators (agreement 83% to 100%), 20 safety indicators (agreement 77% to 100%) and 23 recommended endoscopy-reporting elements (agreement 91% to 100%) were identified. The consensus process identified a clear need for high-quality clinical and outcomes research to support quality improvement in the delivery of endoscopy services. The

  8. 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.

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

    Science.gov (United States)

    Zhiwei, Jia; Guozheng, Yan; Bingquan, Zhu

    2014-10-01

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

  10. Role of virtual reality simulation in endoscopy training.

    Science.gov (United States)

    Harpham-Lockyer, Louis; Laskaratos, Faidon-Marios; Berlingieri, Pasquale; Epstein, Owen

    2015-12-10

    Recent advancements in virtual reality graphics and models have allowed virtual reality simulators to be incorporated into a variety of endoscopic training programmes. Use of virtual reality simulators in training programmes is thought to improve skill acquisition amongst trainees which is reflected in improved patient comfort and safety. Several studies have already been carried out to ascertain the impact that usage of virtual reality simulators may have upon trainee learning curves and how this may translate to patient comfort. This article reviews the available literature in this area of medical education which is particularly relevant to all parties involved in endoscopy training and curriculum development. Assessment of the available evidence for an optimal exposure time with virtual reality simulators and the long-term benefits of their use are also discussed.

  11. Development of positron sensor for multi-modal endoscopy

    Energy Technology Data Exchange (ETDEWEB)

    Shimazoe, Kenji, E-mail: shimazoe@it-club.jp [Department of Bioengineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan); Takahashi, Hiroyuki [Department of Nuclear Engineering and Management, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan); Fujita, Kaoru [Japan Atomic Energy Agency, 4-29 Tokaimura, 319-1184 Ibaraki (Japan); Mori, Hiroshi; Momose, Toshimitsu [Department of Bioengineering, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8656 (Japan)

    2011-08-21

    Endoscopy is an important inspection device to detect cancers in the human body, but there exists the case of cancer that is hard to detect with only an optical device. Double inspection with optical and radio images is preferable for high accuracy diagnosis, and real time radio imaging is also promising for real time surgery with an endoscope. We have simulated, designed and fabricated a Si-based positron imaging probe for more accurate cancer detection in multi-modality endoscope systems. The fabricated Si-based detector with 2 mm diameter and 1 mm thickness was tested with gamma and positron sources, and also tested to detect cancers in a tumor bearing mouse. The direct positron imaging could have an advantage over gamma imaging in its high sensitivity and resolution.

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

    DEFF Research Database (Denmark)

    Rondonotti, E; Pennazio, M; Toth, E

    2008-01-01

    BACKGROUND AND STUDY AIM: Small-bowel tumors account for 1% - 3% of all gastrointestinal neoplasms. Recent studies with video capsule endoscopy (VCE) suggest that the frequency of these tumors may be substantially higher than previously reported. The aim of the study was to evaluate the frequency......, clinical presentation, diagnostic/therapeutic work-up, and endoscopic appearance of small-bowel tumors in a large population of patients undergoing VCE. PATIENTS AND METHODS: Identification by a questionnaire of patients with VCE findings suggesting small-bowel tumors and histological confirmation...... of the neoplasm seen in 29 centers of 10 European Countries. RESULTS: Of 5129 patients undergoing VCE, 124 (2.4%) had small-bowel tumors (112 primary, 12 metastatic). Among these patients, indications for VCE were: obscure gastrointestinal bleeding (108 patients), abdominal pain (9), search for primary neoplasm...

  13. Gastric volvulus following diagnostic upper gastrointestinal endoscopy: a rare complication.

    Science.gov (United States)

    Karthikeyan, Vilvapathy Senguttuvan; Sistla, Sarath Chandra; Ram, Duvuru; Rajkumar, Nagarajan

    2014-02-10

    Esophagogastroduodenoscopy (EGD) is a commonly used, safe diagnostic modality for evaluation of epigastric pain and rarely its major complications include perforation, haemorrhage, dysrhythmias and death. Gastric volvulus has been reported to complicate percutaneous endoscopic gastrostomy but its occurrence after diagnostic EGD has not yet been reported in literature. The successful management relies on prompt diagnosis and gastric untwisting, decompression and gastropexy or gastrectomy in full thickness necrosis of the stomach wall. A 38-year-old woman presented with epigastric pain and EGD showed pangastritis. Immediately after EGD she developed increased severity of pain, vomiting and abdominal distension. Emergency laparotomy carried out for peritoneal signs revealed eventration of left hemidiaphragm with the stomach twisted anticlockwise in the longitudinal axis. After gastric decompression and untwisting of volvulus, anterior gastropexy and gastrostomy was carried out. Hence, we report this rare complication of diagnostic endoscopy and review the existing literature on the management.

  14. Transforming a conventional theatre into a gynaecological endoscopy unit.

    Science.gov (United States)

    Anastasakis, E; Protopapas, A; Daskalakis, G; Papadakis, M; Milingos, S; Antsaklis, A

    2007-01-01

    Most minimally invasive procedures are now performed in operating rooms that were originally designed for traditional open surgery. We designed an endoscopic theatre based on our experience with special features specific for gynaecological endoscopy. We designed a detailed plan with an architect's aid of a gynaecological unit (based on a Greek presidential decree published in 1991). The space utilized was that of a conventional theatre. With the architectural plan we anticipated every area needed in a gynaecological endoscopic theatre. A twin theatre was considered appropriate in order for the surgical team to operate alternatively in one theatre while the other is being cleaned and prepared for use. The design of a unit dedicated to gynaecologic laparoscopy is a multidisciplinary task where the endoscopic surgeon undertakes an active and prominent role. It is a project with great benefits and rewards for all parties involved. We present our design for evaluation.

  15. About human taeniasis and Taenia saginata diagnosis by endoscopy.

    Science.gov (United States)

    Galán Puchades, María Teresa

    2016-10-01

    La carta al editor se refiere al artículo de Canaval-Zuleta et al. aceptado para publicación, titulado "Endoscopy as an alternative diagnostic and therapeutic technique for Taenia saginata". El trabajo presenta una serie de incorrecciones que deben ser aclaradas, o al menos parte de ellas en solo 300 palabras. La información sobre las vias de infeccion en taeniasis, así como la patogenia y técnicas de diagnóstico, no se ajustan a la realidad. Asimismo, ya está publicado que el diagnóstico por endoscopia es una técnica muy sensible pero nada específica, pues no permite distinguir entre las 3 especies humanas del género Taenia.

  16. Balance and flexibility.

    Science.gov (United States)

    2003-12-01

    The 'work-life balance' and flexible working are currently key buzz terms in the NHS. Those looking for more information on these topics should visit Flexibility at www.flexibility.co.uk for a host of resources designed to support new ways of working, including information on flexible workers and flexible rostering, the legal balancing act for work-life balance and home working.

  17. A STUDY OF CORRELATION BETWEEN NASAL ENDOSCOPY AND CT SCAN IN CASES OF CHRONIC RHINOSINUSITIS

    Directory of Open Access Journals (Sweden)

    Arun Kumar

    2015-07-01

    Full Text Available BACKGROUND: The accurate diagnosis of Chronic Rhinosinusitis (CRS is still a challenge therefore, the American Academy of Otorhinolaryngology - Head and Neck Surgery (AAO - HNS 1 has met in a multidisciplinary encounter and formulated a consensus based on only clinical symptoms. The computed tomography (CT scan and the nasal endoscopy (NE were introduced to make an accurate diagnosis of CRS and verify the disease severity. AIM: The aim of this study is to make a correlation between nasal endoscopy and CT scan in cases of clinically diagnosed Chronic Rhinosinusitis patients. METHOD: A study was carried out on 90 patients at Jhalawar Medical College, Jhalawar (Raj. during Sept. 20 12 to Dec. 2014. Diagnostic Nasal Endoscopy and CT Scan PNS done in patients, suffering from Chronic Rhinosinusitis. As a classification instruments, Metson / Gliklich's classification was used to evaluate the tomographic diagnosis and the Stankiewicz / Chow' s classification to evaluate the endoscopic diagnosis of Chronic Rhinosinusitis. RESULTS: Our study showed high specificity of endoscopy in comparison to CT scan though CT scan results are more sensitive. CONCLUSION: Endoscopy can confirm a Chronic Rhinosi nusitis diagnosis, but cannot rule it out, and that CT should be performed in cases of suspected CRS even if mucopurulence is not noted on endoscopy. The CT scan and the nasal endoscopy making easier the treatment planning and the disease resolution.

  18. Impact of educational intervention on the inter-rater agreement of nasal endoscopy interpretation

    Science.gov (United States)

    Colley, Patrick; Mace, Jess C.; Schaberg, Madeleine R.; Smith, Timothy L.; Tabaee, Abtin

    2015-01-01

    OBJECTIVE Nasal endoscopy is integral to the evaluation of sinonasal disorders. However, prior studies have shown significant variability in the inter-rater agreement of nasal endoscopy interpretation amongst practicing rhinologists. The objective of the current study is to evaluate the inter-rater agreement of nasal endoscopy amongst otolaryngology residents from a single training program at baseline and following an educational intervention. METHODS 11 otolaryngology residents completed nasal endoscopy grading forms for 8 digitally recorded nasal endoscopic examinations. An instructional lecture reviewing nasal endoscopy interpretation was subsequently provided. The residents then completed grading forms for 8 different nasal endoscopic examinations. Inter-rate agreement amongst residents for the pre- and post-lecture videos was calculated using the unweighted Fleiss’ kappa statistic (Kf) and intra-class correlation agreement (ICC). RESULTS Inter-rater agreement improved from a baseline level of fair (Kf range 0.268–0.383) to a post-educational level of moderate (Kf range 0.401–0.547) for nasal endoscopy findings of middle meatus mucosa, middle turbinate mucosa, middle meatus discharge, sphenoethmoid recess mucosa, sphenoethmoid recess discharge and atypical lesions (ICC, pendoscopy interpretation amongst otolaryngology residents. The inter-rater agreement for the majority of the characteristics that were evaluated improved after educational intervention. Further study is needed to improve nasal endoscopy interpretation. PMID:25781864

  19. Comparison of a novel bedside portable endoscopy device with nasogastric aspiration for identifying upper gastrointestinal bleeding.

    Science.gov (United States)

    Choi, Jong Hwan; Choi, Jae Hyuk; Lee, Yoo Jin; Lee, Hyung Ki; Choi, Wang Yong; Kim, Eun Soo; Park, Kyung Sik; Cho, Kwang Bum; Jang, Byoung Kuk; Chung, Woo Jin; Hwang, Jae Seok

    2014-07-07

    To compare outcomes using the novel portable endoscopy with that of nasogastric (NG) aspiration in patients with gastrointestinal bleeding. Patients who underwent NG aspiration for the evaluation of upper gastrointestinal (UGI) bleeding were eligible for the study. After NG aspiration, we performed the portable endoscopy to identify bleeding evidence in the UGI tract. Then, all patients underwent conventional esophagogastroduodenoscopy as the gold-standard test. The sensitivity, specificity, and accuracy of the portable endoscopy for confirming UGI bleeding were compared with those of NG aspiration. In total, 129 patients who had GI bleeding signs or symptoms were included in the study (age 64.46 ± 13.79, 91 males). The UGI tract (esophagus, stomach, and duodenum) was the most common site of bleeding (81, 62.8%) and the cause of bleeding was not identified in 12 patients (9.3%). Specificity for identifying UGI bleeding was higher with the portable endoscopy than NG aspiration (85.4% vs 68.8%, P = 0.008) while accuracy was comparable. The accuracy of the portable endoscopy was significantly higher than that of NG in the subgroup analysis of patients with esophageal bleeding (88.2% vs 75%, P = 0.004). Food material could be detected more readily by the portable endoscopy than NG tube aspiration (20.9% vs 9.3%, P = 0.014). No serious adverse effect was observed during the portable endoscopy. The portable endoscopy was not superior to NG aspiration for confirming UGI bleeding site. However, this novel portable endoscopy device might provide a benefit over NG aspiration in patients with esophageal bleeding.

  20. NOAA Average Annual Salinity (3-Zone)

    Data.gov (United States)

    California Natural Resource Agency — The 3-Zone Average Annual Salinity Digital Geography is a digital spatial framework developed using geographic information system (GIS) technology. These salinity...

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

    DEFF Research Database (Denmark)

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

    2018-01-01

    mm polyps in colon capsule endoscopy (97%; 95% CI: 94-100) was superior to colonoscopy (89%; 95% CI: 84-94). A complete capsule endoscopy examination (N=134) could detect patients with intermediate or greater risk (according to the European guidelines) with an accuracy, sensitivity, specificity...... and positivity rate of 79%, 93%, 69% and 58% respectively, using a cut-off of at least one polyp >10 mm or more than two polyps. CONCLUSION: Colon capsule endoscopy is superior to colonoscopy in polyp detection rate and per-patient sensitivity to >9 mm polyps, but only in complete CCE examinations. The rate...

  2. Canadian Association of Gastroenterology Consensus Guidelines on Safety and Quality Indicators in Endoscopy

    Directory of Open Access Journals (Sweden)

    David Armstrong

    2012-01-01

    Full Text Available Several organizations worldwide have developed procedure-based guidelines and/or position statements regarding various aspects of quality and safety indicators, and credentialing for endoscopy. Although important, they do not specifically address patient needs or provide a framework for their adoption in the context of endoscopy services. The consensus guidelines reported in this article, however, aimed to identify processes and indicators relevant to the provision of high-quality endoscopy services that will support ongoing quality improvement across many jurisdictions, specifically in the areas of ethics, facility standards and policies, quality assurance, training and education, reporting standards and patient perceptions.

  3. World Ocean Atlas 2005, Salinity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — World Ocean Atlas 2005 (WOA05) is a set of objectively analyzed (1° grid) climatological fields of in situ temperature, salinity, dissolved oxygen, Apparent Oxygen...

  4. Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

      Title:   Clinical Efficacy of Proton Pump Inhibitor versus Prompt Endoscopy for Management of People with Dyspepsia: A Randomized Clinical Trial in General Practice.     Purpose: To compare the clinical efficacy of two strategies for management of dyspepsia in general practice in a RCT design.......   Setting: June 2000 to August 2002, 41 GPs, Aarhus County, Denmark   Methods: 368 people with dyspepsia (epigastric pain/discomfort, no alarm symptoms) were randomly assigned to treatment with omeprazol 40 mg/day for two weeks (PPI group, n:185) or endoscopy (endoscopy group, n:183). Due to migration......, dyspeptic contacts to GP or patients' satisfaction. Conclusions: Prompt endoscopy was superior to proton pump inhibitor concerning symptom improvement in management of dyspepsia in general practice when pain/discomfort was the primary symptom. There were no differences between the two strategies in respect...

  5. Endoscopic treatment of chronic pancreatitis: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline

    NARCIS (Netherlands)

    Dumonceau, J.-M.; Delhaye, M.; Tringali, A.; Dominguez-Munoz, J. E.; Poley, J.-W.; Arvanitaki, M.; Costamagna, G.; Costea, F.; Devière, J.; Eisendrath, P.; Lakhtakia, S.; Reddy, N.; Fockens, P.; Ponchon, T.; Bruno, M.

    2012-01-01

    Background and aims: Clarification of the position of the European Society of Gastrointestinal Endoscopy (ESGE) regarding the interventional options available for treating patients with chronic pancreatitis. Methods: Systematic literature search to answer explicit key questions with levels of

  6. Individual polyp detection rate in routine daily endoscopy practice depends on case-mix.

    Science.gov (United States)

    Loffeld, R J L F; Liberov, B; Dekkers, P E P

    2015-07-01

    The adenoma detection rate (ADR), a marker of endoscopic quality, is confounded by selection bias. It is not known what the ADR is in normal daily practice. To study the polyp detection rate (PDR) in different endoscopists in the course of years. All consecutive endoscopies of the colon done in 11 years were included. Endoscopies in the regular surveillance programme after polyp removal and after surgery because of colorectal cancer or diverticular disease were scored separately. The number of yearly procedures per endoscopist and presence of polyps, anastomoses, surveillance and cancer were noted. In the period of 11 years, 14,908 consecutive endoscopies of colon and rectum were done by four endoscopists. Two endoscopists had a significantly lower PDR than the other two (p case-mix of patients presented for endoscopy. This result debates the use of the ADR as quality indicator for individual endoscopists.

  7. Valeur de l'endoscopie de routine dans le diagnostic de la gastrite ...

    African Journals Online (AJOL)

    Valeur de l'endoscopie de routine dans le diagnostic de la gastrite chronique antrale à Yaoundé. D Noah Noah, F Ankouane Andoulo, SAF Eloumou Bagnaka, PJA Atangana, C Tzeuton, EC Ndjitoyap Ndam ...

  8. The burden of upper gastrointestinal endoscopy in patients with Barrett's esophagus

    NARCIS (Netherlands)

    Kruijshaar, M. E.; Kerkhof, M.; Siersema, P. D.; Steyerberg, E. W.; Homs, M. Y. V.; Essink-Bot, M.-L.

    2006-01-01

    BACKGROUND AND STUDY AIMS: Patients with Barrett's esophagus are recommended to undergo regular surveillance with upper gastrointestinal endoscopy, an invasive procedure that may cause anxiety, pain, and discomfort. We assessed to what extent patients perceived this procedure as burdensome. PATIENTS

  9. New lidocaine lozenge as topical anesthesia compared to lidocaine viscous oral solution before upper gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Mogensen, Stine; Treldal, Charlotte; Feldager, Erik

    2012-01-01

    To evaluate the effect and acceptance of a new lidocaine lozenge compared with a lidocaine viscous oral solution as a pharyngeal anesthetic before upper gastrointestinal endoscopy (UGE), a diagnostic procedure commonly performed worldwide during which many patients experience severe discomfort...

  10. A prospective randomized study comparing transnasal and peroral 5-mm ultrathin endoscopy

    Directory of Open Access Journals (Sweden)

    Lian-Feng Lin

    2014-06-01

    Conclusion: PO intubation seems an excellent alternative method when using a 5-mm ultrathin endoscopy because it achieves comparable patient tolerance, acceptance, and satisfaction as TN intubation, takes less time and causes lower intubation failure and epistaxis.

  11. Competence and quality assessment: the future of training in GI endoscopy

    NARCIS (Netherlands)

    V.E. Ekkelenkamp (Vivian)

    2014-01-01

    markdownabstract__Abstract__ __Introduction__: Training procedural skills in gastrointestinal endoscopy once focused on threshold numbers. However, as threshold numbers poorly reflect individual competence, the focus gradually shifts towards a more individual approach. Tools to assess and

  12. Usefulness of post-mortem ophthalmological endoscopy during forensic autopsy: a case report.

    Science.gov (United States)

    Tsujinaka, Masatake; Akaza, Kayoko; Nagai, Atsushi; Nakamura, Isao; Bunai, Yasuo

    2005-01-01

    Post-mortem intraocular findings in two autopsy cases with traumatic intracranial haemorrhage were obtained using an ophthalmological endoscope. The endoscopy results clearly revealed the presence of intraocular haemorrhages and papilledema caused by intracranial haemorrhage. Post-mortem ophthalmological endoscopy offers several benefits. First, post-mortem intraocular findings can be directly observed in corpses with post-mortem clouding of the cornea. Secondly, the endoscopy only requires a 0.9 mm incision in the sclera and does not require the removal of the eye from the corpse, a procedure that should be avoided for ethical and cosmetic reasons. Thus, post-mortem opthalmological endoscopy is a useful method for obtaining intraocular findings in autopsies.

  13. New flexible endoscope for otologic application

    Science.gov (United States)

    Marchan, Mark L.

    1993-07-01

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

  14. Flexible magnetoimpedance sensor

    KAUST Repository

    Li, Bodong; Kavaldzhiev, Mincho; Kosel, Jü rgen

    2015-01-01

    Flexible magnetoimpedance (MI) sensors fabricated using a NiFe/Cu/NiFe tri-layer on Kapton substrate have been studied. A customized flexible microstrip transmission line was employed to investigate the MI sensors's magnetic field and frequency

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

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    Propofol sedation by non-anaesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this ev...

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

    DEFF Research Database (Denmark)

    Dumonceau, J.M.; Riphaus, A.; Aparicio, J.R.

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this evi...

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

    NARCIS (Netherlands)

    Dumonceau, J. M.; Riphaus, A.; Aparicio, J. R.; Beilenhoff, U.; Knape, J. T. A.; Ortmann, M.; Paspatis, G.; Ponsioen, C. Y.; Racz, I.; Schreiber, F.; Vilmann, P.; Wehrmann, T.; Wientjes, C.; Walder, B.; Aabakken, L.; Axon, A.; Costamagna, G.; Giostra, E.; Hornslet, P.; Ladas, S.; Marek, T.; Dinis-Ribeiro, M.

    2010-01-01

    Propofol sedation by non-anesthesiologists is an upcoming sedation regimen in several countries throughout Europe. Numerous studies have shown the efficacy and safety of this sedation regimen in gastrointestinal endoscopy. Nevertheless, this issue remains highly controversial. The aim of this

  18. [Videocapsule endoscopy as a useful tool to diagnose primary intestinal lymphangiectasia].

    Science.gov (United States)

    Vignes, S; Bellanger, J

    2007-03-01

    Primary intestinal lymphangiectasia (Waldmann's disease) lead to a protein-losing enteropathy due to lymph leak into intestinal tract. A 28-year-old woman presented a bilateral lower limb lymphedema. Laboratory examination showing lymphopenia, hypoalbuminemia, hypogammaglobulinemia suggested the diagnosis of primary intestinal lymphangiectasia. Gastroscopy was normal and second duodenum biopsies were negative. Videocapsule endoscopy gave evidence of intestinal lymphangiectasia of the small bowel. Videocapsule endoscopy may be proposed to confirm intestinal lymphangiectasia and to precise their localization when gastroscopy is not conclusive.

  19. Improving safety of personnel exposed to disinfectants by introducing an Endoscopy Quality Assurance Program

    OpenAIRE

    Ahmed Gado; Basel Ebeid; Aida Abdelmohsen; Anthony Axon

    2014-01-01

    Background: Chemical disinfection is the most commonly used method in gastrointestinal endoscopy reprocessing. The main problem with chemical disinfection is that it is potentially harmful to humans. Risk assessment of employees using toxic substances is recommended and the control of exposure to these substances is required. In 2003, an endoscopy quality-assurance program was instituted in a secondary care governmental hospital in Egypt. Aim: The aim of the study was to assess the risk to...

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

    Science.gov (United States)

    Adler, Samuel N; Bjarnason, Ingvar

    2012-10-16

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

  1. Autofluorescence imaging endoscopy can distinguish non-erosive reflux disease from functional heartburn: A pilot study.

    Science.gov (United States)

    Luo, Xi; Guo, Xiao-Xu; Wang, Wei-Feng; Peng, Li-Hua; Yang, Yun-Sheng; Uedo, Noriya

    2016-04-14

    To investigate whether autofluorescence imaging (AFI) endoscopy can distinguish non-erosive reflux disease (NERD) from functional heartburn (FH). In this prospective observational trial, 127 patients presenting with typical reflux symptoms for > 6 mo were screened. All the participants underwent endoscopy, during which white light imaging (WLI) was followed by AFI. Finally 84 patients with normal esophageal appearance on WLI were enrolled. It was defined as being suggestive of NERD if one or more longitudinal purple lines longer than one centimeter were visualized in the distal part of the esophagus during AFI endoscopy. Ambulatory 24-h multichannel intraluminal impedance and pH monitoring was also performed. After standard proton-pump inhibitor (PPI) tests, subjects were divided into an NERD group and an FH group and the diagnostic performance of AFI endoscopy to differentiate NERD from FH was evaluated. Of 84 endoscopy-negative patients, 36 (42.9%) had a normal pH/impedance test. Of these, 26 patients with favorable responses to PPI tests were classified as having NERD. Finally 10 patients were diagnosed with FH and the others with NERD. Altogether, 68 (81.0%) of the 84 patients were positive on AFI endoscopy. In the NERD group, there were 67 (90.5%) patients with abnormal esophageal findings on AFI endoscopy while only 1 (10%) patient was positive on AFI endoscopy in the FH group. The sensitivity and specificity of AFI in differentiating NERD from FH were 90.5% (95%CI: 81.5%-96.1%) and 90.0% (95%CI: 55.5%-99.7%), respectively. Meanwhile, the accuracy, positive predictive value and negative predictive value of AFI in differentiating between NERD and FH were 90.5% (95%CI: 84.2%-96.8%), 98.5% (95%CI: 92.1%-99.9%) and 56.3% (95%CI: 30.0%-80.2%), respectively. Autofluorescence imaging may serve as a complementary method in evaluating patients with NERD and FH.

  2. Upper gastrointestinal endoscopy for dyspepsia: Εxploratory study of factors influencing patient compliance in Greece

    Directory of Open Access Journals (Sweden)

    Kouroumalis Elias

    2011-02-01

    Full Text Available Abstract Background Upper gastrointestinal endoscopy is the most preferable diagnostic examination for patients over fifty when upper gastrointestinal symptoms appear. However, limited knowledge exists in concerns to the compliance of primary care patients' to the doctors' recommendations for endoscopy. Methods Patients who visited primary care practices in Greece and experienced upper gastrointestinal symptoms within a 10 days screening study, were referred for an upper endoscopy exam. The patients which refused to complete the endoscopy exam, were interviewed by the use of an open- ended translated and validated questionnaire, the Identification of Dyspepsia in General Population (IDGP questionnaire. A qualitative thematic analysis grounded on the theory of planned behavior was performed to reveal the reasons for patients' refusal, while socio-demographic predictors were also assessed. Results Nine hundred and ninety two patients were recorded, 159 of them (16% were found positive for dyspepsia and gastro-esophageal reflux disease according to the IDGP questionnaire. Out of the above, 131 (83.6% patients refused further investigation with endoscopy. Patients who refused upper endoscopy were predominantly female (87.8% (p = 0.036 and over the age of 50. The lack of severe symptoms, fear of pain, concerns of sedation, comorbidity and competing life demands were reported by patients as barriers to performing an endoscopic investigation. Conclusions Patients with dyspepsia in rural Greece tend to avoid upper gastrointestinal endoscopy, with two major axons considered to be the causes of patients' refusal: their beliefs towards endoscopy and their personal capability to cope with it. Future research examining reasons of low compliance should be carried out in combination with modern behavioral theories so as to investigate into the above.

  3. Flexible Carpooling: Exploratory Study

    OpenAIRE

    Dorinson, Diana; Gay, Deanna; Minett, Paul; Shaheen, Susan

    2009-01-01

    Energy consumption could be reduced if more people shared rides rather than driving alone yet carpooling represents a small proportion of all potential carpoolers. Prior research has found that many who might carpool were concerned about reduced flexibility with carpooling. If flexibility is one of the barriers how could carpooling be organized to be more flexible? In Northern Virginia a flexible system has evolved where there are 3,500 single-use carpools per day. In another example there ...

  4. Clinicoepidemiologic characterization and endoscopy in patients with colorectal cancer

    International Nuclear Information System (INIS)

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

    2010-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Won Gun Kwack

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Stephen Woods

    2015-01-01

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

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

    Science.gov (United States)

    Woods, Stephen; Constandinou, Timothy

    2015-01-01

    Wireless capsule endoscopy (WCE) enables the detection and diagnosis of inflammatory bowel diseases such as Crohn's disease and ulcerative colitis. However treatment of these pathologies can only be achieved through conventional means. This paper describes the next generation WCE with increased functionality to enable targeted drug delivery in the small intestinal tract. A prototype microrobot fabricated in Nylon 6 is presented which is capable of resisting peristaltic pressure through the deployment of an integrated holding mechanism and delivering targeted therapy. The holding action is achieved by extending an “anchor” spanning a 60.4 mm circumference, for an 11.0 mm diameter WCE. This function is achieved by a mechanism that occupies only 347.0 mm3 volume, including mechanics and actuator. A micropositioning mechanism is described which utilises a single micromotor to radially position and then deploy a needle 1.5 mm outside the microrobot's body to deliver a 1 mL dose of medication to a targeted site. An analysis of the mechanics required to drive the holding mechanism is presented and an overview of microactuators and the state of the art in WCE is discussed. It is envisaged that this novel functionality will empower the next generation of WCE to help diagnose and treat pathologies of the GI tract. PMID:26258143

  8. Fluorescence Endoscopy in vivo based on Fiber-bundle Measurements

    Energy Technology Data Exchange (ETDEWEB)

    Zufiria, B.; Gomez-Garcia, P.; Stamatakis, K.; Vaquero, J.J.; Fresno, M.; Desco, M.; Ripoll, J.; Arranz, A.

    2016-07-01

    High-resolution imaging techniques have become important for the determination of the cellular organization that is coupled to organ function. In many cases the organ can be viewed without the need of ionizing radiation techniques in an easier way. This is the case of the gastrointestinal tract, an organ that can be directly accessed with endoscopy avoiding any invasive procedure. Here we describe the design, assembly and testing of a fluorescence high-resolution endoscope intended for the study of the cellular organization of the colon in an experimental mouse model of colon carcinoma. Access to the colon of the mouse took place using a fiber-optic bundle that redirects the light coming from a LED to produce fluorescence and detect it back through the fiber bundle. Results from in vivo and ex-vivo test using our fluorescence fiber bundle endoscope show altered tissue structure and destruction of the intestinal crypts in tumor-bearing areas compared with healthy tissue. (Author)

  9. Narrow-Band Imaging: Clinical Application in Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Sandra Barbeiro

    2018-03-01

    Full Text Available Narrow-band imaging is an advanced imaging system that applies optic digital methods to enhance endoscopic images and improves visualization of the mucosal surface architecture and microvascular pattern. Narrow-band imaging use has been suggested to be an important adjunctive tool to white-light endoscopy to improve the detection of lesions in the digestive tract. Importantly, it also allows the distinction between benign and malignant lesions, targeting biopsies, prediction of the risk of invasive cancer, delimitation of resection margins, and identification of residual neoplasia in a scar. Thus, in expert hands it is a useful tool that enables the physician to decide on the best treatment (endoscopic or surgical and management. Current evidence suggests that it should be used routinely for patients at increased risk for digestive neoplastic lesions and could become the standard of care in the near future, at least in referral centers. However, adequate training programs to promote the implementation of narrow-band imaging in daily clinical practice are needed. In this review, we summarize the current scientific evidence on the clinical usefulness of narrow-band imaging in the diagnosis and characterization of digestive tract lesions/cancers and describe the available classification systems.

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

    Science.gov (United States)

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

    2008-02-01

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

  11. Non-technical skills and gastrointestinal endoscopy: a review of the literature.

    Science.gov (United States)

    Hitchins, Charlotte R; Metzner, Magdalena; Edworthy, Judy; Ward, Catherine

    2018-04-01

    Non-technical skills (NTS) have gained increasing recognition in recent years for their role in safe, effective team performance in healthcare. Gastrointestinal endoscopy is a procedure-based specialty with rapidly advancing technology, significant operational pressures and rapidly changing 'teams of experts'. However, to date there has been little focus on the effect of NTS in this field. This review aims to examine the existing literature on NTS in gastrointestinal endoscopy and identify areas for further research. A systematic search of MEDLINE, Embase, Cochrane Library, PsychINFO, CINAHL Plus and PubMed databases was performed using search terms Non-Technical Skills, Team Performance or Team Skills, and Endoscopy, Colonoscopy, OGD, Gastroscopy, Endoscopic Retrograde Cholangio-Pancreatography or Endoscopic Ultrasound. Eighteen relevant publications were found. NTS are deemed an essential component of practice, but so far there is little evidence of their integration into training or competency assessment. Those studies examining the effects of NTS and team training in endoscopy are small and have variable outcome measures with limited evidence of improvement in skills or clinical outcomes. NTS assessment in endoscopy is in its early phases with a few tools in development. The current literature on NTS in gastrointestinal endoscopy is limited. NTS, however, are deemed an essential component of practice, with potential positive effects on team performance and clinical outcomes. A validated reliable tool would enable evaluation of training and investigation into the effects of NTS on outcomes. There is a clear need for further research in this field.

  12. The endoscopy Global Rating Scale – Canada: Development and implementation of a quality improvement tool

    Science.gov (United States)

    MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; van Zanten, Sander Veldhuyzen; Daniels, Sandra; Ghattas, George

    2013-01-01

    BACKGROUND: Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. OBJECTIVE: To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. METHODS: Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). RESULTS: The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes/no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. CONCLUSION: The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide. PMID:23472242

  13. Abdominal compression during endoscopy (the Bolster technique) demonstrates hidden Schatzki rings (with videos).

    Science.gov (United States)

    Jouhourian, Caroline; Bonis, Peter A; Guelrud, Moises

    2016-05-01

    Schatzki rings are found in the distal esophagus, are associated with hiatal hernias, and present with intermittent dysphagia to solid foods. They can be identified by radiology (GI series or barium swallow studies) or endoscopy. Rings are not always visualized during endoscopy in patients in whom they are suspected clinically. The Bolster technique involves application of epigastric abdominal pressure, which offers the potential to reveal a Schatzki ring that is otherwise obscured within a reduced hiatal hernia. The aim of this study was to determine whether the Bolster technique improves endoscopic detection of Schatzki rings. We reviewed 30 symptomatic patients with a history of a Schatzki ring in a tertiary care center. The Bolster technique was applied to patients in whom the ring was not visible during standard endoscopy. The main outcome measurement was identification of the Schatzki ring after the Bolster technique. A Schatzki ring was visible during standard endoscopy in 26 of the 30 patients. In the remaining 4, the ring was visible only after the application of the Bolster technique. The Bolster technique is a simple maneuver that can increase detection rates of Schatzki rings during endoscopy. Copyright © 2016 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2016-02-01

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

  15. The endoscopy Global Rating Scale-Canada: development and implementation of a quality improvement tool.

    Science.gov (United States)

    MacIntosh, Donald; Dubé, Catherine; Hollingworth, Roger; Veldhuyzen van Zanten, Sander; Daniels, Sandra; Ghattas, George

    2013-02-01

    Increasing use of gastrointestinal endoscopy, particularly for colorectal cancer screening, and increasing emphasis on health care quality highlight the need for endoscopy facilities to review the quality of the service they offer. To adapt the United Kingdom Global Rating Scale (UK-GRS) to develop a web-based and patient-centred tool to assess and improve the quality of endoscopy services provided. Based on feedback from 22 sites across Canada that completed the UK endoscopy GRS, and integrating results of the Canadian consensus on safety and quality indicators in endoscopy and other Canadian consensus reports, a working group of endoscopists experienced with the GRS developed the GRS-Canada (GRS-C). The GRS-C mirrors the two dimensions (clinical quality and quality of the patient experience) and 12 patient-centred items of the UK-GRS, but was modified to apply to Canadian health care infrastructure, language and current practice. Each item is assessed by a yes⁄no response to eight to 12 statements that are divided into levels graded D (basic) through A (advanced). A core team consisting of a booking clerk, charge nurse and the physician responsible for the unit is recommended to complete the GRS-C twice yearly. The GRS-C is intended to improve endoscopic services in Canada by providing endoscopy units with a straightforward process to review the quality of the service they provide.

  16. [Sedation with intravenous midazolam during upper gastrointestinal endoscopy--changes in hemodynamics, oxygen saturation and memory].

    Science.gov (United States)

    Mizuno, Ju; Matsuki, Michiko; Gouda, Yoshinori; Nishiyama, Tomoki; Hanaoka, Kazuo

    2003-09-01

    Cardiorespiratory adverse effects are often observed in patients undergoing upper gastrointestinal endoscopy with sedation. In this study, we examined hemodynamics, oxygen saturation and memory during upper gastrointestinal endoscopy under sedation with intravenous midazolam. Eight healthy outpatients without any obvious complications received intravenous midazolam 5 mg for sedation for upper gastrointestinal endoscopy. Blood pressure, heart rate and percutaneous arterial oxygen saturation (SpO2) were measured before, during and after endoscopy. After the arousal by intravenous flumazenil, we inquired the patients about the level of memory during the endoscopy. Blood pressure decreased significantly two minutes after midazolam administration, but increased significantly after the insertion of an endoscope which was not different from the control value. Heart rate increased significantly one and three minutes after the insertion of the endoscope. SpO2 decreased significantly after midazolam administration and stayed at around 95%. No patients remembered the procedure. Sedation with intravenous midazolam during upper gastrointestinal endoscopy is useful to control the cardiovascular responses, and to obtain amnesia. However, a decrease in SpO2 should be watched carefully.

  17. Last Glacial Maximum Salinity Reconstruction

    Science.gov (United States)

    Homola, K.; Spivack, A. J.

    2016-12-01

    It has been previously demonstrated that salinity can be reconstructed from sediment porewater. The goal of our study is to reconstruct high precision salinity during the Last Glacial Maximum (LGM). Salinity is usually determined at high precision via conductivity, which requires a larger volume of water than can be extracted from a sediment core, or via chloride titration, which yields lower than ideal precision. It has been demonstrated for water column samples that high precision density measurements can be used to determine salinity at the precision of a conductivity measurement using the equation of state of seawater. However, water column seawater has a relatively constant composition, in contrast to porewater, where variations from standard seawater composition occur. These deviations, which affect the equation of state, must be corrected for through precise measurements of each ion's concentration and knowledge of apparent partial molar density in seawater. We have developed a density-based method for determining porewater salinity that requires only 5 mL of sample, achieving density precisions of 10-6 g/mL. We have applied this method to porewater samples extracted from long cores collected along a N-S transect across the western North Atlantic (R/V Knorr cruise KN223). Density was determined to a precision of 2.3x10-6 g/mL, which translates to salinity uncertainty of 0.002 gms/kg if the effect of differences in composition is well constrained. Concentrations of anions (Cl-, and SO4-2) and cations (Na+, Mg+, Ca+2, and K+) were measured. To correct salinities at the precision required to unravel LGM Meridional Overturning Circulation, our ion precisions must be better than 0.1% for SO4-/Cl- and Mg+/Na+, and 0.4% for Ca+/Na+, and K+/Na+. Alkalinity, pH and Dissolved Inorganic Carbon of the porewater were determined to precisions better than 4% when ratioed to Cl-, and used to calculate HCO3-, and CO3-2. Apparent partial molar densities in seawater were

  18. Delayed bleeding and hemorrhage of mucosal defects after gastric endoscopic submucosal dissection on second-look endoscopy.

    Science.gov (United States)

    Ono, Shoko; Ono, Masayoshi; Nakagawa, Manabu; Shimizu, Yuichi; Kato, Mototsugu; Sakamoto, Naoya

    2016-04-01

    Although second-look endoscopy is performed within several days after gastric endoscopic submucosal dissection (ESD), there has been no evidence supporting the usefulness of the intervention. We investigated the relationship between delayed bleeding and hemorrhage of mucosal defects after ESD on second-look endoscopy and analyzed risk factors of active bleeding on second-look endoscopy. A total of 441 consecutive ESD cases with gastric cancer or adenoma were retrospectively analyzed. Second-look endoscopy was performed in the morning after the day of ESD. Bleeding of mucosal defects on second-look endoscopy was classified according to the Forrest classification, and active bleeding was defined as Forrest Ia or Ib. Delayed bleeding was defined as hematemesis or melena after second-look endoscopy. A total of 406 second-look endoscopies were performed, and delayed bleeding occurred in 11 patients. The incidence rate of delayed bleeding after second-look endoscopy in patients with Forrest Ia or Ib was significantly higher than that in patients with Forrest IIa, IIb or III (7.69 vs. 2.02 %, p 35 mm, the odds ratio of active bleeding on second-look endoscopy was 1.9. Active bleeding of mucosal defects on second-look endoscopy is a risk factor for delayed bleeding.

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

    Directory of Open Access Journals (Sweden)

    Arif Ali Kolethekkat

    2013-11-01

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

  20. Productive use of saline lands

    International Nuclear Information System (INIS)

    2003-01-01

    Water is essential for life, and not least for agricultural activity. It interacts with solar energy to determine the climate of the globe, and its interaction with carbon dioxide inside a plant results in photosynthesis on which depends survival of all life. Much of the water available to man is used for agriculture and yet its usage has not been well managed. One result has been the build up of soil salinity. The Department of Technical Co-operation is sponsoring a programme, with technical support from the Department of Research and Isotopes, to make more productive use of salt-affected land and to limit future build up of salinity. (IAEA)

  1. The role of endoscopy in pediatric gastrointestinal bleeding

    Science.gov (United States)

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

    2016-01-01

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

  2. Advanced virtual endoscopy for endoscopic transsphenoidal pituitary surgery.

    Science.gov (United States)

    Wolfsberger, Stefan; Neubauer, André; Bühler, Katja; Wegenkittl, Rainer; Czech, Thomas; Gentzsch, Stephan; Böcher-Schwarz, Hans-Gerd; Knosp, Engelbert

    2006-11-01

    Virtual endoscopy (vE) is the navigation of a camera through a virtual anatomical space that is computationally reconstructed from radiological image data. Inside this three-dimensional space, arbitrary movements and adaptations of viewing parameters are possible. Thereby, vE can be used for noninvasive diagnostic purposes and for simulation of surgical tasks. This article describes the development of an advanced system of vE for endoscopic transsphenoidal pituitary surgery and its application to teaching, training, and in the routine clinical setting. The vE system was applied to a series of 35 patients with pituitary pathology (32 adenomas, three Rathke's cleft cysts) operated endoscopically via the transsphenoidal route at the Department of Neurosurgery of the Medical University Vienna between 2004 and 2006. The virtual endoscopic images correlated well with the intraoperative view. For the transsphenoidal approach, vE improved intraoperative orientation by depicting anatomical landmarks and variations. For planning a safe and tailored opening of the sellar floor, transparent visualization of the pituitary adenoma and the normal gland in relation to the internal carotid arteries was useful. According to our experience, vE can be a valuable tool for endoscopic transsphenoidal pituitary surgery for training purposes and preoperative planning. For the novice, it can act as a simulator for endoscopic anatomy and for training surgical tasks. For the experienced pituitary surgeon, vE can depict the individual patient's anatomy, and may, therefore, improve intraoperative orientation. By prospectively visualizing unpredictable anatomical variations, vE may increase the safety of this surgical procedure.

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

    Directory of Open Access Journals (Sweden)

    Oluwafunmilayo Funke Adeniyi

    2016-12-01

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

  4. Monitoring wound healing by multiphoton tomography/endoscopy

    Science.gov (United States)

    König, Karsten; Weinigel, Martin; Bückle, Rainer; Kaatz, Martin; Hipler, Christina; Zens, Katharina; Schneider, Stefan W.; Huck, Volker

    2015-02-01

    Certified clinical multiphoton tomographs are employed to perform rapid label-free high-resolution in vivo histology. Novel tomographs include a flexible 360° scan head attached to a mechano-optical arm for autofluorescence and SHG imaging as well as rigid two-photon GRIN microendoscope. Mitochondrial fluorescent NAD(P)H, fluorescent elastin, keratin, and melanin as well as SHG-active collagen can be imaged with submicron resolution in human skin. The system was employed to study the healing of chronic wounds (venous leg ulcer) and acute wounds (curettage of actinic or seborrheic keratosis) on a subcellular level. Furthermore, a flexible sterile foil as interface between wound and focusing optic was tested.

  5. Office flexible cystoscopy.

    Science.gov (United States)

    Kavoussi, L R; Clayman, R V

    1988-11-01

    Since the development of the first purpose-built flexible cystoscope in 1984, flexible cystoscopy has become an accepted diagnostic and therapeutic modality. Indeed, it is estimated that more than 10 per cent of practicing urologists are already familiar with this technology. The flexible cystoscope has markedly extended the urologist's ability to examine the bladder, and it has become a valuable adjunct to the rigid cystoscope. Although the operation of this instrument is vastly different from that of its rigid counterpart, with practice, the technique can be learned. After experience is obtained with diagnostic flexible cystoscopy, the urologist will likely prefer this new instrument for bladder inspection, as it provides for a more thorough yet less morbid and less expensive examination. In the future, the development of improved and smaller instrumentation will further extend the therapeutic indications for flexible cystoscopy. Indeed, advances in laser technology are already providing the urologist with 300- to 600-micron (0.9 to 1.8F) flexible probes capable of incision (KTP laser), fulguration (Nd:YAG laser), and stone disintegration (tunable dye laser). Lastly, the skills obtained in using the flexible cystoscope are all readily applicable to the development of dexterity with the already available flexible nephroscope and the more recently developed flexible ureteroscope.

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

    International Nuclear Information System (INIS)

    Sun, Z.; Allen, Y.; Fitzsimmons, B.; Hartely, D.; Lawrence-Brown, M.

    2007-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-06-15

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

  8. Spiral CT biliary virtual endoscopy: preliminary clinical applications in the detection of biliary calculus

    International Nuclear Information System (INIS)

    Xiong Minghui; Wang Dong; Song Yunlong; Zhang Wanshi; Xu Jiaxing

    2000-01-01

    Objective: To evaluate imaging features and clinical value of CT biliary virtual endoscopy in the detection of biliary calculus. Methods: Eighteen patients with biliary calculi underwent volume scanning using spiral CT (Hispeed Advantage CT/i GE ). All data were transferred to computer workstation, and CT biliary virtual endoscopy images with pseudocolor encoding were generated from the volumetric data using the Navigator Smooth soft-ware. All cases were proved by ultrasound, axial CT or operation. Results: Among 18 cases, gallstones were found 8 in cases, common bile duct stones in 2 cases, gallstones and bile duct stones in 6 cases. The stones were 0.3-3.2 cm in size. CT biliary virtual endoscopy correctly demonstrated the surface details of stones which were viewed from extra- or intraluminal orientation in a 3D fashion. The findings were consistent with those of US, CT or operation. Conclusion: The CT virtual biliary endoscopy is a further development of virtual endoscopy for observing biliary calculus from intra- and extra-luminal views and providing three dimensional information of stone

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

    International Nuclear Information System (INIS)

    Leja, M.; Lejnieks, A.; Pokrotnieks, J.; Sosare, L.; Reinholds, E.; Brezinskis, G.; Aboltins, A.

    2002-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Abreu, João Paulo Saraiva

    2011-01-01

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

  11. Endoprobe: A system for radionuclide-guided endoscopy

    International Nuclear Information System (INIS)

    Raylman, Raymond R.; Srinivasan, Amarnath

    2004-01-01

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

  12. Saline water irrigation for crop production

    Energy Technology Data Exchange (ETDEWEB)

    Khan, A R [Directorate of Water Management Research, Indian Council of Agricultural Research (ICAR), Walmi Complex, P.O. - Phulwari Sharif, Patna (India); [Abdus Salam International Centre for Theoretical Physics, Trieste (Italy); Singh, S S; Singh, S R [Directorate of Water Management Research, Indian Council of Agricultural Research (ICAR), Walmi Complex, P.O. - Phulwari Sharif, Patna (India)

    2001-05-01

    Salinity is one of agriculture's most complex production problems. Excessive salts from irrigation water or high water tables can severely limit crop production. Years of saline water irrigation on poorly drained soils can eventually make economic crop production impossible. About 10% of all land are affected by salinity problems. They occur in every continent in different proportions, more frequently in arid and semi-arid areas. This paper discusses a range of problems related to use of saline water for crop irrigation.

  13. Saline water irrigation for crop production

    International Nuclear Information System (INIS)

    Khan, A.R.; Singh, S.S.; Singh, S.R.

    2001-05-01

    Salinity is one of agriculture's most complex production problems. Excessive salts from irrigation water or high water tables can severely limit crop production. Years of saline water irrigation on poorly drained soils can eventually make economic crop production impossible. About 10% of all land are affected by salinity problems. They occur in every continent in different proportions, more frequently in arid and semi-arid areas. This paper discusses a range of problems related to use of saline water for crop irrigation

  14. UPPER GASTROINTESTINAL ENDOSCOPY FINDINGS IN PATIENTS REFERRED WITH UPPER GASTROINTESTINAL SYMPTOMS IN ELDORET, KENYA: A RETROSPECTIVE REVIEW.

    Science.gov (United States)

    Ayuo, P O; Some, F F; Kiplagat, J

    2014-08-01

    Dyspepsia is one of the major indications for upper gastrointestinal endoscopy. Other indications include dysphagia, odynophagia and gastrointestinal bleeding. Endoscopy is an expensive procedure that is out of reach of many patients in resource constrained region such as western Kenya. We reviewed endoscopy records from both public and private health institutions spanning ten years. To determine the pattern of referral and endoscopy diagnoses in patients referred for upper gastrointestinal endoscopy in Eldoret, Kenya. Retrospective chart review. Moi Teaching and Referral Hospital, private hospitals and private clinics in Eldoret, Kenya. One thousand six hundred and ninety (1690) Patients who underwent upper GI endoscopy from 1993 to 2003 were reviewed after obtaining clearances from the respective institutions. Information on age, sex, symptoms, and endoscopy diagnosis were extracted and subjected to statistical analysis. The most common symptom was dyspepsia in 1059 (62.7%) followed by dysphagia in 224 (13.3%). Others were referred with diagnosis of cancer of the stomach or oesophagus. Common endoscopy diagnoses were cancer of the oesophagus in 199 (11.8%) and duodenal ulcer in 186 (11.0%). The majority of the patients (30.4%) had normal endoscopy findings. Of the 1059 patients with dyspepsia, only 154 (14.5%) had duodenal ulcer and 34 (3.2%) had gastric ulcers, the majority, 37.2% had normal endoscopy findings. Dyspepsia was main reason for referral, but the majority of such patients had normal findings. Cancer of the oesophagus was the main diagnosis in patients with dysphagia. In view of the cost of endoscopy, only those with dyspepsia and alarm symptoms be referred for the procedure.

  15.  Cost-effectiveness of medicine vs. endoscopy for dyspeptic patients

    DEFF Research Database (Denmark)

    Kjeldsen, Hans Christian; Lauritzen, Torsten; Christensen, Bo

      Background: Decision analyses conclude that empirical anti-secretory therapy is more cost-effective than endoscopy for managing patients with dyspepsia however RCTs including economic evaluation come to diverging results Aim: to compare the cost-effectiveness of two strategies for management.......   Results The incremental cost effectiveness (CE) ratio for one day free of dyspeptic symptoms using the endoscopy strategy was €/day 300 compared with the PPI strategy. The incremental CE ratio for one patient free of dyspeptic symptoms after one year using the endoscopy strategy was € 13,600 based....... The empirical PPI strategy was hence the more cost-effective strategy for managing patients with dyspepsia in general practice especially if reflux was the predominant symptom.  ...

  16. Is Endoscopy Really Necessary in My Case? A Four Year Retrospective Study.

    Science.gov (United States)

    Dinesh, H N; Kumar, Cd Jagadish; Sanjay, H M; Sachin, V; Basavaraju

    2015-07-01

    About 40% of the general population report dyspepsia at some time in their life making it a fairly common disease. Uncomplicated dyspepsia refers to patients whose dyspepsia is not accompanied by alarm features or associated with NSAIDS usage. To assess the need for UGI Endoscopy and find out the patterns of different endoscopic presentations in patients presenting with uncomplicated dyspepsia. Our study conducted in KR Hospital, Mysore, Department of General Surgery is a retrospective endoscopic study of 1450 patients with uncomplicated dysepsia. A significant 64% of the patients presenting with uncomplicated dyspepsia were found to have findings on endoscopy. The most common age range for positive endoscopic findings was 40-50 years in our hospital. Malignancy was diagnosed in 2.5% patients. We recommend upper GI endoscopy in patients presenting with uncomplicated dyspepsia for patients above 40 years of age in our hospital.

  17. A global algorithm for estimating Absolute Salinity

    Science.gov (United States)

    McDougall, T. J.; Jackett, D. R.; Millero, F. J.; Pawlowicz, R.; Barker, P. M.

    2012-12-01

    The International Thermodynamic Equation of Seawater - 2010 has defined the thermodynamic properties of seawater in terms of a new salinity variable, Absolute Salinity, which takes into account the spatial variation of the composition of seawater. Absolute Salinity more accurately reflects the effects of the dissolved material in seawater on the thermodynamic properties (particularly density) than does Practical Salinity. When a seawater sample has standard composition (i.e. the ratios of the constituents of sea salt are the same as those of surface water of the North Atlantic), Practical Salinity can be used to accurately evaluate the thermodynamic properties of seawater. When seawater is not of standard composition, Practical Salinity alone is not sufficient and the Absolute Salinity Anomaly needs to be estimated; this anomaly is as large as 0.025 g kg-1 in the northernmost North Pacific. Here we provide an algorithm for estimating Absolute Salinity Anomaly for any location (x, y, p) in the world ocean. To develop this algorithm, we used the Absolute Salinity Anomaly that is found by comparing the density calculated from Practical Salinity to the density measured in the laboratory. These estimates of Absolute Salinity Anomaly however are limited to the number of available observations (namely 811). In order to provide a practical method that can be used at any location in the world ocean, we take advantage of approximate relationships between Absolute Salinity Anomaly and silicate concentrations (which are available globally).

  18. 40 CFR 230.25 - Salinity gradients.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 24 2010-07-01 2010-07-01 false Salinity gradients. 230.25 Section 230.25 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) OCEAN DUMPING SECTION 404(b... Physical and Chemical Characteristics of the Aquatic Ecosystem § 230.25 Salinity gradients. (a) Salinity...

  19. Salinity: Electrical conductivity and total dissolved solids

    Science.gov (United States)

    The measurement of soil salinity is a quantification of the total salts present in the liquid portion of the soil. Soil salinity is important in agriculture because salinity reduces crop yields by reducing the osmotic potential making it more difficult for the plant to extract water, by causing spe...

  20. Organizational flexibility estimation

    OpenAIRE

    Komarynets, Sofia

    2013-01-01

    By the help of parametric estimation the evaluation scale of organizational flexibility and its parameters was formed. Definite degrees of organizational flexibility and its parameters for the Lviv region enterprises were determined. Grouping of the enterprises under the existing scale was carried out. Special recommendations to correct the enterprises behaviour were given.

  1. Reversibly Bistable Flexible Electronics

    KAUST Repository

    Alfaraj, Nasir

    2015-05-01

    Introducing the notion of transformational silicon electronics has paved the way for integrating various applications with silicon-based, modern, high-performance electronic circuits that are mechanically flexible and optically semitransparent. While maintaining large-scale production and prototyping rapidity, this flexible and translucent scheme demonstrates the potential to transform conventionally stiff electronic devices into thin and foldable ones without compromising long-term performance and reliability. In this work, we report on the fabrication and characterization of reversibly bistable flexible electronic switches that utilize flexible n-channel metal-oxide-semiconductor field-effect transistors. The transistors are fabricated initially on rigid (100) silicon substrates before they are peeled off. They can be used to control flexible batches of light-emitting diodes, demonstrating both the relative ease of scaling at minimum cost and maximum reliability and the feasibility of integration. The peeled-off silicon fabric is about 25 µm thick. The fabricated devices are transferred to a reversibly bistable flexible platform through which, for example, a flexible smartphone can be wrapped around a user’s wrist and can also be set back to its original mechanical position. Buckling and cyclic bending of such host platforms brings a completely new dimension to the development of flexible electronics, especially rollable displays.

  2. Flexible magnetoimpidence sensor

    KAUST Repository

    Kavaldzhiev, Mincho

    2015-05-01

    Recently, flexible electronic devices have attracted increasing interest, due to the opportunities they promise for new applications such as wearable devices, where the components are required to flex during normal use[1]. In this light, different magnetic sensors, like microcoil, spin valve, giant magnetoresistance (GMR), magnetoimpedance (MI), have been studied previously on flexible substrates.

  3. Flexibility within Fidelity

    Science.gov (United States)

    Kendall, Philip C.; Gosch, Elizabeth; Furr, Jami M.; Sood, Erica

    2008-01-01

    The authors address concerns regarding manual-based treatments, highlighting the role of flexibility and creativity. A cognitive-behavioral therapy for youth anxiety called the Coping Cat program demonstrates the flexible application of manuals and emphasizes the importance of a child-centered, personalized approach that involves the child in the…

  4. Flexible position probe assembly

    International Nuclear Information System (INIS)

    Schmitz, J.J.

    1977-01-01

    The combination of a plurality of tubular transducer sections and a flexible supporting member extending through the tubular transducer sections forms a flexible elongated probe of a design suitable for monitoring the level of an element, such as a nuclear magnetically permeable control rod or liquid. 3 claims, 23 figures

  5. Flexible Carbon Aerogels

    Directory of Open Access Journals (Sweden)

    Marina Schwan

    2016-09-01

    Full Text Available Carbon aerogels are highly porous materials with a large inner surface area. Due to their high electrical conductivity they are excellent electrode materials in supercapacitors. Their brittleness, however, imposes certain limitations in terms of applicability. In that context, novel carbon aerogels with varying degree of flexibility have been developed. These highly porous, light aerogels are characterized by a high surface area and possess pore structures in the micrometer range, allowing for a reversible deformation of the aerogel network. A high ratio of pore size to particle size was found to be crucial for high flexibility. For dynamic microstructural analysis, compression tests were performed in-situ within a scanning electron microscope allowing us to directly visualize the microstructural flexibility of an aerogel. The flexible carbon aerogels were found to withstand between 15% and 30% of uniaxial compression in a reversible fashion. These findings might stimulate further research and new application fields directed towards flexible supercapacitors and batteries.

  6. Global Sourcing Flexibility

    DEFF Research Database (Denmark)

    Ørberg Jensen, Peter D.; Petersen, Bent

    2013-01-01

    the higher costs (but decreased risk for value chain disruption) embedded in a more flexible global sourcing model that allows the firm to replicate and/or relocate activities across multiple locations. We develop a model and propositions on facilitating and constraining conditions of global sourcing...... sourcing flexibility. Here we draw on prior research in the fields of organizational flexibility, international business and global sourcing as well as case examples and secondary studies. In the second part of the paper, we discuss the implications of global sourcing flexibility for firm strategy...... and operations against the backdrop of the theory-based definition of the construct. We discuss in particular the importance of global sourcing flexibility for operational performance stability, and the trade-off between specialization benefits, emerging from location and service provider specialization, versus...

  7. Upper gastrointestinal endoscopy at the korle bu teaching hospital, accra, ghana.

    Science.gov (United States)

    Aduful, Hk; Naaeder, Sb; Darko, R; Baako, Bn; Clegg-Lamptey, Jna; Nkrumah, Kn; Adu-Aryee, Na; Kyere, M

    2007-03-01

    To study the indications for endoscopy, the endoscopic diagnosis and other lessons learnt. A retrospective and prospective audit of all upper gastrointestinal endoscopies performed in the Endoscopy Unit of the Korle-Bu Teaching Hospital from January 1995 to December 2002 was performed. A total of 6977 patients, 3777 males and 3200 females with age range 1 year 8 months to 93 years were endoscoped. The mean age of males was 43.5 +/- 0.5 and females 43.7 +/- 0.6 years. Epigastric pain (42.5%), dyspepsia (32.8%) and haematemesis and melaena (14.2%) were the commonest reasons for endoscopy. Chronic duodenal ulcer (19.6%), acute gastritis (12.7%), duodenitis (10.2%), oesophagitis (7.5%) were the commonest diagnoses. Normal endoscopy was reported in 41.1% patients, and was higher in the younger age group compared to the older (R = 0.973, P<0.001). Nine hundred and ninety (14.2%) patients were endoscoped for haematemesis and melaena of which chronic duodenal ulcer (32.1%), gastritis/gastric erosions (12.8%), oesophageal varices (9.8%), carcinoma of the stomach (6.4%), and duodenitis (4.2%), were the commonest causes. No lesion was found in 20.6% of these patients. Urease test was positive in 75% of all biopsy specimen and 85% in chronic duodenal ulcer, gastritis and duodenitis. The normal endoscopy rate is high and needs to be reduced in order to help prolong the lives of the endoscopes. Chronic duodenal ulcer is usually associated with H. pylori infection and is the commonest cause of upper gastrointestinal bleeding.

  8. Outcomes of patients hospitalized with peptic ulcer disease diagnosed in acute upper endoscopy.

    Science.gov (United States)

    Malmi, Hanna; Kautiainen, Hannu; Virta, Lauri J; Färkkilä, Martti A

    2017-11-01

    The incidence and complications of peptic ulcer disease (PUD) have declined, but mortality from bleeding ulcers has remained unchanged. The aims of the current study were to evaluate the significance of PUD among patients admitted for acute upper endoscopy and to evaluate the survival of PUD patients. In this prospective, observational cohort study, data on 1580 acute upper endoscopy cases during 2012-2014 were collected. A total of 649 patients were included with written informed consent. Data on patients' characteristics, living habits, comorbidities, drug use, endoscopy and short-term and long-term survival were collected. Of all patients admitted for endoscopy, 147/649 (23%) had PUD with the main symptom of melena. Of these PUD patients, 35% had major stigmata of bleeding (Forrest Ia-IIb) in endoscopy. Patients with major stigmata had significantly more often renal insufficiency, lower level of blood pressure with tachycardia and lower level of haemoglobin, platelets and ratio of thromboplastin time. No differences in drug use, Charlson comorbidity class, BMI, smoking or alcohol use were found. Of the PUD patients, 31% were Helicobacter pylori positive. The 30-day mortality was 0.7% (95% confidence interval: 0.01-4.7), 1-year mortality was 12.9% (8.4-19.5) and the 2-year mortality was 19.4% (13.8-26.8), with no difference according to major or minor stigmata of bleeding. Comorbidity (Charlson>1) was associated with decreased survival (P=0.029) and obesity (BMI≥30) was associated with better survival (P=0.023). PUD is still the most common cause for acute upper endoscopy with very low short-term mortality. Comorbidity, but not the stigmata of bleeding, was associated with decreased long-term survival.

  9. High definition versus standard definition white light endoscopy for detecting dysplasia in patients with Barrett's esophagus.

    Science.gov (United States)

    Sami, S S; Subramanian, V; Butt, W M; Bejkar, G; Coleman, J; Mannath, J; Ragunath, K

    2015-01-01

    High-definition endoscopy systems provide superior image resolution. The aim of this study was to assess the utility of high definition compared with standard definition endoscopy system for detecting dysplastic lesions in patients with Barrett's esophagus. A retrospective cohort study of patients with non-dysplastic Barrett's esophagus undergoing routine surveillance was performed. Data were retrieved from the central hospital electronic database. Procedures performed for non-surveillance indications, Barrett's esophagus Prague C0M1 classification with no specialized intestinal metaplasia on histology, patients diagnosed with any dysplasia or cancer on index endoscopy, and procedures using advanced imaging techniques were excluded. Logistic regression models were constructed to estimate adjusted odds ratios and 95% confidence intervals comparing outcomes with standard definition and high-definition systems. The high definition was superior to standard definition system in targeted detection of all dysplastic lesions (odds ratio 3.27, 95% confidence interval 1.27-8.40) as well as overall dysplasia detected on both random and target biopsies (odds ratio 2.36, 95% confidence interval 1.50-3.72). More non-dysplastic lesions were detected with the high-definition system (odds ratio 1.16, 95% confidence interval 1.01-1.33). There was no difference between high definition and standard definition endoscopy in the overall (random and target) high-grade dysplasia or cancers detected (odds ratio 0.93, 95% confidence interval 0.83-1.04). Trainee endoscopists, number of biopsies taken, and male sex were all significantly associated with a higher yield for dysplastic lesions. The use of the high-definition endoscopy system is associated with better targeted detection of any dysplasia during routine Barrett's esophagus surveillance. However, high-definition endoscopy cannot replace random biopsies at present time. © 2014 International Society for Diseases of the Esophagus.

  10. Risk factors for nasal bleeding in patients undergoing transnasal gastrointestinal endoscopy

    Directory of Open Access Journals (Sweden)

    Mitsuyo Mieda

    2018-05-01

    Full Text Available Transnasal endoscopy is widely used in screening for upper gastrointestinal lesions because of less associated pain. Nasal bleeding is the most severe adverse effect, but specific risk factors have not been identified. The aim of this study is to identify risk factors for nasal bleeding during transnasal endoscopy. Nasal bleeding occurred in 160/3035 (5.3% of patients undergoing transnasal endoscopy as part of health checkups. Patient data were retrospectively evaluated including anthropometric, medical, and life-style parameters with multiple logistic regression analysis. Multiple logistic regression revealed that nasal bleeding was significantly associated with age in decades [odds ratio/10 years 0.78, 95% confidence interval (CI 0.63–0.97, p = 0.027], female gender (2.15, 95% CI 1.48–3.12, p < 0.001, a history of previous upper gastrointestinal endoscopy (0.55, 95% CI 0.36–0.82, p = 0.004, and chronic/allergic rhinitis (0.60, 95% CI 0.36–0.98, p = 0.043. Other factors including the use of antiplatelet and/or anticoagulant drugs were not significantly associated with nasal bleeding. Female and young patients are significantly associated with an increased risk of bleeding from transnasal endoscopy, but antiplatelet and/or anticoagulant medications and a history of chronic/allergic rhinitis may not be associated. Keywords: Transnasal endoscopy, Nasal bleeding, Risk factors

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

    Science.gov (United States)

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

    2011-11-01

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

  12. Stochastic modeling of soil salinity

    Science.gov (United States)

    Suweis, S.; Porporato, A. M.; Daly, E.; van der Zee, S.; Maritan, A.; Rinaldo, A.

    2010-12-01

    A minimalist stochastic model of primary soil salinity is proposed, in which the rate of soil salinization is determined by the balance between dry and wet salt deposition and the intermittent leaching events caused by rainfall events. The equations for the probability density functions of salt mass and concentration are found by reducing the coupled soil moisture and salt mass balance equations to a single stochastic differential equation (generalized Langevin equation) driven by multiplicative Poisson noise. Generalized Langevin equations with multiplicative white Poisson noise pose the usual Ito (I) or Stratonovich (S) prescription dilemma. Different interpretations lead to different results and then choosing between the I and S prescriptions is crucial to describe correctly the dynamics of the model systems. We show how this choice can be determined by physical information about the timescales involved in the process. We also show that when the multiplicative noise is at most linear in the random variable one prescription can be made equivalent to the other by a suitable transformation in the jump probability distribution. We then apply these results to the generalized Langevin equation that drives the salt mass dynamics. The stationary analytical solutions for the probability density functions of salt mass and concentration provide insight on the interplay of the main soil, plant and climate parameters responsible for long term soil salinization. In particular, they show the existence of two distinct regimes, one where the mean salt mass remains nearly constant (or decreases) with increasing rainfall frequency, and another where mean salt content increases markedly with increasing rainfall frequency. As a result, relatively small reductions of rainfall in drier climates may entail dramatic shifts in longterm soil salinization trends, with significant consequences, e.g. for climate change impacts on rain fed agriculture.

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

    Science.gov (United States)

    Benoist, L B L; de Vries, N

    2015-09-01

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

  14. Diagnostic Performance of Magnifying Endoscopy for Helicobacter pylori Infection: A Meta-Analysis.

    Directory of Open Access Journals (Sweden)

    Qingqing Qi

    Full Text Available Diagnosis of Helicobacter pylori (H. pylori infection using magnifying endoscopy offers advantages over conventional invasive and noninvasive tests.This meta-analysis aimed to assess the diagnostic performance of magnifying endoscopy in the prediction of H. pylori infection.A literature search of the PubMed, Medline, EMBASE, Science Direct and the Cochrane Library databases was performed. A random-effects model was used to calculate the diagnostic efficiency of magnifying endoscopy for H. pylori infection. A summary receiver operator characteristic curve was plotted, and the area under the curve (AUC was calculated.A total of 18 studies involving 1897 patients were included. The pooled sensitivity and specificity of magnifying endoscopy to predict H. pylori infection were 0.89 [95% confidence interval (CI 0.87-0.91] and 0.82 (95%CI 0.79-0.85, respectively, with an AUC of 0.9461. When targeting the gastric antrum, the pooled sensitivity and specificity were 0.82 (95%CI 0.78-0.86 and 0.72 (95%CI 0.66-0.78, respectively. When targeting the gastric corpus, the pooled sensitivity and specificity were 0.92 (95%CI 0.90-0.94 and 0.86 (95%CI 0.82-0.88, respectively. The pooled sensitivity and specificity using magnifying white light endoscopy were 0.90 (95%CI 0.87-0.91 and 0.81 (95%CI 0.77-0.84, respectively. The pooled sensitivity and specificity using magnifying chromoendoscopy were 0.87 (95%CI 0.83-0.91 and 0.85 (95%CI 0.80-0.88, respectively. The "pit plus vascular pattern" classification in the gastric corpus observed by magnifying endoscopy was able to accurately predict the status of H. pylori infection, as indicated by a pooled sensitivity and specificity of 0.96 (95%CI 0.94-0.97 and 0.91 (95%CI 0.87-0.93, respectively, with an AUC of 0.9872.Magnifying endoscopy was able to accurately predict the status of H. pylori infection, either in magnifying white light endoscopy or magnifying chromoendoscopy mode. The "pit plus vascular pattern

  15. Comparative study of image registration techniques for bladder video-endoscopy

    Science.gov (United States)

    Ben Hamadou, Achraf; Soussen, Charles; Blondel, Walter; Daul, Christian; Wolf, Didier

    2009-07-01

    Bladder cancer is widely spread in the world. Many adequate diagnosis techniques exist. Video-endoscopy remains the standard clinical procedure for visual exploration of the bladder internal surface. However, video-endoscopy presents the limit that the imaged area for each image is about nearly 1 cm2. And, lesions are, typically, spread over several images. The aim of this contribution is to assess the performance of two mosaicing algorithms leading to the construction of panoramic maps (one unique image) of bladder walls. The quantitative comparison study is performed on a set of real endoscopic exam data and on simulated data relative to bladder phantom.

  16. Upper gastrointestinal endoscopy in patients aged 85 years or more. Results of a feasibility study in a district general hospital.

    NARCIS (Netherlands)

    Kouwen, M.C.A. van; Drenth, J.P.H.; Verhoeven, H.M.; Bos, L.P.; Engels, L.G.

    2003-01-01

    We performed a cross sectional analysis of the feasibility and yield of upper gastrointestinal endoscopy (UGE) in a cohort of patients aged 85 years or more. The study involved 218 patients who underwent diagnostic upper gastrointestinal endoscopy in a district general hospital between 1994 and

  17. [The flexible fiberoptic bronchoscopy report: medico-legal issues].

    Science.gov (United States)

    Trosini-Désert, V; Morin, J-M; Fournier, C; Similowski, T; Vergnon, J-M

    2010-09-01

    The flexible bronchoscopy report is one of the tools permitting exchange of medical information in respiratory medicine and is an integral part of the medical record. Currently, there is no consensus on its content, and consequently, there are no recommendations. A survey was carried out involving experts from the Groupe d'Endoscopie de Langue Française (GELF--Endoscopy Research Group of the French Language Society of Pneumology) and a lawyer from the legal affairs and patient's rights department of the Paris public hospital system. Thirty-four questions distributed in eight chapters were asked in an eight-part questionnaire covering: 1) general administration, 2) environmental safety, 3) medical and anatomical description of the examination, 4) tolerance/complications of the examination, 5) conclusion, 6) image and video sequence capture, 7) administrative data for archiving, 8) disposable elements used during the examination. The results showed as many areas of convergence as they did divergence, between physicians, and between physicians and lawyer. Collective consideration is required to harmonize the writing of bronchoscopy reports, to provide a tool that is not only consensual and complete, but also valid and sound from the medicolegal viewpoint. Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  18. A broadband helical saline water liquid antenna for wearable systems

    Science.gov (United States)

    Li, Gaosheng; Huang, Yi; Gao, Gui; Yang, Cheng; Lu, Zhonghao; Liu, Wei

    2018-04-01

    A broadband helical liquid antenna made of saline water is proposed. A transparent hollow support is employed to fabricate the antenna. The rotation structure is fabricated with a thin flexible tube. The saline water with a concentration of 3.5% can be injected into or be extracted out from the tube to change the quantity of the solution. Thus, the tunability of the radiation pattern could be realised by applying the fluidity of the liquid. The radiation feature of the liquid antenna is compared with that of a metal one, and fairly good agreement has been achieved. Furthermore, three statements of the radiation performance corresponding to the ratio of the diameter to the wavelength of the helical saline water antenna have been proposed. It has been found that the resonance frequency increases when the length of the feeding probe or the radius of the vertical part of the liquid decreases. The fractional bandwidth can reach over 20% with a total height of 185 mm at 1.80 GHz. The measured results indicate reasonable approximation to the simulated. The characteristics of the liquid antenna make it a good candidate for various wireless applications, especially the wearable systems.

  19. [Gastro-entero anastomosis with flexible endoscope with the help of rare-earth magnets on biosynthetic model made of the gastrointestinal tract of slaughtered pigs].

    Science.gov (United States)

    Lukovich, Péter; Jónás, Attila; Bata, Pál; Tari, Krisztina; Váradi, Gábor; Kádár, Balázs; Mehdi, Sadat Akhavi; Kupcsulik, Péter

    2007-04-01

    Gastro-entero anastomosis with flexible endoscope with the help of rare-earth magnets on biosynthetic model made of the gastrointestinal tract of slaughtered pigs Numerous malignant diseases may cause gastric outlet obstruction. The surgical gastrointestinal bypass, besides the fact that it requires narcosis, is also associated with high risks for patients with poor general condition. Endoscopic insertion of self-expandable metal stent is less invasive, but often causes complications. In the last years some studies examined a new minimal invasive technique, in which magnets are used to create gastroenteric anastomosis. A biosynthetic model was developed from combined synthetic materials with biogenic specimens taken from slaughtered domestic pigs. The procedure was performed with endoscopic and fluoroscopic guidance. To increase X-ray contrast differences the model was put into physiological saline solution. Two rare-earth magnets (Br: 2500 Gauss, D: 10 mm) with central hole were inserted with the help of a guiding wire and duodenal probe. The first magnet was placed in the first jejunal loop; the second one was placed in the stomach. The gastric magnet was maneuvered using the endoscope. When the magnets reached the right position, the guiding wires were removed to let the magnets stick together. The pressure between the magnets will result in a sterile inflammation on the living tissue which develops adhesion between the bowels, and 7-10 days later anastomosis will develop as a result of the necrosis. The biosynthetic model could be used for training endoscopy without sacrificing animals. In the end of the procedure the magnets stuck together across gastric and jejunal walls in all ten cases successfully. By practice the period necessary for the procedure could be decreased from 40 to 20 minutes. The technique could be made with standard upper endoscope and instruments, and after practice on living animals it could potentially be a useful solution for complaints

  20. Flexible Word Classes

    DEFF Research Database (Denmark)

    • First major publication on the phenomenon • Offers cross-linguistic, descriptive, and diverse theoretical approaches • Includes analysis of data from different language families and from lesser studied languages This book is the first major cross-linguistic study of 'flexible words', i.e. words...... that cannot be classified in terms of the traditional lexical categories Verb, Noun, Adjective or Adverb. Flexible words can - without special morphosyntactic marking - serve in functions for which other languages must employ members of two or more of the four traditional, 'specialised' word classes. Thus......, flexible words are underspecified for communicative functions like 'predicating' (verbal function), 'referring' (nominal function) or 'modifying' (a function typically associated with adjectives and e.g. manner adverbs). Even though linguists have been aware of flexible world classes for more than...

  1. Reversibly Bistable Flexible Electronics

    KAUST Repository

    Alfaraj, Nasir

    2015-01-01

    Introducing the notion of transformational silicon electronics has paved the way for integrating various applications with silicon-based, modern, high-performance electronic circuits that are mechanically flexible and optically semitransparent

  2. Flexibility in insulin prescription

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2016-01-01

    Full Text Available This communication explores the concept of flexibility, a propos insulin preparations and insulin regimes used in the management of type 2 diabetes. The flexibility of an insulin regime or preparation is defined as their ability to be injected at variable times, with variable injection-meal time gaps, in a dose frequency and quantum determined by shared decision making, with a minimal requirement of glucose monitoring and health professional consultation, with no compromise on safety, efficiency and tolerability. The relative flexibility of various basal, prandial and dual action insulins, as well as intensive regimes, is compared. The biopsychosocial model of health is used to assess the utility of different insulins while encouraging a philosophy of flexible insulin usage.

  3. Streaming video-based 3D reconstruction method compatible with existing monoscopic and stereoscopic endoscopy systems

    NARCIS (Netherlands)

    Bouma, H.; Mark, W. van der; Eendebak, P.T.; Landsmeer, S.; Eekeren, A.W.M. van der; Haar, F.B. ter; Wieringa, F.P.; Basten, J.P. van

    2012-01-01

    Compared to open surgery, minimal invasive surgery offers reduced trauma and faster recovery. However, lack of direct view limits space perception. Stereo-endoscopy improves depth perception, but is still restricted to the direct endoscopic field-of-view. We describe a novel technology that

  4. The Utility of Endoscopic Biopsies in Patients with Normal Upper Endoscopy

    Directory of Open Access Journals (Sweden)

    Anouar Teriaky

    2016-01-01

    Full Text Available Background and Aims. Upper endoscopy is a valuable tool in the workup of gastrointestinal (GI complaints. The purpose of this study is to determine cost and yield of taking biopsies in a normal upper GI tract. Methods. This is a retrospective study where all upper GI biopsies were identified between May 2012 and April 2013, at a tertiary care center. Clinical, procedural, and pathology reports were reviewed to identify patient demographics, procedure information, and pathology diagnosis. Results. Biopsies of the upper GI tract were taken in 1297 patients with normal upper endoscopies. In patients with normal upper endoscopy, 22% of esophageal, 44% of gastric, and 12% of duodenal biopsies were abnormal. The most frequent abnormality was reflux esophagitis in 16% of esophageal biopsies, chronic gastritis in 23% of gastric biopsies, and increased intraepithelial lymphocytes in 6% of duodenal biopsies. The additional cost for taking biopsies in a normal upper GI tract for a diagnosis of eosinophilic esophagitis was $2963 Canadian (CAD, H. pylori associated gastritis was $1404 CAD, and celiac disease was $3024 CAD. Conclusions. The yield of biopsy in normal upper endoscopy varied with location, but the additional expense can be costly and should be tailored to appropriate clinical situations.

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

    NARCIS (Netherlands)

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

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

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

    DEFF Research Database (Denmark)

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

    2014-01-01

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

  7. Prevalence of small-bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

    NARCIS (Netherlands)

    Haanstra, Jasmijn F.; Al-Toma, Abdul; Dekker, Evelien; Vanhoutvin, Steven A. L. W.; Nagengast, Fokko M.; Mathus-Vliegen, Elisabeth M.; van Leerdam, Monique E.; de Vos tot Nederveen Cappel, Wouter H.; Sanduleanu, Silvia; Veenendaal, Roeland A.; Cats, Annemieke; Vasen, Hans F. A.; Kleibeuker, Jan H.; Koornstra, Jan J.

    2015-01-01

    The aim was to determine the prevalence of small-bowel neoplasia in asymptomatic patients with Lynch syndrome (LS) by video capsule endoscopy (VCE). After obtaining informed consent, asymptomatic proven gene mutation carriers aged 35-70 years were included in this prospective multicentre study in

  8. Prevalence of small-bowel neoplasia in Lynch syndrome assessed by video capsule endoscopy

    NARCIS (Netherlands)

    Haanstra, Jasmijn F.; Al-Toma, Abdul; Dekker, Evelien; Vanhoutvin, Steven A. L. W.; Nagengast, Fokko M.; Mathus-Vliegen, Elisabeth M.; van Leerdam, Monique E.; Cappel, Wouter H. de Vos tot Nederveen; Sanduleanu, Silvia; Veenendaal, Roeland A.; Cats, Annemieke; Vasen, Hans F. A.; Kleibeuker, Jan H.; Koornstra, Jan J.

    2015-01-01

    Objective The aim was to determine the prevalence of small-bowel neoplasia in asymptomatic patients with Lynch syndrome (LS) by video capsule endoscopy (VCE). Design After obtaining informed consent, asymptomatic proven gene mutation carriers aged 3570 years were included in this prospective

  9. Use of endoscopy in diagnosis and management of patients with dysphagia in an African setting.

    Science.gov (United States)

    Mudawi, H M Y; Mahmoud, A O A; El Tahir, M A; Suliman, S H; Ibrahim, S Z

    2010-04-01

    The objectives of this study were to define the utility of esophagogastroduodenoscopy in the diagnosis and management of patients presenting with dysphagia and to determine the relative incidence of the various causes of dysphagia in Sudan. This is a prospective, cross-sectional, descriptive, hospital-based study carried out at the endoscopy unit of Soba University Hospital, Khartoum, Sudan. All patients complaining of dysphagia underwent upper gastrointestinal endoscopy with therapeutic intervention when necessary. A total of 114 patients were enrolled in the study, with a mean age of 47 years SD +/- 19 and a male to female ratio of 1 : 1.04. A benign condition was diagnosed in 56% of the cases; this included esophageal strictures in 21% of the cases and achalasia in 14%. Malignant causes were mainly due to esophageal cancer (40.4%) and cancer of the stomach cardia (3.5%). Therapeutic intervention was attempted in 83% of the cases. Risk factors predictive of a malignant etiology were age over 40 years (P dysphagia lasting between 1 month and 1 year (P endoscopy in our African setting is an accurate and useful investigation in the diagnosis and management of patients presenting with dysphagia. Patients over the age of 40 years presenting with dysphagia and weight loss are more likely to have a neoplastic disease and should be referred for urgent endoscopy.

  10. Capsule endoscopy for the detection of oesophageal mucosal disorders: a comparison of two different ingestion protocols

    NARCIS (Netherlands)

    de Jonge, Pieter J. F.; van Eijck, Brechje C.; Geldof, Han; Bekkering, Frank C.; Essink-Bot, Marie-Louise; Polinder, Suzanne; Kuipers, Ernst J.; Siersema, Peter D.

    2008-01-01

    OBJECTIVE: To assess the accuracy of a new ingestion protocol for capsule endoscopy (CE) in evaluating patients with gastro-oesophageal reflux disease (GORD). METHODS: Oesophago-gastroduodenoscopy (OGD) was performed 1 week prior to CE. The first 28 subjects swallowed the capsule following the

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

    DEFF Research Database (Denmark)

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

    2017-01-01

    Capsule endoscopy (CE) has revolutionized the diagnosis and monitoring of small bowel Crohn’s disease (CD). the procedure is patient friendly and noninvasive, and compared to cross-sectional imaging, CE allows a direct and detailed evaluation of the entire small bowel mucosa witha high sensitivit...

  12. Endoscopy and autopsy follow-up of biodegradable oesophageal anastomoses in dogs.

    Science.gov (United States)

    Kovács, T; Németh, T; Orosz, Z; Köves, I

    2001-01-01

    The biofragmentable Anastomosis Ring (BAR) is a mechanical device composed of absorbable material and creates an inverting, atraumatic compressive anastomosis with no foreign material at the anastomotic site after healing. The aim of the present experimental study was to assess the safety of oesophagoscopy in early days after oesophageal anastomoses performed with the BAR and to follow-up the healing of BAR anastomoses by in vivo endoscopy and autopsy examination. Thirty mongrel dogs divided into subgroups according to the time-points of endoscopy and autopsy (4th, 7th, 14th, 28th day) were used. There was no significant difference in the healing of anastomoses performed under or above the tracheal bifurcation. Pleural adhesions helped to cover and seal small subclinical leaks. The mortality was 13.3% (4 dogs) and the overall leakage rate 14.3%. We looked for bleeding, haematoma, erosion, ulceration and granulation tissue in the anastomosis. Due to the high mechanical strength of these anastomoses, oesophagoscopy was a safe, easy and feasible method for follow-up BAR intrathoracic anastomoses, with no significant difference between the number of lesions found with endoscopy as compared to the autopsy data. The overall sensitivity of oesophagoscopy to discover mucosal lesions was 73.1%. Endoscopy had no complications, therefore it is a useful method of follow-up and may help predict the normal or compromised healing of oesophageal anastomoses.

  13. [Endoscopy-assisted sialolithectomy for the calculus of the Stensen's duct].

    Science.gov (United States)

    Ye, Xin; Xie, Xiaoyan; Liu, Denggao; Zhang, Lei; Zhang, Zuyan; Yu, Guangyan

    2014-11-01

    To investigate the clinical effects of endoscopy-assisted sialolithectomy for the calculus in the Stensen's duct. From August 2005 to July 2013, 67 consecutive patients with calculus (or foreign bodies) in the Stensen's duct underwent explorative and interventional endoscopy in our hospital. The stones (or foreign bodies) were removed by endoscopy-assisted technique. After operation, the patients were followed-up periodically, and treatment effects were analyzed. Among the 67 patients, the stones (or foreign bodies) were completely removed in 58 cases, and almost completely removed in 3 cases, with a success rate of 87% (58/67). Among the 61 stone-removed cases, treatment options included direct removal with aid of basket or forceps (24 cases), basket entrapment and opening-up of the ostium (21 cases), basket entrapment and mucosal incision near the ostium (8 cases), open removal via buccal incision (2 cases) and open removal via pre-auricular flap (6 cases). During the 6-90 months' follow-up of the 61 cases, 48 cases were asymptomatic, 7 had mild symptoms, 3 developed ductal obturation, 1 had numbness in the parotid region, and the remaining 2 were missed. Endoscopy-assisted sialolithectomy is a safe and effective gland-preservation technique for the patients with parotid gland calculus.

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

    NARCIS (Netherlands)

    Sommen, van der F.; Zinger, S.; Schoon, E.J.; With, de P.H.N.

    2013-01-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The recent development of High-Definition (HD) endoscopy has enabled the specialist physician to identify cancer at an early stage. Nevertheless, it still requires considerable effort and training to be able to recognize

  15. "Leopard skin sign": the use of narrow-band imaging with magnification endoscopy in celiac disease.

    Science.gov (United States)

    Tchekmedyian, Asadur J; Coronel, Emmanuel; Czul, Frank

    2014-01-01

    Celiac Disease (CD) is an immune reaction to gluten containing foods such as rye, wheat and barley. This condition affects individuals with a genetic predisposition; it targets the small bowel and may cause symptoms including diarrhea, malabsorption, weight loss, abdominal pain and bloating. The diagnosis is made by serologic testing of celiac-specific antibodies and confirmed by histology. Certain endoscopic characteristics, such as scalloping, reduction in the number of folds, mosaic-pattern mucosa or nodular mucosa, are suggestive of CD and can be visualized under white light endoscopy. Due to its low sensitivity, endoscopy alone is not recommended to diagnose CD; however, enhanced visual identification of suspected mucosal abnormalities through the use of new technologies, such as narrow band imaging with magnification (NBI-ME), could assist in targeting biopsies and thereby increasing the sensitivity of endoscopy. This is a case series of seven patients with serologic and histologic diagnoses of CD who underwent upper endoscopies with NBI-ME imaging technology as part of their CD evaluation. By employing this imaging technology, we could identify patchy atrophy sites in a mosaic pattern, with flattened villi and alteration of the central capillaries of the duodenal mucosa. We refer to this epithelial pattern as "Leopard Skin Sign". Since epithelial lesions are easily seen using NBI-ME, we found it beneficial for identifying and targeting biopsy sites. Larger prospective studies are warranted to confirm our findings.

  16. Impact of operator fatigue on endoscopy performance: implications for procedure scheduling.

    LENUS (Irish Health Repository)

    Harewood, Gavin C

    2009-08-01

    With increasing volumes of endoscopic procedures, endoscopists\\' workload has had to increase to meet this escalating demand. The aim of this study was to characterize the impact of endoscopist fatigue on quality of endoscopy performance by comparing outcomes based on chronological procedure order.

  17. Additional Value of Upper GI Tract Endoscopy in the Diagnostic Assessment of Childhood IBD

    NARCIS (Netherlands)

    Hummel, Thalia Z.; ten Kate, Fiebo J. W.; Reitsma, Johannes B.; Benninga, Marc A.; Kindermann, Angelika

    2012-01-01

    Objectives: For the choice of treatment in children with inflammatory bowel disease (IBD), it is important to make a distinction between Crohn disease (CD) and ulcerative colitis (UC). To look for pathognomonic features of CD, upper gastrointestinal tract (UGT) endoscopy has become part of the

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

    Directory of Open Access Journals (Sweden)

    Hiroyuki Miyatani

    2009-04-01

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

  19. Evaluation and comparison of textural feature representation for the detection of early stage cancer in endoscopy

    NARCIS (Netherlands)

    Setio, A.A.A.; Sommen, van der F.; Zinger, S.; Schoon, E.J.; With, de P.H.N.

    2013-01-01

    Esophageal cancer is the fastest rising type of cancer in the Western world. The novel technology of High Definition (HD) endoscopy enables physicians to find texture patterns related to early cancer. It encourages the development of a Computer-Aided Decision (CAD) system in order to help physicians

  20. Bupivacaine Lozenge Compared with Lidocaine Spray as Topical Pharyngeal Anesthetic before Unsedated Upper Gastrointestinal Endoscopy

    DEFF Research Database (Denmark)

    Salale, Nesrin; Treldal, Charlotte; Mogensen, Stine

    2014-01-01

    Unsedated upper gastrointestinal endoscopy (UGE) can induce patient discomfort, mainly due to a strong gag reflex. The aim was to assess the effect of a bupivacaine lozenge as topical pharyngeal anesthetic compared with standard treatment with a lidocaine spray before UGE. Ninety-nine adult...... with a lidocaine spray proved to be a superior option as topical pharyngeal anesthetic before an UGE....

  1. An upper gastrointestinal ulcer still bleeding after endoscopy : what comes next?

    NARCIS (Netherlands)

    Craenen, E. M. E.; Hofker, Hendrik; Peters, Frans; Kater, G. M.; Glatman, K. R.; Zijlstra, J. G.

    Introduction: Recurrent bleeding from an upper gastrointestinal ulcer when endoscopy fails is a reason for radiological or surgical treatment, both of which have their advantages and disadvantages. Case: Based on a patient with recurrent gastrointestinal bleeding, we reviewed the available evidence

  2. Endoscopic findings in patients presenting with dysphagia: analysis of a national endoscopy database.

    Science.gov (United States)

    Krishnamurthy, Chaya; Hilden, Kristen; Peterson, Kathryn A; Mattek, Nora; Adler, Douglas G; Fang, John C

    2012-03-01

    Dysphagia is a common problem and an indication for upper endoscopy. There is no data on the frequency of the different endoscopic findings and whether they change according to demographics or by single versus repeat endoscopy. To determine the prevalence of endoscopic findings in patients with dysphagia and whether findings differ in regard to age, gender, ethnicity, and repeat procedure. This was a retrospective study using a national endoscopic database (CORI). A total of 30,377 patients underwent esophagogastroduodenoscopy (EGD) for dysphagia of which 4,202 patients were repeat endoscopies. Overall frequency of endoscopic findings was determined by gender, age, ethnicity, and single vs. repeat procedures. Esophageal stricture was the most common finding followed by normal, esophagitis/ulcer (EU), Schatzki ring (SR), esophageal food impaction (EFI), and suspected malignancy. Males were more likely to undergo repeat endoscopies and more likely to have stricture, EU, EFI, and suspected malignancy (P = 0.001). Patients 60 years or older had a higher prevalence of stricture, EU, SR, and suspected malignancy (P findings differs significantly by gender, age, and repeat procedure. The most common findings in descending order were stricture, normal, EU, SR, EFI, and suspected malignancy. For patients undergoing a repeat procedure, normal and EU were less common and all other abnormal findings were significantly more common.

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

    Directory of Open Access Journals (Sweden)

    I. Xinias

    2012-10-01

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

  4. Outcomes of Propofol Sedation During Emergency Endoscopy Performed for Upper Gastrointestinal Bleeding.

    Science.gov (United States)

    Park, Chan Hyuk; Han, Dong Soo; Jeong, Jae Yoon; Eun, Chang Soo; Yoo, Kyo-Sang; Jeon, Yong Cheol; Sohn, Joo Hyun

    2016-03-01

    Although propofol-based sedation can be used during emergency endoscopy for upper gastrointestinal bleeding (UGIB), there is a potential risk of sedation-related adverse events, especially in patients with variceal bleeding. We compared adverse events related to propofol-based sedation during emergency endoscopy between patients with non-variceal and variceal bleeding. Clinical records of patients who underwent emergency endoscopy for UGIB under sedation were reviewed. Adverse events, including shock, hypoxia, and paradoxical reaction, were compared between the non-variceal and variceal bleeding groups. Of 703 endoscopies, 539 and 164 were performed for non-variceal and variceal bleeding, respectively. Shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding (12.2 vs. 3.5%, P bleeding (non-variceal bleeding vs. variceal bleeding: hypoxia, 3.5 vs. 1.8%, P = 0.275; paradoxical reaction interfering with the procedure, 4.1 vs. 5.5%, P = 0.442). Although shock was more common in patients with variceal bleeding compared to those with non-variceal bleeding, most cases could be controlled without procedure interruption. Paradoxical reaction, rather than shock or hypoxia, was the most common cause of procedure interruption in patients with variceal bleeding, but the rate did not differ between patients with non-variceal and variceal bleeding.

  5. Historical analysis of experience with small bowel capsule endoscopy in a spanish tertiary hospital.

    Science.gov (United States)

    Egea Valenzuela, Juan; Carrilero Zaragoza, Gabriel; Iglesias Jorquera, Elena; Tomás Pujante, Paula; Alberca de Las Parras, Fernando; Carballo Álvarez, Fernando

    2017-02-01

    Capsule endoscopy was approved by the FDA in 2001. Gastrointestinal bleeding and inflammatory bowel disease are the main indications. It has been available in our hospital since 2004. We retrospectively analysed data from patients who underwent small bowel capsule endoscopy in our hospital from October 2004 to April 2015. Indications were divided into: Obscure gastrointestinal bleeding (occult and overt), inflammatory bowel disease, and other indications. Findings were divided into: Vascular lesions, inflammatory lesions, other lesions, normal studies, and inconclusive studies. A total of 1027 out of 1291 small bowel studies were included. Mean patient age was 56.45 years; 471 were men and 556 women. The most common lesion observed was angiectasia, as an isolated finding or associated with other lesions. Findings were significant in up to 80% of studies when the indication was gastrointestinal bleeding, but in only 50% of studies in inflammatory bowel disease. Diagnostic yield was low in the group «other indications». No major complications were reported. Small bowel capsule endoscopy has high diagnostic yield in patients with gastrointestinal bleeding, but yield is lower in patients with inflammatory bowel disease. Our experience shows that capsule endoscopy is a safe and useful tool for the diagnosis of small bowel disease. The diagnostic yield of the technique in inflammatory bowel disease must be improved. Copyright © 2016 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  6. Disparities in Receipt of FOBT versus Endoscopy among Filipino American Immigrants

    Science.gov (United States)

    Maxwell, Annette E.; Danao, Leda L.; Crespi, Catherine M.; Antonio, Cynthia; Garcia, Gabriel M.; Bastani, Roshan

    2009-01-01

    Background This report examines disparities associated with the type of colorectal screening test, fecal occult blood test (FOBT) versus endoscopy, within a particular racial/ethnic group, Filipino American immigrants. Methods Between July 2005 and October 2006, Filipino Americans age 50-75 from 31 community organizations in Los Angeles completed a 15-minute survey in English (65%) or Filipino (35%). Results Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer (CRC) screening. Among the 230 subjects who had ever received a routine screening test, 78 had FOBT only (16% of the total sample) and 152 had endoscopy with or without FOBT (31% of the total sample). After controlling for access to care and key demographic variables in a multivariate analysis, only two characteristics distinguished between respondents who had FOBT only versus those who had endoscopy: acculturation, assessed by percent lifetime in the U.S. and language of interview, and income. Conclusions Our data suggest a two tier system, FOBT for less acculturated Filipino Americans with lower income versus endoscopy for Filipino immigrants with higher levels of acculturation and income. The disparity persists after adjusting for access to care. Instead of treating minority groups as monolithic, differences within groups need to be examined so that interventions can be appropriately targeted. PMID:18708385

  7. Disparities in the receipt of fecal occult blood test versus endoscopy among Filipino American immigrants.

    Science.gov (United States)

    Maxwell, Annette E; Danao, Leda L; Crespi, Catherine M; Antonio, Cynthia; Garcia, Gabriel M; Bastani, Roshan

    2008-08-01

    This report examines disparities associated with the type of colorectal screening test, fecal occult blood test versus endoscopy, within a particular racial/ethnic group, Filipino American immigrants. Between July 2005 and October 2006, Filipino Americans aged 50 to 75 years from 31 community organizations in Los Angeles completed a 15-minute survey in English (65%) or Filipino (35%). Of the 487 respondents included in this analysis, 257 (53%) had never received any type of colorectal cancer screening. Among the 230 subjects who had ever received a routine screening test, 78 had fecal occult blood test only (16% of the total sample), and 152 had endoscopy with or without fecal occult blood test (31% of the total sample). After controlling for access to care and key demographic variables in a multivariate analysis, only two characteristics distinguished between respondents who had fecal occult blood test only versus those who had endoscopy: acculturation, assessed by percent lifetime in the United States and language of interview, and income. Our data suggest a two-tier system, fecal occult blood test for less acculturated Filipino Americans with lower income versus endoscopy for Filipino immigrants with higher levels of acculturation and income. The disparity persists after adjusting for access to care. Instead of treating minority groups as monolithic, differences within groups need to be examined so that interventions can be appropriately targeted.

  8. Capsule Endoscopy in the Investigation of Patients with Portal Hypertension and Anemia

    Directory of Open Access Journals (Sweden)

    Spyros Goulas

    2008-01-01

    Full Text Available INTRODUCTION: Data on small bowel abnormalities in patients with portal hypertension (PHT are limited. Bleeding from the gastrointestinal tract and anemia are common complications in these patients. Capsule endoscopy (CE was used to evaluate small bowel (SB pathology in patients with PHT and anemia, and possible associations with various parameters were examined.

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

    Science.gov (United States)

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

    2016-03-01

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

  10. Pulse oximetry and supplemental oxygen during gastrointestinal endoscopy: a critical review

    DEFF Research Database (Denmark)

    Holm, C; Rosenberg, J

    1996-01-01

    A high proportion of the mortality and morbidity associated with endoscopic procedures may be of cardiopulmonary origin. For this reason, the appropriate degree of monitoring and prophylactic measures to be used in the sedated patient undergoing endoscopy has become a topic of discussion during r...

  11. Flexible displays, rigid designs?

    DEFF Research Database (Denmark)

    Hornbæk, Kasper

    2015-01-01

    Rapid technological progress has enabled a wide range of flexible displays for computing devices, but the user experience--which we're only beginning to understand--will be the key driver for successful designs.......Rapid technological progress has enabled a wide range of flexible displays for computing devices, but the user experience--which we're only beginning to understand--will be the key driver for successful designs....

  12. Therapeutic Endoscopy for the Control of Nonvariceal Upper Gastrointestinal Bleeding in Children: A Case Series.

    Science.gov (United States)

    Banc-Husu, Anna M; Ahmad, Nuzhat A; Chandrasekhara, Vinay; Ginsberg, Gregory G; Jaffe, David L; Kochman, Michael L; Rajala, Michael W; Mamula, Petar

    2017-04-01

    Gastrointestinal bleeding is one of the most common indications for urgent endoscopy in the pediatric setting. The majority of these procedures are performed for control of variceal bleeding, with few performed for nonvariceal upper gastrointestinal (NVUGI) bleeding. The data on therapeutic endoscopy for NVUGI are sparse. The aims of our study were to review our experience with NVUGI bleeding, describe technical aspects and outcomes of therapeutic endoscopy, and determine gastroenterology fellows' training opportunities according to the national training guidelines. We performed a retrospective review of endoscopy database (Endoworks, Olympus Inc, Center Valley, PA) from January 2009 to December 2014. The search used the following keywords: bleeding, hematemesis, melena, injection, epinephrine, cautery, clip, and argon plasma coagulation. The collected data included demographics, description of bleeding lesion and medical/endoscopic therapy, rate of rebleeding, relevant laboratories, physical examination, and need for transfusion and surgery. The study was approved by the institutional review board. During the study period 12,737 upper endoscopies (esophagogastroduodenoscopies) were performed. A total of 15 patients underwent 17 esophagogastroduodenoscopies that required therapeutic intervention to control bleeding (1:750 procedures). The mean ± standard deviation (median) age of patients who required endoscopic intervention was 11.6 ± 6.0 years (14.0 years). Seven out of 17 patients received dual therapy to control the bleeding lesions. All but 3 patients received medical therapy with intravenous proton pump inhibitor, and 3 received octreotide infusions. Six of the patients experienced rebleeding (40%), with 4 out of 6 initially only receiving single modality therapy. Two of these patients eventually required surgical intervention to control bleeding and both patients presented with bleeding duodenal ulcers. There were no cases of aspiration

  13. Virtual reality simulation training for health professions trainees in gastrointestinal endoscopy.

    Science.gov (United States)

    Walsh, Catharine M; Sherlock, Mary E; Ling, Simon C; Carnahan, Heather

    2012-06-13

    Traditionally, training in gastrointestinal endoscopy has been based upon an apprenticeship model, with novice endoscopists learning basic skills under the supervision of experienced preceptors in the clinical setting. Over the last two decades, however, the growing awareness of the need for patient safety has brought the issue of simulation-based training to the forefront. While the use of simulation-based training may have important educational and societal advantages, the effectiveness of virtual reality gastrointestinal endoscopy simulators has yet to be clearly demonstrated. To determine whether virtual reality simulation training can supplement and/or replace early conventional endoscopy training (apprenticeship model) in diagnostic oesophagogastroduodenoscopy, colonoscopy and/or sigmoidoscopy for health professions trainees with limited or no prior endoscopic experience. Health professions, educational and computer databases were searched until November 2011 including The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Scopus, Web of Science, Biosis Previews, CINAHL, Allied and Complementary Medicine Database, ERIC, Education Full Text, CBCA Education, Career and Technical Education @ Scholars Portal, Education Abstracts @ Scholars Portal, Expanded Academic ASAP @ Scholars Portal, ACM Digital Library, IEEE Xplore, Abstracts in New Technologies and Engineering and Computer & Information Systems Abstracts. The grey literature until November 2011 was also searched. Randomised and quasi-randomised clinical trials comparing virtual reality endoscopy (oesophagogastroduodenoscopy, colonoscopy and sigmoidoscopy) simulation training versus any other method of endoscopy training including conventional patient-based training, in-job training, training using another form of endoscopy simulation (e.g. low-fidelity simulator), or no training (however defined by authors) were included.  Trials comparing one method of virtual reality training versus

  14. Detection of Mucosal Recurrent Nasopharyngeal Carcinomas After Radiotherapy With Narrow-Band Imaging Endoscopy

    International Nuclear Information System (INIS)

    Wang, Wen-Hung; Lin, Yen-Chun; Chen, Wen-Cheng; Chen, Miao-Fen; Chen, Chih-Cheng; Lee, Kam-Fai

    2012-01-01

    Purpose: This study evaluated the feasibility of screening mucosal recurrent nasopharyngeal carcinoma with narrow-band imaging (NBI) endoscopy. Methods and Materials: One hundred and six patients were enrolled. All patients underwent conventional white-light (WL) endoscopic examination of the nasopharynx followed by NBI endoscopy. Biopsies were performed if recurrence was suspected. Results: We identified 32 suspected lesions by endoscopy in WL and/or NBI mode. Scattered brown spots (BS) were identified in 22 patients, and 4 of the 22 who had negative MRI findings were histopathologically confirmed to be neoplasias that were successfully removed via endoscopy. A comparison of the visualization in NBI closer view corresponded to histopathological findings in 22 BS, and the prevalence rates of neoplasias in tail signs, round signs, and irregularities signs were 0% (0/6), 0% (0/7), and 44.4% (4/9), respectively (p = 0.048). The sensitivity, specificity, and diagnostic capability were 37.5%, 92.9% and 0.652 for WL, 87.5%, 74.5% and 0.810 for NBI, and 87.5%, 87.8%, and 0.876 for NBI closer view, respectively. NBI closer view was effective in increasing specificity compared with NBI alone (87.8% vs. 74.5%, p < 0.05), and in increasing sensitivity and diagnostic capability compared to WL alone (87.5% vs. 37.5%, p < 0.05; 0.876 vs. 0.652, p = 0.0001). Conclusions: Although NBI in endoscopy can improve sensitivity of mucosal recurrent nasopharyngeal neoplasias, false-positive (nonneoplasia BS) results may be obtained in areas with nonspecific inflammatory changes due to postradiation effects. NBI closer view not only can offer a timely, convenient, and highly reliable assessment of mucosal recurrent nasopharyngeal carcinoma, it can also make endoscopic removal possible.

  15. Endoscopic non-technical skills team training: the next step in quality assurance of endoscopy training.

    Science.gov (United States)

    Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

    2014-12-14

    To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day's training utilising real clinical examples. Pre and post-course evaluation comprised participants' patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams' knowledge and safety attitudes.

  16. The effect of virtual endoscopy simulator training on novices: a systematic review.

    Directory of Open Access Journals (Sweden)

    Weiguang Qiao

    Full Text Available BACKGROUND: Advances in virtual endoscopy simulators have paralleled an interest in medical simulation for gastrointestinal endoscopy training. OBJECTIVE: The primary objective was to determine whether the virtual endoscopy simulator training could improve the performance of novices. DESIGN: A systematic review. SETTING: Randomized controlled trials (RCTs that compared virtual endoscopy simulator training with bedside teaching or any other intervention for novices were collected. PATIENTS: Novice endoscopists. INTERVENTIONS: The PRISMA statement was followed during the course of the research. The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and ScienceDirect were searched (up to July 2013. Data extraction and assessment were independently performed. MAIN OUTCOME MEASUREMENTS: Independent procedure completion, total procedure time and required assistance. RESULTS: Fifteen studies (n = 354 were eligible for inclusion: 9 studies designed for colonoscopy training, 6 for gastroscopy training. For gastroscopy training, procedure completed independently was reported in 87.7% of participants in simulator training group compared to 70.0% of participants in control group (1 study; 22 participants; RR 1.25; 95% CI 1.13-1.39; P<0.0001. For colonoscopy training, procedure completed independently was reported in 89.3% of participants in simulator training group compared to 88.9% of participants in control group (7 study; 163 participants; RR 1.10; 95% CI 0.88-1.37; P = 0.41; I(2 = 85%. LIMITATIONS: The included studies are quite in-homogeneous with respect to training schedule and procedure. CONCLUSIONS: Virtual endoscopy simulator training might be effective for gastroscopy, but so far no data is available to support this for colonoscopy.

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

    Science.gov (United States)

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

    2017-06-01

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

  18. Endoscopic non-technical skills team training: The next step in quality assurance of endoscopy training

    Science.gov (United States)

    Matharoo, Manmeet; Haycock, Adam; Sevdalis, Nick; Thomas-Gibson, Siwan

    2014-01-01

    AIM: To investigate whether novel, non-technical skills training for Bowel Cancer Screening (BCS) endoscopy teams enhanced patient safety knowledge and attitudes. METHODS: A novel endoscopy team training intervention for BCS teams was developed and evaluated as a pre-post intervention study. Four multi-disciplinary BCS teams constituting BCS endoscopist(s), specialist screening practitioners, endoscopy nurses and administrative staff (A) from English BCS training centres participated. No patients were involved in this study. Expert multidisciplinary faculty delivered a single day’s training utilising real clinical examples. Pre and post-course evaluation comprised participants’ patient safety awareness, attitudes, and knowledge. Global course evaluations were also collected. RESULTS: Twenty-three participants attended and their patient safety knowledge improved significantly from 43%-55% (P ≤ 0.001) following the training intervention. 12/41 (29%) of the safety attitudes items significantly improved in the areas of perceived patient safety knowledge and awareness. The remaining safety attitude items: perceived influence on patient safety, attitudes towards error management, error management actions and personal views following an error were unchanged following training. Both qualitative and quantitative global course evaluations were positive: 21/23 (91%) participants strongly agreed/agreed that they were satisfied with the course. Qualitative evaluation included mandating such training for endoscopy teams outside BCS and incorporating team training within wider endoscopy training. Limitations of the study include no measure of increased patient safety in clinical practice following training. CONCLUSION: A novel comprehensive training package addressing patient safety, non-technical skills and adverse event analysis was successful in improving multi-disciplinary teams’ knowledge and safety attitudes. PMID:25516665

  19. Expanding Role of Third Space Endoscopy in the Management of Esophageal Diseases.

    Science.gov (United States)

    Yang, Dennis; Draganov, Peter V

    2018-03-01

    OPINION STATEMENT: "Third space" endoscopy, also commonly referred as submucosal endoscopy, is founded on the principle that the deeper layers of the gastrointestinal (GI) tract can be accessed by tunneling in the submucosal space without compromising the integrity of the overlying mucosa. Peroral endoscopic myotomy (POEM), endoscopic submucosal dissection (ESD), and submucosal tunneling endoscopic resection (STER) are innovative techniques within the field of third space endoscopy in the management of esophageal disorders. POEM has become an accepted minimally invasive therapy for achalasia and related motility disorders with excellent short-term results, with early studies yielding similar efficacy to surgical myotomy and increased durability when compared to pneumatic balloon dilation (PBD). Data are needed to establish long-term outcomes with POEM, with particular interest on the incidence of gastroesophageal reflux, which appears to be higher than initially anticipated. ESD, a mature endoscopic resection technique in Asia, has recently gained traction in the West as a viable option for the management of early Barrett's esophagus (BE) neoplasia. Compared to standard endoscopic mucosal resection (EMR), ESD allows the en bloc resection of lesions irrespective of size, which may facilitate histological interpretation and reduce recurrence rates. Large prospective randomized controlled trials are needed to validate the efficacy and safety of this technique and to further define its role in the endoscopic armamentarium in early BE neoplasia. STER is an attractive technique that theoretically permits the resection of subepithelial esophageal tumors (SETs) arising from the deeper GI layers. Initial studies from highly experienced endoscopic centers support its technical feasibility and safety, although these results should be interpreted with caution due to variability arising from small numbers and heterogeneity among studies. Overall, third space endoscopy is an

  20. Efficacy and safety of flumazenil injection for the reversal of midazolam sedation after elective outpatient endoscopy.

    Science.gov (United States)

    Lee, Sang Pyo; Sung, In-Kyung; Kim, Jeong Hwan; Lee, Sun-Young; Park, Hyung Seok; Shim, Chan Sup

    2018-02-01

    Midazolam sedation during elective endoscopy is widely performed and flumazenil is frequently administered after endoscopy to reverse sedation in clinical practice. This study aimed to investigate the safety and efficacy of flumazenil injections after elective endoscopy under midazolam sedation. Participants who underwent an upper endoscopy under midazolam sedation were randomly divided into two groups. In group I, flumazenil was administered i.v. 10 min after the patient's transfer to the recovery room, and no antidote was injected in group II. The time of stay in the recovery room and adverse events were reviewed through the nursing records. We asked the patients about their pain and degree of satisfaction according to a visual analogue scale (VAS), their memory of the procedure, mental status and the presence of uncomfortable symptoms on the day of the procedure and the day afterwards. The length of stay in recovery was significantly shorter in group I than in group II. No significant differences were found in the number of patients with pain (VAS ≥1), adverse events and discomfort between the two groups. Additionally, there were no differences in the patients' memory of the procedure, satisfaction with sedation, willingness to repeat the endoscopy and mental status. The time in the recovery room after flumazenil administration was significantly shortened, and the use of the drug did not increase the risk of adverse events or discomfort. The use of flumazenil for reversing midazolam sedation seems to be safe and effective. © 2018 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  1. Miniaturized Fourier-plane fiber scanner for OCT endoscopy

    International Nuclear Information System (INIS)

    Vilches, Sergio; Kretschmer, Simon; Ataman, Çağlar; Zappe, Hans

    2017-01-01

    A forward-looking endoscopic optical coherence tomography (OCT) probe featuring a Fourier-plane fiber scanner is designed, manufactured and characterized. In contrast to common image-plane fiber scanners, the Fourier-plane scanner is a telecentric arrangement that eliminates vignetting and spatial resolution variations across the image plane. To scan the OCT beam in a spiral pattern, a tubular piezoelectric actuator is used to resonate an optical fiber bearing a collimating GRIN lens at its tip. The free-end of the GRIN lens sits at the back focal plane of an objective lens, such that its rotation replicates the beam angles in the collimated region of a classical telecentric 4f optical system. Such an optical arrangement inherently has a low numerical aperture combined with a relatively large field-of-view, rendering it particularly useful for endoscopic OCT imaging. Furthermore, the optical train of the Fourier-plane scanner is shorter than that of a comparable image-plane scanner by one focal length of the objective lens, significantly shortening the final arrangement. As a result, enclosed within a 3D printed housing of 2.5 mm outer diameter and 15 mm total length, the developed probe is the most compact forward-looking endoscopic OCT imager to date. Due to its compact form factor and compatibility with real-time OCT imaging, the developed probe is also ideal for use in the working channel of flexible endoscopes as a potential optical biopsy tool. (paper)

  2. Miniaturized Fourier-plane fiber scanner for OCT endoscopy

    Science.gov (United States)

    Vilches, Sergio; Kretschmer, Simon; Ataman, Çağlar; Zappe, Hans

    2017-10-01

    A forward-looking endoscopic optical coherence tomography (OCT) probe featuring a Fourier-plane fiber scanner is designed, manufactured and characterized. In contrast to common image-plane fiber scanners, the Fourier-plane scanner is a telecentric arrangement that eliminates vignetting and spatial resolution variations across the image plane. To scan the OCT beam in a spiral pattern, a tubular piezoelectric actuator is used to resonate an optical fiber bearing a collimating GRIN lens at its tip. The free-end of the GRIN lens sits at the back focal plane of an objective lens, such that its rotation replicates the beam angles in the collimated region of a classical telecentric 4f optical system. Such an optical arrangement inherently has a low numerical aperture combined with a relatively large field-of-view, rendering it particularly useful for endoscopic OCT imaging. Furthermore, the optical train of the Fourier-plane scanner is shorter than that of a comparable image-plane scanner by one focal length of the objective lens, significantly shortening the final arrangement. As a result, enclosed within a 3D printed housing of 2.5 mm outer diameter and 15 mm total length, the developed probe is the most compact forward-looking endoscopic OCT imager to date. Due to its compact form factor and compatibility with real-time OCT imaging, the developed probe is also ideal for use in the working channel of flexible endoscopes as a potential optical biopsy tool.

  3. Fiber-integrated Brillouin microspectroscopy: Towards Brillouin endoscopy

    Directory of Open Access Journals (Sweden)

    Irina V. Kabakova

    2017-11-01

    Full Text Available Brillouin imaging (BI for micromechanical characterization of tissues and biomaterials is a fast-developing field of research with a strong potential for medical diagnosis of disease-modified tissues and cells. Although the principles of BI imply its compatibility with in vivo and in situ measurements, the integration of BI with a flexible catheter, capable of reaching the region of interest within the body, is yet to be reported. Here, for the first time, we experimentally investigate integration of the Brillouin spectroscope with standard optical fiber components to achieve a Brillouin endoscope. The performance of single-fiber and dual-fiber endoscopes are demonstrated and analyzed. We show that a major challenge in construction of Brillouin endoscopes is the strong backward Brillouin scattering in the optical fiber and we present a dual-fiber geometry as a possible solution. Measurements of Brillouin spectra in test liquids (water, ethanol and glycerol are demonstrated using the dual-fiber endoscope and its performance is analyzed numerically with the help of a beam propagation model.

  4. Estuarine turbidity, flushing, salinity, and circulation

    Science.gov (United States)

    Pritchard, D. W.

    1972-01-01

    The effects of estuarine turbidity, flushing, salinity, and circulation on the ecology of the Chesapeake Bay are discussed. The sources of fresh water, the variations in salinity, and the circulation patterns created by temperature and salinity changes are analyzed. The application of remote sensors for long term observation of water temperatures is described. The sources of sediment and the biological effects resulting from increased sediments and siltation are identified.

  5. ( Phaseolus vulgaris L. ) seedlings to salinity stress

    African Journals Online (AJOL)

    The effect of salinity stress on five cultivars of common bean: Bassbeer, Beladi, Giza 3, HRS 516 and RO21 were evaluated on a sand/peat medium with different salinity levels (0, 50 and 100 mM NaCl) applied 3 weeks after germination for duration of 10 days. Salinity had adverse effects not only on the biomass yield and ...

  6. A global algorithm for estimating Absolute Salinity

    Directory of Open Access Journals (Sweden)

    T. J. McDougall

    2012-12-01

    Full Text Available The International Thermodynamic Equation of Seawater – 2010 has defined the thermodynamic properties of seawater in terms of a new salinity variable, Absolute Salinity, which takes into account the spatial variation of the composition of seawater. Absolute Salinity more accurately reflects the effects of the dissolved material in seawater on the thermodynamic properties (particularly density than does Practical Salinity.

    When a seawater sample has standard composition (i.e. the ratios of the constituents of sea salt are the same as those of surface water of the North Atlantic, Practical Salinity can be used to accurately evaluate the thermodynamic properties of seawater. When seawater is not of standard composition, Practical Salinity alone is not sufficient and the Absolute Salinity Anomaly needs to be estimated; this anomaly is as large as 0.025 g kg−1 in the northernmost North Pacific. Here we provide an algorithm for estimating Absolute Salinity Anomaly for any location (x, y, p in the world ocean.

    To develop this algorithm, we used the Absolute Salinity Anomaly that is found by comparing the density calculated from Practical Salinity to the density measured in the laboratory. These estimates of Absolute Salinity Anomaly however are limited to the number of available observations (namely 811. In order to provide a practical method that can be used at any location in the world ocean, we take advantage of approximate relationships between Absolute Salinity Anomaly and silicate concentrations (which are available globally.

  7. An evaluation of in-office flexible fiber-optic biopsies for laryngopharyngeal lesions.

    Science.gov (United States)

    Lee, Francisco; Smith, Kristine A; Chandarana, Shamir; Matthews, T Wayne; Bosch, J Douglas; Nakoneshny, Steven C; Dort, Joseph C

    2018-05-09

    Operative endoscopy and flexible fiber-optic in-office tissue biopsy are common techniques to assess suspicious laryngopharyngeal lesions. The primary outcome was the delay to the initiation of treatment. Secondary outcomes were delay to biopsy, histopathological diagnosis, and assessment at a multidisciplinary oncology clinic. A retrospective analysis was performed to assess the relative delays between these approaches to biopsy of laryngopharyngeal lesions. There were 114 patients in the study cohort; 44 in-office and 70 operative endoscopic biopsies). The mean delay from consultation to biopsy was 17.4 days for the operative endoscopy group and 1.3 days for the in-office group. The mean delay from initial otolaryngology consultation to initiation of treatment was 51.7 days and 44.6 days for the operative endoscopy and in-office groups, respectively. In-office biopsy reduced the time from initial consultation to biopsy. The temporal gains via in-office biopsy did not translate into faster access to treatment. This outcome highlights the opportunity to improve access to treatment for patients with early diagnosis.

  8. Salinity Temperature and Roughness Remote Scanner (STARRS)

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Provides spatially continuous high-resolution surface salinity imagery in a synoptic manner from small aircraft. Its output complements data collected from...

  9. Flexible transparent electrode

    Science.gov (United States)

    Demiryont, Hulya; Shannon, Kenneth C., III; Moorehead, David; Bratcher, Matthew

    2011-06-01

    This paper presents the properties of the EclipseTECTM transparent conductor. EclipseTECTM is a room temperature deposited nanostructured thin film coating system comprised of metal-oxide semiconductor elements. The system possesses metal-like conductivity and glass-like transparency in the visible region. These highly conductive TEC films exhibit high shielding efficiency (35dB at 1 to 100GHz). EclipseTECTM can be deposited on rigid or flexible substrates. For example, EclipseTECTM deposited on polyethylene terephthalate (PET) is extremely flexible that can be rolled around a 9mm diameter cylinder with little or no reduction in electrical conductivity and that can assume pre-extension states after an applied stress is relieved. The TEC is colorless and has been tailored to have high visible transmittance which matches the eye sensitivity curve and allows the viewing of true background colors through the coating. EclipseTECTM is flexible, durable and can be tailored at the interface for applications such as electron- or hole-injecting OLED electrodes as well as electrodes in flexible displays. Tunable work function and optical design flexibility also make EclipseTECTM well-suited as a candidate for grid electrode replacement in next-generation photovoltaic cells.

  10. Flexible magnetoimpedance sensor

    International Nuclear Information System (INIS)

    Li, Bodong; Kavaldzhiev, Mincho N.; Kosel, Jürgen

    2015-01-01

    Flexible magnetoimpedance (MI) sensors fabricated using a NiFe/Cu/NiFe tri-layer on Kapton substrate have been studied. A customized flexible microstrip transmission line was employed to investigate the MI sensors's magnetic field and frequency responses and their dependence on the sensors's deflection. For the first time, the impedance characteristic is obtained through reflection coefficient analysis over a wide range of frequencies from 0.1 MHz to 3 GHz and for deflections ranging from zero curvature to a radius of 7.2 cm. The sensor element maintains a high MI ratio of up to 90% and magnetic sensitivity of up to 9.2%/Oe over different bending curvatures. The relationship between the curvature and material composition is discussed based on the magnetostriction effect and stress simulations. The sensor's large frequency range, simple fabrication process and high sensitivity provide a great potential for flexible electronics and wireless applications. - Highlights: • A flexible magnetoimpedance (MI) sensor is developed. • Studies are carried out using a flexible microstrip transmission line. • An MI ratio of up to 90% is obtained. • The effect of magnetostriction is studied

  11. Education for Flexible Personality

    Directory of Open Access Journals (Sweden)

    Bogomir Novak

    1998-12-01

    Full Text Available Flexible personality transforms both cultural environment and itself. Post-modern personality is both contemplative and active. On one hand, it is subject to inner imagination of a creative act, and on the other hand, to creation of a tangible product What is more, flexible personality is also autonomous, mature, healthy and well balanced, as well as stable and responsive to the demand for change. Due to ever quicker changes, flexible personality is a must. And it is a task. The impact of professional work of adults on the education of children, however, is being conditioned by the exrigid family and rigid enterprises or institutions in which adults are employed. Nevertheless, flexible educational style is not repressive, as it used to be, nor permissive and totally concentrated on the child. It is a choice between the two qualities. The educators' style is dependent on their attitude towards life (play and self-education and not only towards work. Nowadays, flexibility is a way towards quality management of social and personal changes.

  12. Flexible Foam Model.

    Energy Technology Data Exchange (ETDEWEB)

    Neilsen, Michael K.; Lu, Wei-Yang; Werner, Brian T.; Scherzinger, William M.; Lo, Chi S.

    2018-03-01

    Experiments were performed to characterize the mechanical response of a 15 pcf flexible polyurethane foam to large deformation at different strain rates and temperatures. Results from these experiments indicated that at room temperature, flexible polyurethane foams exhibit significant nonlinear elastic deformation and nearly return to their original undeformed shape when unloaded. However, when these foams are cooled to temperatures below their glass transition temperature of approximately -35 o C, they behave like rigid polyurethane foams and exhibit significant permanent deformation when compressed. Thus, a new model which captures this dramatic change in behavior with temperature was developed and implemented into SIERRA with the name Flex_Foam to describe the mechanical response of both flexible and rigid foams to large deformation at a variety of temperatures and strain rates. This report includes a description of recent experiments. Next, development of the Flex Foam model for flexible polyurethane and other flexible foams is described. Selection of material parameters are discussed and finite element simulations with the new Flex Foam model are compared with experimental results to show behavior that can be captured with this new model.

  13. European Society of Gastrointestinal Endoscopy (ESGE): recommendations (2009) on clinical use of video capsule endoscopy to investigate small-bowel, esophageal and colonic diseases.

    Science.gov (United States)

    Ladas, S D; Triantafyllou, K; Spada, C; Riccioni, M E; Rey, J-F; Niv, Y; Delvaux, M; de Franchis, R; Costamagna, G

    2010-03-01

    These recommendations on video capsule endoscopy, an emerging technology with an impact on the practice of endoscopy, were developed by the European Society of Gastrointestinal Endoscopy (ESGE) Guidelines Committee. The first draft of each section was prepared by one or two members of the writing team, who were selected as experts on the content of that section on the basis of their published work. They used evidence-based methodology, performing MEDLINE and PubMed literature searches to identify relevant clinical studies. Abstracts from scientific meetings were included only if there was no published full paper on a particular topic. If there was disagreement, the first author of the Guideline made the final decision. Recommendations were graded according to the strength of the supporting evidence. The draft guideline was critically reviewed by all authors and submitted to the ESGE councillors for their critical review before approval of the final document. The ESGE Guidelines Committee acknowledges that this document is based on a critical review of the data available at the time of preparation and that further studies may be needed to clarify some aspects. Moreover, this Guideline may be revised as necessary to account for changes in technology, new data, or other aspects of clinical practice. This document should be regarded as supplying recommendations only to gastroenterologists in providing care to their patients. It is not a set of rules and should not be construed as establishing a legal standard of care, or as encouraging, advocating, requiring, or discouraging any particular treatment. These recommendations must be interpreted according to the clinician's knowledge, expertise, and clinical judgment in the management of individual patients and, if necessary, a course of action that varies from recommendations must be undertaken. Georg Thieme Verlag KG Stuttgart. New York.

  14. Natural flexible dermal armor.

    Science.gov (United States)

    Yang, Wen; Chen, Irene H; Gludovatz, Bernd; Zimmermann, Elizabeth A; Ritchie, Robert O; Meyers, Marc A

    2013-01-04

    Fish, reptiles, and mammals can possess flexible dermal armor for protection. Here we seek to find the means by which Nature derives its protection by examining the scales from several fish (Atractosteus spatula, Arapaima gigas, Polypterus senegalus, Morone saxatilis, Cyprinius carpio), and osteoderms from armadillos, alligators, and leatherback turtles. Dermal armor has clearly been developed by convergent evolution in these different species. In general, it has a hierarchical structure with collagen fibers joining more rigid units (scales or osteoderms), thereby increasing flexibility without significantly sacrificing strength, in contrast to rigid monolithic mineral composites. These dermal structures are also multifunctional, with hydrodynamic drag (in fish), coloration for camouflage or intraspecies recognition, temperature and fluid regulation being other important functions. The understanding of such flexible dermal armor is important as it may provide a basis for new synthetic, yet bioinspired, armor materials. Copyright © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Flexible magnetoimpedance sensor

    KAUST Repository

    Li, Bodong

    2015-03-01

    Flexible magnetoimpedance (MI) sensors fabricated using a NiFe/Cu/NiFe tri-layer on Kapton substrate have been studied. A customized flexible microstrip transmission line was employed to investigate the MI sensors\\'s magnetic field and frequency responses and their dependence on the sensors\\'s deflection. For the first time, the impedance characteristic is obtained through reflection coefficient analysis over a wide range of frequencies from 0.1 MHz to 3 GHz and for deflections ranging from zero curvature to a radius of 7.2 cm. The sensor element maintains a high MI ratio of up to 90% and magnetic sensitivity of up to 9.2%/Oe over different bending curvatures. The relationship between the curvature and material composition is discussed based on the magnetostriction effect and stress simulations. The sensor\\'s large frequency range, simple fabrication process and high sensitivity provide a great potential for flexible electronics and wireless applications.

  16. Salinity tolerance loci revealed in rice using high-throughput non-invasive phenotyping

    KAUST Repository

    Al-Tamimi, Nadia Ali; Brien, Chris; Oakey, Helena; Berger, Bettina; Saade, Stephanie; Ho, Yung Shwen; Schmö ckel, Sandra M.; Tester, Mark A.; Negrã o, Só nia

    2016-01-01

    High-throughput phenotyping produces multiple measurements over time, which require new methods of analyses that are flexible in their quantification of plant growth and transpiration, yet are computationally economic. Here we develop such analyses and apply this to a rice population genotyped with a 700k SNP high-density array. Two rice diversity panels, indica and aus, containing a total of 553 genotypes, are phenotyped in waterlogged conditions. Using cubic smoothing splines to estimate plant growth and transpiration, we identify four time intervals that characterize the early responses of rice to salinity. Relative growth rate, transpiration rate and transpiration use efficiency (TUE) are analysed using a new association model that takes into account the interaction between treatment (control and salt) and genetic marker. This model allows the identification of previously undetected loci affecting TUE on chromosome 11, providing insights into the early responses of rice to salinity, in particular into the effects of salinity on plant growth and transpiration.

  17. Salinity tolerance loci revealed in rice using high-throughput non-invasive phenotyping

    KAUST Repository

    Al-Tamimi, Nadia Ali

    2016-11-17

    High-throughput phenotyping produces multiple measurements over time, which require new methods of analyses that are flexible in their quantification of plant growth and transpiration, yet are computationally economic. Here we develop such analyses and apply this to a rice population genotyped with a 700k SNP high-density array. Two rice diversity panels, indica and aus, containing a total of 553 genotypes, are phenotyped in waterlogged conditions. Using cubic smoothing splines to estimate plant growth and transpiration, we identify four time intervals that characterize the early responses of rice to salinity. Relative growth rate, transpiration rate and transpiration use efficiency (TUE) are analysed using a new association model that takes into account the interaction between treatment (control and salt) and genetic marker. This model allows the identification of previously undetected loci affecting TUE on chromosome 11, providing insights into the early responses of rice to salinity, in particular into the effects of salinity on plant growth and transpiration.

  18. Role of endoscopy in evaluating upper gastrointestinal tract lesions in rural population

    Directory of Open Access Journals (Sweden)

    Sharanabasavaraj Javali

    2015-01-01

    Full Text Available Background and Objectives: Before the advent of endoscopy direct access to the lesion for the confirmation of the diagnosis was difficult, this posed difficulty in contemplating adequate and appropriate surgery. Endoscopy as a diagnostic and therapeutic tool has grown in recent years. Upper gastrointestinal (GI endoscopy is one of the most fascinating branch which serves not only as a means of resolving or amplifying the diagnosis made clinically or by X-ray, but also a primary diagnostic procedure for conditions not otherwise diagnosable on unoperated case. Fiber optic upper GI endoscopy has already become firmly established as a reliable, quick and inexpensive tool. This study was done to detect the upper gastrointestinal lesions in rural population of Kolar District, the distribution pattern of various upper GI lesions in patients presenting with upper GI symptoms and to follow the endoscopic diagnosis for medical and surgical management. Materials and Methods: The study group includes patients reporting to outpatient department and also the inpatients in wards of General Surgery and other departments, who have upper GI symptoms, were advised endoscopy at R. L. JALAPPA Hospital and Research Centre, Kolar, from a period of December 2011 to August 2013. Results: Of the 600 cases, 370 were males, and 230 were females. Disease incidence was highest in 51-70 years age group, that is, 21.6%. Pain abdomen was the most common symptom. Epigastric tenderness was the most common sign among the patients clinically. Reflux esophagitis and diffuse gastritis formed most common cases (307 cases. The incidence of duodenitis - 7.83%, peptic ulcer -3.3%, esophageal varices - 1.5%, the incidence of carcinoma esophagus and carcinoma stomach was approximately same that is, 4.5% and 4.6% respectively. The incidence of esophageal candidiasis was 4.16%. The majority of the patients had a normal study that is, 14.5%. Conclusion: Upper GI lesions were more common in

  19. Capsule Endoscopy in the Assessment of Obscure Gastrointestinal Bleeding: An Evidence-Based Analysis

    Science.gov (United States)

    2015-01-01

    Background Obscure gastrointestinal bleeding (OGIB) is defined as persistent or recurrent bleeding associated with negative findings on upper and lower gastrointestinal (GI) endoscopic evaluations. The diagnosis and management of patients with OGIB is particularly challenging because of the length and complex loops of the small intestine. Capsule endoscopy (CE) is 1 diagnostic modality that is used to determine the etiology of bleeding. Objectives The objective of this analysis was to review the diagnostic accuracy, safety, and impact on health outcomes of CE in patients with OGIB in comparison with other diagnostic modalities. Data Sources A literature search was performed using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid Embase, the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published between 2007 and 2013. Review Methods Data on diagnostic accuracy, safety, and impact on health outcomes were abstracted from included studies. Quality of evidence was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results The search yielded 1,189 citations, and 24 studies were included. Eight studies reported diagnostic accuracy comparing CE with other diagnostic modalities. Capsule endoscopy has a higher sensitivity and lower specificity than magnetic resonance enteroclysis, computed tomography, and push enteroscopy. Capsule endoscopy has a good safety profile with few adverse events, although comparative safety data with other diagnostic modalities are limited. Capsule endoscopy is associated with no difference in patient health-related outcomes such as rebleeding or follow-up treatment compared with push enteroscopy, small-bowel follow-through, and angiography. Limitations There was significant heterogeneity in estimates of diagnostic accuracy, which prohibited a statistical summary of findings. The analysis was also limited by the fact that there is no

  20. Software industrial flexible

    OpenAIRE

    Díaz Araya, Daniel; Muñoz, Leandro; Sirerol, Daniel; Oviedo, Sandra; Ibáñez, Francisco S.

    2012-01-01

    En este trabajo se pretende investigar y proponer técnicas, métodos y tecnologías que permitan el desarrollo de software flexible en ambientes industriales. El objetivo es generar métodos y técnicas para facilitar el desarrollo de software flexible en ambientes industriales. Las áreas de investigación son los sistemas de scheduling de producción, la generación de software para plataformas de hardware abiertas y la innovación.

  1. Production Flexibility and Hedging

    Directory of Open Access Journals (Sweden)

    Georges Dionne

    2015-12-01

    Full Text Available We extend the analysis on hedging with price and output uncertainty by endogenizing the output decision. Specifically, we consider the joint determination of output and hedging in the case of flexibility in production. We show that the risk-averse firm always maintains a short position in the futures market when the futures price is actuarially fair. Moreover, in the context of an example, we show that the presence of production flexibility reduces the incentive to hedge for all risk averse agents.

  2. The flexibility of flexicurity

    DEFF Research Database (Denmark)

    Jensen, Carsten Strøby

    2011-01-01

    by a special relation between flexibility, social security and active labour market policy, where a high level of social security is seen as a precondition for a labour market characterized by flexibility. In this article it is argued that the Danish labour market is characterized by having not just one model...... of flexicurity, but two. These two models cover different parts of the labour market and different segments of employees. The first model (the blue-collar flexicurity model) – the one that is often focused on in the literature – covers primarily skilled and unskilled workers on the labour market. The second...

  3. Saline water irrigation of quinoa and chickpea

    DEFF Research Database (Denmark)

    Hirich, A.; Jelloul, A.; Choukr-Allah, R.

    2014-01-01

    A pot experiment was conducted in the south of Morocco to evaluate the response of chickpea and quinoa to different irrigation water salinity treatments (1, 4, 7 and 10 dS m-1 for chickpea and 1, 10, 20 and 30 dS m-1 for quinoa). Increasing salinity affected significantly (P

  4. Decline of the world's saline lakes

    Science.gov (United States)

    Wayne A. Wurtsbaugh; Craig Miller; Sarah E. Null; R. Justin DeRose; Peter Wilcock; Maura Hahnenberger; Frank Howe; Johnnie Moore

    2017-01-01

    Many of the world’s saline lakes are shrinking at alarming rates, reducing waterbird habitat and economic benefits while threatening human health. Saline lakes are long-term basin-wide integrators of climatic conditions that shrink and grow with natural climatic variation. In contrast, water withdrawals for human use exert a sustained reduction in lake inflows and...

  5. Estimation of salinity power potential in India

    Digital Repository Service at National Institute of Oceanography (India)

    Das, V.K.; RamaRaju, D.V.

    Salinity gradient as a source of energy has much potential, but this has been recognized only recently. The energy density of this source is equivalent to about 250 m water head for a salinity difference of 35 ppt. This source exists...

  6. Investigations in Marine Chemistry: Salinity II.

    Science.gov (United States)

    Schlenker, Richard M.

    Presented is a science activity in which the student investigates methods of calibration of a simple conductivity meter via a hands-on inquiry technique. Conductivity is mathematically compared to salinity using a point slope formula and graphical techniques. Sample solutions of unknown salinity are provided so that the students can sharpen their…

  7. Flexibility as a service

    NARCIS (Netherlands)

    Aalst, van der W.M.P.; Adams, M.; Hofstede, ter A.H.M.; Pesic, M.; Schonenberg, H.; Chen, L.; Liu, C.; Liu, Q.; Deng, K.

    2009-01-01

    The lack of flexibility is often seen as an inhibitor for the successful application of workflow technology. Many researchers have proposed different ways of addressing this problem and some of these ideas have been implemented in commercial systems. However, a "one size fits all" approach is likely

  8. Valuing Flexibility. Phase 2

    Science.gov (United States)

    2012-10-29

    Quarterly (2): 38-49. Cormier, P., Olewnik, A., and Lewis, K. 2008. An Approach to Quantifying Design Flexibility for Mass Customization in Early...C. Clarkson, P., and Zanker, W. 2004. Change and customisation in complex engineering domains, Res Eng Des 15(1), 1–21. Ekstrom, M. and Bjornsson, H

  9. Flexible Query Answering Systems

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the 12th International Conference on Flexible Query Answering Systems, FQAS 2017, held in London, UK, in June 2017. The 21 full papers presented in this book together with 4 short papers were carefully reviewed and selected from 43 submissions...

  10. Flexible metal bellows

    CERN Multimedia

    CERN PhotoLab

    1975-01-01

    A set of flexible metal bellows being fatigue-tested by repeated offset motion. Such bellows assemblies were used in the SPS vacuum system at places where , for instance, beam stoppers and collimators had to be moved frequently in and out of the beam path.

  11. Flexible energy systems

    DEFF Research Database (Denmark)

    Lund, Henrik

    2003-01-01

    The paper discusses and analyses diffent national strategies and points out key changes in the energy system in order to achieve a system which can benefit from a high percentage of wind and CHP without having surplus production problems, introduced here as a flexible energy system....

  12. A flexible WLAN receiver

    NARCIS (Netherlands)

    Schiphorst, Roelof; Hoeksema, F.W.; Slump, Cornelis H.

    2003-01-01

    Flexible radio receivers are also called Software Defined Radios (SDRs) [1], [2]. The focus of our SDR project [3] is on designing the front end, from antenna to demodulation in bits, of a °exible, multi-standard WLAN receiver. We try to combine an instance of a (G)FSK receiver (Bluetooth) with an

  13. Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

    International Nuclear Information System (INIS)

    Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

    2004-01-01

    The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC 50 values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC 50 obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC 50 ). This LC 50 value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC 50 . For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC 50 and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC 50 of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC 50 values. In contrast, LC 50 determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature

  14. Do laboratory salinity tolerances of freshwater animals correspond with their field salinity?

    Energy Technology Data Exchange (ETDEWEB)

    Kefford, Ben J.; Papas, Phil J.; Metzeling, Leon; Nugegoda, Dayanthi

    2004-06-01

    The degree to which laboratory derived measures of salinity tolerance reflect the field distributions of freshwater biota is uncertain. In this paper we compare laboratory-derived acute salinity tolerance (LC{sub 50} values) of freshwater macroinvertebrates (range 5.5-76 mS/cm) and fish (range 2.7-82 mS/cm) from southeastern Australia with the salinity from which they have been collected in the field. Only 4% of the macroinvertebrates were collected at salinity levels substantially higher than their 72-h LC{sub 50} obtained from directly transferring animals from low salinity water to the water they were tested (direct transfer LC{sub 50}). This LC{sub 50} value was correlated with the maximum salinity at which a species had been collected. For common macroinvertebrates, the maximum field salinity was approximated by the direct transfer 72-h LC{sub 50}. For adult freshwater fish, 21% of species were collected at salinities substantially greater than their acute direct transfer LC{sub 50} and there was a weak relationship between these two variables. Although there was a weak correlation between the direct transfer LC{sub 50} of early life stages of freshwater fish and the maximum field salinity, 58% of the field distribution were in higher than their LC{sub 50} values. In contrast, LC{sub 50} determined from experiments that acclimated adult fish to higher salinity (slow acclimation) provided a better indication of the field distribution: with only one fish species (7%) being in conflict with their maximum field salinity and a strong positive relationship between these variables. This study shows that laboratory measures of acute salinity tolerance can reflect the maximum salinity that macroinvertebrate and fish species inhabit and are consistent with some anecdotal observations from other studies. - Acute laboratory salinity tolerances relate to maximum salinity where organisms occur in nature.

  15. Testicular biopsy in psittacine birds (Psittaciformes): impact of endoscopy and biopsy on health, testicular morphology, and sperm parameters.

    Science.gov (United States)

    Hänse, Maria; Krautwald-Junghanns, Maria-Elisabeth; Reitemeier, Susanne; Einspanier, Almuth; Schmidt, Volker

    2013-12-01

    Histologic examination of a testicular biopsy sample may be required to evaluate the reproductive status of male psittacine birds. The purpose of this study was to evaluate the viability of testicular sampling from live birds by assessing the impact on the birds' health, testicular integrity, and sperm quality. Testicular biopsy samples were obtained by endoscopy 4 times during 12 months from 9 cockatiels (Nymphicus hollandicus) and 7 rose-ringed parakeets (Psittacula krameri). Only 2 of 16 birds showed testicular cicatrization or divided testicular tissue after a single endoscopy. Further complications, such as damage to the air sacs or bleeding, predominantly occurred in subsequent endoscopies. In both species, endoscopy and testicular biopsy caused only minor or transient effects on sperm production and sperm quality. These results support that a single testicular biopsy is a viable method for evaluating the reproductive status of male psittacine birds.

  16. Streaming video-based 3D reconstruction method compatible with existing monoscopic and stereoscopic endoscopy systems

    Science.gov (United States)

    Bouma, Henri; van der Mark, Wannes; Eendebak, Pieter T.; Landsmeer, Sander H.; van Eekeren, Adam W. M.; ter Haar, Frank B.; Wieringa, F. Pieter; van Basten, Jean-Paul

    2012-06-01

    Compared to open surgery, minimal invasive surgery offers reduced trauma and faster recovery. However, lack of direct view limits space perception. Stereo-endoscopy improves depth perception, but is still restricted to the direct endoscopic field-of-view. We describe a novel technology that reconstructs 3D-panoramas from endoscopic video streams providing a much wider cumulative overview. The method is compatible with any endoscope. We demonstrate that it is possible to generate photorealistic 3D-environments from mono- and stereoscopic endoscopy. The resulting 3D-reconstructions can be directly applied in simulators and e-learning. Extended to real-time processing, the method looks promising for telesurgery or other remote vision-guided tasks.

  17. Planned second look endoscopy in patients with bleeding duodenal or gastric ulcers

    DEFF Research Database (Denmark)

    Trap, R; Skarbye, M; Rosenberg, J

    2000-01-01

    1998. Planned second look endoscopy and repeated sclerotherapy were standard care. The effects were evaluated by comparing the expected number of rebleeders with actual rebleeders. At the same time we assessed predicting factors for rebleeding. RESULTS: Fifteen of the admitted seventy patients were...... found to rebleed after initial sclerotherapy. The overall success rate of endoscopic therapy was 63/70 patients (90%). Six patients (9%) had to undergo surgery to obtain haemostasis, and one patient died suddenly after the second endoscopic sclerotherapy. Perforation was seen in two patients (3...... of the present study suggests a beneficial effect on rebleeding rate of patients treated with planned second look endoscopy. Future controlled trails should verify this hypothesis....

  18. A primary intestinal lymphangiectasia patient diagnosed by capsule endoscopy and confirmed at surgery: a case report.

    Science.gov (United States)

    Fang, You-Hong; Zhang, Bing-Ling; Wu, Jia-Guo; Chen, Chun-Xiao

    2007-04-21

    Intestinal lymphangiectasia (IL) is a rare disease characterized by dilated lymphatic vessles in the intestinal wall and small bowel mesentery which induce loss of protein and lymphocytes into bowel lumen. Because it most often occurs in the intestine and cannot be detected by upper gastroendoscopy or colonoscopy, and the value of common image examinations such as X-ray and computerized tomography (CT) are limited, the diagnosis of IL is difficult, usually needing the help of surgery. Capsule endoscopy is useful in diagnosing intestinal diseases, such as IL. We here report a case of IL in a female patient who was admitted for the complaint of recurrent edema accompanied with diarrhea and abdominal pain over the last twenty years, and aggravated ten days ago. She was diagnosed by M2A capsule endoscopy as a primary IL and confirmed by surgical and pathological examination.

  19. An asymmetric resonant coupling wireless power transmission link for Micro-Ball Endoscopy.

    Science.gov (United States)

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

    2010-01-01

    This paper investigates the design and optimization of a wireless power transmission link targeting Micro-Ball Endoscopy applications. A novel asymmetric resonant coupling structure is proposed to deliver power to an endoscopic Micro-Ball system for image read-out after it is excreted. Such a technology enables many key medical applications with stringent requirements for small system volume and high power delivery efficiency. A prototyping power transmission sub-system of the Micro-Ball system was implemented. It consists of primary coil, middle resonant coil, and cube-like full-direction secondary receiving coils. Our experimental results proved that 200mW of power can be successfully delivered. Such a wireless power transmission capability could satisfy the requirements of the Micro-Ball based endoscopy application. The transmission efficiency is in the range of 41% (worst working condition) to 53% (best working condition). Comparing to conventional structures, Asymmetric Resonant Coupling Structure improves power efficiency by 13%.

  20. Role of Endoscopy in Diagnosis and Management of Pediatric Eosinophilic Esophagitis.

    Science.gov (United States)

    Muir, Amanda B; Merves, Jamie; Liacouras, Chris A

    2016-01-01

    Eosinophilic esophagitis (EoE) is a chronic allergic (immune-mediated) disease that leads to esophageal dysfunction and feeding disorders in children. Foods, and possibly environmental triggers, cause an inflammatory response in the esophagus, leading to esophageal inflammation, eosinophilic infiltration, and esophageal dysmotility, which may progress to dysphagia, food impaction, and esophageal stricture. Endoscopy with biopsy and histologic evaluation is currently the only method to diagnose EoE. Once diagnosed with EoE, children undergo follow-up endoscopy after therapy initiation and adjustments to ensure remission. Furthermore, children with food impactions or strictures may require endoscopic intervention such as foreign body removal and/or esophageal dilation. Copyright © 2016 Elsevier Inc. All rights reserved.

  1. Frequency of peptic ulcer disease in patients of dyspepsia an analysis of upper gastrointestinal endoscopy

    International Nuclear Information System (INIS)

    Anwar, S.O.; Ambreen, S.; Ashraf, H.M.

    2010-01-01

    To evaluate the frequency of peptic ulcer disease in patients of dyspepsia on upper gastrointestinal endoscopy. A convenient non probability sampling was done and one hundred patients were selected from out patient department presenting within six months of dyspeptic symptoms. They were all subjected to upper gastrointestinal endoscopy Of all patients 61% (n=61) were males and 39% (n=39) were females with age ranging between 20 - 45 years. Study revealed functional dyspepsia (76%), duodenal ulcer (11%), gastric ulcer (4%) and esophagitis including gastoesophageal reflux disease (9%). This showed an overall frequency of peptic ulcer disease to be 15% in the studied population.Conclusion: Peptic ulcer disease is a common structural cause of dyspepsia and was responsible for 15% of dyspepsia. (author)

  2. Half-unit weighted bilinear algorithm for image contrast enhancement in capsule endoscopy

    Science.gov (United States)

    Rukundo, Olivier

    2018-04-01

    This paper proposes a novel enhancement method based exclusively on the bilinear interpolation algorithm for capsule endoscopy images. The proposed method does not convert the original RBG image components to HSV or any other color space or model; instead, it processes directly RGB components. In each component, a group of four adjacent pixels and half-unit weight in the bilinear weighting function are used to calculate the average pixel value, identical for each pixel in that particular group. After calculations, groups of identical pixels are overlapped successively in horizontal and vertical directions to achieve a preliminary-enhanced image. The final-enhanced image is achieved by halving the sum of the original and preliminary-enhanced image pixels. Quantitative and qualitative experiments were conducted focusing on pairwise comparisons between original and enhanced images. Final-enhanced images have generally the best diagnostic quality and gave more details about the visibility of vessels and structures in capsule endoscopy images.

  3. The role of capnography in endoscopy patients undergoing nurse-administered propofol sedation

    DEFF Research Database (Denmark)

    Slagelse, Charlotte; Vilmann, Peter; Hornslet, Pernille

    2013-01-01

    . The existing literature on capnography for endoscopy patients sedated with nurse-administered propofol sedation (NAPS) is limited. Can the addition of capnography to standard monitoring during endoscopy with NAPS reduce the number, duration, and level of hypoxia. Materials and methods. This study...... capnography, were included in the analysis. The number and total duration of hypoxia was reduced by 39.3% and 21.1% in the intervention group compared to the control group (p > 0.05). No differences in actions taken against insufficient respiration were found. Changes in end-tidal carbon dioxide (R = 0.177, p......-value 0.05). Capnography is able to detect insufficient respiration that may lead to hypoxia prior to changes in pulse oximetry. However, due to a limited clinical benefit and additional costs associated with capnography, we do not find capnography necessary during the use of NAPS....

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

    International Nuclear Information System (INIS)

    Soyer, Philippe

    2012-01-01

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

  5. Prevalence and predictors of columnar lined esophagus in gastroesophageal reflux disease (GERD) patients undergoing upper endoscopy.

    Science.gov (United States)

    Balasubramanian, Gokulakrishnan; Singh, Mandeep; Gupta, Neil; Gaddam, Srinivas; Giacchino, Maria; Wani, Sachin B; Moloney, Brian; Higbee, April D; Rastogi, Amit; Bansal, Ajay; Sharma, Prateek

    2012-11-01

    Chronic gastroesophageal reflux disease (GERD) is a risk factor for Barrett's esophagus (BE), the most important surrogate marker for the development of esophageal adenocarcinoma (EAC). The need to document the presence of intestinal metaplasia in esophageal biopsies from a columnar lined esophagus (CLE) to diagnose BE is debated. The objective of this study was to prospectively evaluate the prevalence and risk factors of CLE in a large cohort of GERD patients undergoing upper endoscopy. Consecutive patients presenting to the endoscopy unit at a tertiary referral center for their index upper endoscopy for evaluation of GERD symptoms were enrolled in this prospective cohort study. Patients were asked to complete a validated GERD questionnaire that documents the onset of GERD symptoms (heartburn and acid regurgitation) and grades the frequency and severity of symptoms experienced over the past year. Demographic information, body mass index, and use of aspirin/nonsteroidal antiinflammatory drugs were recorded. Endoscopic details including length of CLE, presence and size of hiatal hernia were noted. Patients with CLE (cases) were compared with those without CLE (controls) using Fischer's exact test and t-test. All factors that were statistically significant (PGERD symptoms were prospectively enrolled. On index endoscopy, the prevalence of CLE was 23.3%, whereas of CLE with documented intestinal metaplasia was 14.1%. On univariate analysis, male gender, Caucasian race, heartburn duration of >5 years, presence and size of hiatal hernia were significantly associated with the presence of CLE compared with controls (P5 years (odds ratio (OR): 1.50, 95% confidence interval (CI): 1.07-2.09, P=0.01), Caucasian race (OR: 2.40, 95% CI: 1.42-4.03, P=0.001), and hiatal hernia (OR: 2.07, 95% CI: 1.50-2.87, PGERD patients are diagnosed with this lesion. Enrolling all these patients in surveillance programs would have significant ramifications on health-care resources.

  6. Lidocaine lozenges for pharyngeal anesthesia during upper gastrointestinal endoscopy: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Avinash Supe

    2014-01-01

    Full Text Available Background and Objectives: A novel lozenge formulation with advantages of ease of drug administration, palatable taste and improved patient compliance could be the preferred mode of topical pharyngeal anesthesia during upper gastrointestinal endoscopy (UGE. This randomized, open-label, active-controlled study was conducted to evaluate the efficacy and safety of lidocaine lozenges versus lidocaine spray in the diagnostic gastroduodenal endoscopy in Indian patients. Subjects and Methods: Two hundred and forty-seven patients of either sex (18-80 years undergoing diagnostic gastroduodenal endoscopy were randomized either to; lidocaine lozenge 200 mg or lidocaine spray 200 mg to be applied as a single dose before gastroduodenal endoscopy. Ease of procedure, level of gag reflex, ease of application of the local anesthetic, and investigators global assessment were the primary efficacy endpoints. Need for rescue medication and patient′s global assessment were secondary efficacy endpoints. The incidence of any adverse event was the safety endpoint. Between groups, comparison was done by using appropriate statistical test. Results: Investigator reported significantly lesser procedural difficulty (P = 0.0007 and suppressed gag reflex (P < 0.0001 during UGE with lidocaine lozenge compared to spray. Ease of application of local anesthetic was reported easy in significantly more patients as compared with lidocaine spray (P = 0.001. Global assessment by patient and physician was favorable toward lozenge. Incidences of adverse events were similar in both the groups. Conclusions: The study suggests that lidocaine lozenges are an easier way of applying local oropharyngeal anesthesia, produces better suppression of gag reflex and makes the procedure easier when compared with lidocaine spray.

  7. Are Histrionic Personality Traits Associated with Irritability during Conscious Sedation Endoscopy?

    OpenAIRE

    Lee, Sang Shin; Kim, Hyung Hun; Park, Hyo Jung

    2015-01-01

    Aim. We aimed to evaluate whether histrionic personality traits are associated with irritability during conscious sedation endoscopy (CSE). Materials and Methods. A prospective cross-sectional study was planned. Irritability during CSE was classified into five grades: 0, no response; I, minimal movement; II, moderate movement; III, severe movement; IV, fighting against procedure. Patients in grades III and IV were defined as the irritable group. Participants were required to complete question...

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

    Science.gov (United States)

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

    2015-01-01

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

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

    International Nuclear Information System (INIS)

    Song, Sang Gook; Seo, Jeong Jin; Chung, Tae Woong; Kim, Hyeong Kil; Jeong, Gwang Woo; Jeong, Yong Yeon; Kang, Heoung Keun; Cho, Jae Sik

    2000-01-01

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

  10. Provocative Endoscopy to Identify Bleeding Site in Upper Gastrointestinal Bleeding: A Novel Approach in Transarterial Embolization.

    Science.gov (United States)

    Kamo, Minobu; Fuwa, Sokun; Fukuda, Katsuyuki; Fujita, Yoshiyuki; Kurihara, Yasuyuki

    2016-07-01

    This report describes a novel approach to endoscopically induce bleeding by removing a clot from the bleeding site during angiography for upper gastrointestinal (UGI) hemorrhage. This procedure enabled accurate identification of the bleeding site, allowing for successful targeted embolization despite a negative initial angiogram. Provocative endoscopy may be a feasible and useful option for angiography of obscure bleeding sites in patients with UGI arterial hemorrhage. Copyright © 2016 SIR. Published by Elsevier Inc. All rights reserved.

  11. Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy

    OpenAIRE

    Ohira, Tetsuya; Hokama, Akira; Kinjo, Nagisa; Nakamoto, Manabu; Kobashigawa, Chiharu; Kise, Yuya; Yamashiro, Satoshi; Kinjo, Fukunori; Kuniyoshi, Yukio; Fujita, Jiro

    2013-01-01

    Gastric antral vascular ectasia (GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal bleeding. The diagnosis is typically made based on the characteristic endoscopic features, including longitudinal row of flat, reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a watermelon. These appearances, however, can easily be misinterpreted as moderate to severe gastritis. Although it is believed that capsule endoscopy (C...

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

    OpenAIRE

    Vilariño Freire, Fernando Luis

    2006-01-01

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

  13. Microscopic polyangiitis complicated with ileal involvement detected by double-balloon endoscopy: a case report.

    Science.gov (United States)

    Fukushima, Masashi; Inoue, Satoko; Ono, Yuichiro; Tamaki, Yoshitaka; Yoshimura, Hajime; Imai, Yukihiro; Inokuma, Tetsuro

    2013-03-02

    Microscopic polyangiitis is characterized by pauci-immune, necrotizing small-vessel vasculitis and an anti-neutrophil cytoplasmic antibody-associated vasculitis. Although gastrointestinal involvement in microscopic polyangiitis is not rare, endoscopic observation of it is extremely rare. To the best of our knowledge, this is the first case report of small intestinal involvement in microscopic polyangiitis detected and followed up by double-balloon endoscopy. A 70-year-old Japanese woman was transferred to our hospital for close examination of suspected small intestinal lymphoma. Retrograde double-balloon endoscopy revealed various forms of ulcers with redness and edema in the ileum. Histological findings suggested ischemic changes. Because mononeuritis multiplex and a fever spike appeared later, vasculitis was suspected. The perinuclear anti-neutrophil cytoplasmic antibody titer was elevated. Nerve biopsy results suggested vasculitis. From these findings, microscopic polyangiitis was diagnosed. It was suggested that microscopic polyangiitis caused the intestinal involvement. Intravenous pulse cyclophosphamide and oral predonisolone were started. After treatment, perinuclear anti-neutrophil cytoplasmic antibodies decreased to the normal range. Retrograde double-balloon endoscopy after treatment showed ulcer scars and no ulcer. The cause of gastrointestinal involvement in microscopic polyangiitis is ischemia due to vasculitis. It is difficult to diagnose small-vessel vasculitis by endoscopic biopsy. Although histological evidence of microscopic polyangiitis is important, the treatment should not be delayed by repeating the biopsy, because such delay can result in adverse sequela.This case report shows that microscopic polyangiitis should be considered as a differential diagnosis when small intestinal changes like those in the present case are observed by endoscopy.

  14. Videofluoroscopy versus upper G.I. endoscopy: A comparative study as a diagnostic tool in patients presenting with dysphagia

    OpenAIRE

    Sharwak Ramlan; Sai Manohar; Gangadhara Somayaji

    2015-01-01

    Background and Objective: Dysphagia is a major symptom in many of the patients coming to the hospital. There can be various causes of dysphagia and its accurate diagnosis shows the way for the necessary treatment. Videofluoroscopy and upper gastrointestinal (GI) endoscopy are the two most commonly employed primary investigating modalities in assessing dysphagia. The objective of the study was to compare videofluoroscopy and upper GI endoscopy and establish a primary diagnostic tool for assess...

  15. Outcome of endoscopy-assisted microscopic extended transsphenoidal surgery for suprasellar craniopharyngiomas

    Directory of Open Access Journals (Sweden)

    Hidetoshi eIkeda

    2012-02-01

    Full Text Available Objectives. Craniopharyngiomas are difficult to treat. The extended transsphenoidal approach has recently been described in several small series. We describe the usefulness of microscopy-assisted angled endoscopy for visualizing vital structures such as tumor attachment or tumor invasion to the pituitary stalk to achieve confident radical tumor removal.Design and Participants. Between 2006 and 2010, 15 patients underwent the microscopy-assisted extended transsphenoidal approach for resection of entirely suprasellar craniopharyngiomas. 14 patients had the transinfundibular type, and one had the transinfundibular type with the extension to third ventricle. We observed color change within the pituitary stalk by endoscopy. The pituitary stalk was cut intentionally in ten patients, because of suspected tumor invasion surrounding the stalk. Main Outcome Measures and Results. Total removal was accomplished in nine patients. Pathological specimens from the pituitary stalk showed tumor invasion spreading over the surface of the pituitary stalk, shown by a discolored pituitary stalk, and this was essential for confident radical tumor removal. Even after stalk resection, postoperative DI was minimal when a bright signal on T1 in the posterior lobe was not confirmed on preoperative magnetic resonance imaging. Conclusion. Confident radical tumor removal is possible with the introduction of the endoscopy-assisted microscopic extended transsphenoidal approach.

  16. Calculus detection calibration among dental hygiene faculty members utilizing dental endoscopy: a pilot study.

    Science.gov (United States)

    Partido, Brian B; Jones, Archie A; English, Dana L; Nguyen, Carol A; Jacks, Mary E

    2015-02-01

    Dental and dental hygiene faculty members often do not provide consistent instruction in the clinical environment, especially in tasks requiring clinical judgment. From previous efforts to calibrate faculty members in calculus detection using typodonts, researchers have suggested using human subjects and emerging technology to improve consistency in clinical instruction. The purpose of this pilot study was to determine if a dental endoscopy-assisted training program would improve intra- and interrater reliability of dental hygiene faculty members in calculus detection. Training included an ODU 11/12 explorer, typodonts, and dental endoscopy. A convenience sample of six participants was recruited from the dental hygiene faculty at a California community college, and a two-group randomized experimental design was utilized. Intra- and interrater reliability was measured before and after calibration training. Pretest and posttest Kappa averages of all participants were compared using repeated measures (split-plot) ANOVA to determine the effectiveness of the calibration training on intra- and interrater reliability. The results showed that both kinds of reliability significantly improved for all participants and the training group improved significantly in interrater reliability from pretest to posttest. Calibration training was beneficial to these dental hygiene faculty members, especially those beginning with less than full agreement. This study suggests that calculus detection calibration training utilizing dental endoscopy can effectively improve interrater reliability of dental and dental hygiene clinical educators. Future studies should include human subjects, involve more participants at multiple locations, and determine whether improved rater reliability can be sustained over time.

  17. Primary intestinal lymphangiectasia diagnosed by capsule endoscopy and double balloon enteroscopy

    Science.gov (United States)

    Oh, Tak Geun; Chung, Joo Won; Kim, Hee Man; Han, Seok-Joo; Lee, Jin Sung; Park, Jung Yeob; Song, Si Young

    2011-01-01

    Primary intestinal lymphangiectasia (PIL) is a rare disorder characterized by dilated intestinal lymphatics and the development of protein-losing enteropathy. Patients with PIL develop hypoalbuminemia, hypocalcemia, lymphopenia and hypogammaglobulinemia, and present with bilateral lower limb edema, fatigue, abdominal pain and diarrhea. Endoscopy reveals diffusely elongated, circumferential and polypoid mucosae covered with whitish enlarged villi, all of which indicate intestinal lymphangiectasia. Diagnosis is confirmed by characteristic tissue pathology, which includes dilated intestinal lymphatics with diffusely swollen mucosa and enlarged villi. The prevalence of PIL has increased since the introduction of capsule endoscopy. The etiology and prevalence of PIL remain unknown. Some studies have reported that several genes and regulatory molecules for lymphangiogenesis are related to PIL. We report the case of a patient with PIL involving the entire small bowel that was confirmed by capsule endoscopy and double-balloon enteroscopy-guided tissue pathology who carried a deletion on chromosome 4q25. The relationship between this deletion on chromosome 4 and PIL remains to be investigated. PMID:22110841

  18. Development and implementation of a comprehensive quality assurance program at a community endoscopy facility.

    Science.gov (United States)

    Hilsden, Robert Jay; Rostom, Alaa; Dubé, Catherine; Pontifex, Darlene; McGregor, S Elizabeth; Bridges, Ronald J

    2011-10-01

    Quality assurance (QA) is a process that includes the systematic evaluation of a service, institution of improvements and ongoing evaluation to ensure that effective changes were made. QA is a fundamental component of any organized colorectal cancer screening program. However, it should play an equally important role in opportunistic screening. Establishing the processes and procedures for a comprehensive QA program can be a daunting proposition for an endoscopy unit. The present article describes the steps taken to establish a QA program at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Alberta) - a colorectal cancer screening centre and nonhospital endoscopy unit that is dedicated to providing colorectal cancer screening-related colonoscopies. Lessons drawn from the authors' experience may help others develop their own initiatives. The Global Rating Scale, a quality assessment and improvement tool developed for the gastrointestinal endoscopy services of the United Kingdom's National Health Service, was used as the framework to develop the QA program. QA activities include monitoring the patient experience through surveys, creating endoscopist report cards on colonoscopy performance, tracking and evaluating adverse events and monitoring wait times.

  19. Development and Implementation of a Comprehensive Quality Assurance Program at a Community Endoscopy Facility

    Directory of Open Access Journals (Sweden)

    Robert J Hilsden

    2011-01-01

    Full Text Available Quality assurance (QA is a process that includes the systematic evaluation of a service, institution of improvements and ongoing evaluation to ensure that effective changes were made. QA is a fundamental component of any organized colorectal cancer screening program. However, it should play an equally important role in opportunistic screening. Establishing the processes and procedures for a comprehensive QA program can be a daunting proposition for an endoscopy unit. The present article describes the steps taken to establish a QA program at the Forzani & MacPhail Colon Cancer Screening Centre (Calgary, Alberta – a colorectal cancer screening centre and nonhospital endoscopy unit that is dedicated to providing colorectal cancer screening-related colonoscopies. Lessons drawn from the authors’ experience may help others develop their own initiatives. The Global Rating Scale, a quality assessment and improvement tool developed for the gastrointestinal endoscopy services of the United Kingdom’s National Health Service, was used as the framework to develop the QA program. QA activities include monitoring the patient experience through surveys, creating endoscopist report cards on colonoscopy performance, tracking and evaluating adverse events and monitoring wait times.

  20. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect

    Directory of Open Access Journals (Sweden)

    Basavana Gouda Goudra

    2014-01-01

    Full Text Available Background: Providing anesthesia for gastrointestinal (GI endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. Materials and Methods: This retrospective cohort study included patients with a body mass index (BMI >40 kg/m 2 that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. Results: A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA. These desaturation episodes were found to be statistically independent of increasing BMI of patients. Conclusion: Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  1. Significantly reduced hypoxemic events in morbidly obese patients undergoing gastrointestinal endoscopy: Predictors and practice effect.

    Science.gov (United States)

    Goudra, Basavana Gouda; Singh, Preet Mohinder; Penugonda, Lakshmi C; Speck, Rebecca M; Sinha, Ashish C

    2014-01-01

    Providing anesthesia for gastrointestinal (GI) endoscopy procedures in morbidly obese patients is a challenge for a variety of reasons. The negative impact of obesity on the respiratory system combined with a need to share the upper airway and necessity to preserve the spontaneous ventilation, together add to difficulties. This retrospective cohort study included patients with a body mass index (BMI) >40 kg/m(2) that underwent out-patient GI endoscopy between September 2010 and February 2011. Patient data was analyzed for procedure, airway management technique as well as hypoxemic and cardiovascular events. A total of 119 patients met the inclusion criteria. Our innovative airway management technique resulted in a lower rate of intraoperative hypoxemic events compared with any published data available. Frequency of desaturation episodes showed statistically significant relation to previous history of obstructive sleep apnea (OSA). These desaturation episodes were found to be statistically independent of increasing BMI of patients. Pre-operative history of OSA irrespective of associated BMI values can be potentially used as a predictor of intra-procedural desaturation. With suitable modification of anesthesia technique, it is possible to reduce the incidence of adverse respiratory events in morbidly obese patients undergoing GI endoscopy procedures, thereby avoiding the need for endotracheal intubation.

  2. Fifteen-Year-Old Male with Type 2 Autoimmune Pancreatitis: An Argument for Endoscopy

    Directory of Open Access Journals (Sweden)

    Nathan T. Kolasinski

    2017-05-01

    Full Text Available Type 2 autoimmune pancreatitis, an increasingly recognized etiology of pancreatitis in patients less than 20 years old, has characteristically been diagnosed with the histological finding of duct-centric pancreatitis in a patient who lacks elevated serum immunoglobulin G4. We present the case of a nonobese 15-year-old male, without any chronic medical conditions, who presented with the chief complaint of abdominal pain. The laboratory study results were remarkable for a lipase level of 5,419 U/L and a γ-glutamyl transferase level of 373 U/L. Magnetic resonance cholangiopancreatography revealed delayed contrast enhancement of the pancreas, diffuse parenchymal enlargement, and lack of normal lobulation. The patient’s serum immunoglobulin G4 level was found to be 66 mg/dL, which was within normal limits and supportive of a diagnosis of type 2 autoimmune pancreatitis. Despite the absence of intestinal complaints, the patient underwent subsequent endoscopy due to the correlation of type 2 autoimmune pancreatitis with inflammatory bowel disease that has been described in recent literature. Pan-colonic mild colitis was visualized, and the patient began treatment with steroids, to which he quickly responded. Performing endoscopy on this patient allowed for confident initiation of early therapy for both autoimmune pancreatitis and inflammatory bowel disease, and may have limited further surgical intervention and disease progression. For these reasons, this case highlights the utility of endoscopy in pediatric patients with suspected type 2 autoimmune pancreatitis, even in the absence of intestinal symptoms.

  3. Glossopharyngeal Nerve Block versus Lidocaine Spray to Improve Tolerance in Upper Gastrointestinal Endoscopy

    Directory of Open Access Journals (Sweden)

    Moisés Ortega Ramírez

    2013-01-01

    Full Text Available Aim of the Study. To compare the effect of glossopharyngeal nerve block with topical anesthesia on the tolerance of patients to upper gastrointestinal endoscopy. Methods. We performed a clinical trial in one hundred patients undergoing upper gastrointestinal endoscopy. Subjects were randomly assigned to one of the following two groups: (1 treatment with bilateral glossopharyngeal nerve block (GFNB and intravenous midazolam or (2 treatment with topical anesthetic (TASS and intravenous midazolam. We evaluated sedation, tolerance to the procedure, hemodynamic stability, and adverse symptoms. Results. We studied 46 men and 54 women, from 17 to 78 years of age. The procedure was reported without discomfort in 48 patients (88% in the GFNB group and 32 (64% in the TAAS group; 6 patients (12% in GFNB group and 18 (36% in TAAS group reported the procedure as little discomfort (χ2=3.95, P=0.04. There was no difference in frequency of nausea (4% in both groups and retching, 4% versus 8% for GFNB and TASS group, respectively (P=0.55. Conclusions. The use of glossopharyngeal nerve block provides greater comfort and tolerance to the patient undergoing upper gastrointestinal endoscopy. It also reduces the need for sedation.

  4. Effect of music in endoscopy procedures: systematic review and meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Wang, Man Cai; Zhang, Ling Yi; Zhang, Yu Long; Zhang, Ya Wu; Xu, Xiao Dong; Zhang, You Cheng

    2014-10-01

    Endoscopies are common clinical examinations that are somewhat painful and even cause fear and anxiety for patients. We performed this systematic review and meta-analysis of randomized controlled trials to determine the effect of music on patients undergoing various endoscopic procedures. We searched the Cochrane Library, Issue 6, 2013, PubMed, and EMBASE databases up to July 2013. Randomized controlled trials comparing endoscopies, with and without the use of music, were included. Two authors independently abstracted data and assessed risk of bias. Subgroup analyses were performed to examine the impact of music on different types of endoscopic procedures. Twenty-one randomized controlled trials involving 2,134 patients were included. The overall effect of music on patients undergoing a variety of endoscopic procedures significantly improved pain score (weighted mean difference [WMD] = -1.53, 95% confidence interval [CI] [-2.53, -0.53]), anxiety (WMD = -6.04, 95% CI [-9.61, -2.48]), heart rate (P = 0.01), arterial pressure (P music group, compared with the control group. Furthermore, music had little effect for patients undergoing colposcopy and bronchoscopy in the subanalysis. Our meta-analysis suggested that music may offer benefits for patients undergoing endoscopy, except in colposcopy and bronchoscopy. Wiley Periodicals, Inc.

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

    Science.gov (United States)

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

    2017-01-01

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

  6. Detection of active bleeding from gastric antral vascular ectasia by capsule endoscopy

    Science.gov (United States)

    Ohira, Tetsuya; Hokama, Akira; Kinjo, Nagisa; Nakamoto, Manabu; Kobashigawa, Chiharu; Kise, Yuya; Yamashiro, Satoshi; Kinjo, Fukunori; Kuniyoshi, Yukio; Fujita, Jiro

    2013-01-01

    Gastric antral vascular ectasia (GAVE) has been recognized as one of the important causes of occult and obscure gastrointestinal bleeding. The diagnosis is typically made based on the characteristic endoscopic features, including longitudinal row of flat, reddish stripes radiating from the pylorus into the antrum that resemble the stripes on a watermelon. These appearances, however, can easily be misinterpreted as moderate to severe gastritis. Although it is believed that capsule endoscopy (CE) is not helpful for the study of the stomach with its large lumen, GAVE can be more likely to be detected at CE rather than conventional endoscopy. CE can be regarded as “physiologic” endoscopy, without the need for gastric inflation and subsequent compression of the vasculature. The blood flow of the ecstatic vessels may be diminished in an inflated stomach. Therefore, GAVE may be prominent in CE. We herein describe a case of active bleeding from GAVE detected by CE and would like to emphasize a possibility that CE can improve diagnostic yields for GAVE. PMID:23515703

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

    Science.gov (United States)

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

    2001-01-01

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

  8. Diagnosis of chronic rhino sinusitis in patients with cystic fibrosis: correlation between anamnesis, nasal endoscopy and computed tomography

    International Nuclear Information System (INIS)

    Boari, Leticia; Castro Junior, Ney Penteado de

    2005-01-01

    The sinonasal involvement is one of the most common manifestations in cystic fibrosis. Data show a high incidence of chronic rhino sinusitis in these patients. Although it has been found radiographic opacification of the sinus in more than 90% of cases, few are symptomatic. So that, it is difficult to recognize nasossinusal disease in patients with cystic fibrosis. Questionnaire, nasal endoscopy and CT-scan are very important methods in this approach. Aim: to evaluate the diagnosis of chronic rhino sinusitis in patients with cystic fibrosis by anamnesis, nasal endoscopy and CT-scan and compare those results.Study Design: Clinical prospective. Material and method: evaluation of 34 patients - older than 6 years and with a confirmed diagnoses of cystic fibrosis - by anamnesis (questionnaire), nasal endoscopy (score Lund-Kennedy) and CT-scan (score Lund-Mackay). Results: chronic rhino sinusitis was confirmed in: 20,58% of cases by the questionnaire, 73,52% of the cases by the nasal endoscopy and in 93,54% of the cases by the CT-scan. The results showed significant differences. The correlation between nasal endoscopy score (Lund-Kennedy score) and CT-scan score (Lund-Mackay score) was statistically significant. Conclusion: the diagnosis of chronic rhino sinusitis was statistically different between the three methods. It was higher in imaging analysis and lower in questionnaire. The nasal endoscopy is an excellent method to evaluate nasossinusal disease in cystic fibrosis. (author)

  9. Energy Flexibility in Retail Buildings

    DEFF Research Database (Denmark)

    Ma, Zheng; Billanes, Joy Dalmacio; Kjærgaard, Mikkel Baun

    2017-01-01

    Retail buildings has an important role for demand side energy flexibility because of their high energy consumption, variety of energy flexibility resources, and centralized control via building control systems. Energy flexibility requires agreements and collaborations among different actors......), with the discussion of the stakeholders’ roles and their interrelation in delivering energy flexibility with the influential factors to the actual implementation of energy flexible operation of their buildings. Based on a literature analysis, the results cover stakeholders’ types and roles, perceptions (drivers......, barriers, and benefits), energy management activities and technology adoptions, and the stakeholders’ interaction for the energy flexibility in retail buildings....

  10. Influence of salinity and cadmium on the survival and ...

    African Journals Online (AJOL)

    osmoregulated at salinities between 5 and 25 and osmoconformed at salinities greater than 25. Chiromantes eulimene followed a hyper-hypo-osmoregulatory strategy; it hyper-regulated in salinities from 0 up to isosmotic conditions at about 28 (c.

  11. The effect of salinity on some endocommensalic ciliates from shipworms

    Digital Repository Service at National Institute of Oceanography (India)

    Santhakumari, V.

    . Seasonal incidence and relative abundance of these ciliates showed that they were more abundant during the low saline than the high saline periods. Eventhough these ciliates can endure higher salinities through gradual acclimatization of their habitat...

  12. Evaluating physiological responses of plants to salinity stress

    KAUST Repository

    Negrã o, Só nia; Schmö ckel, S. M.; Tester, Mark A.

    2016-01-01

    Background Because soil salinity is a major abiotic constraint affecting crop yield, much research has been conducted to develop plants with improved salinity tolerance. Salinity stress impacts many aspects of a plant’s physiology, making

  13. Diffusion in flexible pipes

    Energy Technology Data Exchange (ETDEWEB)

    Brogaard Kristensen, S.

    2000-06-01

    This report describes the work done on modelling and simulation of the complex diffusion of gas through the wall of a flexible pipe. The diffusion and thus the pressure in annulus depends strongly on the diffusion and solubility parameters of the gas-polymer system and on the degree of blocking of the outer surface of the inner liner due to pressure reinforcements. The report evaluates the basis modelling required to describe the complex geometries and flow patterns. Qualitatively results of temperature and concentration profiles are shown in the report. For the program to serve any modelling purpose in 'real life' the results need to be validated and possibly the model needs corrections. Hopefully, a full-scale test of a flexible pipe will provide the required temperatures and pressures in annulus to validate the models. (EHS)

  14. Flexible cryogenic conduit

    International Nuclear Information System (INIS)

    Brindza, P.D.; Wines, R.R.; Takacs, J.J.

    1999-01-01

    A flexible and relatively low cost cryogenic conduit is described. The flexible cryogenic conduit of the present invention comprises a first inner corrugated tube with single braided serving, a second outer corrugated tube with single braided serving concentric with the inner corrugated tube, and arranged outwardly about the periphery of the inner corrugated tube and between the inner and outer corrugated tubes: a superinsulation layer; a one half lap layer of polyester ribbon; a one half lap layer of copper ribbon; a spirally wound refrigeration tube; a second one half lap layer of copper ribbon; a second one half lap layer of polyester ribbon; a second superinsulation layer; a third one half lap layer of polyester ribbon; and a spirally wound stretchable and compressible filament

  15. Diffusion in flexible pipes

    Energy Technology Data Exchange (ETDEWEB)

    Brogaard Kristensen, S

    2000-06-01

    This report describes the work done on modelling and simulation of the complex diffusion of gas through the wall of a flexible pipe. The diffusion and thus the pressure in annulus depends strongly on the diffusion and solubility parameters of the gas-polymer system and on the degree of blocking of the outer surface of the inner liner due to pressure reinforcements. The report evaluates the basis modelling required to describe the complex geometries and flow patterns. Qualitatively results of temperature and concentration profiles are shown in the report. For the program to serve any modelling purpose in 'real life' the results need to be validated and possibly the model needs corrections. Hopefully, a full-scale test of a flexible pipe will provide the required temperatures and pressures in annulus to validate the models. (EHS)

  16. Flexible Laser Metal Cutting

    DEFF Research Database (Denmark)

    Villumsen, Sigurd; Jørgensen, Steffen Nordahl; Kristiansen, Morten

    2014-01-01

    This paper describes a new flexible and fast approach to laser cutting called ROBOCUT. Combined with CAD/CAM technology, laser cutting of metal provides the flexibility to perform one-of-a-kind cutting and hereby realises mass production of customised products. Today’s laser cutting techniques...... possess, despite their wide use in industry, limitations regarding speed and geometry. Research trends point towards remote laser cutting techniques which can improve speed and geometrical freedom and hereby the competitiveness of laser cutting compared to fixed-tool-based cutting technology...... such as punching. This paper presents the concepts and preliminary test results of the ROBOCUT laser cutting technology, a technology which potentially can revolutionise laser cutting....

  17. Flexible training under threat.

    Science.gov (United States)

    Houghton, Anita; Eaton, Jennifer

    2002-10-01

    As the number of women in medicine and the general demand for a better work-life balance rises, flexible training is an increasingly important mechanism for maintaining the medical workforce. The new pay deal, together with entrenched cultural attitudes, are potential threats. Ways forward include more substantive part-time posts, more part-time opportunities at consultant level, and using positive experiences as a way of tackling attitudes in the less accepting specialties.

  18. Flexible weapons architecture design

    OpenAIRE

    Pyant, William C.

    2015-01-01

    Present day air-delivered weapons are of a closed architecture, with little to no ability to tailor the weapon for the individual engagement. The closed architectures require weaponeers to make the target fit the weapon instead of fitting the individual weapons to a target. The concept of a flexible weapons aims to modularize weapons design using an open architecture shell into which different modules are inserted to achieve the desired target fractional damage while reducing cost and civilia...

  19. Industrial Fuel Flexibility Workshop

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2006-09-01

    On September 28, 2006, in Washington, DC, ITP and Booz Allen Hamilton conducted a fuel flexibility workshop with attendance from various stakeholder groups. Workshop participants included representatives from the petrochemical, refining, food and beverage, steel and metals, pulp and paper, cement and glass manufacturing industries; as well as representatives from industrial boiler manufacturers, technology providers, energy and waste service providers, the federal government and national laboratories, and developers and financiers.

  20. Flexible Land Administration

    DEFF Research Database (Denmark)

    Enemark, Stig

    2014-01-01

    Security of tenure is widely considered to be the missing piece of the puzzle when it comes to eradication of poverty. And, as explained in the previous issue of Geoinformatics, the European Union is now placing land rights at the heart of EU development policy. This article presents a way forwar...... in terms of building flexible and "fit-for-purpose" land administration systems in developing countries. This will ensure security of tenure for all and sustainable management of the use of land....

  1. Use of computer graphics simulation for teaching of flexible sigmoidoscopy.

    Science.gov (United States)

    Baillie, J; Jowell, P; Evangelou, H; Bickel, W; Cotton, P

    1991-05-01

    The concept of simulation training in endoscopy is now well-established. The systems currently under development employ either computer graphics simulation or interactive video technology; each has its strengths and weaknesses. A flexible sigmoidoscopy training device has been designed which uses graphic routines--such as object oriented programming and double buffering--in entirely new ways. These programming techniques compensate for the limitations of currently available desk-top microcomputers. By boosting existing computer 'horsepower' with next generation coprocessors and sophisticated graphics tools such as intensity interpolation (Gouraud shading), the realism of computer simulation of flexible sigmoidoscopy is being greatly enhanced. The computer program has teaching and scoring capabilities, making it a truly interactive system. Use has been made of this ability to record, grade and store each trainee encounter in computer memory as part of a multi-center, prospective trial of simulation training being conducted currently in the USA. A new input device, a dummy endoscope, has been designed that allows application of variable resistance to the insertion tube. This greatly enhances tactile feedback, such as resistance during looping. If carefully designed trials show that computer simulation is an attractive and effective training tool, it is expected that this technology will evolve rapidly and be made widely available to trainee endoscopists.

  2. PTFE films with improved flexibility

    Science.gov (United States)

    Muraca, R. F.; Koch, A. A.

    1972-01-01

    Development and application of flexible polytetrafluroethylene films for expulsion bladders in spacecraft propellant tanks are described. Flexibility of material is obtained by reducing crystallinity through annealing and quenching in water. Physical and mechanical properties of material are presented.

  3. Flexible automated manufacturing for SMEs

    DEFF Research Database (Denmark)

    Grube Hansen, David; Bilberg, Arne; Madsen, Erik Skov

    2017-01-01

    SMEs are in general highly flexible and agile in order to accommodate the customer demands in the paradigm of High Mix-Low Volume manufacturing. The flexibility and agility have mainly been enabled by manual labor, but as we are entering the technology and data driven fourth industrial revolution......, where augmented operators and machines work in cooperation in a highly flexible and productive manufacturing system both an opportunity and a need has raised for developing highly flexible and efficient automation....

  4. Designing structural supply chain flexibility

    NARCIS (Netherlands)

    Mulinski, Ksawery Jan

    2012-01-01

    In a continuously changing business environment the role of supply chain flexibility is constantly increasing. A flexible supply chain can ensure survival in quickly changing market conditions as well as enable sustainable growth. This thesis explores the topic of supply chain flexibility with focus

  5. Global Analysis of Flexible Risers

    DEFF Research Database (Denmark)

    Banke, Lars

    1996-01-01

    Flexible pipes are often a technically attractive alternative to the traditional steel pipe. Often commercial utilisation of oil/gas fields depends on the use of flexible pipes. An example is when floating production vessels are used, where the flexible pipe follows the wave induced motions...

  6. NOAA NOS SOS, EXPERIMENTAL, 1902-present, Salinity

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The NOAA NOS SOS server is part of the IOOS DIF SOS Project. The stations in this dataset have salinity data. *These services are for testing and evaluation use...

  7. Biochar mitigates salinity stress in potato

    DEFF Research Database (Denmark)

    Saleem Akhtar, Saqib; Andersen, M.N.; Liu, Fulai

    2015-01-01

    capability of biochar. Results indicated that biochar was capable to ameliorate salinity stress by adsorbing Na+. Increasing salinity level resulted in significant reductions of shoot biomass, root length and volume, tuber yield, photosynthetic rate (An), stomatal conductance (gs), midday leaf water......A pot experiment was conducted in a climate-controlled greenhouse to investigate the growth, physiology and yield of potato in response to salinity stress under biochar amendment. It was hypothesized that addition of biochar may improve plant growth and yield by mitigating the negative effect...... potential, but increased abscisic acid (ABA) concentration in both leaf and xylem sap. At each salinity level, incorporation of biochar increased shoot biomass, root length and volume, tuber yield, An, gs, midday leaf water potential, and decreased ABA concentration in the leaf and xylem sap as compared...

  8. Three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT: applications and limitations

    International Nuclear Information System (INIS)

    Kim, Su Yeon; Choi, Sun Seob; Kang, Myung Jin; Shin, Tae Beom; Lee, Ki Nam; Kang, Myung Koo

    2005-01-01

    This study was conducted to know the applications and limitations of three dimensional volume rendering virtual endoscopy of the ossicles using a multi-row detector CT. This study examined 25 patients who underwent temporal bone CT using a 16-row detector CT as a result of hearing problems or trauma. The axial CT scan of the temporal bone was performed with a 0.6 mm collimation, and a reconstruction was carried out with a U70u sharp of kernel value, a 1 mm thickness and 0.5-1.0 mm increments. After observing the ossicles in the axial and coronal images, virtual endoscopy was performed using a three dimensional volume rendering technique with a threshold value of-500 HU. The intra-operative otoendoscopy was performed in 12 ears, and was compared with the virtual endoscopy findings. Virtual endoscopy of the 29 ears without hearing problems demonstrated hypoplastic or an incomplete depiction of the stapes superstructures in 25 ears and a normal depiction in 4 ears. Virtual endoscopy of 21 ears with hearing problems demonstrated no ossicles in 1 ears, no malleus in 3 ears, a malleoincudal subluxation in 6 ears, a dysplastic incus in 5 ears, an incudostapedial subluxation in 9 ears, dysplastic stapes in 2 ears, a hypoplastic or incomplete depiction of the stapes in 16 ears and no stapes in 1 ears. In contrast to the intra-operative otoendoscopy, 8 out of 12 ears showed a hypoplastic or deformed stapes in the virtual endoscopy. Volume rendering virtual endoscopy using a multi-row detector CT is an excellent method for evaluation the ossicles in three dimension, even thought the partial volume effect for the stapes superstructures needs to be considered

  9. Microstrip Patch Sensor for Salinity Determination.

    Science.gov (United States)

    Lee, Kibae; Hassan, Arshad; Lee, Chong Hyun; Bae, Jinho

    2017-12-18

    In this paper, a compact microstrip feed inset patch sensor is proposed for measuring the salinities in seawater. The working principle of the proposed sensor depends on the fact that different salinities in liquid have different relative permittivities and cause different resonance frequencies. The proposed sensor can obtain better sensitivity to salinity changes than common sensors using conductivity change, since the relative permittivity change to salinity is 2.5 times more sensitive than the conductivity change. The patch and ground plane of the proposed sensor are fabricated by conductive copper spray coating on the masks made by 3D printer. The fabricated patch and the ground plane are bonded to a commercial silicon substrate and then attached to 5 mm-high chamber made by 3D printer so that it contains only 1 mL seawater. For easy fabrication and testing, the maximum resonance frequency was selected under 3 GHz and to cover salinities in real seawater, it was assumed that the salinity changes from 20 to 35 ppt. The sensor was designed by the finite element method-based ANSYS high-frequency structure simulator (HFSS), and it can detect the salinity with 0.01 ppt resolution. The designed sensor has a resonance frequency separation of 37.9 kHz and reflection coefficients under -20 dB at the resonant frequencies. The fabricated sensor showed better performance with average frequency separation of 48 kHz and maximum reflection coefficient of -35 dB. By comparing with the existing sensors, the proposed compact and low-cost sensor showed a better detection capability. Therefore, the proposed patch sensor can be utilized in radio frequency (RF) tunable sensors for salinity determination.

  10. Salinity management in southern Italy irrigation areas

    Directory of Open Access Journals (Sweden)

    Massimo Monteleone

    Full Text Available After a synthetic review of the most worrisome pressures applied over soils and waters, general criterions and normative principles that have to lead the technical intervention on soil and water protection are accounted, both with respect to farm activity and land planning. The salinity problem is faced, then, through the analysis of the nature and origin of saline soil and of the complex quantitative relationships able to interpret the accumulation and leaching of soil salts. Having specified the theoretical bases of salinity, the related technical features are then considered in order to define a proper management of soil and waters. Particular relevance is assigned to the irrigation and leaching techniques as well as, more briefly, to other agronomic interventions in order to guarantee the most effective salinity control. Another relevant technical facet of salinity control, although quite often neglected or retained of secondary importance in comparison to irrigation, is the drainage and disposal of leached water. The increased sensibility on the environmental impacts that the disposal of these waters can produce has raised today the level of attention on these procedures that are disciplined by norms of law and, therefore, require appropriate techniques of intervention. Finally, after the different scale orders involved in the management of salinity are defined (from the field and farm level up to the land and basin, the fundamental elements in order to work out a risk analysis and an action program are illustrated; some indications about the most up to date salinity monitoring and mapping methods are also provided, considering their great importance to continuously check the possible broadening of salinization and to carefully maintain its control.

  11. Microstrip Patch Sensor for Salinity Determination

    Directory of Open Access Journals (Sweden)

    Kibae Lee

    2017-12-01

    Full Text Available In this paper, a compact microstrip feed inset patch sensor is proposed for measuring the salinities in seawater. The working principle of the proposed sensor depends on the fact that different salinities in liquid have different relative permittivities and cause different resonance frequencies. The proposed sensor can obtain better sensitivity to salinity changes than common sensors using conductivity change, since the relative permittivity change to salinity is 2.5 times more sensitive than the conductivity change. The patch and ground plane of the proposed sensor are fabricated by conductive copper spray coating on the masks made by 3D printer. The fabricated patch and the ground plane are bonded to a commercial silicon substrate and then attached to 5 mm-high chamber made by 3D printer so that it contains only 1 mL seawater. For easy fabrication and testing, the maximum resonance frequency was selected under 3 GHz and to cover salinities in real seawater, it was assumed that the salinity changes from 20 to 35 ppt. The sensor was designed by the finite element method-based ANSYS high-frequency structure simulator (HFSS, and it can detect the salinity with 0.01 ppt resolution. The designed sensor has a resonance frequency separation of 37.9 kHz and reflection coefficients under −20 dB at the resonant frequencies. The fabricated sensor showed better performance with average frequency separation of 48 kHz and maximum reflection coefficient of −35 dB. By comparing with the existing sensors, the proposed compact and low-cost sensor showed a better detection capability. Therefore, the proposed patch sensor can be utilized in radio frequency (RF tunable sensors for salinity determination.

  12. PRODUCTION OF TOMATO SEEDLINGS UNDER SALINE IRRIGATION

    Directory of Open Access Journals (Sweden)

    Carlos Alberto Brasiliano Campos

    2007-01-01

    Full Text Available Processing tomato is the most important vegetable crop of the Brazilian agribusiness and few researches have been conducted to evaluate the tolerance of this crop to saline stress. In this study, the effects of five levels of salinity of the irrigation water (1, 2, 3, 4 and 5 dS m-1 and three equivalent proportions of Na:Ca:Mg (1:1:0.5, 4:1:0.5 and 7:1:0.5 were tested on the emergence and vigor of processing tomato, cultivar IPA 6. Seeds were sowed in expanded polystyrene tray (128 cells and each tray received 1 L of water after sowing. The trays were piled and, four days after sowing, they were placed on suspended supports in a greenhouse. Irrigation was accomplished daily from the fifth day after sowing. Only dry weight of shoot and root was affected by sodium proportions, while linear reductions of the speed of emergence, stem length and the dry weight of shoot and root were observed with increasing salinity. Root was more affected than shoot by salinity and relative growth ratioincreased with salinity levels on the 14-21 days after sowing period, indicating that the crop showed a certain increase of salinity tolerance with the time of exposure to salts.

  13. Flexible Query Answering Systems

    DEFF Research Database (Denmark)

    This book constitutes the refereed proceedings of the 10th International Conference on Flexible Query Answering Systems, FQAS 2013, held in Granada, Spain, in September 2013. The 59 full papers included in this volume were carefully reviewed and selected from numerous submissions. The papers...... are organized in a general session train and a parallel special session track. The general session train covers the following topics: querying-answering systems; semantic technology; patterns and classification; personalization and recommender systems; searching and ranking; and Web and human...

  14. Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care.

    Science.gov (United States)

    Duggan, A E; Elliott, C A; Miller, P; Hawkey, C J; Logan, R F A

    2009-01-01

    Early endoscopy, Helicobacter pylori eradication and empirical acid suppression are commonly used dyspepsia management strategies in primary care but have not been directly compared in a single trial. To compare endoscopy, H. pylori test and refer, H. pylori test and treat and empirical acid suppression for dyspepsia in primary care. Patients presenting to their general practitioner with dyspepsia were randomized to endoscopy, H. pylori'test and treat', H. pylori test and endoscope positives, or empirical therapy with symptoms, patient satisfaction, healthcare costs and cost effectiveness at 12 months being the outcomes. At 2 months, the proportion of patients reporting no or minimal dyspeptic symptoms ranged from 74% for those having early endoscopy to 55% for those on empirical therapy (P = 0.009), but at 1 year, there was little difference among the four strategies. Early endoscopy was associated with fewer subsequent consultations for dyspepsia (P = 0.003). 'Test and treat' resulted in fewer endoscopies overall and was most cost-effective over a range of cost assumptions. Empirical therapy resulted in the lowest initial costs, but the highest rate of subsequent endoscopy. Gastro-oesophageal cancers were found in four patients randomized to the H. pylori testing strategies. While early endoscopy offered some advantages 'Test and treat' was the most cost-effective strategy. In older patients, early endoscopy may be an appropriate strategy in view of the greater risk of malignant disease. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

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

    Directory of Open Access Journals (Sweden)

    Hutchings Hayley A

    2008-01-01

    Full Text Available Abstract Background The availability of routinely collected service-related endoscopy data from NHS endoscopy units has never been quantified. Methods This retrospective observational study asked 19 endoscopy units to submit copies of all in-house, service-related endoscopy data that had been routinely collected by the unit – Referral numbers, Activity, Number of patients waiting and Number of lost slots. Nine of the endoscopy units had previously participated in the Modernising Endoscopy Services (MES project during 2003 to redesign their endoscopy services. These MES sites had access to additional funding and data collection software. The other ten (Control sites had modernised independently. All data was requested in two phases and corresponded to eight specific time points between January 2003 and April 2006. Results Only eight of 19 endoscopy units submitted routinely collected, service-related data. Another site's data was collected specifically for the study. A further two units claimed to routinely collect service-related data but did not submit any to the study. The remaining eight did not collect any service-related endoscopy data routinely and liaised with their Trust for data. Of the eight sites submitting service-related data, only three were MES project sites. Of these three, the data variables collected were limited and none collected the complete set of endoscopy data variables requested. Of the other five sites, two collected all four endoscopy data types. Data for the three MES project sites went back as far as January 2003, whilst the five Control sites were only able to submit data from December 2003 onwards. Conclusion There was a lack of service-related endoscopy data routinely collected by the study sites, especially those who had participated in the MES project. Without this data, NHS endoscopy services cannot have a true understanding of their services, cannot identify problems and cannot measure the impact of any

  16. Anesthesia for gastrointestinal endoscopy in patients with left ventricular assist devices: Initial experience with 68 procedures

    Directory of Open Access Journals (Sweden)

    Basavana G Goudra

    2013-01-01

    Full Text Available Aims and Objectives: Continuous flow left ventricular assist devices (LVAD have emerged as a reliable treatment option for heart failure. Because of bleeding secondary to anticoagulation, these patients present frequently for gastrointestinal (GI endoscopy. The presently available literature on perioperative management of these patients is extremely limited and is primarily based upon theoretical principles. Materials and Methods: Perioperative records of patients with LVAD undergoing (GI endoscopy between 2008 and 2012 were reviewed. Patient, device and procedure specific information was analyzed. Results: A total of 105 LVADs were implanted, and 68 procedures were performed in 39 patients. The most common indication was GI bleed (48/68, with yearly risk of 8.57% per patient. A total of 63 procedures were performed under deep sedation, with five procedures requiring general anesthesia. Intra-procedure hypotension was managed by fluids and (or vasopressors/inotropes (phenylephrine, ephedrine or milrinone guided by plethysmographic waveform, non-invasive blood pressure (NIBP and LVADs pulsatility index (for HeartMate II/flow pulsatility (for HeartWare. No patient required invasive monitoring and both NIBP and pulse oximeter could be reliably used for monitoring (and guided management in all patients due to the presence of native heart′s pulsatile output. Conclusion: In the presence of residual heart function, with optimal device settings, non-invasive hemodynamic monitoring can be reliably used in these patients while undergoing GI endoscopy under general anesthesia or monitored anesthesia care. Transient hypotensive episodes respond well to fluids/vasopressors without the need of increasing device speed that can be detrimental.

  17. OLGA- and OLGIM-based staging of gastritis using narrow-band imaging magnifying endoscopy.

    Science.gov (United States)

    Saka, Akiko; Yagi, Kazuyoshi; Nimura, Satoshi

    2015-11-01

    As atrophic gastritis and intestinal metaplasia as a result of Helicobacter pylori are considered risk factors for gastric cancer, it is important to assess their severity. In the West, the operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) staging systems based on biopsy have been widely adopted. In Japan, however, narrow-band imaging (NBI)-magnifying endoscopic diagnosis of gastric mucosal inflammation, atrophy, and intestinal metaplasia has been reported to be fairly accurate. Therefore, we investigated the practicality of NBI-magnifying endoscopy (NBI-ME) for gastritis staging. We enrolled 55 patients, in whom NBI-ME was used to score the lesser curvature of the antrum (antrum) and the lesser curvature of the lower body (corpus). The NBI-ME score classification was established from images obtained beforehand, and then biopsy specimens taken from the observed areas were scored according to histological findings. The NBI-ME and histology scores were then compared. Furthermore, we assessed the NBI-ME and histology stages using a combination of scores for the antrum and corpus, and divided the stages into two risk groups: low and high. The degree to which the stage assessed by NBI-ME approximated that assessed by histology was then ascertained. Degree of correspondence between the NBI-ME and histology scores was 69.1% for the antrum and 72.7% for the corpus, and that between the high- and low-risk groups was 89.1%. Staging of gastritis using NBI-ME approximates that based on histology, and would be a practical alternative to the latter. © 2015 The Authors. Digestive Endoscopy © 2015 Japan Gastroenterological Endoscopy Society.

  18. Air suctioning during colon biopsy forceps removal reduces bacterial air contamination in the endoscopy suite.

    Science.gov (United States)

    Vavricka, S R; Tutuian, R; Imhof, A; Wildi, S; Gubler, C; Fruehauf, H; Ruef, C; Schoepfer, A M; Fried, M

    2010-09-01

    Bacterial contamination of endoscopy suites is of concern; however studies evaluating bacterial aerosols are lacking. We aimed to determine the effectiveness of air suctioning during removal of biopsy forceps in reducing bacterial air contamination. This was a prospective single-blinded trial involving 50 patients who were undergoing elective nontherapeutic colonoscopy. During colonoscopy, endoscopists removed the biopsy forceps first without and then with suctioning following contact with the sigmoid mucosa. A total of 50 L of air was collected continuously for 30 seconds at 30-cm distance from the biopsy channel valve of the colonoscope, with time starting at forceps removal. Airborne bacteria were collected by an impactor air sampler (MAS-100). Standard Petri dishes with CNA blood agar were used to culture Gram-positive bacteria. Main outcome measure was the bacterial load in endoscopy room air. At the beginning and end of the daily colonoscopy program, the median (and interquartile [IQR] range) bioaerosol burden was 4 colony forming units (CFU)/m (3) (IQR 3 - 6) and 16 CFU/m (3) (IQR 13 - 18), respectively. Air suctioning during removal of the biopsy forceps reduced the bioaerosol burden from a median of 14 CFU/m (3) (IQR 11 - 29) to a median of 7 CFU/m (3) (IQR 4 - 16) ( P = 0.0001). Predominantly enterococci were identified on the agar plates. The bacterial aerosol burden during handling of biopsy forceps can be reduced by applying air suction while removing the forceps. This simple method may reduce transmission of infectious agents during gastrointestinal endoscopies. Copyright Georg Thieme Verlag KG Stuttgart . New York.

  19. Appropriateness guidelines and predictive rules to select patients for upper endoscopy: a nationwide multicenter study.

    Science.gov (United States)

    Buri, Luigi; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria Antonietta; Cipolletta, Livio; Di Giulio, Emilio; Di Matteo, Giovanni; Familiari, Luigi; Ficano, Leonardo; Loriga, Pietro; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Intraligi, Marco; Buscema, Massimo

    2010-06-01

    Selecting patients appropriately for upper endoscopy (EGD) is crucial for efficient use of endoscopy. The objective of this study was to compare different clinical strategies and statistical methods to select patients for EGD, namely appropriateness guidelines, age and/or alarm features, and multivariate and artificial neural network (ANN) models. A nationwide, multicenter, prospective study was undertaken in which consecutive patients referred for EGD during a 1-month period were enrolled. Before EGD, the endoscopist assessed referral appropriateness according to the American Society for Gastrointestinal Endoscopy (ASGE) guidelines, also collecting clinical and demographic variables. Outcomes of the study were detection of relevant findings and new diagnosis of malignancy at EGD. The accuracy of the following clinical strategies and predictive rules was compared: (i) ASGE appropriateness guidelines (indicated vs. not indicated), (ii) simplified rule (>or=45 years or alarm features vs. <45 years without alarm features), (iii) logistic regression model, and (iv) ANN models. A total of 8,252 patients were enrolled in 57 centers. Overall, 3,803 (46%) relevant findings and 132 (1.6%) new malignancies were detected. Sensitivity, specificity, and area under the receiver-operating characteristic curve (AUC) of the simplified rule were similar to that of the ASGE guidelines for both relevant findings (82%/26%/0.55 vs. 88%/27%/0.52) and cancer (97%/22%/0.58 vs. 98%/20%/0.58). Both logistic regression and ANN models seemed to be substantially more accurate in predicting new cases of malignancy, with an AUC of 0.82 and 0.87, respectively. A simple predictive rule based on age and alarm features is similarly effective to the more complex ASGE guidelines in selecting patients for EGD. Regression and ANN models may be useful in identifying a relatively small subgroup of patients at higher risk of cancer.

  20. Endoscopy versus radiology in post-procedural monitoring after peroral endoscopic myotomy (POEM).

    Science.gov (United States)

    Nast, Jan Friso; Berliner, Christoph; Rösch, Thomas; von Renteln, Daniel; Noder, Tania; Schachschal, Guido; Groth, Stefan; Ittrich, Harald; Kersten, Jan F; Adam, Gerhard; Werner, Yuki B

    2018-03-15

    The newly developed technique of peroral endoscopic myotomy (POEM) has been shown to be effective in several short- and mid-term studies. Limited information is available about the adequacy of immediate post-POEM monitoring tests. POEM was performed under general anesthesia in 228 patients (59.6% male, mean age 45.6 ± 15.5 years). Post-procedural checks comprised clinical and laboratory examination, and, during post-procedure days 1-5, endoscopy and-in the first 114 cases-radiologic examination using water-soluble contrast (1st group); the remaining patients underwent post-procedure controls without radiology (2nd group). Main outcome was value of endoscopic compared to radiologic control for recognition of early adverse events. In the first group, routine fluoroscopic contrast swallow suggested minor leakages at the mucosal entry site in two cases which was confirmed endoscopically in only one. Endoscopy revealed two minor entry site leakages and, in six additional cases, dislocated clips without leakage (overall 5.3%). All eight patients underwent reclipping and healed without clinical sequelae. In the 2nd group, endoscopy showed 5 clip dislocations (all reclipped) and one ischemic cardiac perforation in a patient with clinical deterioration on post-POEM day 1 who had to undergo surgery after confirmation of leakage by CT. Radiologic monitoring (contrast swallow) after POEM is not useful and can be omitted. Even routine endoscopic monitoring for detection and closure of minor defects of the mucosal entry site yields limited information with regards to final outcome; major complications are very rare and probably associated with clinical deterioration. Clinical Trials Gov Registration number of the main study: NCT01405417.

  1. A cost and time analysis of laryngology procedures in the endoscopy suite versus the operating room.

    Science.gov (United States)

    Hillel, Alexander T; Ochsner, Matthew C; Johns, Michael M; Klein, Adam M

    2016-06-01

    To assess the costs, charges, reimbursement, and efficiency of performing awake laryngology procedures in an endoscopy suite (ES) compared with like procedures performed in the operating room (OR). Retrospective review of billing records. Cost, charges, and reimbursements for the hospital, surgeon, and anesthesiologist were compared between ES injection laryngoplasty and laser excision procedures and matched case controls in the OR. Time spent in 1) the preoperative unit, 2) the operating or endoscopy suite, and 3) recovery unit were compared between OR and ES procedures. Hospital expenses were significantly less for ES procedures when compared to OR procedures. Reimbursement was similar for ES and OR injection laryngoplasty, though greater for OR laser excisions. Net balance (reimbursement-expenses) was greater for ES procedures. A predictive model of payer costs over a 3-year period showed similar costs for ES and OR laser procedures and reduced costs for ES compared to OR injection laryngoplasty. Times spent preoperatively and the procedure were significantly less for ES procedures. For individual laryngology procedures, the ES reduces time and costs compared to the OR, increasing otolaryngologist and hospital efficiency. This reveals cost and time savings of ES injection laryngoplasty, which occurs at a similar frequency as OR injection laryngoplasty. Given the increased frequency for ES laser procedures, total costs are similar for ES and OR laser excision of papilloma, which usually require repeated procedures. When regulated office space is unavailable, endoscopy rooms represent an alternative setting for unsedated laryngology procedures. NA Laryngoscope, 126:1385-1389, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  2. N2-fixation in fababean (vicia faba l.) grown in saline and non saline conditions using 15N tracer technique

    International Nuclear Information System (INIS)

    Khalifa, Kh.; Kurdali, F.

    2002-09-01

    A pot experiment was conducted to study the performance of growing fababean and barley under saline conditions, in terms of, dry matter yield, total nitrogen and, percentages and amount of N derived from soil, fertilizer and atmosphere using 15 N isotope dilution method. Three saline treatments were performed: First, plants were grown in saline soil and irrigated with saline water (Ws Ss), Second, Plants were grown in saline soil and irrigated with saline water (Ws Ss); and Third, Plants grown in non saline soil and irrigated with saline water (Ws Sn). Furthermore, a control treatment was performed by using non-saline soil and non-saline water (Wn Sn). The different salinity treatments reduced plant growth and the reduction was more pronounced in fababean than in barley. However, under conditions of either saline soil-soft irrigation water or non saline soil-salty irrigation water, the relative growth reduction did not exceed 50% of the control; whereas, a significant negative effect was obtained when plants were grown under completely saline conditions of both soil and irrigation water. Percentage of N 2 -fixed (% Ndfa) was not negatively affected by saline conditions. However, our results clearly demonstrated that the effect of salinity in fababean was more evident on plant growth than on N 2 -fixing activity. Further studies are needed to obtain more salt tolerant faba bean genotypes in terms of growth and yield. This could be simultaneously improve yield and N 2 -fixation under sever saline conditions. (author)

  3. Pilot randomized crossover study comparing the efficacy of transnasal disposable endosheath with standard endoscopy to detect Barrett's esophagus.

    Science.gov (United States)

    Shariff, Mohammed K; Varghese, Sibu; O'Donovan, Maria; Abdullahi, Zarah; Liu, Xinxue; Fitzgerald, Rebecca C; di Pietro, Massimiliano

    2016-02-01

    The transnasal endosheath endoscope is a new disposable technology with potential applicability to the primary care setting. The aim of this study was to evaluate the efficacy of transnasal endosheath endoscopy (TEE) for the detection of Barrett's esophagus, by comparing the diagnostic accuracy of TEE with that of standard endoscopy. This was a prospective, randomized, crossover study performed in a single tertiary referral center. Consecutive patients undergoing surveillance for Barrett's esophagus or referred for diagnostic assessment were recruited. All patients were randomized to undergo TEE followed by standard endoscopy or the reverse. Endoscopy experiences and patient preferences were evaluated using a questionnaire. Endoscopic and histologic diagnosis of Barrett's esophagus, and optical image quality of both endoscopic procedures, were compared. A total of 21 of 25 patients completed the study. TEE had sensitivity and specificity of 100 % for an endoscopic diagnosis of Barrett's esophagus, and of 66.7 % and 100 %, respectively, for the histologic diagnosis of Barrett's esophagus. The mean optical quality of standard endoscopy was significantly better than that of TEE (7.11 ± 0.42 vs. 4.06 ± 0.27; P evaluation in primary care as an initial diagnostic tool. © Georg Thieme Verlag KG Stuttgart · New York.

  4. Asymmetric Flexible Supercapacitor Stack

    Directory of Open Access Journals (Sweden)

    Leela Mohana Reddy A

    2008-01-01

    Full Text Available AbstractElectrical double layer supercapacitor is very significant in the field of electrical energy storage which can be the solution for the current revolution in the electronic devices like mobile phones, camera flashes which needs flexible and miniaturized energy storage device with all non-aqueous components. The multiwalled carbon nanotubes (MWNTs have been synthesized by catalytic chemical vapor deposition technique over hydrogen decrepitated Mischmetal (Mm based AB3alloy hydride. The polymer dispersed MWNTs have been obtained by insitu polymerization and the metal oxide/MWNTs were synthesized by sol-gel method. Morphological characterizations of polymer dispersed MWNTs have been carried out using scanning electron microscopy (SEM, transmission electron microscopy (TEM and HRTEM. An assymetric double supercapacitor stack has been fabricated using polymer/MWNTs and metal oxide/MWNTs coated over flexible carbon fabric as electrodes and nafion®membrane as a solid electrolyte. Electrochemical performance of the supercapacitor stack has been investigated using cyclic voltammetry, galvanostatic charge-discharge, and electrochemical impedance spectroscopy.

  5. The role of endoscopy in the management of paranasal sinus tumours.

    Science.gov (United States)

    Jorissen, M

    1995-01-01

    Only recently management of benign as well as malignant nasal and paranasal sinus tumours by endoscopy, including endoscopic removal, has been introduced. The most important contribution of the endoscope in the management of these tumours is diagnostic, primarily as well as during follow-up. Although, in general, endoscopic sinus surgery has many advantages over classical external surgery, disadvantages are present when tumours are concerned. Some agreement already exists on the role and limitations of endoscopic sinus surgery in benign tumours, but in malignant processes usually more mutilating procedures are needed and only in selected cases might endoscopic removal be used.

  6. Les corps étrangers de l'oesophage : place de l'endoscopie au tube ...

    African Journals Online (AJOL)

    Objectif : Déterminer la place de l'endoscopie au tube rigide dans la prise en charge des CEO. Méthodologie : Il s'agit d'une étude prospective menée chez des patients reçus pour corps étrangers de l'oesophage et qui ont été pris en charge dans le service ; du 1er janvier 2004 au 31 décembre 2008 .78 patients ont été ...

  7. Salinity tolerance of the South African endemic amphipod ...

    African Journals Online (AJOL)

    Salinities were prepared using natural seawater and synthetic sea salt. Grandidierella lignorum tolerated all salinities, but showed highest survival at salinities of 7–42. Salinity tolerance was modified by temperature, with highest survival occurring between 10 and 25 °C. These represent the range of conditions at which ...

  8. Investigation of Soil Salinity to Distinguish Boundary Line between ...

    African Journals Online (AJOL)

    ADOWIE PERE

    Investigation of Soil Salinity to Distinguish Boundary Line between Saline and ... Setting 4 dSm-1 as the limit between saline and non-saline soils in kriging algorithms resulted in a .... number of sample points within the search window,.

  9. Dwarf cashew growth irrigated with saline waters

    Directory of Open Access Journals (Sweden)

    Hugo Orlando Carvallo Guerra

    2009-12-01

    Full Text Available The cashew production is one of the most important agricultural activities from the social-economical viewpoint for the North East of Brazil; besides to produce a great deal of hand labor, it is very important as an exporting commodity. The inadequate use of irrigation in the semi arid regions of the North East of Brazil has induced soil salinization and consequently problems for the irrigated agriculture. In spite of this, few works have been conducted to study the effect of saline stress on the growth and development of the cashew. Because of the lack of information for this crop, an experiment was conducted to study the effect of salinity stress on the phytomass production and nutrient accumulation on the different organs of the precocious dwarf cashew (Anacardium occidentale L. clone CCP76. The study was conducted under controlled conditions using as statistical scheme a randomized block design factorial with six replicates. Five salinity treatments were considered for the irrigation water (electrical conductivities of 0.8, 1.6, 2.4, 3.2 and 4.0 dS m-1 at 25oC. The increasing in salinity of the irrigation water reduced the phytomass at different organs of the studied plant. The nitrogen, phosphorus, potassium, chloride and sodium in the plant varied with the salinity of the irrigation water according with the part of the plant analyzed; in some parts increased, in others decreased, in others increased initially and decreased afterwards, and finally, in other part of the plant the salinity of the irrigation water did not affect the nutrient concentration.

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

    Directory of Open Access Journals (Sweden)

    L. Julián-Gómez

    2010-02-01

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

  11. Making a diagnosis of different lesions of vocal fold mucosa by contact endoscopy: The first usage in our clinical practice

    Directory of Open Access Journals (Sweden)

    Jovanović Milan B.

    2005-01-01

    Full Text Available During laryngomicroscopy, the superficial layers of vocal fold epithelium can be examined in vivo and in situ by contact endoscopy. Methylene blue is applied initially to stain the epihelial cells of the vocal folds. When in contact with mucosal tissue, this endoscope provides 60 and 150 times magnification and clear visualization of cellular patterns of the superficial epithelial layers. For the first time in our laryngological clinical practice, we confirmed a number of previously established parametars such as regularity and arrangement of the epithelium, nucleus contour, and nucleus-cytoplasm ratio, what all enable recognition and easy evaluation of different clinical conditions such as chronic laryngitis, Reinke.s edema, papiloma dyspiasia or vocal fold carcinoma. The advantage of con- tact endoscopy in vivo and in situ allows for detailed scan and mapping of all cell changes of the whole mucosa surface. All these features definitely classify the contact endoscopy into additional diagnostic methods in laryngology.

  12. On flexible and rigid nouns

    DEFF Research Database (Denmark)

    Rijkhoff, Jan

    2010-01-01

    classes. Finally this article wants to claim that the distinction between rigid and flexible noun categories (a) adds a new dimension to current classifications of parts of speech systems, (b) correlates with certain grammatical phenomena (e.g. so-called number discord), and (c) helps to explain the parts......This article argues that in addition to the major flexible lexical categories in Hengeveld’s classification of parts of speech systems (Contentive, Non-Verb, Modifier), there are also flexible word classes within the rigid lexical category Noun (Set Noun, Sort Noun, General Noun). Members...... by the flexible item in the external world. I will then argue that flexible word classes constitute a proper category (i.e. they are not the result of a merger of some rigid word classes) in that members of flexible word categories display the same properties regarding category membership as members of rigid word...

  13. On flexible and rigid nouns

    DEFF Research Database (Denmark)

    Rijkhoff, Jan

    2008-01-01

    Studies in Language 32-3 (2008), 727-752. Special issue: Parts of Speech: Descriptive tools, theoretical constructs Jan Rijkhoff - On flexible and rigid nouns This article argues that in addition to the flexible lexical categories in Hengeveld’s classification of parts-of-speech systems (Contentive......, Non-Verb, Modifier), there are also flexible word classes within the rigid lexical category Noun (Set Noun, Sort Noun, General Noun). Members of flexible word classes are characterized by their vague semantics, which in the case of nouns means that values for the semantic features Shape...... and Homogeneity are either left undetermined or they are specified in such a way that they do not quite match the properties of the kind of entity denoted by the flexible item in the external world. I will then argue that flexible word classes constitute a proper category (i.e. they are not the result of a merger...

  14. Flexible Language Interoperability

    DEFF Research Database (Denmark)

    Ekman, Torbjörn; Mechlenborg, Peter; Schultz, Ulrik Pagh

    2007-01-01

    Virtual machines raise the abstraction level of the execution environment at the cost of restricting the set of supported languages. Moreover, the ability of a language implementation to integrate with other languages hosted on the same virtual machine typically constrains the features...... of the language. In this paper, we present a highly flexible yet efficient approach to hosting multiple programming languages on an object-oriented virtual machine. Our approach is based on extending the interface of each class with language-specific wrapper methods, offering each language a tailored view...... of a given class. This approach can be deployed both on a statically typed virtual machine, such as the JVM, and on a dynamic virtual machine, such as a Smalltalk virtual machine. We have implemented our approach to language interoperability on top of a prototype virtual machine for embedded systems based...

  15. Flexible cultural repertoires

    DEFF Research Database (Denmark)

    Lindegaard, Marie Rosenkrantz; Zimmermann, Francisca

    2017-01-01

    Despite extensive studies of street culture and the risks of offending and victimization in urban marginalized areas, little is known about the role of cultural repertoires for variation in victimization risks among young men not involved in crime. Based on two ethnographic studies, conducted...... independently of the authors in neighbouring township areas of Cape Town, we offer insights into patterns of victimization among young men not involved in crime who live and attend school in the townships. Young men WHO perform decent cultural repertoires are highly exposed to victimization due to their moral...... rejection of crime-involved youth. Young men who perform flexible cultural repertoires, by incorporating and shifting between gang and decent repertoires, experience low victimization due to their adaptation to crime-involved youth. Findings emphasize the importance of detailed investigations of the way...

  16. Flexible helical yarn swimmers.

    Science.gov (United States)

    Zakharov, A P; Leshansky, A M; Pismen, L M

    2016-09-01

    We investigate the motion of a flexible Stokesian flagellar swimmer realised as a yarn made of two intertwined elastomer fibres, one active, that can reversibly change its length in response to a local excitation causing transition to the nematic state or swelling, and the other one, a passive isotropic elastomer with identical mechanical properties. A propagating chemical wave may provide an excitation mechanism ensuring a constant length of the excited region. Generally, the swimmer moves along a helical trajectory, and the propagation and rotation velocity are very sensitive to the ratio of the excited region to the pitch of the yarn, as well as to the size of a carried load. External excitation by a moving actuating beam is less effective, unless the direction of the beam is adjusted to rotation of the swimmer.

  17. Flexible weapons architecture design

    Science.gov (United States)

    Pyant, William C., III

    Present day air-delivered weapons are of a closed architecture, with little to no ability to tailor the weapon for the individual engagement. The closed architectures require weaponeers to make the target fit the weapon instead of fitting the individual weapons to a target. The concept of a flexible weapons aims to modularize weapons design using an open architecture shell into which different modules are inserted to achieve the desired target fractional damage while reducing cost and civilian casualties. This thesis shows that the architecture design factors of damage mechanism, fusing, weapons weight, guidance, and propulsion are significant in enhancing weapon performance objectives, and would benefit from modularization. Additionally, this thesis constructs an algorithm that can be used to design a weapon set for a particular target class based on these modular components.

  18. Conformational flexibility of aspartame.

    Science.gov (United States)

    Toniolo, Claudio; Temussi, Pierandrea

    2016-05-01

    L-Aspartyl-L-phenylalanine methyl ester, better known as aspartame, is not only one of the most used artificial sweeteners, but also a very interesting molecule with respect to the correlation between molecular structure and taste. The extreme conformational flexibility of this dipeptide posed a huge difficulty when researchers tried to use it as a lead compound to design new sweeteners. In particular, it was difficult to take advantage of its molecular model as a mold to infer the shape of the, then unknown, active site of the sweet taste receptor. Here, we follow the story of the 3D structural aspects of aspartame from early conformational studies to recent docking into homology models of the receptor. © 2016 Wiley Periodicals, Inc. Biopolymers (Pept Sci) 106: 376-384, 2016. © 2016 Wiley Periodicals, Inc.

  19. Two-Dimensional High Definition Versus Three-Dimensional Endoscopy in Endonasal Skull Base Surgery: A Comparative Preclinical Study.

    Science.gov (United States)

    Rampinelli, Vittorio; Doglietto, Francesco; Mattavelli, Davide; Qiu, Jimmy; Raffetti, Elena; Schreiber, Alberto; Villaret, Andrea Bolzoni; Kucharczyk, Walter; Donato, Francesco; Fontanella, Marco Maria; Nicolai, Piero

    2017-09-01

    Three-dimensional (3D) endoscopy has been recently introduced in endonasal skull base surgery. Only a relatively limited number of studies have compared it to 2-dimensional, high definition technology. The objective was to compare, in a preclinical setting for endonasal endoscopic surgery, the surgical maneuverability of 2-dimensional, high definition and 3D endoscopy. A group of 68 volunteers, novice and experienced surgeons, were asked to perform 2 tasks, namely simulating grasping and dissection surgical maneuvers, in a model of the nasal cavities. Time to complete the tasks was recorded. A questionnaire to investigate subjective feelings during tasks was filled by each participant. In 25 subjects, the surgeons' movements were continuously tracked by a magnetic-based neuronavigator coupled with dedicated software (ApproachViewer, part of GTx-UHN) and the recorded trajectories were analyzed by comparing jitter, sum of square differences, and funnel index. Total execution time was significantly lower with 3D technology (P < 0.05) in beginners and experts. Questionnaires showed that beginners preferred 3D endoscopy more frequently than experts. A minority (14%) of beginners experienced discomfort with 3D endoscopy. Analysis of jitter showed a trend toward increased effectiveness of surgical maneuvers with 3D endoscopy. Sum of square differences and funnel index analyses documented better values with 3D endoscopy in experts. In a preclinical setting for endonasal skull base surgery, 3D technology appears to confer an advantage in terms of time of execution and precision of surgical maneuvers. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Jejunal varices diagnosed by capsule endoscopy in patients with post-liver transplant portal hypertension.

    Science.gov (United States)

    Bass, Lee M; Kim, Stanley; Superina, Riccardo; Mohammad, Saeed

    2017-02-01

    Portal hypertension secondary to portal vein obstruction following liver transplant occurs in 5%-10% of children. Jejunal varices are uncommon in this group. We present a case series of children with significant GI blood loss, negative upper endoscopy, and jejunal varices detected by CE. Case series of patients who had CE for chronic GI blood loss following liver transplantation. Three patients who had their initial transplants at a median age of 7 months were identified at our institution presenting at a median age of 8 years (range 7-16 years) with a median Hgb of 2.8 g/dL (range 1.8-6.8 g/dL). Upper endoscopy was negative for significant esophageal varices, gastric varices, and bleeding portal gastropathy in all three children. All three patients had significant jejunal varices noted on CE in mid-jejunum. Jejunal varices were described as large prominent bluish vessels underneath visualized mucosa, one with evidence of recent bleeding. The results led to venoplasty of the portal vein in two patients and a decompressive shunt in one patient with resolution of GI bleed and anemia. CE is useful to diagnose intestinal varices in children with portal hypertension and GI bleeding following liver transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2014-06-19

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

  2. Pre-Procedural Patient Education Reduces Fall Risk in an Outpatient Endoscopy Suite.

    Science.gov (United States)

    Hilscher, Moira B; Niesen, Cynthia R; Tynsky, Desiree A; Kane, Sunanda V

    The purpose of this article was to determine whether scripted pre-procedural fall risk patient education and nurses' intention to assist patients after receiving sedation improves receptiveness of nursing assistance during recovery and decreases fall risk in an outpatient endoscopy suite. We prospectively identified high fall risk patients using the following criteria: (1) use of an assistive device, (2) fallen two or more times within the last year, (3) sustained an injury in a fall within a year, (4) age greater than 85 years, or (5) nursing judgment of high fall risk. Using a scripted dialogue, nurses educated high-risk patients of their fall risk and the nurses' intent to assist them to and in the bathroom. Documentation of patient education, script use, and assistance was monitored. Over 24 weeks, 892 endoscopy patients were identified as high fall risk; 790 (88.5%) accepted post-procedural assistance. Documentation of assistance significantly increased from 33% to 100%. Patients receiving education and postprocedural assistance increased from 27.9% to 100% at week 24. No patient falls occurred 12 months following implementation among patients identified as high fall risk. Scripted pre-procedural fall risk education increases patient awareness and receptiveness to assistance and can lead to decreased fall rates.

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

    Directory of Open Access Journals (Sweden)

    Masaki Endo

    2011-01-01

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

  4. Selective endoscopy in management of ingested foreign bodies of the upper gastrointestinal tract: is it safe?

    LENUS (Irish Health Repository)

    O'Sullivan, S T

    2012-02-03

    During a four-year period, 308 patients presented following ingestion of foreign bodies. Ingestion was accidental in 272 cases (88.3%) and deliberate in the remainder. Symptoms at presentation included dysphagia, odynophagia, nausea and vomiting, chest pain and pharyngeal discomfort. Sixty-eight patients were asymptomatic. A policy of expectant management and selective endoscopy was employed. Following initial assessment 202 patients (65.6%) were discharged without treatment, 30 (9.7%) of whom were later reviewed as outpatients and did not require admission. Forty-nine patients (16%) were admitted for treatment; 27 had oesophagoscopy, five bronchoscopy and two had foreign body extraction with direct laryngoscopy. In nine patients who were endoscoped, no foreign body was identified. Twenty-seven others were referred to the otorhinolaryngology service in another hospital. There were no deaths in the group and morbidity was 1.2%. We conclude that a policy of selective endoscopy is safe and effective in the management of patients following ingestion of foreign bodies.

  5. Quality assurance and gastrointestinal endoscopy: an audit of 500 colonoscopic procedures.

    Science.gov (United States)

    Denis, Bernard; Weiss, Anne-Marie; Peter, André; Bottlaender, Jacques; Chiappa, Pascale

    2004-12-01

    The aim of this study was to assess the quality of colonoscopic procedures in our endoscopy unit with the goal of improving performance. We prospectively audited 500 consecutive colonoscopic procedures and assessed sixty-two process or outcome indicators for each procedure. Most of the measured indicators were within standard limits: cecal intubation rate (92%), inadequate bowel preparations (24%), inappropriate procedures (9.7%), normal procedures (54%), yield for neoplasia (32%), morbidity (0.4%), and overall patient satisfaction (95.8%). Some indicators were outside standard limits suggesting our practices should be modified: endoscopy withdrawal time less than 6 minutes (78%), forceps removal of polyps (31%), resected polyps not recovered for pathological examination (12%), adenomas with villous elements (22%), patients unsatisfied because of time spent waiting for the procedure (19%), patients unsatisfied because of inadequate explanations (10%). There was no standard for a few indicators: patient discomfort (6.9%), diagnostic success (89%), therapeutic success (92%). Three new indicators were proposed: proportion of patients agedadvanced adenoma or cancer, and proportion of colonoscopic procedures causing discomfort. The diagnostic yield of colonoscopy was dependent on age, gender, indication and appropriateness of indication but not on the prescriber. This audit allowed us to evaluate our endoscopic practices and to detect certain shortcomings and deviations from standards. It enabled us to change some of our practices with the goal of improving the quality of our colonoscopic procedures.

  6. Gastric carcinoma originating from the heterotopic submucosal gastric gland treated by laparoscopy and endoscopy cooperative surgery

    Science.gov (United States)

    Imamura, Taisuke; Komatsu, Shuhei; Ichikawa, Daisuke; Kobayashi, Hiroki; Miyamae, Mahito; Hirajima, Shoji; Kawaguchi, Tsutomu; Kubota, Takeshi; Kosuga, Toshiyuki; Okamoto, Kazuma; Konishi, Hirotaka; Shiozaki, Atsushi; Fujiwara, Hitoshi; Ogiso, Kiyoshi; Yagi, Nobuaki; Yanagisawa, Akio; Ando, Takashi; Otsuji, Eigo

    2015-01-01

    Gastric carcinoma is derived from epithelial cells in the gastric mucosa. We reported an extremely rare case of submucosal gastric carcinoma originating from the heterotopic submucosal gastric gland (HSG) that was safely diagnosed by laparoscopy and endoscopy cooperative surgery (LECS). A 66-year-old man underwent gastrointestinal endoscopy, which detected a submucosal tumor (SMT) of 1.5 cm in diameter on the lesser-anterior wall of the upper gastric body. The tumor could not be diagnosed histologically, even by endoscopic ultrasound-guided fine-needle aspiration biopsy. Local resection by LECS was performed to confirm a diagnosis. Pathologically, the tumor was an intra-submucosal well differentiated adenocarcinoma invading 5000 μm into the submucosal layer. The resected tumor had negative lateral and vertical margins. Based on the Japanese treatment guidelines, additional laparoscopic proximal gastrectomy was curatively performed. LECS is a less invasive and safer approach for the diagnosis of SMT, even in submucosal gastric carcinoma originating from the HSG. PMID:26306144

  7. Sex differences in dreaming during short propofol sedation for upper gastrointestinal endoscopy.

    Science.gov (United States)

    Xu, Guanghong; Liu, Xuesheng; Sheng, Qiying; Yu, Fengqiong; Wang, Kai

    2013-10-02

    Previous reports suggest that sex differences may exist in dreaming under anesthesia, but their results were inconclusive. The current study explored sex differences in the incidence and content of dreams during short propofol sedation for upper gastrointestinal endoscopy and investigated whether sex differences or dream content affect patient satisfaction with sedation. A total of 200 patients (100 men and 100 women) undergoing upper gastrointestinal endoscopy participated in this study. Patients were interviewed with the modified Brice questionnaire about the incidence and the content of dreams, and satisfaction with sedation was assessed. The results showed that the incidence of dreaming was significantly higher in men (31%) than in women (17%) (P=0.02), but recovery time was similar. In men, 45% (14/31) of dreamers reported positive emotional content and only 6% (2/31) reported negative emotional content. In contrast, in women, 18% (3/17) reported positive and 29% (5/17) reported negative content (P=0.04). Men reported dreams that were more vivid, meaningful, familiar, and memorable (PDreamer satisfaction with sedation was not influenced by sex or dream content.

  8. Upper GI endoscopy in elderly patients: predictive factors of relevant endoscopic findings.

    Science.gov (United States)

    Buri, Luigi; Zullo, Angelo; Hassan, Cesare; Bersani, Gianluca; Anti, Marcello; Bianco, Maria A; Cipolletta, Livio; Giulio, Emilio Di; Matteo, Giovanni Di; Familiari, Luigi; Ficano, Leonardo; Loriga, Piero; Morini, Sergio; Pietropaolo, Vincenzo; Zambelli, Alessandro; Grossi, Enzo; Tessari, Francesco; Intraligi, Marco; Buscema, Massimo

    2013-03-01

    Elderly patients are at increased risk for peptic ulcer and cancer. Predictive factors of relevant endoscopic findings at upper endoscopy in the elderly are unknown. This was a post hoc analysis of a nationwide, endoscopic study. A total of 3,147 elderly patients were selected. Demographic, clinical, and endoscopic data were systematically collected. Relevant findings and new diagnoses of peptic ulcer and malignancy were computed. Both univariate and multivariate analyses were performed. A total of 1,559 (49.5%), 213 (6.8%), 93 (3%) relevant findings, peptic ulcers, and malignancies were detected. Peptic ulcers and malignancies were more frequent in >85-year-old patients (OR 3.1, 95% CI = 2.0-4.7, p = 0.001). The presence of dysphagia (OR = 5.15), weight loss (OR = 4.77), persistent vomiting (OR = 3.68), anaemia (OR = 1.83), and male gender (OR = 1.9) were significantly associated with a malignancy, whilst overt bleeding (OR = 6.66), NSAIDs use (OR = 2.23), and epigastric pain (OR = 1.90) were associated with the presence of peptic ulcer. Peptic ulcer or malignancies were detected in 10% of elderly patients, supporting the use of endoscopy in this age group. Very elderly patients appear to be at higher risk of such lesions.

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

    Directory of Open Access Journals (Sweden)

    Reinaldo Benevides dos Santos

    2011-12-01

    Full Text Available CONTEXT: Intestinal parasites induce detectable histopathological changes, which have been studied in groups with known diagnosis of parasitic disease. There is no available study with a larger base without previous diagnosis. OBJECTIVE: To describe clinical and histopathological findings of parasitosis diagnosed by endoscopic biopsy in patients submitted to upper digestive endoscopy. METHODS: Recorded biopsies archive at "Complexo Hospitalar Professor Edgar Santos" , a general teaching Hospital in the state of Bahia, Northeast Brazil, from January 1995 to January 2009, were reviewed. One thousand ten duodenal biopsy reports were found. Reports positive for parasites had their specimens reviewed and photographed. All blocks of biopsy selected as case were retrieved and reviewed by an experienced pathologist. Clinical, laboratorial and endoscopic data were collected. RESULTS: Eleven biopsies showed parasites, including cases of Cryptosporidium sp. and Strongyloides stercoralis. Vomiting (91%, abdominal pain (78%, diarrhea (78% and weight loss (78% were usual symptoms. Seventy-five percent had duodenal mucosa changes on endoscopy, while 25% have no changes. Anemia and low serum albumin were important laboratorial data. HIV infection association was observed. Villus atrophy and reactive epithelium were usual in Strongyloides cases. CONCLUSIONS: No endoscopic or histopathologic finding was pathognomonic. One percent of duodenal endoscopic biopsies showed parasites.

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

    Science.gov (United States)

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

    2011-10-01

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

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

    International Nuclear Information System (INIS)

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

    2011-01-01

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

  12. High-spatial-resolution isotropic three-dimensional fast-recovery fast spin-echo magnetic resonance dacryocystography combined with topical administration of sterile saline solution

    International Nuclear Information System (INIS)

    Jing, Zhang; Lang, Chen; Qiu-Xia, Wang; Rong, Liu; Xin, Luo; Wen-Zhen, Zhu; Li-Ming, Xia; Jian-Pin, Qi; He, Wang

    2013-01-01

    Objective: This study aims to investigate the clinical performance of three-dimensional (3D) fast-recovery fast spin-echo (FRFSE) magnetic resonance dacryocystography (MRD) with topical administration of sterile saline solution for the assessment of the lacrimal drainage system (LDS). Methods: A total of 13 healthy volunteers underwent both 3D-FRFSE MRD and two-dimensional (2D)-impulse recovery (IR)-single-shot fast spin-echo (SSFSE) MRD after topical administration of sterile saline solution, and 31 patients affected by primary LDS outflow impairment or postsurgical recurrent epiphora underwent 3D-FRFSE MRD and conventional T1- and T2-weighted sequences. All patients underwent lacrimal endoscopy or surgery, which served as a standard of reference for confirming the MRD findings. Results: 3D-FRFSE MRD detected more visualized superior and inferior canaliculi and nasolacrimal duct than 2D-IR-SSFSE MRD. Compared with 2D-IR-SSFSE MRD, 3D-FRFSE MRD showed more visualized segments per LDS, although the difference was not statistically significant. Significant improvements in the inferior canaliculus and nasolacrimal duct visibility grades were achieved using 3D-FRFSE MRD. 3D-FRFSE MRD had 100% sensitivity and 63.6% specificity for detecting LDS obstruction. In 51 out of the 62 LDSs that were assessed, a 90% agreement was noted between the findings of 3D-FRFSE MRD and lacrimal endoscopy in detecting the obstruction level. Conclusion: 3D-FRFSE MRD combined with topical administration of sterile saline solution is a simple and noninvasive method of obtaining detailed morphological and functional information on the LDS. Overall, 3D-FRFSE MRD could be used as a reliable diagnostic method in many patients with epiphora prior to surgery

  13. Diagnostic and Therapeutic Yield of Endoscopy in Patients with Elevated INR and Gastrointestinal Bleeding.

    Science.gov (United States)

    Peloquin, Joanna M; Seraj, Siamak M; King, Lindsay Y; Campbell, Emily J; Ananthakrishnan, Ashwin N; Richter, James M

    2016-06-01

    Gastrointestinal bleeding is a well-known risk of systemic anticoagulation. However, bleeding in the setting of supratherapeutic anticoagulation may have a milder natural history than unprovoked bleeding. It is a common clinical gestalt that endoscopy is common, but bleeding source identification or intervention is uncommon, yet few data exist to inform this clinical impression. Consequently, we sought to examine our institutional experience with gastrointestinal bleeding in the setting of supratherapeutic international normalized ratio (INR) with the aim of identifying predictors of endoscopically identifiable lesions, interventions, and outcomes. A retrospective review was conducted at a tertiary referral academic medical center to identify patients presenting with gastrointestinal bleeding in the setting of warfarin and a supratherapeutic INR (>3.5) who underwent an endoscopic procedure. Relevant clinical covariates, endoscopic findings, need for intervention, and outcomes were collected by review of the medical record. Logistic regression adjusting for potential confounders identified predictors of endoscopically significant lesions as well as intervention and outcomes. A total of 134 patients with INR 3.5 or greater (mean 5.5, range 3.5-17.1) presented with symptoms of gastrointestinal bleeding, most commonly as melena or symptomatic anemia. Antiplatelet agents were used by 54% of patients, and 60% of patients were on concomitant acid suppression on admission. Procedures included esophagogastroduodenoscopy (upper endoscopy; EGD) (n = 128), colonoscopy (n = 73), and video capsule endoscopy (n = 32). Active bleeding at first EGD or colonoscopy was found in only 19 patients (18%), with endoscopic intervention in only 26 patients (25%). At a critical threshold of INR 7.5 at presentation, the likelihood of finding an endoscopically significant lesion fell to therapy (odds ratio [OR] 2.59; 95% confidence interval [CI], 1.13-5.94), timing of EGD within 12 hours of

  14. A score card for upper GI endoscopy: Evaluation of interobserver variability in examiners with various levels of experience.

    Science.gov (United States)

    Neumann, M; Friedl, S; Meining, A; Egger, K; Heldwein, W; Rey, J F; Hochberger, J; Classen, M; Hohenberger, W; Rösch, T

    2002-10-01

    In most European countries, training in GI endoscopy has largely been based on hands-on acquisition of experience in patients rather than on a structured training programme. With the development of training models systematic hands-on training in a variety of diagnostic and therapeutic endoscopy techniques was achieved. Little, however, is known about methods of objectively assessing trainees' performance. We therefore developed an assessment 'score card' for upper GI endoscopy and tested it in endoscopists with various levels of experience. The aim of the study was therefore to assess interobserver variations in the evaluation of trainees. On the basis of textbook and expert opinions a consensus group of eight experienced endoscopists developed a score card for diagnostic upper GI endoscopy with biopsy. The score card includes an assessment of the single steps of the procedure as well as of the times needed to complete each step. This score card was then evaluated in a further conference including ten experts who blindly assessed videotapes of 15 endoscopists performing upper GI endoscopy in a training bio-simulation model (the 'Erlangen Endo-Trainer'). On the basis of their previous experience (i. e. the number of endoscopies performed) these 15 endoscopists were classified into four groups: very experienced, experienced, having some experience and inexperienced. Interobserver variability (IOV) was tested for the various score card parameters (Kendall's rank-correlation coefficient 0.0-0.5 poor, 0.5-1.0 good agreement). In addition, the correlation between the score card assessment and the examiners' experience levels was analysed. Despite poor IOV results for all the parameters tested (Kendall coefficient account (correlation coefficient 0.59-0.89, p < 0.05). The score card parameters were suitable for differentiating between the four groups of examiners with different levels of endoscopic experience. As expected with scores involving subjective assessment of

  15. Freshwater salinization syndrome on a continental scale.

    Science.gov (United States)

    Kaushal, Sujay S; Likens, Gene E; Pace, Michael L; Utz, Ryan M; Haq, Shahan; Gorman, Julia; Grese, Melissa

    2018-01-23

    Salt pollution and human-accelerated weathering are shifting the chemical composition of major ions in fresh water and increasing salinization and alkalinization across North America. We propose a concept, the freshwater salinization syndrome, which links salinization and alkalinization processes. This syndrome manifests as concurrent trends in specific conductance, pH, alkalinity, and base cations. Although individual trends can vary in strength, changes in salinization and alkalinization have affected 37% and 90%, respectively, of the drainage area of the contiguous United States over the past century. Across 232 United States Geological Survey (USGS) monitoring sites, 66% of stream and river sites showed a statistical increase in pH, which often began decades before acid rain regulations. The syndrome is most prominent in the densely populated eastern and midwestern United States, where salinity and alkalinity have increased most rapidly. The syndrome is caused by salt pollution (e.g., road deicers, irrigation runoff, sewage, potash), accelerated weathering and soil cation exchange, mining and resource extraction, and the presence of easily weathered minerals used in agriculture (lime) and urbanization (concrete). Increasing salts with strong bases and carbonates elevate acid neutralizing capacity and pH, and increasing sodium from salt pollution eventually displaces base cations on soil exchange sites, which further increases pH and alkalinization. Symptoms of the syndrome can include: infrastructure corrosion, contaminant mobilization, and variations in coastal ocean acidification caused by increasingly alkaline river inputs. Unless regulated and managed, the freshwater salinization syndrome can have significant impacts on ecosystem services such as safe drinking water, contaminant retention, and biodiversity. Copyright © 2018 the Author(s). Published by PNAS.

  16. Adaptive salinity management in the Murray-Darling Basin: a transaction cost study

    Science.gov (United States)

    Loch, A. J.

    2017-12-01

    Transaction costs hinder or promote effective management of common good resource intertemporal externalities. Appropriate policy choices may reduce externalities and improve social welfare, and transaction cost analysis can help to evaluate policy choices. However, without measurement of relevant transaction costs such policy evaluation remains challenging. This article uses a time series dataset of salinity management program to test theory aimed at transaction cost-based policy evaluation and adaptive resource management over a period of 30 years worth of data. We identify peaks and troughs in transaction costs over time, lag-effects in program expenditure, and calculate the decay in transaction cost impacts. We conclude that Australian salinity management programs are achieving flexible institutional outcomes and effective policy arrangements with long-term benefits. Proposed changes to the program moving forward add weight to our assertions of adaptive strategies, and illustrate the value of the novel data-driven tracnsaction cost analysis approach for other jurisdictions.

  17. Present and future status of flexible spectral imaging color enhancement and blue laser imaging technology.

    Science.gov (United States)

    Osawa, Hiroyuki; Yamamoto, Hironori

    2014-01-01

    The usefulness of flexible spectral imaging color enhancement (FICE) has been reported for evaluating the esophagus, stomach, and small and large intestine. Higher contrast is shown between cancer and the surrounding mucosa in the esophagus and stomach and may facilitate the detection of gastric cancers missed by white light imaging alone. The surface patterns of gastric mucosa are clearly visualized in non-malignant areas but are irregular and blurred in malignant areas, leading to clear demarcation. Capsule endoscopy with FICE detects angiodysplasia and erosions of the small intestine. The surface and vascular pattern with FICE is useful for the differential diagnosis of colorectal polyps. However, FICE remains somewhat poor at visualizing mucosal microvasculature on a tumor surface. Narrow-band imaging (NBI) is dark in observing whole gastric mucosa and poor at visualizing mucosal microstructure. Blue laser imaging (BLI) has the potential to resolve these limitations. Narrow-band laser light combined with white light shows irregular microvessels on both differentiated and undifferentiated gastric cancer similar to those using NBI. In addition, irregular surface patterns including minute white zones are clearly seen on the uneven surface of differentiated lesions, resulting in exclusion of undifferentiated lesions. Using both distant and close-up views, a high contrast between green intestinal metaplasia and brown gastric cancer may lead to early detection of gastric cancers and determination of a demarcation line. BLI produces high-contrast images in esophageal cancer with clear vision of intrapapillary capillary loops and also predicts the histopathological diagnosis and depth of invasion in colorectal neoplasms. © 2013 The Authors. Digestive Endoscopy © 2013 Japan Gastroenterological Endoscopy Society.

  18. Dextrose saline compared with normal saline rehydration of hyperemesis gravidarum: a randomized controlled trial.

    Science.gov (United States)

    Tan, Peng Chiong; Norazilah, Mat Jin; Omar, Siti Zawiah

    2013-02-01

    To compare 5% dextrose-0.9% saline against 0.9% saline solution in the intravenous rehydration of hyperemesis gravidarum. Women at their first hospitalization for hyperemesis gravidarum were enrolled on admission to the ward and randomly assigned to receive either 5% dextrose-0.9% saline or 0.9% saline by intravenous infusion at a rate 125 mL/h over 24 hours in a double-blind trial. All participants also received thiamine and an antiemetic intravenously. Oral intake was allowed as tolerated. Primary outcomes were resolution of ketonuria and well-being (by 10-point visual numerical rating scale) at 24 hours. Nausea visual numerical rating scale scores were obtained every 8 hours for 24 hours. Persistent ketonuria rates after the 24-hour study period were 10 of 101 (9.9%) compared with 11 of 101 (10.9%) (P>.99; relative risk 0.9, 95% confidence interval 0.4-2.2) and median (interquartile range) well-being scores at 24 hours were 9 (8-10) compared with 9 (8-9.5) (P=.73) in the 5% dextrose-0.9% saline and 0.9% saline arms, respectively. Repeated measures analysis of variance of the nausea visual numerical rating scale score as assessed every 8 hours during the 24-hour study period showed a significant difference in favor of the 5% dextrose-0.9% saline arm (P=.046) with the superiority apparent at 8 and 16 hours, but the advantage had dissipated by 24 hours. Secondary outcomes of vomiting, resolution of hyponatremia, hypochloremia and hypokalemia, length of hospitalization, duration of intravenous antiemetic, and rehydration were not different. Intravenous rehydration with 5% dextrose-0.9% saline or 0.9% saline solution in women hospitalized for hyperemesis gravidarum produced similar outcomes. ISRCTN Register, www.controlled-trials.com/isrctn, ISRCTN65014409. I.

  19. Special Issue: Flexible Work Arrangements.

    Science.gov (United States)

    Olmstead, Barney, Ed.

    1996-01-01

    Section 1 contains five chapters on flexible work arrangements, self-employment, working from home, part-time professionals, job sharing, and temporary employment. Section 2 includes reviews of four books on working flexibly, concluding with a list of 23 additional readings. (SK)

  20. Measuring and Comparing Energy Flexibilities

    DEFF Research Database (Denmark)

    Valsomatzis, Emmanouil; Hose, Katja; Pedersen, Torben Bach

    2015-01-01

    induced by time and amount individually, and by their com- bination. To this end, we introduce several flexibility measures that take into account the combined effect of time and energy on flex-offer flexibility and discuss their respective pros and cons through a number of realistic examples....

  1. Sensor Technologies on Flexible Substrates

    Science.gov (United States)

    Koehne, Jessica

    2016-01-01

    NASA Ames has developed sensor technologies on flexible substrates integrated into textiles for personalized environment monitoring and human performance evaluation. Current technologies include chemical sensing for gas leak and event monitoring and biological sensors for human health and performance monitoring. Targeted integration include next generation EVA suits and flexible habitats.

  2. Functional aspects of protein flexibility

    DEFF Research Database (Denmark)

    Teilum, Kaare; Olsen, Johan G; Kragelund, Birthe B

    2009-01-01

    this into an intuitive perception of protein function is challenging. Flexibility is of overwhelming importance for protein function, and the changes in protein structure during interactions with binding partners can be dramatic. The present review addresses protein flexibility, focusing on protein-ligand interactions...

  3. Endoscopic tri-modal imaging for detection of early neoplasia in Barrett's oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system

    NARCIS (Netherlands)

    Curvers, W. L.; Singh, R.; Song, L.-M. Wong-Kee; Wolfsen, H. C.; Ragunath, K.; Wang, K.; Wallace, M. B.; Fockens, P.; Bergman, J. J. G. H. M.

    2008-01-01

    OBJECTIVE: To investigate the diagnostic potential of endoscopic tri-modal imaging and the relative contribution of each imaging modality (i.e. high-resolution endoscopy (HRE), autofluorescence imaging (AFI) and narrow-band imaging (NBI)) for the detection of early neoplasia in Barrett's oesophagus.

  4. Flexible ring seal

    International Nuclear Information System (INIS)

    Abbes, Claude; Gournier, Andre; Rouaud, Christian; Villepoix, Raymond de.

    1976-01-01

    The invention concerns a flexible metal ring seal, able to ensure a perfect seal between two bearings due to the crushing and elastic deformation properties akin to similar properties in elastomers. Various designs of seal of this kind are already known, particularly a seal made of a core formed by a helical wire spring with close-wound turns and with high axial compression ratio, closed on itself and having the shape of an annulus. This wire ring is surrounded by at least one envelope having at rest the shape of a toroidal surface of which the generating circle does not close on itself. In a particular design mode, the seal in question can include, around the internal spring, two envelopes of which one in contact with the spring is composed of a low ductility elastic metal, such as mild steel or stainless steel and the other is, on the contrary, made of a malleable metal, such as copper or nickel. The first envelope evenly distributes the partial crushing of the spring, when the seal is tightened, on the second envelope which closely fits the two surfaces between which the seal operates. The stress-crushing curve characteristic of the seal comprises two separate parts, the first with a relatively sharp slope corresponds to the start of the seal compression phase, enabling at least some of these curves to reach the requisite seal threshold very quickly, then, beyond this, a second part, practically flat, where the stress is appreciably constant for a wide operating bracket [fr

  5. Flexible piezotronic strain sensor.

    Science.gov (United States)

    Zhou, Jun; Gu, Yudong; Fei, Peng; Mai, Wenjie; Gao, Yifan; Yang, Rusen; Bao, Gang; Wang, Zhong Lin

    2008-09-01

    Strain sensors based on individual ZnO piezoelectric fine-wires (PFWs; nanowires, microwires) have been fabricated by a simple, reliable, and cost-effective technique. The electromechanical sensor device consists of a single electrically connected PFW that is placed on the outer surface of a flexible polystyrene (PS) substrate and bonded at its two ends. The entire device is fully packaged by a polydimethylsiloxane (PDMS) thin layer. The PFW has Schottky contacts at its two ends but with distinctly different barrier heights. The I- V characteristic is highly sensitive to strain mainly due to the change in Schottky barrier height (SBH), which scales linear with strain. The change in SBH is suggested owing to the strain induced band structure change and piezoelectric effect. The experimental data can be well-described by the thermionic emission-diffusion model. A gauge factor of as high as 1250 has been demonstrated, which is 25% higher than the best gauge factor demonstrated for carbon nanotubes. The strain sensor developed here has applications in strain and stress measurements in cell biology, biomedical sciences, MEMS devices, structure monitoring, and more.

  6. Orthogonal flexible Rydberg aggregates

    Science.gov (United States)

    Leonhardt, K.; Wüster, S.; Rost, J. M.

    2016-02-01

    We study the link between atomic motion and exciton transport in flexible Rydberg aggregates, assemblies of highly excited light alkali-metal atoms, for which motion due to dipole-dipole interaction becomes relevant. In two one-dimensional atom chains crossing at a right angle adiabatic exciton transport is affected by a conical intersection of excitonic energy surfaces, which induces controllable nonadiabatic effects. A joint exciton-motion pulse that is initially governed by a single energy surface is coherently split into two modes after crossing the intersection. The modes induce strongly different atomic motion, leading to clear signatures of nonadiabatic effects in atomic density profiles. We have shown how this scenario can be exploited as an exciton switch, controlling direction and coherence properties of the joint pulse on the second of the chains [K. Leonhardt et al., Phys. Rev. Lett. 113, 223001 (2014), 10.1103/PhysRevLett.113.223001]. In this article we discuss the underlying complex dynamics in detail, characterize the switch, and derive our isotropic interaction model from a realistic anisotropic one with the addition of a magnetic bias field.

  7. SOCMA study urges flexibility

    International Nuclear Information System (INIS)

    Kirschner, E.

    1993-01-01

    In implementing the 1990 Pollution Prevention Act, regulators and legislators should hold off on cookie-cutter, numerical goal-based requirements to allow for site and process specific programs, says a study sponsored by the Synthetic Organic Chemicals Manufacturers Association (SOCMA; Washington). Companies should have that flexibility to target their resources toward those activities that reduce pollution cost effectively, says SOCMA environmental quality committee chairman Art Gillen, who is also BASF director of environmental regulatory affairs. The study - conducted by Woodward-Clyde Consultants (Denver) - examines four batch and custom chemical manufacturing films. As in the Clean Air Act, the batch processing of SOCMA-member plants should be considered in new regulations, Gillen says. For example, the study found that most wastes are from shutdowns and cleanouts, and there are frequent charges in waste streams and raw materials. Those characteristics do not lend themselves to annual reduction goals. Also, specific goals could have a wide range of costs: measures to reduce stack air emissions run from $18/lb to $1,106/lb. SOCMA says it will present the study to Congress and the Environmental Protection Agency

  8. Integrated engineering increases flexibility

    International Nuclear Information System (INIS)

    Smith, Ray

    1991-01-01

    Integrated Engineering (IE) can be used to describe the best use of increasingly rare good engineering talent in an increasingly competive world. A number of organisations are now moving towards IE without any general agreement on a precise definition. The engineering division of British Nuclear Fuels (BNFL) is one such organisation. This feature covers the reasoning behind the decision, and our experience to date. BNFL engineering division is responsible primarily for the provision of major facilities on BNFL operational sites. This provision includes feasibility, front end and detailed design, procurement, installation and commissioning. Task force working has been used for some of the large projects. But the future workload is expected to comprise many more smaller projects. At the same time, equipment is becoming more complex and the need for mutual understanding and appreciation between disciplines is increasing. To meet this increasing need for flexibility, BNFL has decided to move to the matrix structure of project management and functional departments described in the article. (Author)

  9. Saline agriculture: A technology for economic utilization and improvement of saline environments (abstract)

    International Nuclear Information System (INIS)

    Aslam, Z.; Malik, K.A.; Khurshid, S.J.; Awan, A.R.; Akram, M.; Hashmi, Z.; Ali, Y.; Gulnaz, A.; Hussain, M.; Hussain, F.

    2005-01-01

    The salinity problem is one of the severe constraints for agriculture in Pakistan. In a socio-economic and salinity and drainage survey over an area of about 25000 acres of salt-affected land recently, crop production is found to be very low. Livestock is underfed and malnourished. Pakistan has spent and allocated over one billion US dollars on Salinity Control and Reclamation Projects (SCARP), of course, with dubious results. Over the years, a Saline Agriculture Technology has been developed as a cheap alternative at NIAB for comfortably living with salinity and to profitably utilize saline land rather than its reclamation. The soil improvement is a fringe benefit in this approach. The Saline Agriculture Technology has been tested at laboratory level, at field stations and at farms of some progressive farmers. Now we are sharing this technology with farming communities through a 'Saline Agriculture Farmer Participatory Development Project in Pakistan', with assistance from the National Rural Support Programme. The new project has been launched simultaneously in all four provinces of Pakistan on 25000 acres of salt-affected land. Under this project seeds of salt tolerant crop varieties wheat, cotton, rice, castor, brassica and barley and saplings of trees/shrubs, e.g. Acacia ampliceps, A. nilotica, Casuarina glauca, ber, jaman, etc selected for development work in various institutions of Pakistan are being provided to farmers. Know-how on new irrigation techniques like bed-and-corrugation and bed-and-furrow, agronomic practices like laser land leveling, planting on beds and in auger holes and soil/water amendment practices (use of gypsum and mineral acids) are being shared with farmers. These interventions are quite efficient, save water up to 40% and enable farmers to utilize bad quality water. In general, farmers are being familiarized with prevalent animal diseases, nutritional problems and prophylactic techniques. They are being helped in developing Saline

  10. Correlation between solid gastric emptying and endoscopy after silastic ring vertical gastroplasty

    International Nuclear Information System (INIS)

    Furtado, P.C.; Brunetto, S.Q.; Etchebehere, E.C.S.C.; Sansana, C.R.; Santos, A.O.; Lima, M.C.L.; Ramos, C.D.; Camargo, E.E.; Pareja, J.C.

    2002-01-01

    Bariatric surgeries have been used in the treatment of obese patients. Silastic ring vertical gastroplasty (SRVG) consists of creating a gastric pouch which will lead to changes in the mechanism of digestion and to weight loss Aim: To determine the solid gastric emptying T1/2 in patients who underwent SRVG, and to correlate these findings with endoscopy, body mass index (BMI) and percent loss of excess body weight (PLEBW). Materials and Methods: Thirty six obese patients (30 women and 6 men, mean age 40.3 years) were submitted to SRVG. Endoscopy was performed 6 to 12 months after SRVG to classify the ring introduced into the neo stomach as tight, medium and large. Twelve to 18 months after SRVG the patients were submitted to scintigraphy and evaluation of BMI and PLEBW. Gastric emptying was performed with a solid meal which consisted of a cooked egg labeled with 99m Tc-microcolloid. Patients were placed in the upright position and acquisition was begun after ingestion of the radioactive meal. The gastric emptying T1/2 was calculated. Results: The T1/2 was 53.44 ± 40.26 minutes for patients with a tight ring (47.2% of the patient population); 68.03 ± 43.06 minutes for patients with a medium ring (22.2% of the patient population); and 23.06 ± 25.15 minutes for patients with a large ring (30.6% of the patient population). There was a significant correlation between T1/2 and endoscopic findings (p = 0.0482; ANOVA). Within 18 months after SRVG, patients showed BMI = 32.48 ± 7.51 and PLEBW = 77.41 ± 21.22 %. Statistical analyses showed that there was a tendency towards a direct correlation between T1/2 and PLEBW (r = 0.46; p 0.0045) and a tendency towards an inverse correlation with the BMI (r -0.48; p=0.0028). Conclusions: Despite the significant correlation between T1/2 and the endoscopic, BMI and PLEBW findings, this method was unable to differentiate the ring sizes, probably because endoscopy was performed at least 6 months prior to the gastric emptying study

  11. WE-AB-BRA-12: Virtual Endoscope Tracking for Endoscopy-CT Image Registration

    International Nuclear Information System (INIS)

    Ingram, W; Rao, A; Wendt, R; Court, L; Yang, J; Beadle, B

    2015-01-01

    Purpose: The use of endoscopy in radiotherapy will remain limited until we can register endoscopic video to CT using standard clinical equipment. In this phantom study we tested a registration method using virtual endoscopy to measure CT-space positions from endoscopic video. Methods: Our phantom is a contorted clay cylinder with 2-mm-diameter markers in the luminal surface. These markers are visible on both CT and endoscopic video. Virtual endoscope images were rendered from a polygonal mesh created by segmenting the phantom’s luminal surface on CT. We tested registration accuracy by tracking the endoscope’s 6-degree-of-freedom coordinates frame-to-frame in a video recorded as it moved through the phantom, and using these coordinates to measure CT-space positions of markers visible in the final frame. To track the endoscope we used the Nelder-Mead method to search for coordinates that render the virtual frame most similar to the next recorded frame. We measured the endoscope’s initial-frame coordinates using a set of visible markers, and for image similarity we used a combination of mutual information and gradient alignment. CT-space marker positions were measured by projecting their final-frame pixel addresses through the virtual endoscope to intersect with the mesh. Registration error was quantified as the distance between this intersection and the marker’s manually-selected CT-space position. Results: Tracking succeeded for 6 of 8 videos, for which the mean registration error was 4.8±3.5mm (24 measurements total). The mean error in the axial direction (3.1±3.3mm) was larger than in the sagittal or coronal directions (2.0±2.3mm, 1.7±1.6mm). In the other 2 videos, the virtual endoscope got stuck in a false minimum. Conclusion: Our method can successfully track the position and orientation of an endoscope, and it provides accurate spatial mapping from endoscopic video to CT. This method will serve as a foundation for an endoscopy-CT registration

  12. Prophylactic antibiotics for endoscopy-associated peritonitis in peritoneal dialysis patients.

    Directory of Open Access Journals (Sweden)

    Hsin-Hsu Wu

    Full Text Available INTRODUCTION: Continuous ambulatory peritoneal dialysis (CAPD peritonitis may develop after endoscopic procedures, and the benefit of prophylactic antibiotics is unclear. In the present study, we investigated whether prophylactic antibiotics reduce the incidence of peritonitis in these patients. PATIENTS AND METHODS: We retrospectively reviewed all endoscopic procedures, including esophagogastroduodenoscopy (EGD, colonoscopy, sigmoidoscopy, cystoscopy, hysteroscopy, and hysteroscopy-assisted intrauterine device (IUD implantation/removal, performed in CAPD patients at Chang Gung Memorial Hospital, Taiwan, between February 2001 and February 2012. RESULTS: Four hundred and thirty-three patients were enrolled, and 125 endoscopies were performed in 45 patients. Eight (6.4% peritonitis episodes developed after the examination. Antibiotics were used in 26 procedures, and none of the patients had peritonitis (0% vs. 8.1% without antibiotic use; p=0.20. The peritonitis rate was significantly higher in the non-EGD group than in the EGD group (15.9% [7/44] vs. 1.2% [1/81]; p<0.005. Antibiotic use prior to non-EGD examinations significantly reduced the endoscopy-associated peritonitis rate compared to that without antibiotic use (0% [0/16] vs. 25% [7/28]; p<0.05. Peritonitis only occurred if invasive procedures were performed, such as biopsy, polypectomy, or IUD implantation, (noninvasive procedures, 0% [0/20] vs. invasive procedures, 30.4% [7/23]; p<0.05. No peritonitis was noted if antibiotics were used prior to examination with invasive procedures (0% [0/10] vs. 53.8% [7/13] without antibiotic use; p<0.05. Although not statistically significant, antibiotics may play a role in preventing gynecologic procedure-related peritonitis (antibiotics, 0% [0/4] vs. no antibiotics, 55.6% [5/9]; p=0.10. CONCLUSION: Antibiotic prophylaxis significantly reduced endoscopy-associated PD peritonitis in the non-EGD group. Endoscopically assisted invasive procedures, such

  13. WE-AB-BRA-12: Virtual Endoscope Tracking for Endoscopy-CT Image Registration

    Energy Technology Data Exchange (ETDEWEB)

    Ingram, W; Rao, A; Wendt, R; Court, L [The University of Texas MD Anderson Cancer Center, Houston, TX (United States); The University of Texas Graduate School of Biomedical Sciences, Houston, TX (United States); Yang, J; Beadle, B [The University of Texas MD Anderson Cancer Center, Houston, TX (United States)

    2015-06-15

    Purpose: The use of endoscopy in radiotherapy will remain limited until we can register endoscopic video to CT using standard clinical equipment. In this phantom study we tested a registration method using virtual endoscopy to measure CT-space positions from endoscopic video. Methods: Our phantom is a contorted clay cylinder with 2-mm-diameter markers in the luminal surface. These markers are visible on both CT and endoscopic video. Virtual endoscope images were rendered from a polygonal mesh created by segmenting the phantom’s luminal surface on CT. We tested registration accuracy by tracking the endoscope’s 6-degree-of-freedom coordinates frame-to-frame in a video recorded as it moved through the phantom, and using these coordinates to measure CT-space positions of markers visible in the final frame. To track the endoscope we used the Nelder-Mead method to search for coordinates that render the virtual frame most similar to the next recorded frame. We measured the endoscope’s initial-frame coordinates using a set of visible markers, and for image similarity we used a combination of mutual information and gradient alignment. CT-space marker positions were measured by projecting their final-frame pixel addresses through the virtual endoscope to intersect with the mesh. Registration error was quantified as the distance between this intersection and the marker’s manually-selected CT-space position. Results: Tracking succeeded for 6 of 8 videos, for which the mean registration error was 4.8±3.5mm (24 measurements total). The mean error in the axial direction (3.1±3.3mm) was larger than in the sagittal or coronal directions (2.0±2.3mm, 1.7±1.6mm). In the other 2 videos, the virtual endoscope got stuck in a false minimum. Conclusion: Our method can successfully track the position and orientation of an endoscope, and it provides accurate spatial mapping from endoscopic video to CT. This method will serve as a foundation for an endoscopy-CT registration

  14. Wave Induced Saline Intrusion in Sea Outfalls

    DEFF Research Database (Denmark)

    Larsen, Torben; Burrows, Richard

    1989-01-01

    Experimental and numerical studies have shown that the influence of wave increases the tendency of saline intrusion in multi-riser sea outfalls. The flow field in the diffusor under such unsteady and inhomogeneous circumstances is in general very complex, but when sufficient wave energy is dissip...

  15. Cuticle hydrocarbons in saline aquatic beetles

    Directory of Open Access Journals (Sweden)

    María Botella-Cruz

    2017-07-01

    Full Text Available Hydrocarbons are the principal component of insect cuticle and play an important role in maintaining water balance. Cuticular impermeability could be an adaptative response to salinity and desiccation in aquatic insects; however, cuticular hydrocarbons have been poorly explored in this group and there are no previous data on saline species. We characterized cuticular hydrocarbons of adults and larvae of two saline aquatic beetles, namely Nebrioporus baeticus (Dytiscidae and Enochrus jesusarribasi (Hydrophilidae, using a gas chromatograph coupled to a mass spectrometer. The CHC profile of adults of both species, characterized by a high abundance of branched alkanes and low of unsaturated alkenes, seems to be more similar to that of some terrestrial beetles (e.g., desert Tenebrionidae compared with other aquatic Coleoptera (freshwater Dytiscidae. Adults of E. jesusarribasi had longer chain compounds than N. baeticus, in agreement with their higher resistance to salinity and desiccation. The more permeable cuticle of larvae was characterized by a lower diversity in compounds, shorter carbon chain length and a higher proportion of unsaturated hydrocarbons compared with that of the adults. These results suggest that osmotic stress on aquatic insects could exert a selection pressure on CHC profile similar to aridity in terrestrial species.

  16. Decline of the world's saline lakes

    Science.gov (United States)

    Wurtsbaugh, Wayne A.; Miller, Craig; Null, Sarah E.; Derose, R. Justin; Wilcock, Peter; Hahnenberger, Maura; Howe, Frank; Moore, Johnnie

    2017-11-01

    Many of the world's saline lakes are shrinking at alarming rates, reducing waterbird habitat and economic benefits while threatening human health. Saline lakes are long-term basin-wide integrators of climatic conditions that shrink and grow with natural climatic variation. In contrast, water withdrawals for human use exert a sustained reduction in lake inflows and levels. Quantifying the relative contributions of natural variability and human impacts to lake inflows is needed to preserve these lakes. With a credible water balance, causes of lake decline from water diversions or climate variability can be identified and the inflow needed to maintain lake health can be defined. Without a water balance, natural variability can be an excuse for inaction. Here we describe the decline of several of the world's large saline lakes and use a water balance for Great Salt Lake (USA) to demonstrate that consumptive water use rather than long-term climate change has greatly reduced its size. The inflow needed to maintain bird habitat, support lake-related industries and prevent dust storms that threaten human health and agriculture can be identified and provides the information to evaluate the difficult tradeoffs between direct benefits of consumptive water use and ecosystem services provided by saline lakes.

  17. Salinity extrema in the Arabian Sea

    Digital Repository Service at National Institute of Oceanography (India)

    Shenoi, S.S.C.; Shetye, S.R.; Gouveia, A.D.; Michael, G.S.

    are described. Two of the maxima arise from the influence of Red Sea and the Persian Gulf Water. The third, which lies at the bottom of the Equatorial Surface Water, forms due to freshening at the surface of high salinity Arabian Sea near-surface waters...

  18. Investigations in Marine Chemistry: Salinity I.

    Science.gov (United States)

    Schlenker, Richard M.

    Presented is a unit designed for curriculum infusion and which relies on the hands-on discovery method as an instructive device. The student is introduced to the theory of a functioning salt water conductivity meter. The student explores the resistance of salt water as salinity increases and he treats the data which he has gathered,…

  19. Routine saline infusion sonohysterography prior to assisted ...

    African Journals Online (AJOL)

    53.85%), 8 (30.77%) and 4 (15.38%) respectively. The average duration of the procedure was 6 minutes with a range of 4-9 minutes. Saline infusion sonohysterography is a reliable, cost effective and safe diagnostic tool in the evaluation of the ...

  20. Biomass production on saline-alkaline soils

    Energy Technology Data Exchange (ETDEWEB)

    Chaturvedi, A.N.

    1985-01-01

    In a trial of twelve tree species (both nitrogen fixing and non-fixing) for fuel plantations on saline-alkaline soil derived from Gangetic alluvium silty clay, Leucaena leucocephala failed completely after showing rapid growth for six months. Results for other species at age two showed that Prosopis juliflora had the best productivity.

  1. Current status of core and advanced adult gastrointestinal endoscopy training in Canada: Survey of existing accredited programs.

    Science.gov (United States)

    Xiong, Xin; Barkun, Alan N; Waschke, Kevin; Martel, Myriam

    2013-01-01

    To determine the current status of core and advanced adult gastroenterology training in Canada. A survey consisting of 20 questions pertaining to core and advanced endoscopy training was circulated to 14 accredited adult gastroenterology residency program directors. For continuous variables, median and range were analyzed; for categorical variables, percentage and associated 95% CIs were analyzed. All 14 programs responded to the survey. The median number of core trainees was six (range four to 16). The median (range) procedural volumes for gastroscopy, colonoscopy, percutaneous endoscopic gastrostomy and sigmoidoscopy, respectively, were 400 (150 to 1000), 325 (200 to 1500), 15 (zero to 250) and 60 (25 to 300). Eleven of 13 (84.6%) programs used endoscopy simulators in their curriculum. Eight of 14 programs (57%) provided a structured advanced endoscopy training fellowship. The majority (88%) offered training of combined endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasonography. The median number of positions offered yearly for advanced endoscopy fellowship was one (range one to three). The median (range) procedural volumes for ERCP, endoscopic ultrasonography and endoscopic mucosal resection, respectively, were 325 (200 to 750), 250 (80 to 400) and 20 (10 to 63). None of the current programs offered training in endoscopic submucosal dissection or natural orifice transluminal endoscopic surgery. Most accredited adult Canadian gastroenterology programs met the minimal procedural requirements recommended by the Canadian Association of Gastroenterology during core training. However, a more heterogeneous experience has been observed for advanced training. Additional studies would be required to validate and standardize evaluation tools used during gastroenterology curricula.

  2. Diagnosis of Helicobacter pylori-related chronic gastritis, gastric adenoma and early gastric cancer by magnifying endoscopy.

    Science.gov (United States)

    Soma, Nei

    2016-10-01

    Evaluating the prevalence and severity of gastritis by endoscopy is useful for estimating the risk of gastric cancer (GC). Moreover, understanding the endoscopic appearances of gastritis is important for diagnosing GC due to the fact that superficial mucosal lesions mimicing gastritis (gastritis-like lesions) are quite difficult to be detected even with optimum preparation and the best technique, and in such cases tissue biopsy is often not very accurate for the diagnosis of gastric epithelial neoplasia. Magnifying endoscopy is a highly accurate technique for the detection of early gastric cancer (EGC). Recent reports have described that various novel endoscopic markers which, visualized by magnifying endoscopy with image-enhanced system (ME-IEE), can predict specific histopathological findings. Using ME-IEE with vessels and surface classification system (VSCS) may represent an excellent diagnostic performance with high confidence and good reproducibility to the endoscopists if performed under consistent conditions, including observation under maximal magnification. The aim of this review was to discuss how to identify high-risk groups for GC by endoscopy, and how to detect effectively signs of suspicious lesions by conventional white light imaging (C-WLI) or chromoendoscopy (CE). Furthermore, to characterize suspicious lesions using ME-IEE using the criteria and classification of EGC based upon VSCS. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  3. Usefulness of virtual endoscopy for evaluating the relationship between the neck of intracranial aneurysm and surrounding vessels

    International Nuclear Information System (INIS)

    Ikeda, Jota; Horie, Hitoshi; Ishikura, Reiichi; Ando, Kumiko; Morikawa, Tsutomu; Tominaga, Satoru; Nakao, Norio

    2000-01-01

    Application of three-dimensional CT virtual endoscopy for evaluation of the neck and surrounding vessels of intracranial aneurysms. 3D-CT virtual endoscopy (VE) is a reconstructed image using computer processing of 3D-CT images. We evaluated the usefulness of a virtual endoscopy to analyze the relationship between the neck of an intracranial aneurysm and the surrounding vessels. Eight cases with intracranial aneurysms underwent digital subtraction angiography (DSA) and enhanced CT with transarterial infusion of contrast media. 3D-CT angiogram (3D-CTA) and virtual endoscopic images were obtained from the CT image data sets using surface rendering method. The relationship between the neck of an intracranial aneurysm and the surrounding vessels was confirmed by operation or IVR. VE clearly visualized the neck and surrounding vessels in all cases. Operation/IVR findings agreed with the virtual endoscopic findings in all cases, but not with the DSA or 3D-CTA findings in 4 and 2 cases, respectively. 3D-CTA and virtual endoscopy clearly visualizes the relationship between cerebral aneurysms and surrounding vessels, which is useful for determining IVR procedures. (author)

  4. High-resolution endoscopy plus chromoendoscopy or narrow-band imaging in Barrett's esophagus: a prospective randomized crossover study

    NARCIS (Netherlands)

    Kara, M. A.; Peters, F. P.; Rosmolen, W. D.; Krishnadath, K. K.; ten Kate, F. J.; Fockens, P.; Bergman, J. J. G. H.

    2005-01-01

    Background and study aims: High-resolution endoscopy (HRE) may improve the detection of early neoplasia in Barrett's esophagus. Indigo carmine chromoendoscopy (ICc) and narrow-band imaging (NBI) may be useful techniques to complement HRE. The aim of this study was to compare HRE-ICC with HrE-NBI for

  5. Impact of video-endoscopy on the results of retrosigmoid-transmeatal microsurgery of vestibular schwannoma: prospective study

    Czech Academy of Sciences Publication Activity Database

    Chovanec, M.; Zvěřina, E.; Profant, Oliver; Skřivan, J.; Čakrt, O.; Lisý, J.; Betka, J.

    2013-01-01

    Roč. 270, č. 4 (2013), s. 1277-1284 ISSN 0937-4477 Grant - others:GA MZd(CZ) NS9909 Institutional support: RVO:68378041 Keywords : vestibular schwannoma * acoustic neuroma * endoscopy-assisted microsurgery Subject RIV: FH - Neurology Impact factor: 1.608, year: 2013

  6. Management of saline soils in Israel

    International Nuclear Information System (INIS)

    Rawitz, E.

    1983-01-01

    The main soil salinity problem in Israel is the danger of gradual salinization as a result of excessively efficient water management. Aquifer management is aimed at preventing flow of groundwater into the ocean, causing a creeping salinization at a rate of about 2 ppm per year. Successful efforts to improve irrigation efficiency brought with them the danger of salt accumulation in the soil. A ten-year monitoring programme carried out by the Irrigation Extension Service at 250 sampling sites showed that appreciable salt accumulation indeed occurred during the rainless irrigation season. However, where annual rainfall is more than about 350 mm this salt accumulation is adequately leached out of the root zone by the winter rains. Soil salinity in the autumn is typically two to three times that in the spring, a level which does not affect yields adversely. In the drier regions of the country long-term increasing soil salinity has been observed, and leaching is required. This is generally accomplished during the pre-irrigation given in the spring, whose size is determined by the rainfall amount of the preceding winter. The increasing need to utilize brackish groundwater and recycled sewage effluent requires special measures, which have so far been successful. In particular, drip irrigation with its high average soil-water potential regime and partial wetting of the soil volume has achieved high yields under adverse conditions. However, the long-term trend of water-quality deterioration is unavoidable under present conditions, and will eventually necessitate either major changes in agricultural patterns or the provision of desalinated water for dilution of the irrigation water. (author)

  7. Sodium kinetics in hypertonic saline abortion

    International Nuclear Information System (INIS)

    Telfer, N.; Ballard, C.S.; McKee, D.R.

    1975-01-01

    The sodium kinetics of hypertonic saline abortions have been followed by measuring the radioactivity and the sodium concentrations in amniotic fluid, maternal plasma, urine, the foetus and placenta after intrauterine installation of 20% hypertonic saline labelled with 22 Na in order to determine the reason for abortion of a dead foetus in 24 to 48 hours, and reasons for sodium reactions. There is dilution of the 300 ml of amniotic fluid to a maximum of 1.5 to 2.0 litres in an exponential fashion, by the influx of mainly maternal water, slowing after 8 hours. There is an exponential type of increase in plasma radioactivity, also slowing after 8 hours. However, equilibration is never reached, the specific activity of the amniotic fluid remaining 10 times that of the plasma, and the sodium concentration 3 times that of the plasma. The urine equilibrates with the plasma, and about 3% of the administered dose is lost in 22 hours. The largest foetus and placenta picked up the least radioactivity. Thus, a more mature foetus may be protected to some degree against the hypertonic saline action; this has been observed clinically. Hyperkaliaemia was found in all four subjects, and hypoglycaemia occurred sporadically. These were not accompanied by any symptoms. Factors associated with expulsion of the dead foetus are dehydration and decreased circulation associated with fibrinoid necrosis of the placenta, which may also account for cessation of equilibration between maternal plasma and amniotic fluid. Although no saline reactions occurred, the role of extrauterine deposition of hypertonic saline, as shown in one subject, might be considered. (author)

  8. Salinity Trends in the Upper Colorado River Basin Upstream From the Grand Valley Salinity Control Unit, Colorado, 1986-2003

    Science.gov (United States)

    Leib, Kenneth J.; Bauch, Nancy J.

    2008-01-01

    In 1974, the Colorado River Basin Salinity Control Act was passed into law. This law was enacted to address concerns regarding the salinity content of the Colorado River. The law authorized various construction projects in selected areas or 'units' of the Colorado River Basin intended to reduce the salinity load in the Colorado River. One such area was the Grand Valley Salinity Control Unit in western Colorado. The U. S. Geological Survey has done extensive studies and research in the Grand Valley Salinity Control Unit that provide information to aid the U.S. Bureau of Reclamation and the Natural Resources Conservation Service in determining where salinity-control work may provide the best results, and to what extent salinity-control work was effective in reducing salinity concentrations and loads in the Colorado River. Previous studies have indicated that salinity concentrations and loads have been decreasing downstream from the Grand Valley Salinity Control Unit, and that the decreases are likely the result of salinity control work in these areas. Several of these reports; however, also document decreasing salinity loads upstream from the Grand Valley Salinity Control Unit. This finding was important because only a small amount of salinity-control work was being done in areas upstream from the Grand Valley Salinity Control Unit at the time the findings were reported (late 1990?s). As a result of those previous findings, the U.S. Bureau of Reclamation entered into a cooperative agreement with the U.S. Geological Survey to investigate salinity trends in selected areas bracketing the Grand Valley Salinity Control Unit and regions upstream from the Grand Valley Salinity Control Unit. The results of the study indicate that salinity loads were decreasing upstream from the Grand Valley Salinity Control Unit from 1986 through 2003, but the rates of decrease have slowed during the last 10 years. The average rate of decrease in salinity load upstream from the Grand Valley

  9. Flexibility in fuel manufacturing

    International Nuclear Information System (INIS)

    Reparaz, A.; Stavig, W.E.; McLees, R.B.

    1987-01-01

    From its inception Exxon Nuclear has produced both BWR and PWR fuels. This is reflected in a product line that, to date, includes over 20 fuel designs. These range from 6x6 design at one end of the spectrum to the recently introduced 17x17 design. The benefits offered include close tailoring of the fuel design to match the customer's requirements, and the ability to rapidly introduce product changes, such as the axial blanket design, with a minimal impact on manufacturing. This flexibility places a number of demands on the manufacturing organization. Close interfaces must be established, and maintained, between the marketing, product design, manufacturing, purchasing and quality organizations, and the information flows must be immediate and accurate. Production schedules must be well planned and must be maintained or revised to reflect changing circumstances. Finally, the manufacturing facilities must be designed to allow rapid switchover between product designs with minor tooling changes and/or rerouting of product flows to alternate work stations. Among the tools used to manage the flow of information and to maintain the tight integration necessary between the various manufacturing, engineering and quality organizations is a commercially available, computerized planning and tracking system, AMAPS. A real-time production data collection system has been designed which gathers data from each production work station for use by the shop floor control module of AMAPS. Accuracy of input to the system is improved through extensive use of bar codes to gather information on the product as it moves through and between work stations. This computerized preparation of material tracing has an impact on direct manufacturing records, quality control records, nuclear material records and accounting and inventory records. This is of benefit to both Exxon Nuclear and its customers

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

    International Nuclear Information System (INIS)

    Malik, M.F.; Hussain, T.; Khan, M.N.; Mirza, S.A.

    2010-01-01

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

  11. The radiological and endoscopie appearances of Crohn's disease of the upper gastro-intenstinal tract

    International Nuclear Information System (INIS)

    Kurtz, B.; Steinhardt, H.J.; Malchow, H.; Tuebingen Univ.

    1982-01-01

    Involvement of the upper gastrointestinal tract (oesophagus, stomach, duodenum, jejunum) accounted for 13% of endoscopically proven Crohn's disease in patients at the University Clinic, Tuebingen between 1973 and 1980. The basis for the diagnosis was the presence of epitheloid granulomas. The diagnosis was suspected in 26% of patients in endoscopic appearances alone. In these two groups, the appearances were similar, consisting of atypical or linear ulcers, cobble-stone lesions, chronic erosions, aphthous ulcers, stenoses, coarsening of the mucosa and areas of engorgement and granularity. Most patients were also examined radiologically. The radiological findings correspond with the endoscopic observations. Using a double contrast technique, mucosal changes could be demonstrated which, up to now, were only seen by endoscopy. If these findings are observed either radiologically or endoscopically, it is essential to examine the distal portions of the gut. (orig.) [de

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

    Directory of Open Access Journals (Sweden)

    Xie Xiang

    2007-01-01

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

  13. Intragastric laparoscopic surgery: An option for gastric lesions not resectable by endoscopy.

    Science.gov (United States)

    Manuel Vázquez, Alba; Hernández Matías, Alberto; Bertomeu García, Agustín; Ruiz de Adana Belbel, Juan Carlos

    2016-03-01

    Gastric mucosal and submucosal lesions can be resected by endoscopy, laparoscopy or open surgery. Operative methods have varied depending on the location, endophytic growth and size of the lesion. Interest in minimally invasive surgery has increased and many surgeons are attempting laparoscopic approaches, especially in lesions of the stomach near the esophagogastric junction not amendable to endoscopic removal, because conventional surgery can produce stenosis and distort the postoperative anatomy, and increase morbimortality. We report our experience with laparoscopic intragastric surgery in 3 consecutive patients, with no complications. Laparoscopic intragastric surgery extends the surgeons' armamentarium to resect complex gastric lesions, while offering patients the benefits of minimal access surgery. Copyright © 2015 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. A comparative study of hysterosalpingography and endoscopy/laparotomy in infertile patients

    International Nuclear Information System (INIS)

    Nielsen, D.T.; Rasmussen, F.; Justesen, P.

    1987-01-01

    A comparison of hysterosalpingography (HSG), using Lipiodol ultrafluid as contrast medium, with endoscopy/laparotomy in the evaluation of the tubal function in 124 infertile women is presented. There was agreement between the results of both methods in 73.4% of the patients. The false-negative rate was 2.4% and the false-positive rate was 8.9%. Complications in the form of intravasation were seen in three patients but none of them had any symptoms. The conception rate was 35% in the subgroup of patients with normal HSG. The authors recommended the continuous use of HSG in the overall evaluation of infertile patients. It is recommended to use oil-soluble contrast media because of its high diagnostic accuracy, low frequency of complications and its therapeutic advantages. (orig.)

  15. Is there a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy?

    Science.gov (United States)

    Patanè, Salvatore

    2014-04-01

    Heart valve repair or replacement is a serious problem. Patients can benefit from an open dialogue between both cardiologists and gastroenterologists for the optimal effective patients care. The focused update on infective endocarditis of the American College of Cardiology/American Heart Association 2008 (ACC/AHA guidelines) and guidelines on the prevention, diagnosis, and treatment of infective endocarditis (new version 2009) of the European Society of Cardiology (ESC guidelines) describe prophylaxis against infective endocarditis (IE) as not recommended for gastroscopy and colonoscopy in the absence of active infection but increasing evidence suggests that the role of IE antibiotic prophylaxis remains a dark side of the cardio-oncology prevention. New evidences concerning infective endocarditis due to Streptococcus bovis, Streptococcus agalactiae, Enterococcus faecalis, Enterococcus faecium, Enterococcus durans, and new findings indicate that there is a need for bacterial endocarditis prophylaxis in patients undergoing gastrointestinal endoscopy especially in elderly patients and in cancer and immunocompromised patients, to avoid serious consequences.

  16. Progress in Molecular Imaging in Endoscopy and Endomicroscopy for Cancer Imaging

    Directory of Open Access Journals (Sweden)

    Supang Khondee

    2013-01-01

    Full Text Available Imaging is an essential tool for effective cancer management. Endoscopes are important medical instruments for performing in vivo imaging in hollow organs. Early detection of cancer can be achieved with surveillance using endoscopy, and has been shown to reduce mortality and to improve outcomes. Recently, great advancements have been made in endoscopic instruments, including new developments in optical designs, light sources, optical fibers, miniature scanners, and multimodal systems, allowing for improved resolution, greater tissue penetration, and multispectral imaging. In addition, progress has been made in the development of highly-specific optical probes, allowing for improved specificity for molecular targets. Integration of these new endoscopic instruments with molecular probes provides a unique opportunity for significantly improving patient outcomes and has potential to further improve early detection, image guided therapy, targeted therapy, and personalized medicine. This work summarizes current and evolving endoscopic technologies, and provides an overview of various promising optical molecular probes.

  17. Tumor recognition in wireless capsule endoscopy images using textural features and SVM-based feature selection.

    Science.gov (United States)

    Li, Baopu; Meng, Max Q-H

    2012-05-01

    Tumor in digestive tract is a common disease and wireless capsule endoscopy (WCE) is a relatively new technology to examine diseases for digestive tract especially for small intestine. This paper addresses the problem of automatic recognition of tumor for WCE images. Candidate color texture feature that integrates uniform local binary pattern and wavelet is proposed to characterize WCE images. The proposed features are invariant to illumination change and describe multiresolution characteristics of WCE images. Two feature selection approaches based on support vector machine, sequential forward floating selection and recursive feature elimination, are further employed to refine the proposed features for improving the detection accuracy. Extensive experiments validate that the proposed computer-aided diagnosis system achieves a promising tumor recognition accuracy of 92.4% in WCE images on our collected data.

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

    Directory of Open Access Journals (Sweden)

    Hyun Seok Lee

    2016-01-01

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

  19. Three-dimensional motion tracking correlates with skill level in upper gastrointestinal endoscopy

    DEFF Research Database (Denmark)

    Arnold, Sif H.; Svendsen, Morten Bo Søndergaard; Konge, Lars

    2015-01-01

    untrained medical students) were tested using a virtual reality simulator. A motion sensor was used to collect data regarding the distance between the hands, and height and movement of the scope hand. Test characteristics between groups were explored using Kruskal-Wallis H and Man-Whitney U exact tests......Background and study aim: Feedback is an essential part of training in upper gastrointestinal endoscopy. Virtual reality simulators provide limited feedback, focusing only on visual recognition with no feedback on the procedural part of training. Motion tracking identifies patterns of movement......, and this study aimed to explore the correlation between skill level and operator movement using an objective automated tool. Methods: In this medical education study, 37 operators (12 senior doctors who performed endoscopic retrograde cholangiopancreatography, 13 doctors with varying levels of experience, and 12...

  20. [Rectocolonic polyps in Senegal. Results of 1500 lower endoscopies carried out at the Dakar General Hospital].

    Science.gov (United States)

    Peghini, M; Barabe, P; Seurat, P; Philippon, G; Morcillo, R; Diallo, A; Gueye, P M

    1987-01-01

    57 polyps were discovered during 1,500 low endoscopies, and 24 of them were adenoma. In the same period of time, 26 proctocolitic adenocarcinomas were found. Adenomatous polyps appear to be 5 times less frequent in Senegal than in industrialized countries and frequency of colitic cancer should be of the same frequency, that is far less negligible. Even if proctocolitic cancer does not set up any Public Health problems one could envisage systematic screening of polyadenoma in every patient aged more than 40. Proctosigmoid being the seat of most adenoma, fibrosigmoidoscopy appears well adapted to this kind of screening because it does not require any preparation, it is easy to perform and well accepted.