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Advanced endoscopy

Il Ju Choi, Myeong-Cherl Kook, Young-Il Kim, Soo-Jeong Cho, Jong Yeul Lee, Chan Gyoo Kim, Boram Park, Byung-Ho Nam
BACKGROUND: Patients with early gastric cancers that are limited to gastric mucosa or submucosa usually have an advanced loss of mucosal glandular tissue (glandular atrophy) and are at high risk for subsequent (metachronous) development of new gastric cancer. The long-term effects of treatment to eradicate Helicobacter pylori on histologic improvement and the prevention of metachronous gastric cancer remain unclear. METHODS: In this prospective, double-blind, placebo-controlled, randomized trial, we assigned 470 patients who had undergone endoscopic resection of early gastric cancer or high-grade adenoma to receive either H...
March 22, 2018: New England Journal of Medicine
Xi Li, Hui Li, Xingzhen He, Tingai Chen, Xianyuan Xia, Chunxia Yang, Wei Zheng
Early identification of premalignant and malignant gastric mucosa is crucial to decrease the incidence and mortality of stomach cancer. Spectrum- and time-resolved multiphoton microscopy are capable of providing not only structural but also biochemical information at the subcellular level. Based on this multidimensional imaging technique, we performed a systematic investigation on fresh human tissue specimens at the typical stages of gastric carcinogenesis, including normal, chronic gastritis with erosion, chronic gastritis with intestinal metaplasia, and intestinal-type adenocarcinoma...
February 1, 2018: Biomedical Optics Express
V Arantes, J Espinoza-Ríos
The incidence of esophageal cancer is steadily increasing worldwide. Outcome is poor, given that the majority of cases are diagnosed at advanced disease stages. However, when detected at early stages, esophageal tumors can be curatively treated through less invasive methods, resulting in a 5-year survival rate above 90%. Therefore, it is essential to identify the high-risk population and recommend those patients undergo screening using high-resolution endoscopy, adding the resources of chromoendoscopy with Lugol solution (or digital chromoendoscopy) and magnification...
March 15, 2018: Revista de Gastroenterología de México
Mery Munoz-Persy, Alfredo J Lucendo
Eosinophilic esophagitis (EoE) is a unique form of non-IgE-mediated food allergy characterized by esophageal eosinophilic infiltration that commonly causes dysphagia and food impaction in children and adolescents. Assessing the efficacy of dietary restrictions or drug therapies to achieve clinical and histologic resolution of EoE through randomized controlled trials and meta-analyses has resulted in new evidence-based guidelines. Avoiding food triggers is the only therapy targeting the cause of the disease...
March 17, 2018: European Journal of Pediatrics
Weihong Wang, Lu Xu, Zhenfei Bao, Linyin Sun, Chunyan Hu, Feng Zhou, Lei Xu, Dingmei Shi
OBJECTIVES: This study aims to evaluate whether the participation of an experienced endoscopy nurse in colonoscopy increases the polyp detection rate (PDR) and adenoma detection rate (ADR) of experienced colonoscopists. METHODS: This study was a randomized controlled trial. Patients were randomly assigned to the experienced colonoscopist alone (single observer) group, or experienced nurse participation (dual observer) group. The primary outcome was the PDR and ADR...
March 14, 2018: International Journal of Colorectal Disease
Mohesh Moothanchery, Renzhe Bi, Jin Young Kim, Seungwan Jeon, Chulhong Kim, Malini Olivo
Photoacoustic microscopy (PAM) is a multiscale imaging technique. In optical-resolution photoacoustic microscopy (OR-PAM), a single mode (SM) fiber is normally used as the source of optical excitation to be focused into a diffraction-limited spot. Recent advances in OR-PAM have improved its imaging speed using microelectromechanical systems (MEMS). Here we report for the first time the use of a multimode (MM) fiber as the optical excitation source for high resolution OR-PAM in vivo imaging. A high-speed MEMS scanner based OR-PAM system combined with the mechanical movement to provide wide area imaging was used...
March 1, 2018: Biomedical Optics Express
Cornelia Nitipir, Octav Ginghina, Liliana Popa, Florin Andrei, Nicolaie Tudor, Irina Radu, Cristian Iaciu, Cristina Orlov, Florina Vasilescu, Cristian Balalau, Grigoris Leon, Carolina Negrei, Maria Alexandra Barbu
Although gastric metastases have been estimated to occur in less than 2% of cancer patients, an increased use of upper digestive tract endoscopy allows for a higher detection of secondary gastric tumors. We describe the case of a 66-year-old male patient presenting with mild pain in the sternum and upper abdominal area. Physical examination revealed a right parietal skull tumor, with no other significant clinical changes. Upon exclusion of an acute coronary syndrome, upper digestive tract endoscopy was performed, showing the presence of an ulcerated tumor located in the gastric fundus...
April 2018: Molecular and Clinical Oncology
Emanuele Rondonotti, Cristiano Spada, Samuel Adler, Andrea May, Edward J Despott, Anastasios Koulaouzidis, Simon Panter, Dirk Domagk, Ignacio Fernandez-Urien, Gabriel Rahmi, Maria Elena Riccioni, Jeanin E van Hooft, Cesare Hassan, Marco Pennazio
SMALL-BOWEL CAPSULE ENDOSCOPY (SBCE): 1: ESGE recommends that prior to SBCE patients ingest a purgative (2 L of polyethylene glycol [PEG]) for better visualization.Strong recommendation, high quality evidence.However, the optimal timing for taking purgatives is yet to be established. 2: ESGE recommends that SBCE should be performed as an outpatient procedure if possible, since completion rates are higher in outpatients than in inpatients.Strong recommendation, moderate quality evidence...
March 14, 2018: Endoscopy
Silvia Paggi, Giuseppe Mogavero, Arnaldo Amato, Emanuele Rondonotti, Alida Andrealli, Gianni Imperiali, Nicoletta Lenoci, Giovanna Mandelli, Natalia Terreni, Francesco Simone Conforti, Dario Conte, Giancarlo Spinzi, Franco Radaelli
BACKGROUND:  Linked color imaging (LCI) is a newly developed image-enhancing endoscopy technology that provides bright endoscopic images and increases color contrast. We investigated whether LCI improves the detection of neoplastic lesions in the right colon when compared with high definition white-light imaging (WLI). METHODS:  Consecutive patients undergoing colonoscopy were randomized (1:1) after cecal intubation into right colon inspection at first pass by LCI or by WLI...
March 14, 2018: Endoscopy
Michael R Kolber, Shelley Ross
BACKGROUND AND OBJECTIVES: In Canada, few family physicians (FPs) perform endoscopy. Conflicting evidence exists on the quality of endoscopy performed by Canadian FPs, which may be explained by differing skillsets of these endoscopists. The objective of this study was to perform the first exploration of the practice, skills, and knowledge of Canadian FP endoscopists. METHODS: A cross-sectional survey, including direct knowledge test, was used. RESULTS: Twenty Canadian FP endoscopists completed the survey...
March 2018: Family Medicine
Mauricio Mandel, Carlo Emanuel Petito, Rafael Tutihashi, Wellingson Paiva, Suzana Abramovicz Mandel, Fernando Campos Gomes Pinto, Almir Ferreira de Andrade, Manoel Jacobsen Teixeira, Eberval Gadelha Figueiredo
OBJECTIVE Advances in video and fiber optics since the 1990s have led to the development of several commercially available high-definition neuroendoscopes. This technological improvement, however, has been surpassed by the smartphone revolution. With the increasing integration of smartphone technology into medical care, the introduction of these high-quality computerized communication devices with built-in digital cameras offers new possibilities in neuroendoscopy. The aim of this study was to investigate the usefulness of smartphone-endoscope integration in performing different types of minimally invasive neurosurgery...
March 13, 2018: Journal of Neurosurgery
Yoichi Hamai, Jun Hihara, Manabu Emi, Takaoki Furukawa, Yuji Murakami, Ikuno Nishibuchi, Yasushi Nagata, Yuta Ibuki, Ichiko Yamakita, Tomoaki Kurokawa, Morihito Okada
BACKGROUND: The accurate prediction of a pathologic complete response (ypT0N0M [LYM] 0 ypStage 0) before operation is essential for selecting appropriate strategies for treating esophageal cancer after neoadjuvant chemoradiotherapy. METHODS: We reviewed 130 consecutive patients with esophageal squamous cell carcinoma who were evaluated preoperatively using upper gastrointestinal endoscopy, computed tomography, and18 F-fluorodeoxyglucose-positron emission tomography after neoadjuvant chemoradiotherapy and subsequently underwent esophagectomy...
March 5, 2018: Surgery
Josephine Bryk Rose, Sarah Davies, Kadie M Anderson, Graeme S Allan, Patricia M Dennis, Richard Malik
An approximately 4-yr-old female Bennett's wallaby ( Macropus rufogriseus) was evaluated for chronic left-sided facial swelling and nasal discharge. Computed tomography, endoscopy, biopsy, mycologic culture, and panfungal polymerase chain reaction were consistent with destructive mycotic rhinosinusitis. The patient's infection was treated with a long-term injectable antibiotic, oral antifungal therapy, and multiple intranasal infusions of voriconazole suspended in a reverse thermodynamic pluronic gel. This case represents the first documented case of mycotic rhinosinusitis in a macropod and underlines the importance of advanced cross-sectional imaging in the diagnosis, monitoring, and management of nasal cavity disease in zoo animals...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Jimmy K Limdi, Francis A Farraye
PURPOSE OF REVIEW: Patients with long-standing ulcerative colitis have an increased risk for the development of colorectal cancer (CRC). Colitis-related dysplasia appears to confer the greatest risk. Colonoscopic surveillance to detect dysplasia has been advocated by gastrointestinal societies. The aim of surveillance is the reduction of mortality and morbidity of CRC through detection and resection of dysplasia or detecting CRC at an earlier and potentially curable stage. Traditional surveillance has relied on mucosal assessment with targeted biopsy of visible lesions and random biopsy sampling on the premise that dysplasia was not visible at endoscopy...
March 7, 2018: Current Gastroenterology Reports
Gursimran Kochhar, Michael B Wallace
Advances in imaging technologies have demonstrated promise in the early detection of dysplasia and cancer. They have also provided the ability to assess submucosal and vascular structures, helping differentiate neoplastic from non-neoplastic tissue. The aim of this concise case-based review is to discuss how optical imaging can impact patient management decisions during endoscopy, using real- life scenarios.
March 3, 2018: Clinical Gastroenterology and Hepatology
Xiongbao Luo, Kensaku Mori, Terry M Peters
Interventional endoscopy (e.g., bronchoscopy, colonoscopy, laparoscopy, cystoscopy) is a widely performed procedure that involves either diagnosis of suspicious lesions or guidance for minimally invasive surgery in a variety of organs within the body cavity. Endoscopy may also be used to guide the introduction of certain items (e.g., stents) into the body. Endoscopic navigation systems seek to integrate big data with multimodal information (e.g., computed tomography, magnetic resonance images, endoscopic video sequences, ultrasound images, external trackers) relative to the patient's anatomy, control the movement of medical endoscopes and surgical tools, and guide the surgeon's actions during endoscopic interventions...
March 5, 2018: Annual Review of Biomedical Engineering
Lucas Goense, Alicia S Borggreve, Sophie E Heethuis, Astrid Lhmw van Lier, Richard van Hillegersberg, Stella Mook, Gert J Meijer, Peter Sn van Rossum, Jelle P Ruurda
OBJECTIVE: The perceived burden of diagnostic tests by patients during the assessment of oesophageal cancer warrants attention with the current increase in repeated imaging for purposes of disease monitoring during and after treatment. The purpose of this prospective study was to evaluate the experienced burden associated with repeated MRI and PET/CT examinations during neoadjuvant treatment for oesophageal cancer from the perspective of the patient. METHODS: In 27 patients receiving neoadjuvant chemoradiotherapy (nCRT) for oesophageal cancer MRI and PET/CT examinations were performed before nCRT, during nCRT and before surgery...
March 2, 2018: British Journal of Radiology
Tomoya Iida, Kentaro Yamashita, Sae Ohwada, Yosuke Ohkubo, Takehiro Hirano, Takakazu Miyake, Kei Onodera, Toshiyuki Kubo, Hiroo Yamano, Hiroshi Nakase
AIM: Interval gastric cancers (IGC) are defined as those diagnosed after negative results of endoscopy carried out within the past 10 years. We aimed to investigate the characteristics of IGC and the natural history of gastric cancer (GC) from a retrospective view of endoscopic images of older patients with IGC. METHODS: We retrospectively reviewed endoscopic images of 240 patients with GC who were aged >60 years. We compared past endoscopic images with newer ones, in which GC was diagnosed...
March 2, 2018: Geriatrics & Gerontology International
Joohwan Bae, Dong Hyun Sinn, Wonseok Kang, Geum-Youn Gwak, Moon Seok Choi, Yong-Han Paik, Joon Hyeok Lee, Kwang Cheol Koh, Seung Woon Paik
BACKGROUND AND AIMS: The Baveno VI and the expanded Baveno VI criteria were proposed to help identify patients who could safely avoid screening endoscopies for clinically significant varices among patients with compensated advanced chronic liver disease (cACLD). However, these criteria require cross-validation, especially in Asian populations where the etiologies of liver disease is different. METHODS: A total of 1,035 patients, including 282 patients with cACLD of different etiology, were analyzed...
March 1, 2018: Liver International: Official Journal of the International Association for the Study of the Liver
M J Bourke, H Neuhaus, J J Bergman
Endoscopic submucosal dissection (ESD) was developed in Japan, early in this century, to provide a minimally invasive yet curative treatment for the large numbers of patients with early gastric cancer identified by the national screening program. Previously the majority of these patients were treated surgically at substantial cost with the significant risk of short and long-term morbidity. Enbloc excision of these early cancers, most with a limited risk of nodal metastasis, allowed complete staging of the tumor, stratification of the subsequent therapeutic approach and potential cure...
February 24, 2018: Gastroenterology
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