Journal of interventional gastroenterology最新文献_第7页

Exploring the optimal fluorescein dose in probe-based confocal laser endomicroscopy for colonic imaging. 探讨探针型共聚焦激光内镜下结肠成像荧光素的最佳剂量。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.19953

Muhammad W Shahid, Julia E Crook, Alexander Meining, Aymeric Perchant, Anna Buchner, Victoria Gomez, Michael B Wallace

{"title":"Exploring the optimal fluorescein dose in probe-based confocal laser endomicroscopy for colonic imaging.","authors":"Muhammad W Shahid, Julia E Crook, Alexander Meining, Aymeric Perchant, Anna Buchner, Victoria Gomez, Michael B Wallace","doi":"10.4161/jig.19953","DOIUrl":"https://doi.org/10.4161/jig.19953","url":null,"abstract":"BACKGROUND: Probe-based confocal laser endomicroscopy (pCLE) is an emerging method for in-vivo imaging of the gastrointestinal tract and requires a contrast agent. Fluorescein is the most commonly used agent. The optimal dose of fluorescein for pCLE in colon is unknown. OBJECTIVE: Exploration of optimal dose of fluorescein for pCLE in colon. DESIGN: Comparative, prospective pilot trail. SETTING: Tertiary-care center. PATIENTS: 18 participants underwent colonoscopy without complications. INTERVENTIONS: pCLE videos were recorded in normal cecum, using 10% fluorescein intravenously. MAIN OUTCOME MEASUREMENTS: For subjective analysis, pCLE videos were scored for quality, by 2 observers, independently and blinded to fluorescein dose. For objective analysis, signal-to-noise ratios (SNR) were calculated for each video by an expert. RESULTS: 6 fluorescein doses were used, including 0.5 mL, 1 mL, 2.5 mL, 5 mL, 7.5 mL and 10 mL and each dose was used in three patients. For each dose, median image quality score was 2.5, 2.0, 3.25, 4.0, 4.0 and 3.5 by first observer and 2.0, 3.0, 4.0, 5.0, 4.0 and 4.0 by second observer, respectively. The subjective quality scores increased from 0.5 mL to 5.0 mL, with no evidence of further improved quality at 7.5 mL and 10 mL doses. SNR were not significantly different between doses but trended higher for higher doses. LIMITATIONS: Small sample size. The results can not be applied to other parts of gastrointestinal tract i.e. duodenum, esophagus with different blood supply. CONCLUSION: This preliminary study suggests that the optimal dose of fluorescein for high quality pCLE imaging in colon is approximately 5.0 mL.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 4","pages":"166-171"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350888/pdf/jig0104_0166.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30619152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 29

Feasibility of colonoscopy with water infusion in minimally sedated patients in an Asian Community Setting. 在亚洲社区环境中，微创镇静患者输水结肠镜检查的可行性。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.1.4.19961

Yu-Hsi Hsieh, Kuo-Chih Tseng, Jin-Jian Hsieh, Chih-Wei Tseng, Tsung-Hsing Hung, Felix W Leung

{"title":"Feasibility of colonoscopy with water infusion in minimally sedated patients in an Asian Community Setting.","authors":"Yu-Hsi Hsieh, Kuo-Chih Tseng, Jin-Jian Hsieh, Chih-Wei Tseng, Tsung-Hsing Hung, Felix W Leung","doi":"10.4161/jig.1.4.19961","DOIUrl":"https://doi.org/10.4161/jig.1.4.19961","url":null,"abstract":"BACKGROUND: Investigators in the US described large volume water infusion with marked benefits but acknowledged the limitation of male veteran predominance in the study subjects. The aim of this study was to assess the feasibility of large volume water infusion in Asian patients undergoing minimal sedation diagnostic colonoscopy in a community setting. METHODS: Consecutive patients who underwent colonoscopy were randomized to receive large volume (entire colon) (Group A, n=51), limited volume (rectum and sigmoid colon) (Group B, n=51) water infusion, or air insufflation (Group C, n=51). Pain during insertion, completion rate, cecal intubation and total procedure times, and patient satisfaction were evaluated. Pain and satisfaction were assessed with a 0-10 visual analog scale. RESULTS: The mean pain scores during insertion were lower in the Group A and Group B than in Group C, 3.3±2.4, 3.0±2.2 and 4.4±2.6, respectively (p=0.028 and p=0.004). The completion rates and cecal intubation times were similar among the three groups. The procedure time was significantly longer in Group A than in group C (15.3±5.9 min vs. 13.1±5.4 min, p=0.049). Overall satisfaction with the procedure was greater in Group B than in Group C only (9.7±0.5 vs. 9.4±0.8, p=0.044). CONCLUSIONS: Diagnostic colonoscopy with large volume water infusion without air insufflation appears to be feasible in minimally sedated Asian patients in a community setting. Measures to improve the outcome further are discussed.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 4","pages":"185-190"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350893/pdf/jig0104_0185.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30617924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34

Meet the Executive Editor-in-Chief: Professor Joseph Leung. 见见执行总编辑:梁振英教授。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.19950

引用次数: 0

Introduction to the fourth issue. 第四期内容简介。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.19951

引用次数: 0

The water method is effective in difficult colonoscopy - it enhances cecal intubation in unsedated patients with a history of abdominal surgery. 水法在困难的结肠镜检查中是有效的-它加强了有腹部手术史的未镇静患者的盲肠插管。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.19960

Felix W Leung, Surinder K Mann, Joseph W Leung, Rodelei M Siao-Salera, Jackson Guy

{"title":"The water method is effective in difficult colonoscopy - it enhances cecal intubation in unsedated patients with a history of abdominal surgery.","authors":"Felix W Leung, Surinder K Mann, Joseph W Leung, Rodelei M Siao-Salera, Jackson Guy","doi":"10.4161/jig.19960","DOIUrl":"https://doi.org/10.4161/jig.19960","url":null,"abstract":"BACKGROUND: Colonoscopy in unsedated patients in the US is considered to be difficult. Success rate of cecal intubation is limited by discomfort. Colonoscopy in patients with a history of abdominal surgery is also considered to be difficult due to adhesion-related bowel angulations. The water method has been shown to significantly reduce pain during colonoscopy. OBJECTIVE: To test the hypothesis that the water method enhances the completion of colonoscopy in unsedated patients with a history of abdominal surgery. DESIGN: The data bases of two parallel RCT were combined and analyzed. SETTING: Two Veterans Affairs endoscopy units. PATIENT AND METHODS: The water and air methods were compared in these two parallel RCT examining unsedated patients. Those with a history of abdominal surgery were selected for evaluation. MAIN OUTCOME MEASUREMENTS: Completion of unsedated colonoscopy. RESULTS: Among patients with a history of abdominal surgery, the proportion completing unsedated colonoscopy in the water group (19 of 22) was significantly higher than that (11 of 22) in the air group (p=0.0217, Fisher's exact test). LIMITATIONS: Small number of predominantly male veterans, unblinded colonoscopists, not all types of abdominal surgery (e.g. hysterectomy, gastrectomy) predisposing to difficult colonoscopy were represented. CONCLUSION: This proof-of-principle assessment confirms that in patients with a history of abdominal surgery the water method significantly increases the proportion able to complete unsedated colonoscopy. The water method deserves to be evaluated in patients with other factors associated with difficult colonoscopy.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 4","pages":"172-176"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350889/pdf/jig0104_0172.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30619153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 24

Treatment of fecal incontinence - review of observational studies (OS) and randomized controlled trials (RCT) related to injection of bulking agent into peri-anal tissue. 大便失禁的治疗——观察性研究(OS)和随机对照试验(RCT)与肛门周围组织注射填充剂相关的综述。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.1.4.19952

Felix W Leung

{"title":"Treatment of fecal incontinence - review of observational studies (OS) and randomized controlled trials (RCT) related to injection of bulking agent into peri-anal tissue.","authors":"Felix W Leung","doi":"10.4161/jig.1.4.19952","DOIUrl":"https://doi.org/10.4161/jig.1.4.19952","url":null,"abstract":"PURPOSE: Novel treatments are needed to augment medical therapy for fecal incontinence. METHODS: Medline and Google search (fecal incontinence and injection treatment), English publications. RESULTS: Twenty-two observational studies and 4 randomized controlled trials were identified. OS mostly with limited sample sizes reported promising results. Repeated injection was necessary in some patients. Effect on anal sphincter pressures was highly variable. Significant improvements in the length of anal high-pressure zone, asymmetry index and maximum tolerable rectal volume were suggested. Four randomized controlled trials (n=176) revealed: 1. Short-term benefits from injection of Bioplastique under ultrasound guidance compared with digital guidance; 2. Silicone biomaterial (PTQ) provided some advantages and was safer than carbon-coated beads (Durasphere); 3. PTQ did not demonstrate clinical benefit compared to control injection of saline; 4. There was significant improvement at 6 weeks post injection, but no difference between Bulkamid and Permacol. A 2010 Cochrane review, however, noted that these data were inconclusive due to limited number and methodological weaknesses. CONCLUSION: Further studies are warranted to assess patient-centered outcomes (e.g. adequate relief) in addition to the attenuation of severity of incontinence symptoms in ambulatory patients. In nursing home residents, cost-effectiveness studies combining injection treatment and prompted voiding (to mitigate constraints of immobility and dementia) in preventing peri-anal skin complications deserves to be considered.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 4","pages":"202-206"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350896/pdf/jig0104_0202.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30617929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 7

A pilot study of contrast harmonic endosonography using DEFINITY™ in the evaluation of suspected pancreatic and peri-ampullary malignancies. 使用DEFINITY™对疑似胰腺和壶腹周围恶性肿瘤进行评估的对比谐波超声的初步研究。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.19958

Tiing Leong Ang, Eng Kiong Teo, Daphne Ang, Andrew Boon Eu Kwek, Kwong Ming Fock

{"title":"A pilot study of contrast harmonic endosonography using DEFINITY™ in the evaluation of suspected pancreatic and peri-ampullary malignancies.","authors":"Tiing Leong Ang, Eng Kiong Teo, Daphne Ang, Andrew Boon Eu Kwek, Kwong Ming Fock","doi":"10.4161/jig.19958","DOIUrl":"https://doi.org/10.4161/jig.19958","url":null,"abstract":"AIM: Contrast harmonic endosonography (CHEUS) is not widely available. This study assessed the utility of CHEUS using DEFINITY™, a second generation ultrasonic contrast agent, in the evaluation of suspected pancreatic and peri-ampullary malignancies. METHODS: Prospectively enrolled patients with suspected pancreatic and peri-ampullary malignancies underwent EUS followed by CHEUS. The incremental yield of CHEUS over EUS was analyzed. The gold standard for diagnosis of malignancy was positive cytology or histology; a negative diagnosis for malignancy was based on negative cytology or histology and benign clinical course. RESULTS: Twenty-nine patients were enrolled and underwent CHEUS. The final diagnoses were: pancreatic adenocarcinoma (16/29); metastases to pancreas (4/29); pancreatitis with inflammatory mass (4/29); normal pancreas with focal fat sparing (1/29); ampulla adenocarcinoma (2/29); serous cystic neoplasm (1/29); peri-pancreatic lymph node due to lymphoma (1/29). One bengin case of chronic pancreatitis had calcification casting artifacts that prevented accurate EUS examination and was excluded, leaving 28 cases for comparative analysis between EUS and CHEUS. CHEUS enhanced tumor margins. CHEUS detected vascular invasion missed by EUS in 2/16 patients with pancreatic adenocarcinoma. Masses appeared hypoechoic with EUS. With CHEUS malignant masses had an inhomogeneous hypoechoic pattern associated with abnormal vessels while lesions due to focal pancreatitis or fat sparing were characterized by diffuse enhancement (p<0.001). CONCLUSION: CHEUS improved the visualization of tumor margins and vascular invasion, and differentiated benign from malignant masses.","PeriodicalId":89416,"journal":{"name":"Journal of interventional gastroenterology","volume":"1 4","pages":"160-165"},"PeriodicalIF":0.0,"publicationDate":"2011-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3350887/pdf/jig0104_0160.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"30619151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 9

Contrast enhanced ultrasonography in the diagnosis of IgG4-negative autoimmune pancreatitis: A case report. 超声造影诊断igg4阴性自身免疫性胰腺炎1例

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.1.4.19968

Min-Min Zhang, Duo-Wu Zou, Yin Wang, Jian-Ming Zheng, Hua Yang, Zhen-Dong Jin, Zhao-Shen Li

引用次数: 3

The water method - untapped potential in extended flexible sigmoidoscopy for colorectal cancer screening? 水法在扩展柔性乙状结肠镜筛查中尚未开发的潜力?

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.1.4.19972

Adrian William Bak

引用次数: 0

Endoscopic management of complete colonic obstruction. 完全性结肠梗阻的内镜治疗。

Journal of interventional gastroenterology Pub Date : 2011-10-01 DOI: 10.4161/jig.1.4.19969

Evan B Grossman, Mark A Schattner, Christopher J Dimaio, Hans Gerdes, Douglas W Wong, Arnold J Markowitz

引用次数: 4