Objectives
Peutz–Jeghers syndrome (PJS) is a rare autosomal dominant hereditary disease with a clinical features related to gastrointestinal (GI) hamartomatous polyposis, frequently observed in the ...small bowel. Balloon-assisted enteroscopy (BAE) has made non-surgical treatment of GI polyps possible. Endoscopic mucosal resection (EMR) has been performed but was associated with complications and difficulties. Recently, endoscopic ischemic polypectomy (EIP) has been developed and its usefulness reported. The study evaluated the feasibility and safety of EIP and the clinical outcomes of patients with PJS.
Methods
We retrospectively collected data of consecutive patients with PJS between September 2009 and March 2021. Data regarding clinical characteristics, follow-up methods, endoscopic management, and complications were collected. EIP feasibility and safety were assessed.
Results
Twenty-two patients were included. The observation period was 70 months (range, 5–153). Of the 124 therapeutic endoscopy procedures performed, 68 used BAE. Of the 607 polyps treated, 329 polyps were located in the small bowel. EIP was able to treat a greater number of polyps per patient than EMR (
P
< 0.003), without any complications, carcinoma, or intussusception in the small bowel (
P
< 0.001). During the follow-up period, 3 patients developed GI cancer.
Conclusion
Long-term follow-up in patients with PJS showed that EIP was a feasible and safe technique.
Chronic enteropathy associated with solute carrier organic anion transporter family, member 2A1 (SLCO2A1) (CEAS) is a rare autosomal recessive hereditary disease characterized by chronic persistent ...anemia and hypoproteinemia. Its diagnosis typically requires a genetic analysis. The efficacy of immunohistochemical staining with SLCO2A1 polyclonal antibody as a pre-diagnostic tool for CEAS has been previously reported. We herein report a patient with CEAS in whom immunohistochemical staining confirmed SLCO2A1 protein expression. The immunopositive results may have been due to nonsense-mediated RNA decay. As immunohistochemical staining of SLCO2A1 protein may show immunopositive results, a genetic analysis should also be performed when CEAS is strongly clinically suspected.
Abstract
In a high intensity ion accelerator, a non-destructive beam monitor is required to realize a continuous measurement of the beam for improving the beam quality in operation for users. We have ...developed a non-destructive 2-D beam profile monitor detecting photons produced by interaction between a beam and a sheet-shaped gas. Though the developed monitor is a non-destructive type, the injected gas sheet should induce scattering of the beam particles which makes the beam emittance large. We have measured a beam current and a phase space distribution of the J-PARC 3 MeV, 60 mA H
−
beam with change of the gas sheet flux. It was found that the beam current reduction was in linear relation and the root mean square emittance was constant or decreased by up to 4.5% in
y-y
′ plane and did not change in
x-x
′ plane against a rise in the gas sheet flux. These result indicate that the developed monitor can be utilized as a non-destructive one depending on the gas sheet flux condition.
Background and Aim
Oral therapeutic and invasive endoscopy requires deep sedation to reduce patient distress due to prolonged examination and procedures. The usefulness of capnography and bispectral ...index (BIS) monitoring in the early hypoxia detection in oral therapeutic and invasive endoscopy has yet to be evaluated. This study aimed to investigate the clinical impact of capnography and BIS monitoring on hypoxic events during oral therapeutic and invasive endoscopic procedures.
Methods
This is a prospective observational study. Trans‐oral non‐intubated therapeutic and/or invasive endoscopic procedures were performed with conventional monitoring (pulse oximetry, pulse, and blood pressure) as well as additional monitoring (BIS and end‐tidal CO2 concentration). Hypoxia is defined as oxygen saturation of <90% that lasts >15 s. The clinical impact of capnography and BIS monitoring on hypoxic events during oral therapeutic and invasive endoscopic procedures were investigated with the risk factors for hypoxia in each patient.
Results
Patients with hypoxia had significantly more apneas detected using capnography than other patients. The multivariate analysis revealed the detected apnea by capnography as an independent risk factor for hypoxia (odds ratio: 3.4895% confidence interval: 1.24–9.78, P = 0.02). The BIS was not significantly different as a risk factor for hypoxia; however, per‐event analysis revealed significantly decreased BIS values over time in 3 min before hypoxic events.
Conclusions
Apnea detected by capnography was an independent predictor of hypoxia. The BIS value was not associated with hypoxia events; however, it showed a significant downward trend before hypoxia events.
Abstract
A non-destructive beam spatial profile monitor system using a gas sheet has been developed. The 4 mm thick gas sheet of over 40 mm width enables increase of the local gas pressure high ...enough to record a two-dimensional beam profile. A CCD camera coupled to an image intensifier detects photons produced by beam-gas interaction with the signal intensity that makes the time evolution study of the beam possible. We demonstrated that the J-PARC 3MeV, 60 mA H
-
beam profile which is measured with intensity error of 8.4-12% and spatial resolution of 1 mm changed depending on the controls of the acceleration cavity in the beam pules of 50
μ
s.
Current status of colon capsule endoscopy Hosoe, Naoki; Limpias Kamiya, Kenji J. L.; Hayashi, Yukie ...
Digestive endoscopy,
20/May , Letnik:
33, Številka:
4
Journal Article
Recenzirano
Odprti dostop
While both the annual incidence and mortality of colorectal cancer are slowly but steadily decreasing in the United States, the incidence of such malignancy is increasing in Japan. Thus, controlling ...colorectal cancer in Japan is a major concern. In 2006, colon capsule endoscopy was first introduced by Eliakim et al. First‐generation colon capsule endoscopy had a moderate sensitivity for detecting polyps of more than 6 mm. Thus, second‐generation colon capsule endoscopy was developed to achieve higher sensitivity. Colonoscopy is the gold standard tool for colorectal cancer surveillance. With an improvement in the imaging function, the performance of second‐generation colon capsule endoscopy is almost as satisfactory as that of colonoscopy. Certain situations, such as incomplete colonoscopy and contraindication for use of sedation, can benefit from colon capsule endoscopy. Colon capsule endoscopy requires a more extensive bowel preparation than colonoscopy and computed tomography colonography because it requires laxatives not only for bowel cleansing but also for promoting the excretion of the capsule. Another problem with colon capsule endoscopy includes the burden of reading and interpretation and overlook of the lesions. Currently, the development of automatic diagnosis of colon capsule endoscopy using artificial intelligence is still under progress. Although the available guidelines do not support the use of colon capsule endoscopy for inflammatory bowel disease, the possible application of colon capsule endoscopy is ulcerative colitis. This review article summarizes and focuses on the current status of colon capsule endoscopy for colorectal cancer screening and the possibility for its applicability on inflammatory bowel disease.
Pyogenic granuloma (PG) generally appears in the skin or oral cavity, but rarely occurs in the small intestine, where it can cause bleeding. To date, only 35 cases of small intestinal PG have been ...reported in the English literature. We retrospectively collected information from the clinical records of seven cases of small intestinal PG that were managed in our hospital and summarized the characteristics. Further information on the clinical characteristics was obtained from the literature. Capsule endoscopy, useful for identifying the source of hemorrhage in obscure gastrointestinal bleeding, can detect PGs. Treatment can often be accomplished with endoscopic mucosal resection.
All holes on the chamber walls of synchrotrons should be filled with the radiofrequency (RF)-shields to suppress coupling impedances that excite beam instabilities. In a synchrotron, titanium nitride ...(TiN)-coated RF-shields are installed with collimators. If the holes, through which the collimator jaw enters and exits the chamber, are filled with such RF-shields, the shields may break down as the dynamic coefficient of TiN increases in vacuum. At the Rapid Cycling Synchrotron (RCS), the RF-shields are eliminated from the collimator after demonstrating that the effect due to the RF-shields is negligible on the impedance at low frequencies.
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