[Novel endoscopic terminology: NBI visualization].

AIM: To develop new criteria of gastric and duodenal mucosa image assessment using endoscopic system for narrow band imaging (NBI). MATERIAL AND METHODS: Endoscopic and morphological findings were compared in 460 patients with different chronic diseases of the stomach and duodenum. Esophagogastroduodenoscopy was made according to the standard technique by the gastroduodenoscope EVIS EXERA-II GIF H180 (Olympus, Japan) with NBI-system. Biopsy material was studied by standard pathomorphological techniques. RESULTS: The novel system of the visual picture evaluation during conduction of endoscopic investigations in monochromatic light provides higher significance of identification of inflammatory and destructive processes in mucosa including foci of structural alterations, their location and extent. CONCLUSION: We propose a protocol for description of the endoscopic picture in conduction of examinations with application of the NBI-system of visualization in monochromatic light. It can help physicians to correctly estimate the image and interpret the detected changes.

[Atrophic gastritis as a pre-cancer gastric condition: a new view of the old problem].

The aim of the work was to study the relationship between structural changes in gastric mucosa affected by atrophic gastritis and inflammation associated with Hp infection. Endoscopic examination and NBI-visualization were used to assess distribution and severity of inflammation in 500 patients with different gastric pathologies. Histological material was studied to detect Hp. Structural changes of metaplastic type most frequently occurred in patients with atrophic gastritis (72 of 81, 88.9%), surface and erosive gastritis (13 or 3.5% and 16 or 14.3% respectively), p < 0.001. Hp infection and inflammatory-destructive changes showed no apparent trends. Mucosal changes characteristic of atrophy were only rarely accompanied by marked inflammation (14.8%) and were either mild (21%) or moderately severe (64.2%). It suggests that atrophy of gastric mucosa should be regarded as independent condition while the term atrophic gastritis should be used only in case of association between atrophy and inflammation confirmed by microscopic studies.

[Potentialities of digital videoendoscopic diagnosis of Helicobacter infection in chronic inflammatory diseases of the stomach and duodenum].

The aim of the study was to evaluate efficiency of a new endoscopic diagnostic tool based on the NBI-technology for the detection of Helicobacter pylori (Hp) content. A total of 294 patients with chronic inflammatory diseases of the stomach and duodenum were examined for the assessment of severity and extent of inflammatory processes. Staining intensity of gastric and duodenal mucosa in the NBI regime was shown to correlate with the degree of inflammation. Gastric metaplastic foci could be visualized due to their deep blue staining. Their distribution was unrelated to Ph occurrence and content. It is concluded that the use of the NBI technology for routine oesogastroduodenoscopy improves visualization of inflammatory changes in gastric and duodenal mucosa.

[Endoscopic diagnosis of erosive and ulcerative lesions in the stomach and duodenum using NBI technology].

The study was designed to assess the value of a new NBI-based digital videoendoscopic system for the diagnosis of erosive and ulcerative lesions in the stomach and duodenum of 136 patients in comparison with 185 ones examined with the use of conventional fiber-optic and videoendoscopes. Patients of group 1 were examined using a GIF-H180 EVIS Exera-I apparatus ("Olympus", Japan), controls with GIF-Q40 and GIF-Q160 EVIS Exera-II endoscopes ("Olympus", Japan). Endoscopic signs of inflammation, its extent and severity were recorded. NBI endoscopy revealed perifocal inflammatory changes associated with ulcerative lesions in the stomach and duodenum as spots of different tones of blue. This method allowed for the detection of lesions not visualized by conventional techniques. The use of NBI technology for routine endogastroduodenoscopy in patients with erosive and ulcerative lesions in the stomach and duodenum improves visualization of even minor changes in gastric and duodenal mucosa (p < 0.05).

[Chronic duodenitis: new aspects of endoscopic diagnosis with the use of NBI-technology].

The study was designed to evaluate the scope of applications of the new digital videoendoscopic NBI-technology for the diagnosis of chronic duodenitis (CD), the prevalence and clinical manifestations of this pathology. Of 287 patients with CD, 102 were examined using a GIF-H180 EVIS Exerall apparatus (Olympus, Japan) equipped with the NBI system. Control patients were examined with conventional fiber-optic and videoendoscopes GIF-Q49 and GIF-Q160 EVIS Exeral (Olympus, Japan). Evaluation encompassed endosopic signs of inflammation, its spread, and severity. It was shown that manifestations of inflammation of duodenic mucosa correlated with the endoscopic picture in the NBI regime and results of histological studies. The use of the NBI-technique in routine oesophagogastroduodenoscopy of patients with CD enhances efficiency of detection of even mild inflammatory reactions in duodenal mucosa from 20 to 72.5% (P < 0.05).

[Early fibrobronchoscopy and the microbial flora composition of bronchoalveolar lavage fluid in patients with concomitant injury during treatment in intensive care units].

Resuscitative bronchofibroscopy in victims with severe injury and aspiration has been shown to be both a method for diagnosing damages to the bronchus and lung and that for recovering airway patency in them. The most common involvement (47% of cases) in chest injury has been noted to be the lower lung with the development of pyoinflammatory processes caused by etiologically significant microorganisms, such as Staphylococcus aureus and types of Enterobacteriacea, in most cases (more than 50%).

[Efficiency of new NBI technology for endoscopic examination of patients with chronic gastritis].

The aim of this work was to compare efficiency of a new digital endoscopic system in combination with the NBI technology and routine endoscopic examination of patients with chronic gastritis. 181 of the 831 patients with different forms of chronic gastritis were examined with a GIF-H180 Evis Exera-II apparatus (Olympus, Japan) coupled to the NBI system. The control group comprised 650 patients examined using conventional GIF-Q160 and GIF-Q160 Evis Exera-I fiberscopes (Olympus, Japan). Signs of inflammation, its severity and extent were evaluated. Significant correlation was revealed for the first time between inflammation of gastric mucosa, type of gastritis, endoscopic picture in the NBI regime, and results of histologic studies. Inflammation foci and sites of intestinal metaplasia were found to produce characteristic images in which they had different shades of lilac and deep blue respectively. Distribution of the stained foci corresponded to that of inflammation and/or metaplasia. It is concluded that the use of the NBI technology in routine oesophagogastroduodenoscopy improves diagnosis of intestinal metaplasia to 80-100% (p = 0.000).

[Cell composition of bronchoalveolar lavage fluid in compound chest trauma with main damage to the lungs]. / Osobennosti kletochnogo sostava bronkhoal'veoliarnoi lavazhnoi zhidkosti pri sochetannykh travmakh grudi s preimushchestvennym povrezhdenniem legkikh.

Lethal effect on alveolar macrophages is observed cytologically in all cases. Increase of neutrophils in alveols was found against the background of allergisation and inflammatory immune reactions. General state of patients with a syndrome of acute pulmonary damage but without parallel pulmonary pathology improved by day 5-20, neutrophillosis was moderate (22.8 +/- 8.3). On the contrary lavage liquid in patients with parallel pulmonary pathology had a high neutrophillosis (85.5 +/- 6.6). Endopulmonary cytogram allows prognosis and correction of treatment.

[Endoscopic intubation of the trachea in emergencies]. / Endoskopicheskaia intubatsiia trakhei v ékstrennykh situatsiiakh.

The article presents the results of performing endoscopic intubation of the trachea under emergency situations in patients and victims of traumatic and pyo-inflammatory alterations of organs and tissue of the neck. The technique of the trachea intubation is described. It was noted that in such patients there appear serious problems during the intubation of the trachea by the method of direct laryngoscopy which are due to considerable disturbances of the anatomo-topographic interrelations of the organs, marked edema of the tissues and by the presence of the pathological content in the lumen of the oro- and laryngopharynx. The trachea intubation performed under the control of vision with the help of a bronchofibroscope allows to avoid additional traumatization of the tissue of the oro- and laryngopharynx, to rapidly introduce the endotracheal tube into the trachea without hypoxia, to perform sanitation of the oral cavity, pharynx and the tracheobronchial tree.

[Tracheobronchoscopy in injuries of the thorax and neck]. / Trakheobronkhoskopiia pri raneniiakh grudi i shei.

The results of examination and treatment of patients with penetrating wounds of the thorax and the neck are analysed. Diagnostic potential abilities of roentgenography and tracheobronchoscopy are evaluated comparatively. High diagnostic and curative effectiveness of tracheobronchoscopy is detected, which is indicated in diagnosis of the wounds of the larynx and the trachea as well as in cases of technical difficulties during endotracheal intubation. Besides, tracheobronchoscopy is indicated in postoperative period for sanation of the tracheobronchial tree under visual control for prevention of broncho-pulmonary complications.

[Fiber bronchoscopy in the early diagnosis and treatment of aspiration in patients with severe craniocerebral and associated injuries]. / Bronkhofibroskopiia v rannei diagnostike i lechenii aspiratsii u bol'nykh s tiazheloi cherepno-mozgovoi i sochetannoi travmoi.

The use of fiber bronchoscopy (FBS) for early diagnosis of aspiration in patients with grave craniocerebral (CCI) and combined injury is analyzed. Aspiration is not always associated with a clear-cut clinical picture in this cohort of patients, and x-ray examination of thoracic organs during the first hours after the injury is ineffective. High diagnostic potentials of BFS and possibility of removing the contents from the tracheobronchial tree under visual control dictate this measure for all cases with grave CCI and combined injuries during the first hours of hospitalization.

[Diagnosis and removal of foreign bodies of the trachea and bronchi]. / Diagnostika i udalenie inorodnykh tel trakhei i bronkhov.

The article presents results of examination and treatment of patients with foreign bodies in the tracheobronchial tree. It was noted that clinical manifestations were not leading in diagnosis of aspirated foreign bodies. The X-ray diagnosis is also not sufficiently effective, especially in cases with organic foreign bodies. Fiber bronchoscopy was used in 45 patients for diagnosis and removal of foreign bodies from the tracheobronchial tree. Practical recommendations are given on the method of removal of the foreign bodies depending on the shape, size and kind of the foreign body. The authors consider that the main criterion for fulfilling diagnostic fiber bronchoscopy in cases of suspected foreign body is information from the patient of probable aspiration of a foreign body. High efficiency of both diagnostic and curative fiber bronchoscopy for foreign bodies in the tracheobronchial tree is noted.