Image-Enhanced Capsule Endoscopy Improves the Identification of Small Intestinal Lesions.

Image-enhanced endoscopy is useful for diagnosing and identifying lesions in the gastrointestinal tract. Recently, image-enhanced endoscopy has become a breakthrough technology that has attracted significant attention. This image enhancing technology is available for capsule endoscopy, which is an effective tool for small intestinal lesions and has been applied in flexible spectral color enhancement technology and in contrast capsule like narrow-band imaging. In this field, most researchers focus on improving the visibility and detection of small intestinal lesions. This review summarizes previous studies on image-enhanced capsule endoscopy and aims to evaluate the efficacy of this technology.

Odontogenic infection and antiresorptive agent-related osteonecrosis of the jaw with facial subcutaneous abscess formation: A retrospective clinical study of difficult-to-diagnose cases.

OBJECTIVE: The objective of this study was to analyze difficult-to-diagnose cases of odontogenic infection and antiresorptive agent-related osteonecrosis of the jaw (ARONJ) with facial subcutaneous abscesses by otolaryngologists. METHODS: The study was conducted in the department of otolaryngology of a university hospital. Seven patients exhibiting odontogenic infection and ARONJ with facial subcutaneous abscesses diagnosed at the department of otolaryngology in our hospital from January 2008 to December 2018 were included in the study. We investigated the following information obtained from the patients: clinical department for initial treatment, sex, age, offending tooth, causative disease, site of the fistula, symptoms, methods of diagnoses, and therapy. RESULTS: Odontogenic infection with facial subcutaneous abscess formation can occur in individuals in a wide range of age groups; however, the pathological manifestations of ARONJ are often observed in older women, frequently at the chin and accompanied by nodules and pain in the adjacent teeth. Computed tomography and orthopantomography are useful for diagnosis and are especially indicated for patients under long-term follow-up or with frequent recurrences. Magnetic resonance imaging, cytodiagnosis, and histological analysis might be necessary to exclude the possibility of tumors. Management of such facial subcutaneous abscesses comprises dental treatment and infection control, and f surgical removal of the abscess is usually not required. Treatments such as sequestrectomy and sitafloxacin administration are useful for patients with ARONJ. CONCLUSION: Our results demonstrated that for patients with facial subcutaneous abscesses, involvement of odontogenic infection and ARONJ should be considered.

Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1.

OBJECTIVES: Recent studies have suggested the necessity of therapeutic intervention for patients with ulcerative colitis at high risk of clinical relapse with a Mayo endoscopic score (MES) of 1. The aim of this retrospective cohort study was to demonstrate the impact of intramucosal capillary network changes and crypt architecture abnormalities to stratify the risk of relapse in patients with an MES of 1. METHODS: All included patients had an MES of ≤1 and confirmed sustained clinical remission between October 2016 and April 2019. We classified patients with an MES of 1 as "intramucosal capillary/crypt (ICC)-active" or "ICC-inactive" using endocytoscopic evaluation. We followed patients until October 2019 or until relapse; the main outcome measure was the difference in clinical relapse-free rates between ICC-active and ICC-inactive patients with an MES of 1. RESULTS: We included 224 patients and analyzed data for 218 (82 ICC-active and 54 ICC-active with an MES of 1 and 82 with an MES of 0). During follow-up, among the patients with an MES of 1, 30.5% (95% confidence interval 20.8-41.6; 25/82) of the patients relapsed in the ICC-active group and 5.6% (95% confidence interval 1.2-15.4; 3/54) of the patients relapsed in the ICC-inactive group. The ICC-inactive group had a significantly higher clinical relapse-free rate compared with the ICC-active group (P < 0.01). CONCLUSIONS: In vivo intramucosal capillary network and crypt architecture patterns stratified the risk of clinical relapse in patients with an MES of 1 (UMIN 000032580; UMIN 000036359).

White light-emitting contrast image capsule endoscopy for visualization of small intestine lesions: a pilot study.

BACKGROUND AND STUDY AIMS: Capsule endoscopy (CE) has become a routine means of diagnosing obscure gastrointestinal bleeding (OGIB) in the small intestine. Capsules using novel blue-enhanced white light-emitting diodes are expected to acquire clearer contrast images (CIs) of the small bowel vasculature. We conducted a pilot study to examine whether CIs facilitate visualization of small bowel erosions, ulcers, and areas of angioectasia compared with standard white light images (WLIs). PATIENTS AND METHODS: A total of 24 patients with OGIB were recruited in this study. The main outcome measure was visibility of lesions on CIs compared with WLIs. We also examined the color difference between lesions and normal mucosa (ΔE) with each imaging modality. RESULTS: Three experienced physicians retrospectively evaluated 138 images of small bowel lesions (107 erosions, or ulcers, and 31 areas of angioectasia) obtained from 24 CE examinations. The endoscopists judged that compared with WLIs, CIs afforded easier identification of erosions or ulcers in 29 of 107 cases (27.1 %), were non-inferior in 68 of 107 cases (63.6 %), and were inferior in 10 of 107 cases (9.3 %). Identification of angioectasia was judged to be easier with CIs in 15 of 31 cases (48.4 %), non-inferior in 13 of 31 cases (41.9 %), and inferior in 3 of 31 cases (9.7 %). ΔE was significantly higher for CIs than WLIs, especially for angioectasia, potentially explaining why lesions were easier to visualize. CONCLUSIONS: CIs obtained by CE appear to facilitate identification of small bowel erosions, ulcers, and areas of angioectasia compared with WLIs.

Surface-mediated photoalignment of discotic liquid crystals on azobenzene polymer films.

This paper describes a simple strategy for the formation of photoaligned and micropatterned discotic liquid crystal (DLC) film on the surface of photoirradiated azobenzene-containing polymer thin film. The key material for the surface-mediated photoalignment of the DLCs was poly[4-(4-cyanophenylazo)phenyl methacrylate] (pMAzCN). Optical anisotropy was generated in a pMAzCN film by oblique exposure to nonpolarized light which resulted in angle-selective photoisomerization and reorientation of the azobenzenes. Subsequent annealing of the film at 240 degrees C enhanced the photoaligned state of the p-cyanoazobenzenes due to strong intermolecular dipole-dipole interaction and semicrystalline nature of the pMAzCN. This combination of photoirradiation and subsequent annealing of the pMAzCN film made it possible to realize the surface-assisted orientation control of a DLC molecule, which displays both columnar (Col) and discotic nematic (N(D)) phases over 152 degrees C. When the pMAzCN film was exposed to linearly polarized light from the surface normal, the DLC molecules showed homeotropic orientation with the director perpendicular to the substrate surface. In the contrast, oblique irradiation of the pMAzCN film with nonpolarized light gave rise to tilted DLC orientation with well-ordered optical birefringence at the N(D) phase. Rapid cooling from the N(D) phase produced a well-aligned glassy N(D) state at room temperature, which was adequately stable for 10 months even though no covalent cross-linking among the DLCs was performed. The spatial orientation of photoaligned DLCs in both their bulk film and in their interface region was characterized by means of optical birefringence, X-ray diffraction, and fluorescence measurements. At the N(D) phase, the DLC molecules were aligned in a hybrid manner such that their tilt angles varied throughout the thickness of DLC film. The direction of tilted DLCs was opposite to the propagation of the actinic nonpolarized light. The photoaligned DLC films exhibited polarized fluorescence emission with an s-polarized/p-polarized intensity ratio of 4.1, despite the nonpolarized excitation of only DLC at outmost surface. These results indicate that the three-dimensionally aligned azobenzene moieties of the pMAzCN thin film were transferred to the tilted DLC molecules at air/DLC interface. Finally, we demonstrated micrometer-scale photopatterned orientation of DLC molecules on the pMAzCN surface by oblique nonpolarized irradiation of the film through a photomask.