Showing papers by "Hirohisa Machida published in 2004"

Appearance of enhanced tissue features in narrow-band endoscopic imaging.

Abstract: This study was performed to examine the usefulness of medical endoscopic imaging utilizing narrow-band illumination. The contrast between the vascular pattern and the adjacent mucosa of the underside of the human tongue was measured using five narrow-band illuminations and three broadband illuminations. The results demon- strate that the pathological features of a vascular pattern are depen- dent on the center wavelength and the bandwidth of illumination. By utilizing narrow-band illumination of 415630 nm, the contrast of the capillary pattern in the superficial layer was markedly improved. This is an important benefit that is difficult to obtain with ordinary broad- band illumination. The appearances of capillary patterns on color im- ages were evaluated for three sets of filters. The narrow, band imaging (NBI) filter set (415630 nm, 445630 nm, 500630 nm) was selected to achieve the preferred appearance of the vascular patterns for clini- cal tests. The results of clinical tests in colonoscopy and esophagos- copy indicated that NBI will be useful as a supporting method for observation of the endoscopic findings of early cancer. © 2004 Society of

Narrow-band imaging in the diagnosis of colorectal mucosal lesions: a pilot study.

Abstract: BACKGROUND AND STUDY AIMS A newly developed narrow-band imaging (NBI) technique, in which modified optical filters were used in the light source of a video endoscope system, was applied during colonoscopy in a clinical setting. This pilot study evaluated the clinical feasibility of the NBI system for evaluating colorectal lesions. PATIENTS AND METHODS A total of 43 colorectal lesions in 34 patients were included in the study. The quality of visualization of colorectal lesions and the accuracy of differentiation between neoplastic and non-neoplastic lesions using the NBI system were evaluated in comparison with results from conventional colonoscopy and with chromoendoscopy. RESULTS For pit pattern delineation, NBI was superior to conventional endoscopy (P < 0.001), but inferior to chromoendoscopy (P < 0.05). NBI achieved better visualization of the mucosal vascular network and of the hue of lesions than conventional endoscopy (P < 0.05). However there was no significant difference between NBI and chromoendoscopy in differentiating neoplastic from non-neoplastic lesions (both techniques had a sensitivity of 100 % and a specificity 75 %). This was better than the results of conventional colonoscopy (sensitivity 83 %, specificity 44 %; P < 0.05 for specificity). CONCLUSIONS These results suggest that in the examination of colonic lesions the NBI system provides imaging features additional to those of both conventional endoscopy and chromoendoscopy. For distinguishing neoplasms from non-neoplastic lesions, NBI was equivalent to chromoendoscopy.

Endoscopic mucosal resection and submucosal dissection method for large colorectal tumors

Abstract: The goal of endoscopic mucosal resection (EMR) is to allow the endoscopist to obtain tissue or resect lesions not previously amenable to standard biopsy or excisional techniques and to remove malignant lesions without open surgery. In this article, we describe the results of conventional EMR and EMR using an insulation-tipped (IT) electrosurgical knife (submucosal dissection method) for large colorectal mucosal neoplasms and discuss the problems and future prospects of these procedures. At present, conventional EMR is much more feasible than EMR using IT-knife from the perspectives of time, money, complication, and organ preservation. However, larger lesions tend to be resected in a piecemeal fashion; and it is difficult to confirm whether EMR has been complete. For accurate histopathological assessment of the resected specimen en bloc EMR is desirable although further experience is needed to establish its safety and efficacy. Further improvements of in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms.

New methods &m aterials

Abstract: After re-39 moval,accuratehistopathologicevaluationofapolyp40 is crucial to future diagnostic and therapeutic41 management. For this purpose, the entire polyp42 must be retrieved. However, retrieval of resected43 polyps can be cumbersome; a resected polyp usually44 can be found in the immediate vicinity of the45 resection site, but occasionally it will fall, under46 the influence of gravity, outside the field of view and47 may be difficult to find. The proportion of resection48 specimens lost after polypectomy or EMR ranges49 from 2.1% to 16.5%.