AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ile...AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidalanti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum.展开更多
Capsule endoscopy(CE) offers state-of-the-art imaging of the small bowel.In Crohn's disease its clinical role is still uncertain.This report analyses the usefulness of CE in patients with suspected Cronh's dis...Capsule endoscopy(CE) offers state-of-the-art imaging of the small bowel.In Crohn's disease its clinical role is still uncertain.This report analyses the usefulness of CE in patients with suspected Cronh's disease,in patients with established Crohn's disease(when assessing severity,occult gastrointestinal bleeding and/or as a guide to therapy),in patients with inflammatory bowel disease unclassified(IBDU),and in individuals with ulcerative colitis.The first item in this group is the most important although there is no strong evidence to establish the position of CE in the diagnostic workup.In patients with established Crohn's disease,recently developed activity scores are promising tools for an accurate assessment of severity.As a guide to therapy,CE should be focused on patients with unexplained symptoms when other investigations are inconclusive.In postoperative Crohn's Disease,international consensus recommended considering CE only ifileocolonoscopy is contraindicated or unsuccessful.In the case of IBDU,studies have shown a significant proportion of patients reclassified with Crohn's disease.In this setting,CE could have a role determining small bowel involvement.The role of CE in ulcerative colitis is limited.Some authors advocate CE before colectomy for refractory cases in order to exclude Crohn's disease.In summary,CE offers a new horizon in inflammatory bowel disease,and a better knowledge of mucosal abnormalities that could offer a paradigm shift:changing from symptombased disease activity estimation to direct mucosal healing monitoring.Nevertheless,randomized controlled studies are still needed to provide stronger evidence in this setting.展开更多
It is a fact that performing endoscopy using conventional methods requires substantial time and development of alternative diagnostic modalities. Replacement of rigid endoscopes with flexible and digital devices in ti...It is a fact that performing endoscopy using conventional methods requires substantial time and development of alternative diagnostic modalities. Replacement of rigid endoscopes with flexible and digital devices in time, faster performance of the procedures and reduced time for them to turn back to work brought about the expectancy. It was possible that easier and more reliable methods could exist. Idea of capsule endoscopy was born following examination of the gastrointestinal tract with an endoscope with shape of a capsule. Although idea of capsule endoscopy was suggested long years ago, it fell behind the advances in conventional step of the endoscopy, especially developmental speed of the flexible devices. Furthermore, three-dimensional (3D) organ views can be processed digitally by means of sophisticated software in the fields of computerized tomography and magnetic resonance imaging. Thus, virtual cystoscopy of high resolution and specificity is possible by means of both methods. Wireless capsule endoscopy is still in the experimental stage. “Steerable independent intracorporeal endoscope” with feature of consecutive instillation in addition to its diagnostic utility is not a dream.展开更多
BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) a...BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) and indeterminate colitis (IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn's Disease Activity Index (PCDAI), and histological indices. AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC. METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion. After informed consent, patient’s demographic and clinical data was abstracted. The current pediatric disease activity index (PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists (Attard TM and Colombo JM) blinded to each other's findings and to the findings on MRE (Mardis NJ). Agreement between WCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed. RESULTS Forty-five patients were included in the study, 18 withdrew and 27 (20 males and 20 CD), mean age (standard deviation) 13.46 (2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good correlation between the two Lewis scores (r=0.875, P<0.001). Concordance between WCE and MRE was poor (69%). In CD patients, when both MRE and WCE were compared using PCDAI>10 as the standard reference reflecting active small intestinal CD, the sensitivity of MRE and WCE were 100% and 83% respectively and the specificity of MRE and WCE were 57.14% and 78.6%, respectively. If the histology in ileum or/and duodenum was used as the reference for active small bowel involvement, WCE had a higher specificity as compared to MRE (83.3% vs 50%). In patients with Crohn’s disease, those with a positive PCDAI (>10) were more likely to have a positive WCE as compared to those with a negative PCDAI (83% vs 21%;P=0.018). CONCLUSION We suggest that MRE and WCE have a complementary role in the assessment of SBI in CD. WCE detected SBI with a much higher specificity while MRE had a higher sensitivity.展开更多
Wireless capsule endoscopy(WCE) is a promising technique which has overcome some limitations of traditional diagnosing tools, such as the comfortlessness of the cables and the inability of examining small intestine se...Wireless capsule endoscopy(WCE) is a promising technique which has overcome some limitations of traditional diagnosing tools, such as the comfortlessness of the cables and the inability of examining small intestine section. However, this technique is still far from mature and asks for the feasible improvements. For example, the relatively low transmission data rate and the absence of the real-time localization information of the capsule are all important issues. The studies of them rely on the understanding of the electromagnetic wave propagation in human body. Investigation of performance of WCE communication system was carried out by studying electromagnetic(EM) wave propagation of the wireless capsule endoscopy transmission channel. Starting with a pair of antennas working in a human body mimic environment, the signal transmissions and attenuations were examined. The relationship between the signal attenuation and the capsule(transmitter) position, and direction was also evaluated. These results provide important information for real-time localization of the capsule. Moreover, the pair of antennas and the human body were treated as a transmission channel, on which the binary amplitude shift keying(BASK) modulation scheme was used. The relationship between the modulation scheme, data rate and bit error rate was also determined in the case of BASK. With the obtained studies, it make possible to provide valuable information for further studies on the selection of the modulation scheme and the real-time localization of the capsules.展开更多
Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate.The purpose of this study was to evaluate the validity and reliability of an automatic post-processing met...Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate.The purpose of this study was to evaluate the validity and reliability of an automatic post-processing method for identifying and classifying wireless capsule endoscopic images, and investigate statistical measures to differentiate normal and abnormal images. The proposed technique consists of two main stages, namely, feature extraction and classification. Primarily, 32 features incorporating four statistical measures(contrast, correlation, homogeneity and energy) calculated from co-occurrence metrics were computed. Then, mutual information was used to select features with maximal dependence on the target class and with minimal redundancy between features. Finally, a trained classifier, adaptive neuro-fuzzy interface system was implemented to classify endoscopic images into tumor, healthy and unhealthy classes. Classification accuracy of 94.2% was obtained using the proposed pipeline. Such techniques are valuable for accurate detection characterization and interpretation of endoscopic images.展开更多
Wireless capsule endoscopy(CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential...Wireless capsule endoscopy(CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal(GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.展开更多
The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction...The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure's inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn's disease patients who have undergone ileocolonic resection for the treatment of Crohn's disease complications, and in patients' management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis.展开更多
Wireless capsule endoscopes (WCEs) have been used widely to detect abnormalities inside regions of the small intestine that are not accessible when using traditional endoscopy techniques. However, an experienced clini...Wireless capsule endoscopes (WCEs) have been used widely to detect abnormalities inside regions of the small intestine that are not accessible when using traditional endoscopy techniques. However, an experienced clinician must spend an average of 2 hours to view and analyze the approximately 60,000 images produced during one examination. Therefore, developing a computeraided system for processing WCE images is crucial. This paper proposes a novel method used for detecting bleeding and ulcers in WCE images. This approach involves using color features to determine the status of the small intestine. The experimental results revealed that the proposed scheme is promising in detecting bleeding and ulcer regions.展开更多
Wireless capsule endoscopy is a new technique that allows complete exploration of the small bowel without external wires. Its role has been analyzed in many small bowel diseases such as obscure gastrointestinal bleedi...Wireless capsule endoscopy is a new technique that allows complete exploration of the small bowel without external wires. Its role has been analyzed in many small bowel diseases such as obscure gastrointestinal bleeding, Crohn's disease and gastrointestinal polyposis syndromes with promising results. Studies on other pathologies (i.e. small bowel tumour, celiac disease) are under evaluation to define the role of this technique.展开更多
The wireless capsule endoscope,as a small electronic device,has conquered some limitations of traditional wired diagnosing tools,such as the uncomfortableness of the cables for the patient and the inability to examine...The wireless capsule endoscope,as a small electronic device,has conquered some limitations of traditional wired diagnosing tools,such as the uncomfortableness of the cables for the patient and the inability to examine the very convoluted small intestine section.However,this technique is still encountering a lot of practical challenges and is looking for feasible improvements.This work investigates the RF performance of the wireless capsule endoscope system by studying the electromagnetic(EM) wave propagation within the human body.A wireless capsule endoscopy transmission channel model is constructed to serve the purpose of investigating signal attenuations according to the relative position between the transmitter and the receiver.Within 300-500 MHz,the S_(21) results are regular and do not display any sudden changes,which allows a suitable expression to be derived for S_(21) in terms of frequency and offset.The results provide useful information for capsule localization.展开更多
AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,s...AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,size and number of small-intestinal polyps.Patients'age,sex,years of observation after surgery,type of surgery,duodenal polyps and colorectal cancer at surgery were analyzed.RESULTS:During WCE,polyps were detected in 9/14(64.3%)patients.Duodenal adenomatous polyps were found in nine(64.3%)patients,and jejunal and ileal polyps in seven(50%)and eight(57.1%),respectively.The Spigelman stage of duodenal polyposis was associated with the presence of jejunal and ileal polyps.Identification of the ampulla of Vater was not achieved with WCE.Importantly,the findings of WCE had no immediate impact on the further clinical management of FAP patients.No procedure-related complications were observed in the patients.CONCLUSION:WCE is a promising noninvasive new method for the detection of small-intestinal polyps.Further investigation is required to determine which phenotype of FAP is needed for surveillance with WCE.展开更多
We outline probable and possible developments with wireless capsule endoscopy. It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. This will be attractiv...We outline probable and possible developments with wireless capsule endoscopy. It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. This will be attractive to patients especially for cancer or varices detection because capsule endoscopy is painless and is likely to have a higher take up rate compared to conventional colonoscopy and gastroscopy. Double imager capsules with increased frame rates have been used to image the esophagus for Barrett's and esophageal varices. The image quality is not bad but needs to be improved if it is to become a realistic substitute for flexible upper and lower gastrointestinal endoscopy. An increase in the frame rate, angle of view, depth of field, image numbers, duration of the procedure and improvements in illumination seem likely. Colonic, esophageal and gastric capsules will improve in quality, eroding the supremacy of flexible endoscopy, and become embedded into screening programs. Therapeutic capsules will emerge with brushing, cytology, fluid aspiration, biopsy and drug delivery capabilities. Electrocautery may also become possible. Diagnostic capsules will integrate physiological measurements with imaging and optical biopsy, and immunologic cancer recognition. Remote control movement will improve with the use of magnets and/or electrostimulation and perhaps electromechanical methods. External wireless commands will influence capsule diagnosis and therapy and will increasingly entail the use of real-time imaging. However, it should be noted that speculations about the future of technology in any detail are almost always wrong.展开更多
Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bowel diseases. The main indication at present is the evaluation of GI bleeding of obscure origin, Crohn’s disease, coelia...Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bowel diseases. The main indication at present is the evaluation of GI bleeding of obscure origin, Crohn’s disease, coeliac disease and small bowel tumors. Studies suggest that capsule endoscopy is associated with few adverse events. Whether cardiac pacemaker may interfere with capsule endoscopy is still a controversial issue. We here report a case showing that there is a possibility of interference between the two procedures, cardiac pacemaker affecting the proper functioning of capsule endoscopy and that this is related to the distance between the pacemaker and the recorder.展开更多
Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgica...Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgically altered upper gastrointestinal anatomy.Aim:To evaluate the diagnostic yield,technical success and safety of WCE in patients with surgically altered upper gastrointestinal anatomy.Methods:Retrospective chart review of all patients with surgically altered upper GI anatomy who underwent WCE between 2006 and 2016 at the Medical University of South Carolina.Technical success,diagnostic yield,adverse events and therapeutic yield data was collected.Results:Thirty-one cases met inclusion criteria.Two were excluded as they did not undergo WCE due to failed patency capsule.The mean age was 58(69%female).The capsule was ingested in 18 cases and endoscopically placed in 11.The most common surgical anatomy was Roux-en-Y gastric bypass(n=13).Technical success,defined as the capsule reaching the cecum,was achieved in 89.7%of cases.The diagnostic yield was 44.8%,with the most common finding being angioectasia.No intra-or postprocedural adverse events were noted.Discussion:Capsule endoscopy in patients with surgically altered upper GI anatomy appears to show no elevated risk of adverse events and shows similar technical success and diagnostic yield as in patients with native anatomy.展开更多
An on-demand wireless capsule endoscope with fulldigital and bidirectional communication is presented,aiming at fulfilling the requirements of micromation and micropower consumption of modern wireless endoscope.The pr...An on-demand wireless capsule endoscope with fulldigital and bidirectional communication is presented,aiming at fulfilling the requirements of micromation and micropower consumption of modern wireless endoscope.The proposed multifunctional operation and unique radio transmission system cuts down the power consumption efficiently and on-demand bidirectional communication in vitro improves the detection rate of focus.Meanwhile,gray dilatation is introduced in a bit plane that optimizes the distortion rate in the process of image recording and transmission.展开更多
The millimeter-scale capsules with controllable morphology,ultra-low permeability and excellent mechanical stability were fabricated by millifluidics.Viscosity of inner phase was adjusted to control the morphology and...The millimeter-scale capsules with controllable morphology,ultra-low permeability and excellent mechanical stability were fabricated by millifluidics.Viscosity of inner phase was adjusted to control the morphology and properties of the capsules.In detail,as the concentration of polyvinyl alcohol(PVA)increased from 0 to 8% in the inner phase of the capsules,the diameter of capsules decreased from 3.33 ± 0.01mm to 2.97 ± 0.01 mm,the shell thickness of capsules decreased from 0.183 ± 0.004 mm to 0.155 ± 0.003 mm.While the capsules had round shape and high sphericity.Notably,the capsules with 2% PVA in the inner phase had remarkably decreased water permeability and good morphological stability.Specifically,the end-time of water losing of the capsules was up to 49 days,while the dehydrated capsules maintained spherical appearance,and crushing force of the capsules was up to 13.73 ± 0.79 N,which ensured stability during processing and transportation.This research provides a new strategy for stable encapsulation of small molecules.展开更多
Wireless power transfer(WPT)has been a popular topic in power integrated circuit(IC)designs in the past decade.As slogan"cutting the last wire"presented in ISSCC’15[1],WPT is poised to take over many wired ...Wireless power transfer(WPT)has been a popular topic in power integrated circuit(IC)designs in the past decade.As slogan"cutting the last wire"presented in ISSCC’15[1],WPT is poised to take over many wired power deliveries applica-tions today,just like what happened to wireless communica-tion nowadays.Over the years,WPT has become more mature and more wirelessly charged or powered products have become available on the market.This mini review intends to summarize recent breakthroughs in WPT inte-grated circuits(IC)research.展开更多
Wireless Power Transfer(WPT)technology can provide real-time power for many terminal devices in Internet of Things(IoT)through millimeterWave(mmWave)to support applications with large capacity and low latency.Although...Wireless Power Transfer(WPT)technology can provide real-time power for many terminal devices in Internet of Things(IoT)through millimeterWave(mmWave)to support applications with large capacity and low latency.Although the intelligent reflecting surface(IRS)can be adopted to create effective virtual links to address the mmWave blockage problem,the conventional solutions only adopt IRS in the downlink from the Base Station(BS)to the users to enhance the received signal strength.In practice,the reflection of IRS is also applicable to the uplink to improve the spectral efficiency.It is a challenging to jointly optimize IRS beamforming and system resource allocation for wireless energy acquisition and information transmission.In this paper,we first design a Low-Energy Adaptive Clustering Hierarchy(LEACH)clustering protocol for clustering and data collection.Then,the problem of maximizing the minimum system spectral efficiency is constructed by jointly optimizing the transmit power of sensor devices,the uplink and downlink transmission times,the active beamforming at the BS,and the IRS dynamic beamforming.To solve this non-convex optimization problem,we propose an alternating optimization(AO)-based joint solution algorithm.Simulation results show that the use of IRS dynamic beamforming can significantly improve the spectral efficiency of the system,and ensure the reliability of equipment communication and the sustainability of energy supply under NLOS link.展开更多
基金Supported by (in part) The Foundation "Fondazione Umberto Di Mario, Largo Marchiafava", Rome, Italy
文摘AIM: To investigate the prevalence of proximal small bowel (SB) lesions detected by wireless capsule endoscopy (WCE) in Crohn's disease (CD). METHODS: WCE was performed in 64 patients: 32 with CD of the distal ileum, and 32 controls with iron-deficiency anemia (IDA) or diarrhea. WCE was performed using the Given SB-WCE, followed by small intestine contrast ultrasonography (SICUS). Findings compatible with CD by using WCE included erosions, aphthoid or deep ulcers, and strictures/stenosis. RESULTS: WCE detected proximal SB lesions in 16/32 (50%) patients (14 aphthoid ulcers, 2 deep ulcers, one stricture), which appeared not to be related to clinical parameters [epigastric pain, age, smoking, non-steroidalanti-inflammatory drugs (NSAIDs), IDA]. Among patients with proximal SB lesions, 6 (37%) were smokers, 3 (19%) NSAID users, 3 (19%) had epigastric pain and 4 (25%) had IDA. SICUS detected proximal SB lesions in 3/32 patients (19%) also showing lesions with WCE. No correlations were observed between proximal SB lesions assessed by WCE or by SICUS (χ2 = 1.5, P = 0.2). CONCLUSION: The use of WCE allows the detection of previously unknown upper SB lesions in a high proportion of patients with a previous diagnosis of CD involving the distal ileum.
文摘Capsule endoscopy(CE) offers state-of-the-art imaging of the small bowel.In Crohn's disease its clinical role is still uncertain.This report analyses the usefulness of CE in patients with suspected Cronh's disease,in patients with established Crohn's disease(when assessing severity,occult gastrointestinal bleeding and/or as a guide to therapy),in patients with inflammatory bowel disease unclassified(IBDU),and in individuals with ulcerative colitis.The first item in this group is the most important although there is no strong evidence to establish the position of CE in the diagnostic workup.In patients with established Crohn's disease,recently developed activity scores are promising tools for an accurate assessment of severity.As a guide to therapy,CE should be focused on patients with unexplained symptoms when other investigations are inconclusive.In postoperative Crohn's Disease,international consensus recommended considering CE only ifileocolonoscopy is contraindicated or unsuccessful.In the case of IBDU,studies have shown a significant proportion of patients reclassified with Crohn's disease.In this setting,CE could have a role determining small bowel involvement.The role of CE in ulcerative colitis is limited.Some authors advocate CE before colectomy for refractory cases in order to exclude Crohn's disease.In summary,CE offers a new horizon in inflammatory bowel disease,and a better knowledge of mucosal abnormalities that could offer a paradigm shift:changing from symptombased disease activity estimation to direct mucosal healing monitoring.Nevertheless,randomized controlled studies are still needed to provide stronger evidence in this setting.
文摘It is a fact that performing endoscopy using conventional methods requires substantial time and development of alternative diagnostic modalities. Replacement of rigid endoscopes with flexible and digital devices in time, faster performance of the procedures and reduced time for them to turn back to work brought about the expectancy. It was possible that easier and more reliable methods could exist. Idea of capsule endoscopy was born following examination of the gastrointestinal tract with an endoscope with shape of a capsule. Although idea of capsule endoscopy was suggested long years ago, it fell behind the advances in conventional step of the endoscopy, especially developmental speed of the flexible devices. Furthermore, three-dimensional (3D) organ views can be processed digitally by means of sophisticated software in the fields of computerized tomography and magnetic resonance imaging. Thus, virtual cystoscopy of high resolution and specificity is possible by means of both methods. Wireless capsule endoscopy is still in the experimental stage. “Steerable independent intracorporeal endoscope” with feature of consecutive instillation in addition to its diagnostic utility is not a dream.
基金Supported by the donation of wireless Small bowel capsule and patency capsules from Giving imaging,Ltd Medtronic company with the funding agreement from Given investigator-initiated study No.13-12
文摘BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) and indeterminate colitis (IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn's Disease Activity Index (PCDAI), and histological indices. AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC. METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion. After informed consent, patient’s demographic and clinical data was abstracted. The current pediatric disease activity index (PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists (Attard TM and Colombo JM) blinded to each other's findings and to the findings on MRE (Mardis NJ). Agreement between WCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed. RESULTS Forty-five patients were included in the study, 18 withdrew and 27 (20 males and 20 CD), mean age (standard deviation) 13.46 (2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good correlation between the two Lewis scores (r=0.875, P<0.001). Concordance between WCE and MRE was poor (69%). In CD patients, when both MRE and WCE were compared using PCDAI>10 as the standard reference reflecting active small intestinal CD, the sensitivity of MRE and WCE were 100% and 83% respectively and the specificity of MRE and WCE were 57.14% and 78.6%, respectively. If the histology in ileum or/and duodenum was used as the reference for active small bowel involvement, WCE had a higher specificity as compared to MRE (83.3% vs 50%). In patients with Crohn’s disease, those with a positive PCDAI (>10) were more likely to have a positive WCE as compared to those with a negative PCDAI (83% vs 21%;P=0.018). CONCLUSION We suggest that MRE and WCE have a complementary role in the assessment of SBI in CD. WCE detected SBI with a much higher specificity while MRE had a higher sensitivity.
基金Projects(BK2011352,BK20131183) partially supported by the Natural Science Foundation of Jiangsu Province,ChinaProjects(SYG201011,SYG201211) supported by Suzhou Science and Technology Bureau,ChinaProject(10-03-16) supported by Xi’an Jiaotong-Liverpool University Research Development Fund,China
文摘Wireless capsule endoscopy(WCE) is a promising technique which has overcome some limitations of traditional diagnosing tools, such as the comfortlessness of the cables and the inability of examining small intestine section. However, this technique is still far from mature and asks for the feasible improvements. For example, the relatively low transmission data rate and the absence of the real-time localization information of the capsule are all important issues. The studies of them rely on the understanding of the electromagnetic wave propagation in human body. Investigation of performance of WCE communication system was carried out by studying electromagnetic(EM) wave propagation of the wireless capsule endoscopy transmission channel. Starting with a pair of antennas working in a human body mimic environment, the signal transmissions and attenuations were examined. The relationship between the signal attenuation and the capsule(transmitter) position, and direction was also evaluated. These results provide important information for real-time localization of the capsule. Moreover, the pair of antennas and the human body were treated as a transmission channel, on which the binary amplitude shift keying(BASK) modulation scheme was used. The relationship between the modulation scheme, data rate and bit error rate was also determined in the case of BASK. With the obtained studies, it make possible to provide valuable information for further studies on the selection of the modulation scheme and the real-time localization of the capsules.
文摘Automatic diagnosis tool helps physicians to evaluate capsule endoscopic examinations faster and more accurate.The purpose of this study was to evaluate the validity and reliability of an automatic post-processing method for identifying and classifying wireless capsule endoscopic images, and investigate statistical measures to differentiate normal and abnormal images. The proposed technique consists of two main stages, namely, feature extraction and classification. Primarily, 32 features incorporating four statistical measures(contrast, correlation, homogeneity and energy) calculated from co-occurrence metrics were computed. Then, mutual information was used to select features with maximal dependence on the target class and with minimal redundancy between features. Finally, a trained classifier, adaptive neuro-fuzzy interface system was implemented to classify endoscopic images into tumor, healthy and unhealthy classes. Classification accuracy of 94.2% was obtained using the proposed pipeline. Such techniques are valuable for accurate detection characterization and interpretation of endoscopic images.
文摘Wireless capsule endoscopy(CE) is a technology developed for the endoscopic exploration of the small bowel. The first capsule model was approved by the Food and Drug Administration in 2001, and its first and essential indication was occult gastrointestinal(GI) bleeding. Over subsequent years, this technology has been refined to provide superior resolution, increased battery life, and capabilities to view different parts of the GI tract. Indeed, cases for which CE proved useful have increased significantly over the last few years, with new indications for the small bowel and technical improvements that have expanded its use to other parts of the GI tract, including the esophagus and colon. The main challenges in the development of CE are new devices with the ability to provide therapy, air inflation for a better vision of the small bowel, biopsy sampling systems attached to the capsule and the possibility to guide and move the capsule with an external motion control. In this article we review the current and new indications of CE, and the evolving technological changes shaping this technology, which has a promising potential in the coming future of gastroenterology.
文摘The introduction of wireless capsule endoscopy in 2000 has revolutionized our ability to visualize parts of the small bowel mucosa classically unreached by the conventional endoscope, and since the recent introduction of colon capsule endoscopy, a promising alternative method has been available for the evaluation of large bowel mucosa. The advantages of wireless capsule endoscopy include its non-invasive character and its ability to visualize proximal and distal parts of the intestine, while important disadvantages include the procedure's inability of tissue sampling and significant incompletion rate. Its greatest limitation is the prohibited use in cases of known or suspected stenosis of the intestinal lumen due to high risk of retention. Wireless capsule endoscopy plays an important role in the early recognition of recurrence, on Crohn's disease patients who have undergone ileocolonic resection for the treatment of Crohn's disease complications, and in patients' management and therapeutic strategy planning, before obvious clinical and laboratory relapse. Although capsule endoscopy cannot replace traditional endoscopy, it offers valuable information on the evaluation of intestinal disease and has a significant impact on disease reclassification of patients with a previous diagnosis of ulcerative colitis or inflammatory bowel disease unclassified/indeterminate colitis. Moreover, it may serve as an effective alternative where colonoscopy is contraindicated and in cases with incomplete colonoscopy studies. The use of patency capsule maximizes safety and is advocated in cases of suspected small or large bowel stenosis.
文摘Wireless capsule endoscopes (WCEs) have been used widely to detect abnormalities inside regions of the small intestine that are not accessible when using traditional endoscopy techniques. However, an experienced clinician must spend an average of 2 hours to view and analyze the approximately 60,000 images produced during one examination. Therefore, developing a computeraided system for processing WCE images is crucial. This paper proposes a novel method used for detecting bleeding and ulcers in WCE images. This approach involves using color features to determine the status of the small intestine. The experimental results revealed that the proposed scheme is promising in detecting bleeding and ulcer regions.
文摘Wireless capsule endoscopy is a new technique that allows complete exploration of the small bowel without external wires. Its role has been analyzed in many small bowel diseases such as obscure gastrointestinal bleeding, Crohn's disease and gastrointestinal polyposis syndromes with promising results. Studies on other pathologies (i.e. small bowel tumour, celiac disease) are under evaluation to define the role of this technique.
基金Project (BK20131183) supported by the Natural Science Foundation of Jiangsu Province,ChinaProjects (RDF-14-03-24,RDF-14-02-48) supported by Research Development Fund of Xi’an Jiaotong-Liverpool University,China
文摘The wireless capsule endoscope,as a small electronic device,has conquered some limitations of traditional wired diagnosing tools,such as the uncomfortableness of the cables for the patient and the inability to examine the very convoluted small intestine section.However,this technique is still encountering a lot of practical challenges and is looking for feasible improvements.This work investigates the RF performance of the wireless capsule endoscope system by studying the electromagnetic(EM) wave propagation within the human body.A wireless capsule endoscopy transmission channel model is constructed to serve the purpose of investigating signal attenuations according to the relative position between the transmitter and the receiver.Within 300-500 MHz,the S_(21) results are regular and do not display any sudden changes,which allows a suitable expression to be derived for S_(21) in terms of frequency and offset.The results provide useful information for capsule localization.
文摘AIM:To detect the prevalence of small bowel polyps by wireless capsule endoscopy(WCE)in patients with familial adenomatous polyposis(FAP).METHODS:We examined prospectively 14 patients with FAP to assess the location,size and number of small-intestinal polyps.Patients'age,sex,years of observation after surgery,type of surgery,duodenal polyps and colorectal cancer at surgery were analyzed.RESULTS:During WCE,polyps were detected in 9/14(64.3%)patients.Duodenal adenomatous polyps were found in nine(64.3%)patients,and jejunal and ileal polyps in seven(50%)and eight(57.1%),respectively.The Spigelman stage of duodenal polyposis was associated with the presence of jejunal and ileal polyps.Identification of the ampulla of Vater was not achieved with WCE.Importantly,the findings of WCE had no immediate impact on the further clinical management of FAP patients.No procedure-related complications were observed in the patients.CONCLUSION:WCE is a promising noninvasive new method for the detection of small-intestinal polyps.Further investigation is required to determine which phenotype of FAP is needed for surveillance with WCE.
文摘We outline probable and possible developments with wireless capsule endoscopy. It seems likely that capsule endoscopy will become increasingly effective in diagnostic gastrointestinal endoscopy. This will be attractive to patients especially for cancer or varices detection because capsule endoscopy is painless and is likely to have a higher take up rate compared to conventional colonoscopy and gastroscopy. Double imager capsules with increased frame rates have been used to image the esophagus for Barrett's and esophageal varices. The image quality is not bad but needs to be improved if it is to become a realistic substitute for flexible upper and lower gastrointestinal endoscopy. An increase in the frame rate, angle of view, depth of field, image numbers, duration of the procedure and improvements in illumination seem likely. Colonic, esophageal and gastric capsules will improve in quality, eroding the supremacy of flexible endoscopy, and become embedded into screening programs. Therapeutic capsules will emerge with brushing, cytology, fluid aspiration, biopsy and drug delivery capabilities. Electrocautery may also become possible. Diagnostic capsules will integrate physiological measurements with imaging and optical biopsy, and immunologic cancer recognition. Remote control movement will improve with the use of magnets and/or electrostimulation and perhaps electromechanical methods. External wireless commands will influence capsule diagnosis and therapy and will increasingly entail the use of real-time imaging. However, it should be noted that speculations about the future of technology in any detail are almost always wrong.
文摘Wireless capsule endoscopy is a new endoscopic tool for the diagnosis and management of small bowel diseases. The main indication at present is the evaluation of GI bleeding of obscure origin, Crohn’s disease, coeliac disease and small bowel tumors. Studies suggest that capsule endoscopy is associated with few adverse events. Whether cardiac pacemaker may interfere with capsule endoscopy is still a controversial issue. We here report a case showing that there is a possibility of interference between the two procedures, cardiac pacemaker affecting the proper functioning of capsule endoscopy and that this is related to the distance between the pacemaker and the recorder.
文摘Background:Wireless capsule endoscopy(WCE)is an effective,minimally invasive tool used for evaluation of the small intestine.To date,there are no studies evaluating the diagnostic yield of WCE in patients with surgically altered upper gastrointestinal anatomy.Aim:To evaluate the diagnostic yield,technical success and safety of WCE in patients with surgically altered upper gastrointestinal anatomy.Methods:Retrospective chart review of all patients with surgically altered upper GI anatomy who underwent WCE between 2006 and 2016 at the Medical University of South Carolina.Technical success,diagnostic yield,adverse events and therapeutic yield data was collected.Results:Thirty-one cases met inclusion criteria.Two were excluded as they did not undergo WCE due to failed patency capsule.The mean age was 58(69%female).The capsule was ingested in 18 cases and endoscopically placed in 11.The most common surgical anatomy was Roux-en-Y gastric bypass(n=13).Technical success,defined as the capsule reaching the cecum,was achieved in 89.7%of cases.The diagnostic yield was 44.8%,with the most common finding being angioectasia.No intra-or postprocedural adverse events were noted.Discussion:Capsule endoscopy in patients with surgically altered upper GI anatomy appears to show no elevated risk of adverse events and shows similar technical success and diagnostic yield as in patients with native anatomy.
基金The National High Technology Research and Development Program of China(2004AA404012)
文摘An on-demand wireless capsule endoscope with fulldigital and bidirectional communication is presented,aiming at fulfilling the requirements of micromation and micropower consumption of modern wireless endoscope.The proposed multifunctional operation and unique radio transmission system cuts down the power consumption efficiently and on-demand bidirectional communication in vitro improves the detection rate of focus.Meanwhile,gray dilatation is introduced in a bit plane that optimizes the distortion rate in the process of image recording and transmission.
文摘The millimeter-scale capsules with controllable morphology,ultra-low permeability and excellent mechanical stability were fabricated by millifluidics.Viscosity of inner phase was adjusted to control the morphology and properties of the capsules.In detail,as the concentration of polyvinyl alcohol(PVA)increased from 0 to 8% in the inner phase of the capsules,the diameter of capsules decreased from 3.33 ± 0.01mm to 2.97 ± 0.01 mm,the shell thickness of capsules decreased from 0.183 ± 0.004 mm to 0.155 ± 0.003 mm.While the capsules had round shape and high sphericity.Notably,the capsules with 2% PVA in the inner phase had remarkably decreased water permeability and good morphological stability.Specifically,the end-time of water losing of the capsules was up to 49 days,while the dehydrated capsules maintained spherical appearance,and crushing force of the capsules was up to 13.73 ± 0.79 N,which ensured stability during processing and transportation.This research provides a new strategy for stable encapsulation of small molecules.
文摘Wireless power transfer(WPT)has been a popular topic in power integrated circuit(IC)designs in the past decade.As slogan"cutting the last wire"presented in ISSCC’15[1],WPT is poised to take over many wired power deliveries applica-tions today,just like what happened to wireless communica-tion nowadays.Over the years,WPT has become more mature and more wirelessly charged or powered products have become available on the market.This mini review intends to summarize recent breakthroughs in WPT inte-grated circuits(IC)research.
基金supported by the National Natural Science Foundation of China 62001051.
文摘Wireless Power Transfer(WPT)technology can provide real-time power for many terminal devices in Internet of Things(IoT)through millimeterWave(mmWave)to support applications with large capacity and low latency.Although the intelligent reflecting surface(IRS)can be adopted to create effective virtual links to address the mmWave blockage problem,the conventional solutions only adopt IRS in the downlink from the Base Station(BS)to the users to enhance the received signal strength.In practice,the reflection of IRS is also applicable to the uplink to improve the spectral efficiency.It is a challenging to jointly optimize IRS beamforming and system resource allocation for wireless energy acquisition and information transmission.In this paper,we first design a Low-Energy Adaptive Clustering Hierarchy(LEACH)clustering protocol for clustering and data collection.Then,the problem of maximizing the minimum system spectral efficiency is constructed by jointly optimizing the transmit power of sensor devices,the uplink and downlink transmission times,the active beamforming at the BS,and the IRS dynamic beamforming.To solve this non-convex optimization problem,we propose an alternating optimization(AO)-based joint solution algorithm.Simulation results show that the use of IRS dynamic beamforming can significantly improve the spectral efficiency of the system,and ensure the reliability of equipment communication and the sustainability of energy supply under NLOS link.
