Objective:Verrucous epidermal nevus(VEN),seborrheic keratosis(SK),verruca plana(VP),verruca vulgaris(VV),and nevus sebaceous(NS)are common verrucous proliferative skin diseases with similar clinical appearances,often ...Objective:Verrucous epidermal nevus(VEN),seborrheic keratosis(SK),verruca plana(VP),verruca vulgaris(VV),and nevus sebaceous(NS)are common verrucous proliferative skin diseases with similar clinical appearances,often posing diagnostic challenges.Dermoscopy and reflectance confocal microscopy(RCM)can aid in their differentiation,yet their specific features under these tools have not been systematically described.This study aims to summarize and analyze the dermoscopic and RCM features of VEN,SK,VP,VV,and NS.Methods:A total of 121 patients with histopathologically confirmed verrucous proliferative skin diseases were enrolled.Dermoscopy and RCM imaging was used to observe and analyze the microscopic features of these conditions.Results:Under dermoscopy,the 5 diseases displayed distinct characteristics:VEN typically showed gyriform structures;SK was characterized by gyriform structures,comedo-like openings,and milia-like cysts;VP and VV featured dotted vessels and frogspawn-like structures;NS presented as brownish-yellow globules.RCM revealed shared features such as hyperkeratosis and acanthosis across all 5 diseases.Specific features included gyriform structures and elongated rete ridges in VEN;pseudocysts and gyriform structures in SK;evenly distributed ring-like structures in VP;vacuolated cells and papillomatous proliferation in VV;and frogspawn-like structures in NS.Conclusion:These 5 verrucous proliferative skin conditions exhibit distinguishable features under both dermoscopy and RCM.The combination of these 2 noninvasive imaging modalities holds significant clinical value for the differential diagnosis of verrucous proliferative skin diseases.展开更多
The high-temperature dissolution behavior of primary carbides in samples taken from GCr15 continuous-casting bloom was observed in-situ by confocal laser scanning microscopy.Equations were fitted to the dissolution ki...The high-temperature dissolution behavior of primary carbides in samples taken from GCr15 continuous-casting bloom was observed in-situ by confocal laser scanning microscopy.Equations were fitted to the dissolution kinetics of primary carbides during either heating or soaking.Dissolution of carbides proceeded in three stages(fast→slow→faster)as either temperature or holding time was increased.During the heating process and during the first and third stages of the soaking process,the original size of the carbides determined the steepness of the slope,but during the middle(“slow”)stage of the soaking process,the slope remained zero.The initial size of the carbides varied greatly,but their final dissolution temperature fell within the narrow range of 1210-1235℃,and the holding time remained within 50 min.Fractal analysis was used to study the morphological characteristics of small and medium-sized carbides during the dissolution process.According to changes in the fractal dimension before and after soaking,the carbides tended to evolve towards a more regular morphology.展开更多
The characteristics of nonmetallic inclusions formed during steel production have a significant influence on steel performance.In this paper,studies on inclusions using confocal scanning laser microscopy(CSLM)are revi...The characteristics of nonmetallic inclusions formed during steel production have a significant influence on steel performance.In this paper,studies on inclusions using confocal scanning laser microscopy(CSLM)are reviewed and summarized,particularly the col-lision of various inclusions,dissolution of inclusions in liquid slag,and reactions between inclusions and steel.Solid inclusions exhibited a high collision tendency,whereas pure liquid inclusions exhibited minimal collisions because of the small attraction force induced by their<90°contact angle with molten steel.The collision of complex inclusions in molten steel was not included in the scope of this study and should be evaluated in future studies.Higher CaO/Al_(2)O_(3)and CaO/SiO_(2)ratios in liquid slag promoted the dissolution of Al_(2)O_(3)-based in-clusions.The formation of solid phases in the slag should be prevented to improve dissolution of inclusions.To accurately simulate the dissolution of inclusions in liquid slag,in-situ observation of the dissolution of inclusions at the steel-slag interface is necessary.Using a combination of CSLM and scanning electron microscopy-energy dispersive spectroscopy,the composition and morphological evolution of the inclusions during their modification by the dissolved elements in steel were observed and analyzed.Although the in-situ observa-tion of MnS and TiN precipitations has been widely studied,the in-situ observation of the evolution of oxide inclusions in steel during so-lidification and heating processes has rarely been reported.The effects of temperature,heating and cooling rates,and inclusion character-istics on the formation of acicular ferrites(AFs)have been widely studied.At a cooling rate of 3-5 K/s,the order of AF growth rate in-duced by different inclusions,as reported in literature,is Ti-O<Ti-Ca-Zr-Al-O<Mg-O<Ti-Zr-Al-O<Mn-Ti-Al-O<Ti-Al-O<Zr-Ti-Al-O.Further comprehensive experiments are required to investigate the quantitative relationship between the formation of AFs and inclusions.展开更多
High-temperature confocal scanning laser microscopy(HT-CSLM)is a potent methodology for investigating various phenomena in the field of metallurgy.Initially applied to the observation of solid phase transformations an...High-temperature confocal scanning laser microscopy(HT-CSLM)is a potent methodology for investigating various phenomena in the field of metallurgy.Initially applied to the observation of solid phase transformations and solidification,this method has gained traction in the field of non-metallic inclusion in steels in recent years.An overview of the experimental capabilities of HT-CSLM and the most important results of recent investigations regarding the topics of clean steel production are provided.It includes the formation of intragranular acicular ferrite(IAF)from the surface of non-metallic inclusions during the continuous cooling and heat treatment,which can be especially beneficial in the toughness of heat-affected zones of welded pieces.Furthermore,the investigation of agglomeration mechanisms of non-metallic inclusions(NMIs)in liquid steel is discussed to improve the insight into attraction forces between particles and clogging phenomena during continuous casting.Also,the dissolution of NMIs in various steelmaking slags can be observed by HT-CSLM to compare dissolution rates and mechanisms of NMI,where significant influences of temperature and chemical composition of the slag were shown.Last but not least,the experimental work regarding the interface between steel and slag is discussed,where novel techniques are currently being developed.A comprehensive summary of experimental techniques using HT-CSLM equipment to investigate different interactions of NMIs with steel and slag phases is compiled.展开更多
Dissolution kinetics of CaO·2Al_(2)O_(3)(CA_(2))particles in a synthetic CaO-Al_(2)O_(3)-SiO_(2)steelmaking slag system have been investigated using the high-temperature confocal laser scanning microscope.Effects...Dissolution kinetics of CaO·2Al_(2)O_(3)(CA_(2))particles in a synthetic CaO-Al_(2)O_(3)-SiO_(2)steelmaking slag system have been investigated using the high-temperature confocal laser scanning microscope.Effects of temperature(i.e.,1500,1550,and 1600℃)and slag composition on the dissolution time of CA_(2)particles are investigated,along with the time dependency of the projection area of the particle during the dissolution process.It is found that the dissolution rate was enhanced by either an increase in temperature or a decrease in slag viscosity.Moreover,a higher ratio of CaO/Al_(2)O_(3)(C/A)leads to an increased dissolution rate of CA_(2)particle at 1600℃.Thermodynamic calculations suggested the dissolution product,i.e.,melilite,formed on the surface of the CA_(2)particle during dissolution in slag with a C/A ratio of 3.8 at 1550℃.Scanning electron microscopy equipped with energy dispersive X-ray spectrometry analysis of as-quenched samples confirmed the dissolution path of CA_(2)particles in slags with C/A ratios of 1.8 and 3.8 as well as the melilite formed on the surface of CA_(2)particle.The formation of this layer during the dissolution process was identified as a hindrance,impeding the dissolution of CA_(2)particle.A valuable reference for designing or/and choosing the composition of top slag for clean steel production is provided,especially using calcium treatment during the secondary refining process.展开更多
Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-sta...Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-stage imaging changes of gastrointestinal disorders are often subtle,and traditional medical image analysis methods rely heavily on manual interpretation,which is time-consuming,subject to observer variability,and inefficient for accurate lesion identification across large-scale image datasets.With the introduction of artificial intelligence(AI)technologies,AI-driven CLE image analysis systems can automatically extract pathological features and have demonstrated significant clinical value in lesion recognition,classification diagnosis,and malignancy prediction of GI diseases.These systems greatly enhance diagnostic efficiency and early detection capabilities.This review summarizes the applications of AI-assisted CLE in GI diseases,analyzes the limitations of current technologies,and explores future research directions.It is expected that the deep integration of AI and confocal imaging technologies will provide strong support for precision diagnosis and personalized treatment in the field of gastrointestinal disorders.展开更多
To investigate the nucleation behavior during the single-phased metallic solidification process,the commercial ultrapure ferritic stainless steels with no(Initial steel)and various melt treatments(R1,MR1,Y2,MY1,and M1...To investigate the nucleation behavior during the single-phased metallic solidification process,the commercial ultrapure ferritic stainless steels with no(Initial steel)and various melt treatments(R1,MR1,Y2,MY1,and M1 steels)were used to carry out the differential scanning colorimetry(DSC)and high-temperature confocal laser scanning microscope(HT-CLSM)experiments.Based on the results of DSC experiments,the equilibrium solidification process as well as the relationship among the critical undercooling degree(△T_(c)^(DSC)),latent heat of fusion/crystallization(△H_(f)/△H_(c)),equiaxed grain ratio(ER),and average grain size(△_(ave)^(ingot))was revealed.ER is increased with the decreasing△T_(c)^(DSC)and increasing△H_(f)/△H_(c);however,△_(ave)^(ingot)is decreased with them.Referring to the results of HT-CLSM experiments,the average sizes of micro-/macrostructures(d_(ave)/D_(ave)/)are decreased with the increasing cooling rate,as well as the difference between and apparent critical undercooling degree(△T_(c)^(CLSM))was revealed.The heterogeneous nucleation of the crystal nuclei occurs only if△T_(c)^(CLSM)>△T_(c)^(DSC).Combining with the interfacial wetting-lattice mismatch heterogeneous nucleation model,the dynamic mechanism of the metallic solidification was revealed.The as-cast grains of the melt-treated samples were obviously refined,owing to the much higher actual heterogeneous nucleation rates(I_(heter.,i))obtained through melt treatments,and the heterogeneous nucleation rates(I_(heter.,ij))for all samples are increased with the cooling rates,firmly confirming that the as-cast grains of each sample could be refined by the increasing cooling rates.展开更多
The solidification process of a conventional superalloy, IN718, was investigated by confocal scanning laser microscope （CSLM）. The liquid fraction during solidification was obtained as a function of real time and te...The solidification process of a conventional superalloy, IN718, was investigated by confocal scanning laser microscope （CSLM）. The liquid fraction during solidification was obtained as a function of real time and temperature in reference with the in-situ observation. The characteristics of L→γ transformation were analyzed and the γ growing rate of each stage was also calculated. Scheil equation was employed to predict the segregation behavior, and the predict results are in consistence with the experimental results. As a result, the confocal scanning laser microscope shows a great potential for solidification process research.展开更多
The interphase nuclei of parenchyma cells and epidermal cells of garlic ( Allium sativum L.) clove were labelled with rabbit anti_actin antibody and FITC_conjugated goat anti_rabbit IgG antibody. The authors observ...The interphase nuclei of parenchyma cells and epidermal cells of garlic ( Allium sativum L.) clove were labelled with rabbit anti_actin antibody and FITC_conjugated goat anti_rabbit IgG antibody. The authors observed results with fluorescence microscopy and confocal laser scanning microscopy. The nuclei showed prominent green_yellow fluorescence, indicating the presence of actin in the nuclei. Fluorescence examination with TRITC_phalloidin showed distinctive red fluorescence in the nuclei, indicating that F_actin is present in the nuclei. Confocal laser scanning microscopy indicated the presence of F_actin containing network structures in the nuclei, but the network structures were absent and the nuclei still showed red fluorescence when the cells were treated with cytochalasin D before fixation; the red fluorescence in the nuclei was hard to be observed when the cells were treated with unlabelled phalloidin before the cells were stained with TRITC_phalloidin. These results indicate that F_actin is in the nuclei and forms network structures in the nuclei of garlic cells.展开更多
A whole-field 3D surface measurement system for semiconductor wafer inspection is described.The system consists of an optical fiber plate,which can split the light beam into N^2 subbeams to realize the whole-field ins...A whole-field 3D surface measurement system for semiconductor wafer inspection is described.The system consists of an optical fiber plate,which can split the light beam into N^2 subbeams to realize the whole-field inspection.A special prism is used to separate the illumination light and signal light.This setup is characterized by high precision,high speed and simple structure.展开更多
AIM: To classify the histological severity of Helicobacter pylori (H. pylori) infection-associated gastritis by confocal laser endomicroscopy (CLE). METHODS: Patients with upper gastrointestinal symptoms or individual...AIM: To classify the histological severity of Helicobacter pylori (H. pylori) infection-associated gastritis by confocal laser endomicroscopy (CLE). METHODS: Patients with upper gastrointestinal symptoms or individuals who were screened for gastric cancer were enrolled in this study. Histological severity of H. pylori infection-associated gastritis was graded according to the established CLE criteria. Diagnostic value of CLE for histo-logical gastritis was investigated and compared with that of white light endoscopy (WLE). Targeted biopsies from the sites observed by CLE were performed. RESULTS: A total of 118 consecutive patients with H. pylori infection-associated gastritis were enrolled in this study. Receiver operating characteristic curve analysis showedthat the sensitivity and specifi city of CLE were 82.9% and 90.9% for the diagnosis of H. pylori infection, 94.6% and 97.4% for predicting gastric normal mucosa, 98.5% and 94.6% for predicting histological active inflammation, 92.9% and 95.2% for predicting glan-dular atrophy, 98.6% and 100% for diagnosing intes-tinal metaplasia, respectively. Post-CLE image analysis showed that goblet cells and absorptive cells were the two most common parameters on the CLE-diagnosed intestinal metaplasia (IM) images (P < 0.001). More his-tological lesions of the stomach could be found by CLE than by WLE (P < 0.001). CONCLUSION: CLE can accurately show the histological severity of H. pylori infection-associated gastritis. Mapping IM by CLE has a rather good diagnostic accuracy.展开更多
In Japan and countries such as South Korea and Tai-wan, China, the standard technique for detecting earlygastric cancer (EGC) is chromoendoscopy. This technique involves a magnified endoscope and the use ofan indigo-c...In Japan and countries such as South Korea and Tai-wan, China, the standard technique for detecting earlygastric cancer (EGC) is chromoendoscopy. This technique involves a magnified endoscope and the use ofan indigo-carmine spray to distinguish between EGCand non-EGC areas. However, this technique is notwidely adopted in many parts of the world. One important reason for limited use is that this technique needsan experienced endoscopist to interpret the imagesduring the procedure. In addition, the sensitivity for detecting gastric intestinal metaplasia (GIM), a precancerous lesion of EGC, is graded as suboptimal. Moreover,the requirement of a cumbersome spraying method isinconvenient and needs preparation time. Easier digitalchromoendoscopy techniques, such as Narrow-bandImaging and Flexible spectral Imaging Color Enhancement, have been reported to facilitate targeted GIM and EGC biopsy. They provide higher sensitivities over conventional white light endoscopy. Recently, the noveltechnology of confocal laser endomicroscopy has been introduced as a high-magnification (1000 ×) real-time evaluation for many early gastrointestinal (GI) cancersand precancerous GI lesions, including colonic polyp,Barrett's esophagus, and GIM. The advantage of this technique is that it can be used as an in vivo confirmation of the presence of GIM and EGC during endoscopic surveillance. This review aims to explain the current information on the usefulness of digital chromoendos-copy and confocal laser endomicroscopy for evaluating GIM and EGC during endoscopic surveillance and the possible future role of these techniques for GI cancerscreening programs.展开更多
AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:...AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and tratment were recruited for this study. Excluded from the study were patients who had liver cirrhosis, impaired renal function, acute gastrointestinal (GI) bleeding, coagulopathy, esophageal varices, jaundice, and GI post-surgery. Also excluded were those who were pregnant, breastfeeding, were younger than 18 years old, or were unable to provide informed consent. All patients had all mucus and bile cleared from their stom-achs. They then received upper GI endoscopy. When a mucosal lesion is found during observation with whitelight imaging, the lesion is visualized using maximal magnification, employing gradual movement of the tip of the endoscope to bring the image into focus. Saved images are analyzed. Confocal images were evaluated by two endoscopists (Huang J and Li MY), who were familiar with CLE, blinded to the related information about the lesions, and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria. The results were compared with the final histopathologic diagnosis. ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI, blinded to the related information about the lesions and CLE images, and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system. The results were compared with the final histopathologic diagnosis. RESULTS: The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities. CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa. The accuracy of the CLE and the ME-NBI diagnosis was 88% (95% CI:78%-98%) and 81% (95% CI: 69%-93%), respectively. The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755; between the histopathology and the in vivo CLE imaging was 0.615. McNemar's test (binomial distribution used) indicated that the agreement was significant (P < 0.05). When patients were diagnosed by MENBI with CLE, the overall accuracy of the diagnosis was 86.21% (95% CI:73%-96%), and the kappa coefficient of agreement was 0.713, according to McNemar's test (P < 0.05). CONCLUSION:Higher diagnostic accuracy, sensitivityand specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.展开更多
Recent technological advances in miniaturization have allowed for a confocal scanning microscope to be integrated into a conventional flexible endoscope,or into trans-endoscopic probes,a technique now known as confoca...Recent technological advances in miniaturization have allowed for a confocal scanning microscope to be integrated into a conventional flexible endoscope,or into trans-endoscopic probes,a technique now known as confocal endomicroscopy or confocal laser endomicroscopy.This newly-developed technology has enabled endoscopists to collect real-time in vivo histological images or "virtual biopsies" of the gastrointestinal mucosa during endoscopy,and has stimulated significant interest in the application of this technique in clinical gastroenterology.This review aims to evaluate the current data on the technical aspects and the utility of this new technology in clinical gastroenterology and its potential impact in the future,particularly in the screening or surveillance of gastrointestinal neoplasia.展开更多
AIM To investigate the application of confocallaser scanning microscopy(CLSM)in tumorpathology and three-dimensional( 3-D )reconstruction by CLSM in pathologic specimensof hepatocellular carcinoma(HCC).METHODS The 30...AIM To investigate the application of confocallaser scanning microscopy(CLSM)in tumorpathology and three-dimensional( 3-D )reconstruction by CLSM in pathologic specimensof hepatocellular carcinoma(HCC).METHODS The 30μm thick sections were cutfrom the paraffin-embedded tissues of HCC,hyperplasia and normal liver,stained with DNAfluorescent probe YOYO-1 iodide and examinedby CLSM to collect optical sections of nuclei and3-D images reconstructed.RESULTS HCC displayed chaotic arrangementof carcinoma cell nuclei,marked pleomorphism,indented and irregular nuclear surface,andirregular and coarse chromatin texture.CONCLUSION The serial optical tomograms ofCLSM can be used to create 3-D reconstruction ofcancer cell nuclei.Such 3-D impressions mightbe helpful or even essential in making anaccurate diagnosis.展开更多
AIM:To review applications of confocal laser endomicroscopy(CLE) in pancreatobiliary lesions and studies that assessed training and interpretation of images. METHODS: A computerized literature search was performed usi...AIM:To review applications of confocal laser endomicroscopy(CLE) in pancreatobiliary lesions and studies that assessed training and interpretation of images. METHODS: A computerized literature search was performed using OVID MEDLINE, EMBASE, Cochrane library, and the ISI Web of Knowledge from 1980 to October 2014. We also searched abstracts from major meetings that included the Digestive Disease Week, Canadian Digestive Disease Week and the United European Gastroenterology Week using a combination of controlled vocabulary and text words related to p CLE, confocal, endomicroscopy, probe-based confocal laser endomicroscopy, and bile duct to identify reports of trials. In addition, recursive searches and crossreferencing was performed, and manual searches of articles identified after the initial search was also completed. We included fully published articles and those in abstract form. Given the relatively recent introduction of CLE we included randomized trials and cohort studies.R E S U LT S : In the evaluation of indeterminate pancreatobiliary strictures CLE with ERCP compared to ERCP alone can increase the detection of cancerous strictures with a sensitivity of(98% vs 45%) andhas a negative predictive value(97% vs 69%), but decreased the specificity(67% vs 100%) and the positive predictive value(71% vs 100%) when compared to index pathology. Modifications in the classification systems in indeterminate biliary strictures have increased the specificity of p CLE from 67% to 73%. In pancreatic cystic lesions there is a need to develop similar systems to interpret and characterize lesions based on CLE images obtained. The presence of superficial vascular network predicts serous cystadenomas accurately. Also training in acquiring and interpretation of images is feasible in those without any prior knowledge in CLE in a relatively simple manner and computer-aided diagnosis software is a promising innovation. CONCLUSION: The role of p CLE in the evaluation of pancreatobiliary disorders might be better suited for those with an intermediate and low probability.展开更多
AIM:To support probe-based confocal laser endomi-croscopy (pCLE) diagnosis by designing software for the automated classification of colonic polyps. METHODS:Intravenous fluorescein pCLE imaging of colorectal lesions w...AIM:To support probe-based confocal laser endomi-croscopy (pCLE) diagnosis by designing software for the automated classification of colonic polyps. METHODS:Intravenous fluorescein pCLE imaging of colorectal lesions was performed on patients under-going screening and surveillance colonoscopies, followed by polypectomies. All resected specimens were reviewed by a reference gastrointestinal pathologist blinded to pCLE information. Histopathology was used as the criterion standard for the differentiation between neoplastic and non-neoplastic lesions. The pCLE video sequences, recorded for each polyp, were analyzed off-line by 2 expert endoscopists who were blinded to the endoscopic characteristics and histopathology. These pCLE videos, along with their histopathology diagnosis, were used to train the automated classification software which is a content-based image retrieval technique followed by k-nearest neighbor classification. The performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists was compared with that of automated pCLE software classification. All evaluations were performed using leave-one-patient- out cross-validation to avoid bias. RESULTS:Colorectal lesions (135) were imaged in 71 patients. Based on histopathology, 93 of these 135 lesions were neoplastic and 42 were non-neoplastic. The study found no statistical significance for the difference between the performance of automated pCLE software classification (accuracy 89.6%, sensitivity 92.5%, specificity 83.3%, using leave-one-patient-out cross-validation) and the performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists (accuracy 89.6%, sensitivity 91.4%, specificity 85.7%). There was very low power (< 6%) to detect the observed differences. The 95% confidence intervals for equivalence testing were:-0.073 to 0.073 for accuracy, -0.068 to 0.089 for sensitivity and -0.18 to 0.13 for specificity. The classification software proposed in this study is not a "black box" but an informative tool based on the query by example model that produces, as intermediate results, visually similar annotated videos that are directly interpretable by the endoscopist. CONCLUSION:The proposed software for automated classification of pCLE videos of colonic polyps achieves high performance, comparable to that of off-line diagnosis of pCLE videos established by expert endoscopists.展开更多
Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and meta...Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network.Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents.Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic process.This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies.展开更多
Since its inception, endoscopy has aimed to establish an immediate diagnosis that is virtually consistent with a histologic diagnosis. In the past decade, confocal laser scanning microscopy has been brought into endos...Since its inception, endoscopy has aimed to establish an immediate diagnosis that is virtually consistent with a histologic diagnosis. In the past decade, confocal laser scanning microscopy has been brought into endoscopy, thus enabling in vivo microscopic tissue visualization with a magnification and resolution comparable to that obtained with the ex vivo microscopy of histological specimens. The major challenge in the development of instrumentation lies in the miniaturization of a fiber-optic probe for microscopic imaging with micron-scale resolution. Here, we present the design and construction of a confocal endoscope based on a fiber bundle with 1.4-μm lateral resolution and 8-frames per second(fps) imaging speed. The fiber-optic probe has a diameter of 2.6 mm that is compatible with the biopsy channel of a conventional endoscope. The prototype of a confocal endoscope has been used to observe epithelial cells of the gastrointestinal tracts of mice and will be further demonstrated in clinical trials. In addition, the confocal endoscope can be used for translational studies of epithelial function in order to monitor how molecules work and how cells interact in their natural environment.展开更多
While flexible endoscopy is essential for macroscopic evaluation,confocal laser endomicroscopy(CLE)has recently emerged as an endoscopic method enabling visualization at a cellular level.Two systems are currently avai...While flexible endoscopy is essential for macroscopic evaluation,confocal laser endomicroscopy(CLE)has recently emerged as an endoscopic method enabling visualization at a cellular level.Two systems are currently available,one based on miniprobes that can be inserted via a conventional endoscope or via a needle guided by endoscopic ultrasound.The second system has a confocal microscope integrated into the distal part of an endoscope.By adding molecular probes like fluorescein conjugated antibodies or fluorescent peptides to this procedure(either topically or systemically administered during on-going endoscopy),a novel world of molecular evaluation opens up.The method of molecular CLE could potentially be used for estimating the expression of important receptors in carcinomas,subsequently resulting in immediate individualization of treatment regimens,but also for improving the diagnostic accuracy of endoscopic procedures by identifying otherwise invisible mucosal lesions.Furthermore,studies have shown that fluorescein labelled drugs can be used to estimate the affinity of the drug to a target organ,which probably can be correlated to the efficacy of the drug.However,several of the studies in this research field have been conducted in animal facilities or in vitro,while only a limited number of trials have actually been carried out in vivo.Therefore,safety issues still needs further evaluations.This review will present an overview of the implications and pitfalls,as well as future challenges of molecular CLE in gastrointestinal diseases.展开更多
基金supported by the Project of Health Committee of Hunan Province(D202304128868),China.
文摘Objective:Verrucous epidermal nevus(VEN),seborrheic keratosis(SK),verruca plana(VP),verruca vulgaris(VV),and nevus sebaceous(NS)are common verrucous proliferative skin diseases with similar clinical appearances,often posing diagnostic challenges.Dermoscopy and reflectance confocal microscopy(RCM)can aid in their differentiation,yet their specific features under these tools have not been systematically described.This study aims to summarize and analyze the dermoscopic and RCM features of VEN,SK,VP,VV,and NS.Methods:A total of 121 patients with histopathologically confirmed verrucous proliferative skin diseases were enrolled.Dermoscopy and RCM imaging was used to observe and analyze the microscopic features of these conditions.Results:Under dermoscopy,the 5 diseases displayed distinct characteristics:VEN typically showed gyriform structures;SK was characterized by gyriform structures,comedo-like openings,and milia-like cysts;VP and VV featured dotted vessels and frogspawn-like structures;NS presented as brownish-yellow globules.RCM revealed shared features such as hyperkeratosis and acanthosis across all 5 diseases.Specific features included gyriform structures and elongated rete ridges in VEN;pseudocysts and gyriform structures in SK;evenly distributed ring-like structures in VP;vacuolated cells and papillomatous proliferation in VV;and frogspawn-like structures in NS.Conclusion:These 5 verrucous proliferative skin conditions exhibit distinguishable features under both dermoscopy and RCM.The combination of these 2 noninvasive imaging modalities holds significant clinical value for the differential diagnosis of verrucous proliferative skin diseases.
基金supported by Independent Research Project of State Key Laboratory of Advanced Special Steel,Shanghai Key Laboratory of Advanced Ferrometallurgy,Shanghai University(SKLASS-2023-Z13)the Science and Technology Commission of Shanghai Municipality(No.19DZ2270200)+1 种基金A portion of the work was performed at US National High Magnetic Field Laboratory,which is supported by the National Science Foundation(Cooperative Agreement No.DMR-1157490 and DMR-1644779)the State of Florida.Thanks also to Mary Tyler for editing.
文摘The high-temperature dissolution behavior of primary carbides in samples taken from GCr15 continuous-casting bloom was observed in-situ by confocal laser scanning microscopy.Equations were fitted to the dissolution kinetics of primary carbides during either heating or soaking.Dissolution of carbides proceeded in three stages(fast→slow→faster)as either temperature or holding time was increased.During the heating process and during the first and third stages of the soaking process,the original size of the carbides determined the steepness of the slope,but during the middle(“slow”)stage of the soaking process,the slope remained zero.The initial size of the carbides varied greatly,but their final dissolution temperature fell within the narrow range of 1210-1235℃,and the holding time remained within 50 min.Fractal analysis was used to study the morphological characteristics of small and medium-sized carbides during the dissolution process.According to changes in the fractal dimension before and after soaking,the carbides tended to evolve towards a more regular morphology.
基金supported by the National Key R&D Program(No.2023YFB3709900)the National Nature Science Foundation of China(No.U22A20171)+2 种基金China Baowu Low Carbon Metallurgy Innovation Foundation(No.BWLCF202315)the High Steel Center(HSC)at North China University of TechnologyUniversity of Science and Technology Beijing,China.
文摘The characteristics of nonmetallic inclusions formed during steel production have a significant influence on steel performance.In this paper,studies on inclusions using confocal scanning laser microscopy(CSLM)are reviewed and summarized,particularly the col-lision of various inclusions,dissolution of inclusions in liquid slag,and reactions between inclusions and steel.Solid inclusions exhibited a high collision tendency,whereas pure liquid inclusions exhibited minimal collisions because of the small attraction force induced by their<90°contact angle with molten steel.The collision of complex inclusions in molten steel was not included in the scope of this study and should be evaluated in future studies.Higher CaO/Al_(2)O_(3)and CaO/SiO_(2)ratios in liquid slag promoted the dissolution of Al_(2)O_(3)-based in-clusions.The formation of solid phases in the slag should be prevented to improve dissolution of inclusions.To accurately simulate the dissolution of inclusions in liquid slag,in-situ observation of the dissolution of inclusions at the steel-slag interface is necessary.Using a combination of CSLM and scanning electron microscopy-energy dispersive spectroscopy,the composition and morphological evolution of the inclusions during their modification by the dissolved elements in steel were observed and analyzed.Although the in-situ observa-tion of MnS and TiN precipitations has been widely studied,the in-situ observation of the evolution of oxide inclusions in steel during so-lidification and heating processes has rarely been reported.The effects of temperature,heating and cooling rates,and inclusion character-istics on the formation of acicular ferrites(AFs)have been widely studied.At a cooling rate of 3-5 K/s,the order of AF growth rate in-duced by different inclusions,as reported in literature,is Ti-O<Ti-Ca-Zr-Al-O<Mg-O<Ti-Zr-Al-O<Mn-Ti-Al-O<Ti-Al-O<Zr-Ti-Al-O.Further comprehensive experiments are required to investigate the quantitative relationship between the formation of AFs and inclusions.
基金the Association SSF Strategic Mobility Grant(No.SM22-0039)theÅForsk Foundation(No.23-540)for supporting the research regarding inclusion engineering.
文摘High-temperature confocal scanning laser microscopy(HT-CSLM)is a potent methodology for investigating various phenomena in the field of metallurgy.Initially applied to the observation of solid phase transformations and solidification,this method has gained traction in the field of non-metallic inclusion in steels in recent years.An overview of the experimental capabilities of HT-CSLM and the most important results of recent investigations regarding the topics of clean steel production are provided.It includes the formation of intragranular acicular ferrite(IAF)from the surface of non-metallic inclusions during the continuous cooling and heat treatment,which can be especially beneficial in the toughness of heat-affected zones of welded pieces.Furthermore,the investigation of agglomeration mechanisms of non-metallic inclusions(NMIs)in liquid steel is discussed to improve the insight into attraction forces between particles and clogging phenomena during continuous casting.Also,the dissolution of NMIs in various steelmaking slags can be observed by HT-CSLM to compare dissolution rates and mechanisms of NMI,where significant influences of temperature and chemical composition of the slag were shown.Last but not least,the experimental work regarding the interface between steel and slag is discussed,where novel techniques are currently being developed.A comprehensive summary of experimental techniques using HT-CSLM equipment to investigate different interactions of NMIs with steel and slag phases is compiled.
基金the Natural Sciences and Engineering Research Council of Canada(NSERC)for funding this researchThis research used a high temperature confocal laser scanning microscope-VL2000DX-SVF17SP funded by Canada Foundation for Innovation John Evans Leaders Fund(CFI JELF,Project Number:32826),a PANalytical X’Pert diffraction instrument located at the Centre for crystal growth,Brockhouse Institute for Materials Research,and a scanning electron microscope-JEOL 6610 located at the Canadian Centre for Electron Microscopy at McMaster University.W.Mu would like to acknowledge Swedish Iron and Steel Research Office(Jernkonteret),STINT and SSF for supporting the time for international collaboration research regarding clean steel.
文摘Dissolution kinetics of CaO·2Al_(2)O_(3)(CA_(2))particles in a synthetic CaO-Al_(2)O_(3)-SiO_(2)steelmaking slag system have been investigated using the high-temperature confocal laser scanning microscope.Effects of temperature(i.e.,1500,1550,and 1600℃)and slag composition on the dissolution time of CA_(2)particles are investigated,along with the time dependency of the projection area of the particle during the dissolution process.It is found that the dissolution rate was enhanced by either an increase in temperature or a decrease in slag viscosity.Moreover,a higher ratio of CaO/Al_(2)O_(3)(C/A)leads to an increased dissolution rate of CA_(2)particle at 1600℃.Thermodynamic calculations suggested the dissolution product,i.e.,melilite,formed on the surface of the CA_(2)particle during dissolution in slag with a C/A ratio of 3.8 at 1550℃.Scanning electron microscopy equipped with energy dispersive X-ray spectrometry analysis of as-quenched samples confirmed the dissolution path of CA_(2)particles in slags with C/A ratios of 1.8 and 3.8 as well as the melilite formed on the surface of CA_(2)particle.The formation of this layer during the dissolution process was identified as a hindrance,impeding the dissolution of CA_(2)particle.A valuable reference for designing or/and choosing the composition of top slag for clean steel production is provided,especially using calcium treatment during the secondary refining process.
基金Supported by Interdisciplinary Program of Shanghai Jiao Tong University,No.YG2024 LC01National Natural Science Foundation of China,No.62406190.
文摘Confocal laser endomicroscopy(CLE)has become an indispensable tool in the diagnosis and detection of gastrointestinal(GI)diseases due to its high-resolution and high-contrast imaging capabilities.However,the early-stage imaging changes of gastrointestinal disorders are often subtle,and traditional medical image analysis methods rely heavily on manual interpretation,which is time-consuming,subject to observer variability,and inefficient for accurate lesion identification across large-scale image datasets.With the introduction of artificial intelligence(AI)technologies,AI-driven CLE image analysis systems can automatically extract pathological features and have demonstrated significant clinical value in lesion recognition,classification diagnosis,and malignancy prediction of GI diseases.These systems greatly enhance diagnostic efficiency and early detection capabilities.This review summarizes the applications of AI-assisted CLE in GI diseases,analyzes the limitations of current technologies,and explores future research directions.It is expected that the deep integration of AI and confocal imaging technologies will provide strong support for precision diagnosis and personalized treatment in the field of gastrointestinal disorders.
基金supported by the National Natural Science Foundation of China(Grant Nos.52274339,52174321,52074186,and 52104337)Natural Science Foundation of Jiangsu Province(Grant No.BK20231317)China Baowu Low-Carbon Metallurgy Innovation Fund(Grant No.BWLCF202108).
文摘To investigate the nucleation behavior during the single-phased metallic solidification process,the commercial ultrapure ferritic stainless steels with no(Initial steel)and various melt treatments(R1,MR1,Y2,MY1,and M1 steels)were used to carry out the differential scanning colorimetry(DSC)and high-temperature confocal laser scanning microscope(HT-CLSM)experiments.Based on the results of DSC experiments,the equilibrium solidification process as well as the relationship among the critical undercooling degree(△T_(c)^(DSC)),latent heat of fusion/crystallization(△H_(f)/△H_(c)),equiaxed grain ratio(ER),and average grain size(△_(ave)^(ingot))was revealed.ER is increased with the decreasing△T_(c)^(DSC)and increasing△H_(f)/△H_(c);however,△_(ave)^(ingot)is decreased with them.Referring to the results of HT-CLSM experiments,the average sizes of micro-/macrostructures(d_(ave)/D_(ave)/)are decreased with the increasing cooling rate,as well as the difference between and apparent critical undercooling degree(△T_(c)^(CLSM))was revealed.The heterogeneous nucleation of the crystal nuclei occurs only if△T_(c)^(CLSM)>△T_(c)^(DSC).Combining with the interfacial wetting-lattice mismatch heterogeneous nucleation model,the dynamic mechanism of the metallic solidification was revealed.The as-cast grains of the melt-treated samples were obviously refined,owing to the much higher actual heterogeneous nucleation rates(I_(heter.,i))obtained through melt treatments,and the heterogeneous nucleation rates(I_(heter.,ij))for all samples are increased with the cooling rates,firmly confirming that the as-cast grains of each sample could be refined by the increasing cooling rates.
基金Project(08dj1400402) supported by the Major Program for the Fundamental Research of Shanghai Committee of Science and Technology, China
文摘The solidification process of a conventional superalloy, IN718, was investigated by confocal scanning laser microscope （CSLM）. The liquid fraction during solidification was obtained as a function of real time and temperature in reference with the in-situ observation. The characteristics of L→γ transformation were analyzed and the γ growing rate of each stage was also calculated. Scheil equation was employed to predict the segregation behavior, and the predict results are in consistence with the experimental results. As a result, the confocal scanning laser microscope shows a great potential for solidification process research.
文摘The interphase nuclei of parenchyma cells and epidermal cells of garlic ( Allium sativum L.) clove were labelled with rabbit anti_actin antibody and FITC_conjugated goat anti_rabbit IgG antibody. The authors observed results with fluorescence microscopy and confocal laser scanning microscopy. The nuclei showed prominent green_yellow fluorescence, indicating the presence of actin in the nuclei. Fluorescence examination with TRITC_phalloidin showed distinctive red fluorescence in the nuclei, indicating that F_actin is present in the nuclei. Confocal laser scanning microscopy indicated the presence of F_actin containing network structures in the nuclei, but the network structures were absent and the nuclei still showed red fluorescence when the cells were treated with cytochalasin D before fixation; the red fluorescence in the nuclei was hard to be observed when the cells were treated with unlabelled phalloidin before the cells were stained with TRITC_phalloidin. These results indicate that F_actin is in the nuclei and forms network structures in the nuclei of garlic cells.
文摘A whole-field 3D surface measurement system for semiconductor wafer inspection is described.The system consists of an optical fiber plate,which can split the light beam into N^2 subbeams to realize the whole-field inspection.A special prism is used to separate the illumination light and signal light.This setup is characterized by high precision,high speed and simple structure.
基金Supported by A Program from Clinical Projects of Ministry of Health of China (2007) and Taishan Scholar Program of Shandong Province
文摘AIM: To classify the histological severity of Helicobacter pylori (H. pylori) infection-associated gastritis by confocal laser endomicroscopy (CLE). METHODS: Patients with upper gastrointestinal symptoms or individuals who were screened for gastric cancer were enrolled in this study. Histological severity of H. pylori infection-associated gastritis was graded according to the established CLE criteria. Diagnostic value of CLE for histo-logical gastritis was investigated and compared with that of white light endoscopy (WLE). Targeted biopsies from the sites observed by CLE were performed. RESULTS: A total of 118 consecutive patients with H. pylori infection-associated gastritis were enrolled in this study. Receiver operating characteristic curve analysis showedthat the sensitivity and specifi city of CLE were 82.9% and 90.9% for the diagnosis of H. pylori infection, 94.6% and 97.4% for predicting gastric normal mucosa, 98.5% and 94.6% for predicting histological active inflammation, 92.9% and 95.2% for predicting glan-dular atrophy, 98.6% and 100% for diagnosing intes-tinal metaplasia, respectively. Post-CLE image analysis showed that goblet cells and absorptive cells were the two most common parameters on the CLE-diagnosed intestinal metaplasia (IM) images (P < 0.001). More his-tological lesions of the stomach could be found by CLE than by WLE (P < 0.001). CONCLUSION: CLE can accurately show the histological severity of H. pylori infection-associated gastritis. Mapping IM by CLE has a rather good diagnostic accuracy.
文摘In Japan and countries such as South Korea and Tai-wan, China, the standard technique for detecting earlygastric cancer (EGC) is chromoendoscopy. This technique involves a magnified endoscope and the use ofan indigo-carmine spray to distinguish between EGCand non-EGC areas. However, this technique is notwidely adopted in many parts of the world. One important reason for limited use is that this technique needsan experienced endoscopist to interpret the imagesduring the procedure. In addition, the sensitivity for detecting gastric intestinal metaplasia (GIM), a precancerous lesion of EGC, is graded as suboptimal. Moreover,the requirement of a cumbersome spraying method isinconvenient and needs preparation time. Easier digitalchromoendoscopy techniques, such as Narrow-bandImaging and Flexible spectral Imaging Color Enhancement, have been reported to facilitate targeted GIM and EGC biopsy. They provide higher sensitivities over conventional white light endoscopy. Recently, the noveltechnology of confocal laser endomicroscopy has been introduced as a high-magnification (1000 ×) real-time evaluation for many early gastrointestinal (GI) cancersand precancerous GI lesions, including colonic polyp,Barrett's esophagus, and GIM. The advantage of this technique is that it can be used as an in vivo confirmation of the presence of GIM and EGC during endoscopic surveillance. This review aims to explain the current information on the usefulness of digital chromoendos-copy and confocal laser endomicroscopy for evaluating GIM and EGC during endoscopic surveillance and the possible future role of these techniques for GI cancerscreening programs.
文摘AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnifica-tion endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE). METHODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and tratment were recruited for this study. Excluded from the study were patients who had liver cirrhosis, impaired renal function, acute gastrointestinal (GI) bleeding, coagulopathy, esophageal varices, jaundice, and GI post-surgery. Also excluded were those who were pregnant, breastfeeding, were younger than 18 years old, or were unable to provide informed consent. All patients had all mucus and bile cleared from their stom-achs. They then received upper GI endoscopy. When a mucosal lesion is found during observation with whitelight imaging, the lesion is visualized using maximal magnification, employing gradual movement of the tip of the endoscope to bring the image into focus. Saved images are analyzed. Confocal images were evaluated by two endoscopists (Huang J and Li MY), who were familiar with CLE, blinded to the related information about the lesions, and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria. The results were compared with the final histopathologic diagnosis. ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI, blinded to the related information about the lesions and CLE images, and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system. The results were compared with the final histopathologic diagnosis. RESULTS: The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities. CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa. The accuracy of the CLE and the ME-NBI diagnosis was 88% (95% CI:78%-98%) and 81% (95% CI: 69%-93%), respectively. The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755; between the histopathology and the in vivo CLE imaging was 0.615. McNemar's test (binomial distribution used) indicated that the agreement was significant (P < 0.05). When patients were diagnosed by MENBI with CLE, the overall accuracy of the diagnosis was 86.21% (95% CI:73%-96%), and the kappa coefficient of agreement was 0.713, according to McNemar's test (P < 0.05). CONCLUSION:Higher diagnostic accuracy, sensitivityand specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.
文摘Recent technological advances in miniaturization have allowed for a confocal scanning microscope to be integrated into a conventional flexible endoscope,or into trans-endoscopic probes,a technique now known as confocal endomicroscopy or confocal laser endomicroscopy.This newly-developed technology has enabled endoscopists to collect real-time in vivo histological images or "virtual biopsies" of the gastrointestinal mucosa during endoscopy,and has stimulated significant interest in the application of this technique in clinical gastroenterology.This review aims to evaluate the current data on the technical aspects and the utility of this new technology in clinical gastroenterology and its potential impact in the future,particularly in the screening or surveillance of gastrointestinal neoplasia.
文摘AIM To investigate the application of confocallaser scanning microscopy(CLSM)in tumorpathology and three-dimensional( 3-D )reconstruction by CLSM in pathologic specimensof hepatocellular carcinoma(HCC).METHODS The 30μm thick sections were cutfrom the paraffin-embedded tissues of HCC,hyperplasia and normal liver,stained with DNAfluorescent probe YOYO-1 iodide and examinedby CLSM to collect optical sections of nuclei and3-D images reconstructed.RESULTS HCC displayed chaotic arrangementof carcinoma cell nuclei,marked pleomorphism,indented and irregular nuclear surface,andirregular and coarse chromatin texture.CONCLUSION The serial optical tomograms ofCLSM can be used to create 3-D reconstruction ofcancer cell nuclei.Such 3-D impressions mightbe helpful or even essential in making anaccurate diagnosis.
基金Supported by Deanship of Scientific Research at King Saud University through the Research Group Project number RGPVPP-279
文摘AIM:To review applications of confocal laser endomicroscopy(CLE) in pancreatobiliary lesions and studies that assessed training and interpretation of images. METHODS: A computerized literature search was performed using OVID MEDLINE, EMBASE, Cochrane library, and the ISI Web of Knowledge from 1980 to October 2014. We also searched abstracts from major meetings that included the Digestive Disease Week, Canadian Digestive Disease Week and the United European Gastroenterology Week using a combination of controlled vocabulary and text words related to p CLE, confocal, endomicroscopy, probe-based confocal laser endomicroscopy, and bile duct to identify reports of trials. In addition, recursive searches and crossreferencing was performed, and manual searches of articles identified after the initial search was also completed. We included fully published articles and those in abstract form. Given the relatively recent introduction of CLE we included randomized trials and cohort studies.R E S U LT S : In the evaluation of indeterminate pancreatobiliary strictures CLE with ERCP compared to ERCP alone can increase the detection of cancerous strictures with a sensitivity of(98% vs 45%) andhas a negative predictive value(97% vs 69%), but decreased the specificity(67% vs 100%) and the positive predictive value(71% vs 100%) when compared to index pathology. Modifications in the classification systems in indeterminate biliary strictures have increased the specificity of p CLE from 67% to 73%. In pancreatic cystic lesions there is a need to develop similar systems to interpret and characterize lesions based on CLE images obtained. The presence of superficial vascular network predicts serous cystadenomas accurately. Also training in acquiring and interpretation of images is feasible in those without any prior knowledge in CLE in a relatively simple manner and computer-aided diagnosis software is a promising innovation. CONCLUSION: The role of p CLE in the evaluation of pancreatobiliary disorders might be better suited for those with an intermediate and low probability.
文摘AIM:To support probe-based confocal laser endomi-croscopy (pCLE) diagnosis by designing software for the automated classification of colonic polyps. METHODS:Intravenous fluorescein pCLE imaging of colorectal lesions was performed on patients under-going screening and surveillance colonoscopies, followed by polypectomies. All resected specimens were reviewed by a reference gastrointestinal pathologist blinded to pCLE information. Histopathology was used as the criterion standard for the differentiation between neoplastic and non-neoplastic lesions. The pCLE video sequences, recorded for each polyp, were analyzed off-line by 2 expert endoscopists who were blinded to the endoscopic characteristics and histopathology. These pCLE videos, along with their histopathology diagnosis, were used to train the automated classification software which is a content-based image retrieval technique followed by k-nearest neighbor classification. The performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists was compared with that of automated pCLE software classification. All evaluations were performed using leave-one-patient- out cross-validation to avoid bias. RESULTS:Colorectal lesions (135) were imaged in 71 patients. Based on histopathology, 93 of these 135 lesions were neoplastic and 42 were non-neoplastic. The study found no statistical significance for the difference between the performance of automated pCLE software classification (accuracy 89.6%, sensitivity 92.5%, specificity 83.3%, using leave-one-patient-out cross-validation) and the performance of the off-line diagnosis of pCLE videos established by the 2 expert endoscopists (accuracy 89.6%, sensitivity 91.4%, specificity 85.7%). There was very low power (< 6%) to detect the observed differences. The 95% confidence intervals for equivalence testing were:-0.073 to 0.073 for accuracy, -0.068 to 0.089 for sensitivity and -0.18 to 0.13 for specificity. The classification software proposed in this study is not a "black box" but an informative tool based on the query by example model that produces, as intermediate results, visually similar annotated videos that are directly interpretable by the endoscopist. CONCLUSION:The proposed software for automated classification of pCLE videos of colonic polyps achieves high performance, comparable to that of off-line diagnosis of pCLE videos established by expert endoscopists.
基金Supported by Research Grant,No.239/2007,entitled OCTEUS,financed by the CNCSIS Romaniaby the Sectoral Operational Programme Human Resources Development (SOP HRD),financed from the European Social Fundby the RomanianGovernment under the contract number POSDRU/89/1.5/S/64109
文摘Gastrointestinal cancers represent a major cause of morbidity and mortality,with incomplete response to chemotherapy in the advanced stages and poor prognosis.Angiogenesis plays a crucial part in tumor growth and metastasis,with most gastrointestinal cancers depending strictly on the development of a new and devoted capillary network.Confocal laser endomicroscopy is a new technology which allows in vivo microscopic analysis of the gastrointestinal mucosa and its microvascularization during ongoing endoscopy by using topically or systemically administered contrast agents.Targeting markers of angiogenesis in association with confocal laser endomicroscopic examination(immunoendoscopy),as a future challenge,will add functional analysis to the morphological aspect of the neoplastic process.This review describes previous experience in endomicroscopic examination of the upper and lower digestive tract with emphasis on vascularization,resulting in a broad spectrum of potential clinical applications,and also preclinical research that could be translated to human studies.
基金supported by the National Key Technology R&D Program of China (2011BAI12B06)National Natural Science Foundation of China (61205197 and 61178077)
文摘Since its inception, endoscopy has aimed to establish an immediate diagnosis that is virtually consistent with a histologic diagnosis. In the past decade, confocal laser scanning microscopy has been brought into endoscopy, thus enabling in vivo microscopic tissue visualization with a magnification and resolution comparable to that obtained with the ex vivo microscopy of histological specimens. The major challenge in the development of instrumentation lies in the miniaturization of a fiber-optic probe for microscopic imaging with micron-scale resolution. Here, we present the design and construction of a confocal endoscope based on a fiber bundle with 1.4-μm lateral resolution and 8-frames per second(fps) imaging speed. The fiber-optic probe has a diameter of 2.6 mm that is compatible with the biopsy channel of a conventional endoscope. The prototype of a confocal endoscope has been used to observe epithelial cells of the gastrointestinal tracts of mice and will be further demonstrated in clinical trials. In addition, the confocal endoscope can be used for translational studies of epithelial function in order to monitor how molecules work and how cells interact in their natural environment.
基金Supported by ERC-like nr.7/2012 "Real-time Evaluation of Treatment Effects in Advanced Colorectal Carcinoma (REACT)",project ID PNII-CT-ERC-2012-1financed by the Executive Agency for Higher Education,Research,Development and Innovation Funding (CNCS-UEFISCDI)+2 种基金Romanian National Authority for Scientific Research,Ministry of National Education,ROMANIAEstablishment of confocal laser endomicroscopy in Copenhagen was possible due to the generous contributions of A.P.Moller and Chastine McKinney Mollers Foundation,Foundation Jochum,The Toyota Foundation and the Foundation of Aase and Ejnar DanielsenThe Foundation of Arvid Nilsson and The Lundbeck Foundation supported the activity of JGK and AS,respectively
文摘While flexible endoscopy is essential for macroscopic evaluation,confocal laser endomicroscopy(CLE)has recently emerged as an endoscopic method enabling visualization at a cellular level.Two systems are currently available,one based on miniprobes that can be inserted via a conventional endoscope or via a needle guided by endoscopic ultrasound.The second system has a confocal microscope integrated into the distal part of an endoscope.By adding molecular probes like fluorescein conjugated antibodies or fluorescent peptides to this procedure(either topically or systemically administered during on-going endoscopy),a novel world of molecular evaluation opens up.The method of molecular CLE could potentially be used for estimating the expression of important receptors in carcinomas,subsequently resulting in immediate individualization of treatment regimens,but also for improving the diagnostic accuracy of endoscopic procedures by identifying otherwise invisible mucosal lesions.Furthermore,studies have shown that fluorescein labelled drugs can be used to estimate the affinity of the drug to a target organ,which probably can be correlated to the efficacy of the drug.However,several of the studies in this research field have been conducted in animal facilities or in vitro,while only a limited number of trials have actually been carried out in vivo.Therefore,safety issues still needs further evaluations.This review will present an overview of the implications and pitfalls,as well as future challenges of molecular CLE in gastrointestinal diseases.
