Several methods have been developed to design and analyze moire magnifier, but these methods are all lack of quantitative consideration on the depth of moire imaging. In this paper, a new design method for moire magni...Several methods have been developed to design and analyze moire magnifier, but these methods are all lack of quantitative consideration on the depth of moire imaging. In this paper, a new design method for moire magnifier based on depth cues from disparity is proposed. By using of the proposed method, the period magnification, the rotation angle of moire pattern can also be calculated, and the moire depth can be analyzed, too. According to the design and analysis results using MATLAB, the period of arrays and the cross angle are the important influence factors as the moire pattern above or below the microlens array. Moreover, with our 3 D design method, we can design different moire magnifier with different size, direction angle and depth of moire pattern as required.展开更多
BACKGROUND Pseudoachalasia closely mimics the clinical symptoms of idiopathic achalasia in both clinical symptoms and diagnostic findings,including those from highresolution manometry and barium esophagography.The sim...BACKGROUND Pseudoachalasia closely mimics the clinical symptoms of idiopathic achalasia in both clinical symptoms and diagnostic findings,including those from highresolution manometry and barium esophagography.The similarities often lead to misdiagnosis and the delay of appropriate treatment management.Although most malignancy-associated pseudoachalasia cases are attributed to adenocarcinoma at the gastroesophageal junction,pseudoachalasia due to esophageal squamous cell carcinoma(ESCC)should also be considered.However,the diffuse infiltrative growth patterns that can occur with ESCC can make diagnosis challenging.CASE SUMMARY We report the case of a 60-year-old man who presented with progressive dysphagia,weight loss,and nocturnal cough.Esophagogastroduodenoscopy,timed barium esophagogram,and high-resolution manometry were conducted.The results of these investigations supported a diagnosis of type Ⅱ idiopathic achalasia.However,preoperative computed tomography revealed atypical findings,which prompted further evaluation.Repeat endoscopy with magnifying narrow-band imaging identified abnormal mucosal and vascular patterns,and endoscopic ultrasound demonstrated hypoechoic submucosal lesions with involvement of the muscularis propria.Targeted biopsies confirmed moderately differentiated ESCC.Positron emission tomography revealed extensive metastatic disease;therefore,the patient was diagnosed with stage IVB ESCC.Peroral endoscopic myotomy was aborted,and the patient was referred for palliative chemoradiotherapy.CONCLUSION Atypical malignant features should be critically examined.Multimodal tools such as magnifying narrow-band imaging and endoscopic ultrasound are essential for diagnosing pseudoachalasia.展开更多
[ Objective] The aim of this study was to solve the problem of photographing small flowers and fruits with a common digital camera in field. [Method] Firstly, the photographic mode of a common digital camera was set ...[ Objective] The aim of this study was to solve the problem of photographing small flowers and fruits with a common digital camera in field. [Method] Firstly, the photographic mode of a common digital camera was set as ＂macro＂ （or ＂soft snap＂ ） and ＂flash off＂. Secondly, the small flower or fruit was magnified with a magnifying glass, and then the magnified flower or fruit was automatically focused with the digital camera lens. After automatic focusing, the shutter button was pressed and the photograph finished. [Result] With this method, the clear inflo- rescence or floral photographs of Eragrostis pilosa （ Gramineae ） , Bidens biternata （Compositae） and Tribulus terrester （Zygophllaceae） were obtained in field. [ Conclusion] The optical system of a digital camera has been changed by the magnifying glass, which improves the photographic function of a common digital camera to small flowers and fruits, and also easily gets their clear photographs.展开更多
While it is very reasonable to use a multigraph consisting of multiple edges between vertices to represent various relationships, the multigraph has not drawn much attention in research. To visualize such a multigraph...While it is very reasonable to use a multigraph consisting of multiple edges between vertices to represent various relationships, the multigraph has not drawn much attention in research. To visualize such a multigraph, a clear layout representing a global structure is of great importance, and interactive visual analysis which allows the multiple edges to be adjusted in appropriate ways for detailed presentation is also essential. A novel interactive two-phase approach to visualizing and exploring multigraph is proposed. The approach consists of two phases： the first phase improves the previous popular works on force-directed methods to produce a brief drawing for the aggregation graph of the input multigraph, while the second phase proposes two interactive strategies, the magnifier model and the thematic-oriented subgraph model. The former highlights the internal details of an aggregation edge which is selected interactively by user, and draws the details in a magnifying view by cubic Bezier curves; the latter highlights only the thematic subgraph consisting of the selected multiple edges that the user concerns. The efficiency of the proposed approach is demonstrated with a real-world multigraph dataset and how it is used effectively is discussed for various potential applications.展开更多
Background: Juvenile Rheumatoid Arthritis (JRA) is an inflammatory disease that affects the joints of children and is associated with ocular complications, like uveitis and cataract. Patients with such complications c...Background: Juvenile Rheumatoid Arthritis (JRA) is an inflammatory disease that affects the joints of children and is associated with ocular complications, like uveitis and cataract. Patients with such complications can benefit from a low vision assessment to improve their functionality and their quality of life. In this case study, the importance of early detection and management of ocular complications of JRA, as well as visual rehabilitation through a low vision assessment, are highlighted and discussed. Case Presentation: A 12-year-old female of East Indian descent presented to the Low Vision Center of the University of the West Indies Optometry Eye Unit, bilaterally aphakic (absence of crystalline lens) as a result of complications she developed secondary to a systemic condition diagnosed as JRA. She presented with a distance visual acuity of 2.30 logMAR in the RE, and 1.64 logMAR in the LE, at near she was able to read 8.0 M and 3.2 M at a distance of 8 cm for RE & LE respectively. She has a history of ocular disorder secondary to JRA such as cataract, uveitis, upon low vision assessment a new spectacle prescription and an illuminated stand magnifier of 8D was issued, the patient was satisfied with the outcome of the treatment, management and low vision device issued. Conclusion: At the end of the low vision assessment, the patient was extremely satisfied and looked forward to the prospect of returning to school. Although JRA can have severe ocular complications, with the correct management, a patient’s quality of life can be dramatically improved thus stressing the importance of these types of visual assessments.展开更多
AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to Jun...AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.展开更多
AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging(ME-NBI) in the diagnosis of early gastric cancer(EGC).METHODS: Systematic literature searches were conducted until February 2014 in ...AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging(ME-NBI) in the diagnosis of early gastric cancer(EGC).METHODS: Systematic literature searches were conducted until February 2014 in Pub Med, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic(ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks' asymmetry test was used to evaluate the publication bias.RESULTS: Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86(95%CI: 0.83-0.89), 0.96(95%CI: 0.95-0.97) and 102.75(95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivityof 0.57(95%CI: 0.50-0.64) and a specificity of 0.79(95%CI: 0.76-0.81). When using "VS"(vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64(95%CI: 0.52-0.75) and 0.96(95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74(95%CI: 0.65-0.82) and 0.98(95%CI: 0.97-0.98).CONCLUSION: ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.展开更多
AIM： To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS： From June 1999 through March 2000, 180 consecuti...AIM： To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS： From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope （CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan） were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types Ⅰ and Ⅱ crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types Ⅲ to Ⅴ crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated. RESULTS： At endoscopy, 24 lesions showed a type Ⅰ or Ⅱ pit pattern, and 186 lesions showed type Ⅲ to Ⅴ pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% （208/210）. The sensitivity and specificity were 92.3% （24/26） and 99.8% （184/186）, respectively. CONCLUSION： Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.展开更多
Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper ...Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.展开更多
AIM: To determine whether the endoscopic findings of depressed-type early gastric cancers(EGCs) could precisely predict the histological type.METHODS: Ninety depressed-type EGCs in 72 patients were macroscopically and...AIM: To determine whether the endoscopic findings of depressed-type early gastric cancers(EGCs) could precisely predict the histological type.METHODS: Ninety depressed-type EGCs in 72 patients were macroscopically and histologically identified. We evaluated the microvascular(MV) and mucosal surface(MS) patterns of depressed-type EGCs using magnifying endoscopy(ME) with narrow-band imaging(NBI)(NBI-ME) and ME enhanced by 1.5% acetic acid, respectively. First, depressed-type EGCs were classified according to MV pattern by NBI-ME. Subsequently, EGCs unclassified by MV pattern were classified according to MS pattern by enhanced ME(EME) images obtained from the same angle.RESULTS: We classified the depressed-type EGCs into the following 2 MV patterns using NBI-ME: a fine-network pattern that indicated differentiated adenocarcinoma(25/25, 100%) and a corkscrew pattern that likely indicated undifferentiated adenocarcinoma(18/23, 78.3%). However, 42 of the 90(46.7%) lesions could not be classified into MV patterns by NBI-ME. These unclassified lesions were then evaluated for MS patterns using EME, which classified 33(81.0%) lesions as MS patterns, diagnosed as differentiated adenocarcinoma. As a result, 76 of the 90(84.4%) lesions were matched with histological diagnoses using a combination of NBI-ME and EME.CONCLUSION: A combination of NBI-ME and EME was useful in predicting the histological type of depressedtype EGC.展开更多
AIM:To evaluate the relationship between Helicobacter pylori(H.pylori)-induced gastritis and white gastric mucosal crypt openings(COs)in the gastric corpus.METHODS:A total of 175 consecutive patients(including 69 pati...AIM:To evaluate the relationship between Helicobacter pylori(H.pylori)-induced gastritis and white gastric mucosal crypt openings(COs)in the gastric corpus.METHODS:A total of 175 consecutive patients(including 69 patients with gastric cancer)were enrolled in this study.We used magnifying endoscopy(ME)to observe the mucosa microsurface of the lesser and greater curvature of the gastric corpus(350 areas in all).We focused on areas with a round pit microstructure(primarily observed in non-atrophied areas)and evaluated the white openings of these gastric pits.We classified the whiteness of the COs as the"white-edged dark spot"type(consisting of a dark spot bordered by white);the"white"type(pure white with no dark spot);and the"dense white pit(DWP)"type(dense white,resembling a snowball).Gastritis was also histologically evaluated according to the updated Sydney System.RESULTS:We detected round COs using ME in 246 of the 350 areas examined.The histological examination showed significantly more mononuclear cells and neutrophil infiltration in the"white"and"DWP"types than the"white-edged dark spot"type(P<0.001).Furthermore,significantly high-grade inflammation and evidence of active H.pylori-induced gastritis was observed in the"DWP"type(P<0.001).Significant differences were observed in the whiteness of COs between H.pylori-positive(n=139)and negative(n=36)patients(P<0.001).The sensitivity and specificity of the"white"and"DWP"types for predicting H.pylori infection were78.5%and 81.7%,respectively.Of the patients with gastric cancer,22.5%(18/80)had"white-edged dark spots",51.3%(41/80)had"white"COs,and 26.3%(21/80)had"DWP"-type COs."DWPs"were frequently observed among patients with undifferentiated gastric cancer[45.7%(16/35)].CONCLUSION:CO whiteness detected via ME was associated with histological evidence of gastritis and helps to predict the severity of inflammation and H.pyloriinduced activity.展开更多
To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in ...To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed. RESULTSOverall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95). CONCLUSIONThe recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.展开更多
Endoscopy plays an important role in the diagnosis and management of gastrointestinal(GI)tract disorders.Chromoendoscopy has proven to be superior to white light endoscopy for early detection of various GI lesions.Thi...Endoscopy plays an important role in the diagnosis and management of gastrointestinal(GI)tract disorders.Chromoendoscopy has proven to be superior to white light endoscopy for early detection of various GI lesions.This has however been fraught with problems.The use of color stains,time taken to achieve an effect and the learning curve associated with the technique has been some of the pitfalls.Narrow band imaging(NBI)particularly in combination with magnifying endoscopy may allow the endoscopist to accomplish a fairly accurate diagnosis with good histological correlation similar to results achieved with chromoendoscopy.Such enhanced detection of pre-malignant and early neoplastic lesions in the gastrointestinal tract should allow better targeting of biopsies and could ultimately prove to be cost effective.Various studies have been done demonstrating the utility of this novel technology.This article will review the impact of NBI in the diagnosis of upper gastrointestinal tract disorders.展开更多
Narrow band imaging(NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By...Narrow band imaging(NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy(NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists.展开更多
AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of...AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were compared.RESULTS:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white light.The mucosal surface was best assessed using filter 4.However,the views obtained were not rated significantly better than those observed with white light.The "gold standard",indigo carmine(IC) dye,was found to be superior to both white light and filter 4.Filter 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained mucosa.When assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light imaging.In the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white light.CONCLUSION:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE.展开更多
BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)...BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)endoscopy for diagnosing Helicobacter pylori(H.pylori)infection,gastric atrophy,and intestinal metaplasia.AIM To compare the diagnostic performance of standard and M-NBI endoscopy for H.pylori gastritis and precancerous conditions.METHODS In 254 patients,standard endoscopy findings were classified into mosaic-like appearance(type A),diffuse homogenous redness(type B),and irregular redness with groove(type C).Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci(type Z-1),more dilated and linear pits without sulci(type Z-2),and loss of gastric pits with coiled vessels(type Z-3).RESULTS The diagnostic accuracy of standard and M-NBI endoscopy for H.pylori gastritis was 93.3%and 96.1%,respectively.Regarding gastric precancerous conditions,the accuracy of standard and M-NBI endoscopy was 72.0%vs 72.6%for moderate to severe atrophy,and 61.7%vs.61.1%for intestinal metaplasia in the corpus,respectively.Compared to type A and Z-1,types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy[odds ratio(OR)=5.56 and 8.67]and serum pepsinogen I/II ratio of≤3(OR=4.48 and 5.69).CONCLUSION Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H.pylori gastritis and precancerous conditions.展开更多
Type I gastric neuroendocrine tumors(TI-GNETs) are related to chronic atrophic gastritis with hypergastrinemia and enterochromaffin-like cell hyperplasia. The incidence of TI-GNETs has significantly increased, with th...Type I gastric neuroendocrine tumors(TI-GNETs) are related to chronic atrophic gastritis with hypergastrinemia and enterochromaffin-like cell hyperplasia. The incidence of TI-GNETs has significantly increased, with the great majority being TI-GNETs. TI-GNETs present as small(< 10 mm) and multiple lesions endoscopically and are generally limited to the mucosa or submucosa. Narrow band imaging and high resolution magnification endoscopy may be helpful for the endoscopic diagnosis of TI-GNETs. TI-GNETs are usually histologically classified by World Health Organization criteria as G1 tumors. Therefore, TI-GNETs tend to display nearly benign behavior with a low risk of progression or metastasis. Several treatment options are currently available for these tumors, including surgical resection, endoscopic resection, and endoscopic surveillance. However, debate persists about the best management technique for TIGNETs.展开更多
Recently, we reported a case of gastric mucosaassociated lymphoid tissue (MALT) lymphoma presenting with unique vascular features. In the report, we defined the tree-like appearance (TLA) on the images of abnormal blo...Recently, we reported a case of gastric mucosaassociated lymphoid tissue (MALT) lymphoma presenting with unique vascular features. In the report, we defined the tree-like appearance (TLA) on the images of abnormal blood vessels which resembled branches from the trunk of a tree in the shiny mucosa, in which the glandular structure was lost. The 67-year-old female was diagnosed with gastric MALT lymphoma. The patient received eradication therapy for H. pylori. Conventional endoscopy revealed multiple ill-delineated brownish depressions in the stomach and cobblestonelike mucosa was observed at the greater curvature to the posterior wall of the upper gastric body 7 mo after successful eradication. Unsuccessful treatment of gastric MALT lymphoma was suspected on conventional endoscopy. Conventional endoscopic observations found focal depressions and cobblestone-like appearance, and these lesions were subsequently observed using magnified endoscopy combined with narrow band imaging to identify abnormal vessels presenting with a TLA within the lesions. Ten biopsies were taken from the area where abnormal vessels were present within these lesions. Ten biopsies were also taken from the lesions without abnormal vessels as a control. A total of 20 biopsy samples were evaluated to determine whether the diagnosis of MALT lymphoma could be obtained histologically from each sample. A positive diagnosis was obtained in 8/10 TLA (+) sites and in 2/10 TLA(-) sites. Target biopsies of the site with abnormal blood vessels can potentially improve diagnostic accuracy of gastric MALT lymphoma.展开更多
基金supported by the National Key Basic Research Program of China(No.2016YFA0400902)
文摘Several methods have been developed to design and analyze moire magnifier, but these methods are all lack of quantitative consideration on the depth of moire imaging. In this paper, a new design method for moire magnifier based on depth cues from disparity is proposed. By using of the proposed method, the period magnification, the rotation angle of moire pattern can also be calculated, and the moire depth can be analyzed, too. According to the design and analysis results using MATLAB, the period of arrays and the cross angle are the important influence factors as the moire pattern above or below the microlens array. Moreover, with our 3 D design method, we can design different moire magnifier with different size, direction angle and depth of moire pattern as required.
文摘BACKGROUND Pseudoachalasia closely mimics the clinical symptoms of idiopathic achalasia in both clinical symptoms and diagnostic findings,including those from highresolution manometry and barium esophagography.The similarities often lead to misdiagnosis and the delay of appropriate treatment management.Although most malignancy-associated pseudoachalasia cases are attributed to adenocarcinoma at the gastroesophageal junction,pseudoachalasia due to esophageal squamous cell carcinoma(ESCC)should also be considered.However,the diffuse infiltrative growth patterns that can occur with ESCC can make diagnosis challenging.CASE SUMMARY We report the case of a 60-year-old man who presented with progressive dysphagia,weight loss,and nocturnal cough.Esophagogastroduodenoscopy,timed barium esophagogram,and high-resolution manometry were conducted.The results of these investigations supported a diagnosis of type Ⅱ idiopathic achalasia.However,preoperative computed tomography revealed atypical findings,which prompted further evaluation.Repeat endoscopy with magnifying narrow-band imaging identified abnormal mucosal and vascular patterns,and endoscopic ultrasound demonstrated hypoechoic submucosal lesions with involvement of the muscularis propria.Targeted biopsies confirmed moderately differentiated ESCC.Positron emission tomography revealed extensive metastatic disease;therefore,the patient was diagnosed with stage IVB ESCC.Peroral endoscopic myotomy was aborted,and the patient was referred for palliative chemoradiotherapy.CONCLUSION Atypical malignant features should be critically examined.Multimodal tools such as magnifying narrow-band imaging and endoscopic ultrasound are essential for diagnosing pseudoachalasia.
基金Supported by National Natural Science Foundation(30770124)~~
文摘[ Objective] The aim of this study was to solve the problem of photographing small flowers and fruits with a common digital camera in field. [Method] Firstly, the photographic mode of a common digital camera was set as ＂macro＂ （or ＂soft snap＂ ） and ＂flash off＂. Secondly, the small flower or fruit was magnified with a magnifying glass, and then the magnified flower or fruit was automatically focused with the digital camera lens. After automatic focusing, the shutter button was pressed and the photograph finished. [Result] With this method, the clear inflo- rescence or floral photographs of Eragrostis pilosa （ Gramineae ） , Bidens biternata （Compositae） and Tribulus terrester （Zygophllaceae） were obtained in field. [ Conclusion] The optical system of a digital camera has been changed by the magnifying glass, which improves the photographic function of a common digital camera to small flowers and fruits, and also easily gets their clear photographs.
基金supported by the National Natural Science Fundation of China(61103081)
文摘While it is very reasonable to use a multigraph consisting of multiple edges between vertices to represent various relationships, the multigraph has not drawn much attention in research. To visualize such a multigraph, a clear layout representing a global structure is of great importance, and interactive visual analysis which allows the multiple edges to be adjusted in appropriate ways for detailed presentation is also essential. A novel interactive two-phase approach to visualizing and exploring multigraph is proposed. The approach consists of two phases： the first phase improves the previous popular works on force-directed methods to produce a brief drawing for the aggregation graph of the input multigraph, while the second phase proposes two interactive strategies, the magnifier model and the thematic-oriented subgraph model. The former highlights the internal details of an aggregation edge which is selected interactively by user, and draws the details in a magnifying view by cubic Bezier curves; the latter highlights only the thematic subgraph consisting of the selected multiple edges that the user concerns. The efficiency of the proposed approach is demonstrated with a real-world multigraph dataset and how it is used effectively is discussed for various potential applications.
文摘Background: Juvenile Rheumatoid Arthritis (JRA) is an inflammatory disease that affects the joints of children and is associated with ocular complications, like uveitis and cataract. Patients with such complications can benefit from a low vision assessment to improve their functionality and their quality of life. In this case study, the importance of early detection and management of ocular complications of JRA, as well as visual rehabilitation through a low vision assessment, are highlighted and discussed. Case Presentation: A 12-year-old female of East Indian descent presented to the Low Vision Center of the University of the West Indies Optometry Eye Unit, bilaterally aphakic (absence of crystalline lens) as a result of complications she developed secondary to a systemic condition diagnosed as JRA. She presented with a distance visual acuity of 2.30 logMAR in the RE, and 1.64 logMAR in the LE, at near she was able to read 8.0 M and 3.2 M at a distance of 8 cm for RE & LE respectively. She has a history of ocular disorder secondary to JRA such as cataract, uveitis, upon low vision assessment a new spectacle prescription and an illuminated stand magnifier of 8D was issued, the patient was satisfied with the outcome of the treatment, management and low vision device issued. Conclusion: At the end of the low vision assessment, the patient was extremely satisfied and looked forward to the prospect of returning to school. Although JRA can have severe ocular complications, with the correct management, a patient’s quality of life can be dramatically improved thus stressing the importance of these types of visual assessments.
基金Supported by Profession Specific Funded Projects in Standar-dization of Targeted Therapy and Cell Therapy and Applied Research of Early Diagnosis and Treatment for Cancer from Chinese Ministry of Health,No.200902002
文摘AIM:To evaluate the diagnostic effectiveness of white light endoscopy,magnifying endoscopy(ME),and magnifying narrow-band imaging endoscopy(ME-NBI) in detecting early gastric cancer(EGC).METHODS:From March 2010 to June 2012,a total of 3616 patients received screening for gastric cancer by magnifying endoscopy. There were 3675 focal gastric lesions detected using conventional high definition white light endoscopy(HD-WLE) in four different referentialhospitals that were recruited for further investigation using ME and ME-NBI. The images obtained from HD-WLE,ME,and ME-NBI were reviewed by four experienced endoscopists to evaluate their diagnostic effectiveness for EGC. The diagnosis of cancerous and non-cancerous lesions was conducted by evaluating the microvascular and microsurface patterns using the VS classification system. The final endoscopic diagnosis of each lesion was determined by consultation when a disagreement occurred. We used histopathological results as the gold standard for the diagnosis of EGC.RESULTS:Among the 3675 lesions found,1508 were validated by pathological findings as chronic gastritis,1279 as chronic gastritis with intestinal metaplasia,631 as low-grade neoplasia,and 257 as EGC. The sensitivity,specificity,positive predictive value,negative predictive value,and accuracy of HD-WLE for the diagnosis of EGC were 71.2%,99.1%,85.5%,97.9% and 97.1%,respectively. The results of ME for diagnosing EGC were 81.3%,98.8%,83.3%,98.6% and 97.6%,respectively. The results of ME-NBI for the diagnosis of EGC were 87.2%,98.6%,82.1%,99.0% and 97.8%,respectively. The diagnostic sensitivity and accuracy of paired ME and ME-NBI were significantly better than those of HD-WLE(P < 0.05).CONCLUSION:HD-WLE has a relatively high accuracy for diagnosing EGC and is an effective screening tool. Further investigations of ME and ME-NBI are required to achieve superior accuracy.
基金Supported by National Natural Science Foundation of China,No.81302070 and No.81372623Zhejiang Provincial Natural Science Foundation of China,No.LY13H160019Zhejiang Province Key Science and Technology Innovation Team,No.2013TD13
文摘AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging(ME-NBI) in the diagnosis of early gastric cancer(EGC).METHODS: Systematic literature searches were conducted until February 2014 in Pub Med, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic(ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks' asymmetry test was used to evaluate the publication bias.RESULTS: Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86(95%CI: 0.83-0.89), 0.96(95%CI: 0.95-0.97) and 102.75(95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivityof 0.57(95%CI: 0.50-0.64) and a specificity of 0.79(95%CI: 0.76-0.81). When using "VS"(vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64(95%CI: 0.52-0.75) and 0.96(95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74(95%CI: 0.65-0.82) and 0.98(95%CI: 0.97-0.98).CONCLUSION: ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.
文摘AIM： To clarify whether mucosal crypt patterns observed with magnifying colonoscopy are feasible to distinguish non-neoplastic polyps from neoplastic polyps. METHODS： From June 1999 through March 2000, 180 consecutive patients with 210 lesions diagnosed with a magnifying colonoscope （CF-200Z, Olympus Optical Co., Ltd., Tokyo, Japan） were enrolled. Magnification and chromoendoscopy with 0.2% indigo-carmine dye was applied to each lesion for mucosal crypt observation. Lesions showing types Ⅰ and Ⅱ crypt patterns were considered non-neoplastic and examined histologically by biopsy, whereas lesions showing types Ⅲ to Ⅴ crypt patterns were removed endoscopically or surgically. The correlation of endoscopic diagnosis and histologic diagnosis was then investigated. RESULTS： At endoscopy, 24 lesions showed a type Ⅰ or Ⅱ pit pattern, and 186 lesions showed type Ⅲ to Ⅴ pit patterns. With histologic examination, 26 lesions were diagnosed as non-neoplastic polyps, and 184 lesions were diagnosed as neoplastic polyps. The overall diagnostic accuracy was 99.1% （208/210）. The sensitivity and specificity were 92.3% （24/26） and 99.8% （184/186）, respectively. CONCLUSION： Magnifying colonoscopy could be used as a non-biopsy technique for differentiating neoplastic and non-neoplastic polyps.
文摘Recently,a new disease entity termed gastric adenocarcinoma of fundic gland type(GA-FG) was proposed.We treated five cases of GA-FG with endoscopic submucosal dissection.All tumors were small and located in the upper third of the stomach.Four tumors were macroscopically identified as 0-IIa and one was identified as 0-Ⅱb.Narrow-band imaging with magnifying endoscopy showed an irregular microvascular pattern in 2 cases and a regular microvascular pattern in the remainder.All tumors arose from the deep layer of the lamina propria mucosae and showed submucosal invasion.Lymphatic invasion was seen only in one case,while no venous invasion was recognized.All tumors were positive for pepsinogen-Ⅰ and MUC6 by immunohistochemistry.None showed p53 overexpression,and the labeling index of Ki-67 was low in all cases.All cases have been free from recurrence or metastasis.Herein,we discussed the clinicopathological features of GA-FG in comparison with past reports.
文摘AIM: To determine whether the endoscopic findings of depressed-type early gastric cancers(EGCs) could precisely predict the histological type.METHODS: Ninety depressed-type EGCs in 72 patients were macroscopically and histologically identified. We evaluated the microvascular(MV) and mucosal surface(MS) patterns of depressed-type EGCs using magnifying endoscopy(ME) with narrow-band imaging(NBI)(NBI-ME) and ME enhanced by 1.5% acetic acid, respectively. First, depressed-type EGCs were classified according to MV pattern by NBI-ME. Subsequently, EGCs unclassified by MV pattern were classified according to MS pattern by enhanced ME(EME) images obtained from the same angle.RESULTS: We classified the depressed-type EGCs into the following 2 MV patterns using NBI-ME: a fine-network pattern that indicated differentiated adenocarcinoma(25/25, 100%) and a corkscrew pattern that likely indicated undifferentiated adenocarcinoma(18/23, 78.3%). However, 42 of the 90(46.7%) lesions could not be classified into MV patterns by NBI-ME. These unclassified lesions were then evaluated for MS patterns using EME, which classified 33(81.0%) lesions as MS patterns, diagnosed as differentiated adenocarcinoma. As a result, 76 of the 90(84.4%) lesions were matched with histological diagnoses using a combination of NBI-ME and EME.CONCLUSION: A combination of NBI-ME and EME was useful in predicting the histological type of depressedtype EGC.
文摘AIM:To evaluate the relationship between Helicobacter pylori(H.pylori)-induced gastritis and white gastric mucosal crypt openings(COs)in the gastric corpus.METHODS:A total of 175 consecutive patients(including 69 patients with gastric cancer)were enrolled in this study.We used magnifying endoscopy(ME)to observe the mucosa microsurface of the lesser and greater curvature of the gastric corpus(350 areas in all).We focused on areas with a round pit microstructure(primarily observed in non-atrophied areas)and evaluated the white openings of these gastric pits.We classified the whiteness of the COs as the"white-edged dark spot"type(consisting of a dark spot bordered by white);the"white"type(pure white with no dark spot);and the"dense white pit(DWP)"type(dense white,resembling a snowball).Gastritis was also histologically evaluated according to the updated Sydney System.RESULTS:We detected round COs using ME in 246 of the 350 areas examined.The histological examination showed significantly more mononuclear cells and neutrophil infiltration in the"white"and"DWP"types than the"white-edged dark spot"type(P<0.001).Furthermore,significantly high-grade inflammation and evidence of active H.pylori-induced gastritis was observed in the"DWP"type(P<0.001).Significant differences were observed in the whiteness of COs between H.pylori-positive(n=139)and negative(n=36)patients(P<0.001).The sensitivity and specificity of the"white"and"DWP"types for predicting H.pylori infection were78.5%and 81.7%,respectively.Of the patients with gastric cancer,22.5%(18/80)had"white-edged dark spots",51.3%(41/80)had"white"COs,and 26.3%(21/80)had"DWP"-type COs."DWPs"were frequently observed among patients with undifferentiated gastric cancer[45.7%(16/35)].CONCLUSION:CO whiteness detected via ME was associated with histological evidence of gastritis and helps to predict the severity of inflammation and H.pyloriinduced activity.
基金Supported by the National R&D Program for Cancer Control,Ministry for Health,Welfare and Family Affairs,South Korea,No.0920050the Medical Research Center Program through the National Research Foundation of Korea grant funded by the Korea government,No.NRF-2015R1A5A2009656
文摘To assess the accuracy of a new magnifying endoscopy (ME) classification for predicting depth of invasion of superficial esophageal squamous cell carcinoma (SESCC). METHODSThis study included a total of 70 lesions in 69 patients with SESCC who underwent ME with narrow-band imaging (ME-NBI) before resection from August 2010 to July 2016. Accuracy of ME-NBI for predicting depth of invasion of SESCC was analyzed by using a new ME classification proposed by the Japan Esophageal Society (JES), and interobserver agreement was assessed. RESULTSOverall accuracy of ME-NBI for estimating depth of invasion of SESCC was 78.6%. Sensitivity and specificity of type B1 for tumors limited to the epithelial layer (m1) or invading into the lamina propria (m2) were 71.4% and 100%, respectively. Sensitivity and specificity of type B2 for tumors invading into the muscularis mucosa (m3) or superficial submucosa (≤ 200 μm, sm1) were 94.4% and 73.1%, respectively, while those of type B3 for tumors invading into the deep submucosa (> 200 μm, sm2) were 75.0% and 97.8%, respectively. Interobserver agreement was excellent (κ = 0.86, 95%CI: 0.76-0.95). CONCLUSIONThe recently developed JES ME classification is useful for predicting depth of invasion of SESCC, with reliable interobserver agreement.
文摘Endoscopy plays an important role in the diagnosis and management of gastrointestinal(GI)tract disorders.Chromoendoscopy has proven to be superior to white light endoscopy for early detection of various GI lesions.This has however been fraught with problems.The use of color stains,time taken to achieve an effect and the learning curve associated with the technique has been some of the pitfalls.Narrow band imaging(NBI)particularly in combination with magnifying endoscopy may allow the endoscopist to accomplish a fairly accurate diagnosis with good histological correlation similar to results achieved with chromoendoscopy.Such enhanced detection of pre-malignant and early neoplastic lesions in the gastrointestinal tract should allow better targeting of biopsies and could ultimately prove to be cost effective.Various studies have been done demonstrating the utility of this novel technology.This article will review the impact of NBI in the diagnosis of upper gastrointestinal tract disorders.
文摘Narrow band imaging(NBI) endoscopy is an optical image enhancing technology that allows a detailed inspection of vascular and mucosal patterns, providing the ability to predict histology during real-time endoscopy. By combining NBI with magnification endoscopy(NBI-ME), the accurate assessment of lesions in the gastrointestinal tract can be achieved, as well as the early detection of neoplasia by emphasizing neovascularization. Promising results of the method in the diagnosis of premalignant and malignant lesions of gastrointestinal tract have been reported in clinical studies. The usefulness of NBI-ME as an adjunct to endoscopic therapy in clinical practice, the potential to improve diagnostic accuracy, surveillance strategies and cost-saving strategies based on this method are summarized in this review. Various classification systems of mucosal and vascular patterns used to differentiate preneoplastic and neoplastic lesions have been reviewed. We concluded that the clinical applicability of NBI-ME has increased, but standardization of endoscopic criteria and classification systems, validation in randomized multicenter trials and training programs to improve the diagnostic performance are all needed before the widespread acceptance of the method in routine practice. However, published data regarding the usefulness of NBI endoscopy are relevant in order to recommend the method as a reliable tool in diagnostic and therapy, even for less experienced endoscopists.
基金Supported by Consejería de Educación,Cultura y Deportes,Gobierno de Canarias PI2002/138,the Instituto de Salud Carlos III C03/02
文摘AIM:To validate high definition endoscopes with Fujinon intelligent chromoendoscopy(FICE) in colonoscopy.METHODS:The image quality of normal white light endoscopy(WLE),that of the 10 available FICE filters and that of a gold standard(0.2% indigo carmine dye) were compared.RESULTS:FICE-filter 4 [red,green,and blue(RGB) wavelengths of 520,500,and 405 nm,respectively] provided the best images for evaluating the vascular pattern compared to white light.The mucosal surface was best assessed using filter 4.However,the views obtained were not rated significantly better than those observed with white light.The "gold standard",indigo carmine(IC) dye,was found to be superior to both white light and filter 4.Filter 6(RGB wavelengths of 580,520,and 460 nm,respectively) allowed for exploration of the IC-stained mucosa.When assessing mucosal polyps,both FICE with magnification,and magnification following dye spraying were superior to the same techniques without magnification and to white light imaging.In the presence of suboptimal bowel preparation,observation with the FICE mode was possible,and endoscopists considered it to be superior to observation with white light.CONCLUSION:FICE-filter 4 with magnification improves the image quality of the colonic vascular patterns obtained with WLE.
基金the Soonchunhyang University Research Fund,No.20200023.
文摘BACKGROUND Advances in endoscopic imaging enable the identification of patients at high risk of gastric cancer.However,there are no comparative data on the utility of standard and magnifying narrow-band imaging(M-NBI)endoscopy for diagnosing Helicobacter pylori(H.pylori)infection,gastric atrophy,and intestinal metaplasia.AIM To compare the diagnostic performance of standard and M-NBI endoscopy for H.pylori gastritis and precancerous conditions.METHODS In 254 patients,standard endoscopy findings were classified into mosaic-like appearance(type A),diffuse homogenous redness(type B),and irregular redness with groove(type C).Gastric mucosal patterns visualized by M-NBI were classified as regular round pits with polygonal sulci(type Z-1),more dilated and linear pits without sulci(type Z-2),and loss of gastric pits with coiled vessels(type Z-3).RESULTS The diagnostic accuracy of standard and M-NBI endoscopy for H.pylori gastritis was 93.3%and 96.1%,respectively.Regarding gastric precancerous conditions,the accuracy of standard and M-NBI endoscopy was 72.0%vs 72.6%for moderate to severe atrophy,and 61.7%vs.61.1%for intestinal metaplasia in the corpus,respectively.Compared to type A and Z-1,types B+C and Z-2+Z-3 were significantly associated with moderate to severe atrophy[odds ratio(OR)=5.56 and 8.67]and serum pepsinogen I/II ratio of≤3(OR=4.48 and 5.69).CONCLUSION Close observation of the gastric mucosa by standard and M-NBI endoscopy is useful for the diagnosis of H.pylori gastritis and precancerous conditions.
文摘Type I gastric neuroendocrine tumors(TI-GNETs) are related to chronic atrophic gastritis with hypergastrinemia and enterochromaffin-like cell hyperplasia. The incidence of TI-GNETs has significantly increased, with the great majority being TI-GNETs. TI-GNETs present as small(< 10 mm) and multiple lesions endoscopically and are generally limited to the mucosa or submucosa. Narrow band imaging and high resolution magnification endoscopy may be helpful for the endoscopic diagnosis of TI-GNETs. TI-GNETs are usually histologically classified by World Health Organization criteria as G1 tumors. Therefore, TI-GNETs tend to display nearly benign behavior with a low risk of progression or metastasis. Several treatment options are currently available for these tumors, including surgical resection, endoscopic resection, and endoscopic surveillance. However, debate persists about the best management technique for TIGNETs.
文摘Recently, we reported a case of gastric mucosaassociated lymphoid tissue (MALT) lymphoma presenting with unique vascular features. In the report, we defined the tree-like appearance (TLA) on the images of abnormal blood vessels which resembled branches from the trunk of a tree in the shiny mucosa, in which the glandular structure was lost. The 67-year-old female was diagnosed with gastric MALT lymphoma. The patient received eradication therapy for H. pylori. Conventional endoscopy revealed multiple ill-delineated brownish depressions in the stomach and cobblestonelike mucosa was observed at the greater curvature to the posterior wall of the upper gastric body 7 mo after successful eradication. Unsuccessful treatment of gastric MALT lymphoma was suspected on conventional endoscopy. Conventional endoscopic observations found focal depressions and cobblestone-like appearance, and these lesions were subsequently observed using magnified endoscopy combined with narrow band imaging to identify abnormal vessels presenting with a TLA within the lesions. Ten biopsies were taken from the area where abnormal vessels were present within these lesions. Ten biopsies were also taken from the lesions without abnormal vessels as a control. A total of 20 biopsy samples were evaluated to determine whether the diagnosis of MALT lymphoma could be obtained histologically from each sample. A positive diagnosis was obtained in 8/10 TLA (+) sites and in 2/10 TLA(-) sites. Target biopsies of the site with abnormal blood vessels can potentially improve diagnostic accuracy of gastric MALT lymphoma.
