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At least 343 records · Page 19Linked to original sources

PubMed2004

A prospective comparison of capsule endoscopy and push enteroscopy in patients with GI bleeding of obscure origin.

BACKGROUND: Capsule endoscopy is used to investigate the small bowel in patients with GI bleeding of obscure etiology. Capsule endoscopy was compared prospectively with push enteroscopy in 20 patients with GI hemorrhage. METHODS: Twenty patients (8 men, 12 women; mean age 65.5 years, range 38-80 years) were enrolled in the study. All had undergone non-diagnostic EGD, colonoscopy, and barium contrast radiography of the small bowel. All patients underwent capsule endoscopy followed by push enteroscopy. The physician performing the enteroscopy (senior endoscopist) interpreted the capsule endoscopy in an unblinded manner, while a second blinded reviewer (endoscopy fellow) interpreted the capsule endoscopy to establish interinterpreter reliability. RESULTS: There was complete agreement between the blinded and the unblinded physicians in 18 of 20 cases; minor disparities were noted in the remaining two cases. In the small bowel, capsule endoscopy identified positive findings in 14 (70%) patients, whereas, push enteroscopy identified positive findings in 5 (25%) patients. Despite these results, the findings were definitive in only 6 of the 20 patients by using capsule endoscopy, and in two of 20 patients with push enteroscopy. CONCLUSIONS: When strict standards of interpretation were used, capsule endoscopy resulted in more positive findings than push enteroscopy, but the number of definitive findings for both imaging methods was low. There was a high degree of reliability between a novice and an experienced endoscopist with respect to the interpretation of capsule endoscopy.

Adult↗

PubMed2004

Diagnostic yield and clinical outcomes of capsule endoscopy.

BACKGROUND: Capsule endoscopy is proving to be superior to push enteroscopy and barium contrast radiography for evaluation of the small bowel. However, its impact on clinical outcome has not been thoroughly investigated. This study assessed changes in therapy based on capsule endoscopy findings and on the impact of such changes on patient outcomes. METHODS: Forty-four consecutive capsule endoscopies in 43 patients were reviewed. Data were collected by systematic review of patient records and included indication, results of prior diagnostic tests, and capsule endoscopy findings. Specific interventions after capsule endoscopy and clinical outcome were noted. RESULTS: The indication for capsule endoscopy was obscure GI bleeding in 40 patients, iron deficiency anemia in one, and right lower quadrant abdominal pain in two patients. Overall diagnostic yield was 42% (18/43 patients). Diagnostic findings included angiodysplasias (n = 13), intestinal ulcers (n = 2), Crohn's disease (n = 2), and mass lesion (n = 1). As a result of the capsule endoscopy findings, a specific intervention was implemented in 12 of 18 patients with positive findings. These included endoscopy with coagulation (n = 5), laparotomy (n = 2), pharmacotherapy (n = 4), and discontinuation of medication (n = 1). At a mean follow-up of 6.7 months, the clinical outcome was considered positive in 7 of 43 patients (16%). CONCLUSIONS: Although it has a high diagnostic yield, capsule endoscopy has a positive influence on clinical outcome in a relatively small proportion of patients. Larger studies are needed that assess the influence of capsule endoscopy on clinical outcomes.

Abdominal Pain↗

PubMed2005

A prospective two-center study comparing wireless capsule endoscopy with intraoperative enteroscopy in patients with obscure GI bleeding.

BACKGROUND: Capsule endoscopy enables noninvasive diagnostic examination of the entire small intestine. However, sensitivity and specificity of capsule endoscopy have not been adequately defined. We, therefore, compared capsule endoscopy by using intraoperative enteroscopy as a criterion standard in patients with obscure GI bleeding. METHODS: Forty-seven consecutive patients with obscure GI bleeding (11 with ongoing overt bleeding, 24 with previous overt bleeding, and 12 with obscure-occult bleeding) from two German gastroenterologic centers were included. All patients who had a prior nondiagnostic evaluation, including upper endoscopy, colonoscopy with a retrograde examination of the distal ileum, and push enteroscopy, underwent capsule endoscopy followed by intraoperative enteroscopy. RESULTS: Capsule endoscopy identified lesions in 100% of the patients with ongoing overt bleeding, 67% of the patients with previous overt bleeding, and 67% of the patients with obscure-occult bleeding. Angiectasias were the most common source of bleeding (n = 22). Capsule endoscopy showed the source of bleeding in 74.4% of all patients. The method was more effective in patients with ongoing bleeding. Compared with intraoperative enteroscopy sensitivity, specificity, and positive and negative predictive values of capsule endoscopy were 95%, 75%, 95%, and 86%, respectively. CONCLUSIONS: Capsule endoscopy has high sensitivity and specificity to detect a bleeding source in patients with obscure GI bleeding. Thus, wireless capsule endoscopy can be recommended as part of the routine work-up in patients with obscure GI bleeding.

Adolescent↗

PubMedDate not supplied

A profile of patients with adhesive capsulitis.

The purpose of this descriptive study is to develop a profile of patients with adhesive capsulitis and to describe the patients' perceived clinical progression. A total of 32 patients diagnosed with adhesive capsulitis and 31 control subject completed anonymous questionnaires designed to elicit demographic data as well as medical information. The adhesive capsulitis and control samples were selected from the same facilities in an effort to reduce bias. Data comparing the adhesive capsulitis group with the control group was analyzed using the Odds Ratio and Taylor Series Confidence Interval for Odds Ratio. Twenty-seven patients (84.4%) diagnosed with adhesive capsulitis fell within the age range of 40-59 years. Diabetes and heart disease appeared to be more prevalent in patients diagnosed with adhesive capsulitis as compared with the control group and general population. The majority of patients with adhesive capsulitis (90.6%) reported a perceived clinical progression that started with a pattern of pain followed by loss of motion. Age and concomitant medical conditions appeared to be most correlated with the occurrence of adhesive capsulitis. Possible reasons for the prevalence of diabetes and heart disease in adhesive capsulitis patients are discussed.

Adult↗

PubMed2002

Collagen IV in the developing lens capsule.

The lens capsule is a specialized thickened basement membrane that completely surrounds the lens and provides anchoring sites for zonules, the filamentous bodies that suspend the lens. Like other basement membranes, the lens capsule contains collagen IV, which is a family of six polypeptides, subunits alpha1(IV)-alpha6(IV), each of which is encoded by a distinct gene. We have investigated the presence of collagen IV subunits in the developing lens capsule by using confocal immunohistochemistry and antibodies against each of the six collagen IV subunits. In murine embryos, subunits alpha1(IV), alpha2(IV), alpha5(IV) and alpha6(IV) were detected in the basement membrane surrounding the lens vesicle, and they persisted in the capsule until adulthood. In contrast, neither collagen alpha3(IV) nor alpha4(IV) was detected in the lens capsule until 2 weeks postnatal. Similarly, we detected no collagen alpha3(IV) or alpha4(IV) in lens capsules of 54-day human embryos, while collagen alpha3(IV) and alpha4(IV) were detected in adult humans. Thus, in the lens capsule, there is a developmental shift in detectable collagen IV subunits; early in development we observed subunits alpha1(IV), alpha2(IV), alpha5(IV) and alpha6(IV), which is consistent with the presence of fibrillar [alpha1alpha1alpha2] and elastic [alpha5alpha5alpha6] protomers, but later in development components of the more cross-linked [alpha3alpha4alpha5] protomer appear. An elastic lens capsule may be necessary in order to accommodate rapid lens growth in early development, whereas later in development a stronger, more cross-linked capsule may be necessary in order to tolerate the stress caused by postnatal accommodation and disaccommodation of the lens.

Adult↗

PubMedDate not supplied

Shoulder adhesive capsulitis and shoulder range of motion in type II diabetes mellitus: association with diabetic complications.

This study was done to examine the association between shoulder adhesive capsulitis and chronic diabetic complications and diseases closely related to diabetes in Akdeniz University Hospital. Shoulder adhesive capsulitis were evaluated in 297 consecutive type II diabetic patients attending an outpatient diabetic clinic. Shoulder adhesive capsulitis was detected in 86 patients (29%). There was a significant association between shoulder adhesive capsulitis and limited joint mobility (p = 0.006), shoulder adhesive capsulitis and Dupuytren's disease (p = 0.003). Odds ratios (OR) for carpal tunnel syndrome, limited joint mobility, and Dupuytren's disease with shoulder adhesive capsulitis were respectively 1.4, 2.1, and 2.4 [95% confidence interval (CI), respectively, 0.7-2.9, 1.2-3.69, and 1.3-4.4]. Also, shoulder adhesive capsulitis was associated with the age of patients (p = 0.000) and the duration of diabetes (p = 0.03). When other associations between shoulder adhesive capsulitis and diabetic complications were compared, it was associated with retinopathy [p = 0.014, OR = 2.2 (95% CI 1.1-4.2)], but there was no association with neuropathy or macroproteinuria. On the other hand, the degrees of passive abduction, internal rotation, external rotation motions of shoulder joints in the all patients were correlated with age of patients, duration of diabetes, neuropathy, and the other hands' problems (Dupuytren's disease, limited joint mobility) (p<0.05). The presence of shoulder adhesive capsulitis may indicate presence of organ involvement.

Adult↗

PubMed2004

Self-recognition, structure, stability, and guest affinity of pyrogallol[4]arene and resorcin[4]arene capsules in solution.

In the present study, we used diffusion NMR to probe the structures and characteristics of the products obtained from the self-assembly of resorcin[4]arenes 1a and 1b and pyrogallol[4]arenes 2a and 2b in CDCl(3) solutions. It was found that all four molecules self-assemble into hexameric capsules. The hexameric capsules of pyrogallol[4]arenes 2a and 2b were found to be more stable than the capsules of resorcin[4]arenes 1a and 1b in polar media. We also studied the role of water molecules in the self-assembly of the different capsules and found that water molecules are part of the hexameric capsules of resorcin[4]arenes 1a and 1b but not in the capsules of pyrogallol[4]arenes 2a and 2b. It was found that the self-assembly process between the resorcin[4]arenes and pyrogallol[4]arenes proceeds with self-recognition. When mixing two macrocycles of different types in a chloroform solution, no heterohexamers are formed, only the capsule constructed from the same macrocycle is detected. However, when two resorcin[4]arenes (i.e., 1a and 1b) or two pyrogallol[4]arenes (i.e., 2a and 2b) are mixed, heterohexamers are formed over time. In addition, we found that resorcin[4]arenes and pyrogallol[4]arenes differ significantly in their guest affinity. The capsules of 1a and 1b can accommodate both the tertiary alkylamines and their respective ammonium salts, while the capsules of 2a and 2b encapsulate only the neutral tertiary alkylamines.

Journal Article↗

PubMed2005

A pooled analysis to evaluate results of capsule endoscopy trials.

BACKGROUND AND STUDY AIM: Capsule endoscopy is a new tool in the evaluation of the small intestine. To speed evaluation and acceptance of this technology, the manufacturer (Given Imaging Ltd, Yoqneam, Israel) funded several trials. The data from these trials were collected at a central repository using a standardized reporting tool. Presentation of this data to the US Food and Drug Administration (FDA) in July 2003 led to the removal of the adjunctive term with regard to indication for capsule endoscopy, recognizing that the method is of independent importance for evaluating the small bowel. The aim of the present study was to combine the data from several capsule trials to help determine the yield and miss rate of capsule endoscopy for different diseases, compared with alternative diagnostic modalities. METHODS: Capsule studies were identified from a master database of funded studies. Studies were included in the pooled analysis if they reported a prospective comparison with another modality for evaluation of the small intestine. RESULTS: 32 studies with a total of 691 patients were found in the master database, of which 24 studies, representing 530 patients, met inclusion criteria and were entered into the pooled analysis. Prior to study entry, patients had undergone a mean of 6.77 diagnostic procedures, without findings. Of these 24 studies, 14 (involving 310 patients) were categorized as "bleeding" studies, and 10 studies (220 patients) as "nonbleeding small-bowel disorders" studies. The comparison procedure was push enteroscopy in 300 patients (in 45 for nonbleeding disorders), small-bowel series in 140 patients (in 125 for non-bleeding disorders), and colonoscopy with ileoscopy in 90 patients (50 for nonbleeding disorders). Overall analysis per patient showed new findings from capsule endoscopy in 50 % of patients; 17 % had new findings from the comparison method; in 22 % there were similar findings; and in 11 % there were no findings. A total of 1349 instances of disease were identified in the 530 examinations. Capsule endoscopy solely detected 87 % of the disease instances, while the comparison method solely detected 13 %. The yield for push enteroscopy alone was 14.8 %, for small-bowel series it was 9.9 %, and for colonoscopy it was 13.2 %. Capsule endoscopy missed 146 disease instances for a miss rate of 10 %; 989 were missed by the comparison methods for a miss rate of 73 %; and 214 were detected by both methods. CONCLUSION: Capsule endoscopy is the state of the art method for noninvasive detection of small-bowel disease.

Adolescent↗

PubMed2006

Video capsule endoscopy in peutz-jeghers syndrome: a blinded comparison with barium follow-through for detection of small-bowel polyps.

BACKGROUND AND STUDY AIMS: Video capsule endoscopy has shown promise for the surveillance of significant small-bowel polyps in patients with Peutz-Jeghers syndrome. In this study the yield of significant small-bowel polyps by capsule endoscopy was compared to the yield of these polyps by barium follow-through in adults with Peutz-Jeghers syndrome. PATIENTS AND METHODS: A total of 19 adults with Peutz-Jeghers syndrome who were undergoing surveillance underwent both capsule endoscopy and barium follow-through examinations, and the number of small-bowel polyps of at least 1 cm in diameter that were detected was recorded for each method. The two methods were assessed in terms of comfort and convenience for the patients and their preferred future surveillance method, using a questionnaire. RESULTS: Capsule endoscopy detected a median of four significant small-bowel polyps while barium follow-through detected a median of one (P = 0.008). There was a trend towards more participants having at least one significant small-bowel polyp detected by capsule endoscopy than was the case with barium follow-through, though capsule endoscopy seemed to be less reliable for accurate sizing of polyps that were at the limit of clinical significance. Most participants expressed a preference for capsule endoscopy for future surveillance. CONCLUSIONS: Capsule endoscopy should replace barium follow-through for the surveillance of small-bowel polyps in adults with Peutz-Jeghers syndrome, but the findings of this study should be interpreted with caution until a more reliable means of sizing polyps by capsule endoscopy is available.

Administration, Oral↗

PubMed2003

Potential application of silicified microcrystalline cellulose in direct-fill formulations for automatic capsule-filling machines.

Silicified microcrystalline cellulose (SMCC) has physico-mechanical properties that may be of advantage in hard gelatin capsule formulations. The present research was designed to evaluate and compare SMCC's performance to that of other excipients commonly used in hard gelatin capsule direct-fill formulations. All capsules were filled using a fully instrumented Zanasi LZ-64 automatic capsule-filling machine. Four grades of SMCC [SMCC 50, SMCC 90, SMCC HD90, and an experimental-grade (SMCC X)] were investigated. Anhydrous lactose (direct tableting grade), pregelatinized starch (PGS) (Starch 1500), and microcrystalline cellulose (MCC) (Emcocel 90M) were chosen as the control fillers. The following properties were measured: capsule fill weight, relative standard deviation of capsule fill weight, plug ejection force, plug maximum breaking force (MBF), and the dissolution of two marker compounds (acetaminophen and piroxicam). The MBF of capsule plugs increased with increases in compression force from 50N to 100N for all excipients. Starch 1500 and anhydrous lactose plugs exhibited the lowest MBF values. PGS, anhydrous lactose, SMCC HD90, and SMCC X consistently exhibited the lowest ejection forces under the same experimental conditions, this difference being most apparent at higher compression forces. Different patterns were observed in the way compression force affected the fill weight of the materials studied. Overall, there was no clear pattern to the way the relative standard deviation (RSD) of capsule fill weight varied with encapsulation conditions. Sodium stearyl fumarate (SSF) appeared to be somewhat more efficient at reducing the ejection force than magnesium stearate at the same level, this difference being especially apparent at the 14-mm piston height. Formulations containing either 5% piroxicam, 30% acetaminophen, or 50% acetaminophen exhibited faster drug dissolution when MCC or SMCC was the filler than when anhydrous lactose or PGS was the filler. The presence of colloidal silicon dioxide in SMCC did not appear to influence the dissolution of these drugs. The data suggest that SMCC could be a suitable direct-fill excipient for hard shell capsule formulations.

Cellulose↗

PubMed2001

Surgical pathology of spinal schwannomas: a light and electron microscopic analysis of tumor capsules.

OBJECTIVE: Although spinal schwannomas are often encountered, the pathology of the tumor capsule has not been reported. In this study, we describe the ultrastructural pathology of the tumor capsule of spinal schwannomas. METHODS: In 18 patients who underwent total removal of spinal schwannomas (C2-conus), the tumor capsule was collected and examined by light and electron microscopy. RESULTS: The thickness of the tumor capsule ranged from 15 to 800 microm (mostly 30-100 microm) and was composed of three layers from the surface to the center: 1) a thinly stretched nerve tissue layer; 2) a fibrous layer of fibrocytes, abundant collagen fibers, and tumor vessels; and 3) a thin transitional layer intermingled with fibrous components and tumor cells. The thickness of each layer varied in different regions of the surface. There was no clear separation between the tumor capsule and the neoplastic tissue, even on the electron microscopic level. A number of nerve fibers ran through the fibrous layer and beneath the capsule as well as in the nerve tissue layer. CONCLUSION: Compared with vestibular schwannomas, which have been reported to be covered by an extremely thin layer (3-5 microm) of connective tissue, spinal schwannomas were well encapsulated. The capsule was composed of three distinct components; however, the cleavage between thin capsule and tumor cells was indistinct, and the thickness of the axon-containing capsule varied from site to site. Therefore, resection of the nerve of tumor origin, rather than enucleation, would be justified to avoid tumor recurrence. Surgeons should be aware of this pathology when performing the procedure.

Adolescent↗

PubMed1993

Cervical stability after sequential capsule resection.

A portion of the cervical facet joint must be resected to expose and decompress cervical nerve roots from a posterior approach. When posterior fusion is performed, it is common to remove the facet capsule only for the joints being fused. This study was performed to examine the effect of resection of the facet capsule alone, without disruption of the bony facet to determine what degree of facet-capsule resection leads to acute instability. Seven human cervical cadaveric spines were used in the experiment. Nondestructive biomechanical testing was performed in axial load, flexion, extension, and torsion. Each specimen was tested intact and after sequential resection of 25%, 50%, 75%, and 100% of the C5-6 facet capsules. Axial stiffness changed very little during the experiment. In torsion, the displacement increased 1% after a 25% capsule resection, 19% after a 50% resection, and 25% after a 75% or 100% resection. No gross subluxation was seen during the torsional test. In the flexion test, posterior displacement increased 4% after a 25% resection, 5% after a 50% resection, 32% after a 75% resection, and 22% after a 100% resection. There was a statistically increased displacement seen during the flexion test after 75% or 100% of capsule resection. Thus, significant hypermobility did occur during both torsion and flexion testing with greater than 50% resection of the facet capsules. Great care should be taken when exposing an unfused facet to limit facet-capsule resection to less than 50%. With resection of greater than 50% of the capsule, postoperative hypermobility can occur and may require stabilization.

Biomechanical Phenomena↗

PubMed2004

Molecular architecture of the Cryptococcus neoformans capsule.

Many microbes are surrounded by phagocytosis-inhibiting capsules. We took advantage of the large size of the polysaccharide capsule of the pathogenic yeast Cryptococcus neoformans to examine capsular architecture and the relationship between molecular architecture and the interaction of the capsule with potentially opsonic serum proteins. Our experimental design used complementary approaches in which (i) assessment of permeability to macromolecules of different Stokes radii; (ii) determination of the binding of Fab fragments of anticapsular antibodies as a measure of matrix density; (iii) capsular deconstruction by treatment with dimethyl sulphoxide; and (iv) evaluation of capsule plasticity, were used to probe the molecular structure of the capsule. The results showed that the capsule is a matrix with a variable porosity that increases with distance from the cell wall. A high density of the matrix at the capsule interior prevents penetration of large macromolecules to sites near the cell wall. In contrast, the capsular edge that is the interface with phagocytes presents capsular polysaccharide in a very low density that exhibits considerable plasticity and permeability to macromolecules. Notably, the capsule of yeast cells harvested from infected tissue showed a greater matrix density than yeast cells grown in vitro under capsule induction conditions.

Antibodies, Fungal↗

PubMed1986

Studies of capsule and capsular space of cat muscle spindles.

The presence of hyaluronate in the capsular space of the cat muscle spindle was demonstrated using alcian blue staining at various pHs, the critical electrolyte concentration technique and hyaluronidase treatment. In spindles with intact capsules an extracellular marker, the dye Ruthenium Red, gained access to the capsular space through the gap in the sleeve region, but for a limited distance. In muscle spindles with the capsule nicked, the marker diffused into the capsular space in the equatorial region, revealing a dense network in this space which consisted of globular structures interconnected by thin filaments. Based on their thickness, these filaments were inferred to be hyaluronic acid, and the globular structures were inferred to be protein molecules. Longitudinal diffusion of the dye into the capsular space through the nicked site was limited. The limited diffusion is probably due to electrostatic binding of the dye, which is a hexavalent cation, to negatively charged glycosaminoglycan hyaluronate that is present in the space. The transcapsular potential was measured by use of glass micropipettes filled with 3 M-KCl. The value was 15 mV +/- 4 (average +/- S.D., n = 12; range, 10-20 mV) inside negative. The input resistance and capacitance of the capsule, measured with two independent electrodes, varied widely (1.3-8.0 M omega and 0.5-1.3 nF, n = 4) and the capsule showed marked delayed rectification to outward current pulses. [K+] in the space measured with K+-sensitive resin-filled glass micropipettes was a few millimolar higher than that in the bathing solution. The effects of [K+] and [Ca2+] on impulse activities were examined in spindles with intact capsules or with partially resected capsules. In spindles with intact capsules the effects of [K+] and [Ca2+] were significantly less or negligible compared with those in spindles with the capsule opened. Hyaluronidase (approximately 10(-4) g/ml) added to the bathing solution around nicked capsules significantly reduced both resting and stretch-induced impulse activities in 40-50 min. By this time the capsular space was completely collapsed. An increase in [K+] of the bathing solution from 3.5 to 6 or 8 mM restored these impulse activities. A similar restoring effect was also observed when [Ca2+] in the bathing solution was reduced.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMed1992

Interaction of capsulate Haemophilus influenzae with human airway mucosa in vitro.

Two pairs of isogenic capsulate and noncapsulate and one pair of capsulate fimbriate and nonfimbriate strains of Haemophilus influenzae type b were studied in an organ culture of human respiratory mucosa. Over 24 h, the numbers of recovered bacteria increased from the original inoculum size of 10(5) to 10(8) CFU/ml. Transmission electron microscopy and scanning electron microscopy showed that noncapsulate organisms caused significant epithelial damage, whereas capsulate strains did not. Association of noncapsulate bacteria with damaged epithelial cells was observed by 14 h of incubation. In contrast, capsulate organisms were associated with a dense, thick, gel-like matrix which was observed above the epithelial surface. These capsulate organisms were not seen to associate with the epithelial surface (by transmission electron microscopy), though they were occasionally seen adhering to cells by scanning electron microscopy. Fimbriate capsulate H. influenzae showed increased adherence to buccal cells compared with nonfimbriate capsulate organisms. There was also association of fimbriate capsulate bacteria with damaged organ culture epithelium in one of four experiments. It is concluded that both capsule and fimbriae affect the interaction of H. influenzae with human airway mucosa in vitro by influencing adherence to and damage of the epithelium.

Bacterial Adhesion↗

PubMed2003

Clinical utility, safety and tolerability of capsule endoscopy in urban Southeast Asian population.

AIM: Capsule endoscopy has demonstrated its clinical utility in the evaluation of small bowel pathology in several Western studies. In this prospective study, we aimed to determine the clinical utility, safety and tolerability of capsule endoscopy in the evaluation of suspected small bowel disease in an urban Southeast Asian population. METHODS: We used the given (M2A) capsule endoscopy system in 16 consecutive patients with suspected small bowel pathology. In 9 patients the indication was obscure gastrointestinal bleeding, while in 6 patients it was to determine the extent of small bowel involvement in Crohn's disease. One patient underwent capsule endoscopy for evaluation of chronic abdominal pain. Patient's tolerability to the procedure was evaluated by standardized questionnaires and all patients were reviewed at one week to ensure that the capsule had been excreted without any adverse events. RESULTS: Abnormal findings were present in 8 patients (50%). The cause of obscure gastrointestinal bleeding was determined in 5 out of 9 patients. Findings included 2 cases of angiodysplasia, 2 cases of jejunal ulcers and 1 case of both angiodysplasia and jejunal ulcer. One patient had small bowel erosions and foci of erythema of doubtful significance. Ileal lesions were diagnosed in 2 out of 6 patients with Crohn's disease. Capsule endoscopy was well tolerated by all patients. One patient with Crohn's disease had a complication of capsule retention due to terminal ileum stricture. The capsule eventually passed out spontaneously after 1 month. CONCLUSION: Our study, which represented the first Asian series, further confirms the diagnostic utility, safety and tolerability of wireless capsule endoscopy.

Adult↗

PubMed2002

[The histological study of the capsules formed around the mammary prosthesis].

OBJECTIVE: To observe and analyze the pathohistological characteristics of capsules which formed around the mammary prosthesis with different contents. And to provide the selective basis for ideal and safe prosthesis in clinical practice. METHODS: 20 specimen of the capsules were taken from 20 cases who receive the operation of prothesis removal for different reasons. HE, Masson and Mallory staining were used to analyse the tissue structure and characteristics under the light microscope. RESULTS: The common structure including the collagen fibers accumulation, inflammatory cells infiltration and the capillary hyperplasia were found in all specimen. A layer of squamous epithelium-like cell was detected in some specimen. The specific characteristics were also found in different capsules formed around different prosthesis. In the capsules around vegetable oil prosthesis, there was excessive collagen fiber accumulation, and the capsules were much thicker. In the PVP (polyvinylpyrolidone) prosthesis capsules, there was severe inflammatory cell infiltration, and the number of eosinophilic granulocyte increased obviously. In the silicone gel and saline prosthesis capsule, the collagen fibers were well-arranged and the inflammatory cells were much less. Synovial metaplasia was detected in two cases. CONCLUSION: 1. The capsules form around the prosthesis in all cases after mammary augmentation. 2. There will be synovial metaplasis in some cases, for vegetable oil prosthesis, the collagen over-accumulated which lead the capsules become thicker and harder. So it is not a kind of ideal mammary prothesis. 4. The severe infiltration of the inflammatory cells especially the large quantity of eosinophilic granulocyte indicate the possibility of the delayed hypersensitive reaction mediated by eosinophilic granulocyte. Cautious attitude should be taken during application.

Adult↗

PubMed2003

[Capsule endoscopy in small bowel diagnostics].

INTRODUCTION: Capsule endoscopy allows for the first time total and painless imaging of the entire small bowel. The main indication for capsule endoscopy is obscure gastrointestinal bleeding which not explained by upper gastrointestinal endoscopy, colonoscopy and small bowel radiology. Capsule endoscopy has also the capacity to detect tiny small bowel manifestations of other pathologic conditions such as Crohns's disease. METHOD AND AIMS: The GivenM2A wireless capsule endoscopy system for investigation of the whole small bowel was developed in the late 1990s. The small size swallowable capsule contains a miniature video camera, four light sources, two batteries and a radiotransmitter. This paper describes the capsule endoscopy examination method and summerizes the initial achievements from two medical centres, the Petz Aladár County and Teaching Hospital and from the Malmö University Hospital. RESULTS: 42 patients were included of whom 37 patients with obscure gastrointestinal bleeding. Pathological small bowel findings were detected in 62% of the all cases, and the source of bleeding was identified by the M2A capsule in 56.7% of the chronic bleeders. The diagnostic sensitivity of the capsule endoscopy in obscure gastrointestinal bleedings was superior both to that of push enteroscopy, 19%, and enterography, 6.7%. The capsule endoscopy was well tolerated and accepted by the patients. CONCLUSIONS: This new diagnostic method is promising mainly for detection of a small bowel source of obscure bleedings. The availability of the method in major gastroenterological centers is strongly recommended.

Adolescent↗