Modifi ed mode of fujinon intelligent color enhancement (FICE) in the diagnosis of colon lesions

The study aims to evaluate the eff ectiveness of standard and modifi ed settings of the spectral color allocation technology in the diff erential diagnosis of the colon morphological type of epithelial formations. Materials and methods: video colonoscopy using standard and modifi ed mode of technology. A total of 746 patients were selected for spectral colour selection, of whom 80 were selected. There were 36 men, 44 women. The average age of the patients was 60 ± 9 years. There were 171 epithelial fomations, of which 106 (61.9%) were located in the left side of the large intestine: in the rectum — 33 (31.2%), in sigmoid — 52 (49%), in descending part — 21 (19.8%). In the right parts of the colon there were significant lower number of formations — 65 (38.1%): ascending intestine — 26 (40%), transversely — colon — 32 (49.2%), cecum — 7 (10.8%). Endoscopic studies were performed according to standard method using video colonoscopes from Fujinon, EC-590ZW / L, EC-530WL. Results: statistically revealed that the probability of determining the correct morphological type of epithelium is formation is 6 times higher when using the modifi ed spectral color technology highlight compared to standard technology settings. Conclusion: the modifi ed settings of the technology of spectral color highlighting allow much more accurative performance an optical biopsy of epithelial colon formations.

PHOTODYNAMIC DIAGNOSTIC OF NEOPLASTIC PROCESSES OF COLON

Resume. In this work we introduce the results of examination of 35 patients with neoplasia of distal part of colon. During this examination we use a system of fotodynamic diagnostic SFD.M16-1C2 and a pharmacological drug Hyperflav. Endoscopic examination (video colonoscopy) was doing during 7-9 hours after patients had taken 2 capsules of Hyperflav (8 mg. of hyperycine). From areas which had been fluorescent inducted by photosensibilisation, typical for morphological atypical cells, a biopsy was done. Using of photodynamic diagnostic help us to raise accuracy, sensitivity, specificity of verification of neoplastic processes of mucous membrane of the colon up to 99,8%, 94,9%,94,0% in accordance.

The frequency and clinical and endoscopic features of mixed NSAIDs-induced gastrointestinal injuries

Non-steroidal anti-inflammatory drugs (NSAIDs) can cause undesirable reactions in all parts of the gastrointestinal tract (GIT). However, the frequency of mixed injuries of various GIT parts due to the use of these drugs has not been investigated.Objective: to estimate the frequency of mixed NSAID-induced injuries of the upper GIT, small and large intestine.Patients and methods. A total of 112 patients (62.5% were women) (mean age, 56.2±14.6 years) with rheumatic diseases who had regularly taken NSAIDs were examined. All the patients underwent esophagogastroduodenoscopy and video colonoscopy. Video capsule endoscopy was performed in 35 patients with signs of NSAID-induced gastropathy.Results and discussion. The signs of NSAID-induced gastropathy (gastric and duodenal erosions and/or ulcers) were found in 43.8% of patients; those of NSAID-induced enteropathy (small bowel hemorrhages, erosions, and ulcers) were present in 68.6%; and those of NSAIDinduced colopathy (colonic hemorrhages, erosions, and ulcers) were in 14.3%. The concurrence of NSAID-induced gastro- and colonopathy was present in 28.6% of the patients (odds ratio 12.2; 95% confidence interval, 2.619–56.84); that of NSAID-induced gastro-, entero-, and colopathy was in 10 (20.4% of all the patients with NSAID-induced gastropathy). There was a significant association of the risk of mixed pathology in all GIT parts with the diagnosis of spondylarthritis, the presence of abdominal pain, the signs of dysbiosis and bacterial overgrowth syndrome, as well as with the carriage of CYP2C19 gene polymorphism (the CYP2C19*17*1/*17 allele).Conclusion. Mixed injury of various GIT parts due to the use of NSAIDs is a frequent and serious pathology that requires comprehensive diagnostic tests and combined use of preventive therapies with different mechanisms of action.

The performance of routine computed tomography for the detection of colorectal cancer

Introduction Although colonoscopy and computed tomography (CT) colonography in expert hands are the most sensitive investigations for colorectal cancer, some patients may not tolerate the necessary bowel preparation and insufflation of gas into the colon. We assessed the performance of unprepared contrast CT for the detection of colorectal cancer. Methods A retrospective review was undertaken of all patients who had contrast CT of the abdomen and pelvis and then went on to have colonoscopy at our institutions between 2007 and 2010. Results Overall, 96 patients were identified as having had CT prior to colonoscopy. The sensitivity of CT in detecting colorectal cancer was 100% (95% confidence interval [CI]: 19.8–100%) and the specificity was 95.7% (95% CI: 88.8–98.6%). The positive predictive value was 33.3% (95% CI: 6.0–75.9%) and the negative predictive value was 100% (95% CI: 94.8–100%). Conclusions Non-targeted CT that is negative for colorectal malignancy is usually reassuring but the decision for further investigations should be made on a case-by-case basis, taking into account of the likelihood of underlying colorectal malignancy and the underlying co-morbidities of the patient. However, video colonoscopy is usually necessary to assess positive CT findings.