Inflammatory bowel disease and novel endoscopic technologies

Hosoe, Naoki; Ogata, Haruhiko

doi:10.1111/den.12161

Cited by 15 publications

(9 citation statements)

References 50 publications

(107 reference statements)

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“…However, conventional ileocolonoscopy is unable to assess the mid-small intestine. Assessment of small intestinal lesions is critical in patients with CD [9] . Novel technologies to enable IBD diagnosis have been developed, such as capsule endoscopy (CE) and BAE [10][11][12][13] .…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission

Hisamatsu¹,

Matsuoka²,

Kiyohara³

et al. 2016

Digestion

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Introduction: Mucosal healing has emerged as a desirable treatment goal in clinical practice for patients with Crohn's disease (CD). The aim of this study was to assess the relationship between endoscopic activity and the long-term prognosis of CD using simple endoscopic score for Crohn's disease (SESCD) and Rutgeerts' score. Methods: We conducted a cohort study in clinical practice at a single center. Among CD patients who underwent colonoscopy between July 2008 and June 2011 at our hospital, 131 patients with clinical remission were selected, and the patients were divided into 2 groups: a non-surgical group (n = 84) and a surgical group (n = 47). The primary endpoint of this study was to assess the associations between variables and clinical relapse after endoscopic procedures. The cut-off levels of SESCD or Rutgeerts' score for the prediction of relapse were also assessed in patients with clinical remission. Results: In the non-surgical group, SESCD and C-reactive protein at baseline were significantly higher in patients who had clinical recurrence than in patients who maintained remission. A factor of SESCD ≤2 was independently associated with sustained remission, even in patients with clinical remission. In the surgical group, patients with Rutgeerts' scores ≤1 had significantly prolonged clinical remission compared to patients with Rutgeerts' scores ≥3. Conclusion: A cut-off value of SESCD ≤2 and a Rutgeerts' score ≤1 enabled the prediction of long-term prognosis. These cut-off values could be used in clinical trials of endoscopic remission from the point of view of the clinical outcomes of CD.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission

Hisamatsu¹,

Matsuoka²,

Kiyohara³

et al. 2016

Digestion

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“…Furthermore, a single commercial ASM A 1 180 0 generates only 37. 5 [mT] at the centre of the system (see Fig. 8 (a)), but through this first optimization process we find that the same volume can be optimally distributed to generate a global optimal value of 51.9 [mT] (an improvement of about 38%).…”

Section: Optimization Of the Arc-shaped Permanent Magnetsmentioning

confidence: 99%

“…We find that the minimum volume Vmin of 8.1704x10 -6 [m 3 ] can generate 37. 5 [mT] at the centre of the system. This represents an improvement in the volume of the ASM of about 35%.…”

Section: Optimization Of the Arc-shaped Permanent Magnetsmentioning

confidence: 99%

“…In another medical application, Wireless Capsule Endoscopy (WCE), magnetic coupling has been used to remotely actuate different mechanisms embedded in prototypes of robotic capsules. It is envisaged that such mechanisms can enhance the existing WCE's capability as a complementary diagnostic medical tool [5] and may allow medical practitioners to perform more complex procedures such as biopsy [2,6] and wireless insufflation [7].…”

Section: Introductionmentioning

confidence: 99%

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Size Optimization of a Magnetic System for Drug Delivery With Capsule Robots

Munoz

Alici

et al. 2016

IEEE Trans. Magn.

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In this paper, we present a methodology for the size optimization of an external magnetic system made of arcshaped permanent magnets (ASMs). This magnetic system is able to remotely actuate a drug-release module embedded in a prototype of a capsule robot. The optimization of the magnetic system is carried out by using an accurate analytical model that is valid for any arbitrary dimensions of the ASMs. By using this analytical model, we perform parametric studies and conduct a statistical analysis [analysis of variance (ANOVA)] to investigate efficient ways to distribute the volume of the ASMs so that the dimensions and volume of the magnetic system are minimized while optimal flux densities and magnetic torques are obtained to actuate the drug delivery system (DDS). The ANOVA results, at 5% significance level, indicate that changes in the angular width followed by changes in the length of the ASMs have the highest impact on the magnetic linkage. Furthermore, our experimental results, which are in agreement with the analytical results, show that the size optimization of the magnetic system is effective for the actuation of the DDS in capsule robots. In this paper, we present a methodology for the size optimization of an external magnetic system made of arc-shaped permanent magnets (ASMs). This magnetic system is able to remotely actuate a drug release module embedded in a prototype of capsule robot. The optimization of the magnetic system is carried out by using an accurate analytical model that is valid for any arbitrary dimensions of the ASMs. By using this analytical model, we perform parametric studies and conduct a statistical analysis (ANOVA) to investigate efficient ways to distribute the volume of the ASMs so that the dimensions and volume of the magnetic system are minimized while optimal flux densities and magnetic torques are obtained to actuate the drug delivery system (DDS). The ANOVA results, at 5% significance level, indicate that changes in the angular width followed by changes in the length of the ASMs have the highest impact on the magnetic linkage. Furthermore, our experimental results, which are in agreement with the analytical results, show that the size optimization of the magnetic system is effective for the actuation of the DDS in capsule robots.Index Terms-Capsule robot, drug delivery, magnetic actuation, permanent magnets.

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“…In suspected CD, colonoscopy and SBFT should be initially carried out. In established CD, CE should be carried out after ileocolonoscopy/SBFT and CT …”

Section: Small‐bowel Cementioning

confidence: 99%

Current status of capsule endoscopy through a whole digestive tract

Hosoe

Ogata

2014

Digestive Endoscopy

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More than a decade has passed since small-bowel capsule endoscopy (CE) was first reported. Small-bowel CE is a non-invasive tool that allows visualization of the entire small-intestinal mucosa and facilitates detection of small-intestinal abnormalities. Several studies have shown benefit of small-bowel CE for certain disorders. Because it is non-invasive, CE has been applied to other organs including the esophagus, stomach, and colon. The main indications for esophageal CE (ECE) are screening for gastroesophageal reflux disease/Barrett's esophagus, and esophageal varices. However, the clinical benefit of ECE is unconfirmed. Magnetically guided CE (MGCE) was developed to visualize the gastric mucosa. MGCE is a new concept with room for improvement of capsule navigation and the preparation protocol. Recently, two new small-bowel CE tools were released. First-generation colon CE (CCE-1) has moderate sensitivity and specificity compared with colonoscopy for colorectal neoplasia surveillance. To obtain higher accuracy, a second-generation CCE (CCE-2) was developed with a high sensitivity for detecting clinically relevant polypoid lesions. A possible application of CCE is for inflammatory bowel disease. In the near future, CE may include diagnostic and therapeutic functions such as magnifying endoscopy systems, targeted biopsy forceps, and drug delivery systems.

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Inflammatory bowel disease and novel endoscopic technologies

Cited by 15 publications

References 50 publications

Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission

Endoscopic Severity Predicts Long-Term Prognosis in Crohn's Disease Patients with Clinical Remission

Size Optimization of a Magnetic System for Drug Delivery With Capsule Robots

Current status of capsule endoscopy through a whole digestive tract

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