The Diagnosis and Treatment of Early-Stage Colorectal Cancer

The introduction of colorectal endoscopic submucosal dissection (ESD) has expanded the applications for endoscopic treatment; as a result, lesions with low metastatic potential can be treated endoscopically regardless of the lesion size. The most attractive feature of ESD is the achievement of en bloc resection with a lower local recurrence rate in comparison to that of endoscopic piecemeal mucosal resection. However, in case of gastric cancers, ESD is not as widely applied to the treatment of colorectal neoplasms because of its technical difficulty, longer procedural time, and increased perforation risk. In the movement toward diversified endoscopic treatment strategies for superficial colorectal neoplasms, endoscopists who begin to perform ESD need to recognize the indications of ESD, as well as the technical issues and associated complications of this procedure

Spontaneous AV fistula of STA

An arteriovenous fistula of the superficial temporal artery (STA) is a direct and abnormal communication between the STA, feeding artery, and superficial temporal vein, draining veins that bypass the capillary network. Several cases of trauma-induced or iatrogenic-induced arteriovenous fistula (AVF) of the STA have been reported ; however, spontaneous AVF of the STA not associated with trauma or medical treatment are extremely rare. Herein, we present a case of spontaneous AVF of the STA diagnosed in old age

Detectability of Colon Polyp Using Computed Virtual Chromoendoscopy with Flexible Spectral Imaging Color Enhancement

The aim of this pilot study was to assess the feasibility of using computed virtual chromoendoscopy with the flexible spectral imaging color enhancement (FICE) for colon neoplasia screening. A modified back-to-back colonoscopy using FICE and white light in the right-sided colon was conducted prospectively for the consecutive patients attending for the postoperative (sigmoidectomy or anterior resection) follow-up colonoscopy. Histopathology of detected lesions was confirmed by evaluation of endoscopic resection or biopsy specimens. One-hundred and two patients were enrolled, and 100 patients (61 males and mean age 63 years) were finally analyzed. The total number of polyps detected by FICE and white light colonoscopy was 65 and 45, respectively. The miss rate for all polyps with FICE (24%) was significantly less than that with white light (46%) (P = 0.03). Colonoscopy using FICE could beneficially enhance the detection of neoplastic lesions in the right-sided colon compared to white light colonoscopy

Dystonia and Cerebellum : From Bench to Bedside

Dystonia pathogenesis remains unclear; however, findings from basic and clinical research suggest the importance of the interaction between the basal ganglia and cerebellum. After the discovery of disynaptic pathways between the two, much attention has been paid to the cerebellum. Basic research using various dystonia rodent models and clinical studies in dystonia patients continues to provide new pieces of knowledge regarding the role of the cerebellum in dystonia genesis. Herein, we review basic and clinical articles related to dystonia focusing on the cerebellum, and clarify the current understanding of the role of the cerebellum in dystonia pathogenesis. Given the recent evidence providing new hypotheses regarding dystonia pathogenesis, we discuss how the current evidence answers the unsolved clinical questions

Visualization of Laterally Spreading Colorectal Tumors by Using Image-Enhanced Endoscopy

Laterally spreading tumors may sometimes evade detection by colonoscopy. This study aimed to evaluate the use of image-enhanced endoscopy for visualizing laterally spreading tumors of the nongranular type. We reviewed consecutive patients with 47 non-granular-type laterally spreading tumors that had been examined using white-light imaging, autofluorescence imaging, narrow-band imaging, and chromoendoscopy with indigo carmine. The quality of visualization was evaluated using a 5-point scale by less- and more-experienced endoscopists. Autofluorescence imaging provided significantly better visualization than white-light imaging for both less-experienced and experienced endoscopists. On the other hand, no significant differences were observed between the quality of visualization provided by white-light imaging and narrow-band imaging for less-experienced endoscopists. Autofluorescence imaging provides high-quality visualization of non-granular-type laterally spreading tumors on still images. Multicenter trials should be conducted to confirm the usefulness of autofluorescence imaging in detecting laterally spreading colorectal tumors

Cost-Effectiveness of Total Colonoscopy in Screening of Colorectal Cancer in Japan

Introduction. In Japan, the cost-effectiveness of total colonoscopy (TCS) for primary screening of colorectal cancer (CRC) is unclear. We compared the cost of identifying a patient with CRC using two primary screening strategies: TCS (strategy 1) and the immunochemical fecal test (FIT) (strategy 2). Materials and Methods. We retrospectively analyzed the TCS screening database at our institution from February 2004 to August 2010 (strategy 1, n = 15,348) and the Japanese nationwide survey of CRC screening in 2008 (strategy 2, n = 5,267,443). Results. 112 and 6,838 CRC cases were detected in strategies 1 and 2, costing 2,124,000 JPY and 1,629,000 JPY, respectively. The rate of earlier-stage CRC was higher in strategy 1. Conclusions. The cost was higher using TCS as a primary screening procedure. However, the difference was not excessive, and considering the increased rate of detecting earlier CRC, the use of TCS as a primary screening tool may be cost-effective

FaceLooks: A Smart Headband for Signaling Face-to-Face Behavior

Eye-to-eye contact and facial expressions are key communicators, yet there has been little done to evaluate the basic properties of face-to-face; mutual head orientation behaviors. This may be because there is no practical device available to measure the behavior. This paper presents a novel headband-type wearable device called FaceLooks, used for measuring the time of the face-to-face state with identity of the partner, using an infrared emitter and receiver. It can also be used for behavioral healthcare applications, such as for children with developmental disorders who exhibit difficulties with the behavior, by providing awareness through the visual feedback from the partner’s device. Two laboratory experiments showed the device’s detection range and response time, tested with a pair of dummy heads. Another laboratory experiment was done with human participants with gaze trackers and showed the device’s substantial agreement with a human observer. We then conducted two field studies involving children with intellectual disabilities and/or autism spectrum disorders. The first study showed that the devices could be used in the school setting, observing the children did not remove the devices. The second study showed that the durations of children’s face-to-face behavior could be increased under a visual feedback condition. The device shows its potential to be used in therapy and experimental fields because of its wearability and its ability to quantify and shape face-to-face behavior

Dome-type carcinoma of the colon; a rare variant of adenocarcinoma resembling a submucosal tumor: a case report

<p>Abstract</p> <p>Background</p> <p>Dome-type carcinoma (DC) is a distinct variant of colorectal adenocarcinoma and less than 10 cases have been described in the literature. Most of the previously reported cases were early lesions and no endoscopic observations have been described so far. We herein report a case of a DC invading the subserosal layer, including endoscopic findings.</p> <p>Case presentation</p> <p>A highly elevated lesion in the transverse colon was diagnosed by colonoscopy in a 77-year-old man. The tumor appeared to be similar to a submucosal tumor (SMT), however, a demarcated area of reddish and irregular mucosa was observed at the top of the tumor. There were no erosions or ulcers. Laparoscopic-assisted right hemicolectomy was performed and pathological examination revealed a well-circumscribed tumor invading the subserosal layer. The tumor was a well-differentiated adenocarcinoma associated with a dense lymphocytic infiltration and showed expansive growth. The overlying mucosal layer showed high-grade dysplasia.</p> <p>Conclusion</p> <p>The present lesion was diagnosed as a DC of the colon invading the subserosal layer. Because the association of mucosal dysplasia is common in DCs, the detection of dysplastic epithelium would be important to discriminate DCs from SMTs.</p