Cork Screw Research Articles

Equine laryngoplasty: Effects of three anchoring techniques in the muscular process and three positions for suture implantation in the cricoid cartilage.

To compare the effects of three anchoring techniques in the muscular process and three positions of laryngoplasty suture implantation in the cricoid cartilage on abduction of the arytenoid cartilage and interaction with the cricoarytenoid dorsalis (CAD) muscle compartments. Experimental study. Twenty-two cadaveric equine larynges. Three implantation techniques were assessed in the left muscular process. They were the use of a titanium corkscrew (CS), a standard caudal passage using a Jamshidi needle (JCa), and a standard cranial passage using a Jamshidi needle (JCr). Each was assessed in combination with three caudal locations in the cricoid cartilage (right, left, and left lateral). Each suture combination was tightened to submaximal abduction (Dixon grade 2). Force on the suture, degree of larynx caudal rotation, and CAD muscle indentation were evaluated. The force required for optimal arytenoid cartilage abduction was lower (p < .01) for constructs involving a CS (7.45 ± 4 N). The CS also resulted in lower (p < .01) CAD muscle indentation (2.01 ± 1.25 mm) and less larynx rotation (9 ± 3.87°; adjusted p < .05). When inserted into the muscular process at the CAD tendon insertion point, the biomechanical properties of the CS reduced the force required for optimal arytenoid cartilage abduction. The CS also minimized interference with the CAD muscle compartments and reduced caudal displacement of the left arytenoid cartilage when it was under suture tension. The CS implantation avoided larynx deformation and muscle interaction, offering the possibility to combine a nerve graft and laryngoplasty as a treatment for recurrent laryngeal neuropathy.

Ultrasonographic Study of the Corkscrew Arterial Image in Buerger Disease Patients.

Objective: Thromboangiitis obliterans (Buerger disease) is known as an intractable vascular disease that has been reported as thrombosis in distal arteries and occasional venous occlusion, as well as inflammatory changes in the thrombus and vascular wall. Patients often require limb amputation due to limb necrosis. Corkscrew (CS), a small arterial coiling, is an important diagnostic finding that was mainly found with angiography. Recently, however, it can also be identified using a modern ultrasonographic technique. Methods: In these 22 cases, in 48 areas of study, we used the ultrasonographic technique to identify the CS, which allowed us to observe its relationship with the surrounding nerves and arteries. Results: In all cases, it was possible to identify the CS easily and it was confirmed that the CS and the nerve were carried down in their sheath. The sites of the CS existed in areas other than the area around the occluded main arteries and some CS that ran inside the nerve (16 areas) and some CS that accompanied the outside of the nerve (10 areas) were confirmed, suggesting the CS work as collateral blood supply vessels, with well-developed normal vessel-like anatomy. Conclusion: When we observe the CS, it is important to observe not only around the main trunk artery but also areas where nerves mainly run, even if they do not accompany the main trunk artery. (This is a translation of Jpn J Vasc Surg 2023; 32: 345-350.).

Analysis Of Efficacy Of Cork Screw Tipped Telescopic Nailing In Lower Limb Fractures In Cases Of Osteogenesis Imperfecta In Children–Case Series

Analysis Of Efficacy Of Cork Screw Tipped Telescopic Nailing In Lower Limb Fractures In Cases Of Osteogenesis Imperfecta In Children–Case Series

MINIMALLY INVASIVE TOOTH EXTRACTIONS- THE NEWER ADVANCEMENTS TO THE CONVENTIONAL TECHNIQUES

Dental extractions are considered to be one of the procedures that can make a patient quite anxious. However, newer advancements have come to the rescue. Most of the extractions that are being done involve some extent of soft tissue trauma. Due to the damage that occurs to the adjacent tissues while removing the tooth, the rehabilitation and restoration of the tooth has become quite difficult and time consuming. From the crux of the traditional techniques, surgeons realised the importance of preserving the soft tissue and dentofacial complex in the course of tooth implantation. This led to the evolution of the new idea, the Minimally invasive dentistry and the Minimally invasive extraction. Few minimally invasive atraumatic extractions, certain methodsdeveloped are already being used by the clinicians to extract the teeth such as Periotome, Piezotome, Benex vertical extractor, rubber band extraction, extraction using implant drills. Easy Xtrac system is one such procedure which is claimed to be based on cork screw principle is used in tooth extractions. Keywords: Atraumatic Extraction, Preservation of alveolar bone, Absolute healing, Minimally invasive technique, Mucoperiosteal flap elevation.

Genetic dissection of mutual interference between two consecutive learning tasks in Drosophila.

Animals can continuously learn different tasks to adapt to changing environments and, therefore, have strategies to effectively cope with inter-task interference, including both proactive interference (Pro-I) and retroactive interference (Retro-I). Many biological mechanisms are known to contribute to learning, memory, and forgetting for a single task, however, mechanisms involved only when learning sequential different tasks are relatively poorly understood. Here, we dissect the respective molecular mechanisms of Pro-I and Retro-I between two consecutive associative learning tasks in Drosophila. Pro-I is more sensitive to an inter-task interval (ITI) than Retro-I. They occur together at short ITI (<20 min), while only Retro-I remains significant at ITI beyond 20 min. Acutely overexpressing Corkscrew (CSW), an evolutionarily conserved protein tyrosine phosphatase SHP2, in mushroom body (MB) neurons reduces Pro-I, whereas acute knockdown of CSW exacerbates Pro-I. Such function of CSW is further found to rely on the γ subset of MB neurons and the downstream Raf/MAPK pathway. In contrast, manipulating CSW does not affect Retro-I as well as a single learning task. Interestingly, manipulation of Rac1, a molecule that regulates Retro-I, does not affect Pro-I. Thus, our findings suggest that learning different tasks consecutively triggers distinct molecular mechanisms to tune proactive and retroactive interference.

Twin to Twin Transfusion Syndrome

Introduction: Collateral arterial growth is an effective adaptation process to maintain blood supply in myocardial tissue distal to a coronary stenosis and in other vascular beds where feeding arteries are obstructed (1) . The drive for outgrowth and remodelling of arterial collaterals is an increased shear stress due to an enlarged blood flow occurring after the event of stenosis in a near by conduit artery. Remodelling includes increased growth of the diameter and length of the collateral, causing the characteristic tortuous or cork screw appearance (1) .Whilst collateral growth is generally beneficial, we will present evidence that arterial collateral out growth occurred in a monochorionic twin placenta where it jeopardised the pregnancy by causing the twin to twin transfusion syndrome (TTTS).Objective: to report a case of twin-to-twin transfusionCase Report: Reporting a case experienced and taken care in our Clinic Fetomaternal RS. Dr .M. Jamil Hospital. A 34 years old woman, gravida 2, para1, at 31 weeks and 6 days amenorrhea, because her pregnant uterus was too large for gestational Referral to tertiary center followed. At 32 weeks and 2 days amenorrhea biometry indicated estimated fetal weights of 1950 and 1450 g (Hadlock), oligohydramnios and polyhydramnios (amniotic fluid index:23cm. No structural anomaly of the heart was seen. No interventions, one course of corticosteroids were administered for fetal lung maturation. At 33 weeks a slight decrease in heart rate variability of the smaller twin was observed. A Caesarean section under spinal anesthesia was performed. Two girls were delivered of 1585 g and 2135 g and in good condition (Apgar scores 8 and 9 after 1 and 5 min in both girls). The monochorionic diamniotic placenta weighed 740 g. The cord of the recipient was centrally inserted and that of the donor velamentally. Placenta was born monochorion, diamnion.Conclusion: TTTS is caused due to unidirectional deep arteriovenous (AV) anastomoses with the superficial short comings. Hypovolemia, oliguria and oligohydramnion occurs in the donor fetus. Hypervolemia, polyuria and polyhydramnios occurs in the recipient fetus

PREVALENCE OF LAMENESS AND ASSOCIATED FOOT LESIONS IN SAHIWAL DAIRY COWS

Lameness is 3rd most prevalent disease after mastitis and infertility, in the dairy industry today and is an important welfare issue causing significant impact on dairy economics. Lameness leads to involuntary culling of lactating dairy cattle due to significant effect on production and reproduction.Mostly lameness occurs due to foot lesions irrespective of breed, management and of animal. Two hundred and four Sahiwal dairy cows were evaluated for lameness and associated claw lesionsin the study from local dairy farms of Punjab. Clinical lameness (lameness score 2 &amp; 3) was evident in 6 per cent of animals. After lameness scoring, each animal was restrained in chute and hooves were examined before and after paring 1 mm of hoof tissue from weight bearing surface. Seventy three per cent animals had at least one lesion in their hooves. On animal level, under run soles (45%) were found to be most prevalent claw lesion followed by white line lesions (29%), overgrown soles (7%), cork screw hooves (5%), sole avulsions (5%), sole hemorrhages (3%), heel erosions (3%), double soles (2%) and wall cracks (1%). At claw level, prevalence of lesions was 35.3 per cent, among which under run soles were the most prevalent lesion (19.3%) followed by white line lesions (16.3%), overgrown soles (2.82%), cork screw hooves (1.84%), sole avulsions (1.47%), sole hemorrhages (1.04%), heel horn erosions (0.61%), double soles (0.49%), wall cracks (0.25%) and toe hemorrhages (0.12%). Lactation length and parity had no effect on lameness. Comparatively more lesions were seen in hind limb hooves (56.8%) as compared to forelimb hooves (43.2%). Fore lateral and hind medial claws had more lesions (58.8% and 76.47%, respectively) as compared to contralateral claws 52.9% and 70.5%, respectively). Overall, a low prevalence of clinical lameness was seen in Sahiwal dairy cows.

CAMPYLOBACTER AS A MAJOR FOODBORNE PATHOGEN: A REVIEW OF ITS CHARACTERISTICS, PATHOGENESIS, ANTIMICROBIAL RESISTANCE AND CONTROL

Campylobacter, mainly Campylobacter jejuni is viewed as one of the most well-known reasons of foodborne bacterial diarrheal sickness in people around the globe. The genus Campylobacter contains 39 species (spp.) and 16 sub spp. Campylobacter is microaerophilic, Gram negative, spiral-shaped rod with characteristic cork screw motility. It is colonizing the digestive system of numerous wild and household animals and birds, particularly chickens. Intestinal colonization brings about transporter/carrier healthy animals. Consequently, the utilization of contaminated meat, especially chicken meat is the primary source of campylobacteriosis in humans and chickens are responsible for an expected 80% of human campylobacter infection. Interestingly, in contrast with the most recent published reviews that cover specific aspects of campylobacter/campylobacteriosis, this review targets the taxonomy, biological characteristics, identification and habitat of Campylobacter spp. Moreover, it discusses the pathogenesis, resistance to antimicrobial agents and public health significance of Campylobacter spp. Finally, it focuses on the phytochemicals as intervention strategies used to reduce Campylobacter spp.in poultry production.

Hemiarthroplasty of the hip using the direct anterior approach.

ObjectiveMinimally invasive approach in total hip arthroplasty for the treatment of femoral neck fractures with a hemiarthroplasty.IndicationsFemoral neck fractures of patients without hip osteoarthritis where the acetabulum is still intact.ContraindicationsLesions and infections of the skin in the approach area; hip osteoarthritis; surgeon’s lack of experience with the technique.Surgical techniqueThe direct anterior approach (DAA) uses the Smith–Peterson interval between the tensor fasciae latae (TFL) and the rectus and sartorius muscle. After coagulation of the ascending branches of the femoral circumflex vessels, the capsule is opened. The remaining parts of the femoral neck are removed and osteotomized if necessary. The femoral head is removed with a cork screw. Then the shaft is supported by 2 sharp retractors at the greater trochanter from cranial, and the leg is externally rotated, hyperextended, and adducted. A TFL release can be performed which we also recommend. The femoral canal is opened step by step and extended with rasps which are introduced with the double curved broach handle. Cement and the final implant are introduced and after the trial reduction also the final head. The hip is reduced, the capsule adapted and the wound closed.Postoperative managementFor this approach, there are no approach specific recommendations. Postoperative treatment depends on whether the approach was extended with muscle releases and on the type of reconstruction performed. If the approach was limited to the minimally invasive direct anterior portal, quicker rehabilitation can be expected due to the reduced muscle damage. We prefer mobilization with full weight bearing as tolerated on the next day.

The Phosphatase CSW Controls Life Span by Insulin Signaling and Metabolism Throughout Adult Life in Drosophila.

Noonan syndrome and related disorders are caused by mutations in genes encoding for proteins of the RAS-ERK1/2 signaling pathway, which affect development by enhanced ERK1/2 activity. However, the mutations’ effects throughout adult life are unclear. In this study, we identify that the protein most commonly affected in Noonan syndrome, the phosphatase SHP2, known in Drosophila as corkscrew (CSW), controls life span, triglyceride levels, and metabolism without affecting ERK signaling pathway. We found that CSW loss-of-function mutations extended life span by interacting with components of the insulin signaling pathway and impairing AKT activity in adult flies. By expressing csw-RNAi in different organs, we determined that CSW extended life span by acting in organs that regulate energy availability, including gut, fat body and neurons. In contrast to that in control animals, loss of CSW leads to reduced homeostasis in metabolic rate during activity. Clinically relevant gain-of-function csw allele reduced life span, when expressed in fat body, but not in other tissues. However, overexpression of a wild-type allele did not affect life span, showing a specific effect of the gain-of-function allele independently of a gene dosage effect. We concluded that CSW normally regulates life span and that mutations in SHP2 are expected to have critical effects throughout life by insulin-dependent mechanisms in addition to the well-known RAS-ERK1/2-dependent developmental alterations.

Comparison of Intraoperative Motor Evoked Potentials Monitoring with Direct Cranial Stimulation by Peg-Screw and Transcranial Stimulation by Corkscrew for Supratentorial Surgery

Corkscrew (CS) electrodes are usually used for transcranial electrical stimulation (TES) in the intraoperative monitoring of motor evoked potentials (MEP). Direct cranial stimulation with peg-screw (PS) electrodes can elicit MEP. The present study investigated the difference in the initial threshold between PS and CS electrodes for intraoperative MEP monitoring. We retrospectively analyzed TES-MEP monitoring for supratentorial surgery in 72 patients. Of these 72 patients, 44 were monitored with PS and CS electrodes (PS/CS group) and 28 were monitored with CS and CS electrodes (CS/CS group). TES was used to deliver electrical stimulation by a train of 4-pulse anodal constant current stimulation. The initial threshold in each electrode was checked and analyzed. In the PS/CS group, the initial threshold with the PS electrode was 38.3 ± 15.1 mA (mean ± standard deviation) on the affected side, and the initial threshold with the CS electrode was 51.4 ± 13.9 mA on the unaffected side. The initial threshold with the PS electrode was significantly lower than that with the CS electrode (P=0.0001). In the CS/CS group, the initial threshold was 56.2 ± 16.5 mA on the affected side and 62.1 ± 18.6 mA on the unaffected side, with no statistically significant difference (P= 0.23). The initial threshold to elicit MEP was significantly lower with the PS electrode than with the CS electrode. A PS electrode can be used as a feasible stimulation electrode for TES-MEP.

Tension Tests of Cork Screw Chips

Tension Tests of Cork Screw Chips

Clinical and Trichoscopic Study of Tinea Capitis versus Alopecia Areata in Pediatric Patients

AbstractBackground: Trichoscopy (hair and scalp dermatoscopy) facilitates the diagnosis of hair and scalp disorders. The aim of this study was to identify the trichoscopic features in diagnosis of Tinea Capitis (TC) and to compare these findings with those of Alopecia Areata (AA).Material and Methods: The current study included 30 patients with TC and 30 patients with AA. They were recruited from Outpatient Clinics of Dermatology and Venereology Department, Tanta University Hospitals. Clinical examination, laboratory investigations (direct microscopic examination with 10% potassium hydroxide and fungal culture) were done to confirm clinical diagnosis and dermoscopically aiming at finding the different dermoscopic features of TC and AA.Results: Short broken hairs, black dots, comma shaped hairs, corkscrew hairs and zigzag shaped hairs were observed in patients with TC. Short vellus hairs, black dots, exclamation marks, white hairs and pig tail re-growing hairs were observed in patients with AA.Conclusion: Comma shaped hairs, zigzag shaped hairs and cork screw were observed only in patients with TC. Yellow dots, exclamation mark hairs and short vellus hairs were observed only in patients with AA. Dermoscopy is rapid and reliable confirmatory test used to differentiate between TC and AA by detecting their characteristic dermoscopic features.

F169. Muscle evoked potentials after electrical stimulation to the spinal cord can monitor the cortico spinal tract

Introduction Muscle evoked potentials after electrical stimulation to the spinal cord [Sp(E)-MsEP] are stable and likely to be used for intraoperative spinal cord monitoring. However there is an opinion that Sp(E)-MsEP is not specific for being transferred via the cortico-spinal tract but can also be elicited by stimulation of the dorsal column alone. The aim of this study is to clarify that the spinal motor tract can be monitored by Sp(E)-MsEP. Methods Five consecutive patients (4 women and 1 men), with an average age of 63.4 years (range, 40–74 years), were studied during the surgery of cervical or thoracic spine. We recorded MsEP by three types of stimulation methods (1. transcranial electrical stimulation to the brain, 2.electrical stimulation to the spinal cord, 3. simultaneous stimulation to the brain and spinal cord). 1. transcranial electrical stimulation to the brain: Cork screw type electrodes were inserted symmetrically into the outer table of the skull 5 cm lateral and 2 cm anterior to Cz (International 10–20 system). We used a 5 train stimulation of 2 ms ISI with 0.5 ms duration and 150–200 mA intensity. 2. electrical stimulation to the spinal cord: To stimulate the spinal cord, a catheter electrode was inserted into the epidural space caudal to the level of the lesion. Electrical stimulation was delivered as a 5 train stimulation of 2 ms ISI with 0.2 ms duration and 10–40 mA intensity. Results In all patients at simultaneous stimulation to the brain and spinal cord, the wave form of MsEP from abductor hallucis muscle (AH) was similar of that by spinal cord stimulation. By collision method (simultaneous stimulation of Stim 1 and Stim 2), the wave form of the muscle evoked potential from AH muscle is same of that by not stim 1 but stim 2. It means that the volleys of cortico spinal tract after brain stimulation was collided by the antidromic volley after the stimulation to the spinal cord. In other words, electrical spinal cord stimulation can elicit the volleys travelling through the motor tracts. Conclusion This collision study means that the volleys of cortico spinal tract after brain stimulation was collided by the antidromic volleys after spinal cord stimulation. Therefore we can monitor the motor tracts of the spinal cord using Sp(E)-MsEP.

Diagnostic suggestion and surgical consideration for Hirschsprung’s disease associated with high anorectal malformation

Object: The objective of this study were to highlight the finding of vasa recta (tortuous) on the colonic wall as a diagnostic clue for suspecting an associated Hirschsprung’s disease (HD) and to draw attention to the importance of preserving the aganglionic rectum plus a retrorectal pull through in these cases. Background: The association of HD with anorectal malformation (ARM) is both diagnostically and surgically challenging. Patients and methods: Records of cases with ARM treated over 15 years were examined. Among these, five children with an associated HD were analyzed with regard to their clinical, radiological, surgical, histopathological findings, and outcome. Relevant literature was also reviewed. Results: HD was present in 1.26% cases of ARM. All were men with high-type ARM. Two groups were identified. In group 1 (two patients), associated HD was suspected after completion of all stages of ARM repair. They reported prolonged postoperative constipation, abdominal distention, and enterocolitis. Moreover, they endured additional surgeries for HD. In group 2 (three patients), HD was suspected at the time of initial colostomy for ARM in two patients on visualizing tortuous (cork screw) vasa recta on the sigmoid colon surface in a region similar to the transition zone in HD. Biopsy from the site confirmed HD. In the third patient, these vessels were visualized on the colostomy loop at the time of laparoscopic pull through for ARM. Preservation of the aganglionic rectum (to function as a fecal reservoir) as well as a retrorectal pull through was done in both groups. Conclusion: Finding prominent corkscrew vessels on the colonic surface could serve as a clinical clue for the presence of HD in cases of ARM. Moreover, preserving the aganglionic rectum and performing a Duhamel pull through helps provide acceptable continence. Keywords: anorectal malformation, Hirschsprung’s disease, rectal reservoir, tortuous vasa recta

A special instrument to accurately and safely remove the femoral head.

Intracapsular hip fractures occur frequently, and most of them need operation. But current femoral head removal instruments used in the operation have many disadvantages. We optimized them. We added a sleeve to the cork screw to strengthen the torque created by it. A scale is also added to the joint of the sleeve and the cork screw, which can be used to measure the depth of insertion. The optimized instrument decreased the risk and saved the time of operation.

Helicobacter Pylori IgG Antibodies in Iraqi Uremic Patients

Helicobacter pylori is a curved, S-shape Gram negative rod. It is non-sporulating, actively motile with cork screw motion. It has a bundle of (4-6) unipolar sheathed flagella, this sheath thought to protect bacteria against acidity.Our result predicted increase in infection with H.pylori after operation in positive patient for infection while reverse pattern were observed in negative patients for infection.Significant increase of anti H.pylori IgG level percentage in chronic renal patients before, after, and control groups.The developments of high level of IgG could be attributed to the treatment thatmprovide suitable factor for developing infections. The other aspect of gastrointestinal disorders in uremia is mucosal lesions such as esophagitis, gastritis, duodenitis and peptic ulcer.The aim of this research was evaluation of H.pylori IgG antibodies in Iraqi chronic renal failure before and after kidney transplantation.We concluded that High level of H.pylori IgG was estimated in patients with chronic renal failure and treatments of infection required before transplantation.

Postoperative subconjunctival bevacizumab injection as an adjunct to 5-fluorouracil in the management of scarring after trabeculectomy

PurposeScarring after glaucoma filtering surgery remains the most frequent cause for bleb failure. The aim of this study was to assess if the postoperative injection of bevacizumab reduces the number of postoperative subconjunctival 5-fluorouracil (5-FU) injections. Further, the effect of bevacizumab as an adjunct to 5-FU on the intraocular pressure (IOP) outcome, bleb morphology, postoperative medications, and complications was evaluated.MethodsGlaucoma patients (N = 61) who underwent trabeculectomy with mitomycin C were analyzed retrospectively (follow-up period of 25 ± 19 months). Surgery was performed exclusively by one experienced glaucoma specialist using a standardized technique. Patients in group 1 received subconjunctival applications of 5-FU postoperatively. Patients in group 2 received 5-FU and subconjunctival injection of bevacizumab.ResultsGroup 1 had 6.4 ± 3.3 (0–15) (mean ± standard deviation and range, respectively) 5-FU injections. Group 2 had 4.0 ± 2.8 (0–12) (mean ± standard deviation and range, respectively) 5-FU injections. The added injection of bevacizumab significantly reduced the mean number of 5-FU injections by 2.4 ± 3.08 (P ≤ 0.005). There was no significantly lower IOP in group 2 when compared to group 1. A significant reduction in vascularization and in cork screw vessels could be found in both groups (P < 0.0001, 7 days to last 5-FU), yet there was no difference between the two groups at the last follow-up. Postoperative complications were significantly higher for both groups when more 5-FU injections were applied. (P = 0.008). No significant difference in best corrected visual acuity (P = 0.852) and visual field testing (P = 0.610) between preoperative to last follow-up could be found between the two groups.ConclusionThe postoperative injection of bevacizumab reduced the number of subconjunctival 5-FU injections significantly by 2.4 injections. A significant difference in postoperative IOP reduction, bleb morphology, and postoperative medication was not detected.

Narrow Band Imaging Can Differentiate Type Iia Early Gastric Cancer From Adenoma: Correlations of Vascular Patterns With Histopathology

BACKGROUND/AIMS: Narrow band imaging (NBI) systems consist of sequential electronic endoscopes and light sources equipped with modern narrow band filters, and yield very clear images of microvessels on mucosal surfaces. The aim of this study was to assess the relationships between images obtained with an NBI system and histological findings, especially vascular patterns, to distinguish adenoma from early gastric cancer (EGC) type IIa. PATIENTS AND METHODS: We postoperatively confirmed and evaluated 39 elevated lesions, 32 adenomas and seven type IIa early gastric cancers (EGC IIa) in patients who had undergone endoscopic submucosal dissection. We selected three sites per adenoma and four sites per EGC IIa for NBI. The selected sites were classified as four conventional superficial structures (SSs) or irregular microvascular patterns (IMVPs). In addition, the selected sites were divided into two groups based on the presence of corkscrew (CS) vascular patterns over 10% of the field. RESULTS: Regarding IMVP subcategories, (1) slight intrastructural irregular microvascular patterns (ISIMVPs) accounted for 84%, (2) severe ISIMVPs accounted for 6%, (3) fine networks (FNs) accounted for 10%, and (4) corkscrews accounted for 0% of cases in the adenomas. The corresponding proportions in the EGC IIa were (1) 25%, (2) 25%, (3) 50%, and (4) 0%. Slight ISIMVPs, severe ISIMVPs, and FNs reliably distinguished the two diseases: P=0.000 for slight ISMVPs; P=0.010 for severe ISIMVPs; P=0.000 for FNs. Corkscrew vascular patterns were observed in 46% of EGC IIa and 7% of adenoma cases (P=0.000). CONCLUSIONS: NBI can be used to differentiate EGC IIa from gastric adenoma based on IMVP classifications and the presence of corkscrew vascular patterns. Irregular microvascular patterns of adenoma and EGC IIa

The Usefulness of Raman Spectroscopy for the Differential Diagnosis of Colonic Polyps

BACKGROUND/AIMS: Narrow band imaging (NBI) systems consist of sequential electronic endoscopes and light sources equipped with modern narrow band filters, and yield very clear images of microvessels on mucosal surfaces. The aim of this study was to assess the relationships between images obtained with an NBI system and histological findings, especially vascular patterns, to distinguish adenoma from early gastric cancer (EGC) type IIa. PATIENTS AND METHODS: We postoperatively confirmed and evaluated 39 elevated lesions, 32 adenomas and seven type IIa early gastric cancers (EGC IIa) in patients who had undergone endoscopic submucosal dissection. We selected three sites per adenoma and four sites per EGC IIa for NBI. The selected sites were classified as four conventional superficial structures (SSs) or irregular microvascular patterns (IMVPs). In addition, the selected sites were divided into two groups based on the presence of corkscrew (CS) vascular patterns over 10% of the field. RESULTS: Regarding IMVP subcategories, (1) slight intrastructural irregular microvascular patterns (ISIMVPs) accounted for 84%, (2) severe ISIMVPs accounted for 6%, (3) fine networks (FNs) accounted for 10%, and (4) corkscrews accounted for 0% of cases in the adenomas. The corresponding proportions in the EGC IIa were (1) 25%, (2) 25%, (3) 50%, and (4) 0%. Slight ISIMVPs, severe ISIMVPs, and FNs reliably distinguished the two diseases: P=0.000 for slight ISMVPs; P=0.010 for severe ISIMVPs; P=0.000 for FNs. Corkscrew vascular patterns were observed in 46% of EGC IIa and 7% of adenoma cases (P=0.000). CONCLUSIONS: NBI can be used to differentiate EGC IIa from gastric adenoma based on IMVP classifications and the presence of corkscrew vascular patterns. Irregular microvascular patterns of adenoma and EGC IIa