Opaque Substance Research Articles

Novel Endoscopic Findings as Visualized by Magnifying Endoscopy with Narrow-Band Imaging: White Opaque Substance Is Present in Colorectal Hyperplastic Polyps

Background: Magnifying endoscopy (ME) with narrow-band imaging (NBI) can visualize a white opaque substance (WOS) in gastric epithelial neoplasms, gastric intestinal metaplasias, and colorectal epithelial neoplasms. Histological examination showed the WOS to be lipid droplets accumulated in the epithelium. The white appearance of colorectal hyperplastic polyps suggests that they may contain WOS, but this has not been investigated as yet. Aims: The purpose of this study was to determine whether WOS is present in colorectal hyperplastic polyps. Methods: We retrospectively evaluated endoscopic images of 26 consecutive lesions investigated by ME with NBI and subsequently endoscopically resected and confirmed to be hyperplastic polyps. Results: WOS was present in 21 of the 26 colorectal hyperplastic polyps (80.8%) based on the findings of ME with NBI. Adipophilin was present in 24 of the 26 colorectal hyperplastic polyps (92.3%). Conclusions: This study is the first to demonstrate that WOS (i.e. lipid droplets) accumulates in the epithelium of colorectal hyperplastic polyps.

Histologic differentiation and mucin phenotype in white opaque substance-positive gastric neoplasias.

Background and study aims: The authors previously reported that the white opaque substance (WOS) in gastric epithelial neoplasia was caused by accumulation of lipid droplets by immunohistochemical and immunoelectron microscopic studies of adipophilin, which was recently identified and validated as a marker of lipid droplets. The aim of the current study was to investigate the characteristics of the histologic differentiation and mucin phenotype in WOS-positive gastric epithelial neoplasias. Patients and methods: A total of 130 gastric epithelial neoplasias (45 adenomas and 85 early adenocarcinomas) from 120 patients were retrospectively evaluated. The presence or absence of WOS was evaluated by M-NBI. Lipids were examined by immunohistochemical staining for adipophilin. Tissue phenotypes were immunohistochemically classified as intestinal (I), gastrointestinal (GI), and gastric (G) using antibodies against CD10, MUC2, MUC5AC and MUC6. The histologic differentiation and mucin phenotype of WOS-positive neoplasias were characterized and examined according to adipophilin expression. Results: The presence of WOS by M-NBI was correlated with histologic differences between adenoma or differentiated type adenocarcinoma and mixed type or undifferentiated type adenocarcinoma (P = 0.0153). Adipophilin was only expressed in primary adenoma and well to moderately differentiated adenocarcinoma components but not in undifferentiated components. WOS and adipophilin expression were only observed in neoplasias with I or GI phenotypes, but not in those with the G phenotype (P < 0.0001). Conclusions: WOS in gastric epithelial neoplasias might indicate differentiation into a mature histological subtype with GI or I mucin phenotype.

Significance of a white opaque substance under magnifying narrow-band imaging colonoscopy for the diagnosis of colorectal epithelial neoplasms

The aim of this study was to examine the significance of a white opaque substance (WOS) found on magnifying narrow-band imaging (M-NBI) for the diagnosis of colorectal neoplastic lesions. We retrospectively reviewed colonoscopy records from 2006 to 2012 at our institution and identified cases of endoscopically or surgically resected colorectal epithelial neoplasms observed by M-NBI colonoscopy. The colonoscopic and histologic characteristics of the lesions were compared between WOS-positive and WOS-negative lesions. We further classified the WOS as regular or irregular and compared the histologic characteristics between the two types of lesions. There were 105 WOS-positive lesions and 451 WOS-negative lesions. The former were subdivided into lesions with regular and irregular WOS. The incidence of high-grade dysplasia or carcinoma was significantly higher in WOS-positive lesions (61.9%) than in WOS-negative lesions (28.6%) (P < .05). Among the WOS-positive lesions, massive submucosal invasion was more frequent in lesions with irregular WOS (82.4%) than in those with regular WOS (1.4%) (P < .05). Among cancers with massive submucosal invasion, lymph node metastasis was more frequent in cancers with irregular WOS (17.4%) than in those with regular WOS or without the WOS (0%) (P < .05). A WOS in colorectal neoplasms may be an optical marker for high-grade dysplasia and cancer. An irregular WOS may be indicative of massive submucosal invasion and lymph node metastasis.

Lipid is absorbed in the stomach by epithelial neoplasms (adenomas and early cancers): a novel functional endoscopy technique.

Background and study aims: The authors have successfully demonstrated that the white opaque substance (WOS) identified in gastric epithelial neoplasms is an accumulation of minute lipid droplets on the epithelial neoplasm. It is not known whether the lipid droplets originate from externally ingested lipids (typically foods). The purpose of this study was to investigate whether the oral ingestion of foods containing emulsified fats increases the density of the WOS in epithelial neoplasms. Patients and methods: We examined 92 gastric epithelial neoplastic lesions in 89 patients. The patients were given emulsified fatty foods before the procedure, and magnifying endoscopy with narrow-band imaging (M-NBI) was used to image the lesions. An increase in WOS density after the ingestion of emulsified fatty foods was defined as a positive fat-loading test result.The patients were divided into the following groups: control group, no emulsified fat administered; group 1, fatty food administered 16 hours prior; group 3, fatty food administered both 16 and 4 hours prior. The proportion of positive fat-loading test results was determined in all groups. Results: The rates of positive fat-loading test results were as follows: control group, 9 %; group 1, 26 %; group 2, 52 %; group 3, 78 %. The increase in the rates of positive fat-loading test results in groups 2 and 3 relative to the rate in the control group was statistically significant (chi-squared test). Conclusions: This study demonstrated for the first time that the ingestion of external lipids causes lipid droplets to aggregate in situ on the gastric epithelial neoplasm. These results can be used to develop a novel functional endoscopy technique that harnesses the lipid absorption capacity of neoplasms.

Sa1605 Nature of White Opaque Substance Within Colorectal Neoplastic Epithelium As Visualized by Magnifying Endoscopy With Narrow-Band Imaging: Novel Bio-Marker for Colorectal Neoplasia

Sa1605 Nature of White Opaque Substance Within Colorectal Neoplastic Epithelium As Visualized by Magnifying Endoscopy With Narrow-Band Imaging: Novel Bio-Marker for Colorectal Neoplasia

White opaque substance visualized using magnifying endoscopy with narrow-band imaging in colorectal epithelial neoplasms.

The presence of a white opaque substance (WOS) on magnifying endoscopy (ME) with narrow-band imaging (NBI) has been reported for gastric epithelial neoplasms, but the presence of WOS in colorectal epithelial neoplasms has not been investigated. The purpose of this study was to determine whether WOS is present in colorectal epithelial neoplasms and to clarify its clinical significance. A total of 590 colorectal epithelial neoplasms from 368 consecutive patients were retrospectively analyzed using prospectively collected data. Presence or absence of WOS in colorectal epithelial neoplasms was recorded based on the findings of ME with NBI. White opaque substance was present in 236 of the 590 (40 %) colorectal epithelial neoplasms. Compared with WOS-negative patients, WOS-positive patients showed significantly larger tumors (p < 0.0001) and significantly more tumors in the proximal colon (p = 0.0003). WOS was more frequently present in carcinomas (66.0 %) than in adenomas (31.8%; p < 0.0001). WOS was also more frequent in submucosal carcinomas (75.9%) than in intramucosal carcinomas (59.0%; p = 0.0380). This study confirmed the presence of WOS in colorectal epithelial neoplasms, and prevalence increased with the progression of cancer, from adenoma to carcinoma and from intramucosal carcinoma to submucosal carcinoma.

Sa1646 Development of a Novel Functional Endoscopic Technique Applying Lipid Absorption by Gastric Neoplasia to Image Enhanced Endoscopy

The authors identified a white opaque substance (WOS) in epithelial tumors of the stomach and reported its potential as a new optical marker for endoscopic diagnosis. We were able to demonstrate that WOS is a collection of minute lipid droplets (LDs) both within and directly below the neoplastic epithelium. Assuming that a lipid load leads to absorption into the neoplasia and thus a higher WOS density detectable via endoscopy, it should be possible to develop a novel image enhanced endoscopic technique based on the rate of lipophagy in a neoplastic lesion.

Tu1438 Nature of White Opaque Substance Within Colorectal Neoplastic Epithelium As Visualized by Magnifying Endoscopy With Narrow-Band Imaging: a Novel Bio-Marker for Colorectal Neoplasia

We previously reported the presence of a white opaque substance (WOS), opaque to the endoscope light, inside the epithelium when we use magnifying endoscopy (ME) to examine gastric epithelial neoplasia (adenomas and carcinomas) and chronic gastritis (intestinal metaplasia). Through further pathohistological study we elucidated that this substance is comprised of minute lipid droplets (LDs) accumulated below the mucosal epithelium of gastric epithelial neoplasia or intestinal metaplasia. These minute LDs strongly backscatter the projected light, and are visualized as a white substance. When we examined colorectal neoplastic lesions (adenomas and carcinomas) using ME, we observed WOS as in the stomach. However, it is unclear whether WOS in colorectal epithelial tumors is in fact an accumulation of LDs as in the stomach.

Ultrastructure and oil secretion in Hiptage sericea Hook

The oil secreting glands of &lt;i&gt;Hiptage sericea&lt;/i&gt; Hook. consist of three regions: epithelial, sub-epithelial and sub-glandular. In early stages, the oil secreting cells are characterized by the presence of plastids with starch grains and electron translucent vesicles, mitochondria, rER, polysomes, small vacuoles, numerous lipid bodies and well-defined nucleus with nucleolus. Later, the accumulation of plastoglobuli and inclusion bodies occur in the matrix of the plastid. Tubular, smooth endoplasmic reticulum begins to appear in the cytoplasm. With the onset of secretion, the osmiophilic contents of plastids which appear as electron dense, round droplets move-into cytoplasm and often occur in the region of the plasmalemma invaginations. However, in matured glands the lipid bodies disappear from the cytoplasm. The size of the vacuoles increases and are filled with electron opaque substance. Similar substances are also found in the sub-cuticular spaces as well as outside the cuticle.

A fiber-array probe technique for measuring the viscosity of a substance under shock compression

A fiber-array probe is designed to measure the damping behavior of a small perturbed shock wave in an opaque substance, by which the effective viscosity of substance under the condition of high temperature and high pressure can be constrained according to the flyer-impact technique. It shows that the measurement precision of the shock arrival time by using this technique is within 2 ns. To easily compare with the results given by electrical pin technique, the newly developed method is used to investigate the effective viscosity of aluminum (Al). The shear viscosity coefficient of Al is determined to be 1700 Pa·s at 71 GPa with a strain rate of 3.6 × 106 s−1, which is in good agreement with the results of other methods. The advantage of the new technique over the electrical pin one is that it is applicable for studying the non-conductive substances.

A white opaque substance-positive gastric hyperplastic polyp with dysplasia

The endoscopic findings of gastric hyperplastic polyps (HPs) with dysplasia have not been well-defined, and the clinical significance of these lesions, including their malignant potential, is unclear. In this report, we describe a case of a white opaque substance (WOS)-positive gastric HP with dysplasia. A 76-year-old woman was referred to our hospital for endoscopic resection of a gastric HP. Upper endoscopy revealed a 25-mm whitish and reddish polypoid lesion on the greater curvature in the lower third of the stomach. The whitish part was diagnosed as a WOS using conventional and magnifying endoscopy with narrow band imaging. An examination of the biopsy specimen indicated that the lesion was a typical gastric HP. However, because of its color and the presence of a WOS, we suspected that this lesion was an atypical gastric HP. Therefore, we performed a polypectomy. Histopathologically, diffuse low- to high-grade dysplasia was found on the surface of the polyp. We performed immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipid droplets (LDs). LDs were detected in approximately all of the neoplastic cells, especially in the surface epithelium of the intervening apical parts and were located in the subnuclear cytoplasm of the neoplastic cells. According to endoscopic and histopathological findings, the WOS-positive epithelium indicated dysplasia of the gastrointestinal phenotype, which could absorb lipids. The presence of a WOS in a gastric HP may be considered an endoscopic finding that is predictive of the neoplastic transformation of a gastric HP. We suggest that a WOS-positive gastric HP should be resected endoscopically to investigate its neoplastic transformation.

White opaque substance represents an intracytoplasmic accumulation of lipid droplets: Immunohistochemical and immunoelectron microscopic investigation of 26 cases

White opaque substance (WOS) in gastric neoplasias is a unique finding visualized in magnifying endoscopy (ME) with narrow band imaging (NBI) and it represents intramucosal accumulation of lipid droplets using oil red O staining. Subjects were 26 WOS-positive (13 adenomas and 13 well-differentiated adenocarcinomas) and 27 WOS-negative gastric epithelial neoplasias. We carried out immunohistochemical staining using a monoclonal antibody specific for adipophilin as a marker of lipids. Immunoelectron microscopy was used to evaluate morphology of the lipid droplets. Adipophilin was detected in 24 of 25 (96.0%) WOS-positive neoplasias, but it was detected in only two of 27 (7.4%) WOS-negative neoplasias. Lipid droplets were only seen in the surface epithelium in 10 of 11 (91.1%) adenomas, whereas the lipid droplets also existed in the cryptal epithelium in seven of 13 (53.8%) adenocarcinomas. Immunoelectron microscopy revealed numerous lipid droplets mainly existing in the subnuclear cytoplasm of the epithelium. The shape of the lipid droplets in adenomas was round and uniform, whereas that in adenocarcinomas was irregular. The present study confirmed that the presence of WOS in gastric neoplasias was dependent upon intramucosal accumulation of lipid droplets using anti-adipophilin staining. Intraepithelial distribution and morphology of the lipid droplets differed between adenoma and adenocarcinoma.

Nature of white opaque substance in gastric epithelial neoplasia as visualized by magnifying endoscopy with narrow‐band imaging

Magnifying endoscopy (ME) with narrow-band imaging (NBI) revealed a white opaque substance (WOS) within the superficial part of the gastric neoplasia; however, its nature has remained obscure. A WOS noted within the duodenum was reported to comprise lipid droplets (LD) absorbed by the duodenal epithelium. We attempted to ascertain whether the WOS within gastric neoplasia could also comprise LD and whether the presence of this WOS could be correlated with a specific phenotype. Forty-three patients with early gastric epithelial neoplasia underwent ME with NBI. The presence or absence of WOS in the neoplasias was recorded based on the findings of ME with NBI. One biopsy specimen was taken from each of the neoplasias. Cryostat sections underwent oil red O staining for LD. Serial sections were immunostained using the first antibody of CD10, MUC2, CDX2, human gastric mucin, MUC5AC and MUC6. The tissue phenotype was classified as intestinal (I), gastric (G) and gastrointestinal (GI) type based on the results of immunostaining. In total, 49 gastric neoplasias from 43 patients were investigated. Prevalence of LD in WOS-positive versus WOS-negative lesions was 96.2% (25/26) and 4.3% (1/23), respectively (P < 0.001, Fisher's exact test). WOS was present in GI- and I-type lesions, but not in G-type lesions. WOS may be LD that have been accumulated in the superficial part of the gastric neoplasia of a certain intestinal phenotype.

Sa1631 Novel Clinical Application of Magnifying Endoscopy (ME) With Narrow-Band Imaging (NBI): Observation of Fat Absorption by Neoplasia Within the Stomach

Magnifying endoscopy (ME) with narrow-band imaging (NBI) revealed a white opaque substance (WOS) within the superficial part of the gastric neoplasia, which obscured the subepithelial microvascular architecture [1], however, its nature has not been understood. It is reported that the WOS within the duodenum is fat droplets (FDs) absorbed by duodenal epithelium. We assumed that the FDs accumulated in the neoplastic surface epithelium can strongly scatter the projected light. Hence, we attempted to ascertain whether WOS could be made up of FDs absorbed by gastric neoplasia and whether the presence of WOS could be correlated with a specific phenotype.

White opaque substance within superficial elevated gastric neoplasia as visualized by magnification endoscopy with narrow-band imaging: a new optical sign for differentiating between adenoma and carcinoma

The microvascular pattern (MVP) as visualized by magnification endoscopy (ME) is a reliable marker for differentiating between benign and malignant gastric flat lesions. However, in cases of gastric neoplasia of 0-IIa type, it is sometimes impossible to visualize the MVP because a white opaque substance (WOS) obscures the subepithelial MVP. To investigate whether the morphology of the WOS could be a useful optical sign for discriminating between adenoma and carcinoma. Single tertiary referral center. Forty-six gastric neoplasias of only 0-IIa type (18 adenomas and 28 early carcinomas) were evaluated. The prevalence and the morphology of the WOS as visualized by ME with narrow-band imaging (NBI) according to histologic type (adenoma vs carcinoma). The WOS is more frequently present in adenomas than in carcinomas. With regard to the morphology of the WOS, 100% of the examples of WOS within adenomas demonstrated a regular distribution; in contrast, 83% of the examples of WOS within carcinomas showed an irregular distribution. In cases in which a neoplasia of 0-IIa type showed either WOS with a regular distribution or a regular MVP, the sensitivity and specificity for discriminating adenoma from carcinoma were 94% and 96%, respectively. The number of cases was limited. The WOS has not yet been characterized by chemical analysis. In cases in which the WOS is observed, rather than assessing the MVP, morphologic analysis of the WOS could be an alternative new optical sign for discriminating adenoma from carcinoma when using ME with NBI.

A210 2方向からのX線撮影によるスラリーの流れの可視化

A lot of slurry fluids have an opaque substance. It is difficult to visualize using previous photograph system with a visible ray. Therefore, we use the X-ray photograph to visualize inside a slurry fluid. And also to capture three-dimensional flow structure of the slurry flow, we use two X-ray sources and detectors. Time-serial data of the particle position are obtained by particle tracking and stereo-pair matching techniques. 3-Dimensional velocity vectors inside the slurry fluid are obtained

Zebrafish yolk‐specific not really started (nrs) gene is a vertebrate homolog of the Drosophila spinster gene and is essential for embryogenesis

By using retroviral insertional mutagenesis in zebrafish, we have identified a recessive lethal mutation in the not really started (nrs) gene. The nrs mutation disrupts a gene located in linkage group 3 that is highly homologous to the spinster gene identified in Drosophila and to spinster orthologs identified in mammals. In flies, spinster encodes a membrane protein involved in lysosomal metabolism and programmed cell death in the central nervous system and in the ovary. In nrs mutant fish embryos, we detect an opaque substance in the posterior yolk cell extension at approximately 1 day after fertilization. This material progressively accumulates and by 48 hr after fertilization fills the entire yolk. By day 3 of embryogenesis, mutant embryos are severely reduced in size compared with their wild-type siblings and they die a few hours later. By in situ hybridization, we show that the nrs mRNA is expressed in the yolk cell at the time the mutant phenotype becomes apparent. In wild-type embryos, nrs message is present maternally and zygotically throughout embryogenesis and is also detected in adult animals. In nrs homozygous mutant embryos, nrs transcripts are undetectable at the time the phenotype becomes apparent, indicating that the retroviral insertion has most likely abolished expression of the nrs gene. Finally, the nrs phenotype can be partially rescued by microinjection of nrs encoding DNA. These results suggest that the nrs mutation affects an essential gene encoding a putative membrane-bound protein expressed specifically in the yolk cell during zebrafish embryogenesis.

Rectodynamic and Radiological Assessment in Modified Mainz Pouch II Cases

Objective: To evaluate the radiologic findings and to measure the pressure changes in a modified sigmoidorectal pouch (Mainz pouch II procedure).Methods: A total of 26 patients who had a radical cystectomy because of muscle–invasive bladder tumor underwent a Mainz pouch II procedure between 1993 and 1998. The differences from the original definition was a reverse ureteral anastomosis and a detubularized segment at least 30 cm in length. In all cases, sigmoidoscopy was done and sigmoidal pressure and capacity were measured preoperatively and at the 3rd and 6th months postoperatively besides the colon X–rays. The 24–hour pouch pressure changes called ‘natural pouch pressure’ was measured using a handmade system with a central venous pressure (CVP) manometer at the 3rd month postoperatively.Results: Preoperative colon X–rays showed a passage of opaque substance through the descending colon at an average volume of 150 ml (average sigma capacity), whereas postoperative anteroposterior and oblique pouch X–rays showed no passage up to an average volume of 520 ml (270–650) though the descending colon. The sigmoidal colon pressure that was on average 20 cm H₂O at the preoperative evaluation was measured as 6 cm H₂O at the 3rd month and 6.5 cm H₂O at the 6th months during the postoperative period. 24 hour natural pouch pressure was found to be 8.7 cm H₂O on average while the pressure was found to be 13.8 cm H₂O on average when the patient felt abdominal discomfort, in other words the desire to defecat (miction).Conclusions: A modified sigmoidorectal pouch procedure not only provides a reservoir with a higher capacity and lower pressure without a reflux to the upper urinary tract and descending colon with lower metabolic acidosis problem, but it is also a good alternative diversion procedure that whould be preferable especially in Muslim countries as it does not cause any difficulties in terms of Islamic worship.

A rheological, thermal and mechanical study of bone cement—from a suspension to a solid biomaterial

Surgical bone cements are mainly based on acrylic (co) polymers, poly (methyl methacrylate) (PMMA) being the most representative. The curing process is the result of free radical polymerization of a suspension of PMMA powder and methyl methacrylate. The fundamental characteristic of the suspensions before polymerization is the viscosity. Therefore, in this paper, the rheological study of a suspension evolving to hard cement by polymerization is discussed. The effect of concentration (volume fraction) of solids, temperature and nature of inorganic compounds used as filler and opaque substance to X-ray radiations on the viscosity of the suspension are examined. Experimental data and models are discussed. The rheological behaviour corresponds to a shear-thickening model typical for concentrated suspension and data fit to a modified Chong equation. Bone cements obtained by polymerization of the suspension were characterized by differential scanning calorimetry to determine the heat released during the polymerization, the degree of reaction and the glass transition temperature. Mechanical properties are also reported and compared with results for existing commercial sources for bone cement.

Anatomical basis for the separation of four cardiac zones in the walls of human heart ventricles.

The coronary vessels of 70 human hearts were visualized postmortem by injection of the coronary arteries with a X-ray opaque substance (for angiographic studies) or with a low viscosity resin (to obtain vascular casts). Analysis of the data suggests a new anatomical systematization of the vascularization of the myocardial tissue of human heart ventricles: it can be divided into four zones each having a different origin of the arterial vessels. These four components of the heart ventricles are the antero-septal (AS), postero-septal (PS), left-lateral (LL), and right-lateral (RL) zones. They correspond to the territories of the anterior interventricular branch of the left coronary artery (AS zone), of the posterior interventricular branch of the right coronary artery (PS zone), of the left circumflex artery (LL zone), and of the right coronary artery (RL zone) up to the origin of the posterior interventricular artery. This systematization of the arterial heart ventricles in zones offers a balanced division of the myocardial tissue, since each of the four zones occupied about one fourth of the total volume of the ventricles. In our samples, the most common distribution of segments in the wall of heart ventricles was the following: 16 segments in the AS zone, 11 segments in the PS zone, 5 segments in the LL zone, and 4 segments in the RL zone. The separation of four zones in the walls of heart ventricles, each of them made up of different segments, may be helpful in the understanding of the pathophysiology of myocardial ischemia, and also in the choice of surgical strategies to treat aneurisms of the heart ventricle wall.