Real Capsule Research Articles

A clinical study on pseudo-cyst pancreas

BACKGROUND: Pancreatic pseudocysts are walled-off collections of necrotic tissue, old blood, and secretions that are encapsulated. Collections lack a real capsule, and the cyst wall is composed of nearby viscera such as the stomach and/or colon. Pseudocysts are the most frequent side effects of both acute and chronic pancreatic inflammation. In our prospective interventional study, 25 patients with symptomatic pancreatic pseudocysts were included. Majority of patients were belonged to the age group of 31–40 years, with males being more common. The most common cause is alcoholism, followed by idiopathy. Most of them presented with pain abdomen as the chief complaint. Ultrasonography (USG) and computed tomography (CT) of the abdomen were found to be accurate investigations. Acute pseudocysts were managed conservatively, whereas infected cysts necessitated external drainage. In the majority of cases, anastomoses of the cyst to the nearby bowel, either cystogastrostomy or cystojejunostomy, were performed with good results. METHODS: Study design - Hospital-based prospective interventional study. Sample size - 25. The study was the prospective interventional study, conducted at Basaweshwar Hospital from July 2020 to August 2022, 25 patients with symptomatic pancreatic pseudocysts included. Patients had baseline tests as well as specific tests such as serum amylase and serum lipase. All patients underwent USG and CT Abdomen to determine the morphology, and treatment was planned accordingly. RESULTS: A total of 25 patients were included in the study. Out of 25 patients, the cause of pancreatic pseudocyst was found to be alcohol consumption in 80% and other causes in 14%. The common indication for intervention was persistent pain (60%) The type of intervention was chosen based on the physical state of the patient as well as the location and type of the pseudocyst. USG-guided drainage was done in 14% and surgical drainage procedure-cystogastrostomy - 36% and cystojejunostomy 26%. CONCLUSION: The most common cystic lesion of the pancreas is the pancreatic pseudocyst. The disease was common in the age group of 31–50 years and was seen predominantly in males. The most common cause is alcoholism, followed by idiopathy. Pain in the abdomen with tenderness is a common presentation. The most useful tests were an ultrasound and a CT scan. Acute pseudocysts were managed conservatively, while infected cysts required external drainage. In the majority of cases, anastomosis of the cyst to the nearby bowel, either by cystogastrostomy or cystojejunostomy, was performed with good results.

Enhanced segmentation of gastrointestinal polyps from capsule endoscopy images with artifacts using ensemble learning.

Endoscopy artifacts are widespread in real capsule endoscopy (CE) images but not in high-quality standard datasets. To improve the segmentation performance of polyps from CE images with artifacts based on ensemble learning. We collected 277 polyp images with CE artifacts from 5760 h of videos from 480 patients at Guangzhou First People's Hospital from January 2016 to December 2019. Two public high-quality standard external datasets were retrieved and used for the comparison experiments. For each dataset, we randomly segmented the data into training, validation, and testing sets for model training, selection, and testing. We compared the performance of the base models and the ensemble model in segmenting polyps from images with artifacts. The performance of the semantic segmentation model was affected by artifacts in the sample images, which also affected the results of polyp detection by CE using a single model. The evaluation based on real datasets with artifacts and standard datasets showed that the ensemble model of all state-of-the-art models performed better than the best corresponding base learner on the real dataset with artifacts. Compared with the corresponding optimal base learners, the intersection over union (IoU) and dice of the ensemble learning model increased to different degrees, ranging from 0.08% to 7.01% and 0.61% to 4.93%, respectively. Moreover, in the standard datasets without artifacts, most of the ensemble models were slightly better than the base learner, as demonstrated by the IoU and dice increases ranging from -0.28% to 1.20% and -0.61% to 0.76%, respectively. Ensemble learning can improve the segmentation accuracy of polyps from CE images with artifacts. Our results demonstrated an improvement in the detection rate of polyps with interference from artifacts.

A novel method for accurate extraction of liver capsule and auxiliary diagnosis of liver cirrhosis based on high-frequency ultrasound images

Liver cirrhosis is a common chronic progressive disease with a high mortality rate. The early diagnosis and treatment of liver cirrhosis is an important research subject in the medical field. In this paper, a novel method is proposed for the accurate extraction of the liver capsule and auxiliary diagnosis of cirrhosis based on high frequency ultrasound images. First, a self-developed method is used to extract the predictive capsule of ultrasound images, which involves the detection of liver ascites with sliding windows, image enhancement with multiscale detail and fuzzy set, structure segmentation with morphological processing, and predictive capsule detection with traversal search method. Thereafter, the real capsule is obtained by the gray difference method according to different gray values between the liver capsule region of the original ultrasound images and the set threshold. Finally, according to the analysis of smoothness, as well as the continuity and fluctuation of predictive and real capsule, four novel features called NoL, VoS, CV, and NoF are proposed for the computer auxiliary diagnosis model. This model is designed on the basis of support vector machine and k-means clustering and can classify normal liver and three liver cirrhosis stages. The experimental results reveal that the accuracy of the liver capsule extraction using this model is 95.13% and final classification accuracy of four stages can reach 92.54%, 88.46%, 89.23% and 94.55%, respectively. The results also indicate that the method proposed in this paper can achieve the classification of liver cirrhosis stages much more accurately and efficiently compared with previously utilized methods.

Spheroidal and conical shapes of ferrofluid-filled capsules in magnetic fields

We investigate the deformation of soft spherical elastic capsules filled with a ferrofluid in external uniform magnetic fields at fixed volume by a combination of numerical and analytical approaches. We develop a numerical iterative solution strategy based on nonlinear elastic shape equations to calculate the stretched capsule shape numerically and a coupled finite element and boundary element method to solve the corresponding magnetostatic problem, and employ analytical linear response theory, approximative energy minimization, and slender-body theory. The observed deformation behavior is qualitatively similar to the deformation of ferrofluid droplets in uniform magnetic fields. Homogeneous magnetic fields elongate the capsule, and a discontinuous shape transition from a spheroidal shape to a conical shape takes place at a critical field strength. We investigate how capsule elasticity modifies this hysteretic shape transition. We show that conical capsule shapes are possible but involve diverging stretch factors at the tips, which gives rise to rupture for real capsule materials. In a slender-body approximation we find that the critical susceptibility above which conical shapes occur for ferrofluid capsules is the same as for droplets. At small fields capsules remain spheroidal, and we characterize the deformation of spheroidal capsules both analytically and numerically. Finally, we determine whether wrinkling of a spheroidal capsule occurs during elongation in a magnetic field and how it modifies the stretching behavior. We find the nontrivial dependence between the extent of the wrinkled region and capsule elongation. Our results can be helpful in order to quantitatively determine capsule or ferrofluid material properties from magnetic deformation experiments. All results also apply to elastic capsules filled with a dielectric liquid in an external uniform electric field.

Use of adaptive hybrid filtering process in Crohn's disease lesion detection from real capsule endoscopy videos.

The aim of this Letter is to present a new capsule endoscopy (CE) image analysis scheme for the detection of small bowel ulcers that relate to Crohn's disease. More specifically, this scheme is based on: (i) a hybrid adaptive filtering (HAF) process, that utilises genetic algorithms to the curvelet-based representation of images for efficient extraction of the lesion-related morphological characteristics, (ii) differential lacunarity (DL) analysis for texture feature extraction from the HAF-filtered images and (iii) support vector machines for robust classification performance. For the training of the proposed scheme, namely HAF-DL, an 800-image database was used and the evaluation was based on ten 30-second long endoscopic videos. Experimental results, along with comparison with other related efforts, have shown that the HAF-DL approach evidently outperforms the latter in the field of CE image analysis for automated lesion detection, providing higher classification results. The promising performance of HAF-DL paves the way for a complete computer-aided diagnosis system that could support the physicians' clinical practice.

Properties of the spindle-to-cusp transition in extensional capsule dynamics

Our earlier letter (Dodson W. R. III and Dimitrakopoulos P., Phys. Rev. Lett., 101 (2008) 208102) revealed that a (strain-hardening) Skalak capsule in a planar extensional Stokes flow develops for stability reasons steady-state shapes whose edges from spindled become cusped with increasing flow rate owing to a transition of the edge tensions from tensile to compressive. A bifurcation in the steady-state shapes was also found (i.e. existence of both spindled and cusped edges for a range of high flow rates) by implementing different transient processes, owing to the different evolution of the membrane tensions. In this paper we show that the bifurcation range is wider at higher viscosity ratio (owing to the lower transient membrane tensions accompanied the slower capsule deformation starting from the quiescent capsule shape), while it contracts and eventually disappears as the viscosity ratio decreases. The spindle-to-cusp transition is shown to represent a self-similar finite-time singularity formation which for real capsules with very small but finite thickness is expected to be an apparent singularity, i.e. formation of very large (but finite) positive and negative edge curvatures.

Effects of membrane hardness and scaling analysis for capsules in planar extensional flows

AbstractIn this paper, we investigate computationally the effects of membrane hardness on the dynamics of strain-hardening capsules in planar extensional Stokes flows. As the flow rate increases, all capsules reach elongated steady-state configurations but the cross-section of the more strain-hardening capsules preserves its elliptical shape while the less strain-hardening capsules become lamellar. The capsule deformation in strong extensional flows is accompanied with very pointed edges, i.e. large edge curvatures and thus small local edge length scales, which makes the current investigation a multi-length interfacial dynamics problem. Our computational results for elongated strain-hardening capsules are accompanied with a scaling analysis which provides physical insight on the extensional capsule dynamics. The two distinct capsule conformations we found, i.e. the slender spindle and lamellar capsules, are shown to represent two different types of steady-state extensional dynamics. The former are stabilized mainly via the membrane’s shearing resistance and the latter via its area-dilatation resistance, associated with the elongation tension normal forces and thus both types differ from bubbles which are stabilized mainly via the lateral surface-tension normal forces. Our steady-state deformation results can be used to identify the elastic properties of a real capsule, i.e. the membrane’s shear and area-dilatation moduli, utilizing a single experimental technique.

Prediction of the spatial response of a microphone capsule using scattering and lumped-element simulations

When a microphone capsule is placed in an environment with surrounding structures, the electrical response of the capsule will be dictated by the capsule design and by acoustic scattering of the structures surrounding it. Lumped element models of the transducer are typically used in predicting the electrical response to the field, but when the transducer is operating at a frequency where the spatial variation of the field is significant, the simplifying assumptions used in these models no longer hold. In this work, a finite element-based scattering simulation provides blocked-port field quantities to drive a lumped element circuit model, predicting the electrical output as a function of the frequency and incident angle of an incoming plane wave. The scattering simulation allows for the inclusion of mechanical supporting structures and protective screens, and their influence on the field at the rear port of a gradient transducer. Simulated results are shown for the simplified capsule and compared to measurements of a real capsule in free field conditions as well as with surrounding structures.

Kapselendoskopie bei Patienten mit Herzschrittmachern und implantierbaren Cardioverter-Defibrillatoren - Ist die formale Kontraindikation noch gerechtfertigt?

Capsule endoscopy is an established tool for investigation of the small intestine. Because of limited clinical experience in patients with cardiac devices the US Food and Drug Administration and the manufacturers recommend not to use capsule endoscopy in these patients. Studies investigating possible interference between small bowel capsule endoscopy and cardiac pacemakers and implanted cardioverters were analysed. For the review we considered studies published in English or German and indexed in PubMed (Medline) as well as relevant abstracts and technical data from the manufacturer. In vitro and in vivo studies applying real capsules revealed no clinically relevant interference with pacemakers and implanted cardioverters. This evidence already has had an impact on clinical practice and recommendations of scientific societies. On the other hand wireless telemetry can interfere with CE video. According to present evidence, small bowel capsule endoscopy can be used in patients with pacemakers and implanted cardioverters after obtaining informed consent concerning the formal existence of contraindication.

Adolescence: Does good nutrition = good behaviour?

Adolescence is often associated with exploring boundaries, rapid growth, hormones and pimples. A stable feature of this turbulent age is that these young people are highly over-represented in the criminal justice system. Adolescents account for disproportionate proportion of police-recorded crimes, and this seems to be a cross-cultural phenomenon. Furthermore, disaffected young people often have limited routine access to healthy foods and make poor food choices. These people form a large proportion of the prison population and there are concerns that insufficient attention is paid to their health. Hence their diet tends to be poor compared with international standards of dietary adequacy, which typically are set to protect the heart but not for optimal brain function. Thus, it has been posited that a poor diet may be a modifiable causal factor in antisocial behaviours. We tested what happened to the behaviour of violent young adult prisoners (18-21years) when nutrients missing from their diets were reinstated. We used food supplements as an analogue of a better diet because it provided the possibility of a placebo control. On a random basis, where neither the volunteers, prison staff nor researchers in the prison knew who was getting which type, 231 volunteers were given either placebo or real capsules containing broadly the daily requirements of vitamins, minerals and essential fatty acids. The number of proven offences committed by each prisoner was monitored before and while taking supplements. The result was that those who received the extra nutrients committed significantly (26.3%) fewer offences compared with placebos. Those consuming real supplements for at least 2 weeks committed 37% fewer (highly statistically significant) of the most serious offences, such as violence. These findings have been replicated by the Dutch Ministry of Justice; their double-blind study reported a 48% difference between groups. If these studies are widely replicated - and they need to be - we may have a simple and humane means to help reduce and prevent a significant proportion of violence and antisocial behaviour. This should also work in the community, because it is not about where you eat but what you eat. Indeed, criminal justice systems are often over-represented with ethnic minorities, but providing a more nutritious diet is never going to be discriminatory to these young people. The only risk is better health.

Electrochemical imprinted sensor for determination of oleanic acid based on poly (sodium 4-styrenesulfonate-co-acrylic acid)-grafted multi-walled carbon nanotubes-chitosan and cobalt hexacyanoferrate nanoparticles

A novel sensitive and selective imprinted electrochemical sensor for the determination of oleanic acid was constructed on a carbon electrode by stepwise modification of functional multi-walled carbon nanotubes, cobalt hexacyanoferrate nanoparticles and a thin imprinted sol–gel film. The fabrication of a homogeneous porous poly (sodium 4-styrenesulfonate-co-acrylic acid)-grafted multi-walled carbon nanotubes/SiO2–chitosan nanocomposite film was conducted by controllable electrodeposition technology. The surface morphologies of the modified electrodes were characterized by scanning electron microscope. The performance of the imprinted sensor was investigated by cyclic voltammetry, square wave voltammetry and electrochemical impedance spectroscopy in detail. The imprinted sensor displayed high sensitivity and selectivity towards oleanic acid. A linear relationship between the sensor response signal and the logarithm of oleanic acid concentrations ranging from 1.0×10−8 to 1.0×10−3molL−1 was obtained with a detection limit of 2.0×10−9molL−1. It was applied to the determination of oleanic acid in real capsule samples successfully.

Hoffa's recess in the infrapatellar fat pad of the knee on MR imaging.

The infrapatellar fat pad of Hoffa is a structure that is located in the space between the back side of the patellar ligament and the real capsule. It is routinely visualized on magnetic resonance (MR) images of the knee. The purpose of this study was to determine the prevalence and shape of a fluid-like indentation at the inferior posterior margin of the infrapatellar fat pad of the knee (recess) and to look for a relation between the liquid image in the fat pad and joint effusion. Three hundred and fifty consecutive MR imaging examinations of the knee were evaluated for the presence, location, size and shape of a recess in the infrapatellar fat pad and existence of joint effusion. The study population consisted of 145 females and 205 males aged between 5 and 80 years old (mean age 37.5 years). The recess in the infrapatellar fat pad was revealed on MR imaging in 54 of 350 knees (15.43%) and had a variable shape, consisting of 35 linear or ovoid (64.81%), five pipe-shaped (9.26%) and 14 globular (25.92%). Additionally, one ganglion cyst was observed in the infrapatellar fat pad. Globular and pipe-shaped recesses may be confused with cystic infrapatellar fat pad pathologies such as ganglion cyst, meniscal cyst, loose body or nodular synovitis. The existence of an infrapatellar fat pad may not be related to the presence of joint effusion.

Low speed dynamic tests on a capsule configuration

An experimental program supported by the Italian Space Agency was started at Politecnico di Torino. Static and oscillatory data were collected for a reference model of the Apollo Command Module configuration. The experimental results are presented here and the stability of the equivalent real capsule is also discussed.

The morphology of the prostatic capsule with particular regard to the posterosuperior region: an anatomical and clinical problem.

The composition of the prostatic capsule is important from a clinical point of view, since it is considered to be a barrier against the spread of prostatic tumours. Clinical follow-up demonstrates that apparently intracapsular tumours, particularly in the posterosuperior region of the gland, are frequently understaged at clinical diagnosis. The morphology of the prostatic capsule was studied in 6 cadavers. In each case the prostate was obtained in one block together with the basal portion of the bladder, the seminal vesicles, the anterior wall of the rectum and the periprostatic connective tissue. Part of the material was plastinated, while the remainder was studied using histological and immunohistochemical methods. The prostate was found to be surrounded by connective tissue abundant with smooth muscle cells, and continuous with the stromal septa which subdivide the glandular tissue. A rich network of blood vessels was identifiable. In some regions, particularly in the posterosuperior region, a real capsule was not identifiable. The connective tissue seemed to constitute a continuum between the prostate gland and neighbouring organs, in particular, a connective tissue barrier between the prostate and the seminal vesicles was completely absent. Therefore, due to the absence of a capsular barrier and to the presence of a rich vascular network a prostatic tumour which begins in the posterior region of the gland should be considered as potentially extracapsular.