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Mohsin MS, Avdic M, Fitzpatrick K, Lanzarini-Lopes M. UV-C side-emitting optical fiber-based disinfection: a promising approach for infection control in tight channels. Microbiol Spectr 2024; 12:e0004024. [PMID: 38687120 PMCID: PMC11237523 DOI: 10.1128/spectrum.00040-24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 05/02/2024] Open
Abstract
The growth of pathogenic bacteria in moist and wet surfaces and tubing of medically relevant devices results in serious infections in immunocompromised patients. In this study, we investigated and demonstrated the successful implementation of a UV-C side-emitting optical fiber in disinfecting medically relevant pathogenic bacteria (Pseudomonas aeruginosa and Methicillin-resistant Staphylococcus aureus [MRSA]) within tight channels of polytetrafluoroethylene (PTFE). PTFE is a commonly used material both in point-of-use (POU) water treatment technologies and medical devices (dental unit water line [DUWL], endoscope). For a 1-m-long PTFE channel, up to ≥6 log inactivation was achieved using a 1-m-long UV side-emitting optical fiber (SEOF) with continuous 16-h exposure of low UV-C radiation ranging from ~0.23 to ~29.30 μW/cm2. Furthermore, a linear model was used to calculate the inhibition zone constant (k`), which enables us to establish a correlation between UV dosage and the extent of inactivated surface area (cm2) for surface-bound Escherichia coli on a nutrient-rich medium. The k` value for an irradiance ranging from ~150 to ~271.50 μW/cm2 was calculated to be 0.564 ± 0.6 cm·cm2/mJ. This study demonstrated the efficacy of SEOFs for disinfection of medically relevant microorganisms present in medically and domestically relevant tight channels. The impact of the results in this study extends to the optimization of operational efficiency in pre-existing UV surface disinfection setups that currently operate at UV dosages exceeding the optimal levels.IMPORTANCEGermicidal UV radiation has gained global recognition for its effectiveness in water and surface disinfection. Recently, various works have illustrated the benefit of using UV-C side-emitting optical fibers (SEOFs) for the disinfection of tight polytetrafluoroethylene (PTFE) channels. This study now demonstrates its impact for disinfection of medically relevant organisms and introduces critical design calculations needed for its implementation. The flexible geometry and controlled emission of light in these UV-SEOFs make them ideal for light distribution in tight channels. Moreover, the results presented in this manuscript provide a novel framework that can be employed in various applications, addressing microbial contamination and the disinfection of tight channels.
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Affiliation(s)
- Muhammad Salman Mohsin
- Environmental and Water Resources Engineering, Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Melisa Avdic
- Environmental and Water Resources Engineering, Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Katrina Fitzpatrick
- Environmental and Water Resources Engineering, Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Mariana Lanzarini-Lopes
- Environmental and Water Resources Engineering, Department of Civil and Environmental Engineering, University of Massachusetts Amherst, Amherst, Massachusetts, USA
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2
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Effect of a Proton Pump Inhibitor on the Duodenum Microbiome of Gastric Ulcer Patients. Life (Basel) 2022; 12:life12101505. [PMID: 36294939 PMCID: PMC9605190 DOI: 10.3390/life12101505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/19/2022] Open
Abstract
The gut microbiota are regarded as a functional organ that plays a substantial role in human health and disease. Proton pump inhibitors (PPIs) are widely used in medicine but can induce changes in the overall gut microbiome and cause disease-associated dysbiosis. The microbiome of the duodenum has not been sufficiently studied, and the effects of PPIs on the duodenal microbiome are poorly understood. In this study, we investigated the effect of PPI administration on duodenum microbiota in patients with a gastric ulcer. A total of 12 gastric ulcer patients were included, and PPI (Ilaprazole, Noltec®, 10 mg) was prescribed in all patients for 4 weeks. A total of 17 samples from the second portion of the duodenum were analyzed. Microbiome compositions were assessed by sequencing the V3–V4 region of the 16s rRNA gene (Miseq). Changes in microbiota compositions after 4 weeks of PPI treatment were analyzed. a-Diversity was higher after PPI treatment (p = 0.02, at Chao1 index), and β-diversity was significantly different after treatment (p = 0.007). Welch’s t-test was used to investigate changes in phyla, genus, and species level, and the abundance of Akkermansia muciniphila, belonging to the phylum Verrucomicrobia, and Porphyromonas endodontalis, belonging to the phylum Bacteroidetes, was significantly increased after treatment (p = 0.044 and 0.05). PPI administration appears to induce duodenal microbiome dysbiosis while healing gastric ulcers. Further large-scale studies on the effects of PPIs on the duodenal microbiome are required.
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Schindler A, Baijens LWJ, Geneid A, Pizzorni N. Phoniatricians and otorhinolaryngologists approaching oropharyngeal dysphagia: an update on FEES. Eur Arch Otorhinolaryngol 2022; 279:2727-2742. [PMID: 34779927 PMCID: PMC8591442 DOI: 10.1007/s00405-021-07161-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/26/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE Oropharyngeal dysphagia (OD) is a common phenomenon in otorhinolaryngology and phoniatrics. As both sub-disciplines have a strong tradition and clinical experience in endoscopic assessment of the upper aerodigestive tract, the implementation of fiberoptic endoscopic evaluation of swallowing (FEES) was an almost self-evident evolution. This review aims to provide an update on FEES and the role of phoniatricians and otorhinolaryngologists using FEES in Europe. METHODS A narrative review of the literature was performed by experts in the field of FEES both in the clinical context and in the field of scientific research. RESULTS FEES is the first-choice OD assessment technique for both phoniatricians and otorhinolaryngologists. FEES is becoming increasingly popular because of its usefulness, safety, low costs, wide applicability, and feasibility in different clinical settings. FEES can be performed by health professionals of varying disciplines, once adequate knowledge and skills are acquired. FEES aims to determine OD nature and severity and can provide diagnostic information regarding the underlying etiology. The direct effect of therapeutic interventions can be evaluated using FEES, contributing to design the OD management plan. Standardization of FEES protocols and metrics is still lacking. Technological innovation regarding image resolution, frame rate frequency, endoscopic light source specifications, and endoscopic rotation range has contributed to an increased diagnostic accuracy. CONCLUSION The rising number of phoniatricians and otorhinolaryngologists performing FEES contributes to the early detection and treatment of OD in an aging European population. Nevertheless, a multidisciplinary approach together with other disciplines is crucial for the success of OD management.
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Affiliation(s)
- Antonio Schindler
- Department of Biomedical and Clinical Sciences "L. Sacco", Milan University, UOS Foniatria, ASST Fatebenefratelli-Sacco, Ospedale Sacco, Via GB Grassi 74, 20154, Milano, Italy.
| | - Laura W J Baijens
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- School for Oncology and Developmental Biology-GROW, Maastricht University, Maastricht, The Netherlands
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences "L. Sacco", Milan University, UOS Foniatria, ASST Fatebenefratelli-Sacco, Ospedale Sacco, Via GB Grassi 74, 20154, Milano, Italy
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4
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Kurian N, Varghese KG, Dhawan K. Visual inspection of implant screw access hole with an endoscope camera. J Prosthet Dent 2021; 128:1128-1129. [PMID: 34217507 DOI: 10.1016/j.prosdent.2021.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/01/2021] [Accepted: 06/01/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Nirmal Kurian
- Assistant Professor, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
| | - Kevin George Varghese
- Postgraduate Resident, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India.
| | - Kusha Dhawan
- Postgraduate Resident, Department of Prosthodontics and Crown & Bridge, Christian Dental College, Ludhiana, Punjab, India
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Gao J, Zhang X, Meng Q, Jin H, Zhu Z, Wang Z, Qian W, Zhang L, Liu Y, Min M, Chen X, Chen H, Han S, Xiao J, Wang Y, Han W, Lu Y, Cai S, Chen W, Ji W, Xiao X, Zheng Q, Zhang B, Wu W, Lian G, Liu X, Zhao Q, Chen M, Zhuang K, Si W, Shi X, Chen Y, Li Z, Wang D. Linked Color Imaging Can Improve Detection Rate of Early Gastric Cancer in a High-Risk Population: A Multi-Center Randomized Controlled Clinical Trial. Dig Dis Sci 2021; 66:1212-1219. [PMID: 32363529 DOI: 10.1007/s10620-020-06289-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Accepted: 04/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Early diagnosis of gastric cancer is difficult in China due to the lack of a valid method for endoscopic screening. Early gastric cancer, especially flat gastric cancer, lacks specific endoscopic features. Many cases appear to be similar to ordinary gastritis cases under normal white light endoscopy, which can lead to misdiagnosis. AIMS In order to find a new method to improve detection rate of early gastric cancer in China, we designed a trial to validate linked color imaging (LCI) for screening of early gastric cancer in a high-risk population, as compared to white light imaging (WLI). METHOD Subjects were randomly allocated to either the LCI + WLI or WLI group and then subjected to gastroscopy and all endoscopies were made after special preparation. All endoscopists had knowledge of this experiment. The main indicator was the rate of detection of gastric neoplastic lesions. The difference in the detection rate between the two groups is reported. RESULTS The detection rate was 4.31% in the WLI group and 8.01% in the LCI + WLI group. This is a difference of 3.70% with a P value < 0.001 and an OR (95% CI) of 1.934 (1.362, 2.746). The lower limit of the 95% CI was greater than 0, and the superiority margin was 1%. CONCLUSION The detection rate of gastric neoplastic lesions was higher in the LCI + WLI group than in the WLI group, LCI might be an effective method for screening early gastric cancer.
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Affiliation(s)
- Jie Gao
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Xiaofeng Zhang
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Qianqian Meng
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Hangbin Jin
- Department of Gastroenterology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhenhua Zhu
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhijie Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Wei Qian
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Luoman Zhang
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Yan Liu
- Department of Gastroenterology, The Fifth Medical Centre, Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing, China
| | - Min Min
- Department of Gastroenterology, The Fifth Medical Centre, Chinese PLA General Hospital (Former 307th Hospital of the PLA), Beijing, China
| | - Xing Chen
- Endoscopy Center, Shanxi Cancer Hospital, Taiyuan, China
| | - Haihua Chen
- Endoscopy Center, Shanxi Cancer Hospital, Taiyuan, China
| | - Shutang Han
- Jiangsu Province Hospital of TCM and Affiliated Hospital of Nanjing University of TCM, Nanjing, China
| | - Jun Xiao
- Jiangsu Province Hospital of TCM and Affiliated Hospital of Nanjing University of TCM, Nanjing, China
| | - Yalei Wang
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Wei Han
- The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yapi Lu
- Department of Gastroenterology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Shuntian Cai
- Department of Gastroenterology, Zhongshan Hospital Affiliated to Xiamen University, Xiamen, China
| | - Weiqing Chen
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing, China
| | - Wen Ji
- Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital and Chongqing Cancer Institute and Chongqing Cancer Hospital, Chongqing, China
| | - Xuhua Xiao
- Affiliated Hospital of Guilin Medical University, Guilin, China
| | - Qinghua Zheng
- Affiliated Hospital of Guilin Medical University, Guilin, China
| | | | - Wenbin Wu
- Guangdong Provincial TCM Hospital, Guangzhou, China
| | - Guanghui Lian
- Gastroenterology Department of Xiangya Hospital, CSU, Changsha, China
| | - Xiaowei Liu
- Gastroenterology Department of Xiangya Hospital, CSU, Changsha, China
| | - Qiu Zhao
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Min Chen
- Zhongnan Hospital of Wuhan University, Wuhan, China
| | | | - Wangli Si
- Xi'an Central Hospital, Xi'an, China
| | - Xingang Shi
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Youxiang Chen
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhaoshen Li
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China
| | - Dong Wang
- Department of Gastroenterology, Changhai Hospital, The Second Military University, Shanghai, China.
- Digestive Endoscopy Center, Changhai Hospital, The Second Military University, Shanghai, China.
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Jiang R, Kasle DA, Alzahrani F, Kohli N, Lerner MZ. A Manufacturer and User Facility Device Experience Analysis of Upper Aerodigestive Endoscopy Contamination: Is Flexible Laryngoscopy Different? Laryngoscope 2020; 131:598-605. [PMID: 32558941 DOI: 10.1002/lary.28826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 05/04/2020] [Accepted: 05/08/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Several recent studies have observed a high incidence of duodenoscope microbial contamination and an association of contamination with healthcare-acquired infections. This study sought to quantify nasopharyngoscope microbial contamination relative to that of other endoscope categories and characterize the manufacturers, outcomes, and microbial profiles associated with these cases. STUDY DESIGN Retrospective, cross-sectional study. METHODS A total of 3,865 adverse events were collected from 2013 to 2019 using the US Food and Drug Administration Manufacturer and User Facility Device Experience database. The fraction of total device failures associated with contamination was quantified for nasopharyngoscopes, bronchoscopes, duodenoscopes, and gastroscopes. Odds ratios of nasopharyngoscope contamination compared to that of bronchoscopes, duodenoscopes, or gastroscopes were calculated, and significance was assessed by χ2 analysis. The Kruskal-Wallis test was used for nonparametric testing of significance. RESULTS Nasopharyngoscope device failures were reported at an incidence of 0.646 per month; 34.1% involved contamination, comparable to the frequency observed for bronchoscopes (23.4%, P = .118), duodenoscopes (29.2%, P = .493), and gastroscopes (45.3%, P = .178). The frequency of device contamination was observed to be significantly higher for a particular endoscope manufacturer regardless of endoscope category (Kruskal-Wallis P = .021). In instances of contamination, nasopharyngoscopes were significantly less associated with patient harm or death than bronchoscope (odds ratio [OR] = 10.2) and duodenoscope (OR = 4.81) cases. CONCLUSIONS Although the rates of contamination were comparable across all endoscope categories, nasopharyngoscope contamination was less commonly associated with patient harm or death. In an era of rising healthcare costs, determining adequate disinfection standards for nasopharyngoscopes and their impact on patient safety is crucial. LEVEL OF EVIDENCE NA Laryngoscope, 131:598-605, 2021.
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Affiliation(s)
- Roy Jiang
- Yale School of Medicine, New Haven, Connecticut, U.S.A
| | - David A Kasle
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A
| | - Faisal Alzahrani
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A.,Department of Otolaryngology-Head and Neck Surgery, King Saud University, Riyadh, Saudi Arabia
| | - Nikita Kohli
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A
| | - Michael Z Lerner
- Division of Otolaryngology, Department of Surgery, Yale School of Medicine, New Haven, Connecticut, U.S.A
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Cheung DY, Jang BI, Kim SW, Kim JH, Kim HK, Shin JE, Yoon WJ, Lee YK, Chung KH, Cho SJ, Shin HP, Cho SY, Shin WG, Choi KD, Kim BW, Kwon JG, Yang HC, Gweon TG, Kim HG, Ahn DW, Cho KB, Kim SH, Hwang KH, Im HH. Multidisciplinary and Multisociety Practice Guideline on Reprocessing Flexible Gastrointestinal Endoscopes and Endoscopic Accessories. Clin Endosc 2020; 53:276-285. [PMID: 32506894 PMCID: PMC7280845 DOI: 10.5946/ce.2020.106] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 11/22/2022] Open
Abstract
The area of endoscopic application has been continuously expanded since its introduction in the last century and the frequency of its use also increased stiffly in the last decades. Because gastrointestinal endoscopy is naturally exposed to diseased internal organs and contact with pathogenic materials, endoscopy mediated infection or disease transmission becomes a major concern in this field. Gastrointestinal endoscopy is not for single use and the proper reprocessing process is a critical factor for safe and reliable endoscopy procedures. What needed in these circumstances is a practical guideline for reprocessing the endoscope and its accessories which is feasible in the real clinical field to guarantee acceptable prevention of pathogen transmission. This guideline contains principles and instructions of the reprocessing procedure according to the step by step. And it newly includes general information and updated knowledge about endoscopy-mediated infection and disinfection. Multiple societies and working groups participated to revise; Korean Association for the Study of the Liver, the Korean Society of Infectious Diseases, Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Society of Gastroenterology, Korean Society of Gastrointestinal Cancer, Korean Association for the Study of Intestinal Diseases, Korean Pancreatobiliary Association, the Korean Society of Gastrointestinal Endoscopy Nurses and Associates and Korean Society of Gastrointestinal Endoscopy. Through this cooperation, we enhanced communication and established a better concordance. We still need more researches in this field and fill up the unproven area. And our guidelines will be renewed accordingly.
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Affiliation(s)
- Dae Young Cheung
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Sang Wook Kim
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Kroea
| | - Hyung Keun Kim
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jeong Eun Shin
- Department of Internal Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Won Jae Yoon
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yong Kang Lee
- Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Kwang Hyun Chung
- Department of Internal Medicine, Eulji University School of Medicine, Daejeon, Korea
| | - Soo-Jeong Cho
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Phil Shin
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Sun Young Cho
- Department of Internal Medicine, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woon Geon Shin
- Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Kee Don Choi
- Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Joong Goo Kwon
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Hee Chan Yang
- Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
| | - Tae-Geun Gweon
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyun Gun Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Dong-Won Ahn
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kwang Bum Cho
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea
| | | | - Kyong Hwa Hwang
- The Catholic University of Korea Seoul St. Mary’s Hospital, Seoul, Korea
| | - Hee Hyuk Im
- Soon Chun Hyang University Seoul Hospital, Seoul, Korea
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Han J, Kim EY. Sharing Our Experience of Operating an Endoscopy Unit in the Midst of a COVID-19 Outbreak. Clin Endosc 2020; 53:243-245. [PMID: 32252508 PMCID: PMC7137568 DOI: 10.5946/ce.2020.076] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 03/25/2020] [Indexed: 12/21/2022] Open
Affiliation(s)
- Jimin Han
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
| | - Eun Young Kim
- Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
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Min JK, Cha JM, Cho YK, Kim JH, Yoon SM, Im JP, Jung Y, Moon JS, Kim JO, Jeen YT. Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea. Clin Endosc 2018; 51:239-252. [PMID: 29874905 PMCID: PMC5997069 DOI: 10.5946/ce.2018.075] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 05/14/2018] [Indexed: 12/12/2022] Open
Abstract
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.
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Affiliation(s)
- Jun Ki Min
- Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gang Dong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jie-Hyun Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Seoul, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yunho Jung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Jin-Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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10
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Min JK, Cha JM, Cho YK, Kim JH, Yoon SM, Im JP, Jung Y, Moon JS, Kim JO, Jeen YT. [Revision of Quality Indicators for the Endoscopy Quality Improvement Program of the National Cancer Screening Program in Korea]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2018; 71:269-281. [PMID: 29791986 DOI: 10.4166/kjg.2018.71.5.269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Gastroscopy and colonoscopy are widely used for the early diagnosis of stomach and colorectal cancer. The present revision integrates recent data regarding previous quality indicators and novel indicators suggested for gastroscopy and colonoscopy procedures for the National Cancer Screening Program in Korea. The new indicators, developed by the Quality Improvement Committee of the Korean Society for Gastrointestinal Endoscopy, vary in the level of supporting evidence, and most are based solely on expert opinion. Updated indicators validated by clinical research were prioritized, but were chosen by expert consensus when such studies were absent. The resultant quality indicators were graded according to the levels of consensus and recommendations. The updated indicators will provide a relevant guideline for high-quality endoscopy. The future direction of quality indicator development should include relevant outcome measures and an evidence-based approach to support proposed performance targets.
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Affiliation(s)
- Jun Ki Min
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jae Myung Cha
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
| | - Yu Kyung Cho
- Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Jie Hyun Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Seoul, Korea
| | - Soon Man Yoon
- Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Jong Pil Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Yunho Jung
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jeong Seop Moon
- Department of Internal Medicine, Inje University College of Medicine, Seoul, Korea
| | - Jin Oh Kim
- Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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11
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Kanzaki H, Takenaka R, Kawahara Y, Kawai D, Obayashi Y, Baba Y, Sakae H, Gotoda T, Kono Y, Miura K, Iwamuro M, Kawano S, Tanaka T, Okada H. Linked color imaging (LCI), a novel image-enhanced endoscopy technology, emphasizes the color of early gastric cancer. Endosc Int Open 2017; 5:E1005-E1013. [PMID: 29159276 PMCID: PMC5634856 DOI: 10.1055/s-0043-117881] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 06/30/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND AND STUDY AIMS Linked color imaging (LCI) and blue laser imaging (BLI) are novel image-enhanced endoscopy technologies with strong, unique color enhancement. We investigated the efficacy of LCI and BLI-bright compared to conventional white light imaging (WLI) by measuring the color difference between early gastric cancer lesions and the surrounding mucosa. PATIENTS AND METHODS Images of early gastric cancer scheduled for endoscopic submucosal dissection were captured by LCI, BLI-bright, and WLI under the same conditions. Color values of the lesion and surrounding mucosa were defined as the average of the color value in each region of interest. Color differences between the lesion and surrounding mucosa (ΔE) were examined in each mode. The color value was assessed using the CIE L*a*b* color space (CIE: Commission Internationale d'Eclairage). RESULTS We collected images of 43 lesions from 42 patients. Average ΔE values with LCI, BLI-bright, and WLI were 11.02, 5.04, and 5.99, respectively. The ΔE was significantly higher with LCI than with WLI ( P < 0.001). Limited to cases of small ΔE with WLI, the ΔE was approximately 3 times higher with LCI than with WLI (7.18 vs. 2.25). The ΔE with LCI was larger when the surrounding mucosa had severe intestinal metaplasia ( P = 0.04). The average color value of a lesion and the surrounding mucosa differed. This value did not have a sufficient cut-off point between the lesion and surrounding mucosa to distinguish them, even with LCI. CONCLUSION LCI had a larger ΔE than WLI. It may allow easy recognition and early detection of gastric cancer, even for inexperienced endoscopists.
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Affiliation(s)
- Hiromitsu Kanzaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan,Corresponding author Dr. Hiromitsu Kanzaki Department of Gastroenterology and HepatologyOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences2-5-1 Shikata-cho, Kita-kuOkayama 700-8558Japan
| | - Ryuta Takenaka
- Department of Gastroenterology, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Yoshiro Kawahara
- Department of Endoscopy, Okayama University Hospital, Okayama, Japan
| | - Daisuke Kawai
- Department of Gastroenterology, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Yuka Obayashi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yuki Baba
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Sakae
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Tatsuhiro Gotoda
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Yoshiyasu Kono
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Ko Miura
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Masaya Iwamuro
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
| | - Takehiro Tanaka
- Department of Pathology, Okayama University Hospital, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan,Department of Endoscopy, Okayama University Hospital, Okayama, Japan
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Son BK, Kim BW, Kim WH, Myung DS, Cho YS, Jang BI. Korean Society of Gastrointestinal Endoscopy Guidelines for Endoscope Reprocessing. Clin Endosc 2017; 50:143-147. [PMID: 28301923 PMCID: PMC5398366 DOI: 10.5946/ce.2017.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/20/2022] Open
Abstract
The Korean Society of Gastrointestinal Endoscopy (KSGE) issued guidelines for endoscope reprocessing for the first time in 1995, and the version of the guidelines was updated in August 2009, August 2012, and March 2015. Guidelines for endoscope reprocessing should be revised continuously, because new disinfectants and devices are developed and introduced. The current official version of the KSGE guidelines for endoscope reprocessing is explained herein to assist the reader in understanding the KSGE requirements for cleaning and disinfecting endoscopes.
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Affiliation(s)
- Byoung Kwan Son
- Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Won Hee Kim
- Digestive Disease Center, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Dae-Sung Myung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young-Seok Cho
- Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung Ik Jang
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
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Linked color imaging application for improving the endoscopic diagnosis accuracy: a pilot study. Sci Rep 2016; 6:33473. [PMID: 27641243 PMCID: PMC5027569 DOI: 10.1038/srep33473] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/30/2016] [Indexed: 12/13/2022] Open
Abstract
Endoscopy has been widely used in diagnosing gastrointestinal mucosal lesions. However, there are still lack of objective endoscopic criteria. Linked color imaging (LCI) is newly developed endoscopic technique which enhances color contrast. Thus, we investigated the clinical application of LCI and further analyzed pixel brightness for RGB color model. All the lesions were observed by white light endoscopy (WLE), LCI and blue laser imaging (BLI). Matlab software was used to calculate pixel brightness for red (R), green (G) and blue color (B). Of the endoscopic images for lesions, LCI had significantly higher R compared with BLI but higher G compared with WLE (all P < 0.05). R/(G + B) was significantly different among 3 techniques and qualified as a composite LCI marker. Our correlation analysis of endoscopic diagnosis with pathology revealed that LCI was quite consistent with pathological diagnosis (P = 0.000) and the color could predict certain kinds of lesions. ROC curve demonstrated at the cutoff of R/(G+B) = 0.646, the area under curve was 0.646, and the sensitivity and specificity was 0.514 and 0.773. Taken together, LCI could improve efficiency and accuracy of diagnosing gastrointestinal mucosal lesions and benefit target biopsy. R/(G + B) based on pixel brightness may be introduced as a objective criterion for evaluating endoscopic images.
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