Multicenter randomised controlled trial comparing the high definition white light endoscopy and the bright narrow band imaging for colon polyps

AIM To compare high definition white light endoscopy and bright narrow band imaging for colon polyps' detection rates. METHODS Patients were randomised to high definition white light endoscopy(HD-WLE) or the bright narrow band imaging(b NBI) during withdrawal of the colonoscope. Polyps identified in either mode were characterised using b NBI with dual focus(b NBI-DF) according to the Sano's classification. The primary outcome was to compare adenoma detection rates(ADRs) between the two arms. The secondary outcome was to assess the negative predictive value(NPV) in differentiating adenomas from hyperplastic polyps for diminutive rectosigmoid lesions.RESULTS A total of 1006 patients were randomised to HD-WLE(n = 511) or b NBI(n = 495). The mean of adenoma per patient was 1.62 and 1.84, respectively. The ADRs in b NBI and HD-WLE group were 37.4% and 39.3%, respectively. When adjusted for withdrawal time(OR = 1.19, 95%CI: 1.15-1.24, P < 0.001), the use of b NBI was associated with a reduced ADR(OR = 0.69, 95%CI: 0.52-0.92). Nine hundred and thirty three polyps(86%) in both arms were predicted with high confidence. The sensitivity(Sn), specificity(Sp), positive predictive value and NPV in differentiating adenomatous from non-adenomatous polyps of all sizes were 95.9%, 87.2%, 94.0% and 91.1% respectively. The NPV in differentiating an adenoma from hyperplastic polyp using b NBI-DF for diminutive rectal polyps was 91.0%.CONCLUSION ADRs did not differ between b NBI and HD-WLE, however HD-WLE had higher ADR after adjustment of withdrawal time. b NBI surpassed the PIVI threshold for diminutive polyps.

Role of high definition colonoscopy in colorectal adenomatous polyp detection

AIM:To investigate the rates of polyp detection in a mixed risk population using standard definition (SDC) vs high definition colonoscopes (HDC).METHODS:This was a retrospective cohort comparative study of 3 colonoscopists who each consecutively performed 150 SDC (307,200 pixel) and 150 HDC (792,576 pixels) in a community teaching hospital.RESULTS:A total of 900 colonoscopies were evaluated (mean age 56,46.8% men),450 with each resolution.Polyps of any type were detected in 46.0% of patients using SDC and 43.3% with HDC (P=0.42).There was no significant difference between the overall number of polyps,HDC (397) and SDC (410),detected among all patients examined,(P=0.73).One or more adenomatous polyps were detected in 24.2% of patients with HDC and 24.9% of patients with SDC colonoscopy (P=0.82).There was no significant difference between HDC (M=0.41) and SDC (M=0.42) regarding adenomatous polyp (P=0.88) or advanced adenoma (P=0.56) detection rate among all patients examined.CONCLUSION:HDC did not improve yield of adenomatous polyp,advanced adenoma or overall polyp detection in a population of individuals with mixed risk for colorectal cancer.

Improving sessile serrated adenoma detection rates with high definition colonoscopy:A retrospective study

BACKGROUND Sessile serrated adenomas(SSAs)are important premalignant lesions that are difficult to detect during colonoscopy due to poor definition,concealment by mucous caps,and flat appearance.High definition(HD)colonoscopy may uniquely aid in the detection of these inconspicuous lesions compared to standard definition(SD)colonoscopes.In the absence of existing clinical guidelines to obligate the use of HD colonoscopy for colorectal cancer screening in average-risk patients,demonstrating the benefit of HD colonoscopy on SSA detection rate(SSADR)may help strengthen the evidence to recommend its use in all settings.AIM To evaluate the benefit of HD colonoscopy compared to SD colonoscopy on SSADR in average-risk patients undergoing screening colonoscopy.METHODS Data from screening colonoscopies for patients aged 50-76 years two years before and two years after the transition from SD colonoscopy to HD colonoscopy at our large,academic teaching center were collected.Patients with symptoms of colorectal disease,positive occult blood test,history of colon polyps,cancer,polyposis syndrome,inflammatory bowel disease or family history of colon cancer or polyps were excluded.Patients whose endoscopists did not perform colonoscopies both before and after scope definition change were also excluded.Differences in individual endoscopist SSADR,average SSADR,and overall SSADR with SD colonoscopy vs HD colonoscopy were also evaluated for significance.RESULTS A total of 3657 colonoscopies met eligibility criteria with 2012 colonoscopies from the SD colonoscopy period and 1645 colonoscopies from the HD colonoscopy period from a pool of 11 endoscopists.Statistically significant improvements of 2.30%in mean SSADR and 2.53%in overall SSADR were noted with HD colonoscopy(P=0.00028 and P=0.00849,respectively).On the individual level,three endoscopists experienced statistically significant benefit with HD colonoscopy(+5.74%,P=0.0056;+4.50%,P=0.0278;+4.84%,P=0.03486).CONCLUSION Our study suggests that HD colonoscopy statistically significantly improves sessile serrated adenoma detection rate in the screening of average risk patients during screening colonoscopy.By improving the detection and removal of these lesions,adoption of HD colonoscopy may reduce the significant premalignant burden of sessile serrated adenomas.

ZTE IPTV Low Bit Rate High Definition Transcoding Solution Nominated for Global IPTV Industry Award

ZTE Corporation announced on 1 March that its innovative IPTVlowbitrate highdefinition transcoding solution has been nominated for the World＇s Best Component or Enabler Award by the IPTV World Forum. The ZTE solution is on display at the Mobile World Congress 2012 （MWC 2012） in Barcelona.

The Real Time Mixing Module Design for HDTV Data of SMPTE 274M and PC Video Data

A real time mixing module for high definition television (HDTV) data of SMPTE 274M and PC video data is designed. The hardware implementation, algorithm and simulation of the mixing module are given. In order to improve the capability of data processing, an anti-fuse FPGA chip and a mechanism of pipelining and modularization are adopted. With 6 parallel LUTs and a fast algorithm, it can mix 4∶2∶2 component signals in luminance and chrominance space respectively in real time. According to the simulation, the module has the ability to mix the uncompressed HDTV data with PC video data in real time, which can not be fulfilled by current ASIC chips. Furthermore, it can be extended to multi-stage mixing with the thoughts implied by the design. The mixing module can be widely used in HDTV production systems.

High total variation-based method for sparse-view photoacoustic reconstruction

We propose a novel method by combining the total variation（TV） with the high-degree TV（HDTV） to improve the reconstruction quality of sparse-view sampling photoacoustic imaging（PAI）. A weighing function is adaptively updated in an iterative way to combine the solutions of the TV and HDTV minimizations. The fast iterative shrinkage/thresholding algorithm is implemented to solve both the TV and the HDTV minimizations with better convergence rate. Numerical results demonstrate the superiority and efficiency of the proposed method on sparse-view PAI. In vitro experiments also illustrate that the method can be used in practical sparse-view PAI.

Endoscopic assisted facial rejuvenation: a 35 year personal journey

Aim:Traditional facelift techniques rely on pulling.They approach the superficial or intermediate layers where the facial nerves and muscles are located,increasing the risk of facial nerve injury.They approach the central oval from the periphery and produce unnatural vectors of pull and aesthetic results.Alternative techniques that work on the subperiosteal plane using endoscopic techniques are described.Modern concepts of volume augmentation,beautification and rejuvenation of the facial expression are an inherent part of such techniques,or can be easily integrated.Methods:The central oval is approached via four small scalp incisions and additional intraoral,upper gingivo-buccal incisions.The interconnected frontal subperiosteal,temporal subfascial and midface subperiosteal areas are lifted,imbricated and suspended sequentially.The brow/forehead is suspended to the skull using cortical screws.The midface and lower periorbita are suspended to the fascia of the temporal muscle.The buccal fat pad is used to enhance the ogee line of the midface.Other three-dimensional volumetric maneuvers can easily be applied.In this setting,upper and lower lid blepharoplasties become more straightforward,skin only procedures.Actinic or nicotine damaged skin can be treated with lasers,peels or fluidified fat grafting in the same setting.The excess skin on the lower face and neck can be redrapped with standard cervicofacial techniques.Deep subplatysmal cervicoplasty can be done concomitantly,or at another time to complete comprehensive rejuvenation.Results:The procedures described herein has been performed in 824 patients with excellent aesthetic results and low complication rate.The average rate of rejuvenation was 18 years. ;Conclusion:These combination techniques are called Biplanar Endoscopic Assisted Mask and Triplanar Endoscopic Assisted Mask facial rejuvenation.They are advanced techniques of facial rejuvenation that provide comprehensive,natural,long lasting results.