Analysis of Tissue Vasculature Using Near Infrared and Near Suprapurple Endoscopy : Development of the System and its Application to Diagnosis and Treatment of Early Malignant Tumors and other Disorders

早期小肿瘤的内镜检测和治疗是临床和社会观点的重要问题。虽然传统的内窥镜检查主要依靠人眼，计算机定量对于早期发现胃肠道和支气管中的微小癌症是必要的。研究人员已经开发出计算机辅助电子内窥镜，具有近红外和近紫上光源。该内窥镜系统能够以小于0.01 mm^2/点的分辨率分析30，000个点的组织血液血红蛋白分布。该系统还检测胃肠道粘膜中的粘膜下脉管系统。本文研究了正常人和消化性溃疡、胃癌及各种慢性胃炎患者胃肠道粘膜血流动力学和粘膜下血管反应的微异质性。采用荧光定量PCR（fl）方法检测细胞增殖和非倍性。 关于我们 流式细胞术。此外，开发了一种算法来分析单个毛细血管的氧饱和度。幽门螺杆菌感染已被报道为胃癌和慢性萎缩性胃炎的重要流行病学因素。在一项动物实验中，将幽门螺杆菌的产物氨长期给予大鼠。结果表明，氨减弱粘膜细胞的能量代谢，减少细胞内粘蛋白含量，并增加粘膜细胞脱落和细胞增殖。细胞群和粘膜组织学外观（包括胃血管）也发生了变化。这些变化与人体胃粘膜红外电子内镜所显示的变化相一致。尽管内镜下光动力疗法、内镜下切除术和内镜下化疗已成为治疗早期胃癌的重要方法，但由于存在缓解的可能性，这些治疗方法尚未广泛应用。研究人员还使用红外内窥镜系统检查了各种药物对胃肠道血流动力学的影响。乙醇刺激内皮素-1和白三烯的释放，导致胃粘膜血流停滞，而某些抗氧化药物降低粘膜血液血红蛋白含量。这些药物在内镜治疗中可能的协同作用和计算机控制的内镜治疗系统的开发仍有待于进一步研究。少

Endoscopic detection and treatment of early small cancers are important issues in clinical and social view points. Although convensional endoscopy have relied mainly on human eye, . computerized quantitation has been necessary for early detection of minute cancers in gastrointestinal tractlind bronchus. The investigators have developed computer-assisted electronic endoscopes which are also equ i"!% with near infrared and near suprapurple light source. This endoscopic system is possible to analyze tissue blood hemoglobin distribution at 30, 000 points with a resolution less than 0.01 mm^2/point. The system also detects submucosal vasculature in the gastrointestinal mucosa. Microheterogeneity of gastrointestinal mucosal hemodynamics and subrnucosal vascular responses were investigated in normal subjects and patients with various disorders including peptic ulcer, gastric cancer and various chronic gastritis. The cell proliferation and aniploidity of these subjects were also analyzed by fl … More owcytometry. Furthermore, an algorithm was developed to analyze oxygen saturation of a single capillary for more. precise analysis of tissue hemodynamics.Helicobacter pylori infection has been reported an important epidemiological factor of gastric cancer as well as chronic atrophic gastritis. In an animal experiment, ammonia, which is a product of Helicobacter, was chronically administered to rats. The results revealed that ammonia attenuates mucosal cellular energy metabolism, decreases intracellular mucin content, and increases mucosal cell exfoliation and cell proliferation. Cell population and mucosal histological appearance including gastric vasculature also changed. These changes are quite consistent with those of human gastric mucosa which are shown by the infrared electronic endoscopy. Moreover, another experiment have shown that ammonia is a potent promoter of gastric cancer.Although endoscopic photodynamic therapy, endoscopic resection and endoscopic chemotherapy have been important modalities for treatment of early gastric cancer, these therapy have not distributed widely because of possible remission of the disease. The investigators also examined the effects of various agents on gastrointestinal hemodynamics using the infrared endoscopic system. Ethanol stimulates endothelin-1 and leukotriene releases and causes gastric mucosal blood flow stasis, while a certain antiinflammatory drug decreases mucosal blood hemoglobin content. Possible synergic effect of these agents on endoscopic therapies and development of computer-controlled endoscopic treatment system remain to be examined in the further investigations. Less