Many techniques have been developed to reduce the number of missed lesions during colonoscopy screening. Autofluorescence imaging (AFI) is one of the newly developed image-enhanced endoscopy (IEE) techniques, which functions similar to narrow band imaging (NBI) and flexible spectral imaging color enhancement (FICE), that can improve the detection and characterization of both polypoid and non-polypoid colonic neoplasms by enhancing their macroscopic features. We have previously reported that AFI, when used in combination with a transparent hood mounted on the tip of the endoscope to maintain distance from the colonic mucosa, results in the detection of approximately 1.6 times more colorectal neoplasms than conventional white light (WLI) colonoscopy. We have also revealed that AFI results in a higher flat neoplasm detection rate than WLI. Because the images of colorectal lesions visualized using AFI differ between histological lesion types, AFI also offers the possibility of differentiating neoplastic from non-neoplastic lesions. However, the difference between neoplastic and non-neoplastic lesions in the images generated using AFI relies on the density of the magenta coloring of the image and is therefore somewhat subjective. Recent studies suggest that NBI with magnification may be a superior modality for characterizing the neoplastic status of small colonic polyps. Although further developments are needed, the recent development of IEEs allows us to efficiently detect and differentiate colorectal neoplasms during colonoscopy screening. This article reviews the use of AFI in the diagnosis of colorectal neoplasms and discusses its advantages and limitations.
Colon ; Colonic Neoplasms ; Colonic Polyps ; Colonoscopy ; Colorectal Neoplasms ; Endoscopes ; Endoscopy ; Humans ; Light ; Mass Screening ; Mucous Membrane ; Narrow Band Imaging ; Optical Imaging

Methods: This study included 229 patients (107 men and 122 women; mean age, 68.9 years) who received one or two levels of MISTLIF, and the patient’s age, gender, disease, paralysis, preoperative physical functions, duration of symptom(s), and surgery-associated factors (waiting for surgery, number of surgical levels, surgical time, and intraoperative blood loss) were studied. Radiographic characteristics and clinical outcomes such as Oswestry Disability Index (ODI) scores and Visual Analog Scale (VAS; 0–100) ODI scores for low back pain, leg pain, and numbness were studied. One year following surgery, patient satisfaction (defined as satisfaction for surgery and for present condition; 0–100) was assessed using VAS and its relationships with investigation factors were examined. Results: The mean VAS scores of satisfaction for surgery and for present condition were 88.6 and 84.2, respectively. The results of multiple regression analysis showed that preoperative adverse factors of satisfaction for surgery were being elderly (β =-0.17, p =0.023), high preoperative low back pain VAS scores (β =-0.15, p =0.020), and postoperative adverse factors were high postoperative ODI scores (β =-0.43, p <0.001). In addition, the preoperative adverse factor of satisfaction for present condition was high preoperative low back pain VAS scores (β =-0.21, p =0.002), and postoperative adverse factors were high postoperative ODI scores (β =-0.45, p <0.001) and high postoperative low back pain VAS scores (β =-0.26, p =0.001). Conclusions According to this study, significant preoperative low back pain and high postoperative ODI score after surgery are linked to patient unhappiness.

OBJECTIVESTo investigate the association of smoking habits with blood pressure (BP) and intraocular pressure (IOP), and to examine whether the smoking-BP association is related to the IOP level.

METHODSThis study was conducted on the basis of a cross-sectional design using annual health check-up data during one-year between August, 1999 and August, 2000 for 611 middle and old-aged Japanese residents living in Ibaraki prefecture, Japan.

RESULTSAfter adjustment for age, gender, body mass index and alcohol intake score, the proportion of hypertensives, and the mean systolic and diastolic blood pressure (SBP and DBP) of the subjects without antihypertensive medications were the highest (50.4%, 129.6 mmHg and 75.9 mmHg, respectively) in the "smokers of 25 or more cigarettes per day with intraocular pressure (IOP)≥15 mmHg" of six subgroups crossed by three smoking categories (non-smokers, 1 to 24 cigarettes per day, and 25 or more cigarettes per day) and two IOP categories (less than 15 mmHg, and 15mmHg or greater). On the other hand, the adjusted proportion of hypertensives, and the adjusted mean SBP and DBP decreased with increasing smoking category in the individuals with less than 15 mmHg of the IOP (p for trend=0.028 for proportion of hypertensives 0.008 for the SBP, and 0.001 for the DBP, respectively).

CONCLUSIONSHeavy smoking may be specifically related to 'high BP accompanied by high IOP', although the BP may be inversely associated with smoking under the condition without high IOP.