Biocompatibility update

Payal Saxena,Saurabh Kumar Gupta,Vilas Newaskar 대한치과보존학회 2013 Restorative Dentistry & Endodontics Vol.38 No.3

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials. (Restor Dent Endod 2013;38(3):119-127)

Biocompatibility of root-end filling materials: recent update

Payal Saxena,Saurabh Kumar Gupta,Vilas Newaskar 大韓齒科保存學會 2013 Restorative Dentistry & Endodontics Vol.38 No.3

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials.

Biocompatibility of root-end filling materials: recent update

Saxena, Payal,Gupta, Saurabh Kumar,Newaskar, Vilas The Korean Academy of Conservative Dentistry 2013 Restorative Dentistry & Endodontics Vol.38 No.3

The purpose of a root-end filling is to establish a seal between the root canal space and the periradicular tissues. As root-end filling materials come into contact with periradicular tissues, knowledge of the tissue response is crucial. Almost every available dental restorative material has been suggested as the root-end material of choice at a certain point in the past. This literature review on root-end filling materials will evaluate and comparatively analyse the biocompatibility and tissue response to these products, with primary focus on newly introduced materials.

Establishing a submucosal endoscopy program in a gastrointestinal unit

Poornima Varma,Payal Saxena 소화기인터벤션의학회 2020 International journal of gastrointestinal interven Vol.9 No.2

Establishing a submucosal endoscopy program in a new unit is a difficult but exciting task. There are several key steps and teams involved in the success and failure of this endeavour. Careful thought, planning and implementation at the start will allow an easier transition to the development and progression of this program. An interested gastrointestinal unit with skilled proceduralists holds the key to the commencement of a submucosal program. The opportunity for ongoing learning and training through animal models and simulations, are important for proceduralists to continue to enhance their skills and train other staff. A collaborative team with surgical, nursing and technical support, hospital board approval, and credentialing, as well as the acquisition of appropriate equipment are essential components.

Establishing a submucosal endoscopy program in a gastrointestinal unit

Poornima Varma,Payal Saxena 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.2

Establishing a submucosal endoscopy program in a new unit is a difficult but exciting task. There are several key steps and teams involved in the success and failure of this endeavour. Careful thought, planning and implementation at the start will allow an easier transition to the development and progression of this program. An interested gastrointestinal unit with skilled proceduralists holds the key to the commencement of a submucosal program. The opportunity for ongoing learning and training through animal models and simulations, are important for proceduralists to continue to enhance their skills and train other staff. A collaborative team with surgical, nursing and technical support, hospital board approval, and credentialing, as well as the acquisition of appropriate equipment are essential components.

Endoscopic Ultrasound-Guided Vascular Procedures: A Review

Dominic A. Staudenmann,Arthur J. Kaffes,Payal Saxena 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.5

Since the 1980s, endoscopic ultrasound has advanced from being purely diagnostic to an interventional modality. The gastrointestinaltract offers an exceptional window for assessing the vascular structures in the mediastinum and in the abdomen. This has led to a rapidly growing interest in endoscopic ultrasound-controlled vascular interventions as a minimally invasive alternative to surgicaland radiological procedures.

Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett’s esophagus: An Australian pilot study (with video)

Dominic Andre Staudenmann,Ellie Patricia Skacel,Tatiana Tsoutsman,Arthur John Kaffes,Payal Saxena 소화기인터벤션의학회 2021 International journal of gastrointestinal interven Vol.10 No.3

Background: Five to ten percent of all patients undergoing radiofrequency ablation (RFA), which is the most established technique for Barrett’s esophagus (BE) ablation-develop strictures. Hybrid-argon plasma coagulation (APC) combines APC with submucosal saline injection that was recently developed to tackle this problem. The aims of this pilot study were to evaluate the feasibility, tolerance, safety and long-term efficacy of hybrid-APC for the treatment of BE. Methods: Patients with histological proven BE were selected for hybrid-APC. Prior to APC thermal ablation the mucosa was lifted using a submucosal high-pressure water jet injection system (Erbejet 2; Erbe, Tuebingen, Germany). Short-term (< 48 hours) and long-term (> 48 hours) safety were evaluated. Efficacy of ablation was measured at 3, 6, 12 and 24 months at follow-up endoscopy by evidence of macroscopically complete resolution of BE mucosa and/or histologically complete resolution of intestinal metaplasia (CRIM). Results: Eleven patients were included in the study (average age, 68.2 years; male 72.7%). Eight patients (72.7%) were treatment naive, 9.1% (n = 1) had prior RFA and 18.2% (n = 2) had prior endoscopic mucosal resection. Two patients were excluded from the study. Nine patients (100%) had macroscopic remission and 88.9% (n = 8) had macroscopic remission and microscopic CRIM at 24 months after hybrid-APC ablation. No treatment-related stricture or other major complications were observed, 1 patient (11.1%) reported minor adverse effects. Conclusion: In this prospective pilot study, hybrid-APC appears safe, feasible and effective after 24 months, which has not been evaluated so far. Further large, multi-centre trials are warranted to confirm the present results.

The diagnostic yield of specimens obtained from endoscopic ultrasound guided fine needle biopsy of solid masses with the AcquireTM needle

Mark Bonnichsen,Ellie Skacel,James Kench,Arthur Kaffes,Payal Saxena 소화기인터벤션의학회 2020 Gastrointestinal Intervention Vol.9 No.3

Background: Recent developments in the design of needle tips used for fine needle biopsy via endoscopic ultrasound (EUS) allows for the procurement of core tissue for histological assessment in addition to cytology. Core tissue provides tissue architecture as well as the ability to perform molecular profiling investigations. We present a single centre study of experience with a new EUS needle with a Franseen tip (AcquireTM; Boston Scientific, Natick, MA, USA). The aim of the study was to assess the diagnostic yield of biopsies from solid lesions throughout the gastrointestinal tract. Methods: We performed a retrospective study of consecutive patients undergoing EUS biopsy between January 2017 and November 2018. Cystic lesions with no solid component were excluded or if samples were not sent for both cytology and histology. Rapid onsite evaluation (ROSE) was performed and the core tissue obtained was sent for histology. Results: Forty-six patients underwent EUS biopsy of solid lesions with specimens sent for both cytology and histology. Lesions included solid pancreatic masses (n = 31), lymph node (n = 3), gastric subepithelial lesion (n = 3), other (n = 9). The mean number of passes per lesion was 1.9 (range 1–4). In 43/46 (93%) of cases, a core specimen was obtained. Tissue obtained by EUS biopsy was adequate for evaluation by ROSE in 39/46 cases (85%). Histological diagnosis was confirmed in 41/46 (89%) cases compared to 31/46 (67%) cases with cytology (P = 0.011). Subgroup analysis of pancreatic lesions showed histological diagnosis was superior to cytology (90% vs 61%, P = 0.007). There were no adverse events. Conclusion: Histological analysis of specimens obtained via EUS biopsy was superior to cytology, particularly in assessment of solid pancreatic lesions.

Safety and long-term efficacy of hybrid-argon plasma coagulation for the treatment of Barrett’s esophagus: An Australian pilot study (with video)

Dominic Andre Staudenmann,Ellie Patricia Skacel,Tatiana Tsoutsman,Arthur John Kaffes,Payal Saxena 소화기인터벤션의학회 2021 Gastrointestinal Intervention Vol.10 No.3

Background: Five to ten percent of all patients undergoing radiofrequency ablation (RFA), which is the most established technique for Barrett’s esophagus (BE) ablation-develop strictures. Hybrid-argon plasma coagulation (APC) combines APC with submucosal saline injection that was recently developed to tackle this problem. The aims of this pilot study were to evaluate the feasibility, tolerance, safety and long-term efficacy of hybrid-APC for the treatment of BE. Methods: Patients with histological proven BE were selected for hybrid-APC. Prior to APC thermal ablation the mucosa was lifted using a submucosal high-pressure water jet injection system (Erbejet 2; Erbe, Tuebingen, Germany). Short-term (< 48 hours) and long-term (> 48 hours) safety were evaluated. Efficacy of ablation was measured at 3, 6, 12 and 24 months at follow-up endoscopy by evidence of macroscopically complete resolution of BE mucosa and/or histologically complete resolution of intestinal metaplasia (CRIM). Results: Eleven patients were included in the study (average age, 68.2 years; male 72.7%). Eight patients (72.7%) were treatment naive, 9.1% (n = 1) had prior RFA and 18.2% (n = 2) had prior endoscopic mucosal resection. Two patients were excluded from the study. Nine patients (100%) had macroscopic remission and 88.9% (n = 8) had macroscopic remission and microscopic CRIM at 24 months after hybrid-APC ablation. No treatment-related stricture or other major complications were observed, 1 patient (11.1%) reported minor adverse effects. Conclusion: In this prospective pilot study, hybrid-APC appears safe, feasible and effective after 24 months, which has not been evaluated so far. Further large, multi-centre trials are warranted to confirm the present results.

The diagnostic yield of specimens obtained from endoscopic ultrasound guided fine needle biopsy of solid masses with the AcquireTM needle

Mark Bonnichsen,Ellie Skacel,James Kench,Arthur Kaffes,Payal Saxena 소화기인터벤션의학회 2020 International journal of gastrointestinal interven Vol.9 No.3

Background: Recent developments in the design of needle tips used for fine needle biopsy via endoscopic ultrasound (EUS) allows for the procurement of core tissue for histological assessment in addition to cytology. Core tissue provides tissue architecture as well as the ability to perform molecular profiling investigations. We present a single centre study of experience with a new EUS needle with a Franseen tip (AcquireTM; Boston Scientific, Natick, MA, USA). The aim of the study was to assess the diagnostic yield of biopsies from solid lesions throughout the gastrointestinal tract. Methods: We performed a retrospective study of consecutive patients undergoing EUS biopsy between January 2017 and November 2018. Cystic lesions with no solid component were excluded or if samples were not sent for both cytology and histology. Rapid onsite evaluation (ROSE) was performed and the core tissue obtained was sent for histology. Results: Forty-six patients underwent EUS biopsy of solid lesions with specimens sent for both cytology and histology. Lesions included solid pancreatic masses (n = 31), lymph node (n = 3), gastric subepithelial lesion (n = 3), other (n = 9). The mean number of passes per lesion was 1.9 (range 1–4). In 43/46 (93%) of cases, a core specimen was obtained. Tissue obtained by EUS biopsy was adequate for evaluation by ROSE in 39/46 cases (85%). Histological diagnosis was confirmed in 41/46 (89%) cases compared to 31/46 (67%) cases with cytology (P = 0.011). Subgroup analysis of pancreatic lesions showed histological diagnosis was superior to cytology (90% vs 61%, P = 0.007). There were no adverse events. Conclusion: Histological analysis of specimens obtained via EUS biopsy was superior to cytology, particularly in assessment of solid pancreatic lesions.