The Mexican consensus on the detection and treatment of early gastric cancer. / Consenso mexicano sobre detección y tratamiento del cáncer gástrico incipiente.

Gastric cancer is one of the most frequent neoplasias in the digestive tract and is the result of premalignant lesion progression in the majority of cases. Opportune detection of those lesions is relevant, given that timely treatment offers the possibility of cure. There is no consensus in Mexico on the early detection of gastric cancer, and therefore, the Asociación Mexicana de Gastroenterología brought together a group of experts and produced the "Mexican consensus on the detection and treatment of early gastric cancer" to establish useful recommendations for the medical community. The Delphi methodology was employed, and 38 recommendations related to early gastric cancer were formulated. The consensus defines early gastric cancer as that which at diagnosis is limited to the mucosa and submucosa, irrespective of lymph node metástasis. In Mexico, as in other parts of the world, factors associated with early gastric cancer include Helicobacter pylori infection, a family history of the disease, smoking, and diet. Chromoendoscopy, magnification endoscopy, and equipment-based image-enhanced endoscopy are recommended for making the diagnosis, and accurate histopathologic diagnosis is invaluable for making therapeutic decisions. The endoscopic treatment of early gastric cancer, whether dissection or resection of the mucosa, should be preferred to surgical management, when similar oncologic cure results can be obtained. Endoscopic surveillance should be individualized.

Mantle cell lymphoma with involvement of the digestive tract. / Linfoma del manto con afección del tubo digestivo.

INTRODUCTION AND AIM: Mantle cell lymphoma is an aggressive subtype of B-cell non-Hodgkin lymphoma and its incidence is 0.5/100,000 inhabitants. Gastrointestinal involvement at diagnosis is 15-30%. The aim of our study was to analyze the clinical and endoscopic characteristics of mantle cell lymphoma affecting the digestive tract. MATERIAL AND METHODS: A retrospective study was conducted, based on a case series of patients with mantle cell lymphoma affecting the gastrointestinal tract that were diagnosed over a 10-year period. RESULTS: Ten patients (11.7%) had gastrointestinal tract involvement. The upper endoscopic findings were polypoid lesions (66%), thickened folds (44%), and nonspecific changes in the mucosa (33%). At colonoscopy, polypoid lesions were viewed in 100% of the patients and ulcerated lesions in 40%. CONCLUSION: Polypoid lesions are the most common endoscopic characteristics in patients with mantle cell lymphoma of the gastrointestinal tract. Upper endoscopy and colonoscopy should be carried out on patients with mantle cell lymphoma, even those with nonspecific symptoms, to check their gastrointestinal status. Gastrointestinal involvement has an impact on disease staging.

Dual-sensitivity profilometry with defocused projection of binary fringes.

A dual-sensitivity profilometry technique based on defocused projection of binary fringes is presented. Here, two sets of fringe patterns with a sinusoidal profile are produced by applying the same analog low-pass filter (projector defocusing) to binary fringes with a high- and low-frequency spatial carrier. The high-frequency fringes have a binary square-wave profile, while the low-frequency binary fringes are produced with error-diffusion dithering. The binary nature of the binary fringes removes the need for calibration of the projector's nonlinear gamma. Working with high-frequency carrier fringes, we obtain a high-quality wrapped phase. On the other hand, working with low-frequency carrier fringes we found a lower-quality, nonwrapped phase map. The nonwrapped estimation is used as stepping stone for dual-sensitivity temporal phase unwrapping, extending the applicability of the technique to discontinuous (piecewise continuous) surfaces. We are proposing a single defocusing level for faster high- and low-frequency fringe data acquisition. The proposed technique is validated with experimental results.

Coherent digital demodulation of single-camera N-projections for 3D-object shape measurement: co-phased profilometry.

Fringe projection profilometry is a well-known technique to digitize 3-dimensional (3D) objects and it is widely used in robotic vision and industrial inspection. Probably the single most important problem in single-camera, single-projection profilometry are the shadows and specular reflections generated by the 3D object under analysis. Here a single-camera along with N-fringe-projections is (digital) coherent demodulated in a single-step, solving the shadows and specular reflections problem. Co-phased profilometry coherently phase-demodulates a whole set of N-fringe-pattern perspectives in a single demodulation and unwrapping process. The mathematical theory behind digital co-phasing N-fringe-patterns is mathematically similar to co-phasing a segmented N-mirror telescope.

Robust adaptive phase-shifting demodulation for testing moving wavefronts.

Optical interferometers are very sensitive when environment perturbations affect its optical path. The wavefront under test is not static at all. In this paper, it is proposed a novel and robust phase-shifting demodulation method. This method estimates the interferogram's phase-shifting locally, reducing detuning errors due to environment perturbations like vibrations and/or miscalibrations of the Phase-Shifting Interferometry setup. As we know, phase-shifting demodulation methods assume that the wavefront under test is static and there is a global phase-shifting for all pixels. The demodulation method presented here is based on local weighted least-squares, letting each pixel have its own phase-shifting. This is a different and better approach, considering that all previous works assume a global phase-shifting for all pixels of interferograms. Seeing this method like a black box, it receives an interferogram sequence of at least 3 interferograms and returns the modulating phase or wavefront under test. Here it is not necessary to know the phase shifts between the interferograms. It does not assume a global phase-shifting for the interferograms, is robust to the movements of the wavefront under test and tolerates miscalibrations of the optical setup.

Multiplicative phase-shifting interferometry using optical flow.

Fringe patterns with a multiplicative phase shift among them appear in experimental techniques as photoelasticity and RGB shadow moiré, among others. These patterns cannot be processed using standard phase-shifting demodulation techniques. In this work, we propose to use a multiframe regularized optical flow algorithm to obtain the interesting modulating phase. The proposed technique has been applied to simulated and experimental interferograms obtaining satisfactory results.

Synchronous phase-demodulation and harmonic rejection of 9-step pixelated dynamic interferograms.

We propose a novel synchronous phase-demodulation of pixelated interferograms using squared 3x3 phase-shifted unit-cells. This 3x3 unit-cell is tiled over the CCD image sensor to create a two-dimensional (2D) pixelated carrier. Our synchronous phase-demodulation uses this 2D carrier to demodulate the pixelated interferogram as in the standard 2x2 unit-cell case. The main motivation behind the use of a 3x3 pixelated carrier (instead of the usual 2x2) is its higher harmonic robustness, allowing one to demodulate intensity-distorted fringe patterns. The harmonic rejection robustness of our spatial 3x3 configuration equals the robustness of the temporal least-squares 9-step phase-shifting algorithm (PSA). In other words, extending from the usual 2x2 phase-shifting unit-cell to 3x3 unit-cells, one extends the harmonic rejection of the demodulation algorithm. Finally we also prove that our proposed 9-step, 3x3 pixelated carrier uses the 2D available spectral space more efficiently than using these 9-steps in a linear spatial-carrier configuration.

Fast two-dimensional simultaneous phase unwrapping and low-pass filtering.

Here, we present a fast algorithm for two-dimensional (2D) phase unwrapping which behaves as a recursive linear filter. This linear behavior allows us to easily find its frequency response and stability conditions. Previously, we published a robust to noise recursive 2D phase unwrapping system with smoothing capabilities. But our previous approach was rather heuristic in the sense that not general 2D theory was given. Here an improved and better understood version of our previous 2D recursive phase unwrapper is presented. In addition, a full characterization of it is shown in terms of its frequency response and stability. The objective here is to extend our previous unwrapping algorithm and give a more solid theoretical foundation to it.

Harmonics rejection in pixelated interferograms using spatio-temporal demodulation.

Pixelated phase-mask interferograms have become an industry standard in spatial phase-shifting interferometry. These pixelated interferograms allow full wavefront encoding using a single interferogram. This allows the study of fast dynamic events in hostile mechanical environments. Recently an error-free demodulation method for ideal pixelated interferograms was proposed. However, non-ideal conditions in interferometry may arise due to non-linear response of the CCD camera, multiple light paths in the interferometer, etc. These conditions generate non-sinusoidal fringes containing harmonics which degrade the phase estimation. Here we show that two-dimensional Fourier demodulation of pixelated interferograms rejects most harmonics except the complex ones at {-3(rd), +5(th), -7(th), +9(th), -11(th),…}. We propose temporal phase-shifting to remove these remaining harmonics. In particular, a 2-step phase-shifting algorithm is used to eliminate the -3(rd) and +5(th) complex harmonics, while a 3-step one is used to remove the -3(rd), +5<(th), -7(th) and +9(th) complex harmonics.

Phase-shifting interferometry corrupted by white and non-white additive noise.

The standard tool to estimate the phase of a sequence of phase-shifted interferograms is the Phase Shifting Algorithm (PSA). The performance of PSAs to a sequence of interferograms corrupted by non-white additive noise has not been reported before. In this paper we use the Frequency Transfer Function (FTF) of a PSA to generalize previous white additive noise analysis to non-white additive noisy interferograms. That is, we find the ensemble average and the variance of the estimated phase in a general PSA when interferograms corrupted by non-white additive noise are available. Moreover, for the special case of additive white-noise, and using the Parseval's theorem, we show (for the first time in the PSA literature) a useful relationship of the PSA's noise robustness; in terms of its FTF spectrum, and in terms of its coefficients. In other words, we find the PSA's estimated phase variance, in the spectral space as well as in the PSA's coefficients space.

Design of phase-shifting algorithms by fine-tuning spectral shaping.

To estimate the modulating wavefront of an interferogram in Phase Shifting Interferometry (PSI) one frequently uses a Phase Shifting Algorithm (PSA). All PSAs take as input N phase-shifted interferometric measures, and give an estimation of their modulating phase. The first and best known PSA designed explicitly to reduce a systematic error source (detuning) was the 5-steps, Schwider-Hariharan (SH-PSA) PSA. Since then, dozens of PSAs have been published, designed to reduce specific data error sources on the demodulated phase. In Electrical Engineering the Frequency Transfer Function (FTF) of their linear filters is their standard design tool. Recently the FTF is also being used to design PSAs. In this paper we propose a technique for designing PSAs by fine-tuning the few spectral zeroes of a PSA to approximate a template FTF spectrum. The PSA's spectral zeroes are moved (tuned) while gauging the plot changes on the resulting FTF's magnitude.

Two-step self-tuning phase-shifting interferometry.

A two-step self-tuning phase-shifting method is presented. The phase-step between the two interferograms is not known when the experiment is performed. Our demodulating method finds, in a robust way, this unknown phase-step. Once the phase-step is estimated we proceed to phase demodulate the interferograms. Moreover our method only requires the fringe patterns to have a constant unknown phase-shift between them. As a consequence, this technique can be used to demodulate open and closed-fringed patterns without phase-sign ambiguity. The method may be regarded as a self-tuning quadrature filter, which determines the phase-shift between the two fringe patterns and finally estimates the demodulated phase map. The proposed technique has been tested with simulated and real interferograms obtaining satisfactory results.

Fourier transform demodulation of pixelated phase-masked interferograms.

Recently a new type of spatial phase shifting interferometer was proposed that uses a phase-mask over the camera's pixels. This new interferometer allows one to phase modulate each pixel independently by setting the angle of a linear polarizer built in contact over the camera's CCD. In this way neighbor pixels may have any desired (however fixed) phase shift without cross taking. The standard manufacturing of these interferometers uses a 2x2 array with phase-shifts of 0, pi/2, pi, and 3 pi/2 radians. This 2x2 array is tiled all over the video camera's CCD. In this paper we propose a new way to phase demodulate these phase-masked interferograms using the squeezing phase-shifting technique. A notable advantage of this squeezing technique is that it allows one the use of Fourier interferometry wiping out the detuning error that most phase shifting algorithms suffers. Finally we suggest the use of an alternative phase-mask to phase modulate the camera's pixels using a linear spatial carrier along a given axis.

Error-free demodulation of pixelated carrier frequency interferograms.

Recently, pixelated spatial carrier interferograms have been used in optical metrology and are an industry standard nowadays. The main feature of these interferometers is that each pixel over the video camera may be phase-modulated by any (however fixed) desired angle within [0,2pi] radians. The phase at each pixel is shifted without cross-talking from their immediate neighborhoods. This has opened new possibilities for experimental spatial wavefront modulation not dreamed before, because we are no longer constrained to introduce a spatial-carrier using a tilted plane. Any useful mathematical model to phase-modulate the testing wavefront in a pixel-wise basis can be used. However we are nowadays faced with the problem that these pixelated interferograms have not been correctly demodulated to obtain an error-free (exact) wavefront estimation. The purpose of this paper is to offer the general theory that allows one to demodulate, in an exact way, pixelated spatial-carrier interferograms modulated by any thinkable two-dimensional phase carrier.

The general theory of phase shifting algorithms.

We have been reporting several new techniques of analysis and synthesis applied to Phase Shifting Interferometry (PSI). These works are based upon the Frequency Transfer Function (FTF) and how this new tool of analysis and synthesis in PSI may be applied to obtain very general results, among them; rotational invariant spectrum; complex PSI algorithms synthesis based on simpler first and second order quadrature filters; more accurate formulae for estimating the detuning error; output-power phase noise estimation. We have made our cases exposing these aspects of PSI separately. Now in the light of a better understanding provided by our past works we present and expand in a more coherent and holistic way the general theory of PSI algorithms. We are also providing herein new material not reported before. These new results are on; a well defined way to combine PSI algorithms and recursive linear PSI algorithms to obtain resonant quadrature filters.

Spectral analysis of phase shifting algorithms.

Systematic spectral analysis of Phase Shifting Interferometry (PSI) algorithms was first proposed in 1990 by Freischlad and Koliopoulos (F&K). This analysis was proposed with the intention that "in a glance" the main properties of the PSI algorithms would be highlighted. However a major drawback of the F&K spectral analysis is that it changes when the PSI algorithm is rotated or its reference signal is time-shifted. In other words, the F&K spectral plot is different when the PSI algorithm is rotated or its reference is time-shifted. However, it is well known that these simple operations do not alter the basic phase demodulation properties of PSI algorithms, except for an unimportant piston. Here we propose a new way to analyze the spectra of PSI algorithms which is invariant to rotation and/or reference time-shift among other advantages over the nowadays standard PSI spectral analysis by F&K.

Noise in phase shifting interferometry.

We present a theoretical analysis to estimate the amount of phase noise due to noisy interferograms in Phase Shifting Interferometry (PSI). We also analyze the fact that linear filtering transforms corrupting multiplicative noise in Electronic Speckle Pattern Interferometry (ESPI) into fringes corrupted by additive gaussian noise. This fact allow us to obtain a formula to estimate the standard deviation of the noisy demodulated phase as a function of the spectral response of the preprocessing spatial filtering combined with the PSI algorithm used. This phase noise power formula is the main result of this contribution.

An observational cohort study of the meniscus test to detect intravascular epidural catheters in pregnant women.

BACKGROUND: The meniscus test is a rapid non-pharmacologic method of confirming epidural catheter placement by observing a normal saline meniscus while physically manipulating the catheter. The aim of this study was to assess whether the meniscus test improves diagnostic accuracy of aspiration to detect intravascular or intrathecal placement of epidural catheters in pregnant women. METHODS: In this prospective observational study, parturients at >or= 36 weeks of gestation were recruited. In the sitting position, participants received a multiorifice epidural catheter for elective cesarean delivery or labor analgesia. After aspiration was confirmed to be negative for blood and cerebrospinal fluid, the meniscus test was performed. Subsequently, a pharmacologic test dose was given with 1.5% lidocaine 3 mL and epinephrine 15 microg. Intravascular placement was diagnosed if the patient experienced an increase in heart rate >or= 20 beats/min within 2 min with or without tinnitus, metallic taste, dizziness, palpitations, headache, or anxiety. RESULTS: The overall intravascular catheter rate was 5.7% (24/419). The rate of intravascular catheter location not detected by aspiration was 0.95% (4/419). Given negative catheter aspiration, the meniscus test demonstrated 25% sensitivity, 87.5% specificity, and 1.9% positive predictive value for intravascular catheter insertion. No intrathecal catheters were observed. CONCLUSIONS: For obstetric patients in the sitting position, the meniscus test does not improve diagnostic accuracy of aspiration for detecting intravascular multiorifice epidural catheter placement.

Phasorial analysis of detuning error in temporal phase shifting algorithms.

Phase error analysis in Temporal Phase Shifting (TPS) algorithms due to frequency detuning has been to date only performed numerically. In this paper, we show an exact analytical expression to obtain this phase error due to detuning using the spectral TPS response. The new proposed method is based on the phasorial representation of the output of the TPS quadrature filter. Doing this, the detuning problem is reduced to a ratio of two symmetrical spectral responses of the quadrature filter at the detuned frequency. Finally, some popular cases of TPS algorithms are analyzed to show the usefulness of the proposed method.