ENDOMICROSCOPY

From Big Medical Encyclopedia

ENDOMIKROS.KOPYYa (Greek endon inside + mikros small + skopeo to consider, observe) — the method of an endoscopic research with use of a microscope allowing to track and photograph visually intravital structural changes of top coats of epithelial tissues of cavities of internals, not visible with the naked eye. It is applied for the purpose of preventive inspection and early diagnosis of various diseases.

Founders of a method consider the Austrian scientists Antawn and Grün-bergera (T. Antoine, V. Griinberger), to-rye in 1949 together with employees of the optical plant «Reichert» in Vienna designed kolpomik-roskop and applied it to diagnosis of diseases of a neck of uterus. It allowed to examine and photograph an object with increase 175 — 280.

The endomicroscopic method is based on examining of the object painted by special dyes in a reflected light by means of an endomicroscope (a kolpomik-roskop, a rektomikroskop, a bronkhomikroskop, etc.), the distal end to-rogo densely adjoins to the explored site. The method can be considered as development of endoscopy (see). At increase 15 and 35 it is possible to see the structural elements creating a mucosal surface of a cover, and at increase 170 and above — changes at the level of a cell and its components. The data received at different increase at the same patient allow to judge various parties patol. the processes happening in a mucous membrane or a cell. However E. cannot replace gistol. researches since in the first case hl are considered. obr. superficial structures of a mucous membrane, and in the second — its cross sections.

In the USSR works as V. F. Savinova, K. A. Abragami are known to V. S. Vladimirova,

A. B. Derazhna (1956 — 1960) about use E. in gynecology. Researchers painted a mucous membrane of a neck of uterus gistol. dyes: 1% water solution of hematoxylin or 1% water solution of toluidine blue. Coloring of a mucous membrane of a neck of uterus by solution of hematoxylin requires 3 — 4 min. then appears is long the remaining coloring. Coloring by toluidine blue comes quicker, in

1 — 2 min., but coloring less resistant. AA. a mucous membrane of a neck of uterus it can be carried out in polyclinic conditions. Selection of sites for E. carry out by means of a preliminary koljposkopiya (see).

Since the 80th in scientific research institute of a proctology M3 of RSFSR V. P. Strekalovsky and S. JI. Hankin carry out works on intravital endomicroscopy of a mucous membrane of a large intestine. In 1982 they received the first results of use of a method of a kolo-nomikroskopiya with increase 35, and in 1983 the technique of carrying out E is developed. stomach and coloring of tumors and hyperplastic changes of a mucous membrane of a large intestine. In 1984 works on E are carried out. a large intestine with increase 170 that gave the chance to differentiate structures of an epithelium of a large intestine at the cellular level.

For E. apply various endomicroscopes. Technology of their introduction to cavities is similar to technology of introduction of endoscopes. Orientation of an endomicroscope is made depending on design features of the device and methods of coloring of the explored site. As a rule, carry out preliminary endoscopy.

During the carrying out a research difficulties in recognition patol are possible. sites because breath of the patient or peristalti intestines can affect the clearness and sharpness of an observed picture since increase in endomicroscopes makes from 80 to 300, and depth of sharpness at the same time is insignificant. Indications and contraindications to E. same, as at endoscopy.

During improvement of endomicroscopes quality of optical and lighting systems, mechanisms of management and orientation of the device in a cavity improves, in a number of the countries there were endomicroscopes having complex optical systems and fiber light guides.

In the USSR at the beginning of the 70th in the All-Russian Research Institute of medical instrument making it is developed rektomikroskop by RMS-1 for intravital microscopic examination of a mucous membrane of a rectum in a reflected light of the visible range of a range at increase 110, 154, 220. For transfer of light the fiber light guide is used. As a light source to sighting apply a filament lamp of KIM-12-100, and to photographing — a flashlight valve of IFP-250, to-rye are mounted in the special case of the lighter of OS-100. For photographing of an object usually use the Zenit of VE-2 camera. Orientation of the device in a cavity of a rectum is carried out by means of a rektoskop with a fiber light guide of Re-VS-3. After the site of a mucous membrane of a rectum intended for detailed consideration is painted by solution of hematoxylin or toluidine blue, instead of mandrin enter a tube of a rektomikroskop before contact of a surface of protective glass of a lens with the studied fabric into a hollow tube of a rektoskop. Image sharpness at visual survey and photography is regulated by means of the mechanism of management of a mirror and the mechanism of focusing of optical system which are on the proximal end of the device.

184 ENDOPLASMIC RETIKA LUM


In State optical in-those of S. I. Vavilov are developed the contact fluorescent endomicroscopes (rekto a microscope,

kolpomikroskop, bronkhomikroskop, etc.) allowing to make observation and photography of microstructures of various perigastriums of the person in the light of their visible fluorescence (see the Microscope). These devices have no analogs abroad. As a light source at visual survey use a filament lamp of KIM-9-75, and at photography — a flashlight valve of IFT-200. Use special light filters to elimination of the radiations exciting fluorescence. In case of observation of objects with weak fluorescence there is an opportunity to increase their illumination by increase in tension given on a filament lamp up to 11 — 13 century

to Endo microscopes, as well as other optical medical devices store in the dry heated room; working parts of devices before a research need to be wiped with alcohol.

The medical staff taught technique of carrying out E is allowed to work with endomicroscopes.

Bibliography: Abragam K. A. A role

of a kolpomikroskopiya in diagnosis of cancer and precancerous conditions of a neck of uterus, Vopr. onkol., t. 5, JMb 6, page 716, 1959; Lordly I. Ya., Polyakov N. I. and Yakubenas B.-A. B. Contact microscopy, M., 1976, bibliogr.; D e-razhne A. B. Vital staining hematoxylin in clinical and histologic diagnosis of early stages of cancer of neck of uterus, Vopr. onkol., t. 6, Na 1, page 60, 1960; Drozdova JI. P. Devices of intravital microscopy for shank bores of a body, in book: Medical tekhn., Scientific review, century 6, page 61, M.,

1968, bibliogr.; it, Fotorekto-mikroskop, Medical tekhn., No. 2, page 27, 1972; Strekalovsky V. P., Khan-kin S. D. and Zakharyan V. G. Endoscopic microscopy of a stomach,

Rubbed. arkh., t. 55, JS6 2, page 76, 1983; Khan-kin S. JI., Belyaev M. V. and about r-@ e sh to about T. P. A contact ondomikro-skopiya of a large intestine with big increase, Klin, medical, t. 62, JMV 1, page 126, 1984; Antoine T. u. G of y n b e-ger of Y. Atlas der Kolpomikroskopie, Stuttgart, 1956. JI. P. Drozdova.

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