A generous philanthropic grant has made this issue available free online. Don’t fail to Z-VAD-FMK purchase take advantage of the opportunity to read and share the entire issue, which should change our approach to colonoscopy surveillance in inflammatory bowel disease. “
“Tonya Kaltenbach, MD, Editor The challenge to a renaissance in endoscopic imaging is significant because of the seed that was planted some three decades ago. As video endoscopy was introduced, our endoscopy forefathers chose the color charge coupled device (CCD), while their Japanese counterparts used the black and white (B&W) CCD. The color CCD provided a lower resolution video, but was preferred because it used white light that was more pleasing

to the eyes. The B&W CCD, on the other hand, used sequential red, green, and blue lights, which provides a superior imaging. However, it can appear to flicker and thus is less pleasing. With the lower quality endoscope imaging, western endoscopists have come to rely more on text and pathology

to describe their findings, rather than on the detailed images. Thus, in the United States, the nonpolypoid precancers and early cancers were not appreciated. The techniques to enhance visualization of the nonpolypoid tumors were not prioritized, as few were found. Endoscopic mucosal Y-27632 mw resection techniques were not routine in the practice of endoscopy; there was no flat lesion to cut. Since then, our CCD and endoscopy technology have significantly improved. With it came the recognition of the importance of the nonpolypoid tumors. But, generations of endoscopists were never taught the detection,

diagnosis, or treatment techniques of the nonpolypoids. Thus, today, in the United States, we find ourselves with IBD practice guidelines that are outdated and endoscopy techniques that are largely ineffective. Of utmost concern, we lack the manuals and only have few teachers to disseminate the renewals. How are we then going to move forward? The ubiquitous use of the electronic media may provide one avenue. We are indebted for the opportunity given by Dr Lightdale to prepare this issue, and to the contributing authors for their generosity to share knowledge. We are especially thankful to the Maxine and Jack Zarrow Family Foundation Ribonuclease T1 for their support to make this issue free online as a resource for all patients and health providers. Renaissance in endoscopic imaging in IBD can only begin when the patients demand, and the providers are able to deliver, the required care. Our sincere hope is that this (electronic) issue and atlas provide the first of the new guides in endoscopy for IBD. Thus, we can move forward and fulfill our promise—the Hippocratic Oath—to the fullest: “I will apply, for the benefit of the sick, all measures [that] are required ….” In the surveillance for colorectal neoplasms in patients with IBD, the art and science of the detection, diagnosis, and treatment of the nonpolypoid precancers and early cancers are required.