An embedded system is some combination of computer hardware and software; either fixed in capability or programmable that is Specifically designed for a particular kind of application device. Industrial machines, automobiles, medical equipment, cameras, as well as the more obvious cellular phone are among the myriad possible hosts of an embedded system. Embedded systems that are programmable are provided with a programming interface. In the past, doctors who needed to diagnose digestive problems would either use X-rays or endoscopy, which involves sedating A person and guiding a narrow tube with a camera attached down the throat and into the stomach and upper intestinal tract. Before endoscopy, doctors would have to perform surgery to assess some problems. Capsule endoscopy allows us to see places inside the small bowel where other methods cannot reach.

Endoscopy is the examination of the inside of the body using a lighted, flexible instrument called an endoscope. In general, an Endoscope is placed into the body through a natural opening like the mouth or anus. The most common endoscopic procedures evaluate the esophagus (swallowing tube), stomach, and portions of the intestine, colon.


Capsule camera, endoscopic capsule or video pill is a camera with the size and shape of pill. The Imaging Capsule contains a miniature camera, battery, light, computer chip and wireless transmitter. The target destination for the device is the small bowel, where the miniature camera may help physicians detect sources of bleeding or diagnose disease.



At the present time, the capsule camera is primarily used to visualize the small intestine. Whereas the upper gastrointestinal tract (esophagus, stomach, and duodenum) and the colon (large intestine) can be very adequately visualized with scopes (cameras placed at the ends of thin flexible tubes), the small intestine is very long (average 20-25 feet) and very convoluted. No available scope is able to traverse the entire length of the small intestine. The capsule camera travels through the length of the small intestine in about 4 hours, and wirelessly transmits two images every second to a receiver carried by the patient. The images are of very good quality, comparable to those from scopes. The test carries a high sensitivity and specificity for detecting lesions. The main uses today are for detecting the cause of gastrointestinal bleeding, and for inflammatory bowel disease, such as Cohn’s disease






A 2002 TEC Assessment (1) concluded that wireless capsule endoscopy met the TEC criteria as a technique to investigate obscure gastrointestinal (GI) bleeding suspected of being of small bowel origin. (2) Specifically, the TEC Assessment reviewed 2 articles that focused on the clinical applications of wireless capsule endoscopy in patients with obscure GI bleeding. Obscure GI bleeding is defined as “recurrent or persistent irondeficiency anemia, positive fecal occult blood test, or visible bleeding with no bleeding source found at original endoscopy. The first comparative study included 20 patients with obscure digestive tract bleeding. Capsule images were reported as good or excellent by the 2 physician reviewers, 1 of whom was blinded to clinical information and results of push enteroscopy. Overall, wireless capsule endoscopy found a bleeding site in 11 of 20 (55%) patients studied and provided additional information not detected by push enteroscopy in 5 of 20 (25%) cases. An updated literature search performed for the period of 2005 through January 2006 did not identify any additional articles that would prompt reconsideration of the relevant policy statement, which remains unchanged. Published studies continue to support the role of the capsule camera in the evaluation of obscure GI bleeding. The policy was updated with a literature search through February 2007. Eliakim evaluated 106 patients (93 with GER and 13 with Barrett esophagus) with wireless endoscopy followed by standard endoscopy as the gold standard. (18) A blinded adjudication committee reviewed all discrepant findings. The authors reported a sensitivity of 92% (61 of 66) and specificity of 95%. Lin and colleagues reported results of a prospective blinded (without adjudication) study of capsule endoscopy compared to conventional endoscopy for Barrett’s esophagus in 66 screening and 24 surveillance patients. (19) This study reported a sensitivity of 67% (14 of 21) and specificity of 84%. The policy was updated with a literature review in June 2008 using MEDLINE. Delvaux studied both esophagogastroduodenoscopy (EGD) and capsule endoscopy (CE) in a European study of 98 patients, enriched to include abnormal esophageal


findings in two-thirds of patients. (21) EGD was normal in 34 patients and showed esophageal findings in 62 (esophagitis 28, hiatus hernia 21, varices 21, Barrett's esophagus 11, others 7). Average esophageal transit time of the capsule was 361 seconds. Capsule endoscopy (CE) was normal in 36 patients but detected esophagitis in 23, hiatus hernia in 0, varices in 23, Barrett's esophagus in 18, and others in 4. Overall agreement per patient was moderate between EGD and capsule endoscopy for the perpatient (kappa = 0.42) and per-findings (kappa = 0.40) analyses. The policy was updated with a literature search through mid-July 2009. Literature was reviewed for several indications for capsule endoscopy and for the patency capsule. A recent meta-analysis summarized available studies comparing capsule endoscopy to a reference standard of duodenal biopsy. (33) The pooled analysis of 3 studies showed a sensitivity of 83% and a specificity of 98%. The sensitivity of the test does not seem to be sufficient to replace duodenal biopsy for the diagnosis of celiac disease. The policy statement is unchanged; the use of capsule endoscopy remains investigational for the evaluation of celiac disease.


Wireless capsule endoscopy is performed using the PillCam, which is a disposable imaging capsule manufactured by Given Imaging, Ltd (Norcross, GA). The capsule measures 11 by 30 mm and contains video imaging, self-illumination, and image transmission modules as well as a battery supply that lasts up to 8 hours. The indwelling camera takes images at a rate of 2 frames per second as peristalsis carries the capsule through the gastrointestinal tract. The average transit time from ingestion to evacuation is 24 hours. The device uses wireless radio transmission to send the images to a receiving recorder device that the patient wears around the waist. This receiving device also contains some localizing antennae sensors that can roughly gauge where the image was taken over the abdomen. Images are then downloaded onto a workstation for viewing and processing. Evaluation of the esophagus requires limited transit time, and it is estimated that the test takes 20 minutes to perform. Alternative techniques include upper endoscopy. In 2006, the FDA also provided clearance for the Given AGILE patency system. This system is an accessory to the PIllCam video capsule is intended to verify adequate patency of the GI tract prior to administration of the PillCam in patients with known or suspected strictures. This capsule is of similar size to the endoscopy capsule, but is made of lactose and barium and dissolves within 30-100 hours of entering the GI tract. It carries a tracer material that can be detected by a scanning device. Excretion of the intact capsule without symptoms (abdominal pain or obstruction) is reported to predict the uncomplicated passage of the wireless capsule.


The procedure involves the patient taking a small capsule, or endoscope with a tiny camera, light and radio transmitter inside it. The patient also wears small sensors attached to the abdomen with adhesive sleeves. A mini-lens on the tip of the capsule would be connected to a tiny "engine" running off electrical signals. An antenna would take in the electric signals and send out the data collected and the "brain" behind the whole system would be a microchip operating with hi-tech fluids. As the capsule moves through the digestive system it records images and sends them by radio signal to a receiver/recorder worn by the patient on a waist Belt as the patient goes about his or her regular day. The procedure takes about 12 hours and the final recording is about 8 hours long. Afterward, a doctor takes the disk from the recorder and views the video on a high-resolution monitor. The device takes two frames every second, providing about 58,000 images in eight hours as it makes it way through the patient’s entire digestive tract.

Fig. 5.1.PILL CAMERA OF THE FUTURE The camera transmits digital images to a recording device the patient wears on a belt. Later, the recorder’s data is downloaded to a physician’s computer. As the video 8

progresses, the images on the screen reveal thousands of villi, liquids and particles passing through the intestine. More important, the images reveal any telltale signs of inflammation or sores, all in great detail. The finished product is a documentary-like series of photographs that provide a first-person view of the journey through the digestive tract.

The physician can stop the fast-moving photos for closer inspection, then mark and copy images showing suspected abnormalities. The patient’s entire test can be copied onto a compact disc for later use in consultation. It is used to diagnose problems in the gut also. In general, capsule endoscopy provided good views from mouth to colon and successfully imaged small-

Fig. 5.2.WORKING OF CAPSULE CAMERA Bowel pathologic features. Conventional endoscopy involves a lighted tube being inserted into the gut via the throat or rectum. Video images were transmitted via radio signals to aerials taped.


To the body and the strength of the signal was used to calculate the position of the capsule in the body. These promote greater efficiency in medical Institutions and help improve quality of life for the patients. Gastrointestinal endoscopes are now recognized as the only medical devices that can simultaneously perform observations, diagnoses (tissue extraction), and treatment. As tiny as a pill measuring just 9 millimeters in diameter and 23 mm in length, the Norika3 capsule endoscope developed by RF is uniquely painless. "Though it hasn't been in practical use yet. Although the company says it is still preparing to conduct clinical studies with other medical institutions, it expects to market the Norika3 by the end of the year both in Japan and overseas. It will accommodate a CCD camera of 0.41 mega pixels and is likely be initially marketed at $100. The capsule moves painlessly through the gastrointestinal tract while transmitting color images on a real-time basis. The device accommodates a plastic CCD camera with a 0.6-millimeter lens as well as four Light-Emitting Diode (LED) flashing devices to supply light in the dark intestines. The camera can transmit up to 30 images per minute, as long as the patient is wearing the vest that transmits microwaves to the capsule.



(1) Technology of capsule endoscope: Compact, low power-consumption imaging technology, wireless transmission technology. (2) Wireless power supply system: Eliminates constraints on operating time and energy levels. (3) Drug delivery system: Administer drugs directly to the affected area. (4) Body fluid sampling technology: Extracts body fluid for diagnosis and analysis. (5) Self-propelled capsule: Propels (capsule) freely within the gastrointestinal tract.

1. 2. 3. 4. 5. 6. 7. 8. 9. Little discomfort Does not require sedation Eliminates potential sedation related cardiopulmonary complications. Offers a simple, safe and less invasive alternative. Patient satisfaction Comfort during procedure Convenience Immediate recovery Preferred by patient over traditional endoscopy

1. A physician cannot stop the camera’s progress to change the angle or take a prolonged look when it nears suspicious areas. 2. There is no air insufflations pumping in air to open up intestinal folds for Examination.


Modern endoscopic techniques have revolutionized the diagnosis and treatment of diseases of the upper gastrointestinal tract (esophagus, stomach, and duodenum) and the colon.

  

It is Very effective to use. And by using this can obtain best results. Capsule endoscope technology is developed by using capsule camera. It is to be in great use in near future.


• • • • • www.msdn.microsoft.com www.wikipedia.org www.asptoday.com www.capsule-endoscopy.info www.google.com