Diseases of the stomach and small intestine account for approximately 20% of all gastrointestinal (GI)-related mortality. Biopsy of the stomach and small intestine remains a key diagnostic tool for most of the major diseases that affect the GI tract. While endoscopic means for obtaining biopsy is generally the standard of care, it has several limitations that make it less ideal for pediatric patients and in low resource areas of the world. Therefore, non-endoscopic means for obtaining biopsy samples is of interest in these settings. Areas covered: We review non-endoscopic biopsy techniques reported thus far, and critically examine their merits and demerits regarding their suitability for obtaining biopsy samples in non-sedated subjects. Expert commentary: Esophagogastroduodenoscopy (EGD) is the current standard for acquiring biopsy from the GI tract, however, its limitations include subject sedation, expensive endoscopy infrastructure, expert personnel, and a small but significant risk of complications. A less costly, minimally-invasive and non-endoscopic means for obtaining biopsy samples is therefore of interest for addressing these issues. Such a technology would be of significant impact in low- and middle-income countries where conducting endoscopy is challenging.

This chapter discusses recent advances in biomedical applications of magnetohydrodynamics (MHD). The magnetohydrodynamic (MDH) effect is a physical phenomenon describing the motion of a conducting fluid flowing under influencing of an external magnetic field. The chapter covers four primary areas of research: (1) laser beam scanning, (2) nano-particle manipulation, (3) imaging contrast enhancement, and (4) targeted drug delivery. The state-of-the-art devices based on magnetohydrodynamic principles are also presented, providing a broad view of biomedical MHDs. As the field of biomedical MHDs continues to grow, advances towards micro-scale transitions will continue to be made, maintaining its clinically driven nature and motion towards real-world applications.

We propose a simple and high-performance scheme for demultiplexing coherent Nyquist TDM signals by photo-mixing on a photo-detector with Nyquist LO pulses. This scheme takes advantage of the time-domain orthogonality of Nyquist pulses, which enables high-SNR demultiplexing and homodyne detection simultaneously in spite of a strong overlap with adjacent pulses in the time domain. The feasibility of this scheme is demonstrated through a demultiplexing experiment employing 80 Gbaud, 64 QAM Nyquist pulse OTDM signals. This scheme exhibits excellent demultiplexing performance with a much simpler configuration than a conventional ultrafast all-optical sampling scheme.

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Histopathologic analysis of biopsy specimens obtained via white light endoscopy (WLE) is the gold standard for the diagnosis of several mucosal diseases in the upper gastrointestinal (GI) tract. However, this standard of care entails a series of critical shortcomings such as missing depth information, high costs, time inefficiency, low-resolution imaging in vivo, high sampling variability, missing intrinsic tissue-specific contrast, and anesthesia related risk. In the quest for a diagnostic technology to replace the current standard of care, in vivo optical endomicroscopy has emerged as a promising alternative. This paper tells the story of a cluster of optical microscopy-based modalities invented, further developed, or first-validated in the laboratory of Dr. Guillermo J. Tearney (Tearney Lab) at the Wellman Center for Photomedicine of Massachusetts General Hospital over the past two decades, that combined lead to a novel method for diagnosis of eosinophilic esophagitis (EoE). Rather than being a comprehensive literature review, this paper aims to describe the translational journey towards a disease specific diagnostic and research tool for this increasingly recognized yet poorly understood immune-mediated disorder of the esophagus.

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Introduction: Diseases such as celiac disease, environmental enteric dysfunction, infectious gastroenteritis, type II diabetes and inflammatory bowel disease are associated with increased gut permeability. Dual sugar absorption tests, such as the lactulose to rhamnose ratio (L:R) test, are the current standard for measuring gut permeability. Although easy to administer in adults, the L:R test has a number of drawbacks. These include an inability to assess for spatial heterogeneity in gut permeability that may distinguish different disease severity or pathology, additional sample collection for immunoassays, and challenges in carrying out the test in certain populations such as infants and small children. Here, we demonstrate a minimally invasive probe for real-time localized gut permeability evaluation through gut potential difference (GPD) measurement.Materials and Methods: The probe has an outer diameter of 1.2 mm diameter and can be deployed in the gut of unsedated subjects via a transnasal introduction tube (TNIT) that is akin to an intestinal feeding tube. The GPD probe consists of an Ag/AgCl electrode, an optical probe and a perfusion channel all housed within a transparent sheath. Lactated Ringer’s (LR) solution is pumped through the perfusion channel to provide ionic contact between the electrodes and the gut lining. The optical probe captures non-scanning (M-mode) OCT images to confirm electrode contact with the gut lining. A separate skin patch probe is placed over an abraded skin area to provide reference for the GPD measurements. Swine studies were conducted to validate the GPD probe. GPD in the duodenum was modulated by perfusing 45 ml of 45 mM glucose.Results: GPD values of −13.1 ± 2.8 mV were measured in the duodenum across four swine studies. The change in GPD in the duodenum with the addition of glucose was −10.5 ± 2.4 mV (p < 0.001). M-mode OCT images provided electrode-tissue contact information, which was vital in ascertaining the probe’s proximity to the gut mucosa.Conclusion: We developed and demonstrated a minimally invasive method for investigating gastrointestinal permeability consisting of an image guided GPD probe that can be used in unsedated subjects.

Polarization dependent image artifacts are common in optical coherence tomography imaging. Polarization insensitive detection scheme for swept source based optical coherence tomography systems is well established but is yet to be demonstrated for all fiber spectrometerbased Fourier domain optical coherence tomography systems. In this work, we present an all fiber polarization insensitive detection scheme for spectrometer based optical coherence tomography systems. Images from chicken breast muscle tissue were acquired to demonstrate the effectiveness of this scheme for the conventional Fourier domain optical coherence tomography system.