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  • 1
    ISSN: 1432-2218
    Keywords: Esophageal varices ; Endoscopic injection sclerotherapy ; Transparent overtube ; Negative pressure
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Endoscopic injection sclerotherapy (EIS) using the transparent overtube (OT) method can be conducted safely and easily not only in elective esophageal varices but also in emergency cases because of the ability to obtain a good field of view and fixation of the varix. However, application of the OT method is limited because intravariceal injection into small varices through the slit of the OT is impossible. We devised a technique to apply the OT method to small varices by utilizing negative pressure in the OT (np-OT method). By using negative pressure, EIS with a transparent overtube is now suitable for all grades of esophageal varices, and the accuracy of puncture in EIS has been improved. Injection of the target area was successful in all cases. The rate of intravariceal injection has also been improved (47% in low-grade varices) because injection of all sites was possible. We call EIS by the np-OT method “np-EIS”.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-2568
    Keywords: OKADAIC ACID ; MICROTHROMBUS ; COLON ; PARACELLULAR PATHWAY
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Effects of okadaic acid (OA) on mucosal damagewere examined in rat colon. OA was sprinkled on ratcolon mucosa under observation with anelectronic-endoscopic system, and OA was also applied tothe in vivo microscopic field. The OA-induced changesin transepithelialconductance (Gt) weremeasured by the Ussing voltage clamp technique. Byendoscopic observation, the luminal sprinkling of OA (60nmol/kg) evoked transient microthrombi in the submucosalvenule, which was followed by mucosal edema.Histological study after endoscopic observation showedsubmucosal fluid retention, suggesting an increase of vascular permeability. The microthrombi werealso detected by in vivo microscopy. Byelectrophysiological study after endoscopic observationwith and without OA addition, the basal Gtvalues were 54 ± 6.2 and 36.2 ± 4.2 mS/cm2,respectively (P 〈 0.01). Furthermore in control rats,the serosal addition of OA evoked an increase inGt in a concentration-dependent mannerwithout increasing lactate dehydrogenase release. 2,4,6-Triaminopyrimidinium inhibitedOA-induced Gt change by 60%. These resultsindicate that OA evokes an increase in paracellularpermeability of epithelium. We conclude that thedeveloped microthrombi are the first key event of OA-induced mucosaldamage, followed by an increase in permeability in thesubmucosal venule and in the paracellular pathway of theepithelium.
    Type of Medium: Electronic Resource
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