BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely ...BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely reported in the literature.CASE SUMMARY We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy.The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy.It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum.The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope,resulting in high pressure water jet.Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability.CONCLUSION This is the first report of mucosa injury from a colonoscope water jet malfunction.Endoscopists should recognize the potential for endoscopic malfunction.展开更多
Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury. In this study, we examined the effects of penehyclidine hydrochlori...Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury. In this study, we examined the effects of penehyclidine hydrochloride （PHC）, a selective M-receptor inhibitor, on dichlorvos-induced acute lung injury in swine. Methods Twenty-two female swines were randomly divided into control （n=5）, dichlorvos （n=6）, atropine （n=6）, and PHC （n=5） groups. Hemodynamic data, extravascular lung water index （EVLWI）, and pulmonary vascular permeability index （PVPI） were monitored; blood gas analysis and acetylcholinesterase （AchE） levels were measured. PaO2/FiO2, cardiac index （CI）, and pulmonary vascular resistance indices （PVRI） were calculated. At termination of the study, pulmonary tissue was collected for ATPase activity determination and wet to dry weight ratio （W/D） testing 6 hours post-poisoning. TUNEL assay, and Bax, Bcl-2, and caspase-3 expression were applied to pulmonary tissue, and histopathology was observed. Results After poisoning, PHC markedly decreased PVRI, increased CI more effectively than atropine. Anticholinergic treatment reduced W/D, apoptosis index （AI）, and mitigated injury to the structure of lung; however, PHC reduced AI and caspase-3 expression and improved Bcl-2/Bax more effectively than atropine. Atropine and PHC improved ATPase activities; a significant difference between groups was observed in Ca2＋-ATPase activity, but not Na＋-K＋-ATPase activity. Conclusions The PHC group showed mild impairment in pathology, less apoptotic cells, and little impact on cardiac function compared with the atropine group in dichlorvos-induced acute lung injury.展开更多
文摘BACKGROUND Screening colonoscopies are routinely performed and have low occurrences of adverse events such as perforation,bleeding,infection,and post-polypectomy syndrome.True device related adverse events are rarely reported in the literature.CASE SUMMARY We report a case of a 51-year-old patient without past medical history who presented for her first screening colonoscopy.The patient was thought to have friable mucosa in the cecum and oozed upon water irrigation during screening colonoscopy.It was later identified that the colonoscope used during the index procedure had malfunctioned and produced a pin-point water jet which damaged the colon mucosa of cecum.The maintenance service identified a piece of rubber fragment lodged in the instrument component at the tip of the scope,resulting in high pressure water jet.Repeat colonoscopy with a functioning colonoscope confirmed normal colon mucosa without friability.CONCLUSION This is the first report of mucosa injury from a colonoscope water jet malfunction.Endoscopists should recognize the potential for endoscopic malfunction.
文摘Background Organophosphate poisoning is an important health problem in developing countries which causes death mainly by inducing acute lung injury. In this study, we examined the effects of penehyclidine hydrochloride （PHC）, a selective M-receptor inhibitor, on dichlorvos-induced acute lung injury in swine. Methods Twenty-two female swines were randomly divided into control （n=5）, dichlorvos （n=6）, atropine （n=6）, and PHC （n=5） groups. Hemodynamic data, extravascular lung water index （EVLWI）, and pulmonary vascular permeability index （PVPI） were monitored; blood gas analysis and acetylcholinesterase （AchE） levels were measured. PaO2/FiO2, cardiac index （CI）, and pulmonary vascular resistance indices （PVRI） were calculated. At termination of the study, pulmonary tissue was collected for ATPase activity determination and wet to dry weight ratio （W/D） testing 6 hours post-poisoning. TUNEL assay, and Bax, Bcl-2, and caspase-3 expression were applied to pulmonary tissue, and histopathology was observed. Results After poisoning, PHC markedly decreased PVRI, increased CI more effectively than atropine. Anticholinergic treatment reduced W/D, apoptosis index （AI）, and mitigated injury to the structure of lung; however, PHC reduced AI and caspase-3 expression and improved Bcl-2/Bax more effectively than atropine. Atropine and PHC improved ATPase activities; a significant difference between groups was observed in Ca2＋-ATPase activity, but not Na＋-K＋-ATPase activity. Conclusions The PHC group showed mild impairment in pathology, less apoptotic cells, and little impact on cardiac function compared with the atropine group in dichlorvos-induced acute lung injury.
