Endoscopic

At present, all over the world the X-ray television systems, instruments based on magnetic heat and eddy-current methods are used to check the air-passengers luggage and to check staff when entering the hazardous objects. In banks, security services and etc. the optic-television and endoscopic technical vision systems are widely used. 

Theory and Equipment. Many diseases of the human body can be identified by visual appearance. Tumors in the upper gastrointestinal (GI) tract, for example, possess a characteristic salmon pink color (3). The presence of such a color can be an indication of disease. Endoscopy is the medical imaging tool used to detect such colors in the inside of hoUow internal organs such as the rectum, urethra, urinary bladder, stomach, colon, etc. An endoscope is the instmment used to perform endoscopy. Endoscopic imaging involves the production of a tme color picture of the inside of the human body using lenses and either hoUow pipes, a fiber optic bundle, or a smaU CCD camera. AU three use a large field-of-view, sometimes referred to as a fish eye, lens to aUow a 180° field of view. 

Endoscopes containing a CCD camera replace the fiber optic bundle with a smaU monochrome CCD chip at the focal point of the fish eye lens (4). 

The largest use of endoscopic techniques is in the examination of the gastrointestinal tract. Upper intestinal endoscopy is the examination of the esophagus, stomach, and proximal duodenum. Colonoscopy is the examination of the colon, large intestine, and in some cases the distal parts of the small intestine. Cholangiopancreatography is the examination of the biUary tree and pancreas. 

Each of the endoscopic imaging procedures is relatively risk free and painless when performed by competent and weU-trained individuals using a local anesthetic. Eetoscopy has the highest risk. There is a 10% increased probabiUty of premature deUvery and 10% higher fetal loss rate. 

Special small ultrasound transducers, often referred to as endoscopic transducers, have been designed which can be inserted into blood vessels to examine blockages in arteries (43). These transducers operate at approximately 20 MHz and have a viewing distance of less than a centimeter. Such devices are capable of producing ultrasound images of the inside of arteries and veins. The quaUty of the ultrasound image is sufficient to determine the type of blockage. 

M. O. Blackstone, Endoscopic Interpretation—Mormal and Pathologic Appearances of the Gastrointestinal Tract, Raven Press, New York, 1984. 

Disinfectants are used in janitorial suppHes for hospitals and the home to treat toilet bowls, floors and walls in sick rooms, operating rooms, and wherever infective microorganisms are a problem. Instmments such as scalpels, scissors, catheters, and endoscopes used to invade tissues are treated with disinfectants, as are dental instmments. Laws require that hospital waste must be disinfected so that bacteria and vimses, such as the hepatitis vims and the AIDS vims, do not infect hospital workers and people in the community. 

Automation of disinfection procedures, e.g. use of automatic machines, still with a good standard of general ventilation, for disinfecting endoscopes... 

Ease of use 2-6°C storage. Multiple application devices (linear, spray tips, endoscopic, etc.), 20 min preparation time. Set-up time = 30 s-3 min. May wash away in presence of active bleeding. Requires trained personnel to operate equipment. Preparation time required to obtain plasma component. Room temperature storage. 5 min preparation time. Single syringe applicator per kit. Set-up time - 3 min. Effective at site of active bleeding. 

Midazolam (Versed), a short-acting benzodiazepine CNS depressant, is used as a preanesthetic drug to relieve anxiety for induction of anesthesia for conscious sedation before minor procedures, such as endoscopic procedures and to supplement nitrous oxide and oxygen for short surgical procedures. When the drug is used for induction anesthesia, the patient gradually loses consciousness during a period of 1 to 2 minutes. 

This chapter discusses drug s used to treat urinary tract infections (UTIs) and certain miscellaneous drag > used to relieve the symptoms associated with an overactive bladder (involuntary contractions of the detrusor or bladder muscle). Structures of the urinary system that may be affected include the bladder (cystitis), prostate gland (prostatitis), the kidney, or the urethra (see Pig. 47-1). These drug s also help control the discomfort associated with irritation of the lower urinary tract mucosa caused by infection, trauma, surgery, and endoscopic procedures. 

Direct Visualization. The most direct way of examining a fetus Is to look directly at It, and an Instnunent has been developed for this purpose — the fetoscope (15). This Instrument Is a modified endoscope which can be Inserted Into the amnlotlc cavity through a 14 gauge needle. Since this needle Is fairly large In diameter, there Is a significant possibility of uterine or placental bleeding associated with Its Introduction. In addition, lack of flexibility Interferes with... 

Tuberculosis is on the increase in developed countries such as the USA and UK furthermore, MAI may be associated with AIDS sufferers. Hospital-acquired opportunistic mycobacteria may cause disseminated infection and also lung infections, endocarditis and pericarditis. Transmission of mycobacterial infection by endoscopy is rare, despite a marked increase in the use of flexible fibreoptic endoscopes, but bronchoscopy is probably the greatest hazard for the transmission ofM tuberculosis and other mycobacteria. Thus, biocides used for bronchoscope disinfection must be ehosen carefully to ensure that such transmission does not occur. 

An alternative method of managing patients with cerebellar infarction causing obstructive hydrocephalus is endoscopic third ventriculostomy. Baldauf et al. ° reviewed 10 cases managed by the use of endoscopic third ventriculostomy, 8 of whom had clinical improvement (measured as an improvement in the level of consciousness). This therapy is still experimental, and improvement in outcome has not been demonstrated. 

Baldauf J, Oertel J, Gaab MR, Schroeder HW. Endoscopic third ventriculostomy for occlusive hydrocephalus caused hy cerehellar infarction. Neurosurgery 2006 59(3) 539-544. Schwab S, Aschoff A, Spranger M, Albert F, Hacke W. The value of intracranial pressure monitoring in acute hemispheric stroke. Neurology 1996 47(2) 393-398. 

Humans Hydrogen peroxide has been used as an enema or as a cleaning agent for endoscopes and may cause mucosal damage when applied to the surface of the gut wall. Hydrogen peroxide enteritis can mimic an acute ulcerative, ischaemic or pseudomembranous colitis, and ranges from a reversible, clinically inapparent process to an acute, toxic fulminant colitis associated with perforation and death (Bilotta and Waye, 1989). It is conceivable that anecdotal reports of exacerbation of IBD by iron supplementation (Kawai et al. 1992) are mediated by hydroxyl radical production by the Fenton reaction. 

Only one study to date has been conducted on the treatment of acute pancreatitis with antioxidants. Clemens et al. (1991) were unable to show any difference in the incidence or severity of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in a prospective, randomized, double-blind, placebo-controlled trial of allopurinol. However, Salim (1991) performed a similar trial of the effect of allopurinol and DMSO in patients with pain from recurrent pancreatitis, and found significant benefit. On the basis that depletion of antioxidants is important in the pathogenesis of chronic pancreatitis, the administration of a cocktail of antioxidants was assessed for its effect on pain in this disease. Treatment with a combination of organic selenium, d-carotene, vitamins C and E, and methionine was of benefit in the initial pilot study, and in a placebo-controlled trial (San-dilands etal., 1990 Uden et al., 1990). 

EPA Eicosapentaenoic acid EpDIF Epithelial-derived inhibitory factor also known as epithelium/derived relaxant fector EPO Eosinophil peroxidase EPOR Erythropoietin receptor EPR Effector cell protease EPX Eosinophil protein X ER Endoplasmic reticulum ERCP Endoscopic retrograde cholangiopancreatography E-selectin Endothelial selectin formerly known as endothelial leucocyte adhesion molecule-1 (ELAM-1)... 

In mart, an overlooked feature is the occurrence of mucoid-like plugs in the foetal nostrils (Schaeffer, 1910). The presence of this blockage can be confirmed by endoscopic inspection in utero these plugs seem likely to affect free amniotic flow, since they appear to be reinforced by a folded membranous gathering at the nasal vestibule (PI. 4B). A degree of restriction of fluid access to the VN aperture, which is immediately caudal to the nostril aperture, and is patent in foetal life, may be a protective feature (Jordan, 1972). The timing of the dissolution of these sealant devices prior to parturition is regrettably not known. 

---