In April, 1978, we carried out a survey covering 27 hospitals, in which colonoscopy is performed on a routine basis. With respect to the size of the hospital, the equipment available and the level of training of the examiner, this selection may be regarded as representative. A total of 35,892 colonoscopies, 7,365 polypectomies, 58 electrocoagulations and 14 rugectomies were analysed with respect to the nature, localization and treatment of any complications that arose. The rate of complications seen in diagnostic colonoscopy was 0.008% for bleeding and 0.14% for perforation, the mortality rate being 0.02%. As expected, the complication rate for colonoscopic polypectomy was higher. Bleedings were reported in 2.24%, perforations in 0.34% and deaths in 0.1% of the examinations. Of particular importance would seem to be the possibilities of preventing complications. It was shown on the basis of the survey that a good, standardized training of the endoscopist, the strict observance of the contraindications, the non-use of analgesics and general anaesthesia, fluoroscopic control of "difficult" colons and the use of the best instruments and aids presently available, reduce the complication rate to a minimum.
Until recently a laparotomy was necessary to carry out polypectomy for diagnostic, prophylactic or therapeutic purposes.With the aid of a diathermy wire loop (or snare) developed by us, and a flexible coloscope, we have succeeded in removing 6 colionic polyps through the anus. The operation is completely painless and is carried out without anaesthesia or the previous administration of analgesics. 'fhe patient is sa ved the operation of laparotomy with the attendant period of hospitalisation.Endoscopy 2 (1971) 103-105
In rat brain slices preincubated with various radiolabelled putative neurotransmitters, methionine-enkephalin diminished the potassium-evoked release of dopamine and acetylcholine. The effect was antagonised by naloxone. The potassium-induced effux of three other neurotransmitters, histamine, 5-hydroxy-tryptamine and gamma-aminobutyric acid, were unaffected by methionine-enkephalin. A probable physiological function for the endogenous ligands in specifically affecting the catecholaminergic and cholinergic transmission is suggested.
An increased frequency of kidney stone formation is reported in patients with inflammatory bowel disease. In order to investigate its pathogenesis, the concentrations of factors known to enhance calcium oxalate stone formation (oxalate, calcium, uric acid) as well as of inhibitory factors for nephrolithiasis (magnesium, citrate) were determined in the urine of 86 patients with Crohn's disease and compared with those of 53 metabolically healthy controls. Six patients with Crohn's disease already had experienced calcium oxalate nephrolithiasis. Patients with Crohn's disease had significantly higher urinary oxalate and lower magnesium and citrate concentrations. Among all patients magnesium and citrate were significantly lower in those with a positive history of kidney stones. Our results demonstrate that the increased propensity for renal stone formation in patients with Crohn's disease is a result not only of increased urinary oxalate, but also of decreased urinary magnesium and citrate concentrations.
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