| 4 | Conventional endoscopic retrograde cholangiopancreaticography vs the Olympus V-scope system显示文摘AIM: To compare the new Olympus V-scope (VS) to conventional endoscopic retrograde cholangiopancreati-cography (ERCP). METHODS: Forty-nine patients with previous endoscopic papillotomy who were admitted for interventional ERCP for one of several reasons were included in this single-centre, prospective randomized study. Consecutive patients were randomized to either the VS group or to the conventional ERCP group. ERCP-nave patients who had not undergone papillotomy were excluded. The main study parameters were interventional examination time, X-ray time and dose, and premedication dose (all given below as the median, range) and were investigated in addition to each patient's clinical outcome and complications. Subjective scores to assess each procedure were also provided by the physicians and endoscopy assistants who carried out the procedures. A statistical analysis was carried out using the Wilcoxon rank-sum test.RESULTS: Twenty-five patients with 50 interventions were examined with the VS ERCP technique, and 24 patients with 47 interventions were examined using the conventional ERCP technique. There were no significant differences between the two groups regarding the age, sex, indications, degree of ERCP difficulty, or interventions performed. The main study parameters in the VS group showed a nonsignificant trend towards a shorter interventional examination time (29 min, 5-50 min vs 31 min, 7-90 min, P = 0.28), shorter X-ray time (5.8 min, 0.6-14.1 min vs 6.1 min, 1.6-18.8 min, P = 0.48), and lower X-ray dose (1351 cGy/m2 , 159-5039 cGy/m2 vs 1296 cGy/m2 , 202.2-6421 cGy/m 2 , P = 0.34). A nonsignificant trend towards fewer adverse events occurred in the VS group as compared with the conventional ERCP group (cholangitis: 12% vs 16%, P = 0.12; pain: 4% vs 12.5%, P = 0.33; post-ERCP pancreatitis: 4% vs 12.5%, P = 0.14). In addition, there were no statistically significant differences in assessment by the physicians and endoscopy assistants using subjective questionnaires.CONCLUSION: ERCP using the short-guidewire V-system did not significantly improve ERCP performance or patient outcomes, but it may reduce and simplify the ERCP procedure in difficult settings. | Martin Raithel Andreas Ngel Jürgen Maiss Dane Wildner Alexander Fritzkarl Hagel Sandra Braun Hiwot Diebel Eckhart Georg Hahn | 2013 | World Journal of Gastroenterology2013，19，12： | 1 |
| 9 | Spontaneous exudative retinal detachment in a patient with sturge-weber syndrome after taking arginine, a supplement for erectile dysfunction显示文摘Background:Patients with Sturge-Weber syndrome can have ipsilateral diffuse or circumscribed choroidal hemangiomas.These hemangiomas have been seen to undergo spontaneous exudative or hemorrhagic retinal detachments.There is no definitive treatment for these types of retinal detachments,but radiotherapy,photodynamic therapy,oral propranolol,pegaptinib and bevacizumab have been used.Case presentation:A 26-year-old male with Sturge-Weber Syndrome developed an exudative retinal detachment that occurred immediately after taking a supplement containing arginine.The patient was treated with intravitreal bevacizumab 1.25 mg in 0.05 ml solution.Resolution of the retinal detachment was seen after 4 treatments over a six-month period.Conclusions:Arginine and other medications that cause a release of nitric oxide may lead to intravascular leakage and exudative retinal detachments in patients who have a choroidal hemangioma. | Austin Bach Aaron S Gold Victor M Villegas Andrea C Wildner Fiona J Ehlies Timothy G Murray | 2014 | Eye and Vision2014，1，1： | 0 |
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