Safety of preoperation endoscopic tattoo with india ink for identification of colonic lesions.

BACKGROUND: Colonic tattooing with india ink is a widely practiced technique regarded as safe, accurate, and reliable. In this series, the largest reported, the safety of this technique is studied. METHODS: A retrospective study of 8,125 consecutive patients who undersent colonoscopy over a 64-month period was conducted. India ink colonic mucosal tattooing was used for either preoperative marking or future endoscopic identification of a lesion. RESULTS: During the study, 195 patients underwent endoscopic injection of india ink. Of these, 50 patients were marked before surgery, and 145 underwent marking with the intent of facilitating future endoscopic localization. Patients were followed by either telephone interviews or physical examination. None of the patients developed fever, persistent abdominal pain, or abdominal tenderness on examination. All surgeons were interviewed. They uniformly reported the tattoo as intensely visible and of great utility in locating the lesions. CONCLUSIONS: Preoperative mucosal tattooing with india ink is recommended as a safe and necessary procedure.

Endothelium-dependent inhibition of Na(+)-K+ ATPase activity in rabbit aorta by hyperglycemia. Possible role of endothelium-derived nitric oxide.

Hyperglycemia has been shown to diminish Na(+)-K+ ATPase activity in rabbit aorta. To examine the basis for this effect, aortic rings were incubated for 3 h in Krebs-Henseleit solution containing 5.5 or 44 mM glucose, and Na(+)-K+ ATPase activity was then quantified on the basis of ouabain-sensitive (OS) 86Rb-uptake. Incubation with 44 mM glucose medium caused a 60% decrease in Na(+)-K+ ATPase activity in rings with intact endothelium (from 0.22 +/- 0.01 to 0.091 +/- 0.006 nmol/min per mg dry wt; P less than 0.01). Similar decreases (45%; P less than 0.01) in Na(+)-K+ ATPase activity were seen when rings incubated with 5.5 mM glucose were exposed to NG-monomethyl L-arginine (300 microM), an inhibitor of endothelium-derived nitric oxide (EDNO) synthesis or when the endothelium was removed (43% decrease). The decrease in Na(+)-K+ ATPase activity induced by hyperglycemia was totally reversed upon adding to the medium either L-arginine, a precursor of EDNO biosynthesis or sodium nitroprusside, which bypasses endothelium and directly activates the soluble guanylate cyclase in vascular smooth muscle. A decrease in Na(+)-K+ ATPase activity (42%; P less than 0.05), only seen in the presence of endothelium, was also observed in aortas taken directly from alloxan-induced diabetic rabbits. These studies suggest that the decrease in vascular Na(+)-K+ ATPase activity induced by hyperglycemia is related, at least in part, to a decrease in the basal release of EDNO. They also suggest that alterations in basal EDNO release and possibly Na(+)-K+ ATPase activity contribute to the impairment in vascular relaxation caused by hyperglycemia and diabetes.