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What happens after upper endoscopy?
After your upper endoscopy, your physician will explain the results to you. Someone must drive you home from
the hospital because of the medications used during your
examination. Use of a taxi is not permitted. If no ride is
available, the procedure cannot be started.
Even if you
feel alert after the procedure, your judgment and reflexes may be impaired by the sedation for the rest
of the day. This makes it unsafe for you to drive or
operate machinery after your procedure. No important
decisions should be made on the day of your procedure.
Contact your gastroenterologist if you have a fever,
difficulty swallowing, chest or abdominal pain, or difficulty

Norwalk Hospital Outpatient Registration
breathing after the procedure.
Patients coming to Norwalk Hospital for outpatient
procedures can save time by pre-registering.
To the patient
the Express Service, Monday through Friday, 11 Because education is an important part of compre- am to 6 pm, so that you may obtain the necessary hensive medical care, you have been provided with information. The telephone number is 203-852- this information to prepare you for your procedure. If you have any questions about the need for upperendoscopy, alternative tests, the cost of the procedure, If you have any questions, please ask your physician
methods of billing, or insurance coverage, speak with or the medical assistant prior to starting the procedure.
your doctor or your doctor's office staff. Endoscopists
are highly trained specialists who welcome your questions
regarding their credentials and training. If you have any
questions that have not been answered, please discuss
them with your physician prior to your examination.

Department of Gastroenterology
Patient Information: Upper Endoscopy
Please read the information given below completely,
What about my current medications?
before the day of your procedure. Your physician has
If your upper endoscopy is to be performed in the afternoon,
determined that an upper endoscopy is necessary for you may take most medications in the early morning, further evaluation or treatment of your medical with a small amount of water. If your procedure is to be
condition. This brochure has been prepared to help performed in the morning, you may take medication after
you understand the procedure. It includes answers to the procedure. Consult with your physician about all
questions patients ask most frequently. Please read medication use, either before or after your procedure.
Endoscope highlighting it carefully. If you have any questions, please discuss the esophageal area to them with the endoscopy nurse or your physician Aspirin products, arthritis medications, anticoagulants look for irritation caused by acid reflux before the examination begins. Make sure you have
(blood thinners) such as Coumadin®, Plavix®, Pradaxa, arranged for a ride home from the Endoscopy Lab. If no
Xarelto, Persantine®, or Ticlid®, insulin, Vitamin E, ride is available, the procedure will not be started.
Ginkgo, and iron products are examples of medicationsyou should discuss with your physician prior to the What is an upper endoscopy?
examination. Inform your physician about all medications
Upper endoscopy is a procedure performed by a used and any allergies to medications. In addition, some
gastroenterologist, a specialist trained in the use of medications for depression (MAO inhibitors) may modify the endoscope. Your doctor will use the endoscope to
your anesthesia needs. Please notify your physician if look closely for any problems that may require evaluation,
you are taking such medications. You should alert your
diagnosis, or treatment.
physician if you require antibiotics prior to undergoing
dental procedures, and for such reasons as artificial

The endoscope is a long, thin, flexible tube with a joints and artificial heart valves. Inform your physician
(forceps) through the endoscope. This procedure tiny video camera and light on the end. By adjusting about those needs at least one week prior to your should cause you no discomfort. Remember, biopsies the various controls on the endoscope, the gastroen- procedure. It may require additional time prior to your are taken for many reasons and do not necessarily terologist can safely guide the instrument to carefully procedure for preparation in the Endoscopy Lab.
mean cancer is suspected. In some cases, treatment examine the lining of the upper digestive system.
for problems, such as active bleeding or dilation of a This includes the esophagus, stomach and duodenum What can I expect during an upper endoscopy?
narrowed area, may take place during your examination.
(first portion of the small intestine).
Your physician and endoscopy assistant will help keep You will be asked to give your doctor permission to you comfortable during your procedure. The procedure
perform these procedures.
generally lasts approximately 15 to 30 minutes. You may
What preparation is needed?
have your throat sprayed or be asked to gargle with a
You will be asked not to eat anything for at least six
What are the possible complications of upper endoscopy?
local anesthetic to keep you comfortable as the endoscope
hours prior to your procedure. You will be allowed to
Years of experience have proven that upper endoscopy is
is passed. You may also receive sedative medication
drink clear liquids until four hours before the procedure.
a safe procedure. Complications rarely occur. These
which will make you relaxed and drowsy.
You may rinse your mouth until the time of the include perforation (a puncture of the esophagus, stomach, or intestinal wall), which could require As you lie on your side, the endoscope is slowly and immediate surgical repair. Bleeding is also a potential carefully inserted. Air is introduced through it to help complication of endoscopy. This could require a blood your doctor see more clearly. During the procedure, transfusion, or, rarely, surgery. Heart and respiratory you should feel no pain, and it will not interfere with problems can occur with the use of sedation. In Consent – You will be asked to sign a form that
your breathing.
addition, the aspiration of gastric juices into the verifies that you have read and understand the
lungs, and/or infection is possible. However, such information given to you. This will give the
In some cases, it may be necessary to take a sample complications are uncommon. Be sure to discuss any physician the consent to perform the procedure.
of tissue called a biopsy for later examination under specific concerns you may have with your doctor, the microscope. This is done by passing an instrument prior to the procedure.


3D Cell Culture: A Review of Current Techniques Brad Larson, Senior Applications Scientist, Applications Department, BioTek Instruments, Inc., Winooski, VT Over the last decade, a central focus of drug discovery efforts has been the incorporation of in vitro testing models that better mimic in vivo conditions found within the target patient. An initial step saw a move away from biochemical assays using purified drug target, in favor of a cell-based approach which utilized over-expression of drug target in common host cell lines, such as CHO and HEK-293. The quest for greater physiological relevance proceeded to the use of primary cells, preferably human if supply was adequate, and the reliance on endogenous expression of drug target should detection technology be sensitive enough. A large percentage of these cell types, being naturally adherent, allowed simple culturing workflows that seeded cells in a coated microplate well, incubating the microplate to encourage the cells to attach in a two dimensional (2D) monolayer before performing the prescribed assay. While providing initial improvements over biochemical and immortalized cell lines, an abundance of evidence now supports the reality that culturing cells in this 2D manner is often problematic and is a relatively poor model for in vivo conditions and behaviors. Using a 2D model, attrition rates of drug candidates for cancer were approximately 95%1, stemming from in vitro drug efficacy values that did not translate to the clinic, as well as unforeseen toxicity issues. In 2011 alone, out of approximately 900 anti-cancer therapies in clinical trials or under Federal Drug Administration review2, only twelve achieved approval3; resulting in the loss of hundreds of millions of dollars that were spent on pre-clinical and clinical trials. The reason for these shortfalls can be traced to using conventional 2D conditions, where extracellular matrix (ECM) components, cell-to-cell and cell-to-matrix interactions, important for differentiation, proliferation and cellular functions in vivo, are lost4.

REVIEW ARTICLEJ Korean Sleep Res Soc 2013;10:1-6 Imaging the Sleep Deprived Brain: A Brief Review Michael WL Chee, MBBS, FRCP (Edin)Neuroscience and Behavioral Disorders Program, Duke-NUS Graduate Medical School, Singapore Key Words: fMRI, Cognitive tasks, Attention, Default mode network, Sleep deprivation.