A phase I pilot study evaluating the beneficial effects of black raspberries in patients with Barrett's esophagus.

Black raspberries inhibit a broad range of cancers in preclinical models which has led to clinical evaluations targeting premalignant lesions of the colon, oral cavity and esophagus. A phase I pilot study was conducted in twenty Barrett's esophagus (BE) patients to investigate the effect of lyophilized black raspberries (LBR) on urinary metabolites and markers of lipid peroxidation, DNA damage and tissue markers of cellular proliferation, detoxification, and inflammation. Surveys, biopsies, blood and urine samples were collected before and after 6 months of LBR treatment (32 or 45 g).

Transitioning from preclinical to clinical chemopreventive assessments of lyophilized black raspberries: interim results show berries modulate markers of oxidative stress in Barrett's esophagus patients.

Increased fruit and vegetable consumption is associated with decreased risk of a number of cancers of epithelial origin, including esophageal cancer. Dietary administration of lyophilized black raspberries (LBRs) has significantly inhibited chemically induced oral, esophageal, and colon carcinogenesis in animal models. Likewise, berry extracts added to cell cultures significantly inhibited cancer-associated processes.

Using contrast-enhanced MR cholangiography with IV mangafodipir trisodium (Teslascan) to evaluate bile duct leaks after cholecystectomy: a prospective study of 11 patients.

Objective: The purpose of our study was to determine whether contrast-enhanced MR cholangiography using IV mangafodipir trisodium can accurately detect the presence and location of bile duct leaks in patients who have undergone cholecystectomy.

Subjects And Methods: Our study group included 11 patients with suspected bile duct leaks after cholecystectomy. Axial single-shot fast spin-echo and gradient-echo images were acquired in all patients before and 1-2 hr after IV administration of mangafodipir trisodium.

Detection of bile duct leaks using MR cholangiography with mangfodipir trisodium (Teslascan).

Mangafodipir trisodium (Teslascan), a hepatobiliary contrast agent, has the potential of providing functional biliary imaging similar to hepatobiliary scintigraphy. To our knowledge. the potential role of this biliary contrast agent in the detection of bile duct leaks has not been reported.

Effect of chronic inflammation on ileal short-chain fatty acid/bicarbonate exchange.

Short-chain fatty acids (SCFA) have been demonstrated to at least partially ameliorate chronic intestinal inflammation. However, whether and how intestinal SCFA absorption may be altered during chronic intestinal inflammation is unknown. A rabbit model of chronic ileitis produced by coccidia was used to determine the effect of chronic inflammation on ileal SCFA/HCO(-)(3) exchange.

Unique mechanism of inhibition of Na+-amino acid cotransport during chronic ileal inflammation.

In the chronically inflamed ileum, unique mechanisms of alteration of transport processes suggest regulation by different immune-inflammatory mediator pathways. We previously demonstrated that Na+-glucose cotransport in the chronically inflamed ileum was inhibited by a decrease in cotransporter number without a change in glucose affinity. The aim of this study was to determine the alterations in Na+-amino acid cotransport in chronically inflamed ileum produced by coccidial infection in rabbits.

Pulmonary infections in hospitalized patients with cirrhosis.

We have further characterized pulmonary infections by bronchoalveolar lavage in hospitalized patients with cirrhosis. Sixty-seven consecutive patients admitted to the Ohio State University Medical Center from 1992 to 1995 with liver disease who underwent bronchoscopy with bronchoalveolar lavage were identified. Twenty-one patients with cirrhosis and pneumonia were further analyzed.

Endoscopic appearance of cryptosporidial duodenitis.

Cryptosporidial oocyst infection is a common cause of diarrhea in patients with AIDS. Concomitant symptoms can include crampy abdominal pain, nausea, vomiting, and anorexia. Esophagogastroduodenoscopy is then useful for delineating potentially treatable pathogens.

Upper-gastrointestinal bleeding from angiodysplasia of the minor papilla.

Angiodysplasia is an often unrecognized cause of upper-gastrointestinal bleeding, most commonly found in the antrum of the stomach but also in the duodenum and rarely in the esophagus. Small-intestinal angiodysplasia is the source of gastrointestinal bleeding of obscure origin in 30-40% of cases. The diagnosis is usually made by esophagogastroduodenoscopy, push enteroscopy, or selective angiography.

Pancreatic tuberculosis.

Pancreatic tuberculosis is a rare clinical entity. It most often is associated with miliary tuberculosis or occurs in the immunocompromised patient and is extremely uncommon in nonendemic geographic regions. Described is a case of isolated infection of the pancreas by Mycobacterium tuberculosis occurring in an otherwise healthy individual from North America who presented with recurrent hyperamylasemia and fevers.

Metastatic Crohn's disease. A rare cutaneous manifestation.

Cutaneous extraintestinal manifestations of Crohn's disease are common. Lesions contiguous with the gastrointestinal tract, such as perianal, peristomal, and perifistular inflammation are characterized by the histologic demonstration of granulomas. Rarely a cutaneous granulomatous lesion occurs that is noncontiguous with the gastrointestinal tract and is separated from it by normal skin.

Gastroesophageal reflux disease: diagnosis and medical therapy.

Gastroesophageal reflux disease (GERD) is a common clinical condition that affects all age groups, particularly older adults. Its presentation is diverse and can range from occasional heartburn to disabling complications. A complete history can usually lead to the diagnosis, although further testing may be needed for refractory symptoms, complications, and atypical presentations.

Familial Barrett's esophagus associated with adenocarcinoma.

A family with six cases of Barrett's esophagus over three generations is described. The Barrett's esophagus affected only males, and there were three associated adenocarcinomas. The mechanism of inheritance is compatible with an autosomal dominant pattern with nearly complete penetrance.

Early surgical treatment of gastrinoma.

Medical treatment of the Zollinger-Ellison syndrome has been generally accepted because of the proven efficacy of the histamine (H2)-receptor antagonists in achieving symptomatic relief, and because of early reports indicating that few, if any, gastrinomas were resectable for cure. Gastrin radioimmunoassay (RIA) has made earlier and more certain diagnosis possible, and therefore reevaluation of the surgical management of gastrinomas is necessary. Experience with 60 gastrinoma patients is reported.

Acute pancreatitis in elderly patients. Pathogenesis and outcome.

Forty patients over 70 years of age with acute pancreatitis were studied. The most common cause of pancreatitis was biliary tract disease (14 patients, 35 percent). Twelve patients (30 percent) were discharged with a diagnosis of idiopathic pancreatitis, but tests such as endoscopic retrograde cholangiopancreatography that might have established the cause of disease were frequently not employed.

Observations on the effect of a somatostatin analog in the Zollinger-Ellison syndrome: implications for the treatment of apudomas.

Somatostatin is known to inhibit hormone release and gastrointestinal secretion and hence may be useful in the treatment of amine precursor uptake, decarboxylase tumors. Clinical application has been limited by the short half-life, potency, and specificity of the natural hormone. Our study evaluated the effect of a synthetic analog of somatostatin, SMS 201-995 (Sandoz, Inc.

Endoscopic retrograde cholangiopancreatography in the management of pancreatic pseudocysts.

The value of ERCP was studied in 25 patients with pancreatic pseudocysts. There were no episodes of sepsis; however, acute pancreatitis developed in one patient for an overall complication rate of 4 percent. Results of ERCP were positive in 24 of the 25 patients (96 percent), with filling of the pseudocyst in 17 and pancreatic ductal obstruction in 7.

Sonographic measurement of the extrahepatic bile duct before and after retrograde cholangiography.

The maximum diameter of the extrahepatic bile duct visible on cholesonograms was measured immediately before and immediately after endoscopic retrograde cannulation and injection of the biliary and pancreatic ducts (ERCP) in 24 patients. Sonographic bile duct diameter increased by 3 mm or more in nine patients, all of whom had had a previous cholecystectomy. Bile duct diameter was unchanged in the remaining 15 patients, six of whom had had cholecystectomy.

Pancreatic cystadenoma in Von Hippel-Lindau disease: an unusual cause of pancreatic and common bile duct obstruction.

Pancreatic cystadenoma is an unusual lesion of the pancreas, typically occurring as an isolated lesion in a middle-aged woman with abdominal pain or an asymptomatic epigastric mass. Jaundice is unusual. Two types of pancreatic cystadenoma are distinguished: microcystic and mucinous; the latter has a tendency to malignant degeneration.

Activation of the alternative complement pathway in ascitic fluid during spontaneous bacterial peritonitis.

We studied complement and immunoglobulin profiles on the serum and ascitic fluid of a patient before and during gram-negative spontaneous bacterial peritonitis (SBP). During the infection, activation of the alternative complement pathway in ascitic fluid was manifested by a 35% reduction in functional activity and depression of both properdin and factor B concentrations to nondetectable levels. Activation of the complement cascade was also demonstrated by a 50% reduction in the C3 concentration and depression of total hemolytic complement.

Spontaneous bacterial peritonitis associated with acute viral hepatitis.

Spontaneous bacterial peritonitis (SBP) occurs most frequently in patients with cirrhosis and preexistent ascites; SBP has not been previously recognized in association with acute liver disease. We report two patients with acute hepatitis B infection who developed SBP. Patient 1 had Streptococcus pneumoniae peritonitis and bacteremia, but did not have ascites until after the peritoneal infection was evident.

Pseudomonas aeruginosa sepsis following retrograde cholangiopancreatography (ERCP).

Endoscopic retrograde cholangiopancreatography (ERCP) has become a routine examination in a number of medical centers within the past several years. We report a life-threatening case of acute pancreatitis with Pseudomonas aeruginosa sepsis immediately following ERCP. Cultures of the blood, the inner channel of the duodenoscope, and irrigating water bottles all were positive for Pseudomonas aeruginosa.