Long-term survival after treatment of malignant colonic polyps.

Purpose: This study was designed to evaluate the long-term outcome and survival of patients treated for malignant colonic polyps.

Methods: A retrospective review of 15,975 cases of colonoscopies with 8,685 endoscopic polypectomies performed between 1972 and 1990 was undertaken. In 65 patients, the polypectomy specimens contained invasive carcinoma.

Subthreshold receptive fields and baseline excitability of "silent" S1 callosal neurons in awake rabbits: contributions of AMPA/kainate and NMDA receptors.

The contribution of NMDA and non-NMDA receptors to excitatory subthreshold receptive fields was examined in callosal efferent neurons (CC neurons) in primary somatosensory cortex of the fully awake rabbit. Only neurons showing no traditional (suprathreshold) receptive fields were examined. Subthreshold responses were examined by monitoring the thresholds of efferent neurons to juxtasomal current pulses (JSCPs) delivered through the recording microelectrode.

Outpatient bowel preparation for elective colon resection.

To determine the safety and cost-effectiveness of outpatient preoperative bowel preparation with polyethylene glycol-electrolyte lavage solution, we retrospectively analyzed 726 cases of colectomy done by colon and rectal surgeons between July 1987 and July 1991. Included were 319 patients who had elective segmental or total abdominal colectomy with primary anastomosis. Patients who required protective proximal stoma were excluded.

Predictive value of technetium Tc 99m-labeled red blood cell scintigraphy for positive angiogram in massive lower gastrointestinal hemorrhage.

Purpose: This study was performed to evaluate whether the time interval from injection of technetium Tc 99m (99mTc)-labeled red blood cells to the time of a radionuclide "blush" (positive scan) can be used to improve the efficacy in predicting a positive angiogram.

Method: A retrospective review revealed 160 patients who received 99mTc-labeled red blood cell scintigraphy for evaluation of massive lower gastrointestinal hemorrhage between 1989 and 1994. Patients were included who demonstrated signs of shock on admission, had an initial decrease in hematocrit of > or = 6 percent, or required a minimum transfusion of two units of packed red blood cells.

Cholinergic innervation of the lateralis medialis-suprageniculate nuclear complex (LM-Sg) of the cat's thalamus: a double labeling immunohistochemical study.

The purpose of this study was to investigate morphological characteristics of the synaptic relations of choline acetyltransferase (ChAT)-positive terminals that are made with a variety of post-synaptic profiles in the lateralis medialis-suprageniculate nuclear complex (LM-Sg) using ChAT, gamma-aminobutyric acid (GABA) and glutamate immunohistochemistry in combination with electron microscopical observations. The ChAT immunopositive profiles make asymmetrical synaptic contacts with glutamate immunopositive dendrites that are presumably derived from projection neurons, and/or GABA immunopositive interneurons. The present results indicate that ascending cholinergic mechanisms may be important for modifying information in both the extrinsic and intrinsic circuitries of LM-Sg.

Perineal repair of rectal prolapse.

Perineal approaches to the repair of rectal prolapse are frequently used in elderly or high-risk patients. These repairs have lower operative mortality and morbidity than intra-abdominal repairs but in general have higher recurrence rates. This study reviews our recent results with perineal prolapse repairs, briefly summarizes the literature, and discusses the available perineal operations.

Antibodies to glutamate, aspartate and glycyl-D-aspartate reversibly suppress stimulus-evoked, extracellularly recorded responses in slices of rat neocortex.

Polyclonal antibodies raised against glutamate, aspartate and the dipeptide, glycyl-D-aspartate were dissolved in artificial cerebrospinal fluid (aCSF) and administered at concentrations as low as 0.05% to slices of prefrontal cortex maintained in vitro. These antisera caused a reversible attenuation of evoked field potentials and/or single-unit activity recorded extracellularly following the delivery of shocks to the underlying white matter, or to cortical layer IV.

Postpolypectomy colonic hemorrhage.

Purpose: This study was undertaken to evaluate the incidence, diagnostic methods, and treatment of hemorrhage occurring after colonoscopic polypectomy.

Methods: A retrospective chart review was conducted of 12,058 patients who underwent colonoscopy at an academic referral center between January 1989 and July 1993. Of these, 6,365 patients required polypectomies or biopsies.

Colostomy closure. Ochsner Clinic experience.

Purpose: We retrospectively reviewed the records from our past five years of experience with colostomy closure at a large multispecialty hospital to determine postoperative morbidity.

Results: From March 1988 to April 1993, 46 patients underwent colostomy closure. Patients ranged in age from 24 to 87 (mean, 41.

Amino acids as the source of considerable excitation in cerebral cortex.

A number of different factors contributed to the rationale for providing a critical review of the field of excitatory amino acids in the cerebral cortex at this time. In addition to the recent growing realisation by clinicians that the excitatory amino acids are linked critically to a number of neurological conditions, including neurodegenerative syndromes such as Alzheimer's disease, cortical damage due to stroke and cerebral ischemia, epilepsy, amyotropic lateral sclerosis, and schizophrenia, the recent cloning and membrane reconstitution of specific receptors known as AMPA, NMDA, kainate, and metabotropic receptors and their known subunits have prompted a surge of renewed interest in this important family of synaptic transmitter molecules. Moreover, recent advances in our understanding of the molecular events involved in growth promotion in the early stages of the development of the cortex have shown that both NMDA and non-NMDA receptor subtypes perform important roles in certain aspects of target selection and neurite outgrowth, in cone stimulation and guidance, and in spine formation and morphological alterations.

Somatosensory cortical efferent neurons of the awake rabbit: latencies to activation via supra--and subthreshold receptive fields.

1. Latencies to peripheral sensory stimulation were examined in four classes of antidromically identified efferent neurons in the primary somatosensory cortex (S1) of awake rabbits. Both suprathreshold responses (action potentials) and subthreshold responses were examined.

Colon surveillance after colorectal cancer surgery.

Purpose: This study was performed to determine cost-effective colonoscopy guidelines for patients with prior colorectal adenocarcinoma.

Method: A retrospective review was performed of patients who had been treated for colorectal adenocarcinoma and later underwent follow-up colonoscopy from 1984 to 1994.

Results: During this study period, 389 patients previously treated for colorectal adenocarcinoma underwent follow-up colonoscopy.

Procedures used by North Carolina dairies for vitamins A and D fortification of milk.

New research findings have documented fortification errors in fortified milk products all across the US milk industry. Also, the consumption of overfortified bovine milk has led the public to question whether vitamin fortification is safe. Therefore, North Carolina dairies were surveyed to determine vitamin fortification procedures used and to determine differences among these procedures.

A projection linking motor cortex with the LM-suprageniculate nuclear complex through the periaqueductal gray area which surrounds the nucleus of Darkschewitsch in the cat.

Whereas a previous study by one of us (Hicks et al., 1986) suggested that periaqueductal gray (PAG) neurons projecting to the lateralis medialis-suprageniculate (LM-SG) complex might mediate transmission of affective-related nociceptive information, our present work suggests instead, a function in processes related to movement. Cells of the nucleus of Darkschewitsch (ND) are known to have reciprocal projections with the motor cortex (MX), in particular with the hand area of MX, and also to project to the rostral medial accessory olivary (MAO) nucleus (Onodera and Hicks, 1995a).

The effects of D-alpha-aminoadipic acid on long-term potentiation in the hippocampus of the rat in vitro.

Many studies on long-term potentiation (LTP) in hippocampal region CA1 focus on receptor-mediated events that are often presumed to be linked to postsynaptic processes. Whereas it is now well-known that LTP consists of multiple components involving increases in postsynaptic responsiveness as well as enhanced presynaptic release of transmitter, little specific information has accrued on the nature of the presynaptic receptor-linked events. In the course of a series of experiments examining the actions of several antagonists of N-methyl-D-aspartate (NMDA) receptors on LTP, we made certain observations that suggested the role of a novel type of amino acid receptor which possibly was located presynaptically and that seemed to contribute to the induction of LTP.

Infant feeding caries: Part II. The Simcoe and Muskoka-Parry Sound Health Unit Project.

IFC is a serious and expensive dental health problem affecting about five per cent of children in Simcoe County. Although the habits leading to IFC may be difficult to eliminate, efforts at prevention may be more successful. Health promotion efforts are an economic and superior manner to promote wellness as compared to treatment.

Patterns of transmitter labelling and connectivity of the cat's nucleus of Darkschewitsch: a wheat germ agglutinin-horseradish peroxidase and immunocytochemical study at light and electron microscopical levels.

Immunocytochemical studies using antibodies raised against a number of probable synaptic transmitters of the mesodiencephalic area, and fibre-tracing studies using wheat germ agglutinin-horseradish peroxidase (WGA-HRP), have been performed in adult cats. Glutamate and aspartate immunoreactivity produced a strong labelling of many cell bodies and terminals in the nucleus of Darkschewitsch (ND). gamma-Aminobutyrate (GABA) immunoreactivity in the ND appeared as a moderate label in some small neurones, and as a strong label in a few glial-like cells, in addition to being present in high levels to produce strong labelling in many GABA-immunopositive terminals that possessed pleomorphic vesicles.

Metabotropic glutamate receptors and visual cortical synaptic plasticity.

Two forms of use-dependent synaptic plasticity, called long-term potentiation (LTP) and long-term depression (LTD), can be elicited in the visual cortex following different paradigms of electrophysiological stimulation. These neurobiological phenomena often are considered as necessary components of models for the alteration in function of the nervous system that must occur at some level for the establishment and (or) maintenance of memory engrams, for learning processes, or for the consolidation of active neural connections and regression of inactive contacts in the developing brain. It has been postulated that for LTP and LTD to be produced in the hippocampus, activation of a particular subtype of excitatory amino acid receptor, the metabotropic receptor, is a critical requirement.

Fecal seepage and soiling: a problem of rectal sensation.

Purpose: To determine the physiologic alteration resulting in fecal seepage and soiling, results of anorectal manometric testing were evaluated in patients with varying degrees of fecal incontinence.

Methods: Anal manometric studies performed on 170 patients with fecal incontinence were reviewed. Results of their studies, including mean resting pressure, maximum resting pressure, maximum squeezing pressure, minimum rectal sensory volume, and minimum volume at which reflex relaxation first occurs, were compared with those of 35 control group subjects with normal fecal continence.

Colonoscopic follow-up of adenomas and colorectal cancer.

Increasing experience with colonoscopy has altered recommendations for the frequency of follow-up surveillance examinations for adenomatous polyps and colorectal cancer. Current recommendations include a follow-up colonoscopy at 1 year for patients with more than two adenomatous or highly suggestive polyps and after curative surgery for colorectal cancer. Other patients can safely receive a follow-up colonoscopy at longer intervals of 3 years.

Practice parameters for sigmoid diverticulitis. The Standards Task Force American Society of Colon and Rectal Surgeons.

It should be recognized that these guidelines should not be deemed inclusive of all proper methods of care or exclusive of methods of care reasonably directed to obtaining the same results. The ultimate judgment regarding the propriety of any specific procedure must be made by the physician in light of all of the circumstances presented by the individual patient.

Induction of LTD but not LTP through metabotropic glutamate receptors in visual cortex.

Long-term potentiation (LTP) and long-term depression (LTD), often used as essential components in synaptic models for learning, memory and forgetting, can be produced in cortical tissue by repetitive activation of neural pathways under different stimulus conditions. The involvement of metabotropic glutamate receptors (mGluRs) has been postulated to be necessary for the establishment of either or both forms of synaptic plasticity in hippocampus. The recent introduction of a specific antagonist for mGluRs, (+/-)-alpha-methyl-4-carboxyphenylglycine, prompted the investigation of the respective involvement of this receptor population in the induction of LTP and LTD in visual cortex of the rat in vitro.