A randomized prospective study of endoscopic bipolar electrocoagulation and heater probe treatment of chronic rectal bleeding from radiation telangiectasia.

Background: Our purposes were to (1) evaluate efficacy and safety of bipolar or heater probe endoscopic coagulation compared to prior medical therapy for bleeding radiation telangiectasia, and (2) consider the impact of treatments on patients' impression of their overall health and activity.

Methods: Twelve months of medical management had failed in 18 men and 3 women with chronic, recurrent hematochezia and anemia after radiation treatment of pelvic malignancies. Patients had multiple rectal telangiectasias coagulated with bipolar or heater probes in a randomized, prospective study.

Precursor lesions for cancer of the cardia.

This article gives the rationale for the likelihood that the precursor lesion for cancer of the cardia is either short segments of Barrett's esophagus or even intestinalized (globlet cell change) mucosa at a normally located squamo-columnar junction. Intestinal metaplasia of the cardia is likely a wear and tear phenomenon in many individuals without gastroesophageal reflux disease (GERD). Markers that stratify risk further are required before routine biopsy specimens of the Z-line can be obtained in the clinical evaluation of patients with GERD.

Involvement of mitogen-activated protein kinase and translocation of cytosolic phospholipase A2 to the nuclear envelope in acetylcholine-induced prostacyclin synthesis in rabbit coronary endothelial cells.

We previously showed that acetylcholine (ACh) stimulates production of prostacyclin, measured as immunoreactive 6-keto-prostaglandin F1 alpha (6-keto-PGF1 alpha), in coronary endothelial cells (CEC) of rabbit heart by increasing influx of extracellular Ca2+ through a receptor-operated Ca2+ channel and by activating a pertussis toxin-insensitive G protein. The purposes of this study were to elucidate the type of phospholipase A2 (PLA2) involved in 6-keto-PGF1 alpha production and the mechanism(s) by which ACh activates PLA2 in cultured CEC. In CEC transiently transfected with cytosolic PLA2 but not secretory PLA2 antisense oligonucleotide, ACh failed to increase 6-keto-PGF1 alpha; this was prevented by cotransfection with cPLA2 sense oligonucleotide.

Endogenous vertebrate antibiotics. Defensins, protegrins, and other cysteine-rich antimicrobial peptides.

Although newly recognized, endogenous cystine-stabilized beta-sheet antimicrobial peptides have ancient origins. These peptides can arm circulating phagocytes and cells of the gastrointestinal, respiratory, and genitourinary tracts to resist invasion by bacteria, mycobacteria, fungi, and enveloped viruses. Defensins and protegrin-like peptides are likely to play a considerable role in innate immunity and may provide molecular templates that can be used to generate novel antibiotics for topical and systemic use.

Regulation of the mouse retinal taurine transporter (TAUT) by protein kinases in Xenopus oocytes.

The goal was to investigate the role of protein kinases in modulating taurine transporter activity in Xenopus laevis oocytes expressing the mouse retinal Na+/C-/taurine transporter. The currents generated by the taurine transporter were studied with a two-electrode voltage clamp and we recorded the maximal current (Imax), presteady-state charge transfer Q, and membrane capacitance Cm. 8-Br-cAMP, a membrane-permeable activator of the cAMP-dependent protein kinase (PKA), decreased Imax (41%), Q (41%) and Cm (10%).

Intraoperative vascular endoscopy: early and late results.

In a prospective study, 60 consecutive cases of vascular endoscopy were analyzed to examine the role of angioscopy in infrainguinal vascular procedures. A total of 52 patients had 60 separate vascular endoscopy procedures performed as an adjunct to various vascular procedures; results of intraoperative arteriography were available in 38 of 60 cases. All patients were followed for at least 42 months.

Test-retest reliability of the WAIS-R Satz-Mogel short form in a normal elderly sample.

Test-retest reliability of the WAIS-R Satz-Mogel short form was tested on a sample of 122 normal elderly volunteer subjects with mean age of 70.4. Subjects' performance was assessed over 3 annual probes.

Direct determination of free triiodothyronine (T3) in undiluted serum by equilibrium dialysis/radioimmunoassay (RIA).

Unlabelled: We have devised a practical, sensitive, and reliable assay for measurement of free T3 concentration in serum. The assay employs a convenient and disposable plastic equilibrium dialysis cell and a buffer that resembles the in vivo biochemical environment (Nelson JC, Tomei RT 1988 Clin Chem 34:1737). A 200-microliters aliquot of serum was dialyzed against 2.

Complex pancreatic injuries.

The majority of pancreatic injuries are minor in nature and can be managed easily and definitively with external drainage. The complexity of management increases significantly when a pancreatic ductal injury is present. It is requisite that thorough preoperative and intraoperative work-up be complete and systematic if injuries are to be properly recognized and managed.

A prospective study on the reliability and cost effectiveness of preoperative ultrasound screening of the "marginal" liver donor.

With the growing shortage of available liver donors, many donors with risk factors that would have traditionally precluded liver procurement are now being considered. In this prospective study, we evaluated 50 "marginal" liver donors with pre-procurement abdominal ultrasounds and correlated results with findings at procurement and with subsequent allograft function. The results show that the ultrasounds have a specificity of 96% and a sensitivity of 68% in predicting abnormalities in donor livers that precluded transplantation.

Lower limb intraarterial thrombolysis as an adjunct to the management of arterial and graft occlusions.

Intraarterial thrombolysis is used increasingly for management of arterial and bypass graft occlusions. Current research has been directed at the indications for and methods of catheter-directed thrombolysis. Streptokinase, urokinase, and tissue plasminogen activator (t-PA) are the most commonly used agents.

Indications and results of arterial stents for occlusive disease.

The application of stents for treatment of peripheral arterial occlusive disease has gained widespread clinical use, but their safety and efficacy remain unclear. Stent technology is still evolving, and long-term follow-up data are sorely needed. Stents have had good success in providing a scaffold to maintain the intraluminal structure and patency of an artery.

Current status of atherectomy for peripheral arterial occlusive disease.

Atherectomy physically removes plaque by cutting, pulverizing, or shaving it in atherosclerotic arteries using a mechanical, catheter-deliverable endarterectomy device. Theoretically, atherectomy offers the following advantages over percutaneous transluminal angioplasty (PTA): It shows a greater immediate success rate with less dissection and acute occlusion, treats complex lesions, and reduces the restenosis rate. This article presents the unique features of four atherectomy devices designed to meet the above challenges: Simpson AtheroCath, Transluminal Extraction Catheter (TEC), Trac-Wright Catheter, and Auth Rotablator.

Transfemoral endovascular repair of abdominal aortic aneurysm: results of the North American EVT phase 1 trial. EVT Investigators.

Purpose: This report describes the results of a phase 1 trial of endovascular repair of abdominal aortic aneurysm, conducted under FDA protocol in 13 U.S. medical centers from February 1993 to December 1994.

Susceptibility of Neisseria gonorrhoeae to protegrins.

We developed a sensitive and quantitative radial diffusion method to ascertain the susceptibility of six strains of Neisseria gonorrhoeae to antimicrobial peptides derived from mammalian leukocytes. The test organisms included the well-characterized serum-resistant FA19 and serum-sensitive F62 strains plus four antibiotic-resistant clinical isolates. Although each N.

Localization and characterization of the subtypes(s) of muscarinic receptor involved in prostacyclin synthesis in rabbit heart.

The present study was conducted to localize and characterize the subtype(s) of muscarinic receptor involved in prostacyclin production elicited by the cholinergic transmitter acetylcholine (ACh) in various cell types in the rabbit heart. ACh increased prostacyclin synthesis, measured as 6-keto-prostaglandin(1 alpha) (6-keto-PGF(1 alpha)), in cultured coronary endothelial cells and freshly dissociated ventricular myocytes in a dose-dependent manner, but not in cultured coronary smooth muscle cells of rabbit heart. McN-A-343 {(4-hydroxy-2-butynyl)-1-trimethylammonium-m-chlorocarbanilate chloride}, a selective M1 muscarinic ACh receptor (mAChR) agonist, did not alter 6-keto-PGF(1 alpha) synthesis in these cell types.

Severe upper gastrointestinal tumor bleeding: endoscopic findings, treatment, and outcome.

Background And Study Aims: The aim of the present study was to review endoscopic findings, treatment, and clinical outcomes in patients with severe upper gastrointestinal bleeding due to tumors.

Patients And Methods: A retrospective analysis was made of prospectively gathered data on all patients with severe upper gastrointestinal bleeding who were admitted to two large referral centers during a 45-month period.

Results: Nine hundred thirty-five patients had severe upper gastrointestinal bleeding, of whom 42 (5%) were found to have tumors.

Transcellular prostaglandin production following mast cell activation is mediated by proximal secretory phospholipase A2 and distal prostaglandin synthase 1.

Prostaglandins mediate many biological processes. Arachidonic acid, the common precursor for all prostaglandins, is released from membrane phospholipids by both secretory and cytoplasmic forms of phospholipase A2. Free arachidonate is converted to prostaglandin H2, the common precursor to all prostanoids, by prostaglandin synthase.

Magnetic resonance imaging of plantar plate rupture.

Degenerative plantar plate failure is an under-recognized cause of lesser metatarsalgia. We performed magnetic resonance imaging (MRI) with a small receiver coil in 13 patients in whom plantar plate ruptures of the second or third metatarsophalangeal joint were clinically suspected. In eight patients, MRI showed focal hyperintensity in the plantar plate that was interpreted as a rupture of the plate.