Phacoemulsification with indocyanine green versus manual expression extracapsular cataract extraction for advanced cataract.

Purpose: To compare the outcomes of indocyanine green dye (ICG)-assisted phacoemulsification with manual expression extracapsular cataract extraction (ECCE) in eyes with advanced cataract.

Setting: Parkland Memorial Hospital and Dallas Veterans Affairs Medical Center, Dallas, Texas, USA.

Methods: In this retrospective study, 72 consecutive cases of advanced or mature cataract extractions performed in a 1-year period were reviewed.

Hallmarks of cancer progression in Barrett's oesophagus.

Context: Hanahan and Weinberg proposed in 200 that carcinogenesis involves DNA changes that enable cells to:provide their own growth signals, ignore growth-inhibitory signals, avoid apoptosis, replicate without limit, sustain angiogenesis, and invade and proliferate in unnatural locations. The metaplastic cells of Barrett's oesophagus are predisposed to develop these cancer hallmarks.

Starting Point: The genetic changes that have been described in Barrett's oesophagus can be categorised according to the predominant cancer hallmark affected.

Molecular and biologic basis of upper gastrointestinal malignancy--esophageal carcinoma.

Esophageal cancer is one of the most deadly forms of gastrointestinal cancer. Even though the incidence of esophageal adenocarcinoma has been rising in Western populations over the past two decades, esophageal squamous cell carcinoma remains the predominant type of esophageal malignancy in the remainder of the world. With the recent advances in molecular biology, high-output genome wide screening has provided comprehensive profiles of molecular alterations in human esophageal carcinomas.

Bioeffects of myocardial contrast microbubble destruction by echocardiography.

Background: Microbubble destruction during contrast echocardiography is known to cause capillary leaks and red blood cell extravasation in skeletal muscle. This study evaluated the biological effects of microbubble destruction on cardiac muscle.

Methods: Contrast echocardiography was performed in 36 rats randomized to receive either Definity or Optison at a mechanical index (MI) of 1.

Racial differences in the frequency of symptoms and complications of gastro-oesophageal reflux disease.

Background: A number of reports have suggested that there are substantial racial differences in the frequency of gastro-oesophageal reflux disease and its complications, but few studies have compared directly the frequency of this disorder amongst different racial groups.

Aim: To explore the racial differences in the frequency of gastro-oesophageal reflux disease and its complications.

Methods: We reviewed endoscopy reports and medical records for data on race and complications of gastro-oesophageal reflux disease in 2,477 consecutive patients who had endoscopic examinations at the general endoscopy unit of an academic hospital.

Evaluating sequential values using time-adjusted biological variation.

One can compare the difference between two sequential values with the biological variation. Biological variation is a measure of the random disturbances of an analyte's value, measured at different times. When the difference > Z square root 2 SD(BV) then the difference is due to an underlying disease process or physiologic change.

Creative stress-management techniques for self-renewal.

The daily stress and pressure of today's nurses are profound. As workloads escalate and staffing declines, nurses must be proactive and develop healthier lifestyles. Creative stress management techniques offer health-promoting strategies to manage stress in nurses' lives.

Acid exposure activates the mitogen-activated protein kinase pathways in Barrett's esophagus.

Background & Aims: To explore mechanisms whereby acid reflux might contribute to carcinogenesis in Barrett's esophagus (BE) we studied: (1) the effects of acid on the mitogen-activated protein kinase (MAPK) pathways, cell proliferation, and apoptosis in a Barrett's adenocarcinoma cell line (SEG-1); and (2) the ability of acid to activate the MAPK pathways in vivo in patients with BE.

Methods: SEG-1 cells were exposed to acidic media for 3 minutes, and the activities of 3 MAPKs (ERK, p38, and JNK) were determined. Proliferation was assessed using flow cytometry; cell growth and apoptosis were assessed using cell counts and an apoptosis ELISA assay.

TNFalpha activates c-Jun amino terminal kinase through p47(phox).

Reactive oxygen intermediates have been implicated in the transduction of TNFalpha signals, although the source of such oxidants has not been established. We found that activation of ECV-304 cells by TNFalpha was accompanied by a transient burst of oxidants and activation of JNK, both of which were suppressed by two distinct inhibitors of the phagocyte NADPH oxidase and the thiol antioxidant N-acetyl cysteine (NAC). We cloned partial and full-length cDNA sequences from ECV-304 cells and human umbilical vein endothelial cells (HUVEC), respectively, for p47(phox), demonstrating that these nonphagocytic cells express this adapter protein known to specifically initiate assembly of the NADPH oxidase in professional phagocytes.

Classification of oesophageal motility abnormalities.

Manometric examination of the oesophagus frequently reveals abnormalities whose cause is unknown and whose physiological importance is not clear. A large body of literature dealing with oesophageal motility abnormalities has evolved over the past few decades but comparisons among studies have been compromised by the lack of a widely accepted system for classifying the abnormal motility patterns, and by the lack of uniform diagnostic criteria for the putative disorders. Based on an extensive review and analysis of the literature, this report suggests an operational scheme to be used for the general classification of oesophageal motility abnormalities, and proposes standardised manometric criteria for the putative oesophageal motility disorders.

Assessment of aortic regurgitation by transesophageal color Doppler imaging of the vena contracta: validation against an intraoperative aortic flow probe.

Objectives: This study was performed to validate the accuracy of color flow vena contracta (VC) measurements of aortic regurgitation (AR) severity by comparing them to simultaneous intraoperative flow probe measurements of regurgitant fraction (RgF) and regurgitant volume (RgV).

Background: Color Doppler imaging of the vena contracta has emerged as a simple and reliable measure of the severity of valvular regurgitation. This study evaluated the accuracy of VC imaging of AR by transesophageal echocardiography (TEE).

A molecular rationale for the how, when and why of colorectal cancer screening.

Colorectal cancer remains a leading cause of cancer-related mortality in the United States. Recently, colorectal cancer screening and colorectal cancer prevention have gained national attention. In response, the American Gastroenterological Association, the American College of Gastroenterology and the Agency for Healthcare Policy and Research have published recommendations for colorectal cancer screening and surveillance in patients with sporadic as well as hereditary forms of colorectal cancer.

AIDS vasculopathy.

Persons infected with HIV display a variety of vascular abnormalities and harbor particularly striking alterations in endothelial morphology and function. We review the effects of the virus and viral products on the endothelium and emphasize their effects on altering the clinical expression of HIV-associated diseases.

Detection of telomerase by in situ hybridization and by the polymerase chain reaction-based telomerase activity assay.

The onset of human cancer typically requires numerous genetic mutations, generally specific for the tissue type from which the cancer originates. Thus, it has been difficult to screen all tumor types for a single mutation. In recent years, telomerase activity has been associated with at least 85% of human malignancies as well as with some lesions considered preneoplastic by traditional cytology (1,2).

Microsatellite Analysis of the Insulin-Like Growth Factor II Receptor in Colorectal Carcinomas.

The insulin-like growth factor II (IGFII) growth control pathway is comprised of three major components: IGFII ligand, insulin-like growth factor I receptor (IGFIR), and insulin-like growth factor II receptor (IGFIIR). IGFIR and IGFIIR work together to maintain constant circulating levels of IGFII. IGFII is a potent mitogen, produced by epithelial cells, which stimulates cell growth and prevents apoptosis by binding to IGFIR (1,2).

Bacterial Infections of the Colon.

The colon is a common site of infection for a heterogeneous group of bacterial pathogens. The presentation of disease in the colon is generally in the form of distinct syndromes, and it is important for physicians to recognize the causative organisms, because specific treatment is highly effective. The flouroquinolones have emerged as the treatment of choice for most food-borne bacterial pathogens.

Gastroesophageal Reflux Disease.

Prior to the advent of proton pump inhibitors, internists recommended antireflux surgery primarily for patients whose gastroesophageal reflux disease (GERD) failed to respond to medical therapy. Although many physicians still cling to the notion that antireflux surgery is a procedure best reserved for "medical failures," today this position is inappropriate. Modern medical treatments for GERD are extraordinarily effective in healing reflux esophagitis.

Selective inhibition of cyclooxygenase-2 suppresses growth and induces apoptosis in human esophageal adenocarcinoma cells.

Adenocarcinoma in Barrett's esophagus has been increasing in incidence at a rapid rate for more than two decades. Cyclooxygenase (COX)-2 appears to play an important role in gastrointestinal carcinogenesis, and COX-2 overexpression has been demonstrated both in esophageal adenocarcinomas and in the metaplastic epithelium of Barrett's esophagus. The aim of our study was to determine whether selective inhibition of COX-2 by NS-398 would alter the rates of cell growth and apoptosis in human Barrett's-associated esophageal adenocarcinoma cell lines.

Helicobacter pylori-related disease: guidelines for testing and treatment.

Objective: To develop practical guidelines for the treatment of patients with suspected and documented Helicobacter pylori-related gastroduodenal diseases.

Methods: A panel of physicians with expertise in H. pylori reviewed, critically appraised, and synthesized the literature on assigned topics and presented their overviews to the panel.

GERD and its complications.

Gastroesophageal reflux disease (GERD) is the condition that results when gastric material that refluxes into the esophagus or oropharynx causes symptoms, tissue injury, or both. Endoscopic examination usually is not required merely to establish a diagnosis of GERD, but endoscopy is the best diagnostic test for Barrett's esophagus, a sequela of GERD that predisposes to esophageal adenocarcinoma. Patients found to have Barrett's esophagus will require regular endoscopic surveillance for early, curable neoplasia.

Expression of the wild-type insulin-like growth factor II receptor gene suppresses growth and causes death in colorectal carcinoma cells.

The insulin-like growth factor II receptor (IGFIIR) has been implicated as a tumor suppressor gene in human malignancy. Frequent mutation, loss of heterozygosity, and microsatellite instability (MSI) directly affecting the IGFIIR gene have been reported in several primary human tumor types. However, to our knowledge, dynamic functional evidence of a growth-suppressive role for IGFIIR has not yet been provided.

Effects of very low dose daily, long-term aspirin therapy on gastric, duodenal, and rectal prostaglandin levels and on mucosal injury in healthy humans.

Background & Aims: The safety of low-dose daily aspirin therapy in the gastrointestinal tract is uncertain. Our objectives were to evaluate the long-term effects of very low daily aspirin doses in the gastrointestinal tract and effects on platelet-derived serum thromboxane levels in volunteers.

Methods: Subjects were randomized to receive 10 mg (n = 8), 81 mg (n = 11), or 325 mg (n = 10) aspirin daily for 3 months.

The advent of highly selective inhibitors of cyclooxygenase--a review.

Cyclooxygenase (COX) exists in two isoforms, COX-1 and COX-2, COX-1 is present and is constitutively expressed in most cells and tissues, whereas COX-2 is felt to principally mediate inflammation. However, this distinction appears to be challenged by recent observations. This review addresses the roles of COX-1 and COX-2 isoforms in physiologic and pathophysiologic states and reviews potential therapeutic roles for selective COX inhibitors.

Electrostatic channeling of oxaloacetate in a fusion protein of porcine citrate synthase and porcine mitochondrial malate dehydrogenase.

Mitochondrial malate dehydrogenase and citrate synthase are sequential enzymes in the Krebs tricarboxylic acid cycle. We have shown [Lindbladh, C., Rault, M.