The early diagnosis and prevention of gastrointestinal cancer: problems and promises.

Early detection and prevention of gastrointestinal cancer involves screening and surveillance. The efficacy of early detection tests should be subjected to well-designed studies. Clinical recommendation should be made after evaluation of new therapeutic approaches that will be based on our understanding of the molecular and cellular biology and the genetics of gastrointestinal premalignancy and cancer.

Repair of carotid artery perforations during transsphenoidal surgery.

Background: Hemorrhage from carotid artery injury during transsphenoidal surgery is an unusual, but potentially fatal complication.

Methods: Among six patients experiencing laceration or perforation of the carotid artery, we treated four with a new technique using Teflon mesh and methyl methacrylate to form an external, artificial wall over the laceration and the carotid artery.

Results: In all four cases, hemorrhage was successfully controlled without neurologic deficit to the patient or complications frequently associated with the standard technique of nasal and sphenoid sinus packing removal.

Ventricular tachycardia: a life-threatening arrhythmia in a patient with congenitally corrected transposition of the great arteries.

Ventricular tachycardia (VT) is an uncommon finding in patients with congenitally corrected transposition of the great arteries (CCTGA). Cardiac death in patients with CCTGA has been attributed to complete heart block, systemic ventricular dysfunction, or severe AV valve regurgitation with heart failure. We describe the case of a patient who presented with palpitations and near-syncope that was associated with clinical episodes of VT.

Asparagine-linked carbohydrate chains of inducible rat parotid proline-rich glycoprotein contain terminal beta-linked N-acetylgalactosamine.

Rats treated with daily injection of DL-isoproterenol for 10 consecutive days (25 mg kg(-1) body weight) showed marked induction of a proline-rich glycoprotein (GPRP) of 220 kDa. Proteinase K digestion of GPRP produced a homogeneous glycopeptide with an average chemical composition as follows (residues per mol): Pro4, Glx3, Asx2, Gly1, His1, Thr1, Arg1, GlcNAc5, GalNac1, Man3, Gal2-3, and Fuc1. The structural analysis of the asparagine-linked carbohydrate unit was performed by methylation, periodate oxidation and enzymatic degradation.

Fetal spinal cord transplants rescue some axotomized rubrospinal neurons from retrograde cell death in adult rats.

Intraspinal transplants of fetal spinal cord may contribute to recovery after spinal cord injury by keeping axotomized neurons alive. In this study we examined whether transplants rescued axotomized red nucleus (RN) neurons from retrograde cell death in adult rats. RN neurons were labeled by retrograde transport of Fluorogold (FG); 1 week later right-sided RN neurons were axotomized by left-sided hemisection at C3-4 vertebral level, and Embryonic Day 14 spinal cord or gelfoam was introduced into the cavity.

Altered expression of the twist gene in young versus senescent human diploid fibroblasts.

We have recently reported the cloning and characterization of the human twist gene (H-twist), which encodes an evolutionarily conserved helix-loop-helix transcription factor. In several species, twist has been shown to play a role in mesoderm differentiation. We now report on the differential expression of H-twist as a function of in vitro life span in human diploid fibroblasts.

Ischemic preconditioning decreases oxidative stress during reperfusion: a chemiluminescence study.

The mechanism responsible for ischemic preconditioning (IPC) is still unknown but may involve the induction of antioxidant enzymes decreasing oxidative stress during subsequent periods of ischemia (I) and reperfusion (RP). The purpose of this study was to determine whether, in fact, an antioxidant mechanism is involved in the protection afforded by IPC. Lucigenin-enhanced chemiluminescence (LEC), a direct, continuous, nondestructive, on-line method was used to monitor the net amount of free oxygen radicals (FOR) produced during perfusion of rat hearts.

Cell-free transfer of cholesterol from lysosomes to phospholipid vesicles.

The objective of this work was to develop a cell-free system for studying the transfer of cholesterol from lysosomes to membrane acceptor particles. The methods involved: 1) loading of CHO cells at 15 degrees C with [3H]cholesteryl oleate-reconstituted LDL, such that it accumulated undegraded in endosomes; 2) homogenization of cells, followed by preparation of an endosome-lysosome donor fraction; 3) incubation of the donor fraction at 37 degrees C in a defined cytosol-like medium containing acceptor particles of egg phosphatidylcholine small unilamellar vesicles (PC-SUV); and 4) measurement of cholesteryl oleate (CO) hydrolysis and transfer of the resulting free cholesterol (FC) to vesicles. During cell-free incubation, LDL-loaded endosomes fused with lysosomes leading to the lysosomal hydrolysis of LDL cholesteryl ester.

The etiology, treatment, and prevention of nursing caries.

Despite the decline in the dental caries rate over the last 20 years, one particular segment of the population does not seem to have benefited significantly. This group is composed of infants and children afflicted with widespread caries destruction of deciduous teeth, most commonly referred to as nursing caries. Untreated cases of the disease have resulted in pain, loss of function, premature tooth loss, delays in development, hearing and speech difficulties, and psychosocial disturbances.

alpha-galactosyl (Galalpha1-3Galbeta1-4GlcNAc-R) epitopes on human cells: synthesis of the epitope on human red cells by recombinant primate alpha1,3galactosyltransferase expressed in E.coli.

Developing methods for in vitro synthesis of the carbohydrate structure Galalpha1-3Galbeta1-4GlcNAc-R (termed the alpha-galactosyl epitope) on human tumour cells may be of potential clinical significance in cancer immunotherapy. Tumour vaccines with this epitope would be opsonized in vivo by the natural anti-Gal antibody, which is present in large amounts in humans, and which interacts specifically with alpha-galactosyl epitopes. Binding of anti-Gal to alpha-galactosyl epitopes on tumour cell membranes is likely to increase uptake of the cell membranes by antigen-presenting cells, such as macrophages, via the adhesion of the Fc portion of anti-Gal to Fc receptors on these cells.

Caries prevention: a team approach to oral health.

Caries is a result of a multifactorial process. In this article, several of these contributing factors are examined and their interrelationships are discussed. These factors must be addressed by the dental team and the family unit to achieve the successful prevention of this destructive and common phenomenon.

Fungal Bursitis: Olecranon Bursitis Caused by Candida parapsilosis with Review of the Literature.

Various Candida species have emerged as clinically important pathogens, as documented by increasing incidence of localized Candida infections, candidemia, and systemic candidiasis. Septic bursitis caused by fungi has been described infrequently. We describe a case of septic olecranon bursitis caused by Candida parapsilosis.

Pharmacokinetics and Pharmacodynamics of Recombinant Human Insulin-Like Growth Factor.

Recombinant human insulin-like growth factor (rhIGF-I) was evaluated in 18 healthy males to determine its effects on serum glucose, its relationship of total IGF levels to serum glucose response and dose proportionality when administered intravenously (IV) and subcutaneously (SQ). One group of six subjects received 60, 120, and 180 &mgr;g kg(minus sign1) IV over 8 h, 1 week apart, and three groups of four subjects received 60, 120, and 180 &mgr;g kg(minus sign1) IV over 8 h, and then 1 week later received 60, 120, and 90 &mgr;g kg(minus sign1) SQ of rhIGF-I, respectively. During each dosing period, placebo and then rhIGF-I was administered on two consecutive days.

Falsely elevated serum digoxin levels secondary to endogenous digoxin-like immunoreactive substances.

Endogenous digoxin-like immunoreactive substances (DLIS) are produced by the human body and can be significantly elevated in specific clinical conditions. Commercially available digoxin assays do not have the specificity to fully distinguish DLIS from exogenous digoxin, though DLIS do not possess the same therapeutic properties as do the drug. The resultant artificial elevation of a reported digoxin level or a completely factitious level in a patient not taking the drug can have clinically significant consequences.

An update on bronchiectasis.

Bronchiectasis is associated with heterogeneous predisposing conditions that cause abnormal dilatation and persistent inflammation in the bronchial tree and lung parenchyma. The disease remains a common cause of significant morbidity and mortality, especially when associated with hereditary disorders such as cystic fibrosis, ciliary dyskinesia, and immunodeficiency states. Recent investigations have focused on the inflammatory mediators involved in the pathogenesis of bronchiectasis.

Congenital complete absence (bilateral agenesis) of the diaphragm: a rare variant of congenital diaphragmatic hernia.

Although congenital diaphragmatic hernia is one of the most common congenital anomalies, complete bilateral absence of the diaphragm is a very rare variant, with six cases reported in the literature. A 1040 g black male infant was born at 27 weeks' gestation to a 28-year-old black woman with a history of minimal prenatal care and cocaine abuse during pregnancy. Apgar scores were 2/1/1/0/1 at 1, 5, 10, 15, and 20 minutes, respectively and efforts to resuscitate him were unsuccessful.

Therapeutic Options for Clinically Localized Carcinoma of the Prostate.

Clinically localized carcinoma of the prostate is diagnosed annually in over 50,000 American men. The advent of screening programs using digital rectal examination, transrectal ultrasound, and assays for prostatic specific antigen will increase the magnitude of this public health problem. The range of treatment options for this disease includes observation, radical prostatectomy, external beam irradiation, and adjuvant hormonal manipulation.

Susceptibility of anaerobic bacteria to beta-lactam antibiotics in the United States.

beta-Lactam antibiotics are critical agents in the treatment of anaerobic infections. Susceptibility to these agents, however, varies widely, depending on the specific drug and organism; has not been constant over time; and differs in various geographic locations within the United States for many species. For the organisms in the Bacteroides fragilis group, the beta-lactam antibiotics with the most consistent activity are imipenem and combinations of a beta-lactam drug plus a beta-lactamase inhibitor, such as ticarcillin/clavulanate and ampicillin/sulbactam.