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At least 1,279 records · Page 71Linked to original sources
PubMed1978

Colonic endoscopy in perspective.

Sigmoidoscopy is an easy procedure and should be utilized more frequently. Barium enema examination is incomplete without sigmoidoscopy. Flexible fiberoptic sigmoidoscopy may have a role in the detection of disease of the descending, sigmoid, and rectosigmoid colon. The necessity for its routine usage remains to be determined. The control of colonic polyps by colonoscopy has been the greatest contribution to date by the fiberoptic instrument. Colonoscopy has improved the accuracy of diagnosis of colonic disease and, in certain instances, is helpful in the early detection of cancer of the colon. Colonoscopy complements the use of barium enema examination. Colonoscopy only for the purpose of confirmation of clinical or radiological diagnosis is often unnecessary. While the benefits of endoscopy are obvious, there are definite practical and technological limitations to its use. Complications, although infrequent, are major. Indications for colonoscopy must be clear and findings interpreted with knowledge of the limitations.

Colonic Diseases↗
PubMed1991

[Endoscopic assessment of hemorrhage from the gastrointestinal tract].

The causes of gastrointestinal bleedings was assessed by fiber gastroscopy, rectoromanoscopy and fiber colonoscopy. The most frequent causes of bleedings from the upper gastrointestinal tract are gastric and duodenal ulcers, erosive hemorrhagic gastritis, gastric cancer, liver cirrhosis with bleeding from varicose veins, polyps, diverticuli, Mallory-Weiss syndrome, etc. The most frequent causes of bleedings from the lower gastrointestinal tract are hemorrhoids, anal fissures, colonic polyps, chronic ulcerohemorrhagic colitis, rectal carcinoma, etc. The diagnostic importance of urgent endoscopic examinations is pointed out.

Emergencies↗
PubMedDate not supplied

[Prevalence of adenomatous and hyperplastic polyps of the colon in the population of the General Hospital of Mexico. An autopsy study].

A prospective survey of 450 autopsies was conducted to determine the prevalence of colorectal dysplastic polyps in the population of the General Hospital of Mexico City. The colon and rectum were removed and examined for the presence of polypoid lesions; their size, location, and appearance were described. All of the lesions were examined and classified according to their microscopic diagnosis. Results revealed a single polypoid lesion in nine cases; four were classified as regenerative or inflammatory and five as dysplastic. Four of the latter were in females and one in a male; their mean age was 64 years. Macroscopically four were pedunculated and one sessil; all measured less than 0.6 cm; two were located in the transverse colon and three in the left colon. No hyperplastic polyps were found. After standardization for age, comparison with similar studies performed in other countries showed an extremely low prevalence rate for dysplastic colorectal polyps (2.7%) in our patient population, similar to one reported in Iran and higher than that found in the African Bantus, but it is one of the lowest when compared with European and US series.

Adolescent↗
PubMedDate not supplied

[Polypectomy of the digestive tract].

Endoscopic polypectomy was one of the first therapeutic procedures, as it was done even before the appearance of colonoscopy through rigid endoscopies. Immediately after the use of monopolar current in endoscopy, polyp resection in the digestive tract has been a elective treatment, and is reserved only for surgeries which are very extensive, or those which cannot be surrounded with a wire loop. The impact of the polypectomy in colonic adenomas has been notable because of the possibility of the diagnosis of the entire surgical piece, and for the treatment of lesions with premalignant potential. The success of the complete resection of a colonic polyp is directly proportional to its size and shape, given that pendicular polyps guarantee the complete extirpation of the tumor, in that sessile polyps require additional techniques to elevate the lesion. Among the precautions in prepolypectomy are found the following: Anti-inflammatory non-steroidal (AINS) suspension; anticoagulant suspension, and adequate intestinal preparation. Hemorrhage and perforation occur in 0.1% of each. Postcoagulation syndrome is a secondary effect which only requires vigilance. The inherent complications in the use of secondary current are minimal when its technical principles are known. The success of endoscopic polypectomy depends on the refinement of the procedure, which is achieved through experience.

Child↗
PubMed2006

Roles of survivin isoforms in the chemopreventive actions of NSAIDS on colon cancer cells.

NSAIDs downregulate survivin (an apoptosis inhibitor), increase apoptosis and reduce growth of colon polyps and cancers. Recently, anti- and pro-apoptosis isoforms of survivin were identified. The roles of these isoforms in NSAID-induced colon cancer cell death have not been examined, and is the focus of this study. The anti-apoptosis isoforms, wild-type (WT) survivin and survivin-DeltaEx3, and the pro-apoptosis isoform, survivin-2b, were present in HT-29 and RKO cells. Indomethacin treatment significantly decreased WT survivin and survivin-DeltaEx3 (30.5+/-10.4% and 20.3+/-6.7%, respectively) but not survivin-2b mRNA in RKO cells. In HT-29 cells, all three isoform mRNAs were slightly decreased by indomethacin treatment. Consistently, indomethacin treatment dramatically reduced WT survivin protein in RKO but not HT-29 cells. Indomethacin treatment increased apoptosis and general cell death more significantly in RKO cells (75.7+/-1.1% cell death at 48 h) than in HT-29 cells (25.4+/-3.7% cell death at 48 h). Anti-sense suppression of survivin-2b mRNA increased resistance of both RKO and HT-29 cells to indomethacin. These data support a role for survivin isoforms in colon cancer cell apoptosis, and thus in prevention of colon cancer growth by NSAIDs.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1979

Diagnostic and therapeutic colonoscopy. A critical review of 662 examinations.

The results of 662 therapeutic and diagnostic colonoscopic examinations were reviewed to assess the morbidity, clinical benefit, diagnostic accuracy, and indications for the procedure, with special emphasis on detection and endoscopic excision of small, occult, invasive cancers. Overall, the frequency of detecting occult lesions (19%), the (89%) ability to clarify questionable radiographic findings, and a substantial reduction in laparotomy-colotomy procedures required for removal of colonic polyps (88%), coupled with a low morbidity (3%) and low false-negative examination rate (1%) established colonoscopy as one of the most important advances in the management of colon disease in recent years. Although early experience suggests that small, occult, invasive carcinomas, when properly selected, could be adequately treated by endoscopic excision, larger series and longer follow-up periods are necessary to validate any conclusions regarding the decision to manage these lesions conservatively.

Carcinoid Tumor↗
PubMed2003

CT colonography: does improved z resolution help computer-aided polyp detection?

Multislice helical CT offers several retrospective choices of longitudinal (z) resolution at a given detector collimation setting. We sought to determine the effect of z resolution on the performance of a computer-aided colonic polyp detector, since a human reader and a computer-aided polyp detector may have optimal performances at different z resolutions. We ran a computer-aided polyp detection algorithm on phantom data sets as well as data obtained from a single patient. All data were reconstructed at various slice thicknesses ranging from 1.25 to 10 mm. We studied the performance of the detector at various ranges of polyp sizes using free-response receiver-operating characteristic analyses. We also studied contrast-to-noise ratios (CNR) as a function of slice thickness and polyp size. For the phantom data, reducing the slice thickness from 5 to 1.25 mm improves sensitivity from 84.5% to 98.3% (all polyps), from 61.4% to 95.5% (polyps in the range [0, 5) mm) and from 97.7% to 100% (polyps in the range [5, 10) mm) at a false positive rate of 20 per data set. For polyps larger than 10 mm, there is no significant improvement in detection sensitivity when slice thickness is reduced. CNRs showed expected behavior with slice thickness and polyp size, but in all cases remained high (> 4). The results for the patient data followed similar patterns to that of the phantom case. Thus we conclude that for this detector, the optimal slice thickness is dependent upon the size of the smallest polyps to be detected. For detection of polyps 10 mm and larger, reconstruction of 5 mm sections may be sufficient. Further study is required to generalize these results to a broader population of patients scanned on different scanners.

Colon↗
PubMed1983

Juvenile and inflammatory polyps of the colon--a histological and histochemical study.

A light microscopy and histochemical study of 24 juvenile and 27 inflammatory polyps showed that both may derive from inflammatory processes. Granulation tissue, secondary to spontaneous local inflammation or due to surgical procedures may subsequently be covered by regenerating epithelium which lines haemorrhagic cavities and mucus lakes to form irregular, elongated and cystic glands, which are characteristic of juvenile polyps. Both juvenile and inflammatory polyps showed cystic, metaplastic and 'transitional-type' glands. The mucin distribution was identical in both types of polyps. All these findings suggest a common origin of the polyps. The presence of 'transitional-type' glands seems to confirm these as a secondary regenerative phenomenon rather than pre-neoplastic, although dysplastic changes in juvenile polyps have been described. It is suggested that both the juvenile and inflammatory polyps may undergo dysplasia only in genetically predisposed subjects. However, this event seems to be very rare.

Adolescent↗
PubMed1980

Colonoscopic polypectomy: the first 200.

Colonoscopic polypectomy is a safe, reliable method of excising most colonic polyps. This paper reports 200 colonoscopic polypectomies performed by one surgeon in a Toronto teaching hospital and reviews results and complications of polyp removal and the treatment of malignant polyps. The relative value of colonoscopic and radiologic detection of polyps is assessed and a plan for follow-up after polypectomy discussed.

Aged↗
PubMedDate not supplied

[Technical restatement about double contrast enema (author's transl)].

The prevention of the rectum and colon carcinoma consists principally in the radioendoscopic detection of colonic polyps. The double contrast enema is the best method for this detection. The usual practice of double contrast imposes the restatement of a comfortable method for the patient, simple and reliable for the doctor. The authors mean in this study to compare two groups of patients (group I and II) which differ by the double contrast technique used. If the colonic preparation, the injection implements and the investigation preliminaries are the same in both groups, there is no evacuation time of the barium enema which is added to trimebutine and stopped to the left iliac crest are specific with this method. The results allows an accuracy diagnosis of polyps.

Barium Sulfate↗
PubMed2001

Treating benign colon disorders using laparoscopic colectomy.

Laparoscopic bowel surgery is a recent application of minimally invasive videoscopic techniques. Understanding the anatomy and physiology of the bowel, the background of bowel disorders and their treatment, signs and symptoms of bowel disease, and the patient selection process can help perioperative nurses better care for patients diagnosed with colon polyps, diverticulitis, and inflammatory bowel disease.

Colectomy↗
PubMed1998

Colon carcinoma in patients undergoing liver transplantation.

BACKGROUND: Organ recipients are at risk for certain neoplasms. Ulcerative colitis (UC) is itself a strong risk factor for the development of colon carcinoma (CCa). Transplant patients with UC might be at higher risk for CCa. We analyzed these patients to compare the incidence and pattern of CCa development in these and non-UC patients following liver transplantation (OLTX). PATIENTS AND METHODS: Retrospective study of 1,085 OLTX patients. RESULTS: In 1,022 patients without UC, 1 patient (< 0.1%) developed adenocarcinoma in a colonic polyp 46 months after OLTX. Sixty-three of 108 (60%) patients undergoing OLTX simultaneously had UC. Five OLTX patients (8%) with UC developed colon adenocarcinoma 22 to 66 (mean 48) months after OLTX. Two have died. CONCLUSIONS: Coexistent UC in patients requiring OLTX constitutes a potentially high risk for the development of colonic cancer, a late-appearing event. These patients require close observation and frequent colonoscopic/histologic screening of the colon.

Adenocarcinoma↗
PubMed2004

Exisulind: Aptosyn, FGN 1, Prevatac, sulindac sulfone.

Exisulind [Aptosyn trade mark, FGN 1 trade mark, Prevatac trade mark, sulindac sulfone], the sulfone derivative of sulindac, is the lead compound in a series of selective apoptotic antineoplastic drugs (SAANDs) being developed by OSI Pharmaceuticals. The compounds were originally developed by Cell Pathways, which was acquired by, and integrated into, OSI Pharmaceuticals in June 2003. Exisulind inhibits the enzyme cyclic GMP phosphodiesterase (GMP-PDE), overexpressed in precancerous and cancerous colorectal cells, and induces apoptosis in such cells with minimal effects on normal cells. This apoptotic effect is independent of COX I or COX II inhibition, p53, Bcl-2, or cell-cycle arrest. Preclinical evidence suggests that exisulind also inhibits angiogenesis. Cell Pathways has formed sales and distribution agreements with three healthcare-related companies in the US for its future marketing and support campaign for exisulind. Innovex will hire and train sales representatives for Cell Pathways to launch and promote exisulind, Livingston Healthcare Services will be responsible for customer service, order and distribution administration, and Lash Group will be responsible for the development and implementation of reimbursement support services for exisulind. Cell Pathways has issued an exclusive licence for exisulind to Paladin Labs of Montreal, Canada. The agreement allows Paladin exclusive rights to commercialise the drug in Canada. In August 1999 Cell Pathways submitted an NDA application to the US FDA for exisulind (Aptosyn) for the treatment of familial adenomatous polyposis (FAP). However, in September 2000, the FDA announced that it had found deficiencies in the safety and efficacy data of Cell Pathways' NDA, and returned a non-approvable letter to the company. Cell Pathways then initiated another phase III study of the agent in combination with Aventis' docetaxel and comparing combination therapy with docetaxel alone. Exisulind has fast-track designation for FAP in the US. Phase I and II paediatric trials are also underway in the US. Cell Pathways announced in April 2000 that it had completed enrollment in an open-label phase II study in children with familial adenomatous polyposis (FAP). Patients will be evaluated to determine whether polyp numbers have been reduced after 1 year relative to baseline. In June 2000, Cell Pathways announced the results of a 1-year extension of a 1997-1999 phase III trial that showed that exisulind significantly reduced polyp formation in patients with FAP. Enrollment of 282 patients in a multicentre, placebo-controlled phase III trial for the treatment of sporadic colonic polyps was completed in the US in May 1999. In its 2003 Annual Report, Paladin Labs announced that it is conducting a phase III study of exisulind in patients with prostate cancer in Canada. Exisulind has completed a pivotal phase II/III trial for preventing the recurrence of prostate cancer in the US. Two phase II prostate cancer trials were initiated in June 1999. The first study assessed the efficacy of exisulind in 15 patients who had undergone prostatectomy, were receiving LHRH-agonist hormone therapy and had increasing PSA levels (study EX1001). The second trial was to enroll 20 hormone-refractory patients scheduled for radical prostatectomy within 2-8 weeks of diagnosis (study EX1004). This study compared the effect of exisulind + docetaxel on the rate of apoptosis and GMP-PDE expression in premalignant or malignant and normal prostate tissue. Cell Pathways and Rhône-Poulenc Rorer (now Aventis) agreed to collaborate on clinical trials of exisulind in combination with docetaxel in the treatment of various solid tumours. The first phase I/II trial (study 026) was to enroll previously untreated patients with non-small cell lung cancer (NSCLC). OSI Pharmaceuticals and Bristol-Myers Squibb are conducting a phase I/II trial (study EX 2002) of exisulind in combination with paclitaxel and carboplatin as first-line treatment for patients with NSCLC. Both companies will share costs and information gathered from the SCLC. Both companies will share costs and information gathered from the trial. A phase I/II trial (study EX 2006) of weekly paclitaxel and carboplatin combined with exisulind is also underway in patients with advanced NSCLC. Cell Pathways and Glaxo Wellcome are cooperating in supporting a clinical trial (study EX 2004) of exisulind in combination with vinorelbine as first-line treatment for elderly patients with advanced NSCLC. The study will be conducted at the University of Wisconsin, and the two companies will share the costs of the trial while maintaining the rights to their respective compounds. Cell Pathways and Eli Lilly have a phase I/II trial (study EX 2005) of exisulind in combination with gemcitabine underway in patients with NSCLC. This study will investigate the efficacy and tolerability of escalating doses of exisulind in combination with a standard gemcitabine regimen. The Cancer and Leukaemia Group B (CALGB) initiated a phase II study of exisulind in combination with etoposide and carboplatin in patients with small cell lung cancer in the US in September 2002. The Eastern Cooperative Oncology Group (ECOG) initiated a phase II study in NSCLC patients in September 2002 that will investigate the effects of exisulind in combination with gemcitabine and carboplatin. The objectives of the two studies are to determine the 12-month survival rate and response rates following treatment with the combination regimens. Patents covering the mechanism of action of exisulind have been allowed in Europe and Japan, and extend to the methods of identifying compounds that selectively stimulate apoptosis in precancerous and cancerous cells.

Animals↗
PubMed2001

Detection of blood-borne cells in colorectal cancer patients by nested reverse transcription-polymerase chain reaction for carcinoembryonic antigen messenger RNA: longitudinal analyses and demonstration of its potential importance as an adjunct to multiple serum markers.

The use of reverse transcription-PCR (RT-PCR) to analyze cells in the blood of cancer patients for the detection of mRNA expressed in tumor cells has implications for both the prognosis and the monitoring of cancer patients for the efficacy of established or experimental therapies. Carcinoembryonic antigen (CEA) is expressed on approximately 95% of colorectal, gastric, and pancreatic tumors, and on the majority of breast, non-small cell lung, and head and neck carcinomas. CEA shed in serum is useful as a marker in only approximately 50% of colorectal cancer patients and rarely is shed by some other carcinoma types. RT-PCR has been used previously to detect CEA mRNA in cells in the blood and lymph nodes of cancer patients. Under the assay conditions validated in the studies reported here, 34 of 51 (67%) patients with different stages of colorectal cancer had blood cells that were positive by RT-PCR for CEA mRNA, whereas none of 18 patients with colonic polyps were positive; 2 of 60 apparently healthy individuals (who were age and sex matched with the carcinoma patients and were part of a colon cancer screening program as controls) were marginally positive. The results of CEA PCR in the blood of the carcinoma patients and the other groups showed strong statistical correlation with the disease (P2 < 0.0001). Analyses were carried out to detect both serum CEA protein levels and CEA mRNA in blood cells of colorectal carcinoma patients by RT-PCR. For all stages of disease, 18 of 51 patients (35%) were positive for serum CEA, whereas 35 of 51 (69%) were positive by RT-PCR. More importantly, only 5 of 23 (20%) of stage B and C colorectal cancer patients were positive for serum CEA, whereas 16 of 23 (70%) were positive by RT-PCR. The use of two other serum markers (CA19.9 and CA72-4) for colorectal cancer in combination with serum CEA scored two additional patients as positive; both were positive by RT-PCR for CEA mRNA. Pilot long-term longitudinal studies conducted before and after surgery identified some patients with CEA mRNA in blood cells that were negative for all serum markers, who eventually developed clinical metastatic disease. The studies reported here are the first to correlate RT-PCR results for CEA mRNA in blood cells with one or more serum markers for patients with different stages of colorectal cancer, and are the first long-term longitudinal studies to use RT-PCR to detect CEA mRNA in blood cells of cancer patients. Larger cohorts will be required in future studies to define the impact, if any, of this technology on prognosis and/or disease monitoring.

Adenocarcinoma↗
PubMed1987

CEA and carbohydrate antigens in normal and neoplastic colon mucosa. An immunohistochemical study.

Antibodies raised against tumour-associated antigens have been assessed for tumour selectivity using an indirect immunohistochemical peroxidase staining of formalin-fixed, paraffin-embedded tissue from colon carcinomas, colon polyps and normal mucosa. The following antibodies were used: 1) Unabsorbed polyclonal antibody to carcinoembryonic antigen (poly-CEA). 2) Monoclonal antibodies to CEA (mabs 3851 and 27). 3) Monoclonal antibodies to protein-bound carbohydrates (mabs C 216 and C 242) or to lipid- and protein-bound carbohydrates (C 50 and 19-9). These antibodies had been produced by hybridization of lymphocytes from mice, immunized with colon carcinoma cell lines or colon cancer tissue. All antibodies were used in one concentration only, preselected by initial titration experiments. No antibody was completely tumour-specific, but four antibodies, mabs 3851, 27, C 216 and C 242, showed statistically significant tumour selectivity. Using these antibodies, respectively 19, 19, 19, and 18 of 20 colon cancer were stained compared with 3, 4, 4, and 8 of 15 specimens of colon mucosa from normal controls. An increased frequency of staining was also noted in dysplastic polyps (statistically significant using mabs 3851 and C 216) and in dysplastic mucosa adjacent to a tumour (statistically significant using mabs 3851 and 27). The staining frequency of normal colon mucosa in cases of colon cancer did not differ from that in the normal controls. Poly-CEA and the anti-ganglioside mabs C 50 and 19-9 revealed no tumour selectivity. A pronounced goblet cell staining was seen using C 50, C 242 and 19-9.

Antibodies, Monoclonal↗
PubMed1979

Turcot's syndrome and its mode of inheritance.

Two sisters with Turcot's syndrome, in which malignant cerebral neoplasms are associated with colonic polyposis, are presented. Cases reported in the literature, including some familial cases, have also been analysed. In familial cases, sex was unrelated to the occurrence of this disease and it was found only among siblings of the same parents and not in other members of the family. There was consanguinity in the parents of the patients in two out of three families. We therefore concluded that the mode of inheritance in this condition is autosomal recessive and that it is genetically distinct from the ordinary form of familial polyposis coli. Support is lent to the absence of an association between the two disorders by a difference in the number, size, and distribution of the colonic polyps found in Turcot's syndrome as compared with familial polyposis coli.

Adenoma↗