Hyperoxaluria and bowel disease.
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Biomedical subjects
Publications and source records attributed to D L Earnest.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Cytokines are regulatory polypeptides secreted during the generation of an immune or inflammatory response by lymphocytes, cells of the monocyte/macrophage series, and a variety of other cell types. Alterations in the production, site of action, or metabolism of cytokines by exogenous factors, such as ethanol (EtOH), may have deleterious effects on the immune system as a whole. EtOH has been implicated in the onset of a variety of immune defects in vivo including effects on the production of cytokines critically involved in inflammatory responses (tumor necrosis factor, interleukin 1 and interleukin 6). In this review, we examine current knowledge regarding the effects of EtOH on the release of cytokines in humans and in animal models, in vitro and in vivo, which may help to elucidate the adverse actions of EtOH on mammalian immune systems.
We prospectively evaluated multiple physiologic parameters in 104 consecutive unselected patients undergoing elective colonoscopy. Changes observed during colonoscopy were then correlated with the type of anesthesia and level of sedation, position of the endoscope and presence of looping, existence of comorbid medical conditions, concomitant medication usage, and the occurrence of endoscopy induced pain. Clinically important changes in O2 saturation (54%) and in blood pressure (44%) were most frequently noted. Less frequent were changes in pulse (15%) or respiratory rate (4%). These clinically significant changes were associated with induction of anesthesia or endoscope looping and pain in 58 to 62% of the patients. In the remainder of patients, no obvious factor was associated with the observed alterations in physiologic parameters. There was no correlation with presence of comorbid medical conditions, use of concurrent medication, dose of anesthesia, level of sedation, and/or colon segment reached by the endoscope. Although there was no apparent morbidity associated with the induced changes in physiologic parameters, these data suggest that certain patients may be at increased risk of procedure-related morbidity and support the need for physiologic monitoring in high-risk patients.
It has been demonstrated and confirmed that certain nonsteroidal anti-inflammatory drugs which inhibit cyclooxygenase and the synthesis of prostaglandins and other eicosanoids, can reduce the formation of both colon polyps and cancers in experimental animals given known carcinogens. Additionally, the results of several epidemiologic studies have suggested that nonsteroidal anti-inflammatory drugs may reduce the risk of colon polyp occurrence and/or colon cancer mortality. We have carried out a study to evaluate the methodology of the measurement of prostaglandin E2 (PGE2) in human colonic mucosa because its concentration may serve as a valuable intermediate marker of the pharmacological activity in Phase II studies of nonsteroidal anti-inflammatory drugs as colon cancer preventive agents. We studied all aspects of the actual measurement of PGE2 including the extraction efficiency of the PGE2 from the mucosa, the precision of the assay and calculation of the PGE2 content in terms of milligrams of protein in the sample, the inhibition of PGE2 by indomethacin over time, the reproducibility of the measurement within one homogenate, the rate of PGE2 production over time, the effect of adding indomethacin versus snap freezing on PGE2 production, the stability of PGE2 in tissues over time stored in liquid nitrogen, and the variability of the measurement of PGE2 in separate biopsies from one individual. Our studies indicated that the most reliable method for accurate and consistent measurements of PGE2 was to add the mucosal tissue instantly after biopsy to an indomethacin buffer that effectively inhibited the in vitro formation of PGE2.