Gastrointestinal endoscopy (2)
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Biomedical subjects
Publications and source records attributed to J F Morrissey.
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Tissue activity levels of ornithine decarboxylase (ODC) have been suggested to be a marker of colonic epithelial cell proliferation and risk for colorectal cancer. Supplemental dietary calcium has been hypothesized and reported to suppress colonic epithelial-cell proliferation. We measured sigmoid and rectal mucosal ODC activity levels in 45 healthy, disease-free subjects with strong family histories of colorectal cancer before and after 2 months, during which daily dietary supplementation with calcium carbonate (to provide 600 mg calcium base) was taken. Although the mean ODC activity levels decreased in both sigmoid and rectal specimens, these changes were small in relation to the standard deviation and were not statistically significant. These data suggest that the magnitude of dietary calcium intake does not significantly influence sigmoid-rectal mucosal ODC activity levels and that ODC measurements may not be a useful intermediate endpoint for interventions designed to interrupt the colon carcinogenic sequence.
We describe a simple method for rapid intubation of the small intestine. The method was successful in 13 out of 14 attempts. A forward-viewing fiberscope, two endoscopic biopsy forceps, five rubber bands, and the tube to be positioned are required for the method. It should have broad application for the passage of tubes for small intestinal decompression, jejunal feeding, jejunal biopsy, and biliary and pancreatic drainage studies.
The introduction of modern endoscopes, light sources, and cameras has greatly improved the endoscopist's ability to diagnose and document the presence of reflux esophagitis. A reliable objective diagnosis of reflux esophagitis can be made in the presence of active erosion, friability, and ulceration. Reflux can be suspected in the presence of a patulous cardia. Gross reflux is uncommonly seen in the relaxed patient during endoscopy, but its presence is pathologic. The x-ray and endoscopic diagnosis of hiatal hernia correlate well. Endoscopists must be aware of those rare cases where an infectious cause for esophageal inflammation may be present. Although endoscopic biopsy and brush cytology are of limited value in the diagnosis of esophagitis, they permit an accurate differentiation between benign and malignant lesions in the esophagus and their use is encouraged in chronic cases of esophagitis where an increased risk of malignancy is present.
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Ornithine decarboxylase (ODC), a key enzyme in mammalian polyamine biosynthesis, has been proposed to be a marker of colonic epithelial cell proliferation and risk for colorectal cancer. We investigated the basal levels of ODC activity in sigmoid and rectal mucosae, and basal and tumor promoter 12-O-tetradecanoylphorbol-13-acetate-induced levels of skin ODC activity in individuals with a personal history of colon cancer (n = 9 colon; n = 58 skin), a family history of nonpolyposis hereditary colorectal cancer (n = 49; n = 42), adenomas (n = 16; n = 40), and healthy, family history-negative control subjects (n = 40; n = 79). Using a fresh tissue assay and samples obtained after a standard colon lavage preparation, colon mucosal ODC levels ranged from 0 to 192 pmol/mg/h (sigmoid, 0-163 pmol/mg/h; mean, 36 +/- 32 pmol/mg/h; rectum, 0-192 pmol/mg/h; mean, 35 +/- 32 pmol/mg/h). No differences among the four groups of subjects were found for either colon or skin ODC levels, and there were no sex differences overall or in any group. These results are not compatible with the suggestion that ODC levels are a useful marker of risk for colorectal cancer.