The salty unpleasant taste of the standard polyethylene glycol electrolyte lavage solution constitutes a major drawback, which limits patient compliance. Recently, a new low-sodium cleansing solution was described and introduced as a major advance, allegedly providing a distinctly better taste and improving compliance. We compared the taste of both solutions, seeking a possible preference applying a double-blind randomized design. Twenty-eight healthy volunteers tasted one of the two solutions without a direct comparison. Both solutions were found to have a similar palatability and an equal salty taste. A different group of 50 volunteers compared the two solutions. Twenty-one preferred the standard solution, 25 preferred the new solution (not significant), and 4 subjects had no preference. Among the subjects basing their preference on the saltiness of the solutions, 18 estimated the standard solution to taste more salty than the new low sodium solution, while 18 volunteers found the new solution to taste more salty than the standard solution. This study does not confirm a taste preference for the new low-salt polyethylene glycol electrolyte lavage solution as compared with the standard solution for colonic cleansing. The difference in the salt concentrations of the two solutions could not regularly be distinguished by a group of healthy volunteers.

Adult↗

PubMedDate not supplied

Low sodium solution for colonic cleansing: a double-blind, controlled, randomized prospective study.

The standard polyethylene glycol electrolyte solution for colonic cleansing has a salty unpleasant taste resulting in limited patient acceptance. Introduced as a major advance allegedly providing a distinctly better taste, a new low sodium cleansing solution was recently described. In a double-blind controlled fashion, 66 colonoscopy outpatients were interviewed about general palatability and tolerance of the solution they had ingested for the preparation of endoscopy. Preparation quality was assessed endoscopically. Similar results were obtained for both solutions concerning palatability, tolerance, and cleansing quality. Furthermore, a small quantity of both solutions was tasted and directly compared for taste qualities before endoscopy. Fifty-one and one-half percent of patients preferred the new solution and 48.5% preferred the standard solution or had no preference (not significant). Of the patients, 39.2% were unable to differentiate between the more and the less salty solution. Moreover, 39.6% of patients preferred the solution they judged more salty. We conclude that the new low sodium lavage solution is not superior to the standard solution regarding patient acceptance, compliance, and cleansing quality. Thus, the reduction of salt concentration does not appear to be the appropriate approach to improve patients compliance with colonic cleansing solutions.

Colonoscopy↗

PubMedDate not supplied

Clustered illegitimate recombination events in mammalian cells involving very short sequence homologies.

Mammalian cells possess mechanisms that allow unrelated sequences to recombine (illegitimate recombination), This is evidenced by the high rate of recombination between largely non-homologous sequences after DNA transfection. We have analysed the integrated viral sequences present in the polyoma transformed cell line 82-Rat. Within the single insert of integrated viral sequences there are two regions where multiple recombination events have occurred. The recombination events are particularly interesting as there was no obvious prior selection for their occurrence, and thus they may accurately reflect a normal mechanism of cellular recombination. A total of five recombinant joins have been sequenced. Our results, reported here, indicate that multiple recombinant events occur within small regions (about 50 bp) and that very short homologous stretches (3-4 bp) participate in joining two non-homologous sequences. This suggests that factors other than sequence homologies drive certain recombination events. These results have implications for site-directed recombination following the addition of exogenous DNA.

Animals↗

PubMedDate not supplied

A mouse locus at which transcription from both DNA strands produces mRNAs complementary at their 3' ends.

The organization and large size of the mammalian cell genome allows spatial separation of different transcription units. In those cases where more than one species of messenger are synthesized from the same cellular DNA sequence, they have been found to be generated from transcription proceeding in the same direction. These mRNAs always share regions of homology and can differ from one another as a result of differential processing (splicing and/or polyadenylation) or alternative initiation. In contrast, complementary mRNAs transcribed from opposite strands of the same cellular DNA sequence have not previously been observed. Here we have identified a region of mouse DNA at which processed mRNAs from two adjacent convergent transcription units overlap by 133 base pairs (bp) at their 3'-untranslated ends. One of the transcription units appears to encode a second mRNA which does not contain this overlapping region. This represents the first description of the natural occurrence of processed mammalian cell mRNAs transcribed from opposite strands of the same DNA sequence. The implications of these complementary regions in normal gene regulation are discussed in the context of the finding that the artificial introduction into cells of DNA constructs synthesizing anti-sense RNAs complementary to regions of mRNA transcribed from a chromosomal gene, can inhibit the gene's activity, presumably by the formation of double-stranded RNA.

Animals↗

PubMedDate not supplied

MR defecography: depiction of anorectal anatomy and pathology.

With the advent of open-configuration MR systems, enabling image acquisition in a vertical patient position, MR defecography has become possible. MR defecography permits analyses of the anorectal angle, opening of the anal canal, functioning of the puborectal muscle, and descent of the pelvic floor during defecation. The rectal walls are well delineated on the GRE images, permitting visualization of intussusceptions and rectoceles. The concomitant depiction of structures surrounding the anorectal canal is helpful in the assessment of a spastic pelvic floor and the descending perineum syndrome and in permitting visualization of enteroceles. Dynamic MR defecography is an attractive alternative in the evaluation of defecation disorders.

Adult↗

PubMedDate not supplied

The surf-4 gene encodes a novel 30 kDa integral membrane protein.

The mouse surfeit locus is a tight cluster of at least six genes (surf-1 to -6), unrelated by sequence homology, whose unique organization is conserved in vertebrates. We show that the surf-4 coding sequence is conserved between mouse and human. Primary sequence analysis predicts that the mouse surf-4 protein contains seven transmembrane domains and a double lysine endoplasmic reticulum (ER) retrieval motif on the carboxyl terminus. Translation of the mouse surf-4 cDNA in vitro resulted in the production of a 30 kDa membrane protein. Salt and detergent extraction procedures showed that the surf-4 protein associated tightly with the microsomal membranes. Proteolysis protection of 14 and 3 kDa fragments indicates that the surf-4 protein contains at least two membrane spanning domains: this is consistent with the proposed topology. Addition of the c-Myc epitope into three different regions of the surf-4 protein resulted in transfectants that expressed a myc-tagged protein. Immunofluorescence analysis of the three surf-4 myc chimeras yielded a cytoplasmic staining pattern. Consistent with the presence of the ER retrieval motif, the surf-4 myc protein was not detected at the plasma membrane. A model for the proposed structure of the surf-4 protein is presented.

Amino Acid Sequence↗

PubMedDate not supplied

The LPN-ADN articulation project.

Faced with a staffing situation where RN positions were needed but there were more LPN positions than were needed. Tucson Medical Center began an LPN-ADN articulation project to rectify the situation without resorting to layoffs. With the cooperation of a local junior college, LPNs are enrolled in ADN programs that provide a more flexible work/study situation. This article describes the program and the results thus far.

Arizona↗

PubMedDate not supplied

A randomized trial of pefloxacin plus klindamicin and cefoxitin in hepatobiliary and pancreatic surgery.

BACKGROUND/AIMS: The efficacy and safety of pefloxacin plus klindamicin with cefoxitin were studied in patients undergoing hepatobiliary or pancreatic surgery. MATERIALS AND METHODS: Seventy-five patients with biliary tract, hepatic, or pancreatic pathology were randomly allocated in a prospective open study to receive a combination of either i.v or oral pefloxacin (800mg per day) plus klindamicin (2,400mg per day) or an i.v. cefoxitin (4,000mg per day). RESULTS: Twenty patients had to be withdrawn from the trial because of negative baseline culture or because of isolation of bacteria resistant to the study drugs. In the remaining fifty-five patients, the clinical cure rates were excellent in more than ninety five percent and similar for both groups, the bacteriological success rates were 100% in the pefloxacin plus klindamicin group and 89.1% in the cefoxitin group. No patients were withdrawn from the study because of side effects. CONCLUSION: In our study we have shown the excellent results of the antibacterial therapy with pefloxacin and klindamicin of the patients who underwent complicated hepatobiliary and pancreatic surgery.

Administration, Oral↗

PubMedDate not supplied

Gastric banding in the treatment of morbid obesity.

BACKGROUND/AIMS: Obesity appears to be an epidemic problem now. Thirty percent of men and 40% of women in the fifth decade are obese (> 20% over ideal weight). Extreme obesity in itself decreases life expectancy and is associated with the early development of cardiopulmonary disorders, hypertension, diabetes and many other disorders. The non-operative treatment of extreme obesity rarely leads to permanent weight reduction. Various operative procedures such as vertical banded gastroplasties, malabsorptive operations or gastric bandings have been suggested for the production of permanent weight loss. A relatively high incidence of morbidity following "laparotomy" procedures for obesity treatment prompted us to start laboratory studies in 1991 on laparoscopic gastric banding. MATERIAL AND METHODS: In June 1993 we performed the world's first "laparoscopic" gastric banding in a human and since then, we have operated on more than 60 patients using this method. RESULTS: The 5-year mean post-operative weight loss of -37.4 kilograms, with significant blood pressure decreases at 1-year follow-up and with no significant changes noted in the levels of RBC, electrolytes and transaminase. CONCLUSION: The "laparoscopic" approach in gastric banding enabled us to shorten hospital stay and decrease post-operative complications significantly.

Blood Pressure↗