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PubMed1989

Evaluation of a colonic lavage solution to prepare the colon of the dog for colonoscopy.

Ten dogs were given 3 different doses (60, 80, and 100 ml/kg of body weight) of a commercial colonic lavage solution in 2 equally divided doses, 2 to 4 hours apart. The degree of colonic cleanliness was evaluated subjectively, using a numbered scoring system (1 = clean to 4 = excessive fecal material). Systemic and metabolic effects were assessed by comparing body weight, PCV, total protein concentration, serum osmolality, and urine specific gravity before and 24 hours after administration of the high-dose solution. The lowest mean cleanliness score (1.6) was obtained with the 80 ml/kg dose (P less than 0.001). The solution had no effect on any measurement except urine specific gravity (P = 0.036). Oral administration of a colonic lavage solution in a divided total dose of 80 ml/kg is a safe and effective method of large-intestine preparation in the dog.

Administration, Oral↗

PubMed1988

Colonic neoplasms in asymptomatic first-degree relatives of colon cancer patients.

First-degree relatives of colon cancer patients are at elevated risk for developing colorectal neoplasms. In order to assess the potential usefulness of screening by colonoscopy in this high-risk population, we reviewed the records of 48 colonoscopies performed on asymptomatic patients who were self- or physician-referred for colonoscopy because of a history of one or more first-degree relatives with colon cancer. Twelve (25%) had at least one adenomatous polyp, but no significant atypia was detected. No cancers were detected. One third of the lesions were beyond the reach of a flexible sigmoidoscope. This apparent increase in the prevalence of adenomas was most striking (46%) among men over the age of 50. These preliminary results demonstrate that colonoscopy is effective in detecting and removing adenomatous polyps in a substantial fraction of asymptomatic patients whose sole risk-factor is being a first-degree relative of a patient with colon cancer. Further studies in larger populations are warranted to determine the use of colonoscopy in screening these high-risk individuals.

Adult↗

PubMed1987

Differential production of high molecular weight sulfated glycoproteins in normal colonic mucosa, primary colon carcinoma, and metastases.

Sulfated macromolecules synthesized in tumor and mucosa tissues derived from colorectal cancer patients were labeled with [35S]sulfate and separated into two fractions on DEAE-Sephacel: the slightly acidic peak (peak I) was eluted with 0.2 M NaCl and the highly acidic peak (peak II) was eluted with 0.5 M NaCl. A total of 40 specimens, which included primary colon cancer, liver metastases, and normal mucosa obtained at surgery (16 patients), were examined regarding the amount of peak I and peak II. The amount of peak I significantly decreased in the order of normal mucosa greater than primary tumors greater than metastases, while the amount of peak II did not significantly change among the tissues. Peak I was mostly resistant to chondroitinase ABC and nitrous acid treatment under acidic conditions, whereas combined chondroitinase-sensitive materials and nitrous acid-sensitive materials were greater than 80% of the radioactivity in peak II. The major radioactive component of peak I migrated at a position corresponding to Mr greater than 300,000 by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and became Mr less than 40,000 after alkaline borohydride treatment. The major component of peak I was likely to be a sulfated glycoprotein containing sulfate groups on alkaline labile carbohydrate chains. Peak II consisted of a mixture of heparan sulfate proteoglycans and chondroitin sulfate proteoglycans. Differential incorporation of [35S]sulfate into peak I among normal mucosa, primary colon carcinoma, and colon carcinoma metastasis was observed. Therefore, decreased peak I production may be a biochemical change associated with colorectal cancer progression and metastasis.

Chromatography, Ion Exchange↗

PubMed1982

Tissue bile acids in patients with colon cancer and colonic polyps.

The purpose of this study was to determine whether in man unusual types of concentrations or bile acids were present in colonic polyps, colon carcinomas, or the adjacent, apparently normal tissue. Methods for the determination of soluble and tissue-bound bile acids were validated. Of 14 polyps analyzed, eight contained detectable levels of bile acid, predominantly chenodeoxycholic acid; no lithocholic acid was observed in either the tissue-bound or soluble bile acid fractions. Bile acids were found in four of nine samples of colon carcinoma; in one tumor, tissue-bound lithocholic acid was present. Bile acids were similarly found in seven of 10 samples of normal bowel taken adjacent to the carcinoma. In the soluble bile acid fraction, cholic acid was more abundant than chenodeoxycholic acid. There was no correlation between tissue histology and bile acid composition or concentration. Under the conditions used, this study did not disclose a relationship between tissue bile acids and colorectal histology.

Adenocarcinoma↗

PubMed1994

[Evaluation of colon diseases by using new method of extracorporeal ultrasonic examination during usual colon endoscopy].

Generally two types of ultrasonic colon examination method are carried out. One is extracorporeal ultrasonographic examination (US). And another is endoscopic ultrasonographic examination (EUS). US is technically easy but is difficult to take good image of colon diseases. EUS can give us good and sufficient informations. But it is technically difficult and gives much trouble to patients. During usual endoscopy, we have tried extracorporeal ultrasonic examination by filling de-aired water around the diseased colon area. With this new method, we could easily identify the disease and got much better picture than usual US. And this new method gave almost no trouble and pain to examinees in comparison with EUS.

Calcinosis↗

PubMed1996

Quantitative differences in GlcNAc:beta1-->3 and GlcNAc:beta1-->4 galactosyltransferase activities between human colonic adenocarcinomas and normal colonic mucosa.

The activities of GlcNAc:beta1-->3 and GlcNAc:beta1->4 galactosyltransferases in normal human colonic mucosa and well or moderately differentiated colonic adenocarcinomas and their enzyme-kinetic characteristics were investigated. After UDP-[3H]galactose and N-linked type monoantennary oligosaccharides GlcNAc beta1-->2Man alpha1-->3(6)Man beta1-->4GlcNAc) had been incubated with microsome fractions prepared from these tissues, the synthesized [3H]galactose-labeled oligosaccharides were analyzed by Ricinus communis agglutinin-I agarose chromatography, Streptococcus 6646K beta-galactosidase, Gal beta1-->4-specific diplococcal beta-galactosidase, and Gal beta1-->3GlcNAc-specific lacto-N-biosidase digestion. The beta-galactosyltransferases from normal mucosa synthesized both type 1 and type 2 chains at comparable levels, whereas those from adenocarcinomas predominantly synthesized type 2 chains. To our knowledge, this is the first quantitative estimation of GlcNAc:beta1-->3 galactosyltransferase activity toward N-linked sugar chains. Furthermore, we compared the two galactosyltransferase activities in 10 normal mucosa and adenocarcinoma samples and found that while there existed similar levels of GlcNAc:beta1-->4 galactosyltransferase activity in normal mucosa and adenocarcinomas, GlcNAc:beta1-->3 galactosyltransferase activity apparently decreased from 0.67 +/- 0.26 (normal mucosa) to 0.18 +/- 0.11 nmol/min/mg of protein (adenocarcinomas). These results are consistent with those of comparative structural studies on N-linked sugar chains of carcinoembryonic antigen and its normal counterparts and suggest that in the process of differentiated carcinogenesis of human colonic tissues, the expression of GlcNAc:beta1-->3 galactosyltransferase is negatively regulated.

Acetylglucosamine↗

PubMed1997

Marking and identifying colon lesions. Tattoos, clips, and radiology in imaging the colon.

Precise knowledge of a lesion's location in the colon is infrequently required. Occasionally, however, this information can be of critical clinical importance. A variety of endoscopic and radiologic techniques have been described to localize an area or site within the colon. Tissue staining or tattooing is the most reliable endoscopic method of colon lesion localization, and India ink provides a long-lasting and probably permanent tattoo of the site. Endoscopic clips are less reliable and remain cumbersome to use. Electronic imaging is an intriguing approach but remains experimental. Sites and lesions also can be identified by barium radiography or fluoroscopy, but these techniques involve added expenses and are not as reliable as tattooing with India ink.

Barium Sulfate↗

PubMed1998

GIVIO-SITAC 01: A randomized trial of adjuvant 5-fluorouracil and folinic acid administered to patients with colon carcinoma--long term results and evaluation of the indicators of health-related quality of life. Gruppo Italiano Valutazione Interventi in Oncologia. Studio Italiano Terapia Adiuvante Colon.

BACKGROUND: In 1989, the authors began a randomized trial to determine whether 5-fluorouracil and high dose folinic acid (HD-FUFA) would increase the event free and overall survival of patients with resectable Dukes B and C (AJCC/UICC Stage II and Stage III) colon carcinoma, and to assess the toxicity of the treatment and its impact on selected health-related quality-of-life indicators. Early results were published as a part of an international multicenter pooled analysis (IMPACT) in 1995. The purpose of this report is to update the survival data for patients enrolled in the trial and describe their reported perceptions of their own health and quality of life. METHODS: The trial involved multiple treatment centers, with a centralized randomization between surgery alone and surgery with chemotherapy. The HD-FUFA regimen employed consisted of 5-fluorouracil (370 mg/m2) plus folinic acid (200 mg/m2) administered daily for 5 days every 4 weeks for 6 cycles. Patients' perceptions of their own health status were obtained by means of 3 self-administered questionnaires, which were completed by patients at the time of discharge from the treatment center and at 6 and 24 months after randomization. RESULTS: Overall, 888 patients with resected Dukes B2 and C colon carcinoma were enrolled in the trial. HD-FUFA significantly reduced mortality by 25% (95% confidence interval, 5-41%; P=0.02) and events by 31% (95% confidence interval, 14-45%; P < or = 0.001). Compliance with treatment was good; more than 80% of patients completed the planned therapy. Toxicity was mild, and oral mucositis was the main side effect. None of the health-related quality-of-life parameters investigated (emotional status, worry about the future, changes in social life, impact of the disease, follow-up, and global quality of life) seemed to be affected by the treatment to which patients were allocated. A positive trend in the evolution of patients' psychologic status was observed. CONCLUSIONS: Long term results of this SITAC study confirm that HD-FUFA is a well-tolerated, effective 6-month adjuvant regimen for patients with colon carcinoma that has no detrimental effect on their quality of life.

Adult↗

PubMed1977

Changes in chromosomal proteins in colon cancer: the complexity and DNA-binding properties of tumor-associated proteins and evidence for their association with the malignant state in human colonic epithelium.

The properties of two classes of nonhistone nuclear proteins (NHNP) whose appearance has been correlated with the process of carcinogenesis in the colonic epithelium of rats given 1,2-dimethylhydrazine (DMH) have been investigated. NHNP isolated from adenocarcinomas of the colon were tested for their binding to homologous DNA. The tumor-specific protein class TNP1 (molecular weight ca. 44,000) shows high affinity for DNA while the second class of tumor-specific proteins (TNP2; molecular weight ca. 62,000) does not bind to DNA. When tumor chromatin is subjected to a limited digestion with DNAse I under conditions that are known to preferentially digest active genes, the TNP1 proteins are selectively released, suggesting that this protein fraction is associated with the actively transcribing portions of the genome. The complexity of both tumor-specific protein classes has also been analyzed by two-dimensional gel electrophoresis. This method reveals a high degree of complexity both in TNP1 and TNP2. Protein classes similar to TNP1 and TNP2 that are also found in human colonic adenocarcinomas are not detectable in polyps from familial polyposis-affected patients at times when no sign of malignancy has yet appeared.

Adenocarcinoma↗

PubMed1985

The afferent and sympathetic components of the lumbar spinal outflow to the colon and pelvic organs in the cat. III. The colonic nerves, incorporating an analysis of all components of the lumbar prevertebral outflow.

The cell bodies of the lumbar sensory and sympathetic pre- and postganglionic neurons that project to the colon along the inferior mesenteric artery of the cat have been labeled retrogradely with horseradish peroxidase applied to the central end of their cut axons. The numbers, segmental distribution, location, and size of these labeled somata have been determined quantitatively. Afferent cell bodies were symmetrically distributed bilaterally in dorsal root ganglia T13-L5, with the maximum number (about 80%) in L3 and L4 and most of the rest in L2. Labeled afferent somata were small relative to the entire population of DRG cells. Occasionally a few preganglionic somata were labeled in the intermediate zone of L3 and L4 spinal cord segments. Postganglionic cell bodies were labeled bilaterally in the proximal lobes of the inferior mesenteric ganglion (70-95%), in accessory ganglia of the intermesenteric nerve and of the lumbar splanchnic nerves, and in lumbar paravertebral ganglia. The segmental distribution in the lumbar sympathetic trunk was symmetrical on both sides and was the same as that of the afferent cells. Labeled postganglionic cell bodies in both the IMG and the accessory ganglia were larger than labeled and unlabeled ganglion cells in the paravertebral ganglia. From these data, it is estimated that about 2,100 afferent neurons and about 29,000 postganglionic neurons project in the lumbar colonic nerves. In conjunction with equivalent data for the hypogastric and lumbar splanchnic nerves, the results provide a quantitative and spatial description of the afferent and efferent components of the lumbar innervation of the colon and pelvic viscera.

Animals↗

PubMed1991

A mathematical computer stimulation model for the development of colonic polyps and colon cancer.

Currently known information about the development and progression of colon polyps and cancer is summarized and organized into a mathematical computer simulation model that successfully predicts the natural history of colon polyp and cancer development for an average patient with (1) familial polyposis coli (2) genetic susceptibility as measured by a positive family history, and (3) negative family history with a high fat diet. The mathematical model uses four distinct types of cells (normal, transformed, polypoid, and cancerous) and two kinetic processes (mutation and promotion). Arachidonic acid metabolites play a role in the model in the promotion of cancer from polyps, and account for that promotion through: (1) their effect on encouraging more polypoid cells in mitosis to move toward cancer; and (2) their immunosuppressive effect over time. The model also shows that one defect in allowing more cells to mutate to the transformed state is sufficient to account for the chain of events leading to the clinical sequelae of familial polyposis coli. A second genetic effect at another point in the process is unnecessary. The mechanism of action of Sulindac on colon polyps is explained by the model through inhibition of production of arachidonic acid metabolites, most notably prostaglandin E.

Adenomatous Polyposis Coli↗

PubMedDate not supplied

Inhibition of lung colonization of mouse colon 26 adenocarcinoma by recombinant mouse interferon beta through a modification of platelet function.

Recombinant murine interferon beta (MuIFN-beta) given i.v. efficiently inhibited both pulmonary arrest and formation of lung colonies of NL-17, a highly metastatic variant of mouse colon adenocarcinoma 26. NL-17 was rather resistant to MuIFN-beta in vitro and was highly resistant to natural killer cells of mice even though they were treated in vivo with MuIFN-beta. Platelets isolated from MuIFN-beta-treated mice showed reduced aggregating activity induced by NL-17. Since lung colonization by NL-17 is influenced by platelet aggregation, the inhibition of colonization by MuIFN-beta could be partly mediated through modification of platelet function in vivo. The effect of MuIFN-beta on platelet function and its subsequent inhibition of lung colony formation give new insights into the action of recombinant MuIFN-beta.

Adenocarcinoma↗

PubMed1987

Effect of secoverine on colonic myoelectric activity in diverticular disease of the colon.

The effect of secoverine on colonic smooth muscle was measured in patients with diverticular disease and in healthy subjects. The frequency of slow wave activity was determined using the fast Fourier transform (FFT) and peak identification analysis (SWSA). The mean slow wave frequency was similar (6 cycles/minute) in healthy subjects using both analytic methods. The slow wave frequency in patients with diverticular disease was similar to that in healthy subjects. The peak frequency measured with SWSA was uniformly higher than that measured with FFT. Secoverine, a muscarinic antagonist, did not affect the slow wave frequency. Eating a 1000-kcal meal initiates an increase in colonic spike activity (22 +/- 2 spike potential/30 min) (P less than 0.001) in healthy subjects during the immediate postprandial period. The gastrocolonic response in patients with diverticular disease was prolonged for 60 min. Secoverine inhibited the gastrocolonic response in patients with diverticular disease. These studies suggest patients with diverticular disease have a similar slow wave frequency as healthy subjects, the gastrocolonic response is prolonged in patients with diverticular disease, and secoverine inhibits the colonic response.

Aged↗

PubMed1991

Oral colon lavage solutions containing polyethylene glycol may interfere with ELISA detection of tumor-associated antigens in colonic effluent.

Immunologic methods for detection of colorectal neoplasia based on examination of stool or colonic effluent are being developed. Most current oral lavage preparations contain polyethylene glycol (PEG), and if PEG adversely interferes with immunologic testing these tests may become less useful. We describe a decrease in sensitivity of ELISA for tumor-associated antigens (TAA) when effluent samples are diluted in PEG-electrolyte lavage solution, equivalent to a commonly used oral lavage solution based on PEG. Radioisotope-labeled antigen binding to plastic plates was decreased by dilution in the PEG lavage solution. Antigen binding, present in colonic effluent collected by the laxative purge method, was absent in effluent collected by PEG oral lavage from the same patient. We conclude that PEG and PEG-containing lavage solutions interfere with ELISA detection of TAA in colonic effluents. We speculate that the in vitro, and possibly the in vivo, effect occurs at the level of antigen binding to the plate either by a steric effect or alteration of charge by the nonpolar properties of PEG.

Absorption↗

PubMed1995

Anatomic site distribution of colon cancer by race and other colon cancer risk factors.

PURPOSE: Black patients with colon cancer are more likely to have poorer survival from colon cancer than are white patients. To determine whether anatomic site differences might contribute to survival differences, we compared anatomic site distributions of black and white patients. METHODS: As part of the Black/White Cancer Survival Study, we collected medical record data for 1,045 patients from Atlanta, New Orleans, and San Francisco/Oakland, newly diagnosed in 1985 or 1986 and interviewed 745 of them. RESULTS: In polychotomous logistic regression analysis, site was related to stage, grade, and histologic type and among women with age, parity, and possibly smoking. However, it was not related to race, except perhaps among men age 65 and older, among whom blacks were somewhat likely to have more transverse and distal, not proximal, cancer. These relations were consistent across subgroups and were independent of other factors examined. CONCLUSION: Results suggest that site differences are unlikely to contribute to poorer survival commonly observed among black colon cancer patients in the United States.

Adult↗

PubMed1998

Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction.

PURPOSE: The study contained herein was undertaken to verify if immediate resection with anastomosis with on-site lavage in emergency treatment of left colon obstruction is a safe alternative to the multistage procedure, to look for solutions to practical problems outlined by previous authors, and to check the hospital stay. METHOD: Between 1991 and 1995, all patients (61) admitted with left colon obstruction were treated with intraoperative colonic lavage and primary anastomosis. Personal development of Dudley's technique is reported. Complications and mortality are pointed out. Later, endoscopy was performed to check the status of all survivors. RESULT: Low mortality (2 percent) and major complication rates (3 percent) and short hospital stay (11 days, except for patients with major complications) are reported in our series. CONCLUSION: One-stage surgery with intraoperative lavage is a safe procedure. Patients have a better quality of life (no stoma occurred) with an effective cost-savings.

Aged↗

PubMed1984

Pneumatic perforation of the colon during colonoscopy. Is the hypermobile right colon a risk factor?

Perforation of the colon by pneumatic injury during colonoscopy is a rare complication. Intraoperative observations of a patient who developed massive cecal distention, pneumatosis coli and severe pneumoperitoneum during colonoscopy suggest that an isolated, air-trapping colonic segment is a factor in the mechanism of such injury. The possibility that a poorly fixed, hypermobile cecum and right colon predispose to such injury by air insufflation during colonoscopy is discussed.

Air↗

PubMed1988

Colonic metaplasia with colonic-type polyps on an ileostomy stoma in polyposis coli. Report of a case.

A unique case is reported in which chronic physical and chemical irritation of an ileostomy stoma (after proctocolectomy for polyposis coli) was associated with colonic metaplasia and formation of colonic-type tubular adenomas on the external surface of the ileostomy. The remainder of the terminal ileum and the upper gastrointestinal tract were normal, with no evidence of Gardner's syndrome. This case demonstrates that even metaplastic colonic epithelium is susceptible to the formation of adenomas in polyposis coli patients.

Adenomatous Polyposis Coli↗