Surgeon-initiated screening colonoscopy program based on SAGES and ASCRS recommendations in a general surgery practice.

BACKGROUND: This study aimed to determine the utility of a screening colonoscopy program initiated by general surgeons in an academic center. METHODS: New patients presenting to three general surgeons who met screening colonoscopy indications were asked whether they had undergone colorectal cancer (CRC) screening. The patients who had not undergone CRC screening were offered screening colonoscopies or referred to their gastroenterologists. RESULTS: In the first 9-month period of the program, 200 patients who met the Society of American Gastrointestinal and Endoscopic Surgeons/American Society of Colon and Rectal Surgeons indications for CRC screening were asked whether they had undergone screenings. Only 46% (n = 92) reported any prior appropriate screenings. Of the patients who elected CRC screening by the surgeons, 55 underwent full colonoscopies (2 concurrently with hemorrhoidectomies), and 2 had flexible sigmoidoscopies. As a result of screening, 10 patients (18%) required treatment: 7 had polypectomies, 2 had partial colectomies, and 1 with an indication for surgery deferred treatment. CONCLUSIONS: Most of the patients presenting to the general surgeon likely have not had CRC screening, and diligence in making appropriate recommendations should be routine. Colonoscopic findings requiring intervention are not insignificant.

Alternatively spliced variants of prostate-specific membrane antigen RNA: ratio of expression as a potential measurement of progression.

We examined expression of prostate-specific membrane antigen (PSM) mRNA in normal prostate using reverse transcription-PCR and sequencing. An alternatively spliced variant, PSM', along with the previously described PSM form, was found in normal prostate. PSM' cDNA is shorter (2387 nucleotides) than PSM (2653 nucleotides). The cDNAs are identical except for a 266-nucleotide region near the 5' end of PSM cDNA (nucleotide 114-380) that is absent from PSM'. This deleted region includes the translation initiation codon and codons for the putative transmembrane domain of PSM. Thus, PSM' RNA codes for a protein that has no apparent signal sequence. We verified the existence of spliced mRNA variants in human primary tissue specimens by RNase protection assay. In LNCaP human prostatic cancer cells and in primary prostate tumors, PSM is the dominant form. In contrast, normal human prostate expressed more PSM' than PSM. Benign prostatic hypertrophy samples showed about equal expression of both variants. We quantified the relative expression of each variant by densitometry and compiled a tumor index, which is the ratio of PSM:PSM' level. LNCaP has an index ranging from 9-11, carcinoma of the prostate from 3-6, benign prostatic hypertrophy from 0.75-1.6, and normal prostate from 0.075-0.45. The index reflects the increased expression of PSM over PSM' following the progression from normal to tumor state. This tumor index may be a useful indicator for the measurement of tumor progression. PSM and PSM' may be functionally different proteins as a result of differences in structure or cellular location. We are investigating the prevalence of one form over the other and how it may influence tumor progression.

Multi-residue matrix solid-phase dispersion method for the determination of six synthetic pyrethroids in vegetables followed by gas chromatography with electron capture detection.

An effective multi-residue matrix solid-phase dispersion (MSPD) extraction and gas chromatographic-electron-capture detection method for the determination of six synthetic pyrethroids (fenpropathrin, cyhalothrin, permethrin, cypermethrin, fenvalerate and deltamethrin) in 5 g of vegetables (West Indian gherkin, eggplant, pak-choi, cabbage and garden peas) is described. The method uses a Florisil-based MSPD column for direct in-line clean-up with n-hexane-acetone (9:1). Recoveries calculated at 0.1 and 0.5 micrograms/g fortification levels were between 92 and 113%. The method detection limits were between 5.1 and 91.5 ng/g. The method compared favourably with the traditional method in terms of the sample size, analysis time and overall cost. The method may serve as a screening protocol for the determination of pyrethroids in vegetables.

Matrix solid-phase dispersion extraction and gas chromatographic screening of polychlorinated biphenyls in fish.

A matrix solid-phase extraction (MSPD) and gas chromatographic-electron-capture detection method for determining polychlorinated biphenyls (PCBs) in fish (grass carp) is described. The method uses an octadecylsilyl-derivatized silica and acidic silica gel-based MSPD co-column for direct in-line clean-up. The performance of the method compares favourably with that of the traditional approach but the sample size, analysis time and overall cost are lower. The method may serve as a screening protocol for the isolation and determination of PCBs in fish.