The endoscopic experience involving the study of 114 patients in the geriatric age group (65-89 years) in a district general hospital is described. The cases examined were mainly patients with dyspepsia, gastrointestinal blood loss, suspected upper alimentary tract carcinoma or those who had undergone gastric surgery. The procedure was well tolerated and safe. Useful information was obtained in the majority of patients (93 per cent). When the endoscopic and radiological findings were compared the endoscopist and radiologist were in agreement in 55 per cent of the cases examined by both techniques. In the others endoscopy played an essential role in establishing the presence of radiologically undetected or undetectable disease, and in confirming or excluding radiologically doubtful disease.
colonic contractions. The influence of melatonin on feacal pellet was explored. Results Melatonin release was shown to 2-fold greater than serotonin, when released from the colon (n=6). Melatonin release occurred on demand during mechanical stimulation but was not released by a chemical stimulus, the bile salt deoxycholic acid. EFS of isolated colon segments caused contraction at lower frequencies but relaxation at higher frequencies. In the proximal colon, 5 mM melatonin facilitated contraction at all EFS frequencies (p<0.05, n=6), however this was not altered in the distal colon. In the presence of tetrodotoxin (TTX), melatonin did not alter KCl stimulated muscle contraction. Melatonin caused a reduction in CMMC amplitude in the proximal colon (p<0.01, n=5) but did not influence the distal colon. Melatonin did not influence the velocity of CMMCs (n=5). Melatonin significantly decreased colonic transit times of an artifical faecal pellet (p<0.001, n=5), however luzindole significantly increased colonic transit times (p<0.01, n=5). Conclusions Our findings highlight that melatonin is present and released from the colonic mucosa and has an important functional role in influencing muscle contraction. Therefore, melatonin signalling pathways may serve to be important targets to direct therapeutic development.
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